By Chris Gerbasi
A healthy debate about vaccines
The use of vaccinations stirs advocates, opponents, and parents who want the right to choose.
Measles was supposed to be gone. Now it’s back—with a vengeance.
Through Aug. 22, 1,215 individual cases of measles had been confirmed this year in 30 states. This is the greatest number of cases reported in the United States since 1992 and since measles was declared eliminated in 2000, according to the Centers for Disease Control and Prevention (CDC).
The outbreak is significant not only for the public health threat it poses but also for the debate over vaccinations it has reignited. Measles is a highly contagious viral infection that can cause fatal complications and is especially serious for young children. For most doctors, there is no debate. Vaccines prevent measles and other illnesses, they say, armed with scientific studies validating the safety of vaccinations.
Some doctors and parents, however, maintain that vaccines can cause developmental disorders and illnesses, and say they have the data to back that up. While they generally are dubbed “anti-vaxxers,” more accurately, they favor parental choice. Parents may alter vaccination schedules for their children, accept some shots and not others, or avoid vaccines all together.
One area of agreement in the debate is that more public education is needed, and many parents in Lake and Sumter counties are doing their homework on vaccine safety.
ADVOCATES FOR VACCINES
Dr. Valerie Thomas doesn’t mince words about the importance of vaccinations.
“Vaccines save lives,” the Tavares pediatrician says. “Unfortunately, I have seen children die from vaccine-preventable diseases, including influenza, meningitis, pneumonia, whooping cough, and chickenpox. I have never seen a child die from a vaccine and I have never even talked with a physician who has seen a death from vaccine. Receiving the vaccine is fantastically safer than getting the disease.”
Dr. Thomas, who has been practicing for 31 years, also says she has never seen any permanent side effects from vaccines. Any vaccine potentially can cause side effects. The only side effects she generally sees are minor muscle soreness or a rash around the injection.
The CDC recommends vaccinations for children and adults at various times depending on their age and health conditions. When a vaccine is administered, it stimulates the immune system so it can recognize the disease and protect the body from future infection, thus immunizing the recipient.
A decision to not immunize puts people at risk of illness, states the CDC, which reports that the majority of people who got measles this year were unvaccinated.
Dr. Thomas says once viral or bacterial diseases are established in the body, it’s often too late to treat them effectively and prevent permanent damage or death.
“One of the things that vaccine refusers say is, ‘If my child gets the disease, then we will treat it.’ What they don’t realize is that all of the diseases against which we vaccinate are difficult or impossible to treat once the illness occurs,” the doctor says. “The best way to treat a disease is to prevent one from getting it, and that is what vaccines do.”
MOST UNWANTED LIST
Vaccines are available for these dangerous diseases, according to the Centers for Disease Control and Prevention:
Chickenpox, diptheria, flu, hepatitis A and B, Hib (Haemophilus influenzae type b), HPV (human papillomavirus), measles, meningococcal, mumps, pneumococcal, polio, rotavirus, rubella (German measles), shingles, tetanus, and whooping cough (pertussis).
Many of today’s fears about vaccines are rooted in a 1998 study of 12 children led by Dr. Andrew Wakefield, a British gastroenterologist. The study purported to show a relationship between the measles-mumps-rubella (MMR) vaccine and the development of autism. The MMR vaccine is recommended between 12 and 18 months of age, which coincidentally is when signs of autism may first become evident.
The study was discredited after multiple follow-up studies refuted the results, according to National Library of Medicine reports. Ten of the 12 authors of the study retracted their findings, saying no causal link was found between the vaccine and autism.
Still, fearful comments about vaccine side effects continue to spread on the internet and social media, says Dr. Eugene Tan, a Leesburg pediatrician.
“Most of them are really unfounded,” he says. “A lot of studies prove that no vaccine did cause autism or any major neurological side effects. There’s no proof, really.”
He encounters a few patients who are opposed to vaccinations and tries to explain his views.
“I’ll tell them that vaccine is still the safest way to go rather than risking their child to illnesses, but again, if they already have a preconceived idea, sometimes it’s hard to convince them,” Dr. Tan says.
Some parents are concerned about the number of shots children must receive, but research leading to new vaccines has created the increase, he says. For example, 20 to 30 years ago, doctors didn’t have the pneumococcal or the Hib (Haemophilus influenzae type b) vaccines, and since the introduction of those vaccines, the incidence of those illnesses has decreased significantly, he says.
