Dr.Ian Gibson MP
House of Commons

13th. December 2005

The Group on Scientific Research into M.E.

Dear Dr. Gibson,

I am enclosing two documents ("Is CFS Linked to Vaccinations?" and "Tetanus
Toxoid Vaccination") which I would like to be considered as part of the
inquiry by The Group on Scientific Research into M.E.

It was not until I gained access to my medical notes at the end of 2001
that I noticed that only days before I became ill (a case of "sudden
onset") in February 1993, I had received a routine tetanus booster.

I had become aware of the suggested link between M.E. and vaccinations in
the intervening years, but was shocked to see such an indication in my own
medical history: it naturally hadn't occurred to me at the time, not being
medically knowledegable, but I am surprised that my GP back then didn't
notice that my last visit to the surgery, only ten days prior to the
appointment I'd made as a result of collapsing, had been to receive this
vaccination, and that perhaps I had suffered an adverse reaction. Still,
that's history now.

However, I recently watched the BBC documentary, which you participated in,
"The Irresistible Rise of Tony's Crony", and was further shocked to realise
the extent to which vaccines used by the NHS can be harmful.

In the absence of any other obvious cause of my illness, I consider the
case for it being the result of receiving this tetanus booster to be
compelling. I received the vaccination, batch no. AH154A (or A4154A), on
25th. January 1993 at Reepham Surgery. Within six days I had experienced
two temporary episodes of suddenly feeling faint, disoriented and extremely
ill, and on the twelfth day (4th. February), collapsed completely, as I was
about to leave home for work.

I became increasingly worse over the next three days and was taken to
Reepham Surgery on Monday, 8th. February. I was so ill by then I had had to
write down my symptoms, as I was barely able to speak through a combination
of mental confusion, slurring, loss of strength in my voicebox and throat
muscles, and "lockjaw".

Reading "Tetanus Toxoid Vaccination" (I regret that I don't know where I
found this article on the internet), I immediately recognised the symptoms
described there of adverse reactions to tetanus vaccine. Unfortunately, the
piece of paper I gave my GP on 8th. February (amongst a couple of other
relevant documents) is now missing from my medical file.

I trust this information and the enclosed articles will be of use in the
Group's inquiry into the causes of M.E.

Yours sincerely,
John Sayer

cc. Keith Simpson MP (Mid Norfolk)


Is CFS Linked to Vaccinations?


Winter 2001

By Charles Shepherd, MD,
ME Association, United Kingdom

There is widespread agreement that a variety of infections are capable of
precipitating chronic fatigue syndrome (CFS) in susceptible individuals. In
l988, Lloyd et al reported that several of their patients had linked the
onset of CFS to receiving a vaccination in the absence of any coincidental
infection. [l] Since then, other anecdotal reports have also linked
vaccinations to the onset of CFS. [2,3]

The explanation for vaccine-induced CFS may be because the primary purpose
of any vaccine is to mimic the effects of infection on the immune system.
If an antigenic challenge by infection can precipitate CFS, then it is
conceivable that vaccines could act in a very similar manner.

This reasoning is further strengthened by the fact that immunologically
based illnesses, such as arthritis, can occur when a susceptible host and
an environmental trigger, such as an infection or vaccination, interact.
[4] It is also interesting to note that vaccinations have been suggested as
a possible precipitating factor in the development of Gulf War illness.

Causal vaccines

My research interest in this aspect of developing CFS is largely based on
clinical evidence from patients seen in my practice over the past 10 years.
As a result, I have gathered details on more than 200 patients with a
history of either developing CFS or experiencing a significant
relapse/exacerbation of CFS symptoms following a vaccination.

In addition, I have more than 150 reports referring to such a link from
members of myalgic encephalomyelitis (ME) or CFS self-help support groups
and/or their physicians throughout the world.

This data (although unpublished) suggests that tetanus, typhoid, influenza,
and hepatitis B are the most commonly implicated vaccines in cases of CFS.
I have reports of very few cases involving hepatitis A (using
immunoglobulin), polio, or rubella vaccine, or those predominantly given
during childhood - with the possible exception of Bacillus Calmette -
Guerin vaccine (three cases).

Almost all of my cases involve adults, and in a significant minority the
vaccine was administered when the person had not yet fully recovered from
an infective illness such as infectious mononucleosis (known as glandular
fever in the U.K.) or had already experienced an adverse reaction to a
previous dose of the same vaccine (as is sometimes the case with hepatitis
B vaccine).

