Vaccination: A Conversation Worth Having

While America is still in the grips of swine flu mania, let me use this opportunity to clear up a few things about my beliefs concerning the flu shot, vaccines, and health in general. I do this because there is obviously a lot of curiosity about this subject of vaccines -- it comes up in every interview I do these days, and I've been finding that people, including doctors, are privately expressing a skepticism that is still not very prevalent in public. I feel like I've become a confessor for people who want someone to be raising questions about vaccines.

But I don't want the job. I agree with my critics who say there are far more qualified people than me -- its just that mainstream media rarely interviews doctors and scientists who present an alternative point of view. There is a movement to stop people from asking any questions about vaccines -- they're a miracle, that's it, debate over. I don't think its that simple, and neither do millions of other people. The British Medical Journal from August 25 says half the doctors and medical workers in the U.K. are not taking the flu shot -- are they all crazy too? Sixty-five percent of French people don't want it. Maybe its not as simple as the medical establishment wants to paint it.

Vaccination is a nuanced subject, and I've never said all vaccines in all situations are bad. The point I am representing is: Is getting frequent vaccinations for any and all viruses consequence-free? I feel its unnecessary and counterproductive to try and silence people with condescension. Michael Shermer wrote me an open letter and felt I needed to be told that "vaccinations work by tricking the body's immune system into thinking that it has already had the disease for which the vaccination was given." Thanks, Doc, I thought there might be a little man inside the needle. Yes, I read Microbe Hunters when I was eight, I have a basic idea how vaccines work.

That's not -- or shouldn't be -- where the debate is. I admit, its hard to get as clear a picture of my beliefs, as you could, say, if I had written a book on vaccines, versus someone in the setting of a talk show. So I understand why its easy to take bits of things I have said and extrapolate into something I actually have never said. I understand it, but its not exactly "scientific."

But rather than responding to every absurd thing said, let me just tell you want I do think -- because I will admit, I have gone off half cocked on this issue sometimes, and often only had time on my show to explain a fraction of what needed to be explained, and for that I am sorry. Some of it can't be helped, some of that is the nature of the show we do: live, off the cuff, lots of interruptions. Some of it was just from me being overexcited about finally finding a health regimen that actually made me healthier and feel better. And many a time I have wanted to stop the show and clarify a point or provide the nuance I think it deserves, but I am serving many masters, and you have to get out of the way as much as you can so the guests can say their piece.

But some of it I would do differently. For example, I recently joined Twitter Nation -- what can I say, Demi Moore is a very convincing salesperson -- and what everybody told me about Twitter was that it was supposed to be whatever stray thought or thing just happened to you -- you know, for people who find blogging too formal and stuffy.

But apparently it's taken very seriously, because there was Scott Pelley on 60 Minutes asking the Secretary of Health and Human Services what she thought about the fact that "Bill Maher told his viewers anyone who gets a flu shot is an idiot."

Well, not quite. It was twittered, which I guess doesn't make a huge difference, but as 60 Minutes is the last bastion of TV journalism, accuracy is appreciated. And I see that counts for Twitter, too -- my bad -- so yes, some people are not idiotic to get a flu shot. They're idiotic if they don't investigate the pros and cons of getting a flu shot. But, come on -- it was a twitter from a comedian, not a treatise in the New England Journal of Medicine, that's not what I do.

I'm just trying to represent an under-reported medical point of view in this country, I'm not telling a specific pregnant lady what to do. With unlimited air time, I would have, for example, added to my discussion with Dr. Bill Frist on October 2 that, yes, any flu or health challenge can be dangerous when you're pregnant, and if your immune system is already compromised by, for example, eating a typical American diet, then a flu shot can make sense. But someone needs to be representing the point of view that says the preferred way to handle flus is to have a strong immune system to begin with, and getting lots of vaccines might not be the best way to accomplish that over the long haul.

Now, sometimes its OK to fuck with nature -- I believe "intelligent design" is often anything but intelligent; that "God's perfect universe" is actually full of fuck ups and design flaws, like cleft lips and Down Syndrome -- so correcting nature is sometimes the right thing to do. And then, sometimes its not. For me, the flu shot is in the "not" category.

In addition, my audience is bright, they wouldn't refuse a flu shot because they heard me talk about it, but if they looked into the subject a little more, how is that a bad thing? If they went to the CDC Web site and saw what's in the vaccine -- the formaldehyde, the insect repellent, the mercury -- shouldn't they at least get to have the information for themselves?

