Richard Moskowitz, M. D.
in Journal of the AIH, March 1983;
and included in R. Mendelsohn, ed.,
Dissent in Medicine, Contemporary Books,
Soon I found I could no longer bring myself to give the injections even when the parents asked me to.
At bottom, I have always felt that the attempt to eradicate entire microbial species from the biosphere must inevitably upset the balance of Nature in fundamental ways that we can barely imagine.
Such concerns loom ever
larger as new vaccines continue to be developed for no better reason
than that we have the technical capacity to make them, thus
demonstrating our right and power as a civilization to manipulate
the evolutionary process itself.
For that reason alone,
the public is surely entitled to convincing proof, beyond any
reasonable doubt, that artificial immunization is in fact a safe and
effective procedure in no way injurious to health, and that the
threat of the corresponding natural disease remains sufficiently
clear and urgent to warrant vaccinating everyone, even against their
will if necessary.
Finally, even if such an
emergency did exist and artificial immunization could be shown to be
an appropriate response to it, the decision to vaccinate would
remain essentially a political one, involving issues of public
health and safety that are far too important to be settled by any
purely scientific or technical criteria, or indeed by any criteria
less authoritative than the clearly articulated sense of the
community that is about to be subjected to it.
What I have to say is as yet not quite a formal theory capable of rigorous proof or disproof, but simply an attempt to explain my own experience, a nexus of interrelated facts, observations, reflections, and hypotheses that are more or less coherent and, taken together, make intuitive sense to me.
I offer them to the public because the growing refusal of parents to vaccinate their children is seldom articulated or taken seriously.
The truth is that we have been taught to accept vaccination as a kind of sacrament of our loyal participation in the unrestricted growth of scientific and industrial technology, utterly heedless of the long-term consequences to the health of our own species, let alone to the balance of Nature as a whole.
For that reason alone, the other side of the case urgently needs to be heard.
But the facile assumption that the decline is also attributable to them remains unproven, and continues to be questioned by eminent authorities in the field.
With whooping cough, for instance, both the incidence and severity had already begun to decline precipitously long before the vaccine was introduced, [note 1] a fact which led the epidemiologist C.C. Dauer to remark, as far back as 1943:
Much the same is true not
only of diphtheria and tetanus, but of TB, cholera, typhoid, and
other common scourges of a bygone era, which began to disappear
rapidly at the end of the nineteenth century, doubtless partly in
response to improvements in sanitation and public health, but in any
case long before antibiotics, vaccines, or any specific medical
initiatives to combat them. [note 3]
The principal evidence
that the vaccines are effective dates from the more recent period,
during which the dreaded polio epidemics of the 1940's and 1950's
have never reappeared in the developed countries, and measles,
mumps, and rubella, which even a generation ago were among the
commonest diseases of childhood, have become far less prevalent in
their classic acute forms since the MMR vaccine was introduced into
possibility that they act in some other way than by producing a
genuine immunity is suggested by the fact that the diseases in
question have continued to break even in highly vaccinated
populations, and that in such cases the observed differences in
incidence and severity have often been far less dramatic than
expected, and in some cases not measurably significant at all.
In 1977, 34 cases of measles were reported on the campus of UCLA in a student population that was 91% "immune," according to careful serological testing. [note 7]
In Pecos, New Mexico, during a period of a few months in 1981, 15 out of 20 reported cases of measles had been vaccinated, some of them quite recently. [note 8]
A recent survey of sixth-graders in a fully-vaccinated urban community demonstrated that about 15% of this age group are still susceptible to rubella, a figure essentially identical with that of the pre-vaccine era. [note 9]
Finally, although the yearly incidence of measles in the U. S. has fallen sharply from about 400,000 cases in the early 1960's to about 30,000 cases by 1974-76, the death rate remained exactly the same. [note 10]
And, with the peak
incidence now in adolescents and young adults, the risk of pneumonia
and liver enzyme abnormalities has risen to 3% and 20%,
respectively. [note 11]
Because the vaccine is
therefore a "trick," simulating the true or natural immune response
developed in the course of the actual disease, it is certainly
plausible to expect that such artificial immunity will tend to wear
off rather easily, and perhaps even require additional booster doses
at intervals throughout life to maintain optimal effectiveness.
