Deadly Choices: How the Anti-Vaccine Movement Threatens Us All (27 page)
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Authors: Paul A. Offit M.D.
BOOK: Deadly Choices: How the Anti-Vaccine Movement Threatens Us All
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Bernadine Healy’s appearances on
CBS Evening News
, her articles in
U.S. News and World Report
(where she is an editor), and her statements in newspapers and magazines have had an effect. But Healy’s impact pales in comparison to that of a pediatrician from southern California—a pediatrician who has written a book about vaccines that has influenced a nation.
CBS Evening News
, her articles in
U.S. News and World Report
(where she is an editor), and her statements in newspapers and magazines have had an effect. But Healy’s impact pales in comparison to that of a pediatrician from southern California—a pediatrician who has written a book about vaccines that has influenced a nation.
CHAPTER 10
Dr. Bob
He will look attractive and he will be nice and helpful and he will get a job where he influences a great God-fearing nation and he will never do an evil thing. He will just bit-by-little-bit lower standards where they are important.
—
AARON ALTMAN,
BROADCAST NEWS
AARON ALTMAN,
BROADCAST NEWS
R
obert Sears is the son of William and Martha Sears. Together, William, a Harvard-trained pediatrician, and Martha, a registered nurse and lactation consultant, have authored more than forty books on pregnancy, birthing, attachment, breastfeeding, nutrition, sleeping, and discipline—all part of
The Sears Parenting Library
. Their advice once dominated parenting magazines and the airwaves, the couple having appeared on
20/20
,
Donahue
,
Good Morning America
,
Oprah
,
CBS This Morning
, CNN,
The Today Show
, and
Dateline NBC
. Three of their eight children are also doctors, including Jim, who co-hosts the television program
The Doctors
, and Robert, a pediatrician practicing in southern California.
obert Sears is the son of William and Martha Sears. Together, William, a Harvard-trained pediatrician, and Martha, a registered nurse and lactation consultant, have authored more than forty books on pregnancy, birthing, attachment, breastfeeding, nutrition, sleeping, and discipline—all part of
The Sears Parenting Library
. Their advice once dominated parenting magazines and the airwaves, the couple having appeared on
20/20
,
Donahue
,
Good Morning America
,
Oprah
,
CBS This Morning
, CNN,
The Today Show
, and
Dateline NBC
. Three of their eight children are also doctors, including Jim, who co-hosts the television program
The Doctors
, and Robert, a pediatrician practicing in southern California.
In October 2007, Robert Sears also published a book. He called it
The Vaccine Book: Making the Right Decision for Your Child
. Sears’s goal was clear. He wanted to provide what he believed was a gentler, safer way to vaccinate children—a middle ground for parents who wanted to protect their children but were frightened by so many shots. Sears has excellent credentials; he received his medical degree from Georgetown University and his pediatric training from the Children’s Hospital of Los Angeles. Like his father, who prefers to be called Dr. Bill, Robert Sears prefers Dr. Bob. At the end of his book, Sears offers a revised schedule he believes is safer than that recommended by the CDC and AAP. He calls it “Dr. Bob’s Alternative Vaccine Schedule.” For parents looking for a way to delay, withhold, separate, or space out vaccines, Dr. Bob’s schedule is the way to go; many parents bring it to their doctor’s office and say, “This is the one I want.” Sears’s book is so popular, so influential, and so widely quoted that it deserves a closer look.
The Vaccine Book: Making the Right Decision for Your Child
. Sears’s goal was clear. He wanted to provide what he believed was a gentler, safer way to vaccinate children—a middle ground for parents who wanted to protect their children but were frightened by so many shots. Sears has excellent credentials; he received his medical degree from Georgetown University and his pediatric training from the Children’s Hospital of Los Angeles. Like his father, who prefers to be called Dr. Bill, Robert Sears prefers Dr. Bob. At the end of his book, Sears offers a revised schedule he believes is safer than that recommended by the CDC and AAP. He calls it “Dr. Bob’s Alternative Vaccine Schedule.” For parents looking for a way to delay, withhold, separate, or space out vaccines, Dr. Bob’s schedule is the way to go; many parents bring it to their doctor’s office and say, “This is the one I want.” Sears’s book is so popular, so influential, and so widely quoted that it deserves a closer look.
Many parents are concerned that children are getting too many vaccines too early. (Courtesy of David Gould/Getty Images.)
