Featured Guest Blog: Your Body. Your Baby. Their Flu.

flu-shot-while-pregnantAs a conventionally trained, dyed-in-the-wool psychiatrist, I learned that mental illness is a manifestation of an imbalance of brain chemicals that can be largely reduced to too little serotonin and/or norepinephrine, too little dopamine, or messed up excitatory signals at the membrane level.  These deficits required pharmaceutical intervention for repair, just as one of my attendings once patronizingly said to an inpatient post-suicide attempt: if you had poor vision, you would need glasses.  There would just be no way for you to navigate the world without those glasses no matter how much you wanted to.

I don’t believe this anymore.  I’ve left the church and I’ve run into the woods where I’m listening to the sermons delivered by the natives there…those who believe in a natural order, in the body’s capacity to heal, in the sanctity of a clean environment, and in the interconnectedness of spirit, nourishment, and movement.  But this was a journey for me.  I started to open my eyes during my first pregnancy, when I began my fellowship in treating pregnant and postpartum women.   I learned how to consent them, and what informed consent really looked like, around treatment with psychotropics in pregnancy and lactation.  Many of these women had been on medication for the better part of their adult lives and either found themselves pregnant, were planning to become, or developed symptoms despite treatment.  I poured over the literature for hundreds of hours, memorizing authors and statistics, distilling complex analytic concepts, and building a rational path, with some forks in the road, for these women to travel.  I helped them to understand the known risks, the unknown risks, the alternatives, and allowed them to assess the perceived benefits.  This process would often culminate in a 90-120 minute session involving all and any interested family members and extensive communication with other providers – general psychiatrists, obstetricians, therapists, so that everyone was on the same page.

You can imagine that it began to rub me the wrong way when these very same patients would come in and casually mention that they had gotten a “flu shot”, often without a single medical provider involved (at CVS!), no consent, no discussion.  I didn’t know much about the flu vaccine other than that when I entered medical school, pregnant women and babies were in the “contraindicated” demographic.  I also knew that doctors, residents and med students almost never got the flu shot voluntarily.

I began to look into the literature through my lens of best quality pregnancy data: a prospective cohort study, well-controlled, looking at outcomes during pregnancy, at birth, and up to 5-7 years of childhood age or longer.  I investigated the ingredients (egg proteins and associated unidentified viral DNA from this animal tissue, the allergen gelatin, polysorbate 80 which crosses the blood brain barrier, the carcinogen formaldehyde, the detergent triton x100, sucrose, resin, the antibiotic gentamycin, and thimerosol/mercury) and found that no study has looked at the effect of injecting any one of the ingredients, let alone the combination.  I was hoping to find large studies done annually for each preparation assuming that if there were 25,000 cases in the literature of SSRI exposure, there must be at least that for something formally recommended to pregnant women.  Hereinlies the important philosophical leap:  women are educated to avoid elective exposures to medication in pregnancy.  When there is an indicated intervention, medical, pharmaceutical, surgical, the personal risks and benefits are weighed of treatment vs no treatment vs alternatives.  But, here we have a one-size-fits-all recommendation with no risk-stratification according to immune status, personal medical history, genetic risk factors, or comorbidities.  A formal recommendation of a category C intervention whose package insert states:

“Animal reproduction studies have not been conducted with influenza virus vaccine. It is also not known whether influenza virus vaccine can cause fetal harm when administered to a pregnant woman. Although animal reproductive studies have not been conducted, the prescribing health care provider should be aware of the recommendations of the Advisory Committee on Immunization Practices. The ACIP states that if used during pregnancy, administration of influenza virus vaccine after 14 weeks of gestation may be preferable to avoid coincidental association of the vaccine with early pregnancy loss.”

Who is blowing air into this trumpet? I think we know.

To this day, I remain appalled at the double-speak on the part of the CDC around this intervention that has been conclusively found to be ineffective and dangerous in the general population and is grossly understudied in the pregnant population. Here are some tidbits about vaccinating for influenza:

• As Dr. Lawrence Palevsky, an enlightened pediatrician, discusses in his writings and patient education, we are awash in viruses and bacteria. Exposure does not equal infection. Presumption that 4 strains (the three chosen for the vaccine and the H1N1) are worthy of specific action is not based in evidence, nor common sense.
• Incidence of flu at the population level is grossly inflated as a fear-mongering tactic. When patients present with flu-like symptoms, they are rarely diagnostically confirmed as being Influenza type A or type B, and the vast majority of the time, may be neither. A brilliant 7 year old assessment by Ayoub and Yazbak states:  “In general, most symptoms of the “flu” are not caused by influenza virus but by a variety of noninfluenza viruses, bacteria, other infectious organisms, or even noninfectious conditions. According to the CDC, only about 20% of the cases of ILI are actually caused by the influenza virus. If this is true, then theoretically only 20% of all cases of ILI are preventable by influenza vaccination, and only when there is a perfect antigenic match between the vaccine strain and the circulating virus. Furthermore, even a perfect antigenic match does not guarantee an adequate antibody titer, nor does measurable antibody assure protection.”
• A Cochrane analysis of 50 studies (15 of which were industry funded) demonstrated that in the likely event that the included strains did not match circulating virus, there was a 2% incidence in the unvaccinated vs a 1% incidence in the vaccinated population of presumed influenza. There was no effect of vaccination on hospitalizations of complications. This review also discusses concerning signal for incidence of Guillain-Barre Syndrome (autoimmune paralysis).
• Pregnant patients are not at higher risk, do not die more frequently or suffer more complications from influenza. Ayoub and Yazbak dispute the two non-rigorous studies that are the basis for the claim that pregnant women suffer impaired immunity. Additionally, based on this study of 250,000 pregnant women in Australia and New Zealand, only 0.03% were admitted to the ICU for H1N1 complications and there is suspicion that obesity was the underlying driver of these complications.
• Analysis of CDC statistics reveals that there is 0-1 death per year of identified influenza in reproductive age women from 1997-2002. By comparison, vaccine-induced Guillain-Barre incidence is estimated at 20-40 annually.
• Documented risks of vaccination as sanctioned by a neat little government table include vasculitis, seizure, encephalomyelitis, facial palsy, facial paresis, Guillain-Barré syndrome, hypoesthesia, myelitis, neuritis, neuropathy, paresthesia.
• Common side effects include symptoms like fatigue, fever, body and headaches (aka…the flu!) In the pregnant population, the largest conducted assessment of 49, 585 pregnant women in the Kaiser Permanente Healthcare System over 5 flu seasons demonstrated that no deaths occurred from influenza in the vaccinated or unvaccinated population, and that even in an “at risk” asthma subpopulation, vaccination did nothing to minimize hospitalizations, as the only admissions (0.018%) were for pneumonia. Two wonderful posts on this subject explore the applicability of this study to decision-making for the pregnant woman – Aviva Romm MD, holistic women’s health practitioner and Jennifer Margulis PhD, investigative journalist and women’s health advocate.

So, if we do not know true incidence because we are lumping pneumonia with presumed influenza and typically confirming neither by standardized diagnosis, we have evidence of inefficacy through Cochrane, through Kaiser, and even here at the Lancet where they admit that efficacy was “moderate”, “variable”, “reduced”, or “absent” depending on the season, then at what cost are we administering this intervention? Well, I’m just going to go ahead and assume that if there were even a one in a billion chance of life long paralysis or death, most people would take their chances with a week of the flu instead. And these are obvious adverse events.

Perhaps the most concerning study I came across implicated the influenza vaccination in a strong inflammatory response in the pregnant woman. Here, the investigators identified significantly elevated CRP two days after vaccination and a similar (but non-significant) pattern for TNF-alpha. They address the notion of vulnerable subgroups as being more important than generalizable findings.  For example, the most depressed women at the time of vaccination exhibited an increased inflammatory response to vaccination – suggestive of inflammatory priming by the depressed state or an impairment of the inflammatory attenuation that is typical of a pregnant state. I study and lecture nationally about the inflammatory underpinnings of antepartum and postpartum mood and anxiety disorders. Inflammation in pregnancy is something I am not interested in actively promoting. If a woman’s real risk of developing severe flu is vanishingly remote, comparing that to active exposure to a CRP and IL6 elevating injection approximates malpractice.
This immune activation has been implicated, not only in development of postpartum depression, but in abnormal child behavioral development including autism and schizophrenia. IL6, the very cytokine that was specifically raised by the flu vaccine, is the one that has been implicated in rodents in abnormal behavior in offspring. In this study, the H1N1 vaccine (a popular version since 2009) was found to induce oxidative stress (the driving force behind every chronic disease we now struggle with as a population). In a study by Munoz et al intended to affirm the safety record of influenza vaccines in the pregnant population, careful review of the results indicates that infants who died after birth were not included in the statistical analysis that determined there was no risk to offspring, and vaccinated women suffered higher rates of preeclampsia, gestational diabetes, and hypertension (all inflammatory in nature).

