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161 of 176 people found the following review helpful
5.0 out of 5 stars Straightforward, fact-based, unbiased guide
I bought this book wanting to get the anti-vaccine side of the argument, because I was told this book had references to real white-paper studies and not just the endless string of tear-jerking but scientifically meaningless anecdotal stories that you see on TV and read about online.

I was very impressed with and surprised by this book. It was not anti-vaccine...
Published 20 months ago by N. Shepard

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185 of 257 people found the following review helpful
3.0 out of 5 stars middle-of-the-road
Dr. Sears' book is a good introduction to the topic of vaccines, but it is much too conservative in its opinions. He ultimately advises the parent to follow his modified schedule of vaccines, which would be less dangereous than following the complete schedule, but which is still very dangerous. He advises in his The Autism Book that children who have an autistic sibling...
Published on January 31, 2012 by ciaparker


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161 of 176 people found the following review helpful
5.0 out of 5 stars Straightforward, fact-based, unbiased guide, April 12, 2013
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This review is from: The Vaccine Book: Making the Right Decision for Your Child (Sears Parenting Library) (Paperback)
I bought this book wanting to get the anti-vaccine side of the argument, because I was told this book had references to real white-paper studies and not just the endless string of tear-jerking but scientifically meaningless anecdotal stories that you see on TV and read about online.

I was very impressed with and surprised by this book. It was not anti-vaccine at all, it simply described each vaccine and each ingredient and presented the most current scientific safety study findings on each, along with the corresponding risks of each disease. Drawing no conclusions, Dr. Sears challenges each parent to make their own decision about each vaccine's use and schedule one at a time, with specific advice for various scenarios (breast-fed at home vs 5 days/week in daycare, for example).

My wife and I were pleased to find ourselves intuitively designing our own custom vaccine schedule as we read through the book, custom tailored for our unique situation. After reading, we choose to almost fully vaccinate, but on a schedule we were comfortable with and against a set of risks that we now understand very well and can defend to anyone based on scientific evidence. All facts in the book are backed up with specific white-papers which Dr. Sears annotates as you go through the book, so you can cross-reference the research yourself (some vaccines intrigued me more than others).

This is the only resource (including FDA and CDC) that we have found so far that provides a balanced, fair-minded, non-dogmatic approach to the broad topic of vaccination. The reality is made clear: each vaccine is an individual medical treatment, not a component in a holy war. This book if not for parents who are trying to find a new religion, overthrow the government; instead, it's for parents who prefer to proactively make medical decisions based on white papers they have read and understood (e.g. Engineers).

