From Respectful Insolence – New Study on CAM and Vaccines

Orac at Respectful Insolence has posted a summary of a recent paper examining the relationship between usage of CAM (specifically defined as being treated by chiropractors, naturopaths, acupuncturists, and massage therapists) treatments and vaccine rates. The study looked at children enrolled in two non-Medicaid insurance programs in Washington state, a notoriously woo-friendly place that requires insurance to cover CAM providers. The key findings were stark:

1. ” children using CAM who saw a chiropractor were between 25% and over 40% less likely to have had the four major vaccines studied, against the MMR, chickenpox, diptheria/tetanus, or H. influenzae type B. It was even worse for children who had been under the care of naturopaths. These children were over 75% less likely to have been vaccinated.”

2.  Children who had been cared for by a naturopath had significantly higher incidence of vaccine preventable disease. So did children who had a family member who used CAM therapy.

As Orac points out, it is not possible from these data to determine if the association is due to parents who are suspicious of vaccines seeking our CAM providers rather than science-based medical doctors or if the CAM providers influenced the parents’ decision whether or not to vaccinate. Likely, both factors play a role. And while the study did not find a positive association for use of acupuncture, and did not examine homeopathy, herbal remedies, TCM, or many other CAM modalities, it does support the general contention CAM use is associated with less use of science-based medical care and potentially greater health risk. This should add further weight to the contention that even ostensibly harmless AM methods may contain “hidden harm” in the form of a general belief system or world view that is inconsistent with science and that leads to underutilization of the beneficial medical therapies science offers.

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4 Responses to From Respectful Insolence – New Study on CAM and Vaccines

  1. Rita says:

    Talking about vaccines (again!) is there anything in this, which has appeared recently on a horse forum?………..

    “I would like to make you aware that all 27 veterinary schools in
    North America are in the process of changing their protocols for
    vaccinating dogs and cats. Some of this information will present
    an ethical & economic challenge to vets, and there will be skeptics.
    Some organizations have come up with a political compromise
    suggesting vaccinations every 3 years to appease those who fear loss
    of income vs. those concerned about potential side effects.

    Politics, traditions, or the doctor’s economic well being should not
    be a factor in medical decision.

    NEW PRINCIPLES OF IMMUNOLOGY

    “Dogs and cats immune systems mature fully at 6 months of age.
    If a modified live virus (MLV) vaccine is given after 6 months of age,
    it produces an immunity which is good for the life of the pet (i.e.: canine
    distemper, parvo, feline distemper). If another MLV vaccine is given
    a year later, the antibodies from the first vaccine neutralize the
    antigens of the second vaccine and there is little or no effect. The
    titer is not “boosted” nor is more memory cells induced.” Not
    only are annual boosters for parvo and distemper unnecessary, they
    subject the pet to potential risks of allergic reactions and
    immune-mediated hemolytic anemia. “There is no scientific
    documentation to back up label claims for annual administration of
    MLV vaccines.” Puppies receive antibodies through their mother’s
    milk. This natural protection can last 8-14 weeks. Puppies & kittens
    should NOT be neutralizing the vaccine and little protection (0-38%)
    will be produced.

    Vaccination at 6 weeks will, however, delay the timing of
    the first highly effective vaccine. Vaccinations given 2 weeks apart
    suppress rather than stimulate the immune system. A series of
    vaccinations is given starting at 8 weeks and given 3-4 weeks apart
    up to 16 weeks of age. Another vaccination given sometime after 6
    months of age (usually at 1 year 4 months) will provide lifetime
    immunity. When you neutralize the vaccine little protection (0-38%) will be
    produced. Vaccination at 6 weeks will, however, delay the timing of
    the first highly effective vaccine. Vaccinations given 2 weeks apart
    suppress rather than stimulate the immune system. A series of
    vaccinations is given starting at 8 weeks and given 3-4 weeks apart
    up to 16 weeks of age. Another vaccination given sometime after 6
    months of age (usually at 1 year 4 months) will provide lifetime
    immunity.”

    I know this has been discussed here, but what about these “new protocols” – true?
    Rita

  2. skeptvet says:

    Rita,

    I’m not sure about all the vet schools agreeing on a protocol. That would shock me, but it’s possible. As for the details you listed, it sounds like a mixture of true and false.
    1. immune system matures fully at 6 mos-this is misleading. there is no special, discrete age at which the immune system is fully functional. puppies and kittens can resond to vaccines before 6 mos and can also fail to resond after

    2. MLV last for life-sometimes true sometimes not. The specific resonse of an individual is unredictable as it depends on the competence of their immune system, the assthrough of the vaccine, the current antibiody status, and the secific organism involved. It is likley that a high percentage of proerly vaccinated dogs and cats will be immune for many years, maybe for life, for some of these diseases, but others will not, and the risks of leaving those individuals unprotected and of not achieving sufficient level of herd immunity to protect the population as a whole have to be weighed against the risks of the vaccines, which I still think are lower than this ost implies.

    3. Boosters don’t work-half true. If antibody levels are high, they will diminish the effect of a MLV vaccine. However, if they are low, the booster will generate an anemnastic response and raise titers to protective levels again. And for killed vaccines (such as rabies) titers tend to last shorter priods of time and booster tend to be necessary.

    4. annual boosters unecessary-ture. Now, how often should we boost to protect a sufficient share of the population to maintain herd immunity? I don’t think anyone knows. 3-5 years is a reasonable guess these days, but the studies to suport a defintive answer aren’t there, and “never” is clearly not the right answer.

    5. allergies, immune-mediated disease-true, with the big BUT that the first are minor and treatable, the second are rare and linked to many other causes, including the infections we are trying to vaccinate against, and this doesn’t address the balance between risks and benefits.

    6. maternal antibodies-yes, they do block vaccine efficacy, whih is why we give a series. It is impossible to predict what antibody levels to which organisms a given pupy or kitten will have since it depends on what their mother had immunity to, how well they nursed and at what time after birth, their own individual immune system, and other factors. Maternal antibody levels wane from the day they are taken in until as much as 20 weeks, and that is a reason to given multiple vaccines during this time, NOT to avoid vaccinating!

    7. Schedule-I agre with vaccinating at 8 weeks and then a series of boosters at 12wks and 16 weeks followed by another about 1 year after the last kitten/pupy shot. I do not agree that you can clearly say never again. Titer levels would help predict the need for vaccination for a few diseases (rabies, parvo), but they are not well-correlated with protective immunity for others so even measuring them doesn’t tell us for certain who needs a vaccine and who doesn’t.

    Overall, the issue is balancing the small but real risks of vaccines against the need to protect both the individual and the population for disease, and there is no one perfect rprotocol. As you can see from the references in my article on the subject, the professional organizations have tended to stress general guidelines and individualized strategies rather than a one-size-fits-all protocol, so I’d be surprised if the vet schools adopted one.

  3. bob says:

    Skepvet, you might want to check the letter “P” key. ‘The specific resonse”, ‘unredictable’, and my favorite: ‘the assthrough ‘. LOL

  4. skeptvet says:

    Yup, time for a new laptop keyboard.

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