Are vaccines safe? Response to a reader comment.
On the ‘eve of a pandemic’ everyone is asking me this: Are vaccines safe?
Western medicine generally says “yes” bearing in mind that the small risks are largely outweighed by the benefits of gaining immunity to some pretty nasty infections. I am NOT an expert. I’m just collecting and displaying some facts. For more information, there is a great paper from the Medical Journal of Australia that addresses each of the vaccine components in turn.
A specific comment on my blog reads:
“Why if a patient is already immunocompromised would you recommend the annual seasonal flu vaccination or the H1N1 vaccine that is laden with toxins like mercury, antifreeze, spermicides, adjuvants? Knowing full well there is no efficacy rate or long term clinical studies on fertility or any thing else WHY DO YOU RECOMMEND THIS for anyone let alone patients with underlying problems? “
For our benefit, I will refer to the monographs for seasonal flu vaccination (at the bottom of this entry). Because the H1N1 vaccine is relatively new, still undergoing testing, and does not yet have any long-term data behind it, I will defer comments on it specifically. However, I will say that we may draw some parallels between the seasonal vaccine and that for H1N1, and it would be logical to deduce that the new vaccine will have a similar benefit and risk profile as the established vaccines.
1. Mercury?: Thimerosal from MMR vaccines was reported in the Lancet to be linked with Autism in 12 cases. The late 1990s paper has has since been retracted. The controversy of that article is detailed here; basically, there was an undisclosed conflict of interest, with the prime researcher receiving funding to prove the link. The results did not stand the test of time, as they were never reproduced. A great review of literature, concluding that no link can be drawn between thimerosal-containing vaccines and autism, can be found here. Evidence does not support a causal association.
The CDC agrees that vaccines containing thimerosal are safe. We know that thimerosal is cleared from the body faster than environmental (methylmercury) and less likely to accumulate in our tissues. The doses in most vaccines are insignificant although in a few types of shots (including flu shots), they can be as high as 50ug/dose. See http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/07vol33/acs-06/index_e.html for the government’s perspective. Their bottom-line recommendation is “There is no legitimate safety reason to avoid the use of thimerosal-containing products for children or older individuals, including pregnant women.” Also, if this doesn’t set your mind at ease, you could simply ask for a single vial dose which does not contain the mercury.
2. Antifreeze? (ethlyne glycol/methanol/propylene glycol): This is not present in vaccinations. Perhaps you are thinking of formaldehyde (the systematic name of which is “methanal”) which is present in trace quantities as it is used to deactivate the virus so that it is not active when the vaccine is injected. Formaldehyde is a suspected carcinogen but in studies of those exposed to large volumes (i.e. formaldehyde industry workers) no link has been established (http://www.ncbi.nlm.nih.gov/pubmed/15191929?dopt=Abstract).
3. Spermicides?: I could identify no components that are known to inactivate or kill sperm. I haven’t heard this concern before except with respect to Africa and the public fear of infertility from vaccination. See this article for a good handle on the subject. Also, there are vaccines under development for gonorrhoea and chlamydia which could increase female fertility by preventing Pelvic Inflammatory Disease (PID). On the other side, consideration has been given to an anti-sperm vaccination as a means of contraception.
4. Adjuvant?: Adjuvant is a word that means “something in addition to.” Yes there are preservatives and a solute into which the active portion of the vaccine must be dissolved in order to facilitate delivery. Almost anything we ingest or imbibe follows this pattern. When we peanut butter and jam on our toast, the condiments could be considered adjuvants. The adjuvants in the seasonal flu vaccine are mostly salts (sodium phosphate, sodium chloride) and sugar (sucrose). EDIT: In the context of vaccinations, an adjuvant is a specific chemical added to a vaccine to improve the immune response so that less vaccine is needed to provide protection. See the comments for a very helpful, indepth explanation,
5. No efficacy of flu vaccines?: A study that compared the effectiveness of the inactivated influenza vaccine during influenza seasons with differing degrees of vaccine match illustrates the importance of the fit between circulating influenza virus strains and the vaccine. During the 2004-2005 influenza season, the antigenic match was only 5 percent compared with 91 percent during the 2006-2007 season, which resulted in a vaccine effectiveness of 10 versus 52 percent, respectively. The Cochrane group – one of the most recognized collectives in Evidence Based Medicine – did a meta-analysis of studies pertaining to influenza vaccination and efficacy. Conclusion? “Influenza vaccines are effective in reducing cases of influenza.” Simple.
