Your Immune System, How It Works And How Vaccines Damage It

Your Immune System, How It Works And How Vaccines Damage It

“Chronic illnesses are now so common, having a sick child seems to be the “new normal.”Children are supposed to be vibrant, healthy, free of disease.” – Janet Levatin MD, Pediatrician.

The Theory

Medical theory is that if your child is exposed to a weakened version of the disease, he will produce antibodies to that disease and become ‘immune’, so that he will never contract the illness.
At first glance, this sounds like a solid principle, BUT it only focuses on one small aspect of the immune system, the antibodies, and fails to look at all the other functions responsible for protecting your child’s health.

So, how does the immune system work?

The immune system is also made up of the skin, mucous membranes in the nose and throat, ears and eyes, nasal hairs, saliva, the spleen, intestines, tonsils, the thymus gland and even the brain. All of these parts work together in a holistic way to bring about a whole body immunity, which is only in part to do with antibodies.

• The skin acts as a barrier to prevent bacteria entering the body. It also filters out toxins through fever, which is the purpose of a fever when your child is ill.
• The nasal hairs prevent foreign particles from travelling up the nose, and the mucous membranes excrete a substance which is anti-bacterial.
• Tonsils help prevent respiratory diseases and illnesses such as Polio, and saliva contains substances which destroy and neutralise microbes.
• The spleen and intestines, among other organs, deposit fats and vitamins around the body and protect against viral and bacterial invasion.
• The thymus gland produces thymus cells, known as ‘T’ cells, which are antibodies to infection.
• There are various glands (nodes) in the body that drain it of toxins and useless material. For instance, the cervical nodes drain the head, neck and chest.
• The pituitary gland in the brain directs all of the systems above, so if the brain goes wrong, so does the immune system. It sends electrical impulses to all areas of the body, stimulating cell re-generation and muscle growth. These electrical impulses also stimulate the thymus gland – the centre of immune function.

What effect does vaccination have on this immune function?

Vaccination – the act of artificially acquiring a disease so as to become immune to it – is flawed in a number of ways. Firstly, a vaccine contains many hazardous chemicals and not just the viruses to immunise against. These each have their own toxic affect on the body. Secondly, the route of entry is different to a naturally occurring disease. Most natural diseases would enter through the mouth or the nasal cavity, not the skin.
Vaccination breaks the skin with a needle and injects foreign matter into the blood supply.
This bypasses the skin’s role in immune function, as well as the tonsils, the mucous membranes, and so on.

Normally, the body produces extra antibodies after being primed by the tonsils that there is impending infection. Therefore, if the infection takes hold, there will be an army of white blood cells, ready to neutralise the infection.
In the case of vaccination, this infection goes straight to the blood, with no prior build up for the body, and there are no extra immune cells to deal with it.
Also, with vaccination there is more than one disease present (e.g. measles, mumps, rubella all in one), whereas naturally a child would never contract 3 diseases at the same time. This puts additional strain on the immune system.

What problems can this cause?

Injection of vaccine via this unnatural route can use up 70% of the immune system’s resources, instead of the usual 3 to 4% with a wild occurring disease (according to Cynthia Cournoyer, ‘What About Immunizations?’, Dennis Nelson Publishers, 1991).
Because the body has no extra antibodies waiting to counter the vaccine, it can go into overdrive in an attempt to deal with the situation, taking much needed vitamins away from bones and other organs, to use for the production of more antibodies. This means that the other vital systems go short on vitamins, in extreme cases leading to bone fractures caused by the immune response leaching vitamins to cope with the vaccine. This lack of vitamins can also cause bruising and retinal bleeding and haemorrhaging, which is why some vaccine damaged babies have been falsely labelled as ‘shaken baby syndrome’ cases. These type of vaccine injuries are similar to those caused by trauma.

The massive surge of antibodies created by the vaccine can also cause the body to become hypersensitive and this is responsible for the increase in allergies and auto-immune diseases. Allergies are an over-exposure to toxic elements which the body is unable to cleanse itself of.
If the adrenals, which include the pancreas, the pituitary gland and the spleen, become over-stimulated, for instance, by vaccination, this can cause the body to become toxic and unable to regulate itself. This has been linked to heart disease, diabetes, asthma and bronchitis, to name a few. Over-stimulating the adrenals also causes a decrease in circulation of blood round the body, and atrophying of vascular vessels.
It is in this state of dysfunction and chemical overload, from vaccines, pollution, junk food, pharmaceutical drugs and so on, that our bodies become less able to stay healthy.

‘When the body is in its ideal state of harmony, there is no need for “immunity.” In such a state of harmony and balance, the thymus functions properly as the central regulator for the proper digestion of elements and all that is taken into the body is digested and excreted.’ – (Stonebridge Associated Colleges, 2005).

In the time immediately following vaccination, when extra vitamins are being used up to fight the vaccine, this may actually make the person more susceptible to the disease. For instance, in the Merck, Sharp and Dohme LTD product information for HIB vaccine, it states: ‘Cases of Haemophilus B disease may occur in the weeks after vaccination’, and in Lederle Hibtiter information sheet, ‘Cases of HIB disease, although rare, may occur after vaccination.’ This is known as ‘PROVOCATION disease’, i.e. disease caused by vaccine.
Live vaccines are more likely to pass on the disease to their recipient or his close contacts, as the viruses are excreted in urine, faeces and saliva for upto 3 weeks after each shot.
The polio vaccine was changed from the live oral vaccine to part of the injectable, killed 5 in 1, because the only cases of polio in western countries were caused by the vaccine.

Vaccine caused diseases are often more severe than the naturally occurring disease. For instance, ATYPICAL measles, only got by vaccinated children, is much more serious because the vaccine suppresses the child’s rash, which is his means of excreting the toxins, and this leads to the toxins being pushed deeper into the body and affecting the major organs and sometimes the brain, as atypical measles encephalitis.
Vaccine viruses can also attach themselves to cells, organs and brain tissue and cause cancers, disabilities and brain injury, as in the case of a boy who became autistic and had a seizure disorder after his MMR jab at 15 months. Great Ormand Street Children’s Hospital tested him at 13 years of age and found remains of vaccine viruses in the injured parts of his brain. (The Sunday Express, 6 October 2002).
Antibodies to brain tissue have also been found in blood tests of autistic children.

Disease Mutations

Even with inactivated vaccines, it is possible for the killed virus or bacteria to mutate into a different form of the disease. For instance, a 16 year old Canadian girl died of Meningitis B after her boyfriend had been given the Meningitis C vaccine. Lab tests confirmed that the vaccine can mutate into B form and infect both the recipient and his or her close contacts. (Pulse, doctor’s magazine, 20th November 1999).
Large numbers of chronic diseases have evolved in the place of infectious disease, since the introduction of mass vaccination, including ME, Lupus, Guillain-Barre Syndrome, Autism (previously known as Kanner Syndrome, discovered by Dr. Kanner in the 1940’s), MS, Ebola virus, AIDS, Lichen Planus, Vulvodynia and other hypersensitivity conditions, not to mention the rife and uncontrollable rates of cancer, heart disease, asthma, eczema and other allergies. Even meningitis was extremely rare before the 20th century.

We are killing ourselves in our quest to ‘prevent’ childhood illness, as mother nature is stronger than man, so tampering with immune function can have disastrous consequences for all.

Vaccines Cause Immune Suppression

Immunostimulation Versus Immunosuppression after Multiple Vaccinations: the Woes of Therapeutic Vaccine Development

Three articles in this issue of Clinical Cancer Research show how multiple vaccinations can lead to immunosuppression. Moreover, two studies in patients show that granulocyte macrophage colony-stimulating factor (GM-CSF) as an adjuvant immunostimulant to different kind of vaccines can lead to adverse outcome in terms of relapse-free and overall survival. Modulation of regulatory T-cell activity may be required to overcome this outcome and may be crucial for the successful development of therapeutic vaccines.

Source: (Clin Cancer Res 2009;15(22):6745–7)

Cancer Patients Injected With Cancer Vaccine Caused ‘Early Melanoma Deaths’

Ninety-seven patients with resected melanoma (stage II-IV) were enrolled, stratified by stage, and randomized to receive a cellular melanoma vaccine with or without GM-CSF. The primary endpoint was delayed-type hypersensitivity (DTH) response to melanoma cells. Antibody responses, peripheral leukocyte counts, and survival were also examined.

Results: The GM-CSF arm showed enhanced antibody responses with an increase in IgM titer against the TA90 antigen and increased TA90 immune complexes. This arm also had diminished antimelanoma cell delayed-type hypersensitivity response. Peripheral blood leukocyte profiles showed increases in eosinophils and basophils with decreased monocytes in the GM-CSF arm. These immune changes were accompanied by an increase in early melanoma deaths and a trend toward worse survival with GM-CSF.

Conclusion: These data suggest that GM-CSF is not helpful as an immune adjuvant in this dose and schedule and raise concern that it may be harmful. Based on the discordant findings of an immune endpoint and clinical outcome, the use of such surrogate endpoints in selecting treatments for further evaluation must be done with a great deal of caution.

Source: (Clin Cancer Res 2009;15(22):7029–35)

Partial CD4 Depletion Reduces Regulatory T Cells Induced by Multiple Vaccinations

Results: Multiple vaccinations, rather than boosting the immune response, significantly reduced therapeutic efficacy of adoptive immunotherapy and were associated with an increased frequency and absolute number of CD3+CD4+Foxp3+ T regulatory (Treg) cells. Anti-CD4 administration reduced the absolute number of Treg cells 9-fold. Effector T-cells generated from anti-CD4–treated mice were significantly (P < 0.0001) more therapeutic in adoptive transfer studies than T cells from multiply vaccinated animals with a full complement of CD4+ cells.

