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transmission from breakthrough cases to high-risk persons that may lead to severe disease and even death (CDC, unpublished data); partial or complete susceptibility in 1-dose vaccine recipients as they become adults; the burden on public health agencies due to varicella outbreaks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.
Medical Double Standards in the Third World
When it comes to third world medicine we almost invariably hear from the WHO about the successes of massive vaccination programs. If you look into the recent agenda for the World Health Assembly [1] you will find pandemic influenza vaccines at the top of the technical matters, and in the status section, the eradication of Poliomyelitis is at the top of that section. What is glaringly absent is a discussion of the pervasive double standards in research ethics, health-care safety and professional rigor that exist in the developing world. The WHO and its medical partners won’t talk about it publicly because when you look at the numbers, it is directly implicated in the suffering and ultimate death of millions of people in the developing world. That is what we’ll cover in this piece.
It is well known that needle re-use can be a major cause of virus transmission. In 2000, a WHO press release states:
Unsafe Injection practices have serious large-scale consequences…”unsafe injection practices throughout the world result in millions of infections which may lead to serious disease and death. Each year over-use of injections and re-use of dirty syringes and needles combine to cause an estimated 8 – 18 million hepatitis B virus infections, 2.3-4.7 million hepatitis C virus infections and 80,000 – 160,000 infections with HIV/AIDS worldwide. [2]
That same press release uses an epidemic of Hepatitis C that occurred from Schistosomiasis treatment in Egypt. Notably absent is any discussion of the massive immunization campaigns waged throughout the third world coincident with the massive epidemics of HIV and other infectious diseases. However, someone there must be aware of the potential problem because the press release states the following at the end:
In addition, to ensure the safety of immunization injections, WHO, the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), and the International Federation of the Red Cross and Red Crescent Societies (IFRC) have recently called for the exclusive use of auto-disable (AD) syringes for immunization by the end of 2003.[2]
We know quite reliably that the WHO knew years prior to this press release (2003) that medical practices in the developing world were problematic. As Gisselquist outlines in his 2009 article [3] the WHO was quietly giving UN employees the following advice in 1991.
take special precautions to avoid HIV transmission via blood . . . If you are not carrying your own needles and syringes, avoid having injections unless they are absolutely necessary . . . Avoid tattooing and ear-piercing. Avoid any procedures that pierce the skin, such as acupuncture and dental work, unless they are genuinely necessary. Before submitting to any treatment that may give an entry point to HIV, ask whether the instruments to be used have been properly sterilized.[3]
Vaccine Myths Round Four
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”
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
Vaccine Myths, Round Two
Filed under: Parents' Pages, Vaccine Myths, Vaccine Science, Vaccine/Disease Analysis
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
Pandemic – When did the definition change?
The old version:
WHO_Pandemic_preparedness_May_1_2009
An influenza pandemic
An influenza pandemic occurs when a new influenza virus appears against which the human population has no immunity, resulting in epidemics worldwide with enormous numbers of deaths and illness. With the increase in global transport, as well as urbanization and overcrowded conditions, epidemics due the new influenza virus are likely to quickly take hold around the world. Outbreaks of influenza in animals, especially when happening simultaneously with annual outbreaks of seasonal influenza in humans, increase the chances of a pandemic, through the merging of animal and human influenza viruses. During the last few years, the world has faced several threats with pandemic potential, making the occurrence of the next pandemic a matter of time.
and the new version:
WHO_Pandemic_preparedness_webpage_Sept_2_2009
What is an influenza pandemic?
A disease epidemic occurs when there are more cases of that disease than normal. A pandemic is a worldwide epidemic of a disease. An influenza pandemic may occur when a new influenza virus appears against which the human population has no immunity. With the increase in global transport, as well as urbanization and overcrowded conditions in some areas, epidemics due to a new influenza virus are likely to take hold around the world, and become a pandemic faster than before. WHO has defined the phases of a pandemic to provide a global framework to aid countries in pandemic preparedness and response planning. Pandemics can be either mild or severe in the illness and death they cause, and the severity of a pandemic can change over the course of that pandemic.
The two documents above can also be found at: http://attentiallebufale.it/informazione-scientifica/speciale-bufale-pandemiche-come-difendersi/lanalisi-di-doshi-al-voltafaccia-delloms/
These two documents were sourced and provided by Dr Tom Jefferson, and Peter Doshi.
And here is Fukuda, at WHO, claiming that they didn’t change it!
Now let me move on to the second issue. Did WHO change its definition of a pandemic? The answer is no, WHO did not change its definition.
Vaccines? Safe. Parents? Dangerous.
Lately I’ve been noticing an increasing number of journal articles, blog articles and opinion pieces on a terrible problem: Parents have questions about vaccines.
You would have to look far and wide to find anyone who thinks that these questions are valid and should be taken seriously. Common explanations are:
1) It is all about the parents who think they are really smart.
2) It is all about the parents who are very stupid and read stuff on the Internet.
3) It is all about the bad stuff on the Internet which is deceiving the parents who aren’t very smart and who think they are smarter than doctors. And infinite variations on this theme, which is really one argument…and the real argument is (drum roll)…vaccines are perfect and parents are the problem.
Being called stupid dupes hasn’t worked to shut up the parents with questions. Perhaps this is not a good strategy?
I’m sure you’ve noticed that many articles and blogs offer comment options to the public. If you are following the vaccine related discussions you’ll have noticed that there is a coterie of passionate vaccine defenders who pop up in every such public discussion. These vaccine defenders are fighting for the good of the vaccine program with everything they’ve got.
Oddly, however, the number of parents with questions seems to be increasing. Perhaps the vaccine defenders need to reconsider their approach. Read more