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Yale 62

Vaccines and Vitamins
By Richard Howard

At the July Coffee Hour, classmate Earl Staelin gave a presentation covering various health subjects. I could not attend this meeting and much of what he said went unchallenged. Most of what he said was not accurate. I have written the following for clarification.

1. Mercury and aluminum in vaccines leads to autism.

MERCURY: In 1998, Dr. Andrew Wakefield published a paper in The Lancet claiming that mercury in the MMR vaccine leads to autism after studying 12 children (1). The article proved to be fraudulent and fraught with ethical, financial and methodological impropriety. In 2010 the UK Medical Council revoked his medical license (2-4). The Lancet withdrew the paper. This unfortunate incident of medical fraud led to questioning the safety of vaccines and many parents refusing to have their children vaccinated for measles, mumps and rubella.

Few subjects in medicine have been more thoroughly documented than the non-relationship between vaccines and autism. All of them have concluded that vaccines do not lead to autism (3). Mercury, in the form of thimerosal, is broken down and excreted much more quickly than the methyl mercury found in sea food (5). If you are concerned about mercury and autism, stop eating sea food. There is more mercury in a three ounce can of tuna fish than in a vaccine dose. Thimerosal was removed from all childhood vaccines years ago. Yet, the incidence of autism has not decreased.

ALUMINUM: Concern has also been raised about the association of aluminum in vaccines and autism. Aluminum salts are added for its adjuvant properties (increases the immune response). A large meta-analysis of studies evaluating the risk of autism showed that in pooled data of 1,256,407 children, there was no association between aluminum in vaccines and autism (6). One study, however, based on a finding that countries that have high vaccination rates tend to have high autism spectrum disorder cases; no clinical studies were cited. Furthermore, the incidence of ASD has been rising over the past two decades (7). The authors concluded that a more rigorous evaluation of aluminum adjuvant safety is warranted.

2. COVID vaccine is potentially dangerous and has had numerous adverse events.

As any vaccine COVID vaccines have adverse events that include pain, redness and swelling at the injection site. The incidence of serious adverse events that resulted in disability, hospitalization or life-threatening is 0.6%. But it was 0.5% in a control group of individuals who did not receive the vaccine (8). Many other adverse outcomes have been attributed to COVID vaccine including changes in DNA or RNA, injection of microchips, resulting in the individual becoming magnetic, risks to pregnancy, effects on the menstrual cycle, causes a positive test for COVID, makes one sick with COVID, and many others. Myocarditis has been reported in some vaccine recipients, almost exclusively in young men after the second dose, but these cases have been rare and the recovery is quick. The incidence of myocarditis is much higher in COVID patients. Little discussed is the number of COVID patients who become “long-haulers” have symptoms that persist for weeks or months, requiring care by many specialists including cardiologists, nephrologists and pulmonologists.

While no vaccine is perfect, they save millions of lives each year. Many hospitals are currently overwhelmed with unvaccinated COVID patients, largely infected with the delta variant. The incidence in children due to delta has increased dramatically. Telling is that 99 – 100 percent of patients in hospital ICUs or dying of COVID have not been vaccinated.

Vaccines are always listed among the major developments in the 20th century that led to an improvement in health.

3. Smallpox decreased 90 percent following changes by a town in England. The vaccine did not play a significant role.

The last case of smallpox in the United States was in 1949, the last case in the world occurred in Somalia in 1977. In 1978, a case in England occurred due to a laboratory accident. There has not been a case anywhere in the world since then.

The last case of polio originating in US was in 1979, the last case brought in from another country occurred in 1993. In 2020, there were 147 cases word wide, a 99.96% drop in the estimated 350,000 cases/year in 1988 when the worldwide eradication effort began by the WHO. As of August 17, 2021 only 2 cases have been reported: one in Pakistan, one in Afghanistan.

The total eradication of smallpox and the great reduction in the cases of polio can be attributed to effective vaccines and only to vaccines!

