Why more vaccines won't translate to better health
Dr Jacob Puliyal  and  Professor BM Hegde 16 July 2014
If vaccination was such a good method of disease prevention we should have been able to eradicate many contagious disease, but alas, records show that except small pox we have not been able to eradicate any contagious disease to date

“It is more from carelessness about truth than from intentionally lying that there is so much falsehood in the world.”
                                                                                     -Samuel Johnson
When one gets an infectious disease, by and large, one gets immunity against that infection; sometimes the immunity is lifelong, but in many cases for some time after the first infection. However, the hypothesis that artificial vaccination using various laboratory methods gives complete protection against the disease seems to be based on a shaky foundation. Historically, most infectious disease deaths had fallen significantly long before any vaccination for diseases was introduced. The important changes in sanitation, water supply, good nutrition and education seem to have influenced the fall much more than vaccinations. There are now sporadic reports that recent vaccination against measles and mumps seems to have triggered an epidemic of those diseases significantly in the vaccinated group.
If vaccination was such a good method of disease prevention we should have been able to eradicate many contagious disease, but alas, records show that except small pox we have not been able to eradicate any contagious disease to date. Every Indian should be proud of the fact that smallpox eradication was possible using the Indian ancient Ayurvedic vaccination system with attenuated live small pox virus from the previous year’s small pox patient’s pus. It was in 1767 that Dr TZ Holwell, FRS; FRCP (London) presented a paper on the subject at the Royal College of Physicians at London after having studied this vaccination system for twenty years prospectively in The Bengal where this vaccination was in vogue for “times out of mind” through the five International Universities in India at that time. Edward Jenner of conventional vaccination fame, used cow pox pus, which today we know has nothing to do with small pox. Dr Holwell’s paper can be viewed in the Royal College library at Regent’s Park campus even today, although partially damaged in the great fire of the 18th century.
Indian Prime Minister Narendra Modi has announced four new vaccination programs in the fond hope of preventing, if not eradicating, some diseases as detailed below.
Unfortunately he has been advised wrongly and besides wasting scarce public health resources is likely to result in serious problems for the well-meaning Government.
1.       Policy to vaccinate adults in Japanese Encephalitis (JE) endemic areas.
a)      This disease affects children. In endemic areas it does not affect adults as 90% of adults have developed natural immunity by sub-clinical or clinical infection in childhood.
So the vaccine is to be given in the population who are already immune and are not affected by the disease.
A few adults are affected but according to Borah (PMID 21715224 J Clin Virol 2001;52:45-9) these are in areas of new invasion of the disease (and the adult population is not immune) or where the virus has changed over time. In both these cases the new vaccination program is useless. The vaccine is being targeted to endemic areas and NOT areas where the disease is emerging for the first time, and if the virus has changed and natural immunity is not effective, the chances that the vaccine will be effective are untested and unlikely.
b)      There is another point that needs to be considered. In childhood immunisation, 80 to 90% coverage is considered excellent coverage. Uptake of adult vaccines is much lower.
For JE prevention in adults, 90% of whom are already immune, if the government hopes to reach the 10% of those who are not immune it will have to vaccinate 100% of the population – an impossible task.
So it is clear that this exercise is a complete waste of resources which is better spent in trying to prevent the disease in children who are the main group affected.
2.       Policy to introduce New Rotavirus Vaccine in India
a)      The newly licensed vaccine costs Rs150 per child.  According to Bhandari et al (Lancet 2014; 383:2136-43.) it has only 50% efficacy and 55 children will have to be given the vaccine to prevent one case of diarrhoea in those 55. The cost of giving this vaccine to 55 children in order to prevent one case of diarrhoea by vaccination will be Rs8,250.
Rotavirus infection treated with oral re-hydration solutions (ORS) early will cost Rs10 per child. The money is better spent on water and sanitation projects and to make ORS widely available; this will reduce all diarrhoea deaths – not only rotavirus infections.
b)      Worse still is the risk of intussusceptions that the vaccine causes. Intussusception is a surgical condition that makes the intestine telescope into itself causing intestinal obstruction and passage of bloody stools. This has to be treated immediately or it can result in deaths. A rotavirus vaccine was introduced previously in the US but it was banned when it produced one case of intussusceptions in every 10,000 children vaccinated.
According to the Lancet paper quoted above, the new vaccine seems to produce one excess intussusceptions case in every 2,000 vaccinated children, meaning it is five-times more dangerous than the vaccine that was banned.
The sample studied is too small to tell the real risk of this dreaded complication. It was studied in 4,500 children whereas the US Food and Drug Administration (FDA) required a study in 30,000 children before the new rotavirus vaccine was granted license.
But it seems the Drug Controller of India has granted license and says that adverse effects can be studied in post license marketing surveillance.
Now with the announcement of introduction in the immunisation program it means this experiment will be conducted on 27 million children, who will act as guinea pigs for a vaccine. In poor rural areas where the vaccine will be given by the government, children will develop intussusceptions, passing blood in stools after a few weeks of immunisation and there will be no doctor available to make the diagnosis of intussusceptions. The parents will assume the child died of dysentery. The death will not even be recorded as an adverse event following immunisation.
All this is discussed extensively in the PubMed Commons
3.  Rubella vaccine in babies to prevent Congenital Rubella Syndrome (CRS)
Rubella is a very mild disease, like a cold that lasts for two days and mild fever with a slight transient rash. It is widespread in children and gives lifelong immunity.
However if a girl does not get infected in childhood and is therefore not immune, and she gets the infection in the first three months of pregnancy, the baby in her womb will develop CRS with cataracts, heart disease and mental retardation.
The incidence of CRS is not known and is very low because most children get natural immunity before they reach adolescence.
The best way to reduce CRS is to vaccinate adolescent girls so that if they had escaped natural infection in childhood they can be immune before going into pregnancy.
If we vaccinate children the natural immunity that most children get will be stopped and it is documented that there will be more cases of CRS as adolescents may go into pregnancy without immunity.
This is documented in medical literature and any public health doctor will tell you that. The purpose is not to eliminate such mild viruses from the world but avoid CRS. The new policy will increase CRS. (Anderson and May. Infectious disease in humans: dynamics and control. Oxford Press 1992) (Edmunds et al. Epidemiol. Infect 2000;125:635-50)
4 Injectable Polio Viruses
This needs no explanation. We will never be able to cover the entire population with this very expensive vaccine not only because of the costs of this vaccine, but also because of the cost of giving this vaccine to every child.
Given as an add-on vaccine to OPV there is not much to fault in the decision, except the cost.
Once IPV is introduced, the OPV will be withdrawn and we will have bad epidemics of Polio among the babies not immunised. Importing from neighbouring countries will be needed and all the excellent work of Polio eradication will get undone.
We earnestly hope that this correct scientific viewpoint reaches our Health Minister and our Prime Minister for them to take the right decision. We should not forget that the industry will push vaccines to every gullible government, as vaccines make better business sense compared to curative drugs.
               “Man's mind is so formed that it is far more susceptible to falsehood than to truth.”
                                                                                     -Desiderius Erasmus
(Dr Jacob Puliyal is a pediatrician and member of the National Technical Advisory Group on Immunization (NTAGI) of the Government of India. Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS. He is also Editor-in-Chief of the Journal of the Science of Healing Outcomes, chairman of the State Health Society's Expert Committee, Govt of Bihar, Patna. He is former Vice Chancellor of Manipal University at Mangalore and former professor for Cardiology of the Middlesex Hospital Medical School, University of London.) 
8 years ago
The fact is. This idea of no vaccine and no antibiotic will make us lab rats to prove once again we were right that antibiotics and vaccines will save a life - try living with out a toilet and be messy about the situation, you soon realize that a doctors can save a life. For example I was careless about brushing my teeth I had cavities on the right side of my teeth yet after Colgate with germ fighter it healed - I had a back tooth that dissolved on one side and almost 98% healed now, yet all the the others healed.
8 years ago
This article reminds me of:

Members of the Flat Earth Society claim to believe the Earth is flat. Walking around on the planet's surface, it looks andfeels flat, so they deem all evidence to the contrary, such as satellite photos of Earth as a sphere, to be fabrications of a "round Earth conspiracy" orchestrated by NASA and other government agencies.

The belief that the Earth is flat has been described as the ultimate conspiracy theory. According to the Flat Earth Society's leadership, its ranks have grown by 200 people (mostly Americans and Britons) per year since 2009. Judging by the exhaustive effort flat-earthers have invested in fleshing out the theory on their website, as well as the staunch defenses of their views they offer in media interviews and on Twitter, it would seem that these people genuinely believe the Earth is flat.

With so much knowledge available, can they be serious? And if so, how is this psychologically possible?

Fact is: Immunology is a branch of biomedical science that covers the study of all aspects of the immune system. Our bodies are fully capable benefiting from a vaccine therefore anyone who misunderstands the field of Immunology is doomed to failure - its a time tested prove fact.

With so much knowledge available, can they be serious? And if so, how is this psychologically possible - How is this psychologically possible that a person can save your life, yet doubt the way it happened.
Jagannath Chatterjee
8 years ago
Dorit is very active in the vaccine marketing circles. She is also well known as a person who fights the genuine claims of parents who fight for their vaccine injured, disabled or killed children. She works for a BMGF agency though she claims she works for free. Why should a lawyer work for free?
Dorit Reiss
Replied to Jagannath Chatterjee comment 8 years ago
Anti-vaccine activists, often unable to counter facts and evidence, resort to trying to paint their interlocutors as paid. I work for a law school: I'm an academic. Nor am I a lawyer: I'm a law professor. I do not get to comment online about vaccines: I speak up because I care about children's help.

You are welcome to provide evidence - from a reliable source, unlike the anti-vaccine blog Age of Autism - for your claim that I ever fought a genuine claim of a parent that is fighting for a vaccine injured child. It's not true.

I would suggest that attacking the speaker is not a good substitute to having a substantive response to the comments.
Jagannath Chatterjee
Replied to Dorit Reiss comment 8 years ago
I belong to the 80 lakh (8,000,000)children and adults in India who are on the autism spectrum into which I regressed after the MMR. I was old enough to see the connection and therefore I researched. Yes, we are anti-vaccine activists because we are educated on the subject and have a personal experience (mine over 35 years) to fall back upon. We keep a close eye on people who are busy on the net trying to prove that vaccines are safe and in our best interests even as doctors and the industry are protected from lawsuits as they are well aware of the risks and would not operate otherwise. I was not attacking you, we have met each other many times on such comment or discussion boards. You have always told me that though you work for the BMGF backed agency that pretends to speak for the people but scuttles their interests instead, that you do not get paid. We fight for justice. What do you fight for Dorit? What makes you so interested in this debate? I care little for the reliable sources that portray rosy pictures of the likes of Paul Offit and Poul Thorsen. I would rather go for sources that investigate things for what they are. Your stance of holding high ground does not fool us who keep a close eye on those who push vaccines and those who aid them.
Dorit Reiss
Replied to Jagannath Chatterjee comment 8 years ago
I work for a law school. Calling it a BMGF - whatever that means - is inappropriate. If you mean the Grass Roots organization Voices for Vaccines - I don't work for it: I'm a member of their parent advisory board.

And yes,claiming I am paid to do it is an attack, and an untrue one - and not a substitute to having evidence on your site. All it shows is the weakness of your argument.

Why am I interested in protecting children against disease? Because I think children deserve a chance to live and be well. All the credible evidence is that the small risks of modern vaccines are far outweighed by their tremendous benefits. All that supports the anti-vaccine movement is misinformation - like claiming, against the evidence, that vaccines cause autism. There is no credible evidence supporting that claim - and numerous studies against it.

That's why anti-vaccine activists have to resort to conspiracy theories and to claim that people arguing for protecting children against disease are paid.
Replied to Jagannath Chatterjee comment 8 years ago
There are proponents of both sides of the story and vaccinations have been made mandatory in order to access public schools etc in the US. Unfortunately as parents, it is very difficult to make a decisions as most doctors align with the official vaccination recommendation. Besides MMR are there other vaccines that have been linked to autism?
8 years ago
Dorit Reiss is correct that the efficacy of Rotavirus vaccine is good in Europe and USA reaching up to 90%.
But the trial on the new vaccine that has just been licensed in India shows its efficiency is just 50%. There is an equal chance the vaccine will be completely useless for the individual. The study showed that 55 children had to be vaccinated with a vaccine that costs Rs 180 per child to prevent diarrhea in one child. That means Rs 9900 will have to be spent on rotavirus vaccine to prevent one case of diarrhea. All this is data from the article in the Lancet by Bhandari and colleagues who tested the vaccine.
Does anyone need this vaccine?
Jagannath Chatterjee
Replied to JP comment 8 years ago
8 years ago
My Guru, Mokichi Okada, said all this in the 1930s.
8 years ago
You all can believe what you want. You say vaccines pose no risk. You say there are no toxins. You say vaccines are safe. Well 70 million plus injured children world wide are proof that you may be extremely mistaken. You say safe? Except when that one to two unlucky children for each vial get the bottom of the vial "ingredients" that have not been previously shaken and disbursed. Then that child takes more than their fair share of toxins, now times that by the number of vaccine vials that have been used throughout the world over the last twenty years or so....that's a whole lot of vaccine injury and damage. Don't respond to my post because I am not interested in your opinions. I know what I see all around me...vaccine injured children with ASD, ADHD, and a whole host of neurodevelopmental disorders. You can't hide the truth any longer because they ae becoming the majority. 2024...1 in 2 with Autism.
Meenal Mamdani
8 years ago
This article mixes issues and uses polemics instead of rational discourse. Yes, sanitation and nutrition reduced communicable diseases and yes, vaccine makers are interested in profit but this does not mean that vaccines do not reduce disease burden. Following statements are problematic.
1)Eradication using vaccines is possible in some diseases, unfortunately not all. In the authors' opinion, therefore vaccinations are not worthwhile.
2)Many children in India do not get their required doses of vaccination because of poverty, ignorance, etc. Yet the authors recommend withholding rubella vaccine until puberty in girls so that they get a chance to acquire natural immunity, thus exposing these girls to the risk of having a child with CRS.
3)Injectable polio vaccine is condemned because the authors hypothesize that OPV will be withdrawn if IPV works.
Other commentators have highlighted the authors' inaccurate statements regarding Rota virus.
Dorit Reiss
Replied to Meenal Mamdani comment 8 years ago
Very important points, I think.
Narendra Doshi
8 years ago
Narendra Doshi
8 years ago
VERY WELL SAID AT THE NICK OF TIME by BOTH the doctors.Efforts should be made by Moneylife Team and others so that it reaches our Health Minister Dr Harshvardhan and the PM Shri Narendra Modiji in time BEFORE proposed Vaccination project implementation starts.
Shawn Siegel
8 years ago
LOL. Why Vaccines Translate To Ill Health, should be the title of the article. Depositing poisons, pathogens and proteins via the capillary beds of the muscles into the bloodstream, where they don't belong, is destructive beyond measure.
Dorit Reiss
Replied to Shawn Siegel comment 8 years ago
Luckily, none of the ingredients in vaccines is toxic in the tiny amounts that they are in vaccine.

In contrast, for example, the bacterias that cause diphtheria, tetanus, and pertussis all excrete a toxin. The vaccines protect against them.

You want to protect children? Vaccinate against these dangerous diseases.
Sucheta Dalal
Replied to Dorit Reiss comment 8 years ago
Mr Reiss

I know that pharma companies are canvassing hard to popularise the Rota virus vaccine. But a large number of doctors, who are independent thinkers, believe that manufacturers are creating a needless scare.
There was a huge advertising campaign to frighten parents into getting the Rota vaccine and enriching pharma giants. It was stopped by the Advertising Standards Council of India based on expert opinion of doctors.
Moneylife allows divergent views to be posted to their articles but not when they begin to seem like biased point of view.

I am not saying anything about your comments as yet, but only making a general observation about our policy.
Dorit Reiss
Replied to Sucheta Dalal comment 8 years ago
I provided evidence supporting the points I made about the dangers of rotavirus - including in the U.S.. It is, of course, the publication's choice whether to censor comments, however well supported, that they disagree with. I will preserve copies of my comments, in the event that they are removed, to be able to show which kind of comments the publication chooses to have removed.

I would say it is a show of bias to remove comments that disagree with the article.
Chris Hickie
Replied to Dorit Reiss comment 8 years ago
There is clearly a show of anti-vaccine bias here on this web site. First, the authors ignore the high mortality of rotavirus infections in India (~113,000 deaths from diarrheal rotavirus illness in 2005, per the WHO (http://www.who.int/bulletin/volumes/90/1.... This "review" here also ignores the smaller sample size used for this study in India, compared to the larger sample sizes for the two rotavirus vaccines in the US (see Table 1 of http://www.cdc.gov/mmwr/preview/mmwrhtml...#tab1). Finally, the additive effect of herd immunity--which did not occur for this study in India has been completely ignored. The rotavirus vaccines used in the US have an efficacy of ~ 70-75%, yet, now that the US has vaccination rates > 90% for infants, there has been a HUGE decrease in hospitalization (http://www.webmd.com/children/vaccines/n... -- the effect is now even more pronounced). How anyone here can be against a vaccine that will have clear reduction in morbidity in mortality (and even more so in India like has already happened in other countries like Bolivia (file:///C:/Users/Daddy/Downloads/rotavirus.pdf)is beyond me. You authors really should read this article which spells out point blank why it is critically necessary to vaccinate against rotavirus in countries like India: http://jid.oxfordjournals.org/content/20...

Chris Hickie, MD, PhD
Chris Hickie
Replied to Chris Hickie comment 8 years ago
The like for the information on Boliva and rotaviral vaccination is: http://www.gavialliance.org/library/news... . Apologies
Dorit Reiss
8 years ago
Specifically, from the risk above, about rotavirus: "After completion of a three-dose RV5 regimen, the efficacy of rotavirus vaccine against rotavirus gastroenteritis of any severity was 74%, and against severe rotavirus gastroenteritis (defined by severity of fever, vomiting, diarrhea and changes in behavior) was 98%. Vaccine efficacy varied by rotavirus serotype."

stacy D
Replied to Dorit Reiss comment 8 years ago
Rotovirus is a common and treatable illness, usually resolving with home treatment. Would not let my babies and children anywhere near that vaccination. Why more and more vaccinations!! We dealt with a rather nasty strain of hand foot and mouth recently. Yes it was uncomfortable, but we all did just fine. According to the CDC usually a mild illness as well, but they state they are in the process of developing a vaccine for it!! When will it stop! When people start opening their eyes and thinking more for themselves.
Dorit Reiss
Replied to stacy D comment 8 years ago
In the U.S. before vaccine, Rotavirus caused: "more than 400,000 physician visits, more than 200,000 emergency department (ED) visits, 55,000 to 70,000 hospi- talizations each year, and 20 to 60 deaths." I'd say a disease that causes tens of thousands of hospitalizations and tens of deaths isn't that treatable. And that's in the U.S., with easy access to medical care and less malnutrition than in India.

I think protecting children against a disease that can kill or hospitalize them is a good thing.
Dorit Reiss
8 years ago
This article is extremely inaccurate, and it's unfortunate a pediatrician provides this kind of misinformation. I'll just raise a few points to warn readers to approach this article with caution:

A. It is true that deaths from diseases in developed countries dropped before vaccines - mostly thanks to other medical advances - but the incidence of these diseases did not, it stayed high - sanitation did not reduce it, nor did nutrition: http://jama.jamanetwork.com/article.aspx.... Diseases have other complications besides death.

B. Measles epidemics in the U.S. and Europe have been predominantly in the unvaccinated. Elsewhere too, measles affects mostly the unvaccinated.

C. In contrast to the small scale study linked to here, large scale studies put Rotavirus vaccine effectiveness much higher: http://www.cdc.gov/vaccines/pubs/pinkboo.... Intussusception can happen with the vaccines - but rarely. Rotavirus, in contrast, can kill. Improving sanitation and nutrition is really important, but until that happens, letting children die or suffer horribly with rotavirus is not a good solution.

D. Rubella - countries which tried to use the vaccinate teenage girls only approach had CRS. Like Japan. Japan now moved back to vaccinating all infants at 12 months with MR, measles and rubella. And the rubella's vaccine protection is longterm, probably lifelong.

E. IPV: other countries that moved to IPV after polio was under control did not have outbreaks. Cost is an issue, but then, OPV carries a small risk: one out of about 2.5 million doses leads to paralysis. If IPV can do the job, why not avoid that risk?
Replied to Dorit Reiss comment 8 years ago
Please note that the pediatrician has not only provided correct information but also put it in perspective. The example of polio vaccine development from Bengal experiment is a good case in point. It is also important to remember the immunity aspect emphasised by the author which is a natural and successful way to fight the infection. Due care is also taken to point out that India and its field experience cannot be overlooked nor can you supersede the same with the international experience. A few years back when SARS hit most of the Asian countries , India was virtually unaffected primarily due to the immunity factor. Author is right
in suggesting the practical solution ( especially for India ) of cleanliness and sanitation which is not complex to achieve.

It calls for change of LENS and use the Indian ones.Many more pediatricians and gynaecologists will be able to share practical solutions to the issue.

This issue needs to be re examined and need not be executed in a great hurry.

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