To Vaccinate or Not to Vaccinate? Consider the Story of DPT

800px-thumbnailWhen discussions about vaccinations for children occur, it is the more deeply held beliefs behind the discussion – the skeleton of the argument- that divides debaters most. This is true for all passionately felt and complicated positions. In the abortion dispute, the skeleton argument is when the moment of life begins, i.e. if there is a traditional belief in God. A person who believes in God, who believes that spirit enters the flesh at conception, is going to have a different view on abortion than even an individual who believes in a higher power and whose ideology is more flexible regarding the spirit. All facts about the physical process of abortion are filtered through these beliefs or non-beliefs.

What is the skeleton argument around full vaccinations for children? When I had my first baby, I was a single mother of 19 and overwhelmed with the practicalities of my situation; I was, in many ways, simply too busy surviving to even wonder if I needed to look deeper into the orders of my doctor. My son was fully vaccinated, on the traditional schedule. With the birth of my next baby, I was older and, in what was the sea change for me, had accumulated enough information through journalism, books, college and life to be suspicious of any directive given to me regarding my children. By then, I knew that there was no Great Adult in charge of important organizations; in other words, I had let the child’s idea of a Grown Up God go, and accepted that no organization, however intelligently staffed, morally founded and bountifully funded could be trusted implicitly. I knew that human fallability entered into every aspect of adult life and created, even at the highest levels of society’s functioning, enormous mistakes that only years, decades later were recorded as so in the history books.

By the time I had to decide if, when, and how to vaccinate my second baby, it would be more accurate to say that my trust of the sources of information on vaccines had altered, versus my trust of the actual vaccines themselves: I wasn’t sure if the vaccines were hurting my child or not, but I was sure that the organizations telling me they were safe had a history of duplicity and serious mistakes. The slow doubt began with my oldest son’s burgeoning mysterious health issues. Breastfed as a baby and fed healthy meals as a little boy, he began to have a cross-section of unexplained maladies: hives, stomach pain, headaches, fatigue, under eye circles and then the onset of occasional breathing difficulties. After allergy testing and multiple emergency room and doctor visits, we were told he had exercise induced asthma and was given an inhaler and steroids. To my questions about his other symptoms, the doctors could only shrug and offer that maybe he would “grow out of it.” My inquiries about possible reactions to food additives or a food related inflammatory process or probiotics were condescendingly brushed aside (this was before probiotics were regularly recommended alongside antibiotics).

After six months of fiddling with my son’s diet and giving him specific, targeted supplements along with probiotics, he was as good as new. His ‘exercise induced asthma’ disappeared, along with all other symptoms. His teachers stopped asking me if he got enough sleep at night, and I stopped worrying that one of the ER trips would turn into something more serious. This complete turnaround whose implementation had been totally unsupported, even mocked, by more than one doctor was the first crest of my sea change. Why, I wondered, had I assumed that doctors had the final word?And why had my son’s pediatricians been so dismissive of alternative solutions when traditional medicine failed to supply them?

When my daughter was born in 2002, I was aware of a small, humming discontent around vaccines, without the hurricane level of media storm that occurs today around the issue. Curious, and at this point a more independent thinker, I began to read. And the more I read, the more I needed to read. And the more I needed to read, the broader my reading became, until I was, as they say, more confused than when I started. Here was the turning point: I knew enough to be very concerned, but not enough to be sure exactly what to do. Here also lies the problem- we want to know what to do when it comes to our children. We want to protect them, and ourselves, from serious illness and death, of course! The desire to believe that we have a solution with an acceptable risk profile is enormous, and of course, the danger there is that we will not be open to negative information about a vaccine or all vaccines, that we will shut our ears, eyes and mouth and jab the needle.

The assumptions of my nineteen-year-old self around vaccines were that they were necessary to prevent deaths, that vaccines were largely a safe and sensible solution to horrific diseases with some very rare reactions that occur in some very unlucky rare children who receive them. But, by and large, I believed that vaccines were safe and we were being told all important truths about them. Everyone told me so. Who was everyone? My pediatricians, their waiting room pamphlets, advertisements on TV, health organizations and many of my friends who were mothers. The pressure to vaccinate was enormous and fear and shame based, just as it is now. If you don’t vaccinate you are a bad mother, a shitty American who doesn’t care about protecting other people with weakened immunity, an uneducated zealot, an idiot who will wish you had vaccinated when your child dies of some horrible disease. The words used are the same today. Take this comment I pulled from a Facebook post on my feed, written by a blogger and mother with lupus:

And again I ask those of you who choose not to vaccinate- how dare you when you KNOW it could mean my children will be motherless? Why do you CHOOSE my death over your privilege?