4. Vitamins are effective therapy for the treatment or prevention of many diseases.

There have been numerous studies investigating the efficacy of vitamins in the treatment of prevention of many diseases. I have focused on vitamin use in surgical sepsis, cancer and heart disease. There are so many studies that there are meta-analyses of such studies and reviews of meta-analyses. The great majority of such studies conclude that vitamins do not result in effective treatment or prevention of diseases in humans. Vitamins, of course, are quite effective for the treatment and prevention of vitamin deficiency diseases. I present some of the better reviews and studies. Remember, the conclusions are those of the review authors. An expanded version of this part of the discussion was posted on the class website in July.

SEPSIS: I reviewed five studies and one review of 10 studies examining the efficacy of vitamin C in treating sepsis and septic shock (11 – 17). Another review examined 45 studies of which 31 were randomized trials in cold prevention with vitamin C (18). All the authors of the studies concluded there was no benefit of vitamin C treatment in sepsis or septic shock or in preventing the common cold.

CANCER: I reviewed six large trials of vitamin D in the prevention of cancer. All of the studies showed no overall benefit of vitamin D in preventing cancer (19 – 22). Two studies, however, showed benefit in certain subgroups of patients in their study (19, 22). One study found no overall difference between women who received vitamin D and calcium in overall cancer incidence compared to the control group, but there was a reduction in overall risk in cancers developing after 12 months in women taking vitamin D and calcium (19). A study of 13,32 men taking vitamin D found no overall reduction in risk of cancer, but among 1312 men with a baseline history of cancer there was a reduction in cancer risk (22). Another paper did not report on an actual clinical study (23). Rather based on epidemiological evidence that women with low circulating vitamin D levels are associated with a higher risk of ovarian cancer and vitamin D supplementation is associated with decreased cancer mortality. The final paper reviewed 17 studies on vitamin D exposure and ovarian cancer risk (24). The authors found the studies to be inconsistent. Five of the studies were of sun exposure. One technique some authors use when the overall group of study subjects shows no effect, as these studies did, is to do subgroup analysis. If one carves out small groups from the larger group, one frequently can find evidence for an effect. If you do enough subgroup analyses in any study, statistically you’re likely to find something.

HEART DISEASE: Five studies covering hundreds of trials and thousands of patients reported no benefit of vitamin D on cardiovascular disease or stroke prevention (25 – 28). One paper found no evidence for the benefit of vitamins E and C in preventing cardiovascular disease (29). The final paper examined 107 systematic reviews and 74 meta-analyses of observational studies of plasma vitamin D concentrations and 87 meta-analyses of randomized controlled trials of vitamin D supplementation (30). The authors concluded “highly convincing evidence of a clear role of vitamin D does not exist for any outcome.”

Almost 60,000 instances of vitamin toxicity are reported annually to US poison control centers. Approximately 56 percent of US consumers said they take vitamin supplements, with 44 percent saying they take them daily.

5. Drugs are effective for COVID treatment: ivermectin, hydroxychloroquine and azithromycin.

Ivermectin, hydroxychloroquine and azithromycin have been the subject of numerous clinical trials and articles. Some articles suggest there may be some efficacy of these drugs, but the articles are of low quality, have varying dose schedules, many are not randomized, have no controls or poorly “matched” controls, etc. The articles that do show some efficacy are not published in first-line medical journals. In one article the outcomes in the control group were better than in the group receiving hydroxychloroquine.

IVERMECTIN: One report did find that ivermectin reduced the relative risk of death in hospitalized patients (risk ratio 0.38) among 15 trials, but it graded the trials only of low or moderate quality (31). A Cochrane Database of Systematic Reviews, Ivermectin for preventing and treating COVID-19, reviewed these same articles and many others. Because of the poor quality of several of the studies and lack of comparison of ivermectin treatment with treatments of proven efficacy, the authors could not say whether ivermectin led to a decrease or increase in number of deaths. The evidence available was graded as low or very low quality. They were unable to reach unable to reach any conclusion whether ivermectin: reduces or increases deaths, worsens or improves patients, or increases or reduces adverse events. Based on their review, the authors found no evidence to support the use of ivermectin for treating or preventing COVID-19 (32). (The Cochrane Library houses systematic reviews about many medical subjects. These reviews are done by experts.) Many studies claiming efficacy of ivermectin for COVID-19 have been withdrawn because of fraudulent research (33).

