Six Reason to Question Vaccinations

[Professor Yaffle]

There's an author editorial out there somewhere that went with the paper, that 2-5 per 1,000 figure was taken from, it seems. (google says).

ETA: Oops...sorry Professor Yaffle...here's where you linked to it:
http://press.psprings.co.uk/adc/october/ac130518.pdf

http://www.internationalskeptics.com/forums/showpost.php?p=3134663&postcount=106

Finn was another author on the Cameron paper...that's where the confusion was coming from, I think.

I didn't notice that they had one author in common - that makes more sense now.

 

[Ivor the Engineer]

I accept you may be more likely to die by firearm that from not having measles vaccine and developing measles (but herd immunity comes into the equation somewhere also, reducing the risk of an unvaccinated child encountering measles and therebye becoming ill).

Let's try again:

If 1000 children get measles in the US, one dies. Check out the graph on this page:

http://www.healthsentinel.com/graphs.php?id=54&event=graphs_print_list_item

But there is a simple means to prevent measles, so why not go for it big time?

The issue is with coercing parents to have their children vaccinated using lies, mis-information and (in the US) sanctions for non-compliance for what amount to pretty small risks to the children's health.

 

[Deetee]

OK, how about this explanation model:

For every 100 000 cases of chicken pox in kids, 200 are admitted to hospital (=2/1000)

For each 100 000 children under 16 in any given year there will be 0.82 with severe complications from chicken pox they have contracted. This is the annual incidence of severe complications from chicken pox within the defined population (kids under 16).

Children will only be at risk at one point in time during their 16 years (or whatever the chosen limit is) rather than continuously, and this is where the discrepancy Ivor is getting at appears to come from.

Put another way, take 100 000 under 16 year olds and study them for a year. How many might get chicken pox in that time? Ivors assumption is that it is close to 100 000, but it is not, it will be less than 1/16th of this (say arbitrarily 1/20th)
This is 5000 children.
Out of these 5000 children, we know that 2 in each 1000 will be admitted to hospital (ie 10 children).
But we know the hospitalisation rate with severe complications of chicken pox is 0.85 per 100 000 of the relevant population - lets call it 1/100 000 for simplicity).
This means that of the 10 hospitalised cases, one will have severe complications.

That seems to kind of work out about right, doesn't it Ivor?

 

[kellyb]

Let's try again:

If 1000 children get measles in the US, one dies. Check out the graph on this page:

http://www.healthsentinel.com/graphs.php?id=54&event=graphs_print_list_item

Just a public service announcment/FYI here...
Those are the kinds of charts antivaxers use to say "Measles was on the decline before the vaccine! It was improved sanitation that reduced measles incidence, not the vaccine!"
So you have to dig up the serology studies on people born before the vaccine was used to prove that everyone did, in fact, catch measles not too long ago.
Death went down a lot before, but only the vaccine has impacted incidence of infection with the virus.

 

[Deetee]

Let's try again:

If 1000 children get measles in the US, one dies.

Fair enough.
Lets assume 1 million kids are born in the USA each year.
Without vaccination, all will get measles at some point, and 1000 will therefore die.
But since there is near-universal vaccination in the US, out of the birth cohort in any given year, lets say 98% are vaccinated. Then only 2000 cases of measles will occur in that birth cohort, of whom 2 will die.
Vaccination has prevented 998 deaths. Each year.

ETA to say the case fatality rate for measles in the US is actually less than 1/1000, but I am using your figures to illustrate the point.

 

[Ivor the Engineer]

Just a public service announcment/FYI here...
Those are the kinds of charts antivaxers use to say "Measles was on the decline before the vaccine! It was improved sanitation that reduced measles incidence, not the vaccine!"
So you have to dig up the serology studies on people born before the vaccine was used to prove that everyone did, in fact, catch measles not too long ