Are our children getting more immunizations than we did?
The answer is both surprising and interesting.

For reasons not fully apparent, immunizations excite our imagination.   The idea behind them is actually fairly boring, give a person exposure to a harmless part of a germ, and when the real germ comes along it won’t work, thereby preventing potentially very serious illness at little cost or risk.

But that’s not how the issue is often felt.  For many decades, there has been something about immunizations that excites fear and dread.   This article is about  the concern that we are giving our children a great many more immunizations, creating a big jump in the burden to their immune systems, and that this burden is of concern.

Recent Fears about Immunizations that have been Resolved

In the 1970’s and 1980’s the key fear was that giving your child the DTP shot would cause mental retardation.   It took 10-15 years and hundreds of millions of dollars to see if that fear was true, and then another 5-10 years once it was proven not to be so before we reached our current state- essentially no one believes or even worries that giving any immunization will cause their child to become mentally retarded.

In the years 2000-2014, the fear was that immunizations cause autism.   The exposure to mercury, the measles vaccine, and immunizations in general were widely feared to cause autism.   Once again, it took many years and hundreds of millions of dollars to find out if this fear was true.   And again, observations of children with and without immunizations proved immunizations had nothing to do with autism.  This time, a specific individual who helped create the fear was exposed as a charlatan.  

And as with mental retardation, it took many years for the proof that immunizations did not cause autism to lead to our national community to drop its fear of it doing so.  We are right now living through the collapse and resolution of that fear.

The remaining fear: we are exposing our infants to far more immunizations than we had

That leaves the question of overload as the dominant fear surrounding immunizations today.
The fear goes something like this.    A long time ago, infants got one shot at most at a visit, now they can be expected to receive 3 or 4 shots or immunizations at a visit.   The fear is that this overloads their immune system, causing harm to the baby and child.

Amazingly enough, our infants are receiving a fraction of the burden our grandparents did when they were babies.   In fact, the current immunization schedule delivers 96% less (!) burden than it did in 1960!

Let’s take a look at how this is possible. 

First of all, how many shots do our infants get compared to our grandparents?  When our grandparents were kids, they got one shot series and one oral vaccine series.  The shot was the DTP (for diphtheria-tetanus-pertussis [whooping cough]), and the oral drops were for polio.   The DTP required 5 shots over 5 years, and the polio required 4 doses over 5 years.  That made for a total of at most one shot at infant visits, and a grand total of 5 shots, or 9 immunizations if you include the 4 oral polio doses.  

But today, there is a proliferation of diseases we now can prevent.  The list has expanded from the starting point of diphtheria, tetanus, pertussis, and polio to now include the following:  meningitis from three different germs (Hib, pneumococcal, meningococcal), hepatitis (A and B), stomach flu (rotavirus), measles, mumps, rubella (German measles), and the diseases from the HPV (genital warts, throat and cervical cancer).  That’s a jump from 4 diseases, to 14 if you count all the germs for which routine immunizations are now available. 

So, how can you almost quadruple the number of shots and immunizations and still reduce the burden by 96%?

The answer lies in a key word for this worry- antigen.   At the heart of any plan to immunize lies a neat trick.  Give the body what looks like the germ, and it might just think it’s infected and create a response, even if the item given is a dead germ, or a piece of a germ.  Then, if the real germ shows up, as noted above, the body is ready, kills the germ rapidly, no real infections from that germ can happen.

For example, if you give someone a polio shot, that child receives a dead part of the virus, the body reacts as if the real thing is there, and so if a real polio virus shows up later, the child cannot get polio.

This trick works so well that we have eliminated smallpox from the planet, polio is almost gone, and infants almost never get meningitis or tetanus.

For every germ there is at least 1 protein, sometimes a few more, that give the signal to the body that this germ is here and lead to a reaction that leaves the body protected.   Any protein on any germ that the body uses to recognize it and create a response against it is called an antigen.

Now we come to how is it possible to give so many more shots, but reduce the burden so dramatically.

Yes, we give 14 rather than 4 immunizations, but each immunization contains far, far fewer antigens. 
Consider the pertussis, or whooping cough, vaccine.  Prior to the 1980’s that immunization was made by taking the whole pertussis bacteria and grinding it up.  The pertussis shot contained hundreds, if not thousands, of antigens.   The current pertussis immunization has only those proteins from the germ that actually make the immunization create a response that leaves one protected, which turns to be only 3-4 antigens.

The same is true for nearly all immunizations.  Today’s immunizations contain as few antigens as possible, and in most cases that means a massive reduction in the number of antigens.  Fewer antigens means fewer responses in your child’s immune system, a lighter load, a reduced burden, while at the same time getting a lot more protection.   We are actually able to protect our children from many more deadly diseases, but with a tiny fraction of the antigens being delivered.

What does this mean for the worry about giving so many immunizations at one time?

If you think about it, the reason given for wanting to spread out the immunizations, to give as few as possible at one time, is to reduce the burden on your baby’s immune systems.

But now we know that even giving 3-4 immunizations protecting against 7-8 illnesses, at one time, actually injects 96% fewer items than the single DTP shot and polio drink.
Further, there is no evidence at all that babies who get 3-4 immunizations at once suffer any harm compared to those who get 1.  

Another item to keep in mind is that immunizations actually do serve a purpose.  People who get immunized for meningitis by and large do not get meningitis, whereas people who do not get this protection can get meningitis.  The same is true for each disease we immunize for: polio, measles, whooping cough, tetanus, etc.  

What that means is that a decision to delay an immunization, is a decision to extend the time your child is at risk for very serious diseases.

 To make that last point more clear, we all know if someone decides not to immunize their child against measles, they could get measles.  What is not so well appreciated is that if one decides to delay the 1 year old measles immunization to age 3 years, then that child is put at risk to develop measles from age 1-3.  

Given that we are now exposing our infants and children to 96% fewer antigens, the argument to spread out immunizations offers no benefit and exposes children to needless risks.

1.        Immunizations should be yet another boring science event.   A harmless part of a germ is given, the body thinks the real germ is in the body and creates defenses against it, and when the real germ shows up, it can do no harm.  A disease is prevented or wiped out.
2.       Public reactions to immunizations have been very dramatic, over many, many years.
3.       Two waves of profound concern have come and gone since the 1970’s  The first was the fear that giving the DTP vaccine would cause a child to become mentally retarded.  The second was the fear that giving the child the MMR vaccine, or other vaccines, would cause a child to become autistic.  Both of these propositions have been soundly disproven.  The fear of retardation from vaccines has since completely disappeared, and the fear of autism from vaccines is rapidly disappearing right now.
4.       The main worry about vaccines that persists is that we are exposing our babies and children to a huge increase in germs and their components in today’s immunization schedule.  Surprisingly, that fear turns out to be dramatically untrue.  In fact, just the opposite is true- our children are exposed to 96% fewer types of proteins from germs in today’s immunizations compared to those few shots in 1965.
5.       Delaying immunizations provides no known protection against any known harm, but does expose our children to prolonged periods of risk during which they can come down with quite serious diseases- in fact, that unnecessary risk lasts as long as one chooses to delay the immunization.
6.       The common practice of spreading out immunizations is actually a very specific choice based on a fear that is likely the next to fade away.  As we all become more familiar with just how dramatically the burden on the immune system has disappeared, even with a full schedule, this fear will also go the way of other past fears.  
7.       We at Advanced Pediatrics will of course be most interested in addressing all your questions regarding immunizations, and will respect parents’ choices about them.  We look forward to working with parents to discuss and implement approaches that maximize the well-being of your children, and minimize the risks they face.
To your health,

*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

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