Conclusion: These results suggest that CD4+ Treg cells limit the efficacy of multiple vaccinations and that timed partial depletion of CD4+ T cells may reduce suppression and “tip-the-balance” in favor of therapeutic antitumor immunity. The recent failure of large phase III cancer vaccine clinical trials, wherein patients received multiple vaccines, underscores the potential clinical relevance of these findings.

Source: (Clin Cancer Res 2009;15(22):6881–90)

1 in 5 Americans Suffer From Allergies

If springtime breezes bring you sniffles, you can take comfort in the knowledge that you are not alone.

For reasons that researchers do not fully understand, allergies to pollen, dust, pet dander and food have become more prevalent among Americans in recent decades. Today, one out of every five Americans suffers from allergies, according to the Asthma and Allergy Foundation of America.

“We don’t know why the incidence of allergies is on the rise,” said Maya Jerath, M.D., Ph.D., an assistant professor in the University of North Carolina at Chapel Hill School of Medicine and director of the UNC Allergy and Immunology Clinic.

Nor do researchers understand why an allergy develops in the first place. “That has baffled people and continues to baffle people in this field a lot,” she said.

An allergy is an immune reaction to a harmless substance, such as a pollen grain or peanut protein. Instead of ignoring the substance, the body produces antibodies to mount a fight against it. Allergy symptoms can range from itchy eyes and sneezing to life-threatening anaphylactic reactions.

The causes of allergies remain elusive in part because the immune system’s role is complex, Jerath said. The system must defend the body from countless foreign invaders in food, water and the air around you.

Significantly for allergy sufferers, the immune system must also learn to distinguish particles that are dangerous from those that are not. For most people, this learning occurs during early childhood.

“If it doesn’t get adequate exposure to certain things, those regulatory mechanisms don’t get set up,” Jerath said.

For that reason, some researchers believe that a lack of exposure to microorganisms early in life may precondition a person to allergies. This explanation, called the “hygiene hypothesis,” suggests that growing up surrounded by many other children, dirt or livestock helps the immune system develop a tolerance to harmless irritants.

Source: Physorg.com, by Sara Peach, 24 February 2010.

The spectrum of post-vaccination inflammatory CNS demyelinating syndromes

A wide variety of inflammatory diseases temporally associated with the administration of various vaccines, has been reported in the literature. A PubMed search from 1979 to 2013 revealed seventy one (71) documented cases. The most commonly reported vaccinations that were associated with CNS demyelinating diseases included influenza (21 cases), human papilloma virus (HPV) (9 cases), hepatitis A or B (8 cases), rabies (5 cases), measles (5 cases), rubella (5 cases), yellow fever (3 cases), anthrax (2 cases), meningococcus (2 cases) and tetanus (2 cases). The vast majority of post-vaccination CNS demyelinating syndromes, are related to influenza vaccination and this could be attributed to the high percentage of the population that received the vaccine during the HI1N1 epidemia from 2009 to 2012. Usually the symptoms of the CNS demyelinating syndrome appear few days following the immunization (mean: 14.2 days) but there are cases where the clinical presentation was delayed (more than 3 weeks or even up to 5 months post-vaccination) (approximately a third of all the reported cases).

In terms of the clinical presentation and the affected CNS areas, there is a great diversity among the reported cases of post-vaccination acute demyelinating syndromes. Optic neuritis was the prominent clinical presentation in 38 cases, multifocal disseminated demyelination in 30, myelitis in 24 and encephalitis in 17. Interestingly in a rather high proportion of the patients (and especially following influenza and human papiloma virus vaccination-HPV) the dominant localizations of demyelination were the optic nerves and the myelon, presenting as optic neuritis and myelitis (with or without additional manifestations of ADEM), reminiscent to neuromyelitic optica (or, more generally, the NMO-spectrum of diseases). Seven patients suffered an NMO-like disease following HPV and we had two similar cases in our Center. One patient with post-vaccination ADEM, subsequently developed NMO.

Overal, the risk of a demyelinating CNS disease following vaccination, although non-negligible, is relatively low. The risk of onset or relapse of CNS demyelination following infections against which the vaccines are aimed to protect, is substantially higher and the benefits of vaccinations surpass the potential risks of CNS inflammation. This does not in any way exempt us from “learning” the lessons taught by the reported cases and searching new and safer ways to improve vaccination techniques and increase their safety profile.

Source: Autoimmunity Reviews, Volume 13, issue 3, March 2014.

MODERN CHILDREN ARE SICKER THAN THEY WERE IN THE 1940’s AND 50’s

“In 1947 I was a nursery nurse student working in a nursery for little babies whose mothers needed to work as they were illegitimate and so no fathers were getting a wage.

The babies were very well and very sweet.  There were colds and flu occasionally and scabies now and again.

There was NO asthma, eczema, epilepsy, hyperactivity, cardiac disease or cot death.  Cot death started in 1957 after DPT was started.

You need to be in your 80’s to remember what life was like.  Babies died of pneumonia because the houses were so cold but NOT of the awful diseases they have now.”

Mrs B – Retired Nursery Nurse.

Autoimmune Tissue Scurvy Misdiagnosed as Child Abuse

Abstract
Requests from distressed parents and relatives seeking help after having been falsely accused by doctors of injuring their children are not uncommon. Viraland parasitic infections and vaccines cause an autoimmune disorder, Tissue Scurvy, misdiagnosed as child abuse. This report presents the evidence. Method. Relevant hospital and laboratory reports of three children were examined for evidence of Tissue Scurvy as the cause of the neurological lesions, fractures, bruises and hemorrhages found on them. Results. In all the cases in which appropriate histories and tests were done there was evidence that the doctors either misinterpreted the laboratory evidence or they were unaware of the significance of abnormal tests suggesting Tissue Scurvy as the cause. Conclusion. Some doctors are unaware of the pathophysiological processes of autoimmunity, haemostasis and osteogenesis and are misdiagnosing vaccine induced Tissue Scurvy, absence of Vitamin C within the cell, as Non-accidental Injury.

Full paper here: http://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20130206.17.pdf

Source: Michael D Innis, Autoimmune Tissue Scurvy Misdiagnosed as Child Abuse, Clinical Medicine Research. Vol. 2, No. 6, 2013, pp. 154-157. doi: 10.11648/j.cmr.20130206.17

Biology Video Explains Benefit of Fever and Childhood Diseases (it is pro-vaccine but interesting). Section starts at minute 33.43

Section on how fever kills viruses and how childhood diseases are ‘vital’. Segment is only tiny but interesting, even if video is pro-vaccine. (VAN does not agree that vaccines are harmless or that antibodies always mean you are immune).

Advertisements
Interview with Dr. Judy Mikovits Discussing the Role Vaccines Play In Autism and Numerous Other Diseases

Interview with Dr. Judy Mikovits Discussing the Role Vaccines Play In Autism and Numerous Other Diseases

Dr. Judy Mikovits Condemns Vaccines ‘Play Role In Autism’

dat

This is damning evidence against vaccines. Here is a description of the video from the interviewer, Candyce Estave.

This is is the most shocking & damming interview I have watched regarding vaccine injury. Released only 1 day ago it should go viral. Dr Judy Mikovits, PhD is a Biochemist, cellular and molecular biologist with over 30 years of scientific expertise. She has directed programs on HIV, cancer, epigenetics, and neuroimmune disease, with a focus on development of novel drug and diagnostic technologies. Dr. Mikovits holds a PhD in Biochemistry and Molecular Biology from GeorgeWashington University. Her dissertation was on HIV latency and mechanisms of immune activation in monocytes. Dr. Mikovits was a Postdoctoral Scholar in Molecular Virology at the Laboratory of Genomic Diversity, National Cancer Institute under Dr. David Derse.

Over the past 26 years, she has published 51 scientific papers in peer-reviewed journals, and worked as a government scientist for many years developing viruses and vaccinations. In 2011 when she made a horrifying discovery that was contaminating all vaccinations, she presented her data to government officials and was threatened & told to destroy all her data. When she did not she was jailed, her career systematically destroyed, and a gag order put in place for 4 years threatening that if she spoke out she would be thrown back in jail. That gag order has just lifted, and she’s dumped the government right in it! She speaks about how autism is associated with vaccines, also cancers, chronic fatigue syndrome, alzheimers, auto immune diseases, allergies and more. She discusses how the cocktail of vaccinations pumped into babies mutate to develop months and years down the track into new viruses, cancers and diseases, some they don’t even know about yet. She explains how the viruses injected through vaccines tear open our DNA and insert their own DNA to mutate our genetic makeup and be passed on generation after generation. She has been threatened with a suicide murder cover up, she doesn’t care, she wants it all exposed. The act of the Australian government making vaccinations mandatory is an act of genocide. If your jaw didn’t drop you obviously need to listen to it again. Via Jasmine Yuzwak

Interview with Dr. Judy Mikovits, PhD, 11/22/15 from Candyce Estave on Vimeo.

Bill Gates Faces Trial In India For Illegally Testing Tribal Children With Vaccines

Bill Gates Faces Trial In India For Illegally Testing Tribal Children With Vaccines

Bill Gates Faces Trial in India for Illegally Testing Tribal Children with Vaccines

Christina Sarich
BY CHRISTINA SARICH
POSTED ON OCTOBER 13, 2014

Bill Gates IndiaHave Bill Gates and his eugenicist foundation’s crimes against humanity finally caught up with him? If the Supreme Court of India has anything to say about it, he will face the ramifications of poisoning millions of Indian children with vaccines.

