The charity started by Rosalynn Carter and Betty Bumper and which has Dr Offit on both its Executive Board and Scientific Advisory Board continue to attack me for allegedly misrepresenting his views on vaccination overload. The explanation by resident “expert” Joel Harrison is that I am being naïve in my understanding of Dr Offit’s claim about 10,000 vaccines. Unfortunately, it was not me who made the extravagant and wild claims claims and this is very easy to document. So, it is very interesting if ECBT are now ashamed of them. For instance in 2005 Dr Offit’s institution Children’s Hospital of Philadelphia, alarmingly known as CHOP proudly reproduced a feature from the magazine Babytalk in which the following Q&A appears:
Myth1: Getting so many vaccines will overwhelm my child's immune system
No doubt about it, the immunization schedule recommended by the Centers for Disease Control and Prevention and the American Academy of Pediatrics (AAP) can seem daunting. Your child can receive up to 23 shots by the time she's 2 years old and as many as six shots at a singledoctor visit. So it's not surprising that many parents have concerns about how vaccines might affect a child's developing immunity and often cite these as a reason to refuse a vaccine.
But it should be the least of your worries. "Children have an enormous capacity to respond safely to challenges to the immune system from vaccines," says Dr. Offit. "A baby's body is bombarded with immunologic challenges - from bacteria in food to the dust they breathe. Compared to what they typically encounter and manage during the day, vaccines are literally a drop in the ocean." In fact, Dr. Offit's studies show that in theory, healthy infants could safely get up to 100,000 vaccines at once.
The bottom line: It's safe to give your child simultaneous vaccines or vaccine combinations, such as the five-in-one vaccine called Pediarix, which protects against hepatitis B, polio, tetanus, diphtheria, and pertussis (also known as whooping cough). Equally important, vaccines are as effective given in combination as they are given individually.
In a lecture from 2008 on youtube Dr Offit states:
I think conservatively, one could say that, based on their caveats, that one could probably respond to about 100,000 different vaccines at one time."... "I would say you probably could get 100,000 vaccines every day.
Dr Offit’s claims which originate in an article in PEDIATRICS in 2002 were immediately take up by the United Kingdom Department of Health and National Health Service. A leaflet from the MMR the Facts website from 2002 reads:
What about giving three live vaccines at once – it overloads the immune system? A baby’s immune system has an enormous capacity to fight the thousands of bacteria, viruses and other pathogens that it is bombarded with every day. A study from America shows quite clearly that even babies who are poorly can still produce protective immune responses to vaccines. This study also shows that a baby could, in theory, respond to around 10,000 vaccines at any one time. If, for example, 11 vaccines were given to a baby at one time, this might only use about a thousandth of the immune system. In providing protection vaccines prevent ‘weakening’ of the immune system.
In July 2004 I reported in a letter to BMJ Rapid Responses:
In an NHS leaflet …Sir Liam Donaldson, the Chief Medical Officer is asked: "Does MMR overload young bodies?" to which he replies: "Again, all the evidence refutes this. In fact, a child's immune system is designed to cope with many different viruses at the same time, so a combined vaccine is a natural choice.
I asked mmrthefacts: "Is the CMO entitled to present this as a medically established fact rather than a theoretical proposition? What is the experimental evidence that all children are equally able to sustain multiple exposure? What does the CMO mean by "designed?"
To which I had the reply (received 27 May 2004, 13.10):
“The CMO is entitled to present his statement about the immune system as a medically established fact rather than theoretical proposition. From the moment of birth a child's immune system is able to cope with the constant barrage of pathogens. As the CMO stated, this is what the..."immune system is designed cope tih (sic)..."As for example, the digestive system is "designed" to digest food and liver is "designed" to detoxify the blood. Part of the licensing process of any combination vaccine, such as MMR, has to show that the combination is safe and effective when administered to the age group for which it is intended.
“There is recent research from the US which supports this statement as it has specifically looked at the ability of children's immune systems, estimating that a child's immune system could cope with 10,000 vaccines any one time. Please see Offit PA et al (2002) Addressing parents'concerns: Do multiple vaccines overwhelm or weaken infant's immune system? Pediatics, 109 (1): 124-9
Just the following month I had a further explanation from Dr David Salisbury, head of the UK vaccine program in an email (24 August 10.03am):
Turning to my comments on Newsnight - I suggest you read Paul Offit's paper - as I have done. On page 126, he states: "Current data suggest that the theoretical capacity determined by diversity of antibody variable gene regions would allow for as many as 109 (1,000,000,000) to 1011(100,000,000,000) different antibody specificities". And "... then each infant would have the theoretical capacity to respond to about 10,000 vaccines at any one time" - not antigens. I was speaking very specifically about the infant immune system's ability to respond, in the context of the ridiculous suggestion that the new vaccine combination, containing far fewer antigens than the one it will replace, would overload the immune system. My words were "The immune system of a baby has got huge spare capacity to deal with challenge. If we didn't, the human race wouldn't survive. But let's look specifically at vaccine. This has been studied carefully. A baby's immune system could actually tolerate perfectly well 1,000 vaccines". At no point did I suggest that 1,000 vaccines would not increase the probability of adverse reactions - a quite different matter.
Dr Harrison doubted the existence of this email. In fact, I tried to post it first on BMJ Rapid Responses. If I remember correctly Dr Salisbury refused permission but allowed a comment which must also have been checked with him:
I subsequently had the opportunity to ask Dr Salisbury about this statement, and while I cannot quote him directly he made a distinction between overload - which was the point that he was apparently making in the interview - and the enhanced risk of adverse reaction which he accepted would be the consequence of such an action.
More recently the NHS’s senior vaccine official Dr Elizabeth Miller has again been citing the Offit article:
Despite strong scientific arguments against the immune overload hypothesis and epidemiological studies showing no increased risk of infections after multiple vaccinations, this idea may seem plausible to parents who then hesitate to vaccinate their infant believing that deferral until an older age may be in their best interests.
One would have thought that over such an important issue something more than “strong arguments” ought be a basic requirement. Also, it is interesting than she remarks about “no increased risk of infection” but says nothing about disability or chronic disease. And it is only at an epidemiological level.
OK, so not only is it a preposterous claim it also involves basic bureaucratic doublethink. The justification for vaccines is that, however wonderful the immune system is, some pathogens are harmful or deadly or can at least make you very ill. It by no means follows that all pathogens that the infant body are exposed to it responds to adequately and no reason to assume the pathogens received through vaccination never pose a threat. Moreover, the combinations of exposures involved in vaccination are all synthetic and previously unknown in human development. Also, of course, those products that are delivered by injection also evade the bodies normal systems for dealing with potentially harmful matter – the dust and unsterilised food mentioned by Offit in his lecture which enter the body through the digestive system and the lungs.
And apparently in 15 years no one has been able to think up a less fanciful story.