Dr. Robert W. Sears: Why Partial Vaccinations May Be an Answer


March 23, 2015

Robert W. Sears is a practicing pediatrician and the co-author of several parenting books, including The Vaccine Book: Making the Right Decision for Your Child. This is the edited transcript of an interview conducted on Jan. 7, 2010. It was originally published on April 27, 2010.

Relate your first encounter with an anti-vaccine book with the DTP [diphtheria, tetanus, pertussis] vaccine.

I got interested in the topic of vaccines way back in medical school. A friend of mine convinced me to read a book about vaccines, and it ended up being a very anti-vaccine book. It was all about an old vaccine called the DTP vaccine that we don’t use anymore. But the book talked a lot about the risks and the dangers of that vaccine. The author of that book was calling for that vaccine to no longer be used.

A number of years later, it turns out that they did discover that vaccine was causing a lot of very severe, life-threatening, even fatal side effects, so they did end up taking that vaccine off the market.

So it kind of opened my eyes to the fact that there are some very severe, fortunately very rare, side effects to vaccines, and I wanted to learn more about this issue. I started reading a lot more books.

And unfortunately, when you look at vaccine books on the market, you’ll see they’re for the most part very anti-vaccine. They only tell all the dangers and risks of vaccines, only that side of the story. I found there were no books out there that gave both sides of the story: the risks of vaccines versus the risks of the diseases. So that’s what I set out to write about, was something that gave both sides of the issue so that parents can read something that helps them make an informed, educated decision.

How were your patients’ attitudes toward vaccines changing?

The biggest fear I think every parent has about vaccines is that they don’t want their child to be one of those very rare statistics in which their child suffers a very severe vaccine reaction. … Something like 1 in 100,000 babies has a very severe reaction.

But it’s very scary for a parent to think that they could be one of those, so that just causes parents to raise questions. Exactly how safe are vaccines, and how likely is it that my baby’s going to have a severe reaction? Parents want to know those kinds of numbers so that they can feel that they’re making a more educated decision about vaccines.

I see a growing problem in America, in which more and more parents are choosing not to vaccinate. There’s a growing distrust about the safety of vaccines, so I wanted to put something together that parents can read, that gave them a fair look and an educated look about vaccines so they could understand what the possible reactions are. Fortunately they’re very rare. But parents also need to understand what the risks of the diseases is so that parents can weigh both sides of the story so they’re understanding what’s going on and they can make a decision for their child.

With the growing mistrust of vaccinations in our country, more and more parents are saying no to vaccines. They’re refusing all vaccines altogether. And I think if more and more parents keep making those decisions, we’re going to run into a lot of trouble with these diseases. Illnesses that are very rare right now, that most parents don’t have to fear, could escalate and could start killing babies left and right if fewer and fewer parents are vaccinating. …

Describe your alternative vaccine schedule versus the CDC [Centers for Disease Control and Prevention] schedule.

I see a lot of parents questioning the CDC vaccine schedule. They worry that it’s too overloaded. There’s too many shots at too young of an age, and parents simply are looking for a safer way to do it, something they’re more comfortable with.

I created my alternative vaccine schedule that allows parents to go ahead and vaccinate, simply in a more gradual manner. And I find a lot of worried parents who otherwise would refuse vaccines altogether are very happy to go ahead and vaccinate if they’re doing it in a way that they feel safer about.

Let’s take a look at the two different schedules. One of the main differences that the CDC schedule dictates is they suggest the hepatitis B vaccine be given the day a baby’s born, one month later, and then six months later. Now, if you look at hepatitis B, it’s a sexually transmitted disease. The only way a baby can catch it is through blood or body-fluid exposure, and that’s extremely unlikely to happen for any baby or young child in the United States.

So what I did on my schedule is, I took a more logical look at hepatitis B, and I realized that babies have no risk of catching this disease, so let’s not do the hep B vaccine while a baby’s young and small and more vulnerable. Let’s do a hepatitis B vaccine when a child’s more of a preschool age, where he or she is going to be entering school and be running around with a lot of other kids, and there could be some blood or body-fluid exposures in those kinds of situations. To me, that’s just a more logical time frame to do the hepatitis B vaccine. And some parents would even take it a step further and decide to delay their children’s hep B vaccine until their children are teenagers and the real risks of hepatitis B, such as sexual activity or [intravenous] drug abuse, come into play.

What’s next down the list?

The next point on the vaccine schedule where I differ [from] the CDC schedule is what to do at 2, 4 and 6 months of age. The CDC groups six vaccines all together at 2 months, 4 months and 6 months, and they recommend that pediatricians give all these vaccines in this three-dose series to babies. I think that’s what a lot of parents are worried about.

