Vaccines work – but too many all at once?

I hope you know what you’re doing

An excellent graphic representation at shows how well vaccines have worked in the USA.

The WSJ included it today in a general piece on the Return of the Vaccine Wars. at

Here’s the story with comments, which are interesting:

[spoiler title=”Click to expand for story and comments” open=”0″ style=”1″]The Return of the Vaccine Wars
The controversy over vaccines is as old as vaccination itself
Feb. 20, 2015 3:22 p.m. ET
The controversy over vaccines is as old as vaccination itself. When Edward Jenner, a brilliant English country doctor, discovered the vaccine for smallpox in 1796, he faced as much criticism as praise. Ministers thundered against tampering with the Lord’s grand design. The economist Thomas Malthus worried that vaccines would lead to dangerous population increases. The very idea of injecting animal matter into the human body struck many as dangerous and repulsive. Cartoons appeared showing cows’ horns sprouting from the heads of recently vaccinated children.


Vaccines: Delays, Too, Pose Risks
How Anti-Vaccination Trends Vex Herd Immunity
Five Things to Know About Measles
Vaccine Skeptics on the Rise
Measles Vaccine Debate Shifts Tone
The Anti-Vaccination Epidemic
The current measles outbreak, with more than 140 cases so far, has created a firestorm that may not disappear when this particular crisis ebbs. Last week, New York University Medical School bioethicist Arthur Caplan compared doctors who oppose vaccination to “Holocaust deniers” and demanded that their medical licenses be revoked. Some pediatricians said they would no longer treat the children of vaccine resisters. In response, Barbara Loe Fisher, founder of the National Vaccine Information Center, an antivaccine group, accused the mainstream media of creating a phony crisis to serve the interests of big government and the “massive Pharma-led lobby.”

The vaccine wars in America have been particularly contentious because they involve our most basic rights (personal liberty, religious freedom) and deepest suspicions (government intrusion, rule by elites). Historians generally trace the antivaccine movement to a number of 19th-century groups, including religious activists, radical libertarians and health faddists, who insisted that Jenner’s vaccine actually caused smallpox. Like some current movement activists, these early leaders had a personal story to tell, claiming that a vaccine had harmed or even killed someone close to them, most often a child. Indeed, their most visible symbol was the smiling but entirely limp Raggedy Ann doll created by a popular cartoonist for his daughter, who had fallen ill and would later die, he believed, from a smallpox shot she received without his permission.

The Impact of Vaccines
The issue came to a head in 1905 in the vitally important Supreme Court case of Jacobson v. Massachusetts. As America industrialized, state legislatures passed numerous measures to protect the “public good.” There were laws abolishing child labor, requiring safety inspections in factories and restricting the hours a woman could work outside the home. In Massachusetts, the legislature gave towns the authority to require vaccination “when necessary for public health or safety,” such as the smallpox epidemic then sweeping the state.

Cambridge quickly put an ordinance in place requiring its residents to get the smallpox shot or pay a $5 fine. Henning Jacobson, a minister, refused both options, claiming the ordinance violated his Fourteenth Amendment right to liberty. The U.S. Supreme Court strongly disagreed. A “well-ordered society” must be able to enforce “reasonable regulations” in responding to “an epidemic disease which threatens the safety of its members,” wrote Justice John Marshall Harlan. While the Constitution protected against tyranny, it didn’t afford “an absolute right in each person to be, in all times and in all circumstances, wholly free from restraint

Justice Harlan’s opinion would prevail for much of the 20th century. In 1915, New York City health officers used the logic of Jacobson to quarantine an Irish cook whose patrons kept turning up dead from typhoid fever. When Mary Mallon, or Typhoid Mary, refused to change professions, she was exiled to a barren island in Manhattan’s East River, where she spent the remaining 23 years of her life. Seven decades later, New York forcibly isolated tuberculosis victims who refused treatment, using Jacobson.

There were times when this logic went awry. In Buck v. Bell, an egregious 1927 decision, the Supreme Court specifically used Jacobson to uphold Virginia’s policy of forcibly sterilizing the “feebleminded,” ruling that “the principle sustaining compulsory vaccination [could also] cover cutting the fallopian tubes.” In most instances, though, the true meaning of Jacobson prevailed: The state could—and must—exercise its police powers to protect the public’s health.

In 1905, only the smallpox vaccine existed to fight infectious disease. Others appeared in time: a vaccine for polio in the 1950s; vaccines for measles, mumps and rubella in the 1960s—the list growing by the year. Guided by Jacobson, all 50 states put laws in place by 1980 requiring the mandatory vaccination of school children for most of these diseases. Exceptions were made for medical and certain nonmedical reasons, such as religious conviction, though few used them at the time.

People complied because vaccines worked. New polio cases disappeared in the U.S., and smallpox was eradicated world-wide. In a typical year before the measles vaccine was licensed in 1962, more than half a million American children would come down with the disease, 48,000 would require hospitalization, and 450 would die. Thirty-five years later, the number of annual measles cases had dipped below 100.

The revival of the antivaccine movement in the 1990s had less to do with fears of personal liberties being deprived than with claims of a link between vaccines and various afflictions, especially autism. It hardly mattered that study after study would refute this junk science. Spurred on by the Internet, talk radio and other outlets, these discredited claims gained credence through repetition. Many parents now had second thoughts. Why vaccinate against diseases that rarely, if ever, occurred? Why take any chance at all? In an odd way, vaccines had done their job too well. They had erased the evidence of why they’re always needed.

In a reversal of Jacobson, politicians began to back away from the notion that community protection trumped individual choice. In the 2008 presidential campaign, both Barack Obama and John McCain remained safely neutral on the bogus health scare surrounding vaccination. State legislatures passed laws allowing vaccine exemptions for philosophical reasons—a loophole so vast that almost anyone living in Oregon or Vermont could opt out for himself or his children.

Vaccination rates dropped, in some areas falling below the level of herd immunity needed to control a contagious disease (generally between 85% to 95%). Studies show that most of the outbreaks occur in states where exemptions are easiest to get and where clusters of unvaccinated children gather.

For now, the consequences of vaccine resistance are on full display. Politicians have walked back the sort of comments about free choice and alleged vaccine dangers that were barely controversial only months before. Bills to toughen school vaccination standards are cropping up across the country.

How long this momentum will last is the key question. Vaccination requires one to take an extremely small risk to ensure a safer future for all members of the community. To refuse it, and to live selfishly off the herd immunity of others, is both dangerous and unfair. Vaccination isn’t meant as coercion but rather as a nod to the public good, and that message is again being heard.

—Prof. Oshinsky is a member of the history department at New York University and director of the Division of Medical Humanities at the NYU School of Medicine. His book “Polio: An American Story” won the 2006 Pulitzer Prize for history.

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There are 53 comments.
OldestReader RecommendedThomas GuastavinoThomas Guastavino 7 hours ago
This is a classic example of someones civil rights ending when they start to affect others. Its true that parents do have the right to refuse vaccination if it only affected their children (although a strong case can be made that this is child abuse), but there is the issue of herd immunity which is needed to protect those children who legitimaely cannot be vaccinated. Therefore, these parents should be given a choice. Vaccinate your children or isolate them. Period.

Susan SterrettSusan Sterrett 8 hours ago
I am not sure why there is no mention of the role of global eradication of a virus. The role of smallpox vaccination, which carries significant risk, was to use it wisely to interrupt transmission long enough to get the job of global eradication accomplished. Then vaccinations and the risks associated with them were no longer needed to keep everyone free from smallpox. This is the ideal solution and, when achievable, should be the only solution. Why is this goal for measles not mentioned in this essay? Instead, Oshinsky writes that vaccines have done their job & that “they’re always needed.” No, their job is not finished: global eradication. Or, if not, Oshinsky ought to explain why he doesn’t think so.
That the same goal has existed for measles has been widely discussed. In _Nature_ just last week, there is a special feature about measles and the initiatives for global eradication are discussed. Funding has been an issue. Can we fix that?

Jose CalabroJose Calabro 11 hours ago
The fact that this “debate” is taking place at all is an embarrassing stain on this nation. Deny the imbeciles that refuse these vaccines anesthesia or antibiotics or whatever else it is that medical science employs to better their human condition. Log them, and their objections, whether “philosophical” or “religious”, in some database and instruct them to go rely on “natural” remedies whenever a dental abscess or acute appendicitis condition strikes their precious offspring. Let’s see how well that works out. Perhaps, employing some true Darwinian selection would really help us get rid of these pests and result in a future less ridden with the psychotic brood they are sure to shape in mirror images of themselves less than two decades down the road. Ridiculous. Put these cretins out to pasture.

