Thursday, March 27, 2008

Book Review: The Vaccine Book

I remember my mom mentioning to me years ago how confusing all the controversy about vaccines is, and how she hoped that by the time I had kids, all the vaccine controversy would be sorted out. Yeah. . . right.

I was pretty typically vaccinated through early childhood, and then caught up on any missed shots before entering college (state school requirements), or as needed (tetanus when I had stitches, for example). I didn't get my booster shot for MMR, for example, until college. This probably had mostly to due with the 105.6 degree fever and convulsions that my brother experienced after his first MMR shot :-P. Can you say "emergency room visit"?

A few months ago I mentioned to Adrian that I wasn't wildly enthusiastic about all vaccinations, especially the standard schedule used for infants (especially the vaccine offered at birth, and then loading up several shots at once at successive check-ups - 6 different shots in one visit at age 6 months!), and I wanted to do some research before our baby was born. He thought that was a good idea, but being the wise, level-headed man that he is (*grin*), he told me I had to look at both sides of the issue. That was just fine with me, as I wasn't interested in conspiracy theories or blind acceptance of current practices.

In the last few months I've read (online and through a La Leche League magazine) about Robert Sears' book The Vaccine Book, and finally ordered it last week. It arrived earlier this week, and I devoured the first 10 chapters in one sitting. The rest of the book was polished off in another sitting. I really liked this book.

Now, before I go farther, a disclaimer: "I really liked this book" doesn't mean I completely agree with all of Dr. Sears' recommendations; it does mean that I think the book was well-researched, informative, and very helpful. Dr. Sears is a medical doctor who spent 13 years researching this issue. The pro-vaccine people would think he's too lax and skeptical, and the anti-vaccine folks would think he's way too vaccine-friendly.

The first 12 chapters detail each of the 12 vaccines on the standard vaccination schedule for a child. There are 12 standard vaccines, not 12 standard vaccinated-against diseases; for example, MMR (measles, mumps, rubella) is counted as 1 of the 12 vaccines, since it is standardly given all together, though it can be given separately. Each chapter gives detailed answers to the questions:

What is the disease?
How common is the disease? (mainly in the U.S., but he does bring in some international discussion)
Is the disease serious?
Is it treatable?
When is the vaccine for the disease usually given?
How is the vaccine made?
What ingredients are in the final vaccine solution?
Are any of these ingredients controversial?
What are the side effects of the vaccine?

Then in each chapter he gives reasons to give the vaccine and reasons some people choose not to get the vaccine. Then he highlights [international] travel considerations, options to consider if getting the vaccine (delays, splitting up combined vaccines, etc.), and then a few concluding paragraphs explaining how he views the vacccine.

He does end up recommending more vaccines than I think are necessary, but the nice thing is, he gives the information so parents can make up their own minds, and he thinks that parents have the right to deviate from his opinion.

The last chapters discuss assorted topics such as: the ingredients in the vaccines (more in-depth look at aluminum, formaldehyde, MSG, animal and human components, etc., and the controversies surrounding them), collected statistics about vaccine side effects and disease rates, and some very helpful suggested alternative vaccination schedules that spread out vaccinations (no more than two per visit), limit aluminum-containing vaccinations (no more than one per visit, if any), and in the case of one of the proposed schedules, eliminates the vaccines that he considers to be "less important", like chicken pox, for example. Then he gives rather detailed advice for parents who do delay some of the vaccinations, if they would be worth "catching up on" at some point (pertussis and rotavirus, for example, would not need to be "caught up" if vaccinations are begun after age two, since those diseases are really only serious for babies), how many booster shots would be needed, etc.

This book was written in a very level-headed manner. My husband and my brother are two of the most skeptical people I know (I love you both!) when it comes to conspiracy theories, alternative methods, scare tactics, etc. I know that if I find a book (or article) that I can unashamedly show them, then it is one that is very well done, and this book passes that test (I could call it the "Adrian and Ben test"; I would be happy to show it to either, and I think they would both find little fault with it and actually appreciate it. Adrian plans on reading Dr. Sears' book, and I think he will really appreciate it. Dr. Sears' has a real head for spotting logical fallacies and gaps in statistical data.

Dr. Sears also recognizes that information on vaccinations is constantly changing. A nice plus is that this book was published last year, so it is very up-to-date. But just to ensure it stays that way, he is maintaining a website that has a lot of resources on vaccines, and he posts updates to any of the vaccines, as it becomes available.

