Money and Motivation of the Anti-Vaccine Movement

We often hear the argument that anyone who supports the ideas that vaccines work and that they are safe and necessary must be a shill for Big Pharma. And that pediatricians, even though they are among the lowest paid doctors, are making tons of money from vaccines and even getting bonuses to get kids vaccinated.

Of course, none of these myths and conspiracy theories are true.

Money and Motivation of the Anti-Vaccine Movement

But guess what motivates many of the folks in the anti-vaccine movement?

“Vaccines are a holocaust of poison on our children’s brains and immune systems.”

Claire Dwoskin

For some, it is the idea that vaccines damaged their child.

And then there’s the money.

CNN did a report several years ago on how a few groups were funding researchers and organizations that put out much of the material that scare parents away from vaccinating and protecting their kids.

It wasn’t a surprise though. Many others had been saying the same things for years about:

  • the Dwoskin Family Foundation and CMSRI
  • Barry Segal and Focus for Health
  • JB Handley and Generation Rescue

But anti-vaccine experts aren’t just motivated by the money they directly get from those with deep pockets.

Selling supplements is big business for integrative, holistic, and anti-vaccine folks.
Selling supplements is big business for integrative, holistic, and anti-vaccine folks.

They have discovered many ways to turn the anti-vaccine movement into a money making industry.

Paul Thomas doesn't mention that he gets a big cut of the sales for a "free" summit that costs $197 as he promotes his anti-vaccine lecture.
Paul Thomas doesn’t mention that he gets a big cut of the sales for a “free” summit that costs $197 as he promotes his anti-vaccine lecture.

Many of these folks also get money by:

  • selling anti-vaccine books, e-books, videos, seminars, and movies
  • getting paid to speak at anti-vaccine conferences and summits, often for chiropractors or folks like Gwyneth Paltrow, pushing her GOOP
  • selling supplements and vitamins in a “wellness” store, either online or in their offices, that they claim can detox you from vaccines, protect you from toxins, and even prevent autism
  • ads on their websites and Facebook pages
  • appearing as “experts” in court, as they push the idea that everything is a vaccine injury
  • soliciting donations

Those who are health care providers can also establish integrative or holistic medical practices that don’t accept insurance and only see patients that can pay cash. In addition to selling supplements, these providers offer unproven and disproven alternative therapies, like homeopathy, integrative testing, IV therapy, and cranio-sacral therapy.

Does your holistic pediatrician accept insurance?
Does your holistic pediatrician accept insurance?

But only if you have plenty of cash handy.

Kelly Brogan, MD, for example, who believes in a paleo approach to vaccines and thinks we should co-exist with viruses and bacteria, charges up to $4,497 for your first appointment! But if that’s too much for you, for only $997, you can start living a “happy, healthier life” with her 44 day online program.

“We coexist with bacteria and viruses to a level of enmeshment that makes the perception of ‘vaccine-preventable infections’ a laughable notion.”

Kelly Brogan, MD on Where do Vaccines Fit into a Paleo Lifestyle?

And now, some doctors are even making money by selling vaccine exemptions!

Oliver argued that Sears likes to have it both ways, seeming to support science-based medicine while once in a while saying things like “vaccines don’t cause autism except when they do.”

The line inspired Oliver to fire back with this: “Don’t worry, opportunist quacks writing books that fan the flames of people’s unfounded fears don’t cause a legitimate public health hazard, except when they do.”

John Oliver takes a shot at the anti-vaccine movement and the ‘opportunistic quacks’ behind it

Mostly they just sell fear though.

But that’s all they need to get their foot in the door and keep some parents from vaccinating and protecting their kids.

What to Know About the Money and Motivation of the Anti-Vaccine Movement

Although they cry Big Pharma at the drop of a hat, it should be clear that folks in the anti-vaccine movement are often motivated by money.

More on the Money and Motivation of the Anti-Vaccine Movement

Vaccines and Hemophilia

Kids with hemophilia bleed.