@Jose Calabro
The reasoning for some of us cretins is not whether or not to vaccinate, it is the number and the spacing of the shots. Thirty four shots in thirty six months!
Dig up your childhood shot records or google what the schedule was back then.
Of course some vaccines are good and necessary but not so many and not so close together.

Jose Calabro

Jose Calabro 11 hours ago
@SARAH FARRAR @Jose Calabro How about you go and do little bit of reading about the immune system before tackling vaccine frequency “problems” ? Do yourself a favor and do so…

Anthony AaronAnthony Aaron 11 hours ago
How about we deal with this issue on a personal liability/responsibility basis: if you do not vaccinate your child, and they infect others — you will be personally liable for the medical expenses of those other children your child infects. If your child infects another, and that other dies, you will be charged with voluntary manslaughter.

If your child doesn’t get vaccinated, and gets sick and dies, you will be charged with voluntary manslaughter. If your child gets sick and suffers some form of lifelong disability, you will be charged with felony child endangerment.

In any event, if you do not vaccinate your child, you might have to post a sizable bond to pay the aforementioned medical expenses of those infected by your child.

Let the games begin.

Fair enough?

Samuel WeirSamuel Weir 9 hours ago
@Anthony Aaron

Talk about opening up a slippery slope. I think that people should get vaccinated for flu, measles, and other such diseases, but I can see so many problems with the proposals that you’re making.

Susan SterrettSusan Sterrett 8 hours ago
@Anthony Aaron Actually, the ethics of responsibility are not quite that simple. I’m wondering if you’ve considered the effect of waning immunity in highly vaccinated populations, as the wild virus no longer circulates and most mothers’ immunity is vaccine acquired. It works both ways: our decision as a society to implement policies to achieve high vaccination rates has, over several generations, brought about a population that is far more vulnerable to an imported virus than had been expected. So simply blaming the unvaccinated for every illness is not really justified; babies are more vulnerable, and more likely to transmit the virus, bec of that decision. I won’t spell the effects out in detail here, but if you are interested, you can do research using keywords such as “waning immunity” and “passive immunity” in conjunction with “highly vaccinated populations.” To be clear: what I’m against here is misdirected blame. Not helpful.

Steven ChenSteven Chen 14 hours ago
Informative article.


All I can say, as a grandmother, is that thirty four “shots” within the first thirty six months of an infant’s life—-one starting within the first hour of birth (the HepB)—- is insane.
And we all know why they do it that way : cost.
All of my precious grandchildren have had their responsible, well educated, professional, intelligent parents choose to space their children’s vaccinations out over a period of years.
Not one has had his/her little undeveloped bodies and immune systems blasted with several shots at once. Repeatedly.
We are not Left Coast Left wingers. We are East Coast/Southern conservatives.
Thank God for common sense.

Mary AlexanderMary Alexander 16 hours ago
@SARAH FARRAR Your family has the luxury of transportation. Poor folk often have to take several buses to get to the doctor’s office or Public Health Clinic, exposing their children to illnesses on the way.
They are very grateful to get the shots as scheduled, thereby protecting your little darlings with heightened herd immunities.

Scott JohnsScott Johns 14 hours ago
@SARAH FARRAR How sad that your family puts their children and those children of others at risk of preventable infectious disease. The vaccination schedules are designed based upon evidence based medicine for maximizing current and long term immunity. The immune system is complex and able to handle an extreme quantity of different antigen assaults simultaneously. I can only imagine that thousands of antigens are processed by the typical immune system in a year. 36 more is a drop in the bucket.

@Scott Johns @SARAH FARRAR
When I compare the recommended shot schedule of today versus that for my own children back in the Seventies, I know something is wrong.
There are now way too many shots in too short a period of time and that simply is not safe.
It is up to parents to protect their children from this.

