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Help! Worried about PCV Prevenar 13 Vaccine

(30 Posts)
honeybee93 Sun 03-Jan-16 11:09:30

Hello, I was wondering if anyone can give some advice / share their experiences please?

My DD is 15 months and has had all her vaccines apart from her boosters. She developed facial tics and gut problems after her infant vaccines, so we are worried to give her the boosters.

The main worry is the PCV vaccine as it contains aluminium which we think may have triggered her problems. Did anyone not give this vaccine for the same reason? Would we be completely irresponsible not to give this vaccine?

We're probably going to give the single measles vaccine rather than the MMR, and I think the hib/Men C one.

Thanks in advance!

BranTurner Tue 05-Jan-16 00:22:45

Hi,

Hope you're well. Just a quick background: I'm currently a student at King's college with a hefty background in pharmacology. I understand that you're concerned about your daughter's well-being, but I don't think aluminium would have been the cause of these problems. Aluminium is present in very small quantities (under one milligram) in vaccines - it also naturally occurs in breast milk, as well as some foods and drinking water.

If you're interested, there are a few scientific papers that looked at the amount of aluminium present in infants post vaccine - they both concluded the amount present was below the "minimal risk level." These can be found here:

www.ncbi.nlm.nih.gov/pubmed/12184359.1
www.ncbi.nlm.nih.gov/pubmed/22001122.1

If you're concerned about your daughter having these vaccines then I would suggest you speak to your GP about them, they should be able to discuss the pros and cons of this, and maybe hypothesise about the source of the facial tics, etc. I hope they will be able to put your mind to rest, or at least give you some more information on which you can base your decision.

A good source for reading more about the PCV vaccine is here: www.ovg.ox.ac.uk/pcv

In my opinion, the benefits of giving the vaccine would outweigh the cons, but as I said, I think a thorough discussion with your GP would be a good idea - and I don't know your personal circumstances.

I hope this has answered a few questions you may have had. If you have any more I will do my best to answer them.

All the best!

honeybee93 Tue 05-Jan-16 09:35:08

Thank you very much BranTurner for replying to my message - I really appreciate your time writing back to me.

Thank you for the links. There are conflicting view points with this as I came across this after reading the articles you sent me:

www.ncbi.nlm.nih.gov/pubmed/21568886

My concern is, that I have read Aluminium is processed differently by the body when it is injected rather than consumed (see below) and can be very toxic especially in infants. I am worried that my daughter's tic may have been caused by this build up of Aluminium from her 2,3,4 month vaccines.

"Generally, when medication and nutrition are administered orally, the gastrointestinal tract acts as an efficient barrier to the absorption of aluminum, and relatively little ingested aluminum actually reaches body tissues. However, parenterally administered drug products containing aluminum bypass the protective mechanism of the gastrointestinal tract and aluminum circulates and is deposited in human tissues." www.fda.gov/ohrms/dockets/98fr/oc0367.pdf

Would you agree with this? It seems people know aluminium is toxic but not sure how much could possibly cause damage? I appreciate your comment about seeing the GP, however in my experience our GP has very limited knowledge on vaccination concerns and would always advise to have the recommended vaccinations, rather than look at the child as an individual.

It is such a worry as I am just as concerned about the disease as I am about the vaccination, so it makes for a very difficult decision.

Thanks again for taking the time to reply.

BranTurner Tue 05-Jan-16 11:37:17

Thanks for the reply.

As I'm sure you know: not all articles are equal! I've tried to read the full-length article that you linked, however, I would have to purchase it (usually we can access it through university subscriptions). I've read the abstract and I agree that aluminium, in high doses, can be dangerous as can all other metals in the body. Unfortunately, the abstract does not provide much data, so it's difficult to come to a reasonable assessment of their argument. I think the fact the abstract opens with "experimentally demonstrated neurotoxin" might be a good indicator that they're slightly biased. I would generally advise that you look at reputable organisations and their opinions (i.e. WHO, FDA, NHS, etc.) as they assess the studies produced and give unbiased conclusions.

