Karl-Reinhard Kummer

Abstract

In view of the large number of immunizations recommended and the publicity-driven pressure on critics of mass immunization, it will be necessary to take a fundamental approach to the whole process. Immunization cannot be said to be an attenuated form of the disease. It is a specific memory process in which the child's powers of antipathy are enhanced. Immunizations are thus similar to what happens at a more advanced age. Boosters correspond in principle to allergic processes. Immunizations enforce peripheral digestive activity that may demand too much of the organism. This may pave the way for allergies.

Long-term effects on health cannot be adequately assessed, despite mass programs. Apart from immediate side effects there may be changes in infection spectrum. The actual goal of immunization, which is to reduce the number of injections, may not be reached. Gaps in the program may cause the immune status of whole population sections to be reduced rather than enhanced.

Lack of information on fundamental aspects of immunization is considerable. This concerns schedules, the number of immunizations required or the problem of failures. Information is also needed on the epidemiological effect of major campaigns. Studies on the individual rather than collective statistical methods are demanded.

Global mass immunization programs do not meet individual requirements. The individual or the parents must be allowed to make an individual decision for every immunization procedure.

Current situation

The Staendige Impfkommission (STIKO, Permanent Commission on Immunization) in Germany made major changes to its recommendations in 1994. Diphtheria immunization is recommended more strongly, HIB vaccine to be used up to four times for all infants and young children, MMR vaccine during the 15th month and at age 5 for all children, pertussis vaccine in combination with diphtheria and tetanus (DPT) three times in infancy and a fourth time in the second year of life.

Little emphasis is put on the risks of cellular pertussis vaccines, with pertussis immunization recommended for children with neurologic disease, though the final responsibility is left to the physician. Some "children with progressive neurologic disease, seizures, neurologic conditions that frequently involve seizures"... are stated to be "greatly at risk." "The physician must therefore weigh the risks carefully." Acellular pertussis vaccines still have to prove their value in practice.

Twenty-nine routine immunizations against eight diseases are recommended up to the age of 15, about twice the number recommended by Stickl.

A look at some vaccines

Immunizations and vaccines differ, and distinction must be made especially between immunizations against virus and bacterial infections and those against toxins. Vaccines against viruses are often called "live" vaccines. Quast et al. write: "Use of live vaccines means injection of live attenuated pathogens, i.e. their virulence has been reduced ...." This is incorrect. Virus substance does have some of the properties of life forms but not the properties of life. It can induce specific reactions in the living organism. These are, however, different in quality, e.g. with BCG vaccine, than those seen with measles immunization. Considering them to be equal, as done by Quast et al. (p. 20f.) or Fenyves and Kurth, ignores the differences that exist for vital processes in the organism.

Vaccines against bacterial antigens

Rook distinguishes between toxins, capsular polysaccharides, a mixture of toxins in Bordetella pertussis, lipopolysaccharides in Neisseria gonorrhea and unknown antigens in BCG vaccine (see also Paswell). In his view, problems increase in the given sequence.

According to Steiner, bacteria are "animal plants." They may flourish where there is an excessive "tendency to become animal." Bacterial processes belong to the anabolic aspect of the organism. It is therefore understandable why bacterial vaccines have poor immunizing effects (BCG or live typhoid vaccines). Apart from the toxins, they are not well tolerated, which also applies to cellular pertussis vaccine. Excessive reactions such as BCG abscesses may occur. The antigens to BCG vaccination are not yet known.

Natural immunization against bacterial capsular antigens such as Haemophilus influenzae B starts only at 18 months, with a reliable level of immunity reached only at age 3. Present-day vaccines provoke an immune response even in infants, because bacterial antigens that are not very immunogenic before the third year are conjugated with another antigen - diphtheria, tetanus or meningococcus toxoids. Conjugation of Haemophilus vaccines may be said to be "toxification." The toxoids raise the process to a level where astral antipathies are active. The possible consequences of this are not yet known.

