Author: Vincent Iannelli, MD

Does the flu shot contain a vaginal spermicide?

Many of us are used to hear some far out claims from anti-vaccine folks?

And most of us understand that none of them are true.

There is no antifreeze in vaccines.

And while many vaccines may contain aluminum, formaldehyde, albumin, gelatin, antibiotics, polysorbate 80, and yeast proteins, these are not toxic or dangerous.

Why are those ingredients in a vaccine?

They might be used as an adjuvant, inactivating ingredient, preservative, stabilizer, or as a growth medium.

Does the flu shot contain a vaginal spermicide?

The latest scare story from anti-vaccine folks is that flu shots contain a vaginal spermicide.

Now why would a vaginal spermicide be needed in a vaccine?

To make a long story short - flu vaccines don't contain a vaginal spermicide.
To make a long story short – flu vaccines don’t contain a vaginal spermicide.

It wouldn’t.

Anti-vaccine folks who have exposed are spreading this misinformation have confused octoxynol-9, a vaginal spermicide, with octoxynol-10, an ingredient in vaccines.

Aren’t they the same thing?

While both are a type of Triton X-100 nonionic surfactant, as you likely suspect, they are different. And that’s where the confusion sets in.

“Nonionic surfactant mixtures varying in the number of repeating ethoxy (oxy-1,2-ethanediyl) groups. They are used as detergents, emulsifiers, wetting agents, defoaming agents, etc. Octoxynol-9, the compound with 9 repeating ethoxy groups, is a spermatocide.”

PubChem on Triton X-100

In contrast to octoxynol-9, the compound octoxynol-10 has 10 repeating ethoxy groups.

Octoxynol-10 in Flu Vaccines

Octoxynol-10, which is also known as octylphenol ethoxylate, is a surfactant that is used in some flu vaccines in a 1% concentration to help further inactivate and then “split” the inactivated influenza virus that will ultimately be used in the vaccines.

“The majority of marketed seasonal influenza vaccines are prepared using viruses that are chemically inactivated and treated with a surfactant. Treating with surfactants has important consequences: it produces ‘split viruses’ by solubilizing viral membranes, stabilizes free membrane proteins and ensures a low level of reactogenicity while retaining high vaccine potency.”

Lee et all on Quantitative determination of the surfactant-induced split ratio of influenza virus by fluorescence spectroscopy.

A “low level of reactogenicity” means less side effects. That’s good.

Octoxynol-10 also acts as a stabilizer.

Like many other non-active ingredients, it is mostly filtered out from the final vaccine product.

How much is left?

Only residual amounts.

In Fluzone, it is reported to be at a maximum amount of ≤250 mcg per dose.

Do you know the dose of octoxynol-9 that was used in vaginal spermicides? At least 50mg (one applicator full), inserted vaginally before sex. Keep in mind that since they don’t protect against STD’s, they are typically used in combination with other forms of birth control.

What to Know About Octoxynol-10 in Flu Vaccines

Octoxynol-10 is an important ingredient of flu vaccines and is mostly filtered out of the final vaccine.

More About Octoxynol-10 in Flu Vaccines

How Quickly Can You Debunk Anti-Vaccine Propaganda?

It is well known that much of the stuff on anti-vaccine websites is pure misinformation that is simply put out there to scare parents away from vaccinating and protecting their kids.

At least it is well known by the people who understand that vaccines are safe, vaccines are necessary, and that vaccines work.

If you are on the fence or hesitant to vaccinate your kids, you might not be so sure and might not know who to trust when it comes to getting information about vaccines.

That’s why it is important to get educated, be skeptical, and do your own research.

How Quickly Can You Debunk Anti-Vaccine Propaganda?

What do you think about the following photo description that is making the rounds on anti-vaccine websites and on Facebook?

How quickly could you figure out if the information is true or not?

Is this a photo of kids in iron lungs because of the Cutter Incident?
Is this a photo of kids in iron lungs because of the Cutter Incident?

Of course, the Cutter Incident is actually true and plenty of folks ended up in iron lungs, mostly because of natural polio infections though, not because of the polio vaccine.

“In 1952 alone, nearly 60,000 children were infected with the virus; thousands were paralyzed, and more than 3,000 died.”

Jason Beaubien on Wiping Out Polio: How The U.S. Snuffed Out A Killer

Let’s start doing some research…

The first clue that this isn’t real is that the cases from the Cutter Incident would have been spread out over the five Western and mid-Western USA states where kids got this particular polio vaccine. With about 200 of them severely affected, they almost certainly would not have had such a large group of people in iron lungs, enough to fill a gymnasium, in just one area.

