A doctor shares his view on immunity and vaccines

© DoctorRMosk.com

Richard Moskowitz, M. D

For the past ten years or so, I have felt a deep and growing compunction against giving routine vaccinations to children. It began with the fundamental belief that people have the right to make that choice for themselves.

But eventually the day came when I could no longer bring myself to give the shots, even when the parents wished me to. I have always believed that the attempt to eradicate entire microbial species from the biosphere must inevitably upset the balance of Nature in fundamental ways that we can as yet scarcely imagine. Such concerns loom ever larger as new vaccines continue to be developed, seemingly for no better reason than that we have the technical capacity to make them, and thereby to demonstrate our right and power as a civilization to manipulate the evolutionary process itself.

Purely from the viewpoint of our own species, even if we could be sure that the vaccines were harmless, the fact remains that they are compulsory , that all children are required to undergo them, without sensitivity or proper regard for basic differences in individual susceptibility, to say nothing of the values and wishes of the parents and the children themselves.

Most people can readily accept the fact that, from time to time, certain laws may be necessary for the public good that some of us strongly disagree with. But the issue in this case involves nothing less than the introduction of foreign proteins or even live viruses into the bloodstream of entire populations. For that reason alone, the public is surely entitled to convincing proof, beyond any reasonable doubt, that artificial immunization is in fact a safe and effective procedure, in no way injurious to health, and that the threat of the corresponding natural diseases remains sufficiently clear and urgent to warrant the mass inoculation of everyone, even against their will if necessary.

Unfortunately, such proof has never been given; and even if it could be, continuing to employ vaccines against diseases that are no longer prevalent or dangerous hardly qualifies as an emergency.

Finally, even if there were such an emergency, and artificial immunization could be shown to be an appropriate response to it, the decision would remain at bottom a political one, involving issues of public health and safety that are far too important to be settled by any purely scientific or technical criteria, or indeed by any criteria less authoritative than the clearly articulated sense of the community about to be subjected to it.

For all of these reasons, I want to present the case against routine immunization as clearly and forcefully as I can. What I have to say is not quite a formal theory capable of rigorous proof or disproof. It is simply an attempt to explain my own experience, a nexus of interrelated facts, observations, reflections, and hypotheses, which taken together are more or less coherent and plausible and make intuitive sense to me. I offer them to the public in large part because the growing refusal of some parents to vaccinate their children is so seldom articulated or taken seriously. The fact is that we have been taught to accept vaccination as a kind of involuntary Communion, a sacrament of our participation in the unrestricted growth of scientific and industrial technology, utterly heedless of the long-term consequences to the health of our own species, let alone to the balance of Nature as a whole. For that reason alone, the other side of the case urgently needs to be heard.

1. Are the Vaccines Effective?

There is widespread agreement that the time period since the common vaccines were introduced has seen a remarkable decline in the corresponding natural infections; but the usual assumption that the decline is attributable to the vaccines remains unproven, and continues to be seriously questioned by eminent authorities in the field. The incidence and severity of whooping cough, for example, had already begun to decline precipitously long before the pertussis vaccine was introduced, [1] a fact which led the epidemiologist C. C. Dauer to remark, as far back as 1943:

If the mortality [from pertussis] continues to decline at the same rate during the next 15 years, it will be extremely difficult to show statistically that [pertussis immunization] had any effect in reducing mortality from whooping cough. [2]

Much the same is true not only of diphtheria and tetanus, but also of TB, cholera, typhus, typhoid, and other common scourges of a bygone era, which began to disappear toward the end of the Nineteenth Century, largely in response to improvements in public health and sanitation, but in any case long before antibiotics, vaccines, or any specific medical measures designed to eradicate them. [3]

Reflections such as these led the great microbiologist René Dubos to observe that microbial diseases have their own natural history, independent of drugs and vaccines, in which asymptomatic infection and symbiosis are much more common than overt disease:

It is barely recognized, but nevertheless true, that animals and plants, as well as men, can live peacefully with their most notorious microbial enemies. The world is obsessed by the fact that poliomyelitis can kill and maim several thousand unfortunate victims every year. But more extraordinary is the fact that millions upon millions of young people become infected by polio viruses, yet suffer no harm from the infection. The dramatic episodes of conflict between men and microbes are what strike the mind. What is less readily apprehended is the more common fact that infection can occur without producing disease. [4]

Yet how the vaccines actually accomplish these changes is not nearly as well understood as most people like to think it is. The disturbing possibility that they act in some other way than by producing a genuine immunity is suggested by the fact that the corresponding natural diseases have continued to break out, even in highly immunized populations, and that in such cases the observed differences in incidence and severity between immunized and non-immunized populations have often been much less dramatic than expected, and in some cases not measurably significant at all.

In a recent British outbreak of whooping cough, for example, even fully-immunized children contracted the disease in large numbers, and their rates of serious complications and death were not reduced significantly. [5] In another recent outbreak, 46 of the 85 fully-immunized children studied eventually contracted the disease. [6]

In 1977, 34 new cases of measles were reported on the UCLA campus, among a population that was supposedly 91% immune, according to careful serological testing. [7] In 1981, another 20 cases were reported in the area of Pecos, New Mexico within a few-month period, and 75% of them had been fully immunized, some quite recently. [8] A survey of sixth-graders in a well-immunized urban area similarly revealed that about 15% of this age group are still susceptible to rubella, a figure essentially identical with that of the pre-vaccine era. [9]

Finally, while the incidence of measles has dropped sharply, from about 400,000 cases annually in the early 1960's to about 30,000 by 1974-76, the death rate has remained exactly the same, [10] while among adolescents and young adults, the group with the highest incidence at present, the risk of pneumonia and liver abnormalities has increased quite substantially, to well over 3% and 20%, respectively. [11]

The simplest explanation for these discrepancies would be to stipulate that vaccines confer at most partial and temporary immunity, which sounds reasonable enough, inasmuch as they consist of either live viruses, rendered less virulent by serial passage in tissue culture, or bacteria and bacterial products that have been killed by heat and/or chemical adjuvants, such that they can still elicit an antibody response without initiating a full-blown disease. In other words, the vaccine is a "trick," in the sense that it simulates the true or natural immunity developed in the course of recovering from the natural disease, and it is therefore reasonable to expect that such artificial immunity will in fact "wear off" in time, and even require additional "booster" doses at regular intervals throughout life to maintain peak effectiveness.

