Field of Science

IOM to Public: Childhood Vaccine Schedule is Safe

Hey parents: if you've been taken in by anti-vaccine discussions on the internet, you might want to look at the newest report from the Institute of Medicine.  After a lengthy and thorough review of the evidence, the IOM issued a report last week that found that the current childhood immunization schedule in the United States is safe.

The IOM committee specifically looked for evidence that vaccination is linked to "autoimmune diseases, asthma, hypersensitivity, seizures, child developmental disorders, learning or developmental disorders, or attention deficit or disruptive disorders", including autism.  Their finding: no evidence suggests a link to any of these conditions.

The motivation for the report is the growing incidence of parents who worry that there are "too many, too soon" - a catchphrase that was the basis of an anti-vaccine campaign led by Generation Rescue and its spokesmodel, Jenny McCarthy.  This concern, which sounds reasonable on its face, never had any evidence to support it.

Anti-vaccine activists have pointed out, correctly, that the number of vaccines has increased significantly over the past several decades.  The current schedule has as many as 24 immunizations in a child's first two years, and up to five injections in a single visit.  The reason for this is simple: the scientific community has developed vaccines against a growing number of childhood illnesses.  As a result, many diseases that used to infect millions of children each year, killing or permanently injuring thousands of infants and toddlers, have almost disappeared from modern societies.  This is a good thing.

Many parents have been convinced to "slow down" vaccines after hearing advice from self-proclaimed vaccination authorities, such as "Dr. Bob" Sears.  Sears has published his own alternative vaccine schedule (which he apparently just made up - he certainly didn't do a scientific study) and whose has gotten rich selling his book and offering other advice.  Journalist Seth Mnookin calls Sears "a first-rate huckster."

Noted vaccine expert Paul Offit, in a peer-reviewed article in the journal Pediatrics four years ago, explained how Sears ignores all the science on vaccine safety, sometimes simply replacing objective evidence with his own "facts." Offit also called out Sears for his advising parents not to vaccinate their kids, but then not to tell their neighbors:
“I also warn [parents] not to share their fears with their neighbors, because if too many people avoid the MMR, we'll likely see the diseases increase significantly.” [wrote "Dr. Bob" Sears]  
In this astonishingly selfish comment, Sears admits that herd immunity works, but then says don't tell your neighbors, because then their kids might get sick and infect your unvaccinated kids.

Offit's article is a thorough, point-by-point rebuttal of Sears' numerous claims, many of them either misleading or downright false.  I highly recommend it.  Or  read the IOM's report online, for free.  Don't waste your money on Dr. Bob's book.

Let's hope all parents will follow the recommended vaccine schedule and ignore the voices of fear and unreason who are trying to scare them.  If you're still in doubt, read the heartbreaking story, from just a few days ago, of 7-year-old Alijah Williams in New Zealand.  Alijah's well-educated parents thought they were doing the right thing by withholding vaccines, after reading some scary material on the internet.  Alijah was infected with tetanus last year and fought it for months, nearly dying in the process.  His recovery will take 12 months, during which he will have to re-learn how to eat and walk on his own.  His parents have now become activists trying to spread the word among their community that infections are the real threat - not vaccines.

Congress is killing medical research

Congress is killing medical research.  The tragedy is that they don't want to, but they may do it anyway.

While the ridiculous posturing about the U.S. budget deficit drags on, seemingly without end, biomedical research in the U.S. is crumbling.  Congress's chronic inability to pass a budget, and especially the delays this year, are deeply damaging the core of our entire biomedical research enterprise: the National Institutes of Health.

Outside the beltway, the current battle over the budget probably looks like the usual blustering drama that Congress has been engaged in for years.  Somehow they always come up with another budget, don't they?  They'll tout it as a compromise where no one is very happy, and we move on to the next fight.  Business as usual, right?

Wrong.  There are very real consequences to Congress's inaction, and they are happening right now.  The "continuing resolution" that Congress passed in the fall, which allowed the government to avoid a shutdown, only runs until March.  It includes a 10% across-the-board budget cut to everything.  That includes most of the critical medical research in the U.S.  

Every year, many NIH projects end and many others begin.  (Most only last 3 or 4 years.)  But not this year.  Because of the budget shenanigans, NIH has been forced to cut or delay funding to almost all new projects.  In other words, biomedical research that has already gone through rigorous peer review and been given top priority is on hold.  And just to be clear: these are only the best projects.  80-85% of projects submitted to NIH, many of them excellent, don't make the cut because NIH just doesn't have enough funding for them.

While the budget is in limbo, many talented students, postdoctoral fellows, and research scientists who might work on these projects - some of them just beginning their careers in science - will have to find other work.  Some will go to industry, and some may leave science for another field.  Some of them won't come back.  This is a loss that is hard to measure.

For readers who might think I'm asking for a lot, think again.  The entire NIH budget comes to about $31 billion, which supports research on hundreds of diseases.  The total U.S. budget last year was 3,729 billion (3.7 trillion), so the NIH budget is less than 1% of the total.  A 10% cut from the NIH budget (the so-called "sequester" plan) would save 0.08% of the federal budget.  This matters not a whit in the overall budget debate - but it would be a huge blow to biomedical research, crippling some research programs for years to come.

And for those who want to look at this from an economic perspective , NIH funding is a terrific investment.  A nonpartisan study in 2000 concluded: 
"Publicly funded research in general generates high rates of return to the economy, averaging 25 to 40 percent a year." 
The same report provided detailed examples showing about how NIH-funded work saves billions of dollars per year in health care costs.  But keep in mind that most of these benefits don't appear for many years.  The private sector simply won't make such long-term investments.

If you are reading this, you either already benefit from medical research, or you will some day.  Even if you are in perfect health, someone close to you probably uses a treatment that was supported by NIH. Virtually every major medical center in the United States depends on this funding.  There are few investments with broader impact, and broader public support, than biomedical research.

Does Congress really want to kill medical research?  I think the answer is very clearly no.  The damage to our biomedical research enterprise is entirely unintentional: it's collateral damage in the never-ending partisan fights that consume Washington these days.  Those fights are about power and politics, not science and medicine.  Everyone, even the most intransigent Congressperson, wants better treatments for cancer, heart disease, genetic diseases, infections, and the many other illnesses that afflict us.

So I'm asking the leaders of Congress (yes, I'm talking to you, Congressman John Boehner and Senator Harry Reid) to put aside the fighting for a few minutes.  Bring up the NIH budget and pass it.  Don't cut it by 10% (the "sequester" plan), which would be devastating to biomedical research and would save only 0.08% of the budget.  Don't bundle it into some omnibus "grand bargain" that everyone knows is neither grand nor a bargain.

If they will simply vote on it, I predict that both houses of Congress will pass the NIH budget with overwhelming majorities, and for a brief moment, the country might even admit that Congress was doing its job.  I'll pledge right here to write a blog post titled "Congress delivers a victory to the American people."  So go ahead and do it.  I dare you.

[Disclosure: Like most biomedical scientists in the U.S., I receive funding for my research from NIH.  And also like most biomedical scientists, all of my lab's discoveries are freely shared with the public.]