Dr. Paul Offit's Vaccine Info Webinar "Communicating Good Science Under a Cloud of Doubt"
Dr. Paul Offit spends some of his time teaching others how to convince the public vaccines are safe, even as his own vaccine, Merck's RotaTeq, faces scutiny and recall (in Hong Kong, not the USA).
Click HERE to listen to the April 28th Virtual Immunization Communication Network Webinar "featuring Paul A. Offit, MD, Chief of the Division of Infectious Diseases and the Director of the Vaccine Education Center at the Children's Hospital of Philadelphia.
Dr. Offit will speak on current issues around parent and public concerns about vaccine safety and discuss how health professionals can effectively communicate scientific information to help the public distinguish between bad science and good science."
Review the presentation in .pdf form HERE.
The Virtual Immunization Communication (VIC ) Network is a project of the
National Public Health Information Coalition (NPHIC) and the California Immunization Coalition, funded through a cooperative agreement with the Centers for Disease Control and Prevention.
Below the jump is the straight text pulled from the .pdf. It's not formatted, but you can get an at a glance look at the content. Dr. Offit spends some time discussing Dr. Bob Sears's alternative vaccine schedule, the safety of aluminum, the "too many too soon" debate, and how many antigens an infant can receive.
VIC Network
A nationwide ‘virtual’ immunization community of health educators, public health communicators and others who promote immunizations
Objectives
• Describe communication strategies for public health
professionals to use in counteracting anti-vaccine messages
• Identify fact based messages that engage parents and
community members to help them make informed decisions
• Determine the best approach for communicating science to
the public
• Identify resources and support for immunization providers
who communicate with patients and parents about vaccine
safety.
Communicating Good
Science Under a Cloud of
Doubt
Featuring Paul A. Offit, MD, Chief of the
Division of Infectious Diseases and the
Director of the Vaccine Education Center at
the Children's Hospital of Philadelphia.
Paul Offit, MD
Delaying, Spacing Out,
Separating, and Withholding
Vaccines
Paul A. Offit
Division of Infectious Diseases
Children’s Hospital of Philadelphia
University of Pennsylvania School of Medicine
Too Many Vaccines Too Early
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Fewer immunologic components
are in vaccines today than
100 years ago
Number of antigens in
vaccines
Year Vaccine # of antigens
1900 Smallpox 198
Total 198
Number of antigens in
vaccines
Year Vaccine # of antigens
1960 Smallpox 198
Diphtheria 1
Tetanus 1
Pertussis (wc) ~3000
Polio (OPV) 15
Total ~3215
Number of antigens in
vaccines
Year Vaccine # of antigens
1980 Diphtheria 1
Tetanus 1
Pertussis (wc) ~3000
Polio (OPV) 15
Measles 10
Mumps 9
Rubella 5
Total ~3041
Number of antigens in
vaccines
Year Vaccine # of antigens
Immunological challenges from
the environment vastly exceed
challenges from vaccines
Are infants too young to be
vaccinated?
u Humans first develop the capacity to
respond to foreign antigens at about 14
weeks gestation.
u However, few foreign antigens are present
in utero. As a result, cells of the immune
system are largely naïve at birth.
Are infants too young to be
vaccinated?
u From birth, infants are challenged by
bacteria in the environment (colonizing
bacteria on intestines, skin, and throat;
bacteria inhaled on dust).
u Vigorous sIgA responses within the
first week of life keeps colonizing
bacteria from invading.
Are infants too young to be
vaccinated?
u Excellent immune response to HBV
vaccine at birth.
u About 90% of infants will develop
protective immune responses to HBV, Hib,
DTaP, polio, and pneumococcal vaccines
by 6 months of age.
u Need to be fully immunized against
certain infections (Hib, pertussis,
pneumococcus) by 6 months of age.
Children have an enormous
immunological capacity
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How many is too many vaccines?
u Combinatorial and junctional diversity
of antibody genes account for about
109-1011 different antibodies.
How many vaccines can we respond to?
u Each vaccine contains about 10
immunological components (proteins or
polysaccharides) and each antigen
contains about 10 epitopes (102 epitopes
per vaccine).
u Approximately 107 B cells are present
per ml of blood.
Cohn M, Langman RE. The protecton: the unit of humoral immunity selected by
evolution. Immunol Rev 1990;115:9-147.
How many vaccines can we respond to?
u If we divide 107 circulating B cells per
ml by 102 epitopes per vaccine, then
each person can respond to about 105
different vaccines at the same time.
u Therefore, the 14 vaccines given to
infants in the first 2 years of life will
“use up” about 0.01% of the immune
system.
