"My Crystal Clear Stance on Vaccination" #7: Flawed Research--No Evidence For Babies' Immune System Function

The chiropractor went on to say (emphasis added)

When I bring this point up, I'll get the skeptic asking for specific reference of an infant not producing anti-bodies sufficiently.  Honestly, I don't have it, it's my own logic.  

In other words, another example of the "common sense fallacy", or the arrogance of ignorance.

Image description: traffic-type sign reading "I stick to my opinion. Please do not confuse me with FACTS"

To that I say,

Image description: traffic-type sign reading "Everyone is entitled to their own opinions. They are not entitled to their own facts."

The chiropractor goes on to write,

In the same breath, if I ask them to produce specific reference for an infant that can produce anti-bodies sufficiently, they cannot produce that evidence either.  Pro-vaccinators can't attack the vaccine choice crowd as unscientific with arguments that are unscientific.

Let us take just one example (in addition to the copious sources below),


Neonatal immunization: where do we stand?

PURPOSE OF REVIEW:
Recognition of the high burden of disease in early life and advances in the understanding of neonatal immunology have resulted in renewed interest in maternal and neonatal vaccination. This article reviews existing information and recent advances in neonatal human immunization.

RECENT FINDINGS:
Recent findings have demonstrated the neonatal immune system not to be immature but rather specifically adapted for early postnatal life. This includes the preferential induction of memory B cell rather than antibody-secreting plasma cells and polarization of neonatal T-cell responses away from potentially deleterious T-helper type 1 cytokines. Recent neonatal acellular pertussis and pneumococcal conjugate vaccine trials have proven that a birth dose of acellular pertussis and/or pneumococcal vaccine, in limited samples sizes, are well tolerated and immunogenic; however they have identified vaccine interference as a critical issue to address.

SUMMARY:
Neonatal immunization may be a well tolerated and effective preventive strategy against early life pathogens. Research to better understand how neonatal vaccine responses are elicited and to identify optimal early life adjuvants and formulations may broaden neonatally vaccine-preventable diseases to pertussis, rotavirus and possibly influenza, further reducing disease burden in this vulnerable group. Hurdles to neonatal vaccination include safety concerns, both immunological and clinical, demonstration of vaccine efficacy and public acceptance.

Neil deGrasse Tyson: "The good thing about science is that it's true whether  or not you believe in it"

Summary:
The chiropractor has counter-factual opinions about the evidence for the robustness of the infant immune system.  His claims are in fact unscientific.

Additional Sources on the Neonatal and Infant Immune System:

Catani A,  Pediatric Allergy, Asthma and Immunology Springer; 2008 edition


Chatterjee , O'Keefe C Current Controversies in the USA Regarding Vaccine Safety Expert Rev Vaccines. 2010;9(5):497-502.  http://www.medscape.com/viewarticle/722174_6

Cohn, M. and Langman, R. E. (1990), The Protection: The Unit of Humoral Immunity... Selected by Evolution. Immunological Reviews, 115: 7–147. doi: 10.1111/j.1600-065X.1990.tb00783.xhttp://onlinelibrary.wiley.com/doi/10.1111/j.1600-065X.1990.tb00783.x/abstract


Fadel S, Sarazotti M. Cellular immune responses in neonates. Int Rev Immunol.2000;19 :173– 193 http://www.ncbi.nlm.nih.gov/pubmed/10763708?dopt=Abstract

Holt PG, Jones CA, The development of the immune system during pregnancy and early life (2000), . Allergy, 55: 688–697. doi: 10.1034/j.1398-9995.2000.00118.x http://onlinelibrary.wiley.com/doi/10.1034/j.1398-9995.2000.00118.x/full

Offit PA, Quarles J, Gerber MA, Hackett CJ, Marcuse EK, Kollman TR, Gellin BG, and Landry S, (2002) Addressing Parents’ Concerns: Do Multiple Vaccines Overwhelm or Weaken the Infant’s Immune System? Pediatrics Vol. 109 No. 1 January 1, 2002
pp. 124 -129  (doi: 10.1542/peds.109.1.124) http://pediatrics.aappublications.org/content/109/1/124.full

