AAP: Vaccine Safety: Examine the Evidence

Even though there has never been any reputable, science-based evidence to support a link between vaccines and autism, the antivaxxer crowd continues to pretend that isn't the case as they push retracted papers from discredited "doctors" and self-proclaimed experts, nutritionists, or 'alternative medicine gurus'.  One tactic I tend to see employed on a regular basis is the famed "link dump" where an antivaxxer will share a website or a blog page (often his or her very own blog or webpage) which lists dozens upon dozens of various studies or papers all of which they claim show vaccines are harmful, or show that vaccines cause autism, or show that vaccines are deadly etc.

So often the problem is that these studies and papers are rarely ever peer-reviewed nor are they published in reputable medical journals (or reputable non-medical journals for that matter).  Those that are peer-reviewed or published will often have little to nothing to do with vaccines, and they surely don't prove that vaccines cause autism.  Sadly, I have even seen cases where these websites and blogs contain studies that actually say the exact opposite of what antivaxxers are claiming, but they lack the ability of understanding the subject matter and simply misunderstood a line of text in the abstract.

The other aspect of these link dumps that I find so peculiar is that often times there is zero context other than a title which says "Proof that Vaccines cause Autism" or "Evidence that Vaccines are Killing Us" or some other outrageous claim.  If one cannot even offer the slightest context around the studies they are listing, does it not suggest they haven't bothered to even read them?  Or is it that they have tried to read them but found the subject matter far too complex?  Either way, I have noticed the same lists appearing on antivaxxer blogs and websites (in one occasion even the same typo in the URL of a study which tells me those copying the list didn't even bother to visit all of the sites) and thus it seems as if in some cases antivaxxers are merely sourcing other antivaxxers without bothering to vet the information.  In theory this could lead to antivaxxer A being cited by antivaxxer B who in turn is cited by antivaxxer C who is then cited by antivaxxer A who never realizes they are actually indirectly using themselves as the supporting evidence to claims they themselves originally made.

Confused yet?  I can't blame you, but keep in mind antivaxxers have also been known to create their own blogs and then cite those blogs as sources within comments as if writing something and then linking to your own words adds credibility.

So what is my point you might ask?  Well, during a recent discussion with some colleagues I commented that even though there haven't been any studies that have successfully linked vaccines to autism, there have been several peer-reviewed AND published studies that have shown no link between vaccines and autism and that these studies were widely known.  The problem it seems is that those searching for real live published science are often overwhelmed because when they do find a study they may not understand what it means or they may not understand what the conclusions of a study actually were.

So inevitably the question was asked... where is the easiest place to find these studies, and unfortunately that answer is rather complex.  You could go directly to the journals which publish the studies, you could search pubmed, or you could try browsing the websites of the CDC or the FDA, but if we are honest with ourselves we must admit most people simply don't have the time, nor the patience, to follow this path.

Wouldn't it be nice if someone (a reputable someone) would put a list together that could be shared with parents or laypersons who have an interest in the subject?  Of course blogs and websites do that sort of thing all the time, but what about an actual organization known for their healthcare advocacy or one which is composed of over 60,000 pediatricians or pediatric specialists (you know... doctors who actually specialize in children)?

If you haven't guessed, I'm referring to the American Academy of Pediatrics which has published a memo detailing around 40 of these studies.  They make occasional updates to the list as new information is published, but even more impressive is that they do an amazing job of offering context!  This means they don't just provide a list of studies or sources but rather they summarize each study as well as providing a brief overview of what the author conclusions were, thereby giving those interested a succinct way of seeing the results without necessarily needing to read through hundreds upon hundreds of pages of medical and technical material.

Of course the list is geared towards parents, but I've found myself referring to it on many occasions and I can state in no uncertain terms that it is a useful list for anyone interested in vaccine safety up to an including pediatricians, researchers, and educators.  Thus, if you ever find yourself wondering if there is a nice package detailing the science behind vaccines... this might be right up your alley.  Click the link below, read the summaries and conclusions, dive into the studies themselves, and make up your own mind.  That isn't so hard is it?

Vaccine Safety: Examine the Evidence

The Impossible Demand for 100% Vaccine Safety

What would you say to someone who makes a demand for you to prove to them that all automobiles are

safe?  Do you think you could use safety data to prove that automobiles are more safe than they have ever been?  Maybe you could explain how there are new innovations like airbags, crumble zones, anti-lock brakes, or traction control systems which all work together to increase safety.