What I do instead is I give two vaccines at a time, at 2 months, 4 months and 6 months. I also give two of the vaccines that I’m skipping on alternative months: 3 months, 5 months and 7 months. And I’m avoiding a big overload. I’m giving only a couple vaccines at a time. I feel that babies will experience fewer vaccine reactions; I think babies’ bodies can handle them better. Their immune system can handle them better that way, and I think a lot of parents simply feel more safe about that kind of approach.

What I do on my schedule is I take the most serious diseases and I make sure I’m vaccinating for those right away for babies. I don’t want to delay any vaccine that could protect a baby from a very potentially life-threatening or very common serious illness. And what those illnesses are that I focus on are whooping cough, or pertussis, and rotavirus. Those are two very serious illnesses that I vaccinate babies at 2 months, 4 months and 6 months. What I do at 3, 5 and 7 months is, I give them meningitis vaccines: Hib and pneumococcal meningitis. Those are the four different vaccines that I give in the staggered schedule during the early months of a baby’s life so that the baby’s protection from those vaccines isn’t delayed.

The Centers for Disease Control, on the other hand, groups all those vaccines together at 2 months, 4 months and 6 months, along with polio vaccine and in some cases hepatitis B vaccine as well.

The reason I delay the polio vaccine on my alternative schedule is that we don’t have polio in the United States. We haven’t had it here for over 30 years. We’ve been very fortunate because the vaccination program for polio has been so successful, now we’re reaping the rewards of not having to worry about this disease. Now, I don’t want to delay the polio vaccine too long, because if no children get the polio vaccine, then we are almost guaranteed to see polio come back into our country. So what I do is, I give polio vaccine at 9 months, 12 months and around 2 years of age. I’ve just delayed it a little bit. …

The safety profile of the CDC schedule is thoroughly tested and vetted. Is yours?

Some experts might question changing the vaccine schedule, or doing an approach that’s outside of the CDC’s schedule, where in fact these vaccines are studied in different time intervals and given apart from each other instead of grouped together. They’re studied that way initially, in the initial safety research. The studies that are down to show that vaccines are effective are often done isolated from the regular schedule. So we do know these vaccines work just as well when they’re given staggered or separated from other vaccines as they do when they’re grouped all together.

What isn’t studied separately is the safety profile. We don’t know whether or not it’s safer or more dangerous to group vaccines together versus spreading them apart. For me, it’s a logical approach. It makes common sense to me that giving fewer vaccines at a time should create fewer reactions, but we haven’t researched that to prove whether or not that’s true. I think it’s an approach that parents feel safer about, and I would like to see the CDC do some safety research that compares a staggered, spread-out vaccine schedule and compares the rates of reactions and severe side effects to the current CDC schedule.

Is part of the rationale for a staggered schedule the younger, more vulnerable body versus an older, preschool-age body?

Every parent is worried about their little tiny baby. They don’t want to put anything artificial into their baby. The young babies are at a very critical developmental stage in the first couple years of life, so parents worry about chemicals and metals and artificial things, and parents just want to be careful. I think it’s a logical approach to look at these young babies and to try to limit as much artificial exposures they get. If there are some vaccines that a baby really doesn’t need in the first few months of life, then why give them? Why not delay them until a baby’s brain is more fully developed, their nervous system is healthier? Wait until their immune system is a little healthier before you overload them with so much.

This whole concept about young babies being more vulnerable versus older toddlers being able to handle vaccines better, we don’t know. No one’s ever researched to see what happens if you delay vaccines. And do babies handle vaccines better when they’re older? This is really just a typical fear that parents have when their babies are young and small and more vulnerable. Since I don’t know one way or the other, I’m just happy to work with these parents, understand their fears and their worries, and agree to vaccinate them in a way that they feel is safer for their baby.

Does indulging or validating parents’ fears weaken their trust in the CDC? By offering an alternative, is that indirectly diminishing CDC’s message?

As a doctor, I don’t like to undermine the CDC and to help parents mistrust the CDC. Obviously the CDC does so much good for us. They have our best intentions in mind, and they do so much research. And I think parents can overall trust what the CDC says. Now, as a doctor, I also recognize that no matter how much I say you can trust the CDC, some parents aren’t going to trust them. They don’t trust the conspiracies of Big Pharma and all the financial ties between Big Pharma and the CDC. A lot of parents just worry about that, so they’re not going to listen to what the CDC says.

As a doctor, how I approach that is, I say: “OK, you have the right to your opinion. Let’s figure out how I can work with you as a doctor in a way that understands your worries, understands you don’t trust the CDC. So how can I, as a doctor, work with you?” I don’t want to just kick you out of my office, like most doctors do. If parents question the system, then they often get kicked out of doctors’ offices, and that doesn’t help anybody. …

Are you saying the science isn’t enough to convince parents?

