Vaccine Mandate Musings

Should vaccine passports, or vaccination itself, be mandatory? I can only share my opinions, which are conflicted. Here are my thoughts:

Because of federal medical privacy laws, vaccine passports would have to be issued only on request of the patient/person waiving such privacy, so disclosure is in one sense inherently controlled by the individual and would be voluntary. Additionally, the state and the CDC are routinely notified of your COVID-19 vaccination, so it is not hidden from them; governments already know if you’ve been vaccinated. Another argument is that apps can track your location, but of course location tracking can be disabled for any app or phone, and mandates can also limit tracking to when the app is opened. Many people post their vaccine status on social media and then inconsistently worry about privacy after sharing it with massive companies that have access to their personal data.

Private companies can already mandate vaccines, including medical and nursing home staff, or college campuses (which now offer remote classes), and require masks and distancing unless such private company requirements are banned by law. Some people may want to show these verifiable proofs and find them useful; for example to travel overseas without needing quarantines or invasive testing.  

There are also issues of whether to restrict private companies from offering incentives for people to show vaccination proof to open cruises, concerts, airline or restaurant seating, etc. A government mandate prohibiting private businesses from doing things that are perceived as helping their sales recover faster and protect public health can also be perceived as anti-capitalist and anti-libertarian. The protection of public health often conflicts with normal civil rights in troubled times; both are mandates of governments. In this case, the government in prohibiting private businesses from using customer safety as a competitive selling point is different from a government mandating essential safety practices. This is actually the opposite of asserting a state mandate to protect public health; by legislating a government monopoly on whether/how to do that, rather than trusting the private sector, as most conservatives would normally prefer. 

As businesspeople, if you felt safer during an epidemic or pandemic by requiring masking and distancing, would you want the state prohibiting you from doing what makes you feel safer or from doing what makes your customers feel safer? In Illinois, the state has said it won’t require a vaccine passport, but did not prohibit local governments or private businesses from doing so, and Chicago may require them short-term for concerts and full restaurant capacity so businesses can reopen faster while protecting public health and safety. Is a business offering incentives discriminating against ineligible customers, or is it a justifiable practice; similar to offering private events or other perks for preferred customers?

I know this is more nuanced than social media and news outlets present the issues to us, but there are both plusses and minuses to government mandates and vaccine passports/proof, and winners and losers. 

It also doesn’t address the issue of some people who can’t get vaccinated: the young, people with autoimmune diseases or other medical conditions, those who have had serious reactions to previous vaccines; even pregnancy is an unknown safety factor. Vaccine mandates without reasonable exemptions are going to harm some people; maybe far fewer than might get seriously ill or die from the disease if everyone was unvaccinated, but they would needlessly sacrifice some people for the perceived greater good instead of fine-tuning to make vaccinations even safer. Vaccines aren’t perfect; why pretend that they are?

My problem with routine vaccinations is that there is no willingness or incentive to track a minority that may be harmed by vaccines in order to make them safer by identifying people or traits that are unsuitable for a particular vaccine. The ingredients are also a problem for some; including mercury and aluminum, preservatives, allergens, and other chemicals. Why is there no good study on the safety of the complete vaccination program of some 16 vaccines; some with additional boosters? Why are vaccine critics quickly attacked as anti-science, rather than honestly assessing their claims? Why are calls to fine-tune the vaccination program to make it even safer quickly shut down as anti-vaxxers? I appreciate the elimination of TB, smallpox, measles, etc. But why ignore a minority for whom some vaccines - or some ingredients - may be contraindicated to reduce the criticism? 

Sorry, but I seem to have more questions than answers. 

Iodine and Exposure to Radioactive Nuclear Emissions

What is iodine?

Iodine (I) is a mineral that is essential to human health, which we use to make the thyroid hormones thyroxine (T3) and triiodothyronine (T4). These hormones regulate our metabolism, synthesis of protein, enzymatic activity, and other biochemical reactions. They are also essential to unborn children’s and infants’ development of skeletal and nervous systems. Iodine deficiencies cause goiter; an enlargement of the gland. In addition to thyroid functions, iodine has a role in immunity, including breast health. [1]

How do we absorb iodine?

The element iodine is a gas, but we ingest it as a solid salt and that compound is known as iodide. For example, the potassium salt form of iodine is known as potassium iodide (KI). Iodine readily absorbs (about 96%) in the upper intestine (stomach and duodenum). [1]

How much iodine should we normally have?