If you don't like making your own spreadsheets, at the end of the book Dr. Sears describes the 4-5 categories most people find themselves in after reading (from fully vaccinating on CDC schedule all the way to no vaccinations at all), and provides specific recommended plans for each category of parent. But don't be lazy; make your own plan as you go. If you want, you can then compare you plan to the various plans Dr. Sears recommends, and if you can't justify why your plan is different than one of the recommended ones, do more research until you can explain those differences confidently. Our plan is slightly different than any recommended in this book, but this book gave us the tools we needed to form our plan with confidence that it is optimal for our daughter.
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185 of 257 people found the following review helpful
3.0 out of 5 stars middle-of-the-road, January 31, 2012
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This review is from: The Vaccine Book: Making the Right Decision for Your Child (Sears Parenting Library) (Paperback)
Dr. Sears' book is a good introduction to the topic of vaccines, but it is much too conservative in its opinions. He ultimately advises the parent to follow his modified schedule of vaccines, which would be less dangereous than following the complete schedule, but which is still very dangerous. He advises in his The Autism Book that children who have an autistic sibling not be vaccinated, that children with autism never get another vaccine, and that children with a history of neurological or autoimmune disease in their family not be vaccinated. This disqualifies most children in our society, and is much more truthful, but he doesn't go this far in the Vaccine Book.
My daughter was given the hep-B vaccine at birth (even though I had told her pediatrician I didn't want her to get it: he forgot to tell the staff at the hospital, who gave it to her when she was hours old without asking permission). She reacted with four days and nights of endless, inconsolable screaming. It was vaccine-induced encephalitis, and she was later diagnosed with autism. Dr. Sears recognizes that vaccine-induced encephalitis is relatively common, but says it usually doesn't cause permanent harm (but unfortunately, it often does). The symptoms may be agonized screaming from the brain inflammation, but may be as mild as somnolence or staring episodes (hard to spot in a newborn). Dr. Sears has an interesting chapter on how this vaccine was put on the schedule in 1991 based on totally false and inflated figures. It was only surmised that there must surely be a lot of hep-B among children to account for so many cases among drug-users and those who practiced unsafe sex as adults. The actual evidence has always been completely lacking. The book by Judy Converse, When Your Doctor is Wrong: Hepatitis B Vaccine and Autism is a great book about her son experiencing the same crisis as my daughter, and all parents should read it before making the decision whether to permit their child to get this vaccine (and be aware that they didn't ask permission from either Judy Converse, me, or many others before giving the vaccine at the hospital).
The interested parent should definitely read Dr. Mayer Eisenstein's book Make an Informed Vaccine Decision, Randall Neustaedter's The Vaccine Guide, Wendy Lydall's Raising a Vaccine-Free Child, and both of the books by Hilary Butler, Just a Little Prick, and From One Prick to Another, as well as Dr. Andrew Wakefield's Callous Disregard, which are all exceptionally well-documented and devastating in their detail.
The bottom line is that vaccines are supposed to make the immune system react with inflammation, that makes it react by producing antibodies (which don't necessarily mean immunity, as is popularly supposed). Unfortunately, a large number of people's immune system reacts with excessive inflammation. If it's immediate, it may manifest as encephalitis, which causes the epidemic of autism, ADHD, learning disorders, and seizure disorders we see now. The vaccines skew the immune system from developing an appropriate Th1 response to threats to an inappropriate autoimmune Th2 response. And thence, these confused and overwhelmed immune systems react chronically to their own systems, causing asthma, allergies, diabetes, bowel disease (the GI system has its own lymph tissue, part of the immune system), and many more horrible diseases that were either very rare or completely non-existent before vaccines.
The tetanus vaccine is possibly the safest of the vaccines, but even so, I reacted to a tetanus booster when I was nineteen with both arms being paralyzed for two days (brachoplexal neuropathy, recognized since 1968 as a rare adverse reaction to the tetanus vaccine), and I later developed multiple sclerosis, yet another disease that didn't exist before vaccines. Some people have been permanently paralyzed by the vaccine.
Measles is very rarely a severe disease, especially in children, and giving vitamin A greatly reduces the small risk of complications. The MMR is an extremely dangerous vaccine which no parent should allow their child to get, but even when given as separate measles, mumps, and rubella vaccines, each of these vaccines has a long track record of causing extremely severe adverse reactions, including death. Dr. Sears recommends giving them as separate vaccines. He recommends the DTaP even though this is also still a devastatingly dangerous vaccine, even in its new acellular form. The pertussis component is not very effective, only 30-70%, so that about half of all appropriately vaccinated people can still catch it and spread it. My baby got the vaccine at 2, 4, and 6 months, but still caught pertussis at a La Leche League meeting when she was nine months old, and had the long coughing fits, ten coughs on one breath, coughing up sheets of mucus at the end, for over a month, and gave it to me. But the disease, like measles, has evolved into being not a very dangerous one for everyone over four months old, and it was not dangerous for us. The vaccine, on the other hand, causes asthma, SIDS, seizure disorders, autism, and sometimes death. Young babies should be quarantined to the greatest degree possible regardless of whether or not they are vaccinated, the pertussis vaccine is completely ineffective when given at 2 months of age (Walker 1994), but more than doubles the risk of asthma at seven years old when given then rather than later (Manitoba study, 1998). Dr. Sears recommends this vaccine to be given on the conventional schedule.
Parents should read a lot before making this decision. It is the most important decision you will ever make for your child. Read Dr. Sears' book, but don't stop there. Dr. Sears says that if vaccines are really responsible for the extremely high and unprecedented rates of chronic disease in our society, then that would mean the vaccines are much more dangerous than the diseases they are meant to prevent. The evidence is totally in that this is indeed the case, but Dr. Sears has made a name for himself by keeping a foot in both camps.
In our case, my daughter is autistic from a vaccine I didn't want her to get. I permitted her to get four DTaPs, three IPVs (polio), three Hibs, and one DT at five years old. She breast-fed for years, and only had one course of antibiotics. I said no to the MMR, varicella, and all others, including flu. I wish more than anything in the world that I had not allowed her to get any vaccine, ever, I wish I had told everyone at the hospital from the time I was admitted that I didn't want the hep-B vaccine. My daughter had developed two words by the time she was 18 months old (she had already been brain-damaged, but she was saying uh for up, and uff for dog). After she got the DTaP booster at 18 months, she never said those or any other word again until she was 34 months old. It further damaged her brain. She is extremely healthy, except for the autism, but even though she is high-funtioning, completely normal in math (not the section of her brain that was damaged), she is unlikely to ever lead an independent life, or hold a real job or get married and have children. And all because medicrats hungry for vaccine revenue thought it was worth giving her a vaccine just after birth to protect her for ten minutes from a disease no children born to healthy mothers get.
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26 of 36 people found the following review helpful
5.0 out of 5 stars Highly Recommended, March 14, 2012
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This review is from: The Vaccine Book: Making the Right Decision for Your Child (Sears Parenting Library) (Paperback)
Wow! Stunning. For any parent curious enough to question whether or not they should follow the recommended vaccine schedule, this is a great place to start. Is it flawless? Of course not. Does it offer the most complete critique of vaccination? No. Do I agree with the author's ultimate conclusions about whether or not to vaccinate? Hardly. And yet I would give it six stars (or more) if I could. It may be imperfect and incomplete, but I have seen nothing else of this kind that compares in reasonableness and reliability.

