As promised here’s my first entry for “Vaccine Awareness Week”, I thought I would take a little look at Anti-vaccination in New Zealand. In particular the  Immunisation Awareness Society. This organisation has set itself up as pro-choice on the subject of vaccination but this is essentially a thin smokescreen for their anti-vaccination views. Here, rather than pick apart a certain piece of writing from their website (of which there is much to choose from) I’ll focus on the points they have put forward as their basic philosophies and see how they stand up. Without further ado, once more into the breach…

1. That natural immunity is far superior to artificial immunity.

This is true, but only for a given value of “Better”. If you are concerned with antibody production and response to infection over your life time then yes, often immunity acquired via infection by a pathogen can last longer than that stimulated by vaccination.  One reason for this is that if you live in an area where vaccine uptake is relatively low (because, you know, they are so harmful) then you will be periodically re-exposed to the pathogen which naturally boosts your immune response. Vaccine induced immunity does tend to wane over the years and if your only contact with antigens (those parts of the pathogen that promote antibody production) is via the Vaccine then the only way to combat this is a booster shot.

Therefore, to benefit from this longer lasting immunity you must actually contract the disease. You must then also suffer through the consequences and complications of that disease. Then you must be periodically re-exposed to the disease to keep antibody production high. Those that survive will have superior immunity to those who don’t, I believe it’s called “thinning the herd”.

I also notice some weaselling in the reference to artificial immunity.  It is not the immunity that is artificial but the method of inducing immunity. This may seem like splitting hairs but how we use words affects how those words are understood, by implying that the immunity gained by vaccines is itself artificial this group is subtly undermining how vaccines are perceived. Then again the rest of the website is as subtle as a sledgehammer to the face so…

2. That breast milk is the best immune stimulator for the baby during the first year of life and that a great deal of immunological protection is provided to the child for as long as breastfeeding continues.

That’s fine, I agree that breast feeding has undeniable benefits, but unless you intend to breast feed your child for life, making for the creepiest business lunch ever*, your child will eventually need to acquire immunity in some other fashion. In this instance, see above.

3. That good health, which starts with a balanced diet that includes important vitamins and minerals, is safer, and more effective at preventing many diseases than artificial immunity.

I can’t argue that a balanced diet isn’t good for you, there is good evidence that ensuring your body has the vitamins it needs does improve your immune response to infection. Beyond this diet is not a replacement for acquired immunity, once again vaccination is the best method of acquiring immunity without actually having to contract and suffer the disease itself.

4. That appropriate allopathic (conventional) and homoeopathic/naturopathic treatment in the event of illness is safer and more effective than trying to prevent illness through artificial immunity.

Homeopathy is not a treatment for anything besides thirst. Apart from that , treating the disease is safer than not contracting the disease in the first place? Are you kidding me? So not only do you have to contract the disease and chance any side effect of the disease itself but also any complications from treating the disease. Seems to me it’s better to just sidestep the whole issue and not get sick.

5. That most diseases contracted by a healthy child, at an appropriate age in childhood, provide important challenges to the immune system enabling it to mature and strengthen, and almost always provide lifelong immunity to the disease.

I’m so glad that the potentially life threatening  diseases contracted by children are actually good for you. Whatever doesn’t kill you makes you stronger right? How about Measles, that’s one of the dreaded vaccinations our children now receive, what does the WHO have to say about it’s safety?:

Complications: Up to 75% children may develop complications which include diarrhoea, otitis media,
pneumonia, laryngo-tracheal bronchitis (croup) and encephalitis. Measles also depletes Vitamin A status that
results in severe eye complications and blindness. Measles can lead to longer term brain damage and deafness.

Death: Case–fatality ratios for children under one in emergency settings: 3–30%. The three major causes of
high case–fatality rates are pneumonia, diarrhoea and croup. Children may also die from measles infection or
its sequelae including encephalitis and malnutrition. Measles infection often leads to a prolonged suppression
of the immune system, increasing susceptibility to secondary bacterial and viral infections.

But at least we get life long immunity. Surely the purpose of immunity is to prevent us from getting the disease, in that case a wide vaccination policy will do the same thing and also gives us a chance to wipe out the disease altogether.

Then there is the “important challenges” bit, the number of antigens children are exposed to as part of the vaccine schedule is minuscule compared to the number that they are exposed to every day just interacting with their environment. Our normal body flora, those bacteria that call our skin and gut home, outnumber the cells that we would normally think of as “us” by a factor of 10 or more.

This represents hundreds of different species of organisms, add to that the numbers of bacteria we might come into contact with due to food, dirt, household and public surfaces etc. and the number of antigens represented by the organisms prevented by the vaccine schedule can be seen in their proper context – insignificant. Not just insignificant but not even worth mentioning.

6. That the vast majority of childhood infections are benign and self limiting in a healthy, well-nourished, well cared for child with a healthy immune system.

This must mean that the organisation supports vaccination for those diseases that are life threatening (I couldn’t find any evidence on the website that this is the case though). Say pertussis, or Whooping cough as it is more commonly known (from Wikipedea):

Pertussis is fatal in an estimated one in 100 infants under 6 months, and fatal in one in 200 infants aged 2 to 12 months. Infants under one are also more likely to develop complications (eg pneumonia (20%), encephalopathy, seizures (1%), failure to thrive, and death (0.2%)). Pertussis can cause severe paroxysm-induced cerebral hypoxia and apnea.

