To: Jeff Shuren, M.D., J.D., Director, Center for Devices & Radiological Health, U.S. Food & Drug Administration

Dear Dr. Shuren:

Once again, FDA has failed to act on mercury amalgam.  Indeed, you are ignoring your own scientists.  In December 2010 the Scientific Advisory Panel that you convened advised that you stop amalgam use for children and pregnant women, insisting that mercury-free dental materials be used.

Facing intense public demand for FDA to cease 35 years of inertia on amalgam, you stated at your September 2011 town meetings -- four times -- that FDA intends to make an announcement on amalgam by the end of 2011.  One may view a video of your statement at http://www.youtube.com/watch?v=H2t0J2_1yr0 .   But FDA never made any announcement. 

In an insult to the public -- and to you too -- FDA’s front office says no announcement on amalgam is coming, and FDA has no timetable to act on amalgam. 

Is FDA shelving any action on amalgam?  If so, a public explanation is due forthwith.

Sincerely,

Charlotte Pritt, former State Senator (WV), Caucus Chair

Kevin J. Biggers, former Member, Dental Board of CA

Charles G. Brown, former Attorney General (WV)

Chester Clark, D.D.S., M.P.H., Mayor, Amity (AR)

Lujene G. Clark, former Councilwoman, Carthage (MO)

Ann Clifton, former Assessor, Thurston County (WA)

Barbara Dively, Member, Governor’s Advisory Committee for People with Disabilities (PA)

Jay Goyal, State Representative (OH)

Karen Johnson, former Senator & former Representative (AZ) 

Daylin Leach, State Senator (PA)

Mark A. Mitchell, M.D., M.P.H., former Director, Hartford Health Department (CT)

Jessica Saepoff, D.D.S., Commissioner, Dental Quality Assurance Commission (WA)*

Marvin Van Haaften, former Director, Governor’s Office of Drug Control Policy (IA) and former Sheriff of Marion County (IA)

Chester Yokoyama, D.D.S., former Member, Dental Board of CA

* The views of Commissioner Saepoff do not necessarily reflect the opinions held by other members of the Washington State Dental Quality Assurance Commission.

February 7, 2012

To test which had a stronger effect, researchers took photographs of 75 men, then measured the color of the faces and used a computer program to rate their masculinity.  They found that facial masculinity wasn't nearly as important as skin tone.

According to the study:

“... [I]ncreased skin redness, yellowness, and lightness enhance apparent health ... Masculinity was not found to be associated with attractiveness ... However, skin color was found to be an important predictor of attractiveness judgments ... Our results suggest that more plastic health cues, such as skin color, are more important than developmental cues such as masculinity.”

For a number of years, scientists have been studying "brown fat." 

Brown fat is a heat-generating type of fat that burns energy instead of storing it, and this may have important implications when it comes to weight loss.

Human newborns have a supply of brown fat to keep warm, but by adulthood they lose most of their stores of it.

Brown fat has been located in the neck area, around blood vessels (helping to warm your blood), and "marbled" in with white fat in visceral fat tissue.

In a new study, scientists found that they were able to activate the brown fat still present in adult men by exposing them to cold temperatures.

The men burned more calories when cooled, and lost white fat, the kind that causes obesity.

According to the study's authors¹:

"That adult humans possess brown fat is now accepted - but is the brown fat metabolically active? Does human brown fat actually combust fat to release heat?

... Ouellet et al. demonstrate that metabolism in brown fat really is increased when adult humans are exposed to cold.

This boosts the possibility that calorie combustion in brown fat may be of significance for our metabolism and, correspondingly, that the absence of brown fat may increase our proneness to obesity - provided that brown fat becomes activated not only by cold but also through food-related stimuli."

Research has shown that certain groups of people tend to have more brown fat than others, and there are direct correlations between the activation of brown fat and metabolic measures of good health. For example:

• Slender people have more brown fat than obese people do
• Younger people have more brown fat than elderly people, and
• People with normal blood sugar levels have more brown fat than those with high blood sugar

Cold Temps Boost Brown Fat Activation

Swedish research published in 2009 also found that cold temperatures increased the activity in the subjects' brown fat regions, measured using positron-emission tomography (PET).² In fact, cold-induced glucose uptake was increased by a factor of 15!  While the Swedish researchers dipped the subject's foot into an ice bath while in the scanner, another similar study by researchers in the Netherlands chilled their subjects in a 16 degrees Celsius/61 degrees Fahrenheit room for two hours. They too found an uptick in brown fat activity.

Based on animal models, researchers estimate that just 50g of brown fat (which is less than what most study volunteers have been found to have) could burn about 20 percent of your daily caloric intake—and more if 'encouraged.'

According to a previous article on WebMD³:

"Kirsi A. Virtanen, MD, PhD, of the University of Turku, Finland, and colleagues analyzed brown fat in five young men. One of the men had about 2.2 ounces of brown fat.  "If the brown [fat] in this example were fully activated, it would burn an amount of energy equivalent to approximately 4.1 kilograms [9 pounds]" of fat over the course of a year, the researchers calculate. And that's a low estimate, as this assumes only 50 percent activation of the brown fat."

Activating Your Brown Fat Might Help to Reduce Your Love Handles

No wonder people are anxious to tap into the fat burning capabilities of brown fat! Interestingly, brown fat actually behaves more like muscle than fat, and as you will soon see, there's good reason for that.

One of the researchers in this area is Bruce Spiegelman, PhD, with Harvard University's Dana-Farber Cancer Institute. Over the past five years, his research team has published at least five studies⁴ on the topic of brown fat, and in one, they identified a sort of master switch that promotes the production of brown fat. In 2008, they showed that the molecular switch, known as PRDM16, regulates whether immature cells will turn into brown fat or into muscle cells. In an interview with WebMD, Spiegelman said⁵:

"We showed that brown fat and white fat have completely different origins. Brown fat is derived from muscle. That was a huge surprise."

Another set of researchers from Harvard's Joslin Diabetes Center found another trigger for brown fat—a protein called BMP-7, which also promotes bone growth⁶. The researchers discovered that this protein acts as a growth factor for brown fat. Mice treated with BMP-7 protein grew up to have more brown fat than untreated mice, and the treated mice also used up more energy.

Needless to say, researchers are excited about the potential for a medical intervention that can help people develop more brown fat. But I would be cautious of any solution in a pill form. Instead, I'd suggest trying out some of the non-invasive methods that have been found to promote brown fat production and its activation. For example, in one mouse study, the animals converted white fat into brown fat simply by exercising.

According to Time Magazine⁷:

 "During exercise, the animals' muscles released a newly discovered enzyme called irisin, which triggered the conversion. It's not clear whether the same phenomenon is true in people, though humans do have the same protein. However, the brown fat that is easily observed in humans tends not to be the kind that is derived from white fat."

Ice Therapy: a Viable Strategy?

Tim Ferriss, author of The Four-Hour Work Week, also published a book called The Four-Hour Body⁸, which includes the concept of activating your brown fat to boost fat burning by exposing yourself to frigid temperatures. He claims you can increase your fat burning potential by as much as 300 percent simply by adding ice therapy to your dieting strategy. A LiveStrong article backs up Ferriss' claim stating⁹:

"A NASA scientist told ABC News that's no hyperbole. In studying the effects of temperature on astronauts, he saw people's metabolism boost by 20 percent in environments as mild as 60 degrees. A Joslin researcher told National Public Radio that 3 oz. of brown fat could burn 400 to 500 calories daily."

So, how does Ferriss' Ice Therapy work? Well, by cooling your body down with ice, you're essentially forcing it to burn much more calories by activating your brown fat as the studies above can attest to. His suggestions, from easy to 'hard core,' include the following. Do advance slowly! It may be inadvisable to go straight to the ice bath if you're not used to it!:

• Place an ice pack on your upper back and upper chest for 30 minutes per day (you can do this while relaxing in front of the TV for example)
• Drinking about 500 ml of ice water each morning
• Cold showers
• Immersing yourself in ice water up to your waist for 10 minutes, three times per week. (Simply fill your tub with cold water and ice cubes)

Four More Ways to Boost Your Metabolism

Everyone's metabolism is different, but you can generally speed it up or slow it down within a reasonably short amount of time by making changes to your diet and lifestyle. Aside from resorting to ice therapy, the following common-sense strategies will also help boost your metabolism to encourage weight loss:

1. Avoid sugar (particularly fructose) and grains as they are the leading cause of insulin- and leptin-resistance, which directly affect your hunger levels, your fat-burning potential, and consequently your weight
2. Listen to your hunger, and eat a healthy meal or snack when hunger calls
3. Implement a well-rounded exercise regimen that includes:
1. strength training to build muscle (for every pound of muscle that you gain, your body burns 50-70 calories more per day), and
2. high-intensity interval training, which has been demonstrated to significantly increase fat loss by boosting human growth hormone production
4. Use healthy outlets for stress and negative emotions. Tools like the Emotional Freedom Technique (EFT) are your friend and ally when it comes to losing weight. Meditation, prayer, journaling and even exercise can also provide positive outlets for stress.

Remember, the idea is not to deprive your body or starve yourself into a size 2. The goal is to establish a healthy relationship with food, one that will keep you satisfied, nourished and slim, all at the same time.

REFERENCES:

• ¹ Journal of Clinical Investigation 2012 Feb 1;122(2):486-9
• ² New England Journal of Medicine 2009 Apr 9;360(15):1518-25
• ³ www.webmd.com/diet/news/20090407/can-brown-fat-make-you-thin
• ⁴ www.ncbi.nlm.nih.gov/pubmed?term=spiegelman[author]+AND+PRDM16&TransSchema=title&cmd=detailssearch
• ⁵ www.webmd.com/diet/news/20080820/brown-fat-new-key-to-weight-loss
• ⁶ Proceedings of the National Academy of Sciences in the Unites States of America 2011 Jan 4;108(1):143-8
• ⁷ Time Magazine January 26, 2012
• ⁸ The Four Hour Body
• ⁹ LiveStrong June 6, 2011

By Dr. Mercola

It’s a widely held tenet in our society that if you get sick, you should visit your doctor to “get well.”

But many physicians are relatively clueless about “wellness care,” they are in the business of disease treatment.

This is why the vast majority of physicians’ visits end up with a medication being prescribed, or if that is not appropriate, a surgery or invasive medical test is often recommended.

What is blatantly missing from many of these appointments is a discussion of what is causing your ailment ... which often means hope for a real “cure” is forsaken in favor of expensive and often dangerous symptom management.

Many Americans Dying Prematurely Because of the U.S. Medical System

Medical care is designed to help you when you are sick, but in the United States the term “health care” is an oxymoron. “Sick care” would be more fitting. Consider this: Americans spend more on health care than citizens of any other country, up to 1.5 times more per person -- but we rank 50th in life expectancy and 47th in infant mortality. These are dismal outcomes from the most expensive health care system in the world!

In a new book ("How We Do Harm: A Doctor Breaks Ranks About Being Sick in America”) by Dr. Otis Webb Brawley, chief medical officer of the American Cancer Society, explains CNN:

“ ... a large number of our fellow Americans are suffering and dying avoidable deaths, because of lack of quality health care. ... Doctors deserve some blame for this mess. Appreciation of the science of medicine and the scientific method is often lacking.

It is amazing the number of health care professionals who seemingly reject the scientific method. They prescribe treatments they believe to be appropriate as opposed to therapies that are known to be appropriate based on objective scientific evidence. This form of ignorance is a root cause of much of the overuse of medical therapy.

Too often, doctors fail to distinguish what is scientifically known from what is unknown, from what is believed. This is beyond mere disagreement about interpretation of the science. There is often selective reading of the science, especially by those trained in a specialty wanting to advocate for it.

Health care providers and the public often overlook the emotional and financial conflicts of interest of health care professionals. While I blame the medical profession, blame also rests on hospitals, drug and device manufacturers, insurance companies, lawyers, politicians, government and even with patients.”

When the Treatment is Worse Than the Disease...

Dr. Brawley, a practicing oncologist, gives CNN a telling example in the case of 50-year-old Helen, who was diagnosed with early stage breast cancer in 1990. After receiving surgery, she then was given high dose chemotherapy and a bone marrow transplant, a treatment that resulted in her being hospitalized for nearly a year and “almost killed her several times.” According to Dr. Brawley, this chemo/bone marrow transplant combo treatment was common at the time for women with breast cancer, even though no study had ever proven it beneficial.

In 1999, clinical trials were finally completed showing that not only was the treatment no better than standard therapy, it may have actually been more harmful.

And therein lies the crux of the problem -- medical treatments are often ordered even though evidence to support their effectiveness is lacking, and oftentimes they end up doing more harm than good, sometimes even causing the patient to die.  Why? Sadly, it’s often based on financial gain. Dr. Brawley continued:

“Even without evidence, some patients and their doctors had faith that it worked. The procedure was common because some doctors taught that the transplant was beneficial to patients. Truth be told, it was very beneficial to the doctors and hospitals offering it … The American health care system is fundamentally flawed and encourages inappropriate behavior and a subtle form of corruption. There truly is a combination of greed, ignorance and apathy within health care that is a cancer on this country. There is nothing wrong with medicine as a business, and nothing wrong with making an honest profit. However, in some cases, greed needs to be replaced with public interest, a concern for the national good.”

"Pharmageddon" is Here

Pharmageddon is "the prospect of a world in which medicines and medicine produce more ill-health than health, and when medical progress does more harm than good" -- and it is no longer a prospect but is fully upon us.

Last year an analysis of data from the U.S. Centers for Disease Control and Prevention (CDC) revealed that deaths from properly prescribed drugs now outnumber traffic fatalities in the United States! And when you add in deaths attributable to other medical care modalities, like hospital admissions and surgery, the modern medical system becomes the leading cause of death and injury in the United States.

Authored in two parts by Gary Null, PhD, Carolyn Dean, MD ND, Martin Feldman, MD, Debora Rasio, MD, and Dorothy Smith, PhD, the comprehensive Death by Medicine article described in excruciating detail how everything from medical errors to adverse drug reactions to unnecessary procedures caused more harm than good. That was in 2003. In 2010, an analysis in the New England Journal of Medicine found that, despite efforts to improve patient safety in the past few years, the health care system hasn't changed much at all.ⁱ Researchers noted:

“In a study of 10 North Carolina hospitals, we found that harms remain common, with little evidence of widespread improvement.”

They revealed that 18 percent of patients were harmed by medical care (some repeatedly) and over 63 percent of the injuries could have been prevented. In nearly 2.5 percent of these cases, the problems caused or contributed to a person's death. In another 3 percent, patients suffered from permanent injury, while over 8 percent experienced life-threatening issues, such as severe bleeding during surgery. In all there were over 25 injuries per 100 admissions! In other words you have a one in four chance of getting injured if you are admitted to the hospital -- not very good odds by any stretch.

Medical Care Often Dictated by Your Providers' Financial Interests

In her book, "Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer," Shannon Brownlee also talks about the number of people who die in hospitals due to incorrect care, drug dosage or hospital-acquired infections. Even with new safety regulations in place, 180,000 hospitalized Americans still die every year from largely preventable causes – and the worst part about it, Brownlee says, is that as much as a third of that care does nothing to improve your health!

What happens is that you often get certain medical tests because of what your physician's specialty is, not because that's necessarily the test you need. For example if you have low back pain and see different specialists you will get different tests: rheumatologists will order blood tests, neurologists will order nerve impulse tests, and surgeons will order MRIs and CT scans.

But no matter what tests you get, you'll probably end up with a spinal fusion because it's one of the "more lucrative procedures in medicine," Brownlee says – even though the best success rate for spinal fusions is only 25 percent!

Angioplasties and certain types of chemotherapy with similar low success rates are just as prone to be ordered, Brownlee says, because that's where hospitals' investments lie. You see, they have all this equipment and they need to use it to get a return on it – but they also need to get you out of there as quickly as possible, so they can get the next patient in. What ensues is a type of aggressive patient therapy that can end in disaster: according to the Office of Inspector General for the Department of Health and Human Services, 1 in 7 Medicare recipients will be harmed every year as a result of the medical care they received in the hospital.

Some Physicians are Recognizing the Power of "Alternative" Care

It seems that even while physicians continue to promote the drugs and surgeries upon which this flawed system is based, some health care workers are also poignantly aware of many of the pitfalls of modern medicine … and as such are embracing more holistic modalities when it comes to their own care.

In fact, 76 percent of health care workers use complementary and alternative medicine (CAM), compared to 63 percent of the general population, according to research in the journal Health Services Research.ⁱⁱ Even more revealing, health care providers, including doctors and nurses, were more than twice as likely to have used practitioner-based CAM, and nearly three times as likely to use self-treatment with CAM, during the prior year than support workers.

Alternative medicine, or as I prefer to call it, “traditional” medicine (because many of these therapies have been used for many centuries), typically offers a more positive treatment experience and often produces better results with less risk. And Americans are also increasingly distrustful of prescription medicines -- rightfully so! If more physicians would begin to embrace traditional medicine practices like nutritional-based therapies, as well as advocate for preventive health care strategies like healthy diet, exercise and stress relief, we would likely begin to see a real turnaround in rates of chronic disease, not to mention deaths due to medical care.

As Dr. Brawley wrote on CNN:

“The triad of obesity, lack of physical activity and high caloric intake (bad diet) is creating a tsunami of chronic disease. If the system persists as is, medical costs will grow dramatically over the next several decades as the number of patients with diabetes, cardiovascular diseases, cancer and orthopedic injury dramatically grows.

The current course is not sustainable. Medical costs will rise until the economy collapses. We all need to realize that some Americans are harmed by lack of treatment and others by overtreatment. The cold hard reality is America does not need to reform health care, we need to transform health care.”

You Can Make Your Own Health Care Decisions, and Even Influence Your Doctor

What is the proof that the health care system is in need of urgent transformation? Hundreds of thousands are killed by medical care itself, while others are walking around with far less than stellar health due to these treatments. Rates of chronic diseases are through the roof, and we're facing epidemics of obesity, heart disease, diabetes, depression and too many others to list. As a whole, Americans are not healthy – they're tired, depressed, stressed out and often in pain.

As patients, many people have taken their health into their own hands by abandoning this fatally flawed medical model and embracing holistic modalities that can help heal on a body-wide level.

It’s important to remember that the more you take responsibility for your own health -- in the form of nurturing your body to prevent disease -- the less you need to rely on the "disease care" that passes for health care in the United States. If you carefully follow some basic health principles -- simple things like exercising, eating whole foods, sleeping enough, getting sun exposure, reducing stress in your life, and nurturing personal relationships -- you will drastically reduce your need for conventional medical care, which in and of itself will reduce your chances of suffering ill side effects.

But in the event you do need medical care, seek a health care practitioner who will help you move toward complete wellness by helping you discover and understand the hidden causes of your health challenges ... and create a customized and comprehensive -- i.e. holistic -- treatment plan for you.

What's more, you can have an impact on your doctor's tendency to recommend natural alternatives, as when you inquire about them, some health care providers do in fact listen. Dr. Aditi Nerurkar, an internist and integrative medicine fellow at Harvard Medical School and Beth Israel Deaconess Medical Center, did just that, because of her patients’ requests.

As reported by CommonHealth:ⁱⁱⁱ

"Nerurkar, 35, says she was "inspired by her patients," to pursue the research because so many of them kept telling her how much better they felt — that their insomnia or anxiety had ceased — after taking a meditation or yoga class."

So many people are now asking their health care providers about alternative options that even medical schools have had no choice but to listen -- many are now offering courses in alternative medicine, such as the use of herbs, acupuncture and mind-body medicine! Remember, when you do go to the doctor, know that it's OK to ask questions and opt for less medical intervention while choosing a more natural way of healing your body.

If your physician is not open to such options, it may be time to find one who is, who can help coach you and your family to Take Control of Your Health.

REFERENCES:

• ⁱ New England Journal of Medicine November 25, 2010
• ⁱⁱ Health Services Research August 22, 2011
• ⁱⁱⁱ CommonHealth May 9, 2011

Listen as Dr. Karen Becker discusses Wobbler syndrome – a serious neurologic disease prevalent in large and giant breed dogs.

By Dr. Becker

Wobbler syndrome is a disease of the cervical spine in the area of the neck, in which the spinal cord and spinal cord nerve roots are compressed.

This compression leads to neck pain and neurological problems like the wobbly walk dogs with the syndrome exhibit.

This wobbly gait involves taking short, floating steps with the front legs and a swaying or wobbly movement of the hind legs.

Wobbler syndrome is a very common cause of neurologic problems in large and giant breed dogs.

Most people just call the condition Wobbler's, but medical terms used to describe it include spondylomyelopathy, cervical vertebral instability, cervical vertebral malformation, and cervical spondylopathy.

Causes of Wobbler's in At-Risk Breeds

Wobbler syndrome develops in one of two ways:

• Slipped, bulging or herniated discs
• Bony malformation in the vertebral canal surrounding the spinal cord

Either of these problems can cause the spinal cord and nerve root compression seen in Wobbler's dogs.

The slipped disc presentation is most commonly seen in Dobermans.

Compression caused by bony vertebral malformation is most often seen in other large and giant breeds, including Great Danes, Rottweilers, mastiffs, the Weimaraner, German shepherds, Irish wolfhounds, Bernese mountain dogs and Swiss mountain dogs.

Wobbler syndrome is especially prevalent in Dobermans, Great Danes and mastiffs. Dobermans tend to develop the disease in middle age -- six to seven years old is average.

In Great Danes and mastiffs, the problem is most often seen in dogs under the age of three, and these two breeds usually develop Wobbler's from a bony vertebral malformation rather than a disc problem.

Symptoms of Wobbler Syndrome

Besides the wobbly gait and neck pain, other symptoms of Wobbler's can include:

• Limb weakness and difficulty rising after sitting or lying down
• Partial or complete limb paralysis
• Muscle loss through the shoulders
• Worn or scuffed nails from dragging the foot
• Increased extension of limbs

Wobbler's is usually a slow, progressive disease except in cases of acute trauma when it develops very rapidly.

Weakness, loss of muscle coordination and toe dragging usually begin in the rear limbs. Dogs with these symptoms often stand or walk in a crouched position with the head held very low. There's usually intense neck pain that accompanies this presentation.

The condition progresses to involve the front limbs, but usually with less severe symptoms.

Diagnosis and Traditional Medical Management of Wobbler's

A definitive diagnosis of Wobbler syndrome is made through x-rays, myelographs, a CT scan or MRI.

X-rays can rule out bony malformations but cannot diagnose disc disease.

