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Barbara Loe Fisher
Co-Founder & President
National Vaccine Information Center
Institute of Medicine Vaccine Safety Forum
November 6, 1995
In 1982, when Kathi Williams and Jeff Schwartz
and I got together with a small group of parents in the Washington, D.C.
area and talked about setting up a national organization that would be
dedicated to the prevention of vaccine injuries and deaths through public
education, one of the first goals we listed was to obtain an improved
vaccine adverse event reporting system. All of us had children who had
been injured by the DPT vaccine. We knew that if our pediatricians and
we, ourselves, had been better educated about vaccine high risk factors
and side effects, there was a good chance our children would not have
been injured. We believed then, and continue to believe today, that vaccine
adverse event reporting and record keeping is the key to increased knowledge,
better education and prevention of vaccine associated deaths and injuries.
So when we helped to
create and pass the National Childhood Vaccine Injury Act of 1986, one
of the five vaccine safety provisions that we insisted be at the heart
of that law was the centralization of the government's adverse event reporting
system. Up until that point, private physicians were reporting to the
FDA and public health clinic physicians were reporting to the CDC. Our
hope was that a centralized system, which in fact became the VAERS system
as we know it today, would allow better detection and response to vaccine
adverse event reports.
In order to achieve better
detection and response, we also asked for a vaccine safety provision in
the law that would legally require doctors to report hospitalizations,
deaths and injuries following vaccination. Up until that time, there was
a requirement for public health doctors but no formal requirement for
private doctors to do that.
And we supported the
provision that doctors give parents information about vaccine benefits
and risks prior to vaccination and that doctors keep a permanent record
of vaccinations given, including the manufacturers name and lot number.
Up until that time, there were no requirements for doctors to do that
and we thought that the recordkeeping requirement would be especially
helpful in tracing and quickly removing from the market especially reactive
lots of vaccines.
It was our hope that
these vaccine safety provisions would mean that all doctors, not just
10 percent of them, would report adverse events following vaccination
and that the VAERS system would follow up on each report and we would
have a greater understanding of the nature and scope of adverse events
associated with vaccination.
Most of our hopes and
dreams for increased reporting, better education and prevention of vaccine
deaths and injuries have not been realized through that law. And, again,
as I said this morning, I believe that is because adverse event reporting
and data collection will continue to remain flawed no matter what mechanism
is put in place if there continues to be the presumption, especially by
vaccine providers and government officials, that the case reports of deaths
and injuries following vaccination are only temporally, not causally related
to vaccination. No, I am not suggesting that there be a presumption that
every adverse event case report is causally related to vaccination, although
if your goal really is detection of vaccine adverse events then it is
probably better to prove the vaccine did not play a role rather than to
conveniently assume the vaccine did not play a role.
I believe this is a valid
approach because the act of vaccination is a medical intervention that
is carried out on healthy children who are required by law to participate.
The requirements for adverse event reporting and data collection should
be the most stringent and carefully met of all the biological products
that are licensed for public use. A well funded, well run, well staffed
vaccine adverse event reporting and data collection system should be at
the very top of the national disease control strategy plan. And at every
step along the way - from pre-licensing to post marketing surveillance
- there should be the scientifically responsible presumption, at least,
that a new or old vaccine has the potential to cause health problems that
have not yet been detected because of the limits of human intelligence
and scientific technology.
These, then, are the
steps The National Vaccine Information Center supports to improve vaccine
adverse event reporting and data collection:
1. Promote the introduction into medical school curriculums
a course on vaccines, risks, benefits, side effects, adverse event reporting
and education of parents so physicians can be better partners with parents
in preventing vaccine associated deaths and injuries with the goal of
raising physician reporting rates from 10 percent to 100 percent.
2. Commit HHHS funds to a public education campaign
to educate physicians and the public about the importance of screening
children for high risk factors, monitoring children after vaccination
and reporting adverse events following vaccination to the government.
In 1991 I presented a report to the National Vaccine Advisory Committee
detailing 61 cases of death and injury following vaccination. Only 8
physicians out of the 61 cases ever made a report to VAERS, most of
them telling parents that vaccines don't cause death or injury because
it was all just a coincidence so there is no need to report. Set up
an 800 telephone number for parents to report if physicians refuse to
report. The National Vaccine Information Center helps parents every
week report reactions that their physicians will not report.
3. Make vaccine adverse event reporting a legal requirement
for doctors with penalties attached for failing to report. Like mandatory
vaccination laws which keep children out of school for failing to be
vaccinated, doctors should be prevented from administering vaccines
if they refuse to report hospitalizations, deaths and injuries following
vaccination.
4. Commit HHHS funds to the more efficient operation
of VAERS, including increased staffing so that the VAERS operation is
a model for every country in the world to follow. India, which delivers
vaccines 25 million children every year, has an adverse event reporting
system that includes an on-site investigation and follow-up by a public
health team within 48 hours of every death and injury reported following
vaccination. If a poor country like India can do it, this country should
be able to do it.
5. The National Vaccine Information supports the
concept of large linked databases for data collection on adverse events
only if these linked databases are not used as a club to force vaccinations
on individuals, who choose not to be vaccinated, or to exclude these
individuals from health insurance coverage or to invade the privacy
of individuals by making health information, including vaccination status,
a matter of public record. We do not believe that analysis of large
linked databases can or should replace the valuable information that
can be learned from an efficiently operating VAERS system dedicated
solely to the collection and analysis of reports of vaccine adverse
events.
In summary, we believe
that improved adverse event reporting and data collection will only occur
when it is made an official public health policy priority and government
health agencies do more to educate the public and vaccine providers about
the importance of reporting and collecting data on adverse events following
vaccination.
Barbara Loe Fisher
Co-Founder & President
National Vaccine Information Center
Institute of Medicine Vaccine Safety Forum
November 6, 1995
I think
I can sum up the position of the National Vaccine Information Center on
the subject of improving methodologies for detecting vaccine adverse events
in two sentences: If you don't believe they occur, you won't look for
them. If you don't look for them, you won't find them.
One handout developed
by the National Vaccine Program at the CDC last year suggested to inquiring
parents that the biological effects of injecting viral and bacterial antigens
into the human body are identical to the biological effects of ingesting
milk in the human body for the purposes of calculating the risk of injury
or death on any given day. It is difficult to reconcile that kind of unscientific
rationalization, used to dismiss the known and unknown biological effects
of vaccines on the body and support the nonexistence of vaccine injuries
and deaths, with any hope of improving adverse event detection methodologies.
It is this kind of cavalier
attitude which fails to treat the inherent capability of multiple viral
and bacterial antigens to have a profound impact on the immune system
that I suspect caused the Pentagon to inject U.S. troops heading for the
Gulf War with multiple vaccines, including experimental ones, without
a second thought. Yet there are signs that vaccine adverse event detection
may be heading into a new era as a microbiologist specializing in the
immune system prepares to testify at the Presidential Advisory Committee
on Gulf War Veterans Illnesses tomorrow that multiple vaccinations did,
indeed, contribute to the veterans subsequent health problems by weakening
their immune systems and making them more susceptible to chemical and
biological agents they were exposed to during the War.
Likewise, I believe there
is hope that vaccine adverse event detection may be heading into a new
era because of researchers who are investigating how vaccines may be contributing
to the development of autoimmune, neurological and psychiatric disorders
in some individuals. The new field of neuroimmunology will no doubt one
day give us many answers to questions about how vaccines work in the body
but, in the meantime, the success of detection methodologies are entirely
dependent upon the willingness of those doing the detecting to believe
in the plausibility of cause and effect and explore all possibilities.
