Informed Choice: More than just ‘yes’ or ‘no’

In December, a seven-year-old unvaccinated New Zealand boy contracted tetanus.

In September, someone else did too. Although we didn’t hear a word about that: http://surv.esr.cri.nz/PDF_surveillance/MthSurvRpt/2012/201209SepRpt.pdf

Might that case have been in a vaccinated person?  Why the fuss over the child of uninformed parents and not the case from September?

The media has leapt on this latest one as an example of why not vaccinating is a bad idea, and are using it, along with interviews from the child’s parents, to say that non-vaccinating parents are ignorant and uninformed hippies who make decisions based on baseless Internet conspiracy theories and are putting lives at risk. That non-vaccinating parents ‘think they know everything’, are a threat to public health, and that organisations that promote informed consent (informed being the operative word) and choice such as the IAS are to blame for this child’s illness. The parents are pleading for non-vaccinated children to get vaccinated, as they now have for their other children, because they didn’t realise the consequences of a decision based on conspiracy theories and from neglecting to fully inform themselves.

See this story from the NZ Herald:

http://www.nzherald.co.nz/health/news/article.cfm?c_id=204&objectid=10860122

And this:

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10860122

Firstly, a note to the parents: I’m sorry you’ve had to watch your child suffer. As we are aware, tetanus is a very nasty disease. It isn’t something anybody would wish upon any child, any parent, and we all wish your family all the best and your son a full and speedy recovery.

There are some very big lessons to be learnt from this case.

The first one, which everybody needs to understand above all else, is that informed consent is not made by listening to conspiracy theories, or emotions and feelings.  Informed decision making is also more than just saying ‘yes’ or ‘no’ to an intervention such as vaccination.

Most – not all – people who do vaccinate, likely don’t research the issue at all. If you vaccinate, what is there to research?  You’ve done as you were told.

Contrary to what the NZ Herald and Sunday Star Times stories suggest, most parents who make an informed choice not to vaccinate, will research thoroughly everything they can.  Not just about the diseases, or the vaccines, but what constitutes good health.  These parents do everything to ensure their children remain healthy and happy, and understand the risks involved in ALL the diseases, how to prevent them if possible, how to treat them at home, risk factors for the diseases and complications, and so on.

I bet parents who make a scientifically informed choice don’t make important health decisions on the basis of conspiracy theories online, or call themselves ‘hippies’, or assume that having a science degree makes them well informed; neither do they suddenly find out they are ignorant the night their child falls ill.

The IAS has published many pieces to this effect over the years, and there is a wealth of science-based information available online, despite what this misinformed family may say.

Plainly, no science degree is a sure-fire guarantee of an understanding of how to research, what health truly is, or how to make an informed decision.

We at the IAS believe all parents should make truly factual, informed decisions.

Even school science 101 should tell you that in order to understand something which might threaten you, you must know the “enemy” – in this case, tetanus. So a good first step may be to learn:

1)     What is tetanus?

2)     How many ways does it present?

3)     What are the implications of the varied incubation periods?

4)     How do you determine its severity?

5)     How is it treated?

6)     What are the factors which can result in complications?

7)     How does the medical system treat tetanus?

Knowledge of the disease is a wise core starting point, whether it’s tetanus, polio, hepatitis B, whooping cough, measles or whatever. Such an article is easily found on Internet such as http://www.emedicinehealth.com/tetanus/article_em.htm
Anything less than this starting point, is not “information.”

Your next point of research could be:

8)     The history of that disease in your country.  Data on tetanus cases in NZ throughout the ages can be found at most good medical libraries.

9)     The national immunisation handbook, (which included a potted history) and what it says. In this case, tetanus: http://www.health.govt.nz/system/files/documents/publications/5tetanus.pdf

10)  The tetanus vaccine product data to be found at Medsafe. There are many different formulations, so you would need to know which one you would be looking at.  The example we have here is Infanrix IPV for under 8 year olds: http://www.medsafe.govt.nz/profs/datasheet/i/infanrixhepbinj.htm   The manufacturer’s page http://www.gsk.com.au/products_vaccines_detail.aspx?view=45 has two PDFs on it, which should be read.

11)  You could do a comprehensive PubMed search using the words ‘Tetanus vaccine side effects’, and you come up with studies like this one http://www.ncbi.nlm.nih.gov/pubmed/23142308 Follow through using the “see all” facilities, and also try other combinations of words. Also search the VAERS database. http://www.medalerts.org/

Do a comprehensive PubMed search to try to identify whether there are specific risk factors known to exist in a specific group of people. For instance, complement deficiency increases the risk of bacterial meningitis hugely; vitamin A and nutrient deficiencies vastly increases the likelihood of measles complications. Only recently, have New Zealand researchers started looking at nutrition in children:

Childhood malnutrition, both macronutrient over-nutrition and micronutrient under-nutrition is prevalent in New Zealand (NZ).2

NZ has a large burden from communicable diseases for which, in the developing world, malnutrition is known to play a causal role.1-3 Deficiencies in iron and iodine, micronutrients that play central roles in brain development, cognition and learning, are prevalent in NZ during infancy.4 5”

From: http://journal.nzma.org.nz/journal/125-1357/5246/

This study was only in lower socio-economic regions.  The researchers should also investigate families whose parents have degrees.

