Robert Sears (physician)

Robert William Sears, known as Dr. Bob, is an American pediatrician from Capistrano Beach, California, noted for his unorthodox and dangerous[2][3] views on childhood vaccination.[4][5] His book, The Vaccine Book: Making the Right Decision for your Child (2007), proposes two alternative vaccination schedules that depart from accepted medical recommendations. His proposals have enjoyed celebrity endorsement, but are not supported by medical evidence and have contributed to dangerous under-vaccination in the national child population.[6] While he denies being anti-vaccine,[7] Sears is characterized as anti-vaccine[8][9] and as a vaccine delayer.[10][11]

Robert W. Sears
NationalityAmerican
OccupationPediatrician
Known forControversial book on vaccines and alternative vaccine schedules.
Spouse(s)Cheryl Sears
Children3[1]
Parent(s)William and Martha Sears

Views on vaccines

Sears is known for his views on vaccine scheduling.[4] He recommends that parents avoid or delay vaccinating their children, counter to the consensus recommendations of medical bodies,[6] and his book recommends that parents follow his two alternative vaccine schedules, rather than that of the American Academy of Pediatrics.[12] His proposals are popular with parents who are influenced by incorrect information propagated by anti-vaccination activists who seek a "compromise" between embracing and avoiding vaccination. This has contributed to under-vaccination in the US child population, putting public health at risk.[13]

In 2014, Sears said that he thinks "the disease danger is low enough where I think you can safely raise an unvaccinated child in today's society."[5]

Although he is characterized as an anti-vaccine doctor[8][9] and a vaccine delayer,[10][11] he does admit that vaccines work: "Chicken pox, measles, whooping cough, polio, diphtheria, all these diseases that we no longer see very much of anymore, I do say that the vaccines are responsible for getting rid of these."[14] Sears is against mandatory vaccination.[15]

Sears has encouraged parents who choose not to vaccinate their children not to tell others of their decision, writing: "I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we'll likely see the diseases increase significantly."[16] This position has been criticized as encouraging "free riding" on the herd immunity created by those who do vaccinate: "This is clearly immoral free-riding, it demonstrates a willingness to make unfair use of the contributions others have made to social cooperation."[17] In 2008, Sears told the New York Times that 20% of his patients do not vaccinate at all, and that another 20% vaccinated partially. He also said that “I don’t think [vaccination] is such a critical public health issue that we should force parents into it."[18] He continues to convey these views on his popular podcast, The Vaccine Conversation. Dorit Reiss rejects the podcast episodes as a source of medical information, as they "repeat anti-vaccine talking points, overstate vaccine risks and understate the benefits".[7]

Sears' activism includes opposition to California Senate Bill SB277, a bill which proposes to eliminate non-medical vaccine exemptions. He also invoked Godwin's law by comparing non-vaccinating parents to Nazi-persecuted Jews.[19] A fellow pediatrician considered the comparison "disgraceful":

"To compare the plight of the Jews under Hitler to that of those who willingly forego a preventive treatment that safeguards not only the health of their children, but the community as a whole is to lose all moral grounding. It is to purloin the most appalling suffering of the 20th century’s greatest victims, and assign it to those whose choices make not only themselves but their neighbors less safe. It is repulsive.... Dr. Bob Sears should be ashamed of himself."[19]

Alternative vaccine schedules

In 2007, Sears published The Vaccine Book: Making the Right Decision For Your Child through the Sears Parenting Library, and, as of 2012, it had sold more than 180,000 copies,[20] and garnered support from celebrities.[6] The book includes his two alternative vaccine schedules: "Dr Bob’s Selective Vaccine Schedule" is for those "who want to decline or to delay vaccines". "Dr Bob's Alternative Vaccine Schedule" is for those "who worry that children are receiving too many vaccines too early".[21][7] This schedule involves spreading out the vaccines received by the child, and separating some vaccines that would otherwise be combined.[22] The book has been described by Vox as "basically a guide to skipping vaccines," and that "it may as well be called The Anti-Vaccine Book."[23]