Notice I didn't come right out in this post and announce which (if any) vaccines we have decided to give our son. That's because we haven't firmly decided (though I have a much better idea after reading the book through the first time). Adrian still wants to read through all the info, and then I'm sure we'll talk through pros and cons of various vaccines, and the pros and cons of delaying those we do decide to do.

Oh, and speaking of Brother Dear, he and his Wife Dear now have reason to think about these sorts of things. . . our little baby is going to have a cousin! Yay :-).


Ben Garrison said...

I would be interested to know if he talks about this...the thing that I've always found absent from discussions of "should I vaccinate my child" is the collective action problem. For example, if my baby has a 1/1000th chance of contracting [fill in the blank illness], and a 1/1000th chance of dying from it, but has a 1/100000th chance of dying from the vaccine, it's better for me to not vaccinate my child by a factor of 10. However, that's only a better option for me because everyone else in the country is vaccinated. If we weren't, that 1/1000th chance of contracting the illness would sky rocket. So selfishly speaking, it would be better, but that's ignoring the fact that diseases are a collective problem.

Of course, from what I understand, your issue is primarily with the age at which children are vaccinated - and since children are somewhat less mobile than adults, it is different. I would be interested to know which diseases are primarily contracted from other infected humans as opposed to the environment.

Susan said...

He does have an entire section on crunching probabilities like you mentioned, and comparing risk of vaccination with risk of disease. The problem is, as he mentions, it's rather hard to really pinpoint just how likely it is to have a severe reaction to vaccinations. We have reactions like yours for the MMR that were never recorded and probably were from vaccines; but we don't have proof of that. And then we have reactions that happen after a round of 6 shots is given to a child, vaccinating against 8+ diseases. Which shot caused that? Who knows.

And one reason he ends up suggesting most (if not all) of the diseases be vaccinated against *eventually* is because of the "selfishness" factor you mentioned, or the "better good."

And yes, my primary concern is the age of the child, and Dr. Sears admits that for several of the diseases (which he names), the chance of exposure and contraction of the disease to an infant is ridiculously low if the child is not in daycare and being breastfed. The diseases I would still at any age see as pointless would be ones like the vaccine 12 year old girls are now "required" (in a state school) to take, that protects them from a type of cervical cancer that is solely contracted through sleeping around. I'm not going to protect my daughters against the consequences of their own sins. . . Or polio (until they are older and internationally travel), perhaps.

Susan said...

Oh, and the chickenpox vaccine. I'd really rather just purposely expose my child to that virus (ever heard of a chicken pox party?) and get the whole ordeal over with, during the summertime, when we can isolate for several weeks. That way you get life immunity, not something that requires boosters, and then still wears off in adulthood, when chicken pox is the most dangerous to get. . .

Anonymous said...

Only problem with a chicken pox party is that there won't be a lot of guests there if everyone is getting the vaccine. I've seen older kids get chicken pox and they can get very sick. That is why I opted to get the vaccine.

The Gardisal vaccine is just insulting to good parents! Don't get me started on that.I don't want young girls to get sick, but let the parents decide.

My friend's 6 mos baby died from whooping cough (none of her kids, older or younger, were vax), so I'm a pretty hesitant not to vax my babies.

The book does seem like it is very good. I might have to check it out. Thanks.


Susan said...

There are ways to find people who do have chicken pox, but you're right about it being harder. Part of my problem with the chicken pox vaccine is that it isn't permanent (or 100% either) immunity, so it wears off by the time it is really more serious to get chicken pox. I think it would completely make sense to get the vaccine by about 11 (when the disease becomes worse) if a child hasn't had it naturally. The problem is the vaccine is making it so that is the rule, not the exception, but then you can still get a bad case several years after your delayed vaccine, when it wears off, or you can get shingles, which are awful.

Susan said...

*or 100% effective either

Anonymous said...

you can get shingles without being vaccinated. I took care of many elderly patients with these flare-ups. If I remember, correctly, once you're infected with the varicella virus, it stays for life and reappears as shingles.

I don't think the chicken pox vaccine was necessary.

Typing leftie. Owen's eating. :-)

Anonymous said...

I think it would make sense to vax the chicken pox at age 11 if the child hasn't gooten the illness naturally, like you suggested.

