Author: Vincent Iannelli, MD

Should You Use a Vaccine Ingredient Calculator?

Do you want to make an informed vaccination decision?

Are you looking for more information about the ingredients in the vaccines your kids are about to get?

Have you tried one of those vaccine ingredient calculators?

Should You Use a Vaccine Ingredient Calculator?

As you do your research and look at the risks and benefits of your vaccine decision, you should know that those vaccine ingredient calculators that claim to help reduce toxins aren’t really helping you make an informed decision.

Calculate which vaccine-preventable diseases your child will be protected from when he gets vaccinated.
Calculate which vaccine-preventable diseases your child will be protected from when he gets vaccinated.

They are a propaganda tool that simply works to increase fear about vaccines by making you think that you need to do a vaccine lot search, compare vaccine brands, or work to reduce exposures to  specific ingredients.

Why would you need to do a lot search? There are no hot lots of vaccines that you need to avoid.

Why would you need to compare vaccines based on their brands? Vaccines are safe. Vaccine ingredients are safe. Although the ingredients might vary a bit based on the brand of vaccine, that isn’t going to impact how well a vaccine works or it’s side effects.

And the sites with these types of calculators never mention the risks of skipping or delaying vaccines.

Which Vaccines Contain More Than the FDA Approved Amount of Aluminum?

But what about aluminum?

Depending on the brand, don’t some vaccines do contain more aluminum than others?

“The alternative suggests only one aluminum-containing vaccine at a time in the infant years (the right brands must be chosen). By spreading out the shots, you spread out the exposure so infants can process the aluminum without it reaching toxic levels.”

Bob Sears in The Vaccine Book

The FDA states that “the amount of aluminum in the recommended individual dose of a biological product shall not exceed” 0.85  to 1.25 milligrams.

Not surprisingly, no vaccine exceeds that approved amount of aluminum, no matter what brand you choose.

Why do anti-vaccine folks scare parents into thinking that their kids are getting exposed to potentially toxic levels of aluminum from vaccines?

“WARNING: This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.
Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 [micro]g/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.”

FDA on Aluminum in large and small volume parenterals used in total parenteral nutrition.

The FDA and AAP and others began investigating and then warning folks about aluminum in 1986. They weren’t worried about aluminum in vaccines though. They were concerned that newborns and younger premature infants might be getting too much aluminum if they were getting a lot of IV products with aluminum, especially if they weren’t able to eat on their own and were dependent on total parental nutrition for long periods of time.

So these were high risk infants who were potentially getting high doses of aluminum each and every day for weeks or months at a time. And somehow anti-vaccine folks equated this with other infants who were getting vaccines every few months, at least they did once they started to move away from worrying about thimerosal.

What to Know About Using a Vaccines Ingredient Calculator

Vaccine ingredient calculators are a propaganda tool that anti-vaccine folks use to scare parents away from vaccinating and protecting their kids.

More on Using a Vaccines Ingredient Calculator

Has the United States’ Infant Mortality Rate Ranking Been Dropping as We Vaccinate More Kids?

Of all of the myths about vaccines that confuse and scare some parents, those about infant mortality rates can be especially hard to easily put aside.

After all, why doesn’t the United States rank better for infant mortality rates since most parents do vaccinate and protect their kids?

Vaccines and Infant Mortality Rates

That’s actually fairly easy to answer.

“Globally, the infant mortality rate has decreased from an estimated rate of 64.8 deaths per 1000 live births in 1990 to 30.5 deaths per 1000 live births in 2016.”

WHO on Infant Mortality Situation and Trends

Vaccine-preventable diseases don’t have much effect on infant mortality rates in the United States these days.

What does?

  • birth defects
  • premature births
  • SIDS
  • maternal complications of pregnancy
  • injuries

Think about it… If vaccines did increase infant mortality rates, then why would infant mortality rates be dropping as we vaccinate more kids?

Has the United States’ Infant Mortality Rate Ranking Been Dropping as We Vaccinate More Kids?

The Wisconsin Coalition for Informed Vaccination is pushing myths about SIDS and vaccines.
The Wisconsin Coalition for Informed Vaccination is pushing myths about infant mortality rates and vaccines.

Do you know what has been dropping?