Such an explanation would be disturbing enough to most people. Indeed, the basic fallacy in it is already evident in the fact that there is no way to know how long this partial, temporary immunity will last in any given individual, or how often it will need to be restimulated, since the answers to these questions presumably depend on the same individual variables that would have determined whether and how severely the same person, if unvaccinated, would have contracted the disease in the first place. In any case, a number of other observations suggest equally strongly that this simple explanation cannot be the correct one.

In the first place, one careful study has shown that when a person vaccinated against the measles again becomes susceptible to it, even repeated booster doses will have little or no long-lasting effect. [12]

In the second place, the vaccines do not act merely by producing pale or mild copies of the original disease; they also commonly produce a variety of symptoms of their own, which in some cases may be more serious than the disease, involving deeper structures, more vital organs, and less of a tendency to resolve themselves spontaneously, as well as being typically more difficult to recognize.

Thus in a recent outbreak of mumps in supposedly immune schoolchildren, several developed atypical symptoms, such as anorexia, vomiting, and erythematous rashes, but no parotid involvement, and hence could not be diagnosed without extensive serological testing to rule out other concurrent diseases. [13] The syndrome of "atypical measles" can be equally difficult to diagnose, even when it is thought of, [14] which suggests that it may not seldom be overlooked entirely. In some cases, atypical measles can be much more severe than the regular kind, with pneumonia, petechiæ, edema, and severe pain, [15] and likewise often goes unsuspected.

In any case, it seems virtually certain that other vaccine-related syndromes will be described and identified, if only we take the trouble to look for them, and that the ones we are aware of so far represent only a very small part of the problem. But even these few make it less and less plausible to assume that vaccines produce a normal, healthy immunity that lasts for some time but then wears off, leaving the patient miraculously unharmed and unaffected by the experience.

2. Some Personal Experiences of Vaccine Cases.

I will now present a few of my own vaccine cases, to give a sense of their variety, to show how difficult it can be to trace them, and also to begin to address the underlying question that is seldom asked, namely, how the vaccines actually work, i. e., how they do whatever it is that they do inside the body, and how they produce the results that we see clinically in the patient.

My first case was that of an 8-month-old girl with recurrent fevers of unknown origin. I first saw her in January 1977, a few weeks after her third such episode. These were brief, lasting 48 hours at most, but very intense, with the fever often reaching 105˚F. During the second episode she was hospitalized for diagnostic evaluation, but her pediatrician found nothing out of the ordinary. Apart from these episodes, the child appeared to be quite well, and growing and developing normally.

I could get no further information from the mother, except for the fact that the episodes had occurred almost exactly one month apart, and from consulting her calendar we learned that the first one had come exactly one month after the 3rd of her DPT shots, which had also been given at monthly intervals. At this point the mother remembered that the girl had had similar fever episodes immediately after each injection, but that the pediatrician had dismissed them as common reactions to the vaccine, as indeed they are. Purely on the strength of that history, I gave her a single dose of the ultradilute homeopathic DPT vaccine, and I am happy to report that she had no more such episodes, and has remained entirely well since.

This case illustrates how homeopathic "nosodes," or medicines prepared from vaccines or their corresponding diseases, can be used for diagnosis as well as treatment of vaccine-related illness, which, no matter how strongly they are suspected, might otherwise be almost impossible to substantiate. Secondly, because fever is among the commonest reactions to the pertussis vaccine, and the child seemed perfectly well between the attacks, her response to it has to be regarded as a relatively strong and healthy one, disturbing because of its recurrence and periodicity, but also quite simple to cure, as indeed it proved. But I keep wondering what happens to the vaccine inside those tens and hundreds of millions of children who show no obvious response to it at all.

Since that time, I have seen at least half a dozen cases of babies and small children with recurrent fevers of unknown origin, some associated with a variety of other chronic complaints, like irritability, temper tantrums, and increased susceptibility to tonsillitis, pharyngitis, colds, and ear infections, which were similarly traceable to the pertussis vaccine, and which likewise responded beautifully to treatment with the homeopathic DPT nosode. Indeed on that basis I submit that the pertussis vaccine is an important cause of recurrent fevers of unknown origin in this age group.

My second case was that of a 9-month-old girl who presented acutely with a fever of 105˚F., and very few other symptoms. She too had had two similar episodes previously, but at irregular intervals, and her parents, who were ambivalent about vaccinations to begin with, had so far given her only one dose of the DPT vaccine, but her first episode occurred a few weeks afterward.

I first saw her in June of 1978. The fever remained high and unremitting for 48 hours, despite the usual acute remedies and supportive measures. A CBC showed a white-cell count of 32,000 per cu. mm., with 43% lymphocytes, 11% monocytes, 25% neutrophils (many with toxic granulations), 20% band forms (also with toxic granulations), and 1% metamyelocytes and other immature forms. Without giving any history, I showed the smear to a pediatrician friend, and "pertussis" was his immediate reply. After a single dose of the homeopathic DPT vaccine, the fever came down abruptly, and the girl has remained well since.

This case was disturbing mainly because of the hematological abnormalities, which fell within the leukemoid range, together with the absence of any cough or illness with distinctive respiratory symptoms, all suggesting that introducing the vaccine directly into the blood may actually promote deeper or more systemic pathology than allowing the pertussis organism to set up typical symptoms of local inflammation at the normal portal of entry.

