Immunisation

Many parents in my clinic have asked me for my thoughts on immunisations and I have put them here as clearly and concisely as I can but it must be understood from the outset that a) not getting your children immunised does involves putting them at some risk in the future and b) some potential danger to them in the future and b) getting your children immunised does involve some risk to them in the present.

The stark reality of parenthood, that you cannot prevent your children from being exposed some to risk whatever you do, is bought out earlier than any other in the subject of immunisation and people do not find any of this a happy subject to even think about, let alone discuss.

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Many parents just choose to go with the status quo and hope for the best. I neither judge them, nor blame them, nor try to dissuade them if this is the case. For if you get into the trenches of the pros and cons of vaccinations you will soon see that the relative risks of immunisation-reactions vs. chances of being stuck down by an infectious illness have people on both sides of the argument showing how one choice is scarier than the other. None of this makes for a happy process of healthy debate, in fact I find that the more people get involved in this topic, from either side, the more angry and vitriolic they tend to be about the whole thing. Fear will do that to you.

When people ask me in person I usually say something along the lines of the above to convey a kind of warning about what a treacherous topic this is and I also explain that I most emphatically do not advise parents to either immunise or not immunise. In fact I  take a dim view of how both sides of the argument use scare and fear to push their case forwards.

What I instead suggest to the parent who genuinely does want to consider this matter from more than one angle is that they look into the subject as deeply as they need to and make a choice based on what they think is best for them and their children. The conventional advocacy of immunisations is fairly guaranteed to have been heard in a variety of formats (nurses, doctors, pamphlets, other parents, grandparents, friends etc.) however for most people the other side of the coin has not even been tossed let alone heard. There are plenty of voices out there if you want to hear their point of view; in New Zealand the group who advocates against immunisation can be heard at http://wavesnz.org.nz/

I do recommend that if people are going to get their children immunised that they be careful to ensure that the child is in good health at the time and to not rush into doing too many over a short period. As much as it might suit an overburdened medical system I do not think that multiple vaccinations in short succession are a good idea for any child who is in anything but excellent health. I also think that it might be better to wait until children are older to do so much vaccinating, even though babies are more vulnerable to serious disease (they aren’t born with any immunity to begin with) at the same time they are also more vulnerable to side effects from vaccines and the substances that are injected along with them.

I work a great deal with children of different ages with various health problems, most of them involving their immune systems in one way or another. Many of the approaches that I have found to be the most helpful are summarised in an article on children's health here and for an overview of the vital subject of immunity there is a detailed article that goes into many key areas written up here.

For another viewpoint on this difficult subject I have copied below a letter from the very experienced American herbalist Andrew Bentley that originally came to me as part of an online discussion about the relative merits of tetanus vaccines; it is included here with his permission.

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Andrew Bentley’s story:

The "fear factor" is a pretty big force in human judgement, especially about diseases. Anyone who has seen another person or many people die from a sickness is likely to have some anxiety about it. It seems like just about every culture and time period have come up with some sort of culturally ingrained answer to that fear. In our culture, inoculations have become that deeply ingrained answer to the ancient fear of pestilence. This is why it is often a highly emotional discussion when people talk about them-- it is almost considered impious in many social circles.

When I was a teenager, I was traveling around trying to learn about different traditional systems of healing in the world. In one of the places I went, people believed that it was absolutely necessary to keep a blue glass representation of an eye above a child's bed or around their neck, to prevent the child falling prey to illnesses. Almost everyone I talked to believed this was the case. And these were not barbarians in some remote village, they were people who drove cars, talked on phones, had jobs and lived in a city of half a million people or so. Many of them were well educated or had travelled to other places, and held this opinion just as strongly as the people who weren't well educated or travelled.

I couldn't make this work with my understanding of how the world operated, so I questioned it. This actually upset people, because they felt I was trying to undermine how they kept their children safe. When I asked about evidence, I got all kinds of stories about this or that child, or a whole orphanage full of children, whose caretakers didn't provide them with blue glass eyes, and who met with terrible illness or untimely demise. I had people tell me about how they worked in the hospital, and after you've seen a small child dying or hooked up to a ventilator you just would never want to take the risk of not providing a child with a blue glass eye to watch over them. It was the culturally accepted way of warding off pestilence, and to deviate from it could cause harm not only to one's own child, but to any children around them who might catch their disease. It was like leaving the door open for death to walk in, and as such it was considered highly irresponsible.

But like I said, for me, it didn't seem like something that would work. I thought of disease in terms of bacteria, viruses, genetics, and things like that, because of where I came from, and could not conceive of a plausible mechanism of action whereby a blue glass eye would impact the aetiology of illness. But to them and to their way of thinking on illness (which I do not understand fully, but which had a lot to do with probability and respect and the will of god) it made perfect sense. And they had been using them since time out of mind.

In the end, a tearful old woman pressed one into my hand, giving it as a gift that I could not refuse without causing grave offense. And she begged in exchange that when I had children of my own, that I would hang it above their bed or around their neck. SO I took it and I went home, and years later I did have kids of my own. And it was hanging on the window over the bed (just as a souvenir of my journeys) when my first daughter was a baby. And she was healthy. And somewhere along the line, moving house I suppose, it got lost, and I forgot all about it, and didn't have it when my second daughter was born. And she had serious, life threatening respiratory problems that she struggled with for years. I imagine that everyone who told me about the blue glass eyes would sadly shake their heads and say that they told me so. I STILL don't think the glass eye had anything to do with it, but I might be wrong.

Vaccines fill this same cultural role for most of our society, regardless of whether they work or don't, or are safe or not. --I'm not saying that they do or don't work, or are safe or not safe, as a group. Really there are a lot of them and they are all very different substances and even have different proposed mechanisms of action. Speaking specifically of the tetanus shots, they appear to work pretty well and also have the highest reported rate of adverse events of any vaccine according to the government's Vaccine Adverse Events Reporting System (which is not very high quality data, but it is the data that exists).-- What I am saying is that when clinicians consider these interventions or discuss them with patients and other professionals, it is important to take into account not only the scientific information, but also the fact that these are the culture's charms against pestilence, and as such many people are extremely emotionally invested in them.

And yes, Tetanus was and is a very bad disease to come down with. Once it gets to the point where it is producing neurotoxins and making spasms happen, it is dangerous and difficult. Hygiene and proper wound care are extremely important for this and many other reasons, since no one is claiming that the vaccine offers perfect protection (actually the horse serum vaccine appears to offer pretty close, based on a large retrospective epidemiological study of soldiers who were given it, and also based on numbers from the Cuban health department, but it is so dangerous that it isn't used much anymore). It was pointed earlier out that the chance of getting tetanus is related to how long a wound remains dirty. The environment that tetanus really likes is a burn or penetrating wound that is co-infected with some other organism, in a part of the body that doesn't get much oxygen (like a joint, extremities, or the umbilicus of a newborn). Extra points if the injured person is immunosuppressed, very old, or very young. Many people even on this list of healthcare professionals seem to correlate rusty metal with tetanus, which is largely a myth perception. Tetanus lives in the alimentary canal of animals and in the soil; so bites and injuries from soiled objects (or injuries later contaminated by soil of faeces) are what introduces it into the body, and the rust is just there because metal left in the dirt tends to rust.

Andrew Bentley, Clinical Herbalist
Lexington Ky, USA
http://kentuckyherbalist.com

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© 2011 R.J.Whelan Ltd