The infant mortality rate.

In fact, infant mortality rates continue to drop and are now at their lowest levels ever.

While it is good news that the rate is dropping, most folks think they can be better.

For one thing, some states, like Mississippi, Louisiana, Alabama, Arkansas, and West Virginia, etc., have much higher infant mortality rates than others. Why? Much of those differences, can be explained by socio-economic factors. That’s also though to explain much of the differences in infant mortality rates between the U.S. and other developed countries, most of which have universal health care.

New Jersey, although they have ranked high for autism rates, has lower than average rates of infant mortality.
New Jersey, although they have ranked high for autism rates, has lower than average rates of infant mortality.

Another big difference is that many countries count infant mortality rates using different criteria than the United States.

For example, it is estimated that at least 40% of the differences between infant mortality rates in the United States and other countries is due to those countries not counting extremely preterm births among their statistics.

But why has the United States’ infant mortality ranking fallen relative to other developed nations?

Most European Countries had much higher infant mortality rates than the US in the 1960s and 70s, which affected relative rankings, even as all countries saw infant mortality rates fall.
OECD data shows that most European Countries have historically had much higher infant mortality rates than the US, which have affected relative rankings, even as all countries have seen infant mortality rates fall.

Although anti-vaccine groups try to tie this to ‘routine vaccination,’ it is easy to see that other countries have historically had much higher infant mortality rates than the United States. As they have caught up, the United States’ ranking has dropped relative to theirs, even though all have seen infant mortality rates drop.

Infant Mortality Rates in the Pre-Vaccine Era

But if you really want to understand the relationship of vaccines to infant mortality rates, you just have to look back to the pre-vaccine era. Back then, now vaccine-preventable diseases did have a big effect on infant mortality rates in the United States and elsewhere.

In 1910, for example, the most common causes of death for infants under 1 year were:

  1. diarrhea and enteritis
  2. premature birth
  3. congenital debility
  4. bronchopneumonia
  5. pneumonia
  6. malformations
  7. bronchitis
  8. convulsions
  9. injuries at birth
  10. whooping cough
  11. tuberculosis
  12. meningitis
  13. measles
  14. accident
  15. diphtheria

Although advances in modern medicine would help decrease the mortality from many of those diseases, it was vaccines that truly worked to make sure they were no longer a big part of our infant mortality statistics.

How will we continue to decrease our infant mortality rates?

Most experts think that it will require better access to health care for all members of society.

What to Know About Infant Mortality Rate Rankings

Infant mortality rates are not linked to vaccines.

More Infant Mortality Rate Rankings

Was SIDS Discovered Only After We Began Vaccinating Kids?

There are a lot of myths about SIDS and vaccines.

In the 1970s, many folks tried to say that the DPT caused SIDS. It didn’t.

Rates of most causes of sudden infant death, including SIDS, have dropped since the mid-1990s.
Rates of most causes of sudden infant death, including SIDS, have dropped since the mid-1990s.

Fortunately, because SIDS rates have dropped so much over the years, even as we have added vaccines to the immunization schedule that protect infants against more diseases, it is easy for most parents to see that vaccines are not associated with SIDS.

Well, that isn’t exactly true. Getting vaccinated is actually thought to have a protective against SIDS…

Was SIDS Discovered Only After We Began Vaccinating Kids?

The Wisconsin Coalition for Informed Vaccination is pushing myths about SIDS and vaccines.
The Wisconsin Coalition for Informed Vaccination is pushing myths about SIDS and vaccines.

What about the idea that infants only started dying of SIDS after more kids started getting vaccinated?

Any truth to that?

Well, let’s start with when the term SIDS was first used, in 1969, when it was mentioned at the Proceedings of the Second International Conference on Causes of Sudden Death in Infants.

So would that make 1960 the year for “the initiation of routine vaccination?”

That would be a surprise to the kids in the 1940s who were already getting DPT, smallpox, tetanus, and typhoid vaccines.

“Sudden unexpected death in infancy, or “crib death,” is probably not a new syndrome, but it is one that has been clearly delineated and brought into sharp focus during the past 10 years. The first international conference on this subject, held in 1963, did much to formulate the salient features and to suggest the major areas open to research.”

Bergman et al on Sudden Infant Death Syndrome: Proceedings of the Second International Conference on Causes of Sudden Death in Infants

So just because SIDS finally got a name and an ICD9 code in 1969,  that doesn’t mean that is when it first appeared.

Dr. Kemkes investigated whether 19th century infant deaths attributed to smothering or overlaying shared the same characteristics as known SIDS cases. She analyzed data from the U.S. Federal Mortality Schedule from the years 1850-1880. She found that, just like SIDS, smothering and overlaying deaths occurred primarily during the second to fourth month of the baby’s life, were more likely in the late winter months and amongst boys, and there were more infant deaths among black babies.
The author concludes: “The study strongly supports the hypothesis that these infant deaths represent empirical evidence of 19th century SIDS mortality.”

Was SIDS the cause of infant deaths even 150 years ago?

To get ahead of anti-vaccine folks, while the smallpox vaccine came out in 1798, a similar case can be made for accidental smothering deaths in the medieval period and Renaissance – and before.

Infants have likely been dying of SIDS for ages – it just wasn’t called SIDS and was blamed on other things.

“During the night this woman’s son died because she lay on him.”

1 Kings 3:19

In fact, many people even think that “SIDS” is mentioned in the Bible and was described by the ancient Egyptians and early Greeks.

And again, if vaccines somehow cause SIDS, why have rates of SIDS dropped so much as more and more kids get vaccinated and protected?

What to Know About the History of Vaccines and SIDS

The establishment of SIDS as a medical term in 1969 has nothing to do with vaccines or the immunization schedule.

More on the History of Vaccines and SIDS

When a Vaccine Doesn’t Count and Needs to Be Repeated

Of course, anti-vaccine folks are wrong when they say that vaccines don’t work.

Vaccines work and they work well to protect us from many different vaccine preventable diseases.

At least they do when you get the right vaccine at the right time and it is given properly. If an error is made, sometimes a vaccine dose needs to be repeated.

When a Vaccine Doesn’t Count and Needs to Be Repeated

While it would be unfortunate to have to repeat a vaccine dose, in most cases, if you didn’t, it would leave the child without full protection.

Why might a vaccine dose not count?

The Menomune vaccine has been discontinued, but this label is a good example of things to check before giving a vaccine.
The Menomune vaccine has been discontinued, but this label is a good example of things to check before giving a vaccine.

Although it doesn’t happen often, it is possible that:

  • the wrong vaccine was given
  • the vaccine was given too early, either before the next dose was due or when the child was too young. Although there is some leeway for when most vaccines can be given, there are still some specific rules to follow, especially the minimum time between doses, the earliest age you can get a dose, and the age requirement for booster doses. (sticking to the standard immunization schedule can help avoid these types of errors)
  • the vaccine was mixed improperly (many vaccines are now premixed, making this error less likely to occur)
  • part of the vaccine leaked out when it was being injected, which can happen when kids move, if they aren’t being held well as the shot is being given (rotavirus doses aren’t repeated if a child spits up though)
  • the vaccine had expired or had not been stored properly
  • two live vaccines (except for the typhoid vaccine) were given on separate days, but less than 28 days apart (again, sticking to the standard immunization schedule can help avoid this types of error)
  • the vaccine was given by the wrong route, although depending on the vaccine, this dose might still be valid (most vaccines, except hepatitis B and rabies)

Still, instead of a vaccine dose not counting, the much more common reason for a vaccine dose to be repeated is for folks to lose their vaccine records.

Do You Really Have to Repeat That Vaccine Dose?

Are you worried now that your kids might get a vaccine dose that has to be repeated?

Don’t be. It doesn’t happen very often.

It helps that we don’t actually have a one-size-fits-all immunization schedule and

  • there is a range of recommended ages for most vaccines
  • there is a range of recommended ages for catch-up immunization, which is basically an accelerated immunization schedule, which is why infants can typically start getting their vaccines as early as age 6 weeks and get the first few sets as early as 4 weeks apart

Also, you typically have a grace period, during which early vaccine doses will still count.

