If you want people to get vaccines–then listen

Photocredit: David Litt

It’s pretty clear that most Americans actually believe in vaccines. A Pew research poll from January 29 of this year found that 68% of American adults think that childhood vaccines should be mandatory, so it’s safe to assume that most everyone thinks they are efficacious at preventing disease (which they are). But there are a large number of people who don’t vaccinate their children or themselves for various reasons — such as fear of mercury containing compounds, distrust of pharma companies or the government, and a (non-reproducable and most likely false) link to autism.

Since the recent measles outbreak in Disneyland in California, the vaccine righteous have had a field-day poking fun at those who refuse vaccines. This has taken the form of saying that declining a vaccine is equivalent to having the breaks removed from your car, and general name calling. While people who satirize those who disagree with them may feel clever or be filled a warm feeling inside for telling someone they’re stupid, they’re not helping their case — they’re being counter-productive and are actively discouraging people from getting vaccines. I’m not being facetious; a Scientific American report (originally published in the journal Pediatrics) last year found that after doctors told parents that there was no link between autism and vaccines, parents were less likely to vaccinate their future children than before being told so. This is in spite of the fact that they knew that vaccines were less harmful than they originally thought.

Stop being condescending. Stop being a jerk. That’s no way to convince someone that you’re right or that they should do what you say. Listen to their concerns instead, go home and think about it, and then respond in a thoughtful and meaningful way. These people are intelligent and concerned about the health of themselves and their children. The purpose of this article is to listen to those concerns and respond to them — it’s a starting point for discussion, and while it might not convince everyone to get a vaccine, it should point them in some directions where they can continue their research, and hopefully conclude that the benefits to themselves and most importantly, their children, come as a result of getting vaccinated.

Many people (including friends of mine) don’t want to be exposed to the mercury containing compound, thimerosal, that is found in some vaccines. To start any conversation about toxicity, one needs to talk about dose. Toxicity is a dose dependant property. Water can be toxic if you drink too much of it. Water has actually killed people; the condition is called acute hyponatremia and is caused by overhydration. Chemicals generally perceived as “toxic” means that small doses can be harmful, though anything can be harmful in a large enough dose. I wrote a previous blog post on metallic mercury, which has a hard time killing you, though it still can be dangerous. But the mercury in thimerosal is organic mercury, which can be pretty nasty and generally bioavailable. So why is it used in vaccines? The FDA classifies it as a preservative, because it can kill bacteria (such as staphylococci, or staph) that can contaminate vaccines and infect you once you are injected. Thimerosal is used to kill bacteria because it’s toxic, and if it’s injected in you, maybe that’s less than ideal. Which is why the FDA is working with companies to remove thimerosal from flu vaccines for children (many formulations already are mercury free). Thimerosal also is not used in MMR vaccines. In a similar vein, the FDA also recommends that pregnant women and young children avoid eating swordfish (which is delicious), because there’s bioavailable mercury in it as well. The dose of mercury in vaccines is at most 25 micrograms, compared to 147 micrograms for a scrumptious 4-ounce swordfish steak, and the lethal dose of thimerosal is 75 milligrams per kilogram of patient weight. That is, the amount of mercury present in a vaccine is around 0.003 % of a lethal dose for a 25 pound child, six times less than a fish steak*. Many vaccines now have alternate, milder preservatives without any metals, or no preservative at all. The other preservatives that are currently used are phenol, benzethonium chloride, and 2-phenoxyethanol, which range from one quarter to one-sixteenth as toxic as thimerosal according to lethal dose data (acute toxicity data can be found in section 11 of the material safety data sheets, which are linked). The way I like to think about the preservatives is as follows: before a doctor gives you a shot, they will take an alcohol swab to your arm to kill any surface bacteria that could infect you. The preservatives work the same way — they kill any bacteria that could have potentially contaminated the vaccine, making it safer. The chemicals used as preservatives are in doses well below the toxic range for humans and are only harmful to bacteria, that is, they are safe for all intents and purposes. The problem with using naturally occurring antibiotics as a preservative is that some bacteria are immune to almost all of them, like MRSA, our (not-so) friendly staph bacteria that has contaminated vaccines before preservatives were used.

I get it. Chemicals can be scary. But the thought of a child or loved one dying from an easily preventable disease scares me much more.

As far as trust of big pharma and the government, that’s another issue. Big pharma has profits to make, and the government has a history of telling people what to do. That’s an image, communication, and credibility problem. But if you really think about it, the people who go into medicine to figure out ways to combat infectious disease actually have their hearts in the right place. They aren’t trying to make a magic pill that will allow you to lose weight without diet or exercise. They are trying to find a way to boost your own immune system. That’s what vaccines are — they expose you to a weakened version of the virus or just the protein coat of the virus, to teach your body to recognize it and kill it in case you do become infected. There’s no hocus-pocus, or wand waving; vaccines are effective because they work through natural pathways. They don’t fight diseases for you, nor do they just treat symptoms–they simply allow you or your children to fight diseases more effectively. So:

Is big pharma out to make a profit? Yes.

Do vaccines work? Yes.

Is it OK that big pharma makes money off of an effective treatment? I like to think so. 

Another question is about the government — does the FDA do a good job at regulating the companies if they step out of line? When Upton Sinclair’s publication of The Jungle in 1906 exposed unsanitary conditions in the meatpacking industry, the Bureau of Chemistry (later the FDA) was created the same year to deal with this. If vaccines have chemicals that cause illnesses that hurt children, politicians would be lining up to denounce the companies and the FDA would be working overtime to shut them down. There’s nothing more appealing to a politician than saving the children, and at the end of the day, almost all politicians support vaccines, even in the GOP which is wary of any form of government intervention. That’s a pretty good barometer of their perceived (and actual) safety. 

As for as the alleged relationship between the MMR vaccine and Autism relationship is concerned, that has been dealt with before. Perhaps the most powerful and concise treatment of it that I have seen is a 90 second clip by Penn and Teller, which I highly recommend (contains explicit language). Right now there is no known cause of autism according to the Autism Society of America, and since many vaccines have removed mercury preservatives some years ago and children still develop autism, (and unvaccinated children can also develop autism) there’s really no good reason to believe in a solid connection between the two. I know it can be hard for parents of autistic children looking for answers. I hope they find those answers soon, but they will have to lay the blame elsewhere.

For those of you who already think everyone should be vaccinated, take the time to listen and productively engage with your friends or loved ones who don’t want to be vaccinated, because you actually care about them. They’re more likely to listen to you than to a doctor, or a talking head on TV, or even a blogger on the internet.

For those of you on the fence about vaccination or those of you who are disinclined to vaccinate yourself or your children, all I can say is that vaccines save lives and vaccines can save your children’s lives. Keep doing research, and keep an open mind.

 

Important References:

Nyhan, B. et al. Effective Messages in Vaccine Promotion: A Randomized Trial. Pediatrics. 2014. 133 (4).

 

Thimerosal in vaccines:

http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228

 

Mercury in Fish:

http://www.fda.gov/Food/FoodborneIllnessContaminants/Metals/ucm393070.htm

 

Material Safety Data Sheet for Thimerosal:

http://www.sciencelab.com/msds.php?msdsId=9925236

 

Autism Society of America:

http://www.autism-society.org/

 

*Calculations are done with oral toxicity data.

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