Join us at noon CT (1 p.m. ET/10 a.m. PT) on Tuesday, March 22, for an hour-long chat about vaccines, vaccine safety, the anti-vaccine movement and vaccine injury, with the Tribune's health reporter Trine Tsouderos and panelist Dr. Paul Offit.
Dr. Offit, a pediatrician, is the co-inventor of the RotaTeq rotavirus vaccine, chief of the division of infectious diseases at The Children's Hospital of Philadelphia and author of the new book, "Deadly Choices: How the Anti-Vaccine Movement Threatens Us All." Offit is an expert on vaccines and the anti-vaccine movement. He has written widely about the science behind them in both books, the popular press and medical journals, debunking common myths about these ubiquitous medical interventions.
If you would like to submit a question in advance, please e-mail Trine Tsouderos at firstname.lastname@example.org. Here's your chance to ask questions about immunizations and get science-based answers from one of the world's top experts on vaccines.
Thanks for joining us! We'll be starting at noon. Please ask lots of questions - we will try to get to as many as we can. Okay, see you in 13 minutes...
Tuesday March 22, 2011 11:47 Trine Tsouderos
Okay, so let's start. I just want to say thank you so much to Dr. Paul Offit for joining us for this chat. He's a co-inventor of the RotaTeq vaccine, chief of the infectious diseases division at Children's Hospital of Philadelphia and author of several books, including Deadly Choices: How The Anti-Vaccine Movement Threatens Us All.
Tuesday March 22, 2011 12:00 Trine Tsouderos
Thanks, Trine. Happy to do this.
Tuesday March 22, 2011 12:00 Paul Offit
[Comment From GuestGuest: ]
Is there harm in stretching out the schedule of vaccinations?
Tuesday March 22, 2011 12:00 Guest
The harm in delaying vaccines is that children are then susceptible to certain vaccine-preventable diseases for a longer period of time. And diseases like pneumococcus, pertussis, rotavirus, Haemophilus influenzae type B occur early in life, so you need to be protected as soon as possible.
Tuesday March 22, 2011 12:01 Paul Offit
[Comment From Anne DachelAnne Dachel: ]
Why has there never been an independent comparison study of fully-vaccinated and never-vaccinated children? This should be done in the U.S. by no one connected to the drug industry of the federal health agencies. If never-vaccinated children have the same health concerns as fully-vaccinated children, including a one percent autism rate, the proof would be there for all to see. With so many parents now afraid to vaccinate, the study group is out there. Why aren't you calling for such a study? Anne Dachel Media editor: Age of Autism
Tuesday March 22, 2011 12:02 Anne Dachel
The best way to study vaccine safety is prospectively. Obviously, you could never ethically do this study prospectively because it would be unethical to withhold vaccines, which are known to prevent suffering, hospitalization, and death. Some retrospective studies are starting to emerge. One published by Charles Woods and Michael Smith in Pediatrics looked at fully vaccinated and relatively unvaccinated children and, not surprisingly, found no difference in neurological outcome. But all of the biological evidence for autism points away from vaccines, so calling for such a study seems off the point and largely unfair to parents of children with autism.
Tuesday March 22, 2011 12:05 Paul Offit
[Comment From Dr Terry PolevoyDr Terry Polevoy: ]
The regulated health professions in Ontario prohibit some professionals from anti-vaccine activities. Numerous complaints have been filed against naturopaths who oppose vaccines, and yet no actions have been taken against them. How would Dr. Offit handle such opposition if he was living in our country?
Tuesday March 22, 2011 12:05 Dr Terry Polevoy
Our country tends to be pretty open-minded about alternative treatments and preventives. Naturopaths, homeopaths, chiropractors, accupuncturists generally can do what they want. But it would be interesting to see a wedge lawsuit against clinicians who specifically recommend against vaccines in which the child suffers that advice.
Tuesday March 22, 2011 12:07 Paul Offit
[Comment From GuestGuest: ]
Why is it that my son gets so sick every time he gets shots, but my daughter never does?
Tuesday March 22, 2011 12:07 Guest
The most common reason that people get sick after getting vaccines is that they get them in the pediatrician's office after sitting in a waiting room often filled with sick children. And it's true that boys generally suffer infections more than girls, almost across the board for most infections (let's face it, we're the weaker sex).
