Be informed about Vaccinations

Vaccinations have come to play an important role in disease prevention.  We cannot deny the advantage of vaccination, but at the same time one wonders about the sense of a universal approach, where individualisation would be more appropriate.  Mass preventative measures require an overstated impact, while individualisation be more targeted and fine-tuned.  Unfortunately it does not make financial sense to individualise, because it requires specific evaluation of every case.  We also lack the expertise and knowledge to be able to accurately predict all individual outcomes.
We know that we are dealing with an epidemic of Allergies, Asthma, Attention Deficit Disorder and Autism in children.  We are also seeing an increased incidence of auto-immune disease and malignancies in children (as well as our adult population).  The reasons for this are hard to confirm, but there are numerous theories.  Increased exposure to vaccination at a vulnerable age is one theory.

What do vaccines do?
Vaccines are prepared from either dead or weakened organisms.  Vaccines are grown on cells that could be from human or animal origin (foetal material, monkey kidney tissue, bovine protein, eggs, etc.)  The purpose of vaccination is to artificially create active immunity to the particular pathogen injected, so that the person receiving the vaccine will be resistant to that pathogen when exposed naturally in future.  Immunity is dependent on sero-conversion.  No long-term studies regarding the efficacy or risks exist.

What are the risks?
When speaking to parents of children, who are absolutely certain that their children experienced regression in speech, behaviour and health directly after being vaccinated, one cannot deny the fact that vaccinations are playing a role in the development of sinister changes.  In general it seems as though there are certain predisposing and existing conditions that are further compromised by vaccinating a vulnerable child.

Vaccination carries an objective set of potential short-term side-effects including:
•    Local reaction
•    Fever
•    Malaise, fatigue
•    Flu-like symptoms
•    Skin eruptions, dermatitis, rash
•    Syncope
•    Gastro-intestinal disturbances, such as abdominal pain, food regurgitation, constipation, diarrhoea, gastro-enteritis,
     vomiting, appetite disturbance
•    Serum sickness
•    Anaphylaxis (life-threatening allergic reaction)
•    Central and peripheral nervous system disturbance, including neuralgia, neuritis, encephalomyelitis, convulsions,
     Guillain Barre syndrome, headaches
•    Arthritis, Arthralgia, Myalgia, Muscular cramps
•    Bronchospasm
•    Vaskulitis
•    Angioedema
•    Erythema multiforme
•    Lymphadenopathy (Enlargement of the lymph glands)
•    Lupus-type reactions
•    Disseminated disease related to vaccine:  TB from BCG, Measles from MMR, Whooping cough from DTaP,
     Chicken pox from Varilrix, etc.
•    Sleep disorder, somnolence
•    Thrombocytopenia
•    Rhinitis, Pharyngitis
•    Shock
•    Apnoea

Schedule and comments:
Our current vaccine schedule in South Africa prescribes 34+ vaccines before the age of 5.

At birth:
1.    Vit K:  1 in 100 000 babies are born with vit K deficiency and this will lead to bleeding. This deficiency would often
       be a result of the mother’s insufficient diet during pregnancy.  Foods that contain vit K are broccoli, dark leafy green
       vegetables, herbs, cabbage, Brussels sprouts, cucumber, prunes and spring onions.
2.    Tuberculosis:  BCG:  the efficacy of sero-conversion of BCG at birth is uncertain.
3.    Oral polio vaccine (live virus that can lead to some cases of polio, not being used in the US any more for this reason)

Weeks 6, 10 and 14:
4.    Diphtheria (D):  this is a very rare bacterial infection, which I have never seen in practice, but the eradication is
       contributed to successful vaccination.
5.    Tetanus (T):  Tetanus is a Clostridium bacterium, which produces a toxin that causes muscular paralysis.  Tetanus
       toxoid is administered in case of injuries where dust particles are involved, as well as animal bites.  The toxoid’s effect
       last for approximately 5-10 years.  The incidence of tetanus is 0.16 per 1 000 000 population. (CDC, US)
6.    Acellular Pertussis (aP):  Whooping cough:   We still see cases of Whooping cough from time to time.  I have
       been involved in cases of vaccine damage due to this particular vaccine, as we had a whole cell version until recently.
       There is some research showing an association between this immunisation and asthma.  Vaccination gives an 80% 
       successful conversion. This vaccine should not be administered to anyone with a history or risk of seizure,
       neurological disease or febrile convulsions.
7.    Haemophilus Influenza (HIB):  this is the most common bacterium involved in upper respiratory tract infections in
       children and Pneumococcus (Streptococcus pneumonia) is the second most common.  Haemophilus is also the main
       causative organism of meningitis in the 0-3 year age group.  There is some research which links this vaccine to an
       increase in cases of Insulin Dependent Diabetes Mellitus.

