Madeleine and the Flu

Twelve little girls in two straight lines got the flu!

I was at a performance of Madeleine’s Christmas at a local theater the other day, my two children in tow. Madeleine’s Christmas is a charming book in the Madeleine series by Ludwig Bemelmans, written in 1956.  But as I watched the storyline unfold on stage, I found myself thinking like the MWV that I am, worrying about the eleven little girls suffering from influenza in an age when there was little to help them, besides the warm soup Madeleine (the only one unaffected) was able to serve them. I think my MWV radar was unusually sensitive that day, too, because my sixty-six-year-old father, who had received the flu vaccine this year, had just finished a bad bout with this year’s flu, and my children and I were struggling to kick a variety of different viruses as well.

Luckily, the eleven little girls—and Miss Clavel—all recovered in time to take a magic carpet ride around Paris, but the show did get me to thinking about how unusual this year’s flu season has been and why it’s so important that we see widespread vaccination, so that vulnerable people who might be more suspectible to the flu, even if they’ve been vaccinated (like my father), are better protected.

So I asked the folks at the CDC some of the questions that might be on your mind this flu season. The information below comes directly from CDC press releases, the CDC website, and communication with CDC representatives.

Why does the 2012-2013 flu season seem to be worse than previous flu seasons?

Flu seasons are unpredictable. The severity of influenza seasons can differ substantially from year to year. Over a period of 30 years, between 1976 and 2006, estimates of yearly flu-associated deaths in the United States range from a low of about 3,000 to a high of about 49,000 people during the most severe season. Each year in the United States on average more than 200,000 people may be hospitalized during a flu season. The 2009 H1N1 pandemic is an example of how unpredictable the flu can be. Click here for more information about the 2009 H1N1 pandemic.

The 2011-2012 season began late and was relatively mild compared with previous seasons (see “2011-2012 Flu Season Draws to a Close” for more information). Most of the viruses characterized so far this season have been H3N2 viruses; which are typically associated with more severe seasons.

Did the 2012-2013 flu season start “early”?

Significant increases in flu activity in the United States have occurred in the last two weeks (editor’s note: refers to late November, early December), indicating that an early flu season is upon us. Influenza-like-illness (ILI) activity levels in parts of the country are already higher than all of last season. 5 states are already reporting the highest level of activity possible. Click here for information from the CDC that discusses flu activity thus far. 

How effective is the flu vaccine?

The composition of the flu vaccine is reviewed each year. If needed, the vaccine is updated to protect against the three flu viruses that research indicates will be the most common during the upcoming season. New vaccine is manufactured every season. The 2012-2013 flu vaccine will protect against an influenza A (H1N1) virus, an influenza A (H3N2) virus and an influenza B virus.

Two factors play an important role in determining the likelihood that influenza vaccine will protect a person from influenza illness: 1) characteristics of the person being vaccinated (such as their age and health), and 2) the similarity or "match" between the influenza viruses in the vaccine and those spreading in the community.

In general, the flu vaccine works best among young healthy adults and older children. Lesser effects of flu vaccine are often found in studies of young children (e.g., those younger than 2 years of age) and older adults. Older people, who may have weaker immune systems, often have a lower protective immune response after influenza vaccination compared to younger, healthier persons. This can result in lower levels of vaccine effectiveness in these people. (This might explain why my father, who got the vaccine, still got the flu).

The good news is that most of the viruses characterized at CDC so far this season are well-matched to the vaccine viruses.

I want to make one note about the basic science of flu vaccines. Every once in a while, you might find an anti-vaccine website, like NaturalNews, make a comment about the flu vaccine. Last year, it was a story on its site that said that the reason a new flu vaccine had to be created every year is because the scientists “couldn’t get it right.” Most of you probably see scientific illiteracy in this statement, but in case it’s not clear, the flu virus changes each year, unlike most other vaccine-preventable diseases, and therefore a vaccine must “match” the predicted influenza viruses likely to spread in the community during the upcoming flu season in order to be effective.

You might also hear some people—even people in the world of public health—denigrating the current flu vaccines as ineffective. This shouldn’t be interpreted as a call to forgo the vaccine. Most of the time, when public health authorities, or leaders in the world of epidemiology, such as Michael Osterholm of the University of Minnesota, criticize the flu vaccine, they are advocating for a universal flu vaccine, or at least a better seasonal flu vaccine, both of which scientists are working on. 

I will take 60% protection over nothing any day, having lived through flu myself in years previous. And, without question, I would offer my children that same protection. I’m pretty sure that if that rug merchant in Madeleine’s Christmas had been peddling flu vaccines instead of magic carpets, the twelve little girls in two straight lines would have had a healthier Christmas, too.

The Subtle Way

Those of you have read this blog for some time probably know that I have contacted the local publication MN Parent before due to what I consider its lax fact-checking and tendency to promote anti-vaccine misinformation. I don't necessarily think this is a line of reasoning that the publishers or even the editor follow, but it appears in the pages of this big-circulation free publication from time to time. When I initially complained about MN Parent's profile of an anti-vaccine mother, in which none of her false assertions were fact-checked or even challenged, I initially received a very gracious response from the editor. However, when the next issue was published, the editorial response to my complaint (and the complaints of others) was to say that they don't fact-check parent quotes and shouldn't be expected to do so. They even went on to challenge CDC information about which state has the most cases of autism (the woman profiled claimed it was Minnesota).