A recent report published by Health Impact News shows that a vaccine empire built on lies can only go on for so long. The reports states

“While fraud and corruption are revealed on almost a daily basis now in the vaccine industry, theU.S. mainstream media continues to largely ignore such storiesOutside the U.S., however, the vaccine empires are beginning to crumble, and English versions of the news in mainstream media outlets are available via the Internet.

One such country is India, where the Bill & Melinda Gates Foundation and their vaccine empire are under fire, including a pending lawsuit currently being investigated by the India Supreme Court.”

If you aren’t aware of the key players in the vaccine mayhem being driven into African countries, they are:

  • The Bill & Melinda Gates Foundation
  • PATH (Program for Appropriate Technology in Health, funded by the Gates’ foundation), and
  • GAVI (Global Alliance for Vaccines and Immunization, also funded by the Gates’ foundation)

All four of these organizations will now be expected to explain themselves due to a writ of petition originally submitted to the Supreme Court of India in 2012, by Kalpana Mehta, Nalini Bhanot, and Dr. Rukmini Rao, which has finally been heard by the courts.

The petitioners stated:

“BMGF, PATH and WHO were criminally negligent trialling the vaccines on a vulnerable, uneducated and under-informed population school administrators, students and their parents who were not provided informed consent or advised of potential adverse effects or required to be monitored post-vaccination.”

Furthermore, though absent from most mainstream U.S. media outlets, the Economic Times of India published their report in August 2014, stating that young tribal girls were tested with HPV vaccines. This involved not a handful of children, but 16,000 individuals in Andhra Pradesh, India, where they were given the Gardasil vaccine.

KP Narayana Kumar reported that within a month of receiving the vaccine, many of the children fell ill, and by 2010, five of them had died. Another two children were reported to have died in Vadodara, Gujarat, where another 14,000 tribal children were vaccinated with another brand of the HPV vaccine, Cervarix, manufactured by GlaxoSmitheKline (GSK), who incidentally, has been accused of dumping polio virus into a Belgium river.

Consent forms to administer the HPV vaccine were ‘illegally’ signed by wardens form youth hostels, showing that the Gates’ prey on the indigent without parents. For those who had parents, most were illiterate, and the true potential dangers of the vaccines were not explained to them.

SAMA, an organization in India which promotes women’s health discovered this insidiousness, and reported it, but only now will Gates and his cronies have to answer for their misdeeds. Approximately 120 girls reported epileptic seizures, severe stomach cramps, headaches, and mood swings, of those who did not die. Other girls receiving the Gardasil vaccine have experienced infertility.

The Economic Times further reported:

“The SAMA report also said there had been cases of early onset of menstruation following the vaccination, heavy bleeding and severe menstrual cramps among many students. The standing committee pulled up the relevant state governments for the shoddy investigation into these deaths.

It said it was disturbed to find that ‘all the seven deaths were summarily dismissed as unrelated to vaccinations without in-depth investigations …’ the speculative causes were suicides, accidental drowning in well (why not suicide?), malaria, viral infections, subarachnoid hemorrhage (without autopsy) etc.”

The Bill and Melinda Gates Foundation declared their little vaccine project a total success. I guess the Supreme Court of India will decide that now.

About Christina Sarich:
Author Image

Christina Sarich is a humanitarian and freelance writer helping you to Wake up Your Sleepy Little Head, and See the Big Picture. Her blog is Yoga for the New World. Her latest book is Pharma Sutra: Healing the Body And Mind Through the Art of Yoga.

Read more: http://naturalsociety.com/bill-gates-faces-trial-india-illegally-testing-tribal-children-vaccines/#ixzz3szagOEbn
Follow us: @naturalsociety on Twitter | NaturalSociety on Facebook

YOU HAVE ALL THE RISK – VACCINE MANUFACTURERS HAVE NO LIABILITY

YOU HAVE ALL THE RISK – VACCINE MANUFACTURERS HAVE NO LIABILITY

by Sherri Tenpenny, DO, AOBNMM, ABIHM

Until recently, the concept of mandatory and mass vaccination was thought to be a far off possibility. Vaccination laws are regulated at the state level, and the federal government seemed to keep a watchful distance away from the subject. That appears to be changing, but the push for mandates is not new. This has been coming for a long time.

The groundwork to force everyone to be vaccinated began shortly after 911. President George W. Bush introduced Project BioShield during his State of the Union Address in  January, 2003. Project BioShield created a comprehensive, joint effort between the Department of Homeland Security (DHS), the Department of Health and Human Services (HHS)  and the private pharmaceutical industry to develop drugs and vaccines to be released in the event of a biological and chemical weapon attack. Signed into law in July, 2004, the program was funded with $5.6 billion over ten years.

PROJECT BIOSHIELD PUT FORTH THREE MAJOR COMPONENTS:

  • Indefinite funding  “medical counter-measures” – vaccines, drugs, technologies – to be released as soon as “experts” agree they were “safe enough.” In other words, Project Bioshield allowed the Secretary HHS to purchase – and use – unapproved and unlicensed vaccines/drugs.
  • New authority to the NIH to speed research and development of drugs and vaccines for bioterrorism threats, and
  • Authorized fast-tracking of drugs and vaccines, a fancy way to use medicines barely researched or tested – in the event of an “emergency.”

Between July 2004 and end of 2006, which was also the close the 109th Congress, 11 bills were introduced. Each of these pieces of legislation would have given unprecedented advantages to the drug industry and would have removed all safeguards preventing dangerous vaccines, drugs, and medical devices from reaching consumers.

The reaction against the bills was strong and loud from all political parties, stopping all bills except S. 3678,the Pandemic and All-Hazards Preparedness Act

PROJECT BIOSHIELD: NOT GOOD ENOUGH

buckets of moneyFrustrated and running out of time, Senate Majority Leader, Bill Fritz, a former medical doctor (R-TN), literally bullied a drug company protection bill into law. He used his power and senate rank to get the bill passed during the literal eleventh hour – at 11:20p on a Saturday night. This was long after the House Appropriation Committee members had reached a final agreement on a defense bill, had signed off and (most) had gone home.

Representative Dave Obey (D-WI), Ranking Member of the House Appropriations Committee, gave a first-hand accounting of how complete liability protection for manufacturers become law. Excerpts of his speech are included here:

Senator Frist marched over to the House side of the Capitol, about four hours after the Committee had finished at 6pm and were headed home. He insisted 40 pages of legislation—legislation that had never been seen by Conferees –be attached to the bill Defense Appropriation Bill.

“Speaker [Dennis Hastert R-IL] joined Frist’s insistence, and without a vote, the legislation was unilaterally and arrogantly inserted into the bill. [This was] a blatantly abusive power play by two of the most powerful men in Congress.

“We then discovered that the language provided all sorts of insulation for pharmaceutical companies…not just to drugs developed to deal with the [avian] flu, but for a far broader range of products.

“This is the second time that this Congress has supinely done the bidding of the pharmaceutical industry in the dead of night. The first time, a vote was held open for three hours while the Republican Majority twisted arms to create the complex and ridiculously confusing prescription drug bill that our seniors are now so desperately trying to understand—a bill that was [1000 pages long, costing $400Billion], ushered through this institution by over 600 lobbyists and that protected [drug] companies by preventing the government from even attempting to negotiate lower drug prices.

“If I thought [it would do any good] I would object. But, Mr. Speaker, it has also been made quite clear to me that the Majority will not relent on the language that insulates drug companies.”

[Reading his entire speech here is highly recommended. Or, search the page for FRIST; read to the end.]

Medical-FraudCalled “Division E—Public Readiness and Emergency Preparedness Act (PREPA)” Senator Frist (a medical doctor) handed the drug companies (a special interest group) more immunity than any bill that has ever been passed by Congress.

The legislation provides at least sweeping provisions:

  1. Immunity from all liability.  In the event of an outbreak of any kind, all drugs, vaccines or biological products are completely protected, even if it kills you. The definition is so broad it could include OTC pills such as Tylenol, Advil . . . and would have applied to Vioxx.
  2. The Secretary of HHS has complete authority to declare and emergency. The Secretary of HHS is an appointed, non-medical person who has not accountability to the general public. The president’s hand-picked teammate will have the power to mandate vaccines and other medications for the American people.
  3. Immunity from all accountability. Even if the Company’s dirty facility created a batch of contaminated vaccines that resulted in death or injury to thousands of people, the drug company will have immune from liability.
  4. Immunity from all law suits. A person who suffers any type of loss will be legally prohibited from suing the drug companies.

Through the PREPAct, drug companies have  immunity from almost everything, perhaps even murder. The bill’s language explicitly protects frivolous suits and sets a rigidly high standard for defining negligence. Even if a pharmaceutical company knowingly harms people, the company will be immune from legal prosecution unless the U.S. Attorney General initiates “enforcement action” against the drug company in the name of the claimant. This means the U.S. government would have to go to bat for the plaintiff against the drug company for the lawsuit to move forward.

According to the American Trial Lawyers Association, the bill contains language never before seen in any proposal.One member said,

“At a time when we see the egregious things that are being done by major drug companies, the last thing in the world the consumer needs is immunity for drug companies to act with impunity.”

In simple terms, a plaintiff can only go forward with a claim if s/he can prove that the drug company performed an act of “willful misconduct” that resulted in an injury or a death. In other words, the injured party would have to prove the vaccine maker intentionally caused them harm. Unbelievably, even then the drug company is still immune from accountability.

