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
“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
H1N1 Influenza in the U.S.
While it’s too soon to be sure, influenza numbers are dropping and the season may be coming to an early close. The CDC has these numbers:
During week 51 (December 20-26, 2009), influenza activity decreased slightly in the U.S.
154 (3.9%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
Translation: of thousands of tested cases of “might be flu”, 154 turned out to really be flu, only 3.9% of the total specimens tested. Lots of sneezing and coughing out there, and not an insubstantial number of hospitalizations and deaths for “influenza-like-illness and pneumonia” , but no influenza viruses are the main cause at this point.
2009 H1N1 virus did turn out to be more dangerous to children than the typical yearly influenza virus: the CDC received 225 reports of deaths this year, 130 last year, 88 in 2007 and 78 in 2006.
The breakdown by age:
Since August 30, 2009, CDC has received 225 reports of influenza-associated pediatric deaths that occurred during the current influenza season (42 deaths in children less than 2 years old, 25 deaths in children 2-4 years old, 83 deaths in children 5-11 years old, and 75 deaths in children 12-17 years old).
How likely was a child under 2 to die from H1N1 based on these numbers?
Live births in 2007: 4,317,000, minus 29,000 infant deaths, gives us a starting number of 4,288,000. The number of births has been going up every year for the last few years, so if we assume the same number in 2008 we are erring on the side of caution. We’ve got a total of roughly 8,576,000 children in the U.S. under the age of two. Forty-two of those children died this year as a result of H1N1, according to the CDC. This means that one child out of every 204,190 died from 2009 H1N1 according to the reported number of cases.
Are the reported number of cases reflective of the true burden of illness? Probably not entirely, but in November, CBS news reported that:
It’s a little counter intuitive,” Frieden said, “but the best way to estimate the total burden of illness is not to count the cases, but to estimate them based on the best available science.”
However, Ashton pointed out, things are very different when reporting pediatric flu deaths. She said states are required to document each case with the CDC, and every week the updated numbers are an accurate reflection of the entire country.
The numbers of pediatric deaths from 2009 H1N1 are based, therefore, on actual case counts in the U.S., during 2009.
Infants and toddlers were one of the groups recommended for the 2009 H1N1 vaccine. However, if saving the maximum number of lives is our goal, then there are several other causes of death in infants and toddlers which we feel should be addressed with a vigor to match the actual death and injury rates for each category.
Among 1- to 4-year-old children, injuries accounted for 42 percent of all deaths, followed by deaths due to congenital malformations (birth defects), malignant neoplasms (cancer), homicide, and diseases of the heart.
Or to give some comparative numbers:
More than 16,500 lives could be saved each year in the United States alone if our under-5 mortality rate was the same as Iceland. If the U.S. rate of under-5 mortality was similar to that of France, Germany and Italy (all 4 per 1,000 live births), over 12,000 child lives could be spared.
The causes of child deaths in the industrialized world differ dramatically from those in developing countries. In the developing world, over half of under-5 deaths are caused by pneumonia, diarrhea or newborn conditions. In the industrialized world, these problems rarely lead to death. Children’s deaths are most likely the result of injury suffered in traffic accidents, intentional harm, drowning, falling, fire and poisoning.
New vaccine
Close Encounters with the Vaccine Schedule
Scene: A pediatrician’s office. Behind the desk is the doctor, a pleasant, middle-aged woman in a white coat. Seated in front of the desk are the expectant parents, prosperous, educated, self-confident, and, in the case of the woman, exceedingly pregnant.
Doctor: So, what questions did you have for me today?
Mother: We are concerned about the current vaccine schedule.* We know that babies should be protected from serious diseases, but the current schedule is getting…well, strange. (Pulls a scroll from her purse and starts unwinding it, reading off the schedule as she goes, and inserting comments) So, at birth, they want our baby to get a Hepatitis B vaccination. We both test negative and are not at risk for that disease.
Father: Does our baby really need that one?
Sisyphus and the Conjugate Vaccines
As a punishment from the gods, Sisyphus was compelled to roll a huge rock up a steep hill, but before he reached the top of the hill, the rock always escaped him and he had to begin again. The maddening nature of the punishment was reserved for Sisyphus due to the mortal’s hubristic belief that his cleverness surpassed that of Zeus.
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In September, the AP reported that Prevnar…
“A vaccine that has dramatically curbed pneumonia and other serious illnesses in children is having an unfortunate effect: promoting new superbugs that cause ear infections.”
http://www.msnbc.msn.com/id/20825107/
I always wonder who actually writes these science stories you see in the media.
Yes, the emerging serotypes cause ear infections and other mild illnesses, but they also cause various deadly forms of invasive disease. It’s a phenomenon called “serotype replacement” (or “replacement disease” in other circumstances) and so far all of the conjugate vaccines (Hib, Prevnar, Menactra) have done this in some form or fashion. The vaccines work extremely well against vaccine-included serotypes of streptococcus pneumoniae, but they work so well that they also prevent asymptomatic carriage of these normally commensal organisms.
And that is a problem.
For example, from The Lancet:
“FINDINGS: We noted no reduction of AOM episodes in the pneumococcal vaccine group compared with controls (intention-to-treat analysis: rate ratio 1.25, 95% CI 0.99-1.57). Although nasopharyngeal carriage of pneumococci of serotypes included in the conjugate-vaccine was greatly reduced after pneumococcal vaccinations, immediate and complete replacement by non-vaccine pneumococcal serotypes took place.”
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