While disappointing, I felt good about speaking up--and even better about the other parents who had apparently written in to complain.

Fast forward to last month. I picked up the November edition of Minnesota Parent and flipped to "20 Questions to Ask When You're Pregnant," written by "personality psychologist" Heidi Smith Luedtke. Number five was a straightforward question: "Should I get immunized?" Below is Luedtke's complete response in the article:

Your physician may recommend shots for the flu, hepatitis b, and tetanus (sic), especially if you're at risk. Live-virus vaccines and those for measles, mumps, and varicella (chicken pox) may be harmful during pregnancy. Speak up to make sure you're safe.

This is all sorts of wrong. First, it doesn't answer the question. Second, I think by "tetanus" the writer means the Tdap, which the ACIP (Advisory Committee on Immunization Practices) just recommended for all pregnant women, due to the increasing outbreaks of pertussis, a disease that is particularly devastating to infants.

But what is most interesting--and wrong--here is perhaps a bit subtle to those not involved in trying to increase immunization rates. Luedtke utilizes a scare tactic not uncommon among anti-vaccine activists: Trying to scare you off vaccines by bringing up totally irrelevant information.

Example: She brings up what I assume is the MMR vaccine (she says "measles, mumps" but leaves off the rubella component of the MMR vaccine, which is ironically the most devastating disease for a pregnant woman and her fetus) and the varicella vaccine. These are two vaccines that are NEVER offered to a pregnant woman. Never.

Here's what would happen. If you didn't know if you had been immunized for MMR, you would have a titers drawn to see if you were immune to rubella (I did this when pregnant). This would reveal your level of immunity. If you were not protected for rubella, your doctor would wait until you had given birth before immunization. As far as varicella goes, a pregnant woman would never be offered this vaccine either.

I'm not sure where the author is going with her comment about the Hep B vaccines--if you were a prostitute or drug user, your doctor might encourage you to get vaccinated, but the average pregnant woman would not need to worry about this.

It's pretty easy to locate the CDC's recommendations for vaccines during pregnancy. It would have been nice if the author of this piece--or better yet, her editor--had simply consulted this document instead of writing an error-ridden collection of nonsense designed to confuse a pregnant woman, at best, or scare her off vaccines, at worst.

As lagniappe, Luedtke directs pregnant women to "speak up to make sure you're safe." I don't know if Luedtke is actually opposed to vaccination, but the image she creates is of a vaccine-mad doctor coming at her with a syringe full of MMR vaccine. If it were me in that doctor's office, though, I'd speak up to make sure both of us--my baby and me--were safe by asking for my flu vaccine and Tdap.

Please speak up when you see members of the media mispeaking on vaccines. Most of the time, these are innocent mistakes (with potentially dangerous consequences) and the editors are glad to have them pointed out. The more often parents hold members of the media to a basic standard of accuracy, the better reporting we will get.

Letters to the Editors: Jenny McCarthy Edition

Over at Vaccinate Your Baby/Every Child by Two, the fine folks who run that page are encouraging parents to speak up against the Chicago Sun-Times decision to hire Jenny McCarthy as a columnist offering up parenting and family advice. Let's leave alone the comment such a hire makes on the state of journalism in this country and focus on the fact that McCarthy's anti-vaccine nonsense has been profoundly destructive in this country.

Amy Pisani over at Every Child By Two is asking parents who care about protecting children and vulnerable adults from infectious disease to write to Jim Kirk, the Editor-in-Chief of the Chicago Sun-Times to explain why McCarthy's history as an anti-vaccine activist and her new soapbox at the paper puts all of our children at risk. Below is my contribution, which I just sent. If you're interested in speaking up, email Jim Kirk at the Sun-Times. You can even crib from my letter if it reflects your feeling. Every Child by Two also has sample language on its site.

Dear Mr. Kirk,

It was with great dismay that I learned you hired actress and model Jenny McCarthy to write a daily blog on parenting and family advice. The rise of vaccine-preventable disease in this country can be laid squarely at her feet because of her vociferous and completely erroneous claims about the dangers of vaccines. Having received her degree from the "University of Google," she capitalized on her fame to spread anti-science nonsense and to scare the bejesus out of new and expecting parents.  

In an ideal world, you'd reconsider the decision to hire McCarthy for a column aimed at parents. But I'd also be very happy if she would write a column exonerating vaccines from having any connection with her son's autism diagnosis (which apparently has magically disappeared). I expect better from a paper as long-lived and well-respected at yours. Hire a celebrity model to dole out advice to parents if you wish, but at least choose one who has a basic grasp of science and a willingness to say she was wrong.

Ashley Shelby

Moms Who Vax: "But I Saw it with My Own Eyes!"

By Karen Ernst

A mother's connection to her children is powerful. She is the first to tell when the baby needs to be fed, the first to know that her child is overtired, and the first to know that something is not going well at school. Logic must dictate, then, that she would be the one who would know all about a child's disorders and conditions, be they autism, epilepsy, ADHD, or what have you. She should know when things went awry, why, and how, surely.

Not so fast. 

While a mother might sense when something is wrong, we do need an objective eye to help us discern exact diagnoses and to help us construct the history of our children's conditions. A mother of a sleepless baby may bring her bundle in and announce confidently that it must be an ear infection, only to learn that her children's ears look healthy and normal. Likewise, when we visit our pediatrician's walk-in strep clinic, I'm always struck by the number of “negative” prognoses that are handed out. How can we all be so wrong so often? In these moments, I usually tell my pediatrician, “You can tell which of the two of us actually went to med school.”