Bacterial infections are a puzzle to this day. Heininger showed that while there were pertussis symptoms with whooping cough and parapertussis, no pertussis toxin had been found.9 In the case of HIB immunization, information on the role of antibody affinity is limited, .... reflecting physio- chemical bonding or accurate antibody-to-antigen fit; ... antibody affinity does not necessarily have to correlate with the antibody concentration.

Vaccines against viral antigens

Virus infections indicate a marked tendency towards mineralization and decomposition processes. The organism is forced to produce and replicate the foreign virus substance until it recovers. Healing will only begin if inflammatory reactions are possible. Zur Linden therefore postulated that viruses related to the destructive pole in the organism, i.e. the nervous system. The trend is evident in breakdown of the mucosa with aphthous stomatitis, for instance, or chickenpox. T cells perish in vitro after measles infection, resulting in a form of immunosuppression about which little is known. Cellular immunity, e.g. the tuberculin reaction, is reduced during measles infections.

The inflammatory changes seen with virus infections represent the second, reconstructive healing phase. Measles exanthem actually indicates that (artificial) immunity is beginning to develop. The exanthema subitum of infants, which only develops when the process has finished, is a typical instance.

Because of the mineralizing tendency, it is easy to see why complications seen with immunization against virus diseases such as measles, mumps and rubella affect the nervous system. Degeller ascribed this to the effect mineral substances have on the Ego. The fact that pregnant women have good immunity against virus infections is also explained by increased catabolic activity. Compared to bacterial infections such as tuberculosis or pertussis, where this type of immunity is poor, the cellular component of immunity is less important.

Remarkably little is known about the role of the host. A number of measles virus subtypes are known, but no conclusions can be drawn from this. The polio vaccine virus clearly changes considerably in its passage through the gastrointestinal tract. For combined immunization against types 1, 2 and 3, parts of type 2 are incorporated in attenuated type 3 virus. Numerous other dramatic mutations develop during the weeks following vaccination. Elimination of the vaccine virus takes longer than assumed. In spite of so many facts being known, many questions remain open with reference to the oral polio vaccine.

Vaccines against toxins

Greater certainty exists with regard to vaccination against bacterial toxins. Vaccination with toxoids may be seen as addressing the astral body directly. This is able to react adequately by producing antitoxins. Digestion in the metabolic system is necessary but requires relatively little effort. Immunostimulation is at a high level, and tolerance relatively good.

With immunity limited to toxin activity, transmission of the bacteria is possible despite protection against developing diphtheria. Tetanus shows relatively little metabolic activity, at least compared to diphtheria, which may, among other things, lead to enlargement of lymph nodes. This explains why immunization against tetanus is possible at the intrauterine stage but immunization against diphtheria, which is more metabolic by nature, only at about 3 months.

Vaccination and disease

The aim of immunization is to develop antibodies. Many physicians consider vaccination to be an attenuated form of the disease which has a positive effect on the child's developing immune status. Early vaccinations done by the ancient Chinese or Jenner were intended to avoid serious illness by giving a mild one. The current view is that apart from antibody production, vaccination and disease have little in common.

This limitation to antibody induction was Behring's aim more than 100 years ago. He was only interested in the antitoxic effects. Initially he tried to treat sepsis with iodoform, "like preserving a ham against putrefaction by smoking it," and came to the following conclusion: "Let us assume the morbific effect of virulent pus depends on the presence not only of pus bacteria but also of their chemical products; let us also assume that those chemical products are influenced by iodoform, rather like cadaverin. This explains why iodoform can have a medicinal effect in virulent disease without causing appreciable direct damage to the microorganisms." He suspected that "laws can be demonstrated according to which a relationship exists between an animal's immunity to a bacterial disease and the antibacterial activity of its serum." In 1899 he wrote: "Nothing in the world is influenced by tetanus antitoxin, except tetanus toxin."

In 1901, he started his attempts, together with Katashima, to immunize monkeys with diphtheria toxin, "transferring genuine diphtheria bacilli, the virulence of which has been attenuated, to the human throat organs for the purpose of auto-immunization." He felt the body had to be forced to produce a species-specific antitoxin "that, unlike a foreign antitoxin, remains in the blood for a long time and therefore confers protection against diphtheria for a year and a day.