Myelographs, which are x-rays taken after dye is injected around the spinal cord, as well as CT scans and MRI's, allow visualization of the compressed spinal cord.

The MRI is generally considered the best and safest test to diagnose Wobbler's.

The two primary treatments for Wobbler's are medical management and surgery.

Medical management usually involves medications to reduce inflammation and spinal cord swelling.

A study of over 100 dogs at the Ohio State University College of Veterinary Medicine showed that 50 percent of Wobbler's dogs improve with medical management. About 30 percent remain stable. And for the remaining 20 percent, the condition continues to worsen.

Medical management also means a dog's activity must be severely restricted. Often cage rest is recommended.

No collars or leashes should be placed around these dogs' necks – harnesses must be used.

Medical management is typically attempted with older dogs with mild symptoms, and dogs with multiple locations of spinal cord compression.

My Choice of Treatment: Physical Rehabilitation

I believe the best therapeutic approach for Wobbler syndrome dogs is rehabilitation – essentially dog physical therapy.

Aqua therapy, laser therapy and acupuncture including electro-acupuncture can be beneficial for these dogs.

There are also natural anti-inflammatoriesⁱ, Chinese herbs and antioxidants that cross the blood-brain barrier to help reduce trauma to the central nervous system. But nothing replaces the benefits of physical rehabilitation for canine Wobbler patients.

Surgery for Wobbler's

If medical management and/or rehabilitation and complimentary therapies are unsuccessful in bringing relief to a Wobbler's dog, the only other option to improve quality of life is surgery.

The type of surgery performed depends on the underlying cause of the spinal cord compression.

There are several things to consider when deciding if surgery makes sense, including what technique might be most effective, the number and severity of lesions in the spine, the dog's age, and other concurrent disease processes.

There are a number of surgical approaches to Wobbler syndrome. A dorsal laminectomy is often the surgery of choice to enlarge a very narrow or malformed spinal canal.

If a disc is compressed, a ventral slot procedure may be performed to remove the disc material.

There's also an exciting new surgical technique called cervical arthroplasty for disc-associated Wobbler's. This new technique involves implanting an artificial disc in place of the diseased disc, and the procedure can be used in multiple disc spaces.

Dogs who have undergone this new procedure have had terrific short and long-term results, so this is definitely a promising new technique to bring relief to patients with the disc-related version of Wobbler syndrome.

Helping Your Large or Giant Breed Dog Avoid Wobbler Syndrome

If you own an at-risk breed for developing Wobbler's, I recommend proactive cartilage and disc support -- for example Standard Process Canine Flex Support, or over-the-counter supplements like glucosamine sulfate and MSM -- very early in your dog's life.

As your dog ages, I recommend progressively more intense support, including egg shell membrane and Adequanⁱⁱ.

Supplying an oral musculoskeletal support supplement like Standard Process Canine Musculoskeletal Support can help keep intervertebral discs supple and resilient.

Maintenance chiropractic care is always a good idea, along with consistent use of a harness instead of collars that place stress on the neck.

Helping your pet maintain excellent muscle tone is also very important.

All these steps can help reduce your large or giant breed dog's risk of developing Wobbler syndrome.

• ⁱ Elite Science, About EFAC+, http://www.elitescience.net/pages/about-efac
• ⁱⁱ Adequan Canine Polysulfated Glycosaminoglycan by Novartis, http://www.adequancanine.us/

Mace wants to make sure his stuffed Ninja turtle doesn’t get the jump on him.

By Dr. Becker

Many pet owners include their furry loved ones in Valentine's Day celebrations.

And who better to celebrate on St. Valentine's Day than the one devoted soul in your life who offers true unconditional love?

Valentine's Day Do's

If you'd like to do something special for your four-legged companion on February 14^th, here are a few neat ideas:

• Make an appointment to have professional photos taken of your pet, or hire an artist to paint a portrait of your dog, cat, or other favorite critter.
• Make a permanent clay print of your pet's paw with a special kit.
• If your dog has a favorite activity like riding in the car, hiking a trail with you, or retrieving a tennis ball over and over and over (and over), carve out a couple hours on or around Valentine's Day and indulge him.
• Skip the heart-shaped carb-heavy pet treats and invest the money instead in a small amount of an excellent quality raw, canned or dehydrated dog or cat food.
• Set aside 15 minutes to a half hour and give your animal companion your undivided attention. Don't multi-task during this small window of time. Allow no interruptions. Do nothing but focus on your pet. Soak up her animal energy.
  
  You can spend the time just petting or massaging your pet, bathing or grooming her, or doing an at-home wellness exam. You can take your dog for a short, invigorating walk. Engage your kitty with her favorite toy. Chat with your bird. Set your pocket pet free to investigate a bit of the world outside her cage.

…and a Few Don'ts

Human celebrations of Valentine's Day tend to involve things that can be harmful to pets, including potentially toxic flower and plant arrangements, chocolate, wine or other adult beverages, and candlelit dinners.

• If you're thinking of buying a plant or flower arrangement for your pet-owning sweetie, visit the ASPCA.org for a list of both toxic and non-toxic plants.
• If candy is on your V Day shopping list, keep in mind chocolate is toxic to both cats and dogs. And the darker the chocolate, the more toxic.
  
  Chocolate contains a caffeine-like stimulant substance that when ingested by your pet can cause vomiting, diarrhea, hyperactivity, racing pulse and seizures. Also, the fat content in chocolate can wreak havoc with a pet's pancreas.
• Needless to say, any sort of alcoholic beverage is dangerous for pets. And it doesn't take more than a tiny bit to bring on vomiting, diarrhea, loss of coordination, central nervous system depression, tremors, breathing difficulties and coma.
• If dinner by candlelight is on the agenda for Valentine's Day, be sure to keep the flames well out of the reach of curious pets. And safely extinguish burning candles before you leave a room.

Here's wishing you and your loved one (on two legs or four), a warm, safe and wonderful Valentine's Day!

By Dr. Mercola

Agent Orange, produced by both Monsanto and Dow Chemicals, was used to defoliate jungles during the Vietnam War.

During that time, millions of gallons of the toxic chemical mixture were sprayed on trees and vegetation, and the aftermath left hundreds of thousands of Vietnamese sick, with countless numbers of their children suffering birth defects, and a still growing group of U.S. veterans with related diseases ranging from cancer to Parkinson's disease.

Agent Orange was a horrific chemical concoction that never should have been used, and if you want to see some of its effects on children who were exposed in the womb, you can do so here -- but I warn you the photos are very graphic and upsetting.

Agent Orange is no longer produced -- so why am I bringing it up now?

Because Dow AgroSciences (a subsidiary of Dow Chemicals), who was one of the original manufacturers of Agent Orange (AO), has developed a new generation of genetically modified (GM) crops -- soybeans, corn and cotton -- that are designed to resist a major ingredient in AO: the herbicide called 2,4-Dichlorophenoxyacetic acid (2,4-D).

The use of 2,4-D, however, is not new, as it is actually one of the most widely used herbicides in the world.

What is new – and disturbingly so – is that now that staple crops like soy and corn have been engineered to be resistant to 2,4-D, it may soon be applied to U.S. arable land on an unprecedented scale -- not unlike its indiscriminate application during Vietnam.

The whole point of engineering resistance to an herbicide within a GMO plant, of course, is so that you can "carpet bomb" an entire field, leaving only your "Frankenfoods" standing, without having to exert even a fraction of the effort required raise crops organically and sustainably.

In fact, if 2,4-D resistant crops receive approval and eventually come to replace Monsanto's failing Roundup-resistant crops as Dow intends, it is likely that billions of pounds will be needed, on top of the already insane levels of Roundup now being used (1.6 billion lbs were used in 2007 in the US alone!).

Agent Orange Ingredient to be Used in GMO Crops

Dow's new GM product, dubbed "Enlist," is a three-gene, herbicide-tolerant soybean that has been engineered to be resistant to glyphosate, the active ingredient in Monsanto's popular Roundup herbicide, along with glufosinate and 2,4-D. The company expects to earn $1.5 billion in additional profit in 2013 by selling these triple herbicide-resistant seeds. As noted by the U.S. Department of Veteran Affairs:

"The two active ingredients in the Agent Orange herbicide combination were equal amounts of 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), which contained traces of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)."

Ironically, while Dow's new crops would seriously escalate the use of 2,4-D, Monsanto is currently facing a class-action lawsuit involving the other Agent Orange ingredient, 2,4,5-T. The suit alleges that homes and schools near one of its 2,4,5-T chemical plants are now contaminated with cancer-causing dioxin, a byproduct of the manufacturing process. This should be a wake-up call to those considering widespread application of any toxic Agent Orange ingredient.

Dow, however, is touting the new product as a solution to Monsanto's Roundup Ready GM crops, which currently dominate the GM seed market but are now being overshadowed by problems with weed resistance (not to mention that glyphosate itself is also incredibly toxic, and has been linked to infertility, among other serious health problems).

Where Monsanto has failed, Dow and other chemical rivals like DuPont, Syngenta, and Bayer (which are also working on their own herbicide-resistant GM seeds) see opportunity. So Dow has trotted in on their white horse to offer a new variety of GM crop, which they say will not pose the "superweed" problem that Roundup Ready crops have created.

This is not so, according to an article in the Proceedings of the National Academy of Sciences, in which researchers state that suggesting 2,4-D will not lead to widespread weed resistance "misrepresented the potential for 2,4-dichlorophenoxyacetic acid (2,4-D)–resistant weeds in 2,4-D–resistant cropping systems and exaggerated the sustainability of their approach to addressing glyphosate-resistant weed problems in agriculture."

They, in fact, note 28 species across 16 plant families that have already evolved resistance to similar herbicides to 2,4-D. Further, as stated on GreenMedInfo, the new Enlist crops are setting the stage for even greater and simultaneous herbicide use, the health ramifications of which are completely unknown:

"Instead of learning from Monsanto's colossal mistakes (which happens when you play geneticist-as-God and use a broad spectrum poison to kill all but your "chosen" plants) Dow AgroScience's solution is to multiply the problem by a factor of three, creating the "first-ever, three-gene," herbicide-tolerant staple crops.

What this means is that instead of using only one highly toxic herbicide (Roundup), three will be used simultaneously, further increasing the risk of serious exposures, and setting up the conditions for synergistic toxicities – something that toxicological risk assessments on singular herbicide ingredients, which establish "an acceptable level of harm," never account for."

Studies Show Increases in Cancer, Birth Defects With Use of 2,4-D

What is known about 2,4-D so far is not reassuring, considering the devastation caused by Agent Orange. According to the U.S. Environmental Protection Agency (EPA) regarding 2,4-D specifically:

"Health effects of chronic or acute 2,4-D exposure reported for adults included blood, liver, and kidney toxicity. Specific effects included a reduction in hemoglobin and red blood cell numbers, decreased liver enzyme activity, and increased kidney weight. Acute exposure can result in skin and eye irritation. Acute exposure to very high concentrations of 2,4-D can cause the following clinical symptoms: stupor, coma, coughing, burning sensations in lungs, loss of muscular coordination, nausea, vomiting, or dizziness.

Experimental animal studies of chronic oral exposure have reported adverse effects on the eye, thyroid, kidney, adrenals, and ovaries/testes. In addition, some experimental animal studies have reported teratogenic effects (birth defects) at high doses, including increased fetal death, urinary tract malformation, and extra ribs.

When adult female experimental animals were exposed to 2,4-D during their pregnancy and lactation periods, their exposed offspring exhibited neurological effects, including delayed neurobehavioral development and changes in several neurotransmitter levels or binding activities and ganglioside levels in the brain. Delayed neurobehavioral development was manifested as delays in acquisition of certain motor skills such as the righting reflex."

The glaring problem, of course, is that with approval of Dow's new GM crops, the use of 2,4-D could skyrocket out of control. As reported by The Cornucopia Institute:

""The concern is that, just like Monsanto's genetically engineered corn that is resistant to RoundUp™ (glyphosate) herbicide, the approval of a cultivar resistant to 2,4-D will cause an exponential increase in the use of this toxic agrichemical," says Mark A. Kastel, senior farm policy analyst with The Cornucopia Institute.

And again, as the EPA acknowledges, this is far from a benign chemical. The Cornucopia Institute continues:

"2,4-D is a chlorophenoxy herbicide, and scientists around the world have reported increased cancer risks in association with its use, especially for soft tissue sarcoma and malignant lymphoma. Four separate studies in the United States reported an association with chlorophenoxy herbicide use and non-Hodgkin lymphoma.

… Research by the EPA found that babies born in counties with high rates of 2,4-D application to farm fields were significantly more likely to be born with birth defects of the respiratory and circulatory systems, as well as defects of the musculoskeletal system like clubfoot, fused digits and extra digits. These birth defects were 60% to 90% more likely in counties with higher 2,4-D application rates. The results also showed a higher likelihood of birth defects in babies conceived in the spring, when herbicide application rates peak."

Weed Scientist Says, "We Told You So"

In the same way that Dow is now certain that its new three-gene, herbicide-tolerant soybean will not spur the creation of more herbicide-resistant "super weeds," Monsanto was also historically adamant that Roundup Ready crops would not cause weed resistance either.

Of course, now that the die has been cast, the United States is reaping the consequences with 13 resistant weed species covering more than 11 million acres, mostly those planted with Monsanto's GM soy, corn and cotton crops. Around the world, 21 weed species are now resistant to glyphosate, up from zero in 1996.

The weeds are making Monsanto's promises that their GM crops would reduce pesticide use completely laughable -- since farmers are being forced to use multiple, and more, pesticides to keep weeds in their GM crops under control -- and are turning out to be a very big thorn in Monsanto's proverbial side.

Monsanto's solution is similar to Dow's … add more herbicide-resistant genes to the plants so even more potent herbicide cocktails can be poured over U.S. farmland! According to Monsanto Chief Executive Officer Hugh Grant, who was interviewed in Business Week, the company plans to add resistance to Dicamba, another weedkiller, to Roundup Ready crops by 2015, noting that:

"The cavalry is coming."

The cavalry is coming indeed … unfortunately they are working for the wrong side, with their "war on weeds" causing massive collateral damage to environmental and human health alike. William G. Johnson, a weed scientist at Purdue University, told Business Week, these new technologies may control Roundup-resistant weeds and leave us in "wedded bliss for 10 or 15 years" but "they do select for their own failure:"

 "Now that it has kind of blown up, it's like, 'We told you so,'" he says.

Adding further insult to injury, Johnson explains that "Dicamba and 2,4-D both tend to volatilize, turning the chemicals into vapor that can drift onto neighboring land … " accidentally killing nearby crops and exposing greater expanses to its toxic effects.

Let us also not forget that all the "weeds" these herbicides were designed to kill represent biodiversity, without which we would be left with only a handful of staple crops -- upon which our entire subsistence now precariously depends. Only because we do not find obvious value in a plant, does not mean it is not there.

Emerson once said: "What is a weed? A plant whose virtues have not yet been discovered."

Indeed, when we target as "the enemy" any living plant that does not bear the favored qualities of a GM plant, and use the slash-and-burn, herbicidal approach to eradicate any competing plant life form, we are basically declaring war on the biosphere itself, and thereby setting up the future conditions for the collapse of our entire food production system, as well as poisoning ourselves in the process. Without biodiversity, monoculturing puts "too many eggs in one basket," virtually guaranteeing future crop collapses and famine. In a nutshell, industrial herbicides (and the GM plants designed to thrive when exposed to them), are a dead end – both figuratively, and literally.

Now's the Time to Take Action!

Dow has applied for non-regulated status of its 2,4-D-resistant corn, and you have until February 27, 2012 to comment on the petition. Please let your opinion be heard that approving more herbicide-tolerant crops is not the solution to ending "super weeds"; the real solution lies in eliminating the genetically modified crops that created them in the first place! 

As Jay Feldman, executive director of Beyond Pesticides told The Cornucopia Institute:

"In 2012 the USDA is proposing approving a new GE corn variety that is resistant to a different toxic herbicide, escalating the toxic treadmill in chemical-dependent agriculture. This is nothing more than a band-aid solution to a serious problem, and will only give rise to more superweeds, more herbicide pollution in our environment, more herbicide poisoning, while likely leading to the need for even more toxic herbicides a couple of years down the line. This foolish circle has to end."

It's quite clear that genetically engineered foods are not only threatening the food supply with the creation of herbicide-resistant weeds, but they can also pose potentially serious threats to animal and human health when consumed. Fortunately, now you, too, can let your opinion be heard on this issue. Several organizations, including Mercola.com, the Organic Consumers Association, the Institute for Responsible Technology, and the Environmental Working Group, are working to generate a tipping point of consumer rejection to make GMOs a thing of the past.

Here's how you can get involved:

• If you live in California and are willing to attend a short training session and then start collecting petition signatures (you will be part of a team of 2-4 people) for the California Ballot Initiative, sign up here. (For more information see: The California Ballot Initiative: Taking Down Monsanto.) Also remember to share this information with family and friends in California!
• Whether you live in California or not, please donate money to this historic effort.
• Talk to organic producers and stores and ask them to actively support the California Ballot. It may be the only chance we have to require the proper labeling of genetically engineered foods.
• Distribute WIDELY the Non-GMO Shopping Guide to help you identify and avoid foods with GMOs. Look for products (including organic products) that feature the Non-GMO Project Verified Seal to be sure that at-risk ingredients have been tested for GMO content. You can also download the free iPhone application that is available from the iTunes store. You can find it by searching for ShopNoGMO in the applications.
• For timely updates, please join the Organic Consumers Association on Facebook, or follow them on Twitter
• Look for in-depth coverage of the issue at the Institute for Responsible Technology, subscribe to Spilling the Beans, and check out their Facebook or Twitter.
• You can also join the Non-GMO Project on Facebook, or Twitter

In the meantime, the simplest way to avoid GM foods is to buy whole, certified organic foods. By definition, foods that are certified organic must never intentionally use GM organisms, must be produced without artificial pesticides and fertilizers and come from an animal reared without the routine use of antibiotics, growth promoters or other drugs. Additionally, grass-fed beef will not have been fed GM corn feed, although now that GM alfalfa is approved, grass-fed will not always mean GMO free. You can also look for foods that are "non-GMO verified" by the Non-GMO Project.

Important Action Item: Support California's Ballot Initiative to Label GMO's!

In 2007, then-Presidential candidate Obama promised to "immediately" require GM labeling if elected. So far, nothing of the sort has transpired.

Fortunately, 24 U.S. states have (as part of their state governance) something called the Initiative Process, where residents can bring to ballot any law they want enacted, as long as it has sufficient support. California has been busy organizing just such a ballot initiative to get mandatory labeling for genetically engineered foods sold in their state. The proposed law will be on the ballot for 2012.

Michigan and Washington are also starting similar campaigns.

Since California is the 8th largest economy in the world, a win for the California Initiative would be a huge step forward, and would affect ingredients and labeling nation-wide. Last month, a coalition of consumer, public health and environmental organizations, food companies, and individuals submitted the California Right to Know Genetically Engineered Food Act to the State Attorney General. Now, they need 800,000 signatures to get the Act on next year's ballot.

I urge you to get involved and help in any way you can.

If you live in California, volunteer to gather petition signatures. If you live outside of California, please donate to help support this Initiative and spread the word to everyone you know in California. Be assured that what happens in California will affect the remainder of the US states, so please support this important state initiative, even if you do not live there!

By Dr. Mercola

Dr. Stephanie Seneff is a senior scientist at MIT where she's conducted research for over three decades, and has published hundreds of papers in the peer-reviewed scientific literature.

She also has an undergraduate degree in biology from MIT, and a minor in food and nutrition.

I've previously published two articles detailing Dr. Seneff's groundbreaking views on sulfur and cholesterol—both of which are important in relation to the discussion in this segment about statin drugs.

If you missed the previous two segments, I highly recommend reviewing them now in order to get a more complete picture of how vitamin D, dietary cholesterol, and statin drugs work in tandem to affect your health, for better or worse.

What makes Dr. Seneff uniquely qualified to talk about statins is not clinical experience but rather her expertise in mining and evaluating the available research to reach conclusions about health.

Why it's So Difficult to Learn the Truth about Statin Drugs...

One of the papers Dr. Seneff wrote was on the detrimental impact of low cholesterol and statin drugs on Alzheimer's disease.

"I was very interested in the connection between Alzheimer's and low cholesterol... and statins in particular because they lower cholesterol, [which is] going to make that problem worse," she says.

Her paper was summarily rejected.

"Part of the grounds of rejection had to do with the mention of statins," Dr. Seneff explains. "So we took out all the mentions of statins and resubmitted the paper to a different journal, and then it got accepted. You can read this paper in the European Journal of Internal Medicine."

This is a classic example of what's wrong with the current paradigm. The pharmaceutical industry effectively controls the entire health care system, from research to publication to education.

"I think many people are aware that they cannot get their paper published in one of the high end journals if it mentions something negative about statins," Dr. Seneff says. "It's extremely difficult to get such papers accepted by these journals because of the influence of the statin industry on the journal. I think that's a very serious problem."

Many Doctors are Shockingly Ill- or Misinformed about Statin Risks

Shockingly, one in four Americans over the age of 45 is now taking these drugs, and few are properly warned about the related health risks. Part of the problem is that many doctors are not even aware of all the risks. Needless to say, this is not entirely surprising when you consider how difficult it is for any researcher to publish negative findings about this class of drugs!

A study published last spring highlighted this dilemma.

Most disturbingly, the researchers found that physicians were lacking in awareness of the teratogenic risksⁱ (ability to cause fetal malformations) of statins and other cardiovascular drugs they prescribed for their pregnant patients. The study followed an earlier reportⁱⁱ, which had concluded statins should be avoided in early pregnancy due to their teratogenic capability. An even earlier 2003 studyⁱⁱⁱ had already established that cholesterol plays an essential role in embryonic development, and that statins could play a part in embryonic mutations or even death...

Indeed, it's difficult to look at these facts and not reach the conclusion that the pharmaceutical industry is quite willing to sacrifice human lives for profit. Statins are in fact classified as a "pregnancy Category X medication"^iv; meaning, it causes serious birth defects, and should NEVER be used by a woman who is pregnant or planning a pregnancy.

"It disturbs me greatly that they are prescribing statins to women in their reproductive years and the doctor doesn't even bother to tell the woman that statins are class X for pregnancy, just like thalidomide," Dr. Seneff says. "[Statin drugs] cause severe damage to the neural tube in the embryo—likely leading to a miscarriage if you're lucky, because otherwise you'll have an extremely disabled child. I don't understand why they're not making this clear to women!"

