Monthly Newsletter November 2007
Long-term prevention with alternative vaccines
Alternative vaccines in homeopathic form are available for long-term prevention. Several protocols exist for the administration of homeopathic nosodes or the corresponding remedies for the prevention of whooping cough, meningitis, diphtheria, tetanus, polio, and other diseases during childhood. There exists significant controversy within the homeopathic profession about the appropriateness of using these preparations for long-term prevention. This controversy involves the areas of effectiveness, safety, and ethics.
No long-term studies have been conducted to evaluate the efficacy of this form of prevention. There is no reason to assume that these vaccines continue to act preventively years after administration, unless immunity is shown through an objective test or clinical studies. The research that proponents of homeopathic prophylaxis frequently cite to prove an immunizing effect of these remedies involves studies done on diphtheria. An examination of this research is warranted because it represents the only studies used as evidence.
Homeopathic preparations have not been shown to raise antibody levels. Smits tested the titre of antibodies to diphtheria, polio and tetanus in ten children before and one month after giving homeopathic preparations of these three vaccines (DTPol 30K and 200K). He found no rise in antibody levels (Smits, 1995). He speculates that protection afforded by a homeopathic remedy acts on a "deeper" level than that of antibodies. Other homeopaths have stated similar opinions. Golden says, "unlike conventional vaccines, the Homoeopathic alternative does not rely on antibody formation." He postulates that "Homoeopathic remedies reduce the patient's sensitivity to the dynamic stimulus of the virus or bacteria, thus lessening the patient's predisposition to being overcome by this stimulus" (Golden, 1994).
If homeopathic remedies do not produce an increase in antibody levels, then the only way to measure the effectiveness of homeopathic prophylaxis is through clinical results. This is a formidable undertaking. The cost of long-term studies using homeopathic prophylaxis would be prohibitive, given the present resources available. Ethical problems could also prevent such studies from occurring; it is doubtful that ethics committees would allow children to be deprived of the commonly administered and approved allopathic vaccines. Moskowitz has suggested that the sizable population of unvaccinated children whose parents have refused vaccines, could provide a control group to assess the long-term negative effects of vaccines (Moskowitz, 1985). Perhaps this population could also serve as a test group for homeopathic prophylaxis.
Golden has conducted an informal survey of customers who have purchased a kit of homeopathic medicines intended for use in a long-term prophylaxis program beginning in infancy (Golden, 1994). This kit includes the nosodes for whooping cough, diphtheria, measles, mumps and Haemophilus, as well as tetanus toxin and Lathyrus sativa (for polio). They are administered in repeated doses, one medicine at a time, during the period from one month of age to five years. For example, Pertussin is given at ages 1, 2, 13, and 32 months. Tetanus toxin is given five times at ages 11, 12, 24, 41, and 60 months. The first dose of each remedy is 200 strength, and subsequent doses are 200, 1M and 10M in succession, every 8 hours in one day. The follow-up survey involves a questionnaire sent yearly from 1988 through 1994, to each of the parents who purchased a kit.
During this five-year span, he received 879 returned questionnaires. Only 2 percent of those children contracted one or more of the diseases covered by the program. Parents were also asked whether a child contracted a disease covered by the program after a known exposure to one of these diseases; they reported that 188 children were exposed to one of these diseases, and 20 contracted the disease. This is an 11 percent failure rate for the homeopathic prophylaxis program with a known exposure to disease. Golden does not specify which diseases the exposure entailed. This very preliminary and limited survey suggests that the 188 supposed exposures may have received some level of protection from the program. Golden notes that symptoms were mild in the majority of cases that did contract the disease. No severe adverse effects were reported in this survey for any of the homeopathic medicines.
The only other evidence cited to support long-term prevention through homeopathy refers to the possible short-term protection it affords during epidemics. It is assumed that repeated doses may provide a protective effect that extends over a span of a few weeks, especially if the child is also challenged during this period with the microorganism that can cause similar symptoms to those produced by the medicine. There is no evidence, however, that any long-term effect accrues from this method.
Dosage schedules for homeopathic prophylaxis vary widely depending on the practitioner's preference. The schedule, the potencies used, and the number of repetitions are chosen arbitrarily. Golden devised his schedule to approximate the timing of allopathic vaccines, "to reassure parents that their children are being covered by a comprehensive program...." Eizayaga employs 200c potencies of nosodes as homeopathic prophylaxis. His schedule involves giving one nosode twice per day for three days, waiting one week and then beginning the next nosode in his series. Others advise giving a CM (100,000 dilutions) once, or a 1M (1,000) that will last at least two years (Shepherd, 1967). In the absence of any studies or any way to prove immunity, homeopaths arbitrarily choose dosage schedules.
