A CASE HISTORY

Upon completing the briefing session with a large contingent of Surin provincial and Northeast regional health officials--at which the chief provincial spokesperson confirmed that although post-vaccination shock was a problem in other provinces, there were no known cases being reported in his province evaluation team members departed for their respective village destinations. Upon entering the village of Kanjarong, in the Chom Phra district (only 35 miles distant from the provincial capital) in company with the UNICEF Integrated Services Project Monitor, we encountered and met with the village Head Man and the Deputy Head Man.

In the course of the interview, the Deputy Head Man, with some intensity explained that his own son had experienced what he considered as very serious damage as a result of immunization. The Project Monitor and I returned the following day, at which time we both interviewed the mother and observed the affected child during the interview. As a result of this more careful and thorough interview, the following facts of the case were ascertained:

• Up to the age of 3 months the infant had been breastfed. Breastfeeding was terminated by the mother due to a diagnosed thyroid deficiency, per the "doctor's" request. She subsequently began feeding him powdered milk, supplemented by egg, meat, and white rice. The use of fresh fruit and vegetables in the infants diet remained very marginal.

• At the age of 8 months the infant was taken in for his final DPT (triple antigen) vaccine. He almost immediately went into what was diagnosed and described as a state of "shock," for which he was duly treated by a physician. As well, a whole series of serious problems began:

• chronic sleeplessness o high fever or unbroken colds and runny nose continuing over several months o unbroken crying (except when held) for a period exceeding 2 months o in the eleven months following the vaccine (the child at time of inter-

view was I year 7 months) there appeared to be severely impaired weight and growth developments.

Although cognizant that this case history could be construed (and in turn dismissed) as a rare anecdotal occurrence that was only coincidental to the administration of the triple antigen vaccine, after careful thought I've decided to included it in some detail for three basic reasons:

I. evidence suggest that for multiple reasons--as noted throughout this document--such adverse reactions are likely to be taking place at a significantly greater level than is popularly believed;

II. a calm, intelligent and caring mother's direct experiential observations and hindsight about her child represent a fully valid and trustworthy source of information; and

III. overall, the clarity and force of the evidence was such that the child's reaction was clearly more than a mere coincidence, and thus not attributable to other direct causes. (As well there is clear evidence suggesting that the occurrence and severity of adverse reactions to vaccines--among infants--correlate proportionally to both lack of breast feeding, and Vitamin C deficiency (e.g., see refs. 17 & 18).

The following comments should be made with respect to points (a)-(e) above:

• The evidence of unabated infections suggests general impairment of the child's immune system, i.e., vaccine induced immune malfunction.

• The unbroken crying (its unfortunate that children under the age of one can't verbally explain the nature and extent of their distress) suggest the possibility of permanent nervous system damage. (In observing the child walk about, it was visibly evident that his general motor functions and coordination were impaired.)

The reported growth stunting effect was also visibly obvious, as the child appeared to be at most the size of a one year old. (In that impaired growth is generally not identified in the literature as a vaccine related or induced hazard, this condition may well have been principally related to other factors bearing on the child's nutritional intake and or assimilative capacities.) The mother reported that his weight at birth was 4 kilos (a very heavy baby by Thai standards) and at 5 months, 9 kilos. At the time we visited--though now I year and 2 months older--his weight was unchanged, still at 9 kilos.

It is also worth noting that the mothers three month old grandson, who was present during the interview, had been experiencing high fever, and continuous colds since having received recent inoculations. Given that I visited only 9 out of over 900

participating villages, and then only raised this issue with a fraction of respondents, poses serious concern as to just how widespread and serious the problem of adverse side effects is.

It is known for instance that when mass immunization programs were enforced in Australia's Northern Territory among what was a generally malnourished Aboriginal population (the most notable concern being Vitamin C deficiency) death rates doubled, in some areas approaching 50 percent i.e., "Every Second Child." According to the author of a book by that title and veteran physician to the Aboriginals A. Kalokerinos:

A health team would sweep into an area, line up all the Aboriginal babies and infants and immunize them. There would be no examination no taking of case histories, no checking on dietary deficiencies. Most infants would have colds. No wonder they died Some would die within hours . . . Others would suffer immunological insults and die later from pneumonia, 'gastroenteritis' or 'malnutrition'.19

In Northeastern Thailand, in the villages visited practically all mothers were breastfeeding, and were to some extent including fresh garden vegetables and fruit in their diets. This in turn provided a fair degree of protection from the kind of severe reactions and mortality just noted among Australian Aboriginals. Nonetheless, it is apparent that there still remains a sizable number of malnourished. To quote C. Guthrie:

Malnutrition seems to be declining in the Northeast... Still, malnutrition is widely prevalent. One does not need to go looking for it. In one school . . . in Don Luang, 50 percent of the children were suffering from one level of malnutrition or another. I found it somewhat disturbing to find that the objective expressed by most officials was restricted to the eradication of 3rd degree malnutrition, in spite of the wide prevalence of 1st and 2nd degree malnutrition.20

It appears that the mass coverage obsession common to UCI and EPI, have run roughshod over the repeated qualifications, and warnings that have been issued against administering vaccines to inimunodeficient infants and children, of which malnutrition is a prime indicator. The fact that a March 1988 Annual Report on this Project (p. 5) indicated that a WHO/UNICEF review team found that EPI "drop out rates were high, because of the fear of side effects as expressed by mothers," suggests that the prevalence of vaccine induced complications and morbidity in Northeast Thailand, may well be more significant than heretofore thought. (The broader question and implications of vaccine induced morbidity and mortality will be examined in more detail, later in the report.)