There’s so much safety research behind vaccines that most parents should feel very confident in their safety. But parents just don’t always buy the science. They don’t always trust it. They worry about who’s funding the science. Of course all doctors know that virtually all vaccine safety research is performed by the pharmaceuticals themselves. They’re the ones making the product. They’re the ones that have the responsibility to do and fund the research. And then the CDC and other parts of the government oversee that research to make sure that it is trustworthy. But it just makes common sense to me that some parents would naturally mistrust that, because the basic funding often comes from pharmaceutical companies. …

I think what would increase that trust is if we created completely objective and unbiased advisory panels of physicians and researchers that parents could trust, doctors that have absolutely no ties to the pharmaceutical industry and no ties to vaccine policy and the outcome of the decisions they’re making.

There’s an interesting study [PDF] that came out just about a month ago that took a look at the CDC’s advisory panel on vaccine policies. They looked at all the physicians that are on that panel, doctors that help approve vaccines and decide which vaccines should become part of our nation’s vaccine policy. And they found some very concerning results, in that many of the doctors on the panel had never filled out conflict-of-interest forms. There are some doctors that had very clearly received funding from pharmaceutical companies, that had a clear interest in the outcome of the decisions they’re making, and those doctors weren’t always declaring those conflicts of interest. There were even some cases where doctors voted on vaccine policy decisions after the CDC’s ethics committee had asked them not to, because of a conflict of interest.

It’s situations like that that cause parents to mistrust the system. And I think the CDC has heard this. They understand these worries, and I think they’re taking steps to address them and to improve the system. I hope in the future we can have a completely unbiased vaccine policy system that parents can have more trust in.

Do you believe there’s a conflict of interest? Do you mistrust the system?

As a physician, I do trust the CDC, and I trust the whole system. But I feel like it could be better. We need to identify those areas that we need to change so that parents can have more trust.

A big news story just came out that really has interfered with parents’ trust, and that is that a doctor who was the head of the CDC’s vaccine advisory panel, Julie Gerberding, who just stopped working for the CDC, was just hired by [Merck & Co., Inc.], a vaccine pharmaceutical maker. Parents are naturally going to wonder how much was that doctor’s decision-making influenced by the pharmaceutical companies. It kind of calls into question the decisions that doctor made and the Merck vaccines that that doctor approved while the head of the CDC. Is that somehow, in any way, influenced by the promise or the fact that this doctor was then hired by Merck to make who knows how much money for the rest of her career as a physician? Those kinds of things shouldn’t be allowed to happen. Doctors who are going to take public service [jobs] and serve the public good and work for the government shouldn’t have financial influences on them that could influence their decision making. …

Is Dr. [Paul] Offit a case of a revolving-door scenario?

One of the most popular figures in the pro-vaccine side is Dr. Paul Offit, an infectious disease specialist at probably the best children’s hospital in America, [The Children’s Hospital of Philadelphia]. He’s very well respected among his peers, and he’s a very outspoken advocate of vaccines. Some parents worry, however, because he’s one of the doctors that created a vaccine and made many, many millions of dollars selling the vaccine to a company. A lot of parents are disinclined to trust his information, or they’re worried that he’s one of the doctors that has been influenced by the system. I can understand that worry, but I don’t know Dr. Offit, I’ve never met him personally, and he’s very well respected. I’m sure he definitely has the best interest of kids in mind.

But I would think that he shouldn’t be surprised when parents don’t trust him. He has a very clear financial stake in the success of vaccines. So why wouldn’t that cause some mistrust among parents? He seems very shocked by that, however. He seems to not understand why parents wouldn’t trust his word on it. And I would like to see, personally, the American Academy of Pediatrics and the Centers for Disease Control utilize doctors who don’t have such a clear financial stake in vaccines. Use other doctors that parents can trust so that we can help parents feel more comfortable with the vaccine system.

Offit wrote a critical review of your alternative vaccine schedule. What was your reaction?

I know Dr. Offit is very outspoken against anybody who even questions vaccine issues, and he’s come out against my own advice and my own vaccine schedule, speaking out against it. He wrote an article about my book in the Pediatrics journal, really coming down on my book and unfairly painting it as a very anti-vaccine book, and painting myself as an anti-vaccine doctor.

But the truth is that most of the stuff that Dr. Offit wrote in his article about myself or my book is actually false. He had to make up a lot of anti-vaccine arguments and portray them as being in my book to help make his case. But if you really look at my book, you’ll find very little anti-vaccine information in there. You’ll find it’s very pro-vaccine. And so seeing a doctor like Dr. Offit print some false statements about somebody else, in my mind, really does call [in]to question whether or not parents can trust him.

What is an example, one of his false claims?

For example, he claims that in my book I don’t recommend the teenage meningitis vaccine, whereas it’s very clearly written in my book how severe teenage meningitis is, and the vaccine very clearly shows up right there on my vaccine schedule. I definitely recommend the teenage vaccine.

