Written by Christopher Kelly
Feb. 3, 2015
Christopher: Hello, and welcome to the Paleo Baby Podcast. My name is Christopher Kelly and I'm here with my food scientist, Julie.
Christopher: And Dr. Tommy Wood. Hi, Tommy.
Christopher: For those of you that don't know from our last episode, Tommy is a qualified medical doctor. He graduated from Oxford University in 2011. He has a previous bachelors degree in natural sciences and biochemistry from Cambridge University. After working as a junior doctor in the UK for two years, Dr. Wood is now working towards a PhD in neonatal brain metabolism at the University of Oslo, in Norway, which is pretty cool, as I think I already pointed out in the last episode.
Tommy has kindly agreed to come on today and talk about some rather controversial baby related topics. The first one we're going to hit on is vaccines. So my first question is: Say, I was walking in to your office and I was a patient of yours -- I know you're not practicing right now -- and I told you that I got a history of autoimmunity in my family, maybe some chronic health complaints. What would you tell to me about vaccinations?
I mean, first of all, does it make sense to group all of these vaccinations together in one lump and just address them all in one big group? Or do you think it makes sense to break them down?
Tommy: I think it makes sense to break them down, actually, for a number of reasons. I think before we get into this, it's probably worth saying that, like I said on the previous episode of the podcast, that I don't have children. I haven't had to make these decisions about my own children. So all I can do is look at the state of the science and then see if I can come up with a feasible answer.
Christopher: So this is a very evidence-driven approach? This is just your observation of the literature and it's not medical advice or anything like that?
Tommy: Yeah, absolutely. And I'm traditionally trained medical doctor and they do tell us that vaccinations are absolutely what we should be doing. I originally came from a stance that all vaccines are safe and they're perfectly fine and I don't see what the problem is with them. But then when you dig a little deeper, I think that it's worth bringing up certain points about vaccinations.
One thing that's worth noticing, I think the important thing that's worth noticing is that most of the diseases that vaccines treat or that we vaccinate against nowadays -- things like diphtheria, typhoid, measles -- the early half of the 1900s or 20th century, death rates due to those diseases and infection rates of those diseases dropped. In the US and UK, that's what we've got the best data.
They dropped almost 90% before we introduced vaccines to those diseases. And that happened because living conditions improved, people were eating better, they had better hygiene, electricity, refrigeration, all that kind of stuff came together and that improved or reduced the rates of all the infections that were plaguing us 150 years ago. But then, so a lot of people will say that because the rates of the diseases were dropping naturally then the introduction of vaccines didn't really make much difference and the rate just declined on the normal path that they were headed on anyway.
But I don't think there's actually necessarily any real evidence to support that. And I think that if you're actually trying to eradicate a certain disease, as we did with small pox ,and we nearly did with polio or we have nearly done with polio, I think you need to completely rely on the last little bit of herd immunity that you get from something like vaccinations. A lot of where we stand now came naturally due to better hygiene and living conditions. But I think that the last that will push could have been helped by vaccinations.
Christopher: That makes a lot of sense to me. Our programs, although it's completely different, it worked on a much different scale, are actually the same. So someone comes to me and say they're not sleeping well and they've got brain fog and they're tired in the afternoon, then I know the paleo diet and protecting your photoperiod and a bunch of other diet and lifestyle stuff has to be in place before there's really going to be any use in you doing a bunch of specialist lab work and fixing micronutrient deficiency and getting rid of infections.
So, 80% or, like you said, maybe even 90% of the gains came from that diet and lifestyle stuff. But that doesn't mean that you're going to see full resolution with just those things. That's the most important bit but not the only bit. Sorry, I interrupted you.
Tommy: No. Obviously, there's a lot of controversy about a lot of these things.
I think it really depends on which vaccines you're talking about, which diseases you're looking at. I know you guys have talked about this a little bit before where we both came on and talked about what vaccinations he decided to use. So in the UK, there's a lot of controversies surrounding the MMR vaccine. Dr. Wakefield was the guy who thought he found the link between the MMR vaccine and autism and he was then subsequently struck off by the General Medical Council because they thought that he had misinterpreted or been untruthful with the data.
