One of my brothers is flying to Thailand this weekend. He will be spending six months based in Bangkok, and wants to make short trips into Laos, Borneo, Vietnam, Malaysia and other parts of southeast Asia. Naturally, he waited until yesterday to see a travel medicine specialist. Not the smartest approach, considering that this part of the world is an incubator for infectious diseases. Longstanding problems with sanitation, overcrowding, cohabitation with animals have recently been compounded by a modern age of travel and antibiotic overuse. This is not the place to skimp on protection. I thought I would share some of the thoughts I have been having about vaccination as I have helped my procrastinating brother deal with his crisis.

Vaccines have probably prevented a billion deaths since Edward Jenner’s smallpox vaccine became widely used in the early 1800s. Later vaccines have transformed the human landscape by nearly eradicating polio, measles, mumps, rubella, diphtheria, tetanus and pertussis. Critics argue that the benefits of vaccines have been overstated, and that we have gotten more benefit from improved nutrition and sanitation that took place at the same time ... but I consider them lifesaving medicines. Until recently, the only real side effect of vaccines that really mattered was overpopulation.

But it is not responsible to ignore the potential risks of vaccines. Their potential link to autism has received the most media attention, but the current evidence does not support this. The evidence is flawed for many reasons that I won’t get into here, but as of this writing, there are no studies showing a link between autism and vaccines. Drug companies removed the ethylmercury (thimerosal) from vaccines in North America and Europe because parents did not want their children exposed to this potent neurotoxin, but it has not reduced autism rates. The integrative autism experts have come to understand that it is more likely caused by a combination of genetic changes in utero, bad bacteria in the gut and increased exposure to toxins, which together damage the nervous system and immune system.

They might not be the cause of autism, but vaccines do alter the immune system. Of course they do – that is why we use them, it’s the whole point! Some of the changes may be lifesaving, but others may be harmful. The most well-documented is the increased risk of allergies, asthma, ADHD and eczema. Several studies have found clear differences in levels of these diseases seen in vaccinated and unvaccinated children.

I have met dozens of patients who insist that the first symptoms of their autoimmune diseases appeared shortly after a vaccination. This is not clearly proven, but I suspect that hundreds of other integrative doctors have heard similar stories. This would be a very important research study for someone to do. Molecular mimicry is the term used to explain how exposure to a foreign substance can trigger autoimmunity.

Most modern vaccines contain an adjuvant, which is a substance that temporarily sensitizes the immune system. This is because they contain killed or inactivated virus that do not cause the body much concern on their own. Our bodies are smart enough to sense the difference between live organisms and dead ones, which is incredible if you think about it. But the point here is that when an inactive virus is combined with an adjuvant, it becomes much more of a concern to the immune system. The body responds by developing immunity to this organism.

If you get vaccinated and then go have lunch, the adjuvant will probably increase your odds of becoming allergic to something in your food. This will be much more likely if you have a leaky gut or an immune system that is already overly sensitive, but it is logical to assume that vaccines promote food allergies. This is why I advise people not to eat after they get vaccinated. I suggest that they eat slightly more at breakfast and lunch, get vaccinated in the late afternoon and not eat again until the next morning.

I have also suggested that people visit their acupuncturist after being vaccinated. An alternative is to rub or pinch these points on their own. This is designed to calm down the nervous system, and is a good thing to do anytime you are stressed, nervous or tense. Learning acupressure is a wonderful tool to add to your self-healing skills.

I am not sure what to tell parents who ask me whether they should vaccinate their kids. I totally agree that they are a good idea for society. This is because of the herd effect, which makes it a lot harder for these diseases to spread as long as they stay rare. This is why unvaccinated children have been blamed for recent outbreaks of measles and mumps. While other studies suggest that vaccines don’t work as well as they used to, probably because our immune systems are not what they should be anymore, preventing the spread of dangerous viruses in the human environment is an important reason for us all to get vaccinated. It is a very scientific form of socialism and, if you think about it, an act of altruism.

On the other hand, I am pretty sure that they affect the immune system. This ‘system’ is actually an infinitely complex inter-connected network involving dozens of different cells, producing hundreds of different substances that work together in a delicate balance that is orchestrated by the nervous system’s incredible intelligence, which we know almost nothing about.

We need to know more about the potential risks of vaccines. My brother was given injections for hepatitis A, hepatitis B and typhoid – and drugs to prevent malaria too. These serious diseases should not be under-estimated, and I do not recommend that anyone traveling to the developing world take them lightly. But I cannot believe that the single biggest experiment in medical history is not closely watched by more thoughtful observers to clarify the risks and find ways to make it safer. Particularly since most of the new vaccines are designed to influence mild or rare diseases and are more about profit than the good of humanity. This includes vaccines against HPV, chickenpox and other recent additions to the 'routine'.

The issue of overpopulation is probably the most insidious ethical dilemma that a thoughtful physician can have about the practice of medicine. The big picture question is whether we would rather prevent as many deaths as possible – or have the human race be as healthy as possible. This is just one of many issues we have to confront together if we are to create a sustainable future for ourselves on this lonely planet we call home.

Lots of ideas here, I know, but this is a good time to be thinking about the big picture. Hopefully yours will be happy and healthy in 2011 … and your plans for the year will include doing something to help make a difference.

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