To vaccinate or not to vaccinate? That is the question

If you want to make important decisions regarding vaccines, it’s important to understand the facts. What is the value of vaccines? How do they fight diseases? Dr. Brian Ward, a prominent researcher in the field of immunization, spoke to the Reporter about the vital role vaccinations play in our health and wellbeing.
"I love my kids just as much as these anti-vaccination people and all three of them are fully immunized," says Dr. Brian Ward.
“I love my kids just as much as these anti-vaccination people and all three of them are fully immunized,” says Dr. Brian Ward, a professor of Medicine & Microbiology and a prominent researcher in the field of immunization.

By Neale McDevitt

Immunization has become a fiercely debated topic around the world and here at home. According to an Angus Reid poll, nine out of ten Canadians believe that vaccines protect people from contracting diseases. But two Canadians in five question the scientific development of these remedies as well as the potential side effects.

The anti-vaccination movement seems to be gaining traction, certainly in the media, with celebrities like Jenny McCarthy, Jim Carrey and Donald Trump warning anyone who will listen about the link between vaccines and autism.

But vaccines work. Smallpox, once a major endemic disease that killed some 400,000 Europeans each year in the mid-18th century, was completely eradicated by 1979 thanks to an aggressive global vaccination campaign. Here in Canada, the vaccine for mumps reduced reported cases of the disease in Canada from 43,671 (1950-54) to 1,110 (2007-11).

But, because some people refuse immunization today, a number of Canadian researchers fear that those numbers will rise.

Dr. Brian Ward is a professor of Medicine & Microbiology and a prominent researcher in the field of immunization. An expert on many aspects of infectious diseases, from influenza viruses to blood-borne parasitic infections, Dr. Ward serves on a wide range of government and industry advisory committees related to vaccines, vaccine safety, international health and parasitology. He was a key media spokesperson during the SARS outbreak and recent H1N1 pandemic. 

Recently, Dr. Ward spoke to the McGill Reporter about the efficacy of vaccines, the bad science at the core of the anti-vaccination movement and Sidney Crosby’s recent bout of mumps.

In simple terms, how do vaccines work?

They stimulate an immune response that provides full or partial protection from one or more of the infectious diseases for which they have been developed.

But Sidney Crosby got the Measles Mumps Rubella (MMR) vaccination twice and he still got the mumps this past December. How come vaccinations don’t work 100 per cent of the time?

You’ve honed in on one of the most interesting and important questions. In the old days, people got measles or mumps during childhood. So we not only got infected, we were also given a boost to our immune system periodically when we were exposed to the wild-type viruses that circulated in the community when our brothers, sisters and friends would catch them.

Initially we thought that vaccines provided really solid, lifelong immunity and that one dose of MMR would do it. You had sort of a mixed immunity for a while in the community because people who were being vaccinated also were being exposed to wild-type viruses once or twice to further boost their immunity.

The challenge to our immune system from these wild-type viruses is pretty significant and may not be fully matched by the wimpier vaccine strains. But as those wild-type exposures declined (because more and more of us were immunized), we began to rely exclusively on vaccine-induced immunity.

However, now so many of us are immunized that we’ve essentially eliminated these wild-type circulations of these viruses. Now we’re figuring out that there are small portions of our population that, despite having one or even two doses of these vaccines, will not have lifelong immunity.

Are we heading toward a third round of vaccinations?

We probably are. More to the point, I think we’re heading toward the identification of, or the development of simple diagnostic tests will tell you specifically what you need in terms of vaccines. ‘You’re 52 years old and you are fine for mumps, rubella and varicella. But you really don’t have any evidence of measles immunity.” Then we can say, let’s give you a booster of a cocktail of vaccines that you need. That would be personalized medicine at its best.

How close are we to that scenario?

We aren’t there yet, but maybe in another five years.

It isn’t uncommon for a toddler to receive 3-4 vaccinations during one trip to the pediatrician. Can that overload a child’s immune system?

Has your child ever fallen down and scraped himself on the sidewalk? Well, the number of antigens in your average skinned knee is probably somewhere between four and five times the orders of magnitude higher than that group of 3-4 vaccines.

The idea that a kid’s immune system is somehow overwhelmed by these relatively pure vaccine products compared to the thousands of different bacteria that are in that wound, quite frankly, an uninformed opinion based on a misunderstanding on what is in an injection versus exposures in every day life. Your child’s immune system is completely capable of saying ‘this is dangerous, this is not.’

A lot of anti-vaxxers still point to the now debunked 1998 research paper by former surgeon Andrew Wakefield that linked the MMR vaccine to the development in autism. What is your connection to Wakefield?