“…administering a dose a few days earlier than the minimum interval or age is unlikely to have a substantially negative effect on the immune response to that dose. Known as the “grace period”, vaccine doses administered ≤4 days before the minimum interval or age are considered valid…”

AICP on Timing and Spacing of Immunobiologics

The grace period doesn’t count for the rabies vaccine and while it is an ACIP guideline, it might be superseded by local or state mandates. The grace period also can’t be used to shorten the interval between two live vaccines, which must be at least 28 days.

One last way to get away without repeating an invalid dose would be checking your child’s titers.

When Do You Repeat the Invalid Vaccine Dose?

The next question that comes up after you realize that you have to repeat a dose of a vaccine is when should you repeat it?

It depends.

  • give the correct vaccine as soon as possible if the problem was that the wrong vaccine was given
  • repeat the dose as soon as possible if the problem was an expired, improperly stored, or a dose that had leaked out
  • if the dose was given too early, then you need to wait for the appropriate interval or when your child is old enough to get the dose. Keep in mind that when you repeat the dose, you would generally restart counting your interval from the invalid dose, not from the previous dose. That’s because the invalid dose might interfere with mounting a good immune response.

And in all cases, report the error to the ISMP National Vaccine Errors Reporting Program (VERP) or VAERS.

What to Know About Vaccine Errors

Although they aren’t common, vaccine errors sometimes lead to the need to repeat your child’s vaccines.

More on Vaccine Errors

Why Are We More Careful About Introducing Baby Food Than Giving Vaccines?

The rules about introducing baby food have changed a lot over the years.

Believe it or not, instead of rice cereal, when your baby is ready for solid foods, you can now give her fruits, veggies, meat, or even peanut butter. That’s right, infants can have peanut butter!

baby boy cake child
Let them eat cake, but don’t let that be your baby’s first food… Photo by Henley Design Studio on Pexels.com

In fact, if your baby has eczema, your pediatrician will likely encourage you to introduce peanut butter early, by four to six months, as a way to hopefully avoid peanut allergies later in life.

Why Are We More Careful About Introducing Baby Food Than Giving Vaccines?

Those are some big changes, aren’t they.

Still, a lot of other things stayed the same, including that parents should:

  • wait until at least four months, and often until six months, before they think about starting solid foods
  • only give one new food at a time

So while there are few restrictions on which foods to give now (still no honey before age 12 months and no choke foods), you still want to introduce one new food every three or four days to watch for a reaction.

Why is that different than for vaccines?

It’s because reactions to foods are more common, especially non-allergic type reactions (diarrhea, gas, and fussiness, etc), but also because there is basically no risk to delaying the introduction of new foods by this slow method.

There is also no real benefit to going much faster. Do you really want to introduce your baby to multiple new foods a day?

In addition to allergies and intolerances, there is another type of reaction you are watching for too – your baby simply not liking the food. For example, if one of your baby’s first foods is an apple, strawberry, beet combo puree and he spits it out at the first taste, how are you going to know which flavor he didn’t like? Isn’t it better to go through all of the single ingredient first foods before mixing them up?

Now if you did the same thing with vaccines, your baby would be getting a shot every four days! And it would leave them unprotected for a lot longer period of time.

Considering that serious vaccine reactions are rare, it is easy to understand that there is no benefit to only giving one vaccine at a time and we recommend that folks stick to the standard immunization schedule.

What to Know About Giving Vaccines and Introducing Baby Food

Although it is like comparing peas with peach mango and oatmeal cereal, stick to your pediatricians advice about vaccines and introducing baby food.

More on Giving Vaccines and Introducing Baby Food

Why Do Some Vaccines Need Boosters?

Vaccines work.

They aren’t perfect though, which is why some vaccines need booster doses to help them provide long lasting protection.

Why Do Some Vaccines Need Boosters?

To be clear, just because you get more than one dose of a vaccine, that doesn’t make it a booster dose.

For example, infants get multiple doses of the DTaP, polio, Hib, hepatitis B, Prevnar, and rotavirus vaccines, but those are part of the primary series for those vaccines. They aren’t boosters.

“A “classical” prime-boost immunization schedule is, thus, to allow 4 to 6 months to elapse between priming and booster doses, hence the generic “0-1-6 month” (prime-prime-boost) schedule. Secondary antigen exposure thus results in the production of higher-affinity antibodies than primary responses.”

