I went to school with Dr. Hilary Andrews. She graduated before me, but I recall her then—she had a reputation for brilliance (and was voted class valedictorian, incidentally). Hilary applied that brilliance to childhood health and nutrition, which inevitably included investigation around vaccine safety. Flash forward to current time, Hilary continues to research and lecture extensively on the topic of immunization. She’s developed a number of CE courses available for clinicians.
Make no mistake: Dr. Andrews recognizes the profound benefits of immunization-from the virtual elimination of polio, to the exciting work in cancer. However, Dr. Andrews also recognizes among other things, that one immunization schedule does not fit all. And that optimizing baby’s health, including supporting immune system maturation, ensuring nutrient sufficiency, and adequate detoxification capacity, is essential to ensure the safest, most effective response.
In this podcast we discuss:
- The public health success story of immunization
- Considering an individualized vaccine schedule
- Considering neuro developmental and immunological factors when designing vaccine schedule for the individual
- Factors contributing to increased susceptibility to infectious disease
- Nutrients essential for preventing and treating infectious disease
- The power of passive immunity and its impact on vaccination
- Age to vaccinate
- Preconception health: GI, vaginal microbiome, nutrient status
- How to use titers when determining the schedule for vaccines.
- We discuss the controversial Mawson paper that looks at the health of vaccinated versus unvaccinated children.
Dr. Hilary Andrews graduated from National College of Naturopathic Medicine with academic honors and was voted valedictorian by her fellow graduating class. Her profound interest in optimizing childhood health and nutrition lead to examining the topic of immunizations. She lectures extensively on the topic of immunizations and has created several continuing education courses on the subject.
Dr. Andrew’s website and training programs:
Post herpetic neuralgia and vitamin C
Mawson et al. Pilot comparative study on the health of vaccinated and unvaccinated 6- to 12-year-old U.S. children
See Dr. Andrew’s comments below responding to challenges made to the Mawson papers (Funded by Generation Rescue, population bias–participants selected from homeschooling groups that are/may be biased against vaccination)
“This is just a start but hopefully it will spur on more studies…. Home-schooled children were chosen because this group is the biggest cohort with both vaccinated and unvaccinated children thereby helping to better match controls for the two groups and rule out other influences for the findings. So while the study does have some limitation I don’t think we should “throw the baby out with the bathwater”, we also have some very important findings here that need further investigation.” Dr.HA
Dr. Fitzgerald: Hi everybody, welcome to New Frontiers in Functional Medicine, I am Dr. Kara Fitzgerald and you know, I’m really honored to be speaking with Dr. Hilary Andrews today. We’re going to be talking about vaccines today, folks. Dr. Andrews has really spent her entire career, actually even as a student, thinking about vaccines and doing a really deep drill down into the science. We are going to pretend we’re in a safe bubble where there’s no controversy and where we can dialogue on this topic as thinking clinicians and researchers, and that’s really where we’re going to address it and Hilary’s going to talk about what she has come to over her decade plus research into this arena.
Hilary also, incidentally, Dr. Andrews gave me the most interesting bio I’ve received yet, so just sit back and listen to this and we’ll jump right into our topic.
I was born at the base of the Canadian Rockies into a family committed to nature and environmental conservation. My parents raised me with a love of the earth and of animals, and it is to that end that I became a naturopathic physician. I graduated from National College of Naturopathic Medicine with academic honors and was voted valedictorian by my fellow graduating class. My profound interest in optimizing childhood health and nutrition lead me to examine the topic of immunizations.
I began exploring this topic in depth eight years ago. Actually longer then that, and soon it became a passion of mine. I recognize the importance of vaccines in certain populations, but struggled with many of the immunization practices currently in place, including the ingredients and manufacturing processes of vaccines, the one size fits all approach and the lack of pediatric developmental consideration in the timing of vaccines. It soon became clear to me that there was a better way to administer vaccines, and so I combined the scientific data regarding vaccines, the science of the body and my strong foundational knowledge of health from my naturopathic education to create a more optimal approach to infectious disease.
Since 2006, I’ve lectured extensively on the topic of immunizations and have created several CE courses on the subject. Most recently I began the most passionate job of my life, that of mommy. My naturopathic husband and I are the proud parents of an energetic, spirited baby boy. His birth has strengthened my determination to help doctors understand vaccines and safer ways to vaccinate. To that end, they can help parents create the happiest, healthiest babies on the planet. I hope that my passion for natural health is purely contagious and that I serve as an inspiration.
Well, welcome to New Frontiers, Dr. Andrews.
Dr. Andrews: Thank you. So happy to be here.
Dr. Fitzgerald: Yeah, and jeez, what a beautiful bio. Oh, interesting. Now as I said, we’re going to just talk about this frankly today. I mean, I remember you from school, you graduated before me, but I remember you were already starting to do the training and I remember you were just one of the bright light, sort of brilliant students at NCNM. I absolutely remember that and I’m just thrilled that you’re willing to jump on.
So, years long research. You do think that vaccines are important for the majority of us. Is that correct? I mean, talk to me a little bit about your background and your thinking around it.
Dr. Andrews: Yes, so we absolutely do know that vaccines have had some pretty profound successes at reducing infectious diseases, so with respect to the controversy of the efficacy of vaccines, vaccines are really actually very effective, with a few minor exceptions. That’s a huge success. We know that MMWR from the CBC has published the results showing from the early 20th century, comparing infectious diseases at that time to infectious diseases now and, of vaccine preventable infectious diseases, and those diseases have significantly reduced. We’ve completely eliminated one, smallpox. We’re very close to eliminating polio from the entire planet. So in that way, vaccines have been incredibly successful.
Dr. Fitzgerald: Yeah.
Dr. Andrews: I mean, there’s a number of things. There’s more and more vaccines for infectious diseases and so, depending on which side you sit on, you would see that as a success or not a success, but we’re certainly seeing more like that. We’re also starting to utilize vaccines in the treatment of cancer, which may ultimately have a very profound effect on the treatment and ultimate cure of cancer.
