Last week, Robert F. Kennedy Jr., of the World Mercury Project, orchestrated a major publicity stunt designed to question the safety of vaccines. Since he had no real evidence to present, and the same accusations which have been repeatedly refuted for years, he attempted to garner attention by offering journalists a glimpse at a new anti-vaccine celebrity and the promise of a $100,000 challenge.
During an hour-long press event on Wednesday, Kennedy was joined by other vaccine critics such as ‘Vaxxed’ movie producer Del BigTree, San Antonio District Attorney Nico LaHood, Tony Muhammed of the Nation of Islam and celebrity actor, filmmaker and father of an autistic child, Robert DeNiro.
While each had their turn to suggest there was a worldwide scientific conspiracy to lie about vaccine safety, Kennedy concluded by announcing that he would give a $100,000 award to any American journalist who could produce a study that proved that the level of thimerosal used in vaccines was deemed to be safe.
(Of course, since he failed to mention the fee required to participate in the challenge, made no reference to a scientific expert(s) who would assist in evaluating the science, and refused to accept the mountains of studies that already exist on the subject, his promise of a payout was seen by many as an elaborate publicity scam.)
On Thursday, Kennedy continued his crusade on Capitol Hill by renting out a Congressional briefing room and attempting to lure legislators with the involvement of celebrity Robert DeNiro. While staunch vaccine refusers were invigorated by these meetings, hanging on the hope that Kennedy could possibly make inroads with the current administration and put an end to vaccine injury once and for all, the reality is that hardly anyone was listening.
With about 40 people in attendance on Wednesday, and not one member of Congress showing up on Thursday, it’s safe to say that Kennedy’s message is only echoing among those who already support him. Even DeNiro appeared to have lost interest since he was notably absent from Thursday’s event on Capitol Hill.
As expected, there have already been dozens of commentary that address Kennedy’s misinformation. However, there is still one statement he made that I feel the need to address.
Kennedy claimed, “I’m not anti-vaccine. I’m pro-safe vaccines.”
It’s understandable for people to say,“Yes, I vaccinate, but I don’t feel completely certain that vaccines are safe.” Since we’re unable to guarantee that vaccines will be 100% safe, this “pro-safe vaccine” battle cry is an effective way to appeal to parents who don’t have the time, the understanding or the inclination to delve into the science that supports the widespread use of vaccines.
By using this “pro-safe vaccine” label, Kennedy and others like him play into the emotional need of parents to protect their children while dangerously misleading them into thinking that vaccines are far more dangerous than the diseases they prevent. In essence, this statement is used to help anti-vaccine crusaders turn vaccine safety into a personal and anecdotal issue, when we should all be demanding that vaccine safety be investigated and addressed with scientific objectivity.
Kennedy continues to try to discredit his critics by questioning, “Why wouldn’t anyone be agreeable to studying vaccine safety?” He seems to suggest that anyone who isn’t “with” him in arguing that vaccines aren’t safe, is simply against safe vaccines.
This couldn’t be further from the truth. Vaccine experts ARE agreeable to studying vaccine safety. In fact, that is largely what they do. But unlike Kennedy, they don’t rely on anecdotal evidence. They demand scientific evidence and they go to great lengths to get it.
If we were to go back in history, we would see plenty of examples of how our current vaccine safety protocols have successfully identified problems and taken steps to address them. Consider the history of the rotavirus vaccine. The vaccine was withdrawn in 1999 after scientists associated it with a rare intestinal problem called intussusception. This would not have been identified if it weren’t for the vaccine safety monitoring systems that we currently have in place. And what about the nasal spry flu vaccine which was pulled just prior to this flu season? The Advisory Committee on Immunization Practices (ACIP) decided not to recommend the vaccine based on low efficacy studies, especially among children. Again, an example of action taken by one of our current vaccine oversight committees. There are plenty of other examples of vaccines being pulled from the market – the whole cell pertussis vaccine (DTP), Lyme vaccine, and oral polio to name a few. These instances occurred because of the vaccine safety protocols in place. Read more…
What value do vaccines have in your life?
Throughout July and August, Shot of Prevention is encouraging people to address this question. Today’s guest post, by clinical cardiologist Dharmaraj Karthikesan, provides a personal perspective from someone who is genuinely concerned about the health and well-being of people who choose not to vaccinate themselves or their children.
