Marco Cáceres di Iorio

The Immunocompromised Still Get Vaccinated

One of the more often repeated reasons you hear as to why everyone should get vaccinated is “to protect the immunocompromised”—those persons whose immune system is so weakened or suppressed that they cannot tolerate the effects a vaccine might have on them. These may include patients who are undergoing treatment for a medical condition. For example, chemotherapy for cancer. It may include people with AIDS, or organ transplant patients who are on immunosuppressive drugs. It may include individuals who have inherited diseases, such as congenital agammaglobulinemia or congenital IgA deficiency, that affect their immune system.1

Levi Quackenboss writes:

Proclaiming the need to protect immunocompromised children from the unvaccinated is the cause du jour, isn’t it? Let’s force-vaccinate the American population of children in order to protect all of their immune-deficient classmates. Herd immunity! Protect those that can’t be vaccinated by vaccinating those who can!2

The mainstream corporate media dutifully includes the refrain in many of its vaccine-related articles. Here’s a classic excerpt from an article by Nicholas Kristof last year in The New York Times:

It’s not just cancer patients who can’t be immunized, but also infants, those with vaccine allergies, and people with medical conditions that leave them immunocompromised. And a small proportion of people get the vaccine but never develop immunity, so they, too, depend on others to get vaccinated.

Thus refusing to vaccinate your children is not ‘personal choice’ but public irresponsibility. You no more have the right to risk others by failing to vaccinate than you do by sending your child to school with a hunting knife. Vaccination isn’t a private choice but a civic obligation.3

Not a personal choice but a public responsibility. Why? The argument being made is that individual choice must be removed from many healthy people to protect the few sick people who cannot protect themselves. At first blush, it sounds good in theory but, in practice… not so much. The problem is that the underlying assumption is false.

According to Barbara Loe Fisher, co-founder and president of the National Vaccine Information Center (NVIC), “For all practical purposes, the Centers for Disease Control and medical trade organizations now direct pediatricians and other vaccinators to deny the medical vaccine exemption to 99.99% of Americans.”4

Basically, the Centers for Disease Control now tells doctors that a medical vaccine exemption should only be granted if you are one of the estimated 320,000 children and adults annually receiving chemotherapy; or one of the estimated 47,000 Americans who have had a recent organ or blood cell transplant; or your child is one of the 40 to 100 children born every year with Severe Combined Immune Deficiency, known as SCID.4

The United States has a population of nearly 323 million.5 So the rationale goes something like this… Government must mandate that some 322.6 million people get dozens of doses of vaccines they may not need or want, and which public health officials know will cause an unknown number of those people to experience mild to severe side effects, or even die, in order to “protect” about 367,000 medically diagnosed immune compromised or severely chronically ill people. But even if you think this type of logic makes sense, consider that we’re really not talking about 367,000, because relatively few of those immunocompromised individuals would actually be able to obtain a medical vaccine exemption from their doctors under federal vaccine policy.

To begin to understand why this is true, all you have to do is read the following recommendations from the CDC’s Advisory Committee on Immunization Practices (ACIP): Recommendations of the Advisory Committee on Immunization Practices (ACIP): Use of Vaccines and Immune Globulins in Persons with Altered Immunocompetence. The following are some notable excerpts that clearly direct doctors to vaccinate immune compromised and severely chronically ill persons:

CDC Says Killed Vaccines Not a Problem for the Immune Compromised

<< “Killed or inactivated vaccines do not represent a danger to immunocompromised persons and generally should be administered as recommended for healthy persons. For specific immunocompromising conditions (e.g., asplenia), such patients may be at higher risk for certain diseases, and additional vaccines, particularly bacterial polysaccharide vaccines {Haemophilus influenzae type b (Hib), pneumococcal and meningococcal}, are recommended for them. Frequently, the immune response of immunocompromised persons to these vaccine antigens is not as good as that of immunocompetent persons; higher doses or more frequent boosters may be required, although even with these modifications, the immune response may be suboptimal.”6 >>

<< “… Immunocompromised children should receive Hib conjugate vaccines in the same dosage and schedule as for immunocompetent children.”6 >>

<< “… Because influenza may result in serious illness and complications for immunocompromised persons, vaccination is recommended and may result in protective antibody levels in many immunocompromised recipients.”6 >>

<< “[Pneumococcal] vaccination is also recommended for immunocompromised adults at increased risk of pneumococcal disease or its complications (e.g., persons with splenic dysfunction or anatomic asplenia, Hodgkin’s disease, leukemia, lymphoma, multiple myeloma, chronic renal failure, nephrotic syndrome, or conditions such as organ transplantation associated with immunosuppression). Revaccination should be strongly considered greater than or equal to 6 years after the first dose for those patients at highest risk of fatal pneumococcal infection (e.g., asplenic patients) or for those at highest risk of rapid decline in antibody levels (e.g., those with chronic renal failure, nephrotic syndrome, or transplanted organs).”6 >>