And I think that that particular link, I don't think there's any evidence to suggest that that's true. And the reason that I think the data isn't particularly robust. But also, if you think about the periods since we started vaccinating for something, MMR, maybe 50, a little bit few years than that, that's also the time that we'd been moving less, eating worse, more exposure to toxins like heavy metals and endocrine disruptors and EMF and all that stuff.
I think that as we've seen an increase in the diagnosis of things like autism and ADHD, that's the same time period that all of those stuff has happened. So I think it's very difficult to find a course or link there and I'll be surprised if some of that other stuff wasn't part of that. And also with diagnosing it more and more, so the more diagnosis we get of it, the more the rate increases. I think that's part of it as well.
And when you're talking about something like MMR, you have to remember that if you get -- So we've seen in Wales, in the UK a few years ago and then recently in California, I think there'd been outbreaks of measles because in those populations those people have decided to stop using the MMR vaccine and then we've seen an increase in measles as a result particularly. And with the diseases that they're protecting against.
So measles has a death rate of 0.1% to 0.2% in developed countries. If you're amino compromised, that could be up to 30%. People who get mumps up to 10% can get meningitis, 30% of adult males, if they get mumps, they'll get some kind of testicular inflammation and half of those will get testicular attributes and the testicles will get smaller because of the vaccines. So that's 15% of adult males who contract mumps. And then most of those will have their fertility affected in some way.
Julie: You're talking about that's because of the vaccine?
Tommy: No, I'm talking about if--
Julie: If they don't?
Tommy: If we're not vaccinated, we contract that disease. So I think these are important diseases and we've seen that where people have stopped taken the vaccine then rates have increased and, I think, it's just worth remembering why we're vaccinated against these diseases. But then again I was vaccinated with MMR and I still got mumps when I was a kid.
Julie: That's the point that I was--
Christopher: I was going to say I got it too.
Julie: The thing I was just going to point out and actually I've just been reading about this morning is that there are actually a lot of people, a lot of the moms especially that I'm friends with on Facebook are posting vaccinate your kids MMR, all of these measles outbreak could have been prevented. But actually reading this morning that most of the children that contracted measles in the Disneyland outbreak were already vaccinated. That kind of begs the question for me: If they're not effective or if this particular vaccine is not effective, is it doing more harm than good?
Tommy: Well, I don't think that there's much evidence for that one yet as to doing much harm. The way that they kind of tend to work is it's not necessarily that if you have the vaccine you will be protected. It's kind of you need to get above a certain proportion of the population that are vaccinated and then you will eventually push out the disease and remove pools of the disease. And then reduce rates that way. But they aren't 100% effective.
And something like the flu vaccine, that's something that I find very interesting because, as a doctor, you're told to get the flu vaccine every year. And it only has about 50% or 60% efficacy rate in adults. So if you have the flu vaccine or when you reduce your risk of getting the flu that year by about 50%, and that's because they have to guess about which strains of flu they're treating. And it just doesn't work 10% of the time. And interestingly, because they assumed that all elderly people and children or babies should get vaccinated against the flu, it's considered unethical to do trials in them.
So they just assume that they should all be given them. So there's actually very little data on the efficacy or the safety of flu vaccines in the elderly and the babies because people just assume that we should be giving them.
Christopher: And is that true of all of vaccines? Do you think there's a non-zero risk? Going back to MMR, what risks do you see associated with taking it?
Tommy: I mean, obviously, there's all the risks that you can get with any kind of drug. So, anaphylactic reactions or allergic reactions. A lot of people will get flu like, infection like symptoms. And in all these vaccinations, there are many reports of things like neurological damage. So that's been particularly prevalent or we heard more about it since the introduction of the HPV vaccine or Gardasil.
And I think there's no, as far as I can see, there's no real robust evidence that any of these things are actually causing harm and most of what I see as or interpreted as negative effects are sort of happening at the same kind of rate as you'd see in a non-vaccinated population. And the reason why -- I mean, we talk about MMR so much and I was talking about measles and mumps. But something like, which is very relevant to this podcast, is Rubella, so German measles which is the R in MMR.
Christopher: I'm pretty sure I've had that too, actually.