Dr. Fitzgerald: Clearly there’s no argument here, a) around the power of vaccination, b) around the really remarkable public health feat with regard to vaccines.
Dr. Andrews: Absolutely, incredibly impressive.
Dr. Fitzgerald: Yeah, great. But then we drill down to the individual and we sort of jump ahead to today and what we’re doing, perhaps what’s recommended by the greater medical community today is what we might want to think about, might want to modify, so tell me about, compare and contrast your approach, your thinking around vaccines now, or delivering vaccines to our pediatric population, this patient-centered approach that you call it, with the standard of care.
Dr. Andrews: Okay, very good. Yes, even though I want to acknowledge that vaccines have been hugely effective and successful, they aren’t without their limitations and the limitations are fairly outstanding, but I think with a few tweaks, we could make those limitations, bring those limitations way down. Essentially what I did was really look at the way we currently vaccinate in this country and actually, for a large part, around the world. I found certain things that didn’t quite resonate with me and decided to find ways to change that.
Currently how we do vaccinate, according to the recommendations of the CDC and the State and Local Public Health Agencies, is that there’s a schedule that’s published every year. This vaccine schedule is published through the CDC and it’s those recommended schedules for basically almost every child born in the U.S. and other countries also have their own schedules which are very similar. It takes very little individuality into account. The schedule also doesn’t take into account neurodevelopmental factors and immunological factors into account and no individuality, except for a few very rare instances.
So, essentially the way the schedule is is almost every child in this country can be vaccinated according to this schedule that starts with a vaccine at birth and we end up giving a fair amount, I believe it’s 47 doses of 14 vaccines in a very short period of time, within a five year period. Looking at that and actually when I was in practice, really getting feedback from parents about this feels like maybe too much, maybe it’s too soon, you know we’ve all heard those clichés ‘too much, too soon’, I’m potentially worried about that there may be some negative consequences.
I started really looking at evaluating vaccines on a more individualized basis and looking at the risk of the vaccine versus the risk of the disease and in knowing that, you have to acknowledge that the vaccines, which is a medical modality, do come with a certain degree of risk, as every medical modality does. There’s an acknowledgement that there’s some risk associated with vaccinating and there’s some risk associated with not vaccinating. So then we look at each individual child and we see for each of the different diseases if the risk of vaccinating versus the risk not vaccinating is greater, so what is greater?
Part of how we understand that is to look at what also are the risks of those certain infectious diseases? Because many of the infectious diseases that we vaccinate against really are diseases of susceptibility. If we look at infections, we understand that, I think of infections like an equation, so in order to become infected and develop an infectious disease, you have to have exposure, and you have to have susceptibility. So it’s both exposure and susceptibility that equal infectious disease. We know exposure alone does not equal infectious disease because there can be many people sitting in a room and some of those people in that room will get influenza, the flu, and some won’t.
If anyone has any experience with chicken pox, or some people do chicken pox parties, you’ll know a good 70% of those kids will leave that party not getting chicken pox, so we know that susceptibility also plays a role and those susceptibility factors are actually very, in many of the infectious diseases, are very well studied and are out there in the scientific literature and they’re pretty easy, so we look at those. What makes a child more susceptible to an infectious disease-
Dr. Fitzgerald: Give me some examples, can you? Can you just throw some out there?
Dr. Andrews: Yes, absolutely. One of the easiest examples is haemophilus influenza type B. Haemophilus influenza type B is a bacteria. It has a name that makes you think it’s a virus because in the early 1920s it was thought that it might be responsible for the huge flu, the Great Flu that we had. It turns out it wasn’t, but haemophilus influenza type B is a bacteria and it is at risk of causing meningitis in the young. So kids over six months of age and under five years of age.
It used to at point, be the biggest risk factor for … it was the microbe that caused the most cases of meningitis in this country and so we developed a vaccine for it, but what we know about the risk factors for that particular guy is that lack of breastfeeding and exposure to cigarette smoke are the two biggest risk factors for getting meningitis and in fact, if a child is breastfed and there’s no secondhand smoke exposure, they have virtually no risk of developing haemophilus influenza type B.
Dr. Fitzgerald: Oh, that’s fascinating.
Dr. Andrews: It’s so fascinating. We know immediately who the at risk children are. If a child is exposed to secondhand smoke, if a child is potentially not breastfed, then I can have a conversation with that parent and say, “Your child does have actually some risk factors that might make us feel that the risk of the vaccine is less than the risk of contracting the disease.” Because we don’t want the child to get the disease.
By the way, all of us have had haemophilus influenza infection because we know that by age five, 100% of people have zero converted, so it causes a little mild upper respiratory tract infection. Inevitably we all get exposed, but a very, very, very small percentage of kids, less than 1%, kids who aren’t breastfed and who are exposed to secondhand smoke, their own natural immune system in their nasopharyngeal passage is unable to clear that infection, so that infection is then able to leave the nasopharyngeal passage and enter into the meninges, the lungs, the blood, so it’s biggest thing that it potentially causes is meningitis, sinusitis or pneumonia, depending on where it feeds.
But we know the susceptibility. In fact, breastfeeding is so protective for it. So is Vitamin A and things like that. So in other words, there are things that we can do if a person can’t breastfeed to also reduce susceptibility to it, but that might be a vaccine where I would say, “You know, the risk of this particular vaccine,” because it’s a medical modality that does have some risks, in a child that is breastfed and isn’t exposed to secondhand smoke is actually incredibly small, so we would say, in that particular case, that vaccine may not be needed for this particular child.
And I always let the choice be the parent’s, by the way, so that ultimately we educate the parent and they always get to make the choice, beause it’s a preventative thing, it’s not like the child is presenting with the disease. So in that particular instance, that might be a vaccine that we could skip.
