Vaccine Exemption Shenanigans?

August 30, 2010 by · 16 Comments
Filed under: News, Parents' Pages, Vaccine Exemptions 

Recently we’ve come across multiple examples of local authorities messing with vaccine exemptions. Nothing new, of course, about the media publishing stories which leave out the availability of exemptions when they remind parents of the vaccine “requirements” for school. But there does seem to be something new about counties and school districts coming up with their own paperwork, sometimes in contradiction to state exemption requirements.

For the first time, insidevaccines is asking you to tell us your stories. Has someone given you a hard time when you applied for a vaccine exemption for your kids? Insisted that you need a signature from your pastor? Asked you to sign a form admitting that you are risking the lives of your children and other people’s children? Or?

Comment here, or, if you prefer, send them via e-mail to healthykids@insidevaccines. com

Please share this query on forums and anywhere else you can think of.  The more the merrier.

We will not publish anyone’s stories, but we may provide a list of states where problems have arisen and a general description of the types of harassment parents have encountered.

Thanks in advance.

Do the Right Thing!

August 25, 2010 by · 3 Comments
Filed under: CDC Watch, News, Opinion, Parents' Pages, Vaccine Myths 

Every August we are hit by a wave of publicity for National Immunization Awareness Month, reminding everyone in the United States to get their children vaccinated, themselves vaccinated, their parents vaccinated, probably even their dogs and cats and goldfish vaccinated.

Vaccinations shouldn’t be that difficult to sell. Who wants their child to die of a communicable disease like mumps? And we all know that influenza kills 36,000 Americans each and every year, because this number is mentioned in just about every news story pushing the influenza vaccine, so it shouldn’t be difficult to convince millions to get their annual flu shot. Except that the Wall Street Journal points out that there are some valid questions about this widely publicized number from the CDC. Even mainstream publications sometimes have questions about diseases and vaccines. Once in a while. Read more

Problems with Peers

August 15, 2010 by · 1 Comment
Filed under: News, Opinion 

The public has a perception that peer reviewed medical journals are held in the highest regard in terms of scientific accuracy. So often we hear the question, “Did the study come from a reputable peer reviewed journal?” on the assumption that something reviewed and authorized as ‘true and correct’ by the peers of the writer, must have a bigger, better stamp of authority.

Medical History through the ages, has much to teach us about how the view of peers can be utterly wrong, to the cost of both mothers and children. Oliver Wendell Holmes is only one example.  To those who study medical literature, problems with peer review is nothing new.

Much to Inside Vaccine’s amusement, the sanctity of peer review received another truth-review, when the Scientist http://www.the-scientist.com/article…7601 published an article expressing more of their concerns about the ways in which peer review processes, work against “science” being the primary focus of science publications.

While considered by the public, to be gold standard medical practice, scientists openly discuss the peer review process as a broken system, plagued with the medical equivalent of nepotistic turf protection.

While the Scientist’s article is interesting, other scientists spell out the problems in more precise detail: http://www.ipscell.com/?s=i-hate-your-paper-dr-no-and-the-editors-that-are-ruining-peer-review showing that obstruction can come in the form of editors who turn a blind eye to unreasonable reviews from competitors, or friends of competitors. Reviewers themselves can make suggestions which are either ludicrous, make no sense, or show that they don’t understand the topic (and therefore consider the study worthless). Then there are the reviewers who suggest the researcher obtains better laboratory materials from them, and promptly refuses to supply on request, or doesn’t reply when asked. The list of ways in which peer review can be undermined, is legion, and very entertaining. Particularly the one about the reviewers who approve papers no matter the errors, because they know the person they just reviewed will probably review their work the next time around. Read more

The Economic Burden of NOT Breastfeeding

August 9, 2010 by · 4 Comments
Filed under: News, Parents' Pages, Vaccine Alternatives 

Vaccination with the full CDC-endorsed schedule of vaccines is presented as our absolute best choice to protect and nurture the health of our precious children. Vaccines are believed to be so important that they are mandated [1], subsidized [2], and protected by a special court [3].

Recently, we published an article [4] that discussed the widely promoted claim that vaccines save society billions of dollar every year. Are there other measures that could save society a few billion bucks, and significantly reduce infant and child mortality, morbidity, and related health costs? 

In April 2010, Pediatrics published an article, The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis [5]. This analysis was a review of some of the findings contained in an exceptionally comprehensive report [6] that was published in 2007 by the Agency for Healthcare Research and Quality (AHRQ). The Pediatrics paper determined that if:

“90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess of 911 deaths, nearly all of which would be infants…”

Almost 1,000 excess infant deaths every year, and a cumulative total of $130 billion in costs in 10 years. Low breastfeeding rates in the US should obviously be cause for serious concern. Note that the authors only considered three diseases, none of which are communicable or have vaccines available; necrotizing enterocolitis, otitis media, and gastroenteritis. Pediatrics did not publish new evidence, but simply analyzed data contained in the AHRQ report, which cited numerous studies favoring breastfeeding. Read more

Pertussis Recap

August 7, 2010 by · Comments Off on Pertussis Recap
Filed under: News, Parents' Pages 

With all the noise about whooping cough (sorry…) I thought it would be helpful to provide quick links to our main articles on the topic.

A look at the statistics

Our basic page on DTap

The vaccine and herd immunity

Feel free to share our information in discussions!

A Pox on the Taxpayer

 

A handful of countries recommend the chickenpox (varicella) vaccine for all children and an even smaller group have a chickenpox booster on the schedule. The US leads the pack of countries with a 2 shot schedule, and following along are Ecuador, Saudi Arabia, Germany, Greece, and part of Australia.

Some countries give the shot to adolescents, others offer it to members of “risk groups”… and a few have a one-shot schedule for toddlers: Canada, Costa Rica, Uruguay, Cyprus, Latvia, and Korea. A grand total of 26 countries offer the shot in one way or another. [1]

The US was the first country to recommend the shot for all toddlers, in 1996 :

…. empiric data on medical utilization and costs of work-loss resulting from varicella were used. The results of this study, which were determined using an estimated cost of $35 per dose of vaccine and $5 for vaccine administration, indicated a savings of $5.40 for each dollar spent on routine vaccination of preschool-age children when direct and indirect costs were considered. When only direct medical costs were considered, the benefit-cost ratio was 0.90:1. [2] (emphases added)

But it turned out that a single shot of varicella vaccine didn’t work to suppress chickenpox.

…varicella outbreaks have regularly been observed in populations with high vaccination coverage and are the cause of sizable disease and economic impact for public health departments and the US health system overall. To further reduce varicella disease burden, a routine 2-dose varicella vaccination recommendation was approved by the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) in June 2006 (first dose for children 12–15 months of age, second dose for children 4–6 years of age) . [3]

The single-shot regimen showed a narrow margin of benefit only when placed alongside income lost by parents staying home to care for sick children.

But when the one-shot program failed, the ACIP came up with another cost/benefit justification for the second shot where the evidence….

….included ongoing disease burden and varicella-zoster virus transmission, including transmission from breakthrough cases to high-risk persons that may lead to severe disease and even death (CDC, unpublished data); partial or complete susceptibility in 1-dose vaccine recipients as they become adults; the burden on public health agencies due to varicella outbreaks in highly vaccinated school settings, which have proven disruptive to society and costly to control; and the increased immunity and disease protection from a second dose. Overall, the 2-dose strategy still provides very high cost savings (>$0.9 billion from societal perspective). [3] (emphases added)

So the ACIP justifications for adding a second dose, used the consequences of their decision to recommend the first dose of varicella vaccine. These ingenious calculations created a bigger cost savings than their first round! Read more

Vaccine sleight of hand

July 18, 2010 by · 7 Comments
Filed under: Opinion, Parents' Pages 

Every Child by Two proclaims that vaccines save money! Lots and lots of money!

Childhood Vaccines Save Lives and Money

But then, on the side of their web-page, is a link to a graphic illustration of the rising costs of childhood vaccination.

Looks like they want it both ways: “vaccines save billions” by reducing health care costs, preventing hospitalizations and doctor visits; BUT  “the newer vaccines are more expensive and we need to put a lot more tax dollars into vaccination programs.”

If the numbers with respect to “dollars saved” were solid and existed across the entire vaccine program, the argument would be a good one. Upon further scrutiny, it looks like they are pulling a bait and switch. They put forward some old numbers based on the less expensive vaccines combined with some inflated statistics for predicted epidemics (see the “33,000 deaths prevented” link above for our detailed analysis of these numbers), then slide right past the huge increase in the number and cost of vaccines in the current U.S. schedule.

On top of this, some of the newer vaccines are aimed at illnesses which are of low incidence or fairly mild in most children.  For example, Hepatitis B is very severe, but it isn’t common among infants born in the U.S. On the other side, chickenpox is usually a minor illness, although common. The chickenpox vaccine cost benefit justification actually depended on a monetary estimate of the cost of parental time lost from work. Some convoluted bookkeeping methods would be needed to demonstrate that universal vaccination with ALL of the vaccines on the current schedule results in overall health care savings. There is certainly no sign of these savings in the escalating cost of health insurance in the U.S. Read more

Indian Physicians slapped with anti-vaccine label!

July 8, 2010 by · 2 Comments
Filed under: News, Opinion, Vaccine Science, WHO Watch 

Why? Because they questioned a WHO (World Health Organization) diktat in favor of universal Hib vaccination in India.

Sorry, but this is getting ridiculous. Anyone, at any time who raises any concern about the safety, efficacy, or appropriateness of any vaccine is now called anti-vaccine.

Here is a potted history of the recent outbreak of name-calling.

In the July 2010 issue of the Indian Journal of Medical Research this editorial appeared: Introducing pentavalent vaccine in the EPI in India: A counsel for caution.

The latest WHO position paper on Hib says ‘Hib vaccine should be included in all routine immunization programmes. This suggests that Hib vaccine should be included in the immunization programme universally, irrespective of an individual country’s disease burden, not withstanding of natural immunity attained within the country against the disease, and not taking into account the rights of sovereign States to decide how they use their limited resources. The mandate and wisdom of issuing such a directive, for a disease that has little potential of becoming a pandemic, needs to be questioned.

