|
ABOUT HOMOEOPATHY > VACCINES
How many needle pricks can my
baby take ?
Experts recommend judicious use of vaccines
What’s being pumped into a baby’s body, ask
concerned parents ?
Under-reporting of adverse vaccine reactions
could jeopardise infants’ safety
Storage problem, government laxity raise concern
over oral vaccine
Building natural immunity can gear up body’s
response to future infections
How many needle pricks can my baby take ?
India’s human vaccine
market – estimated at over Rs. 680 crores – is viewed as a
gold mine by multinationals and national vaccine manufacturing
companies. in recent years, a dizzying array of vaccines has
been promoted for the prevention of chicken pox, hepatitis B,
rubella, rabies and typhoid, apart from those already
mandatory included in the national child immunisation progamme
for the prevention of polio, tuberculosis, diphtheria,
pertussis, tetanus and measles.
Advertising campaigns
extolling these vaccines have warned of the ‘dangerous
consequences’ to health should the public disregard
immunisation for children. However, concerned parents have
been left asking, "How many needle pricks can my baby take?"
there are more questions. What are these vaccines made of ?
What is the evidence of long-term immunity ? Are there
long-term complications ? What are the contra-indications and
side-effects ? Is there an alternative to vaccination ?
The Indian Academy of
Pediatricians strongly supports the use of the four vaccines
presently recommended in the government’s child immunisation
programme (BCG, Polio, DPT and Measles). In addition, it has
recommended the inclusion of the rubella and Hepatitis B
vaccines in the national programme. The academy now has a
further list of vaccines which it has declared optional.
Justifying the academy’s
faith in these vaccines, its secretary general GS Hathi cites
the disappearance of smallpox and the decline of polio as
examples of the efficacy of immunisation. The burden of
illness and death due to these infectious diseases has been
considerably reduced nationwide, he says.
Widespread faith in the
‘magic wand’ of vaccines has, however, come under increasing
scrutiny from both a section of the public as well as the
medical profession. At a recent meeting organised in Mumbai by
The Health Awareness Centre, a local NGO, an audience of about
200 concerned parents was eager to debate the available
evidence on vaccination and natural immunity. Many expressed
concern about the safety and efficacy of the whole-cell
pertussis vaccine (for whooping cough), as well as the
vaccines in the child immunisation programme for rubella,
hepatitis B and oral polio.
Vaccine scientist Jal
Mehta says that incidents of vaccine failure have been largely
responsible for the erosion of public confidence in
immunisation programmes. Failures have been known to occur
when the potency of the vaccine is not assured, leading to an
outbreak of the disease in vaccinated children. in many parts
of India, Mr. Mehta adds, the blame rests with the conditions
under which these vaccines are stored.
Before conducting a
vaccination programme, he say, a child’s health record must be
checked to ensure that there is no previous history of
neurological disorders like convulsions, asthma, known
allergies or evidence of immune suppression. In such cases, a
vaccine should not be administered until the child’s health
has stablised.
Field evidence has,
however, revealed that such questions are not asked by
government health staff. While the BMC has created a special
cell to monitor adverse vaccine reactions, such incidents are
not appropriately investigated, admit senior government
doctors. Nor is there a system for receiving regular reports
from private medical practitioners.
UP
Experts recommend judicious use of vaccines
A dizzying array of
vaccines has been promoted for the prevention of chicken pox,
hepatitis B, rubella, rabies and typhoid in the national child
immunisation programme for the prevention of polio,
tuberculosis, diphtheria, pertussis, tetanus and measles.
The Brihanmumbai
Municipal Corpn (BMC) has created a special cell to monitor
adverse vaccine reactions. Recommending a more judicious use
of vaccines, health experts say that immunisation should be
part of a total package that includes clean water, nutrition
and environmental hygiene. In fact, according to some medical
historians, several Western societies have seen a decline in
many infectious diseases long before vaccines appeared on the
scene largely because of improved standards of living.
Many illnesses like
chicken pox are best allowed to run their natural course in
childhood, says Mumbai-based general practitioner Dr. DM
Dayal. According to him, chicken pox in childhood helps create
immunity against severe attacks of shingles or herpes in
adulthood. Evidence of long-term immunity provided by the
newly developed chicken pox vaccine is still awaited, Dr.
