Reconsidering vaccination- a book review

So, I was first surprised, then puzzled, then alarmed at the number of parents who reject vaccination for their children, and adults who decline immunizations for themselves. Some people now fear the vaccines more than the diseases they prevent and we physicians must consider this to help people stay well instead of treating them when sick.

This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.

This information is not intended for diagnosis or treatment. Before making health decisions, discuss with your physician or other qualified healthcare provider to decide what is right for you.

In 1961,  my mother and I went to my school on a Sunday afternoon to receive the newly released oral polio vaccine. She along with other parents eagerly sought a way to prevent a dreaded disease that had the potential to cripple or even kill their children.

In medical school I learned about diphtheria, a painful throat infection due to a bacteria, Corynebacterium diphtheriae. Once a common cause of severe illness and death, a vaccine had rendered it rare. I saw no cases of diphtheria in medical school, nor have I since.

As a young physician I welcomed the introduction of the H.Flu vaccine (Haemophilus influenzae bacteria, not the virus) in 1985. At that time, any infant or toddler with a fever was a potential victim  of  meningitis due to H.Flu, which could be deadly or leave the child with neurological damage.

Similarly, the Hepatitis B vaccine made healthcare a less risky occupation; Hepatitis B is a blood borne infection contracted from contact with infected blood.

VACCINE-PREVENTABLE DISEASES
FROM THE CDC, UPDATED JANUARY 2016– follow link for detail

So, I was  first surprised, then puzzled, then alarmed at the number of parents who reject vaccination for their children, and  adults who decline immunizations for themselves. Some people now fear the vaccines more than the diseases they prevent and we physicians must consider this to help people stay well instead of treating them when sick.

I was intrigued when I heard of a book, by a physician,that seems to promote a compromise-

The Vaccine-Friendly Plan

The Vaccine-Friendly Plan is published by Ballantine Books,  2016

The Vaccine-Friendly Plan by Paul Thomas, M.D., a pediatrician  and Jennifer Margulis, Ph.D.a science journalist.

It is based on his pediatric practice, Integrative Pediatrics,  as well as their extensively noted references. The book’s subtitle summarizes the contents accurately-

“Dr. Paul’s Safe and Effective Approach to Immunity and Health- from Pregnancy through your Child’s Teen Years.”

The book discusses pregnancy, infant and  child care in general, not just vaccination, although that is a major emphasis.There is a chapter about pregnancy and for each stage of child development through adolescence.

The first chapter discusses a popular health topic now- toxins. (As an aside, I don’t know when we started calling poisons  “toxins”) . This should grab your attention-

“Toxins, Toxins, Toxins: Raising Healthy Children in a Poisoned World”.

Anything can be “toxic” if misused, overused,or abused  but they concentrate on these toxins in particular- acetaminophen, aluminum, aspartame, fluoride, methanol, mercury, and what they call endocrine disruptors(this includes pesticides).  They state “environmental toxins are likely contributing to the autism epidemic” as well as other neurodevelopmental and mental disorders in children.  They base their conclusion on an extensive list of review articles from the medical and scientific that support their view (obviously) and also from Dr. Paul’s medical practice of 11,000 children who he calls “among the healthiest in the world.” While I suspect  families who are already health conscious tend to select a physician who is health oriented, this claim sounds impressive.

I agree with some of the advice the authors offer. For example this advice for pregnancy is hard to argue with-

  • Eat a whole foods, organic, non-GMO diet 
  • Skip the soda
  • Drink filtered water
  • Minimize stress
  • Get treatment for addiction
  • Join a support group

But in addition, they recommend declining all vaccinations during pregnancy, certainly not mainstream medicine advice.

A later chapter also offers sound advice:

“ The Best Ways to Support your Child’s Immune System” 

  • Breast feed
  • Enjoy cuddling
  • Laugh a lot
  • Relax often
  • Rock your body
  • Stay hydrated
  • Eat a variety of foods
  • Maintain social connection
  • Read
  • Get Dirty
  • Be cautious but not afraid
  • Choose vaccines based on real science, your family’s needs and common sense
  • Sleep enough
  • Trust your children
  • Trust yourself

He offers an interesting list  Ten Questions to Ask When Looking for a Pediatrician (which I assume would apply if you use a family physician for your child’s care).

As a physician, I have never liked the idea of being “interviewed” by a potential patient; I  want a relationship with patients, not a job. But I think pediatricians routinely offer “get acquainted” visits so you may find it helpful. Some of the questions seem more appropriate to explore  in a long term relationship with a physician, not quick answers in a short visit, like “What would you like me to know in order to keep my family healthy?”

An appendix compares the CDC immunization schedule of 1983 to the current 2016 version, illustrating  many more vaccines and doses are now recommended.

Of course the list is longer since several new vaccines have been developed in the past 30 years and the CDC recommends those considered necessary for the public health. Most areas of medical care have changed dramatically in the past 30 years, we have a lot more of everything-drugs, procedures, etc- so this should not be a surprise.

vaccines
CDC Immunization Schedule– follow link for detail

Also in the appendix is Dr. Paul’s Vaccine Plan at a Glance, which is a much abbreviated version of the CDC recommendations. The plan is offered free at his web site drpaulapproved.com by signing up to receive his newsletter. (There is also a “store” on the web site offering an assortment of vitamins, minerals, probiotics and melatonin.)

