I have written a book that explains why we use vaccines to prevent disease. I have also written a book about mental illnesses: what they are and how they are classified, diagnosed, and treated. So I am well prepared to answer a common question: are the antivaccine zealots out of their minds? The answer is “sometimes”; that determination must be made on a case-by-case basis. Vaccination has long been the mainstay of public health efforts. Being vehemently opposed to the mainstay of public health efforts is not, per se, a mental illness. But neither is it a sign of good mental health, especially not in an educated person. In fact, people who go to great lengths in their antivaccine advocacy are more likely than the average person to have a particular kind of mental illness: a personality disorder.
Antivaccine propaganda has been spreading. As a result, so has the measles. Antivaccine zealots are not worried by measles outbreaks. Instead, they want even more people to catch the measles. These antivaxxers believe that measles is a harmless disease that boosts the immune system. (In reality, measles is dangerous mainly because it damages the immune system.) Lately, antivaxxers have been spreading the myth that in the old days, parents would send their children to “measles parties” at the home of a measles patient. In reality, someone from the local board of health would post a quarantine sign on the patient’s home, to prevent any “measles party” from taking place.
This video is about one of the last Americans to get polio. He got it right before the Salk vaccine came out. For this reason, he is one of the last people to be using an “iron lung” ventilator. Since nobody makes these machines anymore, he had a lot of trouble in finding a mechanic to maintain the machine. Also, nobody was making spare parts for the machine.
Fortunately, a global vaccination campaign is about to drive polio into extinction. After the polio viruses are no longer circulating, we will no longer need to vaccinate anyone against this disease.
Rotary International has played an important role in supporting the polio eradication campaign. For more information, visit: https://my.rotary.org/en/take-action/end-polio.
Many people have been told by an LLMD (Lyme-literate medical doctor) that they have chronic Lyme disease. However, there is really no such thing as an LLMD, and there might be no such thing as chronic Lyme disease. Those patients probably do have a chronic inflammatory disease, but they have been given the wrong diagnosis and are getting the wrong treatment. Many chronic inflammatory diseases can be cured by a simple change in diet. The only way to find out is to try an elimination diet and see what happens. For advice on an elimination diet, people should see an RD (registered dietitian) who works with their regular doctor.
What is an LLMD?
An MD degree, which stands for medical doctor, means that the person has been graduated from an accredited school of medicine. Often, medical doctors have other credentials. For example, FACP means that the doctor is a Fellow of the American College of Physicians. FACOG means that the doctor is a Fellow of the American College of Obstetricians and Gynecologists. Those fellowships are real, meaningful credentials. However, there is no official organization that grants LLMD credentials. In other words, LLMD is a phony credential. Let the buyer beware.
People seek out LLMDs for an understandable reason. When sick people go to a doctor, they mainly want the doctor to answer three questions: What is happening to me? Why is it happening to me? and How can you make it stop happening to me? In many cases, the doctor cannot answer any of those questions. As a result, desperate patients often go from doctor to doctor until they find someone who gives satisfying answers to at least one of those questions. Often, it is a struggle just to find a doctor who believes that they are really sick. Yet the answer that satisfies the patient is not always correct. As a result, people with mysterious chronic illnesses become easy prey for practitioners who provide false but satisfying answers. Many of these practitioners use one catch-all diagnosis, which is a single diagnosis that is given as an explanation for everything that is going wrong in practically every patient’s body. Since Lyme disease can cause many odd symptoms, it is useful as a catch-all diagnosis.
The doctors who call themselves “Lyme-literate” have been giving patients the answers that the patients are desperate to hear: Yes, you really are sick. I know what is happening to you, and I will try to make it stop. The LLMDs then start the patients on a long course of antibiotics, sometimes intravenously. This long-term treatment is profitable for the doctor because the patients must make many appointments. However, the long-term antibiotic treatment does little or no good and can cause serious harm, including death. In other words, the patients are given the wrong diagnosis. As a result, they get the wrong treatment, which probably does more harm than good. Since the treatment involves overuse of antibiotics, it poses a risk to everyone’s health. The long course of antibiotics allows the patient to develop antibiotic-resistant strains of bacteria, which can then spread to other people.
What is Lyme disease?
Lyme disease is useful as a catch-all diagnosis because it produces chronic inflammation. Thus, it produces the same signs and symptoms as many other chronic inflammatory diseases. The first known cases of Lyme disease were originally diagnosed as juvenile rheumatoid arthritis because the patients had hot, swollen, painful joints. Then, someone thought it was odd that so many children from Old Lyme, Connecticut, were coming down with the same rare, noncontagious disease. These children had been playing in the woods, and some of them remembered having tick bites and rashes.
Eventually, a medical entomologist named Willy Burgdorfer found the spiral bacterium (spirochete) that causes Lyme disease. It was named Borrelia burgdorferi in his honor.
Lyme disease is a chronic inflammatory disease. Unless you saw a tick or a rash, Lyme disease looks and feels just like many other chronic inflammatory diseases. The only way to tell these diseases apart is to do some laboratory tests. Unfortunately, the laboratory tests are not always accurate.
A laboratory test is like a burglar alarm. It is supposed to go off whenever there is a burglar in the house, but only when there is a burglar in the house. If it fails to go off when there really is a burglar, the result is a false negative. If the alarm goes off when there is no burglar, the result is a false positive. LLMDs often rely on Lyme disease tests that are nonspecific, which means that they produce a lot of false-positive results. In other words, many of the people who have been told that they have chronic Lyme disease may not have had Lyme disease to begin with. Currently, a two-step process is recommended for diagnosing Lyme disease.
In real cases of Lyme disease, a 2- to 4-week course of antibiotics is effective in curing the infection. So far, we have no evidence that the bacteria can survive the recommended course of antibiotic therapy. Of course, the antibiotic cannot undo the damage that the infection has done to the body. Thus, some people may continue to suffer from symptoms, even after their Borrelia burgdorferi infection has been cured with antibiotics. However, this problem should not be called chronic Lyme disease. Instead, it could be called post Lyme disease syndrome (PLDS). But in many of these cases, the symptoms may be due to some other disease. A patient can have more than one disease at a time!
How can a registered dietitian help?
Many chronic inflammatory diseases are due to a rich, fatty diet. Often, these diseases can be cured by switching to a low-fat, purely plant based (vegan) diet. A few plant-source foods can create problems for some people. The most common offenders are wheat, soy, nuts, citrus fruits, and strawberries. A registered dietitian can help you plan an elimination diet to figure out which foods might be making you sick.
What Is Pneumonia?
Your lung contains many tiny sacs that are supposed to fill with air when you inhale. But if you have a lung infection, those tiny sacs can fill up with pus or other fluid instead. Swelling of the tissue that surrounds the air sacs can also make it hard for the air sacs to inflate. This problem is called pneumonia. If a case of pneumonia gets bad enough, you could suffocate. That is why pneumonia has always been a major cause of death.
Fortunately, there are a few simple things you can do to protect yourself against pneumonia. One is to make sure that you get all of your recommended vaccinations, possibly including the pneumonia shot. The pneumonia shot protects against several strains of Streptococcus pneumoniae, which is also called the pneumococcus. Pneumococcal vaccines are given to babies and to elderly people, as well as to anyone else who is at risk for pneumococcal infection. The vaccine is particularly important for protecting people against the antibiotic-resistant strains of pneumococcus.
Streptococcus pneumoniae is a facultatively anaerobic organism. That means that it thrives in an oxygen-rich environment, such as the upper respiratory tract, but can also live in oxygen-poor environments. As a result, it thrives in the human upper respiratory tract, which is its natural habitat. However, it can also invade deeper tissues, such as the bloodstream, heart, joints, bones, and brain.
Since the pneumococcus naturally lives in the human upper respiratory tract, it is just waiting for an opportunity to cause problems. As a result, it often causes pneumonia and invasive infections in the wake of some other illness, such as a cold or a case of the flu. Thus, the influenza vaccine can also help to protect against pneumonia. Lung diseases such as emphysema, which is due to damage to the walls of the air sacs, can also increase the risk of lung infections and death from pneumonia.