“[The alternative schedule] gives live-virus vaccines one at a time so that a baby’s immune system can deal with each disease separately,” writes Sears. By implying that an infant’s immune system is easily overwhelmed, Sears appeals to a common fear. When Jenny McCarthy and Jim Carrey led their “Green Our Vaccines” rally in front of the Capitol, parents marched to the rhythmic chant “Too many too soon! Too many too soon!” And it’s understandable. No reasonable parent can watch a child receive as many as five shots at one time and not worry it’s too much. But the fear should be allayed by the science.
Although the number of vaccines given to young children today is more than at any time in history, the immunological challenge from vaccines is lower. A hundred years ago, young children received one vaccine: smallpox. Today, they receive fourteen. But it’s not the number of vaccines that counts; it’s the number of immunological components contained in vaccines. Smallpox, the largest virus that infects mammals, contains two hundred viral proteins, all of which induce an immune response. Today’s fourteen vaccines are made using viral proteins, bacterial proteins, and the complex sugars (polysaccharides) that coat bacteria. Each of these components, like viral proteins in the smallpox vaccine, evokes an immune response. The total number of immunological components in today’s fourteen vaccines is about a hundred and sixty, fewer than the two hundred components in the only vaccine given more than a hundred years ago.
Further, Sears fails to consider that vaccines do not significantly increase the immunological challenge that babies encounter and manage every day. In the womb, the unborn child is in a sterile environment. But while passing through the birth canal, the child immediately confronts millions of bacteria. And that’s not the end of it; the food that babies eat isn’t sterile, nor is the dust they inhale. By the time babies are just a few days old, trillions of bacteria live on the lining of their intestines, nose, throat, and skin. Indeed, people have more bacteria living on the surface of their bodies (a hundred trillion) than they have cells in their bodies (ten trillion). And each bacterium contains between two thousand and six thousand immunological components. Some of these bacteria have the capacity to invade the body and cause harm. To prevent this from happening, every day babies make large quantities of different kinds of antibodies—some of these antibodies pour into the bloodstream (immunoglobulin G), others travel to mucosal surfaces (secretory immunoglobulin A).
Bacteria aren’t the only problem. Babies also encounter a variety of viruses that aren’t prevented by vaccines—for example, rhinoviruses (which cause the common cold), parainfluenza virus, respiratory syncytial virus, adenovirus, norovirus, astrovirus, echovirus, coxsackie virus, human metapneumovirus, parechovirus, parvovirus, and enterovirus. And, unlike vaccine viruses, which reproduce poorly or not at all, these natural viruses reproduce thousands of times, causing an intense immune response. Arguably, a single infection with a common cold virus poses a much greater immunological challenge than all current vaccines combined. And common viruses occur commonly; healthy children experience as many as six to eight viral infections every year during their first few years of life.
When Sears advised giving live viral vaccines separately, he implied that children have a limited capacity to respond to vaccines. So, how many can they respond to? Do the fourteen vaccines young children receive exceed their immunological capacity? The most thoughtful answer to this question comes from two immunologists at the University of California at San Diego: Mel Cohn and Rod Langman, who study the component of the immune system most capable of protecting against infection: antibodies. Antibodies are made by cells in the body called B cells. Each B cell makes antibodies against only one immunological unit called an epitope. Given the number of B cells in the bloodstream, the average number of epitopes contained in a vaccine, and the rapidity with which a sufficient quantity of antibodies could be made, babies could theoretically respond to about a hundred thousand vaccines at one time.
The model isn’t perfect. It assumes that the immune response is static, which it isn’t. Every minute new B cells generated in the bone marrow pour into the bloodstream. So, it would be fair to say that at any single point in time a child could theoretically respond to a hundred thousand vaccines. Given that babies are constantly confronted with trillions of bacteria and that each bacterium contains thousands of epitopes, the notion that children could respond to a hundred thousand different vaccines shouldn’t be surprising. In a sense, babies are doing that every day. The challenge from vaccines is dwarfed by this natural onslaught.
In 2010, in response to the growing fear of so many vaccines given so early, researchers at the University of Louisville performed a study of more than a thousand children. They found that children who were vaccinated completely and on time were not more likely to suffer neurological problems than children whose parents had chosen to delay vaccination.
Sears advises, “It’s probably okay to give the combination MMR booster at age five, when a child’s immune system is more mature.” Because the MMR vaccine is recommended for children between twelve and fifteen months of age, Sears implies that a baby’s immune system isn’t mature enough to respond to vaccines. To the contrary, vaccines given in the first year of life induce an excellent immune response. Probably the most dramatic example is the hepatitis B vaccine. Babies born to mothers with hepatitis B virus are not only at high risk of infection, they’re also at high risk of chronic liver damage (cirrhosis) and liver cancer. The greatest risk comes at the time of delivery. When passing through the bloody birth canal of an infected mother, babies come in contact with an amazing amount of hepatitis B virus; each milliliter (about one-fifth of a teaspoon) of blood contains about a billion infectious viruses—and birth exposes babies to a lot of blood. So it’s no wonder that almost all unimmunized children of infected mothers get infected. But despite the fact that the hepatitis B vaccine is given after exposure, almost all babies are protected. It is rather remarkable that following passage through a birth canal containing literally billions of hepatitis B viruses, a one-day-old baby can mount a protective immune response to a vaccine that contains only twenty micrograms (millionths of a gram) of one highly purified viral protein.
Sears doesn’t discourage parents who want to delay vaccines. Under the heading “Delaying Vaccines Until Six Months of Age,” he writes, “This choice is one that some parents make, usually for the same reasons as those who wait until two years. They just don’t feel as comfortable leaving their child unvaccinated as long. If you’ve chosen to delay shots, whether it’s for six months, one year, or more, you should be aware that your child would not need the entire vaccine series when you do eventually start.” Sears implies that a choice to delay vaccines is reasonable. Unfortunately, he fails to describe the importance of preventing diseases like Hib, pneumococcus, and pertussis, all of which typically appear in the first year of life and all of which can exact a terrible toll. Most mothers have antibodies directed against all three of these bacteria and, while pregnant, pass them to their babies through the placenta. But antibodies from the mother fade, leaving the child vulnerable. Vaccines against Hib, pneumococcus, and pertussis are given at two, four, and six months of age so that when the mother’s antibodies wear off, children will have acquired their own protective immunity. Also, young infants, because they have narrower windpipes, are much more likely to die from pertussis than older infants. By stating that a choice to delay vaccines is acceptable, Sears fails to explain why vaccines are given when they’re given.
Sears claims that the most important reason to space out and separate vaccines is to avoid one ingredient: aluminum. “The alternative schedule suggests only one aluminum-containing vaccine at a time in the infant years,” he writes. “By spreading out the shots, you spread out exposure so infants can process the aluminum without it reaching toxic levels.” Sears explains that “some studies indicate that when too many aluminum-containing vaccines are given at once, toxic effects occur.” In fact, studies show just the opposite.
Various preparations of aluminum salts have been used in vaccines since the late 1930s. So, the safety of aluminum in vaccines has been assessed for more than seventy years. Aluminum salts act as adjuvants, enhancing the immune response. Inclusion of aluminum salts in vaccines that otherwise wouldn’t evoke a good immune response makes it possible to reduce the number of doses and the quantity of immunological components within each dose.
Although Sears claims that avoiding aluminum-containing vaccines is an important way to avoid aluminum, it’s not. Aluminum, the third most abundant element on earth, is everywhere. It’s present in the air we breathe, the food we eat, and the water we drink. The single greatest source of aluminum is food; present naturally in teas, herbs, and spices, aluminum is also added to leavening agents, anti-caking agents, emulsifiers, and coloring agents, and is found in pancake mixes, self-rising flours, baking powder, processed cheese, and cornbread. Adults typically ingest 5-10 milligrams (thousandths of a gram) of aluminum every day. Babies are no different; all are exposed to aluminum in breast milk and infant formula. Infants exclusively breast-fed will have ingested ten milligrams of aluminum by six months of age; those fed regular infant formula, thirty milligrams; and those fed soy formula, one hundred and twenty milligrams. All recommended childhood vaccines combined contain four milligrams of aluminum.
Sears is right in stating that aluminum can be toxic, specifically causing brain dysfunction, weakening of the bones, and anemia. But he’s wrong in claiming that the small quantities of aluminum in vaccines can be harmful. That’s because aluminum has been found to be harmful in only two groups of people: severely premature infants who receive large quantities of aluminum in intravenous fluids, and people on chronic dialysis (for kidney failure) who receive large quantities of aluminum in antacids. In other words, for aluminum to cause harm, a child’s kidneys would have to work poorly or not at all
and
the child would have to have received large quantities of aluminum from other sources, such as antacids, which contain more than three hundred milligrams of aluminum per teaspoon.
and
the child would have to have received large quantities of aluminum from other sources, such as antacids, which contain more than three hundred milligrams of aluminum per teaspoon.
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