HYDROXYCHLOROQUINE WITH OR WITHOUT AZITHROMYCIN. Many studies showed no benefit of treating COVID-19 patients with hydroxychloroquine with or without azithromycin. In one the hospital stay was actually shorter in a control group that did not receive these drugs One review, however, did find that hydroxychloroquine was effective in outpatient and inpatient settings (34). Many of the cited studies were small, did not have proper controls, or even lacked a confirmed diagnosis of COVID-19. Of the randomized controlled trials only one of seven cited studies a benefit of hydroxychloroquine and this study was underpowered in that only 31 patients received the study drug. Most reviews and well-controlled studies have found no benefit of hydroxychloroquine in treating COVID-19 (35-37). A recently published randomized trial showed hydroxychloroquine was not effective in treating COVID-19 (37). The Cochrane Database Systematic Review, Chloroquine or hydroxychloroquine for prevention and treatment of COVID-19 examined numerous studies of hydroxychloroquine but found only 12 met their criteria for inclusion (35). Most other reports suffered from methodological problems. They concluded that hydroxychloroquine (HCQ) has no clinical benefit in treating COVID-19 in hospitalized patients, and probably increases adverse events and that this lack of any demonstrable clinical benefit in the treatment of COVID-19 makes it less likely the drug will prevent the illness in those who are exposed. The WHO strongly recommended that hydroxychloroquine should not be used to treat COVID-19 (38).

6. Medical journals will not publish articles that might decrease sales of pharmaceutical company drugs, because they are afraid of losing advertising dollars.

I was on the business board of the American Journal of Transplantation for many years and had many interactions with pharmaceutical companies (yes, we accepted their advertisements). I also have reviewed articles for publication for many medical journals. Never once was there even a hint of basing any decisions on what the advertiser wanted. A journal that would engage in such behavior would never be able to prevent it from becoming widely known. Too many people would learn about it and it would destroy the reputation of the journal. The main reason that studies about alternative medicines, nutritional supplements, etc. are refused most likely has more to do with the fact that they are bad studies: poorly controlled, insufficient data, insufficient number of participants and unclear endpoints.

REFERENCES

1. https://www.sciencedirect.com/science/article/pii/S0140673695908161?via%3Dihub
2. https://www.nature.com/articles/d41586-020-02989-9
3. https://www.historyofvaccines.org/content/articles/do-vaccines-cause-autism
4. https://en.wikipedia.org/wiki/Andrew_Wakefield
5. https://pubmed.ncbi.nlm.nih.gov/22099159/
6. https://www.sciencedirect.com/science/article/pii/S0264410X14006367
7. https://pubmed.ncbi.nlm.nih.gov/22099159/
8. https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/reactogenicity.html
9. https://childrenshealthdefense.org/defender/vaers-injuries-deaths-covid-vaccines-new-highs-biden-mandates/
10. https://www.cdc.gov/vaccinesafety/ensuringsafety/monitoring/vaers/access-VAERS-data.html
11. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html
12. https://pubmed.ncbi.nlm.nih.gov/31567519/
13. https://www.sciencedirect.com/science/article/pii/S0002934319306990
14. Medwave. 2018 Aug 6;18(4):e7235. doi: 10.5867/medwave.2018.04.7236
15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5996765/
16. https://rebelem.com/rebel-cast-ep74-is-it-all-about-the-vitamins-in-sepsis/
17. https://pubmed.ncbi.nlm.nih.gov/31870831/
18. https://pubmed.ncbi.nlm.nih.gov/30113569/
19. https://academic.oup.com/ajcn/article/85/6/1586/4633053
20. https://www.cancer.gov/news-events/cancer-currents-blog/2018/vitamin-d-supplement-cancer-prevention
21. https://pubmed.ncbi.nlm.nih.gov/19116389/
22. https://pubmed.ncbi.nlm.nih.gov/23162860/
23. https://pubmed.ncbi.nlm.nih.gov/32024052/
24. https://pubmed.ncbi.nlm.nih.gov/32059597
25. JAMA Cardiol. 2019;4(8):765-776. doi:10.1001/jamacardio.2019.1870
26. European Heart Journal, Volume 38, Issue 29, 01 August 2017, Pages 2279–2286
27. https://www.sciencedirect.com/science/article/pii/S2352906720300774
28. https://pubmed.ncbi.nlm.nih.gov/31284304/
29. https://pubmed.ncbi.nlm.nih.gov/18997197/
30. https://www.bmj.com/content/348/bmj.g2035
31. Bryant, A. American Journal of Therapeutics 2021; 28 (4): e434.
32. https://doi.org/10.1002/14651858.CD15017.pub2
33. https://www.theguardian.com/science/2021/jul/16/huge-study-supporting-ivermectin-as-covid-treatment-withdrawn-over-ethical-concerns
34. Prodromos,C. New Microbes New Infections 2020; 38: 100776.
35. Singh B, Ryan H, Kredo T, Chaplin M, Fletcher T., Chloroquine or hydroxychloroquine for prevention and treatment of COVID-19., Cochrane Database of Systematic Reviews 2021, Issue 2. Art. No.: CD013587.
36. https://www.nature.com/articles/s41598-021-91089-3
37. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2779044
38. https://www.medicalnewstoday.com/articles/who-strongly-against-hydroxychloroquine-use-for-covid-19-prevention