Business and medicine handshakeEven if a pharmaceutical company knowingly harms people, the company will be immune from legal prosecution unless the U.S. Attorney General initiates “enforcement action” against the drug company in the name of the claimant. This means the U.S. government would have to go to bat for the plaintiff against the drug company for the lawsuit to move forward.

The mainstream media has been pushing for mandatory vaccination of everyone, from children to adults. There have been calls for arresting parents who don’t vaccinate and harassment of doctors who speak out about vaccines and calls for revoking a doctor’s license for daring to question the safety and effectiveness of vaccines.

The question to be asked: Who Stands to Gain from this process? Who stands to gain from selling vaccines? If you are injured? If you lose recourse for your vaccine injury? By forcing you to give up your right to refuse?

Polish Study of Neurologic Adverse Events Following Vaccination

Polish Study of Neurologic Adverse Events Following Vaccination

Prog Health Sci 2012, Vol 2 , No1 Neurologic adverse events vaccination 129 Neurologic adverse events following vaccination Sienkiewicz D.*, Kułak W., Okurowska-Zawada B., Paszko-Patej G. Department of Pediatric Rehabilitation of the Medical University of Bialystok, Poland

ABSTRACT __________________________________________________________________________________________

The present review summarizes data on neurological adverse events following vaccination in the relation to intensity, time of onset, taking into account the immunological and non-immunological mechanisms. The authors described the physiological development of the immune system and the possible immune system responses following vaccination. Toxic property of thimerosal – a mercury-containing preservative used in some vaccines was presented. The neurological complications after vaccination were described. The role of vaccination in the natural course of infectious diseases and the current immunizations schedule in Poland was discussed.

Key words: vaccination, neurologic adverse events following vaccination, immunization schedules __________________________________________________________________________________________ *Corresponding author: Department of Pediatric Rehabilitation Medical University of Białystok 17 Waszyngtona str, 15-836 Białystok Poland E-mail: sdorota11@op.pl (Dorota Sienkiewicz) Received: 29.01.2012 Accepted: 22.02.2012 Progress in Health Sciences Vol. 2(1) 2012·pp 129-141. © Medical University of Bialystok, PolandProg Health Sci 2012, Vol 2 , No1 Neurologic adverse events vaccination 130

INTRODUCTION

Adverse reactions In developed countries, the schedules of mandatory and recommended vaccination for children contain more and more components with a specific emphasis on the co-administration of multiple antigens in combined form. This direction on the one hand provides many benefits and on the other carries an increased risk of side effects, the immunopathogenesis of which is not fully explained in many cases [1]. An adverse event following immunization (AEFI) is an undesirable side effect occurring after the administration of a vaccine [2]. It is a temporary, local or general reaction of the organism to an administered vaccine. A postvaccinal complication (PC) is associated with an excessive or pathological reaction with the characteristics of postvaccinal disease, which in extreme cases can lead to permanent damage, threat to life or even death [3]. Complications affecting the nervous system raise the most controversy; the more so, as the children subjected to vaccination are healthy.

In annex no. 1 to the Ordinance of the Minister of Health of 23rd December 2002 on adverse events following vaccination (Journal of Law from 31/12/2002, no. 241, item 2097, as amended. Journal of Law from 2005, no. 232, item 1973), the following categories of AEFI are presented [4].

1) Local reactions, including:

  • a) local reactions after the BCG vaccine,
  • b) swelling,
  • c) lymphadenopathy,
  • d) abscess at the injection site;

2) Postvaccinal adverse events of the central nervous system:

  • a) encephalopathy,
  • b) febrile convulsions,
  • c) non-febrile convulsions,
  • d) paralytic poliomyelitis caused by vaccine virus,
  • e) encephalitis,
  • f) meningitis,
  • g) Guillain – Barre syndrome;

3) Other adverse events following immunization:

  • a) joint pain,
  • b) hypotonic-hyporesponsive episode
  • c) fever above 39⁰C
  • d) thrombocytopenia,
  • e) continuous inconsolable crying.

Other classifications of postvaccinal reactions can be found in the literature, some of which put an emphasis on the neurological symptoms, while others emphasize the immunological mechanisms.

Byers et al. describing neurological complications, have included as “minor” – mild or severe postvaccinal reactions, occurring up to 48 hours after injection and disappearing without leaving permanent sequelae, the following:

  • prolonged crying,
  • restlessness and hyperactivity,
  • apathy with increased sleepiness,
  • high body temperature,
  • a temporary mild increase in intracranial pressure manifested by a throbbing crown of the head,
  • “cerebral cry” (sometimes included among “major” complications) [5-7].

Among the “major” neurological complications, usually manifesting more than 48 hours after vaccination and which might be the cause of permanent damage to the central nervous system (CNS), the following are listed:

  • seizures – especially if there is no increase in body temperature,
  • hypotonic-hyporesponsive episodes,
  • postvaccinal encephalitis,
  • postvaccinal encephalopathy [6, 8-11]
  • and autism [10, 12-14].

Konior and Strózik [7] have proposed their own classification of postvaccinal reactions taking into account the contribution of the immune system in the vaccinated children. They divided the adverse events into two groups:

1. related to the immune system – patients with immunodeficiencies (mainly cellular) and atopic patients with hypersensitivity to certain vaccine components

2. unrelated to the immune system – patients whose postvaccinal reactions may be related to the toxic effects of the vaccine components or may result from the vaccine virus turning virulent, resulting in complete or abortive symptoms of the disease.

Another classification of adverse events following vaccination distinguishes:

Local postvaccinal reactions (redness, swelling, pain at the injection site) occurring particularly often after the administration of live vaccines (10.8% -15.5% of reports) [15]

 Generalized postvaccinal reactions (fever, malaise, muscle pain, joint pain, headaches, flu-like symptoms, local lymphadenopathy, allergic reactions) – usually disappear spontaneously within 3 days of vaccination, do not require treatment [16].

 Early postvaccinal complications – anaphylactic reaction, described in one in about 1 million of vaccinated individuals, occurs most often after immunization against typhoid, tetanus, pertussis, measles, mumps, rubella [16].

 Late and long-term complications – determined by different immunological mechanisms, occur most often after the administration of preparations containing live micro-organisms (e.g., flaccid paralysis after an oral poliovirus vaccine OPV – 10 individuals annually per 1 million people vaccinated) [16].

Prog Health Sci 2012, Vol 2 , No1

Neurologic adverse events vaccination 131

Reports in many Polish and foreign medical journals lead us to conclude that postvaccinal complications among children can be observed in sporadic cases and that they are disproportionate to the benefits of vaccination in the elimination of dangerous diseases in childhood. This article focuses on several aspects related to overall immunization, including: the physiological development of the immune system, the possible immune system responses following vaccination, the site of vaccination in the natural course of infectious diseases and the current immunization schedule in Poland compared with other countries. The immune system in terms of vaccination

Physiology

Immune system functioning in neonates is characterized by complex mechanisms to adapt to the changed conditions of postnatal life. In infancy and early childhood, the individual components of specific and nonspecific immunity gradually develop and mature [17]. The humoral immunity of neonates is acquired and is associated with active transport of maternal immunoglobulin G through the placenta (starting from the end of the first trimester of pregnancy) mainly in the last 5-6 weeks of pregnancy. A neonate’s humoral response is therefore a state of physiological dysimmunoglobulinemia, i.e. it has an average concentration of its own IgG, minimal or low concentrations of IgA, IgM, IgE, IgD [13, 14]. The level of maternal IgG gradually decreases, while the level of the child’s IgG increases reaching approximately 60% of the adult level after 12 months. In the 2-3 month of life, an intersection of curves takes place – the declining curve of maternal IgG concentration and the increasing curve of infant IgG concentration (graph). The infant’s IgG level is the lowest then [18].

Levels of antibodies in the blood serum of the fetus, neonate and infant [18] From a physiological point of view, according to Jakóbisiak’s [18] classification, the group of secondary immunodeficiency disorders includes conditions such as pregnancy and conditions associated with age (neonates, the elderly). Premature babies are a specific group, whose shortened period of maternal IgG influx leads to compromised anti-infective immunity. On the other hand, according to the author, on account of the existing maternal antibodies, vaccination against certain microorganisms administered shortly after birth does not lead to long-lasting immunity. It should be emphasized that the immune system reaches full immunoregulatory and defensive maturity at about 3 years of age [19]. It is well established that early-life immune responses are weaker and of shorter duration than elicited in immunologically mature hosts. Consequently, vaccine efficacy in early infancy (particularly in the first 6 months of age) is limited [20]. Thus, in oder to provoke and sustain an adequate B-cell immune response in a neonate, strong immune adjuvants and repeated closely spaced booster doses are needed [21]. The problem with this approach is two-fold. First, experimental evidence clearly shows, that simultaneous administration of as little as two to three immune adjuvants, or repeated stimulation of the immune system by the same antigen can overcome genetic resistance to autoimmunity [22]. Second,while it is generally accepted that potency and toxicity of immune adjuvants must be adequately balanced so that the necessary immune stimulation is achived with minimal side effects, in practical terms, such a balance is very difficult to achieve. This is because the same adjuvantedmediated mrchanisms which drive to the immunestimulatory effects of vaccines have the capacity to provoke a variety of adverse reactions [23, 24] Vaccinations and immune response A vaccine is defined as a biological preparation containing antigen(s) of microorganisms that cause specific stimulation of the immune response after administration which protects against infection by this microorganism, with safety precautions taken during administration [18, 25].

