By Stephanie Cave, MD, FAAFP

With Deborah Mitchell

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This is an essential guide for parents about vaccinations. Dr. Stephanie Cave explains their pros and cons and the book provides information to help parents make a knowledgeable, responsible choice about vaccinating their children.


Copyright © 2001 by Stephanie Cave, M.D.

All rights reserved.

Hachette Book Group

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First eBook Edition: September 2001

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ISBN: 978-0-446-53597-7

Book design by Charles S. Sutherland

Cover design by Christine Van Bree


• How are vaccines linked to increases in asthma, juvenile diabetes, attention deficit disorder, sudden infant death syndrome (SIDS), and learning disabilities?

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• Must every girl routinely get a shot for mumps, when the major threat—sterility—affects boys more often?

Don't take risks with the health of your children! Learn more about today's most common vaccinations with...

Author's Note

The information contained in this book is not intended to be a substitute for medical care and advice. You are advised to consult regularly with your physician about matters relating to your health (or with your pediatrician regarding matters relating to your child's health), including matters that may affect decisions as to whether, when, and in what form to administer vaccinations. In particular, if you are pregnant or have any other special condition requiring medical attention, you should consult with your physician.

As for legal issues, this book is sold with the understanding that the author and publisher are not engaged in rendering legal or other professional advice. Laws and practices often vary from state to state and at the federal level; if legal assistance is required, the services of an attorney should be sought.

The identity of some of the patients referred to in this book, and certain details about them, have been modified.

The information provided in this book is based upon sources that the authors believe to be reliable. All such information is current as of December 2000.

This book is dedicated to my husband, Donald, my sons and their wives, Chris and Shannon, Michael and Amy, Patrick and Annah, my grandchildren, Ramsey, Logan, Brennan Lee, and Liam, and to all the precious children in the autism spectrum and their families, who hold a special place in my heart.


I wish to express my gratitude to my associate, Amy Holmes, M.D., whose ideas have added so much to my work; to Sherry Blackwell, my office manager, who unselfishly has given her time whenever needed, and to all of our staff who have worked endless hours in the care of the children in our practice. I also want to thank my family, colleagues, and friends who have encouraged me to complete this book, Deborah Mitchell for her determination and dedication in the process of preparing the text, and Father Mario Termini, who has sustained us with his prayers.

I also wish to express my sincere gratitude to Barbara Loe Fisher for her help in obtaining information vital to the manuscript; and to Dr. Bernard Rimland, who started the quest for safer vaccines when he realized the possible connection for autistic children.

Finally, to Congressman Dan Burton, who has worked tirelessly to make vaccines safer for all children, I extend the gratitude of many parents and professionals.


Back in the middle of the twentieth century, the concept of mass immunization sounded like a good idea: We had deadly childhood diseases, we were developing vaccines that could prevent them, therefore, let's immunize all children so they won't get those diseases. And to make sure all, or nearly all, children were immunized, we made the shots mandatory.

And as the number of polio cases declined dramatically until they were nearly nonexistent, and as the number of children with measles and mumps and diphtheria and whooping cough dropped lower and lower, doctors and parents and health officials nodded and said, job well done.

But beginning in the early 1980s, some parents and medical experts in the United States and elsewhere around the world noticed what appeared to be a connection between serious adverse health effects, including death, and vaccines. As the years passed, more and more parents, doctors, and even government officials began to see an alarming increase in the number of children with autism, learning disabilities, attention deficit disorder, juvenile diabetes, rheumatoid arthritis, sudden infant death syndrome (SIDS), asthma, and other medical conditions.

Their suspicions grew, as did the number of vaccines given to children. Whether vaccines are completely or partially the cause of the health issues named, or whether they have no role at all, has not yet been determined scientifically, but one thing is definite: Parents are concerned and confused about vaccines. That concern and confusion prompted many parents and dedicated medical professionals to raise their voices in protest against unsafe vaccines, and those voices have finally prodded health and government officials to take action. In 1986, Congress passed the National Childhood Vaccine Injury Act, which officially acknowledged that vaccine injuries and deaths are real.

As a family practice physician, I was prompted into action myself around 1997, as more and more autistic children showed up in my office. Although the children came from different social and family environments, their histories were the same in one frightening way: They had all been healthy and developing normally—physically, emotionally, and mentally until age fifteen to eighteen months. Then, the parents reported, their once happy, friendly babies disappeared, as if their inner spark had gone out. Suddenly the children lost speech, would not maintain eye contact, were highly sensitive to touch and noise, and were intentionally injuring themselves. The parents were horrified and frightened. And I did not know what to tell them.

But then as I studied the medical charts, I realized that all the children had one thing in common: All of them had deteriorated within weeks of receiving several vaccines simultaneously. It was then that I began to document my cases and read about other similar instances reported by doctors around the world. I discovered I was not witnessing an isolated pocket of cases where I practiced in Baton Rouge, Louisiana, but that I was verifying a phenomenon that was happening around the globe.

When word got out that I was investigating the relationship between vaccinations and autism, I was inundated with phone calls, letters, and e-mails from the United States and overseas. Most of this correspondence was from parents—parents who were scared and wanted answers. I had none to give them...but I was determined to try.

Autism used to be a rare condition, affecting 1 out of 10,000 infants. Now in some states it is diagnosed in 1 out of every 150 children. Between 1992 and 1997 the incidence of autism increased more than 300 percent. Can these increases be blamed on better diagnostic testing or coincidence? I doubt it. But I needed to know the answer.

I've never considered myself to be a maverick or the type of person who goes looking for conspiracies. As a young girl in school I loved science and medicine, and my fascination with these subjects carried over to Louisiana State University, where I majored in medical technology and then taught for eight years. Along the way I got married and had three sons... and also got a master's degree in clinical chemistry. Then at age thirty-six I took the plunge: I enrolled in Louisiana State University Medical School and fulfilled my dream of being a doctor.

Now I find myself delving into the intriguing and disturbing world of vaccinations, and like the parents of autistic children who come to see me, I want answers, too. These parents did what they'd been told to do: They got their children immunized. If they had had any concerns about vaccines, if they had heard or read about the reports of autism or other problems some children were experiencing, including seizures, muscle diseases, and brain inflammation (encephalitis), they were often told by their doctors that there was nothing to worry about, and that they should consider themselves lucky to be living in a time when vaccinations are available.

But a glaring bit of evidence indicating that that luck was going to run out came on October 23, 1999. A front-page story in the New York Times revealed that the rotavirus vaccine was being recalled because it had been linked to a painful and potentially deadly bowel obstruction. It was the first time a vaccine had been withdrawn from the market because of serious side effects. But will it be the last?

No one, myself included, is suggesting that we stop all vacci-nations and return to the days when the United States was plagued with smallpox, polio, diphtheria, and whooping cough. However, I, along with a growing number of doctors, researchers, and medical professionals, believe we cannot turn a blind eye to the rise in chronic childhood medical conditions that parallels the increase in mandated vaccinations, which dramatically increased vaccination rates.

We also cannot ignore hospitalizations, injuries, deaths, and serious health problems following vaccinations that are reported to the Federal Vaccine Adverse Events Reporting System (VAERS), an entity that records such adverse events. Unfortunately, it is common knowledge that less than 10 percent of all adverse events following vaccinations are reported to VAERS, which means that instead of the 12,000 to 14,000 reports of hospitalizations, injuries, and deaths made every year, there may be as many as 120,000 to 140,000.

Can such a huge number of serious health problems following vaccinations be ignored? Can they be dismissed with the standard answer parents get when they ask about vaccine safety: "Don't worry. Vaccines are safe"?

Parents do worry, and there are many indications that they have every reason to. So shouldn't parents be allowed to review the benefits and risks of a given vaccine and then decide whether the vaccine should be given to their child?

This question raises the issue of who has the right to decide what is an acceptable risk for a child—parents or the government and big business. Vaccine manufacturers, federal health officials, and doctors admit that all vaccines carry a risk of injury and death, but they also dismiss those concerns by saying that side effects are usually mild, that serious reactions are extremely rare, and that the risk of getting the disease is much greater than the chance of suffering a serious reaction.

Why are doctors and health officials afraid to let parents make decisions about their child's vaccinations? Some of them claim that many parents would then not vaccinate their children at all, which could lead to a reemergence of such deadly diseases as polio and whooping cough, perhaps resulting in epidemics that might kill tens of thousands of infants and children.

I think this reason is unrealistic. I believe that the vast majority of parents want safe, effective vaccines supported by reliable scientific research. They also want to know the truth about the vaccines they are considering, things like:

• Why newborns are given hepatitis B vaccine even though there is little risk of the disease for the child.

• Accurate incidences of side effects for all vaccines.

• Which vaccines can be delayed or eliminated.

• Whether combination vaccines like MMR (measles, mumps, rubella) can be given individually.

Parents are usually told the benefits of vaccines, but what about the risks or other unpleasant facts? Here are a few things you may not know about vaccines:

• Some vaccines contain poisons such as mercury, aluminum, and formaldehyde.

• In 1998 the French government suspended school-based vaccination programs giving hepatitis B vaccine to school-age children because a case of multiple sclerosis was linked to the vaccine and more than six hundred cases of immune and neurological conditions were also reported.

• Some vaccines are made using human tissue from aborted fetuses.

• Most states require that by the time a child is five years old, he or she must receive thirty-three doses of ten vaccines.

• Doctors report less than 10 percent of the adverse events associated with vaccines and/or occurring following vaccinations to the Vaccine Adverse Events Reporting System (VAERS), charged with accumulating and tabulating these vaccine adverse events.

• In all states parents can seek a medical waiver to exempt their child from mandated school vaccinations, and in some states they can also file a philosophical or religious exemption.

I'm not saying that doctors and others involved in the vaccine industry withhold information about vaccines because they don't care about children. But I do believe that part of the reason these individuals are afraid to let parents decide about vaccinations is economics: Vaccines are big business. An international high-technology research firm, Frost & Sullivan, predicted that the global human vaccine market would increase from $2.9 billion (1995 figure) to more than $7 billion by the year 2001.

There's much we don't know, but this much I am certain of: Parents who blindly listen to their doctors can no longer afford to do so. It's time for parents to ask questions and learn all they can about vaccines before a shot is scheduled.

This book represents part of my quest to get answers for myself and for parents. It is divided into three parts to make the journey easy. Part One discusses background and basic information about vaccines in general and some of the medical conditions associated with them. Chapter 1 explains the history of vaccines, what they are, how they work, and possible side effects. Chapter 2 explores vaccine safety, including how vaccines are tested, types of side effects, and ingredients found in vaccines. In chapter 3 you will learn about the controversy surrounding the use of mercury (thimerosal) in vaccines and how concerned individuals are working to get it removed from all vaccines. Chapters 4 and 5 discuss the most common medical conditions associated with vaccine use, including autism and other neurological disorders such as learning disabilities and attention deficit disorder; and autoimmune disorders, including diabetes, asthma, rheumatoid arthritis, and others.

Part Two consists of eight chapters. Chapters 6 through 11 explore each of the mandated vaccines individually, in the order in which they are typically given to children: hepatitis B, DTP/DTaP (diphtheria, tetanus, pertussis), Hib, polio, MMR (measles, mumps, rubella), and varicella (chicken pox). Each chapter explains the benefits and risks of the vaccine, the disease(s) it is designed to prevent, the side effects, who should and should not get the vaccine, and unique features, risks, or other information about the vaccine.

In chapter 12 you will read about some of the other vaccines on the market that you or your child may be asked to take (including flu, pneumococcal, meningococcal, hepatitis A, and other vaccines), or may soon be required to take. Chapter 13 introduces you to the vaccines of the future. These are vaccines that are under development, some of which are slated for children. These include vaccines for sexually transmitted diseases and cancer, as well as edible vaccines.

Part Three provides some tools for parents. Chapter 14 explains parents' rights, including information about a nationwide registry that will track children's medical (and vaccine) history, and how parents can apply for medical, religious, and philosophical exemptions. Chapter 15 provides parents with checklists of questions to ask themselves before their child gets a vaccine, questions to ask the doctor before a vaccine is given, and steps parents can take to modify reactions to vaccines. The final chapter covers the Vaccine Adverse Events Reporting System (VAERS), which provides information on how to report an adverse event and how to apply for compensation if a child is injured by a vaccine.