Mandatory vaccination is necessary to maintain “herd immunity,” says Dr. Paul Ehrmann, an osteopathic family physician in Royal Oak, Michigan. Some people can’t be vaccinated due to medical conditions, so keeping the rest of the population vaccinated protects those who are vulnerable.
“Some diseases, like measles, require as much as 95 percent of the population to be vaccinated in order to achieve herd immunity,” he says.
Dr. Ehrmann, as well as Drs. Thomas and Tan, stresses better education for parents. In Michigan, a public information campaign launched in 2017 has significantly improved vaccination rates, according to the American Osteopathic Association.
“It’s up to us to try to protect the public health,” Dr. Ehrmann says. “The way that you do that is trying to educate patients on the advantages of the shots and give good, scientific, evidence-based information, and that’s all we can really do. The rest of it is up to the patient.”
Since 2003, nine CDC-backed studies have found no link between the MMR vaccine and autism, and no link between vaccines containing thimerosal, a mercury-based preservative, and autism.
No increased risk for autism after MMR vaccination was found in a study of 657,461 Danish children published in April in the Annals of Internal Medicine.
Immunization saves 2 million to 3 million lives each year worldwide, the World Health Organization estimates.
Don’t call them “anti-vaxxers.” Some parents who choose not to have their children vaccinated say they’re not completely “anti-vaccination” but rather “pro-choice.” They believe parents should have the right to decide for themselves about vaccines—which ones, when, and how many.
“What people want is the truth and they want to be heard and acknowledged and they want a choice,” says Dr. Cornelia Franz, founder of the Franz Center pediatric practice in Orlando.
Dr. Franz’s truth is that not only are vaccines harmful, but they also don’t work. She points to recent outbreaks of illnesses and adverse incidence statistics from reporting sites. Despite that, her practice offers both alternative and traditional medicine, which includes vaccines.
She often hears about parents’ previous bad experiences.
“Parents have told me the same story over and over: that their child was fine and then 24 hours later or a few days or a week (after a vaccine), the child has lost eye contact, won’t talk, has had neurologic regression,” she says.
“Now, people might say, ‘You can’t prove the vaccine caused it,’ and I say, ‘You can’t prove it didn’t,’” she adds.
One of Dr. Franz’s biggest concerns is the number of shots given to children in a short timeframe. In the past 30 years, the recommended number of vaccinations has quintupled, she says.
The CDC schedule calls for up to 35 doses by the age of 10 and another 11 doses by age 18 for a total of 46 potential doses for 15 different vaccines. But to reach that total, a child would need to have multiple high-risk factors or special health conditions that necessitated all of the shots.
In Florida schools, students are required to have up to 21-24 doses for six different vaccines from kindergarten through 12th grade, according to the state Department of Health. Children can receive waivers from vaccines for medical and religious reasons.
Dr. Franz says the chance for medical errors increases with the number of drugs someone takes.
“If you’re getting this many vaccines, you have a much higher risk of having an adverse event. It’s common sense,” she says.
In her early years in practice, Dr. Franz says she didn’t know what was in vaccines until someone asked her and she started researching. She says vaccine ingredients such as aluminum, formaldehyde, glutaraldehyde, monosodium glutamate, and polysorbate can cause health problems.
“I’ve been in practice a really long time (since 1985) and I have seen a lot of children who had very severe reactions to vaccines and had some permanent disabilities,” she says, noting fainting, seizures, and hyperpathia reactions, a clinical symptom of certain neurological disorders.
Adverse reactions can be reported to the Vaccine Adverse Event Reporting System, a government website; however, VAERS is not an investigative service that determines cause and effect.
For parents who claim vaccines have harmed their children, the National Vaccine Injury Compensation Program (VICP) is a no-fault alternative to civil litigation. The VICP reports that since 1988, more than 6,600 petitioners have received awards totaling about $4.1 billion.
However, about 70 percent of the awards come from negotiated settlements in which the Health and Human Services Department did not conclude that a vaccine caused the alleged injury, according to the U.S. Health Resources and Services Administration.
