Shot of Prevention

It’s encouraging to see what can be accomplished when we insist on accurate vaccination messages.   

Earlier this week, a concerned parent who frequently comments on our Vaccinate Your Baby Facebook page, alerted us to an article on The Discovery Channel’s TLC site entitled “5 Things to Consider When Deciding to Vaccinate Your Child”.  Unfortunately, the article contained numerous inaccuracies and ignored a great deal of scientific evidence regarding vaccines.   Since the average parent is not especially well-versed on this issue, the concern was that this type of reporting could misled readers into forming negative opinions of vaccines based on false information.  Every Child By Two shared their concern with various health related organizations and their consensus was that something needed to be done to correct the false information and ensure parents received scientifically accurate evidence about vaccines.  The AAP offered to draft a letter of concern and multiple organizations signed on in support.

The letter that they delivered to The Discovery Channel last night read as follows:  

One of the most important decisions parents make to ensure their children’s health is the decision to vaccinate them against potentially deadly, vaccine-preventable diseases. To do so, parents need accurate, complete information about immunizations – which they often look for online. So we were astounded when we found an article on a Discovery Company website that perpetuates dangerous myths and untruths about vaccines. We cannot understand how a company that celebrates the latest in scientific achievements would feature an article so inaccurate and wholly biased against science.

The article, “5 Things to Consider When Deciding to Vaccinate Your Child” by Josh Clark begins with the claim that medical science has already “conquered” diseases like polio and pertussis, or whooping cough. Polio is still endemic in parts of the world, and pertussis is killing infants here in the United States. Several states have declared epidemics of pertussis this year. Measles, too, is making a comeback, with more cases in the U.S. in 2011 than in 15 years. These diseases pose real threats to children who are unprotected by vaccines.

As with all medications, vaccines do carry some risks, most commonly fever and pain at the injection site. These risks are tiny compared to vaccines’ benefits. But instead of an honest discussion of the facts, Josh Clark perpetuates false and misleading notions. A few errors were corrected in the second version of the article posted May 16, but we cannot understand how they ever made it through your review process. It would have been easy, for example, to learn that the vaccine that protects against measles, mumps and rubella does not and never did contain thimerosal, and thimerosal has been removed as a preservative from all other childhood vaccines in the United States, except for some influenza vaccines.

The fallacies don’t stop there. Read more…

Modern culture is often reflected in everything from the skewed view of popular reality shows and viral YouTube videos, to the personal discussions friends have on Facebook and in online chat rooms.  Since we are bombarded by such a wide variety of media, today’s parents must constantly navigate the popular messages and decipher between that which serves to entertain, versus that which is intended as news and information.  The challenge is that this is becoming increasingly difficult to do – especially when it pertains to parenting and children’s health.

Recently, one of our Vaccinate Your Baby Facebook friends discovered an online article entitled Why Shouldn’t We Vaccinate Our Children , which appeared in the Family Health section of Discovery’s “The Learning Channel” site.  The author is a senior writer at HowStuffWorks.com, co-host of the Stuff You Should Know podcast, and posts on Facebook at the official Stuff You Should Know page.  While one may read his article in hopes of learning how “stuff” (like vaccines and our immune systems) work, the article fails to deliver anything but broad generalizations and unsupported suggestions.   Rather than providing parents with a clear understanding of the science behind vaccines, the article is a disappointment that suggests parents be concerned about vaccines without offering any solid evidence.

If The Learning Channel were truly committed to helping people “learn”, and the author wanted to write about “stuff you should know“, then the article should have included information from those who do know stuff.  Specifically stuff about vaccines.  That’s not to say that the writer must be an infectious disease specialist in order to present accurate information on  immunizations.  But it would have been better if an expert was actually consulted on the article.  Without any specific references or resources to refer to, this author’s piece is completely unsubstantiated, yet disguised as something that some may consider credible.    Even though he suggests that people do “independent research on this issue,” he fails to direct readers to reputable sources where they can gain further information.

Fortunately, several members of the Vaccinate Your Baby Facebook page were quick to raise concern. Read more…

Science continues to fascinate me!  Personally, I have been grateful for modern medicine many times throughout my own life.  I have seen a premature baby, who arrived weighing  just a few pounds, grow into a thriving child.  I have seen courageous men return from war as amputees, who go onto run marathons.  I have had family members live long lives after having triple bypass surgery.  So to say that I value medicine and science is an understatement.

