Myths 3.2 Chickenpox “the disease can be severe”

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, Round Two

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.

January 3, 2010 by · 1 Comment
Filed under: News 

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.

Does the Inactivated Influenza Vaccine Even Work In the Recommended Age Bracket?

It’s that time of year again!  Having spent last summer consulting the avian set on what’s hot in influenza, the pharmaceutical company has whipped up a fresh batch of flu vaccine, and now they need to move the merchandise!  Fortunately, the CDC is happy to help with sales, by expanding the recommendation to ever more age groups.  The Advisory Committee on Immunization Policy currently recommends the vaccine for all children aged 6 months to eighteen years.  There is just one slight issue that might concern some parents.  Peer-reviewed research in The Archives of Pediatric and Adolescent Medicine, Vol. 162 No. 10, October 2008,1 demonstrates that the vaccine is not effective under age 5!

An inherent assumption of expanded vaccination recommendations is that the vaccine is efficacious in preventing clinical influenza disease. Although studies have documented immune responses following 2 doses of inactivated influenza vaccine as well as vaccine efficacy for culture-confirmed disease in randomized clinical trials, surprisingly little information exists regarding influenza vaccine effectiveness (VE) among young children receiving vaccine in routine health care settings.

Read more

Sisyphus and the Conjugate Vaccines III

March 27, 2008 by · 3 Comments
Filed under: Vaccine/Disease Analysis 

Part III of a three part series. Parts one and two can be found here and here.

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The big question with these conjugate vaccines is “What is the overall effect?”

How many fewer cases of invasive bacterial disease are happening after replacement is accounted for?

The more narrowly you look, the better these conjugate vaccines look. The more broadly you look, the more the apparent effects melt away to nothing. With Hib and “replacement disease”, if you just compare h influenza serotype B to serotype A, it would appear that killing off Hib via mass vaccination was extremely successful in the grand scheme of things. When you look at nontypeable (also known as “non capsulated”) h influenzae plus Hia and Hif, that’s when you start seeing that we’re not really any better off now than we were before the Hib conjugate vaccine. Read more

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