Tuesday, November 5, 2013

"My Crystal Clear Stance on Vaccination" #1: Vaccination Is Not Immunization

Some chiropractors (and other alternative medicine types) claim that "vaccination is not immunization". Here is a sample claim (there's also a whole book, which I will review later).

"My Crystal Clear Stance on Vaccinations" by Kurt Perkins DC, posted May 2012
The essay by the chiropractor has a number of factual inaccuracies, which I will address in a series of posts.

Text version of image, above:
Clarification needs to be created regarding VACCINATION vs. IMMUNIZATION.  I’m all for immunization.  The problem created by media and pharmaceutical influence is that people equate immunization with vaccination.  Vaccination is simply injecting something into your body.  This does not create immunity for your body.  These are 2 totally separate entities.
Commentary:
The chiropractor does not explicitly define what he means by "immunization".  The accepted medical meaning is "the process by which an individual's immune system becomes fortified against an infectious agent".  The chiropractor also has a unique definition of vaccination, "simply injecting something into your body". (Note: not all vaccines are injected; some are inhaled or ingested. But onwards.) The accepted medical definition of "vaccination" is something like "introducing a killed or weakened infectious organism into the body in order to stimulate the body's immune response to said organism, without eliciting disease."  Immunity is defined as "Protection against a disease".

Note that the chiropractor does not provide references for his assertion.

The assertion that "vaccination does not create immunity for your body" is factually wrong.  See for example the primer at Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book), which is available free online at http://www.cdc.gov/vaccines/pubs/pinkbook/index.html. At the foot of the post I've listed some free, online videos on the immune system. Or you could peruse the resources at the National Network for Immunization Information, NNii, starting with How Vaccines Work, http://www.immunizationinfo.org/parents/why-immunize/how-vaccines-work.  The very shortest version possible:

How vaccines work
  1. Specific antigens are introduced into the body (injected, inhaled, swallowed)
  2. Antigens evoke immune response (B and T cells)
  3. B cells produce antibodies
  4. Antibodies destroy antigen
  5. Memory B and T cells are formed

Back to the chiropractor's essay:



Text version, with comments
Another thing that urks [sic] me is my ‘mom’s’ comments about me leaving out stuff and therefore destroying my credibility.   I would like to add I make ZERO money off of this blog.  I may book some speaking gigs from it but those revenues will come nowhere near the $20 BILLION per year the makers of vaccines cherish.  Who do you think has more weight on their shoulders to hide information?  Huh, mom?  Huh?
The assertion: vaccines are profit centers for pharmaceutical companies, therefore they are suspect, if not frankly bad. The chiropractor derives no income from the blog, therefore everything he says is true. I am sure the logical holes in the assertion are easy to spot.

The $20 billion figure is not far off, according to FierceVaccines, but it is important to note that the $20 billion is revenue, not profit. If the chiropractor doesn't understand the distinction, he won't remain in business long.

Turning back to the chiropractor's comments:
With building immunity, it’s a natural process.  With that natural process, your body uses many defenses.  The first layer of defense is your skin.  This blocks out any harmful opportunistic buggers. With a vaccine, this law of nature is totally bypassed by injecting you with a needle full of stuff your skin would never allow past it. 
First, yes, the skin is an important organ in the body's defense, providing a mechanical barrier against invasive organisms, but technically it isn't part of the "immune system" as medical professionals know it. Second, the chiropractor is invoking some sort of imaginary "law of nature".  That is, he is making the argument that vaccination is unnatural and therefore bad.  Well, there are natural things that are "bad" -- think of poison oak, for example, or the thorns on plants, or even infectious bacteria or viruses. They're natural too. The chiropractor is suffering from the logical fallacy known as "the appeal to nature".

Turning back to the chiropractor's comments:
You also have a respiratory system that also aids in defense.  You cough, you sneeze, and you blow your nose, in attempt to expel the potential invader.  Coughing, sneezing, and snorting are results of your immune system working.  Don’t suppress it with fever reducers, anti-histamines, etc.  You’re just making it easier for the invader.
Yes, the respiratory system is an important defense mechanism against infectious agents and other noxious particles in the air, courtesy of the cilia and mucous membranes lining the respiratory tract. Coughing and sneezing can also be a response to an existing infection, rather than a way of repelling an infectious agent.  Second, how does the chiropractor imagine that respiratory viruses like measles spread from person to person?  I don't know about his beliefs, but the facts are, measles are spread via the respiratory system. So the respiratory system is also a vehicle for infection, a point the chiropractor seems to have missed.