A vaccine may contain:

  • 1. Microorganism antigens – bacterial or viral (live-attenuated, dead), isolated antigens – proteins, polysaccharides, DNA and anatoxins (diphtheria, tetanus) with retained immunegenicity but devoid of pathogenic properties,
  • 2. Suspension: water, physiological saline, substrate protein, e.g. egg white, gelatin,
  • 3. Preservatives: thiomerosal (mercury), antibiotics, phenol,
  • 4. Adjuvants, the aim of which is to enhance the immunogenicity of the vaccine – aluminum hydroxide or aluminum phosphate are the most commonly used.

Prog Health Sci 2012, Vol 2 , No1 Neurologic adverse events vaccination 132

According to the literature [18], it is believed that vaccines containing live microorganisms are among the most effective means of inducing immunity against infectious disease. Attenuated microorganisms (viruses, BCG mycobacteria) retain the ability to replicate in host cells, which stimulates cytotoxic T lymphocytes (Tc, CD8 +) that destroy cells infected by them. The way of impact of isolated antigens or antigens derived from whole inactivated microorganisms is different. In this case, a stimulation of the auxiliary Th (CD4+) lymphocyte response takes place. Th lymphocytes contain two distinct – in functional terms – subpopulations: Th1 and Th2. According to Jakóbisiak – with some simplification – it can be assumed that the Th1 lymphocytes perform auxiliary functions in cell-type response and Th2 in humoral response [18]. The mechanism of immune response to various types of vaccine antigens, especially to antigens in multicomponent vaccines, is not fully understood and researched.

The vaccination-stimulated Th2 pathway responsible for the production of antibodies, the pathway which predominates in neonates and infants, in the absence of an adequate balance of Th1 response may lead to the development of allergic reactions [25]. This is symptomatic of the fact that allergic diseases are often referred to as “an epidemic of the XXI century” [26, 27]. As stated in the “European Allergy White Paper”, the clinical symptoms of allergy are present in 35% of the population of developed countries, and according to the ISAAC (The International Study of Asthma and Allergies in Childhood) as many as 40%. Allergy is one of the major health problems on par with AIDS, cancer, cardiovascular diseases, injuries and accidents [28 – 30]. According to other authors, a restriction of the natural environmental infections stimulating Th1 response as well as change of their natural course resulting from mass immunization, an increase in general hygiene and widespread use of antibiotics (“Hygiene Theory”) inhibiting and delaying the adjustment of Th2/Th1 could theoretically also contribute to the growth of the risk of allergic diseases [31, 32]. A confirmation of this thesis was the study of Swiss children from anthroposoic backgrounds, in which significantly less atopy was observed than in children from other backgrounds. In this group, a positive correlation of diseases with the MMR vaccination was found [33]. In addition, in a series of papers, Silverberg et al. have shown that wild type varicella zoster virus infection (WTVZV), but not varicella vaccine (VV), protects against asthma and atopic dermatitis (AD) in young children [34, 35]. The protective effect of WTVZV was attributed to its beneficial effect on stimulating Th1-primed immune responses and suppressing allergy-promoting Th2 responses. According to Silverberg et al. [34], ―The introduction of widespread varicella vaccination and resultant decline of WTVZV in the United States may be a contributing factor in the increased prevalence of AD [atopic dermatitis] over the past few decades.‖ Notably, other than not providing an effective stimulus for proper immune system development, recent research has shown that vaccines are actually capable of disrupting it. For example, annual vaccination against influenza has been shown to hamper the development of virusspecific CD8+ T-cell immunity in children [36] From the above observations it is clear that the proper functioning of the immune system involves a delicate balance between the two arms of the immune equilibrium (Th1/Th2), and its tilt to either side can be harmful for the body [30]. Furthermore, it appears that the necessary Th1/Th2 balance is better provided by natural challenges (i.e., in a form of relatively benign childhood diseases such as chickenpox and mumps) rather than vaccination. Recent research by Singh of the International Institute for Brain Research in the USA confirm the veracity of this statement. In the study, serum and cerebrospinal fluid (CSF) were analyzed in terms of viral and autoimmune markers in Prog Health Sci 2012, Vol 2 , No1 Neurologic adverse events vaccination 133 patients with autism compared with a group of healthy children – both groups were vaccinated with MMR (measles, mumps, rubella vaccine) [37]. This is the first of this type of research examining a positive correlation between viral factors (viral serology) and autoimmune factors (brain autoantibodies). It was found that higher levels of measles antibodies were accompanied by Myelin Basic Protein (MBP) autoantibodies in children with autism (Figure.3). A similar serology was found in CSF. Fig. 3. Correlations between MMR antibodies and MBP autoantibodies in autistic and healthy children. (Source: [37] Singh VK. Phenotypic expression of autoimmune autistic disorder (AAD): A major subset of autism. Annals of Clinical Psychiatry, 2009, 21, 3,148-161; with permission: Healthy Impressions) The results in Table 1 show a comparative study of antibodies against other viral pathogens in the studied population of children which confirmed the pathogenic role of the measles strain.

Table 1. Blood serum levels of antiviral antibodies in healthy and autistic children Virus antibody (units)

Measle s Mu mps Rub ella HH V-6 CMV EBV EA EBN A VC A

  • Normal children 3.3±0. 1 2.5± 0.2 3.2± 0.2 1.6± 0.6 0.28 ±0.4 0.5±0 .04 1.2 ±0.2 1.8± 0.3 (n=32) (n= 30) (n=4 5) (n= 37) (n=3 0) (n=4 4) (n=4 4) (n= 44)
  • Autistic children 4.2±0. 1* 2.6± 0.3 3.3 ±0.1 2.2± 5.3 0.23+ 0.3 0.6 ±0.04 0.9± 0.2 1.4± 0.2 (n=87) (n= 32) (n=7 4) (n= 45) (n=3 0) (n=4 4) (n=4 4) (n= 44) p value .003* .76 .98 .5 .37 .76 .21 .15

(Source: [37] Singh VK. Phenotypic expression of autoimmune autistic disorder (AAD): A major subset of autism. Annals of Clinical Psychiatry, 2009, 21, 3,148-161; with permission: Healthy Impressions)

CMV: cytornegalovirus; EA: early antigen; EBNA: Epstein-Barr nuclear antigen; EBV: Epstein-Barr virus; HHV-6: human herpesvirus-6; VCA: viral capsid antigen; *Student t test was used to evaluate significance at a p value < 0.05 Significantly elevated levels of cytokines – IL-2, IL-12, IFN-γ (factors triggering autoimmune response) – and acute phase proteins were also found in patients [37].

According to the authors of this study, subtle changes in the child’s developing brain caused by an autoimmune reaction, changes in the myelin sheath, may ultimately lead to impairment Prog Health Sci 2012, Vol 2 , No1 Neurologic adverse events vaccination 134 of higher brain functions such as speech, communication, social interaction, as well as other neurological symptoms occurring in children with autism. In this study, the measles viruses were researched, but under the immunization program children also receive vaccinations with simultaneous administration of several viral components. What then occurs in the brain of a child? Presently, there are no studies in this area.

In an earlier study concerning postvaccinal adverse events of the immune system, Mannhalter et al. [38] presented an analysis of T lymphocyte (Th1/Th2) subpopulations in healthy adults before and after the administration of a vaccine containing the tetanus toxin. The result was a decrease in the Th1/Th2 ratio after vaccination, with maximum intensity 3 to 14 days after injection. These reports present a picture of neuroimmune disorders which may be the result of vaccinations carried out on an increasingly wider scale. A clear answer to this hypothesis would require both large-scale epidemiological studies as well as in-depth laboratory research. In Poland, multi-antigen combination vaccines are commonly administered at full cost with parental consent. Most often children are immunized at the same time with: diphtheria and tetanus toxoid, acellular pertussis antigen, polio and H.influenzae (Infanrix-IPV+Hib, Pentaxim vaccines) or with an additional antigen of hepatitis B virus (Infanrix hexa vaccine). These vaccinations are repeated from the second month of life 3 times every 6-8 weeks. The recommended vaccinations against rotavirus and pneumococcal (2-3 doses) are also proposed to children under 6 months of age. Together with the tuberculosis and hepatitis B vaccinations administered in the first 24h of life, an infant receives 24-26 doses of xenogenic antigens. According to Tsumiyama et al. [39] systemic autoimmunity appears to be the inevitable consequence of over-stimulating the host’s immune ‘system’ by repeated immunization with antigen. Indeed, in adults multiple vaccinations have been associated with a variety of autoimmune phenolmena [40 – 42], yet children are regularly exposed to a much higher burden of vaccines than adults under the assumption that such exposures are safe [43] . Vaccinations as an important “training” for the immune system lower its threshold of defense responses, which is a measure to prevent the development of infectious diseases. However, a question arises: how will the not fully mature, still developing immune system of a healthy child and the still forming central nervous system respond to such intense stimulation? Is it able to correctly respond with the same protective effect to so many different stimuli? Do the multi-antigen vaccine side effects change compared to the previously used vaccinations and how? Thus far, these questions lack clear answers. Nonetheless, it is important to emphasize that a burgeoning body of evidence shows that immune molecules play integral roles in CNS development, affecting processes such as neurogenesis, neuronal migration, axon guidance, synaptic connectivity and synaptic plasticity [44 – 46]. Despite the dogma that peripheral immune responses do not affect CNS function, substantial evidence points exactly to the contrary [44, 47, 48]. Thus, it is not reasonable to assume that manipulation of the immune system through an increasing number of vaccinations during critical periods of brain development will not result in adverse neurodevelopmental outcomes [43, 49] Neurological symptoms following vaccination

