Intended for healthcare professionals


US county bars unvaccinated children from public spaces amid measles emergency

BMJ 2019; 364 doi: (Published 28 March 2019) Cite this as: BMJ 2019;364:l1481

Linked opinion

Measles in America—what’s playing out in New York State is nightmarish

Re: US county bars unvaccinated children from public spaces amid measles emergency

Response to Allan S. Cunningham

Cunningham writes: “Does he know that a substantial proportion of cases of paralytic polio has been attributable to injections of vaccines or antibiotics?”

Actually, I have ca 40 papers on provocation/injections/antibiotics and polio, including the ones you list, plus a number of chapters in books. The first documented instances go back to Germany early part of 20th Century when infants received injections of neosalvarsan (an organic arsenic compound) and in 1932 in Western Samoa when the Rockefeller Institute initiated a campaign against Yaws, giving two injections per year of neoarsphenamine to everyone who showed signs of yaws (Smallman-Raynor (2006). And there is some documentation that other injections have shown a causal connection with polio. You also left out the association with tonsillectomies. The response among many health professionals was simply to postpone injections and tonsillectomies until after polio season (Mawdsley, 2013). Note that research exonerated antibiotics (arsenic-based were already no longer used) (ibid). ““The decision to reform public health policy in the US was handled differently in various areas, but appears to have been taken with great care, since it was clear that withholding certain immunisations would jeopardise herd immunity,” said Dr Mawdsley. “Delaying injections until after polio epidemics subsided was an expedient means to achieve a compromise.” (Mawdsley (2013b) However, both injections and tonsillectomies only affected a small, not substantial, proportion of kids, based on timing of exposure to polio virus and injection/tonsillectomy. One also has to take into consideration the devastating mortality from just diphtheria alone prior to vaccinations, “The United States recorded 206,000 cases of diphtheria in 1921, resulting in 15,520 deaths (CDC Clinicians).” With the advent of the Salk vaccine and later the Oral Sabin vaccine, provocational polio paralysis disappeared. And, as I discuss in an article. post-polio syndrome involved many who did not become paralyzed when first infected (Harrison, 2018b). So, I’m quite aware of provocation paralytic polio; but also aware of the number of cases vs the risks from other vaccine-preventable diseases and that once the polio vaccine was introduced, paralytic cases of polio disappeared in the US. With hindsight, it would have been great if earlier on injections and tonsillectomies had been postponed until after polio season; but the fact remains that, tragic as it was, the number of provocation polio paralysis cases paled beside the number of deaths, suffering, and disability that would have resulted if vaccines had not existed.

Cunningham writes: “Will he acknowledge the possibility that this might also be true of acute flaccid myelitis/AFM, the devastating polio-like disease now afflicting children?”

Acute flaccid myelitis has been mainly attributed to a couple of enteroviruses. There exists ca. 100 different strains of enterovirus and when labs were first used to confirm polio back in the 1950s, some cases of paralysis were already attributed to other enteroviruses (Harrison, 2018b). Sporadic cases of non-polio acute flaccid paralysis have been with us for decades. However, studies have found that “the genome had undergone a rearrangement from the initial Fermon strain in the spacer region of the 5’ UTR, which is known to affect the translational efficiency and thought to increase the virulence (Cassidy, 2018; see also Rao, 2012). In a Rapid Response, Cunningham claimed: ““They also say that they are continuing to investigate the possibility of an association, but the AFM Patient Summary Forms that they supply to US state health departments contain no questions about injections or vaccinations.” NOT TRUE (Iannelli, 2018). “In addition, AFM cases are seen at a variety of ages and not at an age when a particular childhood vaccine is regularly given. The average age of AFM cases in the largest published reports from the US is 7 and 9 years, and the age of reported AFM cases ranges from 6 months to 21 years and older. So, the ages of AFM cases vary and are past the time when most childhood vaccines are routinely given.” (Duchin, 2016) Blaming vaccines ignores the fact that viruses mutate. It is also possible that due to more infants surviving, even with various disabilities, that genetic predisposition plays a role.

Cunningham writes: “Does he believe that our knowledge of adverse vaccine effects is complete?”

Complete? This question is problematic. At this very moment, post-marketing surveillance of vaccines continues, not just VAERS, for instance, Vaccine Safety Datalink that collects real time data on several million Americans (CDC Vaccine Safety Publications). Check out PubMed with almost 19,000 entries, some reviews, some editorials, but many research articles. However, at this point the overwhelming evidence tells us that the benefit/cost ratio for vaccines is exponential. Would I like to have vaccines that approach 100% effectiveness and 0% adverse events. You betcha; but I live in the real world.

Cunningham writes: “Does he believe that every vaccine on the US immunization schedule is vital to the health of every American child?”

Another problematic question. Since each of the current vaccines prevent or reduce the severity of diseases with potentially devastating consequences, and herd immunity protects even the most vulnerable, plus safety studies show them to be very safe, we should not play G-d and choose which children’s welfare is more important.

Cunningham writes: “Would he agree that, in addition to humanitarian motives, there are also non-humanitarian motives driving our immunization programs?”

I’ve answered this in a previous RR and in more detail in an article (Harrison, 2019; 2018a). No international conspiracy exists to further the “profits” of the pharmaceutical industry ! ! !


Cassidy H, Poelman R, Knoester M et al (2018 Nov 13). Enterovirus D68 – The New Polio? Frontiers in Microbiology. Available at:

CDC Diphtheria. Clinicians. Available at:

CDC Vaccine Safety Publications. Available at: [click on CDC Vaccine Safety Publications Years]

CDC Vaccine Safety Datalink. Available at:

Duchin J (2016 Nov 7). Why health care providers & public health professionals say vaccines are not the cause of recent acute flaccid myelitis (AFM) cases. Public Health Insider. Available at:

Harrison JA (2018a Feb 26). The So-Called Vaccine Debate: False Balance in The San Diego Union-Tribune. Science-Based Medicine. Available at: [go to page 5]

Harrison JA (2018b Nov 10). Wrong About Polio: A Review of Suzanne Humphries, MD and Roman Bystrianyk’s “Dissoveing Illusions” Part 1. Available at:“Dissolving-Illusions”-long-version.pdf

Harrison JA (2019 Mar 31). Response to John Stone. The BMJ Rapid Responses. Available at:

Iannelli V (2018 Nov 2). The BMJ Asks If Injections Are Part of the “Mystery” of Acute Flaccid Myelitis/AFM. Vaxopedia. Available at:

Mawdsley SD (2013a). Balancing Risks: Childhood Inoculations and America’s Response to the Provocation of Paralytic Polio. Social History of Medicine; 26(4): 759-778.

Mawdsley SD (2013b). Polio provocation – the health debate that refused to go away. University of Cambridge. Available at:
PubMed (2019 May 9). Search Box: “Vaccine Safety” Available at:

Rao CD, Yergolkar P, Shankarappa KS (2012 Nov). Antigenic Diversity of Enteroviruses Associated with Nonpolio Acute Flaccid Paralysis, India, 2007–2009. Emerging Infectious Diseases; 18(11): 1833-1840. Available at:

Smallman-Raynor, Cliff AD (2006). Poliomyelitis: Emergence to Eradication. Oxford Geographical and Environmental Studies.

Competing interests: No competing interests

09 May 2019
Joel A. Harrison
Long-Retired Epidemiologist
I have NEVER worked for the FDA, NIH, CDC, any pharmaceutical company, nor ever purchased pharmaceutical stocks