Siegrist CA. Neonatal and early life vaccinology. Vaccine.2001;19 :3331– 3346 http://www.ncbi.nlm.nih.gov/pubmed/11348697


Wood N, Siegrist CA. Neonatal immunization: where do we stand? Curr Opin Infect Dis. 2011 Jun;24(3):190-5. doi: 10.1097/QCO.0b013e328345d563. http://www.ncbi.nlm.nih.gov/pubmed/21415741

Screen Capture of Chiropractor's Claims 

Source:  "My Crystal Clear Stance on Vaccinations" by Kurt Perkins DC,  posted May 2012

"My Crystal Clear Stance on Vaccination" #6: Flawed Research-- Too Many Vaccines Too Soon for Babies' Immature Immune Systems

The chiropractor makes the following claim:

Even if the whole vaccine theory really worked, it would be absolutely pointless to inject a baby of 6 months or less with a vaccine.  With a child’s immune system being very immature until age 2, the overload of 36 vaccines by the age of 18 months seems about as logical as drinking from a fire hydrant.

This is really a silly, ignorant claim, a strawman with two arms, first positing that infants' only immune challenges are from vaccinations, then claiming that infants can't respond to immunological challenges.

Babies' immune systems begin developing in utero and are presented with trillions of challenges from the moment they enter the birth canal (or emerge into the world, in the case of c-sections).  The immune challenge from vaccinations is trivial compared to the daily encounters even babies in the cleanest, most hygienic households face.  The fire hydrant is daily life.

source: tinyurl.com/kiss-antigens

Text from image:
The average healthy adult human mouth is home to more than 600 unique species of bacteria and a very high number of viruses.  Every milliliter of saliva contains over 100 million bacteria. 

Every time a mother kisses her baby, the baby's immune system is exposted magnitudes more antigens than are present in the entire US childhood immunization schedule. 

A well-functioning immune sysstem is a marvel, protecting against countless viruses and bacteria even in the youngest children. It can handle the challenge presented by the US immunization schedule and it can handle the even-greater challenge from every mother's kiss.

Do not worry about 'too many, too soon'.  Vaccinate your baby on-time, every time.

A more light-hearted approach:

Source: http://tinyurl.com/babies-antibodies

Summary:
The chiropractor has counter-factual opinions about the robustness of the infant immune system and the relative challenges of daily life and immunization.

Sources:

Catani A,  Pediatric Allergy, Asthma and Immunology Springer; 2008 edition

Cohn, M. and Langman, R. E. (1990), The Protection: The Unit of Humoral Immunity... Selected by Evolution. Immunological Reviews, 115: 7–147. doi: 10.1111/j.1600-065X.1990.tb00783.xhttp://onlinelibrary.wiley.com/doi/10.1111/j.1600-065X.1990.tb00783.x/abstract


Fadel S, Sarazotti M. Cellular immune responses in neonates. Int Rev Immunol.2000;19 :173– 193 http://www.ncbi.nlm.nih.gov/pubmed/10763708?dopt=Abstract

Holt PG, Jones CA, The development of the immune system during pregnancy and early life (2000), The development of the immune system during pregnancy and early life. Allergy, 55: 688–697. doi: 10.1034/j.1398-9995.2000.00118.x http://onlinelibrary.wiley.com/doi/10.1034/j.1398-9995.2000.00118.x/full


Offit PA, Quarles J, Gerber MA, Hackett CJ, Marcuse EK, Kollman TR, Gellin BG, and Landry S, (2002) Addressing Parents’ Concerns: Do Multiple Vaccines Overwhelm or Weaken the Infant’s Immune System? Pediatrics Vol. 109 No. 1 January 1, 2002
pp. 124 -129  (doi: 10.1542/peds.109.1.124) http://pediatrics.aappublications.org/content/109/1/124.full

Siegrist CA. Neonatal and early life vaccinology. Vaccine.2001;19 :3331– 3346 http://www.ncbi.nlm.nih.gov/pubmed/11348697


Screen Capture of Chiropractor's Claims 

Source:  "My Crystal Clear Stance on Vaccinations" by Kurt Perkins DC,  posted May 2012

"My Crystal Clear Stance on Vaccination" #5 :Flawed Research--Giving Infants the Same Dose of Vaccines As Adults Doesn't Make Sense

The chiropractor wrote,

Giving a child a vaccine with an adult dose and assume they would react the same way doesn't make sense.