The next clue is that the iron lungs aren’t plugged in.

That led me to a quick search for ‘iron lung photos’ and an article on Understanding Historical Photos that features the iconic “Iron lungs in gym” photo.

“At first glance, this image shocks and saddens from the enormity of the problem of sick children in need of iron lungs. On closer examination, it is clear that the equipment that usually accompanied people using iron lungs, such as tracheotomy tubes and pumps and tankside tables, is not present (compare the picture to photographs in the section on the iron lung). This scene was staged for a film. It is not historically accurate as a respirator ward, but is an example of an established photographic technique (famously used, for example, by WPA photographers in the 1930s) of directing the viewer’s response by creating a shot that would not naturally occur. ”

Smithsonian National Museum of American History on Understanding Historical Photos

A little more research helped me discover that the photo was taken:

  • for an informational film that was being produced by the March of Dimes
  • in the auditorium of the Rancho Los Amigos National Rehabilitation Center in Downey, California USA
  • in 1953

So it took less than a few minutes to figure out that the folks who claim to be “exposing the truth” about vaccines are pushing pure propaganda.

Remember, the Cutter Incident happened in 1955, two years after this photo was taken…

So, a staged 1953 photo for an informational movie for the March of Dimes does not show kids in iron lungs from the Cutter Incident!

How long would you have believed this or other polio myths?

How long would it take you to debunk them?

What to Know About Debunking Anti-Vaccine Propaganda

Learn just how quickly most anti-vaccine misinformation can be debunked if you simply practice being a little skeptical and do your own research.

More About Debunking Anti-Vaccine Propaganda

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Explaining the Correlation of Autism After Vaccines

Vaccines have nothing to do with autism.

It’s not the MMR vaccine. It’s not thimerosal. It’s not anything else about vaccines.

It has been proven time and again.

“The parental focus on vaccines as a possible cause of autism has been encouraged by the recent growth in popularity of ‘unorthodox biomedical’ theories and therapies in autism…”

Fitzpatrick on MMR: risk, choice, chance

Not surprisingly, that hasn’t stopped some parents from continuing to blame vaccines, mostly because they didn’t notice any symptoms of autism until after their child got their routine vaccines as a toddler.

Recognizing the Early Signs of Autism

In 2007, the American Academy of Pediatrics issued guidelines for universal screening of all children for autism at 18 and 24 months. Since then, many kids are getting diagnosed at an earlier age.

That’s good news, as an earlier diagnosis should mean that more kids will be able to benefit from earlier supports and accommodations.

“…the average age of diagnosis for those born before 2005 was just under four years old; for those born during during or after 2005, it was roughly two-and-a-half years old.”

AAP on Children are Diagnosed with Autism at Younger Ages Since Push for Universal Screening

Looking at the early signs and symptoms of autism, it is easy to see why autism isn’t always recognized that early, even with a screening tool, like the M-CHAT-R:

  • What if you don’t recognize that your child isn’t really speaking single words because he or she is simply parroting or echoing what you are saying without knowing what the words mean?
  • What if you don’t recognize that your child isn’t responding to his name being called because he responds to other noises, so sometimes coincidentally turns when you call his name?
  • What if you don’t recognize that your child isn’t bringing objects to share with you (as an interest), because he or she sometimes will bring them to you to have you help open or use them?

And if your child is eventually diagnosed with autism, will you recognize that those were early signs that were just difficult to detect, or just think that your child didn’t have any developmental differences and then lost those skills?

Explaining the Correlation of Autism After Vaccines

Many people understand the idea that “correlation doesn’t imply causation.”

So just because your child was vaccinated and you soon noticed signs and symptoms of autism, that doesn’t mean that it is really linked to vaccines.

Temporal binding is a phenomenon that reinforces that assumption of cause and effect once we have linked two events causally in our minds. The effect biases our memory so that we remember the apparent cause and effect occurring closer together in time. In experiments we tend to remember the cause as happening later and the effect happening earlier.”

Steven Novella

Of course, a phrase about correlation and causation isn’t going to be enough of an explanation for most parents, especially if they have already heard a bunch of vaccine scare stories.