Now what if that same person cited statistics which showed that even in the year 2011 there were still over 32,000 people killed in automobile accidents in the US alone?  Does that suggest that automobiles aren't really that safe after all?

When you really think about it... how do you determine what is "safe"?

Reasonable people will understand that claims about vehicle safety based upon the number of accidents or the number of deaths in a year isn't taking in to account the big picture.  First you need to realize that there are hundreds of millions of miles traveled each and every year and there are million upon millions of drivers.  Next you need to take into account that even if a vehicle has eight airbags and has a five star crash test rating, sometimes things can and do go wrong and it may have nothing to do with the vehicle.

In the end, you would realize that 32,000 deaths may seem like a significant number, but in context of the hundreds of millions of miles driven, and the millions of unique drivers, the millions of different vehicles, the total hours spent in a vehicle throughout the year... well in the end 32,000 deaths is actually a very small number.  You might even show them statistics which prove that we haven't had less traffic fatalities since 1949 when the population and the number of miles traveled were less than half of what we have today.  You might even point out that almost as many people die from accidental poisonings in a given year (more than 33,000 deaths in 2010) than do in automobile accidents.

So perhaps logical people will agree that proving vehicles are safe is based upon certain assumptions.  Number one, you need to define the term "safe" and assume that is based upon historical averages and based upon percentages.  You also need to assume that no vehicle can ever be 100% safe, and you need to accept the fact that there will be accidents, and there will be a certain amount of deaths as a result.

With that in mind, should we ban automobiles because people die every year?  Should we change the laws to only allow them to be sold if they are 100% safe?  Should we demand that the government require automobile companies to be held personally responsible for each and every death that occurs while operating a motor vehicle?  Of course not... that sounds so silly when you put it like that doesn't it?

So with that in mind, why do anti-vaccinationists demand that we prove every vaccine is 100% safe?  Not only do they demand vaccines are 100% safe, but they aren't willing to accept the commonly held definition of the term "safe" (which in this case means involving little or no risk of mishap).

Even though there is overwhelming evidence supporting the efficacy and safety of vaccines, it is doubtful this would appease an antivaxxer because chances are there will always be cases where someone had an allergic reaction to a vaccine or a case where someone suffered a side effect, or cases where someone was fully vaccinated but still contracted the disease they were supposed to be protected against.

In addition to requiring all vaccines to be 100% safe, anti-vaccinationists are quick to point out case where someone was injured by a vaccine over 50 years ago.  They believe that the modern vaccines of today should still be blamed for any problems that existed decades ago, just as we should be blaming modern automobiles for the safety failures of the Chevrolet Corvair or the Ford Pinto.

We can all admit that vaccines have not always been perfect.  There have been cases such as the Rotashield rotavirus vaccine in 1998 and 1999 which was pulled from the market after it was determined it increased the risk of intussusception (a rare type of bowel obstruction) in infants.  There was the "Cutter Incident" back in the 1950s where a live virus was included in a polio vaccine which resulted in 10 deaths, and 200 children suffering from paralysis.

We also know that some polio vaccines were contaminated with Simian vacuolating virus 40 (SV40) which has the potential of leading to tumors.  Granted studies linking SV40 to cancer in humans have been inconclusive, this doesn't remove the negative impact these contaminated vaccines have had.

However, even with these and other failures in mind, is this enough to warrant the elimination of vaccines entirely?  Sadly if you are an antivaxxer the answer is yes.  Antivaxxers are convinced that these failures overshadow any good effects from vaccines, and they believe we would be better off without any vaccinations whatsoever.

They would have us return to the days where polio infected tens of thousands annually and killed as many as 6,000 in the US alone.

They would have us return to the days of millions upon millions of people dying from smallpox and to the time where as many as one out of every seven Russian children would die from the disease.

They would even attempt to convince us that the 18 people that died from measles every hour in 2011 (158,000 deaths total) aren't important.  They would try to claim the 71% reduction in measles deaths due to vaccination is trivial and unimportant.