Indeed, the basic fallacy
inherent in it is painfully evident in the fact that there is no way
to predict how long this partial or temporary immunity will last in
any given individual, or how often it will need to be re-stimulated,
because the answers to these questions clearly depend on the same
mysterious variables that would have determined whether and how
severely the same person, unvaccinated, would have contracted the
disease in the first place.
First, it has been clearly shown that when children vaccinated against the measles again become susceptible to it, booster doses have little or no effect. [note 12]
Moreover, in addition to producing pale or mild copies of the natural disease, nearly all vaccines also produce a variety of symptoms and ailments of their own, some of them more serious, involving deeper structures, more vital organs, showing less tendency to resolve spontaneously, and often more difficult to recognize as well.
Thus in a recent outbreak of the mumps in supposedly immune schoolchildren, several patients developed unusual symptoms such as vomiting, anorexia, and erythematous rashes without parotid involvement, and the diagnosis required extensive serological testing to exclude other diseases. [note 13]
The syndrome known as "atypical measles" is just as vague and covers a sufficiently broad spectrum to be easily confused with other infections or missed altogether, [note 14] even when it is thought of, and even though the illness may be considerably worse than the wild type, with severe pain, pneumonia, clotting defects, and generalized edema. [note 15]
Indeed, I have the sense that the vaccine-related ailments we are presently aware of represent only a very small part of the problem, and that many others will be identified once we take the trouble to look for them.
But even the few that have been described make it less and less plausible to suppose that vaccines produce a natural or healthy immunity that lasts for some time but then "wears off," leaving patients miraculously unharmed and unaffected by the experience.
During one episode she was hospitalized for tests, but her pediatrician found nothing out of the ordinary, and otherwise the child appeared to be quite well and growing and developing normally.
The only peculiar thing I could learn from the mother was that all three episodes had occurred almost exactly one month apart, and, on consulting her calendar, that the first one had come just one month after the third and last of her DPT injections, which had also been given at monthly intervals.
With the help of these calculations, the mother then also remembered that the child had had equally high fevers within hours of each shot, but the doctor had ignored them as common reactions to the vaccine.
On the slender thread of
that history with nothing else to go on, I gave the girl a single
oral dose of homeopathically diluted DPT vaccine, and she never had
another episode and has remained well since.
Secondly, because fever
is indeed the commonest known complication of the DPT vaccine and
the child remained quite well in between the attacks, her response
appeared to be a relatively healthy and vigorous one, disturbing in
its recurrence, but quite simple to cure. Indeed, it mainly prompted
me to wonder how the vaccine acts in those tens and hundreds of
millions of children who show no obvious response to it at all.
Already somewhat ambivalent about giving her any vaccines at all, the parents had belatedly consented to the first DPT, but no more, since the first episode had occurred roughly two weeks afterward. In spite of the usual acute fever remedies and other supportive measures, the temperature held at 104-105° for 48 hours, so I decided to investigate further.
The only notable finding was an extremely high white-cell count of 32,000 per cu.mm., of which 25% were neutrophils, many with toxic granulations,43% lymphocytes, 11% monocytes, and 21% young and immature forms.
Knowing nothing else
about the child, a pediatrician friend to whom I showed the slide
immediately recognized it as pertussis. As before, I gave a single
oral dose of the homeopathic DPT nosode, and the fever came down
abruptly within an hour or so, and the child has remained well
Though he had treated the
child successfully with homeopathic remedies on two previous
occasions, with shrinkage of the liver and spleen back almost to
normal size and a dramatic improvement in the blood picture, full
relapse had occurred both times within a week or two of each
For leukemia is precisely
a cancerous process of the blood and blood-forming organs (liver,
spleen, lymph nodes, bone marrow), which are also the principal
sites of the immune system. Insofar as the vaccines are able to
produce serious effects at all, the blood and the major immune
organs are certainly the logical place to begin looking for them.
It was this case that convinced me once and for all of the need for serious discussion of vaccine-related illness, since rigorous experimental proof of these matters will require years of painstaking investigation and a high level of public commitment to back it up that so far has not been made.