So, because efficient detection is inextricably linked
with acceptance of the possibility of cause and effect by both reporters
and data collectors, it would seem that any efficient detection system
would have to first count on a high reporting rate by private physicians,
public health clinics and emergency rooms of adverse events occurring
within 30 days of vaccination. Parents have to be educated by physicians
about how to recognize negative changes in their children's physical,
mental and emotional health following vaccination and to seek immediate
medical attention as well as report these changes to doctors so doctors
can, in turn, report them to VAERS. If causality continues to be erroneously
determined by providers at the reporting level, there will be no way to
improve detection of vaccine adverse events.
Once a death, hospitalization
or injury is reported following vaccination, data collectors must also
be ready to accept the possibility of cause and effect. Ideally there
should be a 48-hour on-site follow-up and investigation of the report
as occurs in India. If the patient is an adult, he or she should be interviewed.
If the patient is a child, the parents should be interviewed. Deaths labeled
SIDS, especially when they occur under a month of age, should be suspect
and thoroughly investigated. A mechanism should be developed to monitor
the outcome of serious events such as seizures with long term follow-up
at six months, a year and two years to gather data on permanent damage.
But mechanisms for detecting
adverse events which occur within 30 days of vaccination are different
from those which must be set up to detect health problems which have a
more subtle or delayed onset or which do not become measurable until children
attend school, such as is the case with learning disabilities. This kind
of detection would require the kind of retrospective evaluation of historical
data that Dr. Barthelow Classen has described as well as the creation
of prospective studies which include as controls unvaccinated individuals
compared to vaccinated individuals over a period of 10 or 20 years. Expensive?
Yes. Logistically difficult? Yes. But not impossible if we really want
to find out if vaccines are contributing to the development of immune
and neurological damage which does not become apparent until later in
life.
An additional source
of information for detection of adverse events is analysis of VAERS data.
For example, between May 1993 and September 1994, 482 adverse events were
reported following the administration of the newly licensed DPTH vaccine.
Most were in children under a year of age and 50 percent of the reported
events occurred within 24 hours and more than 80 percent within 48 hours
of vaccination. 175 children ended up in the emergency room, 56 had convulsions,
78 were hospitalized, 17 did not recover and 35 died.
And when you take a closer
look at individual reports, you see identifiable patterns of classic vaccine
reactions similar to those described in the medical literature for decades,
including babies screaming and shrieking uncontrollably for hours and
hours. One infant, who had been injected with DPT, HIB, hepatitis B and
OPV at six weeks old, screamed every day from the day after vaccination
until he died two weeks later and his death was written off as SIDS. Another
four month old baby had his first afebrile grand mal seizure within 24
hours of his DPT/HIB/OPV vaccinations just like his sibling did at five
months when he was vaccinated. The same patterns are seen throughout the
more than 40,000 reports made so far to VAERS — reports that represent
only 10 percent of what is occurring.
This is valuable data.
It could be used to not only identify patterns which need further investigation
but also to help identify categories of high risk children who should
be screened out of the mass vaccination program. The rush to develop and
recommend for universal use multiple viral and bacterial vaccines to be
given simultaneously should make the development of failsafe detection
methodologies a priority in any credible mass vaccination program.
Barbara Loe Fisher
Co-Founder & President
National Vaccine Information Center
Institute of Medicine Vaccine Safety Forum
November 6, 1995
Once the vaccine associated adverse event
has been detected, there can be no prevention unless the system responds
in appropriate ways. For those of us whose children have paid the price
for sometimes dangerous vaccine policies that have failed to identify
and screen out high risk children, the issue of how the system has refused
to appropriately respond to the reality of vaccine deaths and injuries
is a very painful one.
