Tag: natural immunity

Alternatives to Getting Vaccinated

Are there any alternatives to getting vaccinated?

Sure. You can read about them all day long from holistic “experts” and on anti-vaccine websites.

Are there any good alternatives to getting vaccinated?

No. At least not if you want to be truly protected from vaccine-preventable diseases.

Alternatives to Getting Vaccinated

Kids who are born with immune disorders don't have to live in isolation bubbles any more, but they still need protection.
Kids who are born with immune disorders don’t have to live in isolation bubbles any more, but they still need protection. Photo by Baylor College of Medicine

Unfortunately, some folks don’t have other options and they need to look at an alternative for protection from vaccine-preventable diseases that doesn’t include vaccines.

These are the folks with contraindications or true medical exemptions for vaccines.

What do they do?

It depends on the specific circumstances, but in most cases, except for live vaccines or any other specific vaccine that is contraindicated, they usually get vaccinated.

Extremely few people can’t get at least some, if not most, of their vaccines, even if they do have contraindications to some others. And many exemptions are temporary.

“Parents need to balance the need of the immunoreconstituted child (post-transplant SCID) to be protected from exposure to infection from live vaccines and close contact–transmitted vaccine-derived infection with the need of the child to integrate into society and develop social and learning skills in group environments.”

Medical Advisory Committee of the Immune Deficiency Foundation

They also try to avoid people who are sick and  try to make sure that everyone around them is vaccinated to help maintain herd immunity levels of protection.

Neither is always possible though.

Post-Exposure Prophylaxis

Post-exposure prophylaxis is another option that is available to help prevent some vaccine-preventable diseases. For example, if your unvaccinated child is exposed to measles, they can often receive immune globulin to help them avoid getting measles.

Regimens for post-exposure prophylaxis are also available for:

  • chicken pox – varicella zoster immune globulin or immune globulin
  • diphtheria – antibiotics
  • hepatitis A – immune globulin
  • hepatitis B – hepatitis B immune globulin
  • influenza – oseltamivir (Tamiflu) and zanamivir
  • meningococcal disease – antibiotics
  • pertussis – antibiotics
  • rabies – rabies immune globulin
  • tetanus – tetanus immune globulin

When possible, immunization typically accompanies these post-exposure prophylaxis regimens.

There is one big problem with these types of post-exposure prophylaxis regimens though. You are not always going to know when your child is exposed to someone else with a vaccine-preventable disease. While some exposures might be obvious, like if your child steps on a rusty nail or is bitten by an unvaccinated dog who has rabies, you might miss some others.

Bogus Alternatives to Getting Vaccinated

What other alternatives to getting vaccinated are out there?

Unfortunately, there are none that work.

Many bogus alternatives to getting vaccinated are pushed by those opposed to vaccines as ways to boost your immunity, and they can include:

  • breastfeeding – while breastfeeding is great and always encouraged, the passive immunity it provides will not protect your baby from most vaccine-preventable diseases, as it contains IgA antibodies, not the IgG antibodies you would need to prevent diseases like measles, tetanus, chicken pox, and Hib, etc.
  • homeopathic vaccines – nosodes are homeopathic vaccines that have been diluted so much that they are supposed to retain a memory of the original substance. Even if they did – that’s not how immunology works.
  • herbs – neither echinacea, goldenseal root, nor elderberry syrup is going to boost your child’s immunity
  • vitamins – unless your child is severely vitamin deficient, taking vitamins isn’t going to boost their immunity, whether they are taking extra vitamin C or extra vitamin D
  • foods – Japanese mushrooms, kale, broccoli, lettuce, cabbage, avocados, ginger, black currants, graviola, green veggies, onion seeds, and berries might all be great to eat, but they aren’t going to boost your immunity
  • probiotics – they may help prevent antibiotic associated diarrhea, but there is not much evidence that taking them regularly does anything else
  • essential oils – they sometimes smell nice, but they aren’t going to boost your child’s immune system
  • chiropractic adjustments – not going to work
  • sun exposure – in addition to the worries about skin cancer, not only does extra sun exposure not boost your immune system, the WHO reports that “Several studies have demonstrated that exposure to environmental levels of UV radiation alters the activity and distribution of some of the cells responsible for triggering immune responses in humans. Consequently, sun exposure may enhance the risk of infection with viral, bacterial, parasitic or fungal infections, which has been demonstrated in a variety of animal models.”
  • fermented cod liver oil – this is not going to boost your child’s immune system, but folks should also know that there have been reports that the products that people have been buying and using for years were rancid and actually making them sick! There are much better ways to get vitamin D and vitamin A in your diet than taking fermented cod liver oil each day.