8.    Polio (IPV):  Polio is a devastating, disabling disease.  There are episodic outbreaks of polio, mostly in Africa.  The
      live polio oral vaccine was the cause of many polio cases before, but the current safer form is the injectable version. 
      (Oral vaccines are still “dumped” in Sub-Saharan Africa!!-see earlier, routinely given at birth).   The IPV contains
      antibiotics, antifungals, cow serum, formaldehyde and ethanol.   This vaccine should bot be given to anyone allergic
      to streptomycin, neomycin and polymyxin B.
9.    Hepatitis B:  is a sexually transmitted and blood borne virus, so the motivation for immunising a baby would be
       dependent on that child’s circumstances, but sounds a little farfetched.  Sero-conversion is more effective at older 
       ages.
10.   Rota:  Rota-virus causes fulminating diarrhoea in babies that can quickly lead to serious dehydration.  This is a
       common viral disease, often contracted during hospitalisation for other diseases!  Breastfed babies are more
       protected than bottle fed babies.  The Rotarix, as well as the RotaTeq vaccines are genetically manufactured, are 
       live attenuated virusses and can potentially contain stealth virusses
11.  Pneumococcus:  Pneumococcus is a very common causative organism (along with Haemophilus Influenza B) of
       Upper Respiratory Tract infections and pneumonia.  Pneumococcus is a streptococcus, which has been associated
       with PANDAS (Paediatric Auto-immune Neuropsychiatric Disorder associated with Streptococcus).

9 months:
12.    Measles

18 months:
•    Booster of DTaP, IPV, HIB
•    MMR:  the MMR contains live attenuated viruses.  By giving these viruses into the muscle, we circumvent the normal
     surface immune processes (Ig on the mucosal membranes.)  There is a common misconception that the MMR contains
     mercury (as Thimerosal), which can potentially be harmful to children.  This is not the case. Live vaccines cannot
     contain mercury, as Thimerosal is added to vaccines as a preservative/antiseptic agent.  The MMR is contraindicated
     where an allergy to gelatine or neomycin exists.
13. Measles (M):  an infection that presents as a flu-like illness with fever, a red skin rash, eye infection and body pains.  The very rare complication is an auto-immune encephalitis (brain tissue infection) and even more rare is SSPE (Subacute sclerosing panencephalitis),  a slow progressing demyelinating condition of the brain, 7 to 10 years after the infection.  Repetition of the vaccination is solely to produce immunity in the small percentage of people who fail to generate immunity after the first inoculation. Measles vaccine may rarely cause encephalitis in immunologically healthy hosts and can cause a persistent CNS infection in immunodeficient individuals.
14.    Mumps (M):  an infection of the salivary glands that, only after puberty, can lead to orchitis (infection of the
        testes) with, rarely, subsequent infertility.
15.    Rubella (R):  German Measles:  a mild illness with fever, skin rash and joint pains.  The most serious complication
        here is that when a pregnant woman contracts this disease it could potentially (not always) lead to congenital
        defects in the foetus.  

Other:
16.    Hepatitis A:  The leading cause of infective jaundice, a disease distributed by faecal-oral contact and often found
         in close communities, such as military camps.
17.    Varicella:  chicken pox:  this vaccine contains egg protein, MSG, antibiotics, DNA, and other chemicals.  Chicken
         pox is normally a mild self-limiting disease, presenting with fever and a blistering skin rash.
18.    Influenza:  Flu:  this is one of the vaccines that still potentially contains Thimerosal, a containing mercury
        preservative.  Sero-conversion after an influenza vaccine is quite low and varies from season to season.  Efficacy and
        safety in young children and the elderly population are not the same with the different formulations.  
19.    HPV:  this vaccine is recommended for teenagers (boys and girls) to prevent the contraction of sexually
        transmitted Human Papiloma virus, as some strains of this virus have been associated with cervical cancer in 
        women.  The truth is that regular PAP smears in sexually active women can identify early changes on the cervix and
        appropriate action can be taken before cervical cancer develops.
20.   Yellow fever:  given when travelling in tropical areas.
21.   Meningococcus:  the efficacy of the vaccine against Neisseria Meningitidis only lasts for 5 years.  Associated with
       Guillain Barre syndrome.
22.   Rabies vaccine:  only given when at risk.


