Immunologist about vaccines
This is a long and informative post from a closed FB group, reposted with the author's permission. Feel free to share far and wide, her name is Kimberly Mulligan.
I want to weigh in on this topic because as a scientist with a PhD from Stanford who has done research at UCSF on the molecular basis of brain development with an emphasis on a group of genes implicated in autism, I feel I have an obligation to try to help people better understand vaccines and the debate surrounding them.
First, I ask that you read this with an open mind. Having an open mind is an integral quality of good scientists - it is the only way to objectively analyze data. (Open minds are wise minds.) I also want to add that this debate gets nasty, but in the end we all love our kids and want what’s best for them (as a mama of two, I get that). I believe my role as a scientist is to arm you with information and help you better understand that information.
Ok, so what are vaccines? (I feel like this very basic question is often not clearly answered.) They are sometimes molecules designed to look like viruses, other times they are viruses that have been modified so they cannot hurt you, but still look like viruses to your immune system. That part is key. When these weakened viruses enter your body your immune system responds by making antibodies that will bind specifically to those viruses, and target them for destruction. Here’s the really cool part - our immune system makes cells called memory B cells that will stay in our body for a really long time (depending on how strong the vaccine is). These memory B cells are primed to make antibodies specific for that virus if you were to get infected again. This is important because our immune response can take a long time. Long enough for viruses to have debilitating and sometimes lethal consequences. If you have those B cells ready to go, your body makes specific antibodies that will get rid of the virus before it hurts you.
What about the other scary sounding stuff in vaccines? They are all there to make sure the vaccine stays safe and effective. And while they sound scary, they are all actually totally safe in the amounts present. For example, formaldehyde sounds awful, but did you know that it is a normal metabolic byproduct that you are constantly producing in small amounts? We produce more formaldehyde in our bodies over a matter of minutes than we would ever get from a vaccine. And our bodies simply process it and get rid of it (again, it knows how since we are always producing it). Aluminum? Present in higher amounts in things ranging from organic pears to natural breast milk. One of the first things biochemistry students learn is that dose matters. Yes, large amounts of aluminum and formaldehyde are bad…but large amounts of water can also be lethal. Oh, and mercury-containing thimerosol is no longer in early childhood vaccines because it was removed due to public outcry. However, there is still zero scientific data to suggest that thimerosol has any detrimental effects. In fact, the type of mercury in thimerosol is ethyl mercury, which is readily flushed from the body. The bad mercury that our body has a harder time getting rid of is methyl mercury (found in tuna).
Why should you trust a big pharma who profits from vaccines? My first answer is that you don't have to. The incredible majority of scientists who have published research on the safety of vaccines are not affiliated with big pharma and do not profit from the results of their findings. They are people like me - who became scientists because they wanted to help learn more about biology in order to diminish human suffering. We work for academic institutions, not big pharma. We ask questions without a vested interest in the answers. That is who you should seek answers from. You can do a search for yourself on the largest database of scientific journals here: http://www.ncbi.nlm.nih.gov/pubmed
You will find that when you search for studies on autism and vaccines, of the hundreds of studies conducted, there is still no scientific data to suggest a link between the two. (In fact, it is currently thought that autism is a neurodevelopmental disorder that begins in utero.)
Back to the big-pharma-makes-a-lot-of-money-argument. Yes, they do. They make money on every drug they produce. I have opinions on big pharma’s business practices that I won’t go into now because it actually has nothing to do with the argument about vaccine effectiveness or safety. For better of for worse, our entire medical system is profit based (our entire economy is, actually). The people at the forefront of the anti-vaccination movement also make a lot of money. That is not why I don’t believe them, though. I don’t believe anti-vaccination proponents because of the lack of scientific data to support their claims. As a scientist, I only believe what the scientific data supports. I read research, not opinions. (That is not meant as a slight to anyone! Simply stating my practices.)
What about vaccine-related injury? The overall risk is something like 0.003%. And the VAST majority of those 0.003% have minor allergic reactions. Severe allergic reactions can occur, though they are extremely rare. There have been a few cases of autoimmune disorders being triggered by a vaccine. It is not entirely clear whether the vaccine was actually the trigger because it could have been triggered by any pathogen. Also, people who are immunocompromised (cancer patients, HIV patients, etc) cannot be immunized because their immune systems are so weak that even the weakened virus might hurt them. All of these people fall into the class of people who should not get vaccinated and who herd immunity is so important for!
