Vaccines Demystified
Welcome to Vaccines Demystified!
Watch this video first so you know what to do next! Then download the e-book here:
Any questions? Problems with the course? E-mail [email protected]
Lessons
Introduction to the CDC Schedule & Ethical Considerations
Length: 4 minutesAuthor: Erika Krumbeck, ND
The CDC recommended schedule For your reference here is an easy-to-read copy of the CDC recommended vaccine schedule. We are going to talk about all of these vaccines (for children 0-6 years of age), which is why I list the schedule here. Ethical considerations How will YOU decide to vaccinate? Make sure you have downloaded the e-book so you can work through these questions. (You guys, I know this isn’t the most “exciting” part of the webinar, but please do go through this section, because it is very important for making decisions about if/how/when you will vaccinate your kids.)
Hepatitis B
Length: 22 minutesAuthor: Erika Krumbeck, ND
Hepatitis B Vaccine Hepatitis B is a virus that causes an infection of the liver, leading to inflammation and swelling. The disease 1-2% develop fulminant hepatitis, often causing death (93%). Many develop chronic hepatitis, which leads to liver cirrhosis and hepatocellular (liver cancer) later in life. 90+% of infected infants will become chronic carriers. Is spread through blood and bodily fluids.. ~100,000 cases per year in the U.S. Very high numbers worldwide (7% or more of the population in some areas). 15 million people worldwide are infected. The vaccine CDC recommended schedule: birth, 1-2 months, 6-18 months. Who should not get the vaccine? Ingredients: 250 mcg aluminum, yeast protein, sodium chloride, phosphate buffers. Special topics What is the relationship between the Hepatitis B vaccine and Multiple Sclerosis? What is the relationship between the Hepatitis B vaccine and risk of developing autism? Is there any thimerosal in the currently used Hepatitis B vaccine? Research citations for Hepatitis B Carey, William MD, et al. “Hepatitis B” First Consult. 13 February 2012. Web. 9 March 2013. Broderick, A MB BCh, MMedSc, FRCPI, et al. “Overview of Hepatitis B virus infection in children” UpToDate. Feb 2014. Web. 13 March 2015. Hamborsky J, Kroger A, Wolfe S. “Epidemiology and Prevention of Vaccine-Preventable Diseases: Hepatitis B” Centers for Disease Control and Prevention. 13th ed. Washington D.C Hepatitis B “Engerix vaccine package insert”. GlaxoSmithKline. Accessed 3/9/2013 Ozakbas S, et al. “Development of multiple sclerosis after vaccination against hepatitis B: a study based on human leucocyte antigen haplotypes.” Tissue Antigens. 2006 Sep;68(3):235-8. Karussis D, Petrou P. The spectrum of post-vaccination inflammatory CNS demyelinating syndromes. Autoimmun Rev. 2014 Mar;13(3):215-24. Mikaeloff Y, et al. Hepatitis B vaccine and risk of relapse after a first childhood episode of CNS inflammatory demyelination. Brain. 2007 Apr;130(Pt 4):1105-10. Epub 2007 Feb 1. Mikaeloff Y, Caridade G, Suissa S, Tardieu M. Hepatitis B vaccine and the risk of CNS inflammatory demyelination in childhood. Neurology. 2009 Mar 10;72(10):873-80. doi: 10.1212/01.wnl.0000335762.42177.07. Epub 2008 Oct 8. Mikaeloff Y, Caridade G, Rossier M, Suissa S, Tardieu M. Hepatitis B vaccination and the risk of childhood-onset multiple sclerosis. S, TAr…
Don’t Mess with the Immune System (Say NO to Tylenol!)
Length: 7 minutesAuthor: Erika Krumbeck, ND
Following along in the e-book? Skip to page 15 for these Special Topics sections. Just say NO to Tylenol Tylenol may reduce the effectiveness of the vaccine. What is the connection between Tylenol/Acetaminophen/Paracetamol with Autism? What is the story with Reye’s syndrome? When did rates of Autism begin to climb? When did the rates of autism “stall?” What is glutathione? Why is this important? Research citations for Acetaminophen/Tylenol Sil A, Ravi MD, Patnaik BN, et al. Effect of prophylactic or therapeutic administration of paracetamol on immune response to DTwP-HepB-Hib combination vaccine in Indian infants.Vaccine. 2017 Apr 24. pii: S0264-410X(17)30315-8. This study shows that acetaminophen (paracetamol) does not affect seroresponse. Schultz ST, Gould GG. Acetaminophen Use for Fever in Children Associated with Autism Spectrum Disorder. Autism-open access. 2016;6(2):170. Liew Z, Ritz B, Virk J, Olsen J. Maternal use of acetaminophen during pregnancy and risk of autism spectrum disorders in childhood: A Danish national birth cohort study. Autism Res. 2016 Sep;9(9):951-8. Use of acetaminophen in pregnancy was related to a specific type of ASD, but not all types. Liew Z, Ritz B, Rebordosa C, Lee PC, Olsen J. Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders. JAMA Pediatr. 2014 Apr;168(4):313-20. Acetaminophen use in pregnancy is more likely to cause ADHD and hyperkinetic disorders. Schultz ST, Klonoff-Cohen HS, Wingard DL, Akshoomoff NA, Macera CA, Ji M. Acetaminophen (paracetamol) use, measles-mumps-rubella vaccination, and autistic disorder: the results of a parent survey.Autism. 2008 May;12(3):293-307. “Acetaminophen use after measles-mumps-rubellavaccination was significantly associated with autistic disorder when considering children 5 years of age or less.” Creagh O, Torres H, Rivera K, Morales-Franqui M, Altieri-Acevedo G, Warner D. Previous Exposure to Anesthesia and Autism Spectrum Disorder (ASD): A Puerto Rican Population-Based Sibling Cohort Study.Bol Asoc Med P R. 2015 Jul-Sep;107(3):29-37. Wysocki J, Center KJ, Brzostek J, et al. A randomized study of fever prophylaxis and the immunogenicity of routine pediatric vaccinations. Vaccine. 2017 Apr 4;35(15):1926-1935. Parker W, Hornik CD, Bilbo S, et al. The role of oxidative stress, inflammation and acetaminophen exposure from birth to early childhood in the induction of autism. J Int Med Res. 2017 Apr;45(2):407-438. “Thus, one explanation for the…