Whether it be a vaccine used to prevent pertussis (whooping cough) or one which has been shown to prevent rotavirus, antivaxxers seem to believe that no vaccine is a good one, and although vaccines are overwhelmingly safe and effective, even if we could guarantee vaccines were safe 99.97% of the time and effective 99.99% of the time it still wouldn't be enough to convince those in the anti-vaccine crowd, because they will never be satisfied with anything less than 100% effectiveness and 100% safety.

So there is a choice... one one hand you could...

• Refuse to acknowledge the safety and effectiveness of vaccines and believe they cause far more harm than good

Or alternatively you can accept reality and...

• Acknowledge that although vaccines are not perfect, they do an incredible job of reducing and in some cases actually eliminating entirely the risk of contracting disease.  Accept that vaccines safe lives and prevent the spread of disease.  Accept that vaccines are overwhelmingly safe and that we have the historical record to show us not only how safe they are, but how effective they are as well.  Acknowledge that we no longer need to fear death from diseases such as smallpox or polio, acknowledge that vaccines are one of humankind's greatest scientific breakthroughs, and agree that vaccines (although not always 100% safe or 100% effective) are far less risky or damaging than the diseases they prevent (which can, and often do lead to death or long-term complications).

Nobody says we have to be satisfied with our current vaccines, and we can (and should) demand for better vaccines, safer vaccines, and vaccines for diseases which currently have no other cure (such as HIV).  We should always be striving for advancements and we shouldn't be afraid to challenge accepted science or to ask the difficult questions.

However there is a vast difference between wishing for vaccines to improve and wishing vaccines didn't exist.  Antivaxxers don't really care about vaccine safety.  They don't care about the millions of lives lost.  They don't care about people suffering from polio or pertussis or smallpox because they have never suffered from these diseases.  They likely aren't old enough to remember a loved one dying from what we now consider to be vaccine preventable diseases, and as such I can think of no other term to describe antivaxxers than the word selfish.

These people don't care about those who have died, and their only concern is pushing a political agenda based upon something they read about on the Internet or a reaction that their cousin's, boyfriend's, sister's, coworker's daughter's, teacher's, kid had after being vaccinated for tetanus.

Demanding improvements is reasonable, demanding 100% safety and effectiveness quite simply is the exact opposite of reasonable.  Just as we understand there is a risk every time we get into an automobile, we also understand there is a risk with each and every vaccination.  The question that should be asked is whether the level of risk is worth engaging in that particular activity, and the data overwhelmingly proves to us that driving in automobiles as well as being vaccinated is well worth the risk.

The Profit of Vaccinations

The New York Times recently published an article about the flu season which shows that the levels of deaths have officially crossed over into "epidemic" territory.  The full article can be found here:  Flu Season Deaths Reach Epidemic Level but May Be at Peak, C.D.C. Says

This is a well balanced article speaking about the impact of the flu as well as explaining that the flu vaccine isn't nearly as effective as some other vaccines like those for the norovirus (aka: the "stomach flu" or gastroenteritis) or pertussis (aka: whooping cough).  Part of this is obviously due to how quickly flu viruses mutate, but another aspect that could be partly responsible is the simple fact that on any given year only around a third of the population bothers to actually get a vaccine.  This means there is a much greater chance that the virus can spread among those who have no protection from the vaccine, as well as among those who the vaccine wasn't effective.

Clearly there are failures in the system and improvements must be made.  Not only do we need better vaccines, but we need to do a better job informing the public as to the benefits.  The good news is we appear to be making progress on both of these fronts, and the percentage of those who receive flu vaccines is on the rise each year.  There are also new vaccines in development that hope to address some of the problems with the current targeted vaccines although progress is slow, and funding is difficult to obtain.

This latter point is one which I wanted to speak about, because all too often we hear antivaxxers complain that vaccines are merely a profit mechanism for pharmaceutical companies and that there is no true benefit.  As the article explains it could take as much as $1 Billion to actually bring a vaccine to market, which at first glance seems like an insurmountable figure.  If a new vaccine was to be developed which either prevented the flu or even merely significantly reduced the chances of contracting a flu virus and if the usage of that vaccine was on par with vaccines for MMR or Hib, chances are we would see a vaccine acceptance rate somewhere above 90%.

So let's be conservative and use a vaccination rate of only 80% for the "one-time" flu vaccine.  We know not everyone would bother to be vaccinated the first year, but after a few years when people realized they no longer need an annual flu vaccine, they would probably be more willing to get the single vaccine, and since many other vaccines have rates well above 90%, I don't think 80% is that unbelievable.