Cholesterol is Essential for a Healthy Pregnancy

Besides the direct harm caused by the drug, it's also important to understand that cholesterol sulfate is essential for babies in utero, and this is one of the reasons Dr. Seneff states that you do not want your cholesterol levels to be too low.

A woman has about 1.5 units of cholesterol sulfate normally in her blood. When she gets pregnant, her blood levels of cholesterol sulfate steadily rise, and it also begins to accumulate in the villi in the placenta—which is where nutrients are transferred from the placenta to the baby. At the end of pregnancy the cholesterol sulfate in the villi rises to levels of about 24 units—a dramatic rise! This is also why it's especially important to get plenty of sun exposure before and during pregnancy, to make sure you're optimizing not only your vitamin D levels, but also your sulfur levels, as the two are connected.

Did You Know? Statins Can Also Cause Diabetes and Heart Failure...

Another discovery is that statins can cause diabetes. One of the most recent pieces of evidence for this came from a meta-analysis published in September last year.^v The analysis looked at 72 trials which together involved close to 160,000 patients. It found that statin treatments significantly increased the rate of diabetes and liver damage.

But that's not all. Dr. Seneff also points out that statins make you age faster in general, causing muscle weakness, arthritis, mental decline, and even heart failure. It's worth noting that "heart failure" is a different disease category from "cardiovascular disease," despite the fact that both involve your heart.

"That's why I think they keep talking about cardiovascular disease," Dr. Seneff says. "They're careful to use that term… which is very convenient because then people don't realize it's the statins that are causing the heart failure!"

Indeed. Few would assume that a drug taken to prevent cardiovascular disease would be a major cause of heart failure, but that's exactly what appears to be happening. Considering the fact that conventional medicine has been telling us that heart disease is due to elevated cholesterol and recommends lowering cholesterol levels as much as possible, Dr. Seneff's claims may come as a complete shock:

"Heart disease, I think, is a cholesterol deficiency problem, and in particular a cholesterol sulfate deficiency problem," she says.

Heart Disease More Likely Caused by Cholesterol Deficiency Rather than Excess!

Through her research, Dr. Seneff has developed a theory in which the mechanism we call "cardiovascular disease" (of which arterial plaque is a hallmark) is actually your body's way to compensate for not having enough cholesterol sulfate. To understand how this works, you have to understand the interrelated workings of cholesterol, sulfur, and vitamin D from sun exposure.

Cholesterol sulfate is produced in large amounts in your skin when it is exposed to sunshine. When you are deficient in cholesterol sulfate from lack of sun exposure, your body employs another mechanism to increase it, as it is essential for optimal heart- and brain function. It does this by taking damaged LDL and turning it into plaque. Within the plaque, your blood platelets separate out the beneficial HDL cholesterol, and through a process involving homocysteine as a source of sulfate, the platelets go on to produce the cholesterol sulfate your heart and brain needs. However, this plaque also causes the unfortunate side effect of increasing your risk of cardiovascular disease.

So how do you get out of this detrimental cycle?

Dr. Seneff believes that high serum cholesterol and low serum cholesterol sulfate go hand-in-hand, and that the ideal way to bring down your LDL (so-called "bad" cholesterol, which is associated with cardiovascular disease) is to get appropriate amounts of sunlight exposure on your skin.

She explains:

"In this way, your skin will produce cholesterol sulfate, which will then flow freely through the blood—not packaged up inside LDL—and therefore your liver doesn't have to make so much LDL. So the LDL goes down. In fact... there is a complete inverse relationship between sunlight and cardiovascular disease – the more sunlight, the less cardiovascular disease."

What this also means is that when you artificially lower your cholesterol with a statin drug, which effectively reduces the bioavailability of cholesterol to that plaque but doesn't address the root problem, your body is not able to create the cholesterol sulfate your heart needs anymore, and as a result you end up with acute heart failure...Backing up this theory is the fact that in the first decade statin drugs were on the market, from 1980 to 1990, the incidence of heart failure doubled. And heart failure keeps going up right along with the increased use of statins...

"It is very clear to me that statins are causing heart failure," Dr. Seneff says.

Statins Impair Numerous Biological Functions

Statin drugs also interfere with other biological functions, including an early step in the mevalonate pathway, which is the central pathway for the steroid management in your body. Products of this pathway that are negatively affected by statins include:

• All sterols, including cholesterol and vitamin D (which is similar to cholesterol and is produced from cholesterol in your skin)
• All your sex hormones
• Cortisone
• The dolichols, which are involved in keeping the membranes inside your cells healthy
• Coenzyme Q10 (CoQ10), which is critical to the energy generation in the Krebs cycle in the cell

Why You MUST Take a CoQ10 Supplement if You're on Statin Therapy

The depletion of CoQ10 is particularly troublesome, and may be one of the primary driving mechanisms behind many of the more horrific side effects of statins. CoQ10 is used by every cell in your body, but especially your heart cells. Cardiac muscle cells have up to 200 times more mitochondria, and hence 200 times higher CoQ10 requirements, than skeletal muscle. So if you take a statin drug, taking a CoQ10 or ubiquinol (the reduced version) supplement is absolutely imperative in order to limit the damage. As mentioned by Dr. Seneff, premature aging is a side effect of statin drugs, and it's also a primary side effect of having too little CoQ10. Deficiency in this nutrient also accelerates DNA damage, and because CoQ10 is beneficial to heart health and muscle function this depletion leads to fatigue, muscle weakness, soreness and, again, heart failure.

As for dosage, Dr. Graveline, a family doctor and former astronaut, made the following recommendation in a previous interview on statins and CoQ10:

• If you have symptoms of statin damage such as muscle pain, take anywhere from 200 to 500 mg
• If you just want to use it preventively, 200 mg or less should be sufficient

In my view it is medical malpractice to prescribe a statin drug without recommending one take CoQ10, or better yet ubiquinol. Unfortunately, many doctors fail to inform their patients of this fact.

If You're Over 25, the Reduced Form of CoQ10 May be Better

If you're under 25 years old your body is capable of converting CoQ10 from the oxidized to the reduced form. However, as you age, your body becomes more and more challenged to convert the oxidized CoQ10 to ubiquinol. Aside from aging, numerous other factors can also impact this conversion process, including:

If you're over 40, I would highly recommend taking the reduced form of coenzyme Q10 because it's far more effectively absorbed by your body. Some reports say your CoQ10 level decline becomes apparent as early as your 20's, however, so I generally recommend it from age 25 and beyond. If you're younger than 25, your body should absorb regular CoQ10 just fine.

References:

• ⁱ Teratogen Use in Women of Childbearing Potential: An Intervention Study, Journal of the American Board of Family Medicine, May to June 2011: 24(3); 262-71, K. A. Morrical-Kline, et al.
• ⁱⁱ Defects in Cholesterol Synthesis Genes in Mouse and in Humans: Lessons for Drug Development and Safer Treatments, Drug Metabolism Reviews, February 2011: 43(1); 69-90, S. Horvat, et al.
• ⁱⁱⁱ Early Embryonic Lethality Caused by Targeted Disruption of the 3-Hydroxy-3-methylglutaryl-CoA Reductase Gene, The Journal of Biological Chemistry, October 31, 2003: 278; 42936-42941, Ken Ohashi, et al.
• ^iv Statins and Pregnancy, eMed TV.
• ^v Adverse Events Associated with Individual Statin Treatments for Cardiovascular Disease: An Indirect Comparison Meta-Analysis, QJM, February 2012: 105(2); 145-57, M. Alberton, et al.

Travel can increase the stress on your immune system, even if it's for fun.

If you're not careful, you may come home from your trip with an unwelcome memento - like a cold or flu.

Some people even expect to get sick during a trip. But it doesn't have to be that way!

It's very important to take care of your immune health while traveling, whether it's for business or pleasure.

Acupressure is the practice of pressing or massaging certain points on your body, which can stimulate your body's self-curative abilities.

CNN Go has collected a list of 8 Acupoints¹, which could be useful for travelers.

Here are a few:

1. Motion sickness and nausea: Press on the inside of your forearm, two thumbs' width above your wrist crease, between the two tendons.

The point is actually located below surface level so pushing deep is more effective.

2. Sore throat and lightheadedness: Loosely interlock your thumbs at the webbing, with both palms facing down.

Keep your wrists straight, and extend your index finger to the skinny edge of your wrist. Under the pad of your index finger you'll find a small depression in the prominent bone; that's the point. Rubbing or pressing this point relieves symptoms associated with colds.

3. Insomnia or disturbed dreams: Find the styloid process muscle on the side of your neck, and follow it up to where it meets your skull. The point is at the A-like depression going toward the back of your head.

For the complete list, please review the original article.²

Does Flying Increase Your Chances of Getting Sick?

Occasional travel exposes you to environmental toxins and pathogens that you aren't routinely exposed to - new people, new places, and toxic airplane cabin air. If you have a strong immune system, your body will be able to handle these insults without much trouble. But if your immune system is compromised, you can end up getting sick.

Air travel, with its frequent delays, security hassles, cramped quarters, and jet lag effects, can be stressful, but does it inherently make you more likely to contract an infectious illness?

A recent WHO report found there is no evidence that recirculation of cabin air facilitates the transmission of infectious disease agents on board.

Additionally, a University of California, San Francisco study found recycled air on short-term flightsis no more likely to cause colds than flights using fresh air. The researchers interviewed 1,100 passengers before and one week after an approximate two-hour flight and reported that the frequency of colds and runny noses were virtually the same between recycled air and fresh air flyers.

As that report confirmed, it is the strength of your body's own immune system that determines whether or not you will get sick. The infectious bacteria and viruses that circulate around an airplane cabin are merely triggers for an already weakened immune system. Cold and flu viruses can last up to 72 hours on plastic surfaces and the nasty Norovirus³ can survive for two to four weeks - so chances are you're very likely to touch a surface with some germs on it while you're in a confined space with many other people, like on an airplane (or in public places general). The best way to prevent getting sick then, is to build up your immunity well in advance of traveling and practice good health habits while away.

The Basics for Protecting Your Immune System While Traveling

So, let's start with the basics.

I actually recommend you follow these tips year-round, regardless of your travel plans, because you will inevitably be exposed to bacteria and viruses in your daily life. The following general guidelines will help you optimize your health and immune function, and by doing so, minimize your risk of becoming ill.

Astaxanthin Can Help Prevent Cellular Damage from Radiation Exposure

The above tips are the very basics. But there are some additional steps you can take that can further increase your odds of staying well. Astaxanthin is a naturally occurring but still little known carotenoid that may be the most potent antioxidant in nature. Carotenoids are the compounds in your foods that give them that vibrant cornucopia of color - from green grasses to red beets, to the spectacular yellows and oranges of your bell peppers. Astaxanthin is what gives wild salmon their vibrant red color.

Not only does astaxanthin give your immune system an enormous boost, but it's also a potent UVB absorber and can help reduce DNA damage. Hence it can help protect you from the increased radiation you are subjected to while flying, and may even offer protection against any harmful radiation exposure from airport scanners.

I recommend taking 4-8 mg of astaxanthin for several weeks prior to flying, and continue taking it throughout your trip.

Avoid X-Ray Airport Scanners if You Can

I recommend avoiding airport X-ray scanners if at all possible. Although some experts claim that X-ray scanners expose you to "1,000 times less radiation than a chest X-ray" and "far less than what you are exposed to in-flight," these analogies are deceptive. As Dr. Russell Blaylock has pointed out, radiation damage depends on the volume of tissue exposed.

Some of the most damaging radiation barely penetrates the skin and is concentrated on top few millimeters of skin surface where some very radiation-sensitive tissues exist, such as your eyes, genitals, and circulating blood cells.

Zinc and Mushrooms: Two More Immune System Defenders

Zinc is another simple, inexpensive antiviral supplement you can take if you suspect you might not be getting enough in your diet. There is some fairly convincing scientific research suggesting zinc can shorten the duration of a cold as well as decreasing the severity, if taken within 24 hours of your onset of symptoms.

It's not completely understood how zinc curbs a cold, but it appears it may prevent the virus from replicating or attaching to your nasal membranes. I recommend supplementing with no more than 50 to 65 milligrams of zinc per day. Again, only consider supplementing if you think you are not getting adequate zinc from your diet, as a little zinc goes a long way.

Foods richest in zinc include oysters, meat and poultry, nuts and seeds, and unsweetened chocolate (cacao). High grain diets impair zinc absorption, so if you eat a fair amount of grain-based foods, you may be zinc deficient.

Medicinal mushrooms offer another powerful immune boost, besides being nutritional powerhouses. They have anti-inflammatory, antitumor, antibacterial, antiviral, and antifungal properties. A supplement consisting of a blend of several medicinal mushrooms is thought to be more powerful than one containing a single mushroom type.

The Best Breakfast on the Road

It is often a challenge to adhere to a good diet when traveling. I travel often, and I have had to develop a dietary plan that is convenient and manageable for me while away from home.

Many eat breakfast in a diner while traveling, or succumb to the in-house breakfast that many hotels now offer. Unfortunately, the food choices are often not very nutritious and usually consist of mostly processed food and sugar, which will NOT help you stay healthy. Typically, what you'll find is an assortment of pancakes, waffles, donuts, cereal, or scrambled eggs… or something that sort of passes for scrambled eggs that I dare guess is loaded with stuff you shouldn't be eating.

I believe a far better option is making a whey shake in your hotel room for breakfast, which will start your day off right with some high-quality protein. Whey shakes have become a staple for me, and they're easy to prepare in any hotel room.

Of course, you DO have to plan, and bring the food with you!

You want a whey product that is specifically from grass-fed, non-hormonally treated cows, and minimally processed. This maximizes its beneficial immune-supporting components and all the key amino acids and other important nutrients.

My Personal Recipe for a Healthy Breakfast

My breakfast recipe has evolved over a number of years but it works well for me so I thought I would share it. Most of the time, I am able to take the ingredients with me so I can consume them when I travel. First I start with a bed of dehydrated cucumber pulp which is broken down to about the size of breakfast cereal. The crunchy texture serves as a healthy bread substitute. This is leftover from my juicing and seasoned with crushed red peppers and Himalayan salt.

I then melt two tablespoons of raw grass fed organic butter over the cucumber flakes. Then I put some chopped organic red onions and a whole cut up organic avocado, and top it off with four raw organic pastured egg yolks. My latest and best addition is about 6-8 ounces of fermented organic vegetables like cabbage, carrots, celery etc. This is one of the healthiest breakfasts that I could come up with, and fully believe it would help many improve their own health.

Up and At 'Em: The Art of Hotel Room Exercise

If you want to stay healthy while traveling, it is a good idea to get some exercise every day. Some hotels have a small workout room, but even if yours doesn't, there are plenty of options for exercising right there in your hotel room. You can always take a brisk walk to a nearby park, climb some stairs, or take advantage of the swimming pool many hotels offer (just beware of heavily chlorinated pools!). Many gyms offer daily or weekly passes for a minimal charge.

But you can get an aerobic workout without ever leaving your room. Try some of the following:

• Jumping jacks
• Pushups
• Tricep dips off a chair
• Squats
• Lunges

You can also do things like yoga and Pilates anywhere you have a floor… and of course, that's pretty much anywhere! The best type of exercise equipment for packing in a suitcase is a resistance band. These are made of strong, thin rubber and come in a variety of resistances, and have handles at the ends. With resistance bands, you can do just about anything - chest presses, rows, shoulder presses, tricep extensions, bicep curls, and even squats - without the need for heavy weights.

Take a look at these exercise videos and you'll see how many exercises you could do with a little "improv" in a standard hotel room. And here is an exercise video demonstrating an exercise routine specifically designed for a hotel room.⁵ Going on vacation doesn't mean a death sentence for your health. With a little planning and attention to your immune system, you can enjoy your vacation and come home refreshed - rather than infected.

References:

• ¹ 8 Secret Acupoints to Cure Travel Ills, CNN GO, November 2, 2011: Toffler Niemuth.
• ² 8 Secret Acupoints to Cure Travel Ills, CNN GO, November 2, 2011: Toffler Niemuth.
• ³ Norovirus, Centers for Disease Control and Prevention.
• ⁴ EFT Eases Nausea – Tapping Without Actually Tapping, EFTUniverse.com.
• ⁵ Best Hotel Room Workout, 5minLife Videopedia.

The latest data on the leading causes of deathⁱ in the United States has been released by the U.S. Centers for Disease Control and Prevention (CDC).

The report, which is based on 2010 data, lists the 10 leading causes of death as follows:

1. Diseases of the heart
2. Cancer
3. Chronic lower respiratory diseases
4. Cerebrovascular diseases (stroke)
5. Accidents (unintentional injuries)
6. Alzheimer's disease
7. Diabetes mellitus
8. Nephritis, nephritic syndrome and nephrosis (kidney disease)
9. Influenza and pneumonia
10. Intentional self-harm (suicide)

In an analysis, 24/7 Wall St. determined that the costs to the economy for these top 10 causes, including not only direct medical care but also the indirect loss of productivity, amounts to a whopping $1.1 trillion!

However, there is one leading cause of death that was left off of this list, and when that is factored in the costs to the economy, and the death toll itself, is actually even higher.

The CDC Left Conventional Medical Care Off of Their Death List -- It Should be #1

Over a decade ago, Professor Bruce Pomerance of the University of Toronto concluded that properly prescribed and correctly taken pharmaceutical drugs were the fourth leading cause of death in the U.S. More recently, an article authored in two parts by Gary Null, PhD, Carolyn Dean, MD, ND, Martin Feldman, MD, Debora Rasio, MD, and Dorothy Smith, PhD, describes in excruciating detail how the modern conventional American medical system has bumbled its way into becoming the leading cause of death and injury in the United States.

From medical errors to adverse drug reactions to unnecessary procedures, heart disease, cancer deaths and infant mortality, the authors took statistics straight from the most respected medical and scientific journals and investigative reports by the Institutes of Medicine (IOM), and showed that on the whole, American medicine caused more harm than good.

In 2010 (the same year from which the CDC data came), years after the original article was written, an analysis in the New England Journal of Medicineⁱⁱ piqued my interest – as the researchers found that, despite efforts to improve patient safety in the past few years, the health care system hasn't changed much at all.

Instead, 18 percent of patients were harmed by medical care (some repeatedly) and over 63 percent of the injuries could have been prevented. In nearly 2.5 percent of these cases, the problems caused or contributed to a person's death. In another 3 percent, patients suffered from permanent injury, while over 8 percent experienced life-threatening issues, such as severe bleeding during surgery.

In all there were over 25 injuries per 100 admissions! In my update to the original Death by Medicine article, you can get an idea of just how deadly the conventional medical care system actually is:

• In a June 2010 report in the Journal of General Internal Medicine, study authors said that in looking over recordsⁱⁱⁱ that spanned from 1976 to 2006 (the most recent year available) they found that, of 62 million death certificates, almost a quarter-million deaths were coded as having occurred in a hospital setting due to medication errors.
• An estimated 450,000 preventable medication-related adverse events occur in the U.S. every year.
• The costs of adverse drug reactions^iv to society are more than $136 billion annually -- greater than the total cost of cardiovascular or diabetic care.
• Adverse drug reactions cause injuries or death in 1 of 5 hospital patients.
• The reason there are so many adverse drug events^v in the U.S. is because so many drugs are used and prescribed – and many patients receive multiple prescriptions at varying strengths, some of which may counteract each other or cause more severe reactions when combined.

How Many Deaths by Medicine are Disguised as Other Causes?

Another issue is just how many "accidents" or "suicides" are actually the result of accidental drug overdoses. Prescription drugs are now killing far more people than illegal drugs, and while most major causes of preventable deaths are declining, those from prescription drug use are increasing -- and this is according to the CDC's own data^vi.

In 2009, there were nearly 4.6 million drug-related visits^vii to U.S. emergency rooms nationwide, with more than half due to adverse reactions to prescription medications – most of which were being taken exactly as prescribed^viii.

Further, between 2001 and 2008, there was a 36 percent increase in hospital admissions^ix, and a 28 percent increase in emergency room visits, among children 5 and younger who had accidentally ingested medication. ER visits for ingestion of prescription opioid painkillers, such as Oxycodone, increased 101 percent! So it is unclear how many deaths from accidental drug overdose are classified as accidents or suicides.

The 9th and 11th Top Killers Might Also be Linked to Medical Care

The 11th leading cause of death according to the CDC is septicemia (sometimes called blood poisoning), which is bacteria in your bloodstream that is often caused by an infection in your body -- an infection that is often acquired in the hospital! A study published in the Archives of Internal Medicine^x showed that sepsis and pneumonia caused by hospital-acquired infections killed 48,000 patients and ramped up health care costs by over $8 billion in 2006. The study also found that 20 percent of people who developed sepsis died; 11 percent of those who developed pneumonia died.

Pneumonia is the 9th leading cause of death, and in some cases may again be related to the high risk of acquiring an infection should you enter the hospital.

A different study in 2006 showed that "central-line-associated" bloodstream infections^xi caused by catheters placed directly into veins resulted in a $26,839 loss for each patient that came down with this type of hospital-acquired infection. This same study estimated that 2 million people come down with hospital-acquired infections of any type in every year, and that approximately 100,000 die from those infections. Despite their high death toll, hospital-acquired infections make no appearance in the CDC's report.

Most of the Leading Causes of Death are Preventable

Most chronic diseases, including cancer, heart disease, diabetes, and obesity, are largely preventable with simple lifestyle changes. Even infectious diseases like the flu can often be warded off by a healthy way of life.

Imagine the lowered death toll, not to mention costs to the economy, if more people decided to take control of their health … heart disease and cancer alone accounted for 47 percent of deaths in the United States in 2010, and there are many strategies you can implement to lower your risk of these diseases … and most of the leading causes of death in the United States.

The added bonus to this is that the healthier you are, the less you will need to rely on conventional medical care, which is a leading cause of death. So what does a "healthy lifestyle" entail?

• Proper Food Choices

For a comprehensive guide on which foods to eat and which to avoid, see my nutrition plan. Generally speaking, you should be looking to focus your diet on whole, unprocessed foods (vegetables, meats, raw dairy, nuts, and so forth) that come from healthy, sustainable, local sources, such as a small organic farm not far from your home.

For the best nutrition and health benefits, you will want to eat a good portion of your food raw. Personally, I aim to eat about 80-85 percent of my food raw, including raw eggs and humanely raised organic animal products that have not been raised on a CAFO (confined animal feeding operation).

Nearly as important as knowing which foods to eat more of is knowing which foods to avoid, and topping the list is fructose. Sugar, and fructose in particular, acts as a toxin in and of itself, and as such drive multiple disease processes in your body, not the least of which is insulin resistance, a major cause of accelerated aging.

