Thirty-five years of medical practice have convinced me that all vaccines carry an important risk of chronic disease that is inherent in the vaccination process and indeed central to how they work. Yet the growing concerns of parents and legislators and media reports about them rarely if ever elicit anything beyond automatic denials by medical and public health authorities alike. Reflecting on this glaring discrepancy is the main focus of this essay. Writing these lines has also helped me appreciate how much the invisibility heightens the risk and how intimately these phenomena are connected, like mirror-images of the same reality, which makes it imperative to study them together.
Since I am mainly a clinician, I will begin with a story. It concerns a 12-year-old boy whom I know of solely from his mother’s letter, but her words are so heartfelt and so congruent with the rest of my experience that I cannot doubt their veracity:
My son Adam was healthy until his first MMR at 15 months. Within 2 weeks he had flu and cold symptoms, which persisted for 6 weeks, his eyes became puffy, and he was hospitalized with nephrotic syndrome. A renal biopsy showed “focal sclerosing glomerulonephritis,” but he didn’t respond to steroids. I asked if it could be related to the vaccine, but they told me it couldn’t, and we accepted that. Over the next 4 years he was hospitalized repeatedly but then went into remission, seeming normal and healthy and staying off all medications for 5 years.
When he turned 10, his pediatrician recommended a booster, saying that a rise in measles cases made it dangerous for him not to be protected. I checked the PDR and other sources but found no warning for kidney disease and no listing of it as an adverse reaction, so I agreed to it. In less than 2 weeks he relapsed, with 4+ proteinuria, swelling, and weight gain, signs that we recognized immediately. He was admitted in hypertensive crisis, with blood in the urine, fluid in the lungs, and massive weight gain. On Cytoxan, massive doses of Prednisone, and three other drugs he slowly improved, but missed another 7 months of school.
It’s been 2 years since that horrible episode, and he still needs Captopril for high blood pressure and spills 4+ protein every day. The doctor says he sustained major kidney damage, will always need medication to control his blood pressure, and will worsen as he grows, necessitating a transplant eventually. This time I was convinced that his condition was related to the vaccine, but still the doctors didn’t take me seriously and told me it was a coincidence.
I searched for information and even contacted the manufacturer of the vaccine. Finally they sent me two case reports of nephrotic syndrome following the MMR vaccine. It’s very difficult for lay people to get information or even ask questions, since we don’t use correct medical terms and feel stupid. Please tell me if my ideas are reasonable. I don’t think my son could tolerate another episode, and I think he’d have normal blood pressure and kidney function if not for that second shot.
I also have great concern for other children who develop nephrotic syndrome some weeks after receiving MMR and whose doctors never make the connection. They could all be at great risk if revaccinated. I realize that this letter has taken up a lot of your time, and I’d appreciate any help you can give me. Thank you.1
Like many others who seek my help, this woman honestly believed that her son had been crippled for life by the MMR vaccine, yet had no intention of suing the drug company who manufactured it, the doctors who administered it, or the Government’s Vaccine Injury Compensation program, as she was entitled to do. Whether she didn’t think she could win, a conclusion my experience would certainly justify, or simply was not a litigious person, as seems more relevant in her case, the absence of such motive only lends further credence to her story. She was writing to me simply to find a physician to hear and validate the truth of her experience, which neither the pediatrician who gave the shots, nor the specialists who treated Adam in the hospital, nor any of the other doctors she spoke to were willing to do. Although I had very little else to offer her, it was more than enough to earn her gratitude.
To those inclined to discredit such tales, I reply that the confidences our patients entrust to us represent the truth as they live it. Yet when vaccines are involved, such stories are routinely dismissed out of hand, as if they couldn’t possibly be true or worthy of serious consideration. That was the reaction of every doctor involved in Adam’s care, despite compelling evidence to the contrary, even after case reports were supplied by the drug company itself. Whether a canny strategy to defeat possible litigation or simply the instinctive shielding of a cherished world-view from threat of change, this defensive and hostile stance is so pervasive in the medical profession as to merit careful study in itself.
