The Ethics Of Vaccines And Public Health
Tuesday, May 4, 2010
Vaccines prevent disease and save countless lives. But all vaccines pose some risks. We'll talk with scientists about how they balance safest and effectiveness when it comes to vaccines.
The next Ethics Center forum "Are Vaccines Really Safe?" is Wednesday, May 5, 2010, at 5:30 pm at the Reuben H. Fleet Science Center in Balboa Park. The event is free and open to the public.
MAUREEN CAVANAUGH (Host): I'm Maureen Cavanaugh, and you're listening to These Days on KPBS. To older generations plagued by childhood diseases like polio and measles, diseases that killed and paralyzed thousands of children each year, the discovery of a vaccine was a godsend. Today, however, some people no longer view vaccines as miracles. Despite strong scientific evidence to the contrary, some parents now believe vaccines actually cause illness and developmental disorders like autism. How and why did the public's view of vaccines change from gratitude to skepticism? And what is the appropriate medical response, regarding an issue that pits parental rights versus public health? As part of our monthly series on ethics in science and technology, we'll be discussing if vaccines are really safe. My guests are Professor Edward Morgan. He’s professor of Immunology at SDSU’s BioScience Center. And, Professor Morgan, welcome to These Days.
DR. EDWARD MORGAN (Professor of Immunology, San Diego State University’s BioScience Center): Thank you very much.
CAVANAUGH: And Professor Stanley Maloy is Dean of the College of Sciences, and professor of Biology at San Diego State. Good morning.
DR. STANLEY MALOY (Dean, College of Sciences, San Diego State University): Good morning, Maureen.
CAVANAUGH: Thank you for being here. And we invite our listeners to join the conversation. Did you hestitate before getting your child vaccinated? What were your concerns? Call us with your questions and your comments. Our number is 1-888-895-5727, that’s 1-888-895-KPBS. Dr. Morgan, if we can, let’s start with a little vaccine 101, if we can. What is a vaccine?
DR. MORGAN: Well…
CAVANAUGH: How does it work on the body?
DR. MORGAN: …a vaccine is basically a way to improve the immune system because people are – people receive or are inflicted with a disease. A vaccine helps the immune response to alleviate that disease…
CAVANAUGH: Now what…
DR. MORGAN: …basically.
CAVANAUGH: …I understand is vaccines contain a little bit of the disease that you want to immunize the patient – what does that trigger in the body?
DR. MORGAN: Basically, what you do is that you take an attenuated organism or a portion of the organism and attach that to a particular biological stimulus and that enhances the immune response to be able to overcome the disease because certain diseases will overcome the body’s immune defense system whereas when you use a vaccination, it alleviates that issue.
CAVANAUGH: Is it kind of like the idea when you actually get a disease sometimes your body gets an immunity from it, like if you got measles, you couldn’t get it twice, so to speak.
DR. MORGAN: That’s correct.
CAVANAUGH: Now what are some of the vaccine preventable diseases?
DR. MORGAN: Vaccine preventable diseases come in multiple formats. You have seasonal vaccines such as influenza because the influenza virus changes. You have longterm, which is such as polio, diphtheria, tetanus and whooping cough. And then you have emerging diseases that we’re working on currently which are the antibiotic resistant strains of bacteria such as MRSA, staphylococcus aureus, as well as Valley Fever, which is a fungal infection. And then you have also the rare varieties. With the hepatitis virus vaccines, cancer vaccines and vaccines against such as HIV.
CAVANAUGH: How long – If you’re inoculated against polio when you’re a child, how long is that vaccine good for? Do they have varying lengths of immunity for the person who gets them?
DR. MORGAN: Well, there were two types of vaccines developed.
DR. MORGAN: One was developed by Jonas Salk, the other was developed by Sabin.
DR. MORGAN: The Salk vaccine was short term, it was an attenuated virus. The Sabin vaccine, which is what everybody takes now on the sugar cube and so forth, is a live virus but it’s an attenuated virus so you have it in your immune system. So basically what happens is that one individual will pass this because you have it in your intestinal tract and you can – one individual – It goes up exponentially. One individual’s vaccinated with this and then it’s passed and it just – one to five to ten to a hundred to a thousand. So that’s a long-lived immunity.
CAVANAUGH: I see. I see what you’re saying. I’m speaking with Edward Morgan. He’s professor of Immunology at the SDSU BioScience Center. My other guest is Stanley Maloy. He’s Dean of the College of Sciences, and professor of Biology at San Diego State University. And we’re talking about the subject of the next Ethics Center Forum, “Are Vaccines Really Safe?” And we’re taking your calls at 1-888-895-5727. Professor Maloy, why are some people today worried about getting specifically their children vaccinated? What are their concerns?