Sears has said that he created his alternative vaccine schedules to allow parents to vaccinate their children "in a more gradual manner" rather than by following the schedule recommended by the Centers for Disease Control and Prevention (CDC).[24] His notions, for example that vaccination risks causing "antigenic overload", are, however, based on misconceptions and not sound scientific evidence.[6][25][26] On an episode of All In with Chris Hayes, Sears admitted that there was no published, peer-reviewed evidence to support the notion of vaccine overload, and that "my precautions about spreading out vaccines are theoretical, a theoretical benefit to kids..."[10] Health journalist Julia Belluz has stated: "From a scientific standpoint, Sears is a quack: while he claims to be a vaccines expert, he is not a researcher and has never conducted his own vaccine science." Regarding his theory of vaccine overload, "according to the data mustered by the scientific community, he's simply wrong."[11]

In 2008, Sears' "intentionally undervaccinated" seven-year-old patient[27][28][29] was identified as the index patient who started a measles epidemic in 2008,[30] an epidemic which was the largest outbreak in San Diego since 1991.[31] The epidemic "resulted in 839 exposed persons, 11 additional cases (all in unvaccinated children), and the hospitalization of an infant too young to be vaccinated....[with] a net public-sector cost of $10,376 per case.... 48 children too young to be vaccinated were quarantined, at an average family cost of $775 per child".[27]

Reception

Sears' viewpoints and The Vaccine Book have been criticized by the press and numerous medical professionals.

Paul Offit wrote that "Sears sounds many antivaccine messages" in the book.[21] Sears has been criticized by David Gorski, who wrote that Sears is anti-vaccine,[8] and by Emily Willingham, who has dismissed The Vaccine Book as "non-evidence-based."[32] Steven Novella criticized the book's attempt to tell both sides of, and assume a moderate position in, the vaccine debate as like "trying to compromise between mutually exclusive positions, like young-earth creationism and evolution".[20]

Pediatrician Rahul Parikh has said Sears is someone whose "understanding of vaccines is deeply flawed," that his Vaccine Book "is a nightmare for pediatricians like me," and "is peppered with misleading innuendo and factual errors". He also writes that "Sears misleads parents," using "tactics [like] soft science, circular logic, reporting rumors and outright falsehoods".[16]

Peter Lipson, a physician who writes about the intersection of science and the media, states that "...Sears is a useful (although hardly unique) example of a dangerous doctor.... Despite his protestations that he is not 'anti-vaccine', his language and his recommendations very clearly guide parents to be suspicious of vaccination and to avoid the safe and effective recommended vaccination schedule." Lipson also considers it less than coincidental that Orange County, California, the same county where Sears practices, has "reported the highest rate of measles in the state last year. It’s also home to some of the state’s highest numbers of unvaccinated children. Of the 20 people infected by the current outbreak [at Disneyland], at least 15 were not vaccinated."[33] Lipson has also written that "The anti-vaccine movement has been driven by lay people such as Jenny McCarthy, and disgraced doctors such as Andrew Wakefield, the author of the fraudulent autism-vaccine paper. He's no longer permitted to practice medicine. But there have been a few actual licensed medical voices over the last several years fighting to keep our kids sick" and said that such doctors should also lose their licenses. As examples of such doctors, Lipson named Sears, Jay Gordon, and Jack Wolfson.[34] Sears responded to Lipson's article in an email. Lipson's response was an extensive point-by-point refutation of each point in the email, a technique known as fisking.[35]

Arthur Caplan calls Sears an "anti-vaxx pediatrician who favors alternative medicine". He also discusses Sears and similar physicians, calling for the revocation of "the license of any doctor who opposes vaccination". He believes they are purveyors of "junk science" who are in violation of the American Medical Association's Code of Ethics. He also states that "California’s medical licensing board frowns on doctors who endanger the public health, and says that 'the board shall take action against any licensee' charged with unprofessional conduct, incompetence or dishonesty. That unprofessionalism is not, the courts have said, limited to 'the actual treatment of a patient.' Sears is squarely in violation."[9]