It is well organized and easy to read. So, it serves well both as a book to read cover to cover and/or as a reference. It is neutral in tone, and painstakingly fair in looking at each issue from "both" sides. Sears does offer his opinion (which I don't always agree with), but only after providing relevant facts sufficient to enable the reader to make up his or her own mind. And his approach to calculating relative risks (though not flawless) is very useful.

I'll just give one example of his fairness toward those who question the CDC guidelines. Regarding a 2003 Study published in Pediatrics, Sears explains, "Although at first it was considered reliable, it was later discovered (in unpublished CDC research made public by the Freedom of Information Act) that the study initially showed that vaccine mercury actually increased the risk of autism seven fold. But instead of publishing that result, researchers expanded the study to include tens of thousands of additional children who were part of a bankrupt HMO that failed to keep adequate medical records, essentially diluting the study with enough nonautistic children to give the result that the mercury did not cause autism. Some CDC officials have subsequently discounted the study, although numerous experts continue to refer back to it" (pp. 215-216). Despite this and the many other similarly disturbing facts that Sears duly notes (don't skip his treatment of aluminum in the "Vaccine Ingredients" chapter), he nevertheless continues to trust the CDC. He writes, "As a physician, I have the utmost faith in CDC policies and research" (p. 187). I don't share his religion. But it may partly explain his tendency to end up recommending virtually all vaccines, with some nuanced reservations. The other major (and legitimate) consideration to which he often appeals is public health.

As a follow-up to this book, I would also recommend Vaccine Epidemic: How Corporate Greed, Biased Science, and Coercive Government Threaten Our Human Rights, Our Health, and Our Children, which is a very different kind of book.
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2 of 2 people found the following review helpful
5.0 out of 5 stars Wonderful!, February 28, 2014
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This review is from: The Vaccine Book: Making the Right Decision for Your Child (Sears Parenting Library) (Paperback)
I bought this book to become more educated about child vaccines and I am so happy with this book. Dr. Sears is a well known and trusted pediatrician. I love the fact that his book isn't BIAS, he gives you simple information. Some books can be very anti-vaccine. He gives you information on the different vaccines as they are administered on the Association of Pediatrics schedule. He breaks down each illness the vaccine targets, the risks for contracting that illness, the vaccines on the market for it and their chemical make-up. He does give some recommendations as to what vaccines he favors over other and why. I really found this book full of great information. I feel more informed about the vaccination process and childhood vaccines. I would highly recommend this book.
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61 of 88 people found the following review helpful
1.0 out of 5 stars cashing in on fear, March 6, 2014
This review is from: The Vaccine Book: Making the Right Decision for Your Child (Sears Parenting Library) (Paperback)
Dr. Sears is a genius. No, not in an Albert Einstein or Pablo Picasso kind of way. He's more of an Oprah or a Madonna kind of genius. He's a genius because he has written a book that capitalizes on the vaccine-fearing, anti-establishment mood of the zeitgeist. The book tells parents what they desperately want to hear, and that has made it an overnight success.

Dr. Robert Sears is perhaps one of the best-known pediatricians in the country. The youngest son of Dr. Bill Sears, the prolific parent book writer and creator of AskDrSears.com, Dr. Bob has become the bane of many a pediatrician's existence. He has contributed to his family dynasty by co-authoring several books, adding content to the family website, and making myriad TV appearances to offer his sage advice. But Dr. Bob is best known for his best-selling The Vaccine Book: Making the Right Decision for your Child. This book, or at least notes from it, now accompanies many confused and concerned parents to the pediatrician's office. Parents who have been misled by the onslaught of vaccine misinformation and fear-mongering feel comforted and supported by the advice of Dr. Sears, who assures parents that there is a safer, more sensible way to vaccinate. He wants parents to make their own "informed" decisions about whether or how to proceed with vaccinating their children, making sure to let them know that if they do choose to vaccinate, he knows the safest way to do it. And for $13.99 (paperback), he'll share it with them.