Hepatitis B is another very great example, probably the most common example that I-
Dr. Fitzgerald: Listen, I just want to jump in. We’re going to circle back to Hep B, I absolutely want to hear what you have to say around susceptibility, but I just wanted to circle back for a second, just in case we don’t jump to it later on. Vitamin A. I mean, there’s some pretty cool data around measles prophylaxis and Vitamin A, and you mention it again for H-Influenza, so just thoughts on Vitamin A and it’s value?
Dr. Andrews: Yes. There is a number of different nutrients that play a really significant role in helping the immune system work properly in preventing infectious diseases. I’m going to sort of answer this is a round about way so that you guys really understand that. If we look at the vaccines that we vaccinate for, almost all of them, except for Hepatitis B and tetanus, almost all of them enter the body through either the nasopharyngeal passage or the gastrointestinal tract, right? Almost all of our vaccines that we vaccinate for are either GI diseases like Hep A, rotavirus, polio, or their upper respiratory tract viruses like measles, rubella, haemophilus influenzae, pneumococcal pertussis, things like that.
If we can protect that area through natural immunity, then we have a humongous barrier for preventing infectious disease and there are a number of nutrients that really support that. Vitamin A is one of them. It increases non-specific immunity very, very well and it’s incredibly nutritive to the nasopharyngeal passage. The other thing is that Vitamin A is really used up during a viral infection, so influenza, viral colds, measles, rubella, we know the immune system uses up a huge amount of Vitamin A, so we’ll see significant drops in Vitamin A after a viral infection.
If we can actually give that Vitamin A prior to an infection, or even prior to vaccinating, for example, then we’re giving the immune system already the building blocks that it needs and sort of the arsenal that it needs prior to that infection so that it can work at it’s optimal way. The other piece of what I’m trying to do is optimize the body’s immune system and neurological system to both prevent infections, but also to potentially make vaccines more effective when we’re giving them.
Dr. Fitzgerald: Yes.
Dr. Andrews: Vitamin A play a significant role in that, especially if we can do Vitamin A drops. I really like Vitamin A drops because you’re delivering them right to the nasopharyngeal passage so that, they’re on the tongue for example, so they’re getting right into that mucosa, all of that and then swallowing them, obviously, into the GI tract.
The other thing that can be very powerful is probiotics. Zinc, magnesium, incredibly important. There’s a few things, and I can go over why each of them are so important if you want to go into that, but mainly because they play such a powerful role in either the immune system or our detoxification pathways.
Dr. Fitzgerald: Vitamin D, I’m assuming, is in this picture?
Dr. Andrews: Oh, sorry, absolutely Vitamin D.
Dr. Fitzgerald: Goes without saying.
Dr. Andrews: Yeah, yeah, absolutely. I have a little list that I get parents to do. Vitamin A, Vitamin D, Zinc, Magnesium, Probiotics, and then there’ll be some other things. Those are the ones that we would give almost everyone, for the most part, and then some other things that we tweak based on who the individual is in front of us, but yeah, absolutely.
Dr. Fitzgerald: Perfect, so let me just back up. I’m somewhat sorry that I’ve already jumped into preparing the child, because I wanted to back up and talk about Hep A, but I want to finish this conversation first and then we’ll jump back. I guess maybe my anal structure self.
Okay, so first of all, Vitamin A, now you’re dosing it probably a heck of a lot differently than a lot of clinicians, so talk about that and talk about the form you’re using. Is it beta-carotene, what is it?
Dr. Andrews: Okay, it isn’t beta-carotene, although it could be, but I’m using an animal based form and so I’m dosing it in drops-
Dr. Fitzgerald: You can tell me, you can go ahead and give brand, you can say exactly what you’re doing.
Dr. Andrews: Well, usually I use Seroyal or Biotics brand drops. There are usually 10,000 or 12,500 IUs per drop.
Dr. Fitzgerald: 10,000 to 12,000 IU drops-
Dr. Andrews: .5 thousand, depending on which of the ones you’re … and the Seroyal is flavored, so sometimes kids like it better, but I find for newer babies, the flavor is not as important to be honest with you, and so it depends on one, if the parents … me as a parent, when I was younger, I didn’t give my child any sugar or anything sweet and stuff like that, so I was more prone to the Biotics one, but other parents, they want to have that flavor, which I totally get.
Anyway, the World Health Organization gives 200,000 IUs, a single bolus of 200,000 IUs, prior to the measles vaccine, or the MMR vaccine. That’s a huge bolus that they’ve shown that that is incredibly effective at preventing pneumonia and diarrhea associated with that vaccine. So I do it a little bit differently than that, but do you notice that is a huge bolus as compared to what we might think, right?
Dr. Fitzgerald: Huge, massive. Yes, yes, yes, yes.
Dr. Andrews: Massive.
Dr. Fitzgerald: Yeah, a lot of us are anxious about the sort of rumors that Vitamin A is a teratogen and I know that has been somewhat challenged, but there’s this residual anxiety.
Dr. Andrews: Yes
Dr. Fitzgerald: But you’re right, the World Health Organization, I’ve read it, and it’s cool because it supports what I think we’ve known and what we were taught as naturopathic students, that you can do this very short term, high dose bolus, but talk to me about-
Dr. Andrews: Yes. The other worry that we have a bit with Vitamin A is that it’s a little bit liver toxic, so it puts some stress on the liver. So for me, what I want physicians to know is that we have some leeway in here. Ideally we want to get in 200,000 IUs, but how we get it in can be different because it’s a fat soluble vitamin, it’s going to be in there for a while. If I have someone and they’re either not going to vaccinate for a while, or they’re not going to vaccinate at all, but we want to get it in, then I might do something like giving them 10,000 IUs a day for 20 days, for example, or if they need to get it in right away, then we would do the whole bolus, or I might even spread it out more than that in fairly …
In kid’s less then a year old, the World Health Organization gives 100,000 IUs, and so I might spread that out where I was doing, because if both of those companies give those high-dose 10 and 12,500 IUs, but they also give a smaller drop dose, which is 2,000 IUs, so I might, in those particular cases, give 2,000 IUs a day for several months over a period, during flu season, for example.