This is an error of common sense (appeal to common sense fallacy), equating the biological activity of a medication (like aspirin, for example) with a vaccine. It's the sort of error you would expect from a person who had no medical education, but it is surprising from someone who belongs to a profession claiming to have an education equal to an MD. Surely this would have included basic pharmacokinetics and pharmacodynamics?

Roughly speaking, medications work by being distributed throughout the body, and achieving a certain concentration in the entire bloodstream.  Thus, adjusting the medication dose for the size of the patient makes sense.

Vaccines, on the other hand, do not circulate evenly throughout the body.  For injected vaccines, the immune response generated by vaccination typically occurs at or near the injection site.  As we saw in a previous post, when the immune system recognizes a vaccine component as "not-self",  cells of the immune system flock to the area and activate the immune system to respond to the invader. Likewise, adjuvants also only act locally.  Once the immune response has succeeded in protecting the body from the invader, a small number of cells -- memory B and T cells--remain, to recognize the specific antigen provided in the vaccine.

Further, not all vaccines given are in the same dosages for children and adults. For example, the adult version of the hepatitis A vaccine, hepatitis B vaccine, and influenza vaccine contain higher doses than the one for children, while Tdap vaccine used in adolescents, teens and adults contains lesser quantities of the diphtheria and pertussis antigens.

Source: Refutations to Antivaccine Memes, http://tinyurl.com/RtAVM-15Sneezes

Source: Refutations to Antivaccine Memes, http://tinyurl.com/RtAVM

Summary:
The chiropractor's thinking about how vaccines work is naïve at best.

Sources:


American Society of Health-System Pharmacists, Concepts in Clinical Pharmacokinetics, Introduction to Pharmacokinetics and Pharmacodynamics http://www.ashp.org/DocLibrary/Bookstore/P2418-Chapter1.aspx


Children's Hospital of Philadelphia Vaccine Education Center, Questions About the Vaccine Schedule http://www.chop.edu/service/vaccine-education-center/vaccine-schedule/vaccine-schedule-qa.html

Offit PA, Moser CA, Vaccines and Your Child: Separating Fact from Fiction (excerpt) http://cup.columbia.edu/book/978-0-231-15307-2/vaccines-and-your-child/excerpt

Screen Capture of Chiropractor's Claims 

Source:  "My Crystal Clear Stance on Vaccinations" by Kurt Perkins DC, posted May 2012

"My Crystal Clear Stance on Vaccination" #4b :Flawed Research--Infants' Signs of Immature Nervous Systems

The chiropractor wrote,

Infants cannot talk, a sign of a mature nervous system.  Infants cannot walk, a sign of a mature nervous system. Infants cannot control urination or defecation, a sign of a mature nervous system.

This is the level of understanding the chiropractor brings to discussions of the maturation of the human nervous system?  This would be acceptable in a paper from a child in elementary school, but far too jejune for even a middle-school discussion.

Elsewhere, he claims the following about his credentials

.... uses his Chiropractic degree and combines his background of biochemistry and genetics with the application of physiology, neurology, and psychology to provide a T.R.U.E. approach to healthcare for his patients and corporations.

Summary:

The chiropractor does not demonstrate the level of understanding of human neurological development commensurate with his claims of expertise.

My Crystal Clear Stance on Vaccinations: The Nervous System Controls the Immune System

Source:  "My Crystal Clear Stance on Vaccinations" by Kurt Perkins DC, posted May 2012

"My Crystal Clear Stance on Vaccination" #4a :Flawed Research--The Nervous System Controls The Immune System

The chiropractor asserts:

A mature nervous system (which controls your immune) system doesn't happen that early. 