Dayal says, and, as of now, he has chosen not to recommend it
to his patients.
Achala Daga, associate
professor of community and preventive medicine at the JJ
Hospital, says that what needs to be urgently addressed is
mal-nutrition, the underlying cause of many diseases among
children under give. Immunisation by itself cannot save these
children from untimely deaths. Dr. Daga adds that while there
has been a decline in the incidence of some
vaccine-preventable diseases like polio, today’s major
culprits are pneumonia, diarrhoea and malaria.
UP
What’s being pumped into a baby’s body, ask concerned
parents ?
Do today’s young,
educated and aware parents buy into the immunisation mantra ?
No way. They now want information on what is being pumped into
their baby’s body. They demand an assurance on the safety of
vaccines and evidence of long-term immunity against disease.
Explaining the logic of
immunisation and the vaccine manufacturing process, Shankar
War, who is in charge of the bacterial vaccine department at
Mumbai’s Haffkine Institute, explains it thus: When a
disease-causing micro-organism enters the body, the immune
system is stipulated to fight the invader. The fighter cells
produce antibodies to neutralise the invasion. If the
individual’s immune mechanism is compromised by poor nutrition
or environmental hygiene, or drug abuse, the body takes a
longer time to marshall its response.
Vaccines, meanwhile, are
injections that contain small amounts of bacteria or viruses,
with the harmful elements removed. bacteria causes diseases
such as diphtheria, pertussis and tetanus, while viruses lead
to polio, hepatitis, rubella, measles, mumps, chicken pox and
rabies. When vaccines are injected, they artificially
stimulate the body to produce antibodies. Consequently, when
the real invader enters, the system is already geared to
recognise the enemy and antibodies are promptly released to do
battle.
Vaccine manufacturing
relies on the use of live organisms that are obtained from
"internationally reputed institutions." These are ‘cultured’
(grown) in the laboratory. For multiplication, the bacteria or
virus depends on the presence of other micro-organisms that it
can feed on – and these are provided by animal or human cells.
By entering the cell and destroying it, the organism then
finds the means to grow.
The organism is killed or
kept alive, depending on the specific vaccine requirement. For
instance, vaccines like oral polio, rubella, measles and mumps
utilise the live but weakened (attenuated) virus. (Animals are
repeatedly infected with the virus over a long period of time
until the virus loses its virulence and is weakened.)
The rabies and the Salk
polio vaccine (named after its inventor, Jonas Salk) utilise
the ‘killed’ virus, which undergoes treatment with heat and
drugs. Although dead, the parasite still stimulates an
antibody response.
The tetanus vaccine
utilises the toxin excreted from the bacteria. The hepatitis B
vaccine uses a new technology called ‘recombinant DNA
technology.’ Here, the genetic information of the virus that
causes this disease is isolated. This reveals the mechanism by
which the hepatitis B surface antigen is manufactured. When
injected into someone, it produces antibodies that fight the
virus.
Meanwhile, the animal or
human cells, used to ‘culture’ the parasite are generally
derived from three sources. They could be ‘human diploid
cells’ derived, for instance, from the lung of a human foetus.
Or they could be ‘vero cells’ from the kidneys of the African
green monkey, or primary chick embryos cells. Once obtained
from the original host, a ‘cell line’ is developed and
maintained in the laboratory and there is no need to go back
to the original host.
The only exception,
however, is in the case of the live (oral) polio vaccine.
Every bulk batch of the polio vaccine requires a return to the
monkey host for obtaining fresh cells, confirms KK Das,
Manager, Oral Polio Vaccine. Haffkine Institute.
A vaccine has a
shelf-life of upto three years, provided it is consistently
maintained at a stable refrigeration temperature of two to
eight degrees Centigrade.
The main concerns about
the vaccine manufacturing process focus on the instability of
the micro-organism, impurity in the ‘cell line’ and the
toxicity of the purification and stabilising agents. The
latter include chemicals and heavy metals like mercury.
Vaccine scientist Jal
Mehta says there is a ‘"far-fetched chance" that mutation can
take place in vaccines when there is chemical, bacterial or
radioactive contamination that enters the genomes of the virus
and changes its chromosomal pattern. The live polio vaccine,
for instance, is highly sensitive to unstable temperature and
s exposed to contamination if the vial is opened and left
unutilised for several hours by health workers.
