Look over here, NOT over there
Filed under: Parents' Pages, Reviews of web-sites, Vaccine Science
(and we strongly recommend that you just take us on faith).
Shot of Prevention recently put up a blog article: Choosing Vaccination for Your Child is an Informed Decision explaining where to go for information on vaccination.
I believe that parents must begin by understanding the importance of research, science and statistics in order to make an informed decision. In other words, it’s not that parents should look for a “neutral page”, as this mother suggests, but more importantly, an accurate one that uses scientific evidence to support their recommendations.
Insidevaccines agrees on the importance of using research, science and statistics to make an informed decision. The challenge is determining which pages are accurate and which use scientific evidence to support their recommendations. The writer on Shot of Prevention recommends various resources and provides links.
One thing the author does not recommend, and we find it an interesting omission, is to simply look at each resource she links to, choose a statement at random, and follow up on the references to see if the citations chosen actually support the statement or not, as the case may be. This simple step would demonstrate that she is actually pointing to science-based rather than faith-based information. We’ve written up evaluations of two vaccine supportive sites and found significant holes in the references. (see: Overinformed Refusal has to be Stopped and Written by Parents? Based on Science? ) This is not a terribly difficult step, and it will lay a real foundation of confidence in the data (or not). Any parent who has ever done a research paper has the basic skills required and the Internet makes it surprisingly easy to find article abstracts and sometimes even full-text articles. Read more
An injection of realism
Are Vaccines Magical?
It is magical thinking that there are virtually no injuries caused by vaccines and the vaccination process. The safety factors promoted are completely unrealistic and could not be achieved by the use of a real placebo. Why? Because virtually all vaccines are injected, and the injection process itself, separate and distinct from the vaccine, is by definition an invasive medical procedure with multiple known risk factor rates greater than current vaccine safety claims.
Ask any responsible medical professional if it is possible to perform 1,000,000 insulin, Vitamin B12, or even saline injections without an injury. Serious adverse reactions from injections happen all the time. And medical error in general is a much larger problem than most people realise.
From the National Academy of Science: Medication Errors Injure 1.5 Million People and Cost Billions of Dollars Annually
This PowerPoint illustrates multiple common errors, see slide 2
Here a technician was using improper injection techniques for flu shots
“But they must be the only ones…” Nope, sorry. It turns out that this is a continuing problem across the entire health care industry.
“3 Myths About Safe Injection Practices”-
….Premier survey conducted in May and June last year, indicating that of 5,446 provider respondents (better hope your HCP is not one of these), the following engage in unsafe injection practices:
- 6% sometimes or always use single-dose/single-use vials for more than one patient
- 9% sometimes or always reuse a syringe but change the needle for a second patient
- 15.1% reuse a syringe to enter a multidose vial
- 6.5% save that vial for use on another patient.
So, are vaccines and vaccination magical? Read more
Written by Parents? Based on Science?
Filed under: News, Parents' Pages, Reviews of web-sites, Vaccine Myths, Vaccine Science
This is our second post reviewing the new pro-vaccine site brought to you by Sanofi Pasteur. In our first post we followed up on the claim that the site is science-based. In this one we’ll have a look at claimed authorship and continue our search for scientific references to back-up their declarations.
On the “About ImmYounity” page it is claimed that the information on the site is written by fellow parents:
“There’s a lot of confusing information today about immunizations and parents need the facts. This is why you can look to ImmYounity and Vaccines.com. This Web site is written by moms for moms (and dads, too!) and is grounded in science — the best tool there is to help you make your own decisions about immunization.”
This is an interesting claim, considering that the answers provided are eerily similar to the soothing answers provided by the CDC and AAP on their websites. Read more
Review: The average cost of measles cases and adverse events following vaccination in industrialised countries
Filed under: Article Reviews, Vaccine Science, Vaccine/Disease Analysis
One of our readers posted a comment asking us: “Can you tease out some facts in this study?” We think we could probably write several papers discussing the issues surrounding this study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC128813/ but we will provide a brief summary because a study such as this isn’t worth spending an inordinate amount of time on.
We are going to make a few opening caveats:
1) Some of us believe that measles might be the only vaccine that is justifiable on a large population basis and that is only because there is some evidence that measles can have a relatively high (still low on an absolute basis) rate of serious side effects in some populations.
2) Cost justification studies (such as this) are usually based on a house of cards, and are only as good as the data that underlies the layers of assumptions made in the model.
3) Cost justification studies that are used to support mass vaccination mandates almost invariably turn out to be wrong due to underestimating the cost of the vaccine program and side-effects and overestimating the effectiveness of the vaccines.