Here’s what Dr. Karthikesan has to say:
I’ve heard people say that deaths from preventable diseases are the will of God. Indeed all men must die, but not all have to die stupid. I believe ignorance is deadly. Sadly, it can also be contagious.
My issue resides with people who are opposed to vaccination and recently this issue became very personal.
See, I have a new nephew in the family. He lives in another country and so I only get to see him on Skype. However, his parents were considering a visit and I was really looking forward to seeing him. But due to the outbreak of diphtheria in Malaysia, where I live, I advised his parents to postpone their visit. See my nephew hasn’t completed his vaccination schedule and I feared for his health.
My fears are not unfounded. This is the reality we are living in; where our lives are dictated by the decision of others. And every decision not to vaccinate affects the health of others in our community and in our world.
As a doctor, I try to appeal to people’s sense and reason when they tell me that they have decided against vaccinating. Sometimes that communication fails and so I’ve decided to try to employ one other method.
Do you instinctively feel that your child is safe without vaccination?
Do you instinctively feel secure knowing that your child will recover regardless of the infectious disease that they may contract?
Do you instinctively feel impervious to all manner of infectious disease, even those which are airborne, just because you eat a certain diet or take certain homeopathic remedies?
If it is difficult to honestly answer these questions affirmatively, then I beg you to consider what I have to say.
Vaccines are safe.
I state the obvious first. I understand and empathize with those who feel that vaccines are dangerous and those who believe vaccines can be harmful or detrimental to health. Let’s assume that this is true. For a moment, let’s assume they are worse than death, or worse than the defects and disabilities they cause.
Let’s start with polio, which can cause disability and even suffocation if it involves the breathing muscles. Assuming your child recovers from polio, he may never run or play like a normal child. Are you prepared to accept that?
How about diphtheria, which affects your child’s breathing. In severe forms, it can affect the heart and nerves leading to death. Are you willing to take that chance?
Now how about pertussis, which is known to cause violent, uncontrollable coughing making it extremely difficult for a child to get air into their lungs. About half of babies who get pertussis need care in the hospital, and 1 out of 100 babies will die. Is this the kind of suffering you want for your child?
There are serious dangers with all vaccine preventable diseases. However, vaccines work to prevent infection by developing an immunity that imitates the infection. This imitation spares one from suffering with severe illness. Instead, vaccination allows the immune system to develop an arsenal of weapons in the form of’ ‘antibodies’. If your child should ever be exposed to these infections in the future, these antibodies will prevent the infection from spreading to your child by eliminating the threat early and preventing your child from getting sick. It’s quite simple actually. Once the body knows the ‘enemy’, it is better able to defeat it.
So the question that begs for an answer is this;
Do you want your child to be facing these diseases alone, or do you want a strong arsenal of vaccines helping to form a protective shield?
The choice is yours. But that’s the problem actually. Vaccines are a choice and people’s choices are sometimes influenced by inaccurate information.
Doctors don’t make money from selling vaccines.
What Have We Learned From Last Year’s Measles Outbreak?
Last year the United States experienced a large, multi-state measles outbreak that was largely responsible for 189 measles cases that spread across 24 states and the District of Columbia. It’s believed that the outbreak started from a traveler who contracted measles overseas and then visited the Disneyland amusement park in California while infectious. Widespread media coverage of the outbreak helped elevate public concerns related to the dangers of measles infection, the consequences of a growing number of school vaccine exemptions and the risks of disease among those who were too young or medically unable to be vaccinated.
At this time last year, it seemed as though we were experiencing a tipping point; a growing number of people were beginning to realize that vaccine refusal had consequences that could threaten our nation’s public health. The fact that the personal decisions of a select few people was able to threaten herd immunity and the health of many unsuspecting families and communities was worrisome.
It was believed that more parents (including some who had previously refused vaccines) were seeking and accepting vaccination for their children as a direct result of the outbreak. However, to determine whether clinicians were experiencing any real or lasting changes in vaccine acceptance, Medscape conducted a survey of vaccine providers to find out.
The survey, conducted in July of 2015, included 1577 physicians, nurse practitioners and physician assistants who worked in pediatrics, family medicine and public health. Responses confirmed that the measles outbreaks induced more acceptance of the measles vaccine and vaccines in general. The survey also indicated that, for some parents, a greater acceptance of vaccines was directly related to the fear of the disease, the consequence of being denied admission to schools, daycares or camps, and a greater knowledge about vaccines as a result of more reading on the subject. However, in some cases there was no change.
