Science, faith, and vaccines

Faith & Science Conversation
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Welcome! I hope you have enjoyed the podcast, as have. I am learning a lot from it.

I am a family physician, and I will tell you as much as I can. I can try to look up as many answers as I can too, if I can’t answer them off the bat.

And above all, I appreciate sincerely your point at the bottom of your note–that we each have a story, and a reason for where we come from. Even if the reasoning is not right, everyone has something to share, a valid fear, and something we all have something we can learn from each other.

Great. I have a lot of questions too. Science is a great place to learn, isn’t it? It is a great source of humility when we ask with sincerity.

Great question. Yes, to start, the 300 million people who have died from smallpox–and their families–would have loved to be in our situation, of having none in the environment currently. Polio killed or maimed more than 500 million. However, see this list of 13 vaccines for more information https://health.clevelandclinic.org/vaccines-that-save-lives-around-the-world-infographic/ (CDC.gov is a great resource too, as is WHO https://www.who.int).

Yes, I can PM you an article reviewing this appropriately. Paul Offit also examines this in detail. Try “Autism’s False Prophets,” “Do You Believe in Magic,” and other books he’s written. http://paul-offit.com/resources/ http://paul-offit.com/ The Lancet also has it more succinctly.

FDA has tested this and there are reasons for giving this protocol; and Sears is wrong here (he gives an alternative schedule). I do not know the various European official recommendations, but WHO is more reliable as some European countries accommodate unproven regimens (Germany, I think, especially; but I don’t have the details). . I personally believe, however, that just giving the vaccine is more important than the schedule.

I do not know all the details of vaccine funding, except that the government often has to support this, as testing is so careful and expensive that drug companies don’t make enough to rationalize production on their own. Children’s vaccines have followed this, especially.

Regarding the opioid crisis, I can tell you a personal story of struggle which you may find empathetic. In medical school in 1999, the grassroots move to push opioid availability was meant well. Many patients were not getting pain control after surgery and acutely after injury. They suffered. Other primary care and pain physicians could not find much for those who suffer with chronic pain (they still don’t have many options, but they are much better than 21 years ago). It is heartbreaking not to be able to fix someone’s pain immediately–opioids did that, though as we see now, with terrible cost.

. As a result of community outcry from paitents and healthcare workers, JCAHO oversight groups and other regulatory agencies tried to get docs to make pain a standard vital sign. A small, poorly made study that said that short term, patients were not frequently addicted to postop meds, was quoted 140 times or so, and misused to construe a lack of harm.

It’s only now that we are seeing the fallout. We now know that there is little evidence that opioids are safe or even effective in the longterm. I can give more information about endorphin dependence, etc in another thread.

You mentioned drug company profits. I have heard about some, but we can’t blame the company for everything. After all, researchers missed warnings from history, doctors prescribed them, and we all missed important warning signs in the hope we could relieve pain.

Thanks.

May I ask another question? With the current pandemic and high mortality rate, would you consider vaccines against the Covid virus?

Also, one little known fact I learned from CDC is that the elderly (because of weak immune response) do not respond well to vaccines. For example, even with a good flu vaccine, it may be only 15% effective. About 50,000 people have already died of the flu this year (it’s usually 35,000 in the US, from my understanding). Most of these are the elderly or immunocompromised, though children also die of the flu frequently.

The only way to prevent that (and likely Covid) is to immunize the healthy, so as to provide herd immunity. These healthy folks then won’t carry the virus to the weak, and more people will be saved.

I am curious if you found that the vaccine was effective, if you would consider taking it–not necessarily to just protect yourself, but also to protect those with cancer, on chemo or arthritis meds, and the elderly? If so, under what circumstances?

The power of the story is great. Currently, there is tremendous suffering–not just from the deaths, but from economic downturn. About 3 million people in the US alone–by far the greatest number on record–have applied for unemployment benefits. Many others are unable, but have lost their jobs.

All this suffering argues strongly for a vaccine–historically, the only reliable way to combat a virus. (see this about the chloroquine and azithromycin, which likely will not help much A Really Bad Clinical Study on COVID-19 - #14 by evograd - Peaceful Science). We need strong questioning of what is effective, yes–but we also need to listen to both sides.

Thank you for your thoughts! God bless. I enjoyed reading your note. It reminds me of some of my own beloved family, who feel the same as you do.

Randy

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Hi Jessica, and welcome to the forum. Thanks for sharing your perspective! It is difficult when this topic becomes personal and involves strong feelings, especially between family members.

I would agree and think we should all be vaccine-safety questioning, just as we should be of anything else. But I’m convinced that most involved “in the trenches” of this issue already are. I’ve had a few conversations with my pediatrician and she even shared with me some concerns she’d had about vaccines decades ago, but at this point is completely pro-vax and recommends that children follow the schedule. One thing I have noticed when it comes to questioning vaccines, that strikes me as similar to many “evolution-questioning” communities, is this habit of focusing on narrow issues far out of proportion to their importance. Randy’s provided an excellent response above and I don’t have any medical credentials, but for what it’s worth, I’ve had to ask whether the sources I listen to are looking at the body of scientific research or not. Not that the details aren’t important, but if we lose the big picture in the process, we can end up fighting the wrong battle.

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Hi Jessica,
I admire how you are asking the right questions to search for the truth and the science about vaccines.

@Randy made a lot of excellent points, which were hopefully helpful to you. I am not a medical doctor, but a PhD trained immunologist working in the biotech industry. My work has been in the area of autoimmune disease and cancer, so the companies I have worked for do not get any money from vaccines. While I have never worked specifically in the area of vaccines or infectious disease, my training has helped me understand how vaccines work and to understand the great value of them to society. My training also helps me read some of the anti-vaccine literature to understand the limitations of their studies (often things like very small sample size or self reporting as opposed to clinical assessment). I have observed that a lot of information circulated by anti-vaccination groups can be very misleading. Also remember that some groups opposed to vaccination benefit from things like the advertising they receive on their websites, social media sites, and you-tube channels, and donations they receive from supporters, so anti-vaccine organizations themselves can biased and have financial incentive for their work.

That all being said, I was very happy to get my children vaccinated as quickly as possible, following the standard protocol recommended by my pediatrician. With diseases such as the measles often coming back in outbreaks (even last year), and knowing that infants are particularly vulnerable to measles, I breathed a sign of relief after the MMR vaccine was given to each of my children, because MMR one of the later vaccines on the schedule (1st dose given at 12 months)

While there are rare instances of some negative reactions to viruses, they are exceedingly rare, and most are self limited, resolving over time. The CDC, the FDA, and the World Health Organization tracks adverse events that occur after a child receives vaccines to ensure vaccine safety.

Information from the WHO:
https://www.who.int/vaccines/questions-and-answers

Some information from the CDC:

and from the FDA:

It sounds like you might not trust information coming from the these government organizations. I do not know why those government organizations would be biased in their assessments of the safety of vaccines, because they do not get any money from pharmaceutical companies. It is the job of the CDC, the FDA and the WHO to promote public health and also to ensure consumer safety of vaccines and pharmaceuticals.

In actuality, scientific and medical evidence is clearly in favor of vaccination, not against it. Anti-vaccinations studies, such as the one by Andrew Wakefield, which included only 12 children, have been clearly debunked. In contrast to misleading, under powered, and biased anti-vaccine reports, a study of 30,000 Japanese children showed that autism cases continued to increase even after the MMR vaccine was no longer available to children in there: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1469-7610.2005.01425.x

As for other resources: This site points to 6 papers comparing vaccinated and unvaccinated kids, with very large sample sizes (which would be necessary for quantitative statistics) and show positive health outcomes:

And a site debunking the myth of a link between MMR vaccine and autism:

I hope some of this information can help you feel better about the safety and effectiveness of vaccines.

My family is currently praying for the development of safe and effective vaccines against the Covid-19 virus, as well as for effective treatments to combat viral replication for people infected who are suffering from more severe outcomes.

My warm and sincere regards,
Michelle

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I also just discussed this vaccine topic with my husband, and he brought up another great point:

In the cases where vaccines have caused demonstrable harm, there has been wide public and scientific debate and re-assessment, which as led to changes in recommendations by organizations, such as the WHO. One example of this was the tragic outcome from Sanofi Pasteur’s Dengue virus vaccine campaign in 2016.

Dengue virus is a special case where some people who have had a prior infection generate antibodies to the virus that can cause a more severe case of illness upon re-infection.

Thus, Sanofi’s vaccine is no longer broadly recommended. It is advised that people who have never been infected with Dengue virus (and are thus seronegative, lacking anti-Dengue virus antibodies) NOT receive the vaccine. However, the vaccine might provide benefit to people who have had a prior infection and are seropositive, decreasing their risk of severe disease upon re-infection with Dengue virus.

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Yes… Another was the rotavirus vaccine that caused intussusception in a very tiny number of cases. It was during my residency…they withdrew it and replaced it with a better vaccine.

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thanks for offering that additional example with the rotavirus vaccine, of which I was not aware. The CDC has a website about the risk. And here is an article talking about the research that was done to prove the association:

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Great, thanks. Yes, and as you said, the power to self-check is one of the benefits of science. I listened to a podcast with Paul Offit, who was involved in the initial vaccine. It still saved many more lives than the tiny proportion of risk, but they insisted a new vaccine–which was right.

In residency, we literally had so many dehydrated kid with the rotavirus that there were pre set history and physical forms to admit and hydrate them. Rotavirus is still a major killer overseas. https://www.who.int/immunization/monitoring_surveillance/burden/estimates/rotavirus/en/

I also had to learn a typical meningitis workup in residency–if you had a fever in a little one, the standard of care was a painful and somewhat dangerous lumbar tap, admission, blood test, etc. However, with the Haemophilus influenzae and pneumococcus vaccines, the rate of meningitis has dropped so much that we no longer do LPs except in rare cases.

I grew up in Niger, West Africa, the son of missionaries. I remember one missionary doctor losing her child and nearly losing the other in one day. The grave remains at the mission station. http://janephilpott.ca/grace-in-the-face-of-grief/
A large percentage (I have heard 1/3) of all Nigeriens carry Hepatitis B, a virus transmitted from mother to child, and causes cirrhosis or liver cancer frequently by age 30-50 (my last case in 2016 was a 30 year old man who hemorrhaged into his abdomen from end stage liver failure). Hepatitis B is very rare in the US now because of newborn vaccines. Nigeriens would love to have that.

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11 posts were split to a new topic: Taking COVID-19 seriously

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A post was merged into an existing topic: Taking COVID-19 seriously

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This is a very interesting Ted talk. Thanks for that.

To summarize, Dr Stebell-Benn is a Danish researcher who worked in Guinea Bissau. She is strongly pro-vaccine–to the point that she lists a live polio virus vaccine as being as important as love and nurture to a newborn baby for its survival. However. she says that the live component lowers mortality by 1/3, even though there is no polio in G-B. She further claims that killed vaccines are narrow spectrum, don’t confer a similar decrease in mortality, and in the case of DTP (diphtheria, tetanus, pertussis), actually increase mortality.

I tried to look up the WHO comment, and found that they did indeed cite her study, but I can’t find a rejoinder. Maybe Dr Matheson would have better insight–his expertise is to vet good studies, as editor of a major science journal.

For what it’s worth, though

  1. She is strongly pro vaccine. I admire her for her work and dedication to the poor in Africa. My parents were medical missionaries in Niger, West Africa, for 13 years. I was born there and seeing the suffering in Africa was a primary reason for my going into medicine.

  2. However, I don’t feel comfortable with her speech for the following reasons:

A) she presents no mechanism for a study whose results are apparently not replicated in the US. See the huge Salk controversy about the IPV and OPV (inactivated and activated) vaccines. It’s precisely the fact that the oral, live vaccine in rare instances mutated to cause polio (1-2/million) that anti-vax people cite that vaccines can cause harm. The IPV replaced the OPV because it was effective. It didn’t cause death like the OPV did. Also, I’d like some clarification. By the same reasoning, we can take any virus, make a live concoction with weakened characteristic, and give it to a patient for the same result.

B) In the US alone, 21,000 lives have been saved yearly by the DTP vaccine (diptheria is a horrible disease, causing suffocation of children by forming a membrane in the back of the throat). It is making inroads in Yemen again because of he war). https://health.clevelandclinic.org/vaccines-that-save-lives-around-the-world-infographic/

C). I would be interested how her intention to treat was made. It would make sense that families that attend a doctor’s clinic to get vaccines would be more attached to the healthcare services, as opposed to those who didn’t. This is the same error that caused use to push postmenopausal estrogen. While the Women’s Health Initiative showed prospectively that women do overall worse on longterm postmenopausal estrogen, the initial observational studies followed women who took estrogen, were active and conscious of their health, and went to their doctors–thus, skewed the results to imply they benefited from it.

I need to read her study better (I found an abstract in Pub Med), but one of the cardinal rules for applying a study is that it’s replicable. Since it doesn’t show up in the West as a typical side effect of increased mortality, where variables are more easily controlled, I would be leery of taking her word for it.

Finally, her generalization about inactive vaccines is not all correct, I believe. I have heard that those who receive the inactivated flu vaccine do better with fighting off other viruses as well.

It’s a good video to prompt questioning. However, I don’t understand why she is approaching a non scientific crowd, asking them to decide about whether a shot in Guinea Bissau is safe or not, when it has been helpful in the West.

Again, I will have to read more, if I can. It is good for my humility.

Finally, make no mistake–she is strongly for vaccines–just her kind of vaccines.

Thanks.

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Not sure how to help here. Her publications are on PubMed and she’s an expert immunologist. I don’t know what you mean by a rejoinder to a citation, but I haven’t (and won’t) watched the video.

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OK, maybe I was wrong, @jessica. However, her Ted talk says that the WHO and CDC disregard that DTP is causing deaths.

Jessica is concerned (understandably) that this means the powers that be are not interested in truth in safety in vaccines. I will look into this more. I did see the Pub Med earlier and had trouble accessing papers but was too busy to do so. I’ll do it later.

Jessica, I’m not sure why she is at loggerheads with the WHO, but it’s good to ask questions. Thanks.

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Wow, thanks to all of you (@Randy @MOls @Laura) for your thorough replies to my post! It will take me some time to wade through everything. . . I’m not an especially scientifically-minded person (I’m an artist, actually) so reading studies, etc. isn’t a quick endeavor for me.

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Me neither! I still haven’t had a chance to purchase an article from Dr Stabell-Benn’s work, but I did listen to a video on the Covid treatment and prevention. There is some hope that the BCG vaccine, used for smallpox, could help the innate immune system to work against Covid, as it seems to do for another type of virus. BCG was initially made to immunize against TB, which is unrelated to Covid or any virus. It’s interesting, but does not really argue that we should not use “killed” vaccines, nor why the oral polio would be specially a good choice over, say the BCG as a blanket stimulant.https://www.youtube.com/watch?v=LqKwAIIy-Mo

Interesestingly, elsewhere in the video series, they talk about using hyperthermia (high temperature, as in a sauna) to improve fighting against Covid–similar to what they did for the 1918 flu H1N1 pandemic. It seems some supportive care can improve monocyte activation and outcomes. Neat stuff! We are still hoping for a better treatment and prevention (vaccine).

Thanks for your kind discussion. It is making me think hard.

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@jessica
Yes, I am also a bit perplexed by Dr Stabell-Benn’s work, which I tried to look up after watching that TED-talk video you posted. I don’t have time to do an extensive review, but one paper I was able to pull up had me wondering if the populations she was comparing were truly random samples, or if they somehow were self-selected in a way that would account for the results. And why did the numbers of children become so small as the time of the study increased. The low numbers of patients at the end of the study would reduce the statistical significance of the magnitude of the result. Her observations seem to also occur in certain countries, and perhaps not in developed, Western nations. It is also odd that the negative result is only observed in girls (why would that be?). As a scientist, what I am left longing for is some type of mechanistic explanation for her observations. And have others been able to repeat those findings, or is it only her group that have made such observations?

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Speaking of vaccines, here is an interview with Dr. Paul Offit that I found very interesting concerning the development of a coronavirus vaccine as well as just some other info about the situation. He points out the challenges that are present and the hurtles to be overcome.

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@Randy and @MOls, would you please post a link to the article(s) you are discussing?

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Wow, that’s really interesting. I am enjoying the interview (Offit is one of my most admired docs, besides Abram Verghese and Paul Brand). I didn’t know that the shortest time to get a vaccine was 4 years (mumps); makes me appreciate their work even more @glipsnort.

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I want to emphasize that I appreciate Dr Stabell-Benn’s willingness to work for the poor. My parents were missionaries in West Africa also (Dad was a surgeon), and I was born there. I grew up greatly impressed by both the suffering of the people (as many at 50% of children under 5 died prior to vaccines; this is improving, in large part because of immunizations). She is, with others, instrumental in great change. It’s this sort of help that made me want to become a family physician.

I found Dr Stabell-Benn’s contact email and asked her if she would kindly clarify what she is concerned about with regard to WHO and CDC guidelines. We will see if she is able to do so.

I found a BMJ (British Medical Journal) article, which Dr Stabell-Benn alluded to as reviewing her work:
https://www.bmj.com/content/355/bmj.i5170 “Association of BCG, DTP, and measles containing vaccines with childhood mortality: systematic review.”

In it, Higgins et al note that all studies were observational, and especially with regard to DTP, had a high bias risk.

They felt that “We do not believe that the available evidence supports a change in either the choice of vaccines or the timing or sequence of immunisations routinely administered to infants and children… At the same time, the data raise sufficient concerns for us to strongly recommend further studies on the possible effects of immunisations on the immune system and on the risk of morbidity and mortality, particularly in relation to DTP. Randomised trials are needed to overcome the difficulties of interpretation of observational studies.”

I would like to read more–especially regarding replicability of tests, based in the West on DTP. As Higgins et al note, DTP has saved many lives based on other observation.

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