The Medical and Scientific Advisory Council of the National Hemophilia Foundation recommends "that patients with bleeding disorders continue to follow the American Academy of Pediatrics’ and CDC’s vaccine recommendation route and schedule for their age."
The Medical and Scientific Advisory Council of the National Hemophilia Foundation recommends “that patients with bleeding disorders continue to follow the American Academy of Pediatrics’ and CDC’s vaccine recommendation route and schedule for their age.”

They bleed into their joints, into their skin (hematoma), and from their mouth and gums. They can bleed after surgery and even after getting their vaccinations.

Vaccines and Hemophilia

Having hemophilia is certainly not a contraindication to getting vaccinated though.

“Your child should get regular immunizations with necessary precautions to prevent bleeding from the injection sites.”

Hemophilia FAQs

There are some precautions that are recommended before giving vaccines to a child with hemophilia, including:

  • using a 23-gauge or smaller caliber fine-gauge needle – consider a 25- or 27-gauge needle
  • when possible, giving the vaccine SQ instead of IM – for example, although the IPV (polio), hepatitis A, and hepatitis B vaccines are usually given IM, studies have shown that they can be given SQ to kids with hemophilia
  • applying firm pressure, without rubbing, after the vaccine is given for at least two minutes and up to 5 to 10 minutes
  • giving acetaminophen for pain relief, if necessary, instead of ibuprofen
  • warning about the risk of a hematoma developing at the injection site

Most importantly, if the child with hemophilia is already getting routine prophylaxis to prevent bleeding, schedule their vaccines around the same time to decrease the risk of bleeding.

Your child’s hematologist will likely give you specific instructions to provide to your pediatrician regarding immunization precautions.

What to Know About Vaccines and Hemophilia

Kids with hemophilia should get all of their vaccines on schedule, but precautions should be taken to decrease the chance of bleeding after getting an immunization.

More About Vaccines and Hemophilia

What Shots Do You Need to Be Around a Newborn?

We often focus on what vaccines a baby will need once they are born, but it is also important that folks around your new baby get vaccinated too.

What Shots Do You Need to Be Around a Newborn?

To protect their new baby, many parents institute a no visit policy for friends and family members who don't get vaccinated.
To protect their new baby, many parents institute a no visit policy for friends and family members who don’t get vaccinated.

Of course, all of your vaccines should be up-to-date, especially if you plan to be around young kids. That’s how we maintain herd immunity levels of protection for those who can’t be vaccinated and protected, including newborns who are too young to be vaccinated.

In addition to routine vaccines, it is especially important that teens and adults who are going to be around a newborn or younger infant have:

  • a dose of Tdap – now routinely given to kids when they are 11 to 12 years old and to women during each pregnancy (to protect newborns against pertussis), others should get a dose if they have never had one. There are currently no recommendations for a booster dose.
  • a flu shot – is it flu season? Then anyone who is going to be around your baby should have had a flu shot. And for the purposes of keeping a newborn safe from the flu, you can assume that flu season extends from September through May, or anytime that flu shots are still available.

That’s it?

Only two shots?

Yes, only two shots assuming you are either immune or are up-to-date on your other vaccines. If you have been delaying or skipping any vaccines, then you might need an MMR, the chicken pox vaccine, and whatever else you are missing.

Other Precautions Around a New Baby

Unfortunately, there are many risks to a new baby that aren’t vaccine preventable.

Just because everyone is vaccinated and protected, that doesn’t mean that you should have a party welcoming your baby home and invite everyone in the neighborhood. Besides the flu, we get concerned about other cold and flu-like viruses, especially RSV.

That means to protect them, you should keep your baby away from:

  • large crowds, or even small crowds for that matter – in general, the more people that your baby is exposed to, the higher the chance that they will catch something
  • people who are sick
  • cigarette smoke – second hand smoke increases the risk of infections, like RSV

And make sure everyone, even if they don’t seem sick, washes their hands well before handling your baby.