• Comprehensive Exercise Program, including High-Intensity Exercise like Peak Fitness

Even if you're eating the healthiest diet in the world, you still need to exercise to reach the highest levels of health, and you need to be exercising effectively, which means including not only core-strengthening exercises, strength training, and stretching but also high-intensity activities into your rotation. High-intensity interval-type training boosts human growth hormone (HGH) production, which is essential for optimal health, strength and vigor. I've discussed the importance of Peak Fitness for your health on numerous occasions, so for more information, please review this previous article.

• Stress Reduction and Positive Thinking

You cannot be optimally healthy if you avoid addressing the emotional component of your health and longevity, as your emotional state plays a role in nearly every physical disease -- from heart disease and depression, to arthritis and cancer. Effective coping mechanisms are a major longevity-promoting factor in part because stress has a direct impact on inflammation, which in turn underlies many of the chronic diseases that kill people prematurely every day. Meditation, prayer, social support and exercise are all viable options that can help you maintain emotional and mental equilibrium.

• Proper Sun Exposure to Optimize Vitamin D

We have long known that it is best to get your vitamin D from sun exposure, and if at all possible, I strongly urge you to make sure you're getting out in the sun on a daily basis. Vitamin D plays an important role in preventing numerous illnesses ranging from cancer to the flu.

The important factor when it comes to vitamin D is your serum level, which should ideally be between 50-70 ng/ml year-round. Sun exposure or a safe tanning bed is the preferred method for optimizing vitamin D levels, but a vitamin D3 supplement can be used as a last resort. Most adults need about 8,000 IU's of vitamin D a day to achieve serum levels above 40 ng/ml, which is still just below the minimum recommended serum level of 50 ng/ml.

• High Quality Animal-Based Omega-3 Fats

Animal-based omega-3 fat like krill oil is a strong factor in helping people live longer, and many experts believe that it is likely the predominant reason why the Japanese are the longest lived race on the planet.

• Avoid as Many Chemicals, Toxins, and Pollutants as Possible

This includes tossing out your toxic household cleaners, soaps, personal hygiene products, air fresheners, bug sprays, lawn pesticides, and insecticides, just to name a few, and replacing them with non-toxic alternatives.

References:

• $1.1 Trillion: What the 10 Leading Causes of Death Cost the U.S. Economy, 24/7 Wall St., January 18, 2012.
• ⁱ Deaths: Preliminary Data for 2010, National Vital Statistics Reports, January 11, 2012: 60(4); 1-69, Sherry L. Murphy, BS, et al. (PDF)
• ⁱⁱ Temporal Trends in Rates of Patient Harm Resulting from Medical Care, New England Journal of Medicine, November 25, 2010: 363(22); 2124-34, C. P. Landrigan, et al.
• ⁱⁱⁱ Are Hospitals Really More Deadly in July, When Novice Doctors Arrive?, JetLib News.
• ^iv Preventable Adverse Drug Reactions: A Focus on Drug Interactions, Centers for Education and Research on Therapeutics. (PDF)
• ^v Preventable Adverse Drug Reactions: A Focus on Drug Interactions, Centers for Education and Research on Therapeutics. (PDF)
• ^vi Deaths: Preliminary Data for 2009, National Vital Statistics Reports, March 16, 2011: 59(4); 1-51, Kenneth D. Kochanek, MA, et al. (PDF)
• ^vii InfoFacts: Drug-Related Hospital Emergency Room Visits, National Institute on Drug Abuse.
• ^viii Highlights of the 2009 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department Visits, The DAWN Report, December 28, 2010.
• ^ix The Growing Impact of Pediatric Pharmaceutical Poisoning, Journal of Pediatrics, February 2012: 160(2); 265-270.e1, G. Randall Bond, MD, et al.
• ^x New Study Shows Sepsis and Pneumonia Caused by Hospital-Acquired Infections Kill 48,000 Patients, EurekAlert, February 22, 2010. (Press Release)
• ^xi Economics of Central Line-Associated Bloodstream Infections, American Journal of Medical Quality, November/December 2006: 21(6); 7S-16S, Richard P. Shannon, MD, et al.

15 of those affected attend LeRoy Junior-Senior High School, leading some to wonder about possible environmental factors.  There is a 41-year-old toxic spill located a few miles from the school.

According to CNN:

“Whatever the cause, many experts in the medical community have expressed skepticism that these symptoms could be the result of toxins in the environment ... [W]henever there is a cluster of cases, it is necessary to thoroughly test for environmental or infectious causes.”

One possibility is an infectious disease.  One doctor who examined the teens in LeRoy found that they tested positive for strep and mycoplasma.

Obsessive-compulsive disease and tic symptoms, as well as Tourettes Syndrome, can be triggered by a bacterial pneumonia infection.  The CDC and individual states don't conduct surveillance for M. pneumonia, even though it is the most common cause of bacteria pneumonia in school-aged children.

And in fact, pneumonia vaccines don't even treat M. pneumonia; they are all S. pneumonia vaccines ... which could very well be the source of the problem.  When children are treated with S. pneumonia vaccines, it can result in an increase in other pneumonia serotypes.  It might be possible that the recent introduction of a new 13-valent vaccine is causing M. pneumonia to flourish.

Here’s some information about pneumonia infections and vaccines from the National Vaccine Information Center.  As you will see, the complications of M. pneumoniae can include nervous system disorders and tics.  And you will also see that pneumonia vaccines themselves can be just as dangerous.

Pneumococcal Disease (Pneumonia)

Quick Facts:

S. Pneumoniae (Pneumococcal infections)

• Streptococcus pneumonia (S. pneumoniae), also known as pneumococcus, is the most common cause of bacterial pneumonia and middle ear infection (otitis media) in the U.S., and the third most frequent cause of bacterial meningitis. The most common causes of viral pneumonia are influenza, parainfluenza and respiratory syncytial virus (RSV).[1]

• S. pneumoniae is found in the upper area of the throat behind the nose, and can be isolated in 5 to 10 percent of healthy adults and 20 to 40 percent of healthy children. It can cause serious illness, including inflammation of the brain, blood infections and pneumoniae.[2] It becomes pneumonia when it spreads to the lungs. The primary cause of death from S. pneumoniae is pneumonia.[3]

• S. pneumoniae is spread by direct or droplet transmission (such as coughing, sneezing or other contact with respiratory secretions) to people in close contact with an infected person. Crowded environments such as daycare centers, military barracks, prisons and homeless shelters, and poor ventilation can make transmission even more conducive.

• The CDC states that each year in the U.S. pneumococcus causes about 4000 cases of blood stream infections (bacteremia), meningitis, or other invasive disease in children younger than 5 years of age. Children under 2 years of age average more than 1 middle ear infection (otitis media) each year, many of which are caused by pneumococcus.[4]

• Symptoms for all forms of pneumococcal infections include sudden onset of fever and malaise. Other symptoms can include cough with sputum and other respiratory conditions such as shortness of breath or sneezing. Patients may feel unwell for several days with an unproductive cough and low-grade fever before the infection worsens. Symptoms of pneumococcal meningitis can include stiff neck, headache, lethargy, or seizures.[4] Symptoms of otitis media include a painful ear, red or swollen eardrum, fever, and irritability.[5]

Pneumococcal Vaccine

• There are two types of pneumococcal vaccines: Pneumococcal polysaccharide vaccine (PPSV) and Pneumococcal conjugate vaccine (PCV). The FDA has approved one PPSV: Merck’s Pneumovax 23; and two PCVs, Wyeth/Pfizer’s 7-valent PCV Prevnar; and Wyeth/Pfizer’s Prevnar 13.[6]

• The FDA recommends a 4-dose schedule of PCV13 to infants and children under 2 years of age, and a 1- or 2-dose schedule of PCV13 for children ages 2 through 18, depending on whether they have previously completely the infant schedule.[5]

• The PPSV23 vaccine is recommended for adults 65 years of age and older.[6] In an accelerated process, on December 30, 2011, the FDA expanded its approval of Prevnar 13 to include adults age 50 and older.[7]

• By 2008, eight years after it was introduced in the U.S., the pneumococcal vaccine was responsible for decreasing the rates of invasive pneumococcal disease in U.S. children age 5 and under to as much as one-fifth of what it was in 1998.[8] However, it was also responsible for increasing the rates of otitis media serotypes not included in the vaccine.[9]

NVIC “Quick Facts” is not a substitute for becoming fully informed about shingles and the shingles vaccine. NVIC recommends consumers read the more complete information following the "Quick Facts", as well as the  vaccine manufacturer product information inserts, and speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child.

Vaccine Reaction Symptoms & Ingredients

Our Ask 8, If You Vaccinate webpage contains vaccine reaction symptoms and more. Calculate vaccine ingredients for potential toxic exposures & print a vaccination plan with the Vaccine Ingredients Calculator. 

Food & Drug Administration (FDA)

Pneumococcal Vaccine, Polyvalent Merck & Co. Inc. Pneumovax 23 and Licensing Information

Pneumococcal 7-Valent Conjugate Vaccine (Diphtheria CRM₁₉₇Protein) Pfizer/ Pharmaceuticals Inc. Prevnar and Licensing Information

Pneumococcal 13-Valent Conjugate Vaccine (Diphtheria CRM₁₉₇Protein) Pfizer/Wyeth Pharmaceuticals Inc. Prevnar 13 and Licensing Information

Centers for Disease Control (CDC)

CDC on Pneumonia

CDC on Pneumococcal Vaccination

Pneumococcal Conjugate (PCV13) Vaccine Information Sheet

Pneumococcal Conjugate (PCV7) Vaccine Information Sheet

Pneumococcal Polysaccharide (PPSV23) Vaccine Information Sheet

Search for Vaccine Reactions

NVIC is proud to host MedAlerts, a powerful VAERS database search engine. MedAlerts examines symptoms, reactions, vaccines, dates, places, and more.

Reporting a Vaccine Reaction

Since 1982 the NVIC has operated a Vaccine Reaction Registry, which has served as a watchdog on VAERS. Reporting vaccine reactions to VAERS is the law. If your doctor will not report a reaction, you have the right to report a suspected vaccine reaction to VAERS.

What is Pneumococcal Disease?

Pneumococcal disease (pneumonia) is an infection of the lungs that is usually caused by bacteria or viruses and, sometimes, fungi living in your nose, mouth, sinuses, or environment.[1]  A few strains that are untreatable by antibiotics have also developed as a result of overuse and inappropriate use of standard antibiotics. Antibiotic-resistant strains of pneumococcal diseases not included in pneumococcal vaccines also have developed as a result of the use of pneumococcal vaccines.

Influenza, parainfluenza, and respiratory syncytial viruses (RSV) are the most common viral causes of pneumonia.

Streptococcus pneumoniae (S. pneumoniae) are the most common bacterial cause of pneumonia. S. pneumoniae are bacteria that live in the nasopharynx, an area in the back of the nose, toward the base of the skull.[3] S. pneumoniae can cause infections in the middle ear, sinuses, trachea, bronchi, and lungs.

The term actually describes a group of illnesses all caused by S. pneumoniae, including pneumonia, bacteremia (bloodstream infection), sepsis (blood poisoning), sinusitis, meningitis (infection of tissues and fluids surrounding the brain and spinal cord), and acute otitis media (middle ear infections). These pneumococcal diseases are called “invasive” diseases because the germs invade parts of the body that are normally free from germs.[10] Less frequently it can also cause endocarditis, septic arthritis and peritonitis.[11]

The exact contribution of S. pneumoniae to childhood pneumonia is unknown, as it is often not possible to identify the causative organisms. In studies of children less than 5 years of age with community-acquired pneumonia, 30 percent of cases were classified as bacterial pneumonia, and 70 percent (21 percent of total community-acquired pneumonia) were found to be due to S. pneumoniae.[12]

According to Harrison’s Principles of Internal Medicine, 5 to 10 percent of healthy adults and 20 to 40 percent of healthy children are infected with S. pneumoniae at any given time, often without becoming sick or showing symptoms of infection. In an adult, these organisms can persist for 4 to 6 weeks, although it is possible for them to persist as long as 6 months. Respiratory syncytial virus (RSV) is the most common cause of pneumonia in children less than 1 year of age.[2]

Worldwide, pneumonia is the No. 1 killer of children under age 5. Strongly linked to malnutrition, poverty, and inadequate access to healthcare, 98 percent of pneumonia deaths are children living in mostly Third World Countries. According to the World Health Organization, 1.8 million children died in 2007 (latest year available) because of pneumonia, and 1.8 million will continue to die every year as long as global efforts to stem the disease are not met.[13]

In the U.S. in 2008 (latest data year available) there were 54,562 deaths due to pneumonia. The majority of these deaths (42,130) were persons aged 75 and older. For babies under 1 year of age, there were 210 deaths; for children ages 1 to 4, there were 118 deaths; for youths ages 5-14, there were 57 deaths. Together with influenza (1,722 deaths) pneumonia was the 8^th leading cause of death in the U.S. in 2008.[14]

NVIC Note: When reporting pneumonia and influenza deaths in the media, health officials often combine the two numbers, which can lead to confusion as to which ones are pneumonia and which ones are flu. For the purposes of this report, NVIC is using the CDC’s latest edition of the National Vital Statistics Report, which breaks the numbers down.

Pneumonia can be mild or severe. Symptoms of S. pneumoniae can mimic a cold or upper respiratory infection such as influenza, and can include sneezing, sore throat, and cough followed by a high fever. Chills and a cough with sputum—which is usually discolored and sometimes bloody—as well as fatigue, nausea, vomiting, rapid breathing or shortness of breath, and chest pain can also be symptoms of pneumonia.[3]

It is especially common for children to carry the bacteria in their throats without being ill from it. But once the droplets are in the lungs, white blood cells begin to attack the bacteria or offending organism, causing the lungs’ air sacs to fill with fluid, leading to difficulty breathing.

Often, the only signs of pneumonia in infants and younger children are fever and lethargy, even though they appear quite ill. Elderly persons can often have very few symptoms.[3]

Mycoplasma pneumoniae (M. pneumoniae) is the leading cause of bacterial pneumonia in school-age children.[15] Since the CDC and individual states do not conduct a surveillance system for M.  pneumoniae, the normal rate of infection for it is unknown. Some CDC reports suggest that M. pneumoniae accounts for 15 to 20 percent of community-acquired lower respiratory infection in adults.[16] With children, recent studies show that M. pneumoniae causes up to 40 percent of community-acquired pneumonia, and as many as 18 percent of cases requiring hospitalization.

Other studies show that M. pneumoniae is also responsible for triggering wheezing in susceptible individuals and for exacerbating, or possibly causing, asthma.[17]

Persons of all ages are at risk of contracting M. pneumoniae, but it’s rarely seen in children less than 5 years old. Outbreaks can occur wherever crowded conditions exist, such as in school or military settings. Commonly referred to as “walking pneumonia,” an M. pneumoniae epidemic was declared in the Boston area in late 2011 after an outbreak was reported in several elementary schools.[18, 19] Previous M. pneumoniae epidemic outbreaks were reported in Ohio, Texas, and New York in 1993.[16]

Symptoms of M. pneumonia can take several days to develop, and can persist for weeks or months. The most common symptoms are sore throat, hoarseness, fever, cough that begins as nonproductive, but later may yield small to moderate amounts of non-bloody sputum, headache, chills, cold-like symptoms, myalgias, earache, and general malaise. Up to one-third of patients with M. pneumoniae may have ear symptoms including otitis externa, otitis media, and myringitis.[17]

With the most severe type of M. pneumoniae, tracheobronchitis accompanied by a variety of respiratory tract symptoms is common. Mild infections and asymptomatic conditions are most common in adults (about 20 percent).[16] However, bronchopneumonia involving one or more lobes of the lungs can develop in 3 to 10 percent of infected persons.

Complications of M. pneumoniae can include nervous system disorders such as encephalitis, cerebellar syndrome and polyradiculitis, cranial nerve palsies, asceptic meningitis or meningoencephalitis, acute disseminated encephalomyelitis, coma, optic neuritis, diplopia, mental confusion, and acute psychosis secondary to encephalitis. Ataxia, cranial nerve palsy, and Guillain-Barre Syndrome have also been reported.[20,21]

Additionally, a 2008 study showed that obsessive-compulsive disease and/or tic symptoms, as well as Tourettes Syndrome may also be triggered my M.  pneumoniae. These symptoms are more commonly classified as pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, or PANDAS.[80]

Hospital-acquired pneumonia (also known as nosocomial pneumonia) is an infection of the lungs that occurs during a hospital stay. This type of pneumonia tends to be more serious because hospitalized persons are often sicker and unable to fight off germs.[22] Also, the types of germs in a hospital are often more dangerous than those acquired in the community, because the organisms tend to be more virulent and often drug resistant.[23] Hospital-acquired pneumonia occurs more often in patients who are on a respirator (ventilator) to help them breathe. When pneumonia occurs in this situation, it’s called ventilator-associated pneumonia.

Risk factors for getting hospital-acquired pneumonia are being on a breathing machine, aspirating food or other substances into the lungs, having chest surgery, being immunosuppressed, having long-term, chronic lung disease, not being fully alert, older age, and having a recent illness.

Community-acquired pneumonia is bacterial or viral pneumonia in people who have not recently been in the hospital or another health care facility such as a nursing home or rehabilitation center. [23,61]

Classic symptoms of typical community-acquired pneumonia are shaking chills, productive cough, fever, and pleuritic chest pain. Atypical symptoms can include gradual onset of mild fever, respiratory problems, and little or no sputum. Cough is typically productive in older children and adults, while a dry, nonproductive cough is more common in infants, young children and the elderly. Other symptoms can include a crackling sound in the lungs or bronchial tubes. [24,61]

Some patients with community-acquired pneumonia may actually have infection due to organisms such as H. influenza, Staphylococcus aureus (particularly in patients who take glucocorticoids), or C. pneumoniae, rather than classic S. pneumoniae. C. pneumoniae is the second most common cause of lung infections in people aged 5 to 35, and is commonly responsible for outbreaks of respiratory infections within families, college dorms, and military training camps.[2,61]

You can get aspiration pneumonia by breathing in or inhaling food, liquids, vomit, or fluids from your mouth into your lungs.[24]

Is Pneumococcal Disease Communicable?

Yes. Pneumococcal diseases are spread person-to-person through contact with persons who are ill, or through healthy persons who carry the bacteria in the back of the nose but are asymptomatic. Transmission is mostly through the spread of respiratory droplets or secretions (mucous) from the nose or mouth of an infected person.[10]

Day care centers are places where transmission can be prevalent, especially penicillin-resistant strains of pneumococcal serotypes. Other places where pneumococcal diseases can spread quite easily are nursing homes, military barracks, prisons, and shelters for the homeless. However, the risk of pneumococcal pneumonia is NOT increased by contact in schools or workplaces, including hospitals.[10]

While health officials have found that being an Alaska native, American Indian, or African-American puts you at higher risk of being susceptible to pneumococcal diseases, Harrison’s Principles of Internal Medicine notes that susceptibility patterns vary greatly between and even within individual communities, and the data are in a state of flux.

More importantly, Harrison’s also notes that the constant trend of all pneumococcal infections is toward more widespread antibiotic resistance.

History of Pneumococcal Disease in America

Pneumonia is a disease whose symptoms were recorded in the times of Hippocrates, as early as 460 B.C. Through the ages, surgeons and scientists referred to it as “acute fever, short rapid breaths,” and other symptoms we identify today with pneumonia.[25] It was Louis Pasteur who, in 1881, identified S. pneumoniae as the major cause of pneumonia in the U.S. Following this discovery, scientists worked at identifying individual serotypes of S. pneumoniae, and by 1940, over 80 had been documented.

Today there are at least 90 known serotypes. Pneumonia has remained as the eighth leading cause of death in the U.S. for the past several years.[14] In the 1930s, however, before antibiotics were widely available, pneumonia was the third leading cause of death in the U.S. The discovery of penicillin in the early 1900s helped bring the numbers down, but did not reduce the actual incidence of the disease, particularly in individuals whose immune systems are deficient.[25]

Today, just seven pneumoniae serotypes are responsible for 80 percent of infections in U.S. children aged 6 years and under. Worldwide, 10 of the most common serotypes are responsible for 62 percent of pneumococcal infections.[10] The CDC estimates that as many as 175,000 hospitalizations occur each year in the U.S. due to pneumococcal pneumonia, with 5 to 7 percent of that number dying. An estimated 50,000 cases of bacteremia occur each year in the U.S., with a case fatality rate of 20 percent, and as much as 60 percent in elderly adults. Between 3000 and 6000 cases of pneumococcal meningitis occur each year.[81]

Scientists began experimenting with rabbit serum in the 1890s in an attempt to discover a vaccine for pneumonia. In 1920, they found the rabbit antibodies could bind to polysaccharides of S. pneumoniae, and various forms of a polysaccharide vaccine soon were available in the U.S. through the 1940s. However, the discovery of penicillin in 1928 caused a lack of acceptance and market for the vaccine until 1977, when a 14-valent vaccine was licensed and approved by the FDA. [26]

A 23-valent pneumococcal vaccine was approved in 1983, but just prior to the FDA’s approval of a 7-valent vaccine in 2000, studies showed that the overall incidence of pneumococcal disease was still 23.2 cases per 100,000 people, for a total of 62,840 cases in 1998. The statistics also showed that disease rates were highest for children younger than 2 years of age and adults aged 65 or older, and that incidents among blacks were 2.6 times higher than among whites.[27]

By 2001, the pneumococcal disease rate in the U.S. had declined 69 percent overall among children under 2 years of age and 78 percent for vaccine and vaccine-related serotypes. The rate of pneumococcal meningitis also went down 59 percent. Interestingly, vaccine effectiveness seemed vary by state, with the largest decline (85 percent) in California. Researchers attributed the lower numbers to the new vaccine, the 7-valent, protein-polysaccharide conjugate, Prevnar.[28]

At the time, however, researchers also questioned whether an increase in disease caused by serotypes not included in the vaccine or not related to those in the vaccine might be possible, since this effect was seen in a different clinical trial, which evaluated Prevnar 7’s efficacy against otitis media. In that study, even though otitis media caused by the serotypes in the vaccine decreased, ear infections caused by non-vaccine serotypes increased by over a third. [29, 30]

By 2009, health officials had confirmed that non-vaccine serotypes were replacing the ones in the vaccine, and that they had caused invasive pneumonia in children to increase by 71 percent.[31,32] And worse, by January 2011, they also knew that the S. pneumoniae strain responsible for pneumonia not only was changing one of its DNA letters every 15 weeks – making it more resistant to antibiotics—but had already done so years before Prevnar even hit the market.[33]

Can Pneumococcal Disease Cause Injury and Death?