Full disclosure: I was an expert witness for the U.S. Department of Justice and was one of their chief expert witnesses in the Omnibus Autism Proceeding [that ended in 2009] that completely threw out Wakefield’s fraudulent claims.

Also, full disclosure: Andrew Wakefield approached me in the early 2000s to work with him and I have had a number of confrontations with him because he had taken and reinterpreted my data. Andrew Wakefield is just a bad scientist.

In what way? 

You can start with his blatantly fraudulent behaviour in which he did not acknowledge that most of the study subjects in his Lancet paper were sent to him by lawyers [looking to launch a class action lawsuit against drug companies which manufactured the MMR vaccine].

He also never disclosed that he had a financial interest in the development of a monovalent measles vaccine.

He and his collaborators also put a five-year gag order on a senior U.S. scientist who had demonstrated conclusively that the results their company had been generating were inaccurate.

Andrew Wakefield has a complete lack of moral compass. It is not just bad science it’s unethical and, many would say, criminal.

There have been children who have died or had complications from natural measles whose parents decided not to have been vaccinated based on Andrew Wakefield’s findings. My feeling is that he is personally culpable.

If you want to know more, you should check out the website of [London Times investigative Reporter] Brian Deers. He has a great website that basically gives the chronology. It’s an expose of what a bad person Andrew Wakefield really is in every respect.

If Wakefield’s findings have been so thoroughly debunked, how do they still have so much traction?

Because many people don’t understand the difference between coincidence and causality.

The fact is we gave the MMR vaccine right around the time of peak diagnoses for autism. It’s exactly when we start to see it in children. The median time of diagnosis is in the 20-22 months area. We give our measles vaccine at 12 month and a year later at 24 months. Some people give it of 18 months. It all happens around the same time and some people are quick to make a connection that doesn’t exist.

In some ways it is understandable. Most kids cry when they get a vaccination and some kids actually become a little sick or fussy. It’s a big event and parents remember big events. I certainly remember my kids getting their vaccines.

You’re handing your kid over to somebody who’s going to stick a needle in their arm. Subsequently, if something else happens that is frightening, some people will link the two events.

So are vaccines without adverse effects?

There are very clearly some vaccine-associated adverse events. For example, the live attenuated polio vaccine resulted in paralysis either for the child or for the caretakers of the child in about 2 to 3,000,000 doses.

We know exactly what happened. It was revertant virus, typically a type III virus. That’s one of the reasons why Canada switched from the oral to the inactivated polio vaccine to avoid that very low but predictable risk.

There is a very low risk of Guillain-Barré syndrome (GBS) following some influenza vaccines in some seasons. We don’t know exactly why yet but it’s there.

If a risk exists in most cases we’re talking about less than one in one million or one in 10 million. These are tiny risks compared to the very real risks of not being vaccinated.

Can we argue that, at the very least, people should have their children vaccinated in order to reduce the chance of having a measles outbreak like we saw originating in Disneyland earlier this year?

Arguments for altruistic vaccination are, at some level, lame. If I have to accept the risk for my child and my child derives no benefit from a vaccination, I’m going to be like any other parent and say ‘no thanks.’ On the other hand, if my child derives a benefit and, in addition, my child’s immunity helps protect others then we’re talking win-win.

As an example, let’s say we live in a dictatorship and the dictator had had a family member die of smallpox and the dictator says ‘I don’t care that smallpox has been eliminated. I’m still sufficiently frightened of it that everyone in this country must be vaccinated with this smallpox vaccine.’ I would do everything in my power to hide my children because the smallpox vaccine, in the context of no smallpox circulation, is actually quite a dangerous vaccine.

The relative risk for vaccines is contextual. In the event that there was smallpox circulating, I wouldn’t hesitate for a microsecond to have my wife, my children and myself immunized.

Can we use the eradication of smallpox as a global blueprint to get rid of other diseases?

If the only reservoir for a disease is human beings then you can eradicate it. Tetanus is in the environment so we will never be able to stop immunizing it. Many people believe that human beings are the only reservoir for measles mumps and polio and probably varicella, so there is at least some possibility of eventually being able to stop vaccinating against a couple of those.

Since chickenpox also causes shingles and that can occur 70 or 80 years after you got chickenpox, it’s pretty hard to imagine ever being able to stop vaccinating against chickenpox.

This type of initiative takes takes political will and organization. Yes, where you have civil wars you have decreasing vaccination rates. But there were civil wars when we eradicated smallpox so it is certainly feasible.

Is polio the next major scourge to be eliminated?