Dr. Fitzgerald: Got it, got it.
Dr. Andrews: The other thing I do is just for all kids and for my whole family is that we do 100,000 IUs at the beginning of winter. Well sort of the beginning, middle of fall, to be honest with you. Like the middle of school season, say October-ish. We’ll do that so we’re sort of getting that bolus in there-
Dr. Fitzgerald: Single dose? Single bolus?
Dr. Andrews: Yeah.
Dr. Fitzgerald: Might divide it up.
Dr. Andrews: I usually do, but you can divide it up.
Dr. Fitzgerald: Okay.
Dr. Andrews: Depending on your comfortability, it appears to be somewhat the same. Unlike Vitamin D, which it looks like giving a bolus might not be as helpful, Vitamin A, as far as I can tell in the research of bolus, can get just as effective giving one bolus or giving drops. But sometimes I look at a child and I feel like they seem a little more fragile and I might then just do it in divided doses, just out a professional instinct that I have, you know? You know how sort of you get that feeling.
Yes, that’s because medicine, there isn’t a one size fits all, in a way, we also have to be clinically aware. That’s sort of what’s so great about when you really understand how the body works, just also being somewhat clinically aware of, “Okay, what’s going to ultimately be the best for this person?” The instinct that I’m getting.
Dr. Fitzgerald: Just one final question on Vitamin A. You just pointed that there’s a really significant drop after illness in Vitamin A levels, so would you re-dose them?
Dr. Andrews: Yes. I have what’s called a pre-vaccine nutritional sort of thing that I go through and a post-vaccine nutritional. Then also a pre-infection and post. For post infection, the two things that I really, or during infection, or the three things, Vitamin A, Vitamin D and Vitamin C.
Dr. Fitzgerald: Okay.
Dr. Andrews: So really helpful, in fact, I think this is coming out of OHSU, Oregon Health University, showing that Vitamin C IV, I think it’s just going to be published, but I just received a pre-published information about it. IV Vitamin C significantly reduces pneumonia and a bunch of secondary infections for all ages in the hospital, so it may actually become part of a protocol where people who are entering the hospital for infectious diseases actually also receive Vitamin C IVs.
Dr. Fitzgerald: Yeah, that’s amazing. I know there was, I think they’re following up on another observation that was made by a clinician recently. I know, it’s just incredible, it’s incredible.
Dr. Andrews: In fact, just as an aside, Vitamin C IVs and shingles. When a person has shingles, shingles you can treat, but postherpetic neuralgia is incredibly-
Dr. Fitzgerald: Yes.
Dr. Andrews: -that’s really the thing that we really-
Dr. Fitzgerald: It’s devastating.
Dr. Andrews: Yeah, it’s very devastating and so while there’s Acyclovir and lots of things to really get the virus quickly under control and different sort of nerve medications, in terms of preventing postherpetic neuralgia, that’s where it becomes really difficult, but Vitamin C IV has been shown to have a fairly impressive level of efficacy at not only reducing the virus, but also in it’s reduction or prevention of postherpetic neuralgia. So I love Vitamin C IV.
Dr. Fitzgerald: Oh, that’s amazing. So listen, let me just ask you a couple of housekeeping questions here. Can you get that Vitamin C postherpetic neuralgia citation to me? Is that possible you can put your hands on that? And then I’ll just post it.
Dr. Andrews: Yes. Are you talking about the one out of OHSU?
Dr. Fitzgerald: Well, OHSU’s you said it wasn’t released yet, but then you talked about the shingles.
Dr. Andrews: Yes, yes I will.
Dr. Fitzgerald: Just send them over and then we’ll post. Folks, I will post these on the transcription page so that you can access this content.
The other question that I have, because I know everybody’s thinking about it, is what your pre and post nutrient protocols are and if people can reach out to you, your public contact information will be there and can they access them that way or do you have anything that you can sacrifice and will post them on my site?
Dr. Andrews: Okay.
Dr. Fitzgerald: Just think about how you want to do that, because there are people interested in this. By the way, folks, as I mentioned in Dr. Andrews’ bio, she does offer continuing education around this area and you can see, from our conversation right now, that any of these questions I’m asking her could sort of explode into 20 sub-questions and we could go on one area forever. I mean, this is a massive topic, so I strongly encourage you clinicians to look into Dr. Andrews’ training, since we are just, just skimming the surface.
All right, so let me circle back to talking about your protocol, like how you might … no it’s not one size fits all, so you have a mom and dad before you and they’ve got their infant, and how do you walk through talking to them about what vaccines you think are essential? Or what vaccines do you and how you might space them out? Yeah, go ahead.
Dr. Andrews: If you recall, I talked about the equation I sort of created, which is exposure + susceptibility = infection.
Dr. Fitzgerald: Yes.
Dr. Andrews: So with each of the different vaccine preventable diseases, I look at risk of exposure, susceptibility risk and then the risk of infection and then if I do feel that a child’s at risk for that particular infection, then we weigh the risk of the infection versus the risk of the vaccine. I have a conversation with the parents to decide that. This sounds very complicated, but the truth is this is minutes. It doesn’t take that long. Then if a parent decides to vaccinate for that particular disease, then we look at when will the child number one, be at risk, so when do we want the child, their susceptibility to not be there? Then, given that window, when is it the most immunologically, neurologically appropriate?
If I’m looking at susceptibility for HIB, like I just gave the example for HIB, the question I might ask is, “Is the child breastfed and how long do you intend to breastfeed?” Obviously, just like how a child who comes in for their routine wellness visit, they would come in for a routine visit with this, where I’m checking because a parent might be pretty sure they’re going to exclusively breastfeed and then two months later are realizing they’re not going to exclusively breastfeed, so it’s changing a little bit all the time.
Are they exposed to secondhand smoke? Are they breastfed? Were they born full term? I’ll ask a bunch of these questions for sort of each of the different diseases-
Dr. Fitzgerald: Is there a big difference-
Dr. Andrews: -what’s the Hepatitis B status?
Dr. Fitzgerald: Is this there a big difference with C-section versus vaginal delivery?
Dr. Andrews: This is what we know about C-section versus vaginal delivery: is that when a baby goes through the vaginal canal … so a baby is growing, a fetus is growing in a completely sterile environment for the most part, except for whatever can get through the placenta, and there are some things that can, evidently, we have drugs and stuff. When a baby is born, it is exposed to a number of different microbes, both that are fecal flora and vaginal flora and that flora sets up the microbiome for that baby. So, as it’s going through the birth canal, it’s taking a huge gulp of all the bacteria and fungus located in the birth canal. It’s taking a huge amount of that. That is what’s really setting up it’s GI tract and it’s skin for this microflora.
Babies who are born via C-section don’t have that, but that’s okay. We always talk about what’s ideal. Not every baby can be born vaginally, that would be absolutely the most ideal. So whatever we can do to support that, it’s the most important. Not every baby can be, so there’s things that we can do afterwards if they can’t be. So skin to skin contact is incredibly important. Kissing the baby, just mouth to mouth contact, all of that and breastfeeding is because breast milk delivers the flora from the mom’s gut to the breast milk.
We used to think breast milk was sterile and that that the way the baby got the flora in the gut through breast milk was actually from the skin on the mother’s nipple. We now know that that plays a very small part, but in fact dendritic cells go into the GI tract, they take huge gulps of the microbiome, they go through the lymphatic system, they carry that and they deposit it into breast milk.
Dr. Fitzgerald: Oh, god, isn’t that wonderful?
Dr. Andrews: I mean, I could give you a paper on that as well, if you want.
Dr. Fitzgerald: Yeah, I would love it, everybody would love it.
Dr. Andrews: So powerful.
Dr. Fitzgerald: So powerful.
Dr. Andrews: Here it is in breast milk, the mom’s GI tract is actually now being given to the baby, and so whatever we can do to facilitate the health of the mom’s GI tract, all of that. Of course, vaginal birth is ideal, and I often actually manipulate and try to make the vagina of the mom as healthy as possible before birth, with the expectation that she’ll have a vaginal birth, and the GI tract as well, because both of those flora, the baby’s going to get exposed to, so if we can set them off with the best start in life right from birth.
The other very important thing that a mom gives the baby is something called gestational immunity, or passive immunity, through the movement of IGG from the mom to the baby. For anything she has antibodies to, she’s going to pass those antibodies on to her baby. That can be very powerful. It’s one of the reasons why babies, we rarely see full term babies because that gestational immunity is passed from 20 weeks of age on, but in the last trimester, they get the biggest inoculation of it, that’s why we rarely see babies getting measles or rubella or chicken pox before age one because that passive immunity passed from the mom to the baby is so effective. Same with HIB, why we rarely see HIB before age six months and almost never even before one year of age. That’s all because of passive immunity, and that passive immunity renders vaccines less effective.
We know that for sure with polio, so they really talk about how because that passive immunity is ready made antibodies, those ready made antibodies will often soak up the antigens in the vaccine quicker than the body is able to then make it’s own immune library.
Dr. Fitzgerald: Isn’t that fascinating?
Dr. Andrews: So if we can wait at least a year, when we know that the majority of that passive immunity’s going to be gone, then we’re going to get the biggest bang for our buck with these vaccines and in fact now we know that vaccinating moms when they’re pregnant, that that’s a way that we’re trying to pass on passive immunity, however it’s starting to backfire on us because these babies are born with a lot of passive immunity, then we’re vaccinating them and the vaccines are less effective because they have passive immunity that’s rendering the vaccine less effective.
We have to think more scientifically in terms of this, about how we can get the best, make the vaccines be the most effective, so we’re really … because that’s, for example, pertussis, we’re seeing the efficacy of pertussis reduced since we’re vaccinating moms.
Dr. Fitzgerald: Wow. Right. God, isn’t that interesting?
Dr. Andrews: But yet we could make them more effective if we just change the timing of the schedule to a more immunologically appropriate way.
Dr. Fitzgerald: Yup, yup, yup. Give me an idea of what kind of a schedule you would recommend in general? I know you’re just very, very individualized, and I appreciate that, but give me the general.
Dr. Andrews: It’s very individualized, but there are a few goals that I have, and they may not always be the same goals as the parents, so I talk about what my goals are and then we talk about what the parent’s goals are and ultimately, we’re going do, once we educate the parents, do what the parents want to do. But my ideal goal is to not vaccinate before one year of age, it’s to never vaccinate pre-term babies.
We know that a study came out showing the risk of vaccines and pre-term babies with respect to autism spectrum disorders, so if we can wait and at the very least age adjust babies, but I like to wait at least a year if I can and that isn’t the case for many. Immunologically, we like to wait a year so that that passive immunity is gone and so that the first TH1, TH2 switch is done, but there’s many different switches going on in the body immunologically.
Dr. Fitzgerald: Right.
Dr. Andrews: Then, ideally, and this can’t always be the case, if we can wait even beyond a year to the second year, then we know that we get blood brain barrier. That barrier term for certain things like aluminum that crosses the blood brain barrier very easily in young babies and not so easily as we age. Because if we set up the cytokine storm, then we may have risks for other things and certainly aluminum has been implicated in studying up things like that. So we look at immunologically and neurologically, those are the ideal. We can’t always live in an ideal world, but we look at that.
Then I evaluate the different risk factors for each of the different diseases, so for example, polio and exposure, remember exposure + susceptibility = disease, exposure for polio, even though people are really terrified of polio, we have I believe it was 37 cases of polio in the entire world last year.
Dr. Fitzgerald: Wow.
Dr. Andrews: The entire world. I mean, that’s how close we are to extinguishing polio.
Dr. Fitzgerald: Incredible.
Dr. Andrews: So exposure is incredibly unlikely.
Dr. Fitzgerald: Yes.