The third case was a 5-year-old boy with chronic lymphocytic leukemia, whom I happened to see in August of 1978, while visiting an old friend and teacher, a family physician with over 40 years' experience. Well out of earshot of the boy and his parents, he told me that the leukemia had first appeared following a DPT vaccination, that he had treated the child successfully with natural remedies on two previous occasions, when the blood picture improved dramatically, and the liver and spleen shrank down to almost normal size, but that full relapse had occurred soon after each DPT booster.

It was shocking enough to think that vaccinations might be implicated in some cases of childhood leukemia, but the idea also completed the line of reasoning opened up by the previous case. For leukemia is a cancerous transformation of the blood and blood-forming organs, the liver, the spleen, the lymph nodes, and the bone marrow, which are also the basic anatomical units of the immune system. Insofar as vaccines are capable of producing serious complications of any kind, the blood and immune organs would be the logical place to begin looking for them.

But perhaps even more shocking to me was the fact that my teacher's remarkable success in treating this boy did not dissuade his parents from revaccinating him at least two more times, and that the connection between the vaccine and the disease was not generally known to the public or seriously considered by the medical community. It was this case that convinced me of the need for frank and open discussion among doctors and patients alike, about our collective experience with vaccine-related illness. While careful scientific investigation of these matters will hopefully ensue, the level of public commitment required even to frame the question properly seems far away.

I will now present two cases from my limited experience with the MMR vaccine.

In December of 1980 I saw a 3-year-old boy with loss of appetite, stomach ache, indigestion, and swollen glands for the past 4 weeks or so. The stomach pains were quite severe, and often accompanied by belching, flatulence, and explosive diarrhea. The nose was also congested, and the lower eyelids were quite red. The mother also reported some unusual behavior changes, extreme untidiness, "wild" and noisy playing, and waking at 2 a.m. to get in bed with her.

The physical examination was unremarkable except for some large, tender posterior auricular and suboccipital lymph nodes, and marked enlargement of the tonsils. That piqued my curiosity, and I learned that the boy had received his MMR vaccination in October, about 2 weeks before the onset of symptoms, with no apparent reaction to it at the time. I gave him a single dose of the highly-dilute homeopathic rubella vaccine, and the symptoms disappeared within 48 hours.

The following spring, the parents brought him back for a slight fever, and a 3-week history of intermittent pain in and behind the right ear, as well as a stuffy nose and other cold symptoms. On examination, the whole right side of the face appeared to be swollen, especially the cheek and angle of the jaw. He responded well to acute homeo-pathic remedies, without requiring the mumps nosode, and has remained well since.

This boy exhibited some interesting features that I have learned to recognize in other MMR cases. At an interval of a few weeks after the vaccine, which is roughly the same as the incubation period for the corresponding diseases, a nondescript illness develops, which then becomes subacute and rather more severe than rubella in the same age group, with abdominal and/or joint pains and marked adenopathy, but no rash. Usually the diagnosis is suspected because of enlargement of the posterior auricular and suboccipital nodes, for which rubella and a few other diseases have a marked affinity, and confirmed by a favorable response to the homeopathic rubella nosode.

Furthermore, his second illness, and especially the parotid enlargement, may well have represented continuing activity of the mumps component of the vaccine, although it cleared up so promptly that I never needed to test that hypothesis by using the homeopathic mumps nosode. Either way, it strongly suggests the possibility that a variety of "mixed" or composite syndromes may occur, representing the patient's responses to two or perhaps all three of the vaccine components, either more or less simultaneously, or one by one over time, as the next case illustrates:

In April of 1981 I first saw a 4-year-old boy for chronic bilateral enlargement of the posterior auricular nodes, which were also somewhat tender at times. The mother had noticed the swelling for about a year, during which time he had also become more susceptible to various upper respiratory infections, none of them very severe. Over the same period of time, she had also observed recurrent parotid swelling at irregular intervals, which began shortly after the MMR vaccine was given at the age of 3.

At his first visit, the boy was not ill, and the mother was about 2 months pregnant; so I decided to observe him but if possible do nothing further until the pregnancy was over. He did develop a mild laryngitis in her third trimester, but it responded well to bed rest and simple acute remedies. The following spring he came down with acute bronchitis, and I noticed that the posterior auricular glands were once again swollen and tender, so I decided to give him a dose of the homeopathic rubella nosode at that point. The cough promptly subsided, and the nodes regressed in size and were no longer tender. But two weeks later, he was back, this time with a hard, tender swelling on the outside of the cheek, near the angle of the jaw, and some pain on chewing or opening the mouth. One dose of the homeopathic mumps nosode was given, and the child has been well since.

What was particularly noteworthy about this case was its strong pattern of chronicity, with an increased susceptibility to weaker, low-grade responses, in contrast to the vigorous, acute responses typically associated with diseases like the measles and the mumps when acquired naturally.

3. How Do the Vaccines Work?

It is dangerously misleading, and indeed the exact opposite of the truth, to claim that a vaccine renders us "immune" to or protects us against an acute disease, if in fact it only drives the disease deeper into the interior and causes us to harbor it chronically instead, with the result that our responses to it become progressively weaker, but show less and less of a tendency to heal or resolve themselves spontaneously. What I propose, then, is to investigate as thoroughly and objectively as I can how the vaccines actually work inside the human body, and to begin by simply paying attention to the implications of what we already know. Consider the process of falling ill with and recovering from a typical acute disease, such as the measles, in contrast with what we can observe following administration of the measles vaccine.