Of the 15-20 mg present in a healthy adult, 70-80% is stored in the thyroid gland. Excess iodine is excreted in the urine. These iodine concentrations are considered adequate in urine samples:

• 100–199 mcg/L in children and adults
• 150–249 mcg/L in pregnant women
• Over 100 mcg/L in lactating women

Values lower than 100 mcg/L in children and non-pregnant adults indicate insufficient iodine intake, and urinary iodine levels lower than 20 mcg/L are considered severe deficiencies.

The US RDA for iodine is:
Table 1: Recommended Dietary Allowances (RDAs) for Iodine [2]

• Birth to 6 months 110 mcg* 
• 7-12 months 130 mcg*
• 1-3 years 90 mcg
• 4-8 years 90 mcg
• 9-13 years 120 mcg
• 14-18 years 150 mcg
• 14-18 years Pregnant 220 mcg
• 14-18 years Lactation 290 mcg
• 19+ years 150 mcg
• 19+ years Pregnant 220 mcg
• 19+ years Lactation 290 mcg

* Adequate Intake (AI)
However, international health agencies recommend that pregnant women get 250 mcg daily.

Typically, mountainous areas and areas subject to flooding have lower soil levels of iodine. Cruciferous vegetables are goitrogenic (inhibit the thyroid’s absorption of iodine), as are deficiencies of vitamin A or iron.

It takes numerous grams (one gram = 1,000 mg or 1,000,000 mcg) of iodine to cause overt toxicity, though side effects are possible at lower amounts. As with some other vitamins and minerals, symptoms of excess mimic those of deficiency. For iodine, these include goiter, elevated thyroid stimulating hormone (TSH) from the pituitary gland, and hypothyroidism (low thyroid function).

This table from the Institute of Medicine lists maximum recommended levels of supplemental iodine. These levels reflect a comfortable safety margin and few people would have side effects from taking iodine up to the amounts shown. In the event of a radiation emergency, higher amounts may be recommended by public health authorities.
Table 3: Tolerable Upper Intake Levels (ULs) for Iodine [2]

• Birth to 6 months Not possible to establish* 
• 7–12 months Not possible to establish*
• 1–3 years 200 mcg
• 4–8 years 300 mcg
• 9–13 years 600 mcg
• 14–18 years 900 mcg
• 19+ years 1,100 mcg

* Formula and food should be the only sources of iodine for infants.
 
Additionally, potassium iodide supplements may interact with some drugs including anti-thyroid medications used to fight overactive thyroid (hyperthyroidism), certain blood pressure medicines (angiotensin-converting enzyme (ACE) inhibitors), and potassium-sparing diuretics. [1]

What are the causes of possible exposure to radioactive iodine?

Radioactive iodine-129 (I-129) and iodine-131 (I-131) are produced by the fission of uranium atoms during the operation of nuclear reactors. Iodine-129 is also formed as a result of nuclear weapon explosions, the source of most of the radioactive iodine in our environment. [1]

How is radioactive iodine dangerous to human and animal health?

The body uses both normal (“stable”) and radioactive iodine, not being able to distinguish between them. Radioactive iodine can cause thyroid problems, yet it is also used to help diagnose and treat certain thyroid problems. Long-term exposure to radioactive iodine can cause nodules or cancer of the thyroid, but treatment with high doses of I-131 (the rapidly decaying one) may be used to treat thyroid cancer. Doctors also use lower doses of I-131 to treat overactive thyroids. [1]

How long is radioactive iodine dangerous?

While iodine-129 persists in the environment for millions of years, iodine-131 has a half-life (the time it takes for it to decay to 50% of the original amount) of only 8 days and will decay completely within months. Radioactive iodine is water soluble and can be ingested by drinking it in contaminated water, inhaling it as an airborne gas, eating produce that has it on the surface, eating fish that have absorbed it from the water, or from consuming milk or meat from animals that have eaten plants exposed to radioactive iodine. While iodine mainly collects in the thyroid gland, where it has a half-life of about 100 days, there are iodine receptors in other parts of the body - such as bone, kidney, spleen, and reproductive organs – where it has much shorter half-lives. [1]

What do public health authorities recommend to limit absorption of radioactive iodine?

In emergencies large doses of stable iodine are used to flood the bloodstream to help prevent the thyroid gland from taking up radioactive iodine, since raising the concentration of stable iodine in circulation would make it far less likely that the gland will absorb much radioactive iodine. These very high doses of stable iodine are not intended for daily use and may be hazardous for some people. [1]

What are good sources of stable iodine?

High dose potassium iodide in pills or capsules is the form given when public health authorities distribute iodine to populations at risk of radiation exposure.

Seafood, including fish and seaweed, and dairy products (due to fortified feed and iodine-based sanitation products used in milking, but the use of both of these are reportedly on the decline) provide significant amounts of stable iodine in the diet, but not enough to block the entry of radioactive iodine into the thyroid gland when an emergency is present.