The authors describe themselves as “pro-vaccine”, have received vaccines themselves and vaccinated their children. But they also believe that physicians and parents should have a choice and make informed decisions about immunization and other procedures. 

Universal vaccination is recommended , but there are individual circumstances where the routine schedule might need to be altered due to a child’s particular medical circumstance, but not for some vague concern that vaccination might not b e “safe”. Neither is infectious disease.

If  you are a parent who has  rejected vaccination for your children,  please read this book soon.

Also, read another review of this book by  Vincent Iannelli, MD , a pediatrician and Fellow of the American Academy of Pediatrics.
Sonia Shah, a science journalist, also wrote about vaccination in her book
Pandemic – Tracking contagions from cholera, to Ebola, and beyond
Read my review at this link 

Pandemic- a book review

Pandemic by Sonia Shah

another post on this topic

Vital questions you should ask about immunization

This coronavirus pandemic is serious. We don’t yet have a vaccine or effective treatments. To protect ourselves, our familes, and our entire communities we should all be practicing social distancing and other hygiene measures as we wait for a safe, effective vaccine and treatments.

exploring the HEART of preventing disease

a stethoscope, a red heart and a heart ekg tracing
exploring the HEART of HEALTH

Dr. Aletha

Life, Liberty and the Pursuit of Health Care

Even though the United States does not officially have “socialized” health care, a large proportion of our medical care is funded by the federal government. Even though I know that, I was still surprised by statistics in a recent article, which stated that  the federal government accounts for

40% of healthcare  spending
$1.3 trillion /year
Covering 100 million individuals

(stats from 2016)

Through 4 federal agencies

  • Department of Health and Human Services 
  • Department of Defense
  • Veterans Administration
  • Department  of Homeland Security

(JAMA (Journal of the American Medical Association), June 21, 2016)

The  United States Congress passed the Patient Protection and Affordable Care Act (ACA) in 2010 to guarantee basic health insurance to all citizens.  People who oppose the ACA ,aka Obama Care, dislike or even fear government involvement in medical care; they consider it interference, control, or even nationalization of the United States healthcare system.

a Veterans Administration clinic
a Veterans Administration clinic (photo by Dr. Aletha)

I think many people, even physicians, don’t realize or forget, how involved the government already is in healthcare. As far back as the American Revolution the fledgling government extended health care benefits to the soldiers and veterans of that war; that system evolved into the current military health care system which covers service members and the Veterans’ Administration system for veterans.

American soldiers serving in Afghanistan
American soldiers serving in Afghanistan

2015 marked the 50th anniversary of two other government healthcare programs- Medicare and Medicaid.

Medicaid provides insurance coverage for adults and children who are unemployed or low income.

Medicare covers disabled children and adults  and persons 65 years and older.

wheelchair-749985_1280
Disabled children and adults may qualify for Medicare.

The numbers are rather staggering.

  • Together these programs cover at least 30% of Americans.
  • Together they comprise 25% of all federal spending.
  • Together they pay 40% of total U.S. health care spending.

An infographic from the Kaiser Family Foundation and JAMA explains this further.

hospital-79605_1280
Children may be eligible for Medicaid if their families cannot obtain health insurance for them.

You may not be eligible for either of these programs now, but chances are eventually you or someone close to you will.

  • Anyone can become disabled from a serious illness or freak accident.
  • You or your spouse may lose your job and your employer sponsored health insurance.
  • Your child may have a disability that will prevent them from working when they grow up.
  • We may all live long enough to qualify for Medicare on the basis of age alone.  Your parents or grandparents are near or already at Medicare age.
Senior adults age 65 and older use Medicare.
Senior adults age 65 and older use Medicare.

It’s important to understand how Medicare works, since it’s not automatic; even if you qualify, you need to sign up to be covered (with a few exceptions). The rules are summarized here. Or consider an easy to understand book here. 

Several government agencies regulate, monitor, promote and/or support  both public and private healthcare through the Deparment of Health and Human Services and other agencies.

Food and Drug Administration- FDA

Centers for Disease Control and Prevention- CDC

National Institutes of Health- NIH

Occupational Safety and Health administration-OSHA

Drug Enforcement Agency-DEA

Congress has enacted several important laws that  concern health care such as

 The Affordable Care Act- ACA

Health Insurance Portability and Accountability Act-HIPPA

Emergency Medical Treatment and Labor Act- EMTALA

Health Information Technology  for Economic and Clinical Health- HITECH

Americans with Disabilities Act-ADA

Family Medical Leave Act-FMLA

LIFE, LIBERTY AND THE PURSUIT OF HEALTHCARE

Sharing the HEART of health

In the Declaration of Independence, the founders of the United States  created a nation based on the “self-evident truths”  of  “Life ,Liberty, and the pursuit of Happiness” as well as  to promote “Safety and Happiness” . 

In the Constitution they vowed to “promote the general Welfare” .

I wonder if they envisioned that would eventually include so much effort and money providing and regulating health care, most of which was not  even imagined at that time? 

Dr. Aletha