Last week, I posted an article on the controversy over the vaccination of children, specifically regarding the MMR (measles, mumps, rubella) vaccine. The piece generated several comments, but one of them, by Donna Cusano, was very thoughtful, though mistaken. It deserved to be quoted and responded to here.

“I have been surprised by how young vaccination is done conventionally–when immune systems may not be fully developed–and how many are given at once. This may not be an ‘either-or’ situation, as in ‘all vaccines bad’ or ‘good’, or thimoseral, but that we are not giving them in the correct sequence or age. Using some logic here…Vaccines are supposed to create an immune response, and logically, if the immune system is underdeveloped, you’re not going to get the right response. (The same reason why flu vaccines are ineffective in many elderly–their immune system just isn’t responding.)

Where is the research on whether we are giving vaccines to children too early or in combinations that are overwhelming to the child’s immune system (especially stacked in one)? This may affect children in brain development, they may have a genetic marker that makes them sensitive to certain vaccines given too young (their immune system), or in combination. In other words, their immune systems can’t handle them and it sets up a chain reaction that compromises their development.

There are too many children out there who’ve been affected negatively by vaccines (as in sudden autism). If I had a child, I would want to give that child multiple vaccines separately and at a later rather than earlier age, so that the immune system would be more fully developed–and responsive. I would be looking back at practices from several decades ago as to timing and age.

Before you dismiss me as a crank, I work in the health tech field and with broader healthcare issues as a writer. I’m no Luddite, but I think this possibility has not been thoroughly researched, especially with the advances in genomics in recent years. It’s a shame it’s been politicized with pressure from the Feds, the states, pediatricians, and pharma companies to stack more vaccines and give them very early to children.

Donna, your questions reflect the doubts and suspicions harbored by the great majority of what I call vaxx-nervous (mothers wringing their hands in anxiety) and vaxx-skeptic, to distinguish from the anti-vaxx ideologues who “deeply believe”, and no facts can induce them to use their prefrontal cortex in place of their amygdala. The latter is beyond rational persuasion. But for the open-minded, as a science writer like you ought to be, there is a comprehensive article that will answer your questions/doubts/suspicions. To answer the specific concerns you raised, here are some real facts.


The immune response in infancy is NOT immature.

Neonates develop the capacity to respond to foreign antigens before they are born. B- and T-cells are present by 14 weeks’ gestation and express an enormous array of antigen-specific receptors. The reason they don’t respond to them is straightforward—they haven’t been exposed to them. They are “naïve”, in immunological lingo, but they lose their “innocence” very quickly after exposure to the specific antigen for which they were predestined to respond. In fact, neonates are capable of generating both humoral and cellular immune responses to pathogens at the time of birth.

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Active immunity in the newborn includes the full range of B-cell responses including the production of IgM, IgG, and secretory and monomeric IgA, as well as the development of helper T-cell (Th) and cytotoxic T-cell responses. In addition, neonates can produce specific Th-cell subsets, including Th1-type cells that participate in cell-mediated immune responses and Th2-type cells that are primarily involved in promoting B-cell responses.

Forgive me if I am getting too technical here, but as a science writer, you might find it useful in researching your articles on the subject.


“Overwhelming” the immune response is almost impossible

Studies on the diversity of antigen receptors indicate that the immune system has the capacity to respond to extremely large numbers of antigens. Current data suggest that the theoretical capacity determined by diversity of antibody variable gene regions would allow for as many as 10 billion to 1 trillion (!) different antibody specificities. Admittedly, this is just the theoretical limit.

A more practical way to determine the diversity of the immune response would be to estimate the number of vaccines, rather than antigens, to which a child could respond at one time. Using this approach, each infant would have the theoretical capacity to respond to about 10,000 vaccines at any one time (obtained by dividing 107 B-cells per mL by 103 epitopes per vaccine). Most vaccines contain far fewer than 100 antigens (for example, the hepatitis B, diphtheria, and tetanus vaccines each contain 1 antigen), so the estimated number of vaccines to which a child could respond is conservative. Of course, we don’t even have that many vaccines. But using this estimate, one would predict that if 11 vaccines were given to infants at one time, then about 0.1% of the immune system would be “used up”. However, because naive B- and T-cells are constantly replenished, a vaccine never really “uses up” a fraction of the immune system. For example, studies of T-cell population dynamics in HIV-infected patients indicate that the human T-cell compartment is highly productive. Specifically, the immune system has the ability to replenish about 2 billion CD4 T-lymphocytes each day. Although this replacement activity is most likely much higher than needed for the normal (and as yet unknown) CD4 T-cell turnover rate, it illustrates the enormous capacity of the immune system to generate lymphocytes as needed.

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As if this enormous capacity is not enough, a group of European scientists recently published, in the well-respected Science Magazine, a paper shedding light on another dimension of the immune response—its plasticity. Specifically, the various T-cell lymphocytes perform their functions via cytokines, each having its own profile of these cellular hormones. As the paper demonstrates, depending on need, T-cells can shift the mixture of the cytokines they secrete, thereby amplifying or reducing the intensity of the response. (Very reminiscent of the nervous system, by the way.) So the suggestion of “overwhelming” this system is simply not credible.


Combination vaccines DO NOT overwhelm or weaken the immune response

If vaccines overwhelmed or weakened the immune system, then one would expect lesser immune responses when vaccines are given at the same time as compared with when they are given at different times. However, this has been shown not to be the case. Specifically, many combination vaccines have been shown to induce similar humoral immune responses when given at the same or different times: I will quote only one, MMR and varicella, but a cursory examination of the pediatric or vaccine literature will show you a whole raft of them.


Bottom line

The immune response has an enormous capacity to respond to any antigenic challenge presented to it. It cannot be overwhelmed or weakened, even in infancy. This is not based on government or pharmaceutical dark conspiracies; it is based on science. And yes, Donna, the research has been done, including the most modern techniques of epidemiology, immunology, and molecular biology.

So, how do you explain the popularity of the anti-vaxx movement in affluent enclaves? In my personal opinion, it only proves that you can be rich, highly educated, and “misinformed” or “under-informed” (euphemisms, some say) at the same time.


P.S. Hot off the press

This is from the Washington Post:

German health authorities reported on an outbreak in January of 254 cases of measles in Berlin and Brandenburg (the area around Berlin). Is it due to low vaccination rate?

…according to the World Health Organization, Germany already has one of the world’s highest immunization rates among 1-year-olds with 97%—compared to the United States with 91 percent. So where do all the new cases come from?

German experts say that one-third of all vaccinated German children either lack a sufficient immunization (which usually requires a second dose), or are vaccinated too late.

Do we need “more studies”?

Dov Michaeli, MD, PhD
Dov Michaeli, MD, PhD loves to write about the brain and human behavior as well as translate complicated basic science concepts into entertainment for the rest of us. He was a professor at the University of California San Francisco before leaving to enter the world of biotech. He served as the Chief Medical Officer of biotech companies, including Aphton Corporation. He also founded and served as the CEO of Madah Medica, an early stage biotech company developing products to improve post-surgical pain control. He is now retired and enjoys working out, following the stock market, travelling the world, and, of course, writing for TDWI.


  1. Dov, this is a ton of great information and based upon it, I’m sure it is valid for MOST children–and adults. But if “The immune response has an enormous capacity to respond to any antigenic challenge presented to it. It cannot be overwhelmed or weakened, even in infancy.” please explain allergies and negative reactions to vaccines. Explain auto-immune diseases where that enormous capacity turns upon a healthy body.

    It smacks of ‘one size fits all’. And you know that is not true with any vaccine, any drug, any food. Vaccines have lists of side effects, don’t they? That means that subjects–perhaps outliers–had a problem.

    Where’s the real challenge? Screening for those children who won’t react well to a particular vaccine, or combination vaccines. Determining if spacing out or maturity is a better practice. Refining practices and application instead of sitting on our hands and accepting it as ‘settled doctrine.’

    Vaccines do work for the majority–but the future of medicine, at least in one view, is personalization and optimization based on genomics and metabolics. And ignoring that refinement is not helping the case for vaccination.

    • I also object strongly to being typed as a ‘vaxx-skeptic’. You’ve set me up as a straw man and I do not accept that. As I said in my comment to the earlier article, this is not an ‘either-or’ situation. How do we make vaccines work better in the population (including spacing out or booster doses, determining individual best age, adult immunization)? How do we optimize results and minimize side effects? In other words, where’s the personalization?

      A far larger problem we have is with illegal immigrants who have had NO immunizations, and that we either can’t find or don’t screen for immunization.


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