Dr. Offit also claims in my book that I don’t recommend the flu shot for young babies, whereas it’s right there in black and white, very clearly on my vaccine schedule, that I recommend babies get a flu shot, starting around 6 months of age.

You wrote about herd immunity, and Dr. Offit said your message is, hide in the herd; just don’t tell anybody you’re hiding. Explain.

There’s a concept called herd immunity in which people are protected in our country from diseases because almost everybody in the herd is vaccinated. If a disease comes into our country, our herd is so well protected that the disease won’t take control and won’t take hold in our country, so that if there’s one or two members in the herd that are not vaccinated, they’ll still be protected, because the disease won’t reach them because of the protection that surrounds them in the herd. It’s a very important concept for our country, and we all really enjoy herd immunity from diseases such as measles, for example, and we eradicated smallpox through herd immunity. And many diseases are very low in our country because of herd immunity.

Now, on my vaccine schedule, when I delay some of the vaccines or I recommend that people delay the vaccine on my schedule, that calls into question, is that person taking advantage of herd immunity? Are they being selfish? Or are they risking our nation’s herd immunity? And I was very careful on my schedule not to recommend any delayed vaccines that would compromise herd immunity. All the delays that I recommend I feel don’t put any babies at risk for any increased cases of disease. Nor does it put our nation at risk as a whole.

Is there really herd immunity for the under- or unvaccinated child anymore, with globalized travel?

Parents wonder if it’s safe to remain unvaccinated or undervaccinated. Just how risky are these diseases, and how likely is it for an unvaccinated child to catch a very severe illness in our country? I believe that there is some risk there. I don’t think it’s a dangerous choice to go unvaccinated. Parents need to have a clear understanding of what the risk is.

Right now, there’s enough herd immunity in our country where a certain percentage of children can safely remain unvaccinated and not have to worry about disease risk. The problem is, if more and more parents make that kind of decision, we will reach the tipping point where our herd immunity is no longer adequate, and diseases will come back into our country. You’ve heard the saying, ”Polio is only a plane ride away,” and that’s true. Now, it hasn’t entered our country in 30 years, so it’s a very unlikely plane ride away, but you have to admit it is possible. And if we have big gaps in our herd immunity, somebody could bring polio into our country, and then any unvaccinated children in the area could come down with a very serious illness.

Talk about exemptions, freedom of choice.

Approximately 20 states in the United States allow personal exemptions from vaccines. To put it simply, vaccines are not mandatory in 20 states. In the other 30 states, you have to have a religious reason to opt out of vaccines. So while [vaccination is] a little bit more mandatory in those states, you could still view that as somewhat optional if you can claim a religious exemption. There are only two states in the country [Mississippi and West Virginia] that actually don’t allow personal or religious exemptions, two states where vaccines pretty much are mandatory and parents in those states don’t have a choice.

I believe that vaccines are a health care decision that parents should have the power to make for their own children. I don’t think it should be mandatory in any state, and I do worry that those rights will be taken away from parents. There’s actually an ongoing battle in every single state legislature, where the groups on both sides of the issue are constantly battling, trying to take away the rights or trying to keep the rights, and trying to change the policy.

What’s the fundamental reason for believing in the right to choose?

I think our Constitution guarantees parents the right to make health care decisions for their children, as long as they’re not putting their children’s life in danger. And by not vaccinating, you’re not putting your children’s life in immediate danger. Yes, you are taking some risk with diseases, but it’s not such a high risk where that should counteract or take away your freedoms as a parent to make your own health care decisions.

The main reason I feel that vaccines should be optional for parents is that every vaccine has the potential to cause a fatal reaction. Whether it’s a severe allergic reaction, a neurologic reaction or some sort of other immunological reaction, fatal reactions do occur from vaccines. It’s very rare, but it does occur. And no government should be able to force parents into putting their child through something that puts that child at risk of dying. I think that’s just a fundamental right that every parent should have.

What is passive and active risk?

… I talk to a number of parents who have chosen not to vaccinate. I’m always curious to hear what their reasoning is. And one of the very common reasons I hear is very interesting. It’s the idea of passive risk versus active risk, or an artificial risk versus the natural risk of the course of day-to-day life. Many parents view vaccinating as an active risk. They’re actively making a decision to do something for their baby that has a very small risk to it, a risk of the severe reaction. And the risk of choosing not to vaccinate is what I call a passive risk, that parents are taking a risk by not doing something. I find a lot of parents that don’t want to vaccinate are more comfortable with that passive risk. They’re more comfortable with just taking the day-to-day risks of the natural course of life and disease and health, and then life and death, and they’re less comfortable with taking that active and artificial risk of injecting something that they’re not comfortable with into their baby.

One reason people are vaccine-hesitant is that we see autism but we no longer see diphtheria, etc. Some say it’s a matter of time before enough children die, the tide will turn, and vaccination rates will climb again.