Every Child By Two also experienced a heightened amount of interest in the months during and immediately following the outbreak with a record number of inquiries from parents. Most were asking for information about the dangers of measles infection and for clarification of the MMR (measles, mumps and rubella) vaccine schedule. There were many parents who were specifically inquiring as to the possiblity of vaccinating their children before the recommended age in order to protect them during the outbreak. Shot of Prevention blog posts that included content specific to measles infection and MMR vaccination had record numbers of views in the early months of 2015, and personal stories relating to the outbreak, were widely shared on social media.
One story that drew a lot of attention was an open letter by Dr. Tim Jacks, whose two children had to be quarantined after they were both exposed to measles at a Phoenix Children’s Hospital clinic. His 3-year-old daughter Maggie had a compromised immune system as a result of fighting acute lymphoblastic leukemia (blood cancer), while his 10 month old son Eli had received all his recommended vaccines, but was still too young for his first dose of MMR vaccine. While neither of his children ended up contracting measles, the frustration he expressed in his letter entitled “To the parent of the unvaccinated child who exposed my family to measles” hit a nerve with a lot of people.
The Focus of Immunization Rates Fades as Cases Dwindle
In reaching out to Dr. Jacks this week, it appears that the attention on vaccinations that was raised during last year’s outbreak appears to have been rather short-lived. He explained,
“As a pediatrician, I regularly discuss vaccines, exemptions, and last year’s outbreak. The cold facts and data only reach so many, so my family’s story adds a personal angle to the issue that questioning parents rarely consider. After the media exposure, many families were aware of our situation. However today, the measles issue is not on as many people’s minds. Vaccine exemption is however a hot issue in Arizona. The Arizona political arena is considering avenues to encourage vaccination and I am hopeful that the coming year will produce progress in that regard.”
Today, a little over a year since the outbreaks began, the good news is that there have only been two reported measles cases so far in 2016. However, it also appears that history may be destined to repeat itself.
Consider, for example, the reports out just this week about a California charter school student who tested positive for measles after returning home from traveling overseas. With just 43% of kindergarteners at the Yuba River Charter School being up-to-date on their MMR vaccine, the California Department of Public Health has attempted to prevent a measles outbreak by first closing the school to all students, and then remaining closed to those without a measles vaccine until April 8 as long as no new cases are documented.
Despite overwhelmingly high vaccination rates across the country, with a mere 1.7% national vaccine exemption rate among kindergartener’s for the 2014-2015 school year, and a 90%+ coverage of MMR vaccine among 19-35 month old children, these small pockets of unvaccinated children continue to present a risk of future measles outbreaks. Read more…
Rafiki, the wise old mandrill in Disney’s Lion King movie, made a profound statement that is extremely relevant to the current U.S. measles outbreak that began in Disneyland in December, 2014:
Yes, the past can hurt. Infectious diseases have a history of being dangerous and deadly.
All you have to do is look at history to see how many millions of lives have been lost, or how many people have been permanently disabled, by infectious diseases. It’s no small number. And, there’s a long list of diseases that we can now prevent that have been leading killers in the past. Today, vaccination greatly reduces disease, disability, death and inequity worldwide. Vaccines given to infants and young children in the U.S. over the past two decades will prevent 322 million illnesses, 21 million hospitalizations and 732,000 deaths over the course of their lifetimes. While it’s hard to see what doesn’t occur, the fact remains that vaccines save lives and prevent suffering.
Some people will choose to run from the past. They’re called vaccine refusers.
No matter how much scientific evidence there is to prove vaccines are responsible for the incredible reduction of disease worldwide, there will always be some people who will run from the truth. They either debate it, or simply ignore it. These are the people who purposely refuse vaccines. Sometimes they focus their efforts on trying to pin every possible ailment known to man (from SIDS, asthma, allergies, autism, etc.) on vaccines. Other times they focus on the risk associated with vaccines. In the case of the MMR vaccine, they prefer to focus on the less than a one in one million chance of a serious adverse reaction rather than the fact that one or two of every 1,000 children who have measles will likely die. What is particularly frustrating is their tendency to ignore the present reality as well as the past. In cases when the scientific community has investigated their concerns, they ignore the findings because they fail to support their previously held beliefs.