Turning back to the chiropractor's comments:
You also have your gut-associated lymph system to fight with the stronger stuff.  If your system is so deficient to get past these natural defenses,  the potential invader, live or dead, enters the blood stream.  Once something is in your blood stream, it can be transported any anywhere in your body, not good at all.  It’s like open bar at a chiropractic convention. 
First, this is rather a naive understanding of the utility of the lymph system, and the inter-relationship between the lymph system, the blood system, and the immune system. In particular, the chiropractor doesn't seem to understand that the immune system consists of elements in both the blood system and the lymph system.  Second, there's the chiropractor's assertion that if an infectious organism gets past the lymph system, then the patient's lymph system (or maybe he means the immune system, it's hard to tell) is somehow "deficient".

Turning back to the chiropractor's comments:  
A vaccine violates all laws of natural immune defenses by taking a potential pathogen along with all the TOXIC ingredients (aluminum, formaldehyde, adjuvants, etc) directly into your blood system.  This process would never occur in building natural immunity. That last sentence is kind of an oxy-moron [sic]. Immunity is a natural thing.  Vaccines are an artificial thing.
First, there are no "laws of natural immune defenses", nor is vaccination any more a violation of "natural immune defenses" than a bee-sting or a laceration.

Second, injected vaccines (as opposed to oral or inhaled vaccines) aren't injected "directly into your blood stream", but into muscle tissue (IM) or under the skin (SC) as this image illustrates:

Image Source: http://www.immunize.org/catg.d/p3085.pdf

Third, the chiropractor doesn't seem to understand the process of attenuating or killing any pathogens used in vaccination, or is dishonestly alleging that the ingredients of vaccines can themselves always cause disease.

Fourth, the chiropractor yells "Toxic!" without appearing to have any sort of understanding of the role of aluminum or formaldehyde in vaccine design and manufacture (safety of ingredients and the role of each will be discussed in a later post), or that aluminum and formaldehyde are naturally present at all times in the human body.  (See http://www.atsdr.cdc.gov/phs/phs.asp?id=1076&tid=34 and http://www.chop.edu/service/vaccine-education-center/vaccine-safety/vaccine-ingredients/formaldehyde.html.

Fifth, the chiropractor doesn't seem to understand that aluminum (in the form of gels or salts) are the only vaccine adjuvants currently licensed for use in the United States. (source http://www.cdc.gov/vaccinesafety/concerns/adjuvants.html ) This basic mistake does not increase my confidence in the chiropractor's deep understanding of vaccines. 

Sixth, the chiropractor commits the genetic fallacy, an error in logic in which the proponent shifts the focus onto attributes or origins.  It leverages existing negative perceptions to make give a negative slant to an element, without actually presenting a case.

Finally, the chiropractor is again indulging in  "the appeal to nature".

Summary:


The chiropractor appears to lack a basic understanding of high school level biology.

Within so many errors in a public statement such as this, one wonders what other medical errors and mistakes he commits on a daily basis with patients. 

For the Curious:

A brief, nontechnical description of the immune system, starting with a graphic representation of the layers of the immune system:

Source: http://www.softchalk.com/lessonchallenge09/lesson/ImmuneSystems/index.html
The immune system is composed of organs, tissues, cells, and chemical messengers that interact to protect the body from external invaders and its own internally altered cells. The chemical messengers are cytokines which are secreted by cells of the immune system that direct immune cellular interactions. Lymphocytes (leukocytes that are categorized as either B cells or T cells) secrete lymphokines. Monocytes and macrophages secrete monokines. Interleukins are a type of cytokine that send messages among leukocytes to direct protective action. The best way to understand this system is through the body's various levels of defense. The goal of pathogens is to breach these levels to enter the body, reproduce, and subsequently exploit healthy tissue, causing harm. The immune system's task is to stop them. 
The above graphic illustrates the levels of defense. The two outside circles represent nonspecific immunity and its two levels of defense. the inner circle represents the various mechanisms of specific immunity, which can be natural (genetic) or acquired in four different ways. Most pathogens can be contained by the first two lines of nonspecific defense. However, some pathogens deserve a "special" means of protection, which is discussed under "Specific Immunity."
Specific Immunity
Specific immunity may be either genetic - an inherited ability to resist certain diseases because of one's species, race, sex, or individual genetics - or acquired. Specific immunity is dependent on the body's ability to identify a pathogen and prepare a specific response (antibody) to only that invader (antigen). antibodies are also referred to as immunoglobulins (lg). The acquired form can be further divided into natural and artificial forms, which in turn can each be either active or passive.  
Specific immunity is dependent on the agraulocytes (lymphocytes and monocytes) for its function. The monocytes metamorphose into macrophages, which dispose of foreign substances. The lymphocytes differentiate into either T lymphocytes (they mature in the thymus) or B lymphocytes (they mature in the bone marrow or fetal liver). Although both types of lympocytes take part in specific immunity, they do it in different ways. 
The T cells neutralize their enemies through a process of cell-mediated immunity. This means that they attack antigens directly. They are effective against fungi, cancer cells, protozoa, and unfortunately, organ transplants. B cells use a process of humoral immunity (also called antibody-mediated immunity). This means that they secrete antibodies to "poison" their enemies.
Types of Acquired Immunity
Acquired immunity is categorized as active or passive and then is further subcategorized as natural or artificial. All describe ways that the body has acquired antibodies to specific diseases. 
Active acquired immunity can take either of the following two forms:
  • Natural: Development of memory cells to protect the individual from a second exposure.
  • Artificial: Vaccination (immunization) that uses a greatly weakened form of the antigen, thus enabling the body to develop antibodies in response to this intentional exposure. 
Passive acquired immunity can take either of the following two forms:
  • Natural: Passage of antibodies through the placenta or breast milk.
  • Artificial: Use of immunoglobulins harvested from a donor who developed resistance against specific antigens
Another quick canter through the immune system: 
Source:OneMinuteMedicalSchool, http://oneminutemedicalschool.com/2013/02/13/immuneoverview/

Source: http://tinyurl.com/vaxvswild

What's the difference between a vaccine-induced immune response and a wild-disease induced one? The way the immune system responds is the same. It only differs in terms of the scale and size of the response. You get a full blown immune response to the wild disease that may involve serious sickness, hospitalization or even death. Vaccination reduces or prevents disease and is far, far safer. 

Sources

Agency for Toxic Substances and Disease Registry, Public Health Safety Bulletin on Aluminum  http://www.atsdr.cdc.gov/phs/phs.asp?id=1076&tid=34

Atkinson W, Wolfe S, Hamborsky J, eds.  Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book) Course  12th Edition Second Printing (May 2012) http://www.cdc.gov/vaccines/pubs/pinkbook/index.html

Centers for Disease Control and Prevention Vaccine Safety,  http://www.cdc.gov/vaccinesafety/index.html

Children's Hospital of Philadelphia Vaccine Information Center, http://www.chop.edu/service/vaccine-education-center/home.html

Immunization Action Coalition http://www.immunize.org/

McNair JC, Baltimore Community College, The Lymphatic and Immune Systems http://www.softchalk.com/lessonchallenge09/lesson/ImmuneSystems/index.html

National Institute of Allergy and Infectious Disease, The Immune System http://www.niaid.nih.gov/topics/immunesystem/Pages/default.aspx

National Network for Immunization Information, "How Vaccines Work",  http://www.immunizationinfo.org/parents/why-immunize/how-vaccines-work

Palmer E, Bryant A,  Top 5 Vaccine Companies by Revenue, FierceVaccines 2012 (March 14, 2013) http://www.fiercevaccines.com/special-reports/top-5-vaccine-companies-revenue-2012

Tarzwell R MD, One Minute Medical School, Overview of the Immune System http://oneminutemedicalschool.com/2013/02/13/immuneoverview/

Your Logical Fallacy Is (website) https://yourlogicalfallacyis.com/ (note: I have chosen to use this website, as informal as it is, because it is accessible to people without formal training in logic, argumentation,  or the scientific method. There are other excellent sites such as http://www.nizkor.org/features/fallacies/)

Video Resources

Broad Institute Midsummer Nights' Science series An Immune System Primer: Vaccines, allergies, and immune-related disease https://www.youtube.com/watch?v=AqgU5KdZT8M

University of California Television (UCTV) University of California Television (UCTV)· Your Immune System 101: Basic Immunology: Nuts and Bolts of the Immune System, https://www.youtube.com/watch?v=mFNxXfwlP3A&list=PLD44D26A1C7FDE43F&index=4 and Introduction to Clinical Immunology https://www.youtube.com/watch?v=_oI0jVN4TTI&list=PLD44D26A1C7FDE43F&index=6 

The Great Courses | Understanding the Human Body: An Introduction to Anatomy and Physiology, https://www.youtube.com/watch?v=fDr8rEORVo0



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