Yes. The primary cause of death from S. pneumoniae is pneumonia. But S. pneumoniae can also cause serious infections such as empyema, endocarditis, meningitis, bacteremia, peritonitis, septic arthritis, brain abscess, pancreatic and liver abscesses, aortitis, tubo-ovarian abscesses, necrotizing fasciitis, and sepsis.[3,35,41,42]

Complications of M. pneumoniae can include nervous system disorders such as encephalitis, cerebellar syndrome and polyradiculitis, cranial nerve palsies, asceptic meningitis or meningoencephalitis, acute disseminated encephalomyelitis, coma, optic neuritis, diplopia, mental confusion, and acute psychosis secondary to encephalitis. Ataxia, cranial nerve palsy, pericarditis, and Guillain-Barre Syndrome have also been reported.[21,35,41,42]

Additionally, a 2008 study showed that obsessive-compulsive disease and/or tic symptoms, as well as Tourettes Syndrome may also be triggered my M.  pneumoniae. These symptoms are more commonly classified as pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, or PANDAS.[80]

M. pneumonia can also cause serious illness such as intravascular coagulation and a rare but severe complication called hemolytic anemia. Acute glomerulonephritis, renal failure, tubulointerstitial nephritis, and IgA nephropathy have also been reported as a consequence of M. pneumonia. Deaths from M. pneumoniae are reported primarily among the elderly and persons with sickle-cell disease.[16,34]

Who is at Highest Risk for Getting Pneumococcal Disease?

Young children are more likely to get pneumococcal diseases than older children or young adults. People most at risk of getting pneumonia are those with anatomic or functional asplenia (including sickle cell disease), patients taking immunosuppressive drugs, those with congenital and acquired immune deficiency (including HIV infections), children with cochlear implants, and those with chronic renal disease.[36]

Studies have also shown that having a vitamin D deficiency can make you more susceptible to getting pneumonia and having more complications from it, including death. For example, once infected, adult patients hospitalized with pneumonia are more likely to die if they are vitamin D deficient.[37] This association between vitamin D deficiency was not explained by patient age, sex, comorbidities, the severity of the systemic inflammatory response, or other known prognostic factors.

An earlier study (1999) in children also showed there is a strong association between pneumonia and nutritional rickets, which is a form of vitamin D deficiency. Other studies support the claim that vitamin D deficiency predisposes children to respiratory diseases.[38.39]

Numerous conditions such as having a prior cold or flu, or if you have been hospitalized for a surgery, especially chest or abdominal surgery, are risk factors for contracting pneumonia.[40] Also, people with recent viral infections, lung disease, heart disease, and swallowing problems, as well as alcoholics, drug users, those with cirrhosis of the liver, and those who have suffered a stroke or seizure are at higher risk for developing pneumonia than the general population.[3]

Overall malnutrition and illnesses that affect many organs or the whole body can also make you susceptible to getting pneumonia. Immunocompromised individuals with neutropenia, asplenia, sickle cell disease, disorders of complement and humoral immunity, human immunodeficiency virus (HIV) infections or chronic underlying disease also are more at risk. Children who have certain illnesses such as cerebral palsy, cystic fibrosis and chronic heart or lung conditions also are at higher risk.

Crowded conditions, group settings such as daycares, nursing homes and hospitals, and poor ventilation can contribute to transmission of S. pneumoniae. According to the CDC, children in an out-of-home day care are at an approximate two-fold increased risk of getting pneumonia. Also, being an Alaska native, African-American or American Indian puts you at an increased risk of invasive pneumonia, although health officials aren’t exactly sure why.[10]

Pregnant women also may be at risk. Other risk factors include being a smoker, having dementia or a neurological disease such as Parkinson’s, or living in a nursing facility.[23,41]

According to Harrison’s Principles of Internal Medicine, the risk of bacteremic pneumonia is relatively high among infants up to 2 years of age and low among teenagers and young adults. Rates begin increasing again at about age 55. Most cases of pneumococcal bacteremia in adults are due to pneumonia, with a mid-winter peak and a dip in summertime.[2]

Another risk for pneumonia is vaccination for rotavirus. According to a study published in 2008 by the FDA, an increase in both pneumonia cases and pneumonia deaths were observed with the rotavirus vaccine Rotarix.[92,95]

Who is at Highest Risk for Suffering Complications of Pneumococcal Disease?

Some people can be more susceptible to both getting pneumonia and having complications from it than others, such as an adult who smokes or drinks excessively, someone with an injury, someone undergoing chemotherapy, or someone taking medication that suppresses the immune system, such as prednisone.[43]

People with chronic illnesses such as heart, pulmonary, liver or renal disease, or people with weakened immune systems such as those living with HIV or anatomic asplenia (sickle cell disease) may also be more susceptible to contracting pneumonia and having serious complications from it. Children with cochlear implants or cerebrospinal (CSF) fluid leaks are more likely to get pneumococcal meningitis.[42.43,81]

Pneumococcal Prevention and Treatment Options

Treatment of pneumococcal diseases includes antibiotics, usually a broad-spectrum cephalosporin and/or vancomycin. Penicillin and other antibiotics are sometimes used; however, in some areas of the U.S., up to 40 percent of invasive pneumonia isolates are resistant to penicillin.[81]

The CDC and World Health Organization recommend pneumococcal and influenza vaccination as a method of preventing pneumococcal diseases, especially for children, the elderly, and people with diabetes, asthma, emphysema, HIV, cancer, or other long-term condition.[1,13,44] They also advocate Haemophilis influenza type b (Hib) vaccination as a preventative against Haemophilis-caused pneumonia.[42]

However, according to the National Institutes of Health and WHO’s UNICEF Global Plan for Prevention and Control of Pneumonia, other interventions can help prevent pneumonia too, particularly in babies and children.[13.42] Some of those strategies include:

• Exclusive breastfeeding for the first six months of life
• Replacing open-fire cook stoves – which increase risks of respiratory problems – with clean and vented stoves
• Improving overall nutrition of both mothers and young children, including adequate micronutrient consumption (vitamins, minerals)
• Preventing low birth weight
• Reducing indoor pollution of all types
• Zinc supplementation for children with diarrhea
• Practicing clean-living standards that reduce the spread of germs
• Promoting good hand washing habits, especially after going to the bathroom, blowing your nose, and diapering a baby, as well as before eating and before preparing foods
• Working to implement improved water and sanitation interventions in developing countries
• Prevention of HIV in children

The Society for Women’s Health Research (SWHR) offers additional advice on how to avoid getting sick and spreading germs and infections of any kind. While hand washing is the single most effective way to prevent the spread of infections, keeping your hands away from face, eyes, nose, and mouth can also limit the transfer of viruses, bacteria, and other harmful pathogens that can make you sick. In family, daycare, or school settings care should be taken not to share eating utensils or toys that may have been exposed to saliva or other bodily excretions.[45]

The CDC also has a webpage with guidelines on proper hygiene and cough etiquette that can help prevent the spread of respiratory infections in public or institutional settings. Help with hand washing in all types of settings, including cruise ships and day cares, is available at the CDC’s website here. Guidelines for preventing healthcare-associated pneumonia can be found here.[46,47,48]

NVIC note: Although the CDC advocates flu vaccination as one way of preventing pneumococcal disease, at least one study has shown that this method isn’t always effective. For example, in a study of immunocompetent elderly people aged 65-94, researchers found that influenza vaccination is not associated with reducing the risk of community-acquired pneumonia.[49]

Whether you choose to vaccinate or not, it is important to know that nutrition and exercise also play a part in prevention of pneumococcal diseases.

Vitamin D status is particularly important: clinical studies have shown that invasive pneumococcal disease, meningococcal disease, and group A streptococcal disease are more common when vitamin D levels are lowest. In Ethiopia, for example, it was found that 42 percent of children hospitalized for pneumonia had rickets, a form of severe vitamin D deficiency.[50] And in Kabul, Afghanistan, it was found that vitamin D3 supplementation, along with antibiotic treatment, can help control repeat pneumococcal infections.[51]

Even in the United States, many studies have shown that nutritional deficiencies can contribute to frequent respiratory tract infections.[57]

Other recent studies also have shown that regular moderate exercise can reduce the risk of catching cold-like symptoms and that physical fitness overall can reduce the frequency and severity of colds and respiratory infections.[52,53,54,55,56]

What is Pneumococcal Vaccine?

There are three pneumococcal vaccines approved in the U.S. for pneumococcal diseases. One is a polysaccharide; the other two are conjugate vaccines.[62]

The polysaccharide vaccine (Merck’s Pneumovax 23) is an inactivated-bacteria vaccine. It works by teaching your body to attack the bacteria if you are exposed to it.[58]

The conjugate vaccines (Wyeth/Pfizer’s 7-valent Prevnar and Prevnar 13) are killed or inactivated vaccines that use a protein or other small pieces taken from the bacteria to teach the immune system to recognize and fight active bacteria.[59]

Prevnar 7-valent is a Wyeth/Pfizer conjugate vaccine with an aluminum adjuvant. It contains the seven pneumococcal serotypes(4, 6B, 9V, 14, 18C, 19F, and 23F) responsible for 86 percent of bacteremia, 83 percent of meningitis, and 60 percent of acute otitis media in children aged 6 years and under. Before the introduction of Prevnar 13, the CDC recommended three doses of Prevnar be given at approximately two-month intervals, with a fourth dose at 12-15 months of age. It is injected directly into the muscle.[60]

According to the manufacturer’s product insert, the protein used to activate the pneumococcal bacteria is diphtheria CRM₁₉₇, a recombinant conjugate diphtheria toxin. The diphtheriae strain is grown in a casamino acids and yeast extract-based medium and purified through ultrafiltration, ammonium sulfate precipitation, and ion-exchange chromatography.[63] Prevnar also contains polysorbate 80, aluminum phosphate as an adjuvant, and no thimerosal.[81]

Although conjugate vaccines have a history of effectiveness, a recent study says there are still many unanswered questions about their use when multiple vaccines are being given, including their effectiveness in special populations.[65]

Efficacy for invasive pneumococcal diseases (IPD) relevant to the seven serotypes in this vaccine is estimated at 94 percent, and is credited with reducing invasive pneumococcal disease in U.S. children by 45 percent overall. Post-marketing surveillance, however, also showed that the incidence of IPD caused by one particular serotype, 19A, nearly tripled after the introduction of Prevnar 7. The rates of meningitis and invasive pneumonia caused by non-vaccine serotypes also increased for all age groups, and the rates of primary bacteremia did not change at al, indicating that non-vaccine strains were replacing those in the vaccine.[70]

According to the manufacturer’s product information insert, researchers already knew this would probably happen: clinical trials showed that while Prevnar-7’s efficacy against acute otitis media (AOM) was 51 percent in the protocol population and 44 percent in the intent-to-treat population, it also put children who received Prevnar-7 at an increased risk of otitis media due to pneumococcal serotypes not represented in the vaccine.[9,64]

The non-serotype disease increase was particularly noticeable in the most vulnerable populations, primarily in the elderly, HIV-positive adults, and children with underlying medical conditions. Almost immediately, one concern for health officials was that the serotypes most responsible for both vaccinated and unvaccinated populations were growing more and more resistant to antibiotics.[66,68,69]

But an even graver concern is that the rate of the complication known as pneumococcal empyema, an accumulation of dense pus between the outer surface of the lung and the chest wall, increased by 70 percent after the vaccine came into widespread use. The greatest increase was in children ages 2 to 4 – and once they were hospitalized, it was found that they were more likely to be so sick they needed surgery.[71,72]

The increased disease caused by non-serotypes was so great that some health officials declared it not cost-effective enough to give.[67]

The FDA’s answer to the problem was to recommend a different, newer vaccine, Prevnar 13, with six additional serotypes as a replacement for Prevnar 7.[73]

Possible adverse reactions with Prevnar-7 vaccination: According to the manufacturer, fever and, rarely, febrile seizures have been reported in children receiving Prevnar. For children who are at higher risk of seizures, the manufacturer suggests that fever-reducing drugs may be given.

Other reactions include tenderness at the injection site, pain at the injection site that interfered with limb movement, erythema, induration, irritability, drowsiness, restless sleep, decreased appetite, vomiting, diarrhea, and urticarial-like rash. In the vaccine trials, hypotonic-hyporesponsive episodes (HHL) also were reported in rare instances. Twelve deaths were reported during clinical trials; four attributed to Sudden Infant Death Syndrome (SIDS) and seven to other non-vaccine-related causes.

In post-marketing, there have been reports of injection site dermatitis, injection site urticarial, injection site pruritis, localized lymphadenopathy at the injection site, face edema, dyspnea, bronchospasm, anaphylactoid reactions including shock, angioneurotic edema, erythema multiforme, and other adverse events.[64]

Warnings and contraindications with Prevnar-7: According to the manufacturer, this vaccine should not be given to infants or children with thrombocytopenia or any coagulation disorder that would contraindicate intramuscular injection unless the potential benefit clearly outweighs the risk of administration. While mild infections with or without a low-grade fever are not necessarily contraindications to getting this vaccine, the manufacturer recommends that the severity of the symptoms be taken into consideration before administering it.

Prevnar-7 should be given with caution to children on anticoagulant therapy. This vaccine has not been tested for any carcinogenic or mutagenic potential, or for impairment of fertility. It’s also not known whether it can cause fetal harm when given to a pregnant woman, or whether the antigens or antibodies are excreted in human milk. This vaccine is NOT recommended for nursing mothers. Safety and immunogenicity data are either limited or not available for children in specific high risk groups for invasive pneumococcal disease (eg, persons with sickle cell disease, asplenia, HIV-infected). Although the vaccine contains diphtheria toxin protein, it does not substitute for routine diphtheria vaccination.[64]

Prevnar 13 contains 13 pneumococcal serotypes; seven of which are in PCV7 (serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F) and six additional serotypes (1, 3, 5, 6A, 7F, and 19A). It was licensed by the FDA for prevention of invasive pneumococcal disease caused by the vaccine’s 13 serotypes, and for otitis media caused by serotypes in the PCV7 vaccine.

Prevnar 13 (PCV13) contains CRM₁₉₇, a mutant protein of diphtheria toxin used to activate the pneumococcal bacteria. The diphtheriae strain is grown in a casamino acids and yeast extract-based medium and purified through ultrafiltration, ammonium sulfate precipitation, and ion-exchange chromatography.[63,75] Although conjugate vaccines have a history of effectiveness, a recent study indicates that there are still many unanswered questions about their use when multiple vaccines are being given, including their effectiveness in special populations.[65]

Each of the 13 serotypes in Prevnar 13 is grown in soy peptone broth. Each dose contains polysorbate 80 and a succinate buffer, with aluminum phosphate as the adjuvant. There is NO latex in the tip cap or rubber plunger of the prefilled syringe.

The FDA has approved Prevnar 13 for children ages 6 weeks through 5 years of age, for children aged 60-71 months with underlying medical conditions; and as a booster dose for children who received 1 or more doses of PCV7 previously, and for adults age 50 and older, even if they have previously received the conventional pneumococcal polysaccharide vaccine (PPSV). According to the manufacturer’s product insert, the indication for adults is based on immune responses (i.e. titers measured in the blood), as there have been no controlled trials in adults demonstrating a decrease in invasive pneumococcal disease or pneumococcal pneumonia after vaccination with Prevnar 13.[74,76]

The approval of Prevnar 13 for adults came on December 30, 2011 in an accelerated process, even though there have been no controlled trials in adults demonstrating a decrease in pneumococcal pneumonia or invasive pneumococcal disease after vaccination with Prevnar 13.[7,74,77]

At the request of FDA, Pfizer is currently conducting post-marketing studies called the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA) to determine whether Prevnar 13 is effective in preventing community-acquired pneumonia caused by the 13 serotypes in the vaccine.[77,78,79]

PCV13 is injected into the muscle as a 4-dose series at 2, 4, 6, and 12-15 months of age. If other vaccines are administered at the same time, they should always be administered with different syringes at different injection sites.

For children who are beyond the age of routine infant schedule, or those who have not received either Prevnar or Prevnar 13, a catch-up schedule is recommended of three doses between 7 and 11 months of age; two doses between 12 and 23 months of age and one dose at age 24 months through age 5, prior to the 6^th birthday.[74]

Children who have received one or more doses of Prevnar may complete the pneumococcal vaccination series with Prevnar 13. Children 15 months through 5 years of age who are completely vaccinated with Prevnar may receive one dose of Prevnar 13 to cover the six additional serotypes. Children who have received Pneumovax 23 previously also should receive the recommended PCV13 doses.[81]

Children 24 through 71 months of age with an underlying medical condition who received fewer than 3 doses of PCV7 before age 24 months should receive a series of 2 doses of PCV13 followed by 1 dose of Pneumovax 23 administered at least 8 weeks later. Children 24 through 71 months of age with an underlying medical condition who received any incomplete schedule of 3 doses of PCV7 before age 24 months should receive 1 dose of PCV13 followed by 1 dose of PPSV23 administered at least 8 weeks later.[81]

For adults age 50 and older, Prevnar 13 is administered as a single dose.

According to the CDC, immune responses to Prevnar 13 were compared to Prevnar 7 studies, which determined that Prevnar 13’s efficacy was similar to Prevnar 7’s, or about 97 percent effective in reducing invasive disease caused by the vaccine-relevant serotypes. Prevnar 13 was then licensed based upon the comparable studies.[81]

In another study of Prevnar 13, children 7-11 months, 12-23 months, and 24-71 months of age who had not received pneumococcal conjugate vaccine doses previously were administered 1, 2, or 3 doses of PCV13 according to age-appropriate vaccination schedules. These schedules resulted in antibody responses to each of the 13 serotypes that were comparable to those achieved after the 3-dose infant PCV13 series in the U.S. immunogenicity trial, except for serotype 1, for which IgG GMC was lower among children aged 24-71 months.[81]

However, according to the manufacturer, immune responses (efficacy) for Prevnar 13 among infants born prematurely have not been specifically studied. In clinical trials, antibody responses to Prevnar 13 were lower in persons over age 65 compared to those aged 50 to 59. Effectiveness of Prevnar 13 in children below the age of 6 weeks or on or after the 6^th birthday have not been established. Also, Individuals with impaired immune responsiveness due to the use of immunosuppressive therapy (including irradiation, corticosteroids, antimetabolites, alkylating agents, and cytotoxic agents) may not respond optimally to active immunization. Also, Prevnar 13 will not protect against disease caused by stains of S. pneumoniae not contained in the vaccine. The effectiveness of Prevnar 13 when given less than 5 years after the 23-valent pneumococcal polysaccharide vaccine is not known.[74,83]

Additionally, immune responses to Prevnar 13 in adults were reduced when given with injected seasonal flu vaccine.[83]

Possible Adverse Reactions to Prevnar 13:

The safety of Prevnar 13 was assessed in 13 studies in over 4700 healthy infants and toddlers who received at least 1 dose of Prevnar 13. The most commonly reported adverse reactions were injection-site reactions, fever, decreased appetite, irritability, gastroenteritis, pneumonia, and increased or decreased sleep. Local reactions included pain/tenderness, redness of the skin, induration, and swelling.[82,83]

In infants and toddlers, the most common side effects were irritability, injection site tenderness, decreased appetite, decreased sleep, increased sleep, fever, injection site redness, and injection site swelling.[83]

Monitoring done during the 2010-11 flu season showed that when flu vaccine and Prevnar 13 are given on the same day, there may be an increased risk of febrile seizures in children 12-23 months old.[82]

According to the manufacturer’s product insert, in clinical trials, solicited adverse reactions classified as serious included bronchiolitis, gastroenteritis, and pneumonia. There were three deaths during the trial, all attributed to sudden infant death syndrome (SIDS). There were four hypotonic-hyporesponsive episodes, all of which occurred when the trial subjects received whole cell pertussis vaccine at the same time.

Unsolicited reactions included crying, hypersensitivity (including face edema, dyspnea, and bronchospasm), seizures (including febrile seizures) and urticarial or urticarial-like rash. Other adverse events were reported within three days of children’s vaccination with Prevnar 13, but they were not included as reactions to the vaccine. Those events included emergency room visits or hospitalizations for bronchiolitis, UTI, acute gastroenteritis, asthma, aspiration, breath holding, influenza, inguinal hernia repair, viral syndrome, URI, croup, thrush, wheezing, choking, conjunctivitis, pharyngitis, colic, colitis, congestive heart failure, roseola and sepsis.

In adult studies, solicited adverse events were similar to children’s studies, and included redness, swelling and pain at the injection site, or limitation of arm movement, fatigue, headache, chills, rash, decreased appetite, or muscle and joint pain. An increase in some systemic reactions such as headache, chills, rash, decreased appetite, muscle and joint pain was noted with Prevnar 13 was administered concomitantly with a flu shot.

Unsolicited serious adverse events in the adult studies included 12 deaths that occurred from three to 309 days after vaccination. Two of the deaths were within 30 days, and one was due to cardiac failure three days after receiving Prevnar 13 and a flu shot together. The reported causes of the 10 reported deaths occurring more than 30 days after vaccination were cardiac disorders, neoplasms, Mycobacterium avium complex pulmonary infection, and septic shock.

Post-marketing adverse reports included injection-site dermatitis, pruritis, urticarial, and lymphadenopathy at the injection site. Other post-marketing reports included anaphylactic reactions, angioneurotic edema, erythema multiforme, and apnea.[74]

Warnings and Contraindications for Prevnar 13:

Safety of Prevnar 13 in children below the age of 6 weeks or on or after the 6^th birthday has not been established. There are no adequate or well-controlled studies in pregnant women who are administered Prevnar 13. This vaccine should be given during pregnancy only if clearly needed. It is not known whether Prevnar 13 is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Prevnar 13 is administered to a nursing woman.[74]

According to the manufacturer’s product insert, data on the safety and effectiveness of Prevnar 13 when administered to immunocompromised individuals (e.g., those with congenital or acquired splenic dysfunction, HIV infection, malignancy, hemotopoietic stem cell transplant, nephrotic syndrome) are not available. These individuals may have reduce antibody responses to this vaccine.