To protect itself against the human immune system, the pneumococcus secretes a complex sugar called a polysaccharide. This polysaccharide forms a capsule around the bacterial cell. The capsule makes it hard for a white blood cell to grasp and swallow the pneumococcal cell. The capsule also hides the bacterial proteins. Thus, it makes it harder for the body to recognize the bacteria as a foreign invader. The human immune system can make antibodies against the polysaccharide. However, each strain of pneumococcus has a different polysaccharide. As a result, the antibodies against one strain of pneumococcus will not protect you against a strain with a different polysaccharide capsule.
Why Are There Two Types of Pneumococcal Vaccine?
Two types of pneumococcal vaccine are available. One type is the polysaccharide vaccine, which is made out of the polysaccharides from 23 different strains of pneumococcus. The other type is a conjugate vaccine. It is made by binding the polysaccharides from 13 different strains of pneumococcus to a bit of protein called a conjugate. The purpose of the conjugate is to help the body develop a stronger, longer-lasting immune response, even in children under 2 years of age.
Who Needs the Pneumonia Vaccine?
The pneumococcal conjugate vaccine is routinely given to babies at age 2, 4, 6, and 12 to 15 months of age, as well as to patients age 65 years or older. It may also be recommended for patients age 2 years to 65 years of age if they have certain health conditions. The pneumococcal polysaccharide vaccine is recommended for patients over 65. It may also be recommended for younger patients who are at high risk for pneumococcal infection.
Jill Stein, a medical doctor who is running for President on the Green Party ticket, has claimed that the pharmaceutical industry has a corrupting influence on the Food and Drug Administration (FDA). She has also claimed that she was part of a public health movement that led to the removal of mercury from childhood vaccines. In reality, we have no evidence that the mercury in childhood vaccines was causing any harm. Nor was any grassroots organization, other than the American Academy of Pediatrics, involved in the decision to stop using a mercury compound called thimerosal as a preservative in vaccines. (Stein is an internist, not a pediatrician.) The decision to make childhood vaccinations mercury-free was made by the FDA and the Centers for Disease Control and Prevention (CDC). Prominent antivaccination activists started speaking out about mercury in vaccines only after the vaccines became mercury-free.
It is disturbing that Republican and Green Party Presidential hopefuls, including some medical doctors, have been using the talking points of the antivaccination movement. What’s worse is that any medical doctor, and especially any medical doctor who wants to be chief executive of the federal government, does not seem to know how the federal government works to protect public health.
Many laymen were horrified to hear that a mercury compound was ever being used as an ingredient in childhood vaccines. Yet that mercury compound is a powerful preservative that was being used to solve a serious safety problem. This problem became obvious in 1928, in a disaster called the Bundaberg Tragedy. A bottle of diphtheria vaccine in a doctor’s office in Bundaberg, Queensland, Australia, became contaminated with a bacterium called golden staph (Staphylococcus aureus). The bacterium was probably carried into the bottle by the needle that was used to draw out one of the first doses from the bottle. Then, the bacteria grew inside the bottle as it sat on a shelf between doses. Twelve of the children who received vaccine from this contaminated bottle died. Five others became seriously ill but recovered. To prevent a similar tragedy from happening in the United States, the US Code of Federal Regulations (21CFR610.15) requires vaccine makers to put a preservative in multiple-dose containers of practically all vaccines. Single-dose containers can be preservative-free but are more expensive.
The regulation does not specify which preservatives must be used. However, it does say that the preservative must be “sufficiently nontoxic so that the amount present in the recommended dose of the product will not be toxic to the recipient.” Also, the preservative must not interfere with the potency of the vaccine. Thimerosal has been used since the 1930s as a preservative in vaccines because it was the most effective option, it did not interfere with the potency of the vaccine, and it was well tolerated. Thimerosal has also been used as a preservative in contact lens solutions. Even today, despite an extensive research effort, we have no evidence that the use of thimerosal in vaccines has caused any health problems.