6. No long term studies on fertility?: A search of PubMed for ‘vaccination and fertility’ revealed NO papers supporting a link between government approved vaccinations designed to prevent infection and a state of infertility in recipients. Usually, phase 4 studies are not undertaken to search for specific consequences, but if they should arise, studies are published. One fallacy of medical literature is that negative results are rarely published. How many papers that say “there is no link between vaccination and infertility over a 20 year study” would be considered glamorous? The lack of negative reporting is something that is changing in medicine, but for now, it is fair to assume that because no links have been drawn, it is unlikely that fertility has been profoundly affected by our policy of universal vaccination.
7. Recommendations to patients with underlying problems: It is specifically because an immunocompromised person has a lessened ability to naturally fight off infection that they would benefit from a preventative measure such as a vaccine. If they were to contract influenza, their risk of morbidity and mortality would be much greater than that of a healthy immunocompetent person. The Lancet put something out in August looking at this very issue.
In my opinion, the regular foods we eat contain often contain more crap than do vaccines, and offer little to nothing in the way of therapeutic benefit. Everything in medicine is about weighing the benefits against the risks. When weighing the options, the potential of a serious illness (or death) compared to the potential of a muscle ache in my arm or an anaphylactic reaction to the components of a vaccine, I’d chose the vaccine. You don’t have to, but you must consider that your choice also affects those around you.
VAXIGRIP® [Inactivated Influenza Vaccine Trivalent Types A and B (Split Virion)]
For the 2009-2010 season each 0.5 mL dose of VAXIGRIP® contains:
15 μg HA A/Brisbane/59/2007 (H1N1)-like strain [A/Brisbane/59/2007 (IVR-148)]
15 μg HA A/Brisbane/10/2007 (H3N2)-like strain [A/Uruguay/716/2007 (NYMC X-175C)]
15 μg HA B/Brisbane/60/2008-like strain (B/Brisbane/60/2008)
≤30 μg formaldehyde, up to 0.5 mL sodium phosphate-buffered, isotonic sodium chloride
solution. 2 μg thimerosal*, Triton® X-100, trace amounts of sucrose and neomycin.
* added as a preservative in multidose presentation only
For the 2009-2010 season each 0.25 mL dose of VAXIGRIP® contains:
7.5 μg HA A/Brisbane/59/2007 (H1N1)-like strain [A/Brisbane/59/2007 (IVR-148)]
7.5 μg HA A/Brisbane/10/2007 (H3N2)-like strain [A/Uruguay/716/2007 (NYMC X-175C)]
7.5 μg HA B/Brisbane/60/2008-like strain (B/Brisbane/60/2008).
≤15 μg formaldehyde, up to 0.25 mL sodium phosphate-buffered, isotonic sodium chloride
solution, 1 μg thimerosal*, Triton® X-100, trace amounts of sucrose and neomycin.
* added as a preservative in multidose presentation only
Fluviral S/F for i.m. injection is a trivalent, split-virion influenza vaccine prepared from virus grown in the allantoic cavity of embryonated hens’ eggs. The virus is inactivated with formaldehyde purified by centrifugation and disrupted with sodium deoxycholate in Triton X-100. Each dose of 0.5 mL of a whitish, slightly opalescent liquid, contains: hemaglutinin 15 µg of each of the following strains: A/Beijing/262/95 (H1N1), A/Sydney/5/97 H3N2, B/Harbin/7/94. The composition of Fluviral S/F is established in agreement with the recommendations of the Canadian National Advisory Committee on Immunization (N.A.C.I.). Thimerosal 0.01% is present in both whole and split-virion preparations as a preservative. Split-virion vaccine also contains trace residual amounts of egg proteins and deoxycholate.(http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20(General%20Monographs-%20F)/FLUVIRAL%20S.html)