In the final chapter of his book (entitled "What should you do now?"), after reinforcing the common vaccine myths of the day, Dr. Sears presents his readers with "Dr. Bob's Alternative Vaccine Schedule." He places this side-by-side with the schedule recommended by the American Academy of Pediatrics and the CDC's Advisory Committee on Immunization Practices. He then explains why his schedule is a safer choice for parents who chose to vaccinate their children. Without a doubt, the alternative vaccine schedule is among the more damaging aspects of this book. It's the part that gets brought along to the pediatrician's office and presented as the the plan going forward for many parents today. But the book is also dangerous in the way in which it validates the pervasive myths that are currently scaring parents into making ill-informed decisions for their children. Dr. Sears discusses these now common parental concerns, but instead of countering them with sound science, he lets them stand on their own as valid. He points out that most doctors are ill-equipped to discuss vaccines with parents, being poorly trained in the science of vaccine risks and benefits. He then claims to be a newly self-taught vaccine expert, a laughable conceit given the degree to which he misunderstands the science he purports to have read, and in the way he downplays the true dangers of the vaccine-preventable diseases he discusses in his book. He then provides parents with what he views as rational alternatives to the recommended vaccination schedule, a schedule designed by the country's true authorities on vaccinology, childhood infectious disease, and epidemiology.

So what does Dr. Sears have to say, exactly, about the risks of vaccines, and just how out of touch is he with medical science and epidemiology?

VALIDATING THE UNTRUTHS

Public versus individual health

It is not uncommon for people to be confused about how public health measures relate to personal or individual health. With regard to vaccines, some feel that recommendations made "for the good of the public " may not necessarily be for the good of the individual. Some feel that while they may understand the rationale for vaccinating on a societal level, they are unwilling or afraid to place the burden of potential vaccine risks on their child. Dr. Sears falls for this line of thinking, and leads parents to believe that certain vaccines protect the community but not the individual child. He gives polio as an example, stating that the risk of polio is zero, and that therefore the vaccine does not protect the individual child from disease. This, of course, is untrue. While new cases of polio no longer arise in the United States (thanks to the success of the polio vaccine) they still do in other areas of the world. As is true for many infectious diseases, imported cases and potential outbreaks are a quick airplane flight away. The more unvaccinated children we have, the more likely an imported case will lead to larger outbreaks of disease. So yes, vaccinating protects the individual child as well as the community at large. Ironically, polio would likely have been eradicated from the earth by 2002 had it not been for the propagation of a vaccine myth. In the impoverished Indian state of Uttar Pradesh (which, in the year 2000, accounted for 68% of all polio cases in the world), a myth that the polio vaccination campaign was really a government conspiracy to sterilize children prevented that campaign from accomplishing its true mission of ridding the world of this horrible disease.

Of course herd immunity, an epidemiological concept, is of vital importance to public health. We know that Dr. Sears understands at least this much, because he advises parents who fear giving their children the MMR vaccine not to tell their neighbors, lest too many parents develop similar fears. He warns that an increasing number of unvaccinated children will result in a resurgence of the disease. He couldn't be more correct. Enlarging pockets of unimmunized and underimmunized children around the country have already resulted in outbreaks of disease. These vaccine-preventable outbreaks are just harbingers of worse outbreaks yet to come, should this trend continue.

Throughout his book Dr. Sears highlights common parental concerns about vaccines. He follows these not with fact-based discussions, but with subtle (and often not so subtle) words of reinforcement. For example, Dr. Sears often downplays the potential danger of vaccine preventable diseases, or the risk of infection for the unimmunized child. Although the book is rife with such misinformation, I will limit my discussion to just a few examples to give a sense of the distortions involved.

DTaP

In his chapter on the DTaP vaccine (against diphtheria, tetanus, and pertussis), in the "Reasons some people choose not to get this vaccine" section, Dr. Sears states:

In truth, tetanus is not an infant disease...Also, diphtheria is virtually non-existent in the United States. So, one could create a logical argument that a baby could skip the tetanus and diphtheria shots for a few years and be just fine.

tetanus in infant tetanus in infant

Infants with tetanus

Perhaps Dr. Sears is unaware that tetanus is indeed a disease of infants, and potentially of anyone. And to make the case that because diphtheria (or any infectious disease) is not endemic to the United States it is therefore not a threat to unimmunized children, betrays Dr. Sears' naivete when it comes to basic principles of epidemiology and infectious disease. Epidemiology and history has shown us that when vaccination rates drop sufficiently, outbreaks of seemingly vanquished diseases return with a vengeance. Diphtheria is no exception. In the newly independent states of the former Soviet Union, declining childhood and adult vaccination rates against diphtheria have played a major role in a massive epidemic of that deadly disease. And as we see more and more pockets of unvaccinated children around this country, we are beginning to see the reemergence of horrific vaccine preventable diseases. Recent outbreaks of invasive Hib disease and of measles should remind us how important it is to maintain our herd immunity against these scourges of the not-so-distant past. Of course, Dr. Sears never challenges the unsupported concerns about vaccine risks. He simply restates these concerns, and then adds fuel to the fire, supporting the irrational fears that led to this growing trend of underimmunization.