Seaweeds have a flaw in that they typically contain less that 1% iodine by dry weight and also may contain undesirable heavy metals that are considered safe at recommended levels. In other words, don’t rely on kelp or dulse for much more than the RDA, or at most the UL (see above), because the levels of arsenic or other metals might also rise enough to become potential health hazards.

Iodized salt also provides essential iodine that can compete with radioactive iodine; a 1.5 gram serving (about ¼ teaspoon) provides about 71 mcg of iodine. Processed foods rarely use iodized salt, which must be declared on the label. However, there is only enough iodine in iodized salt to nourish the thyroid gland, not enough to exclude radioactive iodine from entering and causing harm. [1, 3]

Large doses of stable iodine reportedly protect the thyroid from accumulating radioactive iodine by competitively excluding that form because the thyroid is already full of stable iodine.

How much iodine should I take, and when?

“According to the FDA, the following doses are appropriate to take after internal contamination with (or likely internal contamination with) radioactive iodine:

•Adults should take 130 mg (one 130 mg tablet OR two 65 mg tablets OR two mL of solution).
•Women who are breastfeeding should take the adult dose of 130 mg.
•Children between 3 and 18 years of age should take 65 mg (one 65 mg tablet OR 1 mL of solution). Children who are adult size (greater than or equal to 150 pounds) should take the full adult dose, regardless of their age.
•Infants and children between 1 month and 3 years of age should take 32 mg (½ of a 65 mg tablet OR ½ mL of solution). This dose is for both nursing and non-nursing infants and children.
•Newborns from birth to 1 month of age should be given 16 mg (¼ of a 65 mg tablet or ¼ mL of solution). This dose is for both nursing and non-nursing newborn infants.
A single dose of KI protects the thyroid gland for 24 hours. A one-time dose at the levels recommended in this fact sheet is usually all that is needed to protect the thyroid gland. In some cases, radioactive iodine might be in the environment for more than 24 hours. If that happens, local emergency management or public health officials may tell you to take one dose of KI every 24 hours for a few days. You should do this only on the advice of emergency management officials, public health officials, or your doctor. Avoid repeat dosing with KI for pregnant and breastfeeding women and newborn infants. Those individuals may need to be evacuated until levels of radioactive iodine in the environment fall.” [3]

Taking a higher dose of KI, or taking KI more often than recommended, does not offer more protection and can cause severe illness or death.

When public health or emergency management officials tell the public to take KI following a radiologic or nuclear event, the benefits of taking this drug outweigh the risks. This is true for all age groups. Some general side effects caused by KI may include intestinal upset, allergic reactions (possibly severe), rashes, and inflammation of the salivary glands.

When taken as recommended, KI causes only rare adverse health effects that specifically involve the thyroid gland. In general, you are more likely to have an adverse health effect involving the thyroid gland if you

•take a higher than recommended dose of KI,
•take the drug for several days, or
•have pre-existing thyroid disease.

Newborn infants (less than 1 month old) who receive more than one dose of KI are at particular risk for developing a condition known as hypothyroidism (thyroid hormone levels that are too low). If not treated, hypothyroidism can cause brain damage. Infants who receive KI should have their thyroid hormone levels checked and monitored by a doctor. Avoid repeat dosing of KI to newborns.

Limitations of large dose stable iodine [3]

• Stable iodine may protect the thyroid if taken at the right time and at a high dose. However, it is not proven to protect other parts of the body and stable iodine does not block the radioactive form from the body.
• That limited protection for the thyroid from taking high dose stable iodine only lasts for about 24 hours.
• Stable iodine does not protect the body from any other radioactive materials that may be in the environment.

Final thoughts

People in other countries, such as the United States, will not experience the amount of radiation that those in the immediate vicinity of the nuclear plants could. Since the high-dose potassium iodide (KI) works to protect the thyroid gland only for about 24 hours, it is probably wise to wait for a specific event to actually take that pill. Meanwhile, a reasonable daily dose of iodine within tolerable upper limit (UL) levels (between 200-1,100 mcg; see above) is probably wise to maintain some level of protection against potential low level increases in airborne radioactive iodine and to assure adequate levels in the thyroid so it’s not so anxious to take in whatever form is circulating in the body and there is plenty of the stable form available. High-dose seaweeds like kelp and dulse may also provide heavy metals in excess of safety recommendations and should only be taken at levels closer to the RDA.