DR. MALOY: You know, the big thing that’s happened nowadays versus 30 years ago was that we saw people who were ill with these diseases and so you were afraid of your own child’s health. The vaccines have been so effective that a lot of parents nowadays don’t see these diseases so any low risk, no matter how low it is, seems worse than the disease that they don’t know anything about. The part about that that’s really scary is that the diseases are still in our midst, they’re still around us and so they can inflict great harm.
CAVANAUGH: So there is still polio in the United States?
DR. MALOY: There’s not so much polio in the United States per se but there is polio in parts of the world, and our transportation system is so rapid now that the probability of moving polio from one of those other areas back to our country is very, very high.
CAVANAUGH: Yes, go ahead.
DR. MORGAN: If I may interject on that…
DR. MORGAN: …to talk about what Dr. Maloy had said. Recently, as of last weekend, there’s been an outbreak of polio in east Asia and with 150 patients. The WHO, the World Health Organization, has put a flag on this because people aren’t immunized. And the fact that people feel that, to follow up on what Dr. Maloy said, that the childhood diseases are gone is incorrect. Polio, diphtheria, tetanus, pertussis, whooping cough, they all exist. We just don’t see them because of our quality of vaccines and the vaccination process that we’ve used.
CAVANAUGH: We’re taking your calls at 1-888-895-5727. Let’s take a call right now. Billy’s calling from Chula Vista. Good morning, Billy, and welcome to These Days.
BILLY (Caller, Chula Vista): Good morning. There’s so much information out there. My wife and I at the time we’re considered to be like New Agers and we were trying to go all natural but then when we had our two kids, we made the choice to vaccinate them. We just figured mathematically the odds are in their favor. You get all these bits of information here and there that vaccines do more harm than good and, you know, but there’s just little bits of information. I couldn’t say for a fact that I knew that if they did or didn’t, so I just said I need to trust my doctors’ opinion and have them immunize them. I didn’t realize how many injections throughout their years. I still have their little, you know, booklets with all the shots and there’s just a lot of them. So there’s always that little thought in the back of your mind, but I just figured mathematically the odds are in their favor this way.
CAVANAUGH: Billy, thank you for your call and thanks for your comment. If I may, Billy makes a point. The large number of vaccines given between birth and six years of age, many of them bundled together, are a concern for parents, and I’m wondering, Professor Maloy, what do we know about these clusters of vaccines that are given to kids?
DR. MALOY: Well, so there’s this whole field of epidemiology where you look at what the response is for kids who’ve had these vaccinations. This has been done very thoroughly all over the world in different countries, and the reports come independently so we can cluster all of this information. And with a very high level of assuredness, we feel comfortable that clust – putting these vaccines together does not cause a greater problem than it would be if you did them individually, right. So I think that there is now very good scientific data that suggests that itself is not a problem.
CAVANAUGH: Yes, go ahead, please.
DR. MORGAN: And to follow upon Dr. Maloy’s comments, the reason certain vaccines are clustered is because it improves the ability of the body to respond depending upon such as diphtheria, tetanus and pertussis or measles, rubella and mumps. It improves the ability for the body to protect against by using those combinations.
CAVANAUGH: A lot of people say, you know, there are just so many of them and what do we really know about these vaccines. I’d like both of you to give us some idea of the kind of research that’s been done to prove or disprove a link between vaccines and various diseases. And perhaps you could start us off, Professor Morgan. What kind of research has – scientific research has actually been done to track kids and show us whether or not there is a link?
DR. MORGAN: The bottom line is the majority of the literature and in terms of specifically with autism, that it’s been disproved. The papers have been retracted in regards to the original studies in Lancet. And there is no real association with problematic issues. There was an issue with thimerosal, which was a preservative that was put into vaccines and that appears not to be an issue either. But what we’re doing here at San Diego State University is developing a whole new cadre of adjuvants, meaning immune boosters, what you put in with your potential vaccine. And this is done in collaboration with my – with San Diego State University, the University of Nebraska Medical Center with Dr. Sam Sanderson, and at the University of Texas with Dr. Garry Cole on fungal infections. And we’ve developed a unique methodology that will improve the ability to – it’s basically a new generation of vaccine development using components derived from the body to help activate as an immune booster on these difficult pathogens and improve so you don’t have the issues we had in the 1950s and ‘60s.
CAVANAUGH: I want to ask you more about that later in the program. That sounds fascinating. I want to take a call right now. David is calling us from Oceanside. Good morning, David, and welcome to These Days.
DAVID (Caller, Oceanside): Good morning. Thanks for taking my call.
CAVANAUGH: You’re welcome.
DAVID: My comment is that I’m a 1953 post-polio and, in fact, I’m on my way to the doctor right now. And I can assure everyone that it’s something you really don’t want to get and that, as they remarked, it is endemic so if you go to travel or people travel here, you’re exposed and you can get it as an adult. But my question is I’d like to hear some comment on the lack of a real epidemiological system in this country. For instance, England has a National Health Service that keeps a lot of records that allowed them to detect some things that went undetected here. For instance, the link between prenatal x-rays and leukemia was detected by an English research team not an American one. Don’t we really need an epidemiological system?
CAVANAUGH: To – David, thank you very much. And just to augment what David has said, some of the solid research that’s come out disproving a link between autism and vaccines has come from Denmark and the Scandinavian countries and England because they do have the records in order to make those kinds of – that kind of research possible. So do we need that here?
DR. MALOY: Absolutely. There…
CAVANAUGH: How do we get that?
DR. MALOY: You know, so the main agency that does this type of study in the United States is the Centers for Disease Control. The Centers for Disease Control demands some federal funding to be able to put on a big program like this. They are among the most woefully underfunded of the federal agencies. Everyone likes the Centers for Disease Control when there is some outbreak of a new disease we’re afraid of like SARS or influenza, but during periods where we don’t have some newsworthy outbreak, then the Center for Disease Control’s not on anyone’s mind and it doesn’t seem to be a place where our federal agencies want to invest their money.
CAVANAUGH: And, Professor Maloy, I don’t want to leave this – the idea of the – this persistent idea that there is a link between vaccines and autism despite the scientific research that disproves it. People say, you know, I brought my child in and a couple of weeks later – got vaccinated, a couple of weeks later started to regress, and you hear those anecdotal stories on the internet over and over and over again. What could possibly explain that if, indeed, the vaccines have nothing to do with it?
DR. MALOY: So, Maureen, I’ll put a plug in for the recent PBS show “Vaccine Wars” (sic) that you can still look at online. It does a wonderful job of talking about this. One of the problems is a lot of the kids during the period of the vaccination schedule, it’s very close to the timing when kids, unvaccinated even, would exhibit the symptoms of autism. So it’s not a cause and effect relationship, it’s simply a matter of the two things being collocated in a certain period of time. There’s now very strong evidence that that’s true. A problem that we have is that it’s very difficult for parents to figure out what information is right. You can put anything on the internet. And how can a person who doesn’t have the medical expertise look at the internet and decide, oh, I’m going to believe this and not this. Very difficult problem.
DR. MORGAN: And besides that, the research done by clinical psychologists today have indicated that there are various grades of autism. The improvement in being able to diagnose this disease has improved immensely, so all of sudden you find various grades of things. And Dr. Maloy is correct that what’s right and what is wrong because the information that is disseminated may be correct or may be incorrect.
CAVANAUGH: We are going to continue our conversation with Drs. Morgan and Maloy in just a moment and continue to take your calls at 1-888-895-5727. I want to let everyone know we do have a link to the PBS Frontline documentary “Vaccine War.” You can find it at KPBS.org/thesedays. And These Days will continue in just a few moments here on KPBS.
CAVANAUGH: I'm Maureen Cavanaugh. You're listening to These Days on KPBS. We’re discussing if vaccines are really safe. My guests are Professor Edward Morgan. He is Professor of Immunology at SDSU’s BioScience Center. And Stanley Maloy is Dean of the College of Sciences, and Professor of Biology at San Diego State University. We’re taking your calls at 1-888-895-5727. Now, Professor Morgan, it’s not true for us to say or for anyone to say that there are no side effects or risks in getting vaccines, is that correct?
DR. MORGAN: That is correct. There’s always the issue of advocacy versus toxicity in anything that – it isn’t just with vaccines but it’s any medication you take. So what we try to do is to alleviate the toxicity side, improve the efficacy side on these, and this is what our new goal is in this second generation, as I would put it, of being able to generate vaccines.
CAVANAUGH: Professor Maloy, what kind of side effects would we talk about in general in having an immunization, let’s say somebody gets a flu shot.
DR. MALOY: Well, there are inflammatory side effects, so sometimes you get a certain shot, your arm gets very sore for a period of time. You – It’s possible sometimes there is an infection that’s secondary to that shot. Those are very rare events. Probably the thing that’s associated with vaccines that we don’t understand yet is a syndrome called Guillain-Barre syndrome . It happens to some people who don’t have vaccines and it happens to a certain segment of the population that is vaccinated. It’s a temporary paralysis that occurs. People recover from it. But it seems to be due to some stimulation of the immune system. To be honest, scientists in the medical disciplines do not understand what causes it right now. It’s a very, very rare event in vaccinations.