Fortunately, there is plenty of evidence to back up that idea, including that:

  • many studies have shown that there is no link between vaccines and autism
  • unvaccinated kids develop signs and symptoms of autism at the same time as children who were vaccinated
  • some studies have shown that even when parents think that their child’s first signs and symptoms of autism didn’t occur until right after a specific vaccine, like the 12 month MMR shot, when experts looked at the child’s home movies, they could detect subtle signs at a much earlier age, well before the child got those vaccines
  • while regressive autism is real and some kids with autism regress significantly in their development, losing many of the early skills they had picked up, even then, these children often had some subtle, early developmental delays. They don’t usually have a sudden regressive type of autism.

What about package inserts? Don’t they say vaccines cause autism? No, they do not.

And all of the studies that anti-vax folks say support a link between vaccines and autism? They aren’t what you think they are.

Mostly remember that the scientific evidence overwhelming supports the fact that vaccines have absolutely nothing to do with autism!

What to Know About the Correlation of Autism After Vaccines

Vaccines having nothing to do with autism, even though it might sometimes seem to you that your child’s signs and symptoms of autism are correlated with recently getting vaccinated.

More About Explaining the Correlation of Autism After Vaccines

Vaccine Schedule for Children with Down Syndrome

Has someone got you thinking that you need to skip or delay some vaccines for your child with Down syndrome?

Just because your child has Down syndrome doesn't mean that you should skip or delay any of their vaccines.
Just because your child has Down syndrome doesn’t mean that you should skip or delay any of their vaccines. Photo by Melissa Wall (CC BY 2.0)

Are you now on the fence and looking for a specific vaccine schedule for children with Down syndrome?

Vaccine Schedule for Children with Down Syndrome

Vaccine schedules for children with Down syndrome are quite easy to find.

They are the same as the vaccine schedules for every other children!

Unless they have another medical contraindication, there is no reason to skip or delay any of your child’s vaccines just because they have Down syndrome.

“Administer pneumococcal vaccine, as well as other vaccines recommended for all children unless there are specific contraindications.”

American Academy of Pediatrics Health Supervision for Children With Down Syndrome

In fact, because people with Down syndrome can be more susceptible to some infections, it is extra important that they be vaccinated on time, including that they get a yearly flu shot.

Do they need any extra vaccines?

Many  experts recommend that children with Down syndrome get a dose of the Pneumovax vaccine (pneumococcal polysaccharide vaccine or PPSV23) when they are at least two years old and at least eight weeks after completing their Prevnar 13 series. While the ACIP guidelines for Pneumovax doesn’t specifically mention Down syndrome, they do say that the vaccine is important for some children with chronic medical conditions and immune system problems.

“Well child care: immunizations; If chronic cardiac or pulmonary disease, give 23-valent pneumococcal vaccine age > 2 years.”

National Down Syndrome Society Guide for New and Expectant Parents

Talk to your pediatrician to see if your child with Down syndrome needs Pneumovax, especially if they get sick a lot or have chronic heart or lung problems. Some kids might even need a second dose of Pneumovax five years after the first dose.

What to Know About Vaccines and Down Syndrome

Your child with Down syndrome should be fully vaccinated on time without any delays, as there are no contraindications and he or she could be at increased risk for some infections.

More About Vaccines and Down Syndrome

 

Who Is Poul Thorsen?

Part of the propaganda machine of the anti-vaccine movement is pushing the idea that there is some big conspiracy being hidden by doctors all over the world, the CDC, and Big Pharma – and maybe some Reptilians…

The case of Poul Thorsen is everything they are looking for.

What could be better than a fugitive CDC researcher who published studies that dispute a link between vaccines and autism?

How about a story about a story of a fugitive CDC researcher that everyone is trying to cover up and keep secret?

Or a story about a fugitive CDC researcher who used “crooked research” and tricks “to deceive the public about the evidence linking mercury laced vaccines to autism.”

Who Is Poul Thorsen?

As you might expect, as they did with the so-called CDC Whistle blower, anti-vaccine folks have gotten a little too excited about Poul Thorsen.

Poul Thorsen is one of the Office of Inspector General's most wanted fugitives.
Poul Thorsen is one of the Office of Inspector General’s most wanted fugitives.

Yes, it is terrible that he is accused of stealing grant money that had been awarded “to fund studies of the relationship between autism and the exposure to vaccines, the relationship between cerebral palsy and infection during pregnancy, and the relationship between developmental outcomes and fetal alcohol exposure.”