Several Western
scientists have expressed concern about the use of primate
tissue in vaccine manufacturing, and have urged that a
‘serious effort" be made to stop its use. Last year, Western
newspapers had reported the possibility of an experimental
oral polio vaccine used in Africa in the 1950s being
contaminated with the HIV virus present in the monkey cells
used in the manufacturing process. This, they said, could have
led to the virus jumping species and finding a new host in
humans.
UP
Under-reporting of adverse vaccine reactions could
jeopardise infants’ safety
Seem, a Mumbai housewife,
says her baby was a "bubbly, smiling, healthy and responsible
child" – that was until the child was given her first shot of
the DPT (diphtheria, pertussis and tetanus) vaccine at three
months. It was after that the baby started to ‘rock herself".
The doctors Seems consulted assured her that this was
‘normal’. When the baby was 15 months, she was administered
the MMR (Measles, Mumps and Rubella) vaccine.
"Thereafter, my child
completely withdrew. her babble disappeared, she would not
come to us, she would only look at my feet. I strongly suspect
that it was because of a defective vaccine that my baby
developed features of autism (a neurological disorder)."
There are many Indian
parents like Seema whose story has not come to public
attention because of the social stigma attached to autism. In
Mumbai, the health authorities have not heard of such
vaccine-damaged children. This is because doctors who
administer the vaccine usually do not report cases of adverse
vaccine reactions to the municipal authorities.
In the developed
countries, where there is greater public awareness, vociferous
questioning has forced governments to look this issue squarely
in the face. When some infants in the UK and Japan died after
being administered the whole cell pertussis vaccine (the ‘P
component in the DPT vaccine), a massive public outcry
prompted the governments concerned to suspend use of that
vaccine.
Harvad University’s Dean
of Public Health, Barry Bloom, states in a recent interview
that while the whole cell pertussis vaccine has worked well,
it does have some side-effects, with one in 30,000 children
becoming neurologically damaged.
Suspension of the vaccine
in the UK, however, led to an increase in the incidence of
whooping cough, says Mr. Bloom. This triggered research
leading to the development of the cellular pertussis vaccine,
which Mr. Bloom says is more expensive and less toxic.
The cellular vaccine has
been licensed for use in Japan since 1981 and in the US since
1996 for children two months and older, confirms Stanley
Plotkin, a leading vaccine scientist, who recently visited
Mumbai, India, however, continues to use the whole cell
pertussis vaccine in its national child immunisation
programme.
Cases of healthy babies
being damaged by the whole cell pertussis vaccine in the West
have been documented by H. Coulter, a medical historian, and
B. Fisher, vice present of ‘Dissatisfied Parents Together’, in
their book. ‘A shot in the dark’. The adverse reactions
include convulsions, shock, abnormal screaming episodes and
‘sudden infant death syndrome’ (stoppage of breathing). The
long-term complications include learning disabilities and
hyper-activism, among other forms of brain damage. Such
incidents are under-reported by doctors, for fear of
malpractices suits, the authors of the study say.
Babies who suffer
progressive neurological disease should not be administered
the pertussis vaccine. say manufacturers of the vaccine here.
But is that condition apparent to parents when the first dose
of DPT is mandatorily given at six weeks of age in India ?
A spokesperson of The
Indian Academy of Pediatrics says, "The whole cell vaccine
does give more local reactions. Unless a control trial is
done, it is difficult to talk abut the long-term reactions. We
have always taken the stand that the cellular vaccine is
better than the whole cell, because of the complications that
occur after vaccination. But it is not available in our
country. We have not, however, advocated use of the cellular
vaccine to the government."
A vaccine against rubella
or German measles is now being advocated for inclusion in the
child immunisation programme, to be followed by a booster shot
for adolescent girls. While Indian data on rubella incidence
is inadequate, extrapolations based on worldwide data have
resulted in the claim that the estimated irrevalence in India
is 100-200 per 100,000 population.
A harmless childhood
disease, rubella produces mild symptoms that can pass
unnoticed. Children who contract the infection are likely to
acquire lifelong immunity. Rubella is, however, dangerous for
women in the first six weeks of pregnancy, causing congenital
mal-formations, deafness and mental retardation in babies. if
rubella occurs after the first trimester of pregnancy, the
incidence of foetus abnormality is low, says Mr. Plotkin, who
developed the rubella vaccine.