Polio is on its way to being eradicated worldwide. But there are some roadblocks. The idea of using a polio vaccine worker to try and find Osama Bin Laden in 2011, while smart in terms of getting Bin Laden, was not so smart in terms of polio vaccination programs in certain fundamentalist Muslim environments.

Some 67 polio vaccination workers have been killed in a small number of countries since that time. It has slowed vaccination efforts in some parts of the world. Would you volunteer to go into some of these regions where 67 vaccinations workers have been slaughtered? It is costing us billions and billions of dollars in terms of continuing to have to vaccinate against polio.

How do you respond to people who say a massive conspiracy involving industry, Big Pharma and various levels of government is selling vaccines for huge profits?

My colleagues and I have spent years working very closely with the government, the vaccine industry and academia. If there were a conspiracy we would know about it.

I love my kids just as much as these anti-vaccination people and all three of them are fully immunized. So either I’m really dumb and can’t see this conspiracy or, worse yet, I’m ready to sacrifice my own kids and put them at risk just for my next grant. I don’t think so.

 

Comments on “To vaccinate or not to vaccinate? That is the question”

  • Avatar

    Full disclosure? What about your industry ties Dr. Ward?
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1954854/
    “Competing interests: BJW has served on a number of Canadian and US government advisory committees addressing the issues of vaccine use and safety between 1994 and 2006. He has provided expert testimony for both the US and Quebec vaccine injury compensation programs. Dr Ward has also provided advice and teaching to Canadian government and industry groups in the area of vaccine immunology. He has conducted and participated in several studies of measles vaccine safety sponsored by Canadian and US government funding agencies. He has also conducted a small number of phase I and phase II industry‐sponsored clinical trials of non‐licensed vaccines for smaller biotechnology companies. He has conducted a single, company‐sponsored, immunological study of a licensed, acellular pertussis vaccine.”

  • Avatar
    Ted Kuntz

    For an educated man you are surprisingly uninformed about Dr. Wakefield and his research. Dr. Wakefields’s findings have been replicated by independent labs around the world. Dr. Wakefield was never charged or found guilty of fraud. Dr. Wakefield’s colleague in the research, Dr. Walker Smith, challenged the findings of the BMJ in court and the judge ruled in favour of Wakefield/Walker Smith. Dr. Wakefield was never anti-vaccine. Wakefield recommended the measles, mumps and rubella be received in three separate vaccines until further evidence demonstrated the safety of the combined MMR shot. It was the UK government who stopped licensing the individual shots following Wakefield’s findings that should be held responsible for the decline in vaccination rates.
    Continuing to disseminate false information about Wakefield questions your credibility on this matter and the others you commented on.

  • Avatar

    “The fact is we gave the MMR vaccine right around the time of peak diagnoses for autism. ” Funny how there wasn’t much autism prior to introduction of the MMR vaccine, though, eh? And what of the incidence of autism among the never-vaccinated? Oh, right, we don’t know that.

  • Avatar
    Reality022

    Excellent interview and very interesting.
    It is particularly apt considering Andrew Wakefield is attempting to appear at legislative vaccination healthcare hearings to voice his objection to stiffening the requirements for public school admission.
    Parents who are not already committed anti-vaccinationists need to read how Wakefield is viewed by actual scientists who are experts in the field as opposed to “internet experts” i.e. – crackpots.
    Thank you.

  • Avatar

    “parent” – Perhaps you didn’t notice that I said “never-vaccinated”. These children were only “unvaccinated” against MMR.
    And there have been numerous criticisms of the Denmark study, including this one by Dr. F. Edward Yazbak, retired pediatrician: http://www.vaccinationnews.org/content/mmr-autism-epidemiological-studies-just-distraction
    And this one with Gary Goldman, PhD: http://www.jpands.org/vol9no3/goldman.pdf
    It is also worth noting that one of the authors of this and many other “Denmark” studies is the infamous fugitive Paul Thorsen, who absconded CDC money: https://oig.hhs.gov/fraud/fugitives/profiles.asp

  • Avatar

    The pseudo-science-ers are out today!
    Rita – most people who work in the industry have ‘industry ties’. Didn’t Andrew Wakefield have industry ties when he patented a vaccine? Talk about motive to make the existing vaccine look harmful. He has been so fully debunked it’s not funny.
    Ted – You should really learn the difference between court rulings and science, they are not the same. I can sue anyone on baseless claims and they may settle with me to avoid bad PR or negative image. Does that make my claim right? Is that indeed facts or scientific evidence?
    Sandy – have any data to support your claim? You just need to look to find many cases of unvaccinated children with autism. There have been studies of vaccinated and unvaccinated that show the only difference in sickness and disease is that those unvaccinated have higher rates of vaccine preventable diseases. This is why this doctor vaccinates his children.
    Stop spreading misinformtation. For those considering vaccines and are scared by this fear mongering, here is a link to a bunch of anti-vaxx myths busted: http://pediatrics.about.com/od/immunizations/tp/Anti-Vaccine-Myths-and-Misinformation.htm

  • Avatar

    Why are you not posting rebuttals? Sandy Gottstein tried to respond to “parent” and you never posted the comment. Why not? Were there too many links?