At an AMA House of Delegates' committee hearing, David T. Tayloe, former president of the American Academy of Pediatrics, expressed his opposition to non-medical exemptions and mentioned Sears in that connection:

"The AMA does not need to leave a loophole in its policy for the likes of Jenny McCarthy, Bob Sears, etc ... Our vaccines are extremely safe, and children need to be immunized at 90% or more to achieve herd immunity, and we can't do this with choice."[36]

Accusation of medical negligence

On September 8, 2016, the Medical Board of California released a six-page opinion accusing Sears of "gross negligence", "Repeated Negligent Acts", and "Failure to Maintain Adequate and Accurate Records".[37] If found negligent, he faces a variety of sanctions, including revocation of his medical license.[38] Some doctors believe this accusation is a witch hunt, while others say that his alleged failure to use adequate documentation and appropriate follow-up care are legitimate concerns.[39]

2018 probation order

On June 27, 2018, the Medical Board of California placed Sears on 35 months of probation after he settled a case in which the Medical Board accused him of writing a doctor's note exempting a two-year-old child from vaccinations without obtaining the basic information necessary for decision making prior to excluding the possibility of future vaccines, leaving the patient and his mother, as well as future contacts, at risk for preventable and communicable diseases.[40][41] Per the terms of his probation, Sears is required to take 40 hours of medical education courses annually, attend an ethics class, be monitored by a supervising doctor, and must notify hospitals and facilities of the order, with restrictions on supervising physician assistants and nurse practitioners.[41] Sears denied wrongdoing, saying in a facebook post "Isn’t it my job to listen to my patients and believe what a parent says happened to her baby? Isn’t that what all doctors do with their patients?" and "After all, I don’t want a child to receive a medical treatment that could cause more harm. I am going to first do no harm, every time."[41]

Personal life

Sears is married and has three children. He is one of eight children born to William Sears, a pediatrician and founder of the Sears Parenting Library, and Martha Sears, a registered nurse and author of parenting books.[42][7] Sears received his medical degree from Georgetown University in 1995 and completed his pediatric training at Children's Hospital Los Angeles in 1998.[43] Sears credits his interest in vaccines to reading DPT: A Shot in the Dark (1985) as a medical student. It is an anti-vaccination book positing that the whooping cough vaccine was dangerous. It sparked "a backlash against vaccines".[5] The book has been heavily criticized in the years since its publication, owing to numerous changes to the whooping cough vaccine.[44]

Selected works
  • Father's First Steps (2006). (ISBN 155832335X)
  • The Vaccine Book: Making the Right Decision For Your Child (2007). (ISBN 978-0316180528)
  • The Premature Baby Book: Everything You Need to Know About Your Premature Baby from Birth to Age One (2008). With William Sears (ISBN 978-0316738224)
  • The Autism Book: What Every Parent Needs to Know About Early Detection, Treatment, Recovery, and Prevention (2010). (ISBN 978-0316042802)
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See also