In addition to nasal
congestion and redness of the eyelids, the parents also reported
unusual behavior changes, such as extreme untidiness, wild and noisy
playing, and waking at 2 a. m. to get into their bed.
This fact reminded the mother that the boy had received the MMR vaccine in October, about two weeks before the onset of his illness, with no apparent reaction to it at the time.
Based on this
possibility, I gave the child a single dose by mouth of the
homeopathic nosode made from the rubella vaccine, and the symptoms
disappeared within 48 hours and did not come back.
Upon examination the whole right side of the face appeared swollen and tender, especially the cheek and the angle of the jaw, and the right eye was also red and congested. Looking a bit like a mild case of the mumps, he responded very well to acute remedies and has been in good health since.
First, this boy is a sort of prototype of the ordinary rubella vaccine case:
If the rubella component is suspected on account of the unusual pattern of lymph node involvement, the diagnosis may be confirmed by a favorable response to the rubella nosode.
Even more interesting was
the second illness, where parotid involvement suggests a delayed
activation of the mumps vaccine component, and thus raises the
frightening possibility of "mixed" or composite responses to two,
three, or more combined vaccines either simultaneously or over time.
Moreover, during that same period he had become much more prone to upper respiratory infections, although they were not particularly severe.
Since the mother was two months pregnant and the boy not ill at the time, I was in no hurry to treat him, but not long after the birth he developed acute bronchitis, with recurrent swelling and tenderness of the nodes.
After a dose of homeopathic rubella, the acute illness, cough, and swollen glands promptly subsided, but two weeks later he was back with a hard, tender nodule in the right cheek near the angle of the jaw and some pain on chewing or opening the mouth.
At that point I gave him the mumps nosode, and he has been well ever since.
As in the first case, the striking feature is the gradual or lingering pattern of the condition, with a definite tendency to become chronic and increased susceptibility to other illnesses and to weak, low-grade reactions in general, in contrast to the vigorous responses typical of acute diseases like measles and mumps when they are acquired naturally.
To consider that
possibility, I will examine the process of coming down with and
recovering from a typical acute disease like the measles, in
contrast to what we can observe after giving the measles vaccine.
Once inhaled by a susceptible person, the virus then undergoes a long period of silent multiplication, first in the tonsils, adenoids, and accessory lymphoid tissues of the nasopharynx, later in the regional lymph nodes of the head and neck, and eventually, several days later, passes into the blood and enters the spleen, the liver, the thymus, and the bone marrow, the visceral organs of the immune system. [note 16]
"incubation period," lasting from 10 to 14 days, the patient usually
feels quite well, and experiences few if any symptoms. [notes 17]
In other words, the
illness we know as "the measles" is precisely the attempt of the
immune system to eliminate the virus from the blood, mainly by
sneezing and coughing, i.e., via the same route that it entered in
the first place.
This splendid outpouring leaves little room for doubt that acute illnesses are in fact the decisive experiences in the normal, physiological maturation of the immune system as a whole.
For not only will children who recover from the measles never again be susceptible to it; [note 19] such an experience must also prepare them to respond even more promptly and effectively to whatever other infections they may acquire in the future.
Indeed, the ability to mount a vigorous, acute response to organisms of this type must be reckoned among the fundamental requirements of general health and well-being.
In contrast, when the artificially attenuated measles virus is injected directly into the blood, it bypasses the normal portal of entry, producing at most a brief, mild inflammatory reaction at the injection site, but no incubation period, no local sensitization, no real possibility of eliminating it via the same route, and no generalized immune response to prime the immune system in the future.
Indeed, by cheating the
body in this fashion, we have accomplished precisely what the
evolution of the immune system seems to have been designed to
prevent: we have introduced the virus directly into the blood and
given it free, immediate access to the major immune organs without
any obvious way of getting rid of it.
Indeed, I fear, exactly the opposite is true:
Far from producing a genuine immunity, then, I fear that vaccines act by suppressing or interfering with the immune response as a whole, as radiation, chemotherapy, steroids, and other anti- inflammatory drugs do.
Artificial immunization isolates antibody production, a single aspect of the immune process, and allows it to stand for the whole, in somewhat the same way that chemical suppression of an elevated blood pressure is taken as a valid substitute for healing the patient whose blood pressure happens to be elevated.