As parents’ fears of vaccines grow, I think we may see fewer and fewer parents decide to vaccinate. And then we could see what used to be very rare illnesses become more common. We might see measles escalate. We might see diphtheria come back into the United States. God forbid, we might see polio come back. Then children are going to start dying. And then a lot of those parents that had chosen not to vaccinate might change their mind, and they might start vaccinating again, and then new parents might be more inclined to vaccinate their babies if we see these diseases come back.

Now, I hope and pray that doesn’t happen. I hope that we can maintain adequate herd immunity in our country so we don’t see these diseases return. But that worry of diseases coming back into our country, and the worry of diseases running rampant and killing a lot of babies, I don’t think that supersedes the parents’ basic right to choose what they want to do for their children. And if parents want to accept the disease risk because they don’t trust the vaccines, I think they have the right to make that choice.

The good of the group outweighs the good of the one. But for parents who choose not to vaccinate, that’s the opposite. … Some say it’s selfish of parents to not vaccinate, that they’re ignoring that principle.

There’s a famous statement: ”The good of the many outweighs the good of the few.” And I think that’s true. Many people would look at the decision to not vaccinate, the decision that the few are making, as a selfish decision. You could look at it that they are being selfish. They want to keep their own children safe, they don’t want to take the risk of side effects, and so they’re going to be selfish and be one of the few that don’t vaccinate. …

I think when most parents make decisions for their own children, they actually don’t have the public health’s benefit in mind. They’re not thinking [about] the good of the many. As parents, most of us are going to make selfish decisions when it comes to our children. We’re only thinking about the few, and I think that’s just only natural for a parent. I can’t fault parents for that.

Talk about tracking and finding out the adverse effects of vaccines.

One of the biggest criticisms of the vaccine system that I hear from parents is the worry about side effects and how common or rare these side effects are, and how these side effects are tracked. Parents really want to know, when they give their baby a shot, what is the exact statistical likelihood that they’re going to have a severe reaction, because we don’t know.

The way we’d figure that out is, we would track every single dose on every single child, and monitor every single child for many months after they get a vaccine to see what the reactions are like. That would be really tough to do. There’s 5 million babies born in the country every year. That would just take so much money and be such a huge, monumental effort that no one in the health care industry has ever undertaken that.

Instead, what we have is a passive surveillance system. It’s called the VAERS system, or Vaccine Adverse [Event] Reporting System. Whenever there is a bad reaction that a doctor or a parent feels might be from the vaccine, the doctor or the parent reports it to the CDC. Then those reports are tabulated, and if too many reports of something bad shows up for a certain vaccine, then they write that down as a possible side effect, and they add it as a warning in the prescribing information so that parents can realize what the risk is.

However, there’s a lot of holes in that kind of system. Many vaccine reactions go unreported, and many vaccine reactions that are reported might not be a vaccine reaction at all. It goes both ways. I think parents would feel much more trust in the system if there wasn’t this whole area of doubt, not really knowing how severe the reactions could be or how common they are. If we could develop a system that tracks every vaccine and every child, at least for a number of years so we could collect some very good data that tells us how commonly these severe reactions occur, then parents would be more informed; they would feel more confidence in the system.

How did you use VAERS for your book?

When I was writing my book, I tried to discover and tried to figure out for parents, what is the likelihood your baby might have a very severe reaction? … I want to be able to look a parent in the eye and say, “OK, we know for sure that your baby has a 1 in 500,000 chance of having a very severe reaction, because we’ve studied 10 million babies and determined that that’s the exact rate of severe reactions.” We haven’t done that research, and I don’t know of any plans for anybody to do that research. …

What do you make of social media when it comes to information on vaccines? How do you try to put your patients back on track?

There’s a lot of misinformation when it comes to vaccines on the Internet right now. You search a lot of different Web sites, you get a lot of different opinions and a lot of conspiracy theories. I’ve read a lot of information that has no scientific backing to validate whether or not it’s true. I think parents need to turn to a trusted source. They need to see where the information comes from that they’re reading. They need to see if there’s medical articles, research articles to back up the information. They need to read things that come from people who know what they’re talking about.

People decide which science to believe in. Is there good science and bad science?

There’s a lot of conflicting opinions regarding vaccines, and there’s some conflicting science as well. There’s two types of science that I look at as a pediatrician. Number one, there’s peer-reviewed science, which is scientific studies, research papers and things that are published in what we call peer-reviewed journals …

Now, there’s other types of research published in non-peer-reviewed journals — doctors that do very good research studies, but the conclusions they reach or the study results they have go against the grain or call into question some of the mainstream viewpoints about science. Often those kinds of studies won’t, or are less likely to, get published in a peer-reviewed journal. Doctors will publish that kind of research in a more obscure journal, a more alternatively minded journal or one that is not peer-reviewed by university types of medical researchers. And there’s a big discrepancy when you look at the two different types of research.

