Dr. Bob Sears and Fox Friends
On Saturday, 2 October 2010, Dr. Bob Sears appeared on Fox Friends with Fox News Anchor, Alisyn Camerota (AC) . Ms. Camerota begins the segment with the question:AC: Is there a connection between vaccines and autism? Thousands of families with autistic kids think there is. But the Centers for Disease Control has always maintained that no research supports a link. Now one famous paediatrician has written a book about vaccines who charges the government's studies on vaccines is woefully inadequate.Ms. Camerota introduces Dr. Bob Sears (BS), author of The Vaccine Book, which was published three years ago.
AC: The government says they have studied vaccines and they do not cause autism. But has the government ever studied the amount of vaccines that our children get in 1 sitting?
BS: That is what me and my colleagues at SafeMinds are a little worried about...there is a CDC report that says that usually simultaneous vaccination has not been completely studied for safety and that's what we're worried about. Babies get as many as 6 or 7 vaccines altogether...and the CDC is admitting that they aren't always researched that way. The prime example is the flu vaccine. They've researched the flu vaccine in great detail when given alone, but the CDC has never researched it when given in conjunction with all the other shots...and that's what we're worried about.Interestingly, SafeMinds is a notorious anti-vaccine organisation, also known as the 'mercury militia', that maintains that autism is caused by thimerosal, a preservative used in vaccines that contains ethylmercury. However, mercury toxicity does not resemble autism, and autism rates around the world have been increasing in spite of thimerosal removal from paediatric vaccines and immunoglobulins starting in 1999 in the U.S. and even years earlier in other countries. SafeMinds rejects any studies that demonstrate that thimerosal does not contribute to neurological disorders, even going so far as to storm off a study team, in a huff, the day the results were announced and not to their liking.
Dr. Bob alludes to some CDC report that states that simultaneous vaccination has not been completely studied for safety yet doesn't provide any further information about this. However, the CDC information regarding simultaneous vaccination does not support what Dr. Bob claims. For instance, from the CDC's Vaccine Safety Page:
Dr. Bob mentions that influenza vaccine has not been tested with the childhood schedule as the 'prime example', when, in fact, it's the only example. Vaccine safety studies are addressed later. Ms. Camerota continues:Is simultaneous vaccination with multiple vaccinations safe? Wouldn't it be safer to separate combination vaccines and spread them out, vaccinating against just one disease at a time?
The available scientific data show that simultaneous vaccination with multiple vaccines has no adverse effect on the normal childhood immune system. A number of studies have been conducted to examine the effects of giving various combinations of vaccines simultaneously. These studies have shown that the recommended vaccines are as effective in combination as they are individually, and that such combinations carry no greater risk for adverse side effects. Consequently, both the Advisory Committee on Immunization Practices and the American Academy of Pediatrics recommended simultaneous administration of all routine childhood vaccines when appropriate. Research is underway to find methods to combine more antigens in a single vaccine injection (for example, MMR and chickenpox). This will provide all the advantages of the individual vaccines, but will require fewer shots.
Another advantage is that combination vaccines result in fewer shots and less discomfort for children. In addition, spreading out the administration of separate vaccines may leave children unnecessarily vulnerable to disease.
AC: Let me show (CDC Infant Vaccine Schedule) our viewers how many different vaccines some children can get in one sitting. At two months they get five or six, same at four months. At six months they get tons! At 12 months they get up to six, at 15 months they get up to six. Why isn't the CDC looking at these combinations?
BS: (Nodding in agreement and not providing any corrections to these assertions.) Well I think the CDC is just assuming that they are safe. Because there is no real evidence that they causes [sic] any harm...But I would like to see more research on it and I think that parents want to be confident in vaccines. And as a paediatrician, I give vaccines in my office every day. But I want to know that these large combinations are safe. And what I do as a paediatrician, is I spread the vaccines out. I give no more than two vaccines at a time to any babies in my office. It takes longer to vaccinate them that way but I think it's a safer way to go.Here is the CDC Infant Schedule:
There are not 'tons' of vaccines at six months; actually the same at two and four months and as a matter of course, three or four at 12 months and two or three at 15-18 months. Dr. Bob not only spreads these out but omits some as well, and not necessarily ones that can or should be omitted and not some that should be as delayed as he has them. He also eschews combination vaccines which reduce the number of jabs and vaccine constituents, while getting infants protected more timely than his recommendations. Here are his evidence-free justifications for his recommendations:
- By only giving two vaccines at a time (instead of as many as 6), I decrease the chance of chemical overload from grouping so many vaccines chemicals all together at once. This allows a baby's body to better detoxify the chemicals one or two at a time.
