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: 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 . 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
Filed under: CDC Watch, News, Vaccine Science, Vaccine/Disease Analysis
Dr. Gerberding of the CDC
Remember Hannah Poling? The head of the CDC, dressed in a very nice pink suit, appeared on TV and discussed Hannah’s case. In one of her appearances she said something like this: “Vaccines prevent 33,000 deaths a year in the United States.” Just to make sure I had the statement right, I searched for the phrase and found it again, from CNN, this time in print.
Today, through immunizations given in the first two years of life, we can protect children from 16 diseases, preventing 33,000 deaths and 14 million illnesses per year.
A few searches made it clear that this is a very popular statistic. A variety of news stories included the information that vaccines prevent 33,000 deaths a year in the United States. This is an interesting number to anyone who knows a bit about the history of infectious diseases. I decided to dig deeper.
My next find was this chart, which is on a the web-site of an organization called Every Child by Two. The chart provides morbidity (incidence) and mortality (deaths) for each disease. How in the world would someone be able to calculate (for example) the exact number of cases of diphtheria which would occur and the exact number of deaths which would follow? Amazing! There must be some truly extraordinary scientific research underlying these numbers, don’t you think? Read more