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After graduating and moving back to Orange County, Sears' interest in vaccines escalated. He started dissecting every ingredient in every vaccine pamphlet, highlighting each one and studying its side effects. Ethyl mercury in the preservative thimerosal, which some parents associated with autism, had already been removed from common childhood vaccines starting in 1999, but Sears discovered others that weren't exactly organic. "Some of the chemicals are very toxic and can cause cancer and reproductive problems," he says. "There are chemicals such as formaldehyde. MSG is in some vaccines. There are chemicals that are very similar to antifreeze. Some flu shots actually have a spermicide used as a preservative. But they're all in tiny amounts, and I believe they're probably safe because they're in such tiny quantities."
One chemical did stand out to him—aluminum. It's found in about half of vaccines, and Sears dedicates about 15 pages in his book to the potential dangers of it. (According to a paper published by the AAP, aluminum can cause neurological harm, but the quantity at which it's a threat has not been determined.)
In his practice, Sears would host monthly lectures about his findings. He'd ask parents why they were declining vaccines, and the most common answer was they didn't like the "overload." Back in the 1980s, doctors gave children a total of 12 vaccines throughout their childhood, with no more than three on the same visit. Now, Sears says, doctors give children 54 doses of 12 vaccines, sometimes with seven vaccines on the same day. Parents also expressed they only wanted to give their kids vaccines against diseases that posed a real threat, not long-shot illnesses. Sears listened.
"Most doctors aren't even willing to discuss vaccine options," he says. "They will say every single vaccine is absolutely important and just as important as any other vaccine. Those statements are very closed-minded. If you have disease such as meningitis that does occur in babies and kills babies, and then you have a disease such as Hepatitis B that doesn't occur in babies, how can you say the Hepatitis B vaccine is just as important? When parents hear those types of statements from doctors, they automatically tune them out. Because parents are smarter than that."
He also had an issue with the way vaccines are approved by the government. When a medical manufacturer makes a vaccine, a panel of doctors at the Food and Drug Administration must decide whether to approve it. Doctors on that panel might own stock in the vaccine manufacturers or even work for the vaccine manufacturers. "It's a huge conflict of interest," Sears says. "We're asking doctors to approve these vaccines when their whole life and professional world is being funded by the people that make that vaccine."
With all his material, Sears decided to write an easy-to-digest vaccine guide that presented information for each of the 12 standard vaccines and answered questions about every disease: Is it common? Is it serious? Is it treatable? When is the vaccine given? How is the vaccine made? What ingredients are in the final solution? Should you give this vaccine to your baby? For every vaccine, he included a section called "The Way I See It," in which he simply shared what makes the most sense to him. (Polio: get the shot. Hepatitis A: wait until the child is at least 2. And so on.) He designed two alternative vaccination schedules—one for parents who only wanted the most crucial shots for their children, and the other for parents who wanted to minimize the number of shots per visit to no more than two. Both spaced out the vaccines under the theory that tiny bodies could better process fewer shots at a time. With the alternative schedules, he says, he rarely sees the severe side effects he hears about from patients coming from other doctors' offices.
The Vaccine Book became a parent's bookshelf staple. Vanessa Showalter, a 39-year-old mom in Mission Viejo, started reading it while pregnant with her second child, Justin, now 2. She says she wanted to do things differently from the first time around after learning more about possible links to autism. "As a first-time parent, you really just go along with what the doctors tell you," says Showalter, whose first-born, Jacob, had all the standard vaccines. "Your baby is 2 days old, and the doctor wants to give him a shot, and you don't know any better, so you say yes." With Justin, Showalter went through Sears' book, making notes in the margins and picking out what she felt were "common diseases." She eventually came up with her own vaccination timetable, calling the process "empowering."
Rebecca Estepp, an activist with Talk About Curing Autism, a national organization that offers support and information to families, believes Sears' approach "makes far more sense than the CDC schedule." Her 14-year-old son, Eric, was diagnosed with autism at age 3, and she believes a Hepatitis B vaccine was the cause. "[Sears] spent a lot of time thinking about how to prevent infectious diseases while not creating chronic ones at the same time," says Estepp, who moved from Aliso Viejo to San Diego. "Vaccines should be a risk-benefit analysis." (Sears contends that there is no scientific proof that vaccines trigger autism, but he is pushing for more large-scale research to be done.)