In Forbes, Stephen Salzberg lumped those who are concerned with vaccinations into one group, ‘ anti-vaxxers ‘ and writes that they have “faux concern for the children” and are  “characters.” The lumping of all those concerned with vaccinations into ‘anti-vaxxers’ is hardly Salzberg’s territory alone; many arguments for vaccinations are written parallel with this kind of sloppy journalism where anyone with a serious concern about the safety or necessity of a vaccine is a cartoon character with no brains. Celebrity Jenny McCarthy has been a perfect mark for this kind of reductive argument, a former Playmate who used to be best known for ads where she sat on a toilet, underwear round her ankles, and who now is the face of the argument that vaccinations cause autism. Cue jokes. This kind of aggressive characterization is the most predictable and simplistic reaction to any argument against a mainstream held belief or action, and does nothing to convince anyone who reads them to think anything other than exactly what they came into the piece already believing.

When finding these kinds of character attacks in articles both for and against vaccinations, my desire was to sift through, distill the facts, and then more importantly, keep clarifying until the source of the facts, and all important information about that source, were clear. If this sounds like information you can gather from your doctor’s office, What To Expect in the First Year and a few blog posts on the World Health Organziation’s website and Stir.com, you would be wrong.

The amount of reading that I was getting into illuminated my first mistake — I should have begun the moment I found I was pregnant. But how many women have the time or focus to research and read this amount of information while postpartum and most likely exhausted and overwhelmed? I received a message this week from a new mother, asking me what I thought about vaccinations. I don’t know what to do, she said. Her baby is one-month-old. I know that she and I are not alone in this timeline. There is so much to consider and read while pregnant, especially the first time, that vaccinations rarely come into the forefront. This does not bode well for a highly educated decision, which we can all surely agree is the best way to make such a serious choice- often the first serious choice we make for our child.

The story of Dr. Peter Aaby’s discoveries on the mortality rate of girls receiving the DPT vaccine is rife with examples of why my skeleton beliefs regarding vaccines consist of the belief that I cannot trust the larger corporations in charge to tell us the truth- or all the truth- and why you cannot either. Also illuminated is the kind of protracted reluctance for further research and exposure in the face of a clear-cut evidence that those things are necessary, despite every protest to the contrary.

It’s important to state here — to be clear about my purpose for writing this, which is to inform, not to direct — that I gave my daughter born three years ago the DPT vaccine, and had the booster myself. I am not anti-vaccine; I am pro-information.

The American Academy of Pediatrics in 2013 recommended 17 vaccines (48 total as some are given more than once for what is considered adequate protection) including 113 vaccine antigens over six years. This is a a heavier load than European children carry, and quite more vaccinations than America itself offered just twenty years ago. The first obvious conclusion from those facts is that we have no idea what the schedule of vaccinations we now give is doing to our children’s health over the long term, but our first indication has arrived.

The first study done to look at the effect of immunizations on a child’s immune system was reported on in the BBC in 2011. Dr. Aaby is a well-respected scientist who has spent the last thirty years of his life researching the children of Guinea-Bissau. After discovering that the children there were dying not from malnutrition as other organizations had concluded, but from densely clustered groups of children ill with measles that were creating an unusually powerful measles epidemic, Dr. Aaby happily began immunizing the children with a new measles vaccine, but he did not stop there. Dr. Aaby did what no other scientist has done and reported; he closely followed the children being vaccinated in the years afterward.

The former Deputy Director of the British Medical Research Council’s laboratories recalls how Dr. Aaby explained furthering his research:

“At that stage, Peter said look, one of my beliefs is that we should not only look at the specific effect of vaccines, and whether is stops measles, but I also want to look at the total effect on a community in the longer term. Does it actually reduce mortality.”