What about natural immunity?

While natural immunity can in some ways be more effective than vaccine induced immunity, it often comes at a price. You have to recover from the disease, hopefully without any long term consequences, to develop natural immunity.

What to Know About Alternatives to Getting Vaccinated

People who truly can’t be vaccinated rely on herd immunity, because in most cases, there are no effective alternatives for vaccines.

More On Alternatives to Getting Vaccinated

What Are the Benefits of Vaccines?

Vaccines are safe, effective, and necessary.

They are neither 100% safe nor 100% effective.

That doesn’t make them any less necessary though.

It’s easy to see why when you look at all of the benefits that vaccines have given us.

Perceptions of Risks vs Benefits of Vaccines

One of the reasons that some parents become vaccine-hesitant is that they forget about the many benefits of vaccine.

That’s not surprising, as the better vaccines work, the less obvious their benefits are to everyone. After all, few people remember what it was like in the pre-vaccine era.

A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.
A measles epidemic hit New York City in 1951, as this New York Times article reports.

That makes it easy to for some people to downplay the benefits of vaccines.

Unfortunately, at the same time, some parents might over-estimate the risks of vaccines. And that makes it even easier for them to justify a decision to skip or delay their child’s vaccines.

What Are the Benefits of Vaccines?

For most of us, the greatest benefit of any vaccine is that it keeps us from worrying that our kids will get a vaccine-preventable disease. If they do get sick, we don’t worry that every fever is measles or that every cough is pertussis either.

“It is also much cheaper to prevent a disease than to treat it. In a 2005 study on the economic impact of routine childhood immunization in the United States, researchers estimated that for every dollar spent, the vaccination program saved more than $5 in direct costs and approximately $11 in additional costs to society.”

NIH: National Institute of Allergy and Infectious Diseases

Among the other benefits of available vaccines are that:

The benefits of vaccines become more obvious when folks stop vaccinating.

immunization-program-stages
As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

What happens?

Invariably, we start to see outbreaks.

Then they quickly remember why vaccines are necessary, vaccines rates go up, and the outbreaks get under control.

And everyone understands that all of great benefits of vaccines far outweigh any of their small risks. They also begin to hopefully understand that not everyone can attempt to hide in the herd or follow an alternative immunization schedule. That too can simply lead to more outbreaks, as the number of unvaccinated folks increases, at least temporarily.

What to Know About the Benefits of Vaccines

The great benefits of vaccines, which include that they have saved millions of lives, far outweigh any small risks.

More About the Benefits of Vaccines

Save

Challenging the Concept of Herd Immunity

Before we talked about clusters of unvaccinated children, experts warned about pockets of susceptibles.
Before we talked about clusters of unvaccinated children, experts warned about pockets of susceptibles.
The idea of herd immunity has been around since at least 1923 and became used to describe “the indirect protection afforded to individuals by the presence and  proximity of others who are immune.”

That’s not much different from how the CDC defines herd immunity today:

A situation in which a sufficient proportion of a population is immune to an infectious disease (through vaccination and/or prior illness) to make its spread from person to person unlikely. Even individuals not vaccinated (such as newborns and those with chronic illnesses) are offered some protection because the disease has little opportunity to spread within the community.

Also called community immunity, it is often misunderstood by folks in the anti-vaccine movement.

Challenging the Concept of Herd Immunity

That the idea of herd immunity is being challenged is not new.

“Along with the growth of interest in herd immunity,  there has been a  proliferation of views of what it means or even of whether it exists at all.”

Paul E. M. Fine Herd Immunity: History, Theory, Practice

If you get educated about vaccines and understand how herd immunity works, it is easy to refute these challenges, especially the idea that herd immunity isn’t real just because we still have outbreaks of vaccine-preventable diseases among highly vaccinated communities.

Why do we still have outbreaks then?

It is mostly because we live in open communities that don’t mix randomly.

Keep in mind that the best model for herd immunity is a randomly mixing closed community – “one in which the probability of contact within any time interval is the same for every choice of two individuals in the population.”

