Growing numbers of parents and medical experts question the merits of mass immunization
Peter Goldring, Member of Parliament for Edmonton East, rose in the House of Commons February 18 to issue a call to arms. "Today in Edmonton, an inoculation frenzy is underway," he said. "Meningitis has struck and threatens our youth." Fifteen children and teenagers had been hit since December 1999 with the rare bacterial infection that causes devastating inflammation of the brain lining and spinal cord. Two had died. "Nearly 300,000 of our children will today receive an inoculation cloak to protect them against this evil scourge," declared Mr. Goldring. He asked for Parliament's prayers for Edmontonians and "Dr. Gerald Predy, medical officer for Edmonton Capital Health Authority, [who] leads the troops in this battle against the meningitis menace with his army of over 500 nurses."
The public health phalanx marched on Edmonton and area to combat the outbreak. Alberta's Medical Officer for Health, John Waters, initially declared that $1 million would be devoted to offering the meningitis vaccine free to the province's 70,000 high school students at increased risk of infection. Four days later, he expanded the mass program--and the bill--extending it to all children aged two to 14, adding another 200,000 bodies to the target, and making it the largest vaccination campaign in Canada's history. Dr. Waters readily concedes that the younger population is "not at any increased risk" of meningitis. Indeed, he says, he wouldn't bother to vaccinate his own children under 15. "However, we do understand the public concern with such a serious infection and believe that this expansion will address these concerns. People fear the disease. They want the shot for their children. They will get it.
And they did. In the Capital Health Region surrounding Edmonton alone, 106,629 kids lined up for the jab between February 15 and 23. The "meningitis hotline" was jammed--15,000 people called in the first week of the outbreak. "Parent Panic," screamed the front page of the Edmonton Sun, and talk of the "epidemic" dominated the media. All things considered, the campaign was a smash public relations success for public health officials. It was just the sort of injection they could use right now, considering the hits their mass vaccination campaigns have been suffering lately. Evidence of a grassroots mutiny against the vaccination army has been popping up everywhere. Articles in The American Spectator, Reason magazine, the Washington Post, Insight, The Next City and elsewhere have been openly sceptical of inoculations. ABC's 20/20 aired a program critical of public health orthodoxy last year. Dozens of Internet sites have sprung up from anti-vaccine groups in Canada, the U.S. and New Zealand, threatening to over turn the medical orthodoxy that vaccinations have almost single-handedly eliminated killer plagues and scourges that once terrorized the planet. Many of them detail the tragedies of children damaged or killed after having had routine childhood shots, and they delve into major lawsuits launched against vaccine manufacturers. Growing numbers of medical experts, too, are citing scientific studies and questioning the safety of shots, the intentions of the pharmaceutical giants that make them, and the public health benefits of mass vaccination.
Some parents must be tuning in. In Calgary, vaccination rates have suffered a drop ranging from 3% to 9% for all childhood shots. Throughout Alberta, where 85% to 90% of children were consistently being vaccinated, figures have dipped recently and now hover between 80% to 85%, according to Dr. Waters. In British Columbia, the Health Ministry has a ready-made pamphlet for parents wavering on whether or not to give their kids the jab. "Not all information is truthful or accurate," it warns parents who use "unregulated resources" for vaccine information. Health officials in Ottawa record a drop of at least 4% in the most recent (1996) national figures for diphtheria, pertussis (whooping cough) and tetanus (lockjaw) vaccinations.
Hundreds of millions of dollars in profit are at stake for the pharmaceutical companies which develop and market the shots. The anti-vaccine dissent comes just as pharmaceutical companies are spending billions researching and developing more than 200 new vaccines for everything from AIDS to pregnancy. The average Canadian child already receives 30 vaccination doses for eight different diseases by Grade 1, and six more before completing high school. Soon they'll be offered another--for chicken pox. Varivax, from Merck Frosst Pharmaceuticals, was approved for use in Canada in December 1998. Prince Edward Island will be the first province to add the shot to its routine vaccination schedule in April and other provinces are expected to follow suit. Last May, the National Advisory Committee on Immunization recommended that all children over 12 months of age begin the $58 shot. "We're working towards that," confirms Alberta Health's Dr. Waters.
Chicken pox is a highly infectious disease that most children get. Undoubtedly unpleasant, it is considered benign and, once had, is not usually contracted again. The older a person is when they get it, the more severe the illness.
American Varivax magazine ads warn Parents that "40 American children die each year of chicken pox." (About the same number get hit by lightning.) Merck Frosst spokeswoman Christine Homsy says that the company doesn't intend to use such "scare tactics" here. Rather, the vaccine is being sold using a cost-benefit analysis, accounting the lost wages of parents who stay home with a sick child. But no one knows how long the shot's protection against disease lasts, so a baby immunized at 12 months might be vulnerable again at age 25, with significantly higher risks. "That's always a problem when you introduce a new vaccine," concedes Dr. Waters. "But we can [always] introduce a booster dose."
Many more vaccines for preventable, lifestyle diseases contracted largely through risky behaviours (such as herpes, chlamydia and cocaine addiction) are in the pipeline, too. Researcher Peter Cohen, at the National Institute of Drug Abuse, argued in 1996 that cocaine addiction could be analogized to an "infectious disease." If a vaccine for cocaine addiction followed the trend of the hepatitis B vaccination, it would become part of the routine set of vaccinations administered to all children--in case they become cocaine users.
The hepatitis B vaccine itself has provoked widespread debate. Launched in 1982, it initially targeted groups at high risk for the disease that is transmitted by direct exchange of blood and bodily fluids: IV drug users, homosexuals and prostitutes. Today, in the U.S., it is routinely given to babies two months old and is mandated for all daycare children. Fortytwo states require children to receive the hepatitis B vaccine to attend school. In Canada, the shots are voluntary and offered to teenagers at school, though Health Canada officials have recommended all babies and children be inoculated. Clinical trials for the vaccines, made by Smith Kline Beecham and Merck Sharp and Dohme Canada, however, only involved healthy adults who were monitored for just four to five days after the shots.
Health Canada acknowledges little change in the incidence of hepatitis B cases in Canada. From 1990 to 1994, there were about 10 per 100,000 people. The only reported outbreak of hepatitis B in Canada during the 1995-96 fiscal year was in Ontario, where all 75 cases were linked to one Typhoid Mary technician. Edmonton's meningitis outbreak too, while of understandably grave concern to parents, fell within the normal pattern health officials could have predicted. By February 24 there were 22 cases (including those from December). Each year, 22 to 37 Albertans are diagnosed with meningitis.
Critics charge that giving needless shots to children to pacify parental hysteria is poor public health policy. Kristine Severyn, director of the Ohio-based Vaccine Policy Institute, thinks such policies are fuelled less by good science than "big money" and "politics." So is the growing inclination of health officials to treat every problem with a vaccine, she adds. And with each new vaccine on the market, parents grow increasingly vulnerable. "Parents who opt their children out of vaccine schedules are considered child abusers," says Mrs. Severyn, who holds a doctorate in biopharmaceutics and toxicology.
Meanwhile, vaccine manufacturers are working on a Holy Grail of inoculations: the supervaccine. Researchers are asking the world's governments for $500 million to develop a genetically engineered supervaccine which will contain raw DNA From 20 to 30 viruses, parasites and bacteria. The shot would deliver a timereleased vaccine that would insert itself directly into an infant's cells over a period of time, containing a smorgasbord of viruses including the most feared: HIV diphtheria, malaria, pneumonia, meningitis polio, typhoid fever and tuberculosis. Scientists note this vaccine poses extreme risks, because it could not be "recalled" if a child suffered adverse reactions.
A growing number of medical experts maintain these are just a few of the problems with mass vaccination. Some researchers say immunization programs only appear to eradicate a disease, but in actuality present an opportunity for the disease to reappear later--this time in a mutated, more dangerous form, affecting age groups not previously at risk of the disease. Denver, Colorado, physician Philip Incao has served as a medical expert for families with vaccine-damaged children. Last year, he testified at a U.S. congressional hearing about yet another vaccine concern: the frequency of acute and chronic adverse effects of vaccines are far greater than officially acknowledged. Dr. Incao added that although vaccines may prevent the onset of a particular illness, they modify the immune system and "increase the tendency to chronic allergic and auto-immune reactions." He cited recent research that linked some vaccines to auto-immune diseases, especially diabetes. Other researchers point out that vaccines contain known toxic and carcinogenic chemicals, viruses, bacteria and bacterial toxins, and human-and animal-derived host tissues. These vaccine components are inherently hazardous and can cause disease, disability and death, they maintain. Others are bothered by the use of aborted fetuses in developing certain vaccines (see accompanying story).
Confidence in vaccinations has always been based on the medical community's contention that inoculation is the safest and most effective way to prevent disease. Public health officials do not deny that serious side effects and deaths occur from the shots. They do, however, downplay their severity, fearing that any suggestion of risks may lead parents to reject vaccinations altogether. Health Canada's Vaccine Adverse Events Reporting System receives between 4,000 and 5,000 voluntary case reports per year. It is suspected that thousands more go unreported. Parents are assured, with the arrival of each new vaccine, that the product has been subjected to rigorous tests before approval. Health Canada says the "requirements for licensing vaccines in Canada are stringent and ensure that excellent research into potential adverse effects has been conducted prior to widespread use. No long-term effects have been associated with any vaccine currently in use."
However, late last year the Association of American Physicians and Surgeons (AAPS) demanded a congressional investigation of the vaccine testing and approval process. Typically, a vaccine is manufactured and tested in the U.S., approved by the U.S. Food and Drug Administration, and eventually introduced into Canada. So Canadians had a reason to be concerned when the rotavirus vaccine (aimed at preventing diarrhea in young infants) was abruptly pulled off the U.S. market after just one year. When 15 cases of infants suffered life-threatening intestinal obstructions after the shot, AAPS accused the Food and Drug Administration and the Centers for Disease Control of ignoring or concealing data that recorded problems from the outset. What's more, the AAPS charged that the rate of intestinal obstruction found in clinical trials before FDA granted approval were alarming. One investigation revealed 30 times the expected rate of the deadly condition.
Neither parents nor doctors were warned to watch for symptoms, and the CDC website says only that rotavirus had been "associated with mild problems." In fact, eight infants required surgery, and one lost seven inches of bowel. The rotavirus vaccine has now been recalled.
"We have to wonder whether the rotavirus story is the tip of the iceberg," says Tucson, Arizona, physician Jane Orient, executive director of the AAPS. She questions the safety and integrity of the testing process. "We believe it may be tainted by conflicts of interest in the United States and Canada," she says.
According to Dr. Orient, a conflict is presented by vaccine studies, which are almost always funded by the pharmaceutical companies which manufacture the shots. "These incestuous ties are susceptible to corruption," she says. Vaccines carry risks of "fatal or complicated side effects including brain damage, particularly the pertussis vaccine," Dr. Orient warns. According to the prominent doctor, parents' concerns are well placed. "Vaccines have not been investigated with the intensity they should have been. Now, a whole generation is being subjected to shots with no idea of the outcome, and even more are on the way," she notes.
In addition to limited testing, vaccines are often recalled after they have been administered to children. For example, the American Pediatric Association has recently admitted a plausible link between the oral polio vaccine and polio outbreaks. It has now reversed its long-held earlier position and wants to vaccinate American children by injection instead. Meanwhile, the oral vaccine is still used in Third World countries. Single doses of measles and mumps vaccines are now banned in Britain, though just a few years ago public health officials zealously defended their safety record. It is all too common, according to Dr. Orient, for vaccines to be quietly taken off the market with as little attention paid to the recall as possible.
Accountability is an issue, agrees Catherine Diodati, a Canadian researcher based in Ontario. Ms. Diodati, author of the 1999 book, Immunization, History, Ethics, Law and Health, says long-term studies on vaccines are not conducted. When studies are done at all, "the methodology used is highly questionable." Two groups using different multiple vaccines usually substitute for an unvaccinated control group in studies of adverse events, says Ms. Diodati. Her interest in vaccinations began 14 years ago, after her then six-month-old daughter fell unconscious for an entire week after her third DPT shot. "She began crying and could not be consoled. It continued for hours. Then, my normally bright and responsive baby stopped responding altogether," recalls Ms. Diodati, who immediately called the doctor. "He told me [the baby's] reaction could not possibly be associated with the vaccine. He became defensive and dismissed me as a 'hysterical mother,' and insisted I continue to bring the baby in for further immunizatio ns." Instead, Ms. Diodati embark-ed on her book to counter "public health propaganda."
The greatest threat to future mass vaccination programs and the integrity of public health may well be books like Ms. Diodati's, as well as modem communication tools like the Internet. Still, in the face of damaging anti-vaccination literature, public health officials continue promoting immunizations as "the most important interventions to prevent disease ever discovered." "To have a tool as valuable as vaccines and not use it is considered unconscionable," is Health Canada's advice for health workers encountering dubious parents.
If the vaccine army is successful, the next decade will see children embark on a scientific experiment without precedent in history. At least one expert thinks the result may bring more grief than good. Says Dr. Orient: "There really is such a thing as too much of a good thing."
Did the polio vaccine cause AIDS?
A half century ago, polio evoked the same sort of fear as AIDS: A tragic, crippling infection, the virus paralyzed 65,000 Americans between 1951 and 1954. On its last epidemic sweep through Canada in 1959, it left 2,000 victims behind in wheelchairs. Undoubtedly, polio's disappearance from the western hemisphere is linked to the introduction of the vaccine in the late '50s. It is ironic then that the early polio vaccine itself, may have been spreading an even worse disease--AIDS. The suspicion is not yet proven but is to many minds probably justified.
In his new book, The River, BBC Africa correspondent and United Nations official Edward Hooper advances a compelling case for his extraordinary theory that AIDS in Africa was accidentally introduced in trials of the polio vaccine. Particular, he exposes a trail of evidence linking the CHAT vaccine, which he suspects was grown on virus-tainted cultures of chimpanzee kidneys, to 1950s and '60s vaccine trials in the Belgian Congo where a majority of the first AIDS cases appeared.
John Waters, Alberta's Provincial Health Officer, dismisses Mr. Hooper's theory as "unscientific" (though he has not read the book). Scientific researchers worldwide, however, have been calling for the manufacturer of the CHAT vaccine, the Wistar Institute in Philadelphia, to offer up vials of its early CHAT vaccine on ice for testing. So far, it has not.
A growing cadre of medical researchers believe that another monkey virus that contaminated an early polio vaccine fed to millions of Americans (and several hundred Canadians, according to Dr. Waters) is linked to rare human cancers, too. The February issue of Atlantic Monthly details the fascinating history or the virus, called SV40, which is widely used as a research tool because it so readily produces tumours in laboratory animals. Numerous recent scientific studies show that samples of human cancer tumours are loaded with it, while it's not found in non-cancerous control tissue. Coincidentally, incidences of these cancers are soaring in the American population. When it was discovered in 1960, vaccine manufacturers began screening for SV40. But afraid of causing alarm health officials didn't recall samples, so The contaminated vaccine continued to be used for two more years--bringing the total number of Americans who received it to 98 million.
Today, the World Health Organization acknowledges (on its website) that the early polio vaccine was indeed contaminated with SV40. But, like other public health agencies, it downplays the virus significance. Naturally, the new polio vaccines are screened for SV40 and other known viruses. But modern critics of mass vaccination revisiting the vaccine's ugly past (it was developed on aborted fetal tissue and tested on institutionalized mentally handicapped children on grounds they ate each others feces) can find much to make them wary of medical authority's over confidence. Even the early polio researchers, when they looked back with hindsight, writes the BBC's Mr. Hooper, "would shiver at the risks which they had inadvertently taken in those days of blissful ignorance."
CELESTE MCGOVERN
The abortion connection
In Canada, a number of vaccines are grown on human cells from aborted fetuses. The new chicken pox vaccine made by Merck Frosst Pharmaceuticals is grown on the MRC-5 cell line derived from the normal lung tissue of a 14-week-old male fetus aborted "for psychiatric reasons," So are the polio and hepatitis A vaccines. The rubella virus in the MMR (measles, mumps, rubella) three-in-one shot is grown on the WI-38 cell line--developed in 1961 from an aborted three-month-old female fetus.
For some abortion opponents this is a problem: can they, in good conscience, vaccinate themselves and their children when they are trying to avoid all connection with abortion? Some wonder if vaccines made on such ethical shortcuts can really be beneficial anyway.
For Calgary pharmacist Maria Bizecki, the vaccine-abortion connection was a red flag. She followed the routine immunization schedule with her children, who will turn three and one this month, until she learned about MRC-5 and the MMR. "I don't think it's a grave sin or anything," she says. "It's a risk-benefit assessment." Already questioning the safety of the jab because of recent studies linking it to bowel disorders, Mrs. Bizecki, a Roman Catholic and member of Pharmacists for Life, was tipped against vaccinating. "I don't trust drug companies to begin with," says the pharmacist. "Most of the time they have a conflict of interest in reporting adverse reactions of a vaccine. This just makes them even more questionable."
But Mrs. Bizecki is not "anti-vaccine." She's angry that pharmaceuticals don't use less controversial alternatives available. "I've talked to a lot of parents that have concerns about this," she says.
Enough parents had asked questions about it in England and Wales in 1994 that the Catholic Bishops' Conference there prepared a briefing paper. Catholic parents "have no general obligation to refuse the vaccination" it reads. However, it calls vaccine use of aborted fetal tissue "a kind of evil which is widespread in biomedical research and which people rightly think they should combat when they can." The "practice of medicine is being made parasitic on [the] evils" of abortion and fetal experimentation, it adds, and refusing vaccination is one "way of seeking to turn medicine from a course which will increasingly subvert people's confidence in it."
If people become comfortable with the "regrettable origins of these vaccines," notes Daniel Maher of the National Catholic Bioethics Center in Boston, "it will become more difficult to maintain the distinction between the use of existing fetal cell lines for vaccines and the use of fetal tissue for research and transplantation." Research dependence on fetal tissue could "soon grow so powerful financially," he adds, that there would be little hope of ever reducing abortion.
The U.S. Congress is to begin hearings this month into a lucrative trade in aborted fetal parts that has recently been connected to at least one Canadian tax-funded laboratory, as well as to vaccine manufacturers such as Smith Kline Beecham Pharmaceuticals. In 1993, Canada's Royal Commission on New Reproductive Technologies reported that aborted fetal tissue is used routinely by Canadian pharmaceuticals--primarily for vaccine and viral research.
CELESTE MCGOVERN
