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Eleven years ago, Professor Adrian Lee, head of the School of Microbiology and Immunology at the University of New South Wales commented on the failure of the first Helicobacter vaccine to work in a European trial. The Astra Research Center in Boston, USA collaborated with the New South Wales University on the project. Professor Lee believed that two or three recombinant antigens, and a much more potent adjuvant were required. Not only did the first vaccine, which had only one antigen, not work, but the e. coli and cholera toxin adjuvants caused diarrhoea in the vaccine recipients.
Remember Hannah Poling? The head of the CDC, dressed in a very nice pink suit, appeared on TV and discussed Hannah’s case. In one of her appearances she said something like this: “Vaccines prevent 33,000 deaths a year in the United States.” Just to make sure I had the statement right, I searched for the phrase and found it again, from CNN, this time in print.
Today, through immunizations given in the first two years of life, we can protect children from 16 diseases, preventing 33,000 deaths and 14 million illnesses per year.
A few searches made it clear that this is a very popular statistic. A variety of news stories included the information that vaccines prevent 33,000 deaths a year in the United States. This is an interesting number to anyone who knows a bit about the history of infectious diseases. I decided to dig deeper.
My next find was this chart, which is on a the web-site of an organization called Every Child by Two. The chart provides morbidity (incidence) and mortality (deaths) for each disease. How in the world would someone be able to calculate (for example) the exact number of cases of diphtheria which would occur and the exact number of deaths which would follow? Amazing! There must be some truly extraordinary scientific research underlying these numbers, don’t you think? [Read more →]
In an era where CDC experts are saying, “Just line up for Gardasil, and you’ll have a 70% reduced chance of getting cancer”, are parents asking any critical questions about the crystal ball gazing abilities of these experts now and in the past? Why is there talk of adding a third MMR vaccine into the childhood schedule, and also putting it into adult vaccination programs as regular boosters?
Will most people just roll up their sleeve, assuming the new ideas will have the good outcome the CDC will predict?
Most of those people won’t know, that in 1967, the CDC said: *
For centuries the measles virus has maintained a remarkably stable ecological relationship with man. The clinical disease is a characteristic syndrome of notable constancy and only moderate severity. Complications are infrequent, and, with adequate medical care, fatality is rare.
Effective use of these vaccines during the coming winter and spring should insure the eradication of measles from the United States in 1967.
The Federal Government last week declared its determination to eradicate measles from the U.S. in 1967.
Perhaps because measles always seemed to be an unavoidable part of childhood, it has not loomed as threatening as other diseases, and its characteristic red spots have long been the butt of comic-strip jokes.*
Though the disease fighters were hampered by the public’s unconcern, they were helped by some characteristics of the measles virus. There is only one type, as against three for polio. One shot of vaccine made from live but attenuated virus confers lifelong immunity
Explains Dr. Dull: When two-thirds or more of the children in any community are immune, through having had either the disease or vaccination, the measles virus simply dies out.
“It’s unprecedented in the history of preventive medicine to try to eradicate an entire disease in one year,” says Dr. Dull, “but there is good reason to believe it can be done.”
What “good reason” did Drs. Sencer, Dull, and Langmuir have, to predict:
a ) That one shot would give lifelong immunity?
b ) That when two-thirds of children are immune measles would die out?
c ) That vaccinating a few million children in one year, would “eradicate measles” permanently?
Worldwide, parents were promised that just one shot would eliminate measles, a disease which in developed countries was considered to be relatively mild, even by doctors.
Unknown to most people, new science emerged over the decades, irrefutable facts were quietly changed, goalposts silently shifted, history privately rewritten, until the Canadian Press told the public, in May of 2008:
Before vaccination became commonplace, adults often came in contact with youngsters suffering from mumps, measles, and the other childhood diseases. That remained the case in the early days of vaccine administration when these diseases still commonly circulated.
If people had protection - natural or vaccine-acquired - those exposures were actually helpful. They acted as a sort of natural booster shot, reminding the immune system to be on guard for this threat.