Apnea has been observed in some premature infants who receive this vaccine. Decisions on whether a premature infant should get Prevnar 13 should be made based on consideration of the child’s medical status and the potential benefits and possible risks of vaccination.[74]

Prevnar 13 should not be given to anyone with a history of severe allergic reaction to any component of the vaccine, or to any diphtheria toxoid-containing vaccine.[83]

Pneumovax 23 (PPSV23) is a Merck & Co. purified capsular polysaccharide antigen indicated for vaccination against pneumococcal disease caused by serotypes 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33. It was the first pneumococcal vaccine approved in the U.S. for adults, and is administered as a single dose. In 1988 the ACIP recommended booster doses every six years for patients at highest risk of disease. In 1997, the ACIP changed that recommendation to 1 repeat dose 5 years after the initial dose for patients at highest risk of disease. However, routine revaccination of immunocompetent with Pneumovax 23 is not recommended.[26,81,84]

Pneumovax 23 is approved for adults age 50 and older, and for persons age 2 and older who are at increased risk for pneumococcal disease. It is not approved for children younger than 2 because children of this age do not have an effective immune response to capsular types included in this vaccine. It is injected into the muscle.[86]

This vaccine is also recommended for persons aged 2 to 64 with long-term health problems such as:

• Weakened immune systems, e.g., persons with HIV, leukemia/lymphoma/Hodgkin’s Disease, organ transplant, cancer treatment
• Lack of spleen or non-functionalo splenia such as sickle cell disease
• Diabetes
• Chronic liver or kidney disease
• Other conditions that increase the risk of pneumococcal pneumonia

Additionally, this vaccine is recommended for persons aged 19 to 64 with asthma or who are smokers, and for nursing home residents.[88]

Pneumovax 23 is a clear colorless solution containing phenol as a preservative and saline in addition to the 23 pneumococcal strains. It works by inducing type-specific antibodies that enhance opsonization, phagocytosis, and killing of pneumococci by leukocytes and other phagocytic cells.[84]

Effectiveness at preventing disease with Pneumovax 23 varies. According to the manufacturer, it has a 57 percent overall effectiveness against invasive infections caused by serotypes in the vaccine.[87] By patient condition, reported effectiveness in clinical trials was:

• 65% Chronic pulmonary disease
• 69% Congestive heart failure
• 73% Coronary vascular disease
• 75% Immunocompetent patients aged 65 and older
• 84% Diabetes

Cautioning that effectiveness cannot be confirmed for certain groups of immunocompromised patients, Merck said in an efficacy report that it had not been able to recruit sufficient numbers of unvaccinated patients from each disease group to study effectiveness in them. [87]

According to the manufacturer’s product insert, children younger than 2 do not have an effective enough immune response for this vaccine to be of use for them. Also, in a randomized clinical study, it was found that persons receiving Zostavax, a vaccine for shingles, concurrently with Pneumovax 23 had a reduced immune response to the Zostavax.[84]

The most common adverse reactions to Pneumovax 23 in clinical trials included injection site pain/soreness tenderness, swelling/induration at injection site, headache, injection-site erythema, asthenia, fatigue, and myalgia. Fever, diarrhea, chills, dyspepsia, nausea, back and neck pain, upper respiratory infection, and pharyngitis were also reported occasionally.

Serious adverse experiences within 14 days after Pneumovax 23 included angina pectoris, heart failure, chest pain, ulcerative colitis, depression, and headache/tremor/stiffness/sweating. Other serious adverse experiences included cerebrovascular accident, lumbar radiculopathy, and pancreatitis/myocardial infarction resulting in death. Also, the rate of vaccine-related systemic adverse reactions was higher following revaccination (37.5 percent) than following initial vaccination in subjects aged 65 or older.[84]

Additional adverse reactions reported in post-marketing included cellulitis, malaise, fever in excess of 102 degrees F, decreased limb mobility, peripheral edema in the injected extremity, nausea, vomiting, lymphadentitis, lymphadenopathy, thrombocytopenia in patients with stabilize idiopathic thrombocytopenic purpura, hemolytic anemia in patients who have had other hematologic disorders, leudocytosis, anaphylactoid reactions, serum sickness, angioneurotic edema, arthralgia, arthritis, paresthesia, radiculoneuropathy, Guillain-Barre syndrome, febrile convulsion, rash, urticarial, and cellulitis-like reactions.[84]

Warnings and contraindications for Pneumovax 23

Persons who have experienced previous allergic reactions to any components in this vaccine should not get this vaccine. Vaccination should also be deferred in persons with a moderate or severe acute illness.[87]

It is not known whether Pneumovax 23 can cause fetal harm when administered to a pregnant women or can affect reproduction capacity. It should be given to pregnant women only if clearly needed. It also is not known whether this drug is excreted in human milk. Therefore, caution should be exercised when Pneumovax 23 is administered to a nursing woman.[84]

Pneumovax 23 should not be given to children less than 2 years of age. Persons who are immunocompromised, including those receiving immunosuppressive therapy, may have a diminished immune response to this vaccine.[84]

Since elderly individuals may not tolerate medical interventions as well as younger individuals, the manufacturer warns that a higher frequency and/or a greater severity of reactions in some older individuals cannot be ruled out. The manufacturer also urges caution and appropriate care in administering this vaccine to individuals with severely compromised cardiovascular and/or pulmonary function in whom a systemic reaction would pose a significant risk.[87]

NVIC note: After reviewing reports of increased systemic and local site reactions following some second doses of Pneumovax 23, Australian health officials announced on Jan. 12, 2012 that they are now recommending a second dose of this vaccine only for specific risk groups, where the benefits of the vaccine outweigh the risk of the adverse reactions, and only if at least 5 years have passed since the first vaccination. Australian officials also said that a second dose of Pneumovax 23 should NOT be routinely given to Australian citizens with healthy immune systems.[90,91]

Pneumococcal Vaccines and Advance Market Commitments

Another pneumococcal vaccine, GlaxoSmithKline’s Synflorix, is approved for use in many Third World countries. It contains 10 serotypes, including three of the most prevalent in the developing world. Synflorix was the first pneumococcal vaccine to receive WHO “prequalification” for global use for participation in the global Advance Market Commitment (AMC) plan. In December 2011, Pfizer/Wyeth’s Prev(e)nar 13 was the second pneumococcal vaccine approved for Third World use under AMC’s.[89,90]

The AMC announcement came in conjunction with the FDA’s approval of Prevnar 13 for use in adults age 50 and older. In addition to the U.S., the European Union, Australia, Mexico, and more than 10 other countries also approved Prevnar 13 for adults. Boosted by a grant from the Bill and Malinda Gates Foundation, Pfizer agreed to supply the vaccine to needy countries at a 90 percent discount. [93]

AMC’s are legally binding agreements that developed countries make with vaccine makers to purchase vaccines that are needed in developing countries; the vaccine makers then promise to not only develop the vaccine, but to either sell it at reduced prices or donate it to designated countries. According to WHO, the purpose of an AMC is to provide incentives to vaccine manufacturers to invest in the necessary research and manufacturing capacity needed to bring a vaccine for the developing world to market.[96]

World health officials said the reason for choosing pneumococcal vaccines as the first AMC was because of the cost-effectiveness the vaccine would have relative to the cost of disease and lives saved. More than 1.5 million children, mostly in Third World countries, die every year from pneumonia, more than any other disease. Having the pneumococcal vaccine available at a discount price not only could save as many as 603,000 lives each year, but would be the most cost effective way of saving their lives, health officials said.[94,97]

However, in a strongly worded critique published in Economic & Political Weekly in November 2011, a member of India’s National Technical Advisory Group on Immunization, Jacob Puliyel, disagreed with its use as an AMC there. “This AMC “looks like a policy not to have a policy, but to utilize vaccines indiscriminately,” Puliyel said. In India, the pneumococcal vaccine costs considerably more than it does to simply treat the disease, and prevents only 4 cases of pneumococcal infections out of every 1,000 children, he said. Claiming that everyone but the pharmaceutical companies was paying for the vaccine, Puliyel said the Indian government needed to re-evaluate this vaccine’s cost effectiveness before making further commitments to administer it on a widespread basis. “If we are being asked to make long-term advance market commitments before evaluating the utility or even the market value of a vaccine, this policy needs a careful scrutiny,” he said.[98,99]

History of Pneumococcal Vaccine Use in America

Scientists began working on a vaccine for select strains of pneumoniae as early as 1911, and a hexavalent (6 serotypes) was available from E.R. Squibb in 1954. However, interest in a vaccine was low at that time because of the introduction of penicillin in the 1940s. A14-valent pneumococcal vaccine was first licensed in the U.S. in 1977. Twenty-three years later, in 2000, 7-valent Prevnar was licensed. The 23-valent polysaccharide vaccine for adults and select populations, Pneumovax 23, was licensed in 1983. Prevnar 13 was introduced in 2000, as a primary replacement for Prevnar 7, due to an increase in pneumococcal diseases not covered by the original vaccine.[26]

According to the CDC, besides the pneumococcal vaccines, there are several other vaccines that target bacteria or viruses that can cause pneumonia. These vaccines include: Haemophilus influenza type b (Hib); pertussis (whooping cough); varicella chickenpox); measles; and influenza.[1]

Prior to Prevnar 7 being introduced in the U.S. in 2000, studies from 1998 showed that the overall incidence of pneumococcal disease was 23.2 cases per 100,000 people, or a total of 62, 840 cases. Disease rates were higher for children younger than 2 years of age and adults aged 65 or older.[5]

Subsequent studies showed that the vaccine was highly effective in reducing the number of severe lung, blood and brain infections in infants and children, including pneumococcal pneumonia, sepsis and meningitis. But at the same time, a serious and sometimes fatal complication known as pneumococcal empyema increased—and the children who were hospitalized for this condition were often so sick they needed to be hospitalized. By 2009, health officials had also found that non-vaccine serotypes had rapidly replaced the vaccine-related ones, causing an increase in non-vaccine pneumococcal disease in both children and adults.[72,100,101,102]

As a result, Prevnar 13 was adopted in 2000.[74]

Then, in December 2011 in an accelerated process, the FDA approved it for people ages 50 years and older. And in January 2012, the Centers for Medicare and Medicaid Services announced that they are requiring hospitals to offer the pneumococcal vaccine to all patients 65 years old and older, and to patients between the ages of 6 and 64 if they have diabetes, nephritic syndrome, end stage renal disease (ESRD), congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), spleen removed or not functioning, HIV, or asthma. [78,103,104]

How Effective Is Pneumococcal Vaccine?

According to the CDC, in a large clinical trial, PCV7 was shown to reduce invasive disease caused by vaccine serotypes by 97 percent, and reduce invasive disease caused by all serotypes, including serotypes not in the vaccine, by 89 percent.  Children who received PCV7 had 7 percent fewer episodes of acute otitis media and underwent 20 percent fewer tympanostomy tube placements than did unvac­cinated children. There was evidence that PCV7 reduces naso­pharyngeal carriage of pneumococcal serotypes included in the vaccine. PCV13 was licensed in the United States based upon studies that compared the serologic response of children who received PCV13 to those who received PCV7. These studies showed that PCV13 induced levels of antibodies that were comparable to those induced by PCV7 and shown to be protective against invasive disease. [8]

Other clinical studies show that after 3 doses, 90 percent of healthy infants who received 7-valent Prevnar had antibodies to the vaccine’s seven serotypes. Initially, the vaccine appeared to reduce invasive pneumococcal disease by as much as 97 percent, but the duration of protection against those seven serotypes was unknown. A few years after the introduction of the vaccine, it was discovered that serotypes not included in Prevnar were quickly replacing the 7 vaccine serotypes.[105,106,107]

Additionally, it was found that non-vaccine serotypes were causing an increase in antibiotic-resistant cases of severe ear infections. But even though the estimates of the vaccine's efficacy against ear infections — 57 percent efficacy against serotype-specific pneumococcal otitis media and 6 percent efficacy against acute otitis media from any cause — were lower than the estimated efficacy of other childhood vaccines, health officials still said they believe that the vaccine’s overall effectiveness was “substantial.”[9]

Effectiveness of Prevnar 13 was measured in a randomized, double-blind trials that found antibody levels for the new vaccine were comparable to Prevnar 7, although immune responses varied, depending on the pneumococcal serotype. After a 4^th dose was added to the Prevnar 13 schedule, studies showed that immune response was from 97 to 100 percent in healthy children. In children with underlying medical conditions, they found limited and inconclusive data available on the efficacy and effectiveness of Pneumovax 23. [76]

Children with impaired immune responsiveness, whether due to the use of immunosuppressive therapy (including irradiation, corticosteroids, antimetabolites, alkylating agents, and cytotoxic agents), a genetic defect, HIV infection, or other causes, may have reduced antibody response to active immunization.[64,74]

Although vaccination is the CDC’s preferred method of pneumococcal disease prevention, some studies have shown that vaccination isn’t always effective. In fact, a 2009 analysis of 22 clinical trials concluded that, in adults, pneumococcal vaccination does not appear to be effective in preventing pneumonia, even in populations for whom the vaccine is currently recommended.[8,114]

A 2009 patent application for a potential Novartis pneumococcal vaccine adjuvanted with M59 (squalene, Polysorbate 80, sorbitan trioleate 85, and citrate buffer) repeated these findings, asserting that clinical trials with Pneumovax 23 in Germany did not show any protective effectiveness against pneumococcal pneumonia. And in laying the groundwork for the need for the new adjuvant, the patent applicant even goes so far to say, “Nonetheless, the pneumococcus vaccine is recommended in industrialized countries by the respective national ministries, medical associations and advising committees for the elderly, immunosuppressed adults and also children with chronic illnesses, among others (STIKO vaccine recommendations).”[109]

But according to the FDA, clinical trials with PPV23 showed that it had an aggregate effectiveness of 50 to 80 percent for the prevention of invasive pneumonia in elderly individuals.[111]

The manufacturer, Merck, also reports efficacy numbers in its product insert.[84] Merck says:

• The levels of antibodies that correlate with protection against pneumococcal disease have not been clearly defined.
• Persons who are immuncompromised, including persons receiving immunosuppressive therapy, may have a diminished immune response to Pneumovax 23.
• A retrospective cohort analysis study based on the U.S. Centers for Disease Control and Prevention pneumococcal surveillance system, showed 57% overall protective effectiveness against invasive infections caused by serotypes included in Pneumovax 23 in persons aged 65 and older.
• Pneumovax 23 shows a 65 to 84% effectiveness among specific patient groups (e.g., persons with diabetes mellitus, coronary vascular disease, congestive heart failure, chronic pulmonary disease, and anatomic asplenia)
• It also shows a 75% effectiveness in healthy persons aged 65 or older

Merck also says that Vaccine effectiveness could not be confirmed for certain groups of immunocompromised patients.

A study in Spain on individuals living with HIV found that introduction of the 7-valent pneumococcal conjugate vaccine preceded a sharp drop (81 percent) in incidence of invasive pneumonia among HIV-positive adults in Spain. However, HIV-positive people who did get invasive pneumonia had higher rates of respiratory failure, more frequent intensive care unit admission (nearly three times as likely), and were three times more likely to need mechanical ventilation. The study authors said that “widespread use of highly active antiretroviral therapy, polysaccharide vaccine, and 7-valent pneumococcal conjugate vaccine has contributed to these [observed] changes.”[112]

The World Health Organization also hesitates to call Pneumovax 23 a total success in stemming the rates of pneumonia worldwide. In a public statement in March 2008, the WHO wrote:

“Despite the existence of multiple studies conducted over more than 30 years, the efficacy and effectiveness of PPV23 in children and adults remain poorly defined and the subject of controversy. Numerous problems contribute to the difficulty of measuring the efficacy and effectiveness of this vaccine, including the rarity of the most specific outcome, i.e., S. pneumoniae infection; the non-specificity of the diagnostic criteria for more common outcomes, e.g., pneumococcal pneumonia; and the likelihood/biological plausibility that efficacy and effectiveness vary with the presence and severity of various underlying conditions associated with an increased risk of pneumococcal infection.”

WHO also noted, “Furthermore, there have been very few studies of the efficacy or effectiveness of PPV23 in children.” Commenting that observational studies did show some effectiveness of this particular vaccine, WHO said the organization would not advise against its use, so long as it didn’t “detract from achieving high levels of coverage with PCV7 among infants.”

Can Pneumococcal Vaccine Cause Injury and Death?

With any vaccine, it is possible to suffer reactions that cause injury and death, including allergic reactions to components in the vaccine, whether they are active or inactive. That’s why the manufacturer instructs physicians to determine whether you or your child is a good candidate for a vaccine in advance to administering it. As a precaution, the manufacturers also advise that your physician have epinephrine and other life-saving agents readily available before administering the vaccine.[64,74,84]

NVIC is proud to host MedAlerts, a powerful database search engine that offers an alternative to searching for adverse vaccine events through the U.S. Government’s official search engine, Vaccine Adverse Events Reporting System (VAERS). MedAlerts examines symptoms, reactions, vaccines, dates, places, and more. MedAlerts contains the same information as the government’s website, but offers a better user interface, more powerful search capabilities, and more extensive reporting.

According to MedAlerts, data from VAERS as of November 14, 2011 showed more than 50,000 reports of adverse events in connection with the three pneumococcal vaccines. Some of these events may include multiple symptoms. Of this number, 264 were  deaths.

There also have been reported deaths in clinical trials of pneumococcal vaccines. Children in groups who got the pneumococcal vaccine suffered more seizures, irritability, high fevers and other reactions. There were 12 deaths in the Prevnar group, including 5 Sudden Infant Death Syndrome (SIDS) deaths.[64]

In January 2012, GlaxoSmithKline was fined 400,000 pesos ($93,000) by an Argentine judge for allegedly being responsible for the deaths of 14 babies who were in GSK pneumococcal vaccine clinical trials in Argentina and Panama. The judge agreed with Argentina’s National Administration of Medicine, Food and Technology that GSK conducted illegal lab trials in 2007 and 2008 with its pneumococcal vaccine Synflorix.

Two of the trial’s investigators were also charged and fined $70,000 each. According to the Buenos Aires Herald, the charges included preying on illiterate parents by forcing them to sign 28-page consent agreements, experimenting with human beings, falsifying parental authorizations so babies could participate in vaccine-trials, and refusing to release parents and their children from the trials when they tried to exit them early. GSK officials responded that none of the deaths was related to the trials because all of the dead children had been given placebos, and that they planned to appeal the judgment.[115]

In November 2009, Netherlands officials announced they were suspending use of an entire batch of Prevnar after three babies died following administration of the PCV. The vaccine’s maker, Pfizer, denied that the vaccine was connected to the deaths.[116]

And in India in 2008, clinical trials for Prevnar 13 were stopped when a baby in the trials died after receiving the vaccine. Since the baby had a pre-existing cardiac abnormality, officials claimed that trial criteria protocol had not been followed in allowing the baby to be part of the trial. Subsequently, Indian health officials canceled all further trials.[117]

A transient increase in HIV replication has also been reported following Pneumovax 23 vaccine. No clinical or immunologic dete­rioration has been reported in these persons.[8]

Who is at highest risk for complications from pneumococcal vaccine?

A child who is sick or has been recently sick may be at increased risk for having a  serious vaccine reaction. Ask your doctor to give your child a physical exam to make sure your child is healthy before vaccination.

Through monitoring vaccine administration during the 2010-11 flu season, the CDC found that there may be an increased risk of febrile seizures in children 12 to 23 months old who get the flu and pneumococcal vaccines on the same day.[10]

Infants born prematurely who receive Prevnar 13 may experience sleep apnea.

Also, according to the manufacturer’s product information sheet, elderly individuals may experience more severe adverse reactions than younger persons. Some individuals with underlying medical conditions of varying severity may experience local reactions and fevers associated with clinical deterioriation requiring hospital care.[84]

Who should not get pneumococcal vaccine?

Anyone who has experienced a hypersensitivity to any components in any pneumococcal vaccine, including diphtheria toxoid, should not get this vaccine.

Prevnar 7 is for pediatric use only. Prevnar should be given with caution to children on anticoagulant therapy.[64]

Prevnar 13 should be administered to premature infants only after weighing the risks versus the benefits of vaccinating for pneumonia, and only after considering the child’s medical status.[74]

Pneumovax 23 is not approved for children less than 2 years of age. Pregnant women should only get this vaccine if clearly needed.

Women who are at high risk of pneumococcal disease and who are candidates for pneumococcal vaccine should be vaccinated before preg­nancy, if possible.[8]

Questions to Ask Doctors about Pneumococcal Vaccine

Before you vaccinate, NVIC suggests reviewing our If You Vaccinate, Ask  8! here to familiarize yourself with important information that can help you make a choice on whether and when you want you or your child to get the pneumococcal vaccine.

Other questions you should ask your doctor:

• What are the benefits and risks of this vaccine?
• What side effects may I expect to see?
• How do I recognize an unusual or dangerous side effect?
• What should I do if my child appears very ill or has a high fever after vaccination?
• Do you offer a modified vaccine schedule (if you’re interested in spreading out the number of vaccines your child is getting at one time)?

Why NVIC is Opposed to a Pneumococcal Vaccine Mandate:

Flawed Clinical Trials Did Not Prove Safety: Wyeth Lederle and Kaiser Permanente compared one experimental vaccine (pneumococcal) against another (meningococcal), which seriously compromised the scientific validity of the trial. Children in groups who got the pneumococcal vaccine suffered more seizures, irritability, high fevers and other reactions. There were 12 deaths in the Prevnar group, including 5 Sudden Infant Death Syndrome (SIDS) deaths. And in a follow-up observational study of the VAERS reports on Prevnar through February, 2002, there were 608 serious adverse events already reported, including 117 deaths.[64,123]

No Long Term Studies: There are no long term studies to evaluate whether pneumococcal vaccines given alone or in combination with other vaccines is associated with chronic illness or disability, such as the development of diabetes, asthma, seizure disorders, learning disabilities, ADHD, or autism.

Vaccine Components Not Thoroughly Evaluated: Each 0.5ml dose of Prevnar 7 and Prevnar 13 contains 0.125 mg. of aluminum, a metal that is neurotoxic. Additionally, Prevnar 13 contains Polysorbate 80, which can cause severe nonimmunologic anaphylactoid reactions.[118]

The vaccine manufacturers also state that this vaccine “has not been evaluated for any carcinogenic or mutagenic potential, or impairment of fertility."[64,74,84]

Efficacy Low for Preventing Ear Infections: Despite the suggestion by the manufacturer and Kaiser Pemanente officials in pre-licensure press releases that Prevnar vaccine is an ear infection vaccine, the vaccine was never licensed by the FDA to prevent ear infections. Clinical trials showed that the vaccine when introduced  decreased a child's chance of getting an ear infection by only 7 percent. And later studies showed that because of serotype replacement, it not only actually increased incidences of acute otitis media, but also increased antibiotic-resistant pneumococcal strains.[76,105,106,107]

Voluntary Use of the Vaccine Is High: Wyeth Lederle, the CDC and AAP have done an excellent job promoting the mass use of this vaccine by children. Prevnar topped the sales charts as the No. 1 best-selling new pharmaceutical among all pharmaceuticals brought on the market in the year 2000, generating $461 million in sales. By 2009, when Pfizer acquired Wyeth, Prevnar sales were $3.7 billion a year. And now, with the introduction of Prevnar 13,sales of the new vaccine are expected to $6 billion a year by 2015.[121,122]

Read NVIC's written statement to the National Vaccine Advisory Committee opposing any mandate that doesn't provide medical, religious and personal belief exemptions for health care workers.

