Vaccinations: what every parent needs to know

Here are the key questions to ask, with guidance to follow:

1. How effective are vaccines?

2. How dangerous is the disease?

3. What are the side-effects of the vaccination?

4. Are combination vaccines more dangerous or less effective?

5. When, if at all, is the best time to be vaccinated?

Mercury and Aluminium

Before 2004, vaccines routinely contained mercury (as Thimerosal), an extremely toxic metal, which may have contributed to the increase of children developing autism, hyperactivity, speech disorders and a number of other developmental problems.2 Thankfully, this is no longer added (except to some adult influenza vaccines), but another poisonous metal, aluminium, is still present in most vaccines available on the NHS.3 Aluminium is also highly toxic and implicated in brain damage and behavioural problems in children.4 And worryingly, the addition of more vaccines to the immune schedule means that the quantity of aluminium given to babies is increasing. VIEW: Potential harm can be reduced by minimising the aluminium load wherever possible. Request vaccines which contain the least aluminium – for example, of the three available Meningitis vaccines, Meningitec (Wyeth) contains the lowest amount.5 Also, reduce the amount your baby is exposed to at any one time. So instead of having the Pediacel (5-in-1), Men C and pneumococcal vaccines all on the same day, spread them over a longer time period. And if you can afford to go privately, you can pay for single and small combination baby vaccines, where the vaccines are either aluminium-free or have the lowest aluminium content available. Encouragingly, none of the single measles, mumps and rubella vaccines, the combination MMR or the Hib/Men C booster contain aluminium.

The New 5-in-1 Vaccination

The 5-in-1 vaccine Pediacel – which combines polio, whooping cough (pertussis), diphtheria, tetanus and Hib – was launched in 2004 and contains safer polio and whooping cough vaccines.6 However, research published in the Journal of Allergy and Clinical Immunology has shown that the risk of childhood asthma doubled when the first dose of diphtheria, whooping cough and tetanus was given at the recommended time (ie two months old) versus being delayed by more than two months (ie at least four months old).7 In addition, the risk decreased with delays in giving all of the doses. Although this research looked at a slightly different type of whooping cough vaccine, the new 5-in-1 vaccine has polio and Hib added, so the load on a child’s immune system is further increased. VIEW: You could decide to delay giving the first dose of this vaccine until your baby is at least four months old, and then further space out the two follow-up jabs over their first year. This is particularly advisable if there is a family history of asthma, or if your child has ever suffered from eczema. And if you can afford to go privately, you could opt to have separate or small combination vaccines spread over an even longer timeframe.

Polio

While polio is a serious disease, it is worth noting that in June 2002, the World Health Organisation (WHO) certified that Europe was polio-free, with the last case being reported in the UK in 1982, and only one case of imported polio from overseas in 1993. In addition, according to the WHO’s Global Polio Eradication Initiative, there were only 1,303 reported cases of Polio worldwide in 2007, with most cases being reported in India and Nigeria. VIEW: If you are not planning to visit a region where the risk of contracting polio is relatively high, you may question the benefits of vaccinating. But if you are travelling with your child to Asia or Africa, then vaccination should definitely be considered.

Whooping Cough (Pertussis)

Dr Gordon Stewart, one of Britain’s experts in this area, claims that whooping cough is no longer a serious threat to the life and health of our children. But the vaccine may be dangerous for some. According to Dr Richard Halvorsen, author of The Truth about Vaccines and a GP who runs a private clinic (www.babyjabs.com) that offers a choice of baby vaccines, there is some research to suggest that in rare and isolated cases, the whooping cough vaccination is linked to cot death.8 Furthermore, a study published in the British Medical Journal indicated that the vaccine may not even be that effective as school age children still had symptoms of whooping cough, despite 86% of them being immunised as infants.9 VIEW: This vaccine appears to have a questionable level of effectiveness, but as it’s part of the 5-in-1, your baby can’t avoid it. However, as previously recommended, aim to wait until your child is at least four months old before immunising.

Tetanus

Tetanus is a bacteria commonly present in our environment, such as in the soil. Its normal route of infection is through an open wound, rather than from person to person. So the risk of infection can be minimised by cleaning wounds properly. VIEW: As babies are unlikely to be at risk from tetanus, at least until they start crawling and exploring their environment, there is an argument for delaying this vaccine until around six months.

Diphtheria

Diphtheria is caused by a bacterial infection which is usually spread by coughing. While this toxic bacteria is very rare in the UK, it can never be eradicated because the vaccine is active against the poison produced by the bacteria rather than against the bacteria itself. VIEW: This is one of the vaccines that should be considered, and the prevailing view is that it is one of the safest.

