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America the “overvaccinated”?

Blogging on Peer-Reviewed ResearchHe’s baaack.

Yes, that radio voice of the mercury militia, the shock jock Don Imus, who was so ignominiously booted from his nationwide syndicated radio show last spring is coming back to the airwaves on December 3 on WABC radio in New York, with plans to syndicate him again nationwide. Personally, although I consider Imus a clueless twit, I’m not sure that he should have been fired over that remark after he apologized, but CBS had every right to can him over it if it so desired. In any case, as some may know, I live within AM radio range of New York; the reasons Imus’ impending reappearance annoys the hell out of me are because (1) he’s an hugely overrated, unentertaining, boring, obnoxious has-been hack and (2) he’s taking the place of the radio show that I normally listen to during my morning commute and when I happen to be able to be working in my lab or office in the morning. Oh, and there’s also one more reason as well, of course. Don Imus is a True Believer in the mercury militia’s contention that vaccines somehow cause autism, as I pointed out very early on in the history of this blog, and even offered to host staged “debates” between David Kirby and supporters of real science. His return means that the mercury militia will soon regain one of its most famous voices. (Expect Jenny McCarthy to be an early guest…any bets?) It also means that Deirdre Imus, who’s also drunk the Kool Aid, will be more visible. An example appeared on that purveyor of antivaccination propaganda from its very inception, The Huffington Post, where Deirdre Imus has posted a truly inane column, Over Medicated and Over-Vaccinated: The Unintended Consequences of Medicines Meant to Protect (don’t worry; I’ll get to the peer-reviewed literature soon):

Just a few weeks ago another study called into question long prescribed vaccination recommendations and added more “fuel to the fire” in the on going controversy over our nation’s immunization policies.

Published in the New England Journal of Medicine [Nov. 8, 2007] the study, funded by the U.S. Public Health Service, suggests we may want to reevaluate and adjust our nation’s current vaccination recommendations.

Scientists from the Oregon Health & Science University found many of the vaccines administered to millions of American’s may be providing immunity longer than what was first believed, making the need for some booster shots unnecessary.

“Surprisingly, we found that immunity following vaccination with tetanus and diphtheria was much more long-lived than anyone realized, and that antibody responses following viral infections were essentially maintained for life,” stated lead author Dr. Mark Slifka, a scientist at the Vaccine and Gene Therapy Institute. The study also found similar longer than expected immunity for several other vaccines.

So far, not so bad, and I’ll get to what this journal article actually did say in a minute. But then, Imus goes right off the deep end into serious antivax propaganda:

But our kids are getting a lot of booster shots…shots containing heavy metals and viruses. Shots that a growing number of parents, physicians and researchers believe could be contributing to the rise of chronic illnesses and developmental disorders affecting our children. If the booster shots are unnecessary because immunity is present, why expose our children to these toxins?

If this study found there has been no increase in diseases in countries that discontinued the booster shots, as was noted, why is the current policy of over vaccinating our children continuing? Where are the conflict-free studies that prove giving infants and children 49 immunizations – most of them by age 5, are safe and effective?

Ah, yes, the old antivax scaremongering technique, telling us how those evil vaccines are full of…heavy metal and viruses! (You know, that would make a good name for a band.) Never mind that the mercury-containing thimerosal preservative has not been used in childhood vaccines other than the flu vaccine since 2002, and also never mind that the reason there are killed viruses in the vaccines is to what vaccines are designed to do, you know, provoke a specific immune response to the viruses for which they are designed. And the–gasp!–toxins! I am, however, grateful that Imus controlled what surely must have been her urge to list all these toxins individually, a favorite technique of antivaxers.

Not unexpectedly, as I did a few searches, I found that Deirdre Imus is only the most recent of many antivaxers to jump all over this NEJM article as “proof” that Americans are “overvaccinated” (whatever that means). The usual suspects are there, including Barbara Loe Fisher, Dr. Joel Fuhrman, and Chicago Tribune alt-med true believer Julie Deardorff. Of course, in a way, I almost can’t blame them, though. The press release about the story was entitled OHSU research suggests America may over-vaccinate, and a Science Daily column was entitled America May Over-vaccinate, According To New Research. If I were an antivaxer, I’d jump all over such unfortunate “framing” as well. Fortunately, I’m not and decided to go to the source to see what the study actually said, the actual New England Journal of Medicine article being referenced, whose abstract follows:

Duration of Humoral Immunity to Common Viral and Vaccine Antigens
Ian J. Amanna, Ph.D., Nichole E. Carlson, Ph.D., and Mark K. Slifka, Ph.D.