In our view, there can be no greater
responsibility on the part of doctors and public health officials than
for them to fulfill their promise to care about and protect the health
of all the people. We do not expect them to play politics with our lives
and implement official policies that place a higher value on the life
of a child who suffers from a disease than is placed on the life of a
child who suffers from a vaccine reaction. And we don't expect them to
lobby Congress for money to be spent on promotion of vaccination and enforcement
of mandatory vaccination laws while no money is obtained or spent to detect
and prevent vaccine injuries and deaths. And we don't expect them to participate
in the kind of destructive action which, last year, resulted in the gutting
of the federal vaccine injury compensation program which we fought so
hard to provide for victims of vaccine damage.
No matter how hard you
try to make parents believe it was our patriotic duty to sacrifice our
children in the war on disease, you will never succeed because you have
failed to respond to what happened to our children as either caring physicians
or good scientists.
Because it is too late
for our children, the hope that we can do something to prevent this from
happening to others is all we have left. And so parents of vaccine injured
children will continue to come forward and demand that public health officials
respond appropriately to vaccine injuries and deaths so that other children
won't have to suffer like ours have.
We sincerely hope that
this Vaccine Safety Forum will mark the end of protection of the status
quo and the beginning of meaningful responses to the detection of vaccine
adverse events.
1. Make the funding of credible vaccine adverse event
research a priority. There is more than enough taxpayer money being
spent on vaccine development and promotion. Where are the government
funded independently run studies to detect vaccine adverse events or
identify high risk individuals or develop therapies to help vaccine
injured individuals recover their health?
2. Review and update FDA regulations for vaccine
safety screening to reflect the state of the art in scientific technology
so that vaccines are being tested for adventitious agents as well as
toxicity that may be related to additives such as aluminum and formaldehyde;
3. Create large prospective studies to evaluate the
impact of multiple vaccines on the human immune system over time by
comparing groups of vaccinated individuals against groups of unvaccinated
individuals. Prove these vaccines are safe and effective so an Institute
of Medicine committee evaluating proof of cause and effect in the medical
literature doesn't have to come up with the unfortunate conclusion time
and time and time again that there is not enough evidence in the medical
literature to make a determination whether a vaccine does or does not
cause a particular health problem.
In summary, simply be
good scientists and physicians and, when there are clear indications that
vaccines either singly or in combination may be causing health problems
that have not yet been evaluated, don't turn away and pretend it isn't
happening. Please do everything in your power to respond appropriately
to protect children and adults from suffering vaccine associated death
and damage. As public health officials that should be as much a part of
your mission as preventing infectious disease-associated death and damage.
We will be watching you
and making sure that if you don't, the public will know about it so they
can take steps to protect themselves. Because that is our mission.
Barbara Loe Fisher
Co-Founder & President
National Vaccine Information Center
Institute of Medicine Vaccine Safety Forum
November 6, 1995
With the advent of 45
new vaccines, particularly the new supervaccine that reportedly will contain
raw DNA from 40 different kinds of bacteria and viruses that will be squirted
into the mouths of all newborn infants and time released in the body throughout
life, we must be absolutely sure that the vaccine policies which we endorse
today do not weaken the immune and neurological systems of and cause negative
genetic changes in whole generations of children tomorrow. We must be
scientifically certain that it is safe and effective to vaccinate babies
or military recruits or pregnant women or sick people in nursing homes
with so many live viral and killed bacterial simultaneously – or that
it is safe and effective to vaccinate sick children or children with family
histories of vaccine reactions or immune system disorders, which is the
current policy.
The only way we can effectively
detect and respond to vaccine adverse events is to have the will and the
commitment to ask the hard questions and find out the truth about how
vaccines impact on the body. And then we must have the will and commitment
to act responsibly on our conclusions in order to protect the public health.
To do anything less, in our view, is morally unacceptable.
Those of us who have
worked for the past 14 years for meaningful reform of the mass vaccination
system to make it safer, stand ready to work with you in any way we can
to achieve that goal as long as we know that what is being done is not
simply window dressing or maintaining the status quo or playing politics
as usual. The time has come to take action before it is too late for many
other children, who have no choice and have no voice, in a war on disease
that is supposed to save lives and not take them.
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