Vaccines: What Every Parent Should Know

by Paul A. Offit, M.D. and Louis Bell, M.D. (reviewed by Speak the Controversy)

Overview/General Premise
The intention of this book is to discuss vaccination of children, to provide parents with information about the vaccines that children receive, state the side effects of vaccines and weigh the risks against the benefits. The book was published in 1999 so it is somewhat out of date with the current vaccination schedule and as a result does not discuss in depth some of the vaccines that are currently administered to children.

Bias
The general slant of the book is pro-vaccination. Both of the authors are employed in the Department of Infectious Diseases at Children’s Hospital in Philadelphia. Louis Bell received a grant from the CDC to enhance pre-school vaccination. Paul Offit received a grant from the pharmaceutical company, Merck, for the development of a Rotavirus vaccine and shares a patent with the company on the vaccine currently in development. He also serves as a consultant to Merck.

Good Point
The book considers the question, “Are vaccines safe?” The authors pose the following three questions to consider, which they attempt to answer in each chapter about specific vaccines: “(1) What are the chances of catching a particular infection? (2) What are the risks of side effects from a particular vaccine? (3) How effective is the vaccine in preventing disease?” (see page 24). These are definitely important questions to be asking about vaccinations. The additional question that needs to be considered is: What is the source of my information? As Offit said in an interview on 60 Minutes in October 2004, “I think questioning vaccines is perfectly reasonable. But I think that when one looks at the data, and sees that vax are safe and effective and...still...says, 'Well, I think there's a conspiracy to sell vaccines' or 'I think my doctor's lying to me,' I think that's when you cross some sort of critical line. What I'm asking is that people trust their experts. And that's sort of a hard thing to politically accept." This quote (in which Offit is indirectly referring to himself as an expect on vaccines), however, along with the paragraph above about the bias of the authors, brings me to my list of things to question about the information in this book.

Things to Question
Each chapter begins with a fictional story of a child and the disease for which a vaccine is available. Chapter 2 opens with a story of Ed and Emily, one of whom is vaccinated and the other of whom is not. The story makes claims as to the outcome of the children being infected with measles and their immunity. The story, as is the case with other stories in the book, is written to show the extreme experiences of the disease causing fear in the reader (this is further evidenced on page 111 in the discussion of natural immunity versus vaccinated immunity). In the end, the story claims that the vaccinated child was immune as a result of receiving the vaccine while the unvaccinated child risked death and had to endure the pain of disease in order to develop natural immunity. The question is: If vaccines always lead to immunity why was there an outbreak of mumps in Iowa in which 65% of those who received the disease were fully vaccinated against it?

Speaking further on the issue of immunity, on page 29, the authors outline two examples of the right to refuse vaccines and the effect on the community. In a recount about the spread of measles in the early nineties in Philadelphia, the authors write: “Unfortunately, people in the surrounding community did not have a chance to participate in that decision” (speaking of the decision of parents in two churches who refused vaccination and were infected with measles). Didn’t the members have “a chance to participate in that decision” when they chose whether or not to have their own children vaccinated? If the authors claim immunity from vaccines, then no member of a community should have to worry about an outbreak of a disease if they are vaccinated. But the reason that people do become infected even after being vaccinated is because vaccines are not a guarantee of immunity. This is an inaccurate claim that the authors state many times as fact.

However, in the chapter on MMR the authors admit that 5% of children will not develop immunity from the first dose of the MMR, which is part of the reasoning for giving two doses. But the primary reason that the authors give for receiving two doses of MMR is because “only about 87 to 90 percent of children actually receive the measles vaccine. Therefore, a recommendation for a second dose provides many children with a second chance to receive their first dose of the vaccine (p. 66).” It seems to me that what the authors are stating is that my child really only needs one dose of the MMR vaccine for a 95% chance of immunity but because some kids miss the first dose we might as well give everyone two. That logic doesn’t make a whole lot of sense to me and in many ways supports the “conspiracy theory” that vaccines are just another moneymaker for big business and the government.

There are many additional claims made in this book that I question including the authors repeated statements that “the xxx vaccine does not cause serious side effects” when even the CDC and the government is willing to admit that there are potential serious and even deadly side effects from vaccines (see information on the National Vaccine Compensation Program on page 20 or http://www.cdc.gov/nip/publications/vis/), but for the sake of space I will skip to one final question that I have for the authors. In the last chapter of the book titled Vaccines for Adults the authors write: “So whereas about 500 children die every year from diseases that are clearly preventable by vaccines, between 50,000 to 70,000 adults die from these same diseases (p. 208).” Yet we have implemented a vaccination schedule for children that includes at least 24 vaccinations by the age of 2. Is this really because of the threat of disease and its consequences to children or because we can better guarantee the “sale” of vaccines to parents than to adults themselves? The greatest risks of almost all vaccine preventable diseases is in later adolescence and adulthood, so why do we choose to threaten our children’s quality of life with the input of foreign matter and chemicals (see references throughout the book to monkey DNA, cow DNA, chicken DNA, mouse DNA, and formaldehyde) through the administration of vaccines in excess during the most crucial years of their development?

Conclusion
This book is helpful is stirring up questions about vaccination but I am afraid that many people will “trust their experts” as Paul Offit desires and not question the research on both sides of the issue that have led to the discussions covered in this book. It is clear that this book is biased and uses broad, inflammatory, and unsupported statements to scare the readers into believing that vaccines are the best option for their children without adequately or honestly representing the risks involved with that choice.