Episode 6: Vaccine Safety Series 3: Too Many Too Soon?

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For informational purposes only, please discuss getting vaccinated with your physician. Feel free to show them this podcast.

Welcome back to my series devoted to helping parents sort through the propaganda and fear-mongering regarding vaccines.

In episode three we are going to talk about the number of immunizations pediatricians recommend.

Vaccine Schedule

One of the most common myths about immunizations, is that pediatricians are using a vaccine schedule that is far too aggressive; that we are giving kids too many vaccines all at once at it is bad for them. A 2020 study showed that a lot of parents have concerns over the recommended vaccine schedule. Well, I have some great news for you. That idea is not true! In fact, not following the schedule or "spreading out" the vaccines, can do more harm than good.

When I took my son to his two month checkup, and even though I already knew it was safe and the best thing for my child, I was horrified as they came at my baby with so many needles. I absolutely understand the trepidation parents have about giving their children multiple vaccinations at once. Before my son was born I talked to my pediatrician at length about the vaccine schedule and I also had numerous in-depth conversations with my PhD adviser, who just happened to be a world-renowned MD expert on vaccine development, vaccine components, and the human immunological responses to them. I learned so much during that time, but I was lucky to have such resources. Most parents don't have easy access to those kinds of experts so I'm here to save you some time and hopefully some stress.

Let's start at the beginning. The immune system is made of cells and proteins that defend us against infections. When we encounter bacteria, viruses, fungi, parasites, or all of the above found on doorknobs and grocery store shopping carts, our immune cells get to work. Some immune cells fight the baddies directly and others produce antibodies because they don't like to get their hands dirty. The process of making antibodies allows our bodies to remember the baddies so next time they can react even faster; fast enough to save our lives, in fact. And by the way, this is what vaccines do for us. They prime us safely, without having to get sick, so that we won't get deathly ill from a germ we are exposed to in the wild (i.e., everyday life).

Here's something most people don't realize, the immune system of a healthy infant is ready to go. B and T cells are present in developing fetuses at 14 weeks! By then they also express a myriad of antigen-specific receptors - antigens are the proteins and polysaccharides from pathogens that are recognized by immune cells. If your immune cells have the receptors for these antigens, then you can mount an immune response. This stuff happens early! However, babies can't make antibodies to pathogens they've never been exposed to. To circumvent this, moms pass antibodies to their babies in the womb, through the placenta during the last three months of pregnancy. This is how important vaccines are: your kids get the first ones before they are born! This is great and really helps keep our kids healthy when they are newborn.

The baby will only be as immunologically protected as the mother is, though, so it's a great reason not to skip on her vaccines. This is also one of the reasons why preemies have it tougher - they didn't finish their in utero vaccine schedule. During breastfeeding, more antibodies are transferred, but this passive immunization doesn't last very long. And now they are out in the world and may be exposed to some very deadly pathogens, so how do we protect them?

Praise the Lord and Pass the Ammunition - in this case Vaccines! We are lucky enough to live in a time of effective and safe - yes safe - vaccines. We don't have to blow bits of dried pox scabs up our child's nose and hope they live (oh yes this was a real thing: variolation). We can go to the pediatrician and let the nice, highly trained nurse give our child a shot - with a tiny needle. That we can do this is amazing! That parents choose not to because people with no training or education frighten them away from it, is horrific.

Sidebar on infant vaccines: If infant immune systems are ready to go why are newborns particularly susceptible to infection and why can't we give them vaccines under 12 months old? Well, they are susceptible because some pathogens are really bad and like I said, babies can't make antibodies to pathogens they've never been exposed to. If a newborn is exposed, they are tiny...their little bodies and organs are still developing and can become overrun quickly by a virus or bacteria, much faster than their immune system can mount an adequate defense. Plus, if mom wasn't vaccinated, they aren't getting antibodies from her and are even more vulnerable.

Now, risk of illness and death from infectious agents is greatest in the first weeks after an infant is born. It takes time for our bodies to generate an immune response that leads to protection after a vaccine, which would leave those at-risk newborns unprotected for a couple more weeks when they are most vulnerable. Once they make it past that age and maternal antibodies are still protecting them, we wait until they are 12 months for pathogens they are less likely to encounter or get a serious illness from before then, when their vaccine response will be more effective, unless of course they are at increased risk of infection for some reason.

Now about giving infants under 12 months vaccines. We actually do give some vaccines under 12 months old though you may hear a lot about the MMR vaccine which is first given at 12 months. I'll come back to that. But the current recommended schedule includes many vaccines that can be given younger than 12 months including RSV, hepatitis B and rotavirus, as well as inactivated polio and COVID-19 among others.

In the case of vaccines we don't give younger than 12 months, there are a few reasons for it. Studies show that there are a number of factors that affect how well an infant's immune system responds to a vaccine including genetics and environment. For some, the presence of mom's antibodies impacts a baby's ability to make their own antibodies and since they have some protection from mom, if they're not at risk then vaccines can wait until they are 12 months old. For the measles vaccine, vaccine-induced immunity under 12 months is not long lasting, so it's better to wait till 12 months when the protection will be long lasting. However, if an infant is at risk, let's say because they are traveling to someplace with high risk of measles infection or there is an outbreak where they live, doctors will absolutely vaccinate a 6 month old for measles and it's safe to do so. Now, if that happens, because the immune response will not be long term, the child will need to get the regular two doses of the measles vaccine according to the normal schedule starting at 12 months, in order to be fully protected from measles going forward.