About one third of my cases involve vaccine-induced/exacerbated CFS
following receiving the hepatitis B vaccine (HBV). Most of these patients
are health care workers, particularly nurses. Most of the other patients
received HBV for occupational health purposes, often as a condition of
employment and without any information on side effects, such as severe
neurological reactions.

The prognosis in this group has been poor, with less than 10% of the
patients I have personally followed reporting any significant relief of CFS

Although chronic debilitating fatigue is the most frequently reported
symptom of CFS after vaccine administration in this group, around 20% also
complained of significant joint pain/arthralgia, a finding consistent with
several reports linking HBV to arthritis and other autoimmune disorders. [5]

Less than 5% of the patients also reported neurological complications/side
effects such as tremors or one-sided weakness, which appear to be separate
from their CFS symptoms.

For instance, one female patient developed an acute disseminated
inflammation of the brain and spinal cord (encephalo-myelitis) shortly
after the second dose of vaccine. This was followed by the gradual onset of

Hepatitis vaccines are highly immunogenic compounds, and a number of
possible explanations exist as to why they may be more likely to trigger

One explanation involves a preexisting genetic susceptibility, which after
antigenic stimulation with HBV, results in a pathological process (possibly
involving immune complex formation) leading to a clinical disease.

Another explanation is that a hypersensitivity reaction occurs to a
component of HBV, such as the preservative thimerosal. [6]

Researchers in Canada, who made similar observations of a link between HBV
and CFS, hypothesized that this may involve an autoimmune reaction with a
microscopic form of demyelination not visible on magnetic resonance
imaging. [7]

Despite growing anecdotal evidence from other experienced physicians who
also believe that HBV can precipitate CFS, [2] vaccine manufacturers do not
acknowledge any causal link. In fact, a report by an independent working
group in Canada that dismissed any such causal link is frequently quoted as
a reason for dismissing these claims, even though it contained some very
questionable assumptions to support the conclusions. [8]

For example, the report inaccurately states that chronic carriers of
hepatitis B infection without signs of ongoing liver damage do not complain
of tiredness. The report also uses results from a one-week follow-up study
of 700 health care students, which found excessive short-term tiredness in
about 14% after vaccination with HBV to refute any link with chronic

Practical advice

Health care providers caring for CFS patients who require vaccinations
clearly must weigh the pros (i.e., how effective? how necessary?) and cons
(i.e., risks of adverse effects and exacerbation of CFS symptoms) for each
individual vaccine. I would advise against having routine nonessential
vaccinations if a patient is:

a. In the very early stages of CFS, particularly when it obviously follows
an infective episode;

b. Continuing to experience flulike symptoms, including sore throat,
enlarged glands, fevers, and joint pains; or

c. Has previously experienced an adverse reaction to that particular vaccine.

If the vaccination is potentially lifesaving, then considerations relating
to CFS must take a lower priority. As for some of the more commonly
required vaccines, my advice on their use is as follows:

Hepatitis A. Short-lived protection using immuno-globulin does not seem to
cause any problems in CFS patients. I have not received any adverse
feedback from CFS patients who have used hepatitis A vaccine.

Hepatitis B. If a patient requires HBV for occupational health purposes,
clinicians should weigh the pros and cons as previously discussed and then
discuss with the patient.

Influenza. If a patient has any medical condition that could be severely
affected by an attack of the flu, such as heart disease, asthma, or
bronchitis, influenza vaccine should certainly be considered.

My own data indicates approximately 60% of CFS patients experience some
form of exacerbation in  their fatigue and flulike symptoms (sometimes
quite marked) following an influenza vaccine.

Meningitis C. My feedback from approximately 30 children and adolescents
with CFS who have been given the meningitis C vaccine in the U.K. is that
there were no serious side effects or exacerbations of CFS symptoms. The
only adverse effects reported have been minor exacerbations of fatigue and

Polio and diphtheria. One research study showed evidence that people with
CFS do not experience adverse reactions to polio vaccination. [9] This is
also my own impression from feedback received from patients I have advised
receive polio boosters in relation to foreign travel.

Polio vaccinations or boosters should clearly be given to patients
traveling to countries where polio still occurs. The same advice applies to
diphtheria, which is becoming increasingly common in parts of Eastern

Tetanus. Maintaining up-to-date protection is vital for individuals whose
employment (e.g., working on a farm) or leisure activity (e.g., gardening)
places them at risk of contracting tetanus.