I've known "mom's instinct" can lead us astray for some time now, but this idea was revealed clearly to me after a trip to the zoo that ended with itty bitty bits of strawberries and Pizza Rolls.

We were at the “little zoo,” where treats are sold every few feet to ensure my children leave hyper and sticky. This time, I buckled and bought both boys strawberry popsicles—the kind made from actual strawberries. I patted myself on the back for providing an actual fruit treat. I was a good mom. About two and a half hours after we got home, the boys were hungry for lunch. Because I had made such an excellent treat choice, I okayed their choice for a Pizza Roll lunch. 

Fifteen minutes later, I was punished for my choice when the older one broke out in hives up and down his arms and across his forehead. Unfortunately, our history with hives is bad. This same boy had broken out in hives that turned severe as a result of an allergic reaction to an antibiotic. (As a side note, despite his adverse reaction to an antibiotic, I am not part of the anti-antibiotic movement.) 

I admit that I panicked, but I didn't panic hard. I called and got an immediate appointment at our clinic with a pediatrician I had never met. Not knowing our history, she misunderstand my angst about the hives and gave us a referral to the clinic's allergist. (It turns out that this visit was entirely unnecessary.) In a week's time I would see the allergist, but in the meantime, we had Benadryl on our side.

A week later, we went into the allergist. I am forever grateful that we saw this particular doctor. He was kind and listened to my worries. I told him I was sure my child had developed an allergic reaction to strawberries, but he insisted that the timing made it impossible. An allergic reaction would have occurred at least an hour earlier. I believe I actually said, “But I saw it with my own eyes!” He kindly explained to me that what we see and what we believe need to be supported by science. Fortunately, being a fan of science, I cast aside what I “saw with my own eyes!” and chose to believe him.

But the Pizza Rolls! He ate those fifteen minutes before the hives appeared! Do you know how much stuff is in Pizza Rolls? It's a veritable Who's Who of manufactured food bits! How would we ever parse which ingredient gave him the reaction!

The good allergist assured me that it was extremely unlikely that the boy was allergic to anything in Pizza Rolls. And then he said, “But if you want reassurance, do a little test for yourself. Cook some more and cut them up into tiny pieces. Give your child one piece at a time, and monitor him. If he get hives again, call us.”

I liked this plan! However, I was still unsure about the strawberries. Remember, I saw it with my own eyes. I had constructed my own narrative about what had happened, and it was hard to shake. So I also bought strawberries and cut them into tiny pieces, too. We would do the strawberries one day and the Pizza Rolls the next.

The results? Nothing happened. No hives, no anaphylaxis, nothing. The allergist, and science, were right.

I feel for parents who believe they know what happened to their children, only to have that belief contradicted by science. After all, doing a quick food test purely for my own reassurances was easy. A parent cannot give a child another MMR to see if it makes that child more autistic or another DTaP to see if that child becomes more epileptic.

Nonetheless, when study after study after study after study contradict a parent's instinct or experience, we have to side with the science. Parents are simply not the source of all knowledge when it comes to a child's medical issues. Bring your children to doctors and trust the science that supports what they do. And do not be swayed by another parent's eyewitness account. Sometimes what we see should not be believed.

Karen Ernst is a mother and teacher, and the co-founder of Moms Who Vax.

"I'll Take Thimerosal"

Once upon a time, when I was still misapplying the precautionary principle, I got very hot and bothered around this time of year. I wanted my kids to get the flu shot, but I had heard so many scary things about thimerosal and how certain of the flu shots still contained it as a preservative that I would grow very anxious. I'd call around, making sure the clinic had FluMist (no thimerosal) or an otherwise thimerosal-free vaccine, and I'd feel very proud of myself for doing my "due diligence."  I even advocated on my now-defunct blog Science for Sale for "demanding" thimerosal-free flu vaccine at your pediatrician's office or clinic.


Now I say to nurses: "I'll take the thimerosal version."

My fabulous vaccinated children (old picture!)

Well, that's a bit of an exaggeration--not to mention a bit of plagiarism on my part (co-founder of Moms Who Vax, Karen Ernst, was the first person I'd ever heard say she asked a nurse for "the thimerosal one" just to make a point). But not by much. Last week, my three-year-old daughter had her well-child checkup. I wanted her to get her DTaP booster early, because of pertussis outbreaks in Minnesota and beyond and because signs are pointing to the current vaccine losing effectiveness sooner than expected. She'll get that booster later this week, but I was able to get her chicken pox booster and her flu shot at this appointment. When the nurse came into the room with the syringes, she looked at me and said, almost apologetically, "We don't have any thimerosal-free flu shots right now." To me, this was about as meaningful as hearing at Starbucks "I'm sorry, we're out of whipped cream today."

It was only later that night that I marveled at how far I'd come since those days at the Target clinic when I fretted over my older child's flu shot. I've come so far because I finally understand how vaccines actually work, how their components work in our body, and how leaving my child even a "little unimmunized" is a serious health risk--one I'm no longer willing to take. (Risk analytics is a subject I wish I'd studied up on earlier in my parenthood.)