The person who raised the question of the mercury content of medicines (not specifically vaccines) was Frank Pallone, a Democratic Congressman from New Jersey. In 1997, he introduced an amendment to the FDA’s reauthorization bill. This amendment gave FDA two years to compile a list of all medicinal products that contain mercury compounds as ingredients. The FDA had to analyze what kind of mercury compound was in each product, and how much of each mercury compound the product contains. In response to this Congressional mandate, the FDA revisited the question of how much exposure children were getting to thimerosal through their vaccinations.
Because of the introduction of some new vaccines, the amount of thimerosal that children were receiving had gone up. In 1999, scientists at the FDA calculated that the recommended vaccines would deliver a total of 187.5 micrograms of mercury. (A microgram is a millionth of a gram.) However, there was no reliable way to judge whether this amount of mercury exposure is a problem. In the human body, thimerosal is broken down into ethylmercury, but the federal guidelines on mercury toxicity were based on methylmercury. To be on the safe side, the scientists assumed that ethylmercury would be just as dangerous as methylmercury. (We now know that it is not, because it is quickly eliminated through the kidneys.) So they suggested that steps be taken to reduce thimerosal exposure. Back in 1999, we had no evidence that the thimerosal in vaccines was causing problems. By now, we have evidence that it was not causing any of the health problems that were investigated. However, it did become a serious public relations problem.
The FDA and the CDC take vaccine safety seriously. As a result, the recommended vaccines are amazingly safe. Yet there is one thing that we can do to improve safety still further, while restoring public trust in the public health authorities. We must focus on driving diseases like polio, measles, and rubella into extinction through vaccination. Once a disease is extinct, everyone is protected against it, forever. As a result, children do not need to be exposed to even the minimal risks, and the discomfort, of the vaccination. Instantly, the sales of the vaccine drop to zero. By working to eradicate a vaccine-preventable disease, we public health activists make it crystal clear that our goal is public health, not private profit.
A measles virus infection starts off as a respiratory infection. Thus, it starts off looking and feeling like a common cold. But then it takes a dangerous turn: it infects the immune system. Measles can cause long-lasting damage to the immune system. Recent studies have shown that a case of measles can increase a child’s risk of death from other infections for more than 2 years!
Measles is not the only viral infection that is known to produce long-term suppression of the immune system. Another example is the human immunodeficiency virus (HIV), which is the cause of acquired immunodeficiency syndrome (AIDS). However, HIV and the measles virus attack different kinds of white blood cells, which are the workhorses of the immune system.
HIV attacks the T4 lymphocytes, which are often called T-helper cells. T-helper cells help the other cells of the immune system recognize infections and tumor cells. After an HIV-infected person’s T4 cell count drops to dangerously low levels, his or her immune system is less able to fight many infections and some cancers (such as Kaposi’s sarcoma). Thus, the weakening of the immune system gives germs and cancer cells an opportunity to survive and thrive. The resulting diseases are called opportunistic.
People who are infected by HIV will remain infected for the rest of their lives. In contrast, most people who catch the measles will eliminate the measles virus from their body after only a few weeks. Yet the measles infection can cause long-lasting effects on the immune system because it wipes out the immune system’s memory. Measles virus kills the B memory cells, which are the white blood cells that are supposed to remember the germs that the body has successfully fought in the past. After the B memory cells are killed off, the immune system must relearn much of what it had already learned about dangerous germs. In the meantime, the person remains at risk for opportunistic infections.
HIV is bad, and so is measles. Having HIV and measles at the same time is particularly bad. The death rate from measles is particularly high in people who have any other form of immune suppression. Unfortunately, people who have a suppressed immune system cannot be vaccinated against measles, because the measles vaccine is a “live” vaccine. To protect those vulnerable people, we must ensure that practically everyone else is vaccinated against measles.