Well it’s only 0.5-1% of children who die. Tell that to the parents. The best way to prevent this disease is vaccination, not just of the individual child but of all who come into contact with her. Herd immunity is the barrier between potentially fatal diseases and those who are too young to have received the vaccine and those whose immune system is compromised and the vaccine is not as effective.

Ok, that’s just one disease vaccinated against, the rest must be very safe. the vaccination schedule can help us here. The list of diseases vaccinated against and the complications for each is:

DiphtheriaThe bacterial toxin can lead to nerve paralysis and heart failure. Between 2–10 infected people in 100 die.
TetanusThe bacteria produce toxins which cause painful muscle    spasms and lockjaw. Hospital intensive care treatment is needed. About one in 10 patients dies. The risk is greatest for the very young or old.
Whooping CoughCovered above.
Polio – About one in 20 hospitalised patients dies and 0.1–2 in 100 patients who survive is permanently paralysed. The overall risk of paralysis is about one in 100. This increases with age, ie, one in 75 adults. There are 2–10 fatalities in 100 cases from paralytic poliomyelitis. Post-polio syndrome may occur 30–40 years after poliomyelitis (ie, muscle pain and worsening of existing muscle weakness).
Hepatitis BThe virus causes liver infection and acute illness. Severe illness is rare in children. Fatalities are rare and are more likely in adults. Some people become carriers of the virus, especially children (six in 100). Liver cirrhosis occurs in one in 20 carriers (half of these will die). Liver cancer occurs in one in 10 male carriers and one in 20 female carriers and usually leads to death.
Haemophilus influenzae type bAbout one in 20 patients with meningitis dies and one in three survivors has permanent brain or nerve damage.About one in 100 patients with epiglottitis dies
PneumococcalAbout one in 10 children with pneumococcal meningitis die and one in six survivors will have permanent brain damage. About one in three children will be left with a hearing impairment after pneumococcal meningitis. Pneumonia and septicaemia (blood poisoning) leads to hospitalisation. Less severe illness, such as ear infections, may lead to deafness. Children with medical conditions such as congenital heart disease, some chronic lung diseases, kidney diseases, HIV infection, and children whose immune system is lowered through chemotherapy, radiation therapy, or organ transplant are at higher risk of pneumococcal disease. Children with spinal fluid shunts and with cochlear implants are also at higher risk of pneumococcal disease.
MeaslesCovered above.
MumpsIn about one in ten people it causes meningitis, but it is usually relatively mild. It causes encephalitis (inflammation of the brain) in about one in 6000 people, of whom one in 100 will die, and nerve deafness in one in 15,000 people. If infected after puberty, one in 5 males gets testicle inflammation and one in 20 females gets ovary inflammation. In rare cases this leads to infertility.
RubellaFor women in early pregnancy, 85% of babies infected during the first eight weeks after conception will have a major congenital abnormality such as deafness, blindness, brain damage, or a heart defect. This declines to about 10–20% by 16 weeks of the pregnancy. About one in 3000 patients gets thrombocytopaenia (low platelets causing bruising or bleeding). One in 6000 develops encephalitis (inflammation of the brain). This usually occurs in young adults. This may result in death.

Well, they all sound like a barrel of laughs, and perfectly safe. Seriously, the complications from these diseases are serious while the vaccines are relatively safe**.

That’s it for the IAS “philosophies”, while there are good recommendations mixed in (healthy diet, breast feeding) mostly it’s a collection of misinformation, misunderstanding and distortions. I am of two minds about this organisation as a whole, on the one hand I’m a proponent of free speech and that includes topics that I don’t agree with. On the other hand organisations like these have the potential to do great harm, both to individuals and greater society. Balancing these two things can be tricky and where to draw the line between them is not always clear.

On a related note, the Australian based anti-vaccination group the Australian Vaccination Network – has had it’s charitable status revoked. Part of this decision was based on the group’s failure to place a disclaimer on their website stating that it’s purpose was anti-vaccination and that it’s information should not be considered medical advice.

IAS also has charitable status. Under New Zealand law Charities must serve a charitable purpose, as specified by the Charities Act 2005:

Section 5(1) of the Charities Act 2005:
“In this Act, unless the context otherwise requires, charitable purpose includes every charitable purpose, whether it relates to the relief of poverty, the advancement of education or religion, or any other matter beneficial to the community.”

Given that the information distributed is often incorrect or presented in such a way as to misrepresent the facts I consider this organisation to fail both the “educational” and “beneficial” aspects of this definition. As such I would question the validity of it’s charitable status, but that’s for the law to decide not an irritable blogger***.

Finally, for accurate information on vaccines you should head on over to the Immunisation Advisory Centre, which also has a handy list of websites for both Parents and Health professionals.

Footnotes:

*Although This can’t be far behind.

**No active intervention is 100% safe, no-one is claiming that.

***Similar to irritable bowel only more annoying.

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