Immunization Theory Needs Booster

M. Doherty M_Doherty at NIH.gov
Thu Jan 25 11:57:55 EST 1996


In article <4e5hnb$gc at newsbf02.news.aol.com>, ellenaut at aol.com (ELLENAUT) wrote:
 
> Much of the arguement about vaccines boils down to *do the benefits
> outweigh the risks*.  No one seems to deny that there are risks
> associated with vaccines, but these are said to be so small that the
> benefit outweigh this.  This is a numbers game.  At what *number*
> do the risks outweigh the benefit.  If you were told that you can 
> vaccinate your child with DPT, MMR, HIB, OPV, etc,  but
> you have a 1:1,000 chance that your child will be permanently
> handicapped would it be worth it?  What if the odds were 1:500?
> Where is the cut-off?

This is a fair comment, and unlike much of what has been written in the
somewhat fevered vaccine debate shows an appreciation of the real issues. 
However, given the rates at which people are vaccinated, an effect as high
as 1:1000 would give a *very* strong correlation.  I doubt a vaccine that
had such a high defect rate would survive, unless it was for a diabolical
disease (it might be acceptable for high risk workers during an Ebola
outbreak, for instance).

As an example, the swine-flu scare during the early 90's sparked a vaccine
drive which was dropped due an increase in a relatively rare neurological
disease.  A causal relationship could not be proved, but in the public
health arena, even a temporal relationship is usually enough to call
vaccine use into question.  In this case the vaccine was withdrawn
although the rate of adverse reaction was between 1 in 12,000 and 1 in
14,000 - which (in my opinion) was clearly the right thing to do.

> 
> The odds of adverse reaction are based on reactions that were so
> dramatic and so soon after a vaccine as to be undeniable vaccine
> related.  Let's all remember - there is NO laboratory/medical test that
> can be run to *prove* if illness/brain damage has occured due
> to a vaccine.

Actually, in some cases, a direct relationship CAN be proved - if there
are cross-reactive (and clearly recently activated) T cells, together with
associated injury that would meet the standard of reasonable proof.  The
original spark for this debate, the polio vaccine, which can (rarely)
cause neurological sequelae, fills these criteria, and researchers have no
problem identifying vaccine caused pathology from that caused by the wild
virus.  However in many cases of neurological injury there is no obvious
pathology, which makes establishing any sort of link impossible (as you
say).  Autism is particularly problematic, since there is no underlying
injury that we can identify, and also, since it is often diagnosed in
young children, we cannot use alterations in long established patterns of
behaviour as a guide to neurological deficit.


> Can I prove that autism and ADHD are caused by vaccines?  No,
> I can not.   But neither can anyone prove that these disorders
> (at least in some cases) are not vaccine related either.  What
> would adding the incident rate of these disorders do to the
> benefit/risk ratio quoted in immunization literature?  

While I can appreciate that severe autism is a tragedy for any parent, it
is a well established fact that autism also occurrs in children who have
not been vaccinated.  Indeed, I personally know one little boy of whom
this is true.  So we can rule out a direct causal relationship.  However,
autism is a syndrome with a wide variety of manifestations and greatly
differing severity.  It may be caused by a wide variety of underlying
physiological conditions, some of which may be caused by diseases (and
thus also possibly inducible by vaccinations which mimic those diseases). 
But we still don't really know the causes of autism, and so we can't yet
tell who is at risk.

> At the present time, very little is being done to research autism
> from a medical point of view.

As I commented above, this is because we don't really know what autism
is.  Two "autistic" children may present with greatly differing times of
diagnosis, totally different manifestations and so on.  As time goes on,
the diagnosis of autism is broadened to include more people.  The problem
is: where do you start, when even experts in the field can't agree on what
constitutes the condition?


However, I think both of us would agree that more research on autism and
its causes could only be a good thing.

Cheers, Mark



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