Patrick HunterPatrick Hunter 10 hours ago
I saw a 9 month old. Mother was known to be hepatitis B positive. Child was vaccinated at birth to attempt to prevent mother to child transmission. The 9 month visit is a very scary visit for these families. The child has been fully vaccinated and it is time to check to see if the babe has been protected, or infected. Blood draw, wait a few days. I make the phone call to tell mom the news.
Mother to child transmission of hepatitis B will more often than not lead to life long infection in the baby. That means liver cirrhosis, liver failure and cancer. A shortened life. Sad but preventable. People are asking for a cure for cancer, and we have a prevention. And people refuse it.
I called the mom with the good news. She told me she knew it would be good news. Her 8 year old had been protected by the vaccine in the same way.
Than she got mad, sad and vented to me, crying. She was in her early 30’s, liver failing and dying from her disease. Knowing she would not live to see her kids grow up. She wanted to know why her mother did not protect her. She was infected at birth by her mother, now holding anger and resentment towards her. Why won’t she live to see her children grow up?
I explained that the vaccine was developed in the late 80’s, and only became widely used in newborns in the 90’s. Her mother did not have the opportunity to protect her. Her mother did nothing wrong.
Through tears she told me she needed to forgive her mom. I agreed. I think she found a bit of peace. I hope she did.
I hope people understand a little more as to why we vaccinate. To try to limit these tragedies. But we don’t appreciate the times we live in. We aren’t grateful. I wish we had perspective.

Donald ArkinDonald Arkin 8 hours ago
@SARAH FARRAR No disrespect, but being a grandmother does not make you an expert on medicine, or any other scientific field. What does your grandmotherly common sense make of the current controversy over supersymmetry and the standard model of particle physics?

Leonard LovalloLeonard Lovallo 18 hours ago
In response, Barbara Loe Fisher, founder of the National Vaccine Information Center, an antivaccine group, accused the mainstream media of creating a phony crisis to serve the interests of big government and the “massive Pharma-led lobby.”
Anbsolutely Barbara invoke the big pharma lobby bogeyman, explains everything -get a grip.

Mary AlexanderMary Alexander 16 hours ago
@Leonard Lovallo: And she can raise more money from nut-cases, and wallow in the publicity.

I am so sick of this debate. Fine. Let the non-vaccinated get sick and, possibly, die. If these parents believe so strongly that the vaccinations are harmful, so be it. Stop wasting time trying to convince them. Those of us who believe it’s important will continue to vaccinate our children. They will be safe. Let the rest come to school unvaccinated. If there isn’t enough heard immunity to protect them them then those parents can explain to their adult children, assuming they survive to that point, why it was more important that they got sick than to have them vaccinated. Once the first case of polio occurs, maybe that will change their mind.

Mary AlexanderMary Alexander 18 hours ago
@JOHN MCKAY Unfortunately, the ones who suffer the most are the infants who are too young to have been vaccinated. In this current epidemic, there were several infants who acquired measles from children whose parents were too cool to vaccinate. These infants are very vulnerable to serious complications.

I actually know several parents who think that if they give organic food to their offspring, these children will not get polio. So the children get lots of fresh kale, but no vaccines.

M. Ralph SchmidtM. Ralph Schmidt 17 hours ago
I was just thinking about a person who explained the organic movement to me in a series of verses on diseases that are emerging now that we didn’t have before. She said people were once healthier in the sense that they didn’t used to get certain sicknesses. I tried to point out that life expectancies were once much shorter, also, and that maybe the trade off was worth it. I also pointed to the relatively smaller cost of food or at least the general availability of it everywhere.

Mary AlexanderMary Alexander 16 hours ago
@M. Ralph Schmidt She’ll be the first one to sue her doctor if her precious darling gets a vaccine-preventable disease, by saying that the doctor “didn’t explain vaccines well enough”. This despite giving patients reams of literature about shots and consent/refusal forms to sign.

Donald ArkinDonald Arkin 8 hours ago
@Mary Alexander @JOHN MCKAY Yes, and some of these same earth-mothers think that raw organic honey is good for their little ones, or would be, it turns out, except for the real danger of contracting botulism. God save us from these arrogant imbeciles.

Mary AlexanderMary Alexander 18 hours ago
@CHARLES PLUSHNICK The mercury has been out of all childhood vaccines for at least 15 years, with the exception of multiuse vials of flu vaccines for older children. Inactivated polio vaccine has been used in the US for about 25 years, thus lessening the very small risk from live, oral polio vaccines.

Anti-vax proponents make millions from fictitious books, old information, and paying google to push them to the top of searches, to prey upon “educated people” who took Biology for Poets, and have no logic courses to fall back on. I support liberal arts courses, but honestly, gender studies and drama courses do not prepare people to sift through scientific data.