I guess that is why I can’t seem to understand why some people question the number of vaccines on the current immunization schedule.  I consider it a blessing that medical advancements can now protect our children from such a large number of dangerous diseases.  And today, I’m reminded that modern medicine continues to offer a great deal of promise for people who already suffer from various diseases.  It’s based upon the idea that vaccines can actually help us heal.

For the past 30 years, researchers have been working on therapeutic vaccines.  As today’s Boston Globe explains, ”Just as conventional preventative vaccines use the immune system to prevent disease, therapeutic vaccines use the immune system to target and kill a disease already in progress.”

The article acknowledges that there have been ”major failures and minor victories” in this area of research over the years, but that now, “researchers may at last have a deep enough understanding of the immune system to make a difference.”

“Right now, we’re finally at a point where at least the preliminary tools exist for us to deliver something that will start a new trend in medicine,’’ said Garo H. Armen, chief executive of Agenus Inc., a Lexington biotechnology company that is developing a therapeutic herpes vaccine.

In addition to vaccines that attack herpes, therapeutic vaccines are currently under development for hepatitis C, chlamydia, HIV, diabetes, other autoimmune disorders, and there are even vaccines that target nicotine and various cancers.

While I’m sure there will be critics of these advancements, I hope people will be encouraged to learn more about these advancements, as mentioned in today’s Boston Globe.

I am grateful that scientists are working hard to discover new ways we may be able to supplement our own natural defenses.  But I wonder, what are your thoughts and opinions on therapeutic vaccines?

It’s understandable that parents can be concerned about adverse reactions to vaccines.  Although they are rare, we know they exist.  However, from a medical standpoint, it’s also important that parents realize that just because a medical condition surfaces in the hours, days or weeks following a vaccination, doesn’t necessarily suggest that the event has been a result of the vaccination.

Just last week, a business colleague of mine, who has herself been involved in a vaccine trial, shared a relevant story.  Apparently, another participant in the trial had fallen and injured her head during the course of the study.  Even though the fall was a result of dancing on a table in a bar, the injury required a complete investigation to rule out the vaccine as a possible cause.  While most people would laugh at such a ridiculous suggestion, it exemplifies the strict guidelines of medical observation and investigation required during a study of vaccine safety.

It’s likely that when the average person reads about a seizure shortly after vaccination, they may understandably make the assumption that the seizure was caused by the vaccine.  While dancing on a table may be an extremely odd association to attribute to a vaccine,  there are common medical issues that are often mistakenly blamed on vaccination.  Seizures are often one of them.

Take for instance Laura Cossolotto, the mother highlighted in this Washington Post article.  Her daughter Michaela developed seizures three days after receiving her DTP shot.  For years she made the direct association that her daughter’s worsening condition was a direct result of this particular vaccination and in reading the article one can certainly see why.  As the article explains,

Cossolotto, who spent hours online desperately seeking answers, found the vaccine hypothesis persuasive, particularly after doctors failed to offer another explanation.

The article then elaborated on Michaela’s worsening symptoms by stating,

Despite test after test, no doctor could say what kind of epilepsy she had, and no cocktail of medications proved effective in controlling the seizures. Nor did doctors know the reasons for problems that emerged as she aged: delayed speech, mild mental retardation and serious growth deficiency.

As I read this article, my heart went out to this family.  They suffered through more than ten years of testing, medication and attempts at treatment.  Fortunately, a proper diagnosis was finally revealed that would help explain why Michaela’s condition had nothing to do with her vaccination.

The blood test for the SCN1A gene revealed that Michaela had Dravet syndrome, also known as severe myoclonic epilepsy of infancy, a rare and serious form of the seizure disorder….Dravet is usually caused by a spontaneous — not inherited — genetic mutation present at birth that affects the functioning of brain cells…Its hallmark is severe seizures during the first year of life that are difficult to control. Many children with Dravet, which occurs in one in every 20,000 to 40,000 births, also exhibit poor language skills, behavioral problems and cognitive deficits. There is no cure for Dravet, but some medications are effective in controlling seizures….In many cases Dravet emerges when a baby runs a fever, which can occur after receiving an immunization. But, notes Wirrell, chief of pediatric epilepsy at Mayo, “it’s absolutely not the immunization causing Dravet” but rather the fever that causes the existing disorder to surface”. Wirrell, who has seen 20 children with Dravet, said that those who have never been immunized show symptoms after spiking a fever.