In recent years, attention has been brought to the mercury contained in vaccines as a component with toxic and allergic properties. The mercury compound is found in organic combinations in the form of sodium salt – thimerosal (sodium ethylmercuriothiosalicylate, merthiolate). The incidence of allergy to this compound is variously estimated from 13% in the Netherlands to 21% in Austria. Vaccinations are a primary cause of the initial allergic reactions to thimerosal [50]. Mercury’s neurotoxicity (accumulation in the brain), cardiotoxicity, hepatotoxicity, nephrotoxicity, immunotoxicity, and carcinogenicity are mentioned as its toxic activity. It causes, among others, developmental disorders in children and neurodegenerative diseases in adults [7]. According to researchers [51, 52], a manifold incidence increase of psychoneurological diseases such as autism, ADHD, mental retardation, epilepsy and others have been observed all over the world over the past twenty years. As stated, from the 1990s new vaccines for infants containing thimerosal began to be used in America. In the DTP, Hib and Hep B vaccines, children received a dose of 62.5 ug of mercury, which is 125-fold more than the dose considered safe (0.1ug/kg/day). These reports were the reason that Scandinavian countries already prohibited the use of mercury in 1990 [53]. In 2005, a paper was published which describes the sudden death (SUD – Sudden Unexpected Death) of 19 infants within a few hours/days after vaccination with two hexavalent vaccines (DTP-Hib-HepB-IPV). The healthy prior to vaccination children died as a result of postvaccinal cerebral and lung edema and heart attacks. As the authors conclude, despite the lack of direct evidence for a causal relationship of the described SUDs with vaccination, it is a signal that brings to attention the need to monitor the course of vaccination and its complications [54].Prog Health Sci 2012, Vol 2 , No1 Neurologic adverse events vaccination 135

In another study from 2004, Geier et al. [12] confirmed through epidemiological research the direct relationship between increasing doses of thimerosal and the incidence of autism in children in the US from the late 1980s through the mid- 1990s. In addition, there was a potential correlation between the number of primary pediatric measlescontaining vaccines (MMR) administered and the prevalence of autism during the 1980s. Geier et al. [12] also found a statistically significant odds ratios for the development of autism following increasing doses of mercury from thimerosal-containing vaccines (birth cohorts: 1985 and 1990-1995) in comparison to a baseline measurement (birth cohort: 1984). The contribution of thimerosal from childhood vaccines (>50% effect) was greater than that of the MMR vaccine on the prevalence of autism observed in the study. In Poland, according to the documents “Characteristics of Pharmaceuticals”, there are currently several permitted vaccines with significant thimerosal (THIM) content. These are: Euvax (Hepatitis B, LG Life Sciences, Korean manufacture) – 0.01% THIM-50μg/dose, DT (Biomed, Krakow) – 50μg/dose, Td (Biomed, Krakow) – 50μg/dose, DTP (Biomed, Krakow) – 50μg/dose, D,d (Biomed, Krakow) – 50μg/dose, TT (Biomed, Krakow) – 50μg/dose [4, 55]. The frequency of observed reactions and complications depend on the general condition, especially neurological, of the child, the age, immunological resistance status as well as family and genetic load. In the literature, neurological symptoms are usually connected with the pertussis component of the vaccines, including: cerebral cry, according to Cody, occurs in 1:1000 of vaccinated subjects; seizures – mild, feverish – triggered by the pertussis endotoxin, in 10% of vaccinated subjects the convulsions occur without elevated body temperature, and severe seizures occur according to Waller et al. in 1 in 106,000 children [25]. In serious complications, such as encephalitis (about 2.9/10,000,00 of those vaccinated with DTP), encephalopathy (1:140,000 – 1:300,000 of the vaccinated), which may result in mental retardation, recurrent seizures, epilepsy – particularly myoclonic and Lennox-Gastaut Syndrome, changes in the central nervous system comparable to those which occur in the course of meningitis and encephalitis were reported. In the early stages, perivascular lymphocytic infiltration and demyelination outbreaks were observed, then myelin atrophy with intact neuron axial fiber, degenerated microglia and macrophage cells. Some experimental studies suggest the pertussis toxin, which through the membrane receptors causes inhibitory neurotransmitter dysfunction and induces activity of excitatory neurotransmitters [56, 57]. In 2010, a case of a 6-month-old previously healthy boy admitted to hospital on day 6 after vaccination with DTwP (whole cell) was described. The child was in a coma, hypotonia, with focal clonic seizures. MRI of the central nervous system using proton spectroscopy revealed acute necrotizing encephalopathy [58]. Previously, epileptic seizures in children with asymptomatic CMV infection which occurred after vaccination with DTwP and OPV had also been described. In the case of hepatitis C virus (HCV) infection, DTaP (acellular) and IPV (inactivated) vaccinations are recommended [59]. As stated in the Polish literature, acellular vaccines are much better tolerated than whole cell – the risk of fever after the first dose is reduced by over 99%, the risk of hypotonic-hyporesponsive episodes by 56%, similar to seizures, and the risk of inconsolable crying after the first dose is reduced by 87% [4]. According to the current vaccination schedule in Poland, infants receive the first three doses of DTwP in the first 6-8 weeks of life every 6-8 weeks, the 4th dose in the 16th-18th month of life, and a DTaP booster at 6 years of age. Given the often reported neurological complications after whole-cell pertussis (DTwP, DTP) vaccine, most developed countries – European and the US – have introduced changes in their immunization schedules and the safer acellular (DTaP) vaccines are administered to children. Of these countries, the only exceptions are: Bulgaria, Malta and Poland. In Poland, the safe vaccine is paid in full.

Other neurological complications associated with the administered vaccination are listed, among others, as follows:

  • multiple sclerosis after hepatitis B vaccine [60],
  • Guillain-Barre syndrome – after vaccination against influenza, hepatitis, meningitis C, polio and HPV vaccines [61-65],
  • transverse myelitis as a result of vaccination against cholera, typhoid, polio, and influenza,
  • flaccid paralysis, meningitis, encephalitis, convulsions and facial palsy after live polio vaccine [65, 66],
  • rapid progression of retinopathy in premature infants after BCG vaccination [67].

Monitoring In the case of AEFI, the obligation of notification was described in article 21 of the Preventing and fighting infections and infectious diseases in humans Act. According to the Act, a physician who recognizes or suspects the occurrence of AEFI is required, within 24 hours after concluding the suspicion, to notify the State Sanitary Inspector of the suspected case [3]. In order for that to be possible, the child’s guardian must also be accurately informed about the adverse symptoms following vaccination that may occur, then report the problem to the doctor or nurse who will take further steps.

There was an attempt to trace the actual scale of the adverse events following vaccination reported by nurses and doctors. Prog Health Sci 2012, Vol 2 , No1 Neurologic adverse events vaccination 136  The monitoring system was introduced in Poland in 1996 and is based on the WHO recommendations. In the Zieliński study, the number of AEFI reported in 1996-2000 from different provinces was analyzed and clear differences regarding the frequency of recorded entries were found. As the authors write, “they met astonishing examples of ignorance of the medical staff, including specialists, in their duty to report the AEFI” in their epidemiological practice [68]. On the other hand, there is no real possibility of laboratory tests to confirm a causal relationship between the clinical picture and the used vaccine. For example, only a few research laboratories in Poland, of the highest reference level, posses the microbiological methods for distinguishing mycobacteria from the BCG vaccine from other species of the Mycobacterium tuberculosis strain [69]. There are also no reports in the literature (except those listed above) of research work in immunology in the context of reactions following vaccination. It should also be noted that in more developed countries, there is little incentive for doing appropriate follow-up and laboratory tests on individuals who suffered serious adverse reactions following vaccinations [70]. The reason for such oversight is likely due to the fact that historically, vaccines have not been viewed as inherently toxic by the regulatory agencies [68] The resulting lack of evidence of causality between vaccinations and serious adverse outcomes has thus been filled with an assumption that vaccines are safe [71]. Natural history of infectious diseases/ immunizations Based on statistics from the Federal Statistics Office in Wiesbaden, Buchwald published a paper containing long-term observations of morbidity and mortality from infectious diseases. It is interesting that in recent decades a decrease of infectious diseases was generally reported, which took place before the introduction of inoculations against these diseases. According to a 2002 report from Lancet Infectious Diseases [72] ―the weight of evidence collectively suggests that personal and environmental hygiene reduces the spread of infection‖ and ―Thus results from this review demonstrate that there is a continued, measurable, positive effect of personal and community hygiene on infectious‖. The same report showed that the crude death rate from infectious diseases decreased to nearly negligible levels long before introduction of universal vaccination practices. Currently, the developed countries introduce increasingly complex vaccination schedules. Forty years ago, children were immunized against five diseases (diphtheria, tetanus, pertussis, polio, smallpox), today this number has increased to eleven. At the same time, as mentioned previously, repeatedly administered multi-antigen vaccines are recommended. Doctors and researchers point to the worsening state of health of the child population since the 1960s, which coincided with increasingly introduced vaccinations. Allergic diseases, including asthma, autoimmune diseases, diabetes and many neurological dysfunctions – difficulty in learning, ADD (attention deficit disorder), ADHD (attention deficit hyperactivity disorder), seizures, and autism – are chronic conditions, to which attention has been brought [73]. Proposals for modification of the vaccination schedule European countries have different models of vaccination that have been modified in recent decades. In Scandinavian countries, which have the lowest infant mortality, vaccinations are voluntary and infants receive their first vaccination at 3 months of age. In the first year of life, they receive 9 recommended vaccinations, and at 18 months – MMR. The acellular pertussis vaccine (DTaP) is used, as well as IPV. BCG and Hepatitis B vaccines are administered to children from high risk groups. Similar vaccination schedules exist in other European countries, where the vaccination of neonates was abandoned and a ban on the use of thimerosal in vaccines was introduced [4, 74]. Note also that Scandinavian countries have the lowest rates of autism compared to other developed countries in which children are vaccinated much earlier and with greater number of vaccines [49]. Professor Majewska – a neurobiologist, Director of the Marie Curie Chairs Program at the Department of Pharmacology and Physiology of the Nervous System in Warsaw – together with pediatricians, drafted a proposal for changes to the vaccination program in Poland, which is based on an analysis of programs in other European Union countries. The propositions are as follows:

1. Eliminate thimerosal from all vaccines.

2. Discontinue the immunization of infants with the hepatitis B vaccine (vaccinate only newborns at high risk, i.e. of infected mothers).