“Parents or relatives with cold sores should be especially careful not to kiss babies—their immune systems are not well developed until after about 6 months old.”

AAP on Cold Sores in Children: About the Herpes Simplex Virus

Because you can sometimes be contagious even if you don’t have an active cold sore (fever blister), some parents don’t let anyone kiss their baby. Most of this fear comes after news reports of babies getting severe or life-threatening herpes infections after a probable kiss from a family member or friend.

When Can I Take My Newborn Out in Public?

When can you take your baby out in public? Most people try to wait until they are at least two months old.

Is that because that’s when they are protected with their two month shots?

Not really, as your baby won’t really be protected until they complete the primary series of infant vaccinations at six months.

Two months is a good general rule though, because by that age, if your baby gets a cold virus and a fever, it won’t necessarily mean a big work-up and a lot of testing. Before about six weeks, babies routinely get a lot of testing to figure out why they have a fever (the septic workup), even if it might be caused by a virus. That’s because younger infants are at risk for sepsis, UTI’s, and meningitis and they often have few signs when they are sick.

Keep in mind that going out in public is much different from going out. You can go for a walk with your baby at almost any time, as long as they are protected from the sun, bugs, and wind, etc., as long as there aren’t people around.

What to Know About Protecting Newborn Babies

Protect your baby by making sure everyone around them is vaccinated and protected, especially with a dose of Tdap and the flu vaccine.

More on Protecting Newborn Babies

Answers To Frequently Asked Questions About Immunizations

Have questions about your child’s immunizations?

We probably have the answers.

Answers To Frequently Asked Questions About Immunizations

Not surprisingly, many parents have the same questions about immunizations and they want answers to reassure themselves that they are doing the right thing for their kids by getting them vaccinated and protected.

Still have questions?

Rotavirus vaccines are associated with a very small risk of intussusception, but that is not a good reason to miss the benefits of this vaccine.
Like most pediatricians, my kids are vaccinated and protected. Photo by Vincent Iannelli, MD

With so much misinformation out there scaring folks about vaccines, that’s not surprising.

Just keep in mind that every anti-vaccine talking point and myth they push has an easy answer, even as folks continue to move the goalposts in search of new arguments against vaccines.

Yesterday it was mercury. Today it’s aluminum. Tomorrow it will be something else, while they continue to use vaccine scare videos to make you think that vaccines aren’t safe.

Parents who do their research understand that the real threat to their kids isn’t vaccines, it is the anti-vaccine experts that continue to push propaganda about vaccines.

What to Know About Answers To Frequently Asked Questions About Immunizations

The most basic answers to your questions about vaccines are that while vaccines aren’t perfect, they are safe and necessary and they do work well to protect us from vaccine-preventable disease.

More on Frequently Asked Questions About Immunizations

What Are the Changes in the 2018 Immunization Schedules?

As they do every year, the Advisory Committee on Immunization Practices (ACIP) just released an updated immunization schedule.

The 2018 immunization schedule didn't bring any changes for most kids.
The 2018 immunization schedule doesn’t bring any changes for most kids.

And just like in most other recent years, there were few big changes or announcements.

That means that most kids won’t need any extra shots when they go to their next well check up with their pediatrician or to start school.

What Are the Changes in the 2018 Immunization Schedules?

There are some changes though…

  • A third dose of MMR is now recommended for some people during outbreaks of mumps.
  • MenHibrix was removed from the schedule, which was expected, as this combination meningococcal vaccine for high risk kids was discontinued in 2016 because of low demand. Fortunately, this doesn’t mean that any kids will be left unprotected. They can just get one of the other meningococcal vaccines if they need it, with a separate Hib vaccine, just like other infants.
  • Menomune was removed from the schedule, which was expected, as this older meningococcal vaccine was discontinued in 2017, as it was replaced with the newer meningococcal conjugate vaccines (Menactra and Menveo).
  • Shingrix, the new recombinant shingles vaccine is added to the schedule for adults aged 50 or older. They should get 2 doses 2 to 6 months apart, even if they have had shingles in the past or have had the older Zostavax already. And Shingrix becomes the preferred shingles vaccine for those who are at least 60 years old.

