Do the Right Thing!
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
A Pox on the Taxpayer
Filed under: CDC Watch, Opinion, Vaccine Science, Vaccine/Disease Analysis
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
Polio and Sanitation
Filed under: CDC Watch, Parents' Pages, Vaccine Science, Vaccine/Disease Analysis, WHO Watch
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 2010
Filed under: CDC Watch, Parents' Pages, Vaccine Myths, Vaccine/Disease Analysis, WHO Watch
Poliovirus
Over the next few weeks, Inside Vaccines will be taking a closer look at Poliomyelitis infections, exploring aspects of the history of poliomyelitis; describing environmental factors that increase the incidence of paralytic polio; considering the history and efficacy of the vaccines used against polio; and finally, exploring the campaign to eradicate polio.
First, let’s look at some basic information.
When most people think of poliomyelitis, they think of children who had lameness and leg deformities, with their legs in braces, or lying in iron lungs (old-style breathing machines, or ventilators) because they couldn’t breathe. Most people link all paralysis and lameness solely to a group of viruses called POLIOMYELITIS. The World Health Organization describes polio:
Polio is a highly infectious disease caused by a virus. It invades the nervous system, and can cause total paralysis in a matter of hours. The virus enters the body through the mouth and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralysed, 5% to 10% die when their breathing muscles become immobilized. [1]
Now for a more accurate picture of exactly what “poliomyelitis” is.
The poliomyelitis viruses fall within a class of viruses called “human enteroviruses” [2]. Polioviruses belong to the viral family Picornaviridae [3]. There are three types: 1 Brunhilde; 2 Lansing; and 3 Leon. Amongst these types there are hundreds of different strains. Type 1 is considered the most serious virus, followed by type 2.
Technically, a person can “get” poliomyelitis 3 times, since the types do not give cross protection to each other, but in practice, having clinical polio three times is very rare.
How is poliomyelitis virus transmitted?
Poliomyelitis is transmitted by person-to-person spread through fecal-oral and oral-oral routes, or occasionally by a common vehicle (e.g., water, milk). [4]
What happens when people are exposed to polioviruses?
When non-immune persons are exposed to wild poliovirus, inapparent infection is the most frequent outcome (72 percent). [4]
Most people won’t even be aware that they were sick. Read more
Myths 3.2 Chickenpox “the disease can be severe”
Filed under: CDC Watch, Parents' Pages, Vaccine Myths, Vaccine/Disease Analysis
Parents who take their children to chicken pox parties have forgotten how devastating this childhood disease can be according to vaccination experts:
“What happens if you bring your child to a chicken pox party and they’re the one in 10 who has a complication and is hospitalized?” said Dr. Jane Zucker, head of the city Health Department’s immunizations bureau.
We went back to 1951, when chickenpox afflicted millions of children every year in the U.S. to see if complications and hospitalization from chickenpox were common:
In general, chickenpox is a disease of young children and in them it usually runs an uneventful, if uncomfortable, course without leaving behind it any permanent bad effects. In very rare instances, a case of encephalitis or inflammation of the brain may occur after chickenpox, causing such symptoms as sleepiness, stiff neck, convulsions, coma, and even death.
Ordinarily, however, chickenpox is a mild though highly contagious disease…
This view of chickenpox as mild continued to exist in the U.S. for many years as this two part video snippet illustrates. Read more
Vaccine Myths 3.1: The Scourge of Childhood
Filed under: CDC Watch, Parents' Pages, Vaccine Myths, Vaccine/Disease Analysis
“…young parents of today do not remember…”
In 1974 the St. Petersburg Times wrote:
So many people are neglecting to get immunity shots that doctors fear the seven one-time scourges of childhood–polio, mumps, measles, rubella, diphtheria, lockjaw and whooping cough–may strike American communities again.
However, just six years earlier, in 1968, newspaper stories said things like this:
Although mumps is a relatively mild childhood disease, it can cause sterility when it strikes adult males.
At that time the recommendation was to give the recently developed shots to boys if they hadn’t had the mumps by the time they hit adolescence. Read more
“Just because you need a third dose doesn’t mean the two dose schedule is having issues or anything”
Filed under: CDC Watch, News, Opinion, Parents' Pages, Vaccine/Disease Analysis
Because of continued spread, health authorities working with communities in Orange County are giving schoolchildren a third dose of the MMR vaccine. Gallagher says it will be two or three months before it’s known whether the effort succeeded.
Why do they need a third dose?
The infections happened despite high coverage with the measles-mumps-rubella (MMR) vaccine. Among patients ages 7 to 18 — the age group that had the most cases — 85% of patients had received the two recommended MMR vaccine doses.
This doesn’t mean the MMR vaccine isn’t working, says epidemiologist Kathleen Gallagher, DSc, MPH, the CDC’s team leader for measles, mumps, and rubella.
“Two doses of mumps vaccine is believed to be 90% to 95% effective,” Gallagher tells WebMD. “But that means people can still get mumps. If the vaccine is 90% effective and 100 people are exposed to mumps, 10 will get the disease.”
If we imagine that mumps is being sprinkled from the sky and spread evenly throughout the population, then yes, one out of ten vaccinated people would catch mumps if the vaccine was, indeed, 90% effective, or one out of twenty if it were 95% effective. But if the vaccine creates “herd immunity” then the disease shouldn’t be able to jump from vaccinated person to vaccinated person to vaccinated person. Read more
Where Do They Find These Scary Statistics III – Let’s Make a Few Assumptions – Hepatitis B
Filed under: CDC Watch, Vaccine Science, Vaccine/Disease Analysis
Parents have questions about the risk-benefit equation of the Hepatitis B vaccine. It is possible for a parent to be quite certain that their infant is not at risk of prenatal or birth exposure to this disease. The risk factors for exposure during infancy, early childhood, and the elementary school years can be reasonably well assessed on an individual basis. Read more
Health Marketing, Risk Communication, and the Media
Remember the Great Influenza Vaccine Shortage a few years back?
Panic swept the nation after the FDA rejected many European flu shots because of possible contamination during manufacturing. What was left was rationed according to age and risk factors, and the public could be seen every night on the news waiting in long lines to get the remaining doses.
Now, setting aside for the moment the ongoing questions regarding the usefulness of flu shots in any age group, especially the elderly, one might come to wonder what has changed in recent years to bring about this new terror regarding influenza.
The answer, as outlandish and implausible as it might sound, is that this fear has been manufactured and marketed by the people in public health. Read more
Where Do They Find These Scary Statistics? Part II: Gross Estimation–Diphtheria Statistics Defy Reality
Filed under: CDC Watch, News, Vaccine Science, Vaccine/Disease Analysis
Top graph from page 423 of The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century.
Lower graph from page 208 of Trends in Diphtheria Mortality.
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Series Links: Part I, Part III Read more