Did you actually get the flu in the days or weeks after your flu vaccine?
That’s not a side effect of your flu vaccine. Neither the inactivated flu shot, nor the attenuated FluMist can actually cause a flu infection.
Did you get a little sore at the site where you got your flu shot?
That’s a common side effect to getting a flu shot.
So is having some redness and swelling at the site, all of which begin soon after getting the shot and go away in a few days. You can also get a headache, fever, nausea, and muscle aches or signs and symptoms of an allergic reaction.
Do you have a runny nose or a cough? Side effects of the nasal spray flu vaccine can include a few days of runny nose, wheezing, headache, vomiting, muscle aches, fever, sore throat and cough.
Again, a bad cough and cold after a flu shot isn’t a side effect of the vaccine though.
If you found out you were pregnant shortly after getting a flu shot, you wouldn’t think they were associated, would you?
What about narcolepsy?
“An increased risk of narcolepsy was found following vaccination with Pandemrix, a monovalent 2009 H1N1 influenza vaccine that was used in several European countries during the H1N1 influenza pandemic.”
Narcolepsy Following Pandemrix Influenza Vaccination in Europe
Although the focus has been on the Pandemrix flu vaccine as a trigger for narcolepsy in some countries (the vaccine wasn’t used in the United States), interestingly, several countries that weren’t using the vaccine also saw a spike in narcolepsy cases as the 2009 H1N1 pandemic hit.
What about all of the reports of severe reactions and deaths after getting a flu shot that you might hear about? In addition to vaccine injury stories, those reports are to VAERS and typically are not causally related to getting a vaccine.
Why are there so many reports to VAERS and the NVICP about flu vaccines? Since 2006, over 1.6 trillion doses of flu vaccine have been distributed in the United States, which equals about the total of all other vaccines we use.
What Are the Side Effects of This Year’s Flu Shot
Even when folks understand that flu vaccines don’t typically cause serious side effects, the question always comes up whether or not this year’s flu shot is causing more side effects than usual.
That’s actually not unreasonable, even when you consider that the biggest change in most flu vaccines from year to year is the strain of flu viruses they include, and not any of the other ingredients.
In addition to the Pandemrix flu vaccine, in 2010, the use of one brand of flu vaccines in Australia was suspended because they were causing more side effects (fever and febrile seizures) in young children than expected.
“The studies flesh out preliminary findings from CSL in June 2012, which said that the manufacturing process retained more virus component than that of other manufacturers and that the 2010 virus components triggered an excessive immune response in some young kids.”
CSL studies shed light on 2010 flu vaccine seizures
For those of us who grew up watching ER, Mark Green is a household name.
But that’s not the Mark Green I’m talking about…
Who Is Mark Green?
Mark Green is a soon-to-be congressman, recently elected for Tennessee’s Seventh Congressional District.
A Republican, he is also a doctor. Specifically, he became a Army special operations flight surgeon after completing a residency in emergency medicine.
Of note, Dr. Green has also made horrible statements about transgender people, saying that they have a disease and that they are an evil that must be crushed.
Although his previous statements led him to withdraw as Trump’s pick for Army Secretary, that didn’t keep folks in Tennessee from sending him to Congress.
And now we have his comments about vaccines and autism…
At a recent town hall meeting in Tennessee, Green said:
“Let me say this about autism,” Green said. “I have committed to people in my community, up in Montgomery County, to stand on the CDC’s desk and get the real data on vaccines. Because there is some concern that the rise in autism is the result of the preservatives that are in our vaccines.
“As a physician, I can make that argument and I can look at it academically and make the argument against the CDC, if they really want to engage me on it,” Green said.
Has he apologized?
Despite some saying that he has walked back those claims, his main response has been that his comments had been “misconstrued” and that “I’ve vaccinated my kids and let others know they need to vaccinate theirs too.”
“There appears to be some evidence that as vaccine numbers increase, rates of autism increase,” Green said. “We need better research, and we need it fast. We also need complete transparency of any data. Vaccines are essential to good population health. But that does not mean we should not look closely at the correlation for any causation.”
Except for when he doubled down on his statements trying to associate vaccines with autism…
Statements which seemed to cause the Tennessee chapter of the AAP and the Tennessee Department of Health to issue statements of their own.
“Vaccines do not cause autism.”
Tennessee Department of Health Statement on Immunizations
So, is he going to really apologize for his comments, and perhaps learn a bit more about vaccines, vaccine-preventable disease, and autism?