Limitations of analysis
u Naïve lymphocytes are generated
constantly. From studies of HIV-
infected patients, about 2 x 109 naïve
CD4+ T cells are generated each day.
u Therefore, vaccines never really “use
up” the immune system.
Ho DD, et al. Nature 1995;373:123-6
Aluminum Overload
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“The alternative schedule suggests only
one aluminum containing vaccine at a
time in infant years. By spreading out
the shots, you spread out the exposure
so infants can process the aluminum
without it reaching toxic levels.”
Robert Sears, The Vaccine Book, p. 239
Aluminum
u Aluminum is the third most abundant
element on the earth’s surface and the
most abundant metal.
u As a consequence, aluminum is in the
air we breathe, the food we eat, and the
water we drink.
Aluminum in food
u The greatest source of aluminum is in
food.
u Adults typically ingest 5-10 mg of
aluminum per day.
u Aluminum is found naturally in teas,
herbs, and spices.
Aluminum in food
u Aluminum is also added to foods such
as leavening agents, anti-caking agents,
emulsifiers, and coloring agents.
u Found commonly in pancake mixes,
self-raising flours, baking powder,
processed cheese, and cornbread.
Aluminum in food
u Aluminum is also found in breast milk
and infant formulas.
u By 6 months of age:
mg
Breast milk 10 mg
Infant formula 30 mg
Soy formula 120 mg
Disposition of aluminum
u 100% of aluminum is absorbed
following vaccination.
u Only 1% of aluminum is absorbed
after ingestion.
Disposition of aluminum
u Aluminum enters the circulation,
binds to transferrin, and is eliminated
by kidneys.
u 50% eliminated in 24 hour
85% eliminated in 13 days
96% eliminated in 3 years
Disposition of aluminum
u Aluminum is not completely
eliminated from the body.
u End of 1st year of life:
Breast milk 0.1 mg
Infant formula 0.1 mg
Vaccines 0.1 mg
Adult 50-100 mg
How do we know aluminum is safe?
u Aluminum can cause encephalopathy,
osteomalacia, and anemia in two
groups: severely premature infants and
patients on chronic dialysis.
u Must meet two criteria: decreased or
absent renal function AND large source
of exogenous aluminum (i.e., IV
solutions or antacids).
How do we know aluminum is safe?
u Circulating levels of aluminum in those
with symptoms between 100-1,000 ng/ml.
u Typically, children and adults have between
1-5 ng/ml of aluminum in blood.
u Injected vaccines do not raise that level.
Aluminum references
Baylor, NW et al. Aluminum salts in vaccines—US
perspective. Vaccine 2002;20:S18-S23
Bishop NJ et al. Aluminum neurotoxicity in preterm
infants receiving intravenous feeding solutions. N
Engl J Med 1997;336:1557-1561
Committee on Nutrition. Aluminum toxicity in infants
and children. Pediatrics 1996;97:413-416
Keith LS, et al. Aluminum toxicokinetics regarding
infant diet and vaccinations. Vaccine 2002;20:S13-
S17
Pennington JA. Aluminum content in food and diets.
Food Additives and Contaminants 1987;5:164-232
Too Many Shots at One Time
Are more shots more stressful?
u Study showing that two shots are not
more likely to induce cortisol (as a
marker for stress) than one shot.
Ramsay DS, Lewis M. Developmental changes in infant
cortisol and behavioral response to inoculation. Child
Development 1994;65;1491-1502.
The Harm
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Harm in alternative schedule
u Not science based
u More likely to induce needle phobia
u Increase time during which children
are susceptible to vaccine-preventable
diseases
u Responsibility to the waiting room
u No benefit
Q & A Session
Twitter
www.twitter.com/vicnetwork
Resources
www.chop.edu
Vaccine Education Center at Children’s Hospital of Philadelphia
www.pkids.org
Parents of Kids with Infectious Diseases
www.immunize.org
Immunization Action Coalition
www.whyichoose.org
Why I Choose
Resources
www.aap.org
American Academy of Pediatrics
www.ecbt.org
Every Child By Two
www.cdc.gov/vaccines
CDC Vaccine Pages
For more info e-mail
National Public Health Information Coalition
www.nphic.org
California Immunization Coalition
Thank you
Most continuing medical education courses are arranged by "middlemen" companies for pharma so that the conference leaders don't have to declare their paid work as "industry conflicts". The middlemen companies declare themselves "neutral", though they work for the pharmaceutical industry. The CDC wasn't the only entity funding this. http://www.medpagetoday.com/PublicHealthPolicy/Ethics/15301
http://www.ahrp.org/cms/content/view/618/61/
Posted by: Gatogorra | May 10, 2010 at 06:35 PM
Love this:
"Harm in alternative schedule
u Not science based
u More likely to induce needle phobia
u Increase time during which children
are susceptible to vaccine-preventable
diseases
u Responsibility to the waiting room
u No benefit"
What a crock of shit. Well, lets see... given that some of the alternative schedules are not too far off from those of the early '80's and before and we had alot less chronic disease and 1 in 10,000 with autism, I'd say it's a little more science based than the ridiculous schedule of today.