I offer this case for discussion because it highlights the complexities of defining various post-vaccination conditions as adverse reactions.  This story illustrates how easy it is for parents, and even doctors, to mistakenly believe a causal relationship between two events.  However, as science has revealed more about Dravet syndrome, it’s clear to see that it has also provided a more comprehensive understanding of how what may first appear as a adverse reaction to a vaccine is simply part of a child’s genetic makeup.  For instance, The Washington Post article refers to a 2010 study in Lancet Neurology which found that the vaccine did not affect the outcome of Dravet and illustrated that babies whose seizures began after the shot fared no worse than those whose illness surfaced at another time. Additionally, a 2011 report in the journal Pediatrics found that five children presumed to have neurological damage caused by the shot were later discovered to have Dravet.

Certainly, the Cossolotto family had reason to suspect that their child’s condition was brought on by the vaccine. However, we are fortunate to now have the scientific evidence that identifies Michaela Cossolotto’s condition as one of genetic origin.

The belated discovery of what was wrong with her daughter would upend Cossolotto’s long-held views and lead to major improvements in Michaela’s life…As a result of the diagnosis and proper medication, Michaela’s life has dramatically improved. Although she still grapples with cognitive and behavioral problems, her seizures have dwindled to only a handful annually…Without a diagnosis, Cossolotto said, she would probably still believe — erroneously — that the DPT shot caused Michaela’s illness.

It’s true that people who respect the science behind immunizations are sometimes suspect of parents who claim their child is vaccine injured.  However, this doesn’t mean they are questioning a parents’ integrity.  Certainly parents who make claims about adverse reactions believe them to be true.  However, if a reaction is suspected, immunization advocates will suggest that the incident  be fully examined and supported by scientific and medical evidence.   This may be the only way to know whether the reaction was brought on by a patient who had been dancing on a tabletop or who had an undiscovered genetic disorder.

Vaccine safety is certainly not a forum for speculation.  When it comes to investigating vaccine adverse events, we must continue to test new theories, while also accepting the evidence from those already tested.  After all, as Laura Cossolotto states, “Having an answer does make a difference.”

When it comes to issues regarding disease prevention, our choices impact our children now and throughout their adult life.  Whether we choose to vaccinate our children or not, or delay certain vaccines or not, we are making decisions that have consequences.

A child who falls ill with a vaccine preventable disease may end up just fine.  However, others will have to endure permanent health problems.  And still others will suffer and die, like the many whose stories appear on sites like Vaccinate Your Baby and Shot by Shot.

Earlier this week a comment on the Vaccinate Your Baby Facebook page that made me think about the challenges parents face.  A concerned mother, seeking guidance states:

“I have a 28 month old son and have been delaying and selectively vaccinating. I am looking for a neutral page where I can find information to help me make decisions about what vaccines to get. This page appears to be a page that will deliver only one side of the story. Where can I go to get information both positive and negative about vaccinating? I am faced with some decisions very soon and wish to make an informed decision. I have read some information about vaccines, but not enough to be comfortable just yet.”

I have heard these sentiments echoed time and time again.  When faced with uncertainty, parents often delay or selectively vaccinate until they can feel more comfortable with the idea.  While I understand this rationale on an emotional level, I believe that parents must begin by understanding the importance of research, science and statistics in order to make an informed decision.  In other words, it’s not that parents should look for a “neutral page”, as this mother suggests, but more importantly, an accurate one that uses scientific evidence to support their recommendations. Read more…

Last week, there was quite a lot of discussion about a YouTube video entitled, “Why This Nurse WON’T Vaccinate” that was posted by a woman who refers to herself as the “Patriot Nurse”.  I wrote a blog post here on Shot of Prevention that included the video, along with a point by point commentary from a vaccinating nurse who I refered to as the Canadian Nurse.  Since the Patriot Nurse didn’t allow comments on her YouTube video, my intent was to generate an open discussion here on Shot of PRevention, where we are proud to allow differing views in our comments.  As you can see, the post received quite a few comments and since it’s never been our policy to censor them, you can understand the debate that this video has sparked.