Fever, pain at the injection site, and redness and swelling where the shot was given are all common, mild problems that can be associated with almost any vaccine.
Some vaccines might also commonly cause fussiness, tiredness or poor appetite, and vomiting within 1 to 3 days of getting the vaccine. Others can cause a rash, headache, or muscle and joint pain for a few days.
Even syncope or fainting can commonly occur within 15 minutes of teens getting a vaccine.
Other vaccine side effects can include persistent crying, nodules at the injection site, limb swelling, and febrile seizures, etc.
These are well known vaccine side effects that are often minor and temporary though.
Is It a Vaccine Injury?
Although the term is typically associated with the anti-vaccine movement, as they tend to think everything is a vaccine injury, it is important to understand that vaccine injuries, although rare, are indeed real.
Dr. Samuel Johnson once said that “It is incident to physicians, I am afraid, beyond all other men, to mistake subsequence for consequence.”
How does this apply to diagnosing vaccine injuries?
Too often we forget that just because one event is subsequent (happens after) another, it does not mean that it was a consequence (was caused by) the first event. It is another way of saying that correlation does not imply causation.
This is also highlighted by missed vaccine stories, events that would surely be blamed on a vaccine injury, except that a vaccine was never actually given for one reason or another.
Most pediatricians have these types of missed vaccine stories, such as:
an infant who begins vomiting on the way home from a well appointment and is diagnosed with intussusception (9 month old visit and didn’t get any vaccines)
a 4 year old who developed encephalitis just one week after his well check up (no vaccines – DTP had been deferred to his 5 year old visit)
a 2 month old who died of SIDS on the night of his scheduled well child visit (no vaccines as they had forgotten to go to the appointment)
a 4 month old who had a seizure at his well child visit (no vaccines were given yet as they were still being drawn up)
Or they have kids who begin to have symptoms or are diagnosed with a condition right around the time of a check up when they would routinely get one or more vaccines, but haven’t yet. From diabetes and POTS to transverse myelitis, some parents would have blamed their child’s vaccines if they had actually been vaccinated at that time and subsequently got diagnosed.
My own son started getting migraines when he was 12 years old and about to start 7th grade. Should I blame his headaches on his middle school booster shots? While it would be convenient, it is more likely that genetics are to blame. I started getting migraines at about the same age, and he began getting them just before he got his booster shots.
Diagnosing Vaccine Injuries
How do you know if your child had a true vaccine injury?
Does the reaction fit into the vaccine injury type AND “time period for first symptom or manifestation of onset or of significant aggravation after vaccine administration” as described in the NVICP vaccine injury tables?
That time period, also known as a risk interval, is when “individuals are considered at risk for the development of a certain adverse event following immunization (AEFI) potentially caused by the vaccine.”
For example, did your child develop an anaphylactic reaction within four hours of getting the DTaP vaccine? While a reaction 14 hours after the vaccine would be much less likely to be caused by the vaccine, if it occurred within 4 hours, that could certainly be a vaccine injury.
How about a child who developed thrombocytopenic purpura 90 days after getting his MMR vaccine? That is unlikely to be a vaccine injury, as the MMR vaccine typically causes TTP within 7 to 30 days.
If you think that your child has had a vaccine injury, be sure to talk to your pediatrician. You should also report any vaccine reaction to Vaccine Adverse Event Reporting System (VAERS) and if you truly believe that your child has been injured by a vaccine, you can file a claim with the National Vaccine Injury Compensation Program (VICP).
“You may file a claim if you received a vaccine covered by the VICP and believe that you have been injured by this vaccine.”
What You Need to Know About the National Vaccine Injury Compensation Program (VICP)
How will your pediatrician figure out if it is a vaccine injury? Among the things that they will consider when evaluating a reaction after a vaccine will be the answers to some key questions, including:
Is there any evidence that something else caused the reaction? While getting a vaccine could cause an anaphylactic reaction, so could the fact that your child just eat a peanut butter and jelly sandwich.
Is there a laboratory test that implicates the vaccine as a cause of the reaction?
If the reaction is an infection, did it have a vaccine or wild type origin?
Your pediatrician will also consider other factors when making a decision, including whether other patients were affected (might implicate a contaminated vaccine), and will make sure that the original diagnosis is correct.
Being able to answer all of these questions often puts pediatricians in the unique position of correctly evaluating potential vaccine injuries. There is even a standardized algorithm that can help your pediatrician collect and interpret all of the data they will get when evaluating a possible vaccine injury.
