Thursday, August 9, 2012

What Middle Ground?

By Karen Ernst

This morning OCWeekly published an article about self-declared vaccine expert and pediatrician to the stars, Dr. Bob Sears. The article, titled Dr. Robert Sears Takes on Both Sides of the Great Vaccination Divide: The author of 'The Vaccine Book' presents his own alternatives to the CDC-recommended schedules,” is mostly a discussion about reasons that Dr. Sears promotes his own vaccine schedule, available in his book. 

The problems with the article and with Dr. Sears reveal themselves in the headline.  We absolutely cannot allow the media to portray vaccination as something with a “divide” or “middle ground.”  While he-said, she-said journalism works for enticing readers and create buzz, it does an incredible disservice to public health.  So, while the article notes,
For years, the issue seemed to be black and white—moms and dads either gave kids all their shots or were ostracized by doctors and their communities. But now concerned parents are discovering what they see as refreshing middle ground,” this middle ground is, in fact, not refreshing.  This is ground that is risky and fraught with consequences, such as potential illness and additional procedures in the case of emergency. 

And Dr. Bob's waiting room is a prime example of the risks associated with delaying and skipping shots.  Dr. Bob's waiting room was ground zero during a measles outbreak, which originated with one of his unvaccinated patients who had brought measles from a vacation in Switzerland. (Click here for a photo of a child with measles, a disease whose seriousness anti-vax activists and fringe celebrity practitioners like Dr. Jay Gordon have consistently downplayed.Yet, half of Dr. Bob's patients remain in this risky middle ground, according to this OCWeekly article: “Roughly 25 percent of his patients do not vaccinate, and another 25 percent partially vaccinate.”

Clearly, Dr. Bob does as good of a job talking patients out of vaccinating as he does talking them into it.

Why does he continue to endanger the health of his patients?  “Sears sees his role as a bridge between the medical community and those skeptical of it, declaring that vaccinations don't have to be an all-or-nothing decision.”  However, how does one reconcile the idea that vaccines are bad, but I can do some of them?  Or that the CDC doesn't know what it is talking about, except with these vaccines that Sears, as someone with no background in immunology, likes? 

When asked about vaccines, Dr. Bob does not seem to describe them in a positive light: "There are chemicals such as formaldehyde. MSG is in some vaccines. There are chemicals that are very similar to antifreeze. Some flu shots actually have a spermicide used as a preservative. But they're all in tiny amounts, and I believe they're probably safe because they're in such tiny quantities."  He has an addendum at the end about the quantity of various ingredients, and most people with a basic understanding of chemistry know that the dose makes the poison.  
However, he equivocates this position, claiming they are “probably” safe.  This statement is utter falsehood.  The ingredients found in vaccines, as well as vaccines themselves, have been studied exhaustively and proven safe.  Thus, his suppositions about ingredients fall into the category of fear, uncertainty, and doubt.

The ingredients are not Dr. Bob's only issue, though. "He also had an issue with the way vaccines are approved by the government. When a medical manufacturer makes a vaccine, a panel of doctors at the
Food and Drug Administration must decide whether to approve it. Doctors on that panel might own stock in the vaccine manufacturers or even work for the vaccine manufacturers.”  This point may seem valid, if the FDA were the only check in place for vaccine safety.  However, the CDC and the ACIP also review vaccine data and studies, and they are the ones who make the schedule we all follow, which is supported by the AAP and the AAFP.  The system of nepotism that Dr. Bob alludes to is simply nonexistent, unless millions of doctors--uncompensated, by the way-- are in on it.

You would suppose that Dr. Bob just wants to give parents information and let them decide for themselves what to do.  However, “he continues to be an advocate for parents who want choices, and at the moment, that includes fighting against Assembly Bill 2109, which would require parents to obtain a doctor's signature before they can enroll their child in public school if they wish to skip one or more vaccines.”  In other words, he would rather have parents self-educate than seek appropriate information about medicine from an expert in medicine.

Dr. Bob's advice, as always, is to hide in the herd. "Right now, enough people are vaccinating that the herd immunity of our nation is not being compromised yet," he claims. However, he may have missed that vaccine preventable diseases, like measles and pertussis, are coming back.  He may have forgotten the measles outbreak of 2011, but 222 people who contracted it, and the third of them hospitalized with measles, have not forgotten.  Highly contagious diseases like measles and pertussis are merely signs of what is to come if we do not raise our vaccine rates.

"You can argue with these parents that the decision they're making to not vaccinate is bad for public health, but most parents are trying to make a medical decision that's best for their baby," Sears says. "I think we're all selfish when making any decision for our own children. I can't fault parents for thinking that way."
  That true, Dr. Sears.  But I can blame you for supporting and promoting this way of thinking.

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

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