Outbreaks of illnesses also demonstrate the ineffectiveness of vaccines, Dr. Franz says. For example, outbreaks of whooping cough, or pertussis, were reported during 2012-13 in Wisconsin, Vermont, Washington state and elsewhere. The CDC indicated that a majority of cases involved vaccinated children—only about seven of 10 kids are fully protected five years after getting their last dose of DTaP (diptheria-tetanus-acellular pertussis) vaccine. That’s why Tdap, with reduced doses of the diphtheria and pertussis vaccines, is used as a booster shot for adolescents starting at age 11.
Dr. Franz encourages parents to do their own research. Judy Michaux, of Clermont, says she’s a faithful researcher who stopped immunizing her children after finding Dr. Franz.
“She said, ‘Listen, all you have to do is a blood test. If they already have the immunities, you don’t need to keep immunizing,’” Judy says. “It doesn’t make any sense to inject them with all the extra stuff if they already have the immunities.”
Together, Dr. Franz and parents discuss research and choose a course of action. Some parents still want to vaccinate, and her practice supports parental choice and offers a slower vaccine schedule.
“Most people are not opposed or anti-vaccine, it’s like, if they’re going to do it, make them safe, because at this point, the evidence shows they’re not safe,” Dr. Franz says.
DR. FRANZ’S QUESTIONS FOR PARENTS TO ASK DOCTORS:
- Can I vaccinate on a slower schedule?
- Do you know what’s in the vaccine and what the ingredients do?
- Can I get blood tests to indicate immunity levels?
Heather Gingrasso and her husband, Chris, generally get all the recommended vaccinations for their children, Kaitlyn, 18, Nathan, 12, and Micah, 6, along with a foster baby girl. But they don’t get voluntary vaccinations, including flu shots, and Heather supports other parents’ views.
“I think vaccinations are important to help protect our children from diseases that could be a life-or-death situation,” says Heather, of Clermont. “However, I think every parent should have a free choice to vaccinate or not.”
Heather prefers to spread out vaccinations—her doctor allows her children to get one injection per visit—because she has fears about side effects.
“I have only experienced fever, rash, and irritability with my children,” she says, “but it makes me wonder what is going on inside of them if this is what is manifesting outside of them.”
Athena Ross and her husband, Michael, have a daughter, Brylee, who is in preschool and turns 5 in September. They always get the vaccines recommended by their pediatrician, who provides information about safeness and side effects.
Brylee has never had a reaction or complication from vaccines, and Athena, a sergeant with the Sumter County Sheriff’s Office, doesn’t fear for her safety. But she says she understands that vaccines may not be as safe for other children who have serious medical conditions or allergies.
“Now I am not saying that it is easy to make her get the multiple shots, because it is hard to watch her get a shot in every appendage—last visit she had a shot in both arms and legs, which was awful because she cried,” Athena says. “But if it keeps her from getting a disease that could have been prevented, (getting a disease) would be even worse, in my opinion.”
Robin Miller, of Clermont, and her husband had their first child in 2000 and planned to keep his immunizations up to date. But during his first year, he had reactions to shots that included labored breathing, agitation, trouble sleeping, fever, and a seizure, she says. So, they stopped the shots.
“As we continued to research, we felt that the effects of vaccinations were more harmful for our child than helpful,” Robin says.
As a toddler, their son was hyperactive and had difficulty making eye contact, but he grew out of those traits, she says.
“However, I do believe that he would be a very different person if we had continued his vaccinations,” she says. “Because of our journey with our oldest child, we did not have our other three children vaccinated.”
Those three children are healthy. The parents stay aware of possible threats from disease and treat their kids accordingly.
“My husband and I honestly aren’t against vaccinations,” Robin says, “but we are against so many vaccinations at a young age and vaccines that seem unnecessary.”
Judy Michaux saw differences between vaccinating her first two children and not vaccinating her next two kids with her second husband, Kurtis, a Clermont chiropractor.
Brittny, 31, and Tyler, 24, received vaccinations for chickenpox but then got extreme cases of the disease. She stopped vaccinating Tyler at age 10 and instead used blood tests to check his immunities. Emma, 14, and Kai, 11, have not been vaccinated and have not suffered any serious illnesses.
Though Judy fears there is an autism link, she’s not completely against vaccines and she does her homework on the subject. She believes breast-feeding helped immunize her two youngest children and she also credits a healthy lifestyle and diet after marrying Kurtis.
