Israel’s Ministry of Health has been monitoring the sewers since 1988 as an early warning system for the presence of the poliovirus. In June 2013 wild poliovirus was found in the sewage in some of Israel’s southern cities. Testing discovered wild poliovirus in several children who were previously vaccinated with IPV.

Rather than wait until the first case of paralysis or death from polio, the Israeli Ministry of Health, acting on guidance from the World Health Organization (WHO) for situations like this, decided to vaccinate all children under the age of 9 who have already been vaccinated with two doses or more of the Inactivated Polio Vaccine (IPV) (the only one given to children since 2005) with the Oral Polio Vaccine (OPV), a live, attenuated vaccine. The goal was to prevent spreading the virus to those unvaccinated because they are too young or too ill or because of their parents’ choice, or those in whom the vaccine wore off. The decision sparked a controversy in Israel, with even parents who are usually pro-vaccine concerned and parents who are anti-vaccine vocally opposed.

Dr. Suzanne Humphries is an M.D. who now rejects conventional medicine in favor of “holistic” medicine, including homeopathy. She is also an anti-vaccination activist. Dr. Humphries took it upon herself to warn Israeli parents not to vaccinate their children with OPV, undermining the Ministry of Health’s efforts to prevent an outbreak of this dangerous disease.

Dr. Humphries’ first approach to Israeli parents was on a June 30, 2013 Youtube video with problematic, unreliable claims. For example, Dr. Humphries claimed polio epidemics were caused by widespread use of DDT, ignoring both the New York epidemic of 1916 ,which preceded widespread use of DDT, and the fact that the claim has been thoroughly debunked. Worse, Dr. Humphries’ video tries to convince parents that polio is not dangerous; while most people who contract the disease will not have those symptoms, polio can cause paralysis or death. The CDC says  “Estimates of the ratio of inapparent to paralytic illness vary from 50:1 to 1,000:1 (usually 200:1).”

Not content with this, to further discourage parents from vaccinating their children with OPV, Dr. Humphries wrote a blog post claiming parents are frightened and terrorized by the decision to use OPV. This effort is a particular disservice to the anti-vaccination community in Israel, whose children, not vaccinated with IPV, are most at risk if an outbreak of polio happens. The post, like the video, is full of problematic claims – and concludes with religious advice that Dr. Humphries is neither qualified nor knowledgeable enough to offer.

Problematic claims

Dr. Humphries’ post is filled with misleading information and unsupported claims. For example, she overstates the risk from the vaccine virus compared to the wild virus, suggesting the vaccine virus is the more dangerous one.  It is true that the OPV can very rarely cause paralysis, but the risk is at 1 per 2,700,000 for children receiving their first dose of OPV, compared to about 1 per 1,000 from the wild virus.  It is not hard to see which risk is greater.

At any rate, the Israeli Ministry of Health is not exposing the children to that small risk: they are vaccinating only children who already received IPV and should already be immune. The Israeli Ministry of Health points out that while the risk is theoretically possible, it is extremely small. While Israel used the combination there has never been a case of paralysis when a child previously vaccinated with IPV received OPV.  The World Health Organization is only aware of one such case out of millions of children subjected to this regime in the United States, Hungary and elsewhere.

Dr. Humphries is also correct to point out that there could be an outbreak from the vaccine virus, in rare cases, if there is a large enough susceptible (not immune) population. But that requires a “seriously under-immunized” population, which is not the case in Israel – and at any rate, the risk of an outbreak from the more virulent wild virus is much larger.

Dr. Humphries makes a series of impractical or unsupported recommendations. For example, she recommends that parents keep younger children at home until February. What Dr. Humphries does not seem to know is that in most Israeli households parents both parents work, making this option untenable. Another of Humphries’ recommendations is that both parents and children consume at least 2000 mg of Vitamin C per day. There is no published evidence that vitamin C – even at high doses – is as effective as vaccination at preventing polio. It is not an appropriate substitute for vaccination and may actually cause side effects from an overdose of vitamin C.  She suggests, again with no evidence, that a good diet can help – by preventing paralysis, maybe? Neither of these claims has any science or studies behind it. In fact, the WHO points out that “The only way to prevent polio is by immunization.”

Dr. Humphries explains the vaccination effort as a conspiracy to revive a failing global eradication effort. Actually, the eradication effort was very successful: until recently, only Nigeria, Pakistan, and Afghanistan still had wild polio cases. More recently cases were discovered in the horn of Africa (id). Wild Polio Virus cases declined from 350000 in 1988 to 1606  in 2009 to 223 Wild Polio virus cases in 2012, only 6 in non-endemic country, and 70 more vaccine-virus cases. This reads like a dramatic success to me. But at any rate, picking a country as small as Israel to revive the effort is a strange idea – and her need to use a conspiracy theory to justify the Ministry of Health’s desire to avoid an outbreak is also problematic.

Dr. Humphries adds that “This vaccination campaign is a win/win situation for the MOH, WHO and vaccinationists world wide, because it gets the needle into the child and breaks down the parents’ resistance.” But the OPV is an oral vaccine. And her assumption that the Ministry of Health has any direct interest in doing this is unsupported.

In her analysis Dr. Humphries makes unfounded claims and substantial errors, and resorts to conspiracy theory claims without any evidence behind them. All this is done in the guise of encouraging parents to think and act autonomously – a goal which is in tension with Dr. Humphries effort to get parents to accept on faith claims about the effectiveness of treatments that have no evidence behind them and conspiracy theories that are not supported with any data.

Misunderstanding Jewish Law

Dr. Humphries ends her post with a message to religious Jews. In essence she claims that vaccination is in tension with God’s recommendations regarding treatment of diseases, and that the Ministry of Health is ignoring religious commandments in their suggestions. She highlights the fact that God did not order Moses to inoculate the Israelites in the desert when there were diseases to argue that it was against religious principles to vaccinate.

Dr. Humphries misunderstands the nature of religious law. Religious law does not stop with reading the Bible and concluding that if God did not expressly decree a practice it is forbidden, or even not recommended. The bible provides us with a set of rules but also with a set of principles to follow, principles that are interpreted according to established canons to determine the correct result in a given case. It is this ability to interpret religious law which makes it timeless and relevant to the modern world.

Dr. Humphries’ reading of the Bible is simplistic and problematic, because she assumes that God objects to gradual accumulation of human knowledge and to the use of that knowledge to fulfill the basic commandments of preserving life. Unsurprisingly, those with experience in actually interpreting and applying Jewish law conclude differently, and support  the vaccination effort, up to mandating it. The basis for this view is the importance of life and health in Jewish law and the prohibition against placing life or health in unreasonable danger.

In this case, Israel’s Chief Rabbi spoke very clearly, determining that the OPV is compulsory for all healthy children: “it is the obligation and mitzvah for parents to have their children vaccinated.” Similarly, Rabbi Firer, a health expert and religious expert simultaneously said “that based upon the principle of mutual responsibility and societal commitment, the vaccinations should be taken by all healthy children, and only children suffering from health problems should be exempt from it.”

Dr. Humphries tries to discourage parents from vaccinating with OPV, based on advice with no evidence behind it and conspiracy theories. She also offers religious advice that shows lack of understanding of Jewish law and is in tension with the advice of esteemed religious figures. Her advice is irresponsible, problematic and should not be followed.

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