Some Thoughts on the Vaccination Debate - by Nicholas Gonzalez, MD

Some Thoughts on the Vaccination Debate - by Nicholas Gonzalez, MD

What if nutritional deficiencies were behind many of the epidemic "vaccine-preventable" diseases that modern vaccination campaigns have taken credit for? 

I recently had the opportunity to join a Functional Medicine Journal Club online debate on vaccinations that prompted me to write the following response.  In my mind, the discussion, sometimes heated, really brought into my focus the larger, more global issues of infectious disease, the nature of infection, and the all-important participant in the action, the host, issues which I wanted to share with the larger audience at GreenMedInfo.

I will say I don't think it too helpful when physicians and scientists, as happened in the discussion, turn to emotional arguments and pleas that do little to advance a scientific, objective perspective.  Evoking an unvaccinated relative paralyzed by polio, for example, or poor Thai children stricken with diphtheria doesn't teach us what we need to know about the role of innate immunity, and the pathogenicity of microorganisms

In terms of my own background, though I am known to many as a physician offering an intensive nutritional program for patients diagnosed with advanced cancer and other serious diseases, my formal training was in cancer immunology, in a specially designed program created for me by my conventional mentor Robert A. Good, MD, PhD, for years President of Sloan-Kettering.  Dr. Good, called the "father of modern immunology" by the New York Times, was the most published author in the history of medicine, and the scientist who first unraveled the immune complexities of the thymus in the 1950s.  When I joined his group as a fellow, as I have mentioned to Kelly, I lived in his house with his wife, living, breathing, and ingesting immunology, an experience that has served me well in my medical career however far from the conventional it has veered..

Through Dr. Good I learned of Rene Dubos, PhD, the famed Rockefeller University researcher whom I mentioned in a Journal Club debate. Dr. Dubos started his professional life as a soil microbiologist, but then in the 1950s and 1960s emerged as the leading voice insisting we all view infectious disease in an ecological context – a lesson that has stayed with me since I devoured his many books and papers years ago.   Dr. Dubos knew more about the subject that anyone who probably will ever live, and along the way he first warned in the 1950s that antibiotics came with a down side, the disruption if not the destruction of our normal bacteria flora, a problem virtually ignored at the time by the Western research and medical world.

I think, in the current debate, it would be a most useful exercise to go back in time, to review historical examples of allegedly or presumably catastrophic infectious disease, specifically two examples, that of polio and Keshan's disease, for which in both cases a vaccine was thought to be the only solution.  I realize others have addressed polio in other posts and through other links, so I will limit my comments in that case.

I remember the hysteria generated in the media by polio, the well-funded advertising campaigns by organizations such as the March of Dimes, relying on, of course, emotional arguments to raise money from "regular" moms and dads and Girl Scout and Boy Scout troops all over the country.  My childhood vision of polio was that of a true catastrophe, threatening the entire population of the United States, with our only hope the dedication and hard work of our wonderful research scientists who were extolled in the press on a near daily basis.

As a fledging research immunologist under Dr. Good somewhat fascinated by DuBos' perspective, I began to investigate the actual epidemiology and ecology of polio.  As I was to learn it turned out that polio "epidemics" as they were called, didn't really emerge until the late 19th, and early 20th century.  I had been taught in medical school that the epidemic nature of polio showed itself because of growing population density in urban areas associated with poor sanitation.  Though this position seemed logical, since polio transmits through a fecal oral route, the opposite has proven to be the case.

Studies from the late 1940s, before the availability of the Salk vaccine, indicated that in low-income urban areas up to 90% of the population showed antibodies to polio, though most who tested positive had no recollection of having been infected and had not experienced any residual neuro-muscular problems.  For them, the disease seemed no more serious than a brief upper respiratory infection or gastroenteritis.

True, the number of deaths from the disease and cases of paralytic polio did increase significantly in the early 1950s, but these numbers were hardly at the level of full-blown catastrophe.  For example, in 1949, considered an epidemic year, 42,173 cases were identified in the US, with 2, 720 deaths.  Anyone unfortunate enough to be killed, or struck down and left paralyzed would be an individual tragedy, but the numbers just were not there for a major epidemic as has often been portrayed. Even throughout the so-called "epidemic" years of the late 1940s and early 1950s most contracted the virus without any recognition they had been infected with the "deadly" polio organism.

Ironically, the increasing incidence of paralytic cases and deaths, though still relatively small, occurred as intensive public health campaigns to clean up the cities went into full force.  As in most instances, Nature doesn't work the way the human mind would like it to work.  It turns out all these highly funded and well-intentioned efforts to prevent polio by cleaning out and sterilizing the cities came inevitably with unintended consequences. In its usual ecological setting, prior to these public health experts at work, polio rarely struck infants younger than six months old, most commonly infecting children between six months and four years of age when the disease usually presented in its "common cold" form.  With improved sanitation, polio tended to hit at later ages, even into adulthood, when it was quite a different, far more aggressive illness.  So, with improved sanitation, fewer children were exposed to the disease, more adults were, and the results in adults were disastrous.  In "unclean" urban areas, early exposure mitigated the severity of the illness, with the added benefit of providing lifetime immunity.  With improved sanitation the disease became far more deadly. In this context I am reminded of more recent studies demonstrating that children allowed to play in the mud and muck – as I was as a child before germ-phobia became itself an epidemic – and who attend day care centers where they are exposed to all manner of drippy noses and minor infections, tend to have far less asthma, far fewer allergies, and far stronger immunity, than their over-protected colleagues.

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