- I give only 1 aluminum-containing vaccine at a time (instead of the recommended 4). Overloading on this metal can be particularly toxic to the brain (See Resources, page 250 of The Vaccine Book to view the research on this).
- I give only one live-virus vaccine component at a time to allow the body's immune system to better handle the live viruses in these vaccines.
- Giving fewer shots at a time may decrease the side effects, in my experience.
- Giving fewer shots at a time also makes it easier to figure out which vaccine a child is reacting to if a severe reaction occurs.
Dr. Sears creates controversy surrounding vaccine excipients where there really isn't any, by either misinterpreting or omitting relevant scientific literature. It is a shame that Dr. Bob has chosen to pander to anti-vaccine rhetoric, for the premise of his book seemed appropriately timely, however his execution was sophomoric and clearly intended to further his own agenda and biases. Ms. Camerota continues:
AC: It's interesting that you say that because the CDC in part says that they have combined all these vaccines because parents have clamoured for that...parents say, we don't want to have to keep bringing our kids in every two months and giving them different shots, let's just get it all over with. So perhaps they have acquiesced to parents desires but in a dangerous way.
BS: Right, you know 20, 30 years ago we only gave babies two vaccines at a time with a total of about eight injections throughout their childhood. Now we give babies six or seven vaccines each time and over 50 injections spread throughout their childhood. So I think parents would rather go the extra mile and and [sic] spread the vaccines out cause [sic] I think parents feel like their babies are being overloaded.Thirty years ago, infants and children received five DTP, four OPV and one MMR. The U.S. also had about 20,000 Haemophilus influenzae b (HIb) cases in children annually with about 1,000 deaths each year and approximately 16,000 cases of hepatitis b infection in children less than 10 years old each year. Twenty years ago, infants and children received 18 vaccinations with four given at visits for two, four, and six month olds, three or four given at 12 -18 months old and three given from four to six years old. They were DTP, Hib, Hep B, OPV and MMR. There had also been a huge resurgence of measles during that time with more than 55,000 cases and at least 259 deaths.
Today, children are receiving about 30 vaccines by six years old and three of those are not injections, 36 if parents diligently vaccinate their children for influenza, which are actually very few, less than 30% most years. So it is very difficult to determine how Dr. Bob calculated 50 injections, however, his own recommendation to split MMR up into six as opposed to two injections would get children closer to that.
But onto his argument that vaccines have not been tested together. I don't know how he can make this statement when a quick and easy review of the literature reveals quite the opposite. There are numerous studies that examine the safety and efficacy of new vaccines with existing ones, for example:
Hexavac with Hepatitis A
Hexavalent vaccine with Rotateq
DTaP with Hib
PCV-13 with all infant vaccines
MMR and Varicella
PCV-7 with MMR, Hib and Varicella
Pediarix with Hib and Infanrix-hexa
New Hib with all infant vaccines
MMR with Varicella
MMR-V with Hib-HepB
MMR-V with all infant vaccines
Meningococcal-C with Hep B and Pentacel
Pentacel with PCV-7
This is not, by far, an exhaustive list. Additionally, the Vaccine Adverse Event Reporting System (VAERS) and the Vaccine Safety Datalink (VSD) exist to monitor vaccine safety after licensure. Dr. Bob promotes himself as a vaccine expert yet continues to omit relevant facts. There are valid criticisms of vaccines and policy that are supported by the scientific literature but Dr. Bob chooses to raise the spectre of misinformation that he has the solution for.