Richard Horton, Editor of The Lancet, felt the sting of censorship himself after publishing an article linking cases of infantile autism and colitis to the MMR vaccine:
Today vaccines are largely an untouchable subject, their benefits too obvious to be questioned. Any hint of dissent concerning their clinical effectiveness and overall social value is met with bitter rebuttal and resentment. A former President of the UK Academy of Medical Science actually threatened to get me sacked for publishing work that raised questions about the MMR vaccine, while at a dinner party years later, the partner of a government vaccine specialist asked, “Will you ever be forgiven?” Forgiven for what, I wondered?2
Dr. Horton himself neither believed in the research nor endorsed its conclusions. His only “mistake,” if mistake it was, lay in permitting the author, a well-known British gastroenterologist, to publish his findings without regard for their political correctness. Needless to say, the snubs and threats he faced for rocking the boat were less serious than the reprisals exacted against the author, whose work was officially repudiated without testing it, and whose career at a London teaching hospital was abruptly terminated.3
Finally, Adam’s misfortune obliges us to ask how “glomerulonephritis,” “autism,” “encephalopathy,” or any other disease gets to be identified as a bona fide complication of a vaccine, such that the victim becomes eligible to receive damages in court. In spite of two reports of MMR nephritis documented by the manufacturer, renal failure is still not recognized as an adverse effect of the vaccine, an omission that undoubtedly helped Adam’s doctors to frustrate his mother’s inquiries.
Exactly similar editing characterizes the Federal guidelines for compensation of vaccine-injured patients, which would never have been enacted in the first place without the repeated insistence of their parents, and which continue to be pared down even further by the determined opposition of the vaccine manufacturers, the American Academy of Pediatrics, and other authoritative and influential pro-vaccine groups. As reflected in the official compensation guidelines, research studies of vaccine-related injuries are limited to a few extreme reactions to particular vaccines, because these alone occur often enough to attain statistical significance in large populations. Such a policy automatically disquallifies two much larger and partly overlapping classes of phenomena that my own research has uncovered: 1) exacerbation of the ordinary chronic diseases of childhood, according to individual susceptibility, often representing 2) a nonspecific effect of the vaccination process in general, for which any vaccine will do. Restricting the issue of vaccine safety to specific effects of specific vaccines is a major reason why the true extent of vaccine-related illness has always been invisible and will likely remain so until the question is reframed in a more comprehensive way.
An equally troubling problem with the approved list of vaccine-related injuries is their restriction in time to acute events occurring within a few days afterward,4 i. e., soon enough for the vaccine to be regarded as the necessary and sufficient cause of the reaction, as if independently of any prior susceptibility. In Adam’s case as in many others, vague, nondescript symptoms appeared soon after vaccination, but the full picture of nephritis did not emerge and could not be diagnosed until six weeks after the first shot and two weeks after the second, by which time it was no longer an acute or fixed injury, but already a chronic, self-sustaining illness that has continued to develop and worsen over the years, so that a claim on his behalf would undoubtedly have been rejected even if it had been filed.
In what follows I will consider five aspects of the vaccine issue: 1) specific effects of specific vaccines, as described in the literature; 2) nonspecific effects of the vaccination process, based on cases from my own practice; 3) how vaccines actually work; 4) several individual vaccines; and 5) implications for vaccine and health policy.
The vaccination literature contains no mention of adverse effects of the process itself, but only a few documented effects of specific vaccines, such as encephalopathy, autism, anaphylaxis, and so forth, most still hotly contested by authorities in the field. Even those officially recognized as legitimate grounds for compensation under the Federal guidelines are actually vague, generic terms that are applicable to more than one vaccine. Anaphylaxis, for example, is compensable not only for DPT and its components but also for MMR, and will undoubtedly implicate some or all of the newer vaccines in the future.