Maternal infections may promote a similar (or worse depending on biochemical individuality) inflammatory response and have been associated with the development of schizophrenia and cerebral palsy in children exposed in utero, but if the vaccine is not only ineffective at preventing infection, but promotes its own inflammatory response, and potentially other acute and long-term adverse effects, what are we doing here?
As Ayoub and Yazbak conclude: “Because the benefits of influenza vaccination during pregnancy appear lacking, a safety-benefit analysis should not tolerate any risk to vaccine recipients or their offspring, even at a theoretical level.”

I couldn’t agree more.

A red flag was also raised for me, this past flu season when I received a Department of Health advisory in my inbox that stated that pregnant woman may be given thimerosol containing immunizations in the setting of a thimerosol-free vaccine shortage. Tough to make sense of the prohibition of tuna, but the injection of 25 mcg of ethylmercury (the EPA’s allowable limit is 0.1ug/kg/day which is far exceeded by this amount in an average weight female) into the tissue of a woman growing a fetus. Especially when the only primate study that has ever been done on vaccines demonstrates that injection of neonates with thimerosol resulted in definitive abnormal neurodevelopment in these animals.

Mercury has been dubbed the most toxic element on the face of the earth. Any agency that sanctions its active delivery to the most vulnerable in our race is not one I plan to follow blindly. I encourage my patients to do their own homework on all of the exposures that their bodies encounter. My homework on this one left me thrilled that I know of other ways to promote immunity and resilience, and have never had the flu in my life despite more than 13 years of hospital exposure and 4 years of parenting. Sleep, stress-management, whole, colorful, and fermented foods, garlic, ginger, vitamin C, sunshine (or NYer’s sunshine – vitamin D3), a high quality multivitamin/mineral to compensate for any nutrients lost in transit and used up in managing toxic exposures. There’s a better way.
This better way embraces periodic sickness as part of comprehensive wellness. The only way to truly protect ourselves and our infants is through natural immunity bolstered by wild-type exposure in the community. Once you have a particular flu strain, when it comes around again, you will be uniquely protected, and you will pass on this protection to your newborn. There is no replacement for this. We cannot outsource our health to pharmaceutical companies. They just don’t know what health is.

~Kelly Brogan, MD

As an undergraduate at M.I.T, Dr. Brogan studied Cognitive Neuroscience and worked with Harvard undergraduates to create a public forum for the discussion of alternative medicine, directing conferences for the Hippocratic Society. She attended Cornell Medical School where she was awarded the Rudin Scholarship for Psychiatric Oncology and began her work in Reproductive Psychiatry, which she went on to train in during her residency at NYU/Bellevue. A strong interest in the interface of medicine
and psychiatry led her to pursue a fellowship in Consultation Liaison/Psychosomatic Medicine at NYU/Bellevue/VA Hospital. Since that time, she remains on faculty and has focused her efforts on her private practice where she cares for patients with medical illnesses, as well as women at all stages of their reproductive life cycle. A passion for
holistic living, environmental medicine, and nutrition are the bedrock of her functional medicine practice. She has published in the field of Psycho-Oncology, Women’s Health, Perinatal Mental Health, Alternative Medicine, and Infectious Disease. She is Board Certified in Psychiatry, Psychosomatic Medicine, as well as Board Certified in Integrative and Holistic Medicine. Her website is www.kellybroganmd.com.



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17 Responses to Featured Guest Blog: Your Body. Your Baby. Their Flu.

  1. Pingback: Your Body. Your Baby. Their Flu – by Dr. Kelly Brogan, M.D. | APP Advocate Precautionary Principle

  2. worrior mom says:

    Painful read. Just brings to my mind the lovely, perky and so incredibly misguided pregnant nurse who did the “hard sell” on my father w/ pneumonia that lead to a heart failure dx. She was hard selling the pneumnia vax (yes, you read that right, he was there w/ pneumonia). It upset him that i piped up to decline for him. I was told to shut my pie hole w/the holistic crap. He went on to react to that vaccine and no one but me raised an eye. The stream of over paid white coats (who charge $800.00 for every time they stepped foot in the door) just piled on more $$ scripts.

    Very likely, we tax payers get to pay for the lovely nurseys early intervention, public school “services”, social security disability.

  3. Pingback: Your Body. Your Baby. Their Flu. ~ Kelly Brogan, MD | International Medical Council on Vaccination

  4. nostromo says:

    Regarding the monkey study I would have taken some of that non-TCV Hepatitis vaccine that they deliberately put Thimerosal into and used that as a parallel study to help ascertain whether the Thimerosal augmented vaccine had a part in causing the delays they measured.

    Also you would wonder if the monkeys that were only 14 days old that had had a vaccine were having a normal immunological reaction (also known as ‘feeling like crap’!) and so simply showed delay due to temporary effect due to that ? OK that might be fanciful, I don’t know, but its something that occurred to me. At least it would be good to have a follow up and see if the delays faded or persisted.

    And is that THE Andrew Wakefield with his name on the study?

    I would though agree with you that the less mercury in anything the better, and I personally am a lot more comfortable that we do not have Thimerosal in children’s vaccines anymore (since 2000 in my country, I just checked as I was a little worried it might still be in some here), I think it’s better to be safe than sorry when it comes to brains, we only have one.

    • Dawn Turner says:

      Wonderful article! I’m so glad someone is warning pregnant women specifically about the hazards of this stuff.

      To the person who said children’s vaccines no longer contain thimerasol – check again. That’s not true. First, the order was to “phase out” thimerasol over time, not a blanket “remove it now”. SOME companies phased it out and replaced it with aluminum. Others decreased the amount to what the industry calls “trace” amounts; some of those added aluminum so both are in the same vaccine. Others haven’t changed it at all. Second, the govt has decided since that phase out order was put out that thimerasol is okay to keep in vaccines so any phasing out stopped altogether at that point.

      If in doubt, read package inserts for vaccines being given to children these days. They list the ingredients. I’ve seen them myself, and you can readily get them from the vaccine manufacturers or your doctor/pediatrician (if you ask for them, medical personnel are SUPPOSED to give them to you). You will find thimerasol STILL in many of the vaccines children are being given. Also, they KNOW that combining thimerasol (even at decreased amounts) with aluminum actually compounds the effect of both of those neurotoxins, so those vaccines that contain both are even worse than either used alone. So demand to see package inserts, and read them thoroughly. I think you’ll be surprised what you find.

    • Carrie Nicoletti says:

      According to this pediatrician, we have no idea if they are fully thimerosal free, because they are not tested, and we can only take the manufacturers at their word. And since vaccine injury is hard to prove, and they have immunity anyway, they have absolutely NO incentive to tell the truth.

      Haven’t you heard that companies can legally say that something is “fat free” if it contains under a certain percentage of fat? Well, the same with this. In the former, a little fat in a fat free product is only going to add to our waistline. In this case, even less than 1% of mercury is detrimental to us – – but they can list it as thimerosal free. This doc says in this article
      Today, in some states, the flu vaccine given to those under 3
      year of age are supposed to contain no more than a trace level
      of Thimerosal, but with no government agency testing vaccines
      for mercury, the only ones who know whether a preservative free vaccine (flu or otherwise) actually is mercury free are the
      manufacturers themselves.


  5. Jim West says:

    Not only are flu statistics inflated, but the toxicology of flu is aggressively avoided due to the flu paradigm — despite everyone being exposed to flu-causing pollution. Next time you get the flu, think back over the last 10 hours. Stove exhaust in the kitchen? Boiler exhaust? Windows closed? Look at the prior 24 hours of weather (wind speed) and you will find wind speed down, which means air pollution is up. There are other scenarios, but this generally covers most “flu”.

  6. nhokkanen says:

    Wonderfully informative post — thank you!

  7. Alison MacNeil says:

    One of the things I find so appealing about Dr. Brogan’s work is that she balances the western pharmaceutical approach and naturopathic interventions with an evidenced based approach. So grateful she took the time to write for TMR on this subject. The Flu shot in my first pregnancy was the beginning of the medical drama I fault for Nick’s Autism. Thank you again, Kelly. So glad you are such a THINKER!!!

  8. Wolf Binder says:

    There will always be a small percentage of unantecipated problems with any medication, say 1 tp 3 percent could have adverse reactions. That still leaves 99 to 97% that benefit from vaccinations. I think that a lot of your paper is unsubstantiated by TRUE research and is just anothe scare story.

    • Helen says:

      Thank you for a wonderful post. I love that you haven’t just made assumptions without any evidence.

      “There will always be a small percentage of unantecipated problems with any medication, say 1 tp 3 percent could have adverse reactions. That still leaves 99 to 97% that benefit from vaccinations. I think that a lot of your paper is unsubstantiated by TRUE research and is just anothe scare story.”

      This does not mean that 97-99% benefit from vaccinations, it can be as simple as many of those who do not have adverse reactions have a healthy lifestyle (exercise, diet of health benefiting foods, stable mental health, etc) and therefore the vaccination provided little-to-no benefit. We should stop looking at those that are already in reasonable health as promoters of “successful” intervention. Also, we forget that people who have been immunized are being hospitalized for flu related problems just as much as people who have not been immunized. That begs the question, are immunizations providing the health benefits they promote?

      Just for my own little addition. I worked with children aged 5-13 for 3 consecutive years (one of the high-risk groups) and these children were from a poor community. Most of these children were not immunized and the ones who did suffer from any flu-related problems were the ones who came without breakfast and/or lunch, or who came with takeaway food. The rest of the kids, who came with regular breakfast and lunch rarely ever showed flu-like symptoms. Also, the children I know (and I know a lot) who have been immunized show more flu-like symptoms than their non-immunized peers. This is true even for siblings (the eldest having been fully immunized, latter children being half-immunized and youngest not immunized at all), the younger children stay healthy even while at home with sick older siblings. Observing is part of judging evidence.

  9. Laura Hayes says:

    Excellent, excellent article! I look forward to sharing this article with as many people as possible. Thank you, Dr. Kelly Brogan! We need more thinking and caring doctors like you…who appreciate and value the absolute necessity of informed consent…and who understand that their role as a doctor is to first, do no harm. Your last 2 sentences hit the nail on the head: “We cannot outsource our health to pharmaceutical companies. They just don’t know what health is.” Well said!

  10. Shawn Siegel says:

    And when you consider that the EPA allowances for injected mercury were extrapolated from figures attendant mercury poisoning in populations exposed through contaminated drinking water, or polluted belches from industrial smokestacks, both very different from injection, all sense of propriety and relevancy is lost.

    And then when you consider that the CDC’s own 1999 in-house study showed a direct correlation between the increasing amount of mercury in the vaccine schedule and the rise in incidence of speech and learning disorders and autism, but never deemed it necessary to inform the American public, all sense of trust is lost.

  11. Donna Powers says:

    Thank you Dr. Brogan for stepping forward with the neurological science information and exposing the lack of safety studies done. This gives hope and awareness in a situation that is creating so much human suffering and illness.

    P.S. Homeopathy has plenty to offer in prevention and treatment of influenza in any seasonal outbreak, historically (1918 flu) and currently.

  12. Zed says:

    This is spectacular…I will share widely. Thank you so much.

  13. Lisa says:

    Thank you for telling the truth about the flu vaccine. I simply tell pregnant mothers to read the insert. Now I will hand them your article. I get many questions about the flu shot as people know I almost died from the one I received October 15th, 2005 at CVS.

  14. Rebecca Lee says:

    Yay! Thank you for this great article.

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