 
We welcome your comments below.

5 comments to Vaccines and Vitamins

  • Bill Weber

    Richard; Thanks for this fine article as a rebuttal to Earl’s comments on a coffee hour I did attend. As I am unqualified to assess what Earl said it seemed to me he was on the same trip as many of the authors of articles and websites that, for reasons unknown, try to convince the public that vaccines are either harmful or ineffective. Unfortunately this stream of naysayers has a negative effect on the public and may well be the biggest reason our country has so many anti vaccers which causes us to not achieve the necessary level of a country wide decrease of new infections and associated deaths.

  • John Stewart

    Thanks, Richard, for a very complete summation standing against the widely spread mis-information. I have an anti vax dear friend and I’m going to rattle her cage with your article! (Not with any hope at all of changing her mind, sadly)

  • David Bingham, MD

    Thanks, Richard, for your excellent review and for your helpful review of the vaccine and vitamin issues. As a physician who saw literally hundreds for pharmaceutical sales agents over the years, I know all too well that many were pushing drug usage that was inappropriate or later proven to be ineffective and even dangerous (like Oxycontin, which I refused to prescribe from the start due to feds of addiction which proved to be tragically common).

    I have been remarkably fortunate with my health, without taking vitamins, perhaps in part due to being on a 95% vegan diet, which I recommend to others not just for the sake of health and ruction of heart disease, hypertension and obesity, but also for the sake of the planet (substantial reducing my carbon footprint and the other greenhouse
    gases associated with raising animals for food.

    I get my annual flu shots mostly to help keep the spread to others down, and of got the Covid vaccination. Despite the dark rumors that “the shot” will weaken me, I still plaice hockey 3 days a week, and continue to feel great, and love being able to do sport with others who have also been vaccinated.

    Your review is on my list to send to others who are scared of vaccines and “addicted” to supplements. Persistence in educating others can’t hurt, and may be life-saving!

    • David Bingham

      An addendum to the above (sorry for the typos). On re-reading. I note that my first paragraph indicates a healthy skepticism of pharmacy and vitamin advertising. On the other hand, I should have added that only by reviewing the science did I decide what I would prescribe or how long I would wait to prescribe before using promising new drugs that have been remarkable in our lifetime in all fields of medicine.

      And we have been blessed by having the CDC and NIH as well as peer-reviewed journals and specialty societies to help us sort the wheat from the chaff. They are among the least “political” of all our government and non-profit agencies, and fully deserve continued adequate funding.

  • Norman Jackson

    Fine article, Howard! Thanks!

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