Well today I want to update you on some recent developments with The Patriot Nurse.

It appears that the statements made in the video by The Patriot Nurse were troubling to many people, including blog writer Martine O’Callaghan who writes for Autismum and Nerditorial. She too wanted to write about this video and bring it to the attention of her readers. However, she first tried to verify the identify of The Patriot Nurse, in order to establish her educational and occupational background and experience. That prompted her to write a letter to a birthing center in TN where she believed Ms. Greene (aka The Patriot Nurse) has been employed.

Ms. O’Callaghan explains in her recent blog post that she was in no way calling for the dismissal of The Patriot Nurse.  She simply wanted to verify whether this person representing herself as a nurse on the video was currently working for the birthing center.  She also inquired as to whether the Patriot Nurse’s views on vaccination coincided with the policies of the birthing center.  After all, if a member of the birthing center’s staff has opted out of vaccination, shouldn’t the pregnant women giving birth there be informed of this?  After all, there are dangerous vaccine preventable diseases that can be life threatening to an infant who is still too young to be vaccinated and many cases where infants have died as a result.

It appears that since our last posting, The Patriot Nurse took down the YouTube video and has since made a statement on her Facebook page that suggests that her employer had some questions for her in regards to it.

Certainly, there is nothing wrong with a woman sharing her personal opinions regarding vaccines on YouTube, right?

Unless you are a nurse who attempts to speak as an authority on the subject of vaccines and you happen to have direct contact with pregnant women and newborns, is that it?

So, where exactly does the line get drawn?   What are the ethical implications here?  What are the consequences to these actions?  And what should they be? 

I’m curious to hear what you think in regards to this topic?    However, I feel it is only fair to start off with a comment we received from the Canadian Nurse who first attempted to correct some of The Patriot Nurse’s misinformation.  She commented for Shot of Prevention as follows:

Good morning angry supporters of The Patriot Nurse (TPN).

No one is debating your RIGHT to choose whether or not to vaccinate. But if you have the right to NOT vaccinate, then a patient – especially parents who …will be giving birth to a vulnerable neonate under your care – should have the right to choose whether or not you act as their nurse.

NO one is after The Patriot Nurse’s job. A science writer for a legitimate science zine contacted her work to verify her identity. Which is exactly what a responsible writer does before publication – verifies a source.

Non-vaccinating nurses at other hospitals have to take isolation per-cautions(gloves, gown, mask). This is to protect them and protect the patients. Regardless of whether YOU think vaccines work – science sure thinks that they do, and the employers have a right and a duty to protect those under its care.

The Patriot Nurse is a sham. She states in her video that saying this comes as a great cost to her as a nurse. If she so firmly believes in her anti-vaccination rhetoric – so much so that she would post it online AND STATE THAT SHE WAS A NURSE – then she should be well aware of the potential consequences.

All of you crying “free speech” are being deceived. The Patriot Nurse has deleted EVERY SINGLE comment that was not entirely supportive of her. You can’t claim that her free speech is in jeopardy while she refuses that right to others.

The Patriot Nurse made a video. A stupid video. In which she makes very very basic scientific errors. She was called to answer to those errors on her page, on this blog, on Orac’s blog and elsewhere. She refused to do so. She is not interested in having a dialogue. She had her little diatribe and that was that. NO ONE is so special that they can make sweeping, erroneous statements without recourse.

I know that you anti-vaccination activists have a lot of other anti-vaccination friends online. But the fact of the matter is that 94% of people are still vaccinating. You’re a blip on the radar. You’re the new “trendy” thing to be against. But when it comes down to it, all but a handful of people are intelligent enough to realize that:

1) there is NOT a global conspiracy of scientists and doctors trying to poison your children

2) a few bad nurses or doctors do not discount the whole of the scientific method; nor are the opinions of a few more valid than the opinions of millions

 3) researching vaccines on Google is NOT equal to going to post-secondary education for 10+ years to be a physician, pediatrician, immunologist or what have you.

The Patriot Nurse is not a martyr. She is a nurse who is expected to uphold the ideals and principles of her nursing organization and employer. And seeing as those things adhere to evidence-based medicine – and she doesn’t – she now has a problem. She brought it on herself. It was her choice not to vaccinate, and it their choice (and DUTY to the public) to deal with her how they see fit.