Dr. Andrews: I would say that piece, the exposure piece is very low, for example, so I’m looking at each of those variables with that, with respect to that, then, we’ll look at which diseases a child’s at risk for, because there are certain diseases where exposure is the risk, measles, is so infective, that exposure is in fact the risk. Susceptibility plays a much smaller role in that particular disease.
Chicken pox, but you have to have exposure and the size of the inoculation plays a role, so then I’ll say, “Your child is at risk for these guys,” and then some of them, like for example, chicken pox, a parent may or may not say “I’m not afraid of necessarily walking through chicken pox with my child, so maybe I’m willing to delay that vaccine and see if they do in fact contract chicken pox or not.” Or rubella, for example, which has been eradicated from the North Americas, since 2005, I believe, so they might say, “I’d like to wait on that until my child is potentially, prior to puberty, prior to any risk of getting pregnant for a female.”
Things like that, so we talk about that and then we set up a schedule, a vaccine schedule and the idea with the schedule is I want it to try to wait till the body mass also is as big as possible so we can set up a good body mass in the baby so that the effects of the aluminum and other things in the vaccine are going to be less. Then, once we set up a schedule, we count back and we go “Okay, now what nutrients do we want to make sure that this baby has that will make them be as strong as possible?” That includes Vitamin A, Vitamin D, Zinc, Magnesium, probiotics. A lot of these can be given to the mom, so it’ll be transferred in the breast milk.
If I’m lucky enough to work with the mom before she gets pregnant, then we can do some of these nutrient counseling prior to pregnancy, so one of the big reasons I love magnesium is because magnesium competes with aluminum for binding sites in the body. So if we can really saturate the body with magnesium, then we can … you know, aluminum is less likely to bind and then more likely to be excreted.
Then Vitamin C, also which helps with many of the detoxification pathways and then I run a couple of tests sometimes-
Dr. Fitzgerald: Yes.
Dr. Andrews: -the two things that I really want to know, is I want to know what the spleen status is of the child or the baby and often that’s easy because babies are ultrasounded throughout pregnancy so I can get the very last ultrasound and they’ll tell what the spleen status is. If not, I may ask, I do ask for a parent to have the spleen of the child ultrasounded and the reason is is because the spleen plays a profound role in the elimination of strep and meningococcal and even HIB diseases, so it really filters those bacteria out of the body.
Dr. Fitzgerald: Wow.
Dr. Andrews: It does viruses as well, like mono and things like that, but it plays such an important role. It plays a role in all, even like infections that aren’t vaccine preventable necessarily, but I want to know, do I really have to worry about this kid if they were to get strep? Like how, I always want to be on it, but how much do I need to let the parents know, “I want you to be on this,” because in kids that don’t have a viable spleen, strep is a killer and so I do want to know the status of the spleen and often we’ll see that on an ultrasound.
But some of the patients that I work with don’t do ultrasounds during pregnancy, so that would mean I’d ask them to get an ultrasound of that, and then I’m more recently diving into, and I’m not an expert in this, but into MTHFR status, and certain detoxification statuses with respect to autism spectrum disorders and other sort of disorders. Right now we know that certain kids react to vaccines not in the best way, but we don’t know why. That hasn’t been studied, unfortunately and so I’m trying my best to sort of look at the research in a backward way to sort of take a look. We know that kids with autism spectrum disorders tend to have MTHFR and something called COMT pathway dysfunctions, or alleles that make their detoxification pathways less effective and we can help that out with magnesium and Vitamin C often, so interestingly enough, it can be very easy.
So which kids do I have to worry more about in other words, in a way, so that we’re putting kids with the least risk for negative side effects when we ultimately do vaccinate. Seeing vaccines not as completely benign as they’re sometimes seen, but realizing that they are medical procedure, that we need to put some thought into it and that individuals do react very differently. Finally, I recommend, strongly recommend against the use of Tylenol in any way, shape or form with vaccines. Tylenol significantly reduces glutathione. We know in and of itself, there have been studies that show an associated risk of autism spectrum disorder with Tylenol. I really think we should never use Tylenol in kids, so we have to find other ways to reduce fever, either using hydrotherapy, things like that and not using Tylenol at all.
Dr. Fitzgerald: Right.
Dr. Andrews: Part of the reason we brought in Tylenol, it’s because we want the perception of vaccines to be like, “Oh, they’re pretty benign,” so we don’t want parents to see the crying, the pain, the fevers. We’re treating a symptom, that fever is showing that the immune system truthfully, is working, right?
Dr. Fitzgerald: Yes.
Dr. Andrews: It’s seeing an infection and it’s working in the way that it’s supposed to and we’re shutting that down. For me it’s more like letting them know “Yes, you know what? Not everything we’re going to do in my office is going to make the kid feel good right after. It’s ultimately maybe for a better outcome.” But yeah, I highly educate them on the use of, or lack thereof, of Tylenol.
Dr. Fitzgerald: Do you ever use glutathione? I know Vitamin C and magnesium are both going to really help, especially Vitamin C, in recycling glutathione, but do you use n-acetylcysteine or glutathione-
Dr. Andrews: Yes.
Dr. Fitzgerald: Okay.
Dr. Andrews: So not glutathione, I haven’t used, although I think we could, I use n-acetylcysteine all the time. Especially as a treatment, actually, often. But n-acetylcysteine doesn’t taste all that good, orally, so we’ll mix applesauce, things like that. Sometimes I do try to talk to parents about … if at an early age you can make things, like not worry about how they don’t taste so perfectly sweet, kids can become a bit better at that. Although having said that, that’s not always true. I’ve known many people who’ve been religiously good about not giving their kids sweets, and there comes an age, at about age five or whatever, when they go into kindergarten and all their friends are eating much funner foods, that that becomes very difficult, but as much as possible.
