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Should You Vaccinate Your Children?

Since rotavirus immunization of infants was introduced in the United States, hospital visits and admissions have declined by four fifths among the immunized.

by
Theodore Dalrymple

Bio

January 21, 2014 - 3:00 pm

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There is no subject that provokes conspiracy theories quite like the immunization of children. That innocent, healthy creatures should have alien substances forcibly introduced into their bodies seems unnatural and almost cruel. As one internet blogger put it:

Don’t take your baby to get a shot, how do you know if they tell the truth when giving the baby the shot, I wouldn’t know because all vaccines are clear and who knows what crap is in that needle.

The most common conspiracy theory at the moment is that children are being poisoned with vaccines to boost the profits of the pharmaceutical companies that make the vaccines. No doubt such companies sometimes get up to no good, as do all organizations staffed by human beings, but that is not also to assert that they never get up to any good.

A relatively new vaccine is that against rotavirus, the virus that is the largest single cause of diarrhea in children. In poor countries this is a cause of death; in richer countries it is a leading cause of visits to the hospital but the cause of relatively few deaths.

Since rotavirus immunization of infants was introduced in the United States, hospital visits and admissions have declined by four fifths among the immunized. However, evidence of benefit is not the same as evidence of harmlessness, and one has the distinct impression that opponents of immunization on general, quasi-philosophical grounds, almost hope that proof of harmfulness will emerge.

A study published in a recent edition of the New England Journal of Medicine examined the question of one possible harmful side-effect of immunization against rotavirus, namely intestinal intussusception, a condition in which a part of the intestine telescopes into an adjacent part, and which can lead to fatal bowel necrosis if untreated.

The authors compared the rate of intussusception among infants immunized with two types of vaccine between 2008 and 2013 with that among infants from 2001 to 2005, before the vaccine was used. There is always the possibility that rates of intussusception might have changed spontaneously, with or without the vaccine, but the authors think that this is slight: certainly there is no reason to think it.

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They found that there were 6 cases of intussusception after 207,955 doses of one kind of vaccine, whereas only 0.72 cases would have been expected from the 2001 – 2005 figures. Therefore the risk of intussusception increased 8.4 times after immunization.

The authors found no such increase after the use of another type of vaccine, with 8 cases after 1,301,801 doses administered instead of the expected 7.11. This difference was too small to be statistically significant; it might easily have arisen by chance. However, another study of this vaccine, from Australia rather than the United States, suggested that the size of the risk with this vaccine was similar to that of the other.

Therefore, on the balance of probability, immunization against rotavirus does cause intussusception in infants and is therefore not entirely harmless. To that extent the conspiracy theorists are correct. But good in medicine seldom comes without the possibility of harm (the reverse, alas, is not true), and if doctors never prescribed anything that might do harm as well as good they would not prescribe anything at all. The good must always be weighed against the harm and in this case the balance seems overwhelmingly on the side of the good. The very fact that such huge numbers of cases have to be treated to reveal any harm at all is an indication that, in numerical terms at least, it cannot be very great.

****

images courtesy shutterstock /  graphixmania / Dmitry Lobanov

Theodore Dalrymple, a physician, is a contributing editor of City Journal and the Dietrich Weismann Fellow at the Manhattan Institute. His new book is Second Opinion: A Doctor's Notes from the Inner City.

Comments are closed.

Top Rated Comments   
I've seen complete hysteria erupt over the subject of whether or not to vaccinate your children. Shrill, uncontrolled hysteria.
Mostly from parents who grew up in an age of relative safety from the diseases that vaccines had pretty much eradicated in the USA a generation before they were born. I'm a child of the 50s. Dad was a physician. The 4 of us got every vaccine for everything that we possibly could. I remember as a child dreading the month of August, because that was when we got shots, shortly before school started.
Not one of the 4 us is autistic. None of us had any detrimental effect from the multitude of vaccinations we received. It must be a miracle.
26 weeks ago
26 weeks ago Link To Comment
There is a more serious problem at the root of this and that is the belief that medicine should be 100% harmless or it ought not be given. Vaccine produces a benefit which is, on average many times more beneficial than the side effects (which emphatically do not include autism). That said, if your child dies of vaccine related complications, that resolves into a 100% probability of death for your loved one! compared to some lesser risk of the prevented disease.