My suspicion is that
vaccines also make it more difficult to mount a vigorous, acute
response to infection in general, by substituting a much weaker
chronic response with little or no tendency to heal itself
It has been known for decades that live viruses, for example, can remain latent for years within the host cells without continually or indeed ever provoking acute disease.
In most cases, this is
achieved by attaching their own genetic material as an extra
particle or "episome" to that of the host cell and reproducing along
with it, allowing the host cell to continue its normal functions for
the most part, provided it follows encoded instructions to
synthesize viral proteins at the same time. [note 20]
In all of these forms, the latent virus survives as a foreign element within the target cell, so that the immune system must continue to make antibodies against it to the extent that it can still respond to it at all.
But with the virus permanently integrated into the genetic material of the host cell, these antibodies will now have to be directed against the cell itself.
The persistence of live viruses and other foreign antigens within the host thus cannot fail to provoke autoimmune phenomena, because destroying the infected cells is now the only possible way for this constant antigenic challenge to be removed from the body.
Since routine vaccination
introduces live viruses and other highly antigenic material into the
bloodstream of virtually every living person, it is difficult to
escape the conclusion that a significant harvest of autoimmune
diseases must surely result.
As the most familiar examples he cites our ability not only to mount an acute response to infection, but also to reject transplanted tissues or "homografts" from others of the same species, both of which achieve complete and permanent removal of the offending substance from the organism.
If he is correct, then latent viruses, autoimmune phenomena, and cancer evidently represent simply different aspects of the same basic dilemma, which the immune system cannot escape or resolve.
For all of them exemplify
varying degrees of chronic immune failure, states in which it
becomes equally difficult for the immune system to recognize its
cells as unambiguously its own and to eliminate its parasites as
But once the virus becomes latent in the cell, the serum concentration of circulating antibodies is very likely to wane, because they seldom cross the cell membrane and are also powerfully immunosuppressive in their own right. [note 25]
Indeed, the probable effect of circulating antibody after that would only be to keep the virus confined within cells and thus prevent any acute inflammatory response to it, until eventually, perhaps under cumulative stress or emergency circumstances, this precarious balance collapses, and antibodies are produced in large numbers against the cells, resulting in tissue destruction and other autoimmune phenomena.
In this sense, latent
viruses are like biological "time bombs," set to explode at an
indeterminate time in the future. [note 26]
They make a lot more
sense, and must indeed be reckoned as "healthy," if destroying
chronically infected cells is the only way to eliminate their
persistent and even more serious threat to life.
Tumors might then be described as "benign" insofar as the loss of histocompatibility remains strictly limited to their cell type or tissue of origin, and "malignant" to the extent that it spreads to other cell types, tissues, and organs, and even more remotely to other areas in the body.
In any case, if these speculations turn out to be accurate, the net effect of artificial immunization will have been merely to trade off the acute, epidemic diseases of past centuries for the weaker but far less curable chronic diseases of today, whose accumulated suffering and disability continue to appreciate through life, like a high-interest mortgage loan.
In the process, we have also introduced limitless new evolutionary possibilities for the future of ongoing in vivo genetic recombination within the cells of the race.
Boosters are recommended
only for women of childbearing age, when the risk of congenital
rubella syndrome is thought to warrant it, although the
effectiveness of the repeat dose is highly questionable.
Carrying it with them into Mexico undoubtedly contributed to the Spaniards' conquest of the Aztec Empire, in which entire villages were decimated by epidemics of smallpox and measles, leaving only small remnants of cowed and weakened survivors to face the bearded horsemen from across the sea. [note 27]
In more recent outbreaks
among isolated, primitive peoples, the death rate among measles
cases averaged 20 to 30%.[note 28]
This means that the
evolution of a disease like measles from a dreaded killer to a
routine disease of childhood is accomplished by the development of
"herd" immunity in young children, such when exposed they can
activate nonspecific defense mechanisms already in place, resulting
in the prolonged incubation period and usually benign, self-limited
course described above.
Pneumonia, by far the
commonest complication, is for the most part benign and
self-limited, [note 31] and even bacterial pneumonia developing on
top of it can be treated effectively.