Again, that doesn’t mean herd immunity doesn’t work.

It just means we can expect to see some outbreaks when someone in a well vaccinated community visits another community with lower vaccination levels and more disease, gets sick, and returns.

“However,  within the population of a community,  there may be pockets of  susceptibles, either because prior epidemics have failed to spread into the group or because they have not accepted immunization.”

John P. Fox Herd Immunity

You must also consider the size of the community when thinking about herd immunity, for example, a family, school, neighborhood, or city, versus the entire state. So you can have herd immunity levels of protection at the state or city level because of high average vaccination levels, but pockets of susceptibles who live in the same neighborhood or go to the same school can mean that you don’t have herd immunity in those places, leading to outbreaks.

“Hib vaccine coverage of less than 70% in the Gambia was sufficient to eliminate Hib disease, with similar findings seen in Navajo populations.”

RA Adegbola Elimination of Hib disease from The Gambia after…

Lastly, there is not one herd immunity level for all diseases. It is a separate threshold for each and every disease, depending on how easily it spreads, how many people are already immune, how long immunity lasts, if there is a vaccine, and the effectiveness of the vaccine, etc. That means that a community can have herd immunity for Hib and polio, but not the flu, and for rubella and measles, but not pertussis.

What happened in The Gambia is a great example of herd immunity. After introducing a three dose primary Hib immunization schedule (no booster dose), rates of Hib meningitis quickly went from 200 per 100,000 to none. A few years later, there were 6 cases of Hib meningitis in mostly vaccinated children (no booster dose) and in the majority of cases, “close contacts had a history of frequent or recent travel to Senegal, a neighboring country with strong kinship links with The Gambia and where vaccination against Hib was not introduced” until the following year.

With a Hib meningitis rate of 3 per 100,000, they are still far below pre-vaccine levels of disease, and their situation doesn’t mean that herd immunity isn’t real, as you will understand once you review these myths about herd immunity.

Myths About Herd Immunity

What are some common myths about herd immunity?

  • that natural immunity is better than getting vaccinated. Not True. Natural immunity often comes with a price. Remember, many vaccine-preventable diseases are life-threatening, even in this age of modern medicine.
  • you can just hide in the herd. Not True. “Freeloaders” can gamble and hope that their intentionally unvaccinated kids won’t get a vaccine-preventable disease, but it won’t always work. There is a risk to “free-riding, in which individuals profit from the protection provided by a well-vaccinated society without contributing to herd immunity themselves.”
  • most adults aren’t immune because they haven’t been vaccinated or don’t get boosters, but since we aren’t seeing that many outbreaks, herd immunity itself must be a myth. Not True. Adults were either born in the pre-vaccine era and likely have natural immunity or were born in the vaccine era and are vaccinated and immune. But again, herd immunity is disease specific, so when we talk about herd immunity for measles, it doesn’t matter if they have immunity against hepatitis A or Hib. And adults get few boosters or catch-up vaccines. Also, some vaccines, like Hib and Prevnar, have indirect effects, protecting adults even though they aren’t vaccinated because vaccinated kids are less likely to become infectious.
  • most vaccines wear off too soon to provide long lasting protection for herd immunity to be real. Not True. While waning immunity is a problem for a few diseases, like pertussis and mumps, and you need boosters for others, like tetanus, vaccine induced immunity is typically long lasting and often life-long.
  • herd immunity wasn’t developed by observing immunized people, it was all about natural immunity. Not True. The first experiments about herd immunity by Topley and Wilson in 1923 involved vaccinated mice. Ok, they weren’t immunized people, but it wasn’t just about natural immunity! And much earlier, in 1840, it was noted that “smallpox would be disturbed, and sometimes arrested, by vaccination, which protected a part of the population.” That’s herd immunity he was talking about.
  • herd immunity is not a scientifically validated concept. Not True. It has been well studied for almost 100 years.
  • if herd immunity was real, diseases would be eradicated once you reached herd immunity levels. Not True. Reaching herd immunity levels simply starts a downward trend in disease incidence. A little more work has to be done at the final stages of eradication, like was done for smallpox and is being done for polio.
  • natural immunity causes much of the decrease in mortality from a disease in the developed world, even before a vaccine is introduced. Not True. While it is certainly true that there was a big drop in mortality in the first half of the 20th century for most conditions because of improvements in sanitation, nutrition, and medical science, it was not a consequence of natural herd immunity. And we continue to see significant levels of mortality and morbidity for many diseases in the modern era, especially for those that can’t yet be prevented by a vaccine, like RSV, West Nile Virus, and malaria, etc.
  • vaccines aren’t 100% effective, so herd immunity can’t really work. Not True. Part of the equation to figure out the herd immunity threshold for a disease takes into account the effectiveness of a particular vaccine.
  • folks with medical exemptions for vaccines put the herd at risk just the same as those who intentionally skip vaccines. Not True. Children and adults with medical exemptions, including immune system problems, those getting treatments for cancer, and other true medical exemptions don’t have a choice about getting vaccinated.