In regards to your comment about being unsure about the level of aluminium that is harmful; there's an up-to-date study of aluminium pharmacokinetics following infant exposure to aluminium through diet & vaccination here. This article, accepted by the FDA concluded that the benefit of having vaccines outweighs the theoretical risk and that the risk to infants from aluminium is "extremely low."

The WHO also concluded that levels of aluminium in vaccines was below the safe level: www.who.int/vaccine_safety/committee/reports/Jun_2012/en/

It's important to note that aluminium in vaccines is injected once, dealt with by the body, and then excreted. Aluminium in foods is continually processed and absorbed, albeit in small amounts. As such, the maximum safe dose of aluminium in water/diet is lower than the maximum safe dose of aluminium in vaccines.

The pharmacokinetics (how the drug is dealt with by the body) of aluminium does differ between oral and IM/IV (intramuscular/intravenous) administration. When taken orally (i.e. through diet) only 0.3% of the aluminium is absorbed through the GI tract. When injecting vaccines the GI tract is bypassed, so all of the aluminium in the vaccine is present in the bloodstream/the tissue surrounding the injection site. However, 95% of this aluminium becomes bound to transferrin and albumin (proteins found in blood) which are then dealt with by the kidneys and excreted. Extremely little aluminium is retained within the body. Practically negligible amounts.

If you have any more questions/I've missed anything/I've been unclear please let me know. This is proving to be useful for expanding my knowledge of aluminium use in vaccines!

bruffin Tue 05-Jan-16 11:46:25

Tolmonic and shaw are notorious for their badly researched papers.

bruffin Tue 05-Jan-16 11:53:04

tomljenovic paper seriously flawed

honeybee93 Tue 05-Jan-16 19:05:34

Thank you very much for your reply and for including those links. I know it sounds very cynical of me, but I am not sure how much I trust NHS, WHO - as I don't think they would admit to there being a problem with Aluminium in vaccines as it would cause them too many problems .. though that might not be a fair assumption.

Yes it is tricky to work out which articles are the ones we should be paying attention to. Thank you bruffin for posting that link.

With regards to your comment about it being excreted, do you know how long it takes for it to be excreted after vaccination? I have read in the below article that it can stay in the body for up to 1 year, which is worrying. It's a very long article: (I have searched for the word 'injection' which helps get through it quicker!)

www.ncbi.nlm.nih.gov/pmc/articles/PMC2782734/

My fears are that because there is aluminium in the 5 in 1 infant jab (which infants have 3 times), the PCV (x3) and Men C (x1) that infants will be absorbing an enormous amount which then perhaps won't be excreted efficiently enough as their immune system and kidneys haven't fully matured? So will linger and cause problems in the body, such as in the brain. (As it crosses the blood / brain barrier).

I read somewhere that it is worse than Mercury in vaccines. I get the impression that know one really knows yet, and to change the formulation of these vaccines would be expensive and time consuming. So they leave Aluminium in them.

When we were kids, we would have had Alum in vaccines, but far less of them. Now my daughter will have had 25 vaccinations by the time she is 15 months (If I do go ahead with these boosters) And most of these contain Alum.

honeybee93 Tue 05-Jan-16 19:07:44

P.S Interestingly Prevenar 13 is the most reactionary vaccine given in the schedule. According to MedAlert in the USA, since 2010 there have been over 120 deaths reported to VAERS in children under 3 and over 200 serious incidents.

BranTurner Tue 05-Jan-16 20:23:29

I'm unfortunately not sure how long it takes to be excreted. But considering a large amount is bound to albumin/transferrin I would assume not too long - the kidneys are very efficient!

It should be noted that storing aluminium in the body is not problematic - dietary aluminium can be stored too. It's mainly stored in the lungs, brain & bones, with, if I recall correctly, more being stored in the bones. But, again, the doses are so low that it won't cause any pathologies. I think it needs to be said that low levels of aluminium within the body are not problematic or toxic and will not cause any ill-health.

The amount of aluminium salts (which is the form aluminium is present in within vaccines) present in vaccines is below 2 milligrams, with less than a milligram of aluminium being present. (http://www.ovg.ox.ac.uk/vaccine-ingredients#aluminium). The amount of aluminium given in vaccines is well below the minimal safe dose for aluminium of 1mg/kg/day.

Aluminium is present for a good reason - it prolongs the immune response to ensure that the vaccine is as effective as possible. The diseases that could be contracted without immunisation are far worse than the mild side effects that can be experienced with vaccines (e.g. mild fever, etc.).

Does the VAERS report give the children's medical history? Some children may have had underlying illnesses. There are a lot of factors which are usually not revealed in reports. You also have to take into account the sheer number of people receiving this vaccine.

In regards to Prevnar 13, I think you have to decide whether the possible side effects of the vaccine outweigh the prevention of pneumonia infections.

BranTurner Tue 05-Jan-16 20:30:19

In response to the lack of a matured immune system - the immune system doesn't have much of a role to play in the excretion of aluminium from the body, and their kidneys will be able to handle the excretion of aluminium. At this point she will already be excreting dietary aluminium and other toxins.

As mentioned in my previous post, the lingering of aluminium within the body isn't much of a problem due to the majority of it being excreted, and the low dosage.

Sidge Tue 05-Jan-16 20:44:57

www.ovg.ox.ac.uk/vaccine-ingredients

You may find this reassuring. There is no evidence that the aluminium used in vaccines is harmful. I understand your caution considering your daughters issues but you have to balance that with the risk of pneumonia etc.

She will have already had 2 doses of Prevenar but would benefit from the booster dose over the age of one.

The NHS spends a lot of time and money on vaccinations for babies and children and has a very thorough review committee to constantly evaluate the cost/benefit of the U.K. Programme. I am confident that they wouldn't be vaccinating millions of children if they thought the vaccines were harmful as potential liabilities would be catastrophic. Anecdotally, I've vaccinated thousands of children with Prevenar and am not aware of any reported significant averse events related to the children I've vaccinated.

honeybee93 Tue 05-Jan-16 21:01:43

I think there is 125mcg of Aluminum in Prevenar - would that be a safe amount? I'm not sure how that works out with the minimal safe dose of 1mg/kg a day that you mention? (Maths is not my strong point!)

I think with the 5 in 1 DTap it's anywhere up to 625mcg depending on brand.

With regards to VAERS - there is a mix of medical history and no medical history, some children are said to be healthy, but others with medical issues. But you're right, a lot of people around the world receive this vaccine.

May I ask - what is the difference between Aluminium Phosphate and Aluminium hydroxide? I know it's phosphate which is in the PCV. Based on what you know as you obviously have a great deal of knowledge about this - would you not be worried about Aluminium in Vaccinations?

Thanks again for your help and giving me your insight into this, I really do appreciate it.

honeybee93 Tue 05-Jan-16 21:06:45

Thank you Sidge - that is encouraging to know you haven't come across any adverse effects, and I do appreciate that the NHS have this in the schedule for a very important reason.

I suppose because I am aware that tics are neurological I do feel very nervous about giving her another dose of PCV. She also had terrible reflux (GERD more specifically) after her vaccines where she was throwing up 30 times a day for 9 months. Plus eczema, so I'm just wondering if it's all related.

BranTurner Tue 05-Jan-16 21:11:13

625mcg = 0.625mg and 125mcg = 0.125mg. So a child weighing 5kg (11lbs) has a maximum safe dose of 5kg x 1mg per day, so 5mg per day. Which is well above the amount of aluminium in vaccines.

With VAERS we also have to take into account the difference between the health systems. In the US, for example, some people may be more reluctant to get any side effects of vaccines seen by a doctor due to the financial implications. There are a lot of variables involved.