But yes, so NAC is a big part of my sort of arsenal and you know, there’s little things that I give parents. What I like to do is give parents things that they can easily pick up at a health food store or their local grocery store. The one complicated thing, probably, that I recommend is IV Vitamin C sometimes. Otherwise I want it to be something where, when my office is closed, they can quickly run and get it. Or at anytime they can phone me and I can say, “Hey, you can run and go get this.” My other favorite thing is Epsom salts baths, because it’s a great way of getting magnesium in and the sulfur is actually very good at preventing, one of the toxins produced by the pertussis bacteria, it’s a toxin-mediated disease, so the bacteria in and of itself doesn’t cause the big symptoms of pertussis, that’s why we can give antibiotics and kill the bacteria, but it’s a toxin-mediated disease, so that’s why antibiotics are considered not effective in pertussis.
But sulfur is a really good way to, both sulfur and heat, really denature those toxins and so giving Epsom salts baths, which give magnesium, they’re a smooth muscle relaxer for the respiratory tract, then the kids are breathing in that sulfur, which is helping denature one of the particular toxins. It can be really good, I use it as a prevention, if there’s potentially pertussis around, just give them Epsom salts baths every night, just put some Epsom salts in their bath every night. I want to make it as easy as possible for them.
Dr. Fitzgerald: Perfect, that’s fabulous. All right, you know this has just been such a great, useful conversation. I know you’re waiting until body mass is at a certain level, as much as you possibly can-
Dr. Andrews: Ideally, yes.
Dr. Fitzgerald: -and neuro and immuno development are happening and at a certain level of development. Are you giving vaccines, administering one at a time? Is that your typical schedule or do you do a couple? I mean, I know there’s vaccine combos, obviously, but just in general, what are you thinking about that process?
Dr. Andrews: Great question. So I want to give as few at the same time as I can, so if a vaccine is available not in a combo, and there are vaccines like that, like Hepatitis B is available on it’s own, Hepatitis A is available on it’s own, HIB is, pneumococcal is, chicken pox is, rotavirus is, then I would like to give it on it’s own separated from any other vaccines, so I only ever give one vaccine at a time, if I can.
Dr. Fitzgerald: How do you space them?
Dr. Andrews: Very good question. There’s two vaccines that you have to give in combination, they’re only available in combination, and that’s measles, mumps, rubella. You can’t give measles alone, you can’t give mumps alone, you can’t give rubella alone. If you going to give one, you end up always giving three and diptheria, tetanus, pertussis. A child may have no risk for diptheria, but if you want to vaccinate them for pertussis, you’re going to vaccinate them for diptheria. Pertussis has only ever come in a combination vaccine.
There’s a very, very interesting history. The history of pertussis really talks about the whole history of how the vaccine schedule was set up, which I probably can’t talk about, we don’t have time to talk about it now, but fascinating.
Dr. Fitzgerald: Well, we’ll put your contact-
Dr. Andrews: It’s really because of pertussis that we have-
Dr. Fitzgerald: Yeah, go ahead, I know people will be wanting to reach out to you for sure. But I’m sure it’s great, we’ll have a part two maybe also, Dr. Andrews, at some point down the line. Yeah, that’s awesome. Okay, so those two-
Dr. Andrews: What was the second part of your question? I forgot.
Dr. Fitzgerald: How are scheduling these?
Dr. Andrews: We’re looking at a time, if a child truly is at risk for that particular disease, so say there is a child who I really do worry is at risk haemophilus influenza type B, right? I don’t want that child to get meningitis, then I’m going to vaccinate them. The first time usually I hit them at six months of age. I don’t vaccinate them before six months of age, I know that they have passive immunity from their mom before six months of age. So I’m going to vaccinate them at six months of age, and then I want to vaccinate them again at a time when they’re still going to have enough titers to be still in that protective realm and there’s very little research done on that, but usually it’s between four and six months, I’ll give the second dose.
Then, after that second dose, because I’m delaying vaccines, I can often give less in a series. I will often run titers five months later. If the titers are still showing high, I won’t re-vaccinate, if the titers are not reaching that protective level, then I’ll give the third dose.
Dr. Fitzgerald: Oh, okay, perfect. God, that’s great.
Dr. Andrews: Yeah.
Dr. Fitzgerald: All right, and then that’s another useful, just another really fabulous pearl, getting titers and then also understanding that you’ve achieved a level of protection. Do you follow the ranges set forth by the labs?
Dr. Andrews: I do. Yes. The one infectious disease that doesn’t have a range, unfortunately, is pertussis. That’s because a protective titer range has never been established with pertussis, which is so frustrating, but we use it to just see. However, with laboratories, I can at least see like … okay, I will tell you this, kids that have had pertussis have skyrocketing protection for a much longer period than kids who have been vaccinated. Obviously, for most things, we know that natural infection may confer more permanent immunity than vaccinated protection confers, but with pertussis, neither is thought to be lifelong.
But you can get sort of an idea looking at the numbers. Each lab has a bit of a different range. It becomes difficult for pertussis, whether or not it’s protective, but what the lab can tell you is they have no protection, so at least you’ll be able to know if they have no protection or not for pertussis, but for all the other ones, there is titer levels which are thought to establish protection. We also don’t know, tetanus is somewhat similar to that too, in that it’s never been established what the protective titer level is, but it has a better range that’s better to understand. When you get the lab back, you’ll see that yes, we can sort of say we may not need to redose tetanus, because tetanus, for a long time, has been one that we’ve redosed every 10 years, if you recall, back in history.
Dr. Fitzgerald: Yes, that’s terrific. Listen, we’ve just got to wrap up now, but I wanted to just get your thoughts on a paper you and I were chatting about before we started the podcast. The Mawson et al paper. The pilot looking at the health of vaccinated and un-vaccinated kids. I know lots of controversy around this. It’s an open access, folks, so I’ll put the paper up on the transcription site, so you can go ahead and look at it, but what are your comments, Hilary?
Dr. Andrews: This is, for years, many of us have been asking for a research paper that looks at vaccinated versus un-vaccinated kids to fully understand if potentially there is a risk … that vaccines may pose a risk of certain diseases that we’re seeing. Namely, allergies, autism, eczema, autism spectrum disorders and other learning disorders. This is really the first study. It’s so, in a way, revolutionary looking at vaccinated versus non-vaccinated kids and a series, a number of different diseases. So it came out in March, I think around March of 2017. I’m just pulling it up so that I make sure that I give you the most correct information.