As a doctor, I like to look at all kinds of different studies, and I will look at some research that is not peer-reviewed or that is not published in a mainstream journal. And if I feel that the study was done correctly, and they followed the scientific method, and I can’t find any problems with the research, then I might pay attention to that research, whereas a lot of doctors in mainstream medicine will just completely, 100 percent ignore any research that is not peer-reviewed. I think we need to have a meeting of the minds, to have more acceptance of some of these alternative viewpoints that people are researching, so that we can really get to the bottom of a lot of these controversies.

Safety testing. It’s thorough, but part of it isn’t thorough?

Vaccines undergo a lot of thorough safety testing when they’re first developed to determine whether or not they’re safe for general use. Vaccines are generally tested in about 30,000 babies, and they monitor these babies for about a month to look for any severe reactions. If everything pans out OK, then they determine that the vaccine is safe to use.

There are a couple of drawbacks with that system. Now, it is a very thorough system; they do a lot of safety research here. But some of the drawbacks are, number one, the safety testing is paid for and done by the manufacturer of the vaccine, so that would cause some people to question the validity of the safety testing; number two, there’s no long-term safety research. They only study these babies for about a month after they’re vaccinated. No one takes these study groups of 30,000 babies and sees how they’re doing a year later or two or five years later to see if there’s any higher rates of chronic problems or long-term complications that show up. And that’s a big gap in the safety research. I would like to see us do more long-term safety research studies on these large groups of children, so then we can determine that they are safe in the long term.

The CDC’s schedule has gone through that [testing], but your alternative schedule hasn’t. Is that OK?

I’ve heard criticisms that my schedule has not been through any safety testing. However, my schedule does follow within the guidelines, the parameters that you are allowed to give vaccines. The Centers for Disease Control determines when you can give vaccines — what age ranges, how far apart you should give them — and they set up these guidelines that we’re not supposed to go outside. And I don’t. I never recommend anyone give a vaccine outside the age range that it’s designed to be given in.

The only place that my vaccine schedule differs in that regard is simply not giving so many together. I spread them out. That’s not what the CDC says people should do, but they don’t disallow it either. They do say you can spread the vaccines out if you choose to. It does fall within the established parameters of how we should use vaccines. … The AAP [American Academy of Pediatrics] says in their written policies that it’s OK to develop an alternative schedule with these patients, pick and choose vaccines with them, work with them. And I don’t understand why most pediatricians don’t follow that policy.

If a herd of children is following your schedule, does that pose a threat to the unvaccinated child who has a compromised immune system?

… Some children in our society are immunocompromised, or they have cancer and they’re on chemotherapy. These children are very susceptible to getting sick and dying from diseases, and if there are a lot of unvaccinated children in the area, those unvaccinated kids could put the compromised kids at risk. That’s a valid way to look at it. However, I think when parents are trying to decide whether or not to vaccinate their children, they’re really just considering their own child’s benefit. They’re not thinking about the very rare situation in which an immunocompromised kid might come across their own child. I think that just doesn’t enter parents’ minds.

The CDC says the amount of aluminum in vaccines is safe. You question that. List the vaccines that contain aluminum. Do you question the safety?

When I first started doing all my research on vaccines, I took a careful look at the ingredients — there’s a lot of chemical ingredients in vaccines. I looked at every chemical, and then I looked at what the FDA [Food and Drug Administration] says about that chemical. I looked at what safety research has been done to determine that that chemical is safe to use in children.

One of the chemicals I came across that ended up alarming me a little bit is aluminum. Now, you hear the word “aluminum,” and you normally think it sounds pretty harmless. We use aluminum foil. There’s aluminum in antacid medications. It’s kind of all over the place, and why worry about aluminum? And I actually didn’t worry about aluminum at first, but I was curious, and I decided to see what the FDA had to say about aluminum.

When I found what the FDA had to say, I was actually very shocked. I found on the FDA’s Web site that they very clearly limit the amount of aluminum that we are supposed to inject into hospitalized patients. They limit it to about 50 mcg [micrograms] per day, and they say any more than 50 mcg may not be safe for humans. So I thought, OK, that’s interesting. So I decided to look at how much aluminum is in each vaccine. And what I found in each vaccine is that some vaccines contain as much as 650 mcg of aluminum. Some vaccines contain a couple hundred micrograms of aluminum. And if you add up all the vaccines together that all contain aluminum, that you give all at the same time to a 2-month-old baby and a 4-month-old baby and a 6-month-old baby, all the aluminum given altogether adds up to about 1,250 mcg for each one of those days. So I saw on one hand, there’s 1,250 mcg in vaccines given to babies; on the other hand, the FDA says we should limit the amount of aluminum to about 50 [mcg] for adults, and only about 20 mcg for children. …

There’re a lot of mathematical computations and research papers done that are using mathematical models that try to map out how aluminum acts in our body. And those studies are showing that the amount in vaccines are safe. But there’s not one single live human infant study that has ever been done to determine how much aluminum can safely be injected into a human infant. And I challenge anybody to show me just one such study, because I couldn’t find it anywhere.