What is herd immunity? It’s kind of basic math. Viruses cannot replicate on their own -they need to infect a host cell in order to replicate. If they don’t make it into a host cell, they will eventually die. Here's an easy example, a person infected with a virus walks into a room where there are 20 vaccinated people separating him from a single unvaccinated person. That virus cannot move from the infected person and replicate in any of the vaccinated people because once it gets into their bodies, those memory B cells start pumping out antibodies that kill it before it can replicate. Therefore, those 20 vaccinated people make it harder for the virus to make it to the single unvaccinated person. If half of the people were unvaccinated, that virus would get to have a replication party in all of their cells and would have a much easier time spreading and surviving. Herd immunity is just a basic principle about how infectious pathogens spread. If someone tells you it doesn’t exist, you should be wary of any other scientific information they give you because it means that they have never taken or studied immunology or microbiology and are not qualified to have an educated discussion about those topics.
The tricky thing about vaccines and herd immunity is that herd immunity really only works when a high percentage of the population are vaccinated. If not, then viruses have an easier time spreading around our communities, putting at risk our neighbors who cannot be vaccinated (newborns, cancer patients, etc), and who are also much more likely to die as a result of infection. That is why the scientific community is so scared. We feel that even a single death from a vaccine-preventable disease is a tragedy.
Isn’t natural immunity better than vaccine-induced immunity? Well, the immune response is stronger because the viruses are not weakened, so if you make it through the illness you will, in theory, have a great supply of those memory B cells. The problem is that a lot of these vaccine-preventable pathogens can cause blindness, deafness, brain damage, paralysis, or death. I know someone who has a sister who contracted measles while she was pregnant. Her baby was born blind and deaf. So, yes, she now has great immunity to measles. But she would give anything to have had vaccine-induced immunity prior to her pregnancy.
Hopefully, this was helpful to you. Again, I have no financial interest in this debate. As the mama of a 6 month old who is not old enough to have MMR, as the daughter to a wonderful man who spent his final 9 months severely immunocompromised due to chemotherapy, I am certainly emotionally invested in the debate. And as a scientist who has read thousands of pages of scientific research, I only want to help spread knowledge and quell fear.
Her responses to salient questions:
As for vaccines when a kiddo is sick, I think docs generally avoid vaccines if there is a fever, but sometimes not for run of the mill colds. Our immune systems are pretty robust, and even a 6 month old baby can combat multiple pathogens at once (it has to considering the incredible amount of microorganisms in our world; did you know that we have ten times as many bacterial cells in and on us as we do human cells? Don't freak out - we need them to live). Fever happens as a part of the natural inflammatory process (our immune response). If your kiddo gets a fever post vaccination it likely means they're having a very robust response and will have great immunity.
As for the vaccine schedule, I know it seems crazy to think that a little baby can handle such a big immune response, but you should keep in mind that these molecules are not "infectious" in the same way a live virus is (they can't replicate or cause disease). What happens is that their [sweet little baby] body recognizes that there is something present that isn't "self" and the immune system generates antibodies (and memory B cells) specific to that molecule. That job actually isn't so hard if it's to a weakened virus that is non-infectious. Part of that immune response can include the release of molecules called chemokines, which can cause fever....and that often scares the bejesus out of us mommies, but it is just a normal part of the immune response and means that baby is mounting a robust response and making lots of great memory B cells. Babies have to be good at this because of all the microorganisms in our environment. BUT their immune response can often be slow and not that strong...which is only a problem if they are faced with a true live pathogen. And because newborns are more likely to die from these pathogens, doctors want to vaccinate them as soon as they can.
...you want to avoid tylenol and ibuprofen if you can (because the goal we all have is to limit harm to our children, but also limit unnecessary medication; obviously, I count vaccines as necessary). Now, aluminum. The short answer is that not very much aluminum is actually absorbed. Most is excreted by the kidneys, and the remaining amount is WELL below toxic levels associated with any any sort of neurological harm (if you have a kiddo with a kidney problem, you should be concerned, though). Here is a passage from a review.