The data revealed terrible truths. Girls who took the vaccine died of other conditions at a quickening rate. The vaccine was withdrawn, and the old measles vaccine put in its place. Dr. Aaby was not satisfied that the newer measles vaccine was the culprit; he wanted to know why the vaccine had affected specifically girls this way, and researched the problem. This resulted in a game changing discovery: it was the effect of the measles vaccination interacting with the DPT vaccine that was causing the increase likelihood of death in girls.

Aaby’s conclusion was that DPT weakens a child’s immune system. His conclusion went here: he believes that the DPT vaccine causes a 50% greater mortality rate from infants ages two months to nine months of age for all types of mortality.

One of the scientists on the team in Guinea-Bissau stated: “If it all gets accepted in the end, proven, it will be a paradigm shift in the way we think about vaccinating children, and paradigm shifts in the scientific community are very frightening.” The big threat? These questions: “Could we do it different? Could we do it better?” Some scientists fear Dr. Peter Aaby is a danger to the global health care system.

The World Health Organization (WHO) sent over a team of scientists to pour over Dr. Aaby’s research. Dr. Kim Mulholland, now Professor at the London School of Hygiene and Tropical Medicine, but at the time the WHO team leader, was surprised that Dr. Aaby could account for and provide all the necessary research. Not only that, Dr. Mulholland could find no holes in the research; it was solid. He took his team back to WHO headquarters in Geneva and reported the information, expecting to be asked to give a presentation on the team findings. He was not, and ten years later is still worried by the outcome. “Nobody really talked to me much after that, ” he says uncomfortably. People were hoping we were finding some major flaw…to say these were flawed studies.”

WHO concluded, despite their own team’s report, that there was no cause for concern, or further research. Nothing was done. Professor Mulholland says, “It’s worrying…some years ago I did a calculation of what this could mean in terms of mortality, locally, and it’s quite alarming. Why is it that the international community is sitting on their hands and ignoring this, that’s a good question.” Professor Mulholland is, according to his own page on the London School of Hygiene, a ‘leader in the Hib Initiative’ – clearly not anti-vaccine. His concerns come from facts. Meanwhile, Dr. Aaby has written and presented 34 papers on the DPT vaccines lethal effect on girls, dogged in his quest to look further into what can be done to alter the outcome of the DPT and measles vaccinations in girls, and to incite the scientific community to demand a change.

This is exactly the kind of information that forms my personal skeleton beliefs, the sieve which I filter through all information I receive about vaccinations that themselves filter down from the largest fish in the pond, like WHO, to the corporations to hospitals, schools, and local doctors. Obviously, it’s not only this information, but that this particular piece of information reflects the kind of secrecy, unsupportable slowness in addressing serious concerns in any way and reluctance toward change on the part of large corporations that I take into account alongside all discussion regarding vaccinations.

Thirty-six leading scientists have formed a group calling to study a close look at what they call “the non-specific effects of vaccinations.” Dr. Katie Flanagan of the British Research Council reiterates my own concern, that there are no long-term studies on the developing immune systems of children in relation to vaccinations. Dr. Flanagan is currently researching, in real-time, the measurable blood effects of the DPT vaccine in girls and boys. On her own research on Dr. Aaby’s data on the effects of DPT and measles vaccines in succession she says this:

” It is very striking … we are seeing clear differences in the actual inflammatory profile, if you give the vaccines together- the DPT and the measles- compared to giving measles alone, and the effects are completely different in boys and girls. I think I’m beginning to find some very clear immunological patterns that could explain why Peter Aaby is seeing these things, and to support his data, basically.”

Here is what the CDC says about the possibility of vaccine damage to the immune systems of children:

“No evidence suggests that the recommended childhood vaccines can ‘overload’ the immune system. In contrast, from the moment babies are born, they are exposed to numerous bacteria and viruses on a daily basis. Eating food introduces new bacteria into the body; numerous bacteria live in the mouth and nose; and an infant places his or her hands or other objects in his or her mouth hundreds of times every hour, exposing the immune system to still more antigens. When a child has a cold they are exposed to at least 4 to 10 antigens and exposure to “strep throat” is about 25 to 50 antigens.