Most of the deaths due to measles are due to opportunistic infections. Thus, it is hardly surprising that the death rate from measles started to fall after the introduction of antibiotics, even though antibiotics have no effect on the measles virus itself. Yet even with the best of modern medical care, people still die of measles. Even if they survive, they may be left with permanent disabilities, such as blindness, deafness, and brain damage. In some cases, the measles virus infection may persist in the brain. This persistent infection leads to a horrible disease called subacute sclerosing panencephalitis (SSPE), which slowly destroys the brain. Thus, it leads to a slow and horrible death. There is no cure or even any effective treatment. Fortunately, SSPE can be prevented by preventing measles.
The vaccine against measles provides powerful, long-lasting protection. If you have received two doses of the measles vaccine, your chances of catching measles go down by about 97%. Thanks to the widespread use of the measles vaccine, measles was eliminated from the United States by the year 2000. Unfortunately, we still have occasional outbreaks of measles in the United States. Most of these cases can be traced to someone who was exposed to measles in some other country. So the best way to protect ourselves against measles is to drive the measles virus into extinction worldwide.
Unfortunately, many parents are refusing to allow their children to be vaccinated against measles. Many of these parents have been told that it is better to allow their children to get sick, so that they develop immunity naturally. In reality, many of the vaccine-preventable diseases are dangerous because they suppress the immune system. This immune suppression is good for the germ that causes the disease, but it is bad for the person who has the disease. As a result, having a vaccine-preventable infection can increase your risk of dying of some other infection.
Many parents are refusing vaccination because they think that the vaccines are unnecessary and unsafe. Conspiracy theorists claim that vaccines are being promoted simply to make money for the pharmaceutical companies. Yet if some sociopathic “pharma bro” really wanted to make money on vaccines, he would make sure that the vaccine-preventable diseases remain in circulation. Once a disease has been driven into extinction through vaccination, there is no longer any need to vaccinate anyone against it.
Smallpox is extinct. Today, nobody vaccinates children against smallpox. After polio is extinct, the sales of the polio vaccine will drop to zero. Like smallpox and polio, measles is caused by a virus that can be found only in human beings. Once we have wiped measles, mumps, and rubella off the face of the earth, nobody will need the MMR vaccine. But it would be madness to stop vaccinating against those diseases before then.
For information about efforts to eradicate measles, visit the Measles & Rubella Initiative.
Dr. S.H.* is a medical doctor, but she is spreading dangerous false messages about vaccines. In particular, she has been misrepresenting the results of a study of the vaccines against pertussis (whooping cough). Antivaccination activists like to cite scientific research. They want to create the impression that they have done their homework, and that their opinions are scientifically sound. They often claim to be doing “research.” Yet when you look them up in www.pubmed.com, you find that their publication record is thin or nonexistent. Although the antivaccination zealots sometimes read medical journal articles, they typically misunderstand the articles that they discuss. As someone who has edited textbooks and medical journals for a living for more than 25 years, I find their misunderstandings to be irritating. Their work is so full of obvious errors of fact and errors in reasoning that it would never have passed muster at any of the scientific publishing companies for which I have worked. And yet their work is getting plenty of hits on the Internet!
Dr. H.’s basic argument is this: She thinks that it would be better for your baby to catch whooping cough, which is a horrible and sometimes deadly disease, than to be vaccinated against whooping cough. This is what whooping cough is like:
Sometimes, pertussis is even worse than this. Some newborns are not strong enough to cough like this. Instead, they simply stop breathing and die, without warning.
Dr. H. claims that this study by Warfel and coworkers shows that having a natural Bordetella pertussis infection would be better than vaccination for promoting herd immunity. This idea is total nonsense. Whooping cough was once common. It is now rare, thanks to vaccination. Having more natural cases of Bordetella pertussis infection among the population would lead to more illness and more deaths. Better vaccination coverage leads to less illness and fewer deaths.