US studies show that 36
per cent of the young women vaccinated against rubella in
infancy lose their immunity by the time they are adolescents
(Neil Miller, ‘Vaccines and natural health’, Mothering,
Spring, 1994). Those who have never acquired natural immunity
because of the vaccinations in childhood, run the risk of
contracting rubella while pregnant.
Mr. Plotkin says it is
‘easier to vaccinate babies rather than adults". Routine
vaccinations of infants would reduce the circulation of
rubella in the population, he adds. But for that to happen,
governments must ensure that atleast 80 percent of the child
population is covered by their programmes.
A simple but expensive
IgM antibody test already exists to detect whether a woman, on
the verge of motherhood, has antibodies to rubella. No effort
has, however, been made to develop a cheaper test. The
vaccine'’ manufacturers insist that it is easier to vaccinate
the entire population of babies instead.
UP
Storage problem, government laxity raise concern over oral
vaccine
India’s record in
vaccinating 121 million children against polio over two days,
December 6 and 7, 1997, has been cited as one of the "most
staggering achievements in the history of public health" by
Harvard University’s Dean of Public Health, Barry Bloom.
Mr. Bloom, a staunch
proponent of vaccines, has spoken glowing of the campaign in
the US as well, saying that polio is now virtually extinct in
that country. However, he admitted in the course of a recent
interview to a medical journal, that there were still eight to
15 cases reported every year in the US, and that these were
"all derived from a single mutation in one of the live polio
vaccines that causes the virus to revert to virulence."
The US based Centers for
Disease Control are on record to say that the oral polio
vaccine using the live virus has become the dominant cause of
polio in the US today. This, say health experts, raises cause
for concern.
Polio is held to be a
contagious disease caused by an intestinal virus that may
attack the nerve cells of the brain and the spinal chord. In
1955, Jonak Salk, an American physician and microbiologist,
developed a killed-virus vaccine against polio. In 1959,
Albert Sabin, also an American physician and microbiologist,
developed a live-virus 9oral) vaccine against polio. Both
vaccines are considered safe and effective.
The oral, live-virus
polio vaccine is now widely used in India’s child immunisation
programme. In the absence of a monitoring system to detect
cases of polio among those who have been vaccinated, there are
no studies on the efficacy of the immunisation campaign. Nor,
for that matter, have there been widespread complaints on
record. However, there have been some voices of dissent.
In a recent interview,
Pushpa Bhargava, founder director of the Centre for Cellular
and Molecular Biology, Hyderabad, questioned use of the oral
polio vaccine, stating that it provided unreliable immunity.
"OPV has not worked in this country. All evidence available as
of today supports this view."
Dr. Indira Nath of the
All India Institute of Medical Sciences has stated that her
hospital sees numerous polio victims who have had the
mandatory drops.
Health professionals say
that given the instability of the oral polio vaccine, the
often improper storage facilities in this country and laxity
in administration of the vaccine by health workers, it may end
up being defective. Further more, children whose immunity has
been depressed due to a variety of factors, may respond
adversely to the vaccine.
In the US, the
instability of the live virus polio vaccine has now caused its
use to be restricted to the first dose. Subsequent booster
shoots use the killed virus, reports Mr. Bloom.
Some scientists have been
gone so far as to question the use of the polio vaccine,
saying that in the West, the decline in the incidence of polio
occurred long before the appearance of the vaccines.
"Many people mistakenly
believe that anyone who contracts polio either becomes
partially paralysed or dies. However, in most infections
caused by polio, there are few distinctive symptoms," say W.
Volk and M. Wheeler in their book, ‘Basic Microbiology’.
"In fact, the natural
polio virus produces no symptoms at all in over 90 percent of
the people who are exposed to it, even under endemic
conditions," add M. Burnet and D. White in ‘The Natural
History of Infectious Disease.’
This has led more than
one scientific researcher to conclude that the small
percentage of people who do develop paralytic polio may be
"anatomically susceptible" to the disease. The vast remainder
of the population may be naturally immune to the polio germ,
says Richard Moskowite, DD, (‘Immunizations: The Other Side’).