Tommy: If you get it as a kid, you're absolutely fine. Usually, it's a very mild illness. But if you get it as a pregnant woman, you have a 50% chance of having something called congenital Rubella syndrome and those kids, most of them, are completely deaf, most of them are completely blind, most of them have some kind of congenital heart defect. I mean, when you're talking about pregnant women, Rubella is a really nasty disease. So if the MMR is keeping it at bay, which as far as we know at the moment it is keeping it slow, then I think that's definitely a good thing.
Julie: My question and concern has always stemmed from the fact that conversation that didn't happen when Ivy was born and we were struggling to make the decision about when to start vaccines, not necessarily whether or not to start vaccines, but when to start them. Conversation didn't happen, and what was surprising to me is that the pediatrician or nurse practitioner never really asked if there were any circumstances in which would present whether in our family history that would provide reason to not vaccinate.
So never really kind of evaluated any risk specifically to our family or to our circumstances. And that was surprising to me because of everything I've read. There's definitely fragments of the population that shouldn't vaccinate and one of those things is autoimmunity. And if you've got at least one parent with an autoimmune condition, doesn't that at least beg the question should we vaccinate or should we wait to vaccinate?
Tommy: Well, I think that's a very good point. There is a potential that if you're causing -- I think there's a two-fold potential problem. If you're causing this kind of very unnatural immune response, which is what you're doing because you're essentially injecting either a part of a bacteria or a virus or a type of the toxin that they produce, you're injecting that and you usually have to inject something to stimulate the immune system as well.
So that might be something like an aluminium compound which they do to sort of like stimulate, which creates inflammation, so you get the body to react to it. And people who are already at risk of loss of self tolerance, so people with autoimmune disease, may be at an increased risk of them developing those diseases as a result of vaccinations. But, I mean, what I've seen so far is that there's no -- Everything is theoretical.
So it's definitely something that you should think about. And then maybe that's a reason to pick the vaccinations that are potentially the most important ones. But I certainly haven't seen any data that suggests that vaccinations in people at risk of autoimmune disease then increases their risk further. I haven't seen that. At the moment, it's theory.
And the theory is very sound. I think it's a good theory. But I don't think that they've actually found that in any sort of reasonably robust studies.
Christopher: So which of the vaccines you think are absolutely essential?
Julie: We promised there would be no loaded questions.
Tommy: I think we've covered the fact that MMR potentially is important. If it were my kid, I think I would immunize it against MMR. And MMR doesn't have things like thiomersal in it, which people are worried about, which is organic mercury compound that you can get in some vaccines.
Christopher: Yes. Can I interject and let's drill into that a little bit? Tell me, first of all, why is the mercury even there in the vaccine?
Tommy: So it's used as a preservative. The aluminium compounds are used to stimulate an immune reaction but thiomersal is used as a preservative. And that's because I believe back in the '60s and '70s particularly with the DTPs, the Diphtheria, Tetanus, Pertussis vaccination, which we will talk about some more in relation to this and sudden infant death syndrome, when they were first doing that, they found that they were actually -- The vaccines were going bad and then they were basically just injecting people with a high load of bacteria that it kind of started live in the vaccines and these people were dying because of the vaccination but not because of the vaccine itself but because of the fact that bacteria had start to grow in it.
So then they started to use preservatives and thiomersal was the one that kind of became the most widely used. We're using it less now actually because people become more worried about mercury toxicity and there's some good data that suggests that anything above no mercury exposure will give you some kind of toxicity or some kind problem. Most people won't notice it but the safe dose of mercury is zero.
Christopher: Right. I was just wondering about that. Say, you got some kid that's not very old and possible borderline failure to thrive type of situation, and obviously mercury is quite toxic. It's a neurotoxin, right? It actually kills brain cells. What would happen, say, that that kid had a potentially -- So the epithelial cells that line the gut are perhaps compromised or maybe even the blood brain barrier is compromised in some way. What would happen if you injected them with something with mercury in it?
Tommy: That's difficult. That's difficult to tell really because they -- I mean, they could be easily exposed to a much higher dose of mercury in their day to day lives. Just like if you're talking about if they're eating lots of contaminated fish or contaminated just any kind of cosmetic products or food from tins. You don't really get that anymore, but there are still lots of people who have mercury. The moment he's at home and so paints and sort of industrial chemicals.