REFERENCES:

1. NIH: http://ods.od.nih.gov/factsheets/Iodine-HealthProfessional
2. EPA: http://www.epa.gov/rpdweb00/radionuclides/iodine.html
3. CDC: http://www.bt.cdc.gov/radiation/ki.asp

Swine Flu: Does Nutritional Status Aid Immunity?

Swine Flu: Does Nutritional Status Aid Immunity? By Neil E. Levin, CCN, DANLA A new health threat has arrived in our shrinking world: the swine flu. It is an organism for which there is no preventive vaccine; the commonly available flu vaccine does not include this strain, so offers no protection. Likewise, antibiotics target only bacterial strains so are useless to stop the viruses responsible for colds and flus. There are a couple of drugs (Tamiflu® and Relenza®) which are prescribed for those who have actually come down with the flu, and sometimes recommended for those who may come into contact with flu sufferers. However, they are expensive and typically work if you have one at home and take it at the first sign of illness. For example, the Tamiflu® website reports that, if taken within 48 hours of the first appearance of symptoms, adults may feel better about 1.5 days faster than patients who did not take it. When the avian flu (another Type A Influenza, the most common type) scare was around two or three years ago (remember SARS? Avian Flu? Bird Flu?), our family physician offered both my wife and me precautionary prescriptions of Tamiflu®, for which we would have had to pay about $200 out of pocket for a two person one-time supply. It wouldn’t be covered by insurance since we didn’t have an actual diagnosis of influenza. Besides that, there is a shortage and these drugs typically have a relatively short shelf life of only about a year. We respectfully declined the offer. While that is certainly an option for those who want to or need to pay to see a physician and get a prescription, and it may be covered by your insurance, it is not a practical option for most of us just wanting to improve our natural resistance to a known threat; and certainly not a cure. Besides, drugs have their own side effects (including shrinkage of the wallet) that should be noted by potential users. That’s precisely why they are controlled substances that are only available from medical professionals. What is the swine flu and what can we do to protect ourselves from it? According to Dr. Joe Bresee, Chief of the Epidemiology and Prevention Branch of the CDC (Centers for Disease Control and Prevention) Influenza Division, “Swine flu is a respiratory disease of pigs caused by Type A Influenza viruses. The symptoms of [swine] flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and [vomiting] associated with swine flu as well. There is no vaccine available right now to protect against swine flu. However, there are everyday actions that people can take to help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health. Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash can after you use it. Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective. Try to avoid contact with sick people.” Well, that is helpful, but only to a point. Also seemingly important is the fact that Americans who have come down with swine flu to date have had only one death - compared to well over a hundred Mexican deaths - and seem to have had contracted a much milder form of the illness than our unfortunate neighbors to the south. I speculate that the American diet, despite its known shortcomings, may in some ways still be superior in its content of some important nutrients to the average diet of many Mexican citizens, and perhaps support a better immune response. At the time of this writing though, only 20 of the 140 Mexican deaths attributed to pneumonia-like symptoms have actually been confirmed as the swine flu. No doubt new information will be coming in daily. But there are reportedly an estimated 36,000 deaths from the common flu every year, mostly the very old and the very young. After reviewing a number of scientific papers to assess the potential of foods and food supplements to improve our bodies’ natural response to the flu, there are a number of things that you and your physician may want to consider. In the battle to maintain healthy respiratory function and properly modulate immune response, natural nutritional substances can be helpful. Various vitamins, minerals, herbs and amino acids support optimal immune function and respiratory health. In fact, there is evidence that nutrient status of the host even affects the genetic expression of viruses; that is, an unsuitable environment (the well-nourished body) inhibits the ability of the virus to freely replicate and thrive. This is not a list of cures; it is a list of natural substances that have shown promise in improving survival or resistance to influenza as recorded in published studies. Those who want to support their immune system should investigate these with the knowledge and consent of your physician; physicians may want to note these natural products that may support the nutritional status of your patients. · AHCC In a recent study, supplementation with AHCC resulted in a dose-dependent increase in survival in mice in response to acute influenza infection (influenza A virus: avian flu, H1N1, PR8). · Andrographis paniculata has been shown in studies to support a healthy and balanced immune response by modulating the immune system’s production of immune cells (Interferon gamma (IFNg), Interleukin-2 (IL-2), and T-cells). Numerous clinical studies have demonstrated its ability to significantly increase cell-mediated immunity in response to stresses, such as those encountered during seasonal changes. · Astragalus (Astragalus membranaceous) is an Oriental herb well known for aiding the immune system. Astragalus has been shown in non-clinical studies to support a number of aspects of healthy immune function, including