AC: Certainly if they're educated, I think you're right about that. We asked the CDC for their response to that fact that you say their research has been woefully inadequate, here is their response to us:
"Vaccination is the single most important step parents can take to protect their children from life threatening diseases which once killed thousands of children each year. Scientific data from years and years of research show that vaccines are safe and effective. Vaccines do not overload the immune system. Vaccines contain only a tiny fraction of the antigens that babies encounter in their environment every day. We do know that delaying vaccines puts children at known risk of becoming ill with vaccine-preventable diseases."
- Tom Skinner, CDC Spokesperson, 1 October 2010
BS: Well I agree with most of that, especially you don't want to delay vaccines for very serious diseases like meningitis or whooping cough. However I think the CDC's argument about the thousands of germs that we can tolerate every day...I think that's scientifically invalid because I think they are talking about germs that we inhale, or germs that we swallow. Those germs are exposed to our immune system in a natural way, in our intestines and our respiratory passages, our immune system processes those germs. But when you inject germs directly into the body you by-pass the immune system completely and internal part, the bloodstream immune system has to see the germs and attack them, it's a very unnatural type of germ exposure.It appears as though Dr. Bob has attended the 'Jenny McCarthy School of Immunology' . His statements regarding 'natural' versus vaccine immune responses invoke one of the most erroneous and overused canards of anti-vaccinationists. I can't quite parse what Dr. Bob is saying because his description of immunity isn't corroborated by anything known about how the immune system works. How could he possibly explain an immune response to antigens (or germs as he puts it) that are introduced 'directly into our bodies' via cuts or insect vectors? Is this also 'unnatural'? He also seems to believe that this 'natural way' is completely infallible and compartmentalised such that pathogens cannot breech this. So how does he explain the fact that pathogens have adapted to evade our innate immune system and requiring our adaptive immunity (perhaps what he is referring to as 'bloodstream immune system') creating antibodies to rid ourselves of them?
Vaccination does by-pass some front line non-specific immune defences, but certainly don't 'by-pass the immune system completely', for if they did, we wouldn't produce antibodies and immune memory defences against pathogens when we encounter them. The whole point of vaccination is to 'teach' our immune system how to deal with the real thing, by using parts of bacteria or inactivated or attenuated viruses. And they work! Which shouldn't be the case according to Dr. Bob's primer on the immune system. It takes quite a bit of knowledge on a topic to be able to reduce complex concepts down to a few sound bites. So Dr. Bob's conjecture about vaccine versus natural immunity is the chasmic difference between dumbing something down and just sounding dumb.
AC: The CDC also said that they have done lots of research...it's interesting because they, they CDC has long cited 2 studies done by these Danish researchers that show that mercury in vaccines does not cause autism. Well now the lead researcher is being investigated. Why?
BS: Right, he was kind of double-dipping so to speak. He was taking money from the CDC to do this research, he was also under salary from the Danish Universities [sic] and that was against his contract and apparently that went against the rules and now, according to Danish newspapers, he has skipped town with 2 million dollars worth of Danish research money and that sort of calls into question the validity of his research.Let's take a look at those publications first:
Madsen KM, Hviid A, Vestergaard M, Schendel D, Wohlfahrt J, Thorsen P, Olsen J, Melbye M. A population-based study of measles, mumps, and rubella vaccination and autism. N Engl J Med. 2002 Nov 7;347(19):1477-82.
Madsen KM, Lauritsen MB, Pedersen CB, Thorsen P, Plesner AM, Andersen PH, Mortensen PB. Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data. Pediatrics. 2003 Sep;112(3 Pt 1):604-6.
Notice the dates of publication and the order of the authors. Ms. Camerota and Dr. Bob have referred to the lead author which is Dr. Madsen for both, well he isn't the author in question. That would be Dr. Poul Thorsen, the sixth and fourth author, respectively. Respectful Insolence has explained this relevance in great detail, but an author that far down on the list has not made a very significant contribution. In fact, Dr.s Madsen and Melbye, the senior authors of the studies released a statement to the Philadelphia Inquirer several months ago regarding Dr. Thorsen's involvement:
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