These are other studies older than the NZ Medical Journal one.  Information poverty with regard to nutrition is rife in all socio-economic classes.
http://www.ncbi.nlm.nih.gov/pubmed/21040074
http://www.ncbi.nlm.nih.gov/pubmed/20854316
http://www.ncbi.nlm.nih.gov/pubmed/12603797
http://www.ncbi.nlm.nih.gov/pubmed/17635681
http://www.ncbi.nlm.nih.gov/pubmed/19087385

Other diseases often have pre-existing nutrient deficiencies. http://archive.unu.edu/unupress/food/8F102e/8F102E02.htm

Tetanus is one of those diseases. Pre-existing malnutrition not only increases susceptibility to tetanus, but has been known, for decades, to result in very low seroconversion to the tetanus vaccine. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC170102/ .

Nutrition is something which many New Zealand parents are failing to pay appropriate attention to, and is a key risk factor in all diseases. http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10741454

http://www.nzherald.co.nz/index.cfm?objectid=10725229

Given that NZ has a very high rate of vitamin D3 and vitamin A deficiency http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=9006061 , parents should be aware that such a deficiency increases the likelihood of gastrointestinal infections http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150351/

Do a PubMed search using the author Scragg R., and read the upcoming blog on Vitamin D3 on the IAS website.

All these macro and micronutrient deficiencies impair the cellular immune system which is the primary defence mechanism in the event of ANY disease.

Please sit down and really closely examine your family’s nutrition and diet. If you need to, seek out the help of a nutritionist or a nutritionally qualified medical professional.

Since IAS’s inception we have been branded as those weirdos who said, “sugar is poison.”  We still maintain that sugar from a refinery should be avoided where possible, but note with interest that finally the medical profession has caught up to us.  Are we still weirdos? http://www.nzherald.co.nz/lifestyle/news/article.cfm?c_id=6&objectid=10859522 http://www.nzherald.co.nz/lifestyle/news/article.cfm?c_id=6&objectid=10857028.

However, not only do we say that sugar causes obesity, we also say that sugar is a nutrient robber.

We have also previously been described as lunatic fringe fanatics for our long time stance that trans-fatty acids and junk food undermines the immune system resulting in allergies, eczema and constantly runny noses.   It finally seems we are now vindicated in that belief as well by a recent New Zealand study. http://www.stuff.co.nz/national/health/8181772/Fast-food-linked-to-asthma-allergies

Nutrition should revolve around vegetables, fruit, soaked nuts and seeds, limited amounts of grass-fed free-range meat, eggs, and preferably raw organic dairy. The more raw fruit and vegetables, the better. Fermented foods are now being used by some in the medical profession for their ability to maintain proper gut flora and thus contribute to good immunity –yoghurt, kefir, kimchi, sauerkraut, kombucha, and miso are all good examples. Without a good biochemical foundation to build on, nobody can expect amazing health, and the vaccination debate goes out the window anyway.

12)  There are also NZ studies showing that living conditions increase the risk of diseases like pneumonia http://www.ncbi.nlm.nih.gov/pubmed/22085309

Making a factually, scientifically informed choice involves a comprehensive understanding of all the risks involved in saying yes to vaccination, or saying no.

That means that if you say ‘yes’ to a vaccine, you understand the ingredients of the vaccine in case your child is allergic to one of the components; how it is given; how many injections are recommended; what the known risks are; the adverse event rates, and then you need to compare the serious reactions, with the chances of contracting the disease being researched. Be aware that this case http://www.ncbi.nlm.nih.gov/pubmed/17974728 is only one of many proving that the tetanus vaccine will not necessarily protect yourself or your child.

Even more, for the parent who chooses not to vaccinate, knowledge of the above is absolutely imperative, and it is your responsibility as parents, to ensure your child’s nutrition is top-notch.

Contrary to the comments of Linda and Ian Williams, some websites have very knowledgeable, scientific presentations of tetanus, such as  http://beyondconformity.org.nz/resources/tetanus

If you don’t feel secure in whatever choice you have made, then you need to read more widely, rethink your ideas, research more, until you feel more prepared for whatever may come, whether you do or do not vaccinate. Nothing is without risk. No decision you make is an easy one, and if it is, you likely haven’t done enough research.

Whatever decision you make, understand the FACTS, the risks, and look after your bodies.

See our previous blog on tetanus, published just a month before this child came down with the disease: http://www.ias.org.nz/vaccines/lets-talk-about-tetanus/

NOTE: The IAS provides a long list of resources – we would encourage all parents to read through thoroughly, including books, websites, vaccine data sheets, government websites, ones written by non-vaccinating doctors and health professionals, medical journals, researchers… http://www.ias.org.nz/vaccine-information/vaccine-resources/