However, tetanus vaccine can produce side effects in healthy people and may
well cause CFS patients to relapse. The pros and cons need to be carefully
considered as tetanus vaccine has been reported to precipitate CFS. [1,2]

Typhoid. The typhoid vaccine can cause side effects in healthy people. The
feedback I received from my CFS patients, however, indicates that the oral
form of typhoid vaccine was generally well tolerated.

Whenever vaccinations are considered necessary, they should be given when
CFS patients are feeling reasonably well and not under any undue stress. It
is also wise to make sure that all travel vaccinations are completed at
least two weeks before departure in the event a patient experiences
exacerbated symptoms or a relapse.

Not surprisingly, patients with possible vaccine-induced CFS often face
considerable difficulty in obtaining disability benefits on the grounds of
permanent ill health. However, some of my patients in the U.K. have
successfully argued their cases and been awarded injury payments on the
grounds that HBV given for occupational health reasons caused their CFS. I
am also involved in a number of cases where the debate is likely to be
settled in court.


1. Lloyd A et al. What is myalgic encephalomyelitis? Lancet. l988; l: 1286-7.

2. Weir W. The post-viral fatigue syndrome. Current Medical Literature:
Infect Dis. l992; 6: 3-8.

3. CIBA Foundation. Chronic Fatigue Syndrome. Eds. Bock GR et al. J Wiley;
l993; symposium 173.

4.  Symmons DPM et al. Can immunisation trigger rheumatoid arthritis? Ann
Rheum Dis. l993; 52: 843-844.

5. Gross K et al. Arthritis after hepatitis B vaccination. Scand J Rheum.
l995; 24: 50-2.

6. Grotto I et al. Major adverse reactions to yeast-derived hepatitis B
vaccines-a review. Vaccine. l998; 16: 329-34.

7. Hyde B. The clinical investigation of acute onset ME/CFS and MS
following recombinant hepatitis B immunisation. Second World Congress on
CFS and Related Disorders, Brussels. 1999; September 9-12.

8. Report of the working group on the possible relationship between
hepatitis B vaccination and the chronic fatigue syndrome. Canad Med Assoc
J. l993; 149: 314-9.

9. Vedhara K et al. Consequences of live poliovirus vaccine administration
in chronic fatigue syndrome. J Neuroimmun. l997; 75: 183-95.

Dr. Charles Shepherd is in private practice in the United Kingdom (U.K.)
and is a member of the Chief Medical Officer's Working Group on CFS/ME at
the U.K. Department of Health.

© CFIDS Association of America



An overview by Dr. Kris Gaublomme

Tetanus Vaccination by Dr Mendelsohn MD (The People's Doctor Newsletter

You have every right to closely question me on the tetanus vaccine, since
that was the last vaccine I abandoned. It wasn't hard for me to give up
vaccines for whooping cough, measles, and rubella because of their
disabling and sometimes deadly side effects. The mumps vaccine, a
high-risk, low-benefit product, struck me and plenty of other doctors as
silly from the moment it was introduced. Arguments for the diphtheria
vaccine were vitiated by epidemics during the past 15 years which showed
the same death rate and the same severity of illness in those who were
vaccinated vs. those who were not vaccinated. As for smallpox, even the
government finally gave up that vaccine in 1970, and I gave up on the polio
vaccine when Jonas Salk showed that the best way to catch polio in the
United States was to be near a child who recently had taken the Sabin
vaccine. But the tetanus vaccine exercised a hold on me for a much longer

As you point out, I gave up belief in this vaccine in stages. For a while,
I still held onto the notion that farm families and people who work around
stables should continue to take tetanus shots. But in spite of my early
indoctrination with fear of "rusty nails," in recent years, I have
developed a greater fear of the hypodermic needle. My reasons are:

1) Scientific evidence shows that too-frequent tetanus boosters actually
may interfere with the immune reaction.

2) There has been a gradual retreat of even the most conservative
authorities from giving tetanus boosters every one year to every two years
to every five years to every 10 years (as now recommended by the American
Academy of Pediatrics), and according to some, every 20 years. All these
numbers are based on guesses rather than on hard scientific evidence.

3) There has been a growing recognition that no controlled scientific study
(in which half the patients were given the vaccine and the other half were
given injections of sterile water) has ever been carried out to prove the
safety and effectiveness of the tetanus vaccine. Evidence for the vaccine
comes from epidemiologic studies which are by nature controversial and
which do not satisfy the criteria for scientific proof.

