Faculty / Presenter Disclosure. Disclosure of Commercial Support. Mitigating Potential Bias

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2 Faculty / Presenter Disclosure Faculty: Dr. Simon Moore Relationships with Commercial Interests: - The Review Course in Family Medicine (Founder) Faculty: Dr. Kaitlin Dupuis Relationships with Commercial Interests: - The Review Course in Family Medicine (Faculty) Disclosure of Commercial Support - This program has received no financial support. - This program has received no in-kind support. Mitigating Potential Bias - No further mention of The Review Course will be made in this handout

3 Thimerosal (a preservative) is metabolized in to ETHYLMERCURY (not METHYLMERCURY, the harmful form found in fish such as tuna) Ethylmercury t ½ < 1 week and is excreted within days No link has been found between thimerosal and autism in any properly controlled study. Most vaccines are thimerosal-free as of 2002 due to political pressure, not due to scientific reasons. Autism rates have not declined since thimerosal was removed from vaccines. White albacore tuna contains about.407 ppm (mcg/g) methylmercury. A 6 oz. (170 g) can of white tuna would then contain on average about mcg of mercury (170 g *.407 mcg/g = mcg). Eating the full 6 oz. can, then, would mean that you are absorbing mcg of methylmercury. That s over two and a half times the amount of mercury from a thimerosal-containing flu vaccine (which tops out at 25 mcg/dose). FDA, CDC No evidence to support any harm In fact at low doses, aluminum is an effective adjuvant, increasing the ability of the immune system to mount a response Aluminum is found in drinking water, infant formula, flour, and air The human body contains mg of aluminum An average adult in the United States eats about 7 9 mg of aluminum per day in their food. Antacids have mg aluminum hydroxide (approximately mg of aluminum) per tablet Current maximum amount of aluminum injected into an infant in their first year of life in vaccines = mg g-vaccine-ingredients-aluminum.html The chemical structure of the formaldehyde in vaccines is the same as that produced by our own bodies The most formaldehyde that a child is likely to receive via vaccines is probably at the 6 month visit, when they may get HepB, DTaP, IPV and possibly inactivated influenza, for a maximum of 307.5μg (.31mg). It is safe to consume mg of formaldehyde per day Trace amounts of formaldehyde are found in many foods including fruit, as are arsenic and cyanide g-vaccine-ingredients.html rch/ucm htm

4 Vaccines do not contain human cells or tissue Viruses for MMR, varicella, hepatitis A, Rabies, Quadracel and TdP are grown in a human cell line This cell line came from legal abortions in the 1960s Vatican documents confirm that vaccines with moral problems pertaining to them may also be used on a temporary basis ecnum= m Anti-vaccine advocates often show the decline in deaths which began before vaccines were introduced (green line). However when the drop in infections is graphed a clear temporal correlation is evident.

5 Most people today have not seen the complications of vaccine-preventable illnesses so they no longer have a friend or neighbor with permanent sequelae of these diseases: a limp from polio, deafness from measles, or death from tetanus etc. As well most people would agree that it s not ideal to get cancer naturally. (The HPV vaccine prevents cancer) Measles has a high complication rate 1 out of every 4 children with measles require hospitalization; 1 out of every 300 children will die Deaths occur from complications including pneumonia, croup, encephalitis In fact adults who get measles have a higher death rate: 1/150 Mumps can lead to orchitis and resulting infertility, rubella is implicated in cases of autism and birth defects As well see concerns re: varicella (below) CDC, J Infect Dis. (2004) 189 (Supplement 1): S4-S16. There is concern that not getting varicella as a child (due to the vaccine) would result in more severe infection as an adult (due to waning immunity) and increasing risk of shingles. However research suggests there is no decrease in immunity over time. A trial with 14-year follow up (n=7585) showed no decline. It also showed no increased risk of shingles. Multiple other trials have shown that the childhood varicella vaccine decreases incidence of shingles in adulthood J Clin Pathol 2001;54: N Engl J Med 1991;325: J Infect Dis 1989;160: Pediatrics 1986;77: Peds 2013;131(5).

6 The number of antigens in vaccines is declining. For example, in pertussis vaccines before 1995, vaccines had 3000 antigens. Today s pertussis vaccine has up to 5 with equivalent efficacy. However an infant is capable of handling many more than that; infants are exposed to as many as 10,000 antigens per day simply by crawling Based on the number of B cells in the blood, the number produced weekly, and the number of antigens in each vaccine (approximately 100), a baby s immune system is theoretically capable of handling 10,000 vaccines at any one time The Dr. Sears delayed schedule results in increased number of doctors visits (increasing risk of nosocomial disease) without added benefit. His delayed schedule requires visits for vaccines at 2, 3, 4, 5, 6, 7, 9, 12, 15, 18, 21, and 24 months and 2, 2.5, 3, 3.5, 4, 5, and 6 years of age. This can result in decreased vaccine rates. Clin. Microbiol. Rev. 2005:18(2); Pediatrics 2002:109(1); Pediatrics 2009:123;e164-e169 oo_many.html Strong evidence shows that HPV vaccine does not have any significant effect on clinical indicators of sexual behaviour" in a study of Grade 8 Ontario girls (n=128,712) A similar study showed no increase in STIs upon review of insurance data of 21,610 females across the USA CMAJ 2014 Early Release. Available at JAMA Intern Med. 2015;175(4):

7 Parents are concerned about vaccine safety but many are not aware of the rigorous testing Canada has an eight-step vaccine safety program involving pre- and post-market passive & active surveillance, testing of every lot, multiple levels of independent review, and enforced manufacturing standards. The Canadian safety system also benefits from international collaboration from other safety systems The VAERS database is often cited as an example of the many side effects of vaccines but it is passive, unreviewed, has no further inquest and does not indicate causality. For example, anyone can report any adverse effect i.e. it turned me into the hulk an adverse event which was actually submitted by a physician and was subsequently included in VAERS. Arch Pediatr Adolesc Med 2005;159(5): The Toronto Star HPV article from Feb 2015 was subsequently retracted due to poor science That particular article relied on correlation (i.e. the number of shark attacks and ice cream sales increase in the summer, the death rate for people who have eaten pickles is virtually 100%) Journalists are taught to weigh opposite sides equally (i.e. the new transit line will benefit our economy; however opponents say it is a waste of money) However, this results in False Balance because science does not work by equally considering anecdotes from both sides of the argument can lead to inappropriate conclusions (i.e. it has been claimed that people should drink water; however the opposite side of this argument is that people should never drink water) 1/science-shows-hpv-vaccine-has-no-dark-side.html

8 Faces have been obscured as per FMF policy. All images in this presentation are either public domain, used in accordance with the usage rights of the image, or are credited below: "Shingles on the chest" by Preston Hunt - Own work. Licensed under CC BY 3.0 via Wikimedia Commons - _chest.jpg#/media/file:shingles_on_the_chest.jpg