Inside Vaccines

Image from The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century.

Series Links: Part I, Part II, Part III

Do vaccines save 33,000 lives per year?  Dr. Gerberding of the CDC has said it, it is repeated by news sources.  In the previous installments of this series, we have dissected the projected incidence and mortality rates given for diptheria and hepatitis B and found that the numbers do not seem to add up. 1 In this article, we will analyze one of the highest profile examples of vaccination success: paralytic poliomyelitis.

Figure 1

Polio Incidence Rates, 1870-1988

Most CDC charts only show the decline of the disease following the introduction of the vaccine.  I have selected this chart because it begins much earlier than the CDC charts, and creates a much more accurate picture of the pattern and extent of disease notifications for the 43 years preceding the Salk vaccine trials.  To see a chart that traces the incidence from 1870-1998, click on the link below Figure 1.  This discussion will not address the relationship between DDT and polio.

There is an important and little-known qualifier when discussing historical statistics on polio. Between 1954 and 1957, we see a marked decline in polio incidence. While this coincides with the Salk vaccine trials, it also coincides with the radical redefinition of polio. From Dr. Bernard Greenberg, in a 1960 transcript of a meeting discussing the Salk vaccine:

“Prior to 1954 … The criterion of diagnosis … in most health departments followed the World Health Organization definition: “Spinal paralytic poliomyelitis: signs and symptoms of nonparalytic poliomyelitis with the addition of partial or complete paralysis of one or more muscle groups, detected on two examinations at least 24 hours apart.” Note that “two examinations at least 24 hours apart” was all that was required. Laboratory confirmation and presence of residual paralysis was not required. In 1955 the criteria were changed to conform more closely to the definition used in the 1954 field trials: residual paralysis was determined 10 to 20 days after onset of illness and again 50 to 70 days after onset…. This change in definition meant that in 1955 we started reporting a new disease, namely, paralytic poliomyelitis with a longer-lasting paralysis. Furthermore, diagnostic procedures have continued to be refined. Coxsackie virus infections and aseptic meningitis have been distinguished from paralytic poliomyelitis. Prior to 1954 large numbers of these cases undoubtedly were mislabeled as paralytic poliomyelitis. Thus, simply by changes in diagnostic criteria, the number of paralytic cases was predetermined to decrease in 1955-1957, whether or not any vaccine was used.”1

Under the revised definition, the historical data look more like this:

Figure 2

Image from Present State of Polio Vaccination, 1960, Transcript

Even President Franklin Roosevelt, who believed, along with the nation, that he was the victim of polio infection, is now considered to have had a different but similar condition, Guillain-Barre.2 How likely is it that his was the only misdiagnosis?

Any current projections should be based on the current definition.

Depending on whether you consult the CDC data compiled for parents or the CDC data compiled for medical professionals,3 the fatality rate for paralytic polio is between either 2-5% or 5-10%.4 , 5

Up to 95% of all polio infections are inapparent or
asymptomatic. Estimates of the ratio of inapparent to
paralytic illness vary from 50:1 to 1,000:1 (usually 200:1).
Infected persons without symptoms shed virus in the stool
and are able to transmit the virus to others.
Approximately 4%–8% of polio infections consist of a
minor, nonspecific illness without clinical or laboratory
evidence of central nervous system invasion. This clinical
presentation is known as abortive poliomyelitis, and is
characterized by complete recovery in less than a week.
Three syndromes observed with this form of poliovirus
infection are upper respiratory tract infection (sore throat
and fever), gastrointestinal disturbances (nausea, vomiting,
abdominal pain, constipation or, rarely, diarrhea), and
influenza-like illness. These syndromes are indistinguishable
from other viral illnesses.
Nonparalytic aseptic meningitis (symptoms of stiffness of
the neck, back, and/or legs), usually following several days
after a prodrome similar to that of minor illness, occurs in
1%–2% of polio infections. Increased or abnormal sensations
can also occur. Typically these symptoms will last from 2 to
10 days, followed by complete recovery.
Fewer than 1% of all polio infections result in flaccid
paralysis. 6

From the same studies cited in the previous blog entries in the “Scary Stats” series, we have the following charts of annual projected incidence and fatality : 

A : 31 projected cases of paralytic polio per 100,000 children.

B: 60,974 projected cases of polio with 723 deaths

C: average annual 19,794 cases of acute polio (1941-1950) with 1,393 deaths, and an average annual 16,316 cases of paralytic polio (1951-1954) with 1,879 deaths.

Now to crunch some numbers:

The actual historical data from the peak years: 19,794 avg. acute cases in 1941-1950, which is 0.6% of the total average births for the US from 1941-1950 7, with a 7% death rate (or 0.02% of the overall birth rate). In 1951-1954, an avg. 16,316 paralytic cases (notice that this data conveniently stops at the time of the definition change and the introduction of the Salk vaccine, thus implying that subsequent reduction in incidence is due to the vaccine.  Unfortunately for this hypothesis, the Salk vaccine was shown to have very little positive effect, prompting the switch to the Sabin vaccine), or 0.4% of the total average births for the US from 1951-1954 8 , with an 11.5% death rate (or 0.05% of the overall birth rate).

Based on Table 1 from A , using the hypothetical birth cohort of 3,803,295 infants as stated in the article, we get 1,179 paralytic cases per year, with an estimated 23 (2%) to 118 (10%) deaths. For 60,974 cases of polio, using CDC metrics of 200:1 inapparent:paralytic (leaving aside how they can project an estimate for an inapparent infection), we would get 3,048 cases of paralytic polio, resulting in 61 (2%) to 305 (10%) deaths, rather than 723.

Applying these peak mortality statistics, prior to the definition revision, to our hypothetical cohort, we get 760 (0.02%) to 1,901 (0.05%), so that may be where the 728 projected deaths come from.  However, given the B figures for incidence, hypothetical cases of paralytic polio would be much higher on a percentage basis than current CDC estimates, which otherwise appear to support the 0.03% incidence (31 in 100,000).  Additionally, if we look closely at the corrected bar diagram above, we can see that doctors and researchers in the 1960s were recording about 9.5 paralytic cases per thousand, or 0.95%.  If C current figures are correct, there has already been a radical downward revision in cases during the peak period.

To summarize:

So, what can we conclude from these discrepancies and contradictions?  The data doesn’t support the headlines.  The numbers presented by vaccine defenders do not stand up to scrutiny.

The casual reader believes that vaccines save 33,000 lives a year because the researchers repeat it with authority and references.  Unfortunately, neither the peer-reviewers nor the public are taking the time to look behind these superficial assertions, to discover the irregularities underlying them.

Our analysis above shows that data are not consistent within an individual publication, or from one publication to the next.  Sometimes, they do not even correlate with numbers from the CDC, an organization whose primary objective appears to be the defense of vaccines!

As close as we can determine from these articles, the writers defending vaccines appear to believe that, while current levels of polio in the absence of a vaccine would be much lower than during epidemic years, the mortality rates for this illness could be as high as 23%!  This is far in excess of the mortality rates seen during peak years.

Is their work just sloppy, erroneous, or intentionally misleading?  Are they so focused on marketing the vaccines that they are unwilling to critically parse the data?  Perhaps they think parents aren’t paying attention.

Series Links: Part I, Part II, Part III