“Adverse Events Associated with Childhood Vaccines, a 1994 report from the Institute of Medicine, states: ‘In the face of these normal events, it seems unlikely that the number of separate antigens contained in childhood vaccines …would represent an appreciable added burden on the immune system that would be immunosuppressive.’ ”

Clearly more research needs to be done, there are not complete answers here. What is the effect of the measles vaccine alone on infant girl’s immune system? The evidence found by scientist looking so far is, according to the BBC report, that vaccinating has long-term, unexpected effects on the immune system of children, sometimes good, but also sometimes negative, especially in girls. What is the mechanism causing inflammatory process in only girls? Is the order we are giving other vaccines putting children at risk? Are other vaccines damaging our children’s immune systems- are we, in some cases, trading one kind of death for another? What changes need to be made at WHO so that this kind of information suppression does not occur- and more.

What is the skeleton belief behind a choice to fully vaccinate a child on the recommended schedule? If it is that our resources for the most important information about vaccines are honest and forthcoming, we need to look again at the evidence. The story of DPT is not, by far, the only story surrounding vaccines that as a parent, makes my stomach drop. It is one important, documented accounting of the exact, life threatening concerns we all need to keep in mind when we look at each vaccine and decide if it should be injected into our children. My own desire to protect my children and to do the right thing for everyone has at times made it difficult to accept some of the information I come across in my research. How to vaccinate my children has been one of the most difficult decisions of parenting my four children, because the information is complicated and incomplete and the propaganda laden with hyperbole and guilt.

The fact that BBC reported this story with virtually no re-reporting in other major or minor news outlets also begs the question of how much important information we are getting from our sources. I am curious why editors pass on these stories, and inclined to think that they are afraid of people not vaccinating when confronted with concerning information. A scientist interviewed about negative information a large study found about giving girls vitamin A at birth said that she submitted her study to many scientific journals and publications, none of which would publish her work, until finally it was published in the Journal Of Immunology. When asked why she thinks her study was not accepted for report, she replied that she believes no one wants to publish any studies that might discourage people from accepting and taking ‘preventative health care’. In other words, we are having our information curated for us with a strong bias. Is this acceptable?

We often need to look further than we do, toward the bigger picture, all the way, for example, to Guinea-Bissau.

You can listen to the original BBC newscast that this article was based on here.

Maggie May Ethridge is a writer and novelist completing her second novel. She is mother to four kids ages two through 19 years old and while a Southern girl at heart, lives in San Diego, CA. More of her work can be found at Role/Reboot, Huffington Post, Diagram and her blog, Flux Capacitor. Connect on Twitter or Facebook.

Image via Wikimedia Commons/public domain

  • Wendy Ellis

    Thoughtful and insightful. I appreciate the depth of your concern, the breadth of your research and your mother’s heart.
    The responsibility lies with each of us to make the best choice about vaccinations for our own family with the best information we can gather.

  • Wendy I appreciate your comment and agree with what you are saying. This is why ALL information is public property on this issue- it’s a public health issue, and we have right to know.

  • allison carmen

    This is a very tough issue that many of us struggle with. I never knew about the 2011 study about shots weakening a child’s immune system. This was always my greatest concern. More studies and information is definitely needed. Thanks Maggie

  • Allison it is definitely worth listening to the two part BBC series. The research that was done showed that specifically the DPT shot was causing the problems, and only in girls- which brings up the very interesting point that no research has been done on the differing ways that female and male bodies work and respond to any influence, such as a vaccination.

    Some research seems to point that other vaccinations can actually help boost a child’s immune system. More research needs to be done, and more people need to be talking about this.

  • As the mother of a child injured by vaccines in 1994, I so appreciate this thoughtful, non-incendiary piece of reporting, Maggie. I have struggled for so long to remain on the outside of this “debate” — and have despaired at how poorly the media covers the real risks and questions and ambiguities, pitting zealots against zealots and manufacturing outrage the whole while. I wish that your piece could gain some wide coverage and would love to help disseminate it —

  • Elizabeth ‘non-incendiary’ – I love that. I totally agree about the very poor coverage of this issue. It makes reasoned discussion impossible.

