“Pneumonia vaccine ineffective against repeat infections: study” screams the headline. The article goes on to clarify that a study just published seems to suggest that the pneumococcal vaccines in use in Canada do not seem to perform any better than no vaccine. How is that possible? Well, so far as I can tell, it isn’t, and this seems to be another case of dubious reporting by the journalists, and careless conclusions by paper authors.
I could not get my hands on a copy of the full published study the article refers to, although I will probably be able to in the near future. In the mean time, all I can go on is the abstract which can be found at PubMed or at Chicago Journals. Let us examine exactly what this study seems to suggest, based on the publicly available abstract.
Background.There is debate surrounding the effectiveness of the 23‐valent pneumococcal polysaccharide vaccine (PPV). We determined whether PPV was associated with reduced mortality or additional hospitalization for vaccine‐preventable infections in patients previously hospitalized for community‐acquired pneumonia (CAP).
Ok, so first thing to keep in mind: they only studied people who got pneumonia. This is not a study comparing vaccinated vs. unvaccinated, and seeing if there is any protection offered by the vaccine in the form of reduced infection rates. This is a study consisted of only people who got sick, breaking those down into two groups and seeing how each group fared.
Now, it is an accepted fact that no vaccine is 100% effective, meaning that no vaccine will prevent the disease on all people who receive it. For one reason or another, some people get no benefit from any given vaccine. Those people will get sick from the disease, regardless of their vaccination status. By definition, if you are gathering together people who are sick in the hospital, you are already limiting yourself to only that subset of the vaccinated population for whom the vaccine has already failed. So from that point alone, this is like saying “Well let me find all the people for whom the vaccine failed & let me measure how effective the vaccine was for them“. Just to make a comparison, this sounds kind of like saying “let me find out which team lost, and see how likely they are to have won!“.
Beloved Readers, Skepdude will be taking a much needed vacation break through the beginning of July. As I will be spending time in an internet free beach in the Mediterranean (yes, such places still exist), and given that the World Cup will be happening, do not expect many entries from now, through the beginning of July. I know the internet will not be the same without my lovely ramblings, but until then, may I suggest Hulu?
Haven’t done one of these in a while so here goes.
“These poll data should be a wake-up call to the government and the media that a majority of American parents believe that parents, not the state, should decide when and whether to vaccinate their children,”
Skepdude says: Yes Mary, a wake-up call that they need to educate these parents better. Maybe a majority of parents also believe that they should decide when and whether to use car seats too, don’t you think?
As part of its Morbidity and Mortality Weekly Report (MMWR), the Centers for Disease Control and Prevention (CDC) has released a report titled “Preliminary Results: Surveillance for Guillain-Barré Syndrome After Receipt of Influenza A (H1N1) 2009 Monovalent Vaccine — United States, 2009–2010“. This publication reports on an analysis of preliminary data, the focus of which was to look for any signs of increased risk of GBS rates among individuals receiving the 2009 monovalent H1N1 vaccine in the United States.
Guillain-Barre Syndrome is a rare neurological disorder (affecting about 1.65 and 1.79 in 100,000) in which the body’s immune system attacks part of the peripheral nervous system. On some occasions, it has been identified to be triggered by surgery or vaccination. For example, as has been widely reported, especially by the anti-vaccination crowd, the 1976 influenza A (H1N1) vaccine was associated with a statistically significant increased risk for GBS of over 10 cases per million, and it appears that some vaccines may account for a slight overall increase in GBS risk.
Given the history with the 1976 H1N1 vaccine, the CDC has been closely monitoring the 2009 H1N1 vaccines, through its Emerging Infections Program (EIP) since October 2009. Preliminary results of this analysis show an excess of 0.8 cases of GBS for 1,000,000 vaccinations, similar to the rate for seasonal influenza vaccines. If this holds up when the full review is released some time in the Fall of 2010, it would mean that the 2009 H1N1 vaccine will be associated with an 8% increase over the expected GBS rate of 1 in 100,000.