Disagreement exists among homeopathic practitioners about the safety of introducing a homeopathic medication into the body if there are no clear indications for its use. In general, homeopathic medicines are prescribed on the basis of existing symptoms. These symptoms , guide the prescriber to the correct prescription. Classical homeopaths assert that an incorrectly prescribed homeopathic medicine can interfere with the action of other correct prescriptions or disturb the energetic balance of the organism. They generally do not condone the administration of many different nosodes in a single person, as some cases have been rendered apparently incurable by such practices.
Golden has addressed these concerns. He reasons that the damage caused by the administration of the homeopathic nosode is less than the damage caused by conventional vaccines. This is a theoretical assumption that may or may not be true. It is certainly true that homeopathic medicines have never caused the dramatic adverse effects including paralysis, epilepsy, and deaths that are attributed to conventional vaccines. Neither do homeopathic medicines circulate toxic materials in the bloodstream. He further states that the possible adverse consequences of protection using the nosodes are less than the probable adverse consequences of acquiring certain infectious diseases such as polio, diphtheria, and tetanus. Furthermore, even though he finds trust in the protective effect of a constitutional homeopathic medicine attractive in theory, this practice may not prove efficacious, since there are examples of strong and vital individuals and cultures who succumb to infectious disease. His conclusion is that homeopathic vaccines may prove effective, are less toxic than conventional vaccines or the diseases themselves, and are therefore preferable to relying on strictly classical homeopathic prescriptions (Golden, 1989).
Most classical homeopaths would counter that a strong and vital constitution does provide protection from the serious consequences of diseases, unless the disease is different than anything the immune system has ever encountered. Such may be the case with Polynesian islanders exposed to measles, or vital young adults exposed to HIV or the Ebola virus. Parents might also consider this possibility when evaluating needs for protection when children travel to foreign countries with endemic diseases that a child has not previously encountered.
On the other hand, most classical homeopaths will prescribe a preventive medicine or nosode during an epidemic, or following exposure if the effects of the disease could significantly compromise the health of the individual. This practice has some justification, based on the few studies that have been conducted, and on the considerable experience of homeopaths managing epidemics over the past hundred years. In most situations, classical homeopaths tend to rely upon constitutional homeopathic treatment and other immune-enhancing factors in a child's life to develop a strong immune system and prevent serious diseases and their complications, rather than experimenting on patients with unproven preventive medicines that could cause problems. Homeopaths cannot apply a double standard, assuming without any evidence that homeopathic prophylaxis can be used safely and effectively while at the same time criticizing the vaccine industry for exaggerating claims of conventional vaccine effectiveness and minimizing the recognition of adverse effects.
A separate question concerns the advisability of preventing childhood diseases if this will create a greater susceptibility and incidence of the disease in adulthood. Homeopathic prophylaxis results in the same situation as conventional vaccines in this regard. If the homeopathic program is effective, then these nosodes may require repetition throughout the lifespan to protect adults because they have not gained immunity by contracting these infectious diseases during childhood. Since the homeopathic medicines do not apparently act by stimulating measurable antibody responses, there would be no way to determine susceptibility to disease, or the need for repetition of doses. Therefore, the program might require repeated use of these substances on an arbitrary schedule to maintain immunity. Such a maintenance program would be as hopelessly speculative as the dosage schedule is now, since there is no way to document immunity.
The final difficulty with reliance upon long-term homeopathic prophylaxis involves ethical issues. Parents need to understand that there is no evidence to support the use of these homeopathic preparations for long-term prevention. A homeopath who prescribes a prophylactic medicine and assures parents that it will prevent a disease years in the future misrepresents the facts. False reassurance and wishful thinking may dispel parental anxieties about diseases, but they do not represent logical conclusions. There is nothing in the literature that even suggests that homeopathic prophylaxis provides lasting immunity from specific diseases. To claim that they do is an unfounded fabrication.
Some authors have suggested that if parents are given the choice of doing nothing or obtaining the conventional vaccines, then many parents will choose vaccines because they want to do something. Golden forcefully states his argument in this regard. He would "strongly argue that if parents prefer to vaccinate their children rather than provide no specific protection, we as practitioners are professionally obliged to offer them the use of the Homoeopathic alternative. It is then up to the parents concerned to choose between the two options for protection, based on the information available to them" (Golden, 1994). Homeopaths may or may not feel obligated to offer parents a program that has no basis in experience or research. If they do, the information should be accurate and not composed of contrived claims for homeopathic prophylaxis. The decision to use any vaccine rests with the parents. Nonetheless, practitioners cannot advise the use of homeopathic preventives just because they fear that parents will choose conventional vaccines if they offer nothing. This encourages the worst kind of anxieties, and defeats the purpose of a truly informed choice. Fear of disease has bedeviled allopathic medicine for centuries and has led to increasingly toxic methods of suppressing symptoms. Homeopaths would do well to present the facts to parents, and assume that parents have the intelligence and good judgment to come to their own educated opinions. Parents deserve to have access to all the information available, so that their choice about vaccines, conventional or homeopathic, can be an informed one.