Epidemiological missteps

Dr. Sears' understanding of epidemiology and vaccine adverse event surveillance is startlingly poor. He purports to break new ground by doing the first ever statistical vaccine risk-benefit analysis for parents. Unfortunately, his calculations are meaningless as he misunderstands the most basic concepts, like cause-and effect, and fails to grasp the significance of vaccination rates in determining the likelihood of contracting a vaccine-preventable disease. Dr. Sears bases the risk of a child suffering a severe vaccine reaction on his analysis of VAERS data. VAERS (the CDC's Vaccine Adverse Events Reporting System) is a passive surveillance system that everyone (doctors and patients alike) is encouraged to use anytime a vaccination is followed by an adverse event, whether or not they suspect the vaccine is the actual cause of the event. Being an open, voluntary, passive reporting system, VAERS is susceptible to fraud and abuse, as anyone can submit a report. The purpose of the system is to give a very broad look at possible unforeseen events related to vaccination. It is a screening tool, from which trends can be observed, possibly triggering true validated analyses. Raw VAERS data simply cannot be used to analyze the risk of vaccine reactions, because the data does not tell us anything about causality. Despite this, Dr. Sears and others continue to misuse VAERS data, representing it as a true estimate of vaccine adverse events. To quote the CDC,

The purpose of VAERS is to detect possible signals of adverse events associated with vaccines. Additional scientific investigations are almost always required to properly validate signals from VAERS and establish a cause and effect relationship between a vaccine and an adverse event.

But Dr. Sears uses VAERS data to come to the conclusion that "for about every 100,000 doses [of vaccine], one person suffered a severe reaction." He fails to mention that VAERS data tells us absolutely nothing about the risk of developing a vaccine reaction, severe or not. He then takes this number and, by assuming every vaccine dose has the same risk attached to it of creating a severe reaction, determines that a child has a 1/100,000 chance of developing a severe reaction for each vaccine dose he receives. By inappropriately and misleadingly using VAERS data, Dr. Sears concludes that,

The risk that any one child will suffer a severe reaction over the entire, twelve-year vaccine schedule is about 1 in 2600.

He then calculates that,

The risk of a child having a severe case of a vaccine-preventable disease is about 1 in 600 each year for all childhood diseases grouped together.

And then asks parents the ultimate question, concluding with an example of his trade-marked, passive-aggressiveness,

Is vaccinating to protect against all these diseases worth the risk of side effects? That's the million dollar question.

Of course, the answer is so overwhelmingly "yes" that it's difficult to conjure up the energy to respond to Dr. Sears' misleading analysis. Not only does he start his statistical sleight-of-hand by inappropriately using VAERS data, he then calculates the risk of acquiring a vaccine preventable disease using current disease incidence rates. What he doesn't acknowledge is that those rates are predicated on current vaccination rates. The reason a child today is at low risk for contracting these diseases is precisely because our vaccination rates are so high!

Hib

Dr. Sears fails to mention that, while the incidence of severe invasive Hib disease is currently very low, it was actually common in the pre-vaccine era. In the years before the introduction of the vaccine in 1987, approximately 1 in 200 children below the age of 5 acquired invasive Hib disease. He admits that the vaccine is responsible for keeping the disease at bay, but then states,

HIB is a bad bug. Fortunately , it's also a rare bug, so rare that I haven't seen a single case in ten years...Since the disease is so rare, HIB isn't the most critical vaccine.

If parents follow the extremely dangerous, backwards logic of Dr. Sears, we are certain to see the incidence of vaccine-preventable diseases rise, as we are now just beginning to see in the US. Rest assured, it doesn't take long for a disease to reemerge once vaccination rates drop.

Measles

Dr. Sears' discussion of measles consists of a series of downplayed statements. He describes the rash as one that "can look similar to rashes...of other diseases, so its not easy for a doctor, much less a parent, to recognize." And he states that the disease is "transmitted like the common cold". The clinical presentation of measles is striking and very difficult to mistake for any other illness. As I was taught during my residency, there's no such thing as a mild case of measles. Every child with the disease is very ill appearing. And, while it is transmitted by respiratory droplets like the common cold, it seems the sole reason for making this statement is, again, to liken it to other, less dangerous viral infections. In answer to his self-posed question "Is measles serious?", Dr. Sears replies,

Usually not. Most cases, especially in children, pass within a week or so without any trouble. However, approximately 1 in 1000 cases is fatal...Now that measles is rare, many years go by without any fatalities.