To put things in perspective, while the H1N1 vaccine may be associated with less than 1 additional case of GBS per million vaccines, the disease it protects from, H1N1 influenza has been associated with 9.7 deaths per million. According to Wikipedia, 80% of GBS patients recover fully, which means that of the 0.8 additional cases per million vaccination, only about 0.16 will have permanent effects (including paralysis and death). To put this further into perspective, if this association holds, we should expect about 16 cases of additional GBS with permanent side effects, for every 100,000,000 vaccinations. At the same time the death rate from influenza A (H1N1) would be at about 970. And if that is not enough perspective, according to this study, the mortality rate, at least for the period 2000-2004 was at 2.58 %, whereas Wikipedia estimates overall mortality rate to be at around 4%. Using the larger number, the 4% from Wikipedia, if the association holds at the same level, we would expect an additional 3.2 vaccine induced GBS deaths versus 970 influenza H1N1 deaths, per 100 million people.
A Fair Lawn couple admitted on Monday that they failed to take their two-year-old daughter to the hospital as she died from a ruptured appendix.
Raymond and Nicole Ahles, with her attorney, Arthur Zucker, right, said that their daughter, Ocean, was six weeks shy of her third birthday when she became sick in April 2006.
Raymond Ahles, an acupuncturist, and his wife, Nicole, said in Superior Court in Hackensack that their daughter, Ocean, was six weeks shy of her third birthday when she became sick in April 2006.
They said they took the child to a Fort Lee acupuncturist, who advised them to take the girl to the hospital.
“But based on your self-diagnosis, did you knowingly decide not to seek medical care?” defense attorney Paul Brickfield asked Raymond Ahles.
“Yes,” Ahles replied.
Brickfield and Nicole Ahles’ attorney, Arthur Zucker, said the couple thought the girl was suffering from a routine stomach bug.
“Appendicitis in such young children is misdiagnosed by the medical profession 70 percent of the time,” they said in a written statement.
The couple’s other daughter was also diagnosed with appendicitis last year at the age of two, and that she fully recovered after surgery, the attorneys said.
Yet another Andrew Wakefield paper has been retracted. After the Lancet retracted his 1998 paper that started the unreasonable MMR scare, the results of which we’re still dealing with, and after being struck from the the UK medical register, now the American Journal of Gastroenterology has retracted a 2000 Wakefield paper based on the same 12 children that the 1998 study was based on. Here is the text of the AJG retraction:
Retraction: Enterocolitis in Children With Developmental Disorders
A J Wakefield, A Anthony, S H Murch, M Thomson, S M Montgomery, S Davies, J J O’Leary, M Berelowitz and J A Walker-Smith
Am J Gastroenterol 2000; 95:2285–2295
On 28 January 2010, the UK General Medical Council’s Fitness to Practice Panel raised concerns about a paper published in the Lancet by Dr Wakefield et al. (1). The main issues were that the patient sample collected was likely to be biased and that the statement in the paper, that the study had local ethics committee approval, was false. There was also the possibility of a serious conflict of interest in the interpretation of the data. The Lancet has now retracted this paper (1). This paper in the American Journal of Gastroenterology (AJG) (2) also includes the 12 patients in the original Lancet article and therefore we retract this AJG paper from the public record.
This parent has a very common question in their mind, and unfortunately, they’ve turned to the internet for answers. I do not think posting your health question on some web forum is the best way to get the right answer, but it is what it is and we now have to do our best to help them make the best decision for them and their child. The question is as follows:
He’s 16 weeks and it’s about time for his 4 month shots.Some people say don’t do it might cause autism or death.Others say I don’t have a choice.Do I have a choice? If not now would later be ok.
This is the comment I left. Others need to join in so we can sway him/her to at least discuss this with their pediatrician before they make a decision.
The question is not: are immunizations safe for you child. The question you should ask yourself, and your PEDIATRICIAN, is: Is it safe NOT to immunize your child? 20 seconds of crying can save you boat loads of headaches and stress down the road. This is an issue of your child’s health, and I strongly suggest you don’t limit yourself to internet research but speak to an expert, a pediatrician, or two or three if you want to get more opinions. But remember, quality of opinion matters more than quantity.
Far as choice goes, the CDC schedule is just a recommended schedule; as the parent you’re still given all the freedom to decide not to vaccinate. However, when the time comes for the child to go do daycare/school you will be required to have them caught up in order to attend, but even then you may be able to exempt them from this requirement. See my entry here for details on legal requirements.
Please take a few minutes, add your comment; if we get one parent to do the right thing that is a step in the right direction.