Tuesday March 22, 2011 12:09 Paul Offit
[Comment From GuestGuest: ]
Hi Paul, Can you address the argument that too many vaccines are given to young children - "too many too soon"? What is the science and how should I address those who argue that? Thanks!
Tuesday March 22, 2011 12:09 Guest
Vaccines are well-tested before they're given to children in concomitant-use studies. Vaccines cannot be added to the schedule unless it has been clearly shown that the new vaccine does not interfere with the safety or immunogenicity of existing vaccines and that the existing vaccines don't interfere with the safety or immunogenicity profile of the new vaccine. Also, the immunological challenge from vaccines is pretty trivial when compared with the challenges babies typically encounters in the environment.
Tuesday March 22, 2011 12:11 Paul Offit
[Comment From Guest1118Guest1118: ]
I am 26 years old and never have been vaccinated - What's the harm in that? Seems that I am more healthy than most of my friends....
Tuesday March 22, 2011 12:12 Guest1118
You've taken an unnecessary risk and frankly have been lucky. I guess we all have our biases. Mine is that I work in a hospital. I was on service last week and rounded on two children, both less than 5 years old, who are currently on a heart-lung machine for influenza pneumonia. They're fighting for their lives. Both of these infections could have easily and safely been prevented by an influenza vaccine. But both children were unvaccinated.
Tuesday March 22, 2011 12:14 Paul Offit
[Comment From DavidDavid: ]
Is the controversey about vaccines something that has no basis in fact (like Y2K, 2012, or WMD?) Why is there this much smoke if there is no fire?
Tuesday March 22, 2011 12:14 David
For guest1118: The other problem is that if you do become sick, you can spread it to others. Babies. Elderly people. Children with compromised immune systems. Pregnant moms.
Tuesday March 22, 2011 12:15 Trine Tsouderos
No, it has a basis in fact. Vaccines, like all medical products, can have severe side effects: severe allergic reactions to egg proteins in flu vaccine or gelatin in the chickenpox vaccine. And the oral polio vaccine could itself cause polio. The problem with today's vaccine safety discussion is that most of what you read or hear about aren't really problems with vaccines (e.g., autism, learning disabilities, MS, diabetes, and others).
Tuesday March 22, 2011 12:16 Paul Offit
[Comment From Jamie Deckoff-Jones MDJamie Deckoff-Jones MD: ]
Are you concerned that the current epidemics of ME/CFS, ASD and GWI are related to vaccines? These neuroimmune disease cohorts are all of mysterious etiology and share many clinical similarities: sensory and cognitive processing deficits, susceptibility to and inability to clear certain infections, an unusual susceptibility to stress, increased oxidative stress, glutathione depletion, methylation blocks, mitochondrial defects, high levels of heavy metals, inflammatory bowel issues, hormone abnormalities and a suspicion that vaccines are implicated in pathogenesis. The pathology in humans is extremely similar to what is known of simple retroviral infections in animals. We have evidence that xenotropic and polytropic MuLVs are infecting humans (Lombardi et al Science Oct 2009, Lo et al PNAS Sept 2010). Given the history of the use of mouse and chick embryo cells for vaccine production coinciding with the history of Epidemic Neuromyasthenia (as documented by Henderson and Shelokov, NEJM 1959), the known presence of animal retroviruses in those cells, and the documented ability of these viruses to infect human cells, aren't you the least bit concerned?
Tuesday March 22, 2011 12:16 Jamie Deckoff-Jones MD
Hi Jamie: I don't agree that problems like glutathione depletion, methylation blocks, etc are associated with ASDs. A study here, a study there, some of dubious quality. I wrote about this last year: www.chicagotribune.com/autism. These ideas are promoted by folks who sell a lot of therapies to "fix" these things when it is not clear they are even there. So I don't think there is good evidence for that.
Tuesday March 22, 2011 12:18 Trine Tsouderos
The xenotropic murine retrovirus story as a cause of neurologic disease, including chronic fatigue syndrome has clearly fallen apart. And for those of us old enough to remember, many careers have fallen off a cliff claiming retroviruses as a cause of a variety of illnesses: most noteworthy, MS and Kawasaki's disease. Retroviruses are so ubiquitous and such a frequent lab contaminant that they're the Sirens of the lab.