Aluminum-containing adjuvants have been used for more than 70 years in billions of doses of vaccines, and have an excellent safety record (Butler et al., 1969; Edelman, 1980; Jefferson et al., 2004). The maximum amount of aluminum adjuvant allowed in human vaccines in the US is 0.85 mg Al/dose, and the amount in licensed vaccines ranges from 0.125 to 0.85 mg Al/dose (Baylor et al., 2002). Aluminum is an abundant metal in the environment and is daily ingested in food and water (Willhite et al., 2012). Aluminum is also commonly used in antacids and antiperspirants. However, only small amounts of aluminum are absorbed via the intestinal barrier and the skin. Most of the aluminum is excreted via the kidneys. Aluminum toxicity from occupational exposure, renal disease, and parenteral nutrition is associated with neurologic disease and bone disease (Willhite et al., 2012). The pharmacokinetics of aluminum following intramuscular injection of AH and AP (0.85 mg/dose) was studied in rabbits using the rare 26Al isotope as a tracer (Flarend et al., 1997). The data indicated that 17% of AH and 51% of AP was released into the blood circulation over a 28 day period. Based on these and other data, it was recently estimated that the concentration of aluminum in blood derived from vaccines administered to infants during the first year of life remains well below the minimum risk level established by the Agency for Toxic Substances and Disease Registry (Mitkus et al., 2011).
From: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3541479/
Memory B cells have different life spans that generally correspond to the strength of the vaccine. Some vaccines aren't that strong (like pertussis), so you need to get boosters more often that replenish those B cells (it's kind of like telling your body it still needs to worry about that pathogen).
...varicella is one of the pathogens that is often mild, unless you are a newborn, immunocompromised, or an adult. So getting your children vaccinated helps maintain herd immunity and protects those in the community who are most at risk. The HPV vaccine is important because of how often it leads to cervical cancer. It is sexually transmitted, but I don't even want to think about how young kids are becoming sexually active these days (my daughter is 6 months old, so I'm going to pretend the average age is 30 for now ;)). According to epidemiological data published in JAMA (peer reviewed medical journal not associated to Merck), out of 23 million doses administered at the time of the analysis there had been 32 deaths reported, but every death was easily attributed to other conditions unrelated to the vaccine (heart failure, diabetes, illicit drug overdose, ALS, etc). I did find one case of a young girl whose death is unexplained and may be from an extreme allergic reaction to the HPV vaccine, but it may also have been asthma related (it's still unclear and may not ever be conclusive).
I'm really surprised Dr Obukhanych has a PhD in immunology. She makes so many mistakes and oversights it makes me wonder if she's intentionally being disingenuous. I was going to write a full critique, but I actually found a very well-written critique already published online that is almost exactly what I would write: http://www.sciencebasedmedicine.org/why-does-this-immunologist-reject-vaccinations/ [I read this and it's scathing and contains many important links within.]
...anyone can be vaccinated - adults, children and babies. Sometimes older children and adults forget to get boosters and their immunity can fade with some vaccines. Vaccines vary in duration of acquired immunity (pertussis vaccine gives immunity for only 10 years whereas the smallpox vaccine gave immunity for 65 years). The dose of vaccines given to babies is determined by immune development more than weight. For example, if a newborn is medically stable and weighs more than 4.4lbs their immune system is developed enough to produce effective antibodies and memory cells in response to the hep b vaccine. When a baby is fussy or feverish after a vaccine it is actually because of the immune response. It may seem counterintuitive, but sometimes a baby being more uncomfortable is a sign of a more robust immune response. This is actually the same reason why adults often get more sick in response to pathogens we've acquired from our kiddos - our immune system has a larger inflammatory response. This is totally anecdotal, but my son was a much smaller baby than my daughter (25th percentile for weight versus 90th percentile), and my daughter was definitely fussier after her vaccinations. Has more to do with temperament in response to the not-so-fun feeling of the inflammatory response.