This is made far worse because the government ordered you to do it. They did this because the vaccines don't always confer 100% immunity but rely on a lesser level of immunization to collapse epidemic formation. Essentially, to provide maximum benefit for all those who participate in the vaccination, everyone has to participate.

Public Health is the one and only area where true collective action by force is *sometimes* warranted. Smallpox does not respect the constitution. Unfortunately, this requires people to have some trust in government.

AIDS would have collapsed, epidemiologically speaking, if the San Francisco bath houses had been promptly closed, as was recommended. After decades of flat out oppression, gays didn't trust even a government they by in large elected.

The social compact requires trust, and trust requires people to be educated about the benefits, but more importantly the limitations of medicine. Epidemiology is pretty mature science, and does not lend itself to political manipulation in an environment of medical transparency, but in a society where I question nearly every action of government as having a political motive to keep Democrats in power, this is very hard.
26 weeks ago
26 weeks ago Link To Comment
All Comments   (25)
All Comments   (25)
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til I looked at the draft saying $5981 , I did not believe ...that...my sister had been actualie making money part-time at there computar. . there great aunt haz done this less than nineteen months and as of now paid for the mortgage on there mini mansion and got a brand new Citroën 2CV .
try this web-site...... http://www.Fizzjob.com
26 weeks ago
26 weeks ago Link To Comment
Once you get the rotarvirus, you can't get it again; your body's immune system will not allow it. But, there are many strains of it. Ergo, not one single shot for this virus will immunize you against all strains. You would have to get your child immunized against whatever strain is prevalent - and even then (as we've found out against the flu) the CDC is not always correct about the strains.

The rotarvirus is a nasty virus and can definitely cause death in small infants. But, this article is a bit misleading. The shot doesn't immunize a person against the virus, but just the strain. And if you already suffered through that strain you don't need the shot.
26 weeks ago
26 weeks ago Link To Comment
The author does not describe the socio-economic class subject to this virus.

Infectious disease does not have the same prevalence across the various classes.

So if you're not a part of the class at risk, the risk-benefit ratio is not in your favor....so don't vaccinate.......
26 weeks ago
26 weeks ago Link To Comment
interesting. a quick read of the original article reveals risk windows of 7 days and 21 days were studied. this makes sense as hypertrophy of the stimulated peyer's patches would be the lead point for intussusception. more importantly,however, this implies a short window, not a life long at risk situation. intussusception is primarily a disease of the young (3 mo to 5 years). i would be very interested to see the statistics for a 5 year follow-up. repetitive incidents? overall increase? overall incidence unchanged, simply shifted? also, it seems that the increase is related to the first dose and not the follow-up doses.

as for mandatory vaccination, this is one that can be argued either way i think. it is not polio, small pox or tetanus. in a third world country, diarrhea kills a lot of kids. in advanced countries it is (usually) not fatal. on the other hand, it is infectious.
26 weeks ago
26 weeks ago Link To Comment
As you pointed out , Intussusception is mechanical, so far as we know, there should be a lead point. At this point there is nothing but epidemiology. There is no proven pathophysiology to explain the small but significant, incidence of Intussusception in infants after the first dose.

Perhaps it may be that the infection itself masked the incidence of Intussusception in the early stages. Those infants who died from the disease perished because of direct toxic causes of the infection. Those who survived had lifelong immunity. Just a hypothesis.

From the point of view of epidemics the rotovirus vaccines have saved many lives. That is not in question. The virus is the enemy and we are destroying it with this vaccine.