Plotkin’s Vaccines (Seventh Edition)

Getting the booster shot in a vaccine series is important to get full protection.
Getting the booster dose in a vaccine series is important to get full protection.

Classic booster doses are the:

But why do we need these booster doses?

While one or more doses of the primary series of the vaccine leads to the production of plasma cells and protective antibodies, the booster dose then causes a secondary immune response and the production of more long-lived plasma cells. That’s how we get higher levels of protective antibodies that will last longer.

Which Vaccines Don’t Need Boosters?

In general, live vaccines don’t need booster doses.

So why do we get a second dose of MMR?

This isn’t a classic booster dose. It protects the small percentage of people who don’t respond to the first dose.

Some folks may need a booster dose of the MMR vaccine in certain circumstances though, specifically if they are caught up in a mumps outbreak.

What to Know About Vaccine Booster Doses

Some vaccines need booster doses to help you get full protection. Don’t skip them.

More on Vaccine Booster Doses

Has the Vaccine Court Compensated over 70 Families for Autism?

Has the Vaccine Court ever compensated the family of an autistic child?

Kind of.

Hannah Poling is autistic and her family was compensated by the Vaccine Court. But she wasn’t compensated for autism.

“Because she had an existing encephalopathy (presumably on the basis of a mitochondrial enzyme defect) and because worsening of an existing encephalopathy following measles-containing vaccine is a compensible injury, Hannah Poling was compensated.”

Why was Hannah Poling compensated?

Hannah Poling was compensated because she had a table injury.

Has the Vaccine Court Compensated over 70 Families for Autism?

Remember the Autism Omnibus Proceedings?

Those were the test cases that represented three different theories of how vaccines could possibly be associated with autism. None of them were upheld by the Vaccine Court and none of the families were compensated.

“The devil is in the details. You can call autism many different things and it looks very much differently to different folks. But at the end of the day, the Vaccine Court has awarded over 70 families that their children now have autism and these children developed encephalitis, which is brain inflammation, that turned into autism. 70 families. And your viewers can google Hannah Poling and Baxter Bailey. Those are two of the most popular cases. And the U.S. government said to them, your child received autism because of this. I mean, they were awarded. So, it’s in the books.”

Liza Longoria Greve on KOCO News 5

So how could anyone be saying that over 70 families of autistic children have been compensated by the Vaccine Court?

"Reaching out for the other side" of some arguments simply allows them to push myths and propaganda.
“Reaching out for the other side” of some arguments simply allows them to push myths and propaganda.

I guess folks can say whatever they want, especially when the media doesn’t understand the idea of false balance and gives them a platform, after all, that’s how you explain much of propaganda of the anti-vaccine movement.

How can they say that encephalitis turns into autism?

Again, folks can say whatever they want, but this is actually a little different from what they usually claim, that autism is encephalitis.

Of course, it isn’t.

70 Families? Google It

So what happens if you ‘google it‘ and actually research Liza Longoria Greve’s claim?

We already know about Hannah Poling… Again, she has a mitochondrial disorder and autism and she was compensated because it was thought that she had an adverse event to getting vaccinated because of her mitochondrial disorder.

And Baxter Bailey? You don’t find anything if you look for Baxter Bailey, but you will eventually find information about Bailey Banks, who was compensated for (acute disseminated encephalomyelitis) ADEM, which led to Pervasive Developmental Delay (PDD). He wasn’t compensated for autism though.

Baily Banks was not compensated for autism.
Baily Banks was not compensated for autism.

What about the other families she is talking about?

A little more googling and you find that she is likely talking about an article,  Unanswered Questions from the Vaccine Injury Compensation Program: A Review of Compensated Cases of Vaccine-Induced Brain Injury, that was published in the Pace Environmental Law Review in 2011 by Mary Holland, in which she reports finding “eighty-three cases of autism among those compensated for vaccine-induced brain damage.”

Instead of proof that vaccines cause autism though, Holland’s paper was little more than a “misleading recasting of VICP decisions.”

And vaccines are still not associated with autism.

What to Know About Vaccine Court and Autism

The vaccine court has never compensated anyone for so-called vaccine-induced autism.

More on Vaccine Court and Autism