the enhancement of T-Cell and Natural Killer (NK) cell activity. Natural killer cells destroy unhealthy cells in the body virtually on contact. · Black Elderberry (Sambucus nigra) standardized extract may provide protection against oxidative stress and modulate inflammatory cytokines to protect respiratory function. Elderberry provides Vitamins A and C, as well as anthocyanins, which are potent free radical scavengers. Clinical and non-clinical studies have demonstrated Elderberry's immune-supporting properties. One article reported that, “Constituents of European elderberry neutralize the hemagglutinin spikes found on the surface of viruses, including flu viruses, preventing the viruses from piercing cell walls and replicating. European elderberry extracts also enhance immune function by increasing cytokine production.” It also reported that two randomized, double-blind, placebo-controlled clinical trials have shown that a European elderberry preparation “can inhibit influenza A and B viruses when given to patients within 48 hours of symptom development”. · Echinacea (Echinacea purpurea and Echinacea angustifolia) is well known for its immune modulating effects. E. purpurea extracts demonstrate significant immunomodulatory activities. “Among the many pharmacological properties reported, macrophage activation has been demonstrated most convincingly.” E. purpurea has been shown to have antiviral effects, with most studies looking at either rhinoviruses (colds) or herpes simplex virus type-1 (HSV-1). Its polysaccharides were able to exert an antiviral action on the development of HSV-1 disease when supplied prior to infection. Reductions in numbers of upper respiratory infections have been noted in several trials, but generally the differences in the large variety of commercial and non-commercial products studied have resulted in conflicting reports. However, a meta-analysis of previously published studies was published in the British medical journal The Lancet Infectious Diseases and concluded, “Published evidence supports echinacea’s benefit in decreasing the incidence and duration of the common cold.” · Garlic (Allium sativum) compounds have been shown to have some antiviral effects. For example, a compound called allitridin (diallyl trisulfide) has anti-human herpes virus (HCMV) activity via a mechanism associated with suppression of the virus’ gene expression. Other important and better known compounds include allicin and ajoene. Allicin has been shown to reduce the incidence of colds and flus. “Among the viruses which are sensitive to garlic extracts are the human cytomegalovirus, influenza B, herpes simplex virus type 1, herpes simplex virus type 2, parainfluenza virus type 3, vaccinia virus, vesicular stomatitis virus, and human rhinovirus type 2. · Larch tree (Larix occidentalis) polysaccharides (arabinogalactans) help to support healthy intestinal flora and aid healthy immune function. “They stimulate the immune system through the activation of phagocytosis, competitive binding of bacterial fimbrae, and the potentiation of the reticuloendothelial system's effects.” · Resveratrol, naturally occurring in grape vines, grape skins and red wine, improves immune response and down-regulates the activation and production of proinflammatory cytokines. · Selenium has been shown to help the immune system modulate inflammatory response in mice challenged with reactive agents. Animals deficient in the mineral had much poorer outcomes than those whose diets were supplemented with this antioxidant mineral. · Vitamin C (ascorbic acid, ascorbate) in divided doses supports immunity. Taking about 500 mg at a time enhances absorption and avoids a laxative effect possible at higher doses. In a two-year long controlled study, “vitamin C administration resulted in an 85-percent decrease in cold and flu symptoms compared to the control group”. In a controlled trial of 226 patients with influenza A, where about half received 300 mg of vitamin C daily: “Pneumonia was reported in two cases in the treatment group and 10 in the control group, while hospital stays for influenza or related complications averaged nine days in the vitamin C group and 12 days in the control group.” · Vitamin D (cholecalciferol, ergocalciferol) deficiencies have been associated with immune challenges (such as the flu) during the winter months when sunlight is not as able to produce the vitamin in our bodies. A deficiency can inhibit the body’s ability to maintain health and immunity. · Vitamin E (alpha-tocopherol) deficiencies have been shown to decrease immune response and increase inflammatory responses leading to possible tissue damage in the respiratory system. · Zinc is recommended for immunity. Use up to 30 mg per day for this use; higher doses could increase the need for copper. These statements have not been evaluated by the FDA. The information provided by this article is intended for scientific and historical reference only and is not intended to diagnose, treat, prevent or cure any disease. If you have been exposed to or think you may have flu or any disease, see a physician as soon as possible. Do not try to self treat swine flu or any other disease; influenza can be life-threatening. Please inform your physician before taking any food supplements if you take any medications or have a known medical condition. Read all product labels carefully and follow all directions and label cautions, and do not exceed the highest recommended servings. Neil E. Levin, CCN, DANLA is a board certified clinical nutritionist with a Diplomate in Advanced Nutritional Laboratory Assessment. He is a professional member of the International & American Associations of Clinical Nutritionists and serves on the Scientific Council of the national Clinical Nutrition Certification Board. 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