But essentially, the study did notice that there was in fact, a difference, a distinct difference in associated risks between vaccinated and non-vaccinated kids in a number of different diseases and so when they looked at the un-vaccinated populations, they saw that the risk of chicken pox and pertussis was higher than the risk of the vaccinated population, which we would hope would be the case, you know, we would assume would be the case. But in terms of the other things that they measured, which included allergies autism spectrum disorder, all of those sorts of things, learning disabilities, they found a significant increase in the vaccinated population. They found that compared to un-vaccinated kids, vaccinated kids have a 30 times greater risk of developing allergic rhinitis. So that’s significant.
Dr. Fitzgerald: Yes.
Dr. Andrews: They had a five times greater risk of learning disabilities, they had a four times greater risk of both autism spectrum disorder and ADHD and that risk was even higher if the child was born pre-term or if the child was a male, so they did see clinically significant increases in all of these diseases that I just sort of talked about, eczema as well.
But the other things that was very interesting about this, and this was what also really stuck out for me, is that for decades, we believed that vaccines have saved a huge amount of money in medical costs, it’s one of the reasons vaccines are pressed so hard, because it’s thought that for every dollar we spend on vaccines, we save up to $17 in indirect and direct medical costs. But in fact, this study found that kids who are vaccinated have more doctor visits, more emergency room visits, higher incidents of pneumonia, higher incidents of otitis media, even though one of the vaccines that we vaccinate for, the pneumococcal vaccine, actually it was developed originally, one of it’s reasons for development was for the prevention of otitis medium.
So that we’re actually seeing significantly greater doctors visits and direct medical care costs with the vaccinated population, than with the un-vaccinated population. The vaccinated population has more use of antibiotics, more fevers, so all of that, it’s something to consider and take into account when we’re now looking at those sort of measurements that we’ve used in vaccine successes, because this is suggesting, this study is suggesting, that in fact that might not be the case. It was small study, there was 666 enrolled in the study, but it was a very well done study.
Dr. Fitzgerald: Yup.
Dr. Andrews: The other thing that’s interesting is that these same researchers then, because they noticed that the greatest risk for autism spectrum disorder was in pre-term vaccinated children, this is a very important take home, I think, for us as docs, even if we’re going to vaccinate according to the CDC schedule, so pre-term vaccinated kids had, I believe it was an eight times greater risk than the un-vaccinated kids of developing autism. If they just looked at pre-term kids without being in the non-vaccinated population, they had no increased risk of autism spectrum disorders.
Dr. Fitzgerald: God, isn’t that fascinating?
Dr. Andrews: So it’s not just the fact of pre-term, it’s being pre-term and being vaccinated, so these same researchers did a follow up research study that’s also published, which I believe you’ll also put up, looking at vaccinating pre-term kids, because we don’t study vaccines in pre-term infants. I think there’s one study that I’m aware of. There may be more, but in general, that’s not usually how we do pre-licensing studies. But we’re vaccinating them right at birth like we do. The CDC just changed, this year, the very first time looking at birth weight and when we dose the Hepatitis B vaccine.
But other than that, that’s not really taken into account, but that baby is actually, if it’s born gestationally four weeks … it’s actually four weeks younger than a baby born at 40 weeks, so immunologically, that plays a very important role, so these two studies, both published by the same groups, I believe their through Public Health in Mississippi, I believe-
Dr. Fitzgerald: Yup.
Dr. Andrews: -had those findings, and because this was really the first time we’re looking at, yes, Jackson State University, looking at these two groups, this really is, as they call it, a pilot comparative study. It really is and I hope, because IOM have been asking for studies looking at vaccinated versus un-vaccinated kids, that we see more of this and we’re really able to determine if in fact, you know this is just the first one, if in fact there is a risk vaccines do present with for more permanent, life long injury, including allergies and autism spectrum disorder.
What I wish they would’ve studied was food allergies, but that one hasn’t been studied. Then maybe that will help motivate us to use this modality in a slightly different way.
Dr. Fitzgerald: Right. Right, yeah, and how you’ve been outlining it, which just really sounds smart and conservative and careful and individualized. How has the IOM received this? To your knowledge, how has the-?
Dr. Andrews: That’s a good question. I don’t know. That’s a really good question. Yeah, I don’t know.
Dr. Fitzgerald: Okay.
Dr. Andrews: I don’t have a direct line. I haven’t heard. The thing is for me, the study was really big, and in terms of mainstream media, this study has gotten no traction whatsoever. That’s just a little bit frustrating for me, is that the four pivotal studies showing no research between vaccines and autism have gotten a huge amount of media play, and then this study has virtually gotten nothing. This is really the first. Those were association studies, only looking at vaccinated kids. This is actually the very first study looking at vaccinated versus un-vaccinated kids. That’s a huge study and it’s gotten no media time, which is slightly unfortunate.
Dr. Fitzgerald: So again, Dr. Andrews, I’m just so glad that we reconnected and you were willing to jump on my podcast today. We’re actually recording, I’m at the Institute for Functional Medicines Annual Conference, so I’m here in lovely Los Angeles.
Dr. Andrews: Oh wow.
Dr. Fitzgerald: Yup, I’m going to hop back down into the lectures. We’re actually talking about neurodevelopmental and neurodegenerative stuff, we’re talking about keeping the brain healthy. That’s what this whole conference is about, so this is perfect for us to be recording this incredibly important topic.
Yeah, and thank you, thank you, thank you. Everything we’ve discussed, we will put on the site, you will know how clinicians, we’ll give you an email to access Dr. Andrews and to attend the CE Training that she’s offering because you can clearly see she’s just a pearl, loads of pearls for our community. So thank you, thank you, thank you for all your hard work. This has just been a pleasure to talk to you today.
Dr. Andrews: Thank you so much. Much appreciated, have a good conference.