We all know that measles is primarily a virus of the upper respiratory tract, both because it is acquired by susceptible persons through inhalation of infected droplets in the air, and because these droplets are produced by the coughing and sneezing of a patient with the disease. Once inhaled by a susceptible individual, the virus undergoes a prolonged period of silent multiplication, first in the tonsils, adenoids, and accessory lymphoid aggregations of the nasopharynx; later in the regional lymph nodes of the head and neck; and eventually, several days later, it passes into the blood and enters the spleen, the liver, the thymus, and the bone marrow, the "visceral" organs of the immune system. [16] Throughout this "incubation" period, which lasts from 10 to 14 days, the patient typically feels quite well, and experiences few or no symptoms of any kind. [17]

By the time that the first symptoms of measles appear, circulating antibodies are already detectable in the blood, and the height of the symptomatology coincides with the peak of the antibody response. [18] In other words, the "illness" that we call the measles is simply the definitive effort of the immune system to clear this virus from the blood. Notice also that this expulsion is accomplished by sneezing and coughing, i. e., via the same route through which it entered in the first place. It is abundantly clear from the above that the process of mounting and recovering from an acute illness like the measles involves a general mobilization of the immune system as a whole, including inflammation of the previously sensitized tissues at the portal(s) of entry, activation of leukocytes, macrophages, and the serum complement system, and a host of other mechanisms, of which the production of circulating antibodies is only one, and by no means the most important.

Such splendid outpourings indeed represent the decisive experiences in the normal physiological maturation of the immune system in the life of a healthy child. For recovery from the measles not only protects children from being susceptible to it again, [19] no matter how many more times they may be exposed to it, but also prepares them to respond promptly and effectively to any other infections they may encounter in the future. The ability to mount a vigorous acute response to infection must therefore be reckoned among the most fundamental requirements of health and well-being that we all share.

By contrast, the live but artificially attenuated measles-virus vaccine is injected directly into the blood, by-passing the normal port of entry, and sets up at most a brief inflammatory reaction at the injection site, or perhaps in the regional lymph nodes, with no local sensitization at the normal portal of entry, no "incubation period," no generalized inflammatory response, and no generalized outpouring. By "tricking" the body in this fashion, we have accomplished precisely what the entire immune system seems to have evolved to prevent: we have placed the virus directly into the blood, and given it free and immediate access to the major immune organs and tissues, without any obvious mechanism or route for getting rid of it.

The result is the production of circulating antibodies against the virus, which can in fact be measured in the blood; but this antibody response occurs as an isolated technical feat, without any overt illness to recover from, or any noticeable improvement in the general health of the recipient. Indeed I submit that exactly the opposite is true, that the price we have to pay for these antibodies is the persistence of viral elements in the blood for long periods of time, perhaps permanently, which in turn carries with it a systematic weakening of our capacity to mount an acute response, not only to the measles, but to other infections as well.

Far from producing a genuine immunity, then, my suspicion and my fear is that vaccines act by interfering with and even suppressing the immune response as a whole, in much the same way that radiation, chemotherapy, corticosteroids, and other anti-inflammatory drugs do. Artificial immunization focuses on antibody production, a single aspect of the immune process, disarticulates it, and allows it to stand for the whole, in much the same way as chemical suppression of an elevated blood pressure is accepted as a valid substitute for genuine healing or cure of the patient whose blood pressure has risen. It is the frosting on the cake, without the cake. The worst part of this counterfeiting is that it becomes more difficult, if not impossible, for vaccinated children to mount a normally acute and vigorous response to infection, by substituting for it a much weaker, essentially chronic response, with little or no tendency to heal itself spontaneously.

Furthermore, excellent models already exist for predicting and explaining what kinds of chronic disease are likely to result from long-term persistence of viral, bacterial, and other foreign proteins within the cells of the immune system. It has long been known that live viruses, for example, are capable of surviving for years within host cells in a latent form, without necessarily provoking acute disease, simply by attaching their own genetic material (DNA or RNA) as an "episome" or extra particle to the genome of the host cell, and replicating along with it, allowing the latter to continue its normal functions for the most part, but adding new instructions for the synthesis of viral proteins as well. [20]

Latent viruses of this type have already been implicated in three distinct types of chronic disease, namely,

1) recurrent or episodic acute diseases, such as herpes simplex, shingles, warts, etc.; [21]

2) "slow-virus" diseases, i. e., subacute or chronic, progressive, and often fatal diseases, such as kuru, Creutzfeldt-Jakob disease, possibly Guillain-Barré syndrome, and subacute sclerosing panencephalitis (SSPE), a rare complication of measles; [22] and

3) tumors, both benign and malignant. [23] In all of these varieties, the latent virus "survives" as a clearly foreign element within the cell, which implies that the immune system must continue to try to make antibodies against it, insofar as it can still respond to it at all. But because the virus is now permanently incorporated within the genetic material of the cell, these antibodies will now have to be directed against the cell itself.

The persistence of live viruses and other foreign antigens within the cells of the host therefore cannot fail to provoke auto-immune phenomena, because attacking and destroying the infected cells is now the only possible way to remove this constant antigenic challenge from the body. Since universal compulsory vaccination introduces live viruses and other highly antigenic material into the blood of virtually every living person, it is not difficult to predict that a significant harvest of auto-immune diseases will automatically result.

Sir Macfarlane Burnet has observed that the various components of the immune system function as if they were collectively designed to help the organism to distinguish "self" from "non-self," i. e., to help us recognize and tolerate our own cells, and to identify and eliminate foreign or extraneous substances as completely as possible. [24]

Lending further credence to this hypothesis are the acute response to infection, as we saw, and the rejection of transplanted tissues or organs from the same species, i. e., homografts, both of which accomplish complete and permanent removal of the offending substances from the body. If Burnet is correct, then latent viruses, auto-immune phenomena, and perhaps cancer could be regarded as different aspects of the same basic reality, which the immune system can neither escape nor resolve. For they all entail a certain degree of chronic immune failure, a state in which it becomes increasingly difficult or impossible for the body either to recognize its own cells as unambiguously its own, or to eliminate its parasites as essentially foreign.