References
  1. "Dr. Bob". Askdrsears.com. Retrieved 31 August 2013.
  2. Mammoser, Gigen. "The Danger in Delaying or Skipping Vaccinations for Children". Healthline.
  3. Snyder, John. "Cashing In On Fear: The Danger of Dr. Sears". Science Based Medicine.
  4. Kirkland A (2012). "The legitimacy of vaccine critics: what is left after the autism hypothesis?". J Health Polit Policy Law. 37 (1): 69–97. doi:10.1215/03616878-1496020. PMID 22003097.
  5. Esquivel, Paloma (September 6, 2014), Vaccination controversy swirls around O.C.'s 'Dr. Bob', Los Angeles Times, retrieved January 27, 2015
  6. Poland GA, Jacobson RM (2012). "The clinician's guide to the anti-vaccinationists' galaxy". Hum. Immunol. (Review). 73 (8): 859–66. doi:10.1016/j.humimm.2012.03.014. PMID 22504410. Sears' alternative vaccination schedule has resulted in significant under-vaccination, putting children at risk from infectious diseases, which is measurable in terms of increased rates of measles and pertussis ...
  7. Gutierrez, Melody (2019-09-03). "Dr. Bob Sears' views on vaccines have inspired loyal followers — and a crush of criticism". Los Angeles Times. Retrieved 2019-09-05.
  8. Gorski, David (September 10, 2009). "After all this time, Dr. Bob Sears finally tips his hand on vaccines, part III". ScienceBlogs. Retrieved 18 July 2013.
  9. Caplan, Arthur (February 6, 2015), Revoke the license of any doctor who opposes vaccination, The Washington Post, retrieved February 11, 2015
  10. Hayes, Chris (February 12, 2015), Challenging vaccine delayers, All In with Chris Hayes, MSNBC, retrieved February 15, 2015
  11. Belluz, Julia (February 6, 2015), The vaccine delayers, Vox Media, retrieved February 11, 2015
  12. Hendrick, Bill (December 29, 2008). "Alternative Vaccine Schedule Stirs Debate". WebMD. Retrieved 18 July 2013.
  13. Jacobson RM (2010). "Vaccination refusal and parental education: lessons learnt and future challenges". Pediatric Health. 4 (3): 239–242. doi:10.2217/phe.10.27. ISSN 1745-5111. Clinicians face a Sisyphean task when educating parents regarding vaccinations. The success of vaccinations has paradoxically made their need less apparent while the expansion in type and variety has resulted in the frequent necessity of multiple simultaneous doses. More often than not, the clinician is often catching up the child with vaccines due. Meanwhile, wary parents hesitate, seeking more information than their predecessors and often finding misinformation from media and internet, misinformation often purposely propagated by those who suspect conspiracy and hold the medical profession in contempt. ...the delays leave the child and others at risk for vaccine-preventable diseases.
  14. KNX 1070 Newsradio (February 17, 2015), KNX Spotlight: The Vaccine Dilemma, CBS, KNX 1070 Newsradio, retrieved February 19, 2015
  15. Sears, Robert (February 18, 2015), Mandatory vaccination is not the answer to measles, Orange County Register, retrieved February 20, 2015
  16. Parikh, Rahul (October 13, 2010), Face off with the best-selling vaccine guru, Salon, retrieved January 25, 2015
  17. Navin, Mark (2015-09-16). Values and Vaccine Refusal: Hard Questions in Ethics, Epistemology, and Health Care. ISBN 9781317653196.
  18. Steinhauer, Jennifer (21 March 2008). "Public Health Risk Seen as Parents Reject Vaccines". The New York Times. Retrieved 15 September 2016.
  19. Summers, Daniel. (June 23, 2015) "Doc Says Anti-Vaxxers Are Treated Like Jews in Nazi Germany", The Daily Beast. Retrieved April 15, 2020.
  20. Woo, Michelle (9 August 2012). "Dr. Robert Sears Takes on Both Sides of the Great Vaccination Divide". OC Weekly. Retrieved 5 April 2014.
  21. Offit, Paul (2009). "The Problem With Dr Bob's Alternative Vaccine Schedule". Pediatrics. 123 (1): 164–169. doi:10.1542/peds.2008-2189. PMID 19117838. Archived from the original on February 3, 2009.
  22. Cohen, Elizabeth (19 June 2008). "Should I vaccinate my baby?". CNN. Retrieved 10 February 2015.