The first vaccine against Bordetella pertussis was introduced in 1940. At the time, roughly 6,000 Americans per year were dying of whooping cough. Roughly 95% of the dead were children. Thanks to the vaccination, the death rate dropped sharply. However, we are still seeing occasional cases of whooping cough, even in highly vaccinated populations. Even the immunity that results from a natural infection lasts for only 4 to 20 years. The protection from vaccination lasts for only about 4 to 12 years. That is why doctors urge people to get booster shots against pertussis. If you have partial immunity to pertussis, you might get only a mild case of the sniffles from a Bordetella pertussis infection. Yet you could pass the bacteria on to someone else, who could get severely ill.
Warfel and coworkers wanted to answer an important question: Is the modern acellular pertussis vaccine less effective than the old-fashioned whole-cell vaccine at preventing the spread of Bordetella pertussis from person to person? Since it would be unthinkable to expose human beings to live Bordetella pertussis, the researchers used baboons as experimental subjects. (Of course, many people have ethical objections to the use of animals, and especially primates, as research subjects.) Like human beings, baboons get a bad cough from a Bordetella pertussis infection.
Warfel and coworkers found that both the acellular vaccine and the whole-cell vaccine were effective for their primary purpose, which is to protect the vaccinated individual from getting sick after exposure to Bordetella pertussis. However, the whole-cell vaccine gave the baboons a little help in clearing the Bordetella pertussis from their upper respiratory tract. The acellular pertussis vaccine did not. It took 21 days for the baboons that received the whole-cell vaccine to clear the Bordetella pertussis from their upper respiratory tract. It took unvaccinated baboons and baboons that received the acellular vaccine about twice as long to clear the bacteria from their upper respiratory tract.
Dr. H. pointed out that the Bordetella pertussis bacteria could not colonize the baboons that were recovering from a recent Bordetella pertussis infection. From that, she concluded that natural infections were better for promoting herd immunity. Yet even the immunity produced by a natural infection declines after a few years. Also, the basic reproduction number of pertussis is 5.5, which means that in a susceptible population, a single natural case of pertussis would tend to lead to an average of 5.5 new cases of pertussis. So if we relied on natural immunity to solve our pertussis problem, we would have huge epidemics of pertussis, as opposed to occasional small outbreaks.
The study by Warfel and coworkers was not about whether to vaccinate against pertussis. It was about which vaccine to use. In the 1990s, Americans switched from the whole-cell vaccine to the acellular vaccine because the whole-cell vaccine sometimes caused children to spike a fever. This fever could sometimes cause a febrile seizure. These seizures were terrifying to the parents, but they do no lasting harm to the child. Some other countries consider this risk of fever to be acceptable because the whole-cell vaccine may be better for stopping the spread of Bordetella pertussis.
Bordetella pertussis is found only in human beings. Thus, we might be able to drive this germ into extinction through vaccination. Once it is extinct, nobody will need to get a pertussis vaccine. Yet to drive pertussis into extinction, we will need a better vaccine, one that provides longer-lasting protection against the carrier state, not just against clinical disease. In the meantime, we need for people to get their children vaccinated and to keep up to date with their pertussis boosters!
*I do not use her real name because I do not like to give people undeserved attention. I explain my reasoning in these two books:
In October of 2016, I saw a news report about a mumps outbreak in Arkansas. The reporter mentioned that mumps causes a flu-like illness that can produce swelling under the jaw, and that the disease can last for about two weeks. However, that report made it sound as if mumps were no big deal. But mumps is a very big deal.
Here are the basic facts that reporters should explain whenever mumps breaks out:
- Mumps is rarely fatal, but it can leave its victims deaf in one or both ears.
- Mumps can cause painful swelling of the testicles and can leave men sterile.
- Mumps is a respiratory virus, which is why it spreads easily from person to person.
- Vaccination is the only reliable way to prevent infections that spread easily from person to person.
- The vaccine against the mumps is part of the measles-mumps-rubella (MMR) combined vaccine.
- To prevent mumps, we need to vaccinate as many people as possible. If a large enough percentage of the population is immunized, then mumps stops spreading.
- By vaccinating everyone who can be vaccinated, we can protect the people who cannot be vaccinated (infants and people with immune system problems).
- A global vaccination campaign could drive measles, mumps, and rubella into extinction.
Here are some useful memes for fighting mumps: