Letters to the editor

Finding a Path Forward

In response to your Winter 2018 article "Searching for a Vaccine Against Mistrust," I can think of no better vaccine than a robust factual discussion. Here are the discussions/ concerns that I wish your article would have addressed:

• The difference between immunity and vaccination.
• The recommended vaccination schedule for children (5 and under) rising steadily from the 1950s to today.
• The suspected neurotoxicity of the adjuvants ("carrier sauce") and preservatives—such as thimerosal (which contains mercury) used in multidose vials—that some think can trigger the hyperactivity of the immune system.
• That the rise of incidence in autism eerily parallels the rise in vaccinations.
• That vaccines do not have the same FDA scrutiny as other drugs, have a separate appeals process, and big-Pharma is often protected from liability and lawsuits (no accountability for outcome).

With rampant rise in autism and autoimmune disorders, something is going on. What is it? I would challenge our JHU folks—the best of the best—to find a path forward. Be the heroes I know you can be. Only the truth, however painful and distressing, can move us forward.

E. Elizabeth Reigel, Engr '06 (MS)
Aberdeen, Maryland

Conflicts of Interest

In response to the article "Searching for a Vaccine Against Mistrust," there are some points that have not been addressed. Without them, the article presents a case that any fear of vaccines and the companies that manufacture them is unwarranted.

The appearance of conflict of interest between the FDA/CDC and vaccine manufacturers is one of the major issues behind much of the anti-vaccine movement. In case after case, most recently the Johnson & Johnson debacle over concerns that asbestos was laced into their baby powder, corporations focus on profit at the expense of the lives of their customers. It is the reason why there is so much regulation surrounding health care products. However, the objective line between the health care product companies and the regulating bodies overseeing product safety is increasingly blurred. Far too often, the heads of Big Pharma and the decision-makers within FDA/CDC interchange roles. It is also no secret that Big Pharma's lobbying efforts and campaign contributions have less to do with eradicating or preventing disease and more to do with securing profits.

Meanwhile, there are more and more documented cases of children and adults being harmed by these vaccines. In many cases there is no recourse of compensation for these affected individuals or their families because of no-liability clauses negotiated by the vaccine manufacturers with the FDA or other regulating governing bodies.

The bottom line is that people want these vaccines to be safe. The appearance of conflict of interest, combined with the documented cases of healthy children and adults harmed from these vaccines, will always lead to mistrust among people who have a strong sense of personal responsibility for their health.

Jeff Cammerata, A&S '93 (MA), '97 (PhD)
Medford Lakes, New Jersey

Vaccines are safe, effective

At the Institute for Vaccine Safety, we hear many questions and concerns from the public. Vaccines are extremely safe and effective, yet no vaccine is perfectly safe nor perfectly effective.

Vaccination is the process of administering a vaccine to a person. Immunity refers to whether or not someone is adequately protected from disease. When a vaccine is effective, the person is immune to the disease. For example, two doses of measles vaccine provide immunity to about 97 percent of people. Vaccine effectiveness is lower for some vaccines, such as influenza. Sometimes a vaccine doesn't provide full protection from the disease but still protects against more serious disease.

Over the past two decades, we have seen more vaccines available to protect against more diseases, such as Haemophilus influenzae type b (Hib), which can cause meningitis—an infection around the brain and spinal cord—as well as intellectual disability, pneumonia, and death. These new vaccines have prevented tremendous suffering and death. One needs to be careful not to assume that because the number of vaccines recommended and used over the past two decades has increased that other events that have increased over this period are caused by vaccines. Autism is such an example. As reviewed on our website, there have been a dozen well-conducted studies examining associations between childhood vaccines and autism. These studies have been conducted by different investigators, using a variety of methods, and among varying populations. All of these studies show no causal relationship between childhood vaccines and autism. A study from Denmark published this month reaffirmed this conclusion, including a focus on siblings of autistic children, who are at increased risk of autism.

Vaccines are held to an extremely high safety standard, as they are given for prevention rather than treatment of disease, are often administered to almost all of the population including children and other vulnerable subpopulations such as pregnant women, and some vaccines are required by states for entry into school. Many people are not familiar with the extensive efforts conducted to make sure that vaccines that are licensed and recommended are very safe and the benefits outweigh the risks. A comprehensive review of the nation's vaccine safety system can be found online.

Vaccines routinely used in the United States are extremely safe, either causing only minor adverse reactions, or more serious adverse reactions only extremely rarely. For example, influenza vaccine can cause Guillain-Barré syndrome, a rare neurological disorder, in about one to three per million persons vaccinated. Influenza vaccine can also prevent GBS as it protects against influenza, which can cause GBS. Ultimately, one must consider both risks and benefits, which is the basis of the immunization schedule. The benefits of the influenza vaccine, and all vaccines on the immunization schedule, clearly outweigh the risks. While these very rare but serious adverse reactions do occur, the U.S. has a vaccine injury compensation program to provide for the medical and other associated costs for persons with these very rare vaccine injuries.

Daniel Salmon
Professor and director of the Institute for Vaccine Safety, Johns Hopkins University