This is manifestly not true (discussed below) but I did try to find a source for this assertion.  I found several, all from site run by chiropractors, such as the one below:

source: Mahalko Family Chiropractic E-Newsletter

Text from Mahalko Family Chiropractic E-Newsletter

Strengthening Your Immune System Naturally
There are many things that you can do naturally to help boost your immune system, that is not in the form of a shot. 

The best thing you can do is to get regular chiropractic adjustments. Chiropractors focus on the nervous system, which controls every organ, muscle, tissue and cell in the body. When the vertebra in our spine misalign (subluxate), it puts pressure on the corresponding nerve(s). Whatever the nerve is controlling is thus affected. Since the nervous system controls the immune system, it makes sense to get adjusted once a month to make sure that your nervous system is working properly or even more often if you are feeling sick.

No, the nervous system does not control the immune system. 
A simple way of thinking about this is to consider persons with spinal cord injuries, especially high spinal cord injuries.  Their nervous systems are impaired.  Other than having a higher risk of infectious disease from the functional aspects of their disabilities, their immune systems are intact.

A more reliable source: The National Institute of Allergy and Infectious Disease


http://www.niaid.nih.gov/topics/immunesystem/pages/nervoussystem.aspx

The Immune System and the Nervous System

Evidence is mounting that the immune system and the nervous system are linked in several ways. One well-known connection involves the adrenal glands. In response to stress messages from the brain, the adrenal glands release hormones into the blood. In addition to helping a person respond to emergencies by mobilizing the body’s energy reserves, these “stress hormones” can stifle the protective effects of antibodies and lymphocytes.

Another link between the immune system and the nervous system is that the hormones and other chemicals that convey messages among nerve cells also “speak” to cells of the immune system. Indeed, some immune cells are able to manufacture typical nerve cell products, and some lymphokines can transmit information to the nervous system. Moreover, the brain may send messages directly down nerve cells to the immune system. Networks of nerve fibers have been found connecting to the lymphoid organs.

Summary:
The chiropractor's understanding of the relationship between the nervous system and the immune system is counter-factual.

My Crystal Clear Stance on Vaccinations: The Nervous System Controls the Immune System

Source:  "My Crystal Clear Stance on Vaccinations" by Kurt Perkins DC, posted May 2012

"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

Source: http://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-schedule-landscape-chart.pdf

Source: http://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule-easy-read.pdf

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

Summary:
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.

Sources:


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.  http://www.medscape.com/viewarticle/780507_1

National Institute on Aging, IMMUNE SYSTEM: Can Your Immune System Still Defend You As You Age? http://www.nia.nih.gov/health/publication/biology-aging/immune-system-can-your-immune-system-still-defend-you-you-age

"My Crystal Clear Stance on Vaccination" #2: Flawed Research--No Randomized, Controlled Trials on Vaccines Have Ever Been Done

The chiropractor seems to have some counter-factual beliefs about how vaccines are developed and tested, as well as not-very-nuanced ideas about clinical research.

FLAWED RESEARCH: The scientific mantra of vaccines is that they are safe and effective based on their research.  Their research is flawed and is a double standard from any other drug product studied.  The Gold Standard in research design is the double blinded, randomized controlled trial (RCT). 

This means that people are split into 2 groups randomly and participants are given either the real thing or the fake thing being tested.  Then progress is charted on who gets better, who gets worse, and the like.  In theory there should be no bias as to reporting because the researchers don’t know who is in the placebo or the real intervention group.

Commentary:
This is a very cursory, but essentially accurate description of RTCs.  A better description would be:

A quantitative study in which selected people are allocated at random (by chance alone) to receive one of several clinical interventions. One of these interventions is the standard of comparison or control. The control condition may be an inert substance ("placebo" or "sugar pill"), or no intervention at all. In a single-blind study, the study subjects do not know whether the are in the control condition or the experimental condition. In a double-blind study, neither the subjects nor the researchers know which participants are in which study conditions. Very careful study design and execution is required to avoid confounders --  a third variable that can make it appear (sometimes incorrectly) that the variable of interest is associated with an outcome, by affecting the measured outcome. Confounders lead to bias that distorts the magnitude of the relationship between two factors of interest.