3. Discontinue BCG vaccination of neonates (use only in regions where the percentage of TB patients is over 40 per 100 thousand).

4. Begin vaccination from 4 months old in the remaining group of children.

5. Discontinue the whole cell pertussis vaccine.

6. Give a maximum of three types of vaccines in one day.

7. Discontinue the administration of live virus vaccines or give them one at a time at safe intervals.

8. Make monovalent vaccines accessible.

9. Commitment of the doctor administering the vaccine to conduct a preliminary interview with the parents about allergies, asthma and other autoimmune diseases and postvaccinal complications in family members, allowing them to predict whether a given child may experience severe postvaccinal reactions. Such a child should have an individual, very careful vaccination program developed.

10. Monitor the health status of children after vaccination in order to notice life- or healththreatening conditions in time.

11. Create a national program for compulsory registration of postvaccinal complications and deaths. These data should be reported to the WHO and information about complications should be provided in the child’s health record book [51]. Prog Health Sci 2012, Vol 2 , No1 Neurologic adverse events vaccination 138

CONCLUSIONS

Despite the assurances of the necessity and safety of vaccinations, there are more and more questions and doubts, which both physicians and parents are waiting to be clarified. This paper describes several aspects of the immunization program of children. It includes:

  • the physiological development of the immune system,
  • the immunization schedule adopted in Poland in comparison with other countries,
  • adverse reactions and complications following vaccination described in scientific publications,
  • the natural course of infectious diseases in conjunction with the vaccination programs implemented
  • and the problem of reporting adverse reactions following vaccination by medical personnel and parents.

The proposal for changes in vaccination in Poland cited at the end of this paper is, according to the authors, part of the answer to the concerns and doubts. A second part would be extensive neuroimmunological research confirming or excluding the relationship of vaccines with the reported adverse events (early, late/long-term) and chronic diseases whose upward trend has been observed in recent decades in children. It seems that it would be worthwhile to apply the precautionary principle – the ethical principle (from 1988) according to which if there is a probable, although poorly known, risk of adverse effects of new technology, it is better not to implement it rather than risk uncertain but potentially very harmful consequences.

ACKNOWLEDGMENTS

We are grateful to Mrs. Ursula HumienikDworakowska for the translation of this article.

Conflicts of interest

We declare that we have no conflicts of interest.