So back to the question at hand. Why isn't it harmful to give your child four vaccines at once? The simple truth is that doing so does not, in fact, over tax their immune system. When our relationship with vaccines was still in the honeymoon phase - 100 years ago, 40 years ago, they contained a ton of antigens because scientists didn't know exactly which ones provided protection and they wanted to cover their bases. Even those vaccines did not overtax the immune system. They might have evoked an immune response that could be detected - e.g., a fever, but they didn't short circuit the immune system. In fact, only a fraction of your child's immune capacity is put to work responding to vaccines, even with thousands of antigens.  Today, we give our children more vaccines - because we love how preventing terrible diseases lets our kids grow into adults - but each one is now streamlined. Scientists have been able to identify the specific antigens truly necessary for immunity and use only those in vaccines. So now it takes an even smaller fraction of your child's immune capacity to respond to their multiple vaccines. Furthermore, the capacity of the immune response is not static - it's regenerated all the time. As cells are put to work, more cells are made. Our bodies are really something fantastic. Check out Table 2 from this very well-researched article:

Addressing Parents Concerns Do Multiple Vaccines Overwhelm or Weaken the Infant’s Immune S.

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It details the number of antigens in vaccines through the short history of these amazing immune boosters. It also provides all the info you might ever like to know about why multiple vaccines are safe - with references. You see, scientists are parents too and take our concerns as parents seriously and are trying to help.

Now we understand that our children are fully capable of handling the small number of antigens found in even multiple vaccines. But you might be thinking, surely it wouldn't hurt my child if I decided to spread out the vaccines, because I'd be more comfortable with that, would it? Well, actually it could. On a couple of levels. Most importantly, if vaccines are delayed, children aren't protected from disease when they need protection the most.

Because their immune systems are still at their earliest stages of development, babies and children are less protected against viruses and other pathogens than healthy adults. The capacity is there but it's not been developed fully. Their bodies and organs also are still developing, which means a disease that causes mild symptoms in a healthy adult may leave a healthy child with severe health complications. This is why diseases like whooping cough and measles kill so many small children and babies.

Another thing to understand about the vaccine schedule is, the reason they get vaccinated multiple times for the same disease is because researchers, through extensive, exhaustive studies learned that to protect our children best, with the fewest side effects, we give small doses a few times. The booster shots are required for full immunity to develop and if the shots are not given within the time frame required, your child won't be protected.

Waiting to vaccinate increases the risk of babies and children becoming really sick or even dying, if and when they are exposed. You want more proof that vaccines save lives? All we have to do is look at child mortality to understand the life saving impact of vaccines. In 1990, around 93 out of every 1,000 children died before the age of five. Today, mortality rates are a third of that number – 37 children per 1,000. Much of this is because of global vaccination programs. Over the last 50 years, vaccines have saved 154 million lives. 101 million of those saved were babies.

And the truth is, being afraid of vaccines is not necessary and doesn't help us help our families. The YouTube videos, the blog posts, the essays, social media posts, and websites telling you vaccines aren't safe are fueled by people with no real knowledge of vaccines, their components, or effects. RFK has zero science training, kills, education or knowledge. are convincing people that vaccines are a giant conspiracy to enrich Big Pharma at the expense of our children's health. But that's just not true. Please know that organizations that sound like a parents best friend could be run by people with a financial stake in the antivax machine like RFK jr, Andrew Wakefield, Del Bigtree, and Brian Hooker. For example, RFK founded and still supports and is closely involved with the Children's Health Defense. On the surface it looks legit and seems to offer answers to parents who have questions about vaccines, but it's filled with lies. It manipulates parents' fears to advance their antivax agenda. They aren't providing real science-backed evidence. These people are so deeply entrenched in the antivax movement that there's no way they can admit their mistakes - it would cost them their livelihoods. They will double down every time. For real science-based, evidence-backed information on vaccines, check out the all the sites linked on my Resources page and check out my other Vaccine Safety Episodes.

Resources

Vaccines don't cause autism or other health catastrophes, they cause adults.

Other References

1. Offit et al. Addressing Parents' Concerns: Do Multiple Vaccines Overwhelm or Weaken the Infant's Immune System? Pediatrics. 2002; 109:1

2. Daley et al. Assessing Potential Confounding and Misclassification Bias When Studying the Safety of the childhood immunization schedule. Acad Pediatr. 2018; 18(7):754

3. Black et al. Apparent decreased risk of invasive bacterial disease after heterologous childhood immunization. Am J Dis Child. 1991; 145:746

4. DeStefano et al. Increasing exposure to antibody-stimulating proteins and polysaccharides in vaccines is not associated with risk of autism. J Pediatrics. 2013; 163(2):561

5. CDC on Multiple Vaccines