So, like other anti-vaccine myths, none of the herd immunity myths you may have heard are true.

That makes it hard to understand why Dr. Russel Blaylock goes so far as to say “that vaccine-induced herd immunity is mostly myth can be proven quite simply.” Does he just not understand herd immunity? That is certainly a possibility, because “although herd immunity is crucial for the elimination of infectious diseases, its complexity and explicit relationship to health politics cause it to remain under-explained and under-used in vaccine advocacy. ”

He is also really big into pushing the idea that adults have no or little immunity, because when he was in medical school, he was “taught that all of the childhood vaccines lasted a lifetime,” but it has now been discovered that “most of these vaccines lost their effectiveness 2 to 10 years after being given.”

The thing is, Blaylock graduated medical school in 1971, when the only vaccines that were routinely used were smallpox (routine use ended in 1972), DPT, OPV, and MMR (it had just become available as a combined vaccine in 1971). Of these, it was long known that smallpox, diphtheria, and tetanus didn’t “last a lifetime,” and the live vaccines OPV and MMR, except for the mumps component, actually do.

Blaylock, like most anti-vaccine folks who push myths about herd immunity, is plain wrong. And like most anti-vaccine myths, using herd immunity denialism to convince parents that it is okay to skip or delay vaccines puts us all at risk for disease.

What To Know About Herd Immunity Myths

Herd immunity is not junk science or a false theory. Herd immunity is real, it works, and explains how people in a community are protected from a disease when vaccination rates are above a certain threshold.

More About Herd Immunity Myths

Is the Chicken Pox Vaccine Creating a Shingles Epidemic?

Once upon a time, with no treatment or vaccine, families would just be quarantined when they had chicken pox.
Once upon a time, with no treatment or vaccine, families would just be quarantined when they had chicken pox. Photo by Howard Liberman.

Shingles is a reactivation of a past chicken pox infection, so both are caused by the same varicella-zoster virus (VZV).

While chicken pox rates are decreasing, as more and more children are vaccinated and protected with the chicken pox vaccine, it is true that we are seeing a rise in shingles cases.

Is the Chicken Pox Vaccine Creating a Shingles Epidemic?

There is actually a plausible theory for why routine use of the chicken pox vaccine could cause a rise in shingles cases in adults.

“Some experts suggest that exposure to varicella boosts a person’s immunity to VZV and reduces the risk for VZV reactivation. Thus, they are concerned that routine childhood varicella vaccination, recommended in the United States in 1996, could lead to an increase in herpes zoster in adults due to reduced opportunities for being exposed to varicella. ”

CDC – Shingles Clinical Overview

And that is why some countries, like the UK, haven’t added the chicken pox vaccine to their routine immunization schedule yet.

There are problems with that theory though, including that:

  • we started seeing a rise in rates of shingles in the US before we even started giving the chicken pox vaccine
  • the rise in shingles cases did not increase after we started giving the chicken pox vaccine
  • other countries that do not routinely give the chicken pox vaccine, like the UK, are seeing  similar trends and increases in shingles cases

So while anti-vaccine folks continue to blame the chicken pox vaccine for a rise in shingles, it has been proven again and again that the chicken pox vaccine is not creating a shingles epidemic.

“Among children aged <10 years during 2000-2006, those with a history of varicella vaccination had a 4 to 12 times lower risk for developing herpes zoster compared with children with history of varicella disease.”

Varicella Active Surveillance Project

If anything, since vaccinated children are thought to have a lower risk of shingles than those with natural immunity, it will hopefully lead to a decrease in cases of shingles in the future.