So if we focus on the United States alone, we know there are around 312,000,000 (312M) people who could potentially be vaccinated.  80% of this is around 250,000,000 people who would likely receive a flu vaccine.  So let's assume the cost of this vaccine is $35.  The current wholesale costs of single year flu vaccines is closer to $10, but a one-time vaccine is likely to be incrementally higher due to the complexity.  For example an adult vaccine for MMR costs around $35 while the vaccine for varicella is over $60.  A childhood vaccine for Hib may be only $12 while rotavirus can be over $70, so it isn't hard to a flu vaccine could cost at least $35 wholesale - at least for the first few years after release.

Ok, so now we have 250,000,000 potential customers each of which will spend $35 for a grand total of $8,750,000,000 ($8.75B).  Even if we assume only a 50% vaccination rate (156M) and an even lower cost of $25 per vaccine, the total is still $3,900,000,000 ($3.9B).

Of course the $1B it takes to bring a vaccine to market does not include the costs to produce, distribute, and market the vaccine, so it isn't as if there will be billions in profit the first year, but the flip side of this equation is that we are only factoring in the population of the US.  Chances are once the vaccine was available it could be submitted for approval in numerous other nations with the potential to sell hundreds of millions of doses to those nations.

The moral of this story is, there would be a lot of money to be made from a one-time flu vaccine, yet to date we haven't seen anything available.  Since antivaxxers seem to feel vaccine manufacturers are only interested in profits, how can they explain that not a single manufacturer has unleashed such a vaccine on the public?  It shouldn't matter if the vaccine is effective or not, because as any good antivaxxer will tell you vaccines don't actually work (and yes I'm being sarcastic).  Antivaxxers are even willing to claim publicly that the polio vaccine and the smallpox vaccine did nothing to prevent those diseases (suggesting the diseases just magically disappeared on their own apparently), and they feel that vaccines are generally ineffective.

These same antivaxxers will tell you that the MMR vaccine does far more harm that good and that there is no evidence that viruses like the Measles have been controlled by the vaccine in any way.  They will also claim that the HPV vaccines don't work at all and that it is merely a method for the manufacturers to collect millions upon millions from insurance companies and the unsuspecting public.

You see this is one of those situations where antivaxxers want to have it both ways.  One one hand they claim vaccine manufacturers are simply in it for the money and that the vaccines themselves don't actually work.  On the other hand, they can't explain why the market hasn't delivered something like a one-time flu vaccine which would quite obviously be a gigantic windfall for the pharmaceutical companies.

So which is it antivaxxers?

It would seem to be the fact we don't have a one-time vaccine for the flu only proves that the system works.  We have clinical trials and data which shows us the effectiveness of vaccines, and if a vaccine is found to be ineffective it wouldn't be approved.  We have a system of checks and balances in place to ensure the public is protected and that vaccines are not only effective but that they are safe.  We have a system which rewards responsibility, and one which puts the safety and health of the public as the priority far head of profit.

We aren't talking about a nutritional supplement or a vitamin that can be sold by anyone trying to make a buck.  Vaccines are subjected to rigorous safety and effectiveness testing which can take years to complete and which requires verifiable proof of efficacy before that vaccine is ever approved for use.  Can we say the same thing about the various supplements and pills sold on antivaxxer websites?

Sort of makes you wonder what type of clinical trial or testing was done on something like the miracle "brain repair" pills sold by a well known anti-vaxxer.  I think we all know the answer, and it rhymes with none.

If vaccines were really all about profit and if the health of the public was an afterthought as so many antivaxxers have suggested, I have no doubt we would have a half dozen one-time flu vaccines on the market this very moment.  Yet we don't - and I've yet to see an antivaxxer who can explain this without contradicting themselves.

Need Another Reason to Get a Flu Shot?

If reducing the risk of suffering from the flu this winter isn't quite enough to convince you to get a flu shot, consider this:  according to two studies presented at the Canadian Cardiovascular Congress, it turns out getting a flu shot can actually decrease the risk of a heart attack by as much as 50%!

So not only can you avoid the flu, you might actually save your life.  Sort of makes you wonder how antivaxxers will spin this to make it look like a bad thing... because saving lives isn't exactly the type of side effect they like to talk about.

