If you are interested in understanding how the anti-vaccine movement works to influence the minds of concerned parents you have to go no further than Deborah Kotz’s post in the US News and World Report Blog, On Medicine. This week she posted commentary on Dr. Paul Offit’s recent deconstruction of the Sears alternate vaccine schedule as published in The Vaccine Book.
In his article, “The Problem with Dr. Bob’s Vaccine Schedule,” published in Pediatrics Dr. Offit constructs a systematic breakdown of the Sears “alternate vaccine schedule” with references and explains in plain terms how Dr. Bob Sears’ book misinforms parents. Most importantly, the article details with extensive references why the Sears “alternate vaccine schedule” is dangerous for children. Ms. Kotz, on the other hand, constructs a position that propagates conspiracy theories, vaccine hesitancy and fear among confused parents.
So where does she go wrong?
Is there such a thing as a ‘flexible approach’ to immunization?
The title of her post makes reference to a ‘flexible approach’ to vaccination suggesting that this is somehow an established, reasonably accepted protocol worthy of point-counterpoint in the pages of a peer reviewed journal.
Contrary to Ms. Kotz’s assertions, altered immunization schedules concocted on an individual physicians whim aren’t worthy of equal time. While she would like you to believe that every parent has the knowledge and right to implement an individualized approach to childhood immunization, this simply isn’t the case. The development and safe scheduling of vaccines to reliably prevent devastating childhood disease is based on our understanding of specific infectious diseases, years of accumulated research as well as the consensus of many of the country’s greatest infectious disease minds. The prevention of childhood disease is not a democratic process where we pick and choose what’s popular or fashionable.
It should also be noted there isn’t a single reference demonstrating that the “alternate vaccine schedule” is actually beneficial for children. While ‘antigen load’ and ‘immune overload’ are buzzwords used to perpetuate fear, they are contrivances created by the anti-vaccination fringe, and popularized by the likes of Jenny McCarthy. These are terms of convenience that have evolved since the revelation that thimerosal has no role in autism. Kotz propagates the ideology of this vocal, but deluded, minority.
Echoing the sounds of a vocal minority
In coming to the defense of Dr. Sears, Ms. Kotz creates the appearance that the flexible schedule is accepted and that Dr. Offit is the odd man out. This is not the case. The majority of pediatricians – those best positioned to advocate for children - understand the basis for our current immunization schedule and use it in their practices. These pediatricians understand that the "alternative vaccine schedule" has never been endorsed, approved, or recognized by any body of physicians.
It should be noted that the alternate vaccine schedule is the sole creation of Dr. Bob Sears who is in the business of selling books and promoting himself as a DAN doctor (Dr. Bob Sears is celebrated as a DAN! doctor here on the pages of the notoriously anti-vaccine website, Age of Autism).
Dr. Offit didn’t invent immunization
The anti-vaccine movement would like you to believe that Dr. Offit is singlehandedly responsible for when and how children receive vaccines. It’s important to understand that the current AAP vaccine recommendations are the result of a consensus opinion of the country’s most respected pediatric infectious disease specialists. According to the January 2009 AAP News
"The Advisory Committee on Immunization Practices (ACIP) is made up of 15 members who include experts in infectious diseases and public health and a consumer representative. In addition, ex-officio representatives from national and international medical, infectious disease, public health, nursing and pharmacist organizations as well as governmental agencies participate in deliberations and provide input to ACIP. The Academy is represented by two members of the Committee on Infectious DIseases (COID).
COID consists of 12 pediatric infectious disease experts appointed to serve two-year terms, a representative of the AAP Section on Infectious Diseases, several consultants who are pediatric infectious disease experts, and liaisons from the Centers for Disease Control and Prevention, American Academy of Family Physicians, Canadian Pediatric Society, National Institutes of Health, Food and Drug Administration and the American Thoracic Society."
But admittedly it’s far more convenient to rest blame on one person. Because, of course, the conspiracy begins to weaken when you see how many people are actually involved.
Kotz ends her article with the rhetorical question, "So, which is better: a one-size-fits-all approach or a flexible one? That's a question I wish the journal editors had decided to address in a full-fledged debate." My rebuttal, as a physician, is why should the whims of one pediatrician, Bob Sears, be given the same weight as the thoughtful deliberations of the American Academy of Pediatrics Red Book Committee?
And, in fact, decisions regarding an individual child's immunizations are not "one-size-fits-all." Exceptions to the schedule are made when there is a reason to delay or omit a vaccine. Customized vaccine strategies are used in patients with special clinical circumstances, such as immunocompromised children or those with chronic diseases. And the schedule is adjusted for situations such as international travel and catch-up
In the final analysis, US News & World Report is doing its part to fuel fear in the minds of parents who depend upon publications like this for balanced reporting of the facts. Ms Kotz, as demonstrated in her piece as well as in other posts, has decided that she has vaccine medicine all figured out – despite what new information or research may appear.
- Thanks to Liz Ditz at I Speak of Dreams for her widsom and valuable input.
- Dr. Sears' rebuttal to Dr. Offit's Pediatrics article may be found here.
- For an interesting side-by-side comparison of the Offit article and the Sears rebuttal, visit Science-Based Parenting
Updated January 5, 2009