For those who don't know, thimerosal is a preservative meant to keep the vaccines safe. If vaccines didn't have preservatives, then you'd really start seeing some "vaccine injuries." The CDC states that thimerosal is "added to vials of vaccine that contain more than one dose to prevent the growth of bacteria and fungi in the event that they get into the vaccine." If you've been following the news, you are probably keenly aware that fungi in injectable medicines is a bad thing--just ask the hundreds of meningitis victims trying to get well right now. However, thimerosal is in almost no childhood vaccines anymore--not MMR, not DTaP, not Hep B. The multi-dose vial of flu shot is really one of the only shots that might contain thimerosal.

When people express concern about thimerosal, they often use the overarching term "mercury." These same people (and I was one of them) almost never know that there is a huge difference between ethylmercury and methylmercury. Some of us (ahem, me) didn't even know there was a difference at all. Even though they have similar names, they are completely different materials. Worth repeating: completely different materials.

The one that people often think of when they hear the word "mercury" is methylmercury. This is the stuff that can be found in certain types of fish, formed in environments where mercury metal exists. High levels of methylmercury can be harmful to the human nervous system, and although federal standards try to control the level of mercury in foods and environments, the truth is we are all exposed to some methylmercury. It's this--methylmercury--that too many people think is part of the thimerosal preservative.

It's not.

The multi-vial dose of flu vaccine contains trace amounts of thimerosal, which contains ethylmercury, which does not "build up" in your body like methylmercury and is easily excreted. It is worth repeating that methylmercury and ethylmercury are different chemical compounds. As the WHO states, "The half-life of ethyl mercury is short (less than one week) compared to methyl mercury (1.5 months) making exposure to ethyl mercury in blood comparatively brief. Further, ethyl mercury is actively excreted via the gut unlike methyl mercury that accumulates in the body." If you need any reassurance or your own personal "chelation therapy" following a visit to the National Vaccine Information Center, take a look at this study from the New England Journal of Medicine that shows ethylmercury having no neurological effect on children who received vaccines with a thimerosal preservative. (There are two more.)

But this is mostly academic, because thimerosal was taken out of the vast majority of childhood vaccines a while ago at the request of the CDC. This wasn't because thimerosal is dangerous. Instead, it was done--against the protests of science-minded organizations--because the CDC feared the anti-vaccine movement had simply poisoned too many minds in their completely erroneous and harmful accusations of some sort of link between thimerosal and autism. The CDC removed thimerosal from vaccines as a preservative because they wanted parents to continue vaccinating and were afraid that the misinformation about it was too entrenched. It was the first time in recent history that science bowed to pseudo-science in this way.

So when I get my flu shot without even wondering if it contains thimerosal or not--when my child gets a flu shot that contains it, even though it's becoming harder and harder to find a thimerosal-containing flu shot--a little part of me feels like I'm standing up for science. Because I am.

Moms Who Vax: Why Am I So Certain?

By Gillian Tarr

People who don’t vaccinate their children intrigue me. If I knew any personally, and was on good enough terms to have a frank discussion, I would be so tempted to put them under a microscope and try to understand where the wires had gotten crossed.  Perhaps that’s why I don’t know anyone who’s ever admitted to me that they don’t vaccinate their children.

Being a typical 21^st-century denizen of the Internet, I’m aware of the wide variety of arguments often used against immunizations.  Whether they’re being spouted by some swindler trying to sell garbage to bamboozled parents or by the bamboozled parents themselves, I haven’t yet read a line I would buy, and certainly none I would stake my children’s lives on.  

Gillian and one of her daughters.

Why am I so certain?  You see, I’m not just the lucky mommy of two amazing little girls.  My first passion in life was infectious disease epidemiology, and I’ve had the great opportunity to work directly with vaccine programs. I also have a Masters degree in epidemiology, as well as a graduate certificate in vaccine science and policy.

My education and all the reading required by my training and the original research I’ve conducted left me assured that immunization was one of the greatest triumphs of public health.  So when it came time to vaccinate my own children, I didn’t hesitate.  I was that parent making the special appointment to get my daughter Prevnar 13 when it came out despite her having already completed her series of Prevnar 7 (protection against six more strains of Streptococcus pneumoniae!). I was that parent convincing our pediatrician to give my 22-month-old daughter FluMist off-label (higher efficacy than the inactivated vaccine in children).

While I made sure my own family was as protected as we could be, I didn’t start paying much attention to the anti-vaccine movement till I was working on a phase 4 vaccine trial with a state health department. Part of my job was to telephone pertussis cases and potential pertussis cases. I talked to hundreds of families.  Anyone can find a website with a description of what pertussis does to a person, but hearing it first-hand was a completely different experience.  Parents described how their children had suffered, and how they felt powerless to help them.  Some even openly lamented their previous choice not to vaccinate their children.  Having my own children, I can’t understand how some parents can set their children up to suffer, leave them open to preventable diseases.

But of course, they think they’re saving their children from something worse. There are so many websites, blog posts, Facebook rants on one side or the other.  Almost everyone claims they’ve read "the literature" and that “science” supports them. Of course there’s also the conspiracy theory folks who purport the published literature is filled with lies and everyone’s in Big Pharma’s pocket. If these people knew how vaccines are developed and studied, they would realize they’re talking about thousands and thousands of people that would have to be paid off.  People like me.  I won’t even go into how little folks in public health are paid...