Another algorithm can help evaluate and manage suspected allergic reactions, including immediate or type 1 hypersensitivity reactions and delayed type 3 hypersensitivity reactions. If the reaction is consistent with an allergic reaction and additional doses of the vaccine are still needed, possible next steps in this algorithm include serologic testing for immunity and skin testing with the vaccine or vaccine components.
For extra help, your pediatrician can consult an allergist or immunologist before considering giving your child another vaccine, if necessary. Experts at the Clinical Immunization Safety Assessment (CISA) are also available for consults about suspected vaccine injuries.
Over-Diagnosing Vaccine Injuries
In addition to vaccine side effects and vaccine injuries, it is much more common for children and adults to develop health problems and symptoms after getting a vaccine that have nothing to do with the vaccine. These are events, sometimes tragic, that would have happened even if they had not been vaccinated.
Despite the evidence against it, some parents may still think that their child has been injured or damaged by a vaccine, especially if they:
For example, studies have repeatedly shown that “vaccination does not increase the overall risk of sudden infant death (SIDS),” and that “the risk of SIDS in vaccinated cases and controls is neither increased nor reduced during the early post-vaccination period.”
So a VAERS report of SIDS on the night that an infant received his 4 month vaccines, while tragic, would likely not end up being classified as a true vaccine injury.
Neither should a case report or package insert about SIDS influence your thinking about SIDS being associated with a vaccine injury.
Still, it is easy to understand why many like to blame vaccines.
Vaccines are an easy target, especially as most vaccine-preventable diseases are under fairly good control compared to the pre-vaccine era. And in some cases of SIDS, a new case of diabetes, or the sudden death of an older child, etc., it may happen soon after the child was vaccinated, and that correlation is hard to ignore for some folks.
At least it is hard to ignore and easy to be influenced by anti-vaccine folks if you don’t understand the background rate of these diseases – or the fact that a certain number of children will be affected no matter what, and because many kids get vaccinated, it is only a matter of chance that the two get correlated together.
“When I undertook the study with the current vaccine strain on my own two triple-negative children and their three playmates, also triple- negatives, I thought: “I am going to do this very carefully now,” and, like Dr. Gear, I set up certain time schedules. I said: “I am going to start to give the vaccine now.” Every time I said “I am going to start to give it” and did not give it, two to three or four days later they came down with either pharyngitis, vomiting and abdominal pain, or a little fever.
I waited for approximately six weeks for those children to stop having some sort of febrile episode. I finally gave up. It so happened that after they got the vaccine they did not have any such episode.”
Albert Sabin on Recent Studies And Field Tests With A Live Attenuated Poliovirus Vaccine
When Albert Sabin was first researching his oral polio vaccine, he understood the problem. How could he really know if any signs or symptoms that occurred after he gave someone his vaccine were really caused by the vaccine, or just a coincidence?
“However, a report later to be given by Dr. Smorodintsev will deal with approximately 7,500 children who had received the vaccine and were carefully followed, as compared with another group, in similar number, who had not, for various types of illnesses which were occurring during the period.”
Albert Sabin on Recent Studies And Field Tests With A Live Attenuated Poliovirus Vaccine
The solution? They studied kids who had not gotten his vaccine.
You can just look at the background rate of a symptom or condition, and compare the periods before and after you start using a vaccine.
For instance, consider this study from Australia about using the HPV vaccine in boys, in which they made some predictions of what would happen after introducing the HPV vaccine.
Assuming an 80% vaccination rate with three doses per person — which equates to about 480 000 boys vaccinated and a total of 1 440 000 doses administered nationally per year in the first 2 years of the program — about 2.4 episodes of Guillain-Barré syndrome would be expected to occur within 6 weeks of vaccination. In addition, about 3.9 seizures and 6.5 acute allergy presentations would be expected to occur within 1 day of vaccination, including 0.3 episodes of anaphylaxis.
Clothier et al. on Human papillomavirus vaccine in boys: background rates of potential adverse events.
Most of you will have heard the maxim “correlation does not imply causation.” Just because two variables have a statistical relationship with each other does not mean that one is responsible for the other. For instance, ice cream sales and forest fires are correlated because both occur more often in the summer heat. But there is no causation; you don’t light a patch of the Montana brush on fire when you buy a pint of Haagan-Dazs.
When correlation doesn’t equal causation, then it’s probably a coincidence. Or it’s at least caused by some other factor.
And coincidences happen all of the time.
Is It a Vaccine Injury or a Coincidence?