Haemophilus influenzae type b (Hib)

Hib is an uncommon but potentially serious disease, although we can carry Hib bacteria in our nose and throat without ever developing any symptoms.10 If an infection does develop, the symptoms are mostly mild, such as an ear infection – but some are much more dangerous, such as blood poisoning, pneumonia and meningitis. However, experts including the Health Protection Agency believe that there has been a rise in adult cases of Hib since the introduction of the Hib vaccination.11 Although the numbers are small, adults are far more likely to die from Hib than children (over 10% of adults and 30% of elderly, compared to 4-5% among children). VIEW: Ideally, it is suggested by experts such as Dr Halvorsen that this vaccine should be given selectively – for example in socially deprived areas or among children with an underlying serious medical problem. However, as it’s now part of the routine 5-in-1, that is not currently possible. Please note that while the current vaccine offers full immunity, it lasts only until your child is five, when their chance of catching Hib is greatly reduced.

Meningitis C and Pneumococcal infection

Like Hib, we can also carry meningitis C (a bacterial form of meningitis) and pneumococcal bacteria (which can cause diseases such as pneumonia, septicaemia and meningitis) harmlessly in our nose, throat and intestines without developing any symptoms.12 While both diseases can be serious, unless a person’s immune system is compromised, very few succumb – and in rare cases where an infection does occur, the vast majority make a full recovery with the proper treatment. VIEW: As both vaccines can be administered separately, there is an argument for children deemed as being at risk (eg with a serious underlying medical condition) being immunised.

The MMR Vaccine

MMR is still undoubtedly the most controversial vaccine. Dr Andrew Wakefield’s 1998 research study, published in The Lancet, reported bowel symptoms in a selected sample of 12 vaccinated children diagnosed with autism spectrum disorders and other disabilities, and alleged a possible connection with the MMR vaccination. Dr Wakefield’s conduct has been the subject of an ongoing hearing at the General Medical Council, with experts trying to discredit him and his findings. While some more recent studies claim to prove that no such link exists, others support Wakefield’s hypothesis (see www.vaproject.org/thrower/mmr-briefing-20070430.htm). For example, in one survey of 825 parents whose children had symptoms that would classify them as autistic, 55 reported clear signs of regression following the MMR vaccine. VIEW: In my view, the jury’s still out on this one. Until we can prove the MMR combination vaccine is safe, I think there is a strong argument for immunising separately, especially because (as explained below) the mumps and rubella components are given at a questionably young age. If you can’t afford to go privately, then aim to give your child the MMR when the measles component is at its most effective – ie around 15 months – and at a time when they don’t appear to be immuno-compromised (ie suffering with any infection or allergy).

Rubella

Rubella is a mild disease. The one exception is when pregnant women become infected (especially in the first 8-10 weeks of pregnancy). So while it is highly recommended to have this vaccination for women to prevent congenital deformities in their babies, it is debatable whether this vaccine should be given at around 13 months and again at three years, rather than around 12 years of age (which was the case in the initial vaccine programme in the 1970s). Follow-up studies in Finland, where a two-stage MMR programme is in operation, have found that approximately one third of girls immunised as young children and now aged around 17 have low levels of rubella antibodies, with the possibility of rubella infections re-emerging during pregnancy. VIEW: As this vaccine is available separately, it would be preferable for teenage girls, rather than babies, to be vaccinated after an antibodyAn antibody is a protein produced by the body’s immune system when it detects a harmful substance known as an antigen. Examples of antigens include… test to ensure they are not already immune.

Mumps

Mumps is also a mild disease in young children, and prior to the vaccine in 1988, many children were infected without developing any symptoms. Although being the most common cause of viral meningitis, it is also one of the most harmless forms, unlike bacterial meningitis which can be severe. In contrast, however, in adolescents and adults (especially boys and men) mumps is more serious. This is particularly important, as there have been a number of recent mumps outbreaks in teenagers and young adults who have received two doses of mumps-containing vaccines.14 There is also some evidence that this vaccine may be more effective on its own. VIEW: As this vaccine is available separately, it would be preferable for pre-pubescent boys to be vaccinated after an antibody test to ensure they are not already immune. For girls, it isn’t considered necessary.

Measles

Although healthy children are generally not at risk from measles or its complications (eg pneumonia), the risks of the disease remain greater than the risk of the vaccine – and it is still a relatively common disease in the UK. VIEW: This vaccination can be given at any time from 12 months, although maximum effectiveness may not be reached before 15 months of age. However, of the triple MMR vaccine, there are more side effects with the measles component because the measles vaccine consists of a weakened live measles virus. This means that there’s a 1 in 10 chance of developing symptoms of a mild measles attack, a 1 in 2,000 risk of a febrile convulsion (a fit), and a 1 in 20,000 chance of a temporary clotting disorder of the blood that will cause a bruise-like rash, which usually goes away on its own and is rarely serious. In view of this – and because of the ongoing controversy over MMR – you may wish to consider having your child immunised privately, where they can have separate doses spread out over a longer time period. Something else to be aware of – according to the results of a study published in the Archives of Disease in Childhood, the antibody count after a measles vaccination is significantly lower among children who develop a fever in the following week, compared to children who don’t.15 Consequently, it may be worth asking for an antibody test if your child experiences this to ensure that he or she has acquired proper immunity.