  • Avatar
    Rob England

    It’s not a question.
    The anti-vaxxers commenting here show the level of lies and propaganda resorted to by the anti-vaxx community. Their leaders are vile sociopaths, intent on spreading death. The rest of them are igorant neurotics afraid of science.
    Society has to act before some terrible diseases come raging back.

  • Avatar

    With regards to Wakefield’s patent, here is his side of the story from ANH Europe ….. “Wakefield in answer to Deer’s accusation that he patented his own vaccine ready to profit when the existing MMR vaccine was discredited, he said: “No vaccine or anything resembling a vaccine was ever designed, developed or tested by me or by any of my colleagues at the Royal Free Hospital…it has never been my aim or intention to design, produce or promote a vaccine to compete with MMR… it was our intention, at one stage, to conduct a formal therapeutic clinical trial of a compound [transfer factor] that might have the ability to promote the body’s immune response to measles in order to assess the effects of this therapy upon the disease in children with regressive autism and bowel disease…. the aim of the patent was to generate funding for the research programme and a new Centre for Gastroenterology at the Royal Free Hospital. This can be substantiated by contemporaneous documentation. The patent application was motivated by two main factors. First, it was felt that there may be difficulty in raising traditional grant funding for cutting edge, controversial work that was vulnerable by virtue of the fact that it might conflict with perceived wisdom and the commercial interests of others. Secondly, there was, and is, a government-led emphasis on commercial exploitation of discoveries within the medical school.”

  • Neale Mcdevitt
    Neale Mcdevitt

    Sorry about Sandy Gottstein’s comment taking a while to be posted. It got filtered into spam. But we found it and have posted it.

  • Avatar

    Thanks Nichola for links to the patent.
    “Abstract Title – Pharmaceutical composition for treatment of MMR virus mediated disease comprising a transfer factor obtained from the dialysis of virus-specific lymphocytes.
    A pharmaceutical composition for the treatment of an MMR virus mediated disease comprises a soluble dialysed leucocyte extract comprising a transfer factor (TF) formed by the dialysis of virus-specific lymphocytes to a molecular weight filter cut-off of 12,500 disposed in a pharmaceutically acceptable carrier or diluent therefor.
    Such a composition may be used as a measles virus vaccine for the treatment of inflammatory bowel disease and regressive behavioural disorder. ”
    Sounds to me like Wakefield was trying to help his patients.
    Here are his other published studies:
    http://www.ncbi.nlm.nih.gov/pubmed/?term=Wakefield%20A%5BAuthor%5D&cauthor=true&cauthor_uid=20680427

  • Avatar

    Interesting that Dr. Ward worked on the “reactogenicity to the new acellular pertussis vaccine [Pasteur Merieux Connaught Ltd (Montreal)]” See: https://web.archive.org/web/20130228115214/http://www.medicine.mcgill.ca/tropmed/txt/research.htm
    Our youngest child was one of the guinea pigs who received the 5 in 1 unlicensed combination “PENTA” vaccine in the early 90’s. This was the whole cell pertussis version, combined with diphtheria, polio, tetanus and Act-Hib. We stopped vaccinating him after his 18 month shots when it was clear that the vaccines caused his life threatening immune system malfunction called anaphylaxis to foods and latex. Access to information requests from other PENTA parents show 11,000 adverse events reported including death. The PENTA vaccine was hurriedly replaced by the acellular pertussis vaccine in 1997. The carnage left behind from that vaccine may be one of the many reasons why you have so many “anti-vaxxers” today, we are parents who had originally fully vaccinated our children.

  • Avatar

    A Doctor investigates – This 1 hour video (dated April 23, 2015) is a result of Dr. Sam Eggertsen MD’s efforts to understand and address parental concerns in his practice re: vaccines. He discusses Dr. Andrew Wakefield at the 40 minute mark. What he discovers should be of interest to everyone! https://www.youtube.com/watch?v=8LB-3xkeDAE
    If you don’t have time to watch the video here is a spoiler. After his investigation, Dr. Eggertsen, a family doctor for 35 years in Washington State, stated, “Looking at the evidence I must now agree with my patient that Andrew Wakefield is not a fraud and if I ever meet Dr. Wakefield I will give him my apology for having said so.”

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