Rotavirus
Length: 22 minutesAuthor: Erika Krumbeck, NDComplexity: Standard
Rotavirus Vaccine Rotavirus is a gastrointestinal viral infection leading to watery diarrhea. It can cause severe dehydration and electrolyte imbalance in infants and young children. Children 3-15 months are most at risk. The disease Is spread through fecal-oral mode of transmission. Can also be spread from hands, toys or other surfaces contaminated with stool. Spreads quickly and easily. Before introduction of the vaccine Rotavirus caused 2.7 million infections per year, with around 20-60 deaths per yea, and was a leading cause of hospitalization in children. The vaccine Is an ORAL, live-virus vaccine. CDC recommended schedule: 2 months, 4 months, 6 months. Must be started and finished by certain ages. (Cannot delay, or the child is no longer eligible to receive the vaccine.) Who should not get the vaccine? Allergy, congenital malformation of the gastrointestinal tract, history intussusception, severe combined immunodeficiency disease. Ingredients: amino acids, dextran, Dulbecco’s Modified Eagle Medium (contains mostly electrolytes, amino acids and nutrients), sorbitol, sucrose. Special topics What is the association between the Rotavirus vaccine and intussusception? Risk of intussusception is around 1 in 49,000 for the first dose, according to one researcher. What is the porcine circovirus? What type is found in the Rotavirus vaccine, and in which brand? Porcine circovirus is a virus found in swine. PCV-2 has been shown to cause a wasting disease in pigs. PCV-1 has not been shown to cause any problems in humans or pigs. PCV-1 was found in the Rotarix vaccine, but has not been shown to cause any actual problems in humans (or pigs). What is the association between the Rotavirus vaccine and celiac disease? The rotavirus vaccine appears to reduce the risk of celiac disease. What are the considerations for choosing the Rotavirus vaccine? What are Dr. Erika’s thoughts on this vaccine? Research citations for Rotavirus Hamborsky J, Kroger A, Wolfe S. Epidemiology and Prevention of Vaccine-Preventable Diseases: Rotavirus. Centers for Disease Control and Prevention. 13th ed. Washington D. Miguel G O’Ryan, MDDavid O Matson, MD, PhD. Clinical manifestations and diagnosis of rotavirus infection. 5 July 2016. Web. 25 November 2016. Chilengi R1,2, Simuyandi M1, Beach L1, Mwila…
SIDS – Sudden Infant Death Syndrome
Length: 2 minutesAuthor: Erika Krumbeck, ND
Sudden Infant Death Syndrome What are the risk factors for SIDS? What should you NOT do? Research citations for Sudden Infant Death Syndrome: Jonville-Bera AP1, Autret E, Laugier J. Sudden infant death syndrome and diphtheria-tetanus-pertussis-poliomyelitis vaccination status. Fundam Clin Pharmacol. 1995;9(3):263-70. Traversa G, Spila-Alegiani S, Bianchi C, Ciofi degli Atti M, Frova L, Massari M, Raschetti R, Salmaso S, Scalia Tomba G; Hera Study Group. Sudden unexpected deaths and vaccinations during the first two years of life in Italy: a case series study. PLoS One. 2011 Jan 26;6(1):e16363. doi: 10.1371/journal.pone.0016363. Jonville-Béra AP1, Autret-Leca E, Barbeillon F, Paris-Llado J; French Reference Centers for SIDS. Sudden unexpected death in infants under 3 months of age and vaccination status- -a case-control study. Br J Clin Pharmacol. 2001 Mar;51(3):271-6. Ottaviani G1, Lavezzi AM, Matturri L. Sudden infant death syndrome (SIDS) shortly after hexavalent vaccination: another pathology in suspected SIDS?Virchows Arch. 2006 Jan;448(1):100-4. Epub 2005 Oct 18. Balci Y1, Tok M, Kocaturk BK, Yenilmez C, Yirulmaz C. Simultaneous sudden infant death syndrome. J Forensic Leg Med. 2007 Feb;14(2):87-91. Ottaviani G1, Lavezzi AM, Matturri L. Sudden infant death syndrome (SIDS) shortly after hexavalent vaccination: another pathology in suspected SIDS? Virchows Arch. 2006 Jan;448(1):100-4. Epub 2005 Oct 18. Prandota J1. Urinary tract diseases revealed after DTP vaccination in infants and young children: cytokine irregularities and down-regulation of cytochrome P-450 enzymes induced by the vaccine may uncover latent diseases in genetically predisposed subjects. Am J Ther. 2004 Sep-Oct;11(5):344-53. Wilson K1, Potter B, Manuel D, Keelan J, Chakraborty P. Revisiting the possibility of serious adverse events from the whole cell pertussis vaccine: were metabolically vulnerable children at risk? Med Hypotheses. 2010 Jan;74(1):150-4. doi: 10.1016/j.mehy.2009.07.014. Epub 2009 Aug 5. Walker AM, Jick H, Perera DR, Thompson RS, Knauss TA. Diphtheria-tetanus-pertussis immunization and sudden infant death syndrome. Am J Public Health. 1987 Aug;77(8):945-51. D’Errico S1, Neri M, Riezzo I, Rossi G, Pomara C, Turillazzi E, Fineschi V. Beta-tryptase and quantitative mast-cell increase in a sudden infant death following hexavalent immunization. Forensic Sci Int. 2008 Aug 6;179(2-3):e25-9. doi: 10.1016/j.forsciint.2008.04.018. Epub 2008 Jun 6.
Hib – Haemophilus influenzae B (not the flu vaccine!)
Length: 5 minutesAuthor: Erika Krumbeck, ND
Haemophilus influenzae type B is a bacterial infection which can cause meningitis, skin infections, joint infections, bone infections or epiglottitis. The disease Invasive Haemophilus influenzae infection can cause meningitis. 15-30% of patients with invasive Hib infection can have lasting neurological damage (like permanent deafness) and 2-5% die. It can also cause skin infections, epiglottiitis, joint infections and bone infections. It is spread through respiratory droplets or direct contact. Risk factors: household crowding, daycare, school-age siblings, low socioeconomic status, chronic disease, Alaskan eskimos or native alaskans. Estimated 20,000+ cases/year in the United States (in all age groups), with over 1,000 deaths per year. Now: Haemophilus influenzae type B appears to be very rare, though there is an increase in other types of Haemophilus influenzae. The vaccine ACIP recommended schedule: 2 months, 4 months, 6 months, 12-15 months. Who should not get the vaccine? Ingredients: varies by brand. ActHib has no aluminum, is preservative free with trace residual formaldehyde (<0.5 mcg/dose), Hib polysaccharide is bound to a tetanus toxoid. PedvaxHib has 225 mcg aluminum, is bound to a Neisseria meningitidis OMPC, and contains 0.9% sodium chloride. The vial stopper does contain rubber latex. Special topics How long is breastfeeding protective against Hib? At what age does the disease (invasive Hib) typically occur? Why is this important? Research citations for Hib Hamborsky J, Kroger A, Wolfe S. Epidemiology and Prevention of Vaccine-Preventable Diseases: Haemophilus influenza B. Centers for Disease Control and Prevention. 13th ed. Washington D.C Watt JP, Wolfson LJ, O’Brien KL, Henkle E, Deloria-Knoll M, McCall N, Lee E, Levine OS, Hajjeh R, Mulholland K, Cherian T. Burden of disease caused by Haemophilus influenzae type b in children younger than 5 years: global estimates. Lancet. 2009 Sep 12;374(9693):903-11. doi: 10.1016/S0140-6736(09)61203-4. Gessner BD, Sutanto A, Linehan M, Djelantik IG, Fletcher T, Gerudug IK, Ingerani, Mercer D, Moniaga V, Moulton LH, Moulton LH, Mulholland K, Nelson C, Soemohardjo S, Steinhoff M, Widjaya A, Stoeckel P, Maynard J, Arjoso S. Incidences of vaccine-preventable Haemophilus influenzae type b pneumonia and meningitis in Indonesian children: hamlet-randomised vaccine-probe trial. Lancet. 2005 Jan 1-7;365(9453):43-52. Gessner BD1, Sedyaningsih ER,…
VAERS
Length: 6 minutesAuthor: Erika Krumbeck, ND
All about VAERS
PCV – pneumococcal conjugate vaccine
Length: 8 minutesAuthor: Erika Krumbeck, NDComplexity: Standard
PCV Vaccine Streptococcus pneumoniae is a bacteria that can cause bacteremia, pneumonia, ear infections, and meningitis. The disease Invasive pneumococcal disease causes serious problems. Formerly the 2nd more common cause of meningitis in children. After introduction of Hib vaccine, it is currently the most common cause of meningitis. Spread via respiratory droplets or direct contact. Risk factors include: HIV infection, immune compromised, daycare, no spleen, Alaska Native, Navajo and White Mountain Apache groups. ~17,000 cases per year in the U.S. and 700 cases of meningitis per year before the vaccine was introduced. The vaccine CDC recommended schedule: 2 months, 4 months, 6 months, 12-15 months. Who should not get the vaccine? Ingredients: saccharides, carrier protein, polysorbate 80, succinate buffer, 125 mcg aluminum. Special topics At what age does invasive pneumococcal disease typically occur? Why is this important? Does this vaccine protect against all the serotypes of Streptococcus? Research citations for PCV Shabir A Madhi and Marta C Nunes. The potential impact of pneumococcal conjugate vaccine in Africa: Considerations and early lessons learned from the South African experience. Hum Vaccin Immunother. 2016 Feb; 12(2): 314–325. Tina Q. Tan * Pediatric Invasive Pneumococcal Disease in the United States in the Era of Pneumococcal Conjugate Vaccines. Clin Microbiol Rev. 2012 Jul; 25(3): 409–419. Increasing rates of new serotypes of S. pneumoniae. Hamborsky J, Kroger A, Wolfe S. Epidemiology and Prevention of Vaccine-Preventable Diseases: Pneumococcal disease. Centers for Disease Control and Prevention. 13th ed. Washington D.C. Author unknown. Polysorbate-80. Environmental Working Group. Web. 6 May 2017. Dagan R, Givon-Lavi N, Porat N, Greenberg D. The effect of an alternative reduced-dose infant schedule and a second year catch-up schedule with 7-valent pneumococcal conjugate vaccine on pneumococcal carriage: a randomized controlled trial. Vaccine. 2012 Jul 20;30(34):5132-40. Weinberger DM, Malley R, Lipsitch M. Serotype replacement in disease after pneumococcal vaccination. Lancet. 2011 Dec 3;378(9807):1962-73. Daniel R. Feikin, Eunice W. Kagucia, Jennifer D. Loo, et al. Serotype-Specific Changes in Invasive Pneumococcal Disease after Pneumococcal Conjugate Vaccine Introduction: A Pooled Analysis of Multiple Surveillance Sites. PLoS Med. 2013 Sep; 10(9): e1001517. World Health Organization (2012) Estimated Hib and…
Thimerosal
Length: 2 minutesAuthor: Erika Krumbeck, NDComplexity: Standard
A note from Dr. Erika: for some reason people seem to think that I’m lying, and that there IS in fact thimerosal in vaccines. I PROMISE! I’m not lying! I’ve read every single vaccine package insert, followed all the vaccine research and changes in formulations, and thimerosal really HAS been removed from nearly all vaccines. Seasonal flu vaccine and the Tetanus-only vaccine are the only pediatric shots that currently contain thimerosal. Thimerosal What is thimerosal? What is it doing in vaccines? Is thimerosal the same as aluminum?
IPV – Polio
Length: 10 minutesAuthor: Erika Krumbeck, NDComplexity: Standard
Dr. Erika update: Why do I say that the amount of formaldehyde in IPV vaccine is “probably safe” and then talk about how important it is to limit formaldehyde exposure from new furniture? Answer: the amount of formaldehyde in the IPV vaccine is VERY SMALL compared with cumulative environmental/airborne exposure from new furniture and other airborne sources. IPV Vaccine – Polio Poliovirus is a gastrointestinal virus that affects the intestines. It can cause paralytic polio leading to permanent paralysis or death. The disease Most infections with poliovirus cause no symptoms. About 1% lead to paralytic polio. Spread via fecal-oral, and is highly contagious. Because most cases of the infection result in no symptoms it can be spread without a person knowing they have it. ~13,000 – 20,000 cases of paralytic polio per year in the U.S. Currently: none. Last case of wild virus polio in the United States was in 1979. The vaccine CDC recommended schedule: 2 months, 4 months, 6-18 months, booster ages 4-6. Who should not get the vaccine? Ingredients: 0.02% formaldehyde, 0.5% 2-phenoxyethanol, trace neomycin, polymyxin B, streptomycin, residual calf serum protein (from growth media) Special topics What is the difference between the Oral Polio Vaccine (OPV) and Inactivated Polio Vaccine (IPV)? Why is IPV given in the United States currently? Research citations for IPV Hamborsky J, Kroger A, Wolfe S. Epidemiology and Prevention of Vaccine-Preventable Diseases: Polio. Centers for Disease Control and Prevention. 13th ed. Washington D.C. Kew OM, Cochi SL, Jafari HS, et al. Possible eradication of wild poliovirus type 3—worldwide, 2012. MMWR Morb Mortal Wkly Rep 2014;63:1031–3 Hagan JE, Wassilak SGF, Craig AS, et al. Progress toward polio eradication—worldwide, 2014–2015. MMWR Morb Mortal Wkly Rep 2015;64:527–31 World Health Organization. Global Polio Eradication Initiative. Polio this week as of 17 May 2017. Geneva, Switzerland: World Health Organization; 2016. Morales M, Nnadi CD, Tangermann RH, Wassilak SGF. Notes from the field: circulating vaccine-derived poliovirus outbreaks—five countries, 2014–2015. MMWR Morb Mortal Wkly Rep 2016;65:128–9. Farag NH, Wadood MZ, Safdar RM, et al. Progress toward poliomyelitis eradication—Pakistan, January 2014–September 2015. MMWR Morb Mortal Wkly Rep 2015;64:1271–5. Polio vaccine IPOL…
Abortion and vaccines (and other religious objections to immunizations)
Length: 4 minutesAuthor: Erika Krumbeck, ND
Abortion and vaccines (and other religious objections to immunizations) Do vaccines require aborted fetal tissue? Do they require new aborted fetal tissue? Why were aborted fetal cells used to make vaccines? Which vaccines use these cell lines? For those of Muslim or Jewish faith – what are the statements of faith regarding use of pork products in immunizations? Research citations for Abortion and other religious objections Rudd, Gene MD. Is Vaccination Complicit with Abortion? Christian Medical & Dental Associations: Changing Hearts in Healthcare. Opinion statement. Web 18 July 2017. Pontificia Academia Pro Vita. Pontifical Academy for Life. Moral Reflections on Vaccines prepared from cells derived from aborted human foetuses. cogforlife.org. Web. 18 July 2017. Collins, Timothy MD. The Vaccination Question. The Angeuls Magazine. Feb 2006. Vasa R., Euteneuer T., Reese B, et al. Aborted Fetal Cell Line Vaccines and The Catholic Family. A Moral and Historical Perspective. Children of God. https://cogforlife.org/vaccines-abortions/ Institute for Vaccine Safety. John Hopkins Bloomberg School of Public Health. Religious Leaders Approval of Use of Vaccines Containing Porcine Gelatin. John Hopkins Bloomberg School of Public Health. Allergens. (Vaccine allergen list.) Web 18 July 2017. http://www.vaccinesafety.edu/components-Allergens.htm Other selected reading: http://www.chabad.org/library/article_cdo/aid/2870103/jewish/What-Does-Jewish-Law-Say-About-Vaccination.htm http://www.vaccinationcouncil.org/2011/01/20/islam-vaccines-and-health-2/ http://www.reuters.com/article/us-amish-parents-idUSTRE75Q5SO20110627 http://www.immunizeca.org/wp-content/uploads/2012/02/Religious-Views-of-Vaccination-At-a-Glance.pdf
DTaP – diphtheria, tetanus and pertussis
Length: 14 minutesAuthor: Erika Krumbeck, ND
DTaP vaccine protects against three things: Diphtheria, Tetanus, and Pertussis. Diphtheria Diphtheria is a bacterial infection causing flu-like symptoms with sore throat. It can cause a membrane to form in the back of the throat which blocks the airway causing death. Diphtheria can also be system, affecting the heart, nervous system, kidneys, and skin. It is treated with antibiotics and anti-toxin. In 1921 there were more than 200,000+ cases, and 15,000+ deaths. Now it is extremely rare (with no cases reported in 2015). Tetanus Occurs from a bacterial infection (Clostridium tetani). The toxin causes tetanus leading to paralysis, spasm, respiratory arrest and death. 11% of cases are fatal (up to 50% of neonatal cases). Occurs more commonly in neonates, the elderly, and diabetics. Neonatal tetanus occurs shortly after birth, usually from umbilical cord stump infection, and only occurs when the mother is not immune to tetanus. Neonatal tetanus is very rare in the United States. Clostridium tetani is found in the soil virtually everywhere. The disease spreads when a puncture wound or cut is contaminated without contact with air. It takes 3-21 days after exposure to develop the disease. 580 cases per year with 472 deaths before the introduction of vaccines. There were 30 cases in the United States in 2015, and 0 cases of neonatal tetanus. An estimated 58,000 infants died from neonatal tetanus in 2010 alone. Pertussis Is also known as “whooping cough.” It is a bacterial infection, the toxin causes symptoms. Cold-like symptoms occur first, leading to severe, paroxysmal cough. Lingering cough can last months. It is highly contagious, spread through respiratory droplets. Newborns and infants are most at risk. It is treated with antibiotics if caught in the early stages. Before vaccines there were 270,000 cases per year and 10,000+ deaths per year. After introduction of vaccinations there are fewer cases, but it is still prevalent, with 20,000+ cases reported in 2015. The vaccine CDC recommended schedule: 2 months, 4 months, 6 months, 15-18 months, 4 years. Who should not get the vaccine? Ingredients: 330 mcg aluminum (Daptacel) or 625 mcg aluminum (Infanrix) ,…
Aluminum in vaccines
Length: 19 minutesAuthor: Erika Krumbeck, ND
Aluminum in vaccines Why is aluminum in vaccines? What is a vaccine adjuvant? What is NOT a vaccine adjuvant? What is the difference between the limit the FDA sets for IV exposure to aluminum and the limit the FDA sets for vaccine (intramuscular injection) exposure to aluminum? Why? Which study shows that aluminum is safe for episodic exposure in infancy? What are some of the criticism of this study? What do some of the mouse studies show? Are there any studies that show that aluminum is definitely unsafe in vaccines? Research citations for Aluminum Bergfors E, Björkelund C, Trollfors B.Nineteen cases of persistent pruritic nodules and contact allergy to aluminium after injection of commonly used aluminium-adsorbed vaccines.Eur J Pediatr. 2005 Nov;164(11):691-7. Frederiksen MS, Tofte H. Immunisation with aluminium-containing vaccine of a child with itching nodule following previous vaccination. Vaccine. 2004 Nov 15;23(1):1-2. Mitkus RJ, King DB, Hess MA, Forshee RA, Walderhaug MO. Updated aluminum pharmacokinetics following infant exposures through diet and vaccination. Vaccine. 2011 Nov 28;29(51):9538-43. Shaw CA, Tomljenovic L. Aluminum in the central nervous system (CNS): toxicity in humans and animals, vaccine adjuvants, and autoimmunity. Immunol Res. 2013 Jul;56(2-3):304-16. “In young children, a highly significant correlation exists between the number of pediatric aluminum-adjuvanted vaccines administered and the rate of autism spectrum disorders. Many of the features of aluminum-induced neurotoxicity may arise, in part, from autoimmune reactions, as part of the ASIA syndrome.” This is a commentary of literature only, and is not a definitive Masson JD, Crépeaux G, Authier FJ, Exley C, Gherardi RK. [Critical analysis of reference studies on aluminium-based adjuvants toxicokinetics]. Ann Pharm Fr. 2017 Jul;75(4):245-256. A critique of the toxicokinetic studies carried out on aluminum absorption. “We reviewed the three reference toxicokinetic studies commonly used to suggest innocuity of aluminum (Al)-based adjuvants. A single experimental study was carried out using isotopic 26Al (Flarend et al., 1997). This study ignored adjuvant cell capture. It was conducted over a short period of time (28 days) and used only two rabbits per adjuvant. At the endpoint, Al retention was 78% for aluminum phosphate and 94% for aluminum hydroxide, both results being incompatible with quick elimination of vaccine-derived Al in urines. Tissue distribution analysis omitted three important retention sites: the injected muscle, the draining lymph node and bone. Two theoretical studies have evaluated the potential risk of vaccine Al…