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Additional Bibliography/Sources/Reading Material:

Medical Literature

Pilishvili T, Lexau C, Farley M, Hadler J, et.al. Sustained Reductions in Invasive Pneumococcal Disease in the Era  of Conjugate Vaccine. 2010. J Infect Dis. (2010) 201(1):32-41. Online. (accessed Jan 2012). http://jid.oxfordjournals.org/content/201/1/32.full.pdf+html?sid=443796ad-d47e-4c38-bdf7-5ddd42c0728b

World Health Organization e-Library of Evidence for Nutrition Actions (eLENA). Vitamin D Supplementation to Improve Treatment Outcomes Among Children Diagnosed with Respiratory Infections. April 2011. Online. (accessed Jan 2012). http://www.who.int/elena/titles/bbc/vitamind_pneumonia_children/en/index.html

Niederman M. In the clinic. Community-acquired pneumonia. Ann Intern Med. 2009;151(7).

Centers for Disease Control and Prevention. Pneumococcal Polysaccharide Vaccine Information Sheet. What You Need To Know. April 2009. (accessed Jan. 2012).  http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-ppv.pdf

O'Brien KL, Wolfson LJ, Watt JP, Henkle E  et al. Burden of disease caused by Streptococcus Pneumoniae in Children Younger than 5 Years: Global Estimates. Lancet. 2009 Sep 12;374(9693):893-902. Online. (accessed Jan 2012). http://www.ncbi.nlm.nih.gov/pubmed/19748398

Dagan R. Serotype Replacement in Perspective. Vaccine. 2009 Aug 21;27 Suppl 3:C22-4. Epub 2009 June 21. Online. (accessed Jan 2012). http://www.ncbi.nlm.nih.gov/pubmed/19545935

Van der Poll T, Opal SM. Pathogenesis, treatment, and prevention of pneumococcal pneumonia. Lancet. 2009;374:1543-1556. Online. (accessed Jan 2012). http://www.sciencedirect.com/science/article/pii/S0140673609611144

Walker VP, Modlin RL. The vitamin D connection to pediatric infections and immune function. Pediatric Research, 2009; 65(5 Pt 2):106R-113R. Online. (accessed Jan 2012). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925470/

Eskola J, Kilpi T, Palmu A, Jukka J, et al. Efficacy of a Pneumococcal Conjugate Vaccine against Otitis Media. N Eng J Med. Feb. 8, 2001;344:403-409. Online. (accessed Jan 2012) http://www.nejm.org/doi/full/10.1056/NEJM200102083440602#t=citedby

Hausdorff WP, Bryant J, Paradiso PR, et al. Which pneumococcal serogroups cause the most invasive disease: implications for conjugate vaccine formulation and use, part I. Clin Infect Dis 2000;30:100–21. Online. (accessed Jan 2012). http://cid.oxfordjournals.org/content/30/1/100.abstract?ijkey=eadccbb61f0ff43bf98cc20a3a6d45719606d30f&keytype2=tf_ipsecsha

Rehman PK. Sub-clinical rickets and recurrent infection. Journal of Tropical Pediatrics, 1994; 40: 58.

Alexander ER, Foy HM, Kenny GE, et al. 1966. Pneumonia due to Mycoplasma pneumoniae. Its incidence in the membership of a co-operative medical group. N. Engl. J. Med. 275:131–136.

J Bryce, C Boschi-Pinto, K Shibuya, RE Black. WHO estimates of the causes of death in children. Lancet 2005; 365: 1147-52. Online. (accessed Jan 2012). http://www.sciencedirect.com/science/article/pii/S0140673605718778

Media Articles

ShareCare.com. Who Should Not Take Diphtheria CRM197 Protein Conjugate? Jan. 2012. Online. (accessed Jan 2012). http://www.sharecare.com/question/who-not-take-diphtheria-crm-protein

Gbenga-Mustapha O. Pneumonia Kills 177,000 Children Yearly. The Nation. Jan. 17, 2012. Online. (accessed Jan 2012). http://www.thenationonlineng.net/2011/index.php/health/33455-pneumonia-kills-177-000-children-yearly.html

World Pharma News. Prevent Pneumococcal Disease in Infants and Young Children in the World’s Poorest Countries. Dec. 19, 2011.  Online. (accessed Jan. 11, 2012) http://www.worldpharmanews.com/pfizer/1912-prevent-pneumococcal-disease-in-infants-and-young-children-in-the-worlds-poorest-countries

National Institutes of Health. NIH Research Matters. Wood Cooking Stoves Combat Pneumonia. Dec. 5, 2011. Online. (accessed Dec 2011). http://www.nih.gov/researchmatters/december2011/12052011stoves.htm

NIH News. Press Release. Wood Stove Intervention Can Reduce Childhood Pneumonia. Nov. 14, 2011. Online. (accessed Dec 2011). http://www.nih.gov/news/health/nov2011/niehs-14.htm

Matthew Herper. What Bill Gates Says About Drug Companies. Forbes. Nov. 10, 2011. Online. (accessed Jan 2012). http://www.forbes.com/sites/matthewherper/2011/11/10/what-bill-gates-says-about-drug-companies-2/

Wikipedia.org. List of Micronutrients. Aug. 23. 2011. Online.  http://en.wikipedia.org/wiki/List_of_micronutrients

FT Cutts, SMA Zaman, G Enwere, S Jaffar, OS Levine, JB Okoko, et al. Efficacy of nine-valent pneumococcal conjugate vaccine against pneumonia and invasive pneumococcal disease in the Gambia: randomized, double-blind, placebo-controlled trial. Lancet 2005; 365: 1139-46.

Rockoff J. Wall Street Journal. Japan Clears Suspended Vaccines. March 25, 2011. Online. (accessed Jan 2012). http://online.wsj.com/article/SB10001424052748704604704576221623126167378.html

Lah K. CNNHealth. Japan Suspends 2 Vaccines While Authorities Investigate Infant Deaths. March 8, 2011. Online. (accessed Jan 2012). http://www.cnn.com/2011/HEALTH/03/08/japan.vaccines/index.html

Geneva: UNICEF/ WHO. Pneumonia, the Forgotten Killer of Children. 2006. Online. (accessed Jan 2012). http://whqlibdoc.who.int/publications/2006/9280640489_eng.pdf

NVIC Press Releases/Statements/Commentaries

Palevsky L.Aluminum and Vaccine Ingredients: What Do We Know? What Don’t We Know? NVIC.org. 2012. Online. http://www.nvic.org/Doctors-Corner/Aluminum-and-Vaccine-Ingredients.aspx

Fisher BL. Doctors Denying Vaccine Risks: An American Tragedy. April  21, 2011. Online. http://www.nvic.org/NVIC-Vaccine-News/April-2011/Doctors-Denying-Vaccine-Risks--An-American-Tragedy.aspx

Fisher BL. No Pharma Liability? No Vaccine Mandates. March 2, 2011. Online. http://www.nvic.org/NVIC-Vaccine-News/March-2011/No-Pharma-Liability--No-Vaccine-Mandates-.aspx

Fisher BL. New Vaccine Science Can Help Bridge the Divide. Jan. 16, 2011. Online. http://www.nvic.org/NVIC-Vaccine-News/January-2011/New-Vaccine-Science-Can-Help-Bridge-the-Divide.aspx

Fisher BL. Plug into new NVIC Advocacy Portal & Protect Vaccine Exemptions. Nov. 2, 2010. Online. http://www.nvic.org/NVIC-Vaccine-News/November-2010/New-NVIC-Advocacy-Portal.aspx

Other Institutions/Organizations

Staff. The History of Vaccines Blog. Approval of Conjugate Pneumococcal Vaccine for Adults. Jan. 10, 2012. Online. (accessed Jan 2012). http://www.historyofvaccines.org/content/blog/approval-conjugate-pneumococcal-vaccine-adults

Bridges CB. Adult Immunization in the United States, 2012. pp.15-18. Update. Jan. 5, 2012. PDF. Online. (accessed Jan 2012). http://www.womeningovernment.org/files/file/CarolynBridges.pdf

Mercola J. UK Scraps Pneumonia Vaccines Because They ‘Don’t Work’. June 20, 2011. Online. (accessed Dec 2011). http://articles.mercola.com/sites/articles/archive/2011/06/20/uk-scraps-pneumonia-vaccines-because-they-dont-work.aspx

Mercola J. Nearly 250,000 Deaths from ONE Common Mistake: Here’s How to Protect Yourself. Feb. 4, 2011. Online. (accessed Jan 2012) http://articles.mercola.com/sites/articles/archive/2011/02/04/death-by-medicine-an-update.aspx

Fisher, Barbara L. Mercola.com. The ‘Vaccine Shock’ of the Year. June 1, 2010. http://articles.mercola.com/sites/articles/archive/2010/06/01/barbara-loe-fisher-may-21-interview.aspx

Narcolepsy is a disabling neurological disorder characterized by excessive daytime sleepiness.  It is often accompanied by causing muscle weakness.

The Herald reports:

“The parents have asked that a centre of excellence be established and that where family doctors see children with day-time sleepiness who had been vaccinated with pandemrix, they should refer these children to the centre.”

Dr. Robet Lustig, arguably the number one enemy of the sugar lobby, has published a well written article in the prestigious scientific journal Nature arguing that sugar is a poison.  He believes that the negative health effects of sugar consumption can no longer be ignored, any more than the health effects of tobacco and alcohol can be ignored.

According to Dr. Lustig, via the website Diet Doctor:

“The problem with sugar isn’t just weight gain ... A growing body of scientific evidence is showing that fructose can trigger processes that lead to liver toxicity and a host of other chronic diseases. A little is not a problem, but a lot kills -- slowly.”

Lustig goes on to argue that sugar used to be available to our ancestors only as fruit or honey -- and then only for a few months of the year.

Experiments showed that fructose activates the same proteins in pancreatic cells that your tongue uses to taste sweets. When these cells are exposed to both glucose and fructose, they secrete more insulin than they do when exposed to glucose alone.

According to Science News:

“Most sugars join the [metabolic assembly line] at a point where a supervisory enzyme can control the flow of goods. But fructose comes in farther down, where it can lead to an overproduction of fat. And because fructose ... doesn’t stimulate the same insulin response that glucose does, the hormone isn’t doing the other regulatory things it usually does, like moderating appetite.”

U.S. farmers have been subsidized in one form or another for more than 200 years.   In 1862, the practice was expanded when congress passed the Homestead Act, known as the Morrill Act, which granted 160 acres of government land to those who wanted to begin farming or ranching.

Between World Wars I and II, several commodity crops received government subsidies to ensure that farmers would produce enough staple crops for the population. At that time, the major subsidized crops were corn, cotton, wheat, oats, sugar, and tobacco.

According to the Organic Consumers Association:

“Our current farm subsidy programs are modern vestiges of earlier government initiatives to provide commodity crops in times of national crisis.  However, as the video ... will show, this system is being abused by Big Ag and is contributing terribly to the climate crisis.”

Bear in mind that researchers recently pointed out that there is a major discrepancy in claims regarding the safety and efficacy of HPV vaccines for girls.  One major concern is the claim that HPV vaccines are an important tool in preventing cervical cancer. But the efficacy of the vaccines in preventing cervical cancer has not been demonstrated because the study periods have been too short.

In fact, even persistent HPV infections do not generally lead to cervical cancer in the long term; most HPV infections resolve spontaneously within 2 years.

According to Medscape:

“HPV vaccines must maintain a near 100% efficacy for a full 15 years, at a minimum, for cervical cancer to be prevented ... So far, Merck has not conducted any studies, nor are any planned, to evaluate the long-term immunogenicity and efficacy of needed booster shots ... Reported serious adverse reactions associated with HPV ... include death, convulsions, paraesthesia, paralysis, Guillain–Barré syndrome, transverse myelitis, facial palsy, chronic fatigue syndrome, anaphylaxis, autoimmune disorders, deep vein thrombosis, pancreatitis, and pulmonary embolism.”

To emphasize the above:  Merck has stated that they do NOT intend to evaluate ANY long term efficacy of cancer prevention.  There IS NO EVIDENCE that that their product prevents cervical cancer.

This question comes up a lot from my female clients. And the answer is, no, most likely you will not.

In fact, gaining more muscle through resistance exercises is an integral part of any well rounded fitness / fat loss program.

Having more muscle on your frame is the best "fat burning friend" that you will ever have.

Below are some advantages to incorporating resistance training (lifting weights) into your fitness / fat loss routine, along with a sound nutrition program, a strong positive mindset, and a social support plan.

Muscle is Five Times More Dense Than Fat

I can understand why many women may be reluctant to start lifting weights.

You may have visions of steroid-bloated female bodybuilders with veins running through their biceps and chests.

Of course, there is that extreme, but keep in mind those women are out of balance.

That kind of build is NOT the typical result of weight lifting, and 99 percent of women simply do not have the level of natural testosterone to gain muscle like men.

It is a common misconception that muscle weighs more than fat. In reality, it's simply a matter of density.

They take up different amounts of space.

Conversely, a pound of fat takes up five times more space on your body than muscle, which means you can gain a pound of muscle and lose a pound of fat, and while your weight stays the same, you will actually shrink in size, and get that toned look you are looking for.

Muscle is five times more dense than fat, meaning it takes up five times less space on your frame, pound for pound.

Burn More Calories 24 hours a Day / 7 Days Per Week

Another great advantage to gaining muscle through resistance training is that you burn more calories.

Why?

Because muscle is anabolic and demands energy just to sit on your frame – even when you sleep!. For every pound of muscle that you gain in the future, your body will burn 50-70 calories more per day. That means, if you add 10 lbs. of muscle through a sensible fitness program (which is very possible), you will burn 500 – 700 calories more per day. And burning more calories leads to shedding excess fat.

How Weight Lifting Can Reduce Your Risk of Diabetes and Heart Disease

Remember, shedding excess fat is about more than just looks. Your body has two types of fat: visceral and subcutaneous. Subcutaneous fat is found just under your skin, and is the type that causes dimpling and cellulite. Visceral fat, on the other hand, shows up in your abdomen and surrounds your vital organs including your liver, heart and muscles.

Visceral fat has been linked to serious health problems such as heart disease, diabetes and stroke, among many other chronic diseases.

If you want to reduce your risk of heart disease (and a host of other chronic diseases), the key is to keep your inflammation levels low, and avoid gaining visceral fat in your body.

Exercise is a critical component for this, as it both lowers inflammation in your body, and is one of the best weapons to fight visceral fat. For example, one study found that volunteers who did not exercise had an 8.6 percent increase in visceral fat after eight months, while those who exercised the most LOST over 8 percent of their visceral fat during that time. So, since increasing muscle-mass puts your calorie burning into overdrive, which reduces fat stores, weight lifting is an essential part of a healthy fitness routine.

One of the Best Ways to Fight Osteoporosis

Your bones are actually very porous and soft, and as you get older, your bones can easily become brittle and less dense. Especially if you are inactive. When you engage in resistance training you put more tension on your muscles, which in turn puts more pressure on your bones. In addition, as you build more muscle, and make the muscle that you already have stronger, you also put more constant pressure on your bones.

Weight-bearing exercise is one of the most effective remedies against osteoporosis. The last thing you want to consider is to take a drug to improve your bone density, as without question, that is more likely to cause long-term harm than benefit.

I have had many clients who have amazed their doctors by reversing osteoporosis and osteopenia by lifting weights a couple times per week. So when it comes to fighting osteoporosis, stay off the meds and incorporate weight-bearing exercises instead. For example, a walking lunge exercise is a great way to build bone density in your hips, even without any additional weights.

You Have the Ability to Sculpt Your Physique

It's important to realize the difference between simple weight loss and the body sculpting so many are trying to achieve. Body sculpting is not possible with cardio exercise only. For example, if you start out with a pear shaped figure and lose weight by calorie restriction and/or cardio work alone, you will simply end up with a smaller pear shape. For many, this is not enough.

However, by including weight training in you program, you have the ability to literally reshape your shoulders, buns, arms, back, and chest. You are the sculptor and can create virtually any changes you so desire.

But don't think that the benefits of resistance training are limited to mere cosmetic adjustments -- although most will agree it does feel great to look good in your birthday suit. You see, the intensity of your resistance training will achieve a number of beneficial changes on the molecular, enzymatic, hormonal, and chemical level, which will help slow down (and many cases stop) many of the diseases caused by a sedentary lifestyle, including:

1. Metabolic syndrome
2. Insulin sensitivity and resistance
3. Diabetes
4. Auto immune diseases

Optimal health is dependent on an active lifestyle; eating fresh, whole foods, avoiding as many processed foods as possible, and addressing the stress in your life. Ignoring any of these basic tenets of health will eventually lead to a decline in health and any number of diseases. So start moving, and do remember to include strength training in your fitness / fat loss program. It is the number one way for you to remain strong, young, and independent well into old age.

By Dr. Mercola

Phil Campbell is a true veteran in the field of fitness with over 35 years experience in training professional athletes.

Over the years Phil has worked with 18,000 athletes, teaching them how to run faster with the proper speed technique.

Phil helped me understand how to practically change my primarily cardio aerobic exercise program to one that actually increases growth hormone and provides more health benefits.

You may not be aware that I first became interested in health and fitness in 1968 when I read Dr. Ken Cooper's book, Aerobics.

In the '60s, exercise was not embraced by the health and medical profession, and Dr. Cooper was the catalyst for increasing the overall awareness about exercise.

I followed his aerobic program for over 40 years as a runner and then, about five years ago, Dr. Al Sears opened my mind to the possibility that high intensity exercise training was superior to the cardiovascular aerobic-type training I had been using for over four decades.

But Phil Campbell helped me understand the connection to human growth hormones (HGH) and how to practically integrate the program. I have been doing Phil's program, referred to as "Sprint 8" in the video but which we refer to as Peak Fitness on our site, now for two years it's really made a remarkable difference in my fitness level.

Why Long, Slow Cardio Doesn't Deliver Desired Results

For those who are not yet familiar with Peak Fitness, it works because it engages your fast and super-fast twitch muscle fibers, which promotes human growth hormone (HGH), a synergistic, foundational biochemical underpinning that helps make your strength training and everything else work like a charm, and effectively burns off calories.

Phil explains:

"Most exercise programs today are built based upon a very incomplete picture of the physiology of your body. For example, long slow cardio, "calories in, calories out," would be a perfect way to look at the body if it were all slow-twitch fiber … [but] there are three muscle fiber types: slow, fast and super-fast … both those types of fast-twitch fibers are essentially 50 percent of your muscle fibers that don't get recruited until you add a velocity of movement."

If you don't actively engage and strengthen all three muscle fiber types and energy systems, then you're not going to work both processes of your heart muscle. Many mistakenly believe that cardio works out your heart muscle, but what you're really working is your slow twitch muscle fibers. You're not effectively engaging the anaerobic process of your heart. Fortunately Peak Fitness type exercises however, do address these fibers and metabolic systems.

Traditional strength training and cardio primarily exercise your slow twitch muscle fibers. Your body kicks in these slow twitch muscles first, in an effort to not recruit your fast twitch muscles, or work your heart anaerobically.

This is why you may not see results even though you spend an hour on the treadmill a few times a week – you're basically denying the natural physiology of your body by not working the other half of your muscle fibers; your fast-twitch muscles.

Phil states:

" … the American Heart Association and the American College of Sports Medicine, they have taken long-slow cardio and have taken it out of the exercise guidelines and the reason is pretty clear. It just doesn't work. It doesn't work both processes of your heart muscle, aerobic process and anaerobic process. It doesn't work for your fast-twitch fiber.

To really work your cardiovascular system the way you should, I'm now saying you do moderate-intensity cardio (which is still pretty intense) five days a week for 30 minutes ─ or vigorous intensity cardio for 20 minutes, three times a week. This is what Sprint 8 has been for years and years now."

You Should NOT do Peak Fitness Every Day

I want to point out that even though Peak Fitness is, in my impression, an essential, crucial element of any exercise training program -- it is NOT something you should do every day, as your body requires more time to heal in between sessions.

Phil says:

"We have to urge caution because research is pretty clear now: if you do long and slow exercise, your muscle -- that's slow-twitch fiber -- can heal pretty quickly in one day. But when you work fast-twitch fiber, whether it's an NFL athlete, or me or anyone, it takes about 48 hours for that fast-twitch fiber to truly heal back and totally recover. Sprint 8 is one of these programs that you really don't want to do every day … we recommend three times a week."

The benefit of doing this program three times a week comes not only from the way it works your fast and super-fast muscle fibers, but also the way it increases your growth hormone with each session.

Each Peak Fitness Workout May Increase Your Growth Hormones by 771 Percent

Human growth hormone is often referred to as "the fitness hormone." The higher your levels of growth hormone, the healthier and stronger you will be. Once you hit the age of 30, you enter what's called "somatopause," at which point your levels of human HGH begin to drop off quite dramatically. This decline of HGH is part of what drives your aging process, so maintaining your HGH levels gets increasingly important with age.

The longer you can keep your body producing higher levels of HGH, the longer you will likely experience more robust health and strength. Some athletes choose to inject it for this very reason, though it is a banned substance in nearly every professional sport. I do not recommend injecting HGH however, due to the potential side effects, the cost and, more importantly, it is likely to cause more long-term harm than good. Fortunately, your body produces HGH naturally when you exercise your super-fast muscle fibers during vigorous, high-intensity exercise like Peak Fitness.

Phil explains:

"You know, walking is a great thing, but it only works the aerobic process of your heart muscle. It doesn't work the anaerobic process. It only recruits your slow-twitch fibers. So those two other muscle fiber types are meant to be used to exercise is necessary to release growth hormones.

… If we look at the body and say, how do you want us to exercise? When you do this – when you do Sprint 8 – it's almost like the result is screaming this: When you do this, I release this hormone that's so powerful, that if you're an Olympic athlete, your test goes positive for injecting growth hormone. That's how significant Sprint 8 is when you look at growth hormones."