Tuesday March 22, 2011 12:19 Paul Offit
The heavy metal connection is especially poor. It comes from a study that found less mercury in the hair of children with autism and concluded that that was proof they had trouble excreting it. A dubious conclusion.
Tuesday March 22, 2011 12:20 Trine Tsouderos
[Comment From Keya GuimaraesKeya Guimaraes: ]
How has the schedule of vaccines changed from the late 70's (when I was born) to now? Is the increase simply due to better science, or is there a change in pharmacology? One might think the vaccines should be less and more potent if there have been advances in the area...
Tuesday March 22, 2011 12:20 Keya Guimaraes
Clearly, more vaccines have been added. As technology improves, it's been easier to make some vaccines now than we could in the past. Specific advances have occurred in protein chemistry, protein purification, and recombinant DNA technology. All has made for better, safer vaccines.
Tuesday March 22, 2011 12:21 Paul Offit
[Comment From Ken ReibelKen Reibel: ]
April 2 is World Autism Awareness Day. What kind if stories would you like to see the news and entertainment media cover, and what advice can you offer to general assignment reporters who are told to find an "autism story"?
Tuesday March 22, 2011 12:21 Ken Reibel
My advice is that reporters should rely on evidence and not anecdotes. The anecdotal stories are compelling, no doubt. But they don't equal scientific data, of which there is a lot when it comes to autism and vaccines. There are loads of stories out there to be done - questions about adults with autism, what to do as children with autism grow up, how children are treated in schools, the costs of autism, etc. Lots of stories. .
Tuesday March 22, 2011 12:23 Trine Tsouderos
I work in a hospital with David Mandell, Hakon Hakanarson, and Bob Schultz, all excellent researchers in the field of autism. And the story of the cause or causes of the disorder is clearly emerging. There's been a lot of wonderful research in this area that involves specific genes, the proteins those genes make, when they make them, structural abnormalities in the brains of children with ASD and others that offers some real hope for the future. I look forward to the time when these stories are the main story, rather than the unfortunate focus on a dead-end hypothesis like vaccines. That discussion has only hurt children with autism, causing some to miss vaccines from which they would have benefited.
Tuesday March 22, 2011 12:25 Paul Offit
If reporters want to explore the vaccines/autism issue, then there are good stories to be written, but like I said, evidence should drive the piece. This isn't an issue where we don't know a whole lot - we do.
Tuesday March 22, 2011 12:25 Trine Tsouderos
[Comment From MeganMegan: ]
What is your view on the concerns raised by Dr. Robert Sears about the high aluminum exposure that children receive from the current AAP-recommended vaccine schedule?
Tuesday March 22, 2011 12:25 Megan
While toxicities from aluminum can occur (bone thinning, anemia, encephalopathy), the kind of child who suffers aluminum toxicity has both a high level of exposure (like antacids or intravenous fluids) and an inability to excrete aluminum due to kidney failure. Where is the evidence that otherwise healthy children get toxic from aluminum in vaccines. Shouldn't there be at least one shred of evidence that this true before unnecessarily scaring parents? Parents deserve better.
Tuesday March 22, 2011 12:29 Paul Offit
One problem I have as a reporter about Dr. Sears is that he really is not an expert on vaccines at all. I would not use him in a story as an expert on vaccines. He has not conducted research to support his assertions on them.
Tuesday March 22, 2011 12:29 Trine Tsouderos
[Comment From Dr. Robert Block] Paul, as President-elect of the American Academy of Pediatrics, I want to thank you for your work and for your book, "Deadly Choices." What is the single best strategy for helping Parents separate the junk from the real facts about vaccines?
Tuesday March 22, 2011 12:29 Chicago Tribune
Maybe I'm naive, but I don't think that it's that hard to distinguish accurate, informed from inaccurate websites on the Internet (at the very least, the good ones aren't advertising products that cure autism or make you live longer). And I think most parents can do this. But they tend to be a quiet majority.
Tuesday March 22, 2011 12:31 Paul Offit
[Comment From HannahHannah: ]
Great question Dr. Block, thank you so much! How do we convince parents who are currently disbelievers, to vaccinate their children??
Tuesday March 22, 2011 12:32 Hannah
I think that we all have to be much more passionate when we talk about what it means to choose not to vaccinate your child. As someone who works in a hospital that sees children suffer and occasionally die from these choices, it's not hard. Children are suffering these fears needlessly. We have to stand up for them. Be passionate.