He then makes the astoundingly misleading statement,

The possible complications of measles, mumps, or rubella are very similar to the side effect of the vaccines themselves.

Because I can't fathom he is that ignorant of the facts, I am inclined to believe that Dr. Sears is simply being deceitful. Here are the facts about the complications of measles:
One in 1000 cases of measles results in encephalitis, with a high rate of permanent neurological complications in those who survive.
Approximately five percent develop pneumonia.
The fatality rate is between one and three per 1000 cases.
Contrary to Dr. Sears' statement, death is most commonly seen in infants with measles.
Subacute sclerosing panencephalitis (SSPE) is a rare complication of measles infection that occurs years after the illness in approximately 10 of every 100,000 cases.

Here are the facts about complications of the measles vaccine:
It causes fever and a mild rash in 5-15% of recipients.
0.03% will have a febrile seizure - likely not a result of the vaccine itself, but simply a child's individual predisposition to febrile seizures.
One in 10,000 children will have a more serious event following the vaccine, such as a change in alertness, a drop in blood pressure, or a severe allergic reaction.
Approximately 1 in 25,000 cases is associated with an asymptomatic drop in the blood platelet count, which quickly returns to normal without any consequences.

Dr. Sears uses reactions listed in the vaccine package insert as if they are true vaccine side effects. This is analogous to using VAERS data to draw conclusions about vaccine reactions, since there is no evidence that any of these are causally related. Most side effects listed in package inserts occur at the same rate as background or placebo rates. Nevertheless, Dr. Sears goes out of his way to reinforce parental concerns, even though the facts are right at his fingertips. The section entitled "Reasons some people choose not to get this vaccine", that occurs at the end of each vaccine discussion, further reinforces parental fears by simply restating parental concerns with no attempt at setting the facts straight. In a box at the end of his discussion of the hepatitis B vaccine, he does attempt to explain the concept that temporality does not imply causality. Ironically, he states in this explanation,

Parents who have watched helplessly as their child develops neurological problems within weeks of being vaccinated will probably always be 100 percent convinced that the vaccine caused the problems. The fact that neurological complications are listed in the product inserts lends credibility to their case.

And so does Dr. Sears with the insidious, misleading messages he uses in his book. He concludes his discussion of causality with this confused statement,

I'm sure the truth of the matter is somewhere between causality and coincidence. Hopefully someday we will know for sure which side effects are truly vaccine related.

Of course we will never "know for sure" if every report of an extremely rare event following a vaccine is causally related or not. We continue to monitor trends and conduct rigorous surveillance, and follow that with sound epidemiological studies when concerns arise. This is why we can say, with good confidence, that these vaccines are extremely safe, and that Dr. Sears' concerns and equivocations are misleading at best.

TOXIC SHOTS

Throughout his book, Dr. Sears discusses the common fears concerning vaccine dangers, never correcting when these fears are based on myth or misinformation. Rather, he presents them in a "we just don't know enough" manner (even when we do), or as matters of fact (even when they're not). Dr. Sears raises the concern in his book that the recommended schedule of childhood vaccines may pose a danger. He suggests that we just don't know if the chemicals contained in the vaccines (which he lists in alarming fashion) may be too great of a burden for the developing child.

Thimerosal

In the very first page of the book's preface, Dr. Sears tells his readers that he is "not going to discuss, at length, mercury or thimerosal in vaccines because, thankfully, these have been taken out of virtually all vaccines" (my emphasis). This is followed by more language that makes it clear he believes thimerosal wasa dangerous additive, and that the little remaining thimerosal in the vaccine supply (contained in one form of the influenza vaccine) is still a risk. Of course, we know that the thimerosal in vaccines was unlikely to ever have been a danger to children, but Dr. Sears uses the same old misinterpretations of the science and conspiracy theories to arrive at the conclusion that it was. In fact he point blank states that "vaccine manufacturers knew that we were overdosing babies with mercury, but no one in the medical community realized the possible implications for almost ten years." This kind of fear mongering is no different than that spewed by the folks at Generation Rescue, and lacks any basis in science. In his section on vaccine ingredients, Dr. Sears (again, either naively or dishonestly) discusses the rise in the rate of autism diagnoses as possibly a result of thimerosal in vaccines. He cites the same tired and poor references (and an article from the LA Times) we've heard before from the likes of Jenny McCarthy, and then asks "so who do we believe?". Again, that question is left hanging.