Background Maintenance of long-term antibody responses is critical for protective immunity against many pathogens. However, the duration of humoral immunity and the role played by memory B cells remain poorly defined.

Methods We performed a longitudinal analysis of antibody titers specific for viral antigens (vaccinia, measles, mumps, rubella, varicella-zoster virus, and Epstein-Barr virus) and nonreplicating antigens (tetanus and diphtheria) in 45 subjects for a period of up to 26 years. In addition, we measured antigen-specific memory B cells by means of limiting-dilution analysis, and we compared memory B-cell frequencies to their corresponding serum antibody levels.

Results Antiviral antibody responses were remarkably stable, with half-lives ranging from an estimated 50 years for varicella-zoster virus to more than 200 years for other viruses such as measles and mumps. Antibody responses against tetanus and diphtheria antigens waned more quickly, with estimated half-lives of 11 years and 19 years, respectively. B-cell memory was long-lived, but there was no significant correlation between peripheral memory B-cell numbers and antibody levels for five of the eight antigens tested.

Conclusions These studies provide quantitative analysis of serologic memory for multiple antigens in subjects followed longitudinally over the course of more than one decade. In cases in which multiple exposures or repeated vaccinations were common, memory B-cell numbers did not correlate with antibody titers. This finding suggests that peripheral memory B cells and antibody-secreting plasma cells may represent independently regulated cell populations and may play different roles in the maintenance of protective immunity.

Basically, subjects were recruited from the Oregon National Primate Research Center as part of a centerwide, comprehensive program to permit serologic testing of people working in close proximity with primates. In the event of an exposure to an animal (e.g., a scratch or bite), an additional serum sample was drawn. Blood samples were also drawn at weekly intervals after smallpox vaccination in a subgroup of eight subjects in order to monitor the acute phase of the immune response.

It’s a bit of a stretch to conclude from this study that Americans are “overvaccinated.” For one thing, it’s a pretty small study, with only 45 subjects. The mean age of the subjects was 52 on enrollment, and many of them had had measles, mumps, or rubella during childhood, leaving only two to five patients as the source of data for some vaccines. Indeed, the authors themselves point out that further studies will be needed before statistically meaningful comparisons can be made. They also pointed out that the subjects examined were all healthy, other than a few cases of hypertension and asthma, neither of which would be likely to affect long lasting antibody responses to vaccination. What we can conclude from this study is that immunity from many common vaccines may last longer than we had previously thought, and that booster vaccines for some diseases may not be required in some populations. As the authors put it:

“We want to emphasize that proper vaccination is vital for protecting people against infectious disease. We also need to mention that over-vaccinating the population poses no health or safety concerns — it may just be unnecessary under certain circumstances. What our study found was that the lifespan of protective immunity for certain vaccines is much longer than previously thought. So what does this mean? Based on this data and other studies, we may want to consider adjusting some of our recommended vaccination schedules. Doing so may reduce the number of required shots that are administered each year in this country while at the same time help extend limited health care resources,” Dr. Slifka explained.

Also, it should be noted that, since we’re talking about humoral immune responses that last decades, we are not discussing that bugaboo of antivaccinationists and the mercury militia, childhood vaccination. This study may suggest that tetanus booster shots may only be necessary every 30 years and that varicella boosters may not be necessary at all; it does not suggest that our children are “overvaccinated.” Unfortunately, the way the study was reported totally feeds into the preferred antivaccinationist terminology, and I really, really wish the word “overvaccinated” hadn’t been used in the press release.

Not that things like facts stop Imus from going off the deep end:

I’m also starting to think that we should follow the lead being set in veterinary medicine. Studies have provided evidence that the over-vaccination of dogs and cats can result in numerous maladies including cancer, skin and ear conditions, arthritis, allergies, diabetes, aggression, behavior problems and other immune system dysfunctions.

There is even a name for the conditions caused by animal over-vaccination, vaccinosis and it is note worthy to read what veterinarians’ say about over-vaccinating our pets.

“Vaccinosis is the reaction from common inoculations (vaccines)…These reactions might take months or years to show up and will cause undue harm to future generations.”

“In a general and frightening context, I see the overall health and longevity of animals deteriorating. The bodies of most animals have a tremendous capacity to detoxify poisons, but they do have a limit.”