The other changes are to the formatting of the schedule and schedule footnotes.

“The schedule footnotes are presented in a new simplified format. The goal was to remove unnecessary text while preserving all pertinent information and maintaining clarity. This was accomplished by a transition from complete sentences to bullets, removal of unnecessary or redundant language, and formatting changes.”

CDC on Changes to This Year’s Schedule

So, unless your child is in a mumps outbreak, the new immunization schedule shouldn’t mean any extra vaccines.

What to Know About the 2018 Immunization Schedule

The 2018 immunization schedule from the CDC, AAP, ACOG, and AAFP incorporates the latest recommendations from the ACIP, including that folks in a mumps outbreak might need a third dose of MMR.

More on the 2018 Immunization Schedule

How to Claim a Vaccine Exemption

Don’t want to get your kids vaccinated?

You might be surprised to know that no one is out there trying to force you into vaccinating them.

Want to enroll your kids in daycare, preschool, school, or college?

Then they will need to be vaccinated.

How to Claim a Vaccine Exemption

Of course, depending on where you live, you could get a vaccine exemption and leave your kids unvaccinated and unprotected.

Does your child qualify for a medical exemption? All states allow kids to claim medical exemptions to getting vaccinated. True medical exemptions are rare though, as you can see from the rates in states that actually require screening and approval of medical vaccine exemptions.

Are you a Christian Scientist? In 47 states, laws allow religious exemptions to vaccinations. Ironically, these exemptions are often abused, as you don’t actually need to belong to a religion that is against vaccines to claim a religious exemption to vaccinations.

“When you are challenged by the viewpoint of a denomination, pastor, publication, or atheist authority: You do not worship any pastor, church, religious publication, or denomination. Your pastor’s personal view on vaccines is irrelevant to your stance because pastors do not learn about the biblical implications of vaccinating during seminary and your pastor isn’t God. (Though if you have a pastor willing to go to bat for you, use him.)”

Megan on How To Get a Vaccine Religious Exemption Like a Boss

It is not even a secret that parents abuse the religious vaccine exemption, claiming them even when they don’t have a sincere religious belief against getting vaccinated.

And in 20 states, it is even easier to claim a vaccine exemption. These are the states that allow philosophical or personal belief vaccine exemptions, in which you can typically just say that you are against vaccinating and protecting your kids “for reasons of conscience.”

Vaccine exemptions are too easy to get in some states, but even with an exemption, your child will still be excluded if there is an outbreak.
Vaccine exemptions are too easy to get in some states, but even with an exemption, your child will still be excluded if there is an outbreak.

What reasons? You don’t usually have to go into much detail…

Why Parents Abuse Vaccine Exemptions

It is not hard to understand why some parents abuse vaccine exemptions.

They abuse vaccine exemptions because they can.

In many states, it is easy to abuse vaccine exemptions because medical exemptions aren’t verified and approved and it is often easier and more convenient to get an exemption than to get vaccinated. Believe it or not, some doctors will even sell you a medical exemption for your child. Also, parents are made to feel so scared by anti-vaccine propaganda that they think that they need to get an exemption.

“Permitting personal belief exemptions and easily granting exemptions are associated with higher and increasing nonmedical US exemption rates. State policies granting personal belief exemptions and states that easily grant exemptions are associated with increased pertussis incidence.”

Omer et al on Nonmedical exemptions to school immunization requirements: secular trends and association of state policies with pertussis incidence.

But just because you can claim an easy exemption in a state without strong vaccine exemption laws doesn’t mean that you should.