What To Know About The Chicken Pox Vaccine and Shingles Trends

The chicken pox vaccine is not creating a shingles epidemic and will likely help kids be at less risk of shingles later in life as compared to those with natural immunity.

More Information on Trends of Shingles and Chicken Pox

How Long Does Immunity from Vaccines Last?

Most vaccines provide long lasting protection.
Most vaccines provide long-lasting protection. Photo courtesy of Judy Schmidt and James Gathany.

One of the benefits of natural immunity is that after you get sick with a disease, you get life long immunity.

At least usually.

It is often a surprise to some people that some diseases don’t give life long immunity, most notably pertussis infections and tetanus, which typically doesn’t give any natural immunity at all.

How Long Does Immunity from Vaccines Last?

What about vaccines?

Do you get life long immunity after vaccines?

If you know about the issues of waning immunity with some vaccines, then you already know the answer. And even if you didn’t know that immunity from the mumps and pertussis vaccines can wear off, then you likely do know that you need a tetanus booster every 10 years, so that vaccine doesn’t give life long immunity.

How long is the protection from other vaccines?

  • the measles vaccine provides protection for at least 35 years
  • the hepatitis B vaccine provides protection for at least 20 years
  • the hepatitis A vaccine provides protection for at least 14 years
  • the chicken pox vaccine provides protection for at least 20 years
  • both the oral and inactivated polio vaccines provide long lasting protection
  • the rubella vaccine provides protection for at least 21 years
  • Gardasil provides protection for at least 8 years
  • the Hib vaccine provides protection for at least 9 years
  • like tetanus, the diphtheria vaccine provides protection for at about 10 years
  • the pneumococcal vaccine (Prevnar) provides protection for at least 5 years

Why do we say “at least” in so many cases?

In general, that’s how long these vaccines have been around. As time goes by, we will hopefully find that they last much longer.

What To Know About the Duration of Protection from Vaccines

Although some vaccines require boosters, most vaccines provide long-lasting protection.

More Information About Duration of Protection from Vaccines

Save

Save

Cognitive Bias and Vaccine Education

Most of us think we use good judgement when we make decisions.

We research things, consider pros and cons, and put a lot of thought into our decisions.

Unfortunately, no matter how careful we are, subconscious cognitive bias can lead us to make mistakes.

Cognitive biases are defined as:

“mental errors caused by our simplified information processing strategies.”

Cognitive biases often make it difficult for vaccine hesitant parents to see through anti-vaccine myths and misinformation and lead them to fall for anti-vaccine talking points.

These cognitive biases include:

  • confirmation bias
  • blind spot bias
  • survivorship bias
  • selective perception
  • backfire effect
  • choice-supportive bias
  • conjunction fallacy
  • Dunning-Kruger effect
  • hindsight bias
  • illusory correlation
  • ostrich effect
  • pessimism bias
  • semmelweis reflex
  • false consensus effect

What’s behind these cognitive biases?

Cognitive Dissonance

One explanation is cognitive dissonance:

“anxiety that results from simultaneously holding contradictory or otherwise incompatible attitudes, beliefs, or the like, as when one likes a person but disapproves strongly of one of his or her habits.”

So for example, if you are scared to vaccinate your child, then also thinking that your intentionally unvaccinated child could catch measles and get very sick might cause some cognitive dissonance. This leads you down the road to also start to believe in much of the pseudoscience of the anti-vaccine movement, including that:

  • vaccines don’t work anyway (they do)
  • vaccine-preventable diseases, like measles, aren’t that bad (they are)
  • it is actually good to get a vaccine-preventable disease (it isn’t)
  • everyone else is vaccinated, so it doesn’t matter if my kids aren’t (it does)
  • bacteria and viruses don’t even cause disease (they do)

Vaccines work. Vaccines are necessary. Get your kids vaccinated.

What to Know About Cognitive Biases

As you get educated about vaccines, don’t let any of these cognitive biases get in your way.

More Information on Cognitive Biases:

Updated on September 24, 2017

SSPE and Natural Immunity from Measles

Subacute sclerosing panencephalitis (SSPE) is a late complication of a natural measles infection.

SSPE is universally fatal about one to two years after it is diagnosed, but symptoms don’t begin until six to eight years after the person recovers from having measles.

The small risk of SSPE is just another reason that natural immunity is riskier than getting vaccinated and protected with a vaccine.

For more information: