We know the risks of dying from the MMR vaccine (extremely rare) vs measles (low), so why would there be a debate about this in the BMJ?
Even Peter Gøtzsche calls out the arguments of the Physicians for Informed Consent for being spurious and absurd.
Oh, there isn’t…
You might think that there is because the so-called Physicians for Informed Consent issued a press release touting an electronic comment (a rapid response) to the editor of the BMJ.
Rapid responses are basically electronic letters to the editor, but anti-vaccine folks treat them like they are peer-reviewed articles that have gotten published in a medical journal.
Are dueling letter’s to the editor considered a debate?
Interestingly, even Peter Gøtzsche, who has raised concerns about HPV vaccines and who has never gotten a flu shot, thinks that Shira Miller’s arguments against the measles vaccine are spurious and absurd.
The latest from Bob Sears helps illustrate exactly why his vaccine misinformation is far from harmless.
Misinformation about febrile seizures from Bob Sears. He neglects to mention that if fewer kids are vaccinated, more will get vaccine-preventable diseases that actually cause febrile seizures!
What’s he talking about?
Vaccine Misinformation from Bob Sears is Not Harmless
He is talking about a study, Childhood seizures and risk of psychiatric disorders in adolescence and early adulthood: a Danish nationwide cohort study, which looked at “the relation between childhood seizures and the risk of psychiatric disorders in adolescence and early adulthood.”
Wait, so this isn’t a study about vaccines?
No, not directly.
“Children with epilepsy and febrile seizures—with and without concomitant epilepsy—are at increased risk of developing a broad range of psychiatric disorders in later life.”
Dreier et al on Childhood seizures and risk of psychiatric disorders in adolescence and early adulthood: a Danish nationwide cohort study
Vaccines come into the discussion because they are one of the causes of febrile seizures.
Kids are more likely to get a febrile seizure after a natural infection though, including many that are vaccine-preventable, such as the flu, measles, mumps, chicken pox, and pneumococcal disease, etc.
In fact, we have seen a protective effect against febrile seizures caused by rotavirus infections since the introduction of the rotavirus vaccine!
And whether or not febrile seizures can rarely be dangerous and cause long-term harm, we know that vaccine-preventable diseases are life-threatening and their complications can definitely cause long-term harm.
“In our study, we have shown that children with febrile seizures do seem to be at slightly higher risk of developing psychiatric disorders as teenagers and young adults, even in the absence of subsequent epilepsy… We noted that the association with mental illness was strongest in individuals with recurrent febrile seizures and with onset of febrile seizures after the age of 3 years.”
Dreier et al on Childhood seizures and risk of psychiatric disorders in adolescence and early adulthood: a Danish nationwide cohort study
Bob Sears also doesn’t mention that the small extra risk was mostly in kids with complex febrile seizures, which aren’t as common as the single, simple febrile seizures that most kids get.
Not surprisingly, Bob Sears also doesn’t mention that vaccines typically cause simple febrile seizures.
“This means for the average pediatrician, who may care for 1000 children younger than 5 including 3 to 500 between 6 and 24 months of age annually, one could expect to see at most 1 child who experiences a febrile seizure every 5 to 10 years due to administration of these vaccines together in the first 2 years of life. This would be in addition to the 30 to 75 patients in each birth year cohort in a practice that would experience a febrile seizure from other causes given the background rate of 2% to 5%.”
Sawyer et al on Vaccines and Febrile Seizures: Quantifying the Risk
Surprisingly, not all of the members of the American Academy of Pediatrics are on the side of advocating for vaccines!
Who Are the Anti-Vaccine Pediatricians?
Sure, except for a few outliers, most of the members of the AAP are typically strong advocates for vaccines.
In fact, one of the very first actions of the AAP was to establish the Committee on Immunization Procedures in 1936. They soon published the first vaccine recommendations for kids in the 1938 pamphlet, Routine measures for the prophylaxis of communicable diseases.
So what happened?
How did we end up with anti-vaccine pediatricians?
In 1954, Dr. Roger L. J. Kennedy, the president of the AAP, declared that he would not allow his own children to get Salk’s polio vaccine during the Polio Pioneer trials.
New York Times April 8, 1954.
Was he right, considering what happened with the Cutter Incident?
Since none of the polio vaccines produced directly by Jonas Salk caused any problems, no, Kennedy wasn’t right and could have put the whole trial at risk if folks had listened to him.
We next saw Dr. Robert Mendelsohn, a pediatrician who was against many standard practices, including ultrasounds in pregnancy, “water fluoridation, immunization, coronary bypass surgery, licensing of nutritionists, and screening examinations to detect breast cancer.”
He appeared on Donahue in the early 1980s, making claims that “The greatest threat of childhood diseases lies in the dangerous and ineffectual efforts made to prevent them through mass immunization.”
The AAP Committee on Infectious Disease called out Dr. Robert Mendelsohn in a Red Book Update published in Pediatrics in 1982
Mendelsohn also appeared as an “expert” in Vaccine Roulette, falsely calling the pertussis vaccine “probably the poorest and most dangerous vaccine that we now have.” Of course, none of the claims against the DPT vaccine ended up being true, but we are still left with the DTaP vaccine which is less effective.
Although he wasn’t the last anti-vaccine pediatrician, he was the last to be formally called out by the American Academy of Pediatrics.
Dr. Jay Gordon, a celebrity pediatrician in California and Fellow of the AAP, appeared on Good Morning America with Cindy Crawford in 2000, saying afterwards that “They edited the segment to make me sound like a vaccination proponent. We also have to understand the impact of a person as well-known as Cindy Crawford delaying vaccines for over six months.”
Delaying vaccines and leaving infants at risk to get a vaccine-preventable disease doesn’t make any sense to most pediatricians.
Since then, he has continued to push the idea that kids should get vaccines on a slower schedule, perhaps only getting one or two at a time.
Bob’s warning about not sharing their fears appeared in the first edition of his book.
Although the AAP hasn’t formally called out today’s disease friendly pediatricians by name, they have repeatedly stated that there are no alternative immunization schedules.
“There is no ‘alternative’ immunization schedule. Delaying vaccines only leaves a child at risk of disease for a longer period of time; it does not make vaccinating safer.
Vaccines work, plain and simple. Vaccines are one of the safest, most effective and most important medical innovations of our time. Pediatricians partner with parents to provide what is best for their child, and what is best is for children to be fully vaccinated.”
Karen Remley, MD, MBA, MPH, FAAP, Executive Director, American Academy of Pediatrics
And the AAP has said that the views of pediatricians who push alternative immunization schedules “are counter to scientific evidence and clearly they do not reflect Academy policy or recommendations.”
“No alternative vaccine schedules have been evaluated and found to provide better safety or efficacy than the recommended schedule, supported by the Advisory Committee on Immunization Practices of the CDC and the Committee on Infectious Diseases of the AAP (the committee that produces the Red Book).
Pediatricians who routinely recommend limiting the numbers of vaccines administered at a single visit such that vaccines are administered late are providing care that deviates from the standard evidence-based schedule recommended by these bodies.”
Countering Vaccine Hesitancy
Are there others?
Unfortunately, there are.
“Most of my patients make the educated decision not to give one vaccine-hepatitis B – to their infants. This is because you catch hepatitis B from sex and IV drug use so if a child is born to a mother that does not have hepatitis B, the child is at no risk of getting this disease. Preschool and young school-aged children are not at risk for hepatitis B, which is why most countries in the developed world only recommend this vaccine for at-risk groups and not for everyone.”
Paul Thomas
Paul Thomas is another pediatrician and Fellow of the AAP who has written a book about vaccines that pushes his own alternative vaccine schedule.
And even though he has written a book about vaccines, it seems clear that he doesn’t really know which vaccines most countries in the developed world actually give to their kids.
Larry Palevsky spoke at an anti-vaccine rally in New York in the middle of a record setting measles outbreak.
Then there is Larry Palevsky, the pediatrician “who utilizes a holistic approach to children’s wellness and illness…”
Some folks are likely wondering how Larry Palevsky still has a medical license after the things he said at the so-called vaccine symposium in Rockland County this year. Yeah, that Rockland County with the longest active measles outbreak since the endemic spread of measles was declared eliminated.
“The pediatrician who spoke on Monday night, Dr. Lawrence Palevsky, is regularly cited in pamphlets circulated in New York City that urge women not to get their children vaccinated. His views have no basis in science, experts said.”
Despite Measles Warnings, Anti-Vaccine Rally Draws Hundreds of Ultra-Orthodox Jews
Most others who are familiar with things he has said in the past aren’t surprised by his statements though. After all, he was an “expert” for the anti-vaccination movie The Greater Good.
Are these alternative pediatricians encouraging parents to only give their kids one vaccine at a time?
And they are familiar with other holistic and integrative pediatricians who are obviously anti-vaccine.
What Makes a Pediatrician Anti-Vaccine?
Although none consider themselves anti-vaccine, preferring to think of themselves as pro-safe vaccine, pro-vaccine choice, or pro-informed consent, as they continue to push myths and misinformation about vaccines, it should be clear who they are and what they are doing.
No, a pediatrician isn’t anti-vaccine just because some of their patients follow a non-standard, parent-selected, delayed protection vaccine schedule. They are anti-vaccine if they encourage parents to skip or delay vaccines, scaring them away from vaccinating and protecting their kids.
“The American Academy of Pediatrics is dedicated to the principle of a meaningful and healthy life for every child. As an organization of physicians who care for infants, children, adolescents, and young adults, the Academy seeks to promote this goal by encouraging and assisting its members in their efforts to meet the overall health needs of children and youth; by providing support and counsel to others concerned with the well-being of children, their growth and development; and by serving as an advocate for children and their families within the community at large.”
preamble to AAP Constitution
It’s time that more pediatricians call them out, even if they aren’t members of the AAP, as we see more outbreaks and more parents following their advice, leaving more kids unvaccinated, unprotected, and at risk to get vaccine-preventable diseases.
Anti-vaccine folks who are talking about “standard of care” when deciding who gets a medical exemption for vaccines obviously don’t really understand what it means.
Why are these advocating against keeping kids protected against life-threatening vaccine-preventable diseases?
Maybe that’s why they put standard of care in quotes in the above infographic against SB276, a new vaccine bill in California that will eliminate fake vaccine exemptions.
What Is Standard of Care?
When we talk about standard of care in medicine, it is important to understand that it is a legal term, with a legal definition:
“That which a minimally competent physician in the same field would do under similar circumstances”
Moffett et al on The Standard of Care: Legal History and Definitions: the Bad and Good News
“Treatment that is accepted by medical experts as a proper treatment for a certain type of disease and that is widely used by healthcare professionals. Also called best practice, standard medical care, and standard therapy.”
NCI Dictionary of Cancer Terms
Just because a few doctors do something a certain way, that doesn’t make it the proper way for it to be done.
These are among the common conditions that the AAP says should NOT delay vaccination and which are often mistakenly thought to qualify someone for a medical exemption.
And that’s why a doctor making up their own rules for what counts as a vaccine medical exemption, especially when it goes against published guidelines and advice, isn’t standard of care.