  • Caitlin

    I don’t disagree with your main points, namely, that there is an almost indigestible amount of material about this topic, and a great deal that seems disturbingly unclear (often purposely so). But what I would like to point out is that EVERY decision you make about your pregnancy/labor/birth/parenting is (or could be, if you did the research) this complicated and this loaded and this awash in confusing and contradictory data. Did you agonize like this over GBS treatment if you were GBS positive? What about an induction, if you were indicated for one? Did you receive any interventions in any of your labors? Did you agonize and pore and research every single one of those? All of these things have sequelae, and most of them are extremely unclear about what the long-term results are. It’s painting a very one-sided picture to pin this sort of terror and agony about vaccines like they’re the end all be all.

    For what it’s worth, my opinions/knowledge are informed by my education as a nurse-midwife. I don’t have all the answers (none of your healthcare providers do), but I am far more educated and versed in these discussions than most.

    • Mary Ethridge

      The author is making a very specific argument revolving around vaccines so I am not sure it makes sense to question her other healthcare/life choices – even if she did no research on any other health choices her arguments have merit. I happen to know that she is highly analytic of most health choices she makes for her family. As a writer and an interested person she has time and impetus to do this where others might not. I am glad she is willing to share her personal journey in this way.

  • Caitlin I can’t say I agonized over my decisions, but yes, I did carefully research all the important decisions involving my childbirth and children- I had my second daughter in a tub, with a midwife present, and no interventions of any kinds, for example. ( My third child was born CSection because she kept flipping head up, head down to the last second ) We eat organic, whole foods and I buy as many chemical free, organic products ( lotions, shampoos, laundry detergent, etc ) as possible, etc.

    I agree that all our choices like this make an impact on our long term health, and that of our children.

  • Jen

    Thank you so much, Maggie. Your findings, questions, and analysis resonate with me. The study that I long to see is that which compares two and three generations of completely unvaccinated people in a developed nation to two or three generations which followed the recommended guidelines for mass vaccination. I believe that such a study would be so telling. Sadly, there is such opposition to any form of non-conformity, and parental right to choose is being threatened. This is so troubling. We must maintain the right to question and formulate decisions with complete information in hand. Thank you again for a fantastic article!

    • Thank you Jen. I would also love to see a study like that.

  • I appreciate your approach to this heated issue as pro-information and not pro-vaccination or anti-vaccination. I agree that more research should be done and that there are unknown risks.

    However, I’m concerned with some of the conclusions your readers may draw by reading the selected excerpts and data you’ve presented. I am a physician and mother and also researched this issue in depth prior to vaccinating our 3 children. I’m not a pediatrician and wanted to make my own conclusions about vaccine safety and timing.

    First, I think it’s important to note that Dr. Aaby’s studies are observational, that is, not randomized or controlled. They can suggest association but not a causal link. There could be something else entirely driving what is seen – factors we can’t measure or control. I’m not saying his work isn’t important, but it has inherent limitations. That’s why at the end of his studies, he often states something to the effect of: randomized studies are needed to measure true impact. He has also suggested that measles vaccines provides additional mortality benefit than what can be attributed to protecting against measles. His work has gone both ways.

    I don’t think the there is a conspiracy (media, doctors, etc) to limit information the public has access to about possible risks of vaccination. Why wouldn’t more media outlets pick up the story? It depends on the quality of a study, where it is published (higher quality study usually gets published in the most reputable and press-worthy journals), and importance. A study that makes tenuous associations in a lower-tier journal is not going to get written up about unless someone is trying to be sensational.

    My personal conclusions from my own research was a) there are known, tangible benefits of full vaccination that *greatly* outweigh any known risks; b) vaccines do NOT weaken or overwhelm the immune system even in the numbers suggested today (good scientific evidence for this, multiple sources, number of antigens in our current vaccines much lower than past and overall less than when I was getting my own childhood vaccines); c) current timing is safe; spacing out simply increases risks of my child contracting preventable illness.

    Could I be wrong? Yes. I do not proclaim to know everything and there are known rare risks. There may be risks that have not been yet discovered.

    It’s confusing. There’s too much information out there and in unreadable form. Just sorting through the actual studies takes blood, sweat and tears. Many summaries of studies and research by the media and the press do not capture the nuances.

    So, yes, I vaccinated on schedule, fully x 3. I wish it did not take so much work, thought, and stressing to get there though. And I do blame the medical profession for not being able to better communicate this.