The chiropractor is partially correct that RTCs are the "gold standard".  Here is a graphic of one version of "the hierarchy of evidence".

Back to the chiropractor's post:

How many vaccines have ever been studied in this manner?  ZERO!  The reason?

This is an inaccurate claim in several dimensions.

First, in 1954, Salk's polio vaccine was tested in an RTC

In all, over 1.3 million children participated in the trial. The trial was a randomized, double-blind test, meaning that children were randomly assigned to either the control group or the vaccine group. Neither the children (or their parents) nor health officials knew which children had received the vaccine and which had received the injected placebo fluid. (A smaller control group received no injection. Rather, officials observed them throughout the trial period for signs of polio infection.)

The outcome?  There were 609 cases of paralytic polio in the unvaccinated children, and only 71 cases of paralytic polio in the vaccinated children.

As to RTC vaccine safety studies, they are almost too many to count, as each new vaccine is tested in the process of development.  

The chiropractor seems blissfully unaware of the stages of vaccine development.  If the infographic below isn't clear enought for you, The History of Vaccines website has a useful overview, as does the HIV Vaccine Trials Network, if you don't like the infographic from the CDC. 

Source: http://www.skepticalraptor.com/skepticalraptorblog.php/study-rule-all-the-vaccine-deniers-dream/

This is a common question from anti-vaccine true believers.  For example, here is a question posed by a naturopath, answered by Mark Crislip MD, an infectious disease specialist, at the Science Based Medicine post Nine Questions, Nine Answers

Show me one double-blind, placebo-controlled study that can prove the safety and effectiveness of vaccines? 

One trial? It took me 55 seconds to find  "Efficacy of 23-valent pneumococcal vaccine in preventing pneumonia and improving survival in nursing home residents: double blind, randomised and placebo controlled trial” and that included time to boot the browser and mis-spell the search terms.  ’Vaccine’, ‘efficacy’,  ’randomized’ and  ’placebo control trial’  results in 416 Pubmed references; add ‘safety’ to the search terms, you get 126 returns. 416 is easily more than one.  Of course, to find them you have to look.

However,  evidently the chiropractor is demanding an RTC in which some children are not vaccinated at all. He is not alone; this demand has been made often enough that it's known as The One Study To Rule Them All.

Allison Hagood writes (here and here)

Multiple studies in multiple countries using multiple research models and multiple research groups, with multiple funding sources, have found no link between vaccines and autism. They have also found no links between vaccines and a long list of other conditions, such as ADHD, asthma, diabetes and auto-immune disorders, that anti-vaccine propagandists attempt to link to vaccinations. 

What would it take to conduct "the One True Study" of all vaccines? An alternate universe. 

These studies have been dismissed by those anti-vaccine propagandists as having the wrong funding source, the wrong research design, the wrong focus, not separating out antigens from other vaccine ingredients, separating antigens from other vaccine ingredients inappropriately, not testing this or that, or some other reason that likely lacks validity.

Meanwhile, those in the anti-vaccine movement want ONE study. The One Study To Rule Them All. The One Study that tests every possible aspect of every vaccine and finds them all, together and separately, through this One Study, to be completely effective and completely safe for all children and not linked to any conditions. 

Back to the chiropractor's post:

The researchers will say they cannot perform an RCT because it would be unethical to NOT give a child a vaccine because if that child dies of something that could have been prevented, then they don’t want to be responsible.  

That's not quite right. In the United States, approval for research involving humans is governed by the Code of Federal Regulations, TITLE 45: PUBLIC WELFARE DEPARTMENT OF HEALTH AND HUMAN SERVICES PART 46 PROTECTION OF HUMAN SUBJECTS, which requires human subject studies to be authorized by Institutional Review Boards (IRBs).

There are three principals fundamental to determining if a research proposal is ethical.

1. Respect for Persons: Subjects must give voluntary consent to participate in research; that subjects are adequately and thoroughly informed about the research and what is required, and that subjects' privacy and confidentiality are protected. 
2. Beneficence: The risks of participating in a research project are justified by potential benefits to the individual or society;  the research design is such that those risks are minimized. 
3. Justice: The risks and benefits are distributed equitably,  meaning that one subset of a population should not take on all the burden of risk and reap all of the rewards; risks and rewards should be applicable and available to all subsets of a community.

