Shots for E

One of the first days of Emmett's short life that we have truly dreaded is now coming to a close: the first vaccination. Yes, the day was complete with him held down by his parents and him looking us in the eyes with the but-I-trusted-you look as his cries shifted another degree in intensity with each poke. It is now late and I have written a long, ranting post below with plenty of frustration interspersed. So, for those that don't have interest in a long, boring vaccine discussion I give you the short of it. Emmett got only two shots (DTaP and HIB---our choice) of the AAP recommended batch of 4 shots+1 oral vaccine. It was really sad to be the source of Emmett's tears, but a little feeding afterward got him to perk up nicely. The good news from the day is that he is still growing (or at least was before the shots): 23 1/2", 12 pounds, 4 ounces (75th percentile each---25th percentile head...I can't remember the size. At least he is not going to tip over from being top heavy).

That is the short, fun part...here is the long, boring rant. Beware all ye who enter.

Andrea and I have known for some time, obviously, that this day was coming. I believe that I have mentioned it here before, but I have been reading Dr. Sears' "Vaccine Book" trying to educate myself as to what we should do. Yes, I do understand the argument that vaccines can be a good social policy and can actually eradicate disease (e.g. small pox, polio (mostly), etc.), but I feel that there has been a shift to immunize on diseases that probably do not need this level of attack: chicken pox, whooping cough, rotovirus. The result, I think, is that we have come to the point that immunizations are being developed and approved for second-tier (at best) diseases at rates that outpace long-term clinical trials for potentially problematic components (e.g. oft-quoted mercury, monkey cells, etc.), and as a result these new-found effects are casting doubt on immunization in general which we will most result in a resurgence of first-tier diseases once held at bay such as polio. Our pediatrician, who we still really like, said that further doubt is being cast on doctors as the populace is now starting to believe that doctors push so many immunizations so they can make more money, and she informed us that they at best break even on the shots. However, in the examination room was a poster alerting us that a pertussis (whooping cough) immunization is also available for adults, and this poster was provided as a "public service by Sanofi Pasteur" who just so happens to make a pertussis vaccination---the one the doctor's office uses. It is really hard to feel that our best interests are being kept in mind and that the vaccinations are truly necessary when our public service messages are provided by the person who pockets payment for their use.

Anyway, recommended by the American Academy of Pediatrics at the two month visit are HIB, Pc, DTaP, Rotovirus and Polio (four shots, one oral) with the same repeated at 4 and 6 months. Dr. Sears recommends what I see as a more reasonable schedule where things are spread out with two vaccines at one month intervals so as to lessen the vaccine load on the baby at any one time. Sears recommends DTaP and Rotovirus at the first visit. DTaP stands for Diphtheria, Tetanus, and Pertussis, and (get this) the only one that poses any real threat to an infant is the third. Can you get a shot of just the third, though? No, but Pertussis is serious enough that we opted to get this shot. One shot, three vaccines, two unnecessary (at least until older), but Sanofi Pasteur is looking out for us. Rotovirus is basically bad diarrhea (more EC practice!!!) and causes ~50 infants to die each year from it, which sounds serious, but they die of dehydration which means bad medical care (what does that say about our medical care if 50 children dehydrate each year from something that can be taken care of by inserting an IV). I went in thinking we didn't need it and our doctor agreed arguing that we are fortunate enough to have medical care that would insert an IV if this set in, so we were down to one.

At this point, however, the doctor threw me for a loop by saying that since we were only doing one vaccine we should add another, and I didn't come fully prepared for her recommendation: HIB (Haemophilus Influenzae Type B). HIB can lead to bad meningitis, so I was fine with him getting the shot under the one condition that it not also be a shot that has aluminum in it.

Aluminum is being added to many vaccines to increase the efficacy (they say), but brilliantly they have never tested the long term effects of aluminum injected through muscle. Surely if it is in the shots it is safe, right---that mercury thing was just an accident. There have been studies that have shown that elevated levels of aluminum in infant's blood can cause long term learning problems, etc. at amounts/body mass levels lower than they inject with these shots, but zero studies looking at the effects of muscle introduction (questions like how fast does the aluminum in muscle get moved to blood, what densities in blood are reached, etc. remain unanswered). As there are some vaccines for which no aluminum-free options exist, Sears recommends not taking more than one aluminum-containing shot at a time...again, what seems to me a reasonable approach to minimize an unknown risk. I believe that we did this, but I will need to check as I left the brand list/aluminum content at work (you would think this would be on the packaging the doctor's office uses or that they would have easy access to the information...I thought that and I was wrong).

Side note: there are three DTaP immunizations of increasing amounts of aluminum, so one might make the easy choice of the lowest, but to throw the whole thing for a curve the one with the lowest aluminum also uses mercury (and you thought mercury was out of children's vaccines?!?). We took the next lowest (Daptacel by Sanofi Pasteur, which also has formaldehyde, a known carcinogen----so you literally get to chose your child's poison). Shots are fun!!!

This whole process had me really frustrated. We, as patients (or worse yet parents of patients) are supposed to make decisions between immunizations that have preservatives or other elements that are known to be harmful or even deadly and try to determine, without real scientific studies having been performed, which vaccine will give us the best chance of defense with the least risk. And what does it say about our FDA that potentially unnecessary immunizations are filled with components whose effects are not fully known (mercury in flu shots for example---mercury-free are becoming more prevalent but at least up to last year the average flu shot had mercury in it). Who are we to trust in making these decisions? Our pediatrician whose walls, pens, post-its, and booklets are decorated with "public service" notices or actual advertisements for the brands the doctors use asking us to assume that they will present an unbiased scientific opinion? The American Academy of Pediatrics, an organization of pediatricians whose offices are decorated in similar fashion? Who?

Sure, a free market is great but it is hard to go through this process and feel that the free market medicine solution is really taking us along the correct health track. In the free market system, what (besides one of their products catching the public attention by being shown to cause harm) is going to drive Sanofi Pasteur or GlaxoSmithKlein to invest in comprehensive testing or re-engineering a vaccine on which they are already making a bunch of money? Why invest in testing when post-it notes and clicker pens are much more fun?