...vaccine shedding is something only possible with a live attenuated virus (so pertussis/whooping cough, which is an acellular vaccine, meaning piece of a viral molecule and not infectious at all, would never “shed”). A live attenuated virus is a weakened virus that reproduces so slowly that a normal immune system will take care of it before it causes any harm. If a person is immunocompromised in any way live attenuated vaccines cannot be used because their immune system might not be able to handle even a weakened virus. The nasal spray flu vaccine does have a risk of vaccine shedding because the vaccine is administered directly into the mucus membranes of the nose, so if that person sneezed onto an immunocompromised person there is a theoretical possibility that the attenuated virus could give that immunocompromised individual the flu, which is why it is recommended to stay away from immunocompromised individuals for a week after getting the nasal spray flu vaccine. Other live attenuated viruses are injected into muscle. Some of the weakened virus will get into the lymphatic system, which is where all that good immunity will happen (production of specific antibodies, effector cells and memory cells that will stay around for a long time). Some of the vaccine can enter saliva and mucus, although it is going to be a much lower amount. I think this is why the CDC only has the recommendation to steer clear of immunocompromised individuals in the case of the nasal spray flu vaccine. BUT, and this is critical, the virus that is shed post-vaccine is the attenuated (weakened) virus that does not cause illness in a person with a normal immune system. This is why vaccine shedding does not cause disease EVER in a person with a normal immune system. It would essentially be like getting an ultra-tiny dose of a vaccine (not enough to even cause an appreciable immune response that would lead to acquired immunity). As a side note (with more personal anecdotes), my son got vaccinations when my daughter was a newborn. I did not blink an eye about it (in case any of you have this concern). My daughter is just fine. Also, my husband was not aware of the more real concern about potential shedding of the nasal spray flu vaccine and both he and my son got that form of the flu vaccine when my daughter was a newborn. She was totally fine and did not get the flu. (And I wasn't really concerned because the threat of potential transmission is so minimal because of the weakened nature of the virus in vaccines and relatively low amount found in mucus.)
Yes, only an immunocompromised newborn would have any sort of chance of getting a disease from vaccine shedding (again, this is theoretical; I could not find any instance of this ever happening). The reason kiddos get MMR at 12 months is mostly because the immune response to MMR is better when a baby is a little older (I think I already wrote this somewhere, but I saw a study that indicated immunity is even better when MMR is administered at 15 months instead of 12 months; though it can be given as early as 6 months). This could be due to passive immunity acquired from a vaccinated mama during pregnancy (antibodies can cross the placenta), which can sometimes last for 6-8 months. If those antibodies were around when a baby was vaccinated then the immune response would not be as robust.
I want to weigh in on this topic because as a scientist with a PhD from Stanford who has done research at UCSF on the molecular basis of brain development with an emphasis on a group of genes implicated in autism, I feel I have an obligation to try to help people better understand vaccines and the debate surrounding them.
First, I ask that you read this with an open mind. Having an open mind is an integral quality of good scientists - it is the only way to objectively analyze data. (Open minds are wise minds.) I also want to add that this debate gets nasty, but in the end we all love our kids and want what’s best for them (as a mama of two, I get that). I believe my role as a scientist is to arm you with information and help you better understand that information.
Ok, so what are vaccines? (I feel like this very basic question is often not clearly answered.) They are sometimes molecules designed to look like viruses, other times they are viruses that have been modified so they cannot hurt you, but still look like viruses to your immune system. That part is key. When these weakened viruses enter your body your immune system responds by making antibodies that will bind specifically to those viruses, and target them for destruction. Here’s the really cool part - our immune system makes cells called memory B cells that will stay in our body for a really long time (depending on how strong the vaccine is). These memory B cells are primed to make antibodies specific for that virus if you were to get infected again. This is important because our immune response can take a long time. Long enough for viruses to have debilitating and sometimes lethal consequences. If you have those B cells ready to go, your body makes specific antibodies that will get rid of the virus before it hurts you.
What about the other scary sounding stuff in vaccines? They are all there to make sure the vaccine stays safe and effective. And while they sound scary, they are all actually totally safe in the amounts present. For example, formaldehyde sounds awful, but did you know that it is a normal metabolic byproduct that you are constantly producing in small amounts? We produce more formaldehyde in our bodies over a matter of minutes than we would ever get from a vaccine. And our bodies simply process it and get rid of it (again, it knows how since we are always producing it). Aluminum? Present in higher amounts in things ranging from organic pears to natural breast milk. One of the first things biochemistry students learn is that dose matters. Yes, large amounts of aluminum and formaldehyde are bad…but large amounts of water can also be lethal. Oh, and mercury-containing thimerosol is no longer in early childhood vaccines because it was removed due to public outcry. However, there is still zero scientific data to suggest that thimerosol has any detrimental effects. In fact, the type of mercury in thimerosol is ethyl mercury, which is readily flushed from the body. The bad mercury that our body has a harder time getting rid of is methyl mercury (found in tuna).