In the case of the attenuated measles virus vaccine, introducing it directly into the blood might continue to provoke an antibody response for a considerable period of time, which of course is the whole point of giving the vaccine, but eventually, as the virus achieves a state of latency, that response would presumably wane, both because circulating antibodies normally cannot cross the cell membrane, and because they are also powerful immunosuppressive agents in their own right. [25]

After that, the effect of circulating antibodies would be in effect to imprison the virus inside the cell, i. e., to continue to prevent any acute inflammatory response, until such time as, perhaps under circumstances of an emergency or cumulative stress, this precarious balance breaks down, antibodies begin to be produced in large numbers against the cells themselves, and frank auto-immune phenomena, including necrosis and tissue damage, are likely to appear. In this sense, latent viruses are like biological "time bombs," set to explode at an indeterminate time in the future. [26]

Auto-immune phenomena have always seemed obscure, aberrant, and bizarre to physicians, because it is not intuitively obvious why the body should suddenly begin to attack and destroy its own tissues. They make a lot more sense, and perhaps should even be regarded as "healthy," to the extent that destroying chronically infected cells is the only possible way to eliminate an even more serious threat to life, namely, the foreign antigenic challenge persisting within the cells of the host.

According to the same model, tumor formation could be understood as simply a more advanced stage of chronic immune failure, inasmuch as the longer the host is subjected to enormous and constant pressure to make antibodies against itself, the less effective that process will likely become. Eventually, under stress of this magnitude, the auto-immune mechanism itself could break down to the point that the chronically infected and genetically transformed cells, no longer clearly "self" or non-self," begin to free themselves from the normal restraints of "histocompatibility" within the architecture of the surrounding cells and tissues, and begin to multiply autonomously at their expense. A tumor could then be described as "benign," if the weakening of histocompatibility remains strictly localized to the tissue of origin, "malignant" if the process spills over into other cell types, tissues, and organs, even in more remote areas, and not necessarily rigidly or permanently one or the other, since they differ primarily in degree and therefore might or might not even change back and forth into each other in due course.

If what I am saying turns out to be true, then all we have achieved by artificial immunization is to have traded off our acute epidemic diseases of past centuries for the weaker and far less curable chronic diseases of the present, with their suffering and disability paid out little by little, rather than all at once, and amortized over the patient's lifetime. Perhaps even more, I fear that in doing so we have opened up limitless possibilities for new diseases in the future by in vivo genetic recombination within the cells of the race.

4. The Individual Vaccines Reconsidered.

I will now consider each of the vaccines individually, in relation to the natural diseases from which they are derived.

The triple MMR vaccine comprises attenuated, live measles, mumps, and rubella viruses, administered in a single intramuscular injection at about 15 months of age. Subsequent booster doses are no longer recommended, except for young women of childbearing age, in whom the risk of Congenital Rubella Syndrome (CRS) is thought to warrant it, even though the effectiveness of such boosters is at best questionable, as we saw.

Before the vaccine era, measles, mumps, and rubella were classified as "routine diseases of childhood," which most schoolchildren acquired before the age of puberty, and from which nearly all recovered, with lifelong immunity and no complications or sequelæ. But they were not always so harmless. Measles, in particular, is devastating when a population encounters it for the first time. Its importation from Spain undoubtedly contributed to Cortez' conquest of the mighty Aztec empire with only a handful of soldiers: whole villages were carried off by epidemics of measles and smallpox, leaving only a small remnant of cowed, superstitious warrior to face the bearded conquistadores from across the sea. [27]

In more recent outbreaks among isolated, primitive peoples, the case fatality rate from measles averaged 20 to 30%. [28] In these so-called "virgin-soil" epidemics, not only measles, but also polio and many other epidemic diseases take their highest toll of death and serious complications among adolescents and young adults, seemingly healthy and vigorous people in the prime of life, and leave relatively unharmed the group of school-age children before the age of puberty. [29]

The evolution of a disease like the measles from a dreaded killer to a routine disease of childhood presupposes the development of non-specific or "herd" immunity in young children, such that when they are finally exposed to it, it activates defense mechanisms already in place to receive it, resulting in the prolonged incubation period and usually benign, self-limited course described above.

Under these circumstances, the rationale for vaccinating young children against it is limited to the fact that a very small number of deaths and serious complications have continued to occur, chiefly pneumonia, encephalitis, and the rare but dreaded subacute sclerosing panencephalitis (SSPE), a slow-virus disease with an incidence of 1 per 100,000 cases. [30] Pneumonia, by far the commonest of them, is also benign and self-limited in most cases, even without treatment, [31] and even in those rare cases when bacterial pneumonia supervenes, adequate treatment is currently available.

By all accounts, then, the death rate from measles is very low in the developed world, the risk of serious complications is very low, and the general benefit to the child who recovers from it, as well as his contacts and descendants, is very great. Even if the vaccine could be shown to lower the risk of death and serious morbidity still further, these small achievements would hardly justify the high probability of auto-immune diseases, cancer, and whatever else may result from the harboring and propagation of latent measles virus in human tissue culture for life.

Ironically, what the vaccine certainly has done is to reverse the historical or evolutionary process to the extent that measles is now once again a disease of adolescents and young adults, [32] with a correspondingly higher risk of complications, and a general tendency to produce more illness and disability than it does in grade-school children.

As for the claim that it has helped to eliminate measles encephalitis, even in my own relatively small general practice I have already seen two children with major seizure disorders that the parents clearly traced to the measles vaccine, although they would never have been able to prove the connection in court, and never even considered the possibility of compensation. Such cases therefore never make it into the official statistics, and are duly omitted from conventional surveys of the problem, in spite of the fact that injecting measles into the blood would naturally favor a higher incidence of visceral complications affecting the lungs, liver, and brain, organs for which the virus has a known affinity.