Hanging out at Trader Joe’s and looking hip does not protect one’s children against pneumococcus, hemophilus influenzae, or measles. Vaccines do.

Paul WeverPaul Wever 18 hours ago
I wonder how many of these vaccine deniers have living relatives who lived through the horrors of the various epidemics (particularly polio) that swept the country before vaccines. If they do, maybe they should talk to them about the consequences of not being innoculated and the fear that came with it.

Anthony AaronAnthony Aaron 11 hours ago
@Paul Wever

Amen — I was in grade school in the mid-50s, and remember classmates with metal braces and crutches — and ones in high school and beyond who still had issues with walking from having had polio.

Robert HennessyRobert Hennessy 20 hours ago
In an absolute sense, yes, but it could very easily be exponentially more complete and honest than it is now.

John W. CondonJohn W. Condon 21 hours ago
Why force anyone to take a vaccine. Just kick them off of ObamaCare.

Richard SullivanRichard Sullivan 21 hours ago
Some folks just don’t cotton to being told what to do. Especially by their government. No idea where they get such foolhardy notions.

Donald ArkinDonald Arkin 8 hours ago
@Richard Sullivan So, what, they now advocate that we should all have our own nuclear reactors in the basement? Funny how these no-cotton fake conservatives will gleefully have the government trounce on anyone whose “freedom” seems dangerous to them. What phonies.

For historical accuracy, vaccination or variolation as it was called, started over a 1000 years ago in China, spread to Turkey, Middle East and after reached Europe in 1700s. One of the main factors for the anti-vaccine attitudes was a publication in the 1990s in a prestigious medical journal that apparently failed to distinguish science from environmental fiction, in that article mercury from vaccines was the source of all the health problems in the develop countries. The problem is that most regulatory agencies in the US and Europe accepted that fiction and demanded changes in vaccine formulations. Once they did that they opened Pandora’s box, gave legitimacy to a pseudo scientific group and created doubts in the minds of people. A mistake that we are seeing the results now. Of course few of us remember the polio epidemic with dozens of iron lungs with children that could not breath; seeing that was a sobering experience and nobody dared to challenge reality

Robert HennessyRobert Hennessy 21 hours ago
Do you think there’s a difference between polio and chicken pox?

Polio is a RNA GI virus while chicken pox in a DNA herpes virus. Also polio does not have a membrane or envelope while chicken pox has an envelope. Yet, both seem to like neural cells. Of course polio is a much more serious disease than chicken pox; i.e. with polio there is no room to avoid vaccination.

Robert HennessyRobert Hennessy 19 hours ago
that’s not what I meant. I meant the effects of infection from them

Donald ArkinDonald Arkin 8 hours ago
@Robert Hennessy @DANTE MARCIANI You have obviously never had either one, nor witnessed a case first-hand in an unvaccinated infant. I pray you don’t ever have to. Try to help make sure none of us ever does.

Mario SegalMario Segal 21 hours ago
the problem is that no matter what studies get performed showing no link between vaccines and autism or any other supposed side effect (the real side effects are disclosed, for example with some vaccines a few people will get the disease) – those opposed will never accept them
There is no acceptable burden of proof for them – even though that they are not able to point scientifically to a link (because just my son got autism after a shot is no proof, it is at most a causal association or pure luck). If I die after eating breakfast it does not mean I died because of breakfast, does it?
I think that the broader society has a duty to protect itself, and if some people do not want vaccines we have a right to exclude their kids from schools and other activities. We do not allow exceptions for smoking or drinking because of personal beliefs (the religious wine exception is for small quantities only for ritual purposes), so why should we allow them for vaccines

Robert HennessyRobert Hennessy 21 hours ago
@Mario Segal
Wouldn’t the real or actual level of harm need to be factored in? If the disease in question could cause widespread significant morbidity and mortality, wouldn’t that be different from a disease that only caused a minor illness?

Donald ArkinDonald Arkin 8 hours ago
@Robert Hennessy @Mario Segal So far as I know, every disease for which there is a mandatory vaccine regimen is potentially either lethal or permanently debilitating. We can prove that innocent infants are killed by anti-vax activist policies; no proof exists of substantial harm caused by modern-day vaccines or vaccine schedules.