I concluded that there might be a problem with aluminum. We shouldn’t overload our babies with aluminum. We should spread it out as best we can. So one of the primary features of my alternative vaccine schedule is making sure, number one, I’m only giving one aluminum vaccine at a time to babies on any given month; number two, I’m choosing the lowest aluminum brands I can when I have a choice, because some vaccines have a lot of aluminum, and a competitor’s brand might have very little aluminum. And so as a consumer, as a doctor, I can make a choice there. …

Do you consider yourself as playing a watchdog role?

I don’t think I consider myself some sort of a vaccine watchdog, because I would really like the CDC to play that role. They should be watching out for our best interests, and they are. … I see myself just more of a middle-of-the-road doctor, or being on both sides of the fence. I help the people who are anti-vaccine, and I help the people who are pro-vaccine. I’m trying to get everyone together in a way that we can understand each other and we can serve everyone’s needs.

Do you feel responsibility for a slippery slope, the watchdog might open the door to the skeptics?

I feel very responsible to make sure every advice I’m giving has a science backing for it. And when it doesn’t, and when it’s just my opinion, I’m going to be very clear about that. I just present the information. I give parents options. It’s all about education. I just like parents to be more educated about it.

One of the common criticisms I hear about aluminum, and the reasons why parents shouldn’t worry about aluminum, is that we swallow aluminum every day. It’s in water, it’s in food, it’s in antacid medications, and we swallow far more aluminum than is ever injected into vaccines. And that’s absolutely true. What is also true is that aluminum that is swallowed passes harmlessly out of our body. It all comes out in the stools. And any doctor that uses the ”Hey, we swallow aluminum every day” argument to try to show that vaccine aluminum is safe is purposely misleading the public. There’s no comparison between swallowed aluminum and injected aluminum. I find it very interesting that doctors and medical centers that put that kind of statement on their Web sites as the primary reason for parents not to worry about aluminum, those doctors know they’re purposely spreading misinformation. They’re purposely misleading their readers. They know full well that swallowed aluminum is harmless. And I would like those kinds of physicians to show me where a study is that shows that the amount of aluminum in our entire vaccine schedule, when injected, is safe.

What you say about aluminum sows doubt. If doubt leads to people not getting vaccinated, what is your responsibility for that?

The doubts and worries about aluminum do not have to lead parents toward not vaccinating at all. They can still vaccinate. They just choose brands of vaccines that don’t have aluminum or have lower levels of aluminum, and they can make sure their baby’s getting only one aluminum vaccine at a time. …

Some say the middle ground is safe but vague, not concrete. It can be confusing, and it doesn’t help public health officials’ message. How do you respond?

When people question the vaccine system, it can create a lot of confusion, and [there’s] a lot of uncertainty in playing the middle road, like I like to play. How I look at it is that the public health officials and mainstream medicine believe that vaccines are perfectly safe and that everybody should get vaccinated. And I agree mostly with that statement. However, what I recognize is that some parents on the other side are not going to agree with that. No matter how much you show them the science, no matter how much you show them they have nothing to worry about, they are just not going to believe you. …

Let’s at least get them partially vaccinated. Let’s at least bring them as far as we can so that we don’t leave a growing number of population unserved and unvaccinated. And I think that’s what I do. I bring these two sides together so that each individual and our entire nation can be better served.

A very common scenario I see in my office that really concerns me is a 4-month-old baby or a 6-month-old baby that comes to me as a new patient because they had a very severe vaccine reaction at 2 months.

Would that be the hep B reaction?

No. Very rarely, a 2-month-old baby will suffer a very severe reaction to their round of six vaccines. They’ll develop high-pitched screaming, several days of fever, become very lethargic, maybe show some neurologic problems; they’ll become withdrawn, maybe even have some seizures. Now, these are very, very rare reactions, but such reactions do occur.

You know what a lot of doctors will tell such patients? They’ll say: ”Don’t worry about it. It probably isn’t the vaccines. Let’s go ahead and vaccinate again at 4 months.” That’s just asking for that baby to become severely damaged by vaccines. When such a baby reacts so severely to the first round of shots, that baby should take a break, not get any more vaccines for a little while, and when you do resume vaccines, do it very carefully, one vaccine at a time, so the baby can better handle them.

However, many doctors view the vaccine system and the vaccine schedule as such a top priority that they sometimes will put aside the best interest of that individual baby. If you have the baby that’s going to have a very severe reaction a second time around and then a third time around, vaccines might not be the right choice for that baby. And I see a lot of doctors push parents into those second and third rounds of vaccines, and the babies get very, very sick. I think those babies should be identified when it happens, and they should more carefully approach vaccines from that point on.