Aluminium phosphate (AlPO4) and aluminium hydroxide (Al(OH)3) are two aluminium salts; basically, just aluminium stuck to some other elements. The physical difference between the salts is the compounds they're 'stuck' to - in the case of aluminium phosphate, the aluminium is stuck to a phosphate group; in the case of aluminium hydroxide it's stuck to three hydroxide groups. I'm not sure what the functional difference is, but they are both present to slow the release of the active part of the vaccine when it's injected, this just helps the vaccine work more efficiently.

BranTurner Tue 05-Jan-16 21:18:29

Sorry - I missed a bit.

I would not be worried about the level of aluminium in vaccinations. I think the immunisation against disease outweighs the potential side effects. I would like to add that I completely understand why you're cautious, and maybe slightly worried, about giving your daughter this vaccination - and I don't think you should feel bad about it. If nothing else, it definitely shows you care!

honeybee93 Tue 05-Jan-16 21:24:50

Thank you for explaining the Maths - that's very helpful, and thanks too for explaining the differences between them both.

I found this abstract after my last post. I'm trying to understand it, and I'm wondering whether the Alum goes to these organs in the order that it mentions? (kidney > spleen > liver > heart > lymph node > brain). Though I am assuming it doesn't if it gets excreted by the kidneys straight away?

www.ncbi.nlm.nih.gov/pubmed/9302736/

Thanks again for explaining this - I hope I'm understanding it all correctly!

BranTurner Tue 05-Jan-16 21:40:46

Okay, so I'll break it down:

Aluminium hydroxide (AH) and aluminium phosphate (AP) adjuvants, labelled with 26Al, were injected intramuscularly (i.m.) in New Zealand White rabbits. Blood and urine samples were collected for 28 days and analysed for 26Al using accelerator mass spectrometry to determine the absorption and elimination of AH and AP adjuvants.

So this part is pretty self-explanatory. They infected two different aluminium salts (AH and AP) intramuscularly into some rabbits. One group of rabbits were injected with AH, the other group with AP. They took blood and urine samples from each rabbit for 28 days and looked how much aluminium was present in them.

26Al was present in the first blood sample (1 h) for both adjuvants.

After one hour aluminium was present in the blood for both the AH and AP group.

The area under the blood level curve for 28 days indicates that three times more aluminium was absorbed from AP adjuvant than AH adjuvant.

When injecting AP more aluminium is absorbed than when injecting AH. This is important because it shows that the two salts are handled differently by the body.

The distribution profile of aluminium to tissues was the same for both adjuvants (kidney > spleen > liver > heart > lymph node > brain).

So, with both salts the aluminium was distributed in the same places. The most was found in the kidneys, less in the spleen, then the liver, then heart, lymph nodes and then the least aluminium was found in the brain.

This study has demonstrated that in vivo mechanisms are available to eliminate aluminium-containing adjuvants after i.m. administration. In addition, the pharmacokinetic profiles of AH and AP adjuvants are different.

This just summarises the study. It's saying that there are bodily mechanisms present that can remove aluminium after injecting it into the muscle. The body also deals with AH and AP differently.

Sidge Tue 05-Jan-16 21:40:57

I understand, I really do. My middle child has a genetic disorder with neurological and metabolic elements. For me, it was even more crucial to vaccinate her against everything possible as I felt she needed all the help she could get. She still got pneumonia at age 3 and nearly ended up in PICU but spent 10 days in critical care instead. I nearly lost her for the third time since her birth. I can't help but wonder what would have happened if she hadn't been immunised, I know it's speculative but you do think that way.

Please try not to get too hung up on micrograms of aluminium absorption and consider the bigger picture. Make sure she eats well, gets fresh air, has her immunisations, everyone washes their hands and you cuddle her often!

BranTurner Tue 05-Jan-16 21:41:45

Sorry, that's a little hard to read. I'll bold it instead.

Aluminium hydroxide (AH) and aluminium phosphate (AP) adjuvants, labelled with 26Al, were injected intramuscularly (i.m.) in New Zealand White rabbits. Blood and urine samples were collected for 28 days and analysed for 26Al using accelerator mass spectrometry to determine the absorption and elimination of AH and AP adjuvants.

