For more than a year, I’ve been holding my tongue on the subject of vaccines for a whole range of reasons. The conversation seems to wax and wane, but now that it is front-and-center once again, I feel as though I am ready to put some of my thoughts and experiences out there.

I will do this in parts because the issues are incredibly complicated and I think they deserve a thorough examination, but because of an experience I had a year ago, I will start with the following letter.  I was invited, by MomsRising to be part of a gathering with Dr. Vivek Murthy, US Surgeon General, to talk about the MMR vaccine. It was positioned as a smallish group of folks that would dig in to the questions and issues surrounding the measles outbreaks that had recently occurred and I spent over a week doing research, asking other moms what they wanted to know, and crafting intelligent questions. When I got to the event, I learned that they had invited hundreds of other people to phone in and listen and instead of a conversation, it was to be a presentation by Dr. Murthy with a few select questions asked at the end (questions vetted by the presenters with no opportunity for follow up clarification or dialogue). Needless to say, I was disappointed and I later discovered that Dr. Murthy was on a tour of cities at the low end of vaccination rates and this was more PR than conversation.

When I asked Kristin, the head of MomsRising, about the format following the event and indicated that I had several unanswered questions, she seemed surprised and offered to forward all of my questions to Dr. Murthy so that I could get answers. I emailed her this letter with the subject line she suggested and have, to date, received no response.

The letter itself is lengthy, I admit, but despite that, I feel as though it barely scratches the surface of the complex issues surrounding vaccines. In Part 2, I will explain my overall thoughts on vaccines and I implore you to either ignore these posts or read them thoroughly and thoughtfully and respond with curiosity versus vitriol.

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1.     Using global statistics to demonstrate the
   effectiveness of the MMR is an unfair comparison. To say that “there have been
   over 15 million lives saved by the MMR vaccine since 2000 alone,” as Dr. Murthy
   did in his closing statement ignores the reality that many of those lives would
   have been lost because the children are living in third world countries without
   proper nutrition or sanitation. It is incendiary and doesn’t adequately portray
   the situation here in the United States to use global numbers to talk about
   domestic issues.
2.       I can locate no long-term studies that have been
   done to determine whether people of my generation (born in the late 1960s and
   early 1970s) who received their full recommended MMR vaccinations actually
   still have blood titer levels that show that they are immune to measles. In
   response to one person’s question, “Does immunity wane as people get older?”
   Dr. Murthy answered, “There doesn’t seem to be any evidence that suggests
   that.” I’m concerned that this conclusion has been reached without any actual
   scientific studies and it may, in fact, “seem” that immunity doesn’t wane
   because of the drastic drop in the incidence of measles in the US. It would
   seem to be a fairly simple examination to undertake a study of adults across
   gender, ethnic, and socioeconomic populations and determine whether or not they
   are still immune to measles thanks to the MMR vaccine. The term “herd immunity”
   or “collective immunity” gets used an awful lot with regard to vaccines, but I
   don’t know that it has ever been tested with regard to vaccinations. There is
   evidence that this phenomenon holds true in animal populations and with
   naturally-acquired disease, but I would like to see a study that shows that it
   is valid for vaccine-acquired immunity. We can’t base public policy on a
   theory.