In fact, an eight-week study conducted by Phil and colleagues found that a Peak Fitness session resulted in an average HGH increase of 771 percent! This also translated to increased fat burning among the study participants. Phil states:

"At the end of the eight weeks, results were phenomenal. The average body fat loss was 31 percent. Sprint 8 was designed to replicate the growth hormone production, which in the average case increases 14.4 percent. Basically, Sprint 8 in this one study on middle-aged workers shows that it's twice as effective in body fat loss as injecting growth hormone."

Peak Fitness Also Increases Your Endurance

Another great facet of Peak Fitness is that it gives you both aerobic and anaerobic benefits at the same time, essentially replacing the need to do long, slow training. In fact, Phil points out that if you're trying to build your endurance levels, replacing tedious distance workouts with Peak Fitness is going to give you better results.

"With long-slow cardio there's some benefits, but we know from the sport sciences now that the best way to increase endurance capacity is through hard, fast anaerobic training," Phil says.

… There's a study … that shows you double endurance capacity with the program very similar to Sprint 8, where you go on an all-cardio cycle for 30 seconds except they would rest for two-four minutes before they do another one. Sprints 8, on the other hand, you only get an accurate recovery of a minute and a half because we're trying to multitask an aerobic workout and an anaerobic workout, where they would just look at endurance capacity. So Sprint 8 is actually much more intense than this exercise protocol. But in that protocol, they showed that you double endurance capacity three workouts a week in two weeks' time."

Summary of a Typical Peak Fitness Workout

Here's a summary of what a typical Peak Fitness routine might look like:

1. Warm up for three minutes
2. Exercise as hard and fast as you can for 30 seconds. You should feel like you couldn't possibly go on another few seconds
3. Recover for 90 seconds
4. Repeat the high intensity exercise and recovery 7 more times

As you can see, the entire workout is only 20 minutes. Twenty minutes! That really is a beautiful thing. And within those 20 minutes, 75 percent of that time is warming up, recovering or cooling down. You're really only working out intensely for four minutes. It's hard to believe if you have never done this that you can actually get that much benefit from four minutes of exercise. That's all it is.

Keep in mind that you can use virtually any type of equipment you want for this – an elliptical machine, a treadmill, swimming, even sprinting outdoors (although you will need to do this very carefully to avoid injury) -- as long as you're pushing yourself as hard as you can for 30 seconds. But do be sure to stretch properly and start slowly to avoid injury. Start with two or three repetitions and work your way up, don't expect to do all eight repetitions the first time you try this, especially if you are out of shape.

Phil states:

"There are many different ways you could do Sprint 8. As long as you can get totally exhausted in 30 seconds or less. That's the key. If you can't go longer than 30 seconds -- no matter if you're a professional athlete or just starting -- that means you're doing it correctly. It has to be so intense that after 30 seconds, you're just praying for those last seconds to go by … "

Phil also mentioned that his study showed doing Peak Fitness on an elliptical machine led to a higher release of growth hormone, and he suspects that it is the most challenging type of equipment to use.

One caveat: a treadmill may not be the best choice for Peak Fitness because of the time it takes for the machine to adjust intensities. So instead of the 30-second sprint, by the time the machine calibrates it will only be 20 seconds.

I really discourage people from using the treadmill because I don't believe it is ideal due to lag time to adjust intensity levels and an increased risk of falling off the equipment and injuring yourself. The elliptical is probably close to the best in my opinion. But if you don't have access to a gym or your own equipment, then you can improvise. You can use virtually any type of cardio exercise, as long as you get your knees up and your heart rate up, that's the key.

I would strongly recommend that you invest in a chest strap heart rate monitor to make sure your intensity is on target. If you are able to exceed your calculative maximum heart rate, which is 220 minus your age, by five or 10 beats, then you know you have trained. And you really need to be accurate within a few beats per minute to get the best results. There's a big difference between 166 and 168, but you're not going to be able to calculate that manually. You need an electronic version.

If funds are limited and you can't join the gym or get a piece of equipment, invest in a heart rate monitor. That's going to give you the information you need to make sure you're doing the activity properly.

You Can Use Peak Fitness Principles for Strength Training, Too

Instead of using an elliptical machine three times a week, you can use strength training to get a Peak Fitness workout in too. This is another way to activate HGH while building up different areas in your muscles. The challenge of relying on any specific exercise, the elliptical or the recumbent bike, and so on is that your body adapts to that.

You really want a comprehensive holistic approach for optimal benefits.

Phil explains how to do this:

"It's the same principle. You're applying the same principle of recruiting fast-twitch muscle fiber with strength training as you can with Sprint 8. Your body is trying to do things not to recruit fast-twitch fiber because your body thinks it's trying to help you get through all day by staying to slow-twitch fiber in the system. So if it's a push or press movement away from the center -- like the chest press, bench press, shoulder press, squat or any push or press movement away from the center of the body -- those muscles return loaded with fast-twitch fiber that a lot of times simply don't get worked.

It's real simple to engage that muscle fiber.

So if you come down like on a push-up or a chest press, pause and then explode out -- don't use momentum to come out -- just pause and then explode with velocity because you're getting an intensity of movement. 

Whether Sprint 8 or lifting weights, you get intensity from the matter resistance and the velocity of movement. So when you factor in a velocity of movement into that equation, you recruit fast-twitch fiber. … And so you get all three muscle fiber types in the same exercise if you do it that way. We recommend doing that on push or press movements. It's the way to observe your body. A great example would be triceps. Triceps are just loaded with fast-twitch fiber. Triceps press for the rope, for example, is a great way to work it. You let a pause, explode. Pause, explode."

How to Make Sure Your Growth Hormone Stays Optimized AFTER Your Workout

Once you have gone through all the time, effort and energy of stimulating growth hormone release, there's an exercise recovery phase of two to three hours, where you have to be somewhat careful about what foods you choose to eat. If you aren't careful, then you could suppress the stimulus and you won't get that growth hormone benefits that you would have if you have been more careful with your diet.

Specifically, in order to promote HGH release, you do need to restrict sugar intake post-exercise (although carbs can benefit those more interested in fast recovery, such as professional athletes).

Phil explains:

"What we recommend … is to get 25 grams of protein afterwards within that 30-minute golden window. There is a lot of research to support that, but there's also some research done by Dr. John Ivy of the University of Texas, a great researcher on a young cyclist who made recovery. They're not looking at growth hormone or maximizing growth hormone. They're trying to get to recover as quickly as possible so they can cycle several days in a row.

They showed that getting a ratio of 4:1 carbs to protein is better for recovery … 4:1 starts recovery faster. If you're going after recovery, that's the best strategy … [if] you're not looking for growth hormone, that is. But on the other side, if your goal for most middle-aged adults and older is to maximize growth hormone to get this wonderful hormone circulating for that full two hours in the surging window for going after body fat (just about like you're doing cardio for two hours), you can do that.

… if you throw too many carbohydrates in … then that releases the hormones called somatostatin. That, for whatever reason, just shuts down growth hormone. That's clear in the research."

So it's important to avoid carbs, especially sugar or fructose-containing foods, in the two hours after your workout, and this includes sports drinks, to be sure you're getting the full HGH benefits.

Now, instead of wasting hours and hours needlessly on slow cardio workouts, you can cut down the time, improve the benefits and improve the quality of your life by doing Peak Fitness exercises for 20 minutes, just three times a week. This is not only about longevity but the quality of your life! For more information, Phil has written a book called Ready Set Go. I strongly recommend picking up a copy of that book if you're interested in using high-intensity exercise to improve your health.

How Does this Change My New Exercise Recommendations?

It is important to recognize that life is a journey and we are constantly growing and learning. I have been exercising for nearly 45 years and most of that time it was FAR from ideal. It certainly helped me more than not exercising but by failing to incorporate many sound foundational principles I wasted loads of time and did not achieve a fraction of the benefits I could have.

One of my goals with this site it to share with you what I learn on my health journey so hopefully you can avoid many of the mistakes I and others make in an effort to achieve high-level health.

I am very grateful to the many mentors in my life. With respect to exercise, Dr. Ken Cooper is responsible for helping me make the lifelong commitment to exercise. More recently Phil Campbell helped me to radically improve my exercise with the concepts articulated in our Peak Fitness Program.

After doing Peak Fitness exercises three times a week for about a year I gradually felt that it was too much for me and I reduced that to once a week, which seemed to work out well.  When I interviewed Phil Campbell a second time for this article, though, he made a compelling argument to increase Peak Fitness workouts to three times a week, so you can get growth hormone produced three times instead of once a week.

Made sense to me so I bumped it back up to three times a week.

However I had to reduce the intensity and back it down by about 5% or so, as I was simply too fatigued between sessions. So instead of getting my heart rate to 173 or so, it would be about ten less. Then I recently interviewed Dr. Doug McGuff who is a strong proponent of Super Slow weight training to achieve similar benefits that Phil discusses in this article.

Dr. McGuff has a bit of a different take on using exercise to increase growth hormone. He believes that you only need 12 minutes of Super Slow type strength training once a week to achieve the benefits. I really enjoyed my interview with him as he helped me appreciate a nagging truth that I hadn't quite captured yet and that is the crucial nature of recovery integrated into listening to your body.

Let Me Explain Further

I have known the importance of recovery in exercise training for ages but never applied it to what I have been teaching for an equally long time, which is to Listen to Your Body when it comes to selecting foods.

The epiphany I had with Dr. McGuff is that I wasn't applying the "Listen to Your Body" principle with respect to my exercise program. When I grilled him on parameters of what is the best way to know if you are recovered from your exercise he said you would have a restless energy and feel like you have to engage in some type of physical activity. You will just want to work out.

Well that had not happened to me for some time as I believe I was pushing myself too hard and had not allowed myself enough recovery time. I don't believe this is a problem for most people who exercise, as they are more likely not pushing themselves hard enough, but when you go to extremes as in Peak Fitness high-intensity training programs, this is a serious risk you need to pay careful attention to.

Putting it All Together

So I am currently in a massive experimentation phase and playing with my exercise program. I am doing Peak Fitness 2-3 times a week and also incorporating some changes with my strength training.  

Along with this I intend to do active isolated stretching on a daily basis and do very specific strengthening exercises that are designed for small muscles that are missed during virtually all traditional multi muscle strength training exercises.  I will likely be exercising the same length of time just breaking it up differently.  I suspect that will be more ideal for me and I intend to report on my results as I seek to refine my program so you can learn from it.

I guess the lesson here to learn is that life is an exciting journey. Lean as much as you can from your mistakes and continue to seek new information from different mentors that you can apply and, here is they key, learn to listen to your body so it can guide you into a path that will provide you with the most efficient and effective benefits.

Watch as cats Abbey and Zoey have very different reactions when they find themselves up to their haunches in snow!

Pets love treats! And pet parents love being able to offer them to four-legged family members.

Unfortunately, the majority of commercial pet treats, while yummy tasting to dogs and cats, are neither species-appropriate nor do they contain high quality ingredients.

In fact, most species-appropriate pet treats won't remotely resemble the cute and colorful dog biscuits and cookies you may be used to seeing on store shelves.

Forming treats into tiny dog bone or fish shapes requires the use of undesirable ingredients like grains and other starches, not to mention fillers, preservatives, sugar, and other additives.

Wouldn't it be great to be able to offer delicious, delectable treats to your pet that also provide your dog or cat with species-appropriate nutrition?

I certainly think it would be, so I asked my team to keep their eyes open for some excellent alternatives to the usual pet treat fare.

I'm sharing a few of the results of our research with my readers here at Mercola Healthy Pets.

I hope these recipes, tips and ideas will inspire you to make those treat calories count by offering nutritious, biologically appropriate snacks to your furry loved ones.

Super Easy Nutritious Pet Treat Recipes

Crunchy Beef Cubes

What you'll need:

• 1 pound lean beef
• Baking sheet covered with baking parchment

To prepare:

• Dice beef into half-inch cubes
• Place cubes close together on baking sheet
• Put baking sheet into cold oven and heat oven to 300^oF
• Cook for 1 hour
• Reduce oven temperature to 200^oF and prop open oven door (to allow moisture to escape)
• Continue cooking for 2 additional hours
• Remove beef cubes from oven and allow to dry overnight at room temperature
• Place beef cubes in airtight container and keep refrigerated or frozen until ready to serve

Chewy Liver Strips

What you'll need:

• Beef livers (butcher shops sometimes throw these away or you can buy them at the supermarket)
• Food dehydrator*

To prepare:

• Cut liver into 1-inch slices
• Apply a non-stick spray on the dehydrator drying racks
• Place the liver slices into the dehydrator for 24 hours
• Seal in airtight container and refrigerate or freeze until ready to serve

*An alternative to using a food dehydrator is to put the liver strips on a greased or non-stick baking sheet and bake them in a 325^oF oven for 45 minutes to an hour.

Livertaters

What you'll need:

• 1 pound liver
• 1 egg
• ½ teaspoon garlic powder
• 1 ¼ cups potato flakes
• Beef or chicken broth
• Food processor
• Greased 13 x 9 pan

To prepare:

• Preheat oven to 400^oF
• Cut liver into approximately 1-inch pieces (to help with the blending and cooking process)
• Place the liver pieces, egg, garlic powder and potato flakes in food processor
• Pulse ingredients to combine
• Add as much broth as needed to make the mixture spreadable (the consistency will be very thick)
• Spread mixture into pan
• Bake for 25 minutes; cool on wire rack for 5 minutes
• Loosen sides with a knife, turn pan over and empty mixture onto wire rack
• Cool completely before slicing
• Place slices in airtight container and refrigerate or freeze until ready to serve

Turkeyballs

What you'll need:

• 1 pound ground turkey
• 1 egg
• 1 teaspoon chopped parsley
• ¼ cup shredded cheese (optional)
• ½ cup chopped veggies (optional)

To prepare:

• Preheat oven to 350^oF
• Mix all ingredients in bowl
• Shape mixture into bite-size balls
• Bake for 10 minutes or until brown
• Cool and serve or seal in airtight container and store in fridge or freezer until ready to serve

Turkey Mash

What you'll need:

• 1 egg
• 1 to 2 tablespoons mashed potatoes
• ½ cup diced cooked turkey meat
• ½ cup chopped cooked veggies
• ¼ cup grated cheese

To prepare:

• Warm a small amount of olive oil in a medium-sized skillet
• Blend the egg and potatoes in a bowl and then spread in the skillet
• Lay the turkey and veggies on top in even layers
• Cover and simmer until the egg is cooked and the mixture is warm
• Sprinkle cheese on top of mixture and cook a few more minutes until cheese is melted and egg is golden brown
• Cool thoroughly, cut into wedges, seal in airtight container and put in fridge or freezer until ready to serve

How to Quickly Turn a Can of Pet Food into Nutritious Treats

If you buy commercial (hopefully human grade) canned food for your dog or cat, you can 'repurpose' a can for use as a supply of healthy treats.

Open a can of your pet's favorite brand, preferably something with a strong aroma, and spoon out little treat sized amounts onto a baking sheet covered with parchment paper.

Put the baking sheet into the freezer until the bite sized bits of food are frozen. Then move them to an airtight container and back into the freezer they go until you're ready to treat your pet to a treat! (Most dogs will enjoy the treats frozen, but you'll need to thaw them to a chewy consistency for kitties.)

Additional Ideas for Quick-and-Easy Pet Treats

Don't count out people food when it comes to offering healthy treats to your pet.

Fed in moderation (meaning fed only occasionally, and in very small amounts – no more than a 1/8 inch square for a cat or small dog and no more than a ¼ inch square for a bigger dog), any of the following items from your kitchen can provide a nutritious snack for your dog or cat:

• Fruit
• Cheese
• Raw almonds, cashews, Brazil nuts
• Blueberries
• Frozen peas

No matter what treats you feed, they should be counted as part of your dog's or cat's daily caloric intake. It's easy to imagine, as you're handing a tiny morsel of this or that to your pet, that those extra calories are inconsequential in such small amounts.

Most pet owners would be surprised at just how many extra calories a treat here and there can add to a pet's daily energy intake.

The European Pet Food Industry Federation (FEDIAF) has launched an initiative to help teach its youngest citizens about responsible pet ownership.

According to the Federation, "Teaching and learning is seen by all modern cultures as the key to the future economic and moral development of the society."

The FEDIAF goes on to note that despite the fact that about 200 million pets live in 70 million homes across Europe, little to no formal curricula exists specifically dedicated to pets – how to deal with them and the benefits of having a pet.

School Programs

The programs being offered to schools in the European Union were developed by educational experts and are published in English on the FEDIAF website.

There are teaching materials for grade school-aged children titled "Fascinating Cats" and "Fascinating Dogs".

There is also information for younger children (ages 3 to 6) titled "Dogs and young children."

There's also a four-minute video trailer for teachers which explains how the materials were developed and how they can be used to help young children understand how to be responsible pet owners.

Per the FEDIAF, "It is essential that children start learning from an early age how dogs behave, how they express fear or aggression, how they become part of the family and how they obey orders."

"Fascinating Cats"

This is a 36-page PDF document containing classroom materials to teach grade school children about cats. In a note to teachers, the goal of the material is explained:

Our priority is that school children can learn to handle cats without supervision and with their own sense of responsibility, and with knowledge and understanding of the biology, behaviour and the "language" of cats. Our aim is that, with this acquired knowledge, school children can adjust and orientate their behaviour and communication with cats in appropriate ways, so that they may familiarise themselves with cats as living beings that need to be taken seriously. Knowing how cats behave and express themselves is essential in establishing a "species-appropriate" relationship between humans and all animals. Children describe their subjective experience of such relationships as original, interesting and loving.

The teaching materials include information sheets on topics like:

• Ancestry of the domestic cat
• Cat language
• Biology of the cat
• Stages in a cat's life
• Treating your cat properly

There are worksheets for the kids for each topic, and tests for teachers to give after all the materials have been presented.

You can download the entire "Fascinating Cats" PDF here.

"Fascinating Dogs"

The teaching materials on dogs have a similar stated purpose to those for cats:

The teaching materials in 'Fascinating Dogs' offer an interesting, basic understanding of these popular pets. The information and materials in this booklet provide practical knowledge and appropriate information about dogs, which will help school children aged 8 to 12 to foster an understanding, respect and sensitivity towards the specific dogs and their needs. Our aim is for school children to learn to handle dogs safely, to develop their own sense of responsibility, along with knowledge and understanding of the biology, behaviour and 'language' of dogs.

This resource will help school children see how they can modify their behaviour around dogs so they can interact safely and happily. Understanding a dog's needs and instinctive behaviours is essential in developing a safe and rewarding relationship.

The content includes information on such topics as:

• The wolf pack
• The dog's family
• The dog's human family
• How to behave when you meet a strange dog
• Caring for your dog

Like the cat materials, the dog teaching materials also include student worksheets and tests.

Download the "Fascinating Dogs" classroom materials. 

"Dogs and Young Children"

Excerpt from a note to teachers:

Why is it important to teach young children about dogs?

The most common victims of dog bites and attacks are younger children, particularly those between the ages of one and six years. We know that dogs can be confused by the erratic, unpredictable behaviour of younger children (e.g. their fast movements and loud noises). We also know that younger children tend to misunderstand animal behaviour as they usually have not been taught to read a dog's body language. It is also clear that younger children are less able to protect themselves physically.

This material is geared to the 3-to-6 year old group, and starts off with a list and brief description of the '7 essential rules to be a responsible pet owner.'

The list is followed by four main learning subjects:

1. Inside the dog's mind
2. What if …?
3. Dangerous situations
4. How to avoid dangerous situations

The approach of the 'What if …?' section is designed to help children see things from a dog's perspective and empathize with different feelings an animal might experience, like hunger, fear, illness or happiness.

Questions for discussion are posed, including, "How would you feel if you couldn't escape from the sunshine and heat?" and "How would you feel if you were insulted or hurt, instead of loved?"

An excerpt from the conclusion of the 'Dogs and young children' teaching materials:

Our relationship with dogs has changed dramatically during the last two decades. Most dog owners consider their pet to be a family member who also has a close relationship with the children. The harmony between them is important for the development of empathy. Caring for and raising an animal helps a child to learn about routine, as well as helping to develop a sense of responsibility, and empathy for others. This experience is also useful for relationships with people and other children.

It is important to emphasize the role of parents, who should supervise all interactions between dogs and children. The early teaching of children, including experience-based education, plays a significant part in this process too.

Download "Dogs and Young Children" PDF.

Every Child Should Learn Responsible Pet Ownership

I love the idea of making responsible pet ownership classes part of the curriculum in elementary schools.

I also really like the 'fascinating' approach the FEDIAF took in creating their teaching materials. I believe helping children understand the nature of dogs and cats as species very different from humans will make them more conscious pet owners.

Pets aren't toys or belongings to be set aside or discarded. And pets also aren't small, strange looking humans. Dogs and cats have long, noble histories and evolutionary reasons for everything they do.

When we learn why the creatures in our care do what they do, and need what they need, it expands our understanding, compassion, and desire to be the best pet guardians we can be.

If you're looking for tools to help your own child become a responsible pet owner, I'd start with your local animal shelter, humane society or SPCA office to see what's available in your area.

And here are a few online resources that you might also find useful:

• Washington State University College of Veterinary Medicine Kids Curriculum
• ASPCA Kids
• AVMA Kids Corner
• AKC Children's Education Catalog (for ordering offline educational tools)

And for all you parents out there, please remember: the very best person to teach your child how to take excellent care of a pet is you, and the example you set every day by being a role model of responsible pet ownership.

It has long been known that mesenchymal stem cells (MSCs) in skeletal muscle are an important part of the muscle repair process.  The scientists discovered that MSCs in muscle are very responsive to mechanical strain.

According to Fight Aging:

“They witnessed MSC accumulation in muscle of mice after vigorous exercise ... Preliminary data suggest MSCs become deficient in muscle with age. The team hopes to develop a combinatorial therapy that utilizes molecular and stem-cell-based strategies to prevent age-related muscle loss.”

Average telomere length, although it declines with age, is somewhat dynamic in response to circumstances.  Recent research found that the white blood cell telomere length in women who were moderately or highly active had a 0.07 standard deviation increase.

According to Fight Aging:

“Greater moderate- or vigorous-intensity activity was also associated with increased [telomere length ... Associations remained after adjustment for body mass index ... Although associations were modest, these findings suggest that even moderate amounts of activity may be associated with longer telomeres, warranting further investigation in large prospective studies.”