MMR – Measles, Mumps, Rubella
Free PreviewLength: 25 minutesAuthor: Erika Krumbeck, ND
MMR vaccine MMR vaccine is designed to protect against three things: measles, mumps and rubella. Measles Measles is a virus which causes high fever, lethargy, cough, nasal discharge, conjunctivitis and a characteristic rash. About 30% of infected patients will have complications, and 1 in 5 will be hospitalized. 1 in 1,000 develop encephalitis, and between 1 in 500 and 1 in 1,000 will die. Highly contagious, spread through respiratory droplets in the air. Worldwide measles infection is the 5th most common cause of death in children under 5. Rare in the United States. Last estimates were 31-39 million illnesses worldwide in a single year. Mumps Virus that usually causes swelling of the parotid glands, but can affect any organ system. Adolescent males can get swelling of the testes (called orchitis) which can reduce fertility or even cause sterility in rare cases. Can also cause miscarriage. Rarely causes encephalitis or deafness. Contagious, but less so than measles or chickenpox. Spread via respiratory droplets (airborne) or by direct contact. Before the vaccine: 200,000+ cases. Now: rare, with periodic outbreaks of up to a few thousand patients. Rubella Virus that causes a fever and characteristic rash. Rarely causes encephalitis. Is a teratogen if Mom contracts rubella in pregnancy. Leads to severe birth defects or miscarriage. Lasting effects of congenital rubella are severe, with no known treatment available. Spread through respiratory droplets in the air, or through the placenta. Moderately contagious. Before: 20,000 cases of congenital rubella per year. Now: rare. The vaccine Is a live, attenuated virus. CDC recommended schedule: 12-15 months, 4-6 years. Who should not get the vaccine? Ingredients: sorbitol, sodium phosphate, sucrose, sodium chloride, gelatin, human albumin, fetal bovine serum, 25 mcg neomycin. Research citations for MMR Hamborsky J, Kroger A, Wolfe S. Epidemiology and Prevention of Vaccine-Preventable Diseases: Measles. Centers for Disease Control and Prevention. 13th ed. Washington D.C World Health Organization. Regional office of the Mediterranean. Measles: Disease Burden. Web 20 June 2017. http://www.emro.who.int/health-topics/measles/disease-burden.html Jochems CE1, van der Valk JB, Stafleu FR, Baumans V. The use of fetal bovine serum: ethical or scientific problem? Altern Lab Anim. 2002 Mar-Apr;30(2):219-27. Sørup S1, Benn CS2, Poulsen A3, Krause TG4, Aaby P5, Ravn…
Autism and Vaccines
Length: 13 minutesAuthor: Erika Krumbeck, NDComplexity: Standard
Autism and Vaccines Is there an association between the MMR and autism? Is there an association between thimerosal-containing vaccines and autism? What about Tylenol around the time of MMR vaccination? What does Dr. Erika think is happening? What does Dr. Erika recommend? (With the understanding that this is just based on common sense, and not necessarily on science…) Research citations for Autism and Vaccines Geier DA, Kern JK, Geier MR. Increased risk for an atypical autism diagnosis following Thimerosal-containing vaccine exposure in the United States: A prospective longitudinal case-control study in the Vaccine Safety Datalink. J Trace Elem Med Biol. 2017 Jul;42:18-24. This was the OLD hepatitis B vaccine. Lyall K, Schmidt RJ, Hertz-Picciotto I. Maternal lifestyle and environmental risk factors for autism spectrum disorders. Int J Epidemiol. 2014 Apr;43(2):443-64. Maternal folate, air pollution are big factors in autism risk. (Consuming maternal folate BEFORE conception reduces risk.) Schmidt RJ, Tancredi DJ, Ozonoff S, Hansen RL, Hartiala J, Allayee H, Schmidt LC, Tassone F, Hertz-Picciotto I. Maternal periconceptional folic acid intake and risk of autism spectrum disorders and developmental delay in the CHARGE (Childhood Autism Risks from Genetics and Environment) case-control study. Am J Clin Nutr. 2012 Jul;96(1):80-9. Leslie DL, Kobre RA, Richmand BJ, Aktan Guloksuz S, Leckman JF. Temporal Association of Certain Neuropsychiatric Disorders Following Vaccination of Children and Adolescents: A Pilot Case-Control Study. Front Psychiatry. 2017 Jan 19;8:3. Geier DA, Kern JK, Geier MR. A Two-Phase Case-Control Study of Autism Risk Among Children Born From the Late 1990s Through the Early 2000s in the United States. Med Sci Monit. 2016 Dec 29;22:5196-5202. Zerbo O, Qian Y, Yoshida C, Fireman BH, Klein NP, Croen LA. Association Between Influenza Infection and Vaccination During Pregnancy and Risk of Autism Spectrum Disorder. JAMA Pediatr. 2017 Jan 2;171(1):e163609. “There was no association between maternal influenza infection anytime during pregnancy and increased ASD risk. There was a suggestion of increased ASD risk among children whose mothers received an influenza vaccination in their first trimester, but the association was not statistically significant after adjusting for multiple comparisons, indicating that the finding could be due to chance. These findings do not call for changes in vaccine policy or practice, but do suggest the need for additional studies on maternal influenza vaccination and autism.” Goin-Kochel RP, Mire SS, Dempsey AG, et al. Parental report…