“Unfortunately, a considerable shortfall in funding at Aarhus University associated with the CDC grant was discovered. In investigating the shortfalls associated with the grant, DASTI and Aarhus University became aware of two alleged CDC funding documents as well as a letter regarding funding commitments allegedly written by Randolph B. Williams of CDC’s Procurement Grants Office which was used to secure advances from Aarhus University. Upon investigation by CDC, a suspicion arose that the documents are forgeries.”

Aarhus Universitet Statement regarding Dr. Poul Thorsen’s involvement in Aarhus University projects 

Over at least six years, Thorsen is said to have diverted over $1 million dollars in CDC grant money to his personal bank account and was indicted on 22 counts of Wire Fraud and Money Laundering. He is currently living and working in Denmark, but not at Aarhus University, from where he resigned in 2009.

Myths About Poul Thorsen

Is anyone trying to keep what he did a secret?

If they are, they are doing a poor job of it, as everything he did is listed on his OIG Fugitive Profile. In addition to Thorsen, who is no longer among their most wanted fugitives, the U.S. Department of Health & Human Services is seeking more than 170 other fugitives “on charges related to health care fraud and abuse.”

More importantly though, did his alleged Wire Fraud and Money Laundering activities affect the research with which he is associated?

As his main vaccine and autism studies were published before 2004, it is hard to understand why they would be:

  • Madsen KM, Hviid A, Vestergaard M, Schendel D, Wohlfahrt J, Thorsen P, Olsen J, Melbye M. A population-based study of measles, mumps, and rubella vaccination and autism. N Engl J Med. 2002 Nov 7;347(19):1477-82.
  • Madsen KM, Lauritsen MB, Pedersen CB, Thorsen P, Plesner AM, Andersen PH, Mortensen PB. Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data. Pediatrics. 2003 Sep;112(3 Pt 1):604-6

For one thing, Thorsen is not one of the lead authors in either study – the researchers who made the most significant contributions to the study. His collaborators have even said that Thorsen did not have the ability to influence the scientific results of those studies.

Andrew Wakefield was the lead author on his retracted paper.
Andrew Wakefield was the lead author on his retracted paper. His name came first.

Have subsequent studies found an increased incidence of autism in Denmark, as some Thorsen critics suggest? No. That isn’t even true. Amazingly, even the studies they cite as their evidence, like one by Grønborg, don’t show that!

And there are many other studies that have replicated and confirm Madsen’s (Thorsen’s) finding – vaccines don’t cause autism.

Show Me The Money

But where did the money go?

While “bank records show that he bought a home in Atlanta, a Harley Davidson motorcycle, an Audi automobile, and a Honda SUV with funds that he received from the CDC grants,” it seems like he spent an awful lot of money building up NANEA, his research unit in Denmark – the North Atlantic Neuro-Epidemiology Alliance. For example, these folks didn’t fly coach – they traveled nicely, used limos, stayed at nice hotels, and had fancy parties, as Thorsen thought this was the way to build the world’s best research institution.

So did he really steal all of the money or simply mismanage it?

Either would have been quite easy, as it doesn’t seem like the folks in Denmark required him to file necessary financial status reports. While Thorsen should have been filing status reports after the end of each budget period, no one actually knew what he had been doing with the money for at least the first seven years of the grant period!

Is he on the run from Interpol, as his critics claim?

He doesn’t seem to be, as he is living and working in Denmark.

While he was charged at least three times with tax evasion, those charges were dismissed each time and ultimately rejected by the Vestre Landsret, the highest court in Denmark.

Will he be extradited to the United States? I have absolutely no idea how extradition treaties work, so I won’t comment on that, but it does not seem very likely that a country would extradite one of it’s own citizens to another country for charges like this…

I do know that there is no evidence that the crimes for which Poul Thorsen is accused tainted his research or change the fact that vaccines do not cause autism.

What to Know About Poul Thorsen

Poul Thorsen was a CDC researcher from Denmark who is accused of stealing grant money that was supposed to be used to study fetal alcohol syndrome, cerebral palsy, and possible links between vaccines and autism.

More About Poul Thorsen

Which Vaccines Are Gluten Free?

Why does gluten sometimes come up in discussions about vaccines?

Is it because a vaccine to treat people with Celiac disease is being tested?

Probably not.

It is more likely that it is because some people worry that vaccines contain gluten.

Which Vaccines Are Gluten-Free?

So which vaccines are gluten-free?