1.            On Tuesday, Dr. Murthy assured MomsRising
   supporters for the second time that they ought not to be concerned about the
   MMR vaccine shedding live virus. “Don’t worry about exposing others,” he said.
   “Carry on about your lives.” However, parents of children who are immunocompromised,
   either naturally or due to medications like chemotherapy drugs, are often told
   by their physicians NOT to get their other children vaccinated with any live
   virus, including the MMR. In addition, the vaccine insert produced by the
   manufacturer, Merck, is written as follows: “Excretion of small amounts of the
   live rubella virus from the nose or throat has occurred in the majority of susceptible individuals 7 to 28 days after vaccination.” (emphasis mine). Additionally,
   this article http://www.cnbc.com/2015/03/03/globe-newswire-public-health-officials-know-recently-vaccinated-individuals-spread-disease.html
   in a mainstream media outlet talks about the fact that experts know that
   recently vaccinated individuals can spread disease. And yet, parents who choose
   to delay or forego certain vaccines for their children are routinely vilified
   and blamed for disease outbreaks. I believe that this is one very compelling
   reason why so many parents are confused about these issues. Whom do we believe?
2.       When vaccines are tested for safety, they are
   tested in isolation; that is, one at a time. But more often than not, they are
   administered to children in tandem with other vaccines. Why are there vaccines
   on the US schedule that are given in the same day but not tested together to
   assess their effects? Much like baking soda and vinegar are inert alone but
   explosive in combination, it is scientifically possible that when two different
   vaccines are put together, they will act differently in the body of a child
   than they did when tested alone. We can say that we think they are probably
   safe together, but without rigorous testing, it is irresponsible to give them
   to children with developing immune systems without being much more certain.
3.       Also, when vaccines are tested for safety, they
   are not tested against truly inert placebos such as saline solution. Often they
   are tested against another cocktail of preservatives and adjuvants that are
   only lacking the vaccine itself. We are not just concerned about the vaccine
   components, we need to know what effect substances like aluminum adjuvants and
   MSG and pig gelatin have on the human body when they are injected. We also need
   to know what effects they have when they are injected in large amounts, as in
   the case of multiple vaccines given on one day. I wouldn’t eat a “safe” dinner
   off of a toxic plate, and I don’t want to inject my children with a “safe”
   attenuated virus that is held within a toxic set of preservatives. We deserve
   to know that each and every component
   of the vaccines we are being given is safe.
4.       All three of the doctors spoke of the Institute
   of Medicine as an independent body that reviews all of the safety and efficacy
   studies on vaccines (among other things). I am curious to know whether the IOM
   crafts and undertakes their own studies or simply reviews the studies done by
   other organizations that may have a vested interest in the outcome. The design
   of a scientific study is as much responsible for the data set that emerges from
   it as anything else, and if truly independent studies are not being designed,
   we cannot hope to get accurate information.
5.       Dr. Murthy encouraged parents to talk to their
   healthcare providers if they have questions about whether or not their children
   should have a particular vaccine. I agree entirely, but I have to say that we
   don’t live in a perfect world where all families have healthcare providers that
   have the time to have detailed conversations during a well-baby check, have the
   intimate knowledge of what a vaccine package insert says, or even get their
   vaccines in a doctor’s office. 
   Families can go into Walmart and get vaccines for flu, chickenpox, HPV,
   pneumococcal pneumonia, hepatitis, meningitis and MMR, in addition to others. I
   am concerned that many of those folks do that because it’s cheaper and easier
   than making a doctor appointment, and I wonder how robust the patient education
   is or whether there are opportunities to ask complex questions, or if most
   parents even know what or how to ask. His answer is predicated on the
   assumption that most parents have a trusting relationship with their child’s
   doctor and I fear that that is inaccurate. I think it is also possible to
   discount the intimidation factor most people have when faced by a person in a
   white coat.  
6.            Dr. Cohn and Dr. Murthy both talked about the
   requirements for providers and vaccine manufacturers to report adverse events
   to the VAERS. Further, Dr. Cohn explained that patients and families can also
   report to this body any adverse effects they experience due to a vaccine. This
   prompted many questions. First, how many parents are told that this is an
   option and offered information on how to go about reporting to VAERS? Second,
   is there an estimate of how many parents don’t report side effects because they
   either can’t tell whether they are related or because it will cause them to
   have to make another doctor appointment for their child, which is both costly
   and time-consuming? Third, in the case of a family who receives their
   vaccinations from a place like Walmart, how likely are they to report any
   issues and to whom? If they don’t know about VAERS and they weren’t going to a
   doctor for their shots in the first place, they aren’t likely to seek one out
   to report negative side effects unless they are severe. Lastly, Dr. Cohn said
   that the CDC, and the Department of Health and Human Services follows up on
   every report made to VAERS and I am curious to know what the threshold is for
   deciding that action is required in the form of further study. How many of the
   same or similar reports have to be made in order for them to determine that
   this is an issue and how much time elapses between the reporting of an adverse
   event and the review?  Finally, I am curious about something Dr. Murthy
   said in regard to autism and MMR. He said that, “because autism symptoms show
   up around the same time that kids are getting the MMR, there are some people
   who think the two are related, but they are not. This is why we need to really
   look at the populations, we need large numbers to do rigorous independent
   study. We need to look at broad data sets to see and what the data says is that
   there is no connection.” I am interested in whether there has ever been a study
   done on the relative health of vaccinated children versus unvaccinated
   children. We know that there are entire pockets of unvaccinated children in the
   United States and it would seem relatively simple to compare them to children
   who have been vaccinated on schedule. This seems like a straightforward study
   that would provide some interesting information about a range of potential
   issues that we haven’t considered might be correlated with vaccines.