But just to reassure all those people who have such a romantic attachment to vaccines: I know, there are vaccines that have had their battles with the bad guys and won -- great! And if you have a compromised immune system and can't boost it naturally, as in poor countries where the children are eating dirt, then a vaccine can be a white knight -- bravo! Does the polio vaccine have the power to prevent children from getting polio, and did it indeed do just that in the 1950s? I believe it does, and it did. But polio had diminished by over 50 percent in the thirty years before the vaccine -- that's a pretty big fact in the polio story that you don't often hear and which merits debate. It may be the case that the vaccine should have been used anyway to finish polio off, but there are some interesting facts on the other side.

So yes, I get it, we learned how to trick our immune systems. And maybe sometimes, you gotta do it. But maybe the immune system doesn't like being tricked so many times. Maybe we should be studying that instead of shouting down debate.

Someone who speaks eloquently about this is Barbara Loe Fisher, founder of the National Vaccine Information Center. I find her extremely credible, as I do Dr. Russell Blaylock, Dr. Jay Gordon and many others, but I shouldn't have even mentioned them because I don't want to be "the Vaccine Guy"!! Look it up yourself, and stop asking me about it -- I'm already the Religion Guy, and that's enough work!

Anyway, Ms. Fisher is someone who says she is not "anti-vaccine," but just has a lot of questions about the long term effect of using a lot of vaccines. After devoting her life to studying this, she says that the influenza vaccine studies that have been done "are not persuasive in proving that a seasonal flu shot provides immunity." She also points out "that what we need, but do not yet have, are studies of vaccinated vs unvaccinated children."

Is it worth it to get vaccines for every bug that goes around? Injecting something into my bloodstream? I'd like to reserve that for emergencies. This is the flu, and there's always a flu. I've said it before, America is a panicky country. It's like we look for things to panic about.The reports from Australia, where they're over their flu season, is that its not a terribly virulent flu. The worldwide numbers support that. But you'd never get that impression from the media in this country.

60 Minutes has done two pieces on swine flu within a month. The first one introduced us to a high school football player named Luke Duvall who, we were told, was the picture of health, and then got hit by the flu so bad he was in the hospital at death's door. But later in the segment we learn that Luke had staphylococcus pneumonia along with the flu. Was that staph bug in him when he got hit by the flu? Its not clear from the reporting, but since every other kid on both football teams got the flu, as well as the cheerleaders ... ahem ... and all of them got over it just fine, then it seems quite possible that Luke had a co-existing infection, and that's why his experience with H1N1 was so different.

On the follow up visit a couple of weeks later on 60 Minutes, we were told Luke had "beaten H1N1." No, he beat H1N1 and staph together: that's very different! If 99 percent of people have relatively mild symptoms, shouldn't science's first job be finding out why the one percent get felled? Having an underlying health issue is the point I was raising with Dr. Frist: maybe Luke wasn't the picture of perfect health they described in the opening.

By the way, when Scott Pelley asked the government spokesman about the fact that only one percent of people who get the flu find it to be anything other than a typical, mild flu, the answer was an analogy to seatbelts, that "only 1 percent of people riding in a car will be in an accident, but you don't want to take a chance on being that 1 percent."

That went unchallenged, which is sad, because what a horrible analogy! I would think vaccines containing many different dicey substances shot directly into the bloodstream have a slightly greater chance of secondary effects than a piece of fabric lying across your waist. Maybe if you had to swallow the seatbelt this would be a good analogy.

If one side can say anything and its not challenged, then of course dissent becomes heresy in the minds of many. I don't trust the mainstream media to be thorough or exacting enough to inform me as much as I need on this subject. Sorry, they're just not up to it. At the very least, they should have pointed out, as we watched Luke fighting for life on a ventilator, that, of course, flu vaccines don't have any therapeutic effect on bacterial infection.

While we're on the subject of bacteria, let me say clearly I understand germ theory also -- I believe they also covered that in Microbe Hunters -- nor have I ever said I was a "germ theory denier." What I've been saying is that Western medicine ignores too much the fact that the terrain in which bacteria can thrive is crucial and often controllable, which shouldn't even be controversial. I don't care what Louis Pasteur said on his death bed -- it was probably, "Either the curtains go or I do" -- that's not the point!

And it's precisely because I am a Darwinist that I fear the overuse of antibiotics, since that is what has allowed nasty killer bugs like MRE to adapt so effectively that they are often resistant to any antibiotic we can throw at it. There are consequences to vaccines and antibiotics. Some people want to study that, and some, it seems, want to call off the debate.

Instead of setting up this straw man of me not understanding germs or viruses, let's have a real debate about how much we should use vaccines and antibiotics. Of course it's good that we have them in our arsenal, but isn't the real skeptic the one who asks if these powerful but toxic methods do harm to what actually is a a very good defensive system, the one you were born with?