Is this the kind of thing that should be reported to VAERS?

Read more here:  The Shot That Prevents Heart Attacks (via Yahoo Health)

Move the Goalposts... It's Time to Talk Aluminum

Spend more than five minutes on an anti-vaccination website and you will soon realize that most antivaxxers aren't exactly fans of aluminum.  No we aren't talking about aluminum cans or cookware, but rather we are talking about aluminum in a salt form which is commonly used in vaccines to act as an adjuvant.  In simple terms, the aluminum increases the effectiveness of a vaccine due to how it triggers a reaction within the immune system.

Aluminum has been used within vaccines for over 80 years, so you might ask yourself why are antivaxxers suddenly so focused upon aluminum when it isn't exactly a new ingredient?

Well to answer that, you first need to realize where we have been.  Antivaxxers have previously attempted to single out other ingredients such as thimerosal as they blamed it for various conditions up to and including autism in children.  They used scare tactics to associate thimerosal with mercury poisoning due to a misunderstanding of the differences between ethylmercury and methylmercury.

However, even prior to these cries of mercury poisoning from the antivaxxer community, the Food and Drug Administration (FDA) was already in the process of reviewing the use of thimerosal in vaccines.  Under the FDA Modernization Act (FDAMA) of 1997, the FDA carried out a comprehensive review of the use of thimerosal in vaccines.  The review found no evidence of harm from the use of thimerosal other than local hypersensitivity reactions near the injection site.

In the early 2000's, the Immunization Safety Review Committee of the Institute of Medicine (IOM) performed a review of all available research including studies in the United States, the United Kingdom, Sweden, and Denmark and they specifically focused upon the hypothesis that thimerosal was a contributing factor to childhood diseases such as autism.  The committee concluded that the available data and studies rejected the casual relationship between thimerosal (or vaccines containing thimerosal) and autism.

This is probably a good time to mention the fact that the IOM is part of the National Academy of Sciences and is a non-governmental institution. That may not seem particularly relevant, but since antivaxxers have a severe distrust for the federal government or any three letter agency (CDC, FDA, EPA et al), it should be clarified that the IOM is an independent organization and therefore would not share the same perceived bias(es) as a government agency.

Even though the IOM rejected the relationship between thimerosal and autism the FDA, as a preventative measure which had begun years earlier, was already in the process of removing thimerosal from vaccines.  As of 2001 thimerosal was removed from all childhood vaccines recommended for children six years of age or younger (keep in mind autism generally presents itself between ages two and four), and the only exception to this were some versions of the inactivated flu vaccine (although thimerosal-free versions are available).  In addition to this, all new non-influenza vaccines licensed since 1999 contain no thimerosal.

So what was the end result of removing thimerosal from childhood vaccines? Did we see a significant drop in the rates of autism? Nope. In fact, since 2001 the rates have actually gone up, and thus the theory that thimerosal was responsible for the "autism epidemic" was quite obviously no longer popular to rally behind. Children who had never received even trace amounts of thimerosal were still being diagnosed with autism and therefore antivaxxers realized they could no longer place blame upon thimerosal. It soon became obvious it was time to try something new.

Move the goalposts - we have another new theory!

When antivaxxers realized that pinning their hopes upon thimerosal might not exactly pan out, they shifted gears a bit and started focusing on one specific vaccine (the MMR vaccine) which they claimed was directly responsible for autism in children.  It was around this time that they started professing that Andrew Wakefield was a genius and seemed to have the secret to unlocking the root cause of autism due to a study he published in 1998 which attempted to link the MMR vaccine with autism.

Of course after Wakefield was discredited and stripped of his medical license, and after his "study" was retracted, and after he was found guilty of fraud and manipulation of data.... well he didn't exactly seem like the great savior afterall and he soon found himself the laughing stock of the scientific community.  It was around this time that many antivaxxers decided to back-peddle a bit and distance themselves from Wakefield (although in some extreme antivaxxer circles, Wakefield continues to be considered a favorite son).

So at that point the antivaxxers decided that instead of focusing on the MMR vaccine specifically, they should simply talk about vaccines or vaccine ingredients in more general terms because scaring people by talking about mercury poisoning or "toxicity" is generally more effective than trying to convince people that a discredited doctor was right all along.

You guessed it - time to pick up those goal posts and slide them back just a bit further!