I had an extremely mild case when I was 9. I had two pock marks. lol. Ihave heard, but never received a definitive answer, that I could get chicken pox again. At my age, that would be bad.

off the subject, slightly. Wasn't it Jonathan Edwards who died after receiving the small pox vaccine?

Susan said...

I have no idea if that was Jonathan Edwards. Anyone else? But yes, if you have an extremely mild case, you can get chicken pox again. Interesting about shingles; hadn't heard that.

Eltinwe said...

We considered this question with Carina, but only ended up adjusting the vaccine schedule the doctor recommended slightly.

The chicken-pox vaccine seems superfluous to me, mostly. I had it in kindergarten (my entire class had it, along with half the school) but I had a decent case with plenty of itching. My younger sister, however, was only 1 at the time and got it too - but only had two or three pox. Obviously, she developed some form of immunity, but she DID get it again some years later, but again, only very mildly. I figure for her that worked as a "booster" for her immunity which probably works about as well as having booster shots.

Many people complain of young children being given too many shots. To my mind, I thought it was better to give what shots I could while she was still breastfeeding, which boosts the immune system and helps produce those immunities properly. And also because it gave her a two-year "break" between age 2 or so and age 4, when honestly it's just a LOT harder to give shots. This time around, I had Carina quite psyched up to be "brave" while getting her shots (it helped that she'd watched me have blood drawn the previous week) so she didn't even cry when she got the shots, much less struggle. She did cry when we got to the car because she said it hurt and being brave only lasts so long when you're 4, but she did handle it MUCH better than she would have in the intervening years when the child is old enough to really cause problems while getting shots and is more likely to remember it long term and be afraid of going to the doctor because of it.

Whatever you decide to give, I'd suggest NOT giving it in that couple year time frame if you can get out of it. I don't suggest postponing those they normally give very young for only a short time and into a time when they can't really understand why being inflicted with pain can be good for them!

Anonymous said...

Yes, I just checked. It was Edwards who died from complications of the vaccine. His health was fragile at the time.

Samara said...

This is a relevant topic and one that gets people pretty animated, to say the least. I am going to reserve this book at the library. Generally, we have been following the standard vaccination schedule, mainly because 1) both my parents work in pediatric health care settings, 2) and our little Mr. is around other kids a lot, many of whose parents do not vaccinate at all, and 3) my Mr.'s family travels back and forth to India regularly, and we expect to begin doing the same. My parents recall vaccinations from the time when they were really a godsend- my dad also being a polio survivor- and their opinions have shifted over the years from "vaccinate for everything" to a little more relaxed.

Anecdotally, both the little guy and I had pertussis last February, before his scheduled vaccination for it. It was going around at work and I suppose I got it on one of my visits to the office while I was working from home. It was awful- not the initial illness but the horrible cough, both of us coughing until we threw up several times a night. It was very draining and really nothing you can do but wait out the weeks.

Chicken pox is something that most folks seem to agree on here. We had 2 bouts of it in our household of 10 growing up, the second when I was in kindergarten. None of us suffered terribly but I had school friends who had sores internally and in the membranes of their noses, mouths, eyelids- yuck. And Gardasil- I suppose if a child of mine were going to marry someone who had been married before (or just not a virgin, for whatever reason) I would want them to have it, gender aside. Same if a child of mine was sexually active before marriage- touchy stuff, I know, but we do what we can to keep each other safe regardless, right?

Anonymous said...

Chicken Pox (varicella)is a herpesvirus which means it has the ability to remain in a host cell during a latent phase and has the ability to replicate. The host cell is usually a neuron. After many years the virus will reactivate because of stress/physical factors as shingles (zoster). The fluid that oozes from the vesicles in shingles carries the varicella-zoster virus which can cause chicken pox in people who haven't had chicken pox. I would assume that the chicken pox vaccine would provide immunity to the person exposed to shingles who was vaccinated.

Just dug out some old textbook from microbiology. :-)


Anonymous said...

i don't vaccinate . more books on the subject that i found helpful were vaccines- tragedy and deception by michael dye , the vaccine guide by randell neausteader (the best one i have read and i've read lots!),dr robert mendohlsohn's book how to have a healthy child in spite of your doctor. ( i LOVE LOVE LOVE this book for all of it's content, not just the vax section)
and dr stephanie cave's book what your doctor may not tell you about your child's vaccinations (she is pro vax on some things while i am not)

Meg G said...