All vaccines are gluten-free. Do they need to labeled 'gluten-free' to convince some vaccine hesitant folks?
All vaccines are gluten-free. Do they need to labeled ‘gluten-free’ to convince some vaccine hesitant folks?

Fortunately, they all are, so you don’t have to worry about skipping or delaying your child’s vaccines if they have Celiac disease, a gluten sensitivity, or if you are simply following a gluten-free diet.

Vaccines and Food Allergies

Non-active components of vaccines can rarely trigger allergic reactions, including antibiotics and latex.

What about non-active vaccine ingredients that might worry someone with food allergies?

There actually are some, including eggs, milk, gelatin, and yeast.

Talk to your pediatrician or a pediatric allergist if you are concerned about vaccine allergies. They can review the “Algorithm for treatment of patients with hypersensitivity reactions after vaccines,” which “provides a rational and organized approach for the evaluation and treatment of patients with suspected hypersensitivity.”

This is especially important if you think that your child is allergic to all vaccines, something that is almost unheard of, as vaccines have different components and are made in different ways.

You don’t have to worry about gluten though.

What To Know About Vaccines and Gluten

There is no gluten in vaccines and vaccines are actually in development to treat people with gluten sensitivity.

For More Information on Vaccine Allergies

 

Buying a Vaccine Refrigerator

Except for a few vaccines that must be frozen, vaccines must be refrigerated.

vaccine-refrigerator
Vaccines must be stored properly at the right temperature or they will lose their potency. Photo by Suplee/NIST

These vaccines should be stored in a vaccine refrigerator at a temperature between 36°F and 46°F (2°C and 8°C), with a target of 40°F (5°C).

You can’t just put vaccines in any old refrigerator though.

Buying a Vaccine Refrigerator

Although there are many types of refrigerators in which you could store your vaccines, ideally, a pediatrician’s best and safest option is a biologic-grade, full-sized, stand-alone refrigerator.

You have options though.

A dormitory style refrigerator is not one of them. However, although it is discouraged, you can use a stand-alone household refrigerator. Just don’t store anything besides vaccines in it at the same time! And make plans to replace it with a medical-grade refrigerator as soon as you possibly can.

Choosing the Best Vaccine Storage Refrigerator

Among the key features to look for when buying a vaccine refrigerator, include:

  • an electronic, microprocessor controlled, digital thermostat, avoiding a mechanical or analog thermostat or dial
  • user programmable temperature alarming in case the refrigerator temperature begins to get too hot or too cold
  • remote alarm contacts
  • an external temperature display so that you don’t have to open the refrigerator door to check the air temperature
  • adjustable wire shelving, instead of solid shelving, to improve circulation
  • a probe access port to allow the entry of a temperature probe wire
  • interior fan-forced air circulation to equalize the temperature throughout the refrigerator
  • a solid door, instead of a glass door, as a solid door will maintain the refrigerator’s temperature longer if the power goes out, although a glass door can help with inventory control
  • an audible door alarm, so that you are alerted if the door is left open
  • a self-closing door
  • a keyed door lock with multiple keys
  • a refrigerator that is large enough to fit all of your inventory without any crowding, especially when you have a full stock of vaccines, including flu vaccines, at your busiest time of year (this is your maximum stock level or calculated peak dose inventory). Remember that you also need extra space for water bottles to help stabilize the temperature during power failures.

And make sure your new vaccine storage refrigerator fits where you want to put it and that the door opens in the direction (right vs left hinged, as they are usually not reversible) that you need it to.

How big of a vaccine refrigerator do you need? The Missouri Dept of Health and Human Service provide a rough guide.
How big of a vaccine refrigerator do you need? The Missouri Dept of Health and Human Service provide a rough guide.

Biologic grade vaccine refrigerators are available from the following companies:

Choosing a vaccine refrigerator can be confusing, especially since most seem to have all of the features that the CDC and other experts recommend that you look for.

To make it a little easier, consider starting your search with these popular vaccine storage refrigerators (not endorsements):

Since price is going to be a factor, be sure to ask the sales rep for your medical supplies which vaccine refrigerators they can get the best deals on.

And make sure your refrigerator meets any other requirements that you have, especially if you are a Vaccines for Children provider.

What to Know About Buying a Vaccine Refrigerator

Do your research and choose a vaccine storage refrigerator that can easily store all of vaccines without crowding and which has key features to keep them safe and at the proper temperature.

More About Buying a Vaccine Refrigerator

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