A few years ago around the time many antivaxxers decided to stop talking about thimerosal or the MMR vaccine, they decided to start talking about other vaccine ingredients such as formaldehyde.  Why the focus on formaldehyde?  Well it surely had nothing to do with science, but rather it was about perception.  It seems most people associate formaldehyde with high school Biology class where a fetal pig or a frog was stored in it prior to dissection.  They recall the strong odor and the fact there were warning labels which stated severe over-exposure to the liquid could result in death.  They also associate formaldehyde with embalming fluid and dead bodies... so surely this isn't something that should be in a vaccine should it?

Well the truth is there is very, very little formaldehyde in vaccines, and it just so happens that we already have far greater quantities of formaldehyde in our bodies at any given point than we ever receive from any vaccine.  It turns out we have around about 2.5 ug of formaldehyde per ml of blood.

Per the Children's Hospital of Philadelphia's (CHOP) Vaccine Education Center: "Assuming an average weight of a 2-month-old of 5 kg and an average blood volume of 85 ml per kg, the total quantity of formaldehyde found in an infant's circulation would be about 1.1 mg, a value at least five-fold greater than that to which an infant would be exposed in vaccines".

In fact, we as humans actually NEED formaldehyde to survive since it is required for the synthesis of DNA and amino acids, thus suggesting the amount in vaccines would somehow be harmful was at best ignorant, and most likely simply dishonest.  Thus after antivaxxers realized the amount of formaldehyde found in vaccines was insignificant, they actually went so far as to suggest there is a difference between "natural" formaldehyde, and "synthetic" formaldehyde... once again showing that antivaxxers seem to ignore even the most basic tenets of chemistry.

The formaldehyde argument didn't seem to gain much traction however - most likely since anyone who has ever taken a basic chemistry course understands what formaldehyde really is - so the antivaxxers soon decided it was time for something new.

Get the shovel out... those goalposts need to be moved yet again!

This brings us to present day - when many antivaxxers have decided the one ingredient within vaccines which is REALLY, REALLY harmful (for reals this time), and the one ingredient that has the potential to cause the most damage is none other than aluminum.  Per the Centers for Disease Control (CDC), "[a]luminum salts, such as aluminum hydroxide, aluminum phosphate, and aluminum potassium sulfate have been used in vaccines for more than 70 years" so you might think the antivaxxers are a bit late to the game... but hey - better late that never right?

I suppose to the layman, telling them you are going to inject them with aluminum sounds about as appealing as telling them you are going to inject them with mercury.  Saying these things scares people... and isn't that the point?  We can't expect people to realize that the aluminum is the most common metal on the entire planet can we?  Can we expect them to know that there is a vast difference between a chemical compound containing aluminum and an actual piece of aluminum that may be used to form a soda can?

The truth is, aluminum is actually all around us, and even in us.  Aluminum is found in our water, it is found in our the soil, it is found in the air, it is commonly used in antacids, aspirin, and yes it is even found in our food including fresh fruits, vegetables, and meat.

So what is an antivaxxer to do when they soon realize that aluminum is all around us? What can they do when they find out the average human contains between 50 and 150 mg of aluminum at any given time?  What do they do when the find out the average daily intake of aluminum may range from 10-110 mg?   Well... they simply decide to focus on the amount of aluminum in vaccines rather than the amount of aluminum anywhere else in our body or our environment. Seems legit.

The problem is, vaccines really don't contain very much aluminum.  A typical vaccine contains no more 0.85 mg of aluminum per dose.  To put this in perspective, aluminum is also found in soy-based infant formula (0.46–0.93 mg/L) and milk-based infant formula (0.058–0.15 mg/L) which means an infant will consume more aluminum in a few days of drinking formula than it would receive from a typical vaccine.

Per CHOP, "During the first 6 months of life, infants could receive about 4 milligrams of aluminum from vaccines. That’s not very much: a milligram is one-thousandth of a gram and a gram is the weight of one-fifth of a teaspoon of water. During the same period, babies will also receive about 10 milligrams of aluminum in breast milk, about 40 milligrams in infant formula, or about 120 milligrams in soy-based formula.

Even more shocking, a common over the counter antacid has around 300-600 mg of aluminum hydroxide (approximately 104–208 mg of aluminum) per tablet, capsule, or 5 milliliter (mL) liquid dose! That means if you take a single tablet of a commonly available antacid, you are consuming as much as 245 times more aluminum than you would get out of a typical vaccine.

So why aren't antivaxxers out there protesting against antacids?  If you consider how much aluminum a typical adult human might consume in a 24 hour period as a result of some heartburn, it would seem to be the equivalent of hundreds and hundreds of vaccinations, yet antivaxxers fail to even mention it.  Why are these same antivaxxers not signing petitions to have soy-based infant formula removed from store shelves when it exposes infants to 30 times as much aluminum as vaccines within the child's first six months of life?  Could it be the antivaxxers are just slightly biased due to all of their previously failed attempts at pinning the root cause of autism on the vaccine industry?

The truth is, even if someone does ingest 2000 mg of aluminum in a single day, it will quickly leave their body via their feces and urine, which results in over half being flushed out of the body within 24 hours and over 70% of the aluminum being flushed out of the body within five days.  There have been some reports of long term complications surrounding high levels of aluminum exposure which I am certain many antivaxxers have latched on to, but unfortunately for them there have been long term complications from exposure to every element and chemical compound known to man.  As it turns out, the number one cause of drowning in humans is a result of too much exposure to H₂O (commonly called "water"), yet I don't hear many people asking for the government to investigate Evian or Aquafina to see if they are killing people.  Go figure.

Sort of makes you wonder where the goalpost will move next doesn't it?

Will Antivaxxers Embrace the HIV Vaccine?

I was reading the latest news about one of the many HIV vaccines in development, and even though the results of the initial phase of testing appear to be very positive, I couldn't help but wonder to myself... how will the antivaxxers spin this to make something as beneficial as a HIV vaccine to be a bad thing?

I understand full well we are a long way away from an actual usable and functional HIV vaccine, but the initial clinical trials suggest that such a vaccine could be right around the corner.  So if we assume a HIV vaccine is within our grasp, and we already know over 33,000 people a year are diagnosed with HIV / AIDS and over 9,000 die from the disease annually, will there be a major push from the antivaxxer community to proclaim the vaccine is more harmful than HIV itself?

Perhaps it is too early to tell.  We don't yet know of any potential side effects of the HIV vaccine so we can't say what harm it may cause.  However if we look to other vaccines as examples of what we might expect it seems highly unlikely that antivaxxers will support such a vaccine even if it is shown to save thousands of lives.

How do we know this?  Simple... just look at something like the HPV vaccine (Gardasil). We know the lifetime risk of developing cervical cancer in the US is 1 in 147 for those women who are unvaccinated while it is only 1 in 400 for those women who are vaccinated.  Knowing the fatality rate of cervical cancer is around 35%, we can use simple math to determine that the HPV vaccine could potentially save approximately 2,500 lives per year in the US alone.  Now antivaxxers are quick to point out that within one year of receiving a Gardasil vaccine there have been at least 68 reported deaths.  Some sources cite slightly higher numbers, some cite lower numbers, but the 68 number is accurate as of June 2011 and came directly from the Vaccine Adverse Event Reporting System (VAERS).  What they fail to tell you however, is that that total includes all deaths... even those which were a result of suicide, car accidents, or unrelated medical conditions.

Now in case you are curious, even if we use the full 68 deaths, and we consider that at that point in time over 35,000,000 doses of the Gardasil vaccine were given it would mean that 68 works out to be 0.0004%.  It is probably also a good time to mention that 0 of those deaths (0.0000000000%) have actually been attributed to Gardasil... and that number doesn't change no matter who has reviewed the data.

However, I'm in generous mood and I'm trying to make a point, so for the sake of discussion, let's just go ahead and assume out of those 68 deaths that the vast majority were a direct result of the vaccine.  For the sake of argument, we will ignore all common sense and logic and simply assume that 50 of those 68 deaths were a direct result of Gardasil.  Now let's also assume that VAERS only captures about 10% of the actual adverse events tied to vaccines, and therefore we need to now extrapolate that 50 deaths to be a total of 500.  So out of 35,000,000 doses of the vaccine given, we are making a wild assumption of 500 deaths.  In case you are curious that works out to be an effective rate of 0.00142%

Do you have any idea how small a number 0.00142 really is? That is roughly one out of 70,000.  That means  if you injected one person each day with Gardasil, you could continue to do so for 192 years before someone might actually die as a result - and that is under the huge assumption that all of these deaths can be directly linked to the vaccine (which we know they cannot).