Then the dose of mercury that you're injecting might be very small in comparison to those. And I think, again, talking about the aluminium that you're injecting as a stimulant in certain vaccines. The dose of aluminium in there is much, much smaller than the dose you get from processed food and cosmetics like deodorants contain aluminium and you're rolling them under your arm.
Tommy: I think the dose, it would really depend on the dose and anything else that's kind of going on. So [0:19:08] [Indiscernible] cause an issue. But if you're already, if a baby is already at risk and then you inject with a dose of mercury, then we know it's a neurotoxin and I believe that mercury is potentially part of the initiating factors of certain neurological diseases. And it could be that all those things together. You have somebody who's at risk to start with and then you give something like you inject them with mercury and then that sort of tips them over the edge, and that's certainly possible. But again, this is largely theory.
Julie: Maybe this is too big in this side to tackle, but the thing that keeps coming back to me. And we probably have a better view into this just because of the work that we do and how we kind of see people coming to us. If you gave me a list of all of the things that were possible risk factors that people were already suffering from and then you ask me whether another vaccine was a good idea for them, I would probably say no.
Because it got every single box that could possibly be checked for exposure to bad environmental toxins. They're eating a poor diet. They're not exercising. They're not sleeping well. Obviously, babies are not 30-year old people who have had a life of this. But if they're coming from those people, it just seems like maybe we're at the stage where all of these compounding factors need to be more considered than they're being considered when people are sitting down to decide or talking with their doctor about vaccinations.
Is it just one another thing that might just be tipping the scales? Do we need to have a different conversation about screening people for whether or not they need to or they should have a vaccine?
Tommy: I think that's a very interesting question. I think that that would really depend on, again, the type of vaccination and the type of disease that you're looking to vaccinate against. And, I think, if we're looking to eradicate something like German measles or diphtheria or pertussis or whooping cough or something like that, then you need to get vaccination above a certain level in order to completely eradicate that.
So then once you're having that conversation, you basically remove the ability to do that. And if you're going to do that, then I think that that's something that is a bigger question for society, if you see what I mean. But then, for different types of vaccinations, so things like the flu virus -- We're never going to get rid of the flu. We'll never. So then what they're trying to do is protect the individual people. But the information on things, on say, babies, whether it works or not, because it doesn't really work that well in adults, and flu vaccines are more likely to have thiomersal in them, then I'm not really sure I would always see the point.
Something like the HPV vaccine, so against human papillomavirus or certain strains of human papillomavirus, which is associated with cervical cancer, they've obviously started this big rollout of vaccinating particularly young girls before sexual activity to try and reduce their risk of cervical cancer. And they've shown that they reduce the risk of pre-cancerous changes but there is actually no evidence to suggest that it does reduce the risk of cervical cancer. And it's a virus and it's a certain virus that we're just not going to get rid of.
And sexually active females throughout their lifetime are probably going to get some kind of HPV virus. But if you're worried about -- They also cause, certain strains also cause genital warts. But you can prevent your risk of that, or dramatically reduce the risk of that just by good safe sexual health practices.
Julie: I also read that you almost have the same effect of reducing your chance of pre-cancer risk changes and things like that just by having, you're going religiously to your yearly exam.
Tommy: Absolutely. And then you can get them found early on and dealt with if they need to be. But also, in the context of a better diet and looking after yourself better, we know that those things reduce your risk of cervical cancer as well. I haven't actually been convinced by the importance of something like the HPV vaccine. And it does. It has been shown to increase risk of things like venous thromboembolism, so basically, if you get clots in your veins, which then go to other places.
And what has been to happen is obviously a very, very low rate. So they had a one death per million doses. But it's an increased risk of pulmonary embolism, so basically a clot in the lungs that can kill you. That is one vaccination that has been shown to have some potentially negative effect. And I'm not really sure that -- It's not something we're going to eradicate and that's something that people can -- That's the kind of disease where I see people making it more of an informed decision as to whether they want to take it.
Christopher: Right. My problem with this is that's the moment you lost me. We're having this sensible conversation about whether or not I should do all vaccines and I was pretty much on board like I believe in the herd immunity thing.