If you’re making a potentially life-or-death decision for your child, whom do you trust?  Do you trust the random blogger who pulls out choice sentences from studies to prove her point but neglects the rest of the study that negates it?  What about the folks that list dozens of animal studies on some vaccine your child wouldn’t even receive?  Dr. Bob Sears, whose only credentials as a vaccine expert are of his own making?  Are you reading the literature yourself and substituting your understanding of it over that of the specialists who’ve devoted their lives to science and the analysis of scientific research?  Do you dismiss the advice of the CDC, the AAP, and the doctors and researchers who have devoted their lives to understanding and improving vaccines?  If so, why?

When did the experts become the ones you can’t trust and the amateurs--many of whom are just trying to sell you something—become the ones you bank your children’s lives on?  

On the rare occasion that I do discuss vaccines with someone, I don’t try to convince them that vaccinating is the right choice.  I simply give them resources so they can see for themselves what the true experts say and try to point out the difference between the consensus of the scientific community and the opinions of a few.

Gillian is the mother of two glorious little girls and trained as an infectious disease epidemiologist. She currently works in the private sector but remains passionate about public health.

Moms Who Vax: Your Baby's Best Shot

By Karen Ernst

The concerns parents have about vaccines could fill a book.  Fortunately, a new book co-written by Stacy Herlihy (SH) and Allison Hagood (AH) addresses these concerns.  Meticulously researched and exhaustively documented, the facts in the Your Baby’s Best Shot are actually presented in a readable and accessible way.  The unassuming tone is no surprise as Herlihy and Hagood are a thoughtful, intelligent pair.  Moms Who Vax recently sat down with them (via email) and picked their brain about a few issues related to YBBS and to vaccines in general.

MWV: What motivated you to write Your Baby's Best Shot?

SH: For me personally it was extreme frustration with debating with hardcore anti-vax nuts online. I’ve been involved in a few parenting message boards over the years. Parenting can be a very lonely experience sometimes, especially if you work at home as I do and don’t always have time to get out much to interact with other parents.

So I became involved in a few boards over the years. Over and over again I’d see this issue come up again and again. I become known after a while as someone who could confront the nuts and help others make sense of this issue if they were on the fence.

The problem was that after a few years I felt as if I were repeating myself time and again. I would write out these very detailed posts only to have them ignored by the anti-vaxxers who would then accuse me of being crazy and over the top on this issue.

So I said to hell with it, walked away, stopped posting and said hey I’ve always wanted to write a book. Why not? But the book was too daunting a project to face alone. So I sought out a co-author. Luckily I found just the right person to work with.

AH:  I’ve been having discussions about this particular issue for a number of years.  I got involved because a friend’s child was diagnosed with autism, and our mutual friends immediately began blaming vaccines.  I thought to myself “that doesn’t sound right,” and started looking into the science.  The more I read, and the more I learned about the lies and misinformation of the anti-vaccine movement, the more passionate I became.

I began to have more online and face-to-face conversations with people about this issue, and realized how widespread the anti-vaccine misinformation had become.  I felt that this was going to be an ongoing battle against people who have no compunction using lies and frauds to manipulate people.  It is incredibly unfair for the anti-vaccine movement to mislead parents about vaccines.

But I didn’t have an idea of writing a book until I “met” Stacy.  We were members of an online discussion board on which vaccine discussions had taken place regularly.  She threw out a “I should write a book!” post, I sent her a private message, and here we are two years later with a book of which we are both very proud.

I love educating people, so the book is a natural existence of that love.

MWV:  Which section of YBBS brings you the most pride?

SH:  The one where we call out the bad anti-vax websites. I had so much fun with it. People like Barbara Loe Fisher and those who run the Age of Autism really annoy me so much. Their websites look so convincing to anyone unfamiliar with this issue. I’ve spent hours trying to explain to people online exactly why they aren’t.

Figuring out polite ways to call them names was both challenging and fun. And hard to get past our editor. Lol

AH:  It’s difficult for me to pick out just one section!  I am very proud of the fact that we managed to communicate the decades of science that supports the safety and efficacy of vaccines in a way that a parent with little to no science background can understand it.  As an educator, that’s always a win.

MWV:  At the beginning of YBBS, Stacy describes a moment in which she is sure she made the wrong decision to vaccinate her child.  Was there an a-ha moment that convinced each of you that, in fact, vaccines were the right choice to make?  What tipped the scales in favor of vaccines?

SH:  I’ve always been pro-vaccine personally. I don’t think you can study history and not feel that vaccines are pretty much the greatest thing ever. I think people today are simply unaware of just how high infant mortality rates were until fairly recently. You can’t read anything about childbearing prior to the last 50 years and be unaware of it.

AH:  I’ve never been anti-vaccine, so there wasn’t a point at which I changed my mind about them.  The tipping point for me getting involved in this issue was encountering the incredibly anti-science propaganda used by the anti-vaccine movement, and realizing that I could address it on a large scale.

MWV:  Do you believe that parents would blame vaccines for autism, ADHD, learning disabilities, and other issues if the anti-vaccine movement were less prominent?

SH:  I think that makes sense. The vaccine equals autism still gets a lot of play in the media today unfortunately.

AH:  I absolutely do.  The anti-vaccine movement is luckily very small, but they are incredibly vocal, and the media has done a great disservice by providing them a platform in the name of a false “balance.”  The overwhelming scientific consensus, based on the research, is that vaccines are safe and effective, and continuing to cover the anti-vaccine movement as if it were of equal strength creates a false controversy

MWV: Which anti-vaccine figure do you believe has done the most damage to public health?

SH:  Andrew Wakefield hands down. He has constantly lied to the public and still continues to do so. He was the driving force behind the first allegation that vaccines and autism are linked. He continues to push that meme forward even though even he must know by now that he’s wrong.

AH:  For me, it’s a toss-up between Andrew Wakefield and Jenny McCarthy.  Mr. Wakefield is either delusional (if he continues to believe in a link between vaccines and autism), or a psychopath (if he knows that there isn’t, and continues to mislead distraught parents). McCarthy, on the other hand, uses her celebrity to provide this charlatan a public voice, and that is almost as damaging as Wakefield’s lies.

MWV:  Since YBBS has been published, has anything about the anti-vaccine movement and the pro-vaccine push back surprised you?

AH:  One anti-vaccine advocate created a hate page against me on Facebook, before the book was even published (the page was removed). I suppose I shouldn’t have been surprised, but that was a bit unexpected.

MWV:  What piece of advice would you give to pediatricians and pro-vaccine parents in their dealings with vaccine hesitant parents?

SH:  I think it depends on how deep that goes. If someone is extremely anti-vaccine I personally think there’s little you can do to change her mind. There’s a hardcore of parents out there who will never believe that vaccines are anything but a great-big-giant-lie-promoted-by-the-pHARMashills. You can’t reach them. You can only avoid them.

We didn’t aim to. Some walls you can’t break down.

Then you have people who are a little on the fence about this. They may want to avoid a few vaccines or stretch out a schedule. Those people I think can and should be reached. The best way to do that, at least in my opinion, is to carefully point out the problems with avoiding such vaccines or demonstrating that a prolonged schedule does not reduce the risk of a vaccine reaction and does increase the possibility of getting a vaccine preventable disease.

Give them good information that treats them like smart human beings and they will listen to you.

AH:  Try to determine what kind of hesitation they have.  If they are committed anti-vaccine activists, there probably won’t be anything that you can say to them to change their minds.  The ability of the dedicated anti-vaccine advocate to dismiss all science that doesn’t support their beliefs is indefatigable.

However, if they are truly hesitant, because they’ve “heard some stuff” about vaccines, then I think spending the time to find out the source of that hesitation can bring about the opportunity to address their concerns.  You might not be able to address their concerns adequately the first time you have that conversation, but I believe that continuing to address it can be successful.  I’ve had several experiences with parents who were initially anti-vaccine, but later realized their fears were unfounded based on ongoing discussions.

Of course, each pediatrician is going to have to decide how much time they have to spend doing this kind of education.  The health care system in this country doesn’t allow for a huge amount of time for each patient, unfortunately!  That’s why it’s so critical that we not just expect this education to come from pediatricians.  The rest of us need to get more involved in addressing and debunking the anti-vaccine propaganda, and holding the media accountable for providing the anti-vaccine lies a platform.

MWV: Do you have any plans for follow-up books?

SH:  We are in discussion about a new book that would address other parenting related issues such as breastfeeding in a similar manner. Once I can get my sixteen month old to get on a more regular sleeping schedule I’d like to think about crafting a new book proposal. That’s probably next year’s project.

AH:  We are discussing ideas about a follow-up, addressing things like birth issues, breastfeeding, attachment parenting, homeschooling, and other aspects of raising children.

Interview by Karen Ernst, mother, teacher, and co-founder of Moms Who Vax.

Moms Who Vax: The Greatest (Non) Story Never Told

By Humble Mom

Among friends and family, I have a bit of a reputation for telling non-stories. Let me set the scene for you. Imagine you're not curled up in a big, comfortable chair. Imagine you don't have a warm hand-knit blanket around you, and you're not holding a mug of hot chocolate. Imagine that the fire isn't crackling in the fireplace, and, in fact, that there isn't a fireplace at all. Now you're ready for a non-story.

As a child and teenager, I received all recommended vaccines, including Gardasil and the chicken pox vaccine. Nothing happened.

When I was pregnant in 2009, I received the H1N1 vaccine. My arm hurt.
A few weeks later, I received the seasonal flu shot. Nothing happened to me, nothing happened to my baby.

When my son was two days old, he received his first hepatitis B shot. Nothing happened.

When my son was one month old, he received a second hepatitis B shot. Nothing happened.

When he was two months old, he received the rotavirus vaccine, the pneumococcal vaccine, and Pentacel, a shot that protects against diphtheria, tetanus, pertussis, haemophilus influenzae b, and polio. Nothing happened, and nothing happened at four months when he received another dose of each.

So it went, with my son uneventfully receiving all vaccines as recommended by the AAP, until his 18 month appointment, when he got his second hepatitis A vaccine, and...nothing happened. No fevers, rashes, second heads, or heinous bouts of fussiness. Nothing dreamed up by a paranoid lawyer.

He is now nearly two and a half years old. He's healthy, active, fun, and seems pretty smart. Yawn.

Before I can end this non-story of mine, there's something I need to clear up.

Earlier I said "nothing happened" but that just isn't true. Behind the scenes, my son's body was mounting antibodies to the antigens in the vaccines, a response that, should he ever be exposed to the actual disease, will help protect him. 

Look, this vaccination thing... it's not exciting. Seeing as this is a non-story, it's only fitting that my son, upon being vaccinated, didn't suddenly sprout a shiny purple superhero cape with the words "I'm immune!" on it (I expect royalty checks from Marvel Comics when they introduce the character Immunity Man!).