Aluminum

Of particular concern to Dr. Sears is the potential dangers of aluminum, which has become his new post-thimerosal villain. Although he worries aloud in his book that "aluminum may end up being another thimerosal", Dr. Sears is unaware that such a comparison doesn't exactly strike fear in the hearts of the scientific community.

Many vaccines contain aluminum as an adjuvant. An adjuvant is a substance that boosts the ability of a vaccine to induce an immune response. It acts locally at the site of injection, as a signal to the immune system, drawing a heightened response to the injected vaccine. Ironically, without adjuvants we would need a larger dose of the vaccine to induce an immune response. I doubt that would go over well in anti-vaccine circles.

Unfortunately, Dr. Sears' concerns about aluminum are the result of a distorted reading of what is known about aluminum toxicity and the risk of vaccines in children. In discussing "controversial ingredients", he states

...some studies indicate that when too many aluminum-containing vaccines are given at once, toxic effects can occur.

In fact, no such studies exist. He does correctly state that there is very little known about the pharmacokinetics of intramuscularly injected aluminum as it occurs in vaccine adjuvants, but he goes on to distort what we do know about aluminum toxicity into a rationale to fear our current vaccine supply and schedule. For instance, we know that aluminum has been blamed for producing neurotoxicity in some patients with renal failure on long-term dialysis, and in some extremely premature infants given prolonged courses of aluminum-containing intravenous nutritional solutions. But this is not comparable to the exposure of healthy infants to adjuvant-containing vaccines given intramuscularly on a few, discrete occurrences over a period of months. Similar to the way the safety data for methylmercury is often incorrectly applied to the ethylmercury in thimerosal (and incorrect inferences of toxicity made), Dr. Sears uses safety limits set for something else, and incorrectly applies them to the aluminum in vaccine adjuvants.

Dr. Sears uses the FDA's maximum permissible level (MPL) of aluminum for large volume bags of intravenous fluids given chronically to premature infants (25 µg/L), and extrapolates it to adjuvant-containing vaccines. He also uses the number 5 µg/kg/day as the amount of aluminum found to cause toxicity in some premature infants receiving intravenous feeding solutions that contain aluminum. What he doesn't mention is that the 25 µg/L number comes from studies showing that this concentration produces no tissue aluminum loading, and that it was chosen to allow room for other exposures. In fact, it is estimated that the aluminum in these intravenous feeding solutions accounts for only 10-15% of the total parenteral aluminum intake per kg body weight that premature infants receive in a given day while in intensive care. The number was set low to leave room for the other sources of parenteral aluminum these infants receive. Still, Dr. Sears uses this number as his standard against which he compares the aluminum content of vaccines. This is misleading for a number of reasons. First, the 25 µg/L MPL for parenteral feeding bags says nothing about the maximum amount of aluminum that can be safely injected. This is obvious as the number is expressed as a concentration, not as an absolute amount of aluminum. The average premature infant would likely receive 100 ml/kg/day of solution, and therefore roughly 2.5-5 µg per day of aluminum from this source. Again, accounting for only about 10-15% of the parenteral aluminum the infant would receive in a given day. Dr. Sears does acknowledge that the number isn't a maximum permissible amount of aluminum for injection, but he uses it anyway stating, in essence, that it's all we've got. But it isn't all we've got, as we shall see in a moment.

The fact that these intravenous, aluminum-containing solutions are administered continuously over long periods of time, whereas vaccines are administered in discrete unit doses at intervals spaced out over time, is also not taken into consideration in Dr. Sears' discussion. But his use of the FDA limits for intravenous feeding solutions is misleading also because it ignores the difference between intravenous and intramuscular or subcutaneous injection of aluminum, as in the case of vaccines. In fact there is evidence, which Dr. Sears must have missed in his exhaustive review of the literature, that the aluminum from vaccines behaves differently than intravenously administered aluminum, and that the body burden of aluminum from vaccines is not so concerning when placed in the context of the background body burden of aluminum.

One piece of evidence that the aluminum in vaccines is handled by the body quite differently than the aluminum in intravenous solutions comes from studies looking at the intramuscular injection of aluminum-containing adjuvants into rabbits. Rather than entering the blood stream directly and accumulating in tissues, as with intravenously injected aluminum, intramuscularly injected aluminum-containing adjuvants are first dissolved by organic acids in the interstitial fluids, and are then rapidly eliminated.

Another reassuring look at aluminum exposure from vaccines comes from an analysis by Keith, et al. from the ATSDR. They looked very closely at the the way in which all sources of aluminum exposure in the infant contribute to the total body burden of aluminum, including inhalation, oral, dermal, and vaccine exposures. They took into consideration uptake, transfer from the blood, release from the injection site, distribution patterns, and retention and elimination rates of aluminum. They used the Priest formula to assess the fate of aluminum once it has entered the body via any route.
R = 0.354dt−0 .32 (where R is the retained fraction, d the uptake dose in mg Al, and t the time in days following uptake. The equation is summed for repetitive intakes such as with multiple vaccinations.)