We can already see that a vaccinated vs. non-vaccinated trial in children would flunk all three principles. It's not necessary that an unvaccinated study subject dies; many of the vaccine-preventable diseases have high risk of other poor outcomes (think of the measles and encephalitis, for example.)

ToddW, who has been part of a number of IRBs, has written a useful series of blog posts on the topic of ethics in research:

• Vaccinated vs. Unvaccinated Part 1 - An RCT Overview
• Vaccinated vs. Unvaccinated Part 2 - A History of Medical Research Ethics
• Vaccinated vs. Unvaccinated Part 3 - Ethical Evaluation
• Vaccinated vs. Unvaccinated Part 4 - The Legal Perspective

Back to the chiropractor's post:

But if someone dies in their trials from taking their anti-depressants, it must be ok.

Wow, what a non-sequitur!  The risk of suicide in clinical trials of antidepressants has been studied.  At any rate, the chirpractor's comments again shows how naive he is about clinical trials for medical interventions.

Back to the chiropractor's post:

Hey drug companies, I will volunteer my child to be in the placebo group and compare him to the health and well being of those that have gotten all the recommended vaccines.  I’m sure I can gather a few hundred thousand more to be in the placebo group to create a large sample.

Again, some naiveté about clinical trials.  Let us recall the idea of "randomized".  Assigning a child to a known treatment arm violates the idea of randomization.  I wonder if the chiropractor would be willing to enroll his child in a true RTC study, in which his child might receive all vaccines?  

Back to the chiropractor's post:

Instead of research to see safety and effectiveness, they instead see if the person builds anti-bodies to the antigen (the foreign invader) that is in the vaccine.  If antibodies are built, then it’s ‘safe and effective,’ or so they lead us to believe. These studies are rarely, if ever done on kids younger than 4 years old.  How can you say it's safe or effective for a baby if it's never studied on a baby?

I don't know where the chiropractor gets the idea that the only research that's done in the process of vaccine development is assessing antibody response.  It's clearly not true.  Look at the Phase I, Phase II and Phase III trials for new proposed vaccines, for example. Also, the bit about "studies rarely done on kids younger than 4" is also clearly false, as a quick look through PubMed will reveal, here are just two out of hundreds: Danchin et al. and Kulkarni et al.

Summary:
The chiropractor seems quite ill-informed, or ill-educated,  about the development of vaccines, and ongoing research into vaccine safety and efficacy.  I have been mulling over whether the chiropractor's statements can accurately be called a series of straw men. I don't think so, quite, because the I suspect that the chiropractor sincerely believes in the inaccurate statements he makes. In other words, if you have been taught falsehoods, and use those falsehoods to argue against a scientific reality, you aren't making a dishonest argument, but an ignorant one.

Screenshot:

"My Crystal Clear Stance on Vaccinations" by Kurt Perkins DC, posted May 2012

Sources:


Danchin M, Kirkwood CD, Lee KJ, Bishop RF, Watts E, Justice FA, Clifford V, Cowley D, Buttery JP, Bines JE. Phase I trial of RV3-BB rotavirus vaccine: a human neonatal rotavirus vaccine. Vaccine. 2013 May 28;31(23):2610-6. doi: 10.1016/j.vaccine.2013.04.008. Epub 2013 Apr 16.

History of Vaccines, Polio http://www.historyofvaccines.org/content/timelines/polio

Thomas Francis, Robert Korn, et al. "An Evaluation of the the 1954 Poliomyelitis Vaccine Trials." American Journal of Public Health 45 (1955), 50 page supplement with a 63 page appendix.


Kulkarni PS, Sapru A, Bavdekar A, Naik SS, Patwardhan M, Barde P, Pandit AN. Immunogenicity of two diphtheria-tetanus-whole cell pertussis-hepatitis B vaccines in infants: a comparative trial. Hum Vaccin. 2011 Sep;7(9):941-4. doi: 10.4161/hv.7.9.15994. Epub 2011 Sep 1.