Why should you trust a big pharma who profits from vaccines? My first answer is that you don't have to. The incredible majority of scientists who have published research on the safety of vaccines are not affiliated with big pharma and do not profit from the results of their findings. They are people like me - who became scientists because they wanted to help learn more about biology in order to diminish human suffering. We work for academic institutions, not big pharma. We ask questions without a vested interest in the answers. That is who you should seek answers from. You can do a search for yourself on the largest database of scientific journals here: http://www.ncbi.nlm.nih.gov/pubmed
You will find that when you search for studies on autism and vaccines, of the hundreds of studies conducted, there is still no scientific data to suggest a link between the two. (In fact, it is currently thought that autism is a neurodevelopmental disorder that begins in utero.)
Back to the big-pharma-makes-a-lot-of-money-argument. Yes, they do. They make money on every drug they produce. I have opinions on big pharma’s business practices that I won’t go into now because it actually has nothing to do with the argument about vaccine effectiveness or safety. For better of for worse, our entire medical system is profit based (our entire economy is, actually). The people at the forefront of the anti-vaccination movement also make a lot of money. That is not why I don’t believe them, though. I don’t believe anti-vaccination proponents because of the lack of scientific data to support their claims. As a scientist, I only believe what the scientific data supports. I read research, not opinions. (That is not meant as a slight to anyone! Simply stating my practices.)
What about vaccine-related injury? The overall risk is something like 0.003%. And the VAST majority of those 0.003% have minor allergic reactions. Severe allergic reactions can occur, though they are extremely rare. There have been a few cases of autoimmune disorders being triggered by a vaccine. It is not entirely clear whether the vaccine was actually the trigger because it could have been triggered by any pathogen. Also, people who are immunocompromised (cancer patients, HIV patients, etc) cannot be immunized because their immune systems are so weak that even the weakened virus might hurt them. All of these people fall into the class of people who should not get vaccinated and who herd immunity is so important for!
What is herd immunity? It’s kind of basic math. Viruses cannot replicate on their own -they need to infect a host cell in order to replicate. If they don’t make it into a host cell, they will eventually die. Here's an easy example, a person infected with a virus walks into a room where there are 20 vaccinated people separating him from a single unvaccinated person. That virus cannot move from the infected person and replicate in any of the vaccinated people because once it gets into their bodies, those memory B cells start pumping out antibodies that kill it before it can replicate. Therefore, those 20 vaccinated people make it harder for the virus to make it to the single unvaccinated person. If half of the people were unvaccinated, that virus would get to have a replication party in all of their cells and would have a much easier time spreading and surviving. Herd immunity is just a basic principle about how infectious pathogens spread. If someone tells you it doesn’t exist, you should be wary of any other scientific information they give you because it means that they have never taken or studied immunology or microbiology and are not qualified to have an educated discussion about those topics.
The tricky thing about vaccines and herd immunity is that herd immunity really only works when a high percentage of the population are vaccinated. If not, then viruses have an easier time spreading around our communities, putting at risk our neighbors who cannot be vaccinated (newborns, cancer patients, etc), and who are also much more likely to die as a result of infection. That is why the scientific community is so scared. We feel that even a single death from a vaccine-preventable disease is a tragedy.
Isn’t natural immunity better than vaccine-induced immunity? Well, the immune response is stronger because the viruses are not weakened, so if you make it through the illness you will, in theory, have a great supply of those memory B cells. The problem is that a lot of these vaccine-preventable pathogens can cause blindness, deafness, brain damage, paralysis, or death. I know someone who has a sister who contracted measles while she was pregnant. Her baby was born blind and deaf. So, yes, she now has great immunity to measles. But she would give anything to have had vaccine-induced immunity prior to her pregnancy.
Hopefully, this was helpful to you. Again, I have no financial interest in this debate. As the mama of a 6 month old who is not old enough to have MMR, as the daughter to a wonderful man who spent his final 9 months severely immunocompromised due to chemotherapy, I am certainly emotionally invested in the debate. And as a scientist who has read thousands of pages of scientific research, I only want to help spread knowledge and quell fear.