Most people have learned from the past, but remain at risk from those who haven’t.
Thankfully, the overwhelming majority of people vaccinate. These are the people who actively try to protect themselves, their families, and others in their community, by contributing to the benefits of herd immunity and trying to reduce the transmission of vaccine preventable diseases. Unfortunately, the minority can sometimes jeopardize the herd.
Take the Van Tornhout family for instance. Today mark’s the fifth anniversary of their daughter Callie’s death. Callie was exposed to pertussis before she was old enough to begin her DTaP (diphtheria, tetanus and pertussis) vaccination series. Her story was featured on CNN last week, as an example of how concerning the current measles outbreak is. Unfortunately, there are many children under the age of one who are too young to receive the regularly scheduled MMR (measles, mumps, rubella) vaccine who are at increased risk of complications of measles as a direct result of this outbreak.
Sadly, the Van Tornhout’s can’t run from the past. Every day without their daughter Callie is a reminder of why they must continue to educate people on the importance of vaccines.
Stories like Callie’s are shared repeatedly. On the national news. On various social media sites. On websites and blogs. And even around the family dinner table. We share these stories so people will realize that these diseases still pose a threat to our children, especially those too young to be fully vaccinated. Unfortunately, some people remain conflicted about the lessons of the past. On the one hand, they consider vaccinating to protect themselves and their children from these preventable diseases because they hear stories about children like Callie. But on the other hand, they’re frightened by prolific misinformation that reinforces their suspicions that vaccines may be harmful. For fear of making the wrong decision, they fail to make the responsible decision to vaccinate, which then results in a decision which jeopardizes the health of everyone else in their communities.
Today, in honor of Callie’s fifth angel-versary, I urge everyone to do what you can to help ensure no other child dies as a result of a vaccine preventable disease. Don’t be reluctant to engage in a conversation about vaccines with friends or family. Don’t refrain from sharing scientifically accurate vaccine information on social media. Don’t be afraid to ask a non-vaccinator what their objections are. And please don’t let the past repeat itself. Sign up to receive notifications from Every Child By Two so you can stay informed of relevant immunization news, now and into the future.
Today Dr. Lara Zibners addresses an inquiry from our Vaccinate Your Baby Facebook page that pertains to provider policies on vaccine refusal. If you have a vaccine related question that you would like us to address, please email email@example.com or send us a message on our Facebook page.
“I am finding an increasing number of new patients whose parents are refusing vaccination. As I am not the medical police, I give my best advice, but continue to accept these patients into my practice. There will always be parents who are dubious about the safety of vaccinations. Any thoughts from MD’s about how you deal with patients who choose to not vaccinate their children?”
Ah, this is a tough one. As doctors we never know what may come through the front door – the vaccinated, the under-vaccinated or the non-vaccinated— yet we do our best to deal with the situation at hand. As a mother, I willfully steer my own children clear of play-dates where I know the other child is likely unvaccinated. But the question is, once stepping back into my white coat and sensible heels, what should we do?
Some pediatricians have chosen to not allow families that refuse to vaccinate into their practices. And I completely understand their reasoning. Vaccine refusal puts the unvaccinated child and others at risk. And this is a deeply emotional issue for many of us, isn’t it? We spend years and years training, and then dedicate our entire lives to the health and well-being of children. And I mean entire. I know a pediatrician who grocery shops at 11pm just to avoid the “Hi Doc! By the way, while we’re standing in the cereal aisle, would you mind taking a peek at Johnny’s left elbow…” Not that we don’t love our patients and their families, but this career does have a way of taking over your days, nights, weekends and occasionally even your choice of mayonnaise.
When you’re as invested as the pediatricians I’m proud to know, it’s difficult not to take vaccine refusal personally since this can mean that our patient’s family is openly disagreeing with our medical advice. Especially when we know their reasoning is often based on fear and misperception, rather than fact and science. And anyone who has tried to counter these misbeliefs (as I do) can quickly become frustrated (as I have). Parents who refuse to vaccinate are often so deeply committed to their decision that reversing their reasoning may seem exhausting, if not impossible. Read more…
Using The “D” Word to Explain the “P” Word
Yesterday I read an interesting post on the Moms Who Vax blog. It has been inspiring to follow along on this new blog and hear how moms from Minnesota have sprung into action to combat vaccine preventable diseases that are making a comeback in their communities. They have become the “boots on the ground” in campaigning for better parent-to-parent communication and supporting stronger immunization legislation in their state.