I have yet to see a pathologic tissue based study showing that hypertrophy of lymphoid tissue in the distal ilium is any greater in infants immunized vs those with the disease.


26 weeks ago
26 weeks ago Link To Comment
"While the length of the intestinal tract contains lymphoid tissue, only the ileum has abundant Peyer's patches, unencapsulated lymphoid nodules that contain large numbers of lymphocytes and other cells of the immune system"

And you are provoking an immune response with the vaccination. Interesting
26 weeks ago
26 weeks ago Link To Comment
yes, and the small bowel narrows with th ileocecal valve being the narrowest place.
26 weeks ago
26 weeks ago Link To Comment
Again interesting and I am playing catch up. Maybe this theory goes nowhere but I doubt it.

"as for mandatory vaccination, this is one that can be argued either way i think. it is not polio, small pox or tetanus. in a third world country, diarrhea kills a lot of kids. in advanced countries it is (usually) not fatal. on the other hand, it is infectious."

Your statistics cannot be argued. You are not manipulating them as judge from the tenor of your writing.

I would rather wait until my kid was 3 or 5 until giving them this type of shot seeing how in an advanced country it is usually not fatal. Again it would be weighing the relative mortality. I just do not see a person without a gut "passing GO" and having a happy life.

I guess the interesting question is if they have identified genetic markers for those at risk or if it just random chance. I also wonder if you could feed the kid something like "metamucil to bulk up the intestine for a few day to prevent the evagination (Just a dumb ideal).

Maybe this vaccination would be better done in a series of shoots starting with weaker strains and then building up so as to ameliorate the immune response.
26 weeks ago
26 weeks ago Link To Comment
By the time your kid is 3 or 5 years there is not much need for vaccine. They have already been exposed.





26 weeks ago
26 weeks ago Link To Comment
i briefly had the same thought about changing the age of vaccination. the problem is that this is a disease of the young. moving it to older children would significantly reduce the benefits. possibly not negate them as herd immunity would still be present.
26 weeks ago
26 weeks ago Link To Comment
I have no ideal what a peyer's patches is, so I have to look it up. I like your post because it has some suggestion as to a causal mechanism for the side effect.
26 weeks ago
26 weeks ago Link To Comment
I was going to ask what could possibly be the MOA that would let any injection "cause" this intussusception.

What if anything EVER *causes* intussusception? I'm all for statistics but one has to reduce it to causation at some point.
26 weeks ago
26 weeks ago Link To Comment
the cause of intussusception is a lead point that peristalsis envaginates. hypothesis (mine-for purpose of answering your question) the lymphoid tissue in the wall of the small bowel (ie peyer's patches) becomes hypertrophic due to the injection (that is the job of the lymphatic tissue). this gives an enlarged "glob" of tissue which peristalsis causes to envaginate. i've seen on more than one occasion. here is a link to a pretty good summary, though i don't agree with everyting in it: https://www.clinicalkey.com/topics/surgery/intussusception.html

there is a summary of causes about halfway down.
26 weeks ago
26 weeks ago Link To Comment
I've seen complete hysteria erupt over the subject of whether or not to vaccinate your children. Shrill, uncontrolled hysteria.
Mostly from parents who grew up in an age of relative safety from the diseases that vaccines had pretty much eradicated in the USA a generation before they were born. I'm a child of the 50s. Dad was a physician. The 4 of us got every vaccine for everything that we possibly could. I remember as a child dreading the month of August, because that was when we got shots, shortly before school started.
Not one of the 4 us is autistic. None of us had any detrimental effect from the multitude of vaccinations we received. It must be a miracle.
26 weeks ago
26 weeks ago Link To Comment
the 50's???? All you got was smallpox ( as an infant ), polio, and tetanus.

