The Vaccine Book

[library_mama]

The Vaccine Book by Dr. Robert Sears Many parents I know are concerned about vaccines. For the most part, unbiased information about them is really tough to find. On the one side, people who claim that vaccines cause autism and reduce the ability of the immune system to deal with disease. On the other hand, mainstream doctors who say that this is pure hogwash and vaccines are absolutely safe, effective and necessary. This book, while not entirely neutral (Sears believes at least in the theoretical value of vaccination) does the best job I’ve seen of discussing the proven benefits and risks of vaccines. For each disease we vaccinate for, the book lists what the disease does, how common (in the US and abroad) serious and treatable it is, the ingredients and side effects of the vaccines, and where it falls in the recommended schedule. He discusses for each how important the vaccine is from an individual and a community standpoint. Do vaccines help prevent diseases? Yes. Can they have serious side effects? Indeed they can, and Sears includes discussion of and reference to studies published in mainstream medical journals, including any industry ties the authors had. The one vaccine I was surprised by his reaction to was the new HPV vaccine. That’s one that seems to me very little testing and a whole lot of money to provide a very limited amount of protection from an easily detectable and treatable disease - but he’s wholeheartedly in favor of it.

In later chapters, Sears discusses controversial ingredients and alternative vaccine schedules. He’s especially concerned about aluminum, which is known to be dangerous given intravenously and is regulated in IVs but not vaccines, where it is often present in much higher doses than allowed in IVs. Studies of aluminum in vaccines have looked only at short term, visible effects, when it’s known that the dangers need to be tested for and often effects show up later. This is even more concerning when multiple aluminum-containing vaccines are given at the same visit, and when newer combo vaccines include many times more aluminum than the sum of the old separate vaccines.

Sears avoids giving straight-out recommendations for the most part. He divides parents into three main groups (ignoring those unwilling to do any vaccinations): those who have no problems with the standard vaccine schedule, those uncomfortable with vaccines who are only willing to vaccinate for serious diseases that their child might get, and those who want to vaccinate on a schedule that spreads out the number and vaccines per visit as well as limiting the total amount of aluminum per visit. For the latter two groups he includes alternative vaccine schedules, putting vaccines so that they will protect from diseases as needed. For example, the minimal vaccine schedule skips the controversial MMR vaccine as well as chicken pox, since most parents in that group would prefer for their children just to have chicken pox. He recommends getting the pertussis and rotavirus during infancy, when they can be deadly, and postpones the sexually transmitted Hep B from birth until age 12. Similar changes are made in the “get them all, but spread them out” schedule, which does no more than two shots per visit and keeps close tabs on the total amount of aluminum per visit, including listing which brands contain less when relevant.

Given the limitations of research - looking only at mainstream studies and written by a busy practicing doctor - this book seems as good as one might hope. Sears is open about the fact that he went into vaccine education believing that fears about vaccines are overblown. He’s still in favor of the idea of vaccines, but has found things to be genuinely concerned about, such as the aluminum issue, that are not discussed in the many places that discuss vaccines from an either entirely pro or con standpoint. I looked for information and especially alternative schedules like this when LB was wee, and plan to make good use of it with New Baby.

Comments

[turnberryknkn.livejournal.com]

Any reasonable pediatrician should be willing to work with you or any other parent regarding their concerns. As I'm sure Dr. Sears points out in his book (I was able to only peruse his website, and not the book itself) there's certainly wiggle room in the exact timing of vaccinations -- we use that wiggle room on immunocompromised and ill children all the time -- and while the official schedule was designed to minimize the number of pokes and the number of office visits, a parent who is willing to have more pokes and bring their child in more often could have alternative vaccination schedules without (as I understand from my own training) all that significant an immunological effect. In my general pediatrics clinic, we do all kinds of special schedules, both for children whom it is medically indicated, and for parents who discuss their concerns with us.

One thing I would recommend, to make your life and your pediatrician's life easier, is talking in advance with your pediatrician. Writing down what you're thinking about, and letting him/her have time to review it in advance. A lot of times, your proposed modifications would be no big deal. Sometimes, however, your doctor probably would want to do his/her own research in advance about your ideas, figure out if she/he has to go order separate vaccines in advance and where to get them, schedule additional appointments, etc. The most productive way to do that is to do it in advance, so that you and your doctor know what's going to happen at what visit ahead of time.

[sapphireone.livejournal.com]

Thanks so much for your comments! You’re right that a good pediatrician should be willing to discuss and work with these things, and that they should be discussed up front. Sears does devote space to how to talk about these things with your child’s doctor. LB’s primary pediatrician has been willing to listen to our concerns and work with them. She always makes sure, for instance, to have mercury-free flu shots for him. But there just isn’t time in a visit to discuss things that we might be concerned about if we knew about it, or to construct a whole alternative schedule that spreads out the vaccines while covering the diseases at the important times. She’s willing to work with whatever schedule we want to use, but it’s felt like we need to know what we want first, and we just didn’t. On the other hand, we met once with another ped in the practice. I expressed concern about the number of vaccines routinely given in one visit – 8 or 10 diseases at a go – and said I thought it might be overwhelming to a baby immune system to learn to deal with that many diseases at once. He said that that wasn’t how vaccines work, that the immune system didn’t learn how to fight the diseases based on the vaccine. We asked then how he thought vaccines worked, and he was unable to. One of the more senior doctors in the practice, and he had no mental model of how vaccines worked that he could share with us. And I also have friends who have been kicked out of practices for disagreeing with standard vaccination schedules… though one hopes this is rare.

[(Anonymous)]

Hmm. And I come here just after looking at another blog, which had this interesting and relevant post:
http://www.child-psych.org/2009/06/pertussis-increases-and-vaccination-refusal.html

[sapphireone.livejournal.com]

Yeah... he does recommend pertussis very early in infancy, even in the limited vaccine schedule, because it is common and especially dangerous to infants. But he also notes that it tends to follow a five-year cycle in general, so that there was a peak in cases when my LB was a baby five years ago, and is probably one again this year.