For ease of reference, some information is repeated throughout the book. Consult with your doctor, and don't skip chapter 15—specifically the precautions that can be taken when you vaccinate your child. There are things you can do the day before, the day of, and the day after your child's vaccination that some doctors may not tell you about.

Vaccines have accomplished more than we ever dreamed they would. But we must not get so caught up in the dream that we refuse to wake up to certain realities about those vaccines when it comes to safety and effectiveness. All children deserve a healthy, safe childhood, and parents should be allowed to make informed decisions about their children's vaccine needs. I pray that this book helps parents make those decisions and leads them to other reliable sources in their search for the truth about vaccines as more research and information becomes available in the media.

Part I


Chapter 1

The Story of Vaccines

PERHAPS YOU'VE SEEN THE BUMPER STICKERS THAT SAY "QUESTION Authority." Well, that's what's happening today with the increasing number of parents who are questioning the safety, effectiveness, and even the necessity of the vaccines being given to their children and required by state law. Parents—and perhaps you are one of them—are questioning health-care providers, state health officials, and each other about immunizations. They are forming and joining action groups so they can learn more, and do more, about vaccine policies in the United States.

Next to the Question Authority sticker should be another one that says "Knowledge Is Power." It's not a good idea to question authority when you don't know what you're talking about, because it won't help you accomplish your goals. And when the goals are safe health care and a healthy life for your children, the stakes are too high for you to miss the mark.

This chapter introduces you to the information you'll need to help you understand the world of vaccines and how they can affect you and your children. It explains what vaccines are, types of vaccines, how they are developed, and how they affect the immune system. You will also learn the answer to the question "Do I have to vaccinate my child?" as well as how to use the rest of this book to answer this question for each of the vaccines required by law and for those that are not.


Today's parents are primarily concerned about the ten vaccines now recommended by the federal government and mandated by the states. That is not to say there is no controversy surrounding other vaccines, like those for influenza, Lyme disease, and hepatitis A. And there are dozens of other vaccines on the horizon, a future you may need to consider if you are a parent or grandparent. These other vaccines are covered in chapters 12 and 13. For now, however, here are the ten that are mandatory in most states:

• Hepatitis B—the first vaccine children are typically given

• DTaP—diphtheria, tetanus, pertussis (whooping cough), which is the newer form of the DPT (DTP) vaccine (see chapter 7 for details)

• Hib—Haemophilus influenzae type B

• Polio—the inactivated polio vaccine, or IPV, is the injected form of the polio vaccine, which as of January 1, 2000, was recommended over the oral polio vaccine (OPV) (see following and chapter 9 for more details)

• MMR—measles, mumps, and rubella combination vaccine

• Varicella—chicken pox


A vaccine is a substance that attempts to protect people against disease. To do that, vaccines are made from the virus or other pathogen (germ) that causes the disease the vaccine is designed to fight. You might say a vaccine uses fire to fight fire: A little bit of the pathogen is specially prepared and usually injected into the body so it can help fight off any "wild," or naturally acquired, versions of the disease. The purpose of that fight is to develop immunity.

The body has a complex system, called the immune system, that has procedures for producing and maintaining immunity. We can avoid long explanations by saying that when you get, say, a cold or flu virus or a bacterial infection, your body responds by producing substances called antibodies, minute protein molecules that fight against (anti) the foreign bodies (the viruses, bacteria). When you recover from the illness, your body retains some of those antibodies so it is ready to fight off the infection should it appear again. This is called immunity.


Natural: Natural immunity is gained when viruses or bacteria (pathogens or antigens) enter the body, cause a disease, and the disease progresses normally. During the disease process, the body produces antibodies and disease-fighting cells, resulting in a natural immunity that is usually permanent.

When a child is naturally exposed to, say, the measles, the immune system responds immediately. Various immune system cells begin to weaken and eliminate the invading pathogens and send signals to other cells in the system, triggering them into action. Depending on the strength of the immune system, the body will reduce or even eliminate the disease before the symptoms show. In fact, experts have shown that the frequency of asymptomatic (having no symptoms of disease) infections outnumber clinical illnesses by at least a hundredfold, simply because the immune system has tremendous natural abilities to fight disease.

Vaccinated: Vaccinated immunity is artificial and often temporary. When vaccines are injected into the body, they bypass many of the body's initial immune system defenses. In a sense, the vaccine, along with the toxic additives in the solution, is thrust into the body unannounced. This "surprise" forces the body to overcompen-sate by producing more disease-fighting cells than it normally would if the infection were natural. This over-stresses the body in two ways—it not only overproduces immune system cells, it must also fight the infection (introduced by the vaccine), along with the chemicals and other additives in the vaccine. (These additives are discussed in chapter 2.)

Which is better, natural or vaccinated immunity? The answer may be a little of both. In any case, in order to find out, the least we (parents, researchers, medical professionals, lawmakers) should do is take a close look at the current immunization schedule, each of the vaccines, and the research on the pros and cons of arbitrarily immunizing all children. Currently, most children are subjected to vaccinations beginning at birth or at two months of age, long before the immune system is ready to even begin to respond. Is this practice safe or wise? Are there alternatives? I believe there are, and it is my hope that you will find some alternatives for yourself in this book.

The main purpose of a vaccine is to stimulate the formation of antibodies at a concentration high enough to stop the pathogen in its tracks, and thus prevent those who get the vaccine from getting the disease. As long as you maintain a certain concentration for a specific disease, you have immunity.

Immunization is no guarantee that your child or you will not get the disease. A small amount of the infectious agent can get past the antibodies and cause individuals to experience some mild symptoms, or occasionally even worse effects of the disease. (More on this topic in subsequent chapters.) However, in most cases, the vaccine prevents more serious symptoms from occurring. An up-to-date list of the vaccines recommended by the U.S. government and mandated by the states can be seen at or downloaded from www.aap.org/family/parents/immunize.htm. An in-depth explanation of each of these vaccines can be found in chapters 6 through 11. Included in these explanations is the Vaccine Information Statement, or VIS. A VIS is an information sheet, produced by the Centers for Disease Control and Prevention, which informs vaccine recipients or their parents or legal guardians about the benefits and risks of the vaccine. Doctors are required by law to distribute a VIS for all mandated childhood vaccines.


Infants come into the world with antibodies they have gotten from their mother through the placenta. Infants who are breast-fed continue to receive many important antibodies in the colostrum (the thick, yellowish premilk that is secreted during the first few days after a woman gives birth) and breast milk. Commercial infant formulas, although inferior to mother's milk, also provide essential nutrients for infants' health.

During the first year of life, the immunity an infant gets from its mother at birth wears off. To help boost the fading ability to fight certain diseases, vaccines are given. The idea behind vaccines is to provide just enough of the disease-causing substance to trick the body into producing antibodies against it. Once the antibodies are produced, they stay around, protecting the child against the disease they were designed to fight. Some vaccines provide this protection for life after just one or two shots; others require additional "boosts" of immunity.

The problem many doctors and parents have with vaccines given during the first few months of life is that an infant's immune system cannot adequately respond to a vaccine until he or she is four to six months old. That's not to say that vaccines should not be given to children. They do save lives. However, I believe we need to look not only at the timing of these vaccinations—when they are given and how many are given at one time—but also at the ingredients in them and the dangers they may cause.


Vaccines have traditionally come in two basic forms: dead (inactivated or killed) or live. The vast majority of both forms are delivered one of two ways: via injection under the skin (subcutaneous) or into the muscle (intramuscular). (Polio and typhoid vaccines are also available in oral form.) In some cases, both live and killed vaccines are available to treat the same disease.

A third type of vaccine, the recombinant DNA vaccine, is the product of genetic engineering. It is the newest form but there are remaining questions about safety and efficacy.

Live Vaccines


  • "A MUST READ... An important resource that respects parents' intelligence and encourages them to be equal partners with doctors in deciding which vaccines their children should get and when they should get them. DR. CAVE'S TOPS ON REDUCING VACCINE RISKS WILL SAVE LIVES."
    --Barbara Loe Fisher, cofounder and president, National Vaccine Information Center

On Sale
Mar 16, 2010
Page Count
368 pages

Stephanie Cave, MD, FAAFP

About the Author

Stephanie Cave, MD, is a family practitioner in Baton Rouge, LA, who specializes in children with autism and related disorders. She has been featued on CNN, has testified in congressional hearings, and frequently speaks around the world on the topic of children and vaccinations.

Learn more about this author