Varicella
Length: 17 minutesAuthor: Erika Krumbeck, ND
Varicella Vaccine Varicella is a virus that causes an infection known as “chickenpox.” The disease Varicella causes flu-like symptoms with characteristic “pox” signs, including spots, vesicles and scabs that are intensely itchy. Usually mild in severity in children aged 1-4, but rarely can cause some complications. Can also cause “shingles” many decades after the primary infection, which is a very painful skin rash. Is extremely dangerous if a newborn contracts the disease. Is very dangerous in immune compromised patients. Has a 25-fold higher risk of death in patients who get the disease after 15 years of age. Spreads through respiratory droplets or direct contact. 4 million cases/year before the vaccine was introduced, 10,000+ hospitalizations, about 100 deaths per year. Last estimates were about 48,000 cases, over a thousand hospitalizations, and about 19 deaths (in 2006). The vaccine CDC recommended schedule: 12-15 months, then age 4-6 years. Who should not get the vaccine? Ingredients: sucrose, gelatin, sodium chloride, monosodium L-glutamate, sodium phosphate dibasic, potassium phosphate monobasic, potassium chloride. Trace residual neomycin, EDTA, fetal bovine serum. No preservative. Special topics Which children should have a thorough work-up before getting a live virus vaccine (like Varicella)? Why is the incidence of shingles (herpes zoster) increasing in adults? Is this related to varicella vaccination? Research citations for Varicella Hamborsky J, Kroger A, Wolfe S. Epidemiology and Prevention of Vaccine-Preventable Diseases: Varicella. Centers for Disease Control and Prevention. 13th ed. Washington D.C Varicella (Chickenpox) package insert. “Varivax package insert” Merck Sharp & Dohme Corp. Web. 7 July 2017 Tarasoff L, Kelly MF. Monosodium L-glutamate: a double-blind study and review. Food Chem Toxicol. 1993 Dec;31(12):1019-35. This was MSG in food doses (oral exposure). This is probably not relevant for vaccine, but I thought I would include the study. Chambille I, Serviere J. Neurotoxic effects of neonatal injections of monosodium L-glutamate (L-MSG) on the retinal ganglion cell layer of the golden hamster: anatomical and functional consequences on the circadian system. J Comp Neurol. 1993 Dec 1;338(1):67-82. Daily injections of MSG, in massive doses, in mice, affect circadian rhythms. Probably not relevant to small doses in humans in vaccines. Cairns BE, Dong X, Mann…
Alternate Vaccine Schedules
Length: 7 minutesAuthor: Erika Krumbeck, ND
Alternate Vaccine Schedules Why does public health NOT recommend alternate vaccine schedules? What are the PRO’s of alternate vaccine schedules? What are the CONS of alternate vaccine schedules? Sample alternate vaccine schedules* *These are examples only, and you should always consult a physician before coming up with a final plan for your child. I am not officially recommending any alternate vaccine schedule. Alternate vaccine schedule 1 Alternate vaccine schedule 1 – chart form Alternate Vaccine Schedule 2 Dr. Sears alternate vaccine schedule Vaccine planning chart
Hepatitis A
Length: 8 minutesAuthor: Erika Krumbeck, ND
Hepatitis A Vaccine Hepatitis A is a virus that affects the liver, causing stomach-flu like symptoms. The disease Most children (younger than age 6) have NO symptoms. Children who do get symptoms have stomach-flu like symptoms like nausea, vomiting, fever, fatigue, sometimes jaundice. It is usually a minor illness in children. Complications typically happen in adults, including immune, nervous, blood, endocrine and kidney problems. Spread through fecal-oral route (contaminated food or water) or direct contact. Before: 110,000 cases/year and ~7,000 hospitalizations, with 100 deaths per year. Globally 1.4 million cases per year. Now: in the U.S. ~ 1,000 cases/year. The vaccine CDC recommended schedule: 12 months then approximately 6 months later. Who should not get the vaccine? Ingredients: HAVRIX: 250 mcg aluminum hydroxide. Amino acid supplement, phosphate-buffered saline solution, polysorbate 20, residual MRC-5 cellular protein (< 5 mcg/mL), formalin, neomycin sulfate. No preservatives. VAQTA: 225 mcg aluminum, sodium borate, sodium chloride, bovine albumin, formaldehyde (formalin), neomycin. Special topics Why is “universal vaccination” recommended by the public health authorities even though Hepatitis A typically doesn’t cause symptoms in children? Research citations for Hepatitis A Hamborsky J, Kroger A, Wolfe S. Epidemiology and Prevention of Vaccine-Preventable Diseases: Hepatitis A. Centers for Disease Control and Prevention. 