Ironically, what it has
already done is to reverse the natural evolutionary process back to
its point of origin, where the disease is seen once again primarily
in adolescents and young adults, [note 32] and results in more
complications and a usually nastier and more disabling clinical
course than it does in younger children.
Such cases are never
included in the official statistics and are therefore routinely
omitted from most surveys of the problem. Indeed, merely injecting
the virus into the blood would naturally promote the development of
visceral complications involving the lungs, liver, and brain, for
all of which measles has a known affinity.
When contracted by children before the age of puberty, it too is a benign, self-limiting disease, recovery from which almost always confers lifelong immunity.
complication is meningoencephalitis, of which mild or subclinical
forms are not uncommon, but the death rate is extremely low, as is
the risk of serious or permanent impairment. [note 33]
Unfortunately, as a result of vaccination it too has become largely a disease of adolescents and young adults, [note 34] age groups which tolerate it much less well. Its commonest and most notorious complication is acute epididymoorchitis, which occurs in 30 to 40% of males affected past the age of puberty, and usually results in atrophy of the testicle on the affected side, [note 35] but the virus has shown a predisposition to attack the ovary and pancreas as well.
The greatest favor we could do for our children would be to expose them to measles and mumps when they are six or seven, which would not only protect them from contracting more serious forms of these diseases when they grow older, but also assist their immunological maturation with minimal risk.
It almost goes without
saying that this is very close to the actual historical evolution of
these illnesses before the MMR was introduced.
The sole impetus for developing a vaccine was the recognition of congenital rubella syndrome, involving viral damage to the developing embryo in utero during the first three months of pregnancy [note 38] and the peak of CRS incidence traceable to the rubella outbreak of 1964.
Once again, mandatory vaccination has transformed an almost entirely benign, self-limiting illness into a considerably nastier disease among teenagers and young adults of reproductive age, precisely the group that most needs to be protected from it.
By far the most effective
way to prevent CRS would be simply to expose our children to rubella
in grade school: reinfection does sometimes occur, but much less
commonly than after vaccination. [note 39]
Second, both vaccines are
prepared not with living diphtheria and tetanus organisms, but only
from poisonous substances elaborated by them, which remain highly
antigenic even when inactivated by heat, and protect not against
infection per se, but against the systemic effect of these toxins,
without which both infections would be of minor significance.
On the other hand, both
diseases are readily controlled by good sanitation and careful
attention to wound hygiene, and both have been disappearing rapidly
from the developed world since long before the vaccines were
Thus in the Chicago outbreak of 1969, 25% of the cases had been fully immunized; 12% had received one or more doses of toxoid and serologically tested as fully immune; and 18% tested partly immune by the same criteria. [note 40]
So once again we must face the probability that the toxoid has produced not a genuine immunity to the disease, but rather some sort of chronic immune tolerance to it, by harboring highly antigenic residues somewhere within the cells of the immune system, with probable long-term suppressive effects on the immune mechanism in general.
This risk is further compounded by the fact that all three of the DPT vaccines are alum-precipitated and preserved with Thiomersal, an organomercury compound, to retard their metabolic breakdown and excretion, so that the antigenic challenge they pose will continue for as long as possible.
The truth is that we do
not know and have never even attempted to discover what actually
becomes of these foreign substances inside the human body.
Much of the pressure to immunize at present must therefore be ascribed to the higher death rate in young infants, which has led to the terrifying practice of giving this most dangerous of vaccines to babies at 2, 4, and 6 months, when their mothers' milk could have protected them from all infections about as well as it can ever be done, [note 45] and its effect on the developing blood and nervous systems could well be catastrophic.
For all of these reasons,
the practice of mandatory immunization against pertussis should be
discontinued immediately, and studies undertaken to assess and
compensate the damage that it has already done.
The standard Sabin
vaccine is trivalent, consisting of attenuated live polio viruses of
each of the three strains associated with paralytic disease, and
seems quite safe, partly because it is administered orally, the same
way the infection is acquired, thus allowing recipients to develop a
kind of natural immunity at the normal portal of entry, the GI
Poliomyelitis thus cannot develop without a particular anatomical susceptibility in the host.