The end result of the investigation into the durability of immunity in the vaccine age could be a recognition that adults need booster shots to prevent outbreaks of what we now consider childhood diseases. Osterholm, for one, thinks that’s likely.
What they’re referring to is called “secondary vaccine failure”, an almost paradoxical situation resulting in the more effective vaccines losing effectiveness over time as a direct result of their own initial effectiveness.
For some time after MMR was introduced, the wild viruses still circulated, which artificially inflated the estimated vaccine efficacy, because people who got the vaccine, still encountered the viruses occasionally. With a higher vaccine uptake, the ability for immunity to be “boosted” by natural exposure disappeared. Such logic is being admitted to now, to prepare adults for being re-vaccinated with the MMR throughout their lives.
While most experts want their current wisdom to be assumed “accurate”, the most accurate statement in the Canadian Press article was:
“I don’t think we know much at all,” acknowledges Dr. Samuel Katz.
If you told CDC doctors today, that vaccinating two-thirds of all children one summer would result in a common virus simply dying out, they would laugh in your face. But the belief that vaccinating a few million children in 1967 could eliminate measles, was not questioned in 1966, because neither parents nor experts knew that the assumed “knowledge” about the natural history of disease, the development and maintenance of immunity, and how both meshed together, was fundamentally flawed.
In 2008, the simple popular view of vaccination continues to say, “if you are vaccinated you can neither catch nor spread the disease in question, which is good for everyone.” Every vaccination program is built on the sort of simplistic ideas which jumpstarted the original National Immunization Program. It is assumed that every new vaccine will fulfill it’s predicted potential, and have well researched effectiveness and safety.
Unfortunately, like most simple pictures, this is not the whole story.
Let’s look at another flaw they missed in the equation:
During the 1989–1991 measles resurgence, incidence rates for infants were more than twice as high as those in any other age group.The mothers of many infants who developed measles were young, and their measles immunity was most often due to vaccination rather than infection with wild virus. As a result, a smaller amount of antibody was transferred across the placenta to the fetus, compared with antibody transfer from mothers who had higher antibody titers resulting from wild-virus infection. The lower quantity of antibody resulted in immunity that waned more rapidly, making infants susceptible at a younger age than in the past.
Secondary vaccine failure resulting in increased potential for serious disease in both babies and adults, as a result of mass vaccination, isn’t the only glitch in the vaccine-created herd immunity system, either.
Let’s look at some of the childhood vaccines and see what the “herd effects” are.
Protection against disease is due to the development of neutralizing antibodies to the diphtheria toxin. Following adequate immunization with diphtheria toxoid, protection persists for at least 10 years. A serum diphtheria antitoxin level of 0.01 IU/mL is the lowest level giving some degree of protection; a level of 0.1 IU/mL is regarded as protective.1 Levels of 1.0 IU/mL are associated with long-term protection.1 Immunization with diphtheria toxoid does not, however, eliminate carriage of C. diphtheriae in the pharynx or nares or on the skin.
Although diphtheria disease is rare in the United States, it
appears that Corynebacterium diphtheriae continues to
circulate in areas of the country with previously endemic
diphtheria.
Tetanus- not a contagious disease, so the question does not apply
Hib and Prevnar-
Both vaccines do prevent transmission of vaccine serotypes, but both vaccines have adverse “herd effects” or “consequences”, such as “replacement disease”.
Read more about the replacement effects here, here, and here.
In the absence of circulating disease, some vaccines lose their “punch” leaving adults vulnerable to childhood illnesses (consider recent outbreaks of mumps in the U.S. and the U.K.), which are generally more dangerous for grown-ups than for children. When that happens, infants are also born with significantly less passive immunity from their mothers, putting them at risk of serious complications and death, as well.
Some vaccines do not prevent the transmission of the disease they are supposed to control, making herd immunity something of an oxymoron.
Some vaccines clear out one disease organism, which is promptly replaced by another disease organism.
