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The Chiropractic War
Shot in the arm: the chiropractic dispute over childhood vaccinations
Transcript of Broadcast: Jan 20, 2004
Who hasn't heard the media message to get a flu shot? After SARS, a lot of us are pretty scared of getting sick. But not everyone. Some people are more concerned about the risk of severe side effects from getting vaccinated.
They're arguing that children should not be vaccinated for anything - not measles, whooping cough, diphtheria, not even polio.
The anti-vaccination movement has many in the mainstream medical community concerned. They point to cases like Nigeria, where polio is making a huge comeback amongst a largely unvaccinated population - religious leaders there have warned that the vaccine can transmit other diseases and viruses, including HIV.
And health officials also point to the UK, where measles recently surfaced in large numbers as more and more people opted not to vaccinate.
In North America, the vaccination debate is strong amongst some chiropractors. One regulatory body has proposed tough new rules to prevent chiropractors from offering advice on vaccination.
This week, Marketplace looks at the chiropractic dispute over childhood vaccinations.
Ted Koren is an American on a mission - to warn people of what he calls the dangers from childhood vaccinations. He's not a disease specialist or a doctor.
He's a chiropractor.
Koren believes chiropractors should be telling their patients to stop vaccinating their children.
He took that message to a conference in Quebec City recently. Koren is so busy on the lecture circuit, he barely has time to treat people anymore.
"We have a whole generation of neurologically damaged kids as a result of vaccination; autism, ADD, ADHD, hyperactivity, all these kids on Ritalin, asthma, allergies barely known before vaccination," Koren told Marketplace.
"Itís an explosion of these diseases since vaccination. And the more you vaccinate, the more you get these kids with these problems."
Koren is not alone in proselytizing against vaccinations. In Kingston, Ontario, we met another chiropractor who has been active in the anti-vaccination movement. Martha Collins makes no bones about her stance being controversial.
"I know this sounds wacko. It sounds wacko from the perspective that for fifty years weíve vaccinated our children. For fifty years weíve relied on this as our main line of defence. And thatís why we want to ensure that people make an informed decision about it."
Among Collins' patients are hundreds of children and some babies - like 18-month-old Ethan McKeown, in for an adjustment while his mother, Dyan, got a refresher on the vaccination debate.
"He was four days old when he had his first adjustment. Dr Martha actually came to our home and adjusted him here. And I can see the immune boost in him," Dyan McKeown said.
Dyan decided to listen to her chiropractor and not her family doctor on the topic of vaccination.
The Canadian Medical Establishment says the risk of serious side effects from vaccinations is tiny compared to the threat diseases like measles, mumps, and rubella can pose.
Major medical associations are big supporters of vaccinations. Health Canada calls the anti-vaccination movement misleading. The Canadian Chiropractic Association also supports childhood vaccination. It says the issue is outside the scope of a chiropractor's training.
Jason Busse agrees with the association. He's a medical researcher who has published studies on chiropractors and the anti-vaccination movement. He's annoyed by claims such as increasing rates of autism are linked to childhood vaccination.
"The reality is there have been very large comprehensive studies looking at hundreds of thousands of children that have had vaccines, looking to see if thereís any higher rates of autism in those groups than in children that have never had the vaccine and there simply isnít. So thereís no evidence to support the view. I donít know why certain chiropractors feel compelled to provide information on this treatment."
Busse is concerned about much of material the anti-vaccination movement relies on for information, including videos where parents - but rarely doctors - talk about serious conditions they believe were caused by vaccines.
"It gives a very, very small part of the overall picture," Busse said. "Itís like describing the entire airline industry based on one airplane crash."
Martha Collins told Marketplace there are more reasons than health care behind movements to vaccinate.
"I think thereís a huge economic issue here, I really do. And I am not speaking as a chiropractor, but I am speaking as Martha Collins, that the relationship between the health care system and the pharmaceutical companies is so greatÖ"
Ted Koren agrees.
"Itís in their interest, to tell people to vaccinate. The medical edifice is built on vaccination and medical procedures."
Medical researcher Jason Busse doesn't buy that argument.
"To suggest there is a conspiracy involving every physician, all medical associations, all nursing associations, every company thatís involved in every stage of vaccine development or manufacturing is I believe a gigantic leap of faith. And one that simply is not supported by any information that has been objectively acquired out there."
At a London, Ontario, high school, students recently were given a booster for pertussis - or whooping cough. The disease can cause brain damage in the most severe cases. Last year, there were nine cases in the city - and at least one was a student who had not been vaccinated.
Mary Ann Simpson, a public health nurse, spoke to the mother and doctor involved. She believes a chiropractor had some influence on the decision not to vaccinate.
The mother first agreed to talk to Marketplace, but then changed her mind, saying her boss - a chiropractor - had told her not to talk about the vaccination issue.
Simpson says part of the problem is many young people have never seen disease.
"They think that because it's gone, we don't have to worry about immunizing. We have to keep our immunization rates high in a community because we could get disease back and we know from our recent experience with SARS how fast a disease can arrive in another country."
Before the polio vaccine in 1955, polio in Canada was so feared it closed schools, emptied streets and kept kids from churches and theatres.
The fear of disease recently returned to the United Kingdom. There was an outbreak of measles after the anti-vaccination movement led to a big drop in vaccinations, which led to a big increase in measles.
In Russia, they're dealing with a bout of diphtheria - and there's been a major outbreak of polio in Nigeria, partly because significant parts of the population have chosen not to vaccinate.
"What we see is the disease rates go right back up as soon as the immunization rates go down," Busse said. "Then when immunization rates are brought back up to where they should be, and people pursue the vaccine again, the disease rates go down. So we have very good natural experiments that you could never do ethically but that have happened all around the world in many different countries."
Busse's worried about a trend he discovered at Canadian Memorial Chiropractic College, where almost three-quarters of Canadian chiropractors are trained. A couple of years ago, Busse decided to get a chiropractic license. He also did a scientific study and found that the percentage of students who bought the anti-vaccination argument was quite small at first. But that changed the longer the students were at the school.
"In first year it was fairly small, around 4 per cent," Busse said. "In second year, it was around 8 per cent. In third year, it was closer to 16 per cent, and in the fourth or final year it was up around 29 per cent. I was shocked. Weíre not taught to administer it, weíre not taught to manage it in any practical or clinical way."
The school's president says the anti-vaccination view is not supported at the school. Despite that, Ted Koren was invited to speak at the college recently.
"I think it says we have academic freedom in this institution," Jean Moss said. "As with any post-secondary institution at any university, I am sure there are speakers who come that the administration would prefer donít, but students have the right to bring people in and listen to their ideas. And what we hope to do is to teach students to be able to critically appraise those ideas."
The anti-vaccination movement among chiropractors has become such an issue that a provincial regulatory body is clamping down. The College of Chiropractors of Ontario is proposing new legislation that says chiropractors are not trained in vaccination and that they should not - in their professional capacity - be expressing views about it.
The move has created a stir among Ontario chiropractors.
"The [college is] being totally hypocritical," Ted Koren said. "They should keep their nose out of that business. I told Ontario chiropractors to start writing letters to the College, to protest this abridgment of their own freedom of speech."
Martha Collins wrote in to complain.
"There are more chiropractors than I would have thought who are questioning this with our College."
But Jean Moss, the college's president, insists most chiropractors are pro-vaccination.
"You know, I think that thereís a small vocal minority that perhaps hold those views. I donít think itís the majority of chiropractors at all."
If the new regulation is approved, Ontario chiropractors could be charged with misconduct and lose their license for up to five years for offering any advice on vaccinations.
As the rules now stand, Collins is allowed to offer information, as long as she gives both sides.
"I give them the websites of the best information thatís possible out there on both sides, not just on one side, but on both sides of the issue."
We asked Jason Busse to evaluate the websites Collins recommends.
"The Chiropractic Awareness Council tends to represent a fairly strong anti-vaccination stance," he said. "Life University actually recently was in danger of having its license revoked by not having their students taught the required information that the governing body deemed necessary to graduate. And the Vaccine Risk Awareness Network also has very negative views towards vaccination. I would say in sum total, the majority of these sites that do have relevance to vaccination speak more towards negative views."
Collins says while her opinion may be not to vaccinate, she can't tell her patients that. But they may understand that's how she thinks.
Back in Quebec City, Ted Koren wraps up his presentation to a conference of chiropractors, with a sales pitch: buy his lecture kit for $400 US. Koren says the kit will quickly pay for itself because using it to deliver just a few anti-vaccination lectures will bring in more patients.
He finds six takers - more chiropractors ready to join the anti-vaccination lecture circuit.