  • Katherine and I appreciate your level headed reply, as well.

    Let me address your points.

    Although Dr. Aarby acknowledges that more studies need to be done, he has expressed- as well as other scientists,including WHO scientists- frustration and serious concern over the fact that WHO did not pursue his findings, DESPITE the fact that the group WHO themselves sent to investigate his studies came back recommending more action ( i.e. studies ) and a need for concern. He specifically states, on the record, that he believes the DPT is causing mortality for infant girls. This is stated directly. And as I mentioned here, there is follow up being done independent of WHO, such as the study done by Katie Flanagan in which she supports findings that there are inflammatory problems with infant girls surrounding this vaccine.

    You ask why more media outlets wouldn’t pick up the story, and my response is, without sarcasm of any kind, just directly, that looking back on the history of our media answers that question. For example, I was just reading Annette T. Rubinstein’s work on early American media, magazines, journals etc, and she was going over the period in the 1800’s where poor American workers were beginning to revolt. Their conditions were largely unknown by the average middle class or well off American, and despite the fact that this was a HUGE, ongoing story- a social revolt, a revolution of sorts- NO MEDIA was covering it, or allowing it to be covered.

    Editors and writers as well as the managers etc. of televised media are seriously concerned that if they offer any information which, exactly as you said, causes them to be ‘concerned with the conclusions’ that the viewer would reach- in other words, they are worried that if they offer this information, people will not vaccinate. Have you seen the cluster of news stories that come out with alarming headlines like ‘Anti-Vaccination Campaigns Cause Serious Illness IN XXX Area ‘? Even Mother Jones, a supposedly subversive intellectual magazine, publishes only pro-vaccination information and articles.

    Although we have free media in this country, the biases of the editors and owners of these newspapers and magazines absolutely have a profound effect on the information we receive. Just look at how politicized our newspapers are!

    If you listened to the entire, two part broadcast, you will see that every scientist involved expressed two things: 1. Dismay that the study had not been further looked at and that more studies are not being done and 2. Dismay – but not surprise- that WHO sat on this information and did not have a panel, even internally, to further discuss the findings.

    Thank you for such a thorough reading and discussion.

  • Melissa

    The Aaby study in Lancet is interesting and more research is needed. However, a couple of things to note: (1) Guinea-Bissau is among the poorest countries on earth and in an observational study it is extremely difficult to disentangle other variables, including disease related to endemic poverty.

    Aaby support vaccination generally. See his interview from 1995: http://anthroniche.com/darkness_documents/0087.htm or his more recent 2012 letter in Lancet: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60015-4/fulltext or this article from 2011: http://sciencenordic.com/vaccines-change-our-immune-defences

    I was a live-and-let-live type regarding vaccines until I contracted whooping cough as an adult. I was diagnosed with bronchitis, then walking pneumonia, and given two round of antibiotics. My (young, US-educated and trained) doctor couldn’t explain why I couldn’t stop coughing. And not just coughing, but coughing so hard I vomited, coughing so hard I turned purple and gasped for air. Here I was, an otherwise perfectly healthy woman in her early 30s, who would go hours without coughing and then suddenly be gripped.

    On my third trip to the doctor, I met a very nice internist from Pakistan who listened to me mid-coughing fit. Whooping cough, she said. I wasn’t contagious anymore, as the azithromycin I’d been given for the walking pneumonia killed off the pertussis. My cough though would last. And last. It isn’t called the 100 day cough for nothing.

    Apart from this, I think travel has really opened my eyes to the reality of unvaccinated life. To see a child with polio or scarring from cutaneous TB is to understand a different reality about the luxury to decline vaccinations.

  • Phyllis

    I am so glad that I read this article. My daughter is due to get her second set of Dtap tomorrow and we were really just looking for any information hopefully reliable to help us decide what to do. What we are worried about is any more negative and or harmful reaction to the vaccinations. It is outright saddening how often this type of info is NOT made available to parents. On top of that the info that is available is confusing, difficult to read and understand and takes real time to sift through. Imagine people with little education trying to decide based on the info available ? I can’t imagine how difficult is it. Much easier to just listen to your doctor and trust him/her.

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