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Risks of Immunization

 

 

    The following graph shows that the effect of a vaccine on insulin dependent diabetes (IDDM) may exceed the effect of a vaccine on an infectious complication. 

 

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    The following table shows that even a small rise in insulin dependent diabetes following immunization, such as 200 cases/100,000,  can result in a large number of children developing diabetes. The financial impact is great since the average cost of a single case of IDDM may be $1 million (US). 

 

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       The following table provides examples that adding a couple of vaccines to the immunization schedule in order to prevent a few cases of infectious diseases may result in a much larger rise in IDDM. The table assumes that each vaccine can induce 50 cases of IDDM/100,000 people immunized and that the annual birth cohort size in the US is 4 million children.

 

 

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Discussion

         The data include in this website demonstrate that the effect of many vaccines on autoimmunity is as large or larger than their effect on the permanent sequelae of the infectious diseases that they are designed to prevent.  One dose of the BCG (tuberculosis) vaccine at birth is associated with a decrease of 50 cases of IDDM/100,000 immunized, one dose of BCG vaccine at school age is associated with an increase of 120 cases of IDDM/100,00,  while the HiB vaccine administered starting after 2 months is associated with an increase of 65 cases of IDDM/100,000 immunized. The potential effect of this phenomenon grows tremendously if one considers that in animals there is an additive effect when administering different vaccines, there is a dosing effect when administering one vaccine, and multiple autoimmune diseases are modulated by vaccines! The effect of changing the first dose of the BCG vaccine from birth to school age may be an increased risk of 177 cases of IDDM/100,000.

 

      A difference of 50 cases of  organ damage /100,000 people is a major event that has caused major changes in immunization practices in the past. The killed polio vaccine is promoted for its safety advantage over live oral polio vaccines, which causes vaccine induced polio at a rate of 0.2 cases/100,000 immunized following the administration of a first dose. This risk has caused some countries including the US to give the killed polio vaccine instead of the live vaccine.  An international effort was started to develop an acellular pertussis vaccine because the risk of permanent brain damage following immunization with the whole cell pertussis vaccine is estimated at 0.2 cases/100,000 doses of vaccine administered. The total risk of permanent brain damage from  DTP immunization, assuming a child receives 5 doses, is 1 case/100,000 immunized.

 

        The effect of administering one dose of vaccine on diabetes exceeds the effect that a single dose of many vaccines have on preventing the sequelae of the infectious diseases that they are designed to prevent. The tetanus toxoid is routinely given throughout the world. Tetanus was a rare disease even prior to the development of the vaccine, the maximum annual number of cases of tetanus in the US was 600 (Bart, Orenstein & Hinman, 1987). Assuming a live birth cohort of 3.25 million at the time, the lifetime risk of tetanus was in the range of 18.5 cases/100,000 people. The World Health Organization promoted the administration of 2 doses of tetanus toxoids to prevent neonatal tetanus which occurred at a rate of 20 cases/100,000 live births in Sri Lanka. This amounted to a per dose reduction of 10 cases/100,000 births.

 

        Many public health officials promote immunization with the Hemophilus influenza vaccine, as opposed to treating symptomatic children, primarily to prevent Hemophilus meningitis. The life time risk of a US child developing Hemophilus influenza meningitis is about 100 cases/100,000 children (Adams, Deaver, Cochiet al.1993). Assuming the Hemophilus influenza vaccines are 90% effective, vaccination is being performed to prevent 90 cases/100,000 children. Of these 90 cases, only 30-40% will have permanent sequela from the infection such as death or mental retardation. Thus HiB vaccination may only prevent 30-36 cases of meningitis complications/100,000 immunized. Three or four doses of Hemophilus influenza vaccine are routinely given to receive this benefit so the net effect per dose is prevention of 22-30 cases of meningitis/100,000 children immunized.

 

        Polio afflicted 21,000 US citizens in 1952, the most at any time in history, however many of these people may have recovered without permanent paralysis. Assuming a birth cohort of 3.25 million, the life time risk of at least transient paralysis was around 656 cases/100,000 children. Polio immunization routinely involves 4 doses so the average per dose effect comes to 164 cases prevented/100,000 people. Each vaccine however contains 3 strains, type-1, type-2, type-3. The net effect is that one dose of one type of polio vaccine prevents on average 55 cases/100,000 people. It should be noted that while polio was more common than insulin dependent diabetes is now, polio is often a less severe disease since it commonly causes people to lose partial function of their legs while diabetes causes people to loose their legs completely due to vascular complications and infectious diseases.