Review: The average cost of measles cases and adverse events following vaccination in industrialised countries

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

Immunizations in foreign countries are unsafe

December 6, 2010 by · 7 Comments
Filed under: News 

What?

A new law, sponsored by Senator Klobuchar, allows children being adopted into the U.S. to skip being vaccinated in their home countries because apparently millions of children are being exposed:

to unsafe immunizations in foreign countries.

The news story continues:

The bill also allows U.S. parents adopting foreign-born children to safely immunize their children in the United States within 30 days of their arrivals, rather than have to subject their children to potentially unsafe immunizations in foreign nations. Previously, parents who adopted internationally were frequently required to immunize their children before bringing them to the United States.

We can only hope that all those foreign nations don’t pick up on this news story and wonder why it is okay for children who are remaining in Africa, Asia, South America or Eastern Europe to receive unsafe vaccines.

There are, of course, two obvious answers to why these vaccines are unsafe.

1) Needle re-use.

2) Mercury content. Due to a lack of refrigeration and a shortage of money, most vaccines in the developed world come in 10 dose vials, preserved with that wonderful, inexpensive toxin, thimerosal.

How could the journalists who put together this lovely, upbeat story miss the huge question of why it is okay for some kids (adopted in to the U.S.) to get “safe” vaccines and other children (remaining in their home countries) to receive unsafe vaccines? Why don’t all of those upbeat stories about vaccine campaigns in developing countries mention the hazards of “unsafe immunizations” and ask donors to give that little bit extra so children’s lives can be saved for real?

Stories like this one:

Burkina Faso has become the first country to begin a nationwide campaign to introduce a new meningitis vaccine that promises to rid the entire region of the primary cause of epidemic meningitis.

“This historic event signals the beginning of the end of a disease that has brought sickness and suffering to generations of Africans,” said Seydou Bouda, Minister of Health of Burkina Faso.

We can hope that despite the very inexpensive vaccine the budget for this campaign allows for the use of needles that cannot be re-used and omits the cheap mercury preservative, or some of the sickness and suffering will come as a consequence of the nationwide campaign.

Returning to our fortunate adoptees, how many vaccines are these kids going to receive within 30 days of their arrival in the U.S? If they are expected to catch up on several years worth of vaccination within 30 days they may still end up with some major health problems…

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

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