Increase chance of needle phobia? You can't be serious. Seems like a child would have more of a chance of developing a needle phobia if they were stuck multiple times at all of their well child visit's.
More susceptible to vaccine preventable diseases... again, please get serious. I don't recall reading about any more kids back in the '70's and '80's being caught in epidemics of disease. And now we have an epidemic of autism.
My kid doesn't owe you or anyone else in the damn waiting room a damn thing. Responsibility to waiting room... yeh you have one alright, but you are far from living up to that responsibility and it's one you took an oath for. That would be to first do no harm.
No benefit... I gues that's why we didn't have epidemics of vaccine preventable disease a few decades ago. those damn vaccines were of no benefit then on that unbloated schedule. Nope, those vaccines didn't work at all. The spread out, alternative comparable schedules of today did nothing to protect a few decades ago...
Kiss my ass Paul Offit. Parents are alot smarter than you will ever realize, and your students and those who go to your lectures are nothing but a bunch of tools who can't think for themselves.
I can't wait for the day you are realized to be what you really are. A selfish, greedy bastard.
Posted by: Angela Warner | May 10, 2010 at 06:01 PM
There is less antigen because there is more aluminum!
They are, in effect, robbing Peter to pay PAUL!
Cannot have less antigen UNLESS, another IRRITANT, like aluminum or thimerosal is given to make the immune system go beserk with worry...
Posted by: annoyedwithsameolsameol | May 10, 2010 at 04:10 PM
Oh no AnaB, it is just some neurodiverse gene that is making your son's immune system attack the myelin in his brain.
Posted by: Natasa | May 10, 2010 at 01:54 PM
Paul Offit and one other doctor was offering a class for physicians regarding vaccinations in the late ninety's. The class received continual medical education credits.
The whole idea of the class was to teach physicians how to make a parent "feel" they were making an "informed decision", even though "they weren't."
The class should have been called, "How to Pull a Successful Vaccination Con.....bunko, flim flam, gaffle, grift, hustle, scam, scheme, swindle or bamboozle."
Offit is teaching them how to exploit the human characteristics to trust and obey.
Posted by: michael framson | May 10, 2010 at 01:27 PM
While Dr. Offit is teaching his class, does he mention that he was officially censured by Congress over conflict of interest re. one of his vaccines?
Posted by: lj | May 10, 2010 at 12:52 PM
Neuromuscul Disord. 2006 Dec;16(12):867-9. Epub 2006 Sep 26.
Atypical presentation of macrophagic myofasciitis 10 years post vaccination.
Ryan AM, Bermingham N, Harrington HJ, Keohane C.
Department of Neurology, Cork University Hospital, Cork, Ireland. [email protected]
Abstract
Macrophagic myofasciitis (MMF) is an uncommon inflammatory disorder of muscle believed to be due to persistence of vaccine-derived aluminium hydroxide at the site of injection. The condition is characterised by diffuse myalgias, arthralgia and fatigue. We describe a patient with histologically confirmed MMF whose presentation was atypical with left chest and upper limb pain beginning more than 10 years post vaccination. Treatment with steroids led to symptomatic improvement. Although rare, clinicians should consider MMF in cases of atypical myalgia.
Therefore there can be an important gap time between vaccination and symptoms.....
Posted by: ml | May 10, 2010 at 07:37 AM
It is unfortunate that in the case of Al the macrophagic myofascitis is not even mentioned....
J Inorg Biochem. 2009 Nov;103(11):1571-8. Epub 2009 Aug 20.
Long-term persistence of vaccine-derived aluminum hydroxide is associated with chronic cognitive dysfunction.
Couette M, Boisse MF, Maison P, Brugieres P, Cesaro P, Chevalier X, Gherardi RK, Bachoud-Levi AC, Authier FJ.
INSERM, Unite U955, Team 1, Creteil F-94010, France.