Also, I have never said there was a medical conspiracy. In fact, when Howard Dean asked me that, my response was "I wouldn't call it a conspiracy." Any more than there's a conspiracy for the Pentagon budget to be obscenely bloated and operated largely for the corporate welfare of defense contractors. If these are conspiracies, they're mostly legal ones that happen in plain sight. (Good time here to plug the hostess' book, Pigs At the Trough, it's all in there!) I have, in fact, used the phrase "medical-pharmaceutical-food industry" complex in comparing it to Eisenhower's famous depiction of a "military-industrial complex."

But no, I don't think the A.M.A. and Big Pharma and Aetna and Dr. Frist's hospital chain all meet in a board room and cackle about keeping us sick. They meet on the golf course. (Just kidding.)

Do pharmaceutical companies want to cure diabetes or do they want to sell diabetes drugs and equipment? Well, they sure do sell a lot these days, and the food companies are what make that possible. Read David Kessler's book about the deliberate way food companies use salt, fat and sugar as foodcrack to get people literally addicted to eating bad food and too much of it. Is that a conspiracy? Only if you define corporations putting profit ahead of human health as conspiracy. The fact that Americans will do anything to each other for money is not a conspiracy, it's a scandal.

I believe in science and I believe in studies to determine the truth. I also believe Senator Ron Wyden of Oregon was correct when he said recently on MSNBC: "If you've got a checkbook in this town, you can get just about any set of facts you want." So if I remind you of a conspiracy theorist, you sometimes remind me of Britney Spears when she said "we should just do whatever the president says to do, and not ask questions and just support him." The medical community can be brutal on dissent, which would hold more weight if I thought this was a terribly healthy country, which it isn't. Health care is one sixth of our economy, and we spend way more on it than any other nation. The elephant in the room of the health care debate is that we are going to have a high health care bill every year no matter what law they pass because we're sick -- we need a lot of drugs and services.

Am I a conspiracy theorist if I suggest that since the network's nightly news broadcasts are sponsored almost entirely by prescription drug ads, that you might have to hold your breath a long time before you hear the alternative point of view to using pharmaceuticals to cure all our ailments?

Is it conspiracy theory to believe that American medicine too much treats symptoms and not root causes of disease? I always ask my friends when they go to the doctor for something, "Did your doctor ask you what you eat?" The answer is almost always 'no,' and a lot can be cured with diet and a healthier lifestyle. (And a lot can't. I also understand the role of genetics and generations of artificial selection). But Americans don't want to hear that, so doctors don't push it. It's easier and more profitable to write a prescription for Lipitor. They're not bad people, and at the end of the day, you can't make someone eat right. I like and respect all the M.D.s I've had over the years, and for the record, I have a naturopath doctor and I have a Western doctor. I would make an analogy to Republicans and Democrats: in both politics and health, I don't commit to either party because I'm on the side of the truth, whoever has it. In both cases, I'm an Independent.

Ms. Fisher said "If we want to create a society that is dependent on shots for immunity -- the same way we are getting dependent on prescription drugs, antibiotics, and surgery -- this is the path we should keep going down."

I don't think its "anti-science" to pause and consider that point of view.

Is This as Good as It Gets From Obama?

Yeah, I'm disappointed, too. I thought we were sweeping into power; I thought change meant Change. I believed all that talk about another First 100 Days, a la Roosevelt. Well, that didn't happen. The question is, is this as good as it gets from Obama, or is he pacing himself? He may have a four and eight-year plan and they included a first year of just gettin' to know you and not gonna rock the boat too much. Well, Mission Accomplished on that.

It's still to early to lose hope in a guy as smart and talented as Barack Obama. But I would counsel him to remember: If you're going undercover to infiltrate how Washington works, so you become one of them for a while, to gain their confidence, well, it can be just like all those movies where a cop goes deep, deep, DEEP undercover with drug people and -- fuck, he's a drug addict, too!

Logic tells me that really smart guys like Obama and Rahm Emanuel know better what they're doing than I do. They certainly know things I don't know. I think we have the same general goals and beliefs. And this is what they do for a living -- I wouldn't even try it. But I will never stop having this doubt: that maybe if they had really charged in there riding the forceful energy of the historic election, and acted like it was an emergency moment -- which it was -- they could have gotten some big victories right up front, and there really could have been an historic "first hundred days" for this administration and the country. Instead of what happened, which is the Obamas got a dog. It could have worked -- the country had given its endorsement to "...and now for something completely different." There might have been a way to knock the Republicans back on their heels right away, with the argument that "The American people demanded we make these changes, and you are unpatriotic to stand in their way."

We'll never know. Because that moment passed, and now it could follow the pattern of World War I and devolve into boring, static trench warfare where nothing really game changing happens while both sides slowly bleed to death.

That said, I do not forget that if the election had gone the other way, we'd right now have a barter economy and be at war with Honduras.