The case for immunizing against mumps and rubella seems a fortiori even more tenuous, for exactly the same reasons. Mumps is also essentially a benign, self-limited disease in children before the age of puberty, and recovery from a single attack likewise confers lifelong immunity. The major complication is meningo-encephalitis, mild or subclinical forms of which are relatively common, but the death rate is extremely low, [33] and sequelæ are rare. The mumps vaccine is prepared and administered in much the same way as the measles, almost always in the same injection, and the dangers associated with it are also comparable. It too is fast becoming a disease of adolescents and young adults, [34] age groups who tolerate it much less well. With them he main complication is epididymo-orchitis, which occurs in 30-40% of affected males past the age of puberty, and usually results in atrophy of the testicle on the affected side, [35] but it also shows a definite affinity for the ovary and pancreas, and may attack these organs as well.

For all of these reasons, the greatest favor we could do for our children would be to expose them to the measles and mumps when they reach school age, which would not only protect them from contracting more serious versions after puberty, but would also greatly enhance their immunological maturation with minimal risk, as was the rule before the vaccine was introduced.

The same discrepancy is evident for rubella or "German measles" as well, which in young children is a disease so mild that it frequently escapes detection, [36] but in adolescents and adults is much more likely to produce arthritis, purpura, and other systemic indications of greater severity. [37] The main impetus for marketing the vaccine was certainly the recognition of Congenital Rubella Syndrome (CRS), resulting from intrauterine damage to the embryo when the mother acquires the virus in her first trimester of pregnancy, [38] and the unusually high incidence of CRS during the rubella outbreak of 1964. Here again, we have an almost entirely benign, self-limited disease made over by the vaccine into a considerably less benign one of adolescents and young adults of reproductive age, precisely the group that most needs to be protected from it, while the easiest and most effective way to prevent it would likewise be to expose kids to the disease in elementary school. Re-infection does sometimes occur after recovery, but much less commonly than after vaccination. [39]

The equation looks rather different for the diphtheria and tetanus vaccines. First of all, both natural diseases are serious and sometimes fatal, even with the best treatment. This is especially true of tetanus, which still carries a mortality of at least 10-20%. Furthermore, these vaccines are not made of live organisms, but only of certain toxins elaborated by them.

These poisonous substances are responsible for all of the death and destruction wrought by these diseases, and remain highly antigenic even after being inactivated by heat. Diphtheria and tetanus "toxoids" thus do not protect against infection per se, but only against the systemic action of these poisons, in the absence of which both infections are of minor importance clinically. It is therefore easy to understand why parents might want their children protected against diphtheria and tetanus, if safe and effective protection were available; and both vaccines have been in use for a long time, with a very low incidence of serious complications reported, so that there has been very little public outcry against them.

On the other hand, both diseases are readily controlled by simple sanitary measures and careful attention to wound hygiene, and both have been steadily disappearing from the industrially developed countries since long before the toxoids were introduced. Diphtheria now occurs only sporadically in the United States, often in areas with significant reservoirs of unvaccinated children.

But the claim that the vaccine is protective is belied by the fact that, when the disease does break out, the supposedly "susceptible" kids are no more likely to develop it than their fully-immunized contacts. In a 1969 outbreak in Chicago, for example, the Board of Health reported that 25% of the cases had been fully immunized; another 12% had received one or more doses and serologically were fully "immune;" and another 18% had been partly immunized, according to the same criteria. [40]

So once again we are faced with the likelihood that diphtheria toxoid has not produced a genuine immunity to diphtheria, but rather some sort of chronic immune tolerance to it, by harboring highly antigenic residues somewhere within the cells of the immune system, presumably with long-term suppressive effects on the immune mechanism generally. This suspicion earns further credence from the fact that all of the DPT vaccine components are alum-precipitated and preserved with Thimerosal, an organomercury derivative, to preserve them from being metabolized too rapidly, so that the antigenic challenge will continue for as long a time as possible. The fact is that we do not know, or even seem to care, what actually becomes of these foreign substances once they are inside our bodies and those of our children.

Exactly the same questions haunt the seemingly favorable record of the tetanus vaccine, which almost certainly has had some impact in reducing the incidence of tetanus in its classic acute form, yet presumably also persists for years or even decades as a potent foreign antigen within the cells of the immune system, with long-term effects on the immune mechanism that for the present are invisible and therefore impossible to calculate.

Much like diphtheria and tetanus, "whooping cough" began to decline as a serious epidemic threat, as we saw, long before the DPT vaccine was introduced. Moreover, the pertussis vaccine has not been particularly effective, even according to its proponents, and the incidence of known side-effects is disturbingly high. Its power to damage the Central Nervous System or CNS, for example, has received growing attention since Dr. Gordon Stewart and his colleagues reported an alarmingly high incidence of encephalopathy and severe convulsive disorders in British children that were traceable to the vaccine. [41]

My own cases, a few of which were cited above, suggest that hematologic disturbances should also be investigated, and that the known complications represent at most a small fraction of the actual total.

In any case, the pertussis vaccine has become controversial even in the United States, where medical opinion remains almost unanimous in favor of vaccines generally, while several other countries, such as West Germany, have discontinued routine pertussis vaccination entirely. [42] The disease pertussis is also extremely variable clinically, ranging in severity from asymptomatic, mild, or inapparent infections, which are not uncommon, to very rare cases in young infants less than 6 months of age, where the mortality is claimed by some to reach 40%. [43] In children over a year old, however, the disease is rarely fatal, or even that serious a threat of future difficulty, despite its intensity, while antibiotics play a very small part in the outcome. [44]

Most of the pressure to immunize at present thus seems attributable to the higher death rate in very young infants, which has led to what to me seems like a terrifying practice of giving this most clearly dangerous of the vaccines to tiny infants, beginning at 2 months of age, when their mothers' milk would normally protect them from all infections about as well as can ever be done for this age group, [45] and its effect on the still-developing blood and nervous systems is most apt to be catastrophic. For all of these reasons, routine pertussis immunization should be discontinued as quickly as possible, until more studies are done to assess and defray the cost of whatever damage it has already done.