Her responses to salient questions:
As for vaccines when a kiddo is sick, I think docs generally avoid vaccines if there is a fever, but sometimes not for run of the mill colds. Our immune systems are pretty robust, and even a 6 month old baby can combat multiple pathogens at once (it has to considering the incredible amount of microorganisms in our world; did you know that we have ten times as many bacterial cells in and on us as we do human cells? Don't freak out - we need them to live). Fever happens as a part of the natural inflammatory process (our immune response). If your kiddo gets a fever post vaccination it likely means they're having a very robust response and will have great immunity.
As for the vaccine schedule, I know it seems crazy to think that a little baby can handle such a big immune response, but you should keep in mind that these molecules are not "infectious" in the same way a live virus is (they can't replicate or cause disease). What happens is that their [sweet little baby] body recognizes that there is something present that isn't "self" and the immune system generates antibodies (and memory B cells) specific to that molecule. That job actually isn't so hard if it's to a weakened virus that is non-infectious. Part of that immune response can include the release of molecules called chemokines, which can cause fever....and that often scares the bejesus out of us mommies, but it is just a normal part of the immune response and means that baby is mounting a robust response and making lots of great memory B cells. Babies have to be good at this because of all the microorganisms in our environment. BUT their immune response can often be slow and not that strong...which is only a problem if they are faced with a true live pathogen. And because newborns are more likely to die from these pathogens, doctors want to vaccinate them as soon as they can.
...you want to avoid tylenol and ibuprofen if you can (because the goal we all have is to limit harm to our children, but also limit unnecessary medication; obviously, I count vaccines as necessary). Now, aluminum. The short answer is that not very much aluminum is actually absorbed. Most is excreted by the kidneys, and the remaining amount is WELL below toxic levels associated with any any sort of neurological harm (if you have a kiddo with a kidney problem, you should be concerned, though). Here is a passage from a review.
Aluminum-containing adjuvants have been used for more than 70 years in billions of doses of vaccines, and have an excellent safety record (Butler et al., 1969; Edelman, 1980; Jefferson et al., 2004). The maximum amount of aluminum adjuvant allowed in human vaccines in the US is 0.85 mg Al/dose, and the amount in licensed vaccines ranges from 0.125 to 0.85 mg Al/dose (Baylor et al., 2002). Aluminum is an abundant metal in the environment and is daily ingested in food and water (Willhite et al., 2012). Aluminum is also commonly used in antacids and antiperspirants. However, only small amounts of aluminum are absorbed via the intestinal barrier and the skin. Most of the aluminum is excreted via the kidneys. Aluminum toxicity from occupational exposure, renal disease, and parenteral nutrition is associated with neurologic disease and bone disease (Willhite et al., 2012). The pharmacokinetics of aluminum following intramuscular injection of AH and AP (0.85 mg/dose) was studied in rabbits using the rare 26Al isotope as a tracer (Flarend et al., 1997). The data indicated that 17% of AH and 51% of AP was released into the blood circulation over a 28 day period. Based on these and other data, it was recently estimated that the concentration of aluminum in blood derived from vaccines administered to infants during the first year of life remains well below the minimum risk level established by the Agency for Toxic Substances and Disease Registry (Mitkus et al., 2011).
From: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3541479/
Memory B cells have different life spans that generally correspond to the strength of the vaccine. Some vaccines aren't that strong (like pertussis), so you need to get boosters more often that replenish those B cells (it's kind of like telling your body it still needs to worry about that pathogen).
...varicella is one of the pathogens that is often mild, unless you are a newborn, immunocompromised, or an adult. So getting your children vaccinated helps maintain herd immunity and protects those in the community who are most at risk. The HPV vaccine is important because of how often it leads to cervical cancer. It is sexually transmitted, but I don't even want to think about how young kids are becoming sexually active these days (my daughter is 6 months old, so I'm going to pretend the average age is 30 for now ;)). According to epidemiological data published in JAMA (peer reviewed medical journal not associated to Merck), out of 23 million doses administered at the time of the analysis there had been 32 deaths reported, but every death was easily attributed to other conditions unrelated to the vaccine (heart failure, diabetes, illicit drug overdose, ALS, etc). I did find one case of a young girl whose death is unexplained and may be from an extreme allergic reaction to the HPV vaccine, but it may also have been asthma related (it's still unclear and may not ever be conclusive).
