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

Pandemic- a book review

If you like history, current events, medical science, or just want to be more knowledgeable about why we should be concerned about infections , antibiotic resistance and vaccine phobia, you should read this book.

update July 25, 2020

When I read and reviewed this book almost 4 years ago, I thought it was only for historical interest. I never imagined you and I would live during and hopefully through a pandemic. I now know that assumption was false; this COVID-19 pandemic is not over, and even when it is, it likely will not be the last.

The world has now spent the majority of this year dealing with a COVID-19 pandemic producing grim statistics.

  • Almost 16 million confirmed cases world wide
  • 640,000 deaths worldwide
  • 4 million cases in the United States
  • Close to 150,000 deaths in the United States
source: Johns Hopkins Coronavirus Resource Center

Pandemic by Sonia Shah

Sonia Shah is a science journalist, not a scientist or physician, who has built a career  writing about medical science. She explains the “what”  of her book in the subtitle-

Tracking contagions from cholera, to Ebola, and beyond

And she answers the “why” in the introduction-

“By telling the stories of new pathogens through the lens of a historical pandemic, I could show both how new pathogens emerge and spread, and how a pathogen that had used the same pathways had already caused a pandemic.”

What is a pandemic?

Let me back up and define some terms. (And tell you this post uses affiliate links for your convenience and to fund this blog’s mission)

Pathogen– any disease producing agent, but especially referring to a living  microscopic organism, such as a virus, bacteria, or  parasite; this includes the organisms that cause Lyme disease, Ebola, West Nile, HIV, bird flu, even the common cold

Pandemic– a disease outbreak that spreads throughout a country, continent, or the world, as opposed to an epidemic, which is localized.

map of the world
In a pandemic, an infectious disease may spread all around the world.

With current focus on chronic diseases like heart disease, diabetes, cancer, and dementia, physicians and patients can get lulled into thinking that infectious disease has been conquered and no long a serious medical threat. This book reminded me that is not the case.

Cholera- a historic pandemic

Ms. Shah recounts the history of cholera, which has caused epidemics on every continent except Antarctica, focussing on the epidemics which devastated London, New York City, and more recently Haiti.

Cholera is little known in the United States now, but in the past it has been deadly both here and throughout the world. Cholera, an infection due to a bacteria Vibrio cholerae causes severe uncontrollable diarrhea which quickly renders its victims helpless, dehydrated and critically ill. The bacteria lives in and is spread by contaminated water, but for many years physicians did not know this; and even when some doctors proposed this as the method of spread, others refused to believe it. Thus the opportunity to control it and prevent thousands of deaths was delayed .

bacteria under the microscope
photo of the Vibrio cholera bacteria under a microscope; used courtesy of CDC/ Dr. William A. Clark
How pandemics spread

The author explains how cholera and other infectious diseases cause so much human suffering by detailing “How disease spreads” in these  chapter titles

Locomotion– Humans and pathogens travelling from place to place spreads disease.

Filth-Waste management and in some cases mis-management, leads to contamination of drinking water by human waste.

Crowds-People living in crowded slums creates perfect conditions to spread disease person to person.

Corruption– Public officials and business people who place profit and power above public health.

Blame No one willing to take responsibility for making hard choices, and too willing to blame someone else.

Ms. Shah uses examples from her personal life, like her annual family trips to India to visit relatives who lived in less than clean and sanitary neighborhoods. She also shares her and her sons’ battle with skin infections due to  MRSA, a form of staph (staphylococcal) that is resistant to many antibiotics and can be difficult to eradicate.

Pandemic includes extensive footnotes and a glossary of terms used in the book.

If you like history, current events, medical science, or just want to be more knowledgeable about why we should be concerned about infections , antibiotic resistance and vaccine phobia, you should read this book.

Other resources that address  the risk of global spread of infections.

For a visual lesson on how pandemics occur, watch this video.Warning: it is rather graphic. 

“How Pandemics Spread”
created by Mark Honigsbaum and animated by Patrick Blower 
When Germs Travel: Six major epidemics that have invaded America since 1900 and the fears they have unleashed
by Howard Markel

“Medical historian and pediatrician Howard Markel, author of Quarantine! tells the story of six epidemics that broke out during the two great waves of immigration to the United States—from 1880 through 1924, and from 1965 to the present—and shows how federal legislation closed the gates to newcomers for almost forty-one years out of fear that these new people would alter the social, political, economic, and even genetic face of the nation.”  (quote from Goodreads)

Dr. Larry Brilliant talks pandemics

Lawrence “Larry” Brilliant is an American epidemiologist, technologist, philanthropist, and author, notable for his 1973 – 1976 work with the World Health Organization, helping to successfully eradicate smallpox.

In this recent TED interview, he discusses COVID-19 , how we’re doing so far, where we’re going, and what we should do to get there

a book by Dr. Brilliant

Sometimes Brilliant: The Impossible Adventure of a Spiritual Seeker and Visionary Physician Who Helped Conquer the Worst Disease in History

Exploring the HEART of pandemics

Dr. Aletha
before you leave, take a look at this post

Why COVID-19 and other infections are not “just a virus”

Unless you haven’t listened to any news for the past 8 weeks, you are well aware of the “challenge” the whole world has been confronting over what some do call “just a virus”; and you know that it has caused much critical illness and death, leading to “public” and private anxiety.