According to some medical
historians, long before the Salk killed-virus vaccine was
introduced, the polio death rates in the US and the UK had
already declined on their own by 47 percent and 55 per cent
respectively. Statistics show a similar decline in other
European countries as well (Michael Anderson, International
Mortality Statistics, Washington DC, Facts on File, 1981).
These historians say that
when the vaccine did become available, many European countries
questioned its effectiveness and refused to inoculate their
citizens systematically.
In 1948, at the height of
the polio epidemic in the US, Dr. Benjamin Sandler, a
nutritional expert at the Oteen Veteran’s Hospital, detailed a
relationship between polio and the excessive consumption of
sugars and starches. He complied records showing that
countries with the highest per capita consumption of sugar had
the greatest incidence of polio. He claimed that such ‘foods’
dehydrated the cells and leeched calcium from the nerves,
muscles, bones and teeth. A serious calcium deficiency, he
said, precedes polio.
UP
Building natural immunity can gear up body’s response to
future infections
Even as concerns remain
about the safety and efficacy of certain vaccines used in the
child immunisation programme is there a case to be made for
the limited use of vaccines in children and adults ? Are
vaccines the only means of building immunity against disease,
or is there an alternative method ?
Medical professionals who
endorse the use of vaccines point to their necessity in time
of epidemics (outbreak of meningitis, Japanese encephalitis
and influenza) and as therapeutic preventive treatment
(anti-rabies vaccine). Dissenters argue against vaccinations
on several counts.
For instance, some would
argue that the use of the anti-rabies vaccine in India is a
double-edged sword. Government hospitals in India continue to
use a ‘nervous tissue vaccine’ against rabies. V. Srinivasan,
a virologist and manufacturer of the modern tissue culture
rabies vaccine, is of the view that the nervous tissue
vaccine, which is cheaply available, tends to be administered
in all dog bite cases, despite causing adverse reactions in
some patients.
According to Mr.
Srinivasan, those in high-risk groups, who routinely deal with
animals, should be vaccinated against rabies. But, he adds, it
is not recommended as a matter of routine for the general
population. The vaccine also provides treatment against rabies
after a dog-bite.
Experts in preventive and
community medicine, meanwhile, recommend the use of preventive
shots against meningitis or Japanese encephalitis at the start
of its outbreak in any given area. They emphasise the
importance of a ‘disease surveillance mechanism’ in districts
that can serve as a timely warning and enable the health
authorities to launch immunisation campaigns. While the
influenza virus is reputed to be highly unstable,
anti-influenza shots are recommended for the old and the very
young who are vulnerable to severe bronchial pneumonia.
Advocates of a natural
health movement, on the other hand, say that building natural
immunity against disease can be an alternative to vaccines.
They argue that vaccines inject microbes directly into the
blood-stream without censoring by the liver. Their view is
that the persistent presence of viruses and other foreign
proteins within the cells of the immune system leads to
chronic and degenerative diseases.
These advocates add that
childhood diseases are decisive experiences in the
physiological maturation of the immune system and prepare the
body for prompt and effective response to future infections.
They should, therefore, not be suppressed.
They subscribe to the
views of German bacteriologist Guenther Enderlein which hold
that certain bacteria are able to take on multiple forms
during a single life-cycle. When a person is healthy, these
microbes live in a symbiotic relationship with other cells and
play a helpful role in the body’s immune system. Any severe
deterioration of the body’s internal environment, however, and
they may change into disease-forming agents. Thus the germ is
nothing but the "terrain is everything".
These researchers believe
that a healthy "terrain" is dependent on a proper diet,
particularly foods that are unrefined, organically grown and
preservative-free. An improper diet tends to overwhelm the
system and lead to disease, which is the cleansing effort of
the body to rid itself of excess toxins and waste material.
The natural health
movement believes that a healthy body requires adequate rest
and sanitary living conditions. When all these requirements
are met, many diseases will pass an ‘subclinical infections’
without acute illness, or if there is illness, it will be
relatively mild.
Alternative systems of
medicine, such as homoeopathy, also question the basis of
vaccinations. According to practitioner Zubin Marolia,
homoeopathy believes that some symptoms resulting in, say,
ordinary fevers or abscess, are a part of the body’s natural
method of ejecting toxins and should not be suppressed.
The debate, for the
moment, appears to be inconclusive.
UP |
|
