Should you delay your child’s vaccination schedule?

Dr. John Snyder, Chief of the Section of General Pediatrics and Medical Director of Pediatric Ambulatory Care at Saint Vincent’s Hospital in New York City, takes on one of the most vexing issues facing the parents of a new baby: should they follow the vaccination schedule recommended by the American Academy of Pediatrics and the CDC’s Advisory Committee on Immunization Practices, or should they follow an alternative vaccination schedule just to be on the safe side?

As Dr. Synder observes in a gripping post on Science-Based Medicine, this alternative schedule is largely the work of Dr. Robert Sears, a celebrity pediatrician, and author of The Vaccine Book: Making the Right Decision for your Child.  Essentially, the message is that there is a safer way to vaccinate your child, but that most doctors don’t know enough about the science of vaccination to offer this advice to parents; however, help is at hand if you are willing to part with the money for Dr. Sears’ book, the fruit of his self-taught expertise in vaccination.

The history of science – and medicine in particular – comes to us as a steep learning curve, where one moment’s conventional wisdom turns into nonsense the next.  But while the accrual of scientific knowledge is now a vast daily enterprise, it is less likely, given the refinements of critical method and the extensive formal and informal peer review given to new theories and treatments, for the lone scientist to stand athwart a field and declare that all its practitioners are deluded and mistaken.

So when Synder notes that Dr.  Sears is a), selling a book; b), is self-taught in the field he is writing about;  and c), offers a completely different view of that field to its established authorities, one should d), be skeptical. Authors, whether scientists or doctors, tend to challenge their fields from within, and by peer-reviewed publication, before taking their message to the general book-buying public. Unfortunately, the public has become so primed to view official expertise with suspicion that the messianic expert (“only I can lead you on the path to truth that no others can see”) is given a free pass, a fat book advance, and an endless revenue stream from sales. It’s an extraordinary social phenomenon, no doubt driven by society’s ever increasing preoccupation with risk combined with  limited scientific literacy.

Which is whyDr. Synder’s expose is a truly jaw-dropping read.  Consider the following extract:

Measles

Dr. Sears’ discussion of measles consists of a series of downplayed statements. He describes the rash as one that “can look similar to rashes…of other diseases, so its not easy for a doctor, much less a parent, to recognize.” And he states that the disease is “transmitted like the common cold”. The clinical presentation of measles is striking and very difficult to mistake for any other illness. As I was taught during my residency, there’s no such thing as a mild case of measles. Every child with the disease is very ill appearing. And, while it is transmitted by respiratory droplets like the common cold, it seems the sole reason for making this statement is, again, to liken it to other, less dangerous viral infections. In answer to his self-posed question “Is measles serious?”, Dr. Sears replies,

Usually not. Most cases, especially in children, pass within a week or so without any trouble. However, approximately 1 in 1000 cases is fatal…Now that measles is rare, many years go by without any fatalities.

He then makes the astoundingly misleading statement,

The possible complications of measles, mumps, or rubella are very similar to the side effect of the vaccines themselves.

Because I can’t fathom he is that ignorant of the facts, I am inclined to believe that Dr. Sears is simply being deceitful. Here are the facts about the complications of measles:

  • One in 1000 cases of measles results in encephalitis, with a high rate of permanent neurological complications in those who survive.
  • Approximately five percent develop pneumonia.
  • The fatality rate is between one and three per 1000 cases.
  • Contrary to Dr. Sears’ statement, death is most commonly seen in infants with measles.
  • Subacute sclerosing panencephalitis (SSPE) is a rare complication of measles infection that occurs years after the illness in approximately 10 of every 100,000 cases.

Here are the facts about complications of the measles vaccine:

  • It causes fever and a mild rash in 5-15% of recipients.
  • 0.03% will have a febrile seizure – likely not a result of the vaccine itself, but simply a child’s individual predisposition to febrile seizures.
  • One in 10,000 children will have a more serious event following the vaccine, such as a change in alertness, a drop in blood pressure, or a severe allergic reaction.
  • Approximately 1 in 25,000 cases is associated with an asymptomatic drop in the blood platelet count, which quickly returns to normal without any consequences.

Dr. Sears uses reactions listed in the vaccine package insert as if they are true vaccine side effects. This is analogous to using VAERS data to draw conclusions about vaccine reactions, since there is no evidence that any of these are causally related. Most side effects listed in package inserts occur at the same rate as background or placebo rates.

And this is only one in a list of substantive criticisms which subjects each of Dr. Sears claims to the critical scientific consensus. Almost as valuable are the comments, many from other doctors.  One particular one, by Wilbert Mason MD, reinforces why measles is far from being a trivial disease:

“Let me share with you our experience with measles at Childrens Hospital Los Angeles during the measles epidemic in 1990. We diagnosed 440 cases between January 1st and June 30th. Of these cases 195 (44%) had to be admitted for one or more complications of measles. We documented the complications in all 440 cases and they included 63% with ear infections, 45% with diarrhea, 39% with dehydration, 36% with pneumonia, 19% with croup, and about 3% with other bacterial infections. Three children died all of pneumonia. Measles is not a trivial infection as you inferred. We would not be having a debate about vaccines at all if people realized the tremendous costs in suffering and human life we incurred before vaccines became available.”

As Dr. Synder notes, by claiming that he wants to avoid indulging in the kind of vaccination hysteria that has done so much to confuse and scare parents, Dr. Sears actually engages in a “more subtle” kind of fear mongering:  he adopts the journalistic rhetoric of giving  “a straight, unbiased story,” but then repeats and reinforces “common parental fears and anti-vaccine myths.”  (hat tip – Shaw’s Eco-logic)

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2 Responses to Should you delay your child’s vaccination schedule?

  1. binky says:

    Your third paragraph is particularly good, a concise and simply stated summary of why instances of this phenomenon deserve extreme skepticism.

    People are probably also primed by the dimly remembered stories of the giants of early science, where the paradigm shifting theory (which we now accept beyond doubt) is dismissed, ignored, mocked, before it’s accepted.
    But yes also as you say, “society’s ever increasing preoccupation with risk,” but surely it’s more specifically around weight loss and nutrition and health, where over the past few decades we’ve been through so many changes in the conventional wisdom, some contradictory, that it’s the stuff of comedy routines.

    But anyway, scary stuff. And you didn’t even mention Jenny McCarthy!

  2. Kris says:

    Another great addition to this blog. We are having another ‘debate’ about vaccination here in Australia at the moment, where yet again, unsupported anecdote is routinely presented alongside the firmest of evidence as if they are equally weighted.

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