While there are no benefits to delaying or skipping vaccines, there are plenty of risks. And the risks aren’t just to your unvaccinated child. We continue to see and hear about kids who are too young to be vaccinated or who couldn’t be vaccinated getting caught up in outbreaks caused by others who simply chose to not get vaccinated.

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”

Dr. Bob Sears in The Vaccine Book

Not surprisingly, websites and organizations that give advice on getting kids easy vaccine exemptions never mention these risks. They also overstate the risks of vaccines and don’t mention the benefits of getting vaccinated.

Vaccines are safe and necessary. Unless your child has a true medical contraindication to getting one or more vaccines, do a little more research before getting a non-medical exemption.

What to Know About Claiming a Vaccine Exemption

While it is typically not hard to claim a vaccine exemption for your child, since vaccines are safe and necessary, be sure you understand the risks of delaying or skipping any vaccines if your child doesn’t need a true medical exemption.

More on Claiming a Vaccine Exemption

 

What to Do If Your Child Is Exposed to Measles

Although the endemic spread of measles was eliminated way back in 2000, we still have measles outbreaks in the United States.

How does that work?

They are usually imported from outside the country, often by an unvaccinated child or adult who travels overseas, gets measles, and returns while still contagious.

How Contagious is Measles?

Measles is highly contagious.

“Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected.”

CDC on Transmission of Measles

In addition to the fact that people with measles are contagious for at least four days before they develop the classic measles rash until four days after, the measles virus can survive for up to two hours in the air and on contaminated surfaces wherever that person cough or sneezed. So you don’t technically need to even be in direct contact with the person with measles – simply entering a room or getting on a bus that the infected person recently left can do it.

An infant hospitalized during a measles outbreak in the Philippines in which 110 people died.
An infant hospitalized during a measles outbreak in the Philippines in which 110 people died. Photo by Jim Goodson, M.P.H.

Still, you are not going to get measles from simply being in the same city as someone else with measles.

The tricky part though, is knowing what to do if your child is exposed to someone with measles, even if you think they are up-to-date with their vaccines.

Remember, kids get their first dose of MMR when they are 12 to 15 months old. While the second dose of MMR isn’t typically given until just before kids start kindergarten, when they are 4 to 6 years old, it can be given earlier. In fact, it can be given anytime after your child’s first birthday, as long as 28 days have passed since their first dose.

“Evidence of adequate vaccination for school-aged children, college students, and students in other postsecondary educational institutions who are at risk for exposure and infection during measles and mumps outbreaks consists of 2 doses of measles- or mumps-containing vaccine separated by at least 28 days, respectively. If the outbreak affects preschool-aged children or adults with community-wide transmission, a second dose should be considered for children aged 1 through 4 years or adults who have received 1 dose. In addition, during measles outbreaks involving infants aged <12 months with ongoing risk for exposure, infants aged ≥6 months can be vaccinated.”

CDC on Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices

And although it won’t count as their first dose, in special situations, kids can get an early MMR once they are six months old.

What to Do If Your Unvaccinated Child Is Exposed to Measles

To be considered fully vaccinated and protected against measles, kids need two doses of MMR – one at 12 to 15 months and another when they are 4 to 6 years.

“During measles, rubella, or mumps outbreaks, efforts should be made to ensure that all persons at risk for exposure and infection are vaccinated or have other acceptable evidence of immunity.”

CDC on Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices

If your unvaccinated child is exposed to measles, you should talk to your pediatrician or local health department about starting post-exposure prophylaxis as soon as possible, including:

  • a dose of immune globulin (IGIM) if they are less than 6 months old
  • either a dose of immune globulin (IGIM) or the MMR vaccine if they are between 6 and 12 months old (this dose of MMR doesn’t count as the first dose of MMR on the immunization schedule and will need to be repeated when the child turns 12 months old)
  • a dose of the MMR vaccine if they are at least 12 months old
  • a dose of immune globulin (IGIV) if they are severely immunocompromised (even if they were previously vaccinated)

Immune globulin should be given within 6 days of exposure, while a dose of MMR vaccine within 72 hours of exposure can decrease their chances of getting measles.

