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SIDS and Seizures

© Harris L. Coulter PhD

Another article on the SIDS-vaccination relationship, fortunately of far superior quality, is Larry J. Baraff, Wendy J. Ablon, and Robert C. Weiss, "Possible Temporal Association Between Diphtheria-Tetanus Toxoid-Pertussis Vaccination and Sudden Infant Death Syndrome." (Pediatric Infectious Diseases 2:1 [January, 1983], 7-11). The authors adopted a simpler, intuitively obvious method of investigation and concluded that there is, indeed, a "temporal association" between the DPT shot and sudden infant death.

They found that 382 cases of SIDS were recorded in Los Angeles County between January 1, 1979, and August 23, 1980, and they simply interviewed the parents of 145 of these cases, either in person or by telephone. They asked: 1) the baby’s sex, 2) the age at death, 3) the last visit to a physician or nurse prior to death, 4) the date of the last vaccination, 5) the name and telephone number of the physician or nurse, and 6) the type of immunization given.

They found a statistically significant excess of deaths in the first day and the first week after vaccination, i.e., a "temporal association."

They rejected the use of a "control group," and instead relied on the intuitively obvious assumption that "there should be no temporal association between DPT immunization and SIDS were there no causal relationship between these two events." I have not found any criticism of this article for relying on “anecdotal evidence.

This study was not financed by the US Government but apparently by the UCLA School of Medicine and the Los Angeles County Department of Health Services.

Another respectable study of the SIDS-vaccination connection is "Diptheria-Tetanus-Pertussis Immunization and Suddent Infant Death Syndrome" by Alexander M. Walker, Hershel Jick, David R. Perera, Robert S. Thompson, and Thomas A. Knauss, published in the American Journal of Public Health 77:8 [August, 1987], 945-951.

This study supports a link between the DPT shot and “sudden infant death syndrome. The authors examined the records of all children born in the Group Health Cooperative of Puget Sound between 1972 and 1983 to see how many had died of SIDS. Total births recorded during this period were 35,581, but of them only 26,500 were eligible for the study. Not all deaths of infants during this period were considered to be SIDS. All deaths which on the basis of death certificate diagnosis, hospital discharge data, and pharmacy use taken together could be clearly ascribed to causes not related to immunization were excluded.” Ultimately, “SIDS was defined as any death for which no cause could be discerned among infants of normal birthweight and without predisposing medical conditions. But, despite these exclusions and restrictions, the authors found “the SIDS mortality rate in the period 0-3 days following a DPT shot to be 7.3 times that in the period beginning 30 days after immunization.

They called the results of this study “worrisome” but consoled themselves with the thought that “only a small proportion of SIDS cases in infants with birthweights greater than 2500 grams could be associated with DPT.” A particular criticism to be made of this study is that children with “predisposing medical conditions” were excluded and their deaths were not considered to be SIDS, whereas in actuality children with “predisposing medical conditions” are routinely vaccinated.

Another study by the same group, of "neurologic events" following vaccination, is slightly more ambiguous than the preceding one but nonetheless raises a red flag about vaccines. Alexander M. Walker, Hershel Jick, David R. Perera, Thomas A. Knauss, and Robert S. Thompson. "Neurologic Events Following Diphtheria-Tetanus-Pertussis Immunization."(Pediatrics 81:3 [March, 1988], 345-349) was an investigation of the same 35,581 children, born between 1972 and 1983, as in the previous study. The attempt was made to identify "new neurologic conditions" in this group, not by interviewing the families, as might have been expected, but by examining hospitalization records and prescription records for the drugs typically used to treat seizures. Since the pharmacy was “on line” only on July 1, 1976, any drug purchases made prior to that date by families who left the Group Health Cooperative before July 1, 1976, would have been missed, as well as “any child neither hospitalized not treated with drug therapy.

Also excluded from the study were children with “uncomplicated first febrile seizures, because these “are not likely to have been hospitalized or treated with drugs.

Also excluded from the study were children whose first seizure occurred prior to 30 days of age -- presumably because no vaccinations were given in the first 30 days of life (although this is not stated).

Also excluded from the study were children in the category “seizure with possible predisposing cause, such as "trauma, asphyxia, congenital malformation, disorders of metabolism, birth weight less than 2500g, central nervous system infection, and neonatal sepsis."

Also excluded were children for whom it was not possible to identify from the available records a clear date of onset of illness.

Ultimately, the group was reduced by 25% -- to 26,600. Of course, when studies such as this exclude whole categories of children -- presumably those who are particularly vulnerable to vaccine damage -- the question immediately arises whether the study is truly a representative sample, since in the “real world” all of the above excluded categories are routinely vaccinated. And if the sample is not “representative,” the study itself has no predictive value.

The authors found 239 seizures without an apparent predisposing cause among the children in the target population. One case, in particular, is worth describing: “The single seizure that occurred within three days of a DPT was in an 11-month old white girl who suffered a 2 ½ hour generalized tonic-clonic seizure on the evening of her third DPT-oral poliovirus vaccination. Her temperature during the seizure was 39 degrees C. (102.2 degrees F.). Results of CSF studies were normal. There was a transient left hemiparesis and right sixth nerve paresis. She was treated with phenobarbitol. At 6 years of age, while still taking phenobarbitol, she was experiencing rare focal left-sided seizures in the absence of fever and continued to have abnormal EEG tracings.

However, this and the other 238 cases were explained away by the authors as part of the “expected incidence” of seizures in this population, a "background incidence", as it were.

If a "background incidence"is stipulated, one would assume that it had been ascertained in a non-vaccinated population. Instead, somewhat surprisingly, the "background incidence"is defined as the incidence in the vaccinated population later than 30 days after a vaccination. The assumption seems to be that any seizure provoked by a vaccination will necessarily occur within the first 30 days after a vaccination; those occurring later than 30 days post-vaccination are thought to be God-given, a part of Nature, as it were. However, there is no evidence for this.

No study of natural seizure incidence, or natural crib-death incidence, in an unvaccinated group of Americans has ever been performed, as far can be determined. Mass vaccination began in the late 1940s, and the medical establishment became concerned about vaccine damage only in the 1970s. Thus they were vaccinating children for over thirty years before they got interested in statistical comparisons; today it is difficult or impossible to locate a group of unvaccinated children sufficiently large to have any statistical value.

Also there seems to be the feeling that not vaccinating a child is “unethical,” and that medical research should not venture into “unethical” areas. If that is how they feel, well and good, but they then should not discourse glibly about the “background incidence” of this or that disease or neurologic condition.

These sorts of unfounded assertions about the “natural” or “background” incidence of seizures or other kinds of vaccine reactions bedevil nearly every study of this subject.

Another trick used by the medical establishment to manipulate public opinion is to cite some study as supporting its arguments when, in actuality, the study came up with contrary conclusions. Sometimes one finds a conflict within the article itself -- for instance, the summary or the abstract will make claims which are not supported in the body of the article. Both of these criticisms can be levelled at: W. Donald Shields, Claus Nielsen, Dorte Buch, Vibeke Jacobsen, Peter Christenson, Bengt Zachau-Christiansen, and James D. Cherry. “Relationship of Pertussis Immunization to the Onset of Neurologic Disorders: a Retrospective Epidemiologic Study.” J. Pediatrics 1988; 113, 801-805.

This, conducted in Denmark, was of two groups of children who received pertussis and other immunizations at different ages, to see if this affected the dates of onset of neurological conditions. Before April, 1970, Danish children got the DPT shot (together with the Salk polio vaccine) at 5, 6, 7, and 15 months of age. After this date children received the monovalent pertussis vaccine at 5 weeks, 9 weeks, and 10 months of age, and the diphtheria, tetanus, and Salk polio vaccines at 5 months, 6 months, and 15 months. At the time of the change the potency of the pertussis vaccine was reduced by 20%, and the aluminum adjuvant (a frequent cause of reactions) was removed.

This study compared 82,518 births in the 1967-1968 period with 73,390 in the 1972-1973 period.

Records of all hospital admissions for seizure disorders and related conditions were examined and “patients whose cases were appropriate for the study were entered into the computer data base. This is the first criticism to be made: the authors do not give further information on the criteria of inclusion.

The authors found that the incidence of neurological diseases increased with the new vaccine schedule: epilepsy went from 0.35% (286 cases) to 0.37% (268 cases); febrile convulsions went from 1.01% (830 cases) to 1.87% (1369 cases), and central nervous system infections rose from 0.16% (136 cases) to 0.29% (214 cases).

This could not have been a very welcome finding, and it had to be explained away somehow.

Take CNS infections, which almost doubled . The authors write: “there was no relationship between the time of the scheduled administration of pertussis vaccine” and these infections, whereas the accompanying table shows that there was a relationship. They then state that it "appeared to represent a change in the referral pattern"but gave no further details. Furthermore, in the "Discussion" section at the end, the authors went from “appeared to represent” to “was due to”: “for CNS infections the change in rate was due to a change in referral patterns.” This appears to be simple prevarication.

The same occurred with respect to epilepsy. The authors write: “there was no relationship between the age of onset of epilepsy and the scheduled age of administration of pertussis vaccine,” whereas the table on the very same page shows that there was such a relationship.

With respect to febrile seizures, they admitted a statistical correlation between the occurrence of first febrile seizures and the scheduled date of pertussis vaccination (p = 0.004). This occurred at the time of the third shot in the 1967-1968 cohort and the fourth shot in the 1972-1973 cohort. They note: “Thus at each period after the usual age of onset of febrile seizures, there was a significant increase in the incidence of febrile seizures in the group receiving pertussis immunization ... 5.9% of all children who developed a first febrile seizure between 28 days and 24 months of age had it as a consequence of fever caused by pertussis immunization.

Then they soften the impact of this finding by claiming: "The majority of convulsions that occur within a few days of pertussis immunization are febrile seizures and therefore are only rarely associated with long-term seizure disorders." What does "only rarely" mean?

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