Abstract
Macrophagic myofasciitis (MMF) is an emerging condition, characterized by specific muscle lesions assessing long-term persistence of aluminum hydroxide within macrophages at the site of previous immunization. Affected patients mainly complain of arthromyalgias, chronic fatigue, and cognitive difficulties. We designed a comprehensive battery of neuropsychological tests to prospectively delineate MMF-associated cognitive dysfunction (MACD). Compared to control patients with arthritis and chronic pain, MMF patients had pronounced and specific cognitive impairment. MACD mainly affected (i) both visual and verbal memory; (ii) executive functions, including attention, working memory, and planning; and (iii) left ear extinction at dichotic listening test. Cognitive deficits did not correlate with pain, fatigue, depression, or disease duration. Pathophysiological mechanisms underlying MACD remain to be determined. In conclusion, long-term persistence of vaccine-derived aluminum hydroxide within the body assessed by MMF is associated with cognitive dysfunction, not solely due to chronic pain, fatigue and depression.
J Child Neurol. 2008 Jun;23(6):614-9. Epub 2008 Feb 15.
Macrophagic myofasciitis in children is a localized reaction to vaccination.
Lach B, Cupler EJ.
Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. [email protected]
Abstract
Macrophagic myofasciitis is a novel, "inflammatory myopathy" described after a variety of vaccinations, almost exclusively in adults. We examined the relevance of histological findings of this myopathy to the clinical presentation in pediatric patients. Muscle biopsies from 8 children (7 months to 6 years old) with histological features of macrophagic myofasciitis were reviewed and correlated with the clinical manifestations. Patients underwent quadriceps muscle biopsy for suspected mitochondrial disease (4 patients), spinal muscular atrophy (2 patients), myoglobinuria (1 patient), and hypotonia with motor delay (1 patient). All biopsies showed identical granulomas composed of periodic acid-Schiff-positive and CD68-positive macrophages. Characteristic aluminum hydroxide crystals were identified by electron microscopy in 2 cases. The biopsy established diagnoses other than macrophagic myofasciitis in 5 patients: spinal muscular atrophy (2), Duchenne muscular dystrophy (1), phospho-glycerate kinase deficiency (1), and cytochrome c oxidase deficiency (1). Three children with manifestations and/or a family history of mitochondrial disease had otherwise morphologically normal muscle. All children had routine vaccinations between 2 months and 1 year before the biopsy, with up to 11 intramuscular injections, including the biopsy sites. There was no correlation between histological findings of macrophagic myofasciitis in biopsies and the clinical symptoms. We believe that macrophagic myofasciitis represents a localized histological hallmark of previous immunization with the aluminum hydroxide adjuvants contained in vaccines, rather than a primary or distinct inflammatory muscle disease
Lupus. 2009 Nov;18(13):1213-6.
Vaccines as a trigger for myopathies.
Orbach H, Tanay A.
Department of Medicine B, Wolfson Medical Center, Holon, Israel.
Abstract
Vaccines are considered to be among the greatest medical discoveries, credited with the virtual eradication of some diseases and the consequent improved survival and quality of life of the at-risk population. With that, vaccines are among the environmental factors implicated as triggers for the development of inflammatory myopathies. The sporadic reports on vaccine-induced inflammatory myopathies include cases of hepatitis B virus, bacillus Calmette-Guérin, tetanus, influenza, smallpox, polio, diphtheria, diphtheria-pertussis-tetanus, combination of diphtheria with scarlet fever and diphtheria-pertussis-tetanus with polio vaccines. However, a significant increase in the incidence of dermatomyositis or polymyositis after any massive vaccination campaign has not been reported in the literature. In study patients with inflammatory myopathies, no recent immunization was recorded in any of the patients. Moreover, after the 1976 mass flu vaccination, no increase in the incidence of inflammatory myopathies was observed. Although rare, macrophagic myofasciitis has been reported following vaccination and is attributed to the aluminium hydroxide used as an adjuvant in some vaccines. Prospective multicenter studies are needed to identify potential environmental factors, including vaccines, as potential triggers for inflammatory myopathies.
Posted by: ml | May 10, 2010 at 07:35 AM
This whole aluminum thing ticks me off. Consuming aluminum through food IS NOT the same as it being injested directly into the bloodstream! Many of our kids have chronic Mastocytosis, which leads to a more permeable blood/brain barrier. Second, he talks about the vaccine issue as if all kids were the same. The put aluminum in the vaccines to over-rev up the immune system so the body responds to the antigen. Well what happens when a kid who is significantly predisposed to autoimmunity is routinely injected with aluminum, a substance put in the vaccines to over-rev up his immune system? Could that encourage his already dysregulated immune system to attack it's owwn body, it's own brain?
Could this be why my son's test results show that his own immune system attacks the myelin in his brain?
Posted by: AnaB | May 10, 2010 at 07:02 AM