The simple picture: “if you are vaccinated you can neither catch nor spread the disease in question” turns out to largely be a overly simplistic fallacy, mostly useful for attacking parents who are perceived to be failing to contribute towards herd immunity because they chose not to vaccinate their children.
While some might ask the question, “How about a vaccination policy based on real scientific facts, for a change?” others might also ask a different question, which is, “Are the facts presented today, to justify new vaccines being introduced, and extending existing childhood vaccines into adult schedules, based on better logic than the CDC “experts” proclaimed in 1966?”
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bottom of page 254:
“The authors are from the Public Health Service’s National Communicable Disease Center, Atlanta, Ga. Dr. Sencer is chief and Dr Dull is assistant chief of the Center. Dr Langmuir is chief of the Epidemiology Program. This paper was presented at the American Publich Health Association’s meeting in San Francisco, November 1, 1966″.
Parenthood is tough! Decisions, decisions, decisions. And here in “The Information Age”, many parents feel that there is no room for poorly informed choices for The Big Decisions. For many parents, the issue of vaccines was at one time a “no brainer”. Children were “completely” vaccinated. Everyone believed that vaccines were necessary to save your baby’s life. For the majority, vaccines were completely beyond debate. Today, many parents are questioning the safety and necessity of the large numbers of vaccines on the schedule, particularly for obscure or milder diseases. Vaccine necessity, which used to be taken for granted, has suddenly become an uncertain, debatable matter that has to be researched in depth.
What are the issues which require consideration as one steps outside the “Just do whatever your doctor tells you to do!” mindset?
1) the ethics of vaccine decisions in light of herd immunity
2) the immediate risk to the baby or child from both the diseases and the vaccines
3) the social stigma of possibly going against the flow and not following the recommended schedule
4) and the confusing, often conflicting ocean of scientific literature on the topic.
So where should a parent start?
Many parents find it helpful to look at individual diseases first.
Here is the US recommended vaccine schedule. It begins with a dose of the Hepatitis B vaccine at birth, followed by rotavirus, DTaP (diphtheria, tetanus, pertussis), IPV (polio), PCV (pneumococcal), Hib, and additional HepB at 2, 4, and 6 months.
After coming up with a list of the diseases you’re interested in possibly vaccinating against, there are a few useful pages you can check out.
a ) The MMWR, selected cities, notifiable diseases page will help you figure out what the immediate disease risk is.
b ) The “Reported Cases and Deaths“, from vaccine preventable diseases from 1950 to 2005″page, along with the “Vaccine Coverage Levels” page are also useful for double checking conflicting accounts of possible disease severity and incidence, and the impact mass vaccination has or hasn’t had.
For example: Look at pertussis and h influenzae on both the “Reported Cases and Deaths” and ”Vaccine Coverage Levels” pages over the last 10 or 15 years. Surprising, isn’t it?
Researching problems with vaccines is a more complicated matter than understanding the basics of the diseases.
If you don’t know where to start looking, internet searches can easily lead you astray. Vaccines are controversial, controversy can attract passion, and passion on occasion, can lead to misinformation and strongly defended extremism. While personal stories can be interesting, they aren’t science, on either side of the debate.
Always check out the facts. Look at how trials are done at clinicaltrials.gov. Check the CDC, check the FDA website where vaccine documents are held, check the articles published in peer reviewed medical journals.
As you read and cross check information, you’ll become more confident. Each new scientific principle you understand will add another building block helping to clarify the bigger picture when it comes to disease, epidemiology, risks, benefits, and how they relate to your specific child’s immune system and your family’s medical history. Any intelligent human being is capable of understanding scientific research, although it takes time and effort.
Checking the manufacturer’s package inserts is useful for information on possible reactions to vaccines. Keep in mind that there are reactions listed under the “rare” category that might or might not be actual side-effects of the vaccine. Causation is difficult to determine in the case of rare events.
Merriam-Webster Online now has a medical dictionary to help. Just click the “medical” box before you search.