Happy Birthday! You're 4! What fun! ;-)

miller_schloss said...

Woo, you're going to be an aunt! I am so excited to be an aunt in August.

Happy birthday, by the way.

I'm glad you recommend this book too. It's on my amazon wish list. I really do need to order it.

miller_schloss said...

We have given K her vaccines on the normal schedule because we have a very "mainstream" pediatrician. (It's a difficult situation for me...he is a wonderful man from our church who is one of Matthew's mentors. We respect him deeply as a Christian man. However, I find my approach to medicine and pediatric care very different from his (he is pro-Babywise, while I lean more toward attachment parenting, for example), and I haven't figured out how to handle the situation)

I did refuse the flu shot for her.

One concern I have is that we plan to be overseas missionaries, and some of the diseases that are now non-existant in the US are still epidemic in other countries.

The latest CNN stories about vaccines and autism are really fascinating. Parents are starting to win legal settlements over a vaccine-autism link. The CDC can keep denying that there's a link, but when they start to pay out settlements, that feels like an admission of guilt to me.

Jody said...

I really want to get this book. Thank you for the review. My husband and I just found out we are expecting our first child in November. I look forward to more 'baby talk' on your blog! May I add you to my blog list?

Jody Dix

Susan said...

Congratulations on expecting :-). How exciting! Yes, feel free to link to my blog. Thanks!

Michelle said...

Hi, Susan! That sounds like an excellent book. We made decisions about vaccinating after wading through the extremist (on both sides) info and trying to figure out where the balance was. My biggest complaint against anti-vaccinators was that everything was so fear-driven. Being a medical person, I can see both sides of these types of issues (like VBAC or c-section, etc.). Many diseases that used to be deadly are now easily treated, especially here in the US. And I was shocked to learn that the big push for the chickenpox vaccine was to decrease the amount of sick days taken by parents and the number of school days missed... a convenience and financial concern more than anything else. I had chicken pox when I was 12 and it was miserable. A teacher of my brother's got it when she was in her 20s and was very, very ill. So like many say, the vaccine is probably a good idea for an older child or an adult that never was exposed... and it IS getting harder to get them exposed naturally.

I think as with so many parenting decisions, you have to look at as much factual info as you can, pray about it, and then make the decision you believe is best, knowing that God holds the outcome in His hands. Remembering that takes away a lot of the stress of decision-making! :)


Michelle said...

Oops... Susan, that was me, Michelle from Ivy Creek... Cass, Em and Garrett say hi! :)

Sara said...

"The diseases I would still at any age see as pointless would be ones like the vaccine 12 year old girls are now "required" (in a state school) to take, that protects them from a type of cervical cancer that is solely contracted through sleeping around. I'm not going to protect my daughters against the consequences of their own sins. . ."
What a terrible thing to believe. First, the HPV vaccine has not yet been mandated for American schools, and it's doubtful at this point if it ever will be. Secondly, HPV isn't just a result of "sleeping around". Good Christian girls (and boys) can be raped. Or marry partners who were not abstinent before marriage. And if they did choose premarital sex -the idea of wanting your own child to be punished for a mistake with CANCER is more horrifying than I can say. There are legitimate arguments against the HPV vaccine, but your views are very troubling. If your son or daughter were to disobey you, and put their hand on a hot stove and burn their hand, would you deny them medical treatment because of their disobedience? No?? But you would be ok with your child getting CANCER?

Susan said...

"Wanting my child to get cancer" is a far cry from not actively protecting them from something. Please don't completely misrepresent what I said :-).

Of course Christian girls can end up marrying non-virgin men, and I don't think that's wrong (Christ's blood covers every sin, including sexual ones), but they could easily get the vaccine then. And I don't think we can possibly protect our children from every possible thing that can happen to them, like obscure situations like rape. I think teaching daughters to not flaunt their bodies and to be alert and stay in safe places is a more effective way of preventing rape than anything else. And, please do not take that last sentence to mean I think only uncareful, immodest girls get raped. That is not at ALL true; my point is merely that there are lots of things to do to reduce the risk of rape, or the consequences thereof (like the off chance that the perpetrator gave the girl this particular STD, which is small), and it's rather frustrating to me that some of those preventive measures are more lauded as "necessary" than others. *sigh*