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

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

Polio 2010

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

Vaccine Myths Round Four

February 28, 2010 by · 9 Comments
Filed under: Parents' Pages, Vaccine Myths, Vaccine/Disease Analysis 

Vaccines saved us:  just visit an old graveyard and look at all the markers for dead babies and children.

Graph provided by Health Sentinel

Click on the graph to enlarge it. For more graphs go here.

When the vaccine arguments are hot and furious, a frequent insult is: “You don’t understand the science!”  The confusion in this case doesn’t arise from ignorance of science, but from ignorance of history.  The people who think that vaccines saved millions of children from death see the story like this:

Childhood illnesses run uncontrolled through the population leaving dead bodies in every house.  Parents are in despair.  Brave doctor cooks up a vaccine, the disease stops dead, and all children come through to a healthy adulthood. Read more

Myths 3.2 Chickenpox “the disease can be severe”

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

“…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”

February 16, 2010 by · 2 Comments
Filed under: CDC Watch, News, Opinion, Parents' Pages, Vaccine/Disease Analysis 

Mumps story:

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

Vaccine Myths, Round Two

Introduction: A while back, we explored some common anti-vax myths.  Because in the great vaccine debates, the myths tend to outnumber the facts, we’ve decided to begin a multipart series dispelling some of the mythologies people argue over which preclude productive discussions over real issues. Below, you will find the facts behind two more common vaccine myths: herd immunity, and whether or not vaccines are profitable to pharmaceutical companies.

Myth: herd immunity isn’t real, and all the vaccine preventable diseases were declining in incidence prevaccine

Reality: vaccine induced herd immunity is a real phenomenon, and the incidences of the “diseases of childhood” (measles and mumps, for example)  averaged out to be constant in the prevaccine era.

Here’s a chart showing the incidence of measles from 1912 till 1960.

Although the “death rate per cases” dropped an amazing amount, the same number of cases were happening per year on average. Read more

Does the Inactivated Influenza Vaccine Even Work In the Recommended Age Bracket?

It’s that time of year again!  Having spent last summer consulting the avian set on what’s hot in influenza, the pharmaceutical company has whipped up a fresh batch of flu vaccine, and now they need to move the merchandise!  Fortunately, the CDC is happy to help with sales, by expanding the recommendation to ever more age groups.  The Advisory Committee on Immunization Policy currently recommends the vaccine for all children aged 6 months to eighteen years.  There is just one slight issue that might concern some parents.  Peer-reviewed research in The Archives of Pediatric and Adolescent Medicine, Vol. 162 No. 10, October 2008,1 demonstrates that the vaccine is not effective under age 5!

An inherent assumption of expanded vaccination recommendations is that the vaccine is efficacious in preventing clinical influenza disease. Although studies have documented immune responses following 2 doses of inactivated influenza vaccine as well as vaccine efficacy for culture-confirmed disease in randomized clinical trials, surprisingly little information exists regarding influenza vaccine effectiveness (VE) among young children receiving vaccine in routine health care settings.

Read more

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