CAVANAUGH: Let’s take a phone call. Vanessa is calling us from San Diego. Good morning, Vanessa, and welcome to These Days.
VANESSA (Caller, San Diego): Hi. Good morning. Thanks for having me.
CAVANAUGH: You’re welcome.
VANESSA: I was just commenting on your first question, was why are people so afraid of vaccines. And just being a mom myself and having that community discussion, people are – I just want to commend the people for actually asking questions of their doctor versus blindly kind of following it in an age where you can just jump online and look up any bit of information. People are afraid, though, because now they’re really understanding what some of that toxicity might be, what those side effects might be. And then I think the other thing that concerns people is, is there an agenda behind some of the vaccinations like you see in anti-depressants. I think people are just a little bit leery and just don’t feel like they’re getting maybe enough or the right information or that it’s, you know, really coming from a direct source and there’s no agenda involved, there’s no money involved behind it.
CAVANAUGH: Thank you so much for your comment, Vanessa. So there’s an example of kind of skepticism that exists out there. First of all, let’s address this idea of just blindly following what your doctor says. Are both of you happy that perhaps people are speaking up a little bit more than they used to?
DR. MORGAN: Yes, indeed. I think that individuals should question physicians, not just go blindly and go with their advice. The more informed you are on the particular infliction you have or disease is very important because it keeps the physicians on their toes, so to speak, and I think that’s very important.
CAVANAUGH: And what about this concept, Professor Maloy, that there are drug companies basically behind these vaccinations and they’re reaping huge amounts of profits by giving vaccinations that perhaps kids and people don’t need.
DR. MALOY: Well, I think that that’s always an issue. When somebody makes money, you have to say is there – are they doing it only for profit or are they doing it for the wellbeing of people? This is where our scientific and medical community comes in. We have a lot data, a lot of people who study these processes. There’s a publication process that they go through, this whole scrutiny, our government, the FDA looks very carefully at these processes. The key thing in evaluating this information is to look at the scientific data, right. If you look at the scientific data, then you can make an informed decision about what’s going on. You don’t want to get your recommendation from a famous actor or someone of that ilk, you want somebody who really knows what’s going on and that – so that’s the key. And you shouldn’t listen blindly to a doctor any more than blindly to an actor. You should make sure you have a good description of what the scientific evidence is.
CAVANAUGH: Let’s take another call. Shannon’s calling us from Rancho Bernardo. Good morning, Shannon, and welcome to These Days.
SHANNON (Caller, Rancho Bernardo): Good morning. I had a quick question with regards to aluminum and immunization. So much focus has been placed on mercury but my husband and I have read Robert Sears’ book and he made some interesting comments about how he felt there was kind of limited, you know, research on the effects of aluminum in immunization shots.
CAVANAUGH: Well, thank you for that question. And who’d like to take that?
DR. MORGAN: Well, I’ll field that one.
CAVANAUGH: Okay, Professor Morgan.
DR. MORGAN: The answer is that there are a number of components in vaccines. These have been FDA approved, they’ve been tested extensively. And I’ll give you an example. Go back to the silver amalgam fillings from 1950, and most of us of the age that I am have had silver amalgam fillings for years and never seen any kind of an effect. Sometimes I think that issues are raised that are, as we say, on the internet are pushed too far. And the answer is, there’s not been a lot of research done on it but if you look at the number of individuals that have been immunized versus the side effects, you find that there’s very little – there’s less likelihood of any effects versus the efficacy of having your children vaccinated.
CAVANAUGH: You know, Professor Maloy, there’s been a lot of questioning about the ethics of the medical industry, the pharmaceutical industry when it comes to vaccines but I’m wondering what about the ethics of people who are not trained as scientists or medical doctors who advocate a certain position when it comes to vaccines that they really don’t know perhaps what they’re talking about.
DR. MALOY: I think that this is a huge problem for us nowadays because of the fact that a lot of people get on the internet, they accept anything that they read as being fact, and so somebody spreading that misinformation can cause a substantial amount of death from people who get infectious diseases, or disability. It really is a very serious problem. And there is no sense of responsibility for such spread of false information.
CAVANAUGH: And, if I can, take that a step farther, the ethics of people who decide not to have their children vaccinated when they know that most people will be vaccinated are not – they’re not sort of assuming any of the risk and yet reaping the benefits of this wide immunization that most – because most people are receiving these vaccines. Do people think about that at all?