I'm really surprised Dr Obukhanych has a PhD in immunology. She makes so many mistakes and oversights it makes me wonder if she's intentionally being disingenuous. I was going to write a full critique, but I actually found a very well-written critique already published online that is almost exactly what I would write: http://www.sciencebasedmedicine.org/why-does-this-immunologist-reject-vaccinations/ [I read this and it's scathing and contains many important links within.]
...anyone can be vaccinated - adults, children and babies. Sometimes older children and adults forget to get boosters and their immunity can fade with some vaccines. Vaccines vary in duration of acquired immunity (pertussis vaccine gives immunity for only 10 years whereas the smallpox vaccine gave immunity for 65 years). The dose of vaccines given to babies is determined by immune development more than weight. For example, if a newborn is medically stable and weighs more than 4.4lbs their immune system is developed enough to produce effective antibodies and memory cells in response to the hep b vaccine. When a baby is fussy or feverish after a vaccine it is actually because of the immune response. It may seem counterintuitive, but sometimes a baby being more uncomfortable is a sign of a more robust immune response. This is actually the same reason why adults often get more sick in response to pathogens we've acquired from our kiddos - our immune system has a larger inflammatory response. This is totally anecdotal, but my son was a much smaller baby than my daughter (25th percentile for weight versus 90th percentile), and my daughter was definitely fussier after her vaccinations. Has more to do with temperament in response to the not-so-fun feeling of the inflammatory response.
...vaccine shedding is something only possible with a live attenuated virus (so pertussis/whooping cough, which is an acellular vaccine, meaning piece of a viral molecule and not infectious at all, would never “shed”). A live attenuated virus is a weakened virus that reproduces so slowly that a normal immune system will take care of it before it causes any harm. If a person is immunocompromised in any way live attenuated vaccines cannot be used because their immune system might not be able to handle even a weakened virus. The nasal spray flu vaccine does have a risk of vaccine shedding because the vaccine is administered directly into the mucus membranes of the nose, so if that person sneezed onto an immunocompromised person there is a theoretical possibility that the attenuated virus could give that immunocompromised individual the flu, which is why it is recommended to stay away from immunocompromised individuals for a week after getting the nasal spray flu vaccine. Other live attenuated viruses are injected into muscle. Some of the weakened virus will get into the lymphatic system, which is where all that good immunity will happen (production of specific antibodies, effector cells and memory cells that will stay around for a long time). Some of the vaccine can enter saliva and mucus, although it is going to be a much lower amount. I think this is why the CDC only has the recommendation to steer clear of immunocompromised individuals in the case of the nasal spray flu vaccine. BUT, and this is critical, the virus that is shed post-vaccine is the attenuated (weakened) virus that does not cause illness in a person with a normal immune system. This is why vaccine shedding does not cause disease EVER in a person with a normal immune system. It would essentially be like getting an ultra-tiny dose of a vaccine (not enough to even cause an appreciable immune response that would lead to acquired immunity). As a side note (with more personal anecdotes), my son got vaccinations when my daughter was a newborn. I did not blink an eye about it (in case any of you have this concern). My daughter is just fine. Also, my husband was not aware of the more real concern about potential shedding of the nasal spray flu vaccine and both he and my son got that form of the flu vaccine when my daughter was a newborn. She was totally fine and did not get the flu. (And I wasn't really concerned because the threat of potential transmission is so minimal because of the weakened nature of the virus in vaccines and relatively low amount found in mucus.)
Yes, only an immunocompromised newborn would have any sort of chance of getting a disease from vaccine shedding (again, this is theoretical; I could not find any instance of this ever happening). The reason kiddos get MMR at 12 months is mostly because the immune response to MMR is better when a baby is a little older (I think I already wrote this somewhere, but I saw a study that indicated immunity is even better when MMR is administered at 15 months instead of 12 months; though it can be given as early as 6 months). This could be due to passive immunity acquired from a vaccinated mama during pregnancy (antibodies can cross the placenta), which can sometimes last for 6-8 months. If those antibodies were around when a baby was vaccinated then the immune response would not be as robust.