Poliomyelitis and the polio vaccines present an entirely different situation. The standard Sabin vaccine is trivalent, consisting of attenuated live polioviruses of each of the three strains known to produce paralytic disease, and administered orally, the same way the infection is acquired in Nature. Thus allowing the recipient to develop something resembling a natural immunity, by sensitizing cells of the digestive tract at the normal portal of entry, could represent a considerable safety factor. On the other hand, wild-type polio viruses produce no symptoms whatsoever in well over 90% of the people who contact them, even under epidemic conditions; [46] and of those who do become ill, the vast majority suffer nothing worse than a typical gastroenteritis that is more or less indistinguishable from any other of the common summer diarrheas in children. Only 1 or 2% of them ever progress to the full-blown picture of paralytic "poliomyelitis," with its typical lesions in the motor neurons of the spinal cord and medulla oblongata. [47] Poliomyelitis thus also requires peculiar and unusual conditions of susceptibility in the host, indeed an anatomical susceptibility, since the virulence of the poliovirus is so low for most people, even under epidemic conditions, and the number of cases resulting in death or permanent disability was always comparatively so small. [48]

Given the fact that polio viruses were ubiquitous before the vaccine was introduced, and could be found routinely in samples of city sewage wherever it was looked for, [49] it is evident that effective natural immunity to them was already as close to being universal as it could ever be, and a fortiori that no artificial substitute could ever equal or even approximate that record. Since the virus was of such low virulence to begin with, it is difficult to imagine what else further attenuation of it could possibly accomplish, other than perhaps to abate the full vigor of the natural immune response to it. For the fact remains that even the attenuated virus is still alive, and that the people who were anatomically susceptible to it before are still susceptible to it now. This means that at least some of these same people will develop paralytic polio from the vaccine, [50] and that all or most of the others may still be harboring the virus in latent form, perhaps within these same target cells.

The only advantage of giving the vaccine, then, would be to expose the population to the virus when its virulence is lowest, [51] i. e., when they are still infants, but this benefit might be more than offset by weakening the immune response, as we have seen. In any case, the whole matter is clearly one of considerable complexity, and also illustrates the hidden dangers and miscalculations inherent in the almost irresistible temptation to try to beat Nature at her own game, to eliminate a problem that cannot be eliminated, the susceptibility to disease itself.

So even in the case of the polio vaccine, which appears to be about as safe as a vaccine ever can be, the same basic dilemma remains. Perhaps the day will come when we will be ready to face the consequences of deliberately feeding live polio viruses to every living infant, and admit that we should have left well enough alone, and addressed ourselves to the art of healing the sick when we have to, rather than the technology of eradicating the possibility of sickness, when we don't have to, and can't possibly succeed in any case.

5. Vaccination and the Path of Medical Technology.

In conclusion, I want to go back to the beginning, to the essentially political aspects of vaccination, that oblige us to reason and deliberate together about matters of common concern, and to reach a clear decision about how we choose to live. I have stated my own views regarding the safety and effectiveness of vaccines, and I hope that others of differing views will do the same.

But I am deeply troubled by the atmosphere of fanaticism that surrounds the subject, whereby vaccines are forcibly imposed on the public in the absence of any public health emergency, often against their will, and serious discussion of them is ridiculed, stifled, and ignored by the medical authorities as if the question had been settled definitively and for all time. Here is a the classic triumphalist view, from the great scientist Macfarlane Burnet, whom we have met before:

It is our pride that in a civilized country the only infectious diseases which anyone is likely to suffer are either trivial or easily cured by available drugs. The diseases that killed in the past have been rendered impotent, and in the process general principles of control have been developed which should be applicable to any unexpected outbreak in the future. [52]

Quite apart from the truth or untruth of these claims, they exemplify the smugness and self-righteousness of a profession and a society that worships its own ability to manipulate and control the processes of Nature itself. That is why, as Robert Mendelsohn has said, "we are quick to pull the trigger, but slow to examine the consequences of our actions." [53] Indeed, methodically slow, one would have to say. In 1978, for example, the American Academy of Pediatrics was commissioned by Congress to formulate guidelines for Federal compensation of "vaccine-related injuries," and included the following eligibility restrictions in its report:

1. Such a reaction should have been previously recognized as a possible consequence of the vaccine given.

2. Such a reaction should have occurred no more than 30 days following the immunization. [54]

These restrictions would automatically exclude all of the chronic diseases, and indeed everything else except the very few adverse reactions that have so far been identified, which clearly represent no more than a tiny fraction of the problem. Still less can either the government or the medical establishment be considered ignorant of the threat that haunts every parent, that vaccines can cause cancer and other chronic diseases. Precisely that possibility was raised by Prof. Robert Simpson of Rutgers, in a 1976 seminar for science writers sponsored by the American Cancer Society:

Immunization programs against flu, measles, mumps, polio, and so forth, may actually be seeding humans with RNA to form latent proviruses in cells throughout the body. These could be molecules in search of diseases: when activated under proper conditions, they could cause a variety of diseases, including rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus, Parkinson's disease, and perhaps cancer. [55]

Unfortunately, this is just the sort of warning that few people are ready, willing, or able to hear, least of all the American Cancer Society or the American Academy of Pediatrics. All of us still want to believe in the "miracle," as Dubos calls it, regardless of the evidence:

Faith in the magical power of drugs often blunts the critical senses, and comes close at times to a mass hysteria, involving scientists and laymen alike. Men want miracles as much today as in the past. If they do not join one of the newer cults, they satisfy this need by worshiping at the altar of modern science. This faith in the magical power of drugs is not new. It helped to give medicine the authority of a priesthood, and to recreate the glamour of ancient mysteries. [56]

The idea of eradicating measles or polio has come to seem attractive to us, simply because the power of medical science makes it seem technically possible: we worship every victory of technology over Nature, just as the bullfight celebrates the triumph of human intelligence over the brute beast. That is why we do not begrudge the drug companies their enormous profits, and gladly volunteer our own bodies and those of our children for their latest experiments. Vaccination is essentially a religious sacrament of our own participation in the miracle, a veritable auto-da-fé in the name of civilization itself.

Nobody in his right mind would seriously entertain the idea that if we could somehow eliminate, one by one, measles and polio and all the known diseases of mankind, we would be any the healthier for it, or that other quite possibly even more serious diseases would not arise and quickly take their place. Still less would a rational being suppose that the illnesses he or she suffered from were "entities" somehow separable from the patients who suffer them, and that with the appropriate chemical or surgical sacrament such a removal can literally be carried out. Yet these are precisely the miracles we are taught to believe in, and the idolatries to which we aspire, forgetting the older and simpler truths that the liability to disease is deeply rooted in our biological nature, and that the phenomena of illness are the expression of our own life energy, trying to overcome whatever it is trying to overcome, trying, in short, to heal itself.

The myth that we can find purely technical solutions to all human ailments seems attractive at first, because it bypasses the problem of healing, which is a genuine miracle in the sense that it can always fail to occur. We are all authentically at risk of illness and death at every moment: no amount of technology can change that. Yet the quixotic mission of technomedicine is precisely to change that: to stand at all times in the front line against disease, to attack and destroy it whenever and wherever it shows itself.

That is why, with all due respect, I cannot have faith in the miracles or accept the sacraments of Merck, Sharp, and Dohme and the Centers for Disease Control. I prefer to stay with the miracle of life itself, which has given us illness and disease, to be sure, but also the arts of medicine and healing, through which we can acknowledge and experience our pain and vulnerability, and sometimes, with the grace of God and the help of our friends and neighbors, an awareness of health and well-being that knows no boundaries. That is my religion; and while I would willingly share it, I would not force it on anyone.

References:

1.Mortimer, E., "Pertussis Immunization," Hospital Practice, October 1980, p. 103.

2.Quoted in Mortimer, op. cit., p. 105.

3.Dubos, R., Mirage of Health, Harper, 1959, p. 73.

4.Ibid., pp. 74-75.

5.Stewart, G., "Vaccination Against Whooping Cough: Efficiency vs. Risks," Lancet 1977, p. 234.

6.Medical Tribune, January 10, 1979, p. 1.

7. Cherry, J., "The New Epidemiology of Measles and Rubella," Hospital Practice, July 1980, pp. 52-54.

8. Unpublished data from the New Mexico Health Department (private communication).

9.Lawless, M., et al., "Rubella Susceptibility in Sixth-Graders," Pediatrics 65:1086, June 1980.

10. Cherry, op. cit., p. 49.

11. Infectious Diseases, January 1982, p. 21.

12. Cherry, op. cit., p. 52.

13. Family Practice News, July 15, 1980, p. 1.

14. Ferrante, J., "Atypical Symptoms? It Could Still Be Measles," Modern Medicine, September 30, 1980, p. 76.

15. Cherry, op. cit., p. 53.

16. Phillips, C., "Measles," in Vaughan, V., et al., Eds., Nelson's Textbook of Pediatrics, 11th Ed., Saunders, 1979, p. 857.

17. Davis, B., et al., Microbiology, 2nd Ed., Harper, 1973, p. 1346.

18.Ibid., p. 1346.

19.Ibid., p. 1342.

20. Ibid., p. 1418.

21.Hayflick, L., "Slow Viruses," Executive Health Report, February 1981, p. 4.

22.Ibid., pp. 1-4.

23.Davis, op. cit., pp. 1418-1449.

24.Burnet, M., The Integrity of the Body, Atheneum, 1966, p. 68.

25.Talal, "Auto-Immunity," in Fudenberg, H., et al., Basic and Clinical Immunology, 3rd Ed., Lange, 1980, p. 22.

26. Hayflick, op. cit., p. 4.

27.McNeill, W., Plagues and Peoples, Anchor, 1976, p. 184.

28.Burnet, M., and White, D., The Natural History of Infectious Disease, Cambridge, 1972, p. 16.

29.Ibid., pp. 90, 121, and passim.

30.Steigman, A., "Slow Virus Infections," in Vaughan, op. cit., p. 937.

31.Phillips, op. cit., p. 860.

32.Infectious Diseases, April 1979, p. 26.

33.Phillips, "Mumps," in Vaughan, op. cit., p. 891.

34.Hayden, G., et al., "Mumps and Mumps Vaccine in the U. S.," Continuing Education, September 1979, p. 97.

35.Phillips, "Mumps," op. cit., p. 892.

36.Phillips, "Rubella," in Vaughan, op. cit., p. 863.

37.Ibid., p. 862.

38.Glasgow, L., and Overall, J., "Congenital Rubella Syndrome," in Vaughan, op. cit., p. 483.

39.Phillips, "Rubella," op. cit., p. 865.

40. Cited in Mendelsohn, R., "The Truth About Immunizations," The People's Doctor, April 1978, p. 1.

41.Stewart, op. cit., p. 234.

42.Mortimer, op. cit., p. 111.

43.Feigin, R., "Pertussis," in Vaughan, op. cit., p. 769.

44.Ibid.

45.Barness, L., "Breast Feeding," in Vaughan, op. cit., p. 191.

46.Burnet and White, op. cit., p. 91ff.

47. Davis, op. cit., p. 1290ff.

48. Ibid., p. 1280.

49. Burnet and White, op. cit., p. 95.

50. Fulginiti, V., "Problems of Poliovirus Immunization," Hospital Practice, August 1980, pp. 61-62.

51.Burnet and White, op. cit., p. 95.

52.Burnet, op. cit., p. 128.

53.Mendelsohn, op. cit., p. 3.

54.Quoted in Wehrle, P., "Vaccines, Risks, and Compensations," Infectious Diseases, February 1982, p. 16.

55.Quoted in Mendelsohn, op. cit., p. 1.

56. Dubos, op. cit., p. 157.

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