As many of you may know, my main focus has switched to my Vaccine Central blog. Here is a sampling of some of the latest entries I posted there:
- California Whooping Cough update 09-07-10 – 8 infants have died so far in the largest outbreak in decades.
- Ohio declares whooping cough outbreak – Franklin county has seen double the number of total 2009 cases, through August of this year only.
- American Academy of Pediatrics recommends mandatory flu shots for all health workers – About time I say.
- Anti Vax claims dissected – just a small sample obviously.
- 100 million children to be vaccinated against measles in China and 1.5 million against polio in Afghanistan
- Vaccine Preventable Death – yet another infant dead of whooping cough
- Flu vaccine efficacy and safety – Study Analysis
An outbreak of polio in Tajikistan has been halted thanks to vigorous vaccination efforts by 1,000 teams of doctors and nurses. The effort took three months to bear fruit, and was sponsored jointly by USAID and the Tajikistan Ministry of Health. The outbreak infected a reported 430 people, with 19 fatalities, before it was brought under control. The most recent round of vaccinations was conducted on 15–19 June . Preliminary data report coverage of 99.3, with coverage higher than 97% reported from all regions and in the groups aged 0–6 and 7–15 years. Correspondingly, no new cases of infection have been recorded since June 21st. International travelers to this area, and other areas where polio is present, are advised to check with their health care provide to ensure that they are properly vaccinated against the disease.
The NSW Health Care Complains Commission (HCCC) describes the information provided by the Australian Vaccination Network (AVN) as “inaccurate and misleading”. However Meryl Dorey from the AVN claims that “all their information is accurate and fully referenced from medical literature”. Obviously someone is telling porkies, and it isn’t the HCCC.
There simply isn’t enough space on my server’s hard drive to detail all the inaccuracies and lies promulgated by the AVN, so I’ll just concentrate on the most obvious ones. Because if the AVN can’t get basic information correct, what hope do they have when the subject becomes more complicated?
The Immunisation Schedule
Surely for Australia’s self-appointed “vaccine safety watchdog”, this would be the most rudimentary knowledge. So can the AVN manage to give correct information on this basic topic? Let’s take a look. Here is what they claim is on the schedule:
Let’s check the real Australian Vaccination Schedule. Ignoring the fact that many of these vaccines are combined and that the AVN have included vaccines given after not by 12 months, their description of the schedule is far from accurate. The Chicken Pox (Varicella) vaccine is given at 18 months, not 12. There is one dose of Meningococcal (at 12 months), not three doses. Finally, there is no influenza vaccine on the schedule at all.
These may seem like minor errors, but let’s not forget that the AVN have claimed on their website that they provide “all the information you need” on vaccination. If they can’t get the schedule right, what hope is there for more complex information?
Another of the most basic vaccination subjects would be ingredients. After all, if they don’t know what’s in vaccines, how could the AVN be expected to offer advice on the purpose and effect of those ingredients? Let’s look at the statement on their Diphtheria page:
The “mercury” they are referring to is Thiomersal, a preservative used in some vaccines since the 1930s which contains about 1 molecule of mercury per dose. So does “every diphtheria vaccine used in Australia” contain it? No. In fact, it’s not in any currently used diphtheria vaccines, let alone all of them. The first thiomersal-free diphtheria vaccine was licensed for use in Australia in 1997, more than a decade before the AVN wrote this article, and every childhood vaccine used in Australia is thiomersal-free.
Again, one must ask: If the AVN cannot get such basic advice correct, what is the chance that the rest of their information is accurate?
- Measles is one of the leading causes of death for children around the world.
- In the year 2000 only 72% of children worldwide had received the first dose (of two) by their first birthday
- In the year 2000 an estimated 733,000 people died of measles worldwide
- In the year 2008 about 83% of children worldwide had received the first dose of measles vaccine by their first birthday
- In the year 2008 an estimated 164,000 people died of measles worldwide, a net gain of over 550,000 lives from 2000
- As high as 10% of measles cases result in death among populations with high levels of malnutrition and a lack of adequate health care.
- More than 10,000,000 people are affected by measles every year
- 1-2 out of every 1,000 children that get measles will die
- Measles can make a pregnant woman have a miscarriage or give birth prematurely
- There are people who claim measles is not a big deal and “natural immunity” via actually getting the disease is to be preferred to vaccinations. Really? When was the last time the measles vaccine caused 733,000 deaths?
“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!“.
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.
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.
Brother and sisters in, metaphorical, arms: Skeptify this poll.
It’s just too bad they did not have a “Seriously????” option; that’s the one I would’ve gone for, instead I had to settle for the simple No. Go on now my minions, all 4 of you, make your master proud!
The U.S. Food and Drug Administration today revised its recommendations for rotavirus vaccines for the prevention of the disease in infants and has determined that it is appropriate for clinicians and health care professionals to resume the use of Rotarix and to continue the use of RotaTeq.
The agency reached its decision based on a careful evaluation of information from laboratory results from the manufacturers and the FDA’s own laboratories, a thorough review of the scientific literature, and input from scientific and public health experts, including members of the FDA’s Vaccines and Related Biological Products Advisory Committee that convened on May 7, 2010 to discuss these vaccines.
The FDA also considered the following in its decision:
- Both vaccines have strong safety records, including clinical trials involving tens of thousands of patients as well as clinical experience with millions of vaccine recipients.
- The FDA has no evidence that PCV1 or PCV2 pose a safety risk in humans, and neither is known to cause infection or illness in humans.
- The benefits of the vaccines are substantial, and include prevention of death in some parts of the world and hospitalization for severe rotavirus disease in the United States. These benefits outweigh the risk, which is theoretical.
A new analysis, published online by The Journal of Infectious Diseases, takes a look at acute gastroenteritis hospitalization (AGE) rates among US children under 5 years old, before and after the introduction of the first Rotavirus vaccine, RotaTeq (RV5) in early 2006. The objective of this analysis was to see if there was any change in gastroenteritis hospitalization rates after the vaccine was licensed for use among infants in the United States. The study I am referring to is this one:
Aaron T. Curns, Claudia A. Steiner, Marguerite Barrett, Katherine Hunter, Emily Wilson, and Umesh D. Parashar
The Journal of Infectious Diseases 2010;201:1617–1624 © 2010 by the Infectious Diseases Society of America. All rights reserved.
Why did they look at gastroenteritis hospitalization rates? Because that disease, commonly referred to as the “stomach flu“, is a viral infection, and rotavirus is the leading cause of severe gastroenteritis in children, credited with causing about 50% of acute gastroenteritis hospitalizations during January-June amoung U.S. children. Logically, if rotavirus causes it, and if an effective vaccine is introduced, we ought to observe statistically significant decreases in gastroenteritis hospitalization rates, and this is what this analysis was set up to do.
Study Summary -The authors gathered approximately 100% complete AGE hospitalization rates for children under 5 years of age, from 18 states, accounting for 49% of the U.S. under 5 children population. Median AGE hospitalization rates from the pre-vaccine years of 2000-2006 were compared with median AGE hospitalization rates from 2007, the first year after the vaccine, and 2008.
Results – Overall AGE hospitalization rates went down by 16% in 2007 and decreased by 45% in 2008. By age group, the reductions line up like this:
- 0-2 months – 28%
- 3-5 months – 42%
- 6-23 months - 50%
- 24-59 months – 45%
Prior to RV5 introduction, children in the 6-11 month age group had the highest hospitalization rates; after vaccine introduction children in the 0-2 month age group had the highest hospitalization rates, and showed the lowest decreases. Given that the first dose of the vaccine is given at 2 months of age, this result is to be expected.