“Persons who continue to be exempted from or who refuse measles vaccination should be excluded from the school, child care, or other institutions until 21 days after rash onset in the last case of measles.”

Manual for the Surveillance of Vaccine-Preventable Diseases

Be sure to alert your pediatrician if you think your child might have measles or another vaccine-preventable disease.
Be sure to alert your pediatrician if you think your child might have measles or another vaccine-preventable disease.

What if your child is incompletely vaccinated, with just one dose of MMR? They could get their second dose of MMR, as long as they are over 12 months old and it has been at least 28 days since their first dose (see below).

Unvaccinated kids who don’t get post-exposure prophylaxis should be quarantined, as you watch for signs and symptoms of measles developing over the next 21 days. Your child might still need to be quarantined if they got immune globulin instead of the vaccine, and the quarantine might extend to 28 days, as immune globulin can prolong the incubation period.

If your exposed child develops measles, be sure to call your health care provider before going in for a visit, so that they can be prepared to see you and so you don’t expose other people to measles. Your child with suspected measles should be wearing a mask before going out in public and if possible, will be put in a negative pressure room in the emergency room or doctor’s office. If a regular exam room is used, it can not be used again for at least two hours. It is very important to understand that simply wearing a mask doesn’t eliminate the risk that your child with measles could expose others, it just reduces the risk. You still want to avoid other people!

What to Do If Your Vaccinated Child Is Exposed to Measles

If your fully vaccinated child is exposed to measles, does that mean you are in the clear?

Again, it depends on what you mean by fully vaccinated.

Is your child fully vaccinated for his age or has he had two doses of MMR?

Since kids get their first dose of MMR at 12 to 15 months and the second when they are 4 to 6 years old, it is easy to see that many infants, toddlers and preschoolers who are following the immunization schedule are not going to be fully vaccinated against measles, even if they are not skipping or delaying any vaccines.

“In the case of a local outbreak, you also might consider vaccinating children age 12 months and older at the minimum age (12 months, instead of 12 through 15 months) and giving the second dose 4 weeks later (at the minimum interval) instead of waiting until age 4 through 6 years.”

Ask the Experts about MMR

In some cases, documentation of age-appropriate vaccination with at least one dose of MMR is good enough protection, which means that toddlers and preschoolers don’t necessarily need an early second dose. That’s because the focus in controlling an outbreak is often on those folks who don’t have any evidence of immunity – the unvaccinated.

And one dose of MMR is about 95% effective at preventing measles infections. A second dose does increase the vaccine’s effectiveness against measles to over 99%, but it isn’t a booster. The second dose of MMR is for those kids that didn’t respond to the first dose.

“Available data suggest that measles vaccine, if given within 72 hours of measles exposure to susceptible individuals, will provide protection or disease modification in some cases. Measles vaccine should be considered in all exposed individuals who are vaccine-eligible and who have not been vaccinated or have received only 1 dose of vaccine.”

AAP RedBook

An early second dose is a good idea though if your child is exposed to measles, has only had one dose of MMR, and is age-eligible for the second dose (over age 12 months and at least 28 days since the first dose). Your child would eventually get this second dose anyway. Unlike the early dose before 12 months, this early dose will count as the second dose of MMR on the immunization schedule.

You should still watch for signs and symptoms of measles over the next 10 to 21 days though, as no vaccine is 100% effective. Your vaccinated child won’t need to be quarantined though.

Most importantly, in addition to understanding that vaccines are safe and necessary, know that the ultimate guidance and rules for what happens when a child is exposed to measles will depend on your local or state health department.

What to Know About Getting Exposed to Measles

Talk to your pediatrician if your child gets exposed to measles to make sure he doesn’t need post-exposure prophylaxis to keep him from getting sick, even if you think he is up-to-date on his vaccines.

More on Getting Exposed to Measles