Supporting your child’s immune system

One of the best ways to support your child’s immune system, and help them avoid catching diseases in the first place, is by giving them a nutrient-packed diet. So opting for meals and snacks that are high in vegetables, fruit, unrefined wholegrains (eg oats, brown rice, wholemeal pasta, rye or wholemeal bread) organic pulses, nuts and seeds, fish, meat and eggs, and low in sugar and additives. Ensuring an optimum intake of nutrients can actually help to reduce risk of disease. For example, studies indicate that children infected with measles have lower levels of vitamin A. Consequently, eating a diet high in vitamin A, rich in fish, and its precursor beta-carotene, rich in green leafy vegetables and yellow-orange coloured fruit and vegetables, may reduce the risk of your child developing measles or its complications. I also recommend supplementing a daily chewable multivitamin and mineral, plus essential fats. There is also logic in avoiding the most common allergens, wheat and dairy products, for a few days after a vaccination (especially MMR), as the immune system becomes activated. Another excellent way of supporting your child’s immune system is by breastfeeding. UNICEF estimates that the lives of 1.3 million children worldwide would be saved and many others greatly improved if they were exclusively breastfed for the first six months of life. And although solids should be introduced at this stage, it is best to keep breastfeeding as well for at least a year.

Conclusion

Only you can decide in the face of conflicting and often confusing information when, and if, to vaccinate your children. My advice is don’t be bullied. Ask your health practitioner for clear answers to your questions, and if you’re not satisfied, ask to see an immunologist. As there is increasing evidence of interactions between combination vaccines or when more than one vaccine is given on the same day, it is important when making a decision about vaccination that you understand that the current UK schedule is not set in stone – you can in fact vaccinate your child outside the recommended time frame, a fact not commonly appreciated. It is also important to know that you can pay privately for single MMR vaccinations (see www. jabs.org.uk/pages/single.asp for a list of clinics). However, as far are as I am aware, the only private clinic currently offering the Pediacel (5-in-1) in single or small combinations is Babyjabs (www.babyjabs.com) based in central London. For more information, read The Truth about Vaccines by Dr Richard Halvorsen (£9.99) – order online at www.patrickholford.com (100%health members receive a 10% discount). Thanks to nutritional therapist Melody Mackeown (www.naturalnutrition.uk.com) for all her excellent research.

References

1. PA Offit, Vaccines and autism revisited – the Hannah Poling case, New England Journal of Medicine (2008), vol 358 (20), pp 2089-2091.

2. R Halvorsen, The Truth about Vaccines (2007), published by Gibson Square, London.

3. R Halvorsen, as above.

4. K Cooke & MH Gould, The health effects of aluminium – a review, Journal of the Royal Society of Health (1991), vol 111(5), pp 163-8.

5. www.babyjabs.co.uk/baby_vaccines.shtml

6. R Halvorsen, as above.

7. KL McDonald et al, Delay in diphtheria, pertussis, tetanus vaccination is associated with a reduced risk of childhood asthma, The Journal of Allergy and Clinical Immunology (2008), vol 121(3), pp 626-642.

8. RK Smith & A Elias-Jones, Risk of life threatening apnoea after immunisation, Archive of Childhood Diseases (2005), vol 90(4), pp 436-437.

9. A Harnden et al, Whooping cough in school age children with persistent cough: prospective cohort study in primary care, British Medical Journal (2006), vol 333(7560), pp 174-177.

10. Immunisations Against Infectious Diseases: The Green Book (2006), published by the Department of Health. Click here to access [please insert link to www.dh.gov.uk/en/Publichealth/Healthprotection/Immunisation/Greenbook/DH_4097254]

11. J McVernon et al, Long-term impact of vaccination on Haemophilus influenzae type b (Hib) carriage in the United Kingdom, Epidemiology & Infection (2004), vol 132(4), pp 765-7.

12. Dr P Mansfield (www.goodhealthkeeping.co.uk) quoting from the Oxford Textbook of Medicine, Third edition (1996), vol 3, pp 4052; and Immunisations Against Infectious Diseases: The Green Book (2004), published by the Department of Health. [please insert link to www.immunisation.nhs.uk/files/greenbook.pdf]

13. I Davidkin et al, Duration of rubella immunity induced by two-dose measles, mumps and rubella (MMR) vaccination: A 15-year follow-up in Finland, Vaccine (2000), vol 18(27), pp 3106-12. 14. GH Dayan, Recent Resurgence of Mumps in the United States, New England Journal of Medicine (2008), vol 358, pp 1580-1589.

14. T Egami et al, Study of antibody titres after measles vaccination: fever within 7 days of vaccination and efficacy of booster doses, Archives of Disease in Childhood (2008), vol 93, pp 319-320.