Vaccination and disease are almost completely dissociated today. Febrile reactions to vaccination are rare in healthy subjects. This means that vaccination has essentially become a process to which there is no inflammatory reaction, a process of coldness. The specific immunization process, vaccination and the general reaction, a respiratory tract infection, may actually run side by side. Mild disease is not considered a contraindication for vaccination. Dennehy et al. found that seroconversion against measles, mumps and rubella was the same in children with and without respiratory tract infection. Like Peter, they concluded that respiratory tract infection is not a contraindication. Long-term side effects were not investigated.

It is, in fact, contraindicated to induce disease by vaccination. With this in mind, many physicians give prophylactic antipyretics when doing a vaccination, even if there is no medical reason for this. Suppression of symptoms is the general principle with vaccination and disease, m the case of vaccination they are usually referred to as "reactions" rather than "complications." The distinction depends on whether it is felt that side effects should be presented as serious or made to look harmless.

Quast et al.’s reference to "vaccination disease" is inconsistent. The virus count does increase with "vaccination measles," but the symptoms are not those of the wild disease. Above all the characteristic psychic changes do not develop. BCG vaccination will result in enlargement of regional lymph nodes or tuberculous skin abscesses. The process shifts to the skin. With tuberculosis it takes place in the internal organism ("hysteria taking place directly in the ether body").

Time form of diseases

A disease is a process in time. Weckenmann investigated tonsillitis and myocardial infarction and found alternation between general and local symptoms following definite laws. This was especially apparent with childhood diseases, but also nephritis, pneumonia and myocardial infarction. Girke found this also applied to sclerotic symptoms. Sclerotic substance is produced during the local phases. A disease goes through numerous rhythmic intermediary processes before recovery is achieved. The recovery process may on occasion be painful but is a necessary part. "Silent" measles immunization is also a process. Here, it is open to the individual to gain immunity with or without manifest disease. The different incubation periods of many infectious diseases suggest that some room exists for individual variation. Evolution is, in fact, always individual, even with the same disease. Vaccination does not take this course in time. It may go against the normal time schedule and prevent the disease in the case of rabies or measles. The building up and breaking down processes normally seen with the disease do not develop/ and particularly also the process of ultimate recovery. Instead of the organism being restructured once the infection is overcome, there is only the development of immune memory, with no healing process.

Vaccination comes from outside, with the organism exposed to it. Behring actually spoke of "forcing" the organism. Vaccination is not intended to be individual but predictable, planned, uniform. An individual process also becomes impossible with regard to onset. With contagious diseases such as measles or chickenpox, some children will not contract the disease on contact but only at a later date or never. They have their own special place in the biography, as does pneumonia. Vaccination makes such individual evolution impossible. The situation becomes even more serious when booster shots are given (v.i.). Entry port into the organism The normal port of entry into the organism, such as the mucosa or lymphatic system of the gastrointestinal tract, is not used as a rule. Behring still went in that direction in his attempts to "vaccinate" the tonsils with diphtheria bacilli. Vaccination by injection or scarification circumvents the digestive process, creating a minor wound and enforcing "parenteral digestion," without addressing the lymphatic system directly. From the anthroposophic point of view we must ask whether injections of any kind do not harm the "rhythmic system," unless the medicament is specially prepared. By its very nature such a medicament is not designed for digestive processes. The organism is mainly protected against foreign matter, "poisoning" by foreign foods, in the gastrointestinal tract, with a limit set to destructive digestive processes.

In the process of digestion, food and organism enter into a close relationship between inner and outer. Weckenmann referred to this as a gesture of sympathy. At the same time a pause is created for the organism, a kind of buffer zone between inner and outer, before the food substances reach the inner organism by the lymphatic route. As a result, contact between foreign matter that is not yet fully degraded and the lymph or blood which is wholly one's own can be delayed a little. It is different with vaccination. Here the foreign substance, generally given by the parenteral route, demands instant reaction, which puts it close to a forced reflex.