<< “… For patients undergoing hemodialysis and for other immunosuppressed patients, higher vaccine doses or increased number of doses are required.”6 >>

<< “… Routine immunization with the quadrivalent vaccine is recommended for certain high-risk groups, including persons with terminal complement component deficiencies and those with anatomic or functional asplenia.”6 >>

<< “… Other vaccines containing killed antigens, including cholera, plague, and anthrax, do not pose a risk to immunocompromised persons and should be used for the same indications as for immunologically normal persons.”6 >>

CDC Says Vaccination Not A Problem for the Chronically Ill

<< “… Certain medical conditions, such as renal failure, diabetes, alcoholic cirrhosis, or asplenia, may increase the patient’s risk for certain diseases. Some antigens, particularly bacterial polysaccharide vaccines, are recommended for such patients. Frequently, the immune response of these patients to these antigens is not as good as that of immunocompetent persons, and higher doses or more frequent boosters may be required. Persons with these conditions are generally not considered immunosuppressed for the purposes of vaccination and should receive routine vaccinations with both live and inactivated vaccines according to the usual schedules.”6 >>

<< “… Patients with chronic renal failure should receive annual influenza immunization.”6 >>

<< “… Pneumococcal vaccine is recommended for use in persons greater than or equal to 2 years of age with chronic illnesses specifically associated with increased risk of pneumococcal disease or its complications (e.g., anatomic or functional asplenia {including sickle cell disease}, nephrotic syndrome, cerebrospinal fluid leaks, and conditions associated with immunosuppression, including HIV infection). Revaccination after 3-5 years should be considered for children with nephrotic syndrome, asplenia, or sickle cell anemia who would be less than or equal to 10 years old at revaccination.”6 >>

<< “… Pneumococcal vaccine is recommended for use in immunocompetent adults who are at increased risk of pneumococcal disease or its complications because of chronic illness (e.g., cardiovascular disease, pulmonary disease, diabetes mellitus, alcoholism, cirrhosis, or cerebrospinal fluid leaks).”6 >>

<< “… Hepatitis B vaccination is recommended for susceptible hemodialysis patients. Although seroresponse to hepatitis B vaccine is lower in hemodialysis patients than in healthy persons, for those patients who do respond, hepatitis B vaccine will protect them from hepatitis B virus infection and reduce the necessity for frequent serologic screening. Hepatitis B vaccine is also indicated for patients whose renal disease is likely to lead to dialysis or transplantation.”6 >>

In other words, vaccines are assumed to be so safe and effective by the CDC and federally appointed members of the Advisory Committee on Immunization Practices (ACIP), that doctors are told to vaccinate 99.99% of all Americans, including most children and adults who are immune compromised or suffering with severe chronic illness. Regardless of whether or not you or your child get vaccinated, nearly all immunocompromised individuals in America will still be subject to vaccination as well.

National vaccination levels among U.S. children with multiple doses of vaccines for diphtheria, tetanus, pertussis, polio, measles, mumps, rubella and varicella zoster (chickenpox) are at an all time high of 94% and reaching 96 to 99% in many states,7 while less than 1% of all children are unvaccinated.8 Unless vaccine failures are so high that herd immunity requires a 99% vaccination rate, the push for a “no exceptions” vaccine policy mandate is not logical.

The specious argument that people have a moral and civic duty to get vaccinated in order to protect the immunocompromised or severely ill is a bogus one when vaccine policy dictates that they—as well as everyone else—get vaccinated.


References:

1 Centers for Disease Control and Prevention (CDC). General Information for Immunocompromised Persons. CDC.gov.
2 Quackenboss L. What About the Immunocompromised? FearlessParent.org Mar. 10, 2015.
3 Kristof N. The Dangers of Vaccine Denial. The New York Times Feb. 7, 2015.
4 Fisher BL. Blackmail and the Medical Vaccine Exemption. NVIC.org May 18, 2015.
5 United States Census Bureau. U.S. and World Population Clock.
6 CDC.Recommendations of the Advisory Committee on Immunization Practices (ACIP): Use of Vaccines and Immune Globulins in Persons with Altered ImmunocompetenceMorbidity and Mortality Weekly Report Apr. 9, 1993.
7 CDC. Vaccination Coverage Among Children in Kindergarten–United States, 2014-15 School Year. Aug. 28, 2015: 64(33): 897-904.
8 CDC. National, State and Selected Local Area Vaccination Coverage Among Children Aged 19-36 Months–United States, 2014. Aug. 28, 2015: 64(33): 889-896.

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