The editorial reviews the available data and on the basis of the science, questions the need for the Hib vaccine in India.

In response to this thoughtful challenge to the WHO policy on Hib, a news commentary was published in the BMJ (British Medical Journal) which called the concerned doctors an “anti-vaccine lobby.”  This article, which is unreferenced, claims:

The Hib organism, which can cause severe bacterial meningitis and pneumonia, is estimated to kill more than 370 000 children worldwide each year, GAVI said. Nearly 20% of these deaths occur in India.

In response to the BMJ article, a rapid response was published in the online version of the BMJ by eight members of the supposed “lobby”

The doctors wrote:

The thrust for including Hib vaccine in India is based on 2 arguments. The first is that there is anecdotal evidence of the existence of Hib disease and Hib meningitis in India and that Hib meningitis may lead to long term morbidity. The second argument is that the well-to-do parents sometimes buy Hib vaccine in the open market to vaccinate their children. The Government of India must therefore provide it free for the poor, on the grounds of equity and fair play (2).

The problem with the anecdotal reports is that they do not specify the size of the universe from which the samples are drawn and public health policies cannot be based on these figures without a denominator. The many systematic surveys done to look at the magnitude of the problem of Hib disease in India have nearly always shown that the incidence of Hib disease is much lower than what was projected for India. Most of these studies have been funded by the WHO and these have been reviewed recently in an open access journal (3).

So, we have the BMJ calling names and publishing an unreferenced attack claiming high numbers of deaths from Hib, while the supposed anti-vaccine lobby provides carefully referenced information debunking the claims.

The pro-vaccine lobby has plumbed to new depths.

Polio and Sanitation

KHAGARIA: On the sandy banks of Kosi river in north Bihar, a quiet crowd of several hundred people is waiting in the sizzling morning sun. A speck appears in the pale blue summer sky, rapidly growing in size — its a gleaming white helicopter. Within seconds it is hovering above the opposite bank, amidst the cornfields.

The crowd is awestruck at the monstrous machine as it settles down in billowing clouds of sand. Out comes the man everybody has been waiting to see — Bill Gates.

Bill Gates has come to find out why polio eradication is failing in Bihar. He asks questions about immunization strategies and tries to figure out what sort of technical problems are blocking universal vaccine delivery.

People complain of lack of basic health facilities…There are only 49 auxilliary nurse and midwives under the PHC, against a sanctioned strength of 76…So, the delivery of basic health services is itself a distant dream…The villagers hope against hope. Isn’t the spread of polio linked to lack of sanitation and basic health facilities? Gates acknowledges this fact but says that it is for the government to do the needful. “We are concentrating on the eradication of polio, which is achievable through vaccines,” he says. [1]

Polio epidemics first appeared in the mid-nineteenth century. Many doctors and scientists struggled with the mystery: why, as living conditions improved, did incidents of paralysis increase? Out of all the changes that came with modernity, improved sanitation was chosen as the change which caused polio to turn from a mild illness to one that left death and permanent damage in its wake.  Here is an excellent example  from a 2007 medical article which summarizes the concept:

Prior to the 20th century, virtually all children were infected with PV while still protected by maternal antibodies. In the 1900s, following the industrial revolution of the late 18th and early 19th centuries, improved sanitation practices led to an increase in the age at which children first encountered the virus, such that at exposure children were no longer protected by maternal antibodies. Consequently, epidemics of poliomyelitis surfaced . [2] Read more

Polio and Acute Flaccid Paralysis

In post one of this series on polio, a term was introduced: “Acute Flaccid Paralysis”. [1]

Acute Flaccid Paralysis is a term which applies to the exact clinical symptoms you would expect to see from poliovirus infection, but which are not necessarily caused by polioviruses. Paralytic polio is actually considered a sub-category in the broad umbrella of acute flaccid paralysis. See pages 300-312 [1] for a chart and summary of many other causes of AFP, a few of which are: Guillaine-Barre syndrome, Cytomegalovirus polyradiculomyelopathy, Acute transverse myelitis, Lyme borreliosis, nonpolio enterovirus and Toxic myopathies.

For many years the medical profession assumed that when they saw paralysis with a particular cluster of symptoms, it was poliomyelitis. The 1954 Francis Trials of the Salk vaccine [2] triggered a reconsideration of this assumption, and a major change in the diagnostic criteria.

How were polio cases counted in 1954?

In 1954 most health departments worked with the WHO definition:

“…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.” [3, p. 88]

How were polio cases counted in 1955?

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. [3, p. 88]

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. At the same time, the number of nonparalytic cases was bound to increase because any case of poliomyelitis-like disease which could not be classified as paralytic poliomyelitis according to the new criteria was classified as nonparalytic poliomyelitis. Many of these cases, although reported as such, were not non-paralytic poliomyelitis. [3, p. 88] (emphasis added)

It was after the SALK vaccine was introduced, when fully vaccinated people continued to get “polio”, that doctors started looking a lot more carefully at the viruses in individuals. Many viruses were found to cause paralysis, for example coxsackie B, enterovirus 71, etc. Read more

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