4) The tetanus vaccine over the decades has been progressively weakened in
order to reduce the considerable reaction (fever and swelling) it used to
cause. Accompanying this reduction in reactivity has been a concomitant
reduction in antigenicity (the ability to confer protection). Therefore,
there is a good chance that today's tetanus vaccine is about as effective
as tap water.

5) Until the last few years, government statistics admitted that 40 percent
of the child population of the U.S. was not immunized. For all those
decades, where were the tetanus cases from all those rusty nails?

6) There now exists a growing theoretical concern which links immunizations
to the huge increase in recent decades of auto-immune diseases, e.g.,
rheumatoid arthritis, multiple sclerosis, lupus erythematosus, lymphoma,
and leukemia. In one case, Guillain-Barre paralysis from swine flu vaccine,
the relationship turned out to be more than just theoretical.

In preparing my courtroom testimony on behalf of a child who allegedly was
brain-damaged as a result of the DPT (diphtheria, pertussis, tetanus)
vaccine, I reviewed the prescribing information (package insert) for the
Connaught Laboratories product which was administered to this child. The
1975 and.1977 package insert information which measured seven-and-a-half
inches long listed three scientific references in support of the
indications, contraindications, warnings, cautions, and adverse reactions
to this vaccine. By 1978, the length of the insert had grown to 13 1/2
inches, and the number of scientific references had increased to 11. By
1980, the package insert was 18 inches long, and the references numbered
14. Of those newly-added references, seven (three from U.S. medical
journals and four from foreign medical journals) dealt specifically with
reactions to the tetanus DPT portion of the (toxoid) vaccine.

An article in the Archives of Neurology (1972) described brachial plexus
neuropathy (which can lead to paralysis of the arm) prom tetanus toxoi Four
patients who received only tetanus toxoid noticed the onset of limb
weakness from six to 21 days after the inoculation. A 1966 article
published in the Journal of the American Medical Association reports the
first case of "Peripheral Neuropathy following Tetanus Toxoid
Administration." A 23-year-old white medical student received an injection
of tetanus toxoid into his right upper arm after an abrasion of the right
knee while playing tennis. Several hours later, he developed a wrist drop
of his right hand. He later suffered from complete motor and sensory
paralysis over the distribution of the right radial nerve (one of the major
nerves innervating the arm and hand). One month later, no residual motor or
sensory deficit could be found.

Reference is made to an article in the Journal of Neurology, 1977, entitled
"Unusual Neurological Complication following Tetanus Toxoid
Administration." The author reports a 36-year-old female who received
tetatus toxoid in her left upper arm following a wound to her finger. Five
days later, she noticed a weakness first of the right, and then of the left
and later of both legs. She complained of dizziness, instability, lethargy,
chest discomfort, difficulty in swallowing, and inarticulate speech. S
staggered when she walked, and she could take only a few steps. Her EEG
showed some abnormalities. After a month, she was discharged without
neurologic disturbance, but she continued to feel weak and anxious.
Examinations during the next 11 months showed continued emotional
instability and some paresthesias (numbness and tingling) in the
extremities. The medical diagnosis was "a rapidly progressing neuropathy
with involvement of cranial nerves, myelopathy, and encephalopathy."

The Journal of Allergy and Clinical Immunology, 1973, carried an article
entitled "Hypersensitivity to Tetanus Toxoid," and in a volume entitled
"Proceedings of the II International Conference on Tetanus" (published by
Hans Huber, Bern, Switzerland, 1967), an article appeared entitled
"Clinical Reactions to Tetanus Toxoid."

A 44-year-old article in the Journal of the American Medical Association
(1940) was entitled "Allergy Induced by Immunization with Tetanus Toxoid."
That same year, an article in the British Medical Journal reported on
"Anaphylaxis (a form of shock) following Administration of Tetanus Toxoid."
In 1969, a German medical journal reported a case of paralysis of the
recurrent laryngeal nerve (the nerve to the voicebox) after a booster
injection of tetanus toxoid. The patient developed hoarseness and was
unable to speak loudly, but the nerve paralysis subsided completely after
approximately two months.

Should your doctor reassure you that tetanus vaccine is completely safe, or
that "the benefits outweigh the risks," or that you should have a shot
"just in case", why not share these citations with him?