Aluminum in vaccines and how does US vaccine program compare to the rest of the world?

Part 3: Vaccine Q&A with Dr Temple – the aluminum debate

Dr Temple, aluminum in vaccines, what are your thoughts?

Still Researching.

FDA does regulate aluminum in vaccines: Federal Regulations for biological products (including vaccines) limit the amount of aluminum in the recommended individual dose of vaccines, to not more than 0.85-1.25 mg (i.e. 850-1250 mcg)

Here is a list of vaccines and aluminum

  • Hib (PedVaxHib brand only) – 225 micrograms per shot.
  • Hepatitis B – 250 micrograms.
  • DTaP – depending on the manufacturer, ranges from 170 to 625 micrograms.
  • Pneumococcus – 125 micrograms.
  • Hepatitis A – 250 micrograms.
  • HPV – 225 micrograms.
  • Pentacel (DTaP, HIB and Polio combo vaccine) – 330 micrograms.
  • Pediarix (DTaP, Hep B and Polio combo vaccine) – 850 micrograms.
  • There is no solid evidence that the amount of aluminum in vaccines is harmful to infants and children – per Dr. Sears, CDC, WHO, Australian/NZ CDC, European CDC.

I have looked into this topic at length and my most favorite post on aluminum and vaccines has been written by Dr. Sears in 2013. Here is a summary of his research:

  • The data evaluated is on IV meds and IV nutrition used in premature babies in the Neonatal Intensive Care Unit. He points out how much aluminum is in IV fluids and in IV nutrition. He then uses these findings as a reference to question dosing of aluminum in vaccines. This is not proof, it is a theory that poses good questions.
  • The FDA limit on continuous infusions is 25mcg/day (continuous infusion = a drip is different to a one time shot = vaccine)
  • Of note, since 2013, there have been aluminum limits placed on vaccines (as I detailed above)
  • There is limited data on aluminum injections vs saline injections in kids (new HPV studies coming out).
  • There is no data on aluminum levels in babies and children after immunizations.   How much aluminum is excreted in urine or feces of healthy children? What are blood levels of aluminum in children after immunizations compared to same age un-immunized children? These are key questions!
  • There is data on aluminum in blood and urine from adults and sick children requiring Intravenous Nutrition, which is a continuous infusion that occurs daily.
  • There is no consensus of what normal values are. In other words, we do not have aluminum levels standards for urine and blood from healthy children. (1)
  • The vaccine data is on global side effects and not on specific vaccine ingredients.
  • Sear’s summary of his own findings:

If I could sum up the aluminum controversy in three sentences, it would be this. There is good evidence that large amounts of aluminum are harmful to humans. There is no solid evidence that the amount of aluminum in vaccines is harmful to infants and children. No one has actually studied vaccine amounts of aluminum in healthy human infants. We need more research on how healthy infants excrete aluminum!

– Vaccines have been shown to be safe in the majority of children in the current dosing schedule and the side effects do not differ between regular vaccine schedule and alternate vaccine schedule. But do we stop there?

Aluminum Pharmacokinetics (how aluminum deposits and gets excreted by humans) have been studied in several papers using healthy adults and animals. (3). For children, the data was interpreted. Also, the theoretical toxicity to children is interpreted from adults, sick children on IV infusions, and mathematical equations. I would like to see data on aluminum excretion in healthy children receiving vaccines.

How do I interpret all this data? Vaccines work to eliminate horrible diseases. Disease which I have treated in my medical career and which I hope to never treat again. But should we take a stand and request vaccines with less ingredients? If they are as effective, Yes. I read every label and the less ingredients the better. This applies to vaccines.

How do I plan to do that? In my US office, I made a chart of all the ingredients in all the vaccines that we have available. The chart compares single vaccines vs combo vaccines. The combo vaccines in our office have less ingredients then individual vaccines.

One further thought. We live in an age of increased mobility, travel, and immigration. Immigrants may not have had access to the immunizations that we have and they do not have the luxury of debating aluminum.  Some of them have watched their children die from preventable diseases and want a better life for their families, so they emigrate to industrialized countries.  I am an immigrant and I am thankful that I had the privilege to emigrate to the US.  I did not get my vaccinations until I arrived in the US. As a physician, it would be irresponsible for me not to have had my vaccinations as I could be spreading the very diseases I’m trying to treat.