not exactly the same as today. and I was there then too.........never ever heard of an autistic child. but we know of them today............something changed..??...
26 weeks ago
26 weeks ago Link To Comment
autism is far from the rotovirus question, but the single best book i have read on the subject is Temple Grandin's "The Autistic Brain". http://www.amazon.com/Autistic-Brain-Thinking-Across-Spectrum-ebook/dp/B009JWCR56/ref=sr_1_1?s=books&ie=UTF8&qid=1390781440&sr=1-1&keywords=temple+grandin+the+autistic+brain

she will take you chronologically through the changes since it was first described in the '40s by Leo Kanner to present day definitions, using scans of her own brain. she is a high functioning autistic (and a professor of animal science at Colorado State University). worth your time if you have any interest in autism.
26 weeks ago
26 weeks ago Link To Comment
Measles, mumps, rubella, whooping cough, tetanus, later chicken pox . . . there were lots of things still running around to be vaccinated for.
What changed? People got used to NOT dying from any disease that ran through the populace, and started looking for something to blame for random imperfections in their children. As well as a huge expansion in the definitions of autism and assorted behavioral issues. So many things are considered medical issues now that were not back then. That's what's changed.
26 weeks ago
26 weeks ago Link To Comment
This is so true. At 30 I was diagnosed with ADD. I couldn't tell you how many parents get on internet forums screaming "It's a made up disease! It's big pharma victimizing us!" Etc, ad nauseum. You try to tell people, "Look, it's a real disease, but still very misunderstood, and diet, sleep and exercise all affect the effectiveness of medication, IF you have the right meds." Healing ADD by Dr. Daniel G. Amen, MD, PHD is a fantastic book that explains it all with brain scans included. IMHO, it's mostly people who would rather their kid suffer than have to face the fact that their precious angel might have a problem that a pill, some wise planning and some parental oversight would be required to fix.
26 weeks ago
26 weeks ago Link To Comment
There is a more serious problem at the root of this and that is the belief that medicine should be 100% harmless or it ought not be given. Vaccine produces a benefit which is, on average many times more beneficial than the side effects (which emphatically do not include autism). That said, if your child dies of vaccine related complications, that resolves into a 100% probability of death for your loved one! compared to some lesser risk of the prevented disease.

This is made far worse because the government ordered you to do it. They did this because the vaccines don't always confer 100% immunity but rely on a lesser level of immunization to collapse epidemic formation. Essentially, to provide maximum benefit for all those who participate in the vaccination, everyone has to participate.

Public Health is the one and only area where true collective action by force is *sometimes* warranted. Smallpox does not respect the constitution. Unfortunately, this requires people to have some trust in government.

AIDS would have collapsed, epidemiologically speaking, if the San Francisco bath houses had been promptly closed, as was recommended. After decades of flat out oppression, gays didn't trust even a government they by in large elected.

The social compact requires trust, and trust requires people to be educated about the benefits, but more importantly the limitations of medicine. Epidemiology is pretty mature science, and does not lend itself to political manipulation in an environment of medical transparency, but in a society where I question nearly every action of government as having a political motive to keep Democrats in power, this is very hard.
26 weeks ago
26 weeks ago Link To Comment
hornspe, TD's essay is thought provoking and excellent, as is your commentary.
26 weeks ago
26 weeks ago Link To Comment
How about changing the question to whether the US should vaccinate children signifcanly more than every other first world country does? Most first world countries don't have the Rotovirus vaccine on their schedule. We give 2-3 times the number of vaccines of other first world countries with no signigficant difference in childhood mortality or life expectency.
27 weeks ago
27 weeks ago Link To Comment
That's a valid question, but mortality rates are arrived at with different criteria in different countries, and this would have to be accounted for.
26 weeks ago
26 weeks ago Link To Comment
I would have also mentioned the herd effect. If others are vaccinated you too are protect. In a sense you are a free rider.
27 weeks ago
27 weeks ago Link To Comment
Gluten free vaccines? That's the ticket! Problem solved!
27 weeks ago
27 weeks ago Link To Comment
Made without the help of GMOs, which, of course, have supplanted the vegan- despised eggs.
27 weeks ago
27 weeks ago Link To Comment
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