DR. MALOY: Well, so, you know, there’s a second ethical problem there. You might say, well, you made that decision about your kids and so if anyone gets sick it’s going to be your kids. Everyone else can get vaccinated. It’s not totally true. Some vaccinations don’t occur until a child is a certain age, maybe six months old. In that case, your child, who wasn’t vaccinated, may transmit a disease to a very young child who has not yet had the opportunity for vaccination and the kinds of diseases that can be transmitted in that way, for example, whooping cough, are very commonly associated with serious illness and death.
DR. MORGAN: If I can interject on that one as well, on this Frontline program that Dr. Maloy was discussing, in San Diego, specially, there was a seven-year-old that contracted measles from being non-vaccinated, transmitted it to a large population of younger children. And measles is a very, very debilitating disease, causes blindness, it causes deafness. And so it is somewhat the parents’ responsibility to consider not only your child but also the population in general.
CAVANAUGH: That’s a hard sell, though, when someone is really concerned that their child might be really hurt…
DR. MORGAN: Umm-hmm.
CAVANAUGH: …by a vaccine. I’m wondering, Professor Morgan, tell us a little bit more about this new generation of vaccines that you’re working to develop.
DR. MORGAN: Okay, what we’re doing is, one, is to try to shift the quotient from toxicity versus efficacy for these. And what we have developed is a whole new generation of immune modifiers or activators to help in terms of vaccination. And these are naturally derived products from the body, your own immune system, and these are applicable in multiple types of infections and we do not see the side effects we potentially would see with the currently used modifiers to help activate, and we’ve been able to be very successful in viral infections such as influenza. We’ve been very successful in fungal infections such as Valley Fever. We’ve been successful in these emerging diseases, as I mentioned, in terms of antibiotic resistant bacterial infections, which are showing up currently, and also parasitic infections. So it’s the new wave of being able to approach these diseases in a much less toxilogical fashion.
CAVANAUGH: Let me just clarify, if I can, does that mean that perhaps we don’t – we wouldn’t have to get a flu shot every year?
DR. MORGAN: No, because those are seasonal vac…
DR. MORGAN: Those are seasonal. When the organism changes every year, such as influenza, then you still have to be immunized. But we may not have the issues, as Dr. Maloy commented, about Guillain-Barre.
CAVANAUGH: Oh, I see. And does that mean that perhaps children would get fewer inoculations?
DR. MORGAN: Potentially, yes. What we’re hoping is that’s the case, that still it’s the mixed vaccine regimen but maybe less injections.
CAVANAUGH: Let’s try to sneak in another call. Alan is calling us from North Park. Good morning, Alan, and welcome to These Days.
ALAN (Caller, North Park): Good morning. You know, with a lot of aspects of life there’s risks and there’s benefits, and we do all have choices. And, unfortunately, a lot of the hazards of vaccinations are not really being presented on this radio program. And it is even surprising to me that your guest refers to, and brings up a totally separate topic of silver amalgam fillings. Well, why did he refer to them as silver amalgam fillings rather than mercury amalgam fillings? Is it because mercury is so highly toxic and he prefers to use a less benign name for them? I think that that may be an indication of also some of the risks of vaccines and…
CAVANAUGH: So, Alan, you think there’s a secret agenda here?
ALAN: I don’t know. I’m trying to ascertain that. But I do know that there is a National Vaccine Information Center that people can refer to which seems to be a very reputable place to look for information. They could probably go to Google and just go to National Vaccine Information Center. Now…
CAVANAUGH: Well, another resource on the internet. And, Alan, thank you. I have to stop you here because – not because there’s a conspiracy but because we’re actually coming up against the clock here and we only have a minute left, and I do want to be able to talk a little bit about the Ethics Center Forum. I guess you’re going to be talking about the internet during this forum when you ask if vaccines are really safe.
DR. MALOY: Yes, and we hope that people will come to the forum and bring questions like the last caller so that we can deal with these issues and talk about them in a public forum.
CAVANAUGH: Okay. Well, I want to thank you both so much for being here. Edward Morgan, Stanley Maloy, thank you for talking with us about this.
DR. MORGAN: Thank you very much.
DR. MALOY: Thank you, Maureen.
CAVANAUGH: And I want to let everyone know, including Alan in North Park, that the next Ethics Center Forum will be tomorrow at 5:30 p.m. at the Reuben H. Fleet Science Center in Balboa Park. It’s free and open to the public. And its topic is: “Are Vaccines Really Safe?” If you’d like to comment on something you’ve heard on the program, you can go online, KPBS.org/thesedays. And thank you for listening. You’ve been listening to These Days on KPBS.