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
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. 
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%.  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