The anti-vaccine movement, to be honest, is a lot more interesting than reality. Their rants and theories are the stuff of trashy novels and Michael Bay movies. I can't compete with their creativity. All I've got for you is this non-story, and with the help of these boring vaccines, I hope my son's medical records remain unworthy of a blockbuster.

Humble Mom is a young vaccinating mom living in a place where neither of those things is common. She runs a Facebook page called Vaccinated and Awesome. 

Note: If you are a parent or a grandparent who vaccinates, we would love to help you share your story. Please e-mail us at momswhovax AT gmail.com

Deuce Bigalow and the Don

By Karen Ernst

Donald Trump, Immunologist

The beginning of school is a simple time for parents who fully vaccinate their children.  If their children are entering Kindergarten, seventh grade, or a new school, they simply send in the immunization records their pediatrician gave them.  Otherwise, they do not give the matter much thought.

The beginning of the school year must be entirely different for anti-vaccine celebrity parents, I imagine.  It must be, because they are coming out in full force with their complaints about vaccines and the accompanying school requirements.

Actor Rob Schneider is speaking out against a California bill, which has passed through the state legislature and is waiting for Governor Jerry Brown's signature.  What is Schneider's issue with this new piece of immunization legislation?  He objects to AB 2109's requirement that parents meet with a licensed health care professional and receive their signature before opting out of vaccinating their children.  That's right.  He objects to people receiving information from doctors.

Dr. Richard Pan, the Assemblyman and pediatrician from Sacramento who sponsored the bill, met with Rob Schneider in an attempt to discuss the bill and immunizations with him, but apparently the discussion did not go well.  According to the LA Times blog, Pan's spokesperson reported that “It stalled out at times just because they’re really working off two different sets of data, one that comes from worldwide scientific opinion and the other that comes from a collection of celebrities”

With AB 2109, California follows in the footsteps of Washington with its new requirement, and the objections, thankfully, will likely come to nothing.  Nevertheless, it begs the question: what are Schneider and the other anti-vaxxers afraid of with this bill?  AB 2109 does not mandate the content of the discussion between a parent and a health care provider.  The bill does not take away a parent's decision to eschew vaccines.  It simply asks that parents hear the the best information available to experts on the topic of vaccines.  Parents can still choose to side with the non-experts at the end of the conversation and send their children into their communities without contributing to community immunity and public health.

On the other coast lies the side of the story Rob Schneider and the rest of the anti-vaccine movement want you to hear, the side they hope drowns out those conversations between doctor and patient.  Donald Trump has entered the conversation in celebrity style, gaining much attention via Twitter and Facebook.

The latest is a photo showing the number of diseases we can prevent with vaccinations today compared to the number we could prevent in 1983.  Of course, Donald Trump frames it differently with this caption: “Look what happened to the autism rate from 1983-2008 since one-time massive shots were given to children. This chart was given to me by a parent of two autistic children. I may not be a doctor but I have lots of common sense. Read my previous statements on autism…”

I'd like to point out other things that have increased since 1983, which we could correlate with the rise in the diagnoses of autism.  Hip Hop was in its infancy in 1983, and now its reach is everywhere.  Cell phones, also, were nearly unheard of in 1983.  Now, like autism, their prevalence has risen.  And, as Lexi Magnusson at Mostly True Stuff has pointed out, JennyMcCarthy's rise in fame is also correlated with the rise in autism.

In fact, connecting vaccines to autism is one large failure to understand that correlation does not equal causation.  Business Week pointed out that we can correlate M. Night Shamaylan's decline in film-making quality with a decline in newspaper sales and Michele Bachmann's presidential candidacy with the show Staten Island Cakes.

It's simple, though.  Vaccines do not cause autism.  They just don't.  Even when anti-vaccine groups have tried to show that the incidence of autism is great among the vaccinated than the unvaccinated, they have failed.  They have also failed to float a theory that links autism to vaccines.  Study after study has disproven any possible link.  In fact, the science exonerating vaccines in the rise of autism is so thorough, that it is considered scientifically settled. 

Behind it all are things a little more insidious.  Part of the anti-vaccine spiel that vaccines cause autism rests on a fear of autism.  This fear of autism leads to all manner of abusive, terrible, and useless therapies, from chelation to bleach enemas.  I have also seen autistic adults being berated and bullied for demanding their right to be accepted for who they are.  In fact, the berating and bullying is present on Donald Trump's Facebook post.  All of this treatment is inhumane, and no person deserves it, whether he is autistic or neurotypical.  Everyone deserves acceptance for who he is and who he cannot help being.

I cannot help but be viscerally angry at celebrities who use their spotlight to instill fear in parents about vaccines, autism, and conversations with their own doctors.  They have a big voice, whether they deserve it or not, and they are using it to shout down experts and to endanger the health of our communities.  Ignorance is something we can all prevent, and no longer can we allow these celebrity voices to outweigh the reasonable voices of scientifically minded parents who intelligently rely on the best, real experts.  We must all speak out.

Karen Ernst is a mother, teacher, and the co-founder of Moms Who Vax

Moms Who Vax: "Slow-Vax" to Pro-Vax

By Melissa Clark

As parents, we are faced with making many decisions. It can seem overwhelming. We are bombarded with information and advice from other parents, friends, the media, doctors—the list goes on. When I was pregnant with my first child three years ago, I knew I wanted the way I parented to fall somewhere on the attachment theory continuum. I hoped for a natural childbirth, planned to breastfeed, to use cloth diapers, to wear my baby, to co-sleep—you get the idea.