And then you've got this [0:25:04] [Indiscernible] problem which is this HPV thing. Why does that vaccine still exit? I don't trust you anymore. If this is nonsense, you just lost me as a person that's going to act on your advice. Why do you think it is then? Why don't they just get rid of that one vaccine and then that would just remove the doubt of all of them?
Tommy: That is a very good question. And they're still pushing this as far as I know. And, obviously, I don't know many people with children of that kind of age getting towards ten or 12. But I believe this is something they're still working with. When you look at these broad scale initiatives to tackle the disease or something or screen for disease like breast cancer screening, you have to look at the severity of the problem and what it will take and the risk you're taking to try and screen or eradicate or whatever.
And I obviously have not looked at the risk factor assessments that they did for something like the HPV vaccine. But, to me, it just doesn't quite add up because it's not something that we can completely eradicate. They can't protect against all the potential strains that could cause cervical cancer. There are lots of other things that can cause cervical cancer. So for that particular example, I'm not sure I really get it. It's also one of the, I believe -- Yes, it's also one of the vaccinations that can contain thiomersal and contains a big dose of aluminium.
Julie: This leads me to another question. At least in the United States, I feel like we're probably one of the ones that use the most number of vaccines especially for very young children. I was just shocked. I mean, I'm pretty young. I'll be 30 this year and Ivy is going on 15 or 16 months. I'm not a lot older than -- I haven't waited a tremendous time to have kids. And I can remember the vaccines that I had when I was kid or at least I've talked to my mom about this in detail.
And just this staggering jump from how many vaccines were normal when I was a child to how many now are considered normal or routine for my daughter. Even going through the list of those, there's definitely some that I can pick out as non life threatening things that will probably never eradicate. Is too much a problem? Or can we get into a situation with antibiotics where we're creating more problems than we're solving by giving vaccines for things that we really shouldn't be vaccinating against?
Tommy: That particular statement there is like antibiotics. Sure they're great problems but--
Julie: No, resistance. I'm talking about antibiotic resistance. So using antibiotics when you shouldn't use antibiotics or overuse.
Tommy: Yeah. But as a general statement--
Julie: No, antibiotics are great. I love antibiotics.
Tommy: Yeah, exactly.
Julie: When you need antibiotics, you need antibiotics. But I'm talking about the overuse of antibiotics which is this really big problem that I think a lot of people would agree is a huge problem. Because if antibiotics stopped working then we're really screwed.
Tommy: Yeah. So, I think, that's a really important point in what you said which is the number of vaccinations that you're getting particularly in the US. And this is kind of the -- And the more I read about vaccinations, I definitely come into the side of some are good but more isn't better. And what started that is I saw this paper published a couple of years ago which found a positive correlation between the number of vaccine doses in the first year of life and infant mortality rates.
And you will be happy to know that in the US, you have the most vaccines doses in the first year of life. That's 26 of any of these. So these are Western countries. So this was from Asia, so places like Japan and Singapore, Europe and Northern America. So these are all places where we would hope there's a similar quality of healthcare and standard of living and all that kind of stuff so we can potentially remove that from the equation.
So you have 26 doses in the first year of life and you have an infant mortality of 6.2 per thousand live births. And compare that to places like Scandinavia, Japan and Singapore, who'd give almost half that number of doses in the first year of life and for fewer diseases and they have an infant mortality rate of less than three per thousand. So that's half the number of vaccines and half infant mortality rate.
Christopher: But what makes anyone think that there's a causal relationship there? I mean, I've been to go visit a supermarket or shopping mall in Sweden or Stockholm and you will see many, many differences from going to do the same thing anywhere in the US. Like we live in a rather affluent part of California and still I see all kinds of horrendous inflammation and metabolic dysfunction. And so I wouldn't see that in Sweden, not at the same scale. So what makes anyone think that there's a causal relationship there?
Tommy: I read this and it immediately made me wary. The reason it made me weary is because they did exactly that. They just plotted one against the other and there was no -- If you're not adjusting for anything else and you're just trying to see a causal relationship between two basic things and taking nothing else into account, I mean, that's just not good. It's not good science and it's not good statistics. There's not a good statistical analysis of the data that you have.