Robert HennessyRobert Hennessy 21 hours ago
The same thing with the chicken pox vaccine that was rushed forward with little evidence to give anyone a good idea of what it would do long term. Then you have pertussis outbreaks and rising evidence that the immunity from MANY vaccines (including influenza) is NOT what it was cracked up to be. So, it’s the lack of honesty and full disclosure that I oppose, deficits that make a true honest robust debate impossible, and give the accusations of bias and “big pharma” influence a credence they couldn’t have without it.

jim murrayjim murray 20 hours ago
@Robert Hennessy Your logic makes sense except so much of medicine is risk analysis over definitive answers. You nearly never get a definitive answer out of a physician as it is and expecting the same with vaccine manufacturers seems inconsistent.

Robert HennessyRobert Hennessy 21 hours ago
I’m a Physician who does NOT oppose vaccines (all of my kids are fully vaccinated) nor do I think they cause any significant adverse effects. However, what bothers me is the lack of full, honest and accurate (sometimes not known) disclosure as to what the consequences on non vaccination are. This article cites the death rate from measles pre-vaccination, and then the difference in INCIDENCE of measles, pre and post vaccine eras. What he (?conveniently?) left out is the “no significant difference” in the death rates, pre and post vaccine eras.

David LongtinDavid Longtin 21 hours ago
By 1905, smallpox was not the only disease against which vaccines were available:
Vaccines are an absolute blessing to society.

There are more than one way to skin a cat
It is ok to question the medical authorities
there are vaccines available without mercury preservatives
Vaccines for those allergic to chicken eggs
The salk vaccine vs. sabin
the alternatives may cost more
Not vaccinating may cost more than money

@CHARLES PLUSHNICK Yes, agreed, but realistically, for example, babies can get more mercury from breast milk, and children/adults from milk, seafood, etc. than they will ever be exposed to from a vaccine. I do think some of this has been over hyped, or at the very least not put into perspective.

Mary AlexanderMary Alexander 18 hours ago
Very overhyped.

James GrundvigJames Grundvig 21 hours ago
Perspective. Measles are bad, definitely unpleasant, but fatal only in a scant few (some .0015%). The CDC has been treating the few 100s of cases as if it were the bubonic plague. Now comes the UCLA superbug outbreak, 179 got it, 2 have died (> 1%), and 7 more critical ill. This outbreak happened 3 weeks ago, but no one in the public was notified until a day or so ago. Yet, the CDC claims they are not responsible for telling the public, but the investigating body in the LA County Dept. of HHS. That’s funny. If the superbug could be passed from one individual to another, then the outbreak not only could have been much worse, but by the time the U.S./LA health officials got around to notifying the public, such a disease could have easily spread across the country and internationally, too. This gives me little comfort or confidence that, in the Mobile-Internet Age, they can’t get the word out faster and more widespread.

Robert SeemanRobert Seeman 21 hours ago
@James Grundvig
and yet your comments are irrelevant to an article about vaccinations.

Robert HennessyRobert Hennessy 21 hours ago
@Robert Seeman @James Grundvig
Comments not irrelevant. (maybe you didn’t understand it?) The point is that without an HONEST balance in Public Health information by the CDC and other health authorities, it’s much more difficult for an average person to inform themselves and reach an intelligent position.

@James Grundvig
Growing up in the Fifties, my siblings, cousins, friends and I all had :
Whooping Cough
Chicken Pox
We all lived.
That is not to say that I don’t think those vaccines should be administered today —-just not a half dozen at a time into a tiny body.
Giving the Hepatitis B to an hour old infant whose mother does not have hepatitis is cruel.

Donald ArkinDonald Arkin 8 hours ago
@SARAH FARRAR @James Grundvig How many times do people have to be reminded that personal experiences aren’t science? Sheesh! Back in the day, you and your friends probably “just knew it was common sense

Stephen GouldStephen Gould 21 hours ago
To Barbara Loe Fisher: Eat ebola and die please.

Milton PrellMilton Prell 21 hours ago
The author states that individuals should take the ‘extremely small risk’ of something going wrong, but he never provides any data on what those risks are. I support vaccination, but it would be useful to know the rate and number of deaths and adverse reactions attributed to vaccines in the US each year.

Mary AlexanderMary Alexander 18 hours ago
@Milton Prell Here you are:


See also how it flies in Dubai, where all countries meet in children playing

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