I was curious about what vaccinosis was. Not surprisingly, it’s not a concept that you often find in the standard medical literature (otherwise I would have heard of it). Indeed, a PubMed search for “vaccinosis” revealed only 10 hits, two of which came from the journal Homeopathy, seven of which came from non-English-speaking literature, mostly Italian (leading me to think that the term means something different in Italian). If you Google the term “vaccinosis,” what comes up are a whole bunch of alternative medicine and antivaccination sites, at least on the first few pages. While it is true that there are some autoimmune syndromes that can on rare occasions be triggered by vaccination, such as Guillain-Barré syndrome, these are defined diseases, not the vague “chronic diseases” to which Imus refers

But if you thought this article was bad up to this point, you ain’t seen nothin’ yet:

What most people don’t realize is that any liquid waste containing more than 200 parts per billion (ppb) mercury must be deposited at a hazardous waste site and that drinking water cannot exceed 2 ppb mercury. But when the influenza vaccines arrive and are injected into pregnant woman and infants as young as six months, those vaccines contain 50,000 ppb mercury. This is an amount that is 250 times higher than hazardous waste. According to EPA guidelines, this amount of mercury can only be considered safe if a person weighs 550 pounds. Even trace amounts of mercury in vaccines can be anywhere from 600 to 2000 ppb.

The CDC and The Institute for Vaccine Safety claim there are “no biological effects” from trace amounts (.3 micrograms) of mercury. So, where are the evidenced based (conflict free) studies that prove the safety of these “trace” amounts and proof that there are “no biological effects” of any amount of mercury being injected into our children and pregnant moms? Also, where are the evidence based studies proving the safety of vaccines given to pregnant moms and our children that contain other toxins such as aluminum and formaldehyde?

[…]

Thimerosal has been proven to be a carcinogen, immunotoxic, genotoxic, nephrotoxic and neurotoxic. One study found thimerosal’s lethal toxicity to developing human neurons below 1 part per billion (Parran et al., 2005). Another study concluded, “thimerosal…has been found not only to render its primary toxic effect, but also capable of changing the properties of cells. This fact suggests that the use of thimerosal for the preservation of medical biological preparations, especially those intended for children, is inadmissible.” (Kravchenko et al., 1983).

The stupid, it really does burn, and bad. I need to apply some Silvadene cream right now.

Let’s just put it this way, Deirdre. Of the multiple large studies done since 1999 looking at the question of whether thimerosal has anything to do with autism, none have found even a hint of a link. Five years after thimerosal was removed from most childhood vaccines, new autism diagnoses in the 3-5 year old cohort show no signs of falling, despite the fact that the amount of mercury to which children are being exposed from vaccines is at its lowest level since the 1970s. Indeed, a very large study failed to find a link between vaccines or thimerosal and a wide variety of neurodevelopmental disorders. You’re just plain wrong. As for your “conflict-free” studies, no doubt the blatant conflict of interest of plaintiff’s “expert” witnesses like Dr. Mark Geier publishing “scientific” papers to bolster their contention that mercury in vaccines causes autism should be of equal concern to you.

I’m sure it’s not though.

In fact, if you want to see just how wrong Deirdre is, you should take a gander at this study in a recent issue of the Journal of the American Medical Association. In essence, it looked at the data and showed a 92% decline in cases of and a 99% decline in deaths from diseases targeted by vaccines before 1980 (diphtheria, mumps, pertussis, and tetanus) and an 80% decrease in cases and deaths from diseases targeted by newer vaccines introduced after 1980 (hepatitis A, acute hepatitis B, Hib, and varicella). That is the true legacy of vaccines, the claims of antivaccination loons like Deirdre Imus notwithstanding.

Of course, antivaccinationists don’t appreciate this. No, they don’t appreciate it at all. They hate it when such studies are reported in the media, they see it as “bias.”

There are none so blind as those who will not see, as they say, and these particular blind will, if they have their way, bring about a resurgence of vaccine-preventable disease, morbidity, and mortality.

REFERENCES:

  1. Amanna IJ, NE Carlson, and MK Slifka (2007). Duration of humoral immunity to common viral and vaccine antigens. N Engl J Med 357: 1903-1915.
  2. Roush SW and TV Murphy (2007). Historical comparisons of morbidity and mortality for vaccine-preventable diseases in the United States. JAMA 298: 2155-2163.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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