4) These studies are often misleading because they are usually sensitive to a few key assumptions and they normalize everything to a dollar value. Here is a sample problem with normalizing everything to a dollar value: let us imagine we have two different vaccines that we want to give to 1 million people. In the testing, 50% of the people suffered 3 days of mild illness causing missed work with no long term effects from vaccine A. 1 person died from vaccine B with no one else suffering any ill effects. The cost of vaccine A would be far higher in almost any financial model, and yet clearly we would much rather fall mildly ill for 3 days rather than risk a 1 in a million chance of dying.
This particular study is interesting in that it is not actually performing a cost comparison or justification. It is only trying to set the cost of a measles case and the cost of a measles vaccine reaction. In order to judge the likelihood of bias in a study, a quick check on the authors reveals that although there are no direct conflicts of interest declared, several of them work for organizations which were desperate to defend the MMR vaccine in the wake of the Wakefield papers from around that time period. There is nothing wrong with that, but it provides context for the timing, content, and potential bias’ of the study. Read more
Lessons from H1N1: How Partial Immunity Can Kill You
Filed under: News, Vaccine Science, Vaccine/Disease Analysis
We are now in the thick of the influenza season, and it is a true shame that the emphasis on vaccines against the flu has drowned out any mainstream discussion much less headlines for an important study recently released in Nature about the 2009 H1N1 influenza virus: Severe pandemic 2009 H1N1 influenza disease due to pathogenic immune complexes [1]. The press release is worth reading.
There are a few initial things that make this study worth noting:
1) It is not funded by the industrial/governmental health care complex
2) It is short, concise, and doesn’t draw any reaching conclusions
3) It furthers our understanding of the 2009 H1N1 Flu by doing a rigorous scientific follow-up of real cases.
The last point is a refreshing change as one of the best ways to learn something is to examine the medical outcomes for real people and this is something we don’t see very often from our medical authorities. The study itself does not address vaccines but the findings have important implications for mass influenza vaccination policies. Read more
Tuberculosis Vaccine Use Based on “Blind Faith”
Filed under: Vaccine Science, Vaccine/Disease Analysis, WHO Watch
UK is planning to introduce the BCG vaccine for all newborns in London because of a resurgence of the disease. The article states:
Health experts believe the threshold at which routine immunisation is required — 40 cases per 100,000 — has been reached across the capital. Current policy has been to offer vaccination to children who are born abroad or whose parents are born abroad. [1]
Why is it that Spain and the U.S. have never used the vaccine and yet have a very low incidence of TB?
The BCG vaccine is the most widely used vaccines of all, as well as the most controversial. The first BCG vaccine trial resulted in a huge disaster which seriously marred its reputation.
The Lubeck disaster will remain a landmark in the history of immunization. In the summer of 1930, in Lubeck, Germany, 240 infants were vaccinated with BCG; 72 of the vaccinated infants developed tuberculosis and died….
Nevertheless, the disaster had done much to harm public acceptance of the vaccine, and mass vaccination of children was only reinstated after 1932, when new and safer production techniques were implemented. Its efficacy has been found to range from 0-80%. [2] Read more
Polio: Causes and Effects, Part I
We saw in our first [1] blog on polio that infection with this virus was common, but paralytic polio was rare. In our second [2] article we reviewed the history of polio and the significant number of cases of paralysis from other causes which were blamed on polio. In the third [3] article we looked at one of the explanations for the rise of paralytic polio in advanced countries and the collapse of this explanation as polio increased in developing countries.
With polio, is there one cause, the virus, and one effect, paralysis? Obviously not, as the results of infection with the polio virus range from absolutely nothing to death. In this series we are going to review some of the factors which, combined with the presence of the virus, can move the situation from no symptoms and no problems, to paralysis.
A characteristic of infection with polio is the length of time it takes to clear the virus from the body and create immunity to polio.
…the interval between initiation of infection and appearance of CNS signs may be as long as several weeks, which accounts for the great variation in the incubation period of the disease. [4]
CNS means inflammation of the central nervous system. Someone can be carrying around a happily multiplying polio virus in the nose, throat and gut system, and other non-neural areas of the body, for a period of weeks without having any symptoms to indicate that the virus is there. “Non-symptomatic response” to polio virus exposure, results in eventual clearing of the virus from the system, permanent immunity to that strain of polio, and is the normal bodily response to the polio virus.
However, if something occurs during the several weeks of polio virus carriage which opens up access to the central nervous system to the virus, then the polio moves from asymptomatic to paralytic. There is a list of provokers which cause polio to invade the CNS. Today we are going to consider one cause which we can credit to the medical profession. 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
Indian Physicians slapped with anti-vaccine label!
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
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