Guidelines:
NEVER vaccinate a child who is ill or on medication, no matter what illness he/she has.  For me the most serious underlying disorder would be any gastro-intestinal abnormally:  constipation, diarrhoea, nausea and vomiting, gastro-enteritis, even reflux, as I believe that underlying gastro-intestinal inflammation predisposes to vaccine complications, especially where the measles vaccine is concerned.  Recurrent infections, Eczema and Allergies present a risk to me as well.
Make sure that development is well within normal limits before vaccinating.  One can postpone vaccination until a safer time, if there is doubt about milestones.  Obviously, where a child has to be enrolled in a crèche or care facility or in a third world situation, where there is concentrated exposure to many other children, the risk of contracting infections is higher, so that would affect one’s consideration.
One can test immunity by doing a blood test.  This is not a cost effective option for third world countries or where cost is a concern, but it is a logical way to individualise the amount of vaccination a child will be exposed to.  

Warning signs:
•    Gastro-intestinal disease (A stool analysis may be an effective tool to rule out inflammation)
•    Recurrent infections
•    Allergies, asthma and eczema
•    Seizures, febrile convulsions
•    Sleep issues
•    Developmental challenges
•    Sensory disregulation (auditory/hearing sensitivity)
•    Behavioural issues
•    Flushing:  red cheeks, red ears, red eyes, red or dark rings under the eyes
•    Failure to thrive

References:
1.    Talbot, Elizabeth A (2010). The Safety of Immunizing with Tetanus–diphtheria–acellular Pertussis Vaccine (Tdap)
       Less than 2 Years following Previous Tetanus Vaccination
2.    2012 Vaccine Schedules for South Africa, compiled by Amayesa Info Services
3.    www.cdc.gov
4.    Package inserts of vaccination products
5.    Bar-On ES, Goldberg E, Hellmann S, Leibovici L (2012). "Combined DTP-HBV-HIB vaccine versus separately
       administered DTP-HBV and HIB vaccines for primary prevention of diphtheria, tetanus, pertussis, hepatitis B and
       Haemophilus influenzae B (HIB)". Cochrane Database Syst Rev (4)
6.    Classen JB, Classen DC.  Autoimmunity.  2003 May; 36 (3):123.
7.    Lysenko E, Ratner A, Nelson A, Weiser J (2005). "The role of innate immune responses in the outcome of
       interspecies competition for colonization of mucosal surfaces". PLoS Pathog 1 (1)
8.    Bines J (2006). "Intussusception and rotavirus vaccines". Vaccine 24 (18)
9.    FDA's MedWatch Safety Alerts: May 2010 Rotarix Vaccine Suspension Lifted.
10.  Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C (2012). "Vaccines for measles, mumps and rubella in children".
       Cochrane Database Syst Rev 2: CD004407.
11.  Bitnun A, Shannon P, Durward A, et al.(1999) Measles inclusion-body encephalitis caused by the vaccine strain of
       measles virus. Clin Infect Dis 29:855–861
12.  Fombonne E. (2001) Is there an epidemic of autism? Pediatrics 107:411–413.
13.  Taylor B, Miller E, Farrington CP, et al. (1999) Autism and measles, mumps and rubella vaccine: no epidemiological
       evidence for a causal association. Lancet 353:2026–2029.
14.   Roger JH.  (2000) The MMR question. Lancet 356:160–161.
15.   Singh VK, Warren RP, Odell JD, Warren WL, Cole P. (1993) Antibodies to myelin basic protein in children with
        autistic behavior. Brain Behav Immun 7:97–103.
16.   Singh VK, Lin SX, Yang VC. (1998) Serological association of measles virus and human herpesvirus-6 with brain
       autoantibodies in autism. Clin Immunol Immunopathol 89:105–108.
17.   Wakefield AJ, Montgomery SM. (1999) Autism, viral infection and measles-mumps-rubella vaccination.
       Isr Med Assoc  J 1:183–187.
18.   Da Silveira CM, Salisbury DM, de Quadros CA. (1997) Measles vaccination and Guillain-Barre syndrome. Lancet
        349:14–16.
19.    Bitnun A, Shannon P, Durward A, et al. (1999) Measles inclusion-body encephalitis caused by the vaccine strain of
         measles virus. Clin Infect Dis 29:855–861.
20.    Neal A. Halsey, MD, Susan L. Hyman, MD, the Conference Writing Panel.  Measles-Mumps-Rubella Vaccine and
        Autistic Spectrum Disorder: Report From the New Challenges in Childhood Immunizations Conference Convened in
        Oak Brook, Illinois, June 12–13, 2000 Pediatrics 2001; 107:5.
21.   Guillain-Barré syndrome among recipients of Menactra meningococcal conjugate vaccine -United States, June July
        2005. MMWR 2005;54:1023--5.