Weckenmann states that digestion outside the intestinal tract occurs only under pathological conditions, as with inflammation. Thus, "parenteral digestion" demands sacrifices from the organism that take the form of abscesses. Any injection calls for "parenteral digestion." The negative effect an injection has on the organism is not purely academic. Strebel et al. found that in 87% of cases of paralytic vaccination polio in Rumania one or several intramuscular injections had been given during the 30 days preceding onset of paralysis.

Problem of elimination

Typical childhood diseases have accompanying eliminatory processes. This may take the form of exanthem, diarrhea or vomiting, with the incidence remarkably high, as shown in a retrospective study by the author. This corrects the variable imbalances between the upper and lower human being as the disease evolves. Exanthema may be seen as peripheral "digestion," and equated with healing. Vaccination does not offer this potential, apart from so-called side effects. This may result in premature sclerotic changes.

With suppression of symptoms, immunizations have become memory and neurosensory processes. Reading Behring's writings we realize that metabolic activity is to be as far as possible excluded. This has two consequences. First, there is no possibility for creating a counterbalance to this neurosensory activity in the metabolic sphere. Secondly, this sense-related function is in the sphere of metabolism. The only kind of counter process the metabolism can find is a metabolic reaction in the sphere of the nerves and senses. The relationship between the upper and the lower human being is thus put under a strain.

Immunizations therefore increase a tendency to higher sensitivity in the nervous system, as described by Wolff. With a strain put on the memory and sensory functions of the organism, it is easy to see why side effects frequently involve the nerves or the senses, e.g. as encephalophathy with pertussis or diphtheria immunization or meningitic changes with measles immunization. The memory functions of the metabolic system are challenged by foreign substances. At the same time the actual metabolic processes, manufacture of the vaccine, take place outside the organism. Steiner referred to the effect of excessive demands made on the organism through external processes in the lower human being as hysteria.

Immunization and memory

A child is a creature of the senses; powers of growth with their sympathy dominate the picture. Sensory processes, tasting processes are active all the way to the body periphery. In the first 7 years of life the physical foundation for the individuality is created. In no other period of life is the tension between "inner" and "outer" as great as in childhood when body substance is created and infectious aspects of the environment have to be overcome.

During its first 7 years a child should only receive easily digestible quantities of new impressions. We know that infants may react with colic to mother's milk and with shyness to strangers. Mothers' milk is the least foreign substance. Its constituents, e.g. iron, are easily taken up. Having high physical surface activity and a high concentration of immunoglobulins it protects the child's sensitive organism.

Memory is only possible if there is conscious awareness. This requires powers of antipathy to the environment which infants and young children do not have. A cold persists for a long time in infants. Virus infections do not cause general febrile reactions followed by rapid recovery. Immunization is only good from birth, and even in utero, in the case of toxoids. Before mass measles immunization was so widespread, immunity conferred by the mothers was so good that measles immunizations did not prove successful before the 15th month. For a full discussion see Johnson et al., though they, too, reported only 74% or 53% success rates with early vaccination in 1994, depending on the method of investigation.

A child's early ability to remember is situation-bound. It will enter afresh into the same situation full of sympathy, perhaps taking the same route again in memory. Isolated facts are not remembered, and no note is taken of them. Only processes are remembered. Vaccination is not a process but a single event, with only the antipathetic aspect experienced. The absence of a process may be one reason why the immunity conferred by vaccination is limited in time, compared to that given by the wild disease (e.g. measles) which is life- long.

Booster shots confer the desired long-term immunity. This, however, is enforced memory and unphysiological in young children. Young children, especially if under 3 years of age, experience every situation as something new, even if they have known it before. This is the age when forgetting is "practiced." Regular habits have an educative effect on the child. Isolated events, on the other hand, especially if enforced, with no opportunity to take them up in play, can prove harmful.

Immunizations, thus, represent one-sided emphasis on memory and "head" processes. The rhythmic functions that facilitate digestion are impeded if not made impossible.

Immunization and immune system

Little reliable information is available on the effect on immune status, though it has been said that "postvaccinal immune weakness" after MMR immunization is possible, at least in theory. Acellular pertussis immunization, currently introduced with considerable publicity, also raises many questions.