A useful tool for finding accurate information is Google Scholar. Here’s a quick tutorial on how to use it:
The “all X versions” function on the right (after you do a search) will take you to fulltext versions a lot of the time.
The “recent articles” function at the top (after you do a search) will take you to the newest research on the subject.
If you find something interesting, use the “cited by X” button under the the title to see what newer research might have confirmed or conflicted with what you just read.
PubMed is another good site. If the fulltext of the abstract you’re reading isn’t available through Pubmed (sometimes it will say “free fulltext at…” in the upper righthand corner) try putting the title of the abstract into Google Scholar, and looking through the “all of X versions” function to see if any of them are fulltexts.
To find a collection of the information that supports a vaccine’s recommendation by the CDC, try using Google with the keywords :
[disease name] vaccine recommendations MMWR.
For example: to find the ACIP’s MMWR recommendation for chickenpox, this search will take you there. Reading official information is important so that you know you have not missed any important information (even if it is sometimes “cherry-picked” or inaccurate) as you make your vaccine decision.
Okay, now you’ve got the tools to do basic research on diseases and vaccines.
More advanced sources and techniques can be found here.
Ready to start work? Make a list of questions or topics you’d like to research. Start a page (either paper or computer) and put down the first topic from your list. Start building a list of search terms. Once you’ve got some possibilities, start searching. Make notes of what you find and save useful links with notes on what they link to and why they are useful. You’ll find yourself refining your search terms as you go along, dropping some terms and adding new ones.
Final advice? Don’t spend your entire life on the computer!
Recent news stories about a link between MRSA and flu deaths in children raise some interesting questions in light of our Sisyphus series (Part I, Part II and Part III).
“Being a carrier of MRSA has increased a lot, especially among school-aged kids,” said Lyn Finelli, chief of influenza surveillance at the CDC. “And being colonized may put them at risk for a severe staph aureus infection when they get the flu.”
This particular news story blames the problem on antibiotic overuse, and, of course, recommends the flu vaccine to save children from this dangerous situation.
At the CDC, investigators decided to review the medical charts of nearly all children admitted to Atlanta-area hospitals with the flu in the winter of 2006-2007. They found that 11 percent of the youngsters also suffered from staph infections, with a little more than half caused by the drug-resistant type.
Prevnar was introduced in 2000 and has probably contributed to the recent increase in staphylococcal colonization. As stated here:
Whether the current increase in severe community-acquired S. aureus infections, including methicillin-resistant S. aureus (6), is partially caused by the recent introduction of the pneumococcal conjugate vaccine is yet to be determined.
We are hoping that the CDC is aware of the connection between Prevnar and the rise in MRSA. Will they consider removing Prevnar from the schedule? Why hasn’t this issue turned up on the Advisory Committee on Immunization Practices (ACIP) meeting agendas? So far, the only public attention the CDC has given to the increase in staph colonization is flag-waving for the flu vaccine.
While the rate of S. aureus continues to rise, and despite a strong link to vaccination as being a major causative factor, research is full-bore ahead for a new 13-valent (vs. the current 7-valent) Prevnar vaccine. In addition, this problem has the potential to spread worldwide, as there is a big push to include Prevnar on vaccination schedules in other countries.
Wyeth Sees Prevnar Vaccine Sales Reaching $3 Billion In 2009 - CNNMoney.com
NEW YORK -(Dow Jones)- Wyeth (WYE) expects sales of its Prevnar vaccine to rise to $3 billion in 2009, driven by overseas growth and new launches,
Insidevaccines is three months old today. In three months our team of writers, editors and proofreaders have put together 23 articles. In the days just before our opening on February 1st we also compiled 22 pages of useful information on a wide variety of vaccine related topics. We have linked to published scientific papers, to the Centers for Disease Control and to manufacturer’s product inserts.
We would like to thank all of the people who have spread links to insidevaccines across the web, with special thanks to Sandy Gottstein of Vaccination News and Ginger Taylor of Adventures in Autism for adding our link to their sites.