So they inferred and they selectively reported the data to suggest that this was a causal relationship. So I didn't quite believe it. And what I actually did is I took this data and I put it into statistical package and I tried to--
Christopher: Oh, really? You had some software that does this?
Tommy: Yes. So this is just the basic, actually assess, like a standard statistics package. I just took their numbers and then I tried to think about other things that I could adjust for. So the one that immediately came to mind was child poverty rates. Again, US leading the way with almost 30% of children living under the poverty line. And so I put in the numbers for child poverty which I thought would maybe equate to child access to healthcare and things like that.
And putting those numbers in it, obviously, reduced the strength of the association between vaccines and mortality rate. But it still stayed there. And there's a number of other things that I could adjust for. And if people are interested in me spending some time doing that, I'm happy to do it. And so, I think, I'd be interested in looking things like parent's smoking rate, which I couldn't find, breastfeeding rates, average level of education and things like that. I think all of those potentially feed into those numbers.
I don't think that we have -- I don't think there's a causal relationship. But it's interesting that when you tank a major factor like child poverty and put it in there, that the association is still there. There's potentially an argument to say that more isn't necessarily better.
Christopher: Okay. And then we should link to that paper for sure.
Tommy: Yeah, I can send that to you.
Christopher: Excellent. I mean, there's not really a takeaway message here, right? I mean, what would you do if it was your kid? What would you do?
Tommy: That's difficult choice and I think it will be based on what is standard for where you are. So, obviously, what's standard in the UK isn't the same as what's standard in the US. So, I think, things like MMR and diphtheria, tetanus, pertussis, I think there's potential benefit for those, something against meningitis. Meningitis C is vaccinated against in some places. And that is a devastating disease where vaccination has been shown to dramatically reduce the risk of you contracting it.
That's again something that potentially I was considering. We nearly got rid of polio but then some places said that the polio vaccination in the third world was part of a US plot to spread AIDS through the third world. So then people stopped using the vaccine and then polio started to come back a bit. So worldwide, I think, in terms of huge benefit, maybe there's benefit to the polio vaccine. But I think in terms of the ones that are definitely not going -- You're not going to eradicate the disease and you might not actually reduce the risk of getting the disease in the first place, then I think that maybe you can make a decision about which those are and potentially think about not including those, if that made sense.
So I haven't read this book but I recently listened to Ben Greenfield on his own podcast and he was talking -- And he goes into huge amount of depth about pretty much everything that he does. And he was saying that if he had gone through a pregnancy or had another child, he would have made sure he read The Vaccine Book by Robert Sears. I don't know if you've heard of it.
Tommy: So I haven't read it but I know that he recommends basically a slowed schedule. So you're getting fewer doses in the first year of life. I think it's 16 rather than the standard 26. And so I can't talk about the validity of that book or the ideas but he basically said -- So, if I was going to give anybody advice I'd say educate yourself as much as possible. And read as much as possible around on the topic and decide which are most beneficial both to you and society potentially because, I mean, there obviously is -- That is part of the idea of vaccines. It's a societal thing rather than an individual thing.
I think it's definitely better to get going with more information, have those conversations that you feel you didn't have. And I'm sure you will get some resistance because doctors will tell that all these are the best thing to do and this is what we want to promote. And we're taught these are the right things. We're doing a good thing by promoting vaccinations.
And so, if you go in and you immediately go on the defensive with your pediatrician or whatever, then I don't think you're going to have a useful productive conversation. But if you go in with some studies and some ideas and you have an open and frank conversation about potential risks and benefits, then I think most people are willing to understand and they're always willing to learn more. So it just really depends on how you approach that kind of conversation.
Christopher: Excellent. I think this is a lot for everybody to take in in one sitting. I'm wondering, we really want to talk to you about sudden infant death syndrome. And I'm wondering whether we should take a break right here and come back and do that in the next episode. How do you feel about that?
Tommy: That's fine for me. I think the two actually, the two potentially linked into each other. So it will be a nice thing to cover in the next one.
Christopher: Okay, sounds good. Well, thank you so much for your time. I really appreciate it.
Tommy: Yeah, bye.
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