That something could be a coincidence is not typically want parents want to hear though, especially if their child has gotten sick.
What does it mean that something happens coincidentally?
“Most sudden cardiac deaths that remain unexplained after necropsy are probably caused by primary cardiac arrhythmias.”
Sudden death in children and adolescents
Often it just means that it is unexplained. And that it is chance alone that it occurred as the same time as something else.
“In the absence of a specific etiology for ASDs, and a tendency among parents of children with a disability to feel a strong sense of guilt, it is not surprising that parents attempt to form their own explanations for the disorder in order to cope with the diagnosis.”
Mercer et al on Parental perspectives on the causes of an autism spectrum disorder in their children
Again, when folks blame vaccines, it is often because they have nothing else to blame.
“In some fraction of the American population, however, the belief in a link remains. One reason is a coincidence of timing: children are routinely vaccinated just as parents begin to observe signs of autism. Most vaccines are administered during the first years of life, which is also a period of rapid developmental changes. Many developmental conditions, including autism, don’t become apparent until a child misses a milestone or loses an early skill, a change that in some cases can’t help but be coincident with a recent vaccination.”
Emily Willingham on The Autism-Vaccine Myth
Think that it is too big of a coincidence that some infants develop spasms shortly after their four month vaccines?
Dr. William James West first described these types of infantile spasms in the 1840s!
And the “Fifth Day Fits,” seizures that began when a newborn was five days old, was described in the 1970s, well before we began giving newborns the hepatitis B vaccine.
But SIDS was only discovered after we began vaccinating kids, right?
“But, with millions upon millions of doses given each year to infants in the first 6 months of life across industrialized countries and with sudden infant death syndrome being the most common cause of infant death among infants 1 month or older, the coincidence of SIDS following DTP vaccination just by chance will be relatively frequent. When the two events occur, with SIDS following vaccination, well-meaning and intelligent people will blame the vaccine. They seek order out of randomly occurring events.”
Jacobson et al. on A taxonomy of reasoning flaws in the anti-vaccine movement
Of course not.
Cases of SIDS have been described throughout recorded history and have been well studied to prove that they are not associated with vaccines.
“Some events after immunisation are clearly caused by the vaccine (for example, a sore arm at the injection site). However, others may happen by coincidence around the time of vaccination. It can therefore be difficult to separate those which are clearly caused by a vaccine and those that were going to happen anyway… Scientific method is then used to determine if these events are a coincidence or a result of the vaccine.
Vaccine side effects and adverse reactions
It is easy to blame a vaccine when something happens and a child was recently vaccinated. That is especially true now that anti-vaccine folks turn every story of a child’s death or disability into a vaccine injury story.
“Autism was known well before MMR vaccine became available.”
Chen et al. on Vaccine adverse events: causal or coincidental?
Blaming vaccines when it is clear that vaccines aren’t the cause doesn’t help anyone though. It scares other parents away from vaccinating and protecting their kids. And it doesn’t help parents who need support caring for a sick child or help coping with the loss of a child.
What to Know About Vaccine Injuries vs Coincidences
While all possible adverse events after getting a vaccine should be reported to VAERS and your pediatrician, remember that just because something happened after getting vaccinated, it doesn’t mean that it was caused by the vaccine.
These CDC reports should even take away any last idea that they are.
If there was any association with vaccines, then why are autism rates so widely different in the 11 states that are tracked by ADDM?
Are immunization rates different in those states?
Autism and Developmental Disabilities Monitoring (ADDM) Network
Anyone who has read the latest report on autism rates understands that it “is not a representation of autism in the United States as a whole, but is instead an in-depth look at the 11 communities in the ADDM Network.”
Those communities have changed for each report, but this time they were in Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin.
Even then, the ADDM Network doesn’t look at all of the children in those states. They are mostly looking at children near large institutions that are hosts for the ADDM Network, such as the University of Arkansas for Medical Sciences, Johns Hopkins University, and Rutgers University, etc.