Disclaimer: Insidevaccines, although it is three months old, has not yet received any of the CDC recommended vaccines. Enter at your peril!
Before any doctor gives your baby vaccines, you should be given Vaccination Information Sheets (VISs) to read.
Developed by the CDC, they inform vaccine recipients, their parents or legal representative, about the benefits and risks of vaccines. (1) Federal Law requires their use. This is a result of the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. 300aa-26. (1) Before 1986, parents didn’t have any right to printed information about vaccines.
VISs sound like a good system. Parents get concise and easy to understand information on a vaccine’s risks and benefits so they can make an informed decision.
Is that really how it works? Let’s examine the nuts and bolts of VISs. [Read more →]
The big question with these conjugate vaccines is “What is the overall effect?”
How many fewer cases of invasive bacterial disease are happening after replacement is accounted for?
The more narrowly you look, the better these conjugate vaccines look. The more broadly you look, the more the apparent effects melt away to nothing. With Hib and “replacement disease”, if you just compare h influenza serotype B to serotype A, it would appear that killing off Hib via mass vaccination was extremely successful in the grand scheme of things. When you look at nontypeable (also known as “non capsulated”) h influenzae plus Hia and Hif, that’s when you start seeing that we’re not really any better off now than we were before the Hib conjugate vaccine. [Read more →]
Insidevaccines will be posting occasional news stories related to vaccines with commentary by our team of editors. Here we go–
In 2002 Robert Goldberg wrote:
Despite significant activity in the area of vaccine design, vaccinology and immunology, vaccine development is on the verge of becoming a brackish backwater of other biotechnology and pharmaceutical enterprises. The market for vaccines is dominated by government purchasers that drive prices down to commodity levels, the regulations for the development and production of new vaccines are mired in the 1950s and sometimes cost more than producing vaccines themselves.
Public health officials and politicians are — depending on the day — either indifferent or outright hostile to the [sic] providing private companies with incentives for investing in new vaccines for a wide range of diseases. Indeed the solution de jour is to have the government — perhaps the Department of Defense (DOD) or some offshoot of the public health service — take over the development and production of vaccines, as if a U.S. government run National Vaccine Authority could magically and efficiently construct and operate billion dollar facilities without any glitches or major disruptions. Only scientists whose only brush with business is food shopping could concoct such an idiotic scheme.
Only a few years later and vaccines are spraying out of the pipeline and into babies, children, teens, and adults at an amazing rate. I guess the government listened to industry and we will all benefit. After all, there is just no limit to the number of vaccines the human body can absorb…is there?
…number of available vaccines in major Western markets could double by 2015 to 75-80 products
….
With the success of its new Human Papillomavirus (HPV) quadrivalent vaccine Gardasil, Merck & Co experienced the fastest growth between 2006-07 reporting $4.2 bn of revenue in 2007 although GlaxoSmithKline and Sanofi Pasteur closely follow. Like Gardasil over the next few years many new vaccines are predicted to achieve blockbuster status (>$1 bn revenue) such as those for meningitis serogroups B and ACWY and pnuemococcal infections.
…focused on supporting key business franchises such as influenza, meningitis and pediatric combinations.
….
For example, new vaccines are being developed to prevent hospital infections caused by MRSA, Clostridium difficile and Psuedomonas aureginosa. Other vaccines are focused on serious infections in the newborn such as group B Streptococcus (GBS), respiratory syncytial virus (RSV) and cytomegalovirus (CMV).
Warm thanks to Vaccination News for offering up thousands of vaccination article links over many years.
Look back to the time of the earliest humans and you’ll find chickenpox. Anywhere you go on the planet, you find human beings who carry and share the virus. No remote village or tribe on Earth has ever been discovered to be free of this virus. Quite an achievement! For the virus…
Scientists have studied small, isolated populations, trying to understand how the virus survives; it has a unique survival strategy we call “shingles”. [Read more →]