Immunization essentially addresses the specialized T cell functions of the immune system, and the antigen specific B cell response. The response to polysaccharide antigens begins in the 2nd or 3rd year and is only fully developed in the 9th year. From the anthroposophic point of view, this is the time when the "Ego" begins to intervene in metabolism. Children are then able to relate fully to their environment both physically and psychologically.

Little is known about immunization effects on nonspecific immune mechanisms. These are highly similar to digestive processes, e.g. complement receptors binding viruses or bacteria, opsonization of these complexes in macrophages and their elimination in the reticuloendothelial system of spleen and liver. Induction of special antibody development may result in nonspecific immune responses being neglected. This may apply especially if vaccination is given in spite of respiratory tract infection. It enhances the dissociation between specific and nonspecific immune processes. There are children with poor resistance to infection, for instance, who have had a large number of immunizations. This reminds of people with allergies who have extremely high IgE levels.

Waking and sleeping, allergy and immunization

The level of consciousness in the upper human being is reduced during illness. People are febrile, experience malaise and feel less bright. On the other hand, they are awake and active in metabolism. The phase of quiescence which follows is necessary to restore full performance capacity. In the case of vaccination, the senses and nervous system are awake, perhaps even excessively so due to the pain of the injection. Just as going to sleep can be difficult after one-sided intellectual work, so can the "going-to-sleep processes" after vaccination present problems because the calming metabolic component is largely absent.

Nothing appears to be known concerning excessive strain on the immune system. We know, however, from everyday life that it needs some degree of health to cope with both physical and nerve stress. Following vaccination, a foreign substance has to be "digested." There is a risk that the astral body is put under strain by this and withdraws, becoming less mobile. As a result the metabolism is not able to digest certain products properly. This leads to conditions which Steiner referred to as childhood hysteria, with the upper aspects of the human being involved outside the organism; the organism is injured by foreign processes.

Unlike digestion, vaccination entails sudden contact with foreign matter. In digestion, food is broken down and assimilated in numerous stages. The foreign matter, intestinal mucosa and flora are in close contact. This involves both sympathetic and antipathetic elements. Sympathetic aspects predominate in the absorption stage. Antipathy only gains the upper hand in the region of the large intestine. The child is actively involved in the process of digestion. The same can be said of childhood play, when the doing is more important than the outcome. With vaccination, the organism is not asked to "digest," and the assimilation process occurs outside the organism in the form of attenuation, production of toxoids, etc.

Weckenmann sees immunity as a process and not a stable state. A disease process alternates between local and general symptoms. Someone who is immune, he says, does not continue in the immune state but is particularly responsive. In his view, the third step in disease is that "it is a form of further development if it helps the individual to develop 'immunity' or encounters an immune individual." For a cure, the right level of reaction has to be found, and for this Weckenmann suggests the term "euergy" rather than immunity. A cure thus represents restoration of the normal conditions under which the organism is able to digest, with losses minimized (economically).

People liable to develop allergies clearly have a general digestive weakness. This is known from the fact that cow's milk proteins taken as food by the mother remain essentially unchanged, passing through numerous barriers, and can be demonstrated in the child's blood. It should also be remembered that the nonspecific immune system is mainly associated with the intestinal tract. An allergic subject thus has the double handicap of primary digestive weakness and primary nonspecific immune deficiency.

Another aspect is the time of first contact. Early contact increases the risk of allergization. Thus it is possible for individuals to be allergic to pollen grains that were seasonal at the time of their birth. This reveals the importance of setting limits. With vaccinations given to very young infants it is possible that the good tolerance shown is merely apparent, and that vaccination only had minor side effects because reactivity had not yet developed. No connection has so far been established, however, between vaccination and subsequent immune capacities.

Problems often arise with the third DPT immunization. Booster shots intentionally interrupt the normal forgetting process. The individual is forced to deal with the foreign substance and unable to avoid it. It is therefore not only the second vaccination which presents problems but also revaccination using the same antigen.

An important aspect is who is in control of forgetting and remembering. Reduced antibody levels after immunization indicate that the organism tends to forget the immunization. Booster immunizations make this impossible. With the disease, the Ego is involved in maintaining immunity for life. With immunization this has to happen from outside. This could be a further explanation of the allergy potential, of being unable to forget, due to immunization.