Great - so the chances of dropping dead within one year of receiving a Gardasil vaccine are 0.00142%.  Fine... I know it is a huge stretch, and we know the numbers are nowhere near that level, but even if we use worse case scenario logic coupled with idiotic assumptions, we still come up with a value which is incredibly small.

So how many lives have been saved by the vaccine during that same period of time?  The Gardasil vaccine was approved by the FDA in June of 2006, so five years later in June 2011 by the time those 35,000,000 doses were distributed, we could have potentially saved 12,500 lives from the vaccine.

So let's be clear - if the vaccine saves 2,500 lives a year (12,500 lives over five years) and if the vaccines results in 500 deaths during that same period, that tells us the end result is a net increase in lives saved.  This means the Gardasil vaccine actually saved at least 12,000 lives.  Yes you can argue the number is larger or smaller, but in the theme of keeping things simple, this is a fairly conservative figure.

So what do antivaxxers say when presented with these numbers?  Do they admit that the net effect of the vaccine is that lives are saved?  No.  Do they admit that even if the vaccine isn't perfect that it is still better than nothing?  Nope.  Instead of looking at the net impact, antivaxxers do what antivaxxers always do when the numbers don't help their cause.  They deny the numbers and claim the math doesn't add up.... or better yet they simply refuse to talk about it.

Now we know it is impossible for even the most diehard antivaxxer to deny basic arithmetic, so instead they simply flatly deny that the vaccine saves any lives.  They even go so far as to claim there is no connection between HPV and cervical cancer.  Yes seriously.  (In case you are wondering, the claim about HPV not causing cervical cancer is flatly untrue and stems from a misunderstanding of the virus.  It is true that not all strains of HPV cause cancer and it is also true that many HPV infections are short-lived and don't result in cervical cancer, but it is widely know that some strains of HPV (namely HPV 16 and HPV 18) do in fact cause more than 99% of all cervical cancers).

So we can see with our own eyes that antivaxxers with do anything and say anything rather than admit a vaccination is actually beneficial.  They will misinterpret data, they will misreport the facts, they will misrepresent scientific studies and even cherry-pick statements out of context.  Even worse, when all else fails... they will just flat out lie.

So if one day we are presented with a HIV vaccine that could potentially save tens of thousands of lives each year, is it possible that antivaxxers would actually embrace the vaccine and admit that it benefits the health of the human race?

Considering many antivaxxers don't even believe that the HIV virus causes AIDS... not bloody likely.

What Do We Really Know About Vaccines?

If you listen to a vaccine conspiracy theorist (aka: an antivaxxer) for long, they will eventually make a comment which resembles one of the following:

• "Vaccines have never even been studied!"
• "There is no science behind vaccines!"
• "The safety of vaccines is unknown!"
• "The efficacy of vaccines has never been proven!"
• "Nobody has ever studied vaccinated vs. unvaccinated children!"  
• "Vaccines don't work at all and aren't even based upon science!"

To that I say... Really?  I can understand someone missing a study or two, but when a five second Google search can provide over 577,000 results it seems antivaxxers are simply going out of their way to ignore what is right in front of them.

Getting more specific, if you want to know about vaccine efficacy the data is available.  If you want to know about vaccine safety the data is available.  Even if you want to know about a specific vaccine such as the Hepatitis B vaccine and you were trying to determine if there was ever a comparison between vaccinated and unvaccinated children, that data is available.

Or perhaps you heard about the Gardasil vaccine and you are curious if the efficacy of that one specific vaccine has ever been examined, the data is available.  Even if you get more specific and are curious if the Gardasil vaccine results in an increased risk of miscarriage (spoiler alert - there is no evidence to support an increased risk) - once again the data is available.  Even if you have some strange desire to know what women in the rural South happen to think about the Gardasil vaccine even if they had never heard of it before being asked... that data is available!

So the next time you hear an antivaxxer claim vaccines have never been studied or that their safety has never been examined it would seem they are either misinformed, they are ignorant to the plethora of scientific available at our fingertips, or they are simply being dishonest.

Perhaps it is true that antivaxxers don't study vaccines, but the scientific community most certainly does.