I commend them, not just because of the advocacy they stand for, but because they are moms using their voices to influence neighbors, doctors and public health. And I, for one, can appreciate that effort.
In yesterday’s post, there was a comment about the fact that many doctors refrain from using the “D” word. (The “D” word, in this case, is Death.) The suggestion was that it is an appropriate term to use when discussing the risks of vaccine preventable diseases.
It was a total “Ah, hah!” moment for me. The writer had hit the nail on the head.
Not only have doctors been trained to avoid the “D” word, they are also expected to be sensitive to patient’s fears and feelings. While it’s understandable to accommodate patients to a certain extent, it’s also imperative that health care decisions are not dictated be a “customer is always right” mentality that other “businesses” must succumb to in today’s competitive economic environment.
The point was made in a very upfront, no-nonsense manner, with the tone of a seasoned mom:
“…it’s all in the delivery, I reminded them. You don’t get the James Mason God-voice and boom “Death!” You say, gently, that you are ethically obligated to let them know that the risk of not vaccinating includes serious disability or death. ‘Nuff said.”
I thought about how relevant this was to a personal experience I had many years ago. I wasn’t very familiar with vaccine advocacy at the time, but I was committed to vaccinating my children in order to protect them from dangerous and sometimes deadly diseases. Unfortunately, I didn’t fully understand the risks of pertussis at the time.
So the story goes like this…
I was at the doctor’s office and he asks if I would like to get a Tdap booster (which stands for tetanus, diphtheria, and pertussis vaccine). While I don’t recall if I was in the office for a sick call or a well visit, I do recall that I had several tired, hungry and active children with me and a long list of things I needed to accomplish before both the children and I went into meltdown mode. (I remember this because it is fairly typical of every other day during this 10 year period of my life when I was working, raising 5 children and dealing with a frequently deployed husband.) I knew that if I were to agree to get a shot that day, I would most definitely be held up in that busy office for much longer than I could sanely afford.
What I didn’t know were the dangers of the “P” word. (In this case, the “P” refers to pertussis.)
It’s hard to admit this now, but I refused this shot, not because I was concerned about the safety of the vaccine, but simply because I was a busy stressed out mom, with lots to do and no real understanding of pertussis and the risk I was posing to myself or others by not vaccinating.
Here’s the part that could kill me – literally.
My doctor simply walked away.
He never asked me why I was declining the vaccine. He never explained what diseases the vaccine would help immunize me against. He didn’t even explain that if I got pertussis, I could be putting children – too young to be vaccinated – at risk for hospitalization or even Death (and yes, I spelled it with a capital “D”).
I just didn’t know and he just didn’t tell me.
Perhaps a simple discussion with my doctor may have resulted in a different outcome. Perhaps my doctor felt like I did – he just didn’t have the time. Or perhaps he felt like most everyone else I know – he didn’t like to be confrontational. I may never know, as we have moved and have a new doctor.
But how many times does this exact scenario play out in hospitals and clinics all over the country?
I’m going to guess…far too many times.
So, the lesson is, vaccine refusal doesn’t necessarily mean that a parent is concerned about the safety of vaccines. It can simply mean that a parent doesn’t know why they should be getting immunized, or what terrible things may happen if they don’t get immunized.
Communication is key and it’s up to parents, as well as doctors, to be open to it.
On the Moms Who Vax blog, the post ended with a real-life example of how a couple, with a newborn baby, had been influenced by their non-vaccinating family members. The glimmer of hope was that a doctor had taken the time to talk with these parents. What’s equally important is that the parents also took the time to listen, learn, and now –thankfully- vaccinate.
There are plenty of ways that parents are trying to communicate with other parents. On the Moms Who Vax blog, on our Vaccinate Your Baby Facebook page, on the Shot By Shot website and in this explicit video. Here a parent shares images of their child suffering with pertussis in order to help others to identify the symptoms and prevent fatal outcomes. This kind of awareness is not intended to generate fear, but to educate about the very real risks of something as dangerous as pertussis. If only I had seen something like this years ago…
Please take a moment to watch this video and then pass the word that adult Tdap boosters can help prevent this kind of suffering.