“There are better ways to give your children the natural immunities that they’re supposed to have,” Judy says.
A MOTHER’S FEARS ABOUT AUTISM
When Traci and John Sickels’ first child, Dallas, was diagnosed at age 5 with autism spectrum disorder, they grasped for reasons.
“We figured it had to be genetic triggered by some environmental cause,” says Traci, a teacher at Minneola Charter School. “In the news media, vaccines as a cause of autism was very popular, and we had no idea what the truth was.”
A 1998 British study claiming a link between vaccinations and autism stoked worldwide fear, though it later was retracted and no scientific studies since have proved any connection.
When the couple’s daughter, Presli, came along around 2008, their vaccine-autism concerns remained. Dallas had received 21 vaccines by age 2 and 30 by age 5. By the age of 6 months, Presli already had received 15 shots.
“This is when I decided, ‘No way am I going to put another child through this!’” Traci says. “I just felt this was an overload to her system.”
The couple stopped giving Presli her shots and put her on an adjusted vaccination schedule until age 5. They were living in Arkansas at the time and were able to obtain a state waiver for her shots based on philosophical reasons, Traci says.
“Once I stopped vaccinations, I felt relieved and watched my child make great strides with no delays,” she says.
Dallas had started showing signs of autism at 3. He received two MMR (measles-mumps-rubella) vaccines within 13 months of each other, at ages 1 and 2. After the second shot, Traci and John noticed that he started to change drastically and stopped speaking.
That was one reason they delayed Presli’s vaccine schedule. When Presli started to speak clearly at 3, the couple felt she was in the clear and started her on a modified schedule to prepare for school: one vaccine at a time and never more than one injection per visit. Many booster shots were no longer needed by that age, so she received about 10 fewer shots. She received the MMR vaccines at ages 7 and 8.
Traci acknowledges that she has only opinions about vaccines and no medical background. But she still is not 100 percent sure that vaccines didn’t affect Dallas, now 18, while Presli, 11, has been healthy with far fewer vaccinations.
“I could have been a crazy, scared parent but I was trying to be cautious, and having one child having autism scared me,” Traci says. “I didn’t want to be the cause of another child having autism because I gave her vaccines.”
STICKING TO SCHEDULE
Here are answers to common questions provided by the American Academy of Pediatrics:
Q: How are the timing and spacing of shots determined?
A: Scientists study what age a child’s immune system will provide the most effective protection after receiving a vaccine and when they are most at risk for each disease.
Q: Why are three or more doses of some vaccines needed?
A: It depends on how long a vaccine provides protection. They are spaced out over a period that gives children the best protection.
Q: Can shots be spread out over a longer period?
A: This would leave a child unprotected for a longer time. Babies are more likely to get very sick from vaccine-preventable diseases, so vaccinating them following the recommended schedule works best with the child’s immune system. Spreading out shots has not been scientifically shown to be safer or offer the same protection.
Q: Do multiple shots in one visit overwhelm a child’s immune system?
A: No. Children are exposed to more germs every day just by playing, eating, and breathing than what is in any combination of vaccines.
DO YOUR HOMEWORK
These websites provide immunization information:
- American Academy of Pediatrics: aap.org/immunizations
- Centers for Disease Control and Prevention: cdc.gov/vaccines
- Florida Health: thepowertoprotect.org
- Immunization Action Coalition: immunize.org
- Shot at Life: shotatlife.org
As a pediatrician with a phd in neuroscience I laugh at your choice of Dr. Franz for the anti-vax side–which is what she is. Any pediatrician so ignorant as to believe in homeopathy (go to her web site, Franza practices this with absurd pride) clearly didn’t learn a thing about science in college or medical school and isn’t fit to have a medical license let alone see patients. This is no “healthy” debate you have here, any more that you would have any real debate between a geologist and a flat earther over whether the earth is round. I guarantee you if you look at the immunization rates around Franz’s practice you will see she is creating a nidus for dangerous vaccine-preventable disease outbreaks. State medical boards need to revoke the licenses of these anti-vax physicians as they are a danger to children and to public health. Vaccines are very safe and effective against infectious diseases that injury and kill. People who believe otherwise are delusional at best. –Chris Hickie, MD, PhD, Mesa Arizona.