Comparison of the aluminum body burden from vaccines to that from ingested breast milk, in relation to the oral MRL for aluminum for infants at the 5th and 50th percentiles for weight, is shown in the figure below (taken from the original article). The analysis assumes injections of vaccines according to the following schedule, with the corresponding aluminum content:
Birth: Hep B (250 µg)
2 months: Hep B + DTaP (1100 µg)
4 months: DTaP (850 µg)
6 months: Hep B + DTaP (1100 µg)
12 months: DTaP (850 µg)

While this leaves out the PCV and Hib vaccines, only one brand of Hib vaccine contains aluminum, and the PCV vaccine contains only 125 µg of aluminum. Thus, this analysis accounts for the bulk of the aluminum that comes from the vaccine series.

Aluminum body burden

As can be seen in the figure, aluminum spikes occur on the day of injection, followed by rapid elimination within a few days. Despite slight and brief overlaps between the vaccine and MRL curves at the time of vaccination, the vaccine curves always fall between the dietary intake curves and the MRL curves. The authors conclude that, in the context of the overall body burden of aluminum with which infants are born and which is added to by ongoing oral, inhalational and parenteral sources, vaccines are likely to constitute only a minor, transient part.

While there is good reason to be confident that the aluminum in vaccines is not the dreaded neurotoxin Dr. Sears fears it is, in his book he suggests otherwise. His mantra is that there are now so many vaccines in the routine schedule that we are overloading our children's bodies with toxic aluminum. This is neither borne out by the science, nor is it likely given what we know about aluminum and the way in which children are exposed via vaccinations.

http://www.sciencebasedmedicine.org/cashing-in-on-fear-the-danger-of-dr-sears/
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4 of 5 people found the following review helpful
5.0 out of 5 stars Great book, December 23, 2013
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This review is from: The Vaccine Book: Making the Right Decision for Your Child (Sears Parenting Library) (Paperback)
I purchased this book and the vaccinations book by Romm. I liked this one a lot more. I like how Dr. Sears discusses the risk of each disease, prevalance, risks when traveling, and what is all in the vaccine. He also gives his opinion at the end of each section and what he would recommend to his patients. I personally feel it was a very objective, non-biased approach to vaccines. Even though he gives his opinion, in no way does it feel like he is forcing you or trying to convince you to side with his opinion. Definitely a great book to use in an office or for an expectant mother.
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2 of 2 people found the following review helpful
5.0 out of 5 stars Well written, December 23, 2013
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This review is from: The Vaccine Book: Making the Right Decision for Your Child (Sears Parenting Library) (Paperback)
I found this book extremely helpful and love the fact that every vaccine is discussed and at the end he gives you 3 alternative vaccine schedules. He gives his opinion of which are the most important to receive and the reasoning behind them. He also says how prevalent each disease is so you can weigh the risks verses the benefits.
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2 of 2 people found the following review helpful
5.0 out of 5 stars Balanced, December 23, 2013
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This review is from: The Vaccine Book: Making the Right Decision for Your Child (Sears Parenting Library) (Paperback)
This is a wonderful source of information. It presents a really balanced view and lets each reader decide what is right for their family. It is easy to read and understand but at the same time gives you all of the information you need to make an informed choice.
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2 of 2 people found the following review helpful
5.0 out of 5 stars The information I have been looking for!, December 21, 2013
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This review is from: The Vaccine Book: Making the Right Decision for Your Child (Sears Parenting Library) (Paperback)
Wow! Dr. Sears did such an amazing job with this book. It is extremely informative in non biased way. Now I can make informative, fact based vaccine decisions for my kids! This is a book every parent should have!
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1 of 1 people found the following review helpful
5.0 out of 5 stars Very good and neutral vaccine guide, April 17, 2014
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The book describes each disease and vaccine that supposedly prevents it. I think that it's a very good guide that shows what the risks of each disease are and each vaccine. The author goes at lengths explaining the different available vaccines from each manufacturer, how they are produce and what they contain. The book is definitely pro vaccine. The author states that many times throughout the book. However, he also thinks that parents should have a choice given the risks of each vaccine and the schedule for each vaccine. His schedule provides a good alternative to the regular one.
If parents want to have a choice, this book is a good guide. If they want to go with the regular CDC schedule and not ask any questions, this book may not be worth it. I still think that it's a great book to have handy. It explains the symptoms of each disease quite well.
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The Vaccine Book: Making the Right Decision for Your Child (Sears Parenting Library)
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