One very sad story that I just encountered last month in my office was an 18-month-old twin, little girl. Both her and her brother were completely healthy. They went in and had a couple of vaccines, and the 18-month girl that night stopped talking. She had had a whole number of words. She stopped talking, and she wouldn’t walk anymore. She would crawl around; she was fussy; she was miserable, no language. She kind of shut down. Mom was obviously very concerned. Fortunately, the baby rebounded after just a few days and came back to life, so to speak — started talking, started walking, and everything was fine. It hadn’t occurred to the mom that this could be a vaccine reaction. She talked to her doctor and everything, and it hadn’t occurred to anybody.

So one month later, the child went in for more vaccines, and the child is now devastated. The child won’t walk; the child won’t talk, is very lethargic; just went from this happy, talking, vivacious, running-around, bouncy little 18-month-old toddler to a child with very severe neurologic problems. I’m not saying that’s going to happen to a lot of people after vaccines, but these very, very rare occurrences do happen. And if that doctor or that parent had questioned that first vaccine reaction that the child had, and they could have taken a closer look at the situation and maybe not vaccinated the child so quickly — just a month later — maybe delayed vaccines for a while and let the child get a little older, and maybe that child could have been saved from such a severe reaction. …

You’ve heard of the Hannah Poling case, where the beautiful, perfectly healthy 18-month-old girl got vaccinated and crashed and burned, developed full-blown autism. And they won their day in court. They were awarded monetary compensation for their child’s neurologic consequences of the vaccines. This is very rare, extremely rare. Thank God it’s rare that it happens. But we just need to be on closer watch for it. …

Why are you so passionate about what you do?

I think what’s made me so passionate about vaccines is that I think vaccines are important. The diseases do pose a risk, and I think vaccines are overall safe. I think they can be given to children in a logical manner, in a way that spreads them out a little bit. But what’s made me cautious is the stories that you hear over and over again about severe vaccine reactions, and the children that get neurologically devastated. Thank God it’s so rare that it happens. But the fact that it does happen has just made me, as a doctor, just a little bit more cautious, and has made me very understanding toward the parents that are worried. …

Has anyone close to you been damaged by vaccines?

Not a family member, no. Personally, I’ve never had one of my own family members or anyone very close to me have a severe vaccine reaction, but I’ve become very close to some families that it has happened to, after the fact — become very close to them as their physician, as I try to help them understand what happened and learn to cope with it.

What’s your stance on the autism-vaccine connection?

It’s so up in the air, I don’t know. We’ll probably leave that to your other experts. …

Do you want to state what you say in your book?

The ultimate worry that parents have is whether or not there’s a connection between vaccines and autism. And there’re a lot of parents with autistic children out there that are claiming yes, there’s a connection. When you look purely at the science, and more specifically the peer-reviewed science in the mainstream medical journals, then the answer is no. There is no direct scientific connection that they’ve been able to put between vaccines and autism.

In my mind, the only way we’d really put this issue to rest is to do a very large scientific study that looks at hundreds of thousands of children who are vaccinated versus hundreds of thousands of children that are not vaccinated, and we compare the rates of autism in those two groups. Such a study probably won’t be done, because many experts feel it’s unethical to put so many children into the unvaccinated group of the study. But if we could put that kind of study together, that’s really the only way to really, absolutely, without any doubt in anyone’s mind, to put this issue to rest.

I think ultimately we may find that some children are born with a genetic susceptibility to having a bad vaccine reaction. Something’s different about their immune system, their neurologic system, and their genetics that makes vaccines and that child not mix. If we can find a way to screen these babies when they’re born, through genetic testing, then we’ll be able to weed out these babies who are going to have the severe neurologic reactions, and either not vaccinate them or delay their vaccines or more carefully vaccinate them. And we then might not have as many severe reactions. I think that kind of technology is coming. We don’t have it yet. But hopefully soon we’ll have the ability to screen out these children that won’t handle vaccines well.

What if vaccines turn out to be a red herring? What if we’re so off the mark with vaccines?

Well, I’m not talking autism. I’m just talking reaction in general. But severe vaccine reactions are not a red herring. We know they happen. You just read any vaccine product information, and you’ll see it stated very clearly: “This vaccine is known to have a risk of creating a very severe neurologic reaction.” It’s plain science. Fortunately, it’s very, very, very rare, and vaccines are safe enough to use in our general population. What we have to do is figure out which babies they’re not safe for, and how do we screen those babies out so that we don’t put them through those severe neurologic reactions, and so that vaccines can be safer for everybody.

Priyanka Boghani

Priyanka Boghani, Digital Editor, FRONTLINE