Even the minor shocks infants show in reaction to injections have significance. The pain of an injection drives the Ego and the astral body out of the rest of the body. This is all the more so once children are older when revaccinated and experience the event more strongly. Physiologic memory processes in childhood take a very different course (v.s.).

Many of the processes involved in vaccination therefore correspond to those seen with allergies. An allergic individual does not forget but is wounded all over again on contact with the allergen, retaining the pathological memory. Renewed contact does not result in a better, but in a worse, reaction. The allergic compulsion of having to react again and again to a foreign substance is applied on purpose with booster shots. The Ego is coerced from outside. This will above all make processes of rest impossible, which the human being chooses in sleeping and waking, for instance. Boostering enforces wakefulness in the immune system.

The allergic phenomena have to be seen as an attempt at elimination, e.g. the powerful secretion of mucus in allergic conjunctivitis, rhinitis or bronchitis. Aggravation of allergic symptoms after vaccination may be seen as an attempt on the part of the organism to forget the vaccination in order to heal itself.

Standard works on pediatric immunology do refer to the problems that arise with immunization of allergic subjects but say little about the allergy potential of immunization. Stueck, too, merely mentions short-term aggravation of neurodermatitis with MMR immunization. Quast et al. do, however, admit: "It has been stated that skin diseases may be exacerbated by immunization. An effect on endogenous eczema (often positive, occasionally negative) due to measles immunization is certainly possible.. .." Bauer states that no work has been done to find an answer to this question. In the author's experience, onset of neurodermatitis was frequently preceded by immunization.

Quast et al. list a number of local and general reactions that are clearly allergic by nature (pp. 162-194). Their assumption is, though there is nothing as yet to prove it: "Reactions of this kind, representing allergy to vaccine constituents, are, however, extremely rare..." (p. 176). On the other hand, they accept "general intolerance of hen's eggs, though anaphylactic and other allergic symptoms have not been clinically confirmed."

Peter accepts only extremely severe hypersensitive reactions as a contraindication to revaccination. Nowadays MMR immunization is actually recommended for children allergic to egg-white. Reinhardt says:

"There is nothing to indicate that the usual immunizations pave the way for food or inhalation allergies. This applies both to the normal population and to individuals with a high risk of developing an allergy (positive family history and raised umbilical cord IgE)."

According to Reinhardt, allergic reactions to vaccines may be due to auxiliary agents, but with today's highly purified vaccines such reactions are extremely rare. Again, no empirical data are given to support these statements.

Immunization - a process relating to old age

Childhood diseases have to do with the head pole coming to terms with metabolism. In most instances, metabolic processes go up into the sphere of the nervous system. These diseases are acute and febrile. Warmth processes and anabolism predominate, especially in morbidity. If there were no excess of febrile and anabolic processes, degenerative processes would develop. It is only in older children that the middle, rhythmic function establishes a balance.

Later in life, growth and regeneration become less active. Catabolic processes predominate. Sensory functions are also different in old people. Reticence takes the place of sympathetic reaction. With immunization, this is, in fact, desirable: recognition of the antigen with minimal systemic reaction and maximum efficiency in antibody production. Yet this process, which belongs to a more advanced age, is generally applied in childhood and youth. The antipathetic reaction pattern of immunizations may result in premature aging and catabolic processes.

Vaccine production involves death processes. Zur Linden drew attention to this in 1962. Polio vaccine is cultivated on monkey kidneys, chick embryos or human diploid cells taken out of their vital context. To avoid direct toxic reactions substances have to be added to attenuate and inactivate the pathogen. Other potentially harmful additives are disinfectants, solvents, emulsifiers, etc. These may also cause side effects.

Cell cultures used to grow the pathogen are artificially kept alive; it is worth noting that they are largely cultures based on tumor cells, i.e. a pathological life process is cultivated for the sake of the vaccine and not to serve the human organism. We thus have a reversal of goals, for it is not the human being who is vitalized in the process but the vaccine.

Karl-Reinhard Kummer, M.D.

Jaegerstr. 19

D-076227 Karlsruhe

Germany