  23. Belluz, Julia (February 9, 2015), The number one kid's health book on Amazon is basically a guide to skipping vaccines, Vox Media, retrieved February 11, 2015
  24. "The Vaccine War". PBS. 7 January 2010. Retrieved 5 February 2015.
  25. Ołpiński, Marian (July 2012), "Anti-Vaccination Movement and Parental Refusals of Immunization of Children in USA", Pediatria Polska, 87 (4): 381–385, doi:10.1016/j.pepo.2012.05.003
  26. Kam, Katherine (July 2, 2012), What Is the Alternative Vaccine Schedule? Experts debate the pros and cons of the alternative vaccine schedule and what it means for parents., WebMD, retrieved January 29, 2015
  27. Sugarman, DE (April 2010), "Measles outbreak in a highly vaccinated population, San Diego, 2008: role of the intentionally undervaccinated", Pediatrics, 125 (4): 747–55, doi:10.1542/peds.2009-1653, PMID 20308208
    "The importation resulted in 839 exposed persons, 11 additional cases (all in unvaccinated children), and the hospitalization of an infant too young to be vaccinated. Two-dose vaccination coverage of 95%, absence of vaccine failure, and a vigorous outbreak response halted spread beyond the third generation, at a net public-sector cost of $10 376 per case. Although 75% of the cases were of persons who were intentionally unvaccinated, 48 children too young to be vaccinated were quarantined, at an average family cost of $775 per child."
  28. Sears, Robert (March 25, 2012), Response by Dr. Bob Sears: In reply to lilady, 25 Mar 2012 9:56 AM, The Huffington Post, retrieved January 22, 2015 "She simply stated that that child was my patient (which is correct,..."
  29. Perkes, Courtney (December 29, 2008), OC's Dr. Bob Sears discusses measle outbreak on NPR, Orange County Register, retrieved January 22, 2015 "As it turns out, the boy who spread measles is a patient of Dr. Bob Sears,..."
  30. CDC (February 29, 2008), Outbreak of Measles – San Diego, California, January–February 2008, Centers for Disease Control and Prevention, retrieved January 22, 2015
  31. Haelle, Tara (January 20, 2015), Five Things To Know About The Disneyland Measles Outbreak, Forbes, retrieved January 22, 2015
  32. Willingham, Emily (23 March 2014). "Worried About Measles? Don't Call Dr. Bob Sears". Forbes. Retrieved 5 April 2014.
  33. Lipson, Peter (January 14, 2015), Measles Spreads From Southern California, Sickens Dozens, Forbes, retrieved January 20, 2015
  34. Lipson, Peter (January 30, 2015), Anti-Vaccine Doctors Should Lose Their Licenses, Forbes, retrieved January 31, 2015
  35. Lipson, Peter (February 2, 2015), Measles Vaccination: A Response From Dr. Bob Sears, retrieved February 3, 2015
  36. Wallan, Sarah (June 7, 2015), AMA: No More Non-Medical Vaccine Exemptions, MedPage Today, retrieved June 21, 2015
  37. "Accusation against: Robert Sears, M.D." Medical Board of California. Retrieved 17 June 2018. Case No. 800-2015-012268
  38. Hamilton, Matt (8 September 2016). "Dr. Bob Sears, critic of vaccine laws, could lose license after exempting toddler". Los Angeles Times. Retrieved 9 September 2016.
  39. Lin II, Rong-Gong (Ron); Karlamangla, Soumya; Xia, Rosanna (12 September 2016). "California wants to pull this doctor's license. Here's how it's sparked a new battle over child vaccinations". Los Angeles Times. Retrieved 17 June 2018.
  40. "Search Results for Sears, Robert William". DCA Search. California Department of Consumer Affairs. Retrieved 2018-06-29.
  41. Karlamangla, Soumya (June 29, 2018). "California doctor critical of vaccines is punished for exempting 2-year-old boy from all childhood immunizations". LA Times. Retrieved June 29, 2018.
  42. Meet the Sears
  43. "Dr. Robert Sears MD Capistrano Beach, CA". US News & World Report. Retrieved 12 December 2019.
  44. Novella, Steven (November 3, 2010). "A Shot in the Dark Revisited". Science-Based Medicine. Retrieved September 11, 2018.
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