13th ed. Washington D.C Gallone MF, Desiante F, Gallone MS, Barbuti G, Tafuri S, Germinario C. Serosurveillance of hepatitis A in a region which adopted the universal mass vaccination. Medicine (Baltimore). 2017 Mar;96(9):e5884. Li F, Hu Y, Zhou Y, Chen L, Xia W, Song Y, Tan Z, Gao L, Yang Z, Zeng G, Han X, Li J, Li J. A Randomized Controlled Trial to Evaluate a Potential Hepatitis B Booster Vaccination Strategy Using Combined Hepatitis A and B Vaccine. Pediatr Infect Dis J. 2017 May;36(5):e157-e161 Combining Hep A and Hep B in a vaccine for booster doses stimulates greater Hep B antibodies. They are considering all Hep B boosters to contain Hep A too. Kury CM, Pinto MA, Silva JP, Cruz OG, Vitral CL. Hepatitis A seroprevalence in public school children in Campos dos Goytacazes, Rio de Janeiro State, Brazil, prior to the introduction of the hepatitis A universal childhood vaccination. Cad Saude Publica. 2016 Nov 1;32(11):e00175614. Mayorga O, Bühler S, Jaeger VK, Bally S, Hatz C, Frösner G6, Protzer U, Van Damme P, Egger M, Herzog C. Single-Dose Hepatitis…
Preventing vaccine reactions
Length: 0 minutesAuthor: Erika Krumbeck, ND
Preventing vaccine reactions What supplements have some evidence for preventing vaccine reactions? (Which ones are controversial?) What should you NOT do? Products Klaire Labs probiotics are my favorite. Find at your local naturopathic doctor, compounding pharmacy or chiropractor. Seeking Health also has liposomal glutathione and a probiotic very similar to my favorite Klaire Labs probiotic. Here is a link to Seeking Health (this is an affiliate link, sorry for misspeaking in the video). Research citations for Preventing Vaccine Reactions Youngster I, Kozer E, Lazarovitch Z, Broide E, Goldman M. Probiotics and the immunological response to infant vaccinations: a prospective, placebo controlled pilot study. Arch Dis Child. 2011 Apr;96(4):345-9. Praharaj I, John SM, Bandyopadhyay R, Kang G. Probiotics, antibiotics and the immune responses to vaccines. Philos Trans R Soc Lond B Biol Sci. 2015 Jun 19;370(1671). Licciardi PV, Ismail IH, Balloch A, Mui M, Hoe E, Lamb K, Tang ML. Maternal Supplementation with LGG Reduces Vaccine-Specific Immune Responses in Infants at High-Risk of Developing Allergic Disease. Front Immunol. 2013 Nov 26;4:381. Supplementing mothers with lactobacillus GG reduces the immune response of infants to Hib, PCV, tetanus. Maidens C1, Childs C, Przemska A, Dayel IB, Yaqoob P. Modulation of vaccine response by concomitant probiotic administration. Br J Clin Pharmacol. 2013 Mar;75(3):663-70. Przemska-Kosicka A, Childs CE, Enani S, Maidens C, Dong H, Dayel IB Tuohy K, Todd S, Gosney MA, Yaqoob P. Effect of a synbiotic on the response to seasonal influenza vaccination is strongly influenced by degree of immunosenescence. Immun Ageing. 2016 Mar 15;13:6. Huda MN, Lewis Z, Kalanetra KM, et al. Stool microbiota and vaccine responses of infants. Pediatrics. 2014 Aug;134(2):e362-72. Kim YG. Microbiota Influences Vaccine and Mucosal Adjuvant Efficacy. Immune Netw. 2017 Feb;17(1):20-24 Quang N. Nguyen, Jonathon E. Himes, David R. Martinez, and Sallie R. Permar. The Impact of the Gut Microbiota on Humoral Immunity to Pathogens and Vaccination in Early Infancy. PLoS Pathog. 2016 Dec; 12(12): e1005997. Oh JZ, Ravindran R, Chassaing B, Carvalho FA, Maddur MS, Bower M, et al. TLR5-mediated sensing of gut microbiota is necessary for antibody responses to seasonal influenza vaccination. Immunity. 2014;41(3):478–92 Wei Zhang, Marli S.P. Azevedo, Ke Wen, Ana Gonzalez, Linda J. Saif, Guohua Li, Ahmed E. Yousef, Lijuan Yuanb,* Probiotic Lactobacillus acidophilus enhances the immunogenicity of an oral rotavirus vaccine in gnotobiotic pigs. Vaccine. 2008 Jul 4; 26(29-30): 3655–3661. Lamichhane A, Azegamia T, Kiyonoa H. The mucosal immune system for vaccine development. Vaccine….
Making shots more comfortable
Free PreviewLength: 5 minutesAuthor: Erika Krumbeck, ND
How to keep kids comfortable Dr. Erika shows you her favorite tricks to keep kids comfortable during shots.
Special Topics #1
Free PreviewLength: 10 minutesAuthor: Erika Krumbeck, ND
Special Topics #1 Topics covered: Probiotics – brands, types, strains What to do if a child has an adverse reaction? Rotavirus – what are the statistics on Rotavirus after introduction of the vaccine? Also a note on why Rotavirus is not recommended after 14 weeks of age. Rotavirus reduces febrile seizures in vaccinated children. Hepatitis B – I’ve moved the sections of Multiple Sclerosis and Does Immunity Last to this Office Hours.
Special Topics #2
Free PreviewLength: 12 minutesAuthor: Erika Krumbeck, ND
Special Topics #2 Topics covered: All about MTHFR! Note: we are going beyond what is known in scientific literature and are wandering through the realm of logical sense, but not logical fact. Antioxidants and helping glutathione.
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Author: Erika Krumbeck, ND
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