Thursday, November 7, 2013

"My Crystal Clear Stance on Vaccination" #3: Flawed Research--Vaccines for the Elderly and Infants Don't Work

The chiropractor believes that giving vaccines to folk with reduced capacity to respond is useless.

The 2 populations that have limited production of anti-bodies [sic] are infants and geriatrics, the 2 most heavily vaccinated populations. 
First, is it true that infants and geriatrics are the two most heavily vaccinated populations?  Let's look at the vaccine schedule from birth to 18 years, and the adult schedule, as recommended by the CDC

Sometimes it is difficult to tell what argument the chiropractor is making, because his language is so imprecise.  Is the chiropractor talking about the number of diseases protected against, or the discrete number of injections the person receives? Let's look at both.

Children between birth and 24 months = protected against 14 diseases with up to 27* injections
Children between 2 years and 4 years =  protected against 14 diseases with an additional 3* injections
Children between 4-6  = protected against 14 diseases with an additional 6* injections

Children between 7-10  protected against 14 diseases with an additional 3* injections
Children between 11-12 = protected against 16 diseases with an additional 7* injections
Children between 13-15 = protected against 16 diseases with an additional 3* injections

Children between 16-18 = protected against 16 diseases with an additional 6* injections

Adults between 19-22 = protected against 16 diseases with an additional 4* injections
Adults between 23-60 = protected against 16 diseases with 1 annual influenza and 1 td (tetanus, diphtheria) booster every 10 years.
Adults 60-110 (or death) = protected against 16 diseases with 1 annual influenza and 1 td (tetanus, diphtheria) booster every 10 years, plus the Zoster immunization (1 injection) and the pneumococcal injection (1 injection).

*assuming that all are immunized within the recommended time frame, and assuming all receive an annual influenza immunization

So yes, infants receive the most injections, followed by children children 11-12, children 4-6, and children 16-18.   Those between 60 and 65 are scheduled for two additional injections.

So the chiropractor is not quite accurate in his claims here, either.  One wonders if he has actually studied the CDC recommendations, or is just parroting someone else's opinion.

Now, is it true that the elderly and infants are alike in having "limited production of antibodies"?  Not really.  

First, let's consider what happens to the immune system as a person ages.  As I pointed out in the first in this series, the chiropractor seems to have an unusual and perhaps limited understanding of the human immune system.  Let us go into some depth. Recall that the body recognizes "me" and "not me", or antigens.  A subset of antigens are pathogens, or things that can cause disease. Recall that there are three aspects of the immune system:

  1. Surface immunity (physical, chemical, and biological)
  2. Innate immunity (generalized responses to antigens, including pathogens--viruses and bacteria)
  3. Adaptive immunity (specific responses to pathogens)

There is a general process in aging called "immunosenescence", which is the collective term for the ways that the innate and adaptive immune systems become less efficient in responding to antigen challenges.

One aspect is that as we age, our innate immune cells become less efficient in communicating with each other, leading to a slower or less efficient response to antigens.  

Another aspect in immunosenescence has to do with the immune system's T cells.   T cells exist in two states: a "naïve state", before a specific T cell has been recruited to recognize a specific antigen, and a "memory state" (or "memory cell") after it has been recruited to combat a particular antigen.  Once a T cell transits to the "memory cell" state, it is primed to attack a specific pathogen, and will persist in the body for decades.  As a person ages, his or her suite of T cells have faced many, many antigens. On balance, the body produces fewer naïve state T cells.   This is why people in their 50s, 60s, and 70s and beyond,  have a less robust response to vaccines, because vaccines generally require naïve T cells to produce a protective immune response.  This T cell response is also why the Zoster vaccine against shingles has been so successful in preventing shingles in adults previously infected with varicella (chicken pox) : shingles are produced by the chicken pox (varicella) virus re-emerging from a dormant state in the body.  The Zoster vaccine, as it were, reminds the memory T cell system that it has "seen" the varicella vaccine before, and provides a robust response.

So adults over 60 have a lessened response to antigens (including pathogens) but not a non-response. A lessened response is not, however, "no response".  Indeed, the lessened response is exactly why certain vaccines are recommended for this age group: to educate the immune system against these diseases before the individual encounters the wild pathogen, giving a greater chance at avoiding the disease, or having a lessened illness if the disease is acquired.

Turning to infants: the infant immune system isn't a defective version of the adult immune system.  It begins developing during pregnancy, and while little challenged in the sterile uterine environment, is robust enough (in nearly all children) to respond to the many thousands of microbes that the neonate encounters in the process of vaginal birth, or in the first moments of life. (The development of the infant immune system will be discussed in greater depth in a later post.)
 If their ability to produce anti-bodies is low, then the vaccine would be pointless.
I am really grateful that the chiropractor stated this so clearly.  This is a variant example of the the "Nirvana Fallacy", which runs like this:

The Nirvana Fallacy assumes the middle cannot exist and a solution is either absolutely perfect or entirely without worth. This is then used to argue that a solution is useless because some part of the problem will remain after it has been implemented.

To return to the chiropractor's claims:
If their ability to produce anti-bodies is low, then the vaccine would be pointless.  The whole premise of the vaccine is that you get injected with a foreign invader and you produce anti-bodies against it.  If you can’t produce anti-bodies well then what’s the use of injecting something to try and stimulate that reaction?
The chiropractor goes on:
With kids, their ability to produce any anybodies until after age 6 months is very limited. This is why breast milk is so important to infants.  Mom passes the anti-bodies to baby, that usually last about 6 months.  The immune system is very primitive that young.  The baby needs to spend way more energy in growth phase opposed to protection phase.
The chiropractor is mixing up several things here.  Yes, infants do not make antibodies to some microbes, but that does not mean the infant produces no microbes. The benefits of breastfeeding are many, including the acquisition of some antibodies via passive immunity from the mother's breastmilk. This has nothing to do with the state of the infant's immune system maturity. Furthermore,  recent research has indicated that the infant immune system is fundamentally different than the adult immune system, not "more primitive" -- a topic that will be discussed in several later posts.

As to the following assertion:
The baby needs to spend way more energy in growth phase opposed to protection phase.
I am really not sure what the chiropractor is trying to say.  I have no idea what "the protection phase" of infant development.
Source: "My Crystal Clear Stance on Vaccinations" by Kurt Perkins DC, posted May 2012
The chiropractor has some quaint and counterfactual ideas about the human immune system in infancy and old age, as well as some counterfactual ideas about the process of acquiring immunity through vaccination.


Goldman AS. The immune system of human milk: antimicrobial, antiinflammatory and immunomodulating properties [review]. Pediatric Infect Dis J. 1993;12:664 –672. Medline

Hanson LA. Breastfeeding provides passive and likely long-lasting active immunity [published correction appears in immunity. Ann Allergy Asthma Immunol. 1999;82:478] [review]. Ann Allergy Asthma Immunol. 1998;81:523 –533. Medline
Larbi A et al., The Immune System in the Elderly: A Fair Fight Against Diseases? Aging Health. 2013;9(1):35-47.

National Institute on Aging, IMMUNE SYSTEM: Can Your Immune System Still Defend You As You Age?

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