I throw around the terms ACIP and Red Book Guidelines a lot, so I thought it would be useful to explain them and attach the relevant document.

The CDC’s advisory committee on immunization practices (“ACIP”) puts out its “best practices” for immunization (read vaccine) administration. The members of the committee are the most (conventionally) recognized members of the infectious disease, epidemiology, and public health community.

The most important parts and the quickest way to get a handle on the document is to look at the introduction, then the section on contraindications and precautions.

Here is the introduction: intro(3) (It is very short).

The Contraindication and Precaution section is the most important part of the guidelines since it lays out by vaccine when a vaccine should not be given. Here it is: contraindications

The heart of the chapter is the multipage chart, 4.1 (starting on page 53) which lists each vaccine, and the one or two contraindications (that means the vaccine should not be given), as well as the precautions, which means that a physician might decide not to give the vaccine. It is a shockingly simple chart for something which carries such reverential status by the public health and infectious disease community. It is protocol-based medicine at its best and worst (though for sure, most of you won’t see it as the best in any sense).

Two important points:

First, some contraindications and precautions are temporary, some are permanent.

And here is the big one, the one which is at odds with the worldview of almost everyone who reads this post.

There is no such thing in the ACIP (or Red Book) guideline as a permanent exemption for all vaccines throughout the duration of childhood. That concept simply does not exist in the conventional view of vaccine safety. There are many reasons for this, but the big one used by the infectious disease specialists is that there is no common ingredient in all vaccines. Hence there can’t be a permanent exemption to all vaccines (A temporary one might be justified if the child is actually immunocompromised because of chemotherapy for example.). I have debated and litigated the point (against the mainstream view) and I don’t intend to do that now, and it is not necessary with this audience. The point to be made is that a permanent medical exemption throughout childhood for all vaccines is not a thing in the infectious disease-based model of vaccine safety.

The concept of a permanent medical exemption for all vaccines appears to be a construct created by physicians and some scientists who are suspicious of vaccines (no judgment intended). So far as I can tell, it was first presented as a possibility in the regular medical literature in 2011 by Yehuda Schoenfeld, who is considered to be the father of vaccine-related autoimmune disease. He and another two researchers published the thought-provoking but unaccepted-by-the-mainstream book entitled “Vaccines and Autoimmunity.” The book collates articles on these topics by researchers from around the world. Not surprisingly, most of the authors do not work in the U.S. It is Schoenfeld and his co-researchers who have established, promoted or at least published the notion that family history (beyond first-degree relatives) can be a reason not to vaccinate. (The ACIP guidelines only mention first-degree family history once or twice.)

The other interesting part of the contraindication chapter is section 4.2 which sets out medical problems which physicians mistakenly think are contraindications but aren’t. Section 4.2 will shock the hell out of you, and make you wonder what group of idiots came up with that list. To me, if there is one thing that shows that the ACIP guidelines are outdated and do not protect children, it is section 4.2 of the ACIP guidelines.

The Red Book

The American Academy of Pediatrics puts out its own vaccination guidelines which it calls the “Red Book.” Care to guess the color of the Book? It is substantially identical to the ACIP guidelines, just some different experts. The AAP asserts that it should be used and followed by all pediatricians as the best practices for all aspects of immunization, and the circumstances in which a particular vaccine should not or might not, in the physician’s judgment, be given to a patient; i.e. contraindications and precautions.

So there you have it on the ACIP and Red Book guidelines. This is how the California medical and public health establishment views the vaccines, their safety, and the conditions under which people can avoid them. You won’t like it, but now you can see in black and white what it says, and what the California health establishment is using to decide all of these vaccine and medical exemption issues.

Rick Jaffe, Esq.