Vaccinate Preterm Infants – Don’t believe the “whistleblower”

Vaccinate Preterm Infants – Don’t believe the “whistleblower”

I was reluctant to wade into what has in the past been a quagmire. The anti-vax (or as some like to be called vaccine-risk aware” movement pops up from time to time with sensational claims. Let me state as well up front that I do not believe those who are anti-vaccination are bad people or poor parents but I do believe that they are unfortunately susceptible to false claims. They want to believe and defend their position so badly that when articles come out suggesting there is conspiracy at work they are really hard to ignore. The one that caught my eye today was a piece from the website Vaccine Impact called “Nurse Whistleblower Confirms NICU Pre-term Babies Being Injured by Vaccines“.

Given that I work in this field and myself have ordered thousands of vaccines for preterm babies over the years I wanted to check it out and see where this claim is coming from.

Who doesn’t love a credible witness! The “whistleblower” in this case is a neonatal nurse who retires due to her inability to continue seeing preterm babies “injured” by vaccines! This person is clearly “in the know” and should be trusted. She is on the inside and has the “evidence”. Interestingly the news story is coming out now yet her claims are from back in 2015. Here is what she said.

“I’ve sat in a room with our on-call staff of physicians and practitioners (when they say) “Oh wow, this is so embarrassing this 25 weeker never actually required a breathing tube and going on the vent after he was born, he was so strong. But we gave him his two month vaccinations and he got intubated last night ha ha, oops how embarrassing. The step-down units are calling the NICU’s and saying “hey we’re going to go ahead and give these four babies their two month shots today, make sure you have beds ready because we all know they’re going to have increased breathing difficulties, feeding and digestion difficulties, apnea, and bradycardia. This is what goes on.”

Does this happen?

It may happen that an infant has increased numbers of bradycardias and apneic events after vaccination. This was shown in the large research study that the article quotes. The article is quick to point out this part of the conclusion from the paper.

“All ELBW infants in the NICU had an increased incidence of sepsis evaluations and increased respiratory support and intubation after routine immunization. “

What did the authors of this anti-vaccination piece leave out (I am sure it was intentional).

  1. The title of the article is completely misleading as it says “pre-term babies”. Preterm babies run the gamut from 22 weeks to 36 weeks and from 400+ grams to 3000g or so. The research that the author is quoting is the following paper. Adverse Events After Routine Immunization of Extremely Low-Birth-Weight Infants. It is right in the title. We are talking about ELBW infants and not all preterm infants. ELBW infants are under 1000g at birth so it is a very select group of infants.
  2. Who was affected by vaccination in this study of 13926 ELBW infants? The greatest impact was in the infants born at 23 to 24 weeks and a prior history of sepsis evaluations where it was found that they had an increased rate of intubation and sepsis evaluations after vaccination. If you look at prevalence of such babies the 23 and 24 week infants would be only a tiny number of babies per year. In our instititution we would see less than 10 compared to about 1500 babies born prior to 37 weeks. It is completely irresponsible to generalize the findings to all “preterm babies”
  3. Overall the following findings were identified. Infants had a higher incidence of sepsis evaluations (adjusted rate ratio [ARR], 3.7; 95% CI, 3.2-4.4), need for increased respiratory support (ARR, 2.1; 95% CI, 1.9-2.5), and intubation (ARR, 1.7; 95% CI, 1.3-2.2) in the 3 days after immunization relative to the 3 days before immunization. These rates are still VERY low.

The conclusion that anti-vaccine article didn’t want you to see

Right after the part of the conclusion that was quoted in the article supporting this “whistleblower” commentary the authors of the JAMA Pediatrics paper concluded with this statement.

Our findings provide no evidence to suggest that physicians should not use combination vaccines in ELBW infants.

Responsibile Reporting

Can very fragile babies get a septic work-up after a vaccine? Absolutely! Working in the NICU for nearly 20 years I can tell you that the babies who we worry about the most do get more evaluations for sepsis and may get intubated more readily. The issue is that if there are even mild deteriorations in an infant who was already on the cusp of being intubated or worked up for sepsis it takes very little to tip the scales and do such a workup. What is the evidence presented in the anti-vaccination piece that injury has occurred to these infants? Nothing. Just the words of a nurse who believes this to be the case. Those who don’t want to vaccinate will embrace articles like this and hold them close and use the word conspiracy to suggest that what I have written here is just all part of the game that doctors are playing.

Let me put it plainly though.

I have seen injury from hemophilus influenza type B, steptococcus pneumoniae and neisseria meningititis among other infectious disease. Meningitis and pneumonia are real and and preventible with vaccination. These are real injuries and can threaten the life of a child. The minimal increase risk of sepsis evaluations and potential intubation for babies born under 1000g is well worth the risk.

Vaccines work.