Vaccination was one of the hottest debate topics in my college philosophy classes. The teacher would always tell us that chiropractors should be against vaccination because: they are poisons or toxins; the procedure interfered with innate; or just that they are flat-out dangerous. I'm sure that it is still being debated at my alma mater as well as in other chiropractic institutions around the world.

I always agreed with the anti-vaccination argument on a philosophical basis, but I also realized that chiropractic is a science in addition to being a philosophy. It bothered me that my instructors could never give me a scientific basis for this reasoning.

This frustration forced me into many of the medical libraries in southern California and New York in search of an answer. After literally hundreds of hours spent in these various institutions, I finally came up with a rational, scientific reason to validate the chiropractors' philosophical stance on vaccination.

My studies have led me to the following conclusions: 1) vaccinations are dangerous; 2) vaccinations do not work as well as the medical profession and the media have made us believe; and 3) some of the great epidemics of the past have been iatrogenically induced.

The Salk and Sabin vaccines have been heralded as one of medicine's "modern miracles." There isn't an individual in this country who has not read in their elementary or high school history books about the heroic discoveries of Drs. Salk and Sabin. People who lived through the epidemics of the '40s and '50s were just as saturated with this thinking as were those who didn't.

Even today, we find ourselves being reminded of this. In one of the presidential debates, George Bush was asked who his heroes were, and he gave, as one, Jonas Salk, "whose discovery saved millions of lives from the dreaded disease of polio," or something to that effect. It is hard to say whether or not this statement was an intentional glorification of the medical profession (knowing how much the AMA and other medical organizations contribute to the presidential campaigns, it would not be surprising). It just goes to show how ingrained this type of thinking is in our subconscious.

I would like to raise this question: Is the polio vaccine really responsible for the decline and relative absence of the disease from our country?

The success of the Salk vaccine, which was introduced several years before Sabin's, is largely based on the decrease in incidence of the disease with its inception. How many of us have tried to tell someone, on a philosophical basis, that vaccines should not be given? Then, some middle-aged individual will turn around and say that he/she lived through the polio epidemics of the 40s and 50s and that they can remember how the vaccine helped eliminate the disease. It's hard to argue your philosophy against another person's experience. However, there are many cold, hard facts that can back up our philosophy on vaccines.

Poliomyelitis first became a reportable disease in our country in 1920. At that time, the attack rate was 2.196 people per 100,000 population. In 1952, the attack rate hit its peak at 37.009 per 100,000 population. It can be seen from these figures that the disease was already in a state of NATURAL decline.

Herbert Ratner, M.D., former director of public health in Oak Park, Illinois, and associate clinical professor of preventive medicine and public health at Stritch School of Medicine in Chicago, makes the following analogy between poliomyelitis and infectious hepatitis: "both diseases were in a state of natural decline when the Salk vaccine was introduced in 1955. Since the wide acceptance of the Salk vaccine was based primarily on the sharp decline in polio incidence, it is important to keep in mind that infectious hepatitis equally declined following the Salk vaccine.

What Dr. Ratner is alluding to is that if the Salk vaccine is to take credit for the decline in polio incidence, than it must also take credit for the decline of infectious hepatitis, which it cannot possibly do.

Vaccination is one of the sacred cows of modern medicine. I have found that when you try to talk to people about the chiropractic viewpoint on vaccination, you will often find yourself under attack from medical doctors and lay people alike. How is it that people have such a devout BELIEF and FAITH in vaccination when, in fact, there is much to be left desired in its logic?

Paul Meier, Ph.D., a former biostatistician from the University of Chicago, raised the same question and this is what he had to say: "The reason for this discrepancy lies, I think, in the attitude of many public health and publicity men. It is hard to convince the public that something is good. Consequently, the best way to push forward a new program is to decide on what you think the best decision is and not question it thereafter, and further, not to raise questions before the public or expose the public to open discussion of the issues." (emphasis added)

This kind of logic does not sound very rational or scientific. Science is supposed to be based on facts, not what you think the best decision is; and scientific facts are supposed to be questioned. If they are sound, they should be able to stand up to the most rigorous questioning.

The "discrepancy" that Dr. Meier is speaking of is the apparent favorable attitude of the public toward the vaccine and the less-than-favorable facts behind it. He continues on this subject by speaking about the theory behind the Salk vaccine: "My own contact with this attitude came when I was a member of the Department of Biostatistics at John Hopkins, where I had an opportunity to talk with some of the people who were connected with vaccine. What troubled me greatly was that it appeared, from the actual data that Salk presented, that the theory did not apply. Assuming that there was some error in my understanding or Salk's, I inquired of the people who knew about this. The answer I consistently received was, 'I see what you mean. I haven't thought about it very carefully myself, but there are many important and competent people who are taking care of this. Don't worry. After all, this is merely a paper for the public and not the real technical goods.' The answer as it emerged later, of course, was no one was taking care of it." If the vaccine was as surefire a thing as the medical people made it sound, then why would they be trying to hide some of the facts from the public?