There is currently a measles epidemic in Germany, with 504 cases of measles by mid April 2017, compared to only 33 cases for the same period last year. WHO has also expressed concerns at the rising cases of Measles in Europe, which is threatening progress against disease elimination. Measles is not a trivial infection, and it can cause pneumonia, dehydration and encephalitis, and 2 months ago (May 2017), a mother of 3 died from Measles in Essen (Germany) aged 37.

So there is a very good reason why a vaccination program is in place in most countries. It is worth noting that in New Zealand and the UK, the government pays for vaccines. The government pays for treatment of chronic disease and adverse events to vaccines. The Medical Council does not take this lightly. I work in New Zealand as a Pediatric Specialist, so my information is first hand. Furthermore, based on my conversations with the NZ CDC, they do their own research and review of the data.   If vaccines are not necessary in NZ, they do not recommend them. After all, why would they spend public funds on something that is not cost effective in saving lives? To this date, they conclude that the studies show vaccines to be safe. Should they find that vaccines cause a rise in chronic disease or adverse effects, they will be the first to voice these findings.

Furthermore, this is particularly so in the NHS of UK, where resources are currently overstretched with many services underfunded e.g. chicken pox vaccine is NOT paid for by the government as it is not deemed to be life-threatening illness and the risk/cost analysis does not work out cost effective for the government. Rotavirus vaccine only started to be funded by the government in 2013 as, prior to that, the risk/cost analysis showed it not to be cost-effective.

As I have emphasized, every child is different and some children may well react to ingredients which are deemed to be save in many others. Therefore it is extremely important that if you are concerned about the side effects, that you discuss them with your physician as advice need to be individualized. Some great questions for the GP/physician might be:

  • How do they order vaccines? Price or ingredients?
  • Is there an option for aluminum-free Hib vaccine?
  • Are there effective combination vaccines available with less aluminum?
  • Does the office have a chart with ingredient breakdown? Ask to see that chart and go through it with your physician!

You mentioned that immunizations are a World Wide Effort. How does the US compare with the rest of the world?

There are slight differences among the schedules because of the various illness that are prevalent or are not prevalent in the respective countries. However, first world countries have on average about the same amount of vaccines. See graphs in the next question below.

Here is a fantastic blog post on how the US compares to other countries and the reasons behind the slight variations in the vaccine schedules. Great Quick Read and it has a link where you can select the country or the vaccine and see how it compares.

How many vaccines for my baby by the age of 12 months?

Let’s take a closer look at how the numbers breakdown:.

  • Specific antigen numbers like Pertussis or Diphteria, These do not come in individual vaccines.
  • Individual vaccines numbers like Dtap, MMR, or Hib. This is how we generally see the US immunization chart, because it identifies every single vaccine possible.  
  • However, we have combination vaccines (like Dtap-IPV-HepB-Hib) for less additives and less pain. 
  • Let’s look at a great example of how we actually give vaccines as per NZ chart

 

  • The actual number represented here is  9 vaccines by the age of 12 months and 20 vaccine for a lifetime in New Zealand.  
  • In the US we also have Hep B at birth (1) Hep A (2), Chicken Pox (1, and 1 combined with MMR), and Meningitis  (2). 
  • Thus in the US,  we give 10 vaccines by 12 months.  We also use the combo vaccine like NZ.  US life time total vaccines 26.

 And here is the schedule for UK. 8 vaccines by 12 months of age, and 15 vaccines in total if you exclude Influenza and HPV (both of which are not compulsory and up to patient choice and mostly administered at schools), and Hepatitis B, TB in at risk individuals. (if you include ALL vaccines assuming uptake of the additional 4 then its 21 so comparable to NZ.

Should we worry about the number of antigens in vaccines?

No. Fun Facts: Antigens

  • In 1970 we had 5 vaccines with 3000 antigens.
  • Currently we recommend 28 vaccines with 150 antigens total for the whole vaccine schedule.
  • Our children who attend day care, school, and generally walk out of the house, are exposed to 2000-3000 antigens per day.
  • Based on these numbers, there is a much higher chances of reacting to a daily environmental antigen then to one in a vaccine. Example, getting kidney disease from the Strep Throat.

In the next part, we will discuss the relationship between vaccines and chronic diseases. Stay tuned!

citation

1 -http://pediatrics.aappublications.org/content/129/1/e142

2 –https://www.fda.gov/biologicsbloodvaccines/scienceresearch/ucm284520.htm

3 –https://vaccinepapers.org/wp-content/uploads/FDA-aluminum-paper.pdf

4 –https://www.ncbi.nlm.nih.gov/pubmed/22001122

5 -https://www.fda.gov/BiologicsBloodVaccines/ScienceResearch/ucm284520.htm

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