So this part is pretty self-explanatory. They infected two different aluminium salts (AH and AP) intramuscularly into some rabbits. One group of rabbits were injected with AH, the other group with AP. They took blood and urine samples from each rabbit for 28 days and looked how much aluminium was present in them.

26Al was present in the first blood sample (1 h) for both adjuvants.

After one hour aluminium was present in the blood for both the AH and AP group.

The area under the blood level curve for 28 days indicates that three times more aluminium was absorbed from AP adjuvant than AH adjuvant.

When injecting AP more aluminium is absorbed than when injecting AH. This is important because it shows that the two salts are handled differently by the body.

The distribution profile of aluminium to tissues was the same for both adjuvants (kidney > spleen > liver > heart > lymph node > brain).

So, with both salts the aluminium was distributed in the same places. The most was found in the kidneys, less in the spleen, then the liver, then heart, lymph nodes and then the least aluminium was found in the brain.

This study has demonstrated that in vivo mechanisms are available to eliminate aluminium-containing adjuvants after i.m. administration. In addition, the pharmacokinetic profiles of AH and AP adjuvants are different.

This just summarises the study. It's saying that there are bodily mechanisms present that can remove aluminium after injecting it into the muscle. The body also deals with AH and AP differently.

BranTurner Tue 05-Jan-16 21:44:17

I wholeheartedly agree with Sidge. Focus on cuddling, not absorption and bioavailability of aluminium - that's for us boring people to deal with!

honeybee93 Tue 05-Jan-16 21:51:40

Gosh, thank you so much both BranTurner and Sidge, you've been so helpful.

BranTurner: thank you for breaking down that study for me - that makes much more sense! You have been so kind to help me like this - I have felt so alone in all of this research and worry. I've been feeling ill with anxiety over it! Before Christmas I had finally decided on giving the single measles vaccine (which I still haven't given as I am unsure) as had done months of research about the MMR, and since then I've been panicking about the Prevenar and Menitorix as she is already 15 months and I hope I haven't left it all too late if I want to stagger them all.

Anyway, you are right Sidge - plenty of good food and love is definitely a good place to start. I'm sorry to hear what you went through with your daughter - it must have been terrifying to go through that, and so often. I hope she is doing well now.

honeybee93 Tue 05-Jan-16 21:57:13

I wish I knew half as much as you do about this all, it would make decisions such as this much easier. Trying to interpret these studies is tricky! You're right though, I've been getting caught up in the nitty gritty. A few weeks ago I was panicking over the differences / disadvantages of chick cells or human diploid cells in the single measles vaccine and it was all too much.

BranTurner Tue 05-Jan-16 22:00:30

No problem! I've learned a lot myself. If you have any more questions about this or any other medical topics (or computer related stuff, that's another one of my interests) feel free to message me and I'll do my best to answer them. I definitely think vaccines are the way to go. If you get time/remember let me know what you decide to do, and how your daughter gets on!

The measles vaccine is very safe, very effective (I had one not too long ago before going on immunosuppressants) and worth having. Measles isn't a great thing to have!

honeybee93 Tue 05-Jan-16 22:04:27

Thank you so much! I appreciate that and I will of course let you know how she gets on. I'd like to just get this decision out of the way, especially that I've read vaccinating after 16 months can increase the risk of febrile seizures.

May I ask - which measles vaccine did you have? Rouvax or M-Vac? Yes I've read that Measles can cause some very nasty complications.

Sidge Tue 05-Jan-16 22:04:31

Thank you, she is a tough cookie and we've come a long way. She'll be 12 soon smile

As well as being a mum of 3 I'm a practice nurse of 16 years (and have been a nurse for 23) and have vaccinated thousands of babies, and cared for many children. I honestly haven't come across any who have suffered serious ill effects from vaccines, but have come across some damaged by diseases such as measles, whooping cough, meningitis and pneumonia. I truly believe vaccination is a public health revolution and whilst I acknowledge that there are a few children who should not be vaccinated the vast majority benefit far more than they risk.

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