Statistics are one of the pillars of modern day science. The medical profession very often uses statistics to back up the "success" of their vaccination programs. When properly done, statistics are an invaluable way of assessing a particular program or situation. However, statistics are easily manipulated, and when they are, they become an honest person's way of telling a lie.

Professor Bernard Greenberg, former head of biostatistics at the University of North Carolina School of Public Health and chairman of the Committee on Evaluation and standards of the American Public Health Association makes the following statements on the statistical analysis of the efficacy of the Salk vaccine: "... my primary concern, my only concern, is the very misleading way that most of this data has been handled from a statistical point of view... a scientific examination of the data, and the manner in which the data were manipulated, will reveal the true effectiveness of the Salk vaccine is UNKNOWN and greatly overrated." (emphasis added)

One of the scare tactics the American Medical Association used on people via television, radio and newspapers was to tell them that the attack rates among unvaccinated children was much higher than for those who were vaccinated. This concept was based on statistics that the United States Public Health Service had accumulated.

The following statement by Dr. Greenberg shows the inadequacies of these statistics: "First of all, the unvaccinated population figure for 5- to 9-year-old children used in the Public Health Service report was the number given in the 1950 census minus the number of children vaccinated. The number of children aged 5 to 9 in 1955 was estimated, however, to be 101,000 more than it was in 1950. The Public Health Service did not take this into account. This omission of 101,000 children from the unvaccinated population would have increased the latter roughly from 236,000 to 337,000 children. Hence, the attack rate for unvaccinated children was OVERESTIMATED by 40 percent." (emphasis added)

This poor statistical analysis was further compounded by diagnostic semantics. Prior to 1954, the criteria accepted by most health departments for diagnosing poliomyelitis was that which was set forth by the World Health Organization: "Spinal paralytic poliomyelitis: signs and symptoms of non-paralytic poliomyelitis with the addition of partial or complete paralysis of one or more muscle groups, detected on two or more examinations at least 24 hours apart." This means exactly what it says -- that in order for a case to be classified as, and hence go into the statistics as being, paralytic poliomyelitis, there must be some form of paralysis that lasts for at least one day.

In 1955, coincident with the introduction of the Salk vaccine, the criteria for classifying a disease as paralytic poliomyelitis was changed so that determination of residual paralysis was made 10 to 20 days after the onset of symptoms and, again, 50 to 70 days from the onset of the disease. Since it was not unusual for a case of paralytic polio to spontaneously remiss, the incidence of the disease would have markedly decreased with these new standards, whether or not any vaccine was used.

Dr. Greenberg goes on to say that "this change in definition meant that in 1955 we started reporting a new disease, namely, paralytic poliomyelitis with a longer lasting paralysis. Furthermore, diagnostic procedures have continued to be refined. Coxackie virus infections and aseptic meningitis have been distinguished from poliomyelitis. Prior to 1954, large numbers of these cases undoubtedly were mislabeled as paralytic poliomyelitis. Thus, simply by changes in diagnostic criteria, the number of paralytic cases was predetermined to decrease in 1955-57, whether or not any vaccine was used."

Herman Kleinman, M.D., a former epidemiologist from the Minnesota Department of Health reinforces this thought by saying: "I would also like to agree with Dr. Greenberg that the insistence upon a sixty-day duration of paralysis is absolutely silly. There isn't a doctor in this room who hasn't seen a case of frank paralytic polio which has not recovered in sixty days, or at least recovered sufficiently so that you could not estimate with clinical certainty that there was some residual paralysis."

Another component of this semantics game can be found when we look at the definition of an epidemic. Epidemic is a powerful word. It connotes a disease which has run rampant among a population leading to sickness, suffering and death among those it affects. Before 1955, an outbreak of polio was considered to be of epidemic proportion when 20 or more cases of polio occurred per 100,000 population. The definition of a polio epidemic, again, coincident with the introduction of the Salk vaccine, was changed to 35 cases of polio per 100,000 population, within a one-year period.

So, the newspaper headlines that read "Polio Epidemics on the Decline as a Result of the Salk Vaccine" were only half right. They were on the decline, not because of the Salk vaccine, but due to increasing natural immunity to the disease and semantical changes in definition. From the above information it can be said, without reservation, that much of the reduction in the incidence of polio-myelitis in this country was nothing more than statistical artifact.

(Part II of Dr. Riker's article on Polio Vaccine will appear in the September issue.)