It has been alleged by Great Minds such as Jenny McCarthy that the US recommends far more vaccinations than other countries.  Her precise statement was, “How come many other countries give their kids one-third as many shots as we do?” She put this into the context of wondering if our current vaccine schedule should be less rigid.  The entire piece was filled with what could charitably called less-than-truthful assertions, but examining simply this one assertion might be useful.  Dr. John Snyder has an excellent analysis of the most important assertion, that of the possible benefits of an “alternative vaccination schedule”  which I would encourage you to read.

First, we need to parse out this “more shots than everyone else” statement.  Some countries–Haiti, for example–give far fewer vaccines due not to fewer recommendations but to adverse economic conditions. Because of this, they have very high rates of vaccine-preventable diseases.  They want to vaccinate more, but can’t.  Then there are countries who can afford to vaccinate. Let’s look at what three industrialized nations recommend before six years of age.

Vaccinations, by disease and country, 0-6 years of age

Vaccine France Germany USA Iceland
Hepatitis B Yes Yes Yes No
Rotavirus No No Yes No
Diphtheria, tetanus, and pertusis Yes Yes Yes Yes
Hib Yes Yes Yes Yes
Pneumococcus Yes Yes Yes No
Polio Yes Yes Yes Yes
Influenza Not reported Not reported Yes No
Meales, mumps, rubella Yes Yes Yes Yes
Varicella No Yes Yes No
Hepatitis A No No Yes No
BCG (disseminated TB) Yes No No No
Meningococcus No Yes For some Yes

The chart, as I’ve presented it, is somewhat imprecise.  Some vaccinations are given in a single shot, others in multiple shots, but these generally represent the childhood vaccinations in each country, and the links provided will take you to the more detailed information.

If I understand Dr. McCarthy correctly, she is using the alleged difference in national vaccine recommendations to show that it is safe to vary vaccination schedules by some method or another.  I would not disagree: vaccination schedules should not be immutable but should (and do) change based on available evidence. But changes should not be based on one or another person’s “feelings”.

The other implication is that other countries, by having one-third fewer vaccinations (sic), will have lower rates of autism.  She bases her assertions about international vaccination rates and autism on a report self-published by her anti-vaccination group Generation Rescue.  In this screed, they allege that the number of “mandatory vaccines” are much greater in the U.S. (there are no “mandatory” vaccines in the US, only those that are recommended or those required for various jobs or schools).  It’s not clear to me how they arrive at their numbers.  Perhaps they count the total number of vaccinations given for each disease (i.e., each DPT counts as three vaccinations, given five times for “15 vaccinations).  Using this method, by my count France “mandates” 35 vaccinations by year six (they report 17) and the U.S. has 36, as they reported.  But this isn’t the counting method they say they used.  In the footnotes they say that:

All vaccine schedules are as of 2006. Some countries use combination vaccines. All schedule counts have been
normalized to compare to the US schedule. For example, if a country uses an MMR-Varicella combination vaccine, it
counts as “2” vaccines.

The report then goes on to try to link these supposedly vastly different vaccine schedules to supposedly vastly different autism rates in the EU vs. the U.S. (If you understand their “methods” better than I do, feel free to explain in the comments.)

European autism statistics are scarce, but high end estimates place them at up to 63/10,000, or 0.9/150, compared to a US estimate of 1/150.  This is hardly a smoking gun, and the “study’s” so-called multipliers are simply error multipliers, given the large range in prevalence estimates.

Jenny McCarthy’s senseless ramblings on health are based on more formal senseless ramblings from a special interest group whose “special interest” appears to be the promotion of infectious diseases.

Posted by Peter Lipson

Peter A. Lipson, MD is a practicing internist and teaching physician in Southeast Michigan.  After graduating from Rush Medical College in Chicago, he completed his Internal Medicine residency at Northwestern Memorial Hospital. He currently maintains a private practice, and serves as a teaching physician at a large community hospital He also maintains appointments as a Clinical Assistant Professor of Medicine at Wayne State University School of Medicine and at Oakland University William Beaumont School of Medicine, the first being a large, established medical school, the latter being a newly-formed medical school which will soon be accepting its first class of students.  He blogs at White Coat Underground at the Scientopia blog network. A primary goal of his writing is to illuminate the differences between science-based medicine and everything else.  His perspective as a primary care physician and his daily interaction with real patients gives him what he hopes is special insight into the current "De-lightenment" in medicine.  As new media evolve, pseudo-scientific, deceptive, and immoral health practices become more and more available to patients, making his job all that much more difficult---and all that much more interesting. Disclaimer: The views in all of of Dr. Lipson's writing are his alone.  They do not represent in any way his practice, hospital, employers, or anyone else. Any medical information is general and should not be applied to specific personal medical decisions.  Any medical questions should be directed to your personal physician.  Dr. Lipson will not answer any specific medical questions, and any emails and comments should be assumed public. Dr. Lipson receives no compensation for his writing. Dr. Lipson's posts for Science-Based Medicine are archived here.