REFERENCES

1. Ward BJ. Vaccine adverse events In the New millennium: is there reason for concern? Bull of the World Health Org. 2000; 78, 2: 205-15. 2. Bernatowska E. Vaccinations and their safety. Centrum Zdrowia Dziecka. Warszawa 2004. (Polish) 3. Taraszkiewicz F, Bogus-Parfieniuk W, Ołdak E, Sulik A. Vaccine adverse events in children between the ages 0 – 2 years. Przegl Epidemiol. 1994; 48, 4: 505-9. (Polish) 4. Kubiak R. Legal basis for the implementation of vaccination. Opinions and interpretations. – Educational workshops: Vaccinations in medical practice – the clinical situation to the optimal decision Med Prakt. 2010; 1: 3-39. (Polish). 5. Byers R, Moll FC. Encephalopathies following prophylactic pertussis vaccine. Pediatrics. 1948; 1:437. 6. Brett EM. Pediatric Neurology. New York: Churchil Livingstone; 1991. 7. Strózik K, Konior R. Vaccine adverse events and complications Medycyna 2000; 1997: 54- 6. (Polish) 8. Placebo-controlled trial of two acellular pertussis vaccines in Sweden–protective efficacy and adverse events. Ad Hoc Group for the Study of Pertussis Vaccines. Lancet. 1988; 30;1(8592):955-60. Erratum in: Lancet 1988 May 28;1(8596):1238. 9. Miller D, Madge N, Diamond J, Wadsworth J, Ross E. Pertussis immunisation and serious acute neurological illnesses in children. BMJ. 1993 Nov; 6; 307(6913):1171-6. 10. Peter G. Childhood immunizations. N Engl J Med. 1992 Dec 17; 327(25): 1794-800. 11. Sidor K, Radzikowski A. Vaccination of children with disorders of the central nervous system. Klin Pediatr. 1996; 2, 4: 57-9. (Polish) 12. Geier DA, Geier MR. A comparative evaluation of the effects of MMR immunization and Mercury doses from thiomersal-containing childhood vaccines on Prog Health Sci 2012, Vol 2 , No1 Neurologic adverse events vaccination 139 the population prevalence of autism. Med Sci Monit. 2004 Mar; 10(3): P133-9. 13. Grether J, Croen L, Theis C, Blaxill M, Haley B, Holmes A. Baby hair, mercury toxicity and autism. Int J Toxicol. 2004 Jul-Aug; 23(4): 275-6. 14. Mutter J, Naumann J, Schneider R, Walach H, Haley B. Mercury and autism: accelerating evidence? Neuro Endocrinol Lett. 2005 Oct; 26(5): 439-46. 15. Zhou W, Pool V, Iskander JK, EnglishBullard R, Ball R, Wise RP, Haber P, Pless RP, Mootrey G, Ellenberg SS, Braun MM, Chen RT. Surveillance for safety after immunization: Vaccine Adverse Event Reporting System (VAERS)–United States, 1991-2001. MMWR Surveill Summ. 2003 Jan; 24; 52(1):1-24. Erratum in: MMWR Morb Mortal Wkly Rep. 2003 Feb 14;52(06):113. 16. Panasiuk B, Prokopowicz D. Is vaccination safe? Nowa Pediatr. 2006; 4:86-9. (Polish) 17. Zeman K. Immune disorders in children. Warszawa: PZWL; 2002. (Polish). 18. Jakóbisiak M. Immunology. Wyd. Naukowe. Warszawa: PWN; 2007. (Polish). 19. Deggeller L. Concerning childhood vaccination today. J Anthroposophic Med. 1992; 9, 2: 1-15. 20. Siegrist CA, Aspinall R. B-cell responses to vaccination at the extremes of age. Nat Rev Immunol. 2009 Mar; 9(3): 185-94. 21. Siegrist CA. Neonatal and early life vaccinology. Vaccine. 2001 May 14; 19(25- 26): 3331-46. 22. Tsumiyama K, Miyazaki Y, Shiozawa S. Selforganized criticality theory of autoimmunity. PLoS One. 2009 Dec 31; 4(12): e8382. 23. Tomljenovic L, Shaw CA. Mechanisms of aluminum adjuvant toxicity and autoimmunity in pediatric populations. Lupus. 2012 Feb; 21(2): 223-30 24. Tomljenovic L, Shaw CA. Do aluminum vaccine adjuvants contribute to the rising prevalence of autism? J Inorg Biochem. 2011 Nov; 105(11):1489-99. 25. Willak-Janc E. Vaccination in children with allergic diseases. Alergia Astma Immunol. 2003; 8, 3: 107-9. (Polish) 26. Hoffmann-Sommergruber and the SAFE consortium. The SAFE Project: „plant-food allergies: field to table strategies for reducing their incidence In Europe‖ an EC-funded study. Allergy. 2005 Apr; 60(4): 436-42. 27. Kaczmarski M, Nowowiejska B, Maciorkowska E. Modern possibilities of preventing the development of allergic diseases in children and adolescents, with particular reference to food allergy. Pol Merkur Lek. 2001; 10: 374-378. (Polish) 28. Aas K, Aberg N, Bachert C, Bergmann K, Bergmann R, Bonini S. European Allergy White Paper. Allergic diseases as a public health problem in Europe. UCB Pharmaceuticals Sector, Braine-l’Alleud, Belgium. 1997; 14-59. 29. Coulie P. Reasons for the increase in the prevalence of allergies. Allergy and Clin Immunol. 2002; 14: 288-9. 30. Osterballe M, Hansen TK, Mortz CG, Høst A, Bindslev-Jensen C. The prevalence of food hypersensitivity in an unselected population of children and adults. Pediatr Allergy Immunol. 2005 Nov; 16(7): 567-73. 31. Constant S, Bottomly K. Induction of Th1 and Th2 CD4+ T cell responses; the alternative approaches. Ann Rev Immunol. 1997; 15: 297-305. 32. Kay AB. Allergy and allergic diseases. First of two parts. N Engl J Med. 2001 Jan 4; 344(1):1263-9. 33. Alm JS, Swartz J, Lilja G, Scheynius A, Pershagen G. Atopy in children of families with an anthroposophic lifestyle. Lancet. 1999 May 1; 353(9163): 1485-8. 34. Silverberg JI, Norowitz KB, Kleiman E, Silverberg NB, Durkin HG, Joks R, SmithNorowitz TA. Association between varicella zoster virus infection and atopic dermatitis in early and late childhood: a case-control study. J Allergy Clin Immunol. 2010 Aug; 126(2): 300-5. 35. Silverberg JI, Norowitz KB, Kleiman E, Durkin H, Smith-Norowitz TA. Varicella zoster virus (wild-type) infection, but not varicella vaccine, in late childhood is associated with delayed asthma onset, milder symptoms, and decreased atopy. Pediatr Asthma Allergy Immunol. 2009 Mar; 22:15- 20. 36. Bodewes R, Fraaij PL, Geelhoed-Mieras MM, van Baalen CA, Tiddens HA, van Rossum AM, van der Klis FR, Fouchier RA, Osterhaus AD, Rimmelzwaan GF. Annual vaccination against influenza virus hampers development of virus-specific CD8⁺ T cell immunity in children. J Virol. 2011 Nov; 85(22): 1995- 2000. 37. Singh VK. Phenotypic expression of autoimmune autistic disorder (AAD): A major subset of autism. Ann Clin Psychiatry. 2009 Jul-Sep; 21(3): 148-61. 38. Eibl MM, Mannhalter JW, Zlabinger G. Abnormal T-lymphocyte subpopulations in healthy subjects after tetanus booster immunization. N Engl J Med. 1984 Jan 19; 310(3): 198-9. 39. Tsumiyama K, Miyazaki Y, Shiozawa S. Selforganized criticality theory of autoimmunity. PLoS One. 2009 Dec 31; 4(12): e8382. Prog Health Sci 2012, Vol 2 , No1 Neurologic adverse events vaccination 140 40. Exley C, Swarbrick L, Gherardi RK, Authier FJ. A role for the body burden of aluminium in vaccine-associated macrophagic myofasciitis and chronic fatigue syndrome. Med Hypotheses. 2009 Feb; 72(2): 135-9. 41. Authier FJ, Cherin P, Creange A, Bonnotte B, Ferrer X, Abdelmoumni A, Ranoux D, Pelletier J, Figarella-Branger D, Granel B, Maisonobe T, Coquet M, Degos JD, Gherardi RK. Central nervous system disease in patients with macrophagic myofasciitis. Brain. 2001 May; 124(Pt 5): 974-83. 42. Shoenfeld Y, Agmon-Levin N. ‘ASIA’ – autoimmune/inflammatory syndrome induced by adjuvants. J Autoimmun. 2011 Feb; 36(1): 4-8. 43. Tomljenovic L, Shaw CA. Mechanisms of aluminum adjuvant toxicity and autoimmunity in pediatric populations. Lupus. 2012 Feb; 21(2): 223-30. 44. Garay PA, McAllister AK. Novel roles for immune molecules in neural development: implications for neurodevelopmental disorders. Front Synaptic Neurosci. 2010 Sep 8; 2:136. 45. Stevens B, Allen NJ, Vazquez LE, Howell GR, Christopherson KS, Nouri N,Micheva KD, Mehalow AK, Huberman AD, Stafford B, Sher A, Litke AM, Lambris JD, Smith SJ, John SW, Barres BA. The classical complement cascade mediates CNS synapse elimination. Cell. 2007 Dec 14; 131(6):1164- 78. 46. Boulanger LM. Immune proteins in brain development and synaptic plasticity. Neuron. 2009 Oct 15; 64(1): 93-109. 47. Besedovsky HO, del Rey A. Central and peripheral cytokines mediate immune-brain connectivity. Neurochem Res. 2011 Jan; 36(1): 1-6. 48. Besedovsky HO, Rey A. Brain Cytokines as Integrators of the Immune–Neuroendocrine Network. [in]: Lajtha A, Besedovsky HO, Galoyan A (eds). Handbook of Neurochemistry and Molecular Neurobiology. Springer. 2008; p. 3-17. 49. Tomljenovic L, Shaw CA. Do aluminum vaccine adjuvants contribute to the rising prevalence of autism? J Inorg Biochem. 2011 Nov; 105(11):1489-99. 50. Kieć-Świerczyńska M. Mercury as an allergizing factor. Med Pracy. 1996; 48, 1: 77- 9. (Polish) 51. Majewska MD. Marie Curie Chair, Department of Pharmacology and Physiology of the Nervous System, Institute of Psychiatry and Neurology, Warsaw. Nieznany Świat. 2010; 230: 62-70. 52. http://www.epa.gov/iris/subst/0073.htm. [2011 Dec 10]. 53. http://www.reuters.com/article/pressRelease/id US108558+03-Jan-2008+PRN 20080103. [2011 Dec 10]. 54. von Kries R, Toschke AM, Strassburger K, Kundi M, Kalies H, Nennstiel U, Jorch G, Rosenbauer J, Giani G. Sudden and unexpected deaths after the administration of hexavalent vaccines (diphtheria, tetanus, pertussis, poliomyelitis, hepatitis B, Haemophilius influenzae type b): is there a signal? Eur J Pediatr. 2005 Feb; 164(2): 61-9. 55. Majewska MD, Urbanowicz E, Rok-Bujko P, Namyslowska I, Mierzejewski P.Agedependent lower or higher levels of hair mercury in autistic children than in healthy controls. Acta Neurobiol Exp (Wars). 2010; 70(2): 196-208. 56. Menkes JH. Textbook of Child neurology. Balitiomore; Williams & Wilkins 1995. 57. Sidor K, Horwath A. Neurological complications following vaccination (Polish). Nowa Pediatr. 1999; 16: 29-31. 58. Aydin H, Ozgul E, Agildere AM. Acute necrotizing encephalopathy secondary to diphtheria, tetanus toxoid and whole-cell pertussis vaccination: diffusion-weighted imaging and proton MR spectroscopy findings. Pediatr Radiol. 2010 Jul; 40(7): 1281-4. 59. Dunin-Wąsowicz D, Milewska-Bobula B, Idzik M, Kapusta M, Kasprzyk-Obara J, Pakuła-Kościesza E. Epilepsy and seizures in infants in the course of cytomegalovirus infection – a problem of preventive vaccination. Neurol Dziec. 2002; 11, 21: 29- 42. (Polish) 60. Girard M. Autoimmune hazards of hepatitis B vaccine. Autoimmun Rev. 2005 Feb; 4(2): 96- 100. 61. Souayah N, Nasar A, Suri MF, Qureshi AI. Guillain-Barré syndrome after vaccination in United States: data from the Centers for Disease Control and Prevention/Food and Drug Administration Vaccine Adverse Event Reporting System (1990-2005). J Clin Neuromuscul Dis. 2009 Sep; 11(1): 1-6. 62. Souayah N, Michas-Martin PA, Nasar A, Krivitskaya N, Yacoub HA, Khan H,Qureshi AI. Guillain-Barré syndrome after Gardasil vaccination: data from Vaccine Adverse Event Reporting System 2006-2009. Vaccine. 2011 Jan 29; 29(5): 886-9. 63. Centers for Disease Control and Prevention (CDC). Update: Guillain-Barré syndrome among recipients of Menactra meningococcal conjugate vaccine—United States, June 2005- September 2006. MMWR Morb Mortal Wkly Rep. 2006 Oct 20; 55(41):1120-4. Erratum in: MMWR Morb Mortal Wkly Rep. 2006 Nov 3; 55(43): 1177. Prog Health Sci 2012, Vol 2 , No1 Neurologic adverse events vaccination 141 64. http://www.cdc.gov/mmwr/preview/mmwrhtm l/mm5541a2.htm Morb Mortal Wkly Rep (MMWR). 2006;55(41):1120-4. 65. Friedrich F. Neurologic complications associated with oral poliovirus vaccine and genomic variability of the vaccine strains after multiplication in humans. Acta Virol. 1998 Jun; 42(3):187-94. 66. Michalak S. Postvaccinal complications within the nervous system. In: Second National Symposium ‘Adverse effects of drugs. Poznań 16.IV.2004, Materials Research. 2004; 37-41. (Polish) 67. Modrzejewska M, Machalińska A, Karczewicz D, Czeszyńska BM, Rudnicki J. Rapid progression of retinopathy of prematurity after vaccination BCG – case report. Pediatr Pol. 2008; 83, 3: 290-4. (Polish) 68. Zieliński A, Czarkowski MP, Rudowska J. Monitoring of vaccinal adverse events in Poland Pediatr Pol. 2002; 78(2): 91-8. (Polish). 69. Zwolska Z, Augustynowicz-Kopeć E, Zabost A, Ziółkowski J, Buchwald J, Płończak M, Walas W, Ziebiński M. The application of modern microbiological methods for diagnosis of complications after BCG vaccination. Description of the cases. Pneumonol Alergol Pol. 2004; 72: 508-10. 70. Zinka B, Rauch E, Buettner A, Ruëff F, Penning R. Unexplained cases of sudden infant death shortly after hexavalent vaccination. Vaccine. 2006 Jul 26; 24(31-32): 5779-80. 71. Tomljenovic L, Shaw CA. One-size fits all? Vaccine. 2011. doi:10.1016/ j.vaccine. 2011. 11.053). 72. Aiello AE, Larson EL. What is the evidence for a causal link between hygiene and infections? Lancet Infect Dis. 2002 Feb; 2(2): 103-10. 73. http//www.whale.to/m/incao.htlm, Hepatitis B Vaccination Testimony in Ohio – March 1, 1999 74. http://www.euvac.net/graphies/euvac/vaccinati on/sweden.html. [cited 2011 August 8]