Spreading fear and misinformation to pregnant women

Antivaxers are lately taking the position of very strongly spreading fear and misinformation about the use of vaccines during pregnancy. One source for this information is Informed Choice Washington (ICW), an organization based near Seattle and run by two women who believe vaccines injured their children. Bernadette Pajer believes her grown son’s dairy allergies were caused by vaccines and Drella Stein believe her grown son’s autism was the result of a vaccine injury. They have made it their mission “to educate and advocate for vaccination policies that serve the best interest of the public and the individual patient.”  The problem is that they don’t espouse good science, and instead, cherry pick only what fits their antivax agenda. They believe they support medical freedom and, as such, are members of something called the Coalition for Informed Consent, a network of other antivax (“medical freedom”) organizations.

Case and point: Their Vaccination during pregnancy page. This purpose of this page is to mislead women into not vaccinating during pregnancy, despite good evidence supporting its benefits and low risks.

The page starts off with a melodramatic and inaccurate video from Del Bigtree, a man with no science background whatsoever) tell viewers the CDC knows flu vaccine during pregnancy causes abortion. This is in reference to a study the CDC detailed here.  This one study found that women who had been vaccinated for flu two years in a row suffered a miscarriage at a higher rate than others. They noted “this study does not quantify the risk of miscarriage and does not prove that flu vaccine was the cause of the miscarriage”  They also noted that earlier studies have not found a link between flu vaccination and miscarriage.

Instead of focusing on the facts, ICW plays up the possibility of a risk and creates a conspiracy theory by accusing the CDC of purposely delaying to release this study. They also ignore the FIVE studies that showed no link between miscarriage and flu vaccine.

This is a classic tactic from ICW and Ms. Pajer, to play up the risks and ignore the studies which do not confirm her biases.

She also makes the point that Currently, no vaccine is approved specifically for use during pregnancy to protect the infant. (her bolding, not mine). It has been explained to Ms. Pajer many times that the FDA approved flu vaccines TDAP and then post-licensure studies demonstrated efficacy and safety during pregnancy, but that does not require relicensing. The vaccines are already licensed. They do not need to be specifically licensed for use during pregnancy. Still, she feels the need to do this on her website:

CAUTION: No vaccine is currently licensed by the FDA for protection of the infant.

Yes, big bold letters warning you of a fictional issue. This is deceptive. On purpose. Further, they cite a paper by David Ayoub and F. Edward Yazbak, both MDs, as evidence the vaccine is dangerous. This paper has a lot of misinformation in it. First of all, it is about the Advisory Committee on Immunization Practice (ACIP) annual report from 2004, which was written before much of the research upon which the current recommendations are based were published. Currently, both ACIP and the American College of Obstetricians and Gynecologists (ACOG) and these are based on recommendations from 2016. To cite a review of recommendations from 2004 is deceptive. Again, ICW is deceiving people on purpose.

Another ICW concern is immune activation. This is a relatively new concern from antivaxers and is code for “vaccines cause autism.” They are concerned that giving vaccines to pregnant women could trigger immune activation thus leading to neurodevelopmental issues in all babies whose mothers were vaccinated. They compare the risk of dying from flu to the risk of immune activation in 100% of vaccinated babies.

• Risk of flu-complication death for pregnant women: .000125%
• Risk of flu-complication death for pregnant women in a pandemic year: .001875%
• Risk of newborn death under three months during a non-major outbreak year: .00015%
• Risk of newborn death under three months during a major whooping cough outbreak: .000375%

These statistics are based on the number of babies and women who died compared to the general public.

It should be noted that there is no evidence that giving a vaccine to pregnant women causes immune or neurodevelopmental issues in the newborn.

ICW also has the usual concerns about vaccine ingredients being dangerous and inserts not specifically stating vaccines are licensed for pregnancy or have been tested during pregnancy. As we have told you many times, inserts are only written about clinical trials. Studies on vaccines for use during pregnancy occurred after licensure, after clinical trials, and are, therefore, not represented in inserts. Inserts have serious limits. Always read more than them.

Ms. Pajer further has concerns that some of the CDC-cited studies were not randomized clinical trials. She has been told by yours truly, several times, that it would be unethical to do randomized clinical trials on pregnant women. The studies which have been done, with willing volunteers, are valid and strong. She criticizes and finds flaws in each of the 13 studies she reviews, which is okay, but does not take them as a body of literature. This is typical of what we call a ‘cherry picker,’ a person who reads studies with a bias in mind and only agrees with studies which confirm her pre-existing bias. So, because no one study meets all her exacting criteria, then none will satisfy her. However, the medical community looks at the ever-growing body of literature showing the safety and efficacy of vaccines during pregnancy. Hence, the recommendations from CDC, ACIP, and ACOG. Again, this is a disingenuous attempt by ICW to mislead people away from vaccinating.

The final concern from ICW is the aluminum salt in vaccines that is used as an adjuvant. The aluminum in vaccines is not a heavy metal. It is not even in a metallic form as portrayed by vaccine fearmongerers. It is in the form of a salt, usually aluminum hydroxide. The aluminum in aluminum hydroxide is not readily bioavailable and retention is extremely low from both ingestion and injection
This is a great explanation. 

It should be noted that we get actual aluminum in our food, including in antacids pregnant women take for acid reflux, a common pregnancy symptom. And, the aluminum salts are about 2 um or 2000 nm, in diameter, as per the work of Christopher Exley. That is much too large to cross the placenta (or the blood-brain barrier, for that matter).  According to my friend with a master’s in chemistry, aluminum salts don’t fit the definition of nanoparticles because they are over 100 nm in any 1 direction.

Here is some reading about the permeability of the placenta.

Most of the literature I’ve seen puts the pore size for the placenta at under 50 nm, and given the size of the adjuvant, I wouldn’t expect it to diffuse across the placenta.

The concerns about aluminum in vaccines are cherry picked and not based on sound science. Here is some excellent reading from learned friends of mine.

Aluminum adjuvant in vaccines – let’s go cherry picking

Torturing more mice in the name of antivaccine pseudoscience, 2017 aluminum edition

Mothers’ Flu Vaccination In Pregnancy Protects Newborns, Even The Second Time Around

Please don’t be scared by antivax websites.  Get the facts. Understand cherry picking does not an argument make.

 

Here are links to more safety studies on vaccines recommended to pregnant women.

Flu vaccine

https://www.cdc.gov/flu/protect/vaccine/qa_vacpregnant.htm

Tdap

https://www.cdc.gov/pertussis/pregnant/research.html

 

Remember to think for yourself!

 

 

Kathy