Tuesday March 22, 2011 12:34 Paul Offit
[Comment From Mark RosenbergMark Rosenberg: ]
do you know what the cause of the several deaths in Japan were within few days of receiving vaccines?
Tuesday March 22, 2011 12:34 Mark Rosenberg
Four children died following receipt of pneumococcal or Hib vaccines in Japan. One within 3 days and three within one day of getting vaccinated. The Ministry has now determined that the vaccines were not the cause. Hard to know without seeing the full reports of the children. Sudden Infant Death Syndrome is certainly a possibility. And while vaccines don't cause SIDS, they also don't prevent it. So some of these temporal associations will occur. Of interest, Japan only started to use these vaccines within the past year. Whereas many other countries have used these vaccines for one or two decades (hundreds of millions of children) without a problem. The Ministry's choice to temporarily suspend these vaccines was unfortunate (elevating a theoretical and arguably disproved risk above the real risk of pneumococcus and Hib).
Tuesday March 22, 2011 12:38 Paul Offit
[Comment From BrianBrian: ]
As a parent and physician, what is your advice regarding allowing children play or be associated with other children that are (a) unvaccinated or (b) vaccinated but are often associated with a large group of unvaccinated children. Thank you.
Tuesday March 22, 2011 12:38 Brian
You are much more likely to catch a vaccine-preventable disease if you are living among a relatively unvaccinated community. Although you are more likely to be protected if vaccinated, no vaccine is 100 percent effective and the more likely you are to be exposed the more likely you are to get sick. And there are thousands of thousands of children in the US who can't be vaccinated (cancer, etc), they depend on those around them to be protected. We should feel some sense of responsibility to these children. They count on us to protect them.
Tuesday March 22, 2011 12:41 Paul Offit
Have you vaccinated your children? Yes
( 63% )
( 2% )
No, I don't have children but I've been vaccinated
( 33% )
No, I don't have children and I haven't been vaccinated
( 2% )
Tuesday March 22, 2011 12:41
[Comment From PabloPablo: ]
Paul - in your book you talk about the Fallacy of the Commons. Do you think that appealing to people's sense of communal responsibility is going to be successful? I fear that the current trend in America, at least, is back toward the Me-first, forget you attitude
Tuesday March 22, 2011 12:42 Pablo
Sadly, Pablo, I agree that it's going to be tough. But I think we have it in us. Those who ran toward the shots in Tucson or toward the World Trade Center in NYC had an instinct toward their fellow man. We just have to find a way to appeal to that. I remember a boy with leukemia in our 9th grade class. He was emaciated, with hair loss. I can't imagine that I could have walked in that room knowing I was exposing him to a disease against which he wouldn't have had a chance.
Tuesday March 22, 2011 12:44 Paul Offit
[Comment From GuestGuest: ]
My child cannot be vaccinated because of an underlying health condition. Is it OK for her to play with children within 10 days of them receiving their live virus vaccines?
Tuesday March 22, 2011 12:44 Guest
Yes. The only live attenuated viral vaccine which had to be avoided in the home of an immunocompromised adult or child was the oral polio vaccine, which we don't give in the US anymore. The other vaccines (MMR, varicella, nasal-spray flu) are either shed in such small quantities are or so highly attenuated or both so as not to be a problem.
Tuesday March 22, 2011 12:45 Paul Offit
[Comment From Amy Pisani, ECBTAmy Pisani, ECBT: ]
Often we hear that we should ensure proper herd immunity to protect those who are vulnerable in our society such as those with immune system issues. Can you expand on this by explaining who falls into these categories and how common this is?
Tuesday March 22, 2011 12:46 Amy Pisani, ECBT
The most vulnerable members of society include young babies who are too young to receive flu vaccine or too young to be fully immunized against diseases like pertussis (hence the 10 deaths in California from pertussis, all in less than 2 month olds). Also, people on chemotherapy for their cancers or immune suppressive therapies for their chronic diseases. About 500,000 people in the US fall into these categories.
Tuesday March 22, 2011 12:48 Paul Offit
[Comment From Stephen Barrett, MDStephen Barrett, MD: ]
Can anything be done about the problem of talk show hosts who repeatedly provide forums for guests who give irresponsible health advice?
Tuesday March 22, 2011 12:48 Stephen Barrett, MD
I think it will be interesting to see whether Oprah gives Jenny McCarthy a platform on her new OWN network.
Tuesday March 22, 2011 12:49 Trine Tsouderos
There was talk of it, I think McCarthy even signed a deal with Oprah a few years ago. But I haven't heard much since.
Tuesday March 22, 2011 12:50 Trine Tsouderos
There is a schism between what these shows are trying to accomplish (which is to be interesting) and what people who care about children's health are trying to accomplish (which is to educate the public). Once a young producer from Dateline NBC said to me, "Our job is to be interesting. If it also happens to be true--great." I think that says it all.
Tuesday March 22, 2011 12:51 Paul Offit
I think people wind up voting with their remotes, and if people want to see those sorts of guests, the hosts will book them.
Tuesday March 22, 2011 12:51 Trine Tsouderos
[Comment From GuestGuest: ]
Do you think we should have vaccine mandates for adults when they, say, renew their drivers' licenses, similar to the mandates for public school children?
Tuesday March 22, 2011 12:51 Guest
You would like to think that we could come to a point in this country where we don't need mandates. Where people would educate themselves about vaccines to the point that they realize that the choice not to get them is a bad one. Unfortunately, there are a lot of bad sources of information out there that lead to a lot of bad decisions. So, we're stuck. You could make the argument that any parent of a newborn should get Tdap vaccine. That's the only way those deaths in California from pertussis could have been prevented. Is it your inalienable right to catch and transmit a potentially fatal infection to your child?
Tuesday March 22, 2011 12:54 Paul Offit
[Comment From MattMatt: ]
Paul, you are a hero to those of us that value objective science and not anecdotal nonsense. I am a researcher and practitioner in Iowa who works with children with autism and has had to help parents who have spent their life savings on pseudo science and CAM.
Tuesday March 22, 2011 12:54 Matt
Thanks, Matt. I appreciate it. The good news is that there are a number of people out there trying hard to get good science into the hands of the public. Much is at stake.
Tuesday March 22, 2011 12:55 Paul Offit
Hi Matt. I have written a lot on that topic, too. One dad in particular has stuck with me. He spent $200,000 on treatments that he admitted had done nothing for her daughter, who was severely affected. He had tried everything under the sun. I felt for him, and for his poor daughter, who had endured a lot of dubious therapies.
Tuesday March 22, 2011 12:56 Trine Tsouderos
[Comment From NicolásNicolás: ]
Also, how likely is it for vaccine preventable diseases to resurge? What about reaching other countries? hugs from Ecuador.
Tuesday March 22, 2011 12:56 Nicolás
In the US we have recently seen a resurgence of some of these diseases: measles, mumps, pertussis. And it's exactly what you would have expected. The most highly contagious diseases come back first. Let immunization rates continue to fall and some of the less contagious diseases could come back: polio, diphtheria. One can only hope that history will teach us that children shouldn't have to suffer our choice not to vaccinate.
Tuesday March 22, 2011 12:58 Paul Offit
That's an interesting question. Today we live in such a global society, with thousands of people from everywhere arriving from everywhere. With their infections.
Tuesday March 22, 2011 12:58 Trine Tsouderos
[Comment From Justin MorganJustin Morgan: ]
I am currently reading your new book. It is excellent. I am a new pediatrician and I see vaccine refusals over such trivial notions every day. It's nice to have the facts to present a safe vaccine strategy. I do wonder how you feel about refusal to see patients if the family decides not to vaccinate their baby/child.
Tuesday March 22, 2011 12:58 Justin Morgan
I feel badly for physicians. They're in a tough spot. If you choose not to see those children, where do they then go for care. On the other hand, if you allow for children to be unvaccinated, or relatively unvaccinated, you're knowingly putting them at unnecessary risk. It's lose-lose.
Tuesday March 22, 2011 12:59 Paul Offit
That's all we have time for. Thank you so much to Dr. Offit for answering an enormous number of questions and sharing his insight and knowledge with us. Thank you to our readers who asked so many that we did not have time to get to them all. Please join us next week on Tuesday at noon for a chat with Deb Shelton about sleep trouble with teens and children.