The 325,483 8-year-olds in the latest ADDM Network report were born in 2006 and live in:
part of Maricopa County in metropolitan Phoenix, Arizona
75 counties in Arkansas
Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, and Jefferson counties in Colorado
Clayton, Cobb, DeKalb, Fulton, and Gwinnett counties in Georgia
Baltimore County, Maryland
parts of two counties (Hennepin and Ramsey) including the large metropolitan cities of Minneapolis and St. Paul, Minnesota
Franklin, Jefferson, St. Charles, St. Louis, and St. Louis City counties in Missouri
Essex, Hudson, Union, and Ocean counties in New Jersey
Alamance, Chatham, Forsyth, Guilford, Orange, and Wake counties in North Carolina
Bedford, Cheatham, Davidson, Dickson, Marshall, Maury, Montgomery, Rutherford, Robertson, Williamson, and Wilson counties in Tennessee
Dane, Green, Jefferson, Kenosha, Milwaukee, Ozaukee, Racine, Rock, Walworth, and Waukesha counties in Wisconsin
“Autism prevalence among black and Hispanic children is approaching that of white children,” said Dr. Stuart Shapira, associate director for science at the CDC’s National Center on Birth Defects and Developmental Disabilities. “The higher number of black and Hispanic children now being identified with autism could be due to more effective outreach in minority communities and increased efforts to have all children screened for autism so they can get the services they need.”
It shows that “there continue to be many children living with ASD who need services and support, now and as they grow into adolescence and adulthood.”
Immunization Rates and the Autism and Developmental Disabilities Monitoring Network
It also helps to dispell any last ideas that vaccines are associated with autism…
Just look at the immunization rates in the ADDM Network counties (4 doses of DTaP, 3 doses of IPV, one dose of MMR, 3 doses of Hib, 3 doses of HepB, 1 dose of Varicella, 4 doses of Prevnar, flu shot, and 1 dose of HepA by age 36 months) and compare them to the autism rates in those same counties.
If vaccines were associated with autism, what should you see? Higher rates of autism in the areas with the highest immunization rates. You don’t see that in any of this data though, do you?
The counties in New Jersey, with the highest rates of autism, have good immunization rates, but they aren’t much different from the immunization rates in Colorado counties or Arizona counties with much lower autism rates.
Some other things we know about vaccines and the latest autism report?
in 2006, when those kids were born, New Jersey had one of the lowest rates for getting newborns a hepatitis B shot on their first day, as recommended, at just 23%. Arizona, with a much lower rate of autism, did much better, getting 65% of newborns their birth dose of hepatitis B vaccine on time. In fact, Maricopa County had one of the highest rates, at 71%.
fewer than half of their mothers likely received a flu shot during their pregnancy, even though they had been recommended since the 1990s
extremely few of their mothers received a Tdap vaccine during their pregnancy, as this didn’t become a routine recommendation until 2011
Does any of this surprise you?
How can vaccines be associated with autism, when counties that have higher immunization rates have lower rates of autism?
What to Know About Vaccines and the Latest Autism Prevalence Report
The latest Autism and Developmental Disabilities Monitoring (ADDM) Network report on autism prevalence from the CDC shows a rate that has increased to 1 in 59 children. And as county level trends in vaccination coverage show no correlation to those autism prevalence rates, folks will hopefully stop trying to associate vaccines with autism.
More on Vaccines and the Latest Autism Prevalence Report
“Vaccine Injury Denialism is rampant across the mainstream media, where child-abusing vaccine pushers like the New York Times, Washington Post and CNN deliberately contribute to the holocaust of vaccine injuries now devastating humanity’s children. Sadly, the same denialism about the alarming growth in medical injuries caused by vaccines is also endemic across universities, science journals and medical schools, where doctors are indoctrinated into a kind of “Flat Earth” denialism of vaccine injury reality.”
Mike Adams on Vaccine Injury Denialism is the denial of fundamental human dignity
Claims of vaccine injury denial come when we are skeptical or don’t believe that anything and everything is a vaccine injury.
“IMAGINE YOU LIVE IN A COUNTRY in which a minority of people are taken in the middle of the night, and beaten, kicked, poisoned, half-drowned… they are crippled for life, maimed, and they are expected to accept a doctor’s or a judge’s view that “It wasn’t the Gestapo” or “It’s not even an injury”.
Imagine that minority amounted to tens of millions of people.
Now imagine that these victims are lured into traps by their own doctors with promises of medicine that will prevent illness – but in reality the doctors are paid for every patient they manage to convince to show up – and the doctors determine which injuries they caused and which were just “coincidences”.
Now imagine the media is primed to tell the world that no such injuries ever occur. Now your neighbors are denying it, calling you crazy for thinking there is a link…”
James Lyons-Weiler on Should Vaccine Risk/Injury Denial Be Prosecutable Offenses?
But doctors and the media, and your neighbors for that matter, don’t deny that claims of vaccine injury are real because of some grand conspiracy or simply because they want to.