I thought one of the decisions I needed to make was whether or not to vaccinate my child. As a nurse, I understood the importance of vaccination, but as a soon-to-be new parent, I fell prey to the “toxins” argument. So I did what any well-intentioned parent would; I began to research vaccines. I turned to Dr. Sears’ Vaccine Book and decided that I would follow his delayed vaccination schedule. I knew that vaccines were important, but I thought there was a “safer” way to administer them to my child that would minimize her risk of exposure to toxins.

Fast forward a couple of years, and I am pregnant with my second child. One morning I saw a post on Facebook in regards to the flu vaccine. It claimed that the vaccine contained aborted fetal tissue. In my head I knew that didn’t sound right, and a simple internet search revealed that I was correct, vaccines do not contain aborted fetal cells.

It was at that moment I realized that if that article was false, what other beliefs about vaccines that I held to be true were actually false? My thinking started to shift. I began digging deeper into the issue of vaccines and found that, in fact, I had been duped by fear. I had bought into the scare tactics. I trusted the opinion of one man, instead of the scientific evidence proven by many.

I felt like a selfish jerk because I realized that not only was my decision to delay vaccinating my daughter arrogant, but even worse, that decision could have had deadly consequences for my daughter as well as other children. Never had I been told that my decision to alter the CDC vaccination schedule myself could cause harm to someone else’s child.  

I also felt guilty for spewing the scare tactics and biased information to other parents, thus potentially influencing their decision to vaccinate. After that lightbulb moment, I knew that I would vaccinate future children on time, according to the CDC schedule; I also began getting my daughter caught up on the vaccines that she was missing.

As my attitude toward vaccines changed, the question came to mind “when did vaccines become a choice?” When did it become okay to purposely expose our children to vaccine-preventable diseases, like chickenpox? Why is the loud voice of the anti-vaccine movement often the only one parents hear when they turn to various media and social outlets for information?

I wish I had the answers. What I can tell you is that I know how easy it is for an educated, well-intentioned parent to be swayed by fear and misinformation. I can tell you how easy it is to see the fear- mongering for what it is once you are presented with scientific truth. Yes, as parents we are tasked with making many difficult decisions on behalf of our children; however, vaccinating is not one of those difficult decisions. The ramifications of not vaccinating your child are not contained within your family; they threaten the safety of public health. So, once you are confronted with the truth of science, what will you do?

Melissa Clark is wife to an amazing husband, and mom to two awesome kids. Her educational background is in nursing, and she is a doula and Lamaze childbirth educator. She enjoys coffee, the Internet, and a sparkling kitchen sink.

Will Pro-Vax Blogs Infect Your Computer? Anti-Vax Activists Want You to Think So

Apparently, some anti-vaccine folks are trying to scare parents way from blogs with a pro-vaccine bent by claiming the blogs will infect computers or that they contain some kind of malware. They've even been reporting such sites as malware to malware reporters, creating headaches for the blog owners and wasting everyone's time. When challenged and asked for specifics, they, of course, can provide no evidence of malware or infection.

This is patently false, in case it needed to be said. It wouldn't, however, be the first time such a claim was made (and in this case he is dealing with it yet again).

In some ways I take this level of mendacity to be a good sign--you would never catch a pro-vaccine activist or parent resorting to such tactics, and I like to think you'd only find an otherwise rational human being making up such nonsense because he or she feels the evidence is against her.

That being said, I still find this very sad. Because we're all parents and we all want the best for our children, no matter what our stand on vaccinations. At the same time, as a parent wanting to know more about vaccine safety, it might be good to put this kind of retributive and frankly downright irrational behavior on the scale when you begin making decisions about which parties you find to be reliable sources of information.

Anyway, rest assured, Moms Who Vax is safe, as are the other blogs you'll find under our Links. In case you'd heard otherwise.

Survey Says...

One of the reasons the anti-vaccine movement was able to get such a foothold in the parenting culture of the last ten years or so is because the public health and medical establishments were, by their own admission, slow to respond. I understandy why. It is, on paper, hard to grasp the reasons why people find information from shadowy websites and Hollywood celebrities more credible than peer-reviewed science and information fromt ehir own pediatricians. The turh is that, as parents, we tend to put a lot of stock in the experiences of our peers, and rightly so. We’re the ones on the ground dealing with everything for the first time, armed with nothing but questions. Parents don’t want to take anyone’s word for it—they want information. Because the Internet has become our go-to source for information, without any attendant filter that might red-flag a site that offers nothing but misinformation, parents have been doing their “research” there.

I mention this because pediatricians and public health officials are starting to respond effectively to anti-vax messaging by turning to parents, and by reaching out to new parents, including the vaccine hesistant (a different crowd from the anti-vaxxers). Heck, I was a vaccine-hesitant parent. It’s okay to be hesitant. It is, however, critically important that we understand where the information we base our decisions on, and whether science factors in to your decision. One place you’ll find some much-needed outreach is at the Minnesota Department of Health’s Immunization website. This website is scheduled for a redesign, and the folks behind it are looking for responses from parents and members of the public at large about what changes might be useful, through an online survey. They are looking for feedback from anyone, whether the parent has been to their site before or not. The goal of the site is to become a place where parents and providers want to go for information—or wants to refer others to.

It’s rare that parents get a chance to tell public health officials how to best communicate with them, though I see it happening more often. So please consider taking a look at the website, then taking the short survey. Be candid. This is a great chance for your voice to make a difference.