Even in the full-scale
epidemics of the 1950's, the attack rate of the poliovirus remained
very low, and the number of cases resulting in death or permanent
impairment remarkably small, in comparison with the huge number of
people exposed and at risk for it. [note 48]
Indeed, because the virulence of the wild-type virus was so low to begin with, it is difficult to see what further attenuation of it could possibly accomplish other than weaken the natural vigor of the immune response at the same time.
For the fact remains that
even the attenuated virus is still alive, and the people who were
anatomically susceptible to the wild type are presumably still
susceptible to it now, so that some of them will develop paralytic
disease from the vaccine, [note 50] while others may continue to
harbor the virus in latent form, perhaps within the same target
In any case, even for the polio vaccine, which is about as safe as any vaccine can ever be, the whole matter is clearly one of enormous complexity, and well illustrates the hidden pitfalls and miscalculations inherent in the temptation to beat nature at her own game, by trying to eliminate a problem that can't be eliminated, namely, the susceptibility to disease itself.
Perhaps the day may come when we can face the consequences of having fed live viruses to babies by the hundreds of millions, and can admit that we should have left well enough alone by addressing the art of healing the sick when we have to, instead of the technology of erasing the possibility of sickness when we don't have to and can't possibly succeed in any case.
Now that I have stated my views on the safety and effectiveness of the usual childhood vaccines, I hope that others of differing views will come forward and do the same.
That is why I am deeply troubled by the air of fanaticism in which vaccines are imposed on the public and serious discussion of them is ignored or stifled by the medical authorities as if the question had already been settled definitively and for all time.
In the words of Sir Macfarlane Burnet,
Apart from the truth or falseness of these claims, they exemplify the smug self-righteousness of a profession that worships its power to manipulate and control Nature itself, and of a society in which, as Robert Mendelsohn has said,
Indeed, in the case of vaccines, one would have to say methodically slow. In 1978, for example, when charged by Congress to formulate guidelines for Federal compensation of "vaccine-related injuries," the American Academy of Pediatrics issued the following restrictions on eligibility:
These restrictions would
automatically exclude all of the chronic diseases and anything other
than the very few adverse reactions that have been identified and
documented thus far, which clearly represent only a small fraction
of the problem.
Unfortunately, this is the sort of warning that very few people are willing or able to take seriously at this point, least of all the American Cancer Society or the American Academy of Pediatrics.
As René Dubos has said, we all want to believe in "the miracle," regardless of the evidence:
The idea of eradicating measles or polio has become attractive to us simply because the power of medical science makes it seem technically possible:
That is why we do not begrudge the drug companies their exorbitant profits and gladly volunteer the bodies of our children for their latest experiments.
essentially a religious sacrament of our own
participation in the miracle of medical science, a veritable auto-da-fé
in the name of modern civilization itself.
Still less would a rational being imagine that the illnesses from which we suffer are "entities" separable from the individuals who suffer them, or that with the appropriate chemical or surgical sacrament the separation can literally be carried out.
Yet these are precisely the miracles we are taught to believe in and the idolatries to which we in fact aspire.
We prefer to forget the
older and simpler but more difficult truths, that the susceptibility
to illness is deeply rooted in our biological nature, and that the
signs and symptoms of disease are the attempt of our own life energy
to overcome whatever we are trying to overcome, trying, in short, to
We are all truly at risk of illness and death at every moment; no amount of technology can change that.
Yet the mission of
technical medicine is precisely to try to change that, by standing
always in the front line against disease, and by attacking and
destroying it wherever and whenever it shows itself.
For myself, I prefer to stay with the miracle of life itself, which has given us not only illness and disease but also the arts of medicine and healing, through which we can acknowledge our pain and vulnerability and at times, with the grace of God and the help of our fellow humans, experience a sense of health and well-being that goes beyond tribe or country.
That is my religion, and though I will gladly share it, I do not force it on anyone.
The next step is to
address the issue of experimental verification, to try to sketch out
how to look for valid and repeatable evidence for the safety,
efficacy, and mode of action of the common vaccines.
Moreover, as I indicated in the text, a number of investigators have already entertained these ideas and even made them public.
The obvious reason why they have not been taken seriously is that they are heretical, that even taking the time to study them would require a "paradigm shift" of some magnitude. [note 58]
What would be a far more interesting and relevant measurement would be the degree to which a vaccine protects against the acute disease when it actually does break out, which could be readily ascertained by looking at its attack rate and severity among those fully or partly "immunized," as compared with their unvaccinated friends and neighbors.
Although saying nothing
about the possibility of immunosuppression, such a study would at
least give a truer measure of the vaccine's power to do what its
proponents want them to do.
The same result could of course be achieved far more efficiently simply by making the vaccines optional, as they are in West Germany, Sweden, the UK, and other developed countries, and thus allowing the experimental and control groups in effect to select themselves.
Conversely, our frantic
efforts to secure 100% compliance with the present mandate succeed
only in making such studies impossible.
Such a study would also measure the incidence and severity of the wild-type or acute disease when it does break out, rather than merely the titer or level of circulating antibody, which is probably far less relevant.
On the basis of the preliminary investigations I cited in the text, my hunch is that both the primary and booster doses of vaccine give considerably less protection in these situations than either a simple drop in incidence or a rise in antibody titer would indicate.
Furthermore, both kinds
of study could easily be carried out in suitable animal populations,
using vaccines against important diseases peculiar to each species,
like canine distemper, leptospirosis, feline leukemia, and so forth,
inasmuch as our basic concern remains the efficacy and mode of
action of vaccines in general.
This could be done relatively simply by measuring baseline antibody titers at regular intervals in everybody, and then retrospectively comparing them in a subgroup of vaccinated kids who later developed the disease with another comparable subgroup who did not.
Finally, both could be compared with identical subgroups among the unvaccinated, all or most of whom would presumably show no measurable titers at all prior to exposure.
This is precisely why the question of their effectiveness ultimately cannot be studied in isolation, without also addressing their mechanism of action in a more comprehensive fashion.
Indeed, the narrow issue of "effectiveness" is itself quite misleading, since it tends to focus our attention on the classic acute disease, and to ignore the broad spectrum of biological responses associated with bacteria, viruses, and the vaccines derived from them, including latent, subclinical, and chronic infection as well.
In particular, we are
already well acquainted with many situations in which inability to
develop acute disease represents the exact opposite of good health,
i. e., a condition of chronic immune tolerance rather than true
In the case of the pertussis vaccine, for example, careful prospective studies could measure the incidence and severity of blood and CNS abnormalities after vaccination at the usual times and at standard intervals before and after.
This could be done
relatively inexpensively by performing complete blood counts (CBC's),
brief neurological exams, and simple behavioral and psychological
assessments on self-selected groups of vaccinated and unvaccinated
The same format would also make it possible to sort out patterns of morbidity peculiar to each particular vaccine. Once again, the crucial importance of large groups of unvaccinated subjects is evident.
With regard to pertussis,
my clinical experience so far strongly suggests that the vaccinated
group would show a much higher incidence and morbidity from chronic
and recurrent infections, with significantly higher rates of
complications and disability (myringotomy, hearing loss, poor school
I hope I'm wrong, but
once again my clinical impression suggests that the vaccinated group
would fare significantly worse in all of these categories.
In this case, there would be two control groups:
Here I could simply
confess a theoretical bias that both control groups, while perhaps
as likely to contract the diseases in question, would show less
acute and chronic morbidity as a result of it than their vaccinated
counterparts, a bias for which I would gladly substitute more
After vaccinating or not vaccinating a given species against the diseases routinely targeted for that animal, we could then measure, for example, leucocyte and macrophage activity both in vivo and in vitro in response to various challenges, such as exposure to unrelated infections, allergens, and chemicals.
Other possibilities might
include comparing standard liver-function tests and the ability of
the spleen and bone marrow in both vaccinated and unvaccinated
animals to reject homografts or to respond to hemorrhage or blood
transfusion if necessary.
With the help of electron
microscopy, painstaking examination could also detect the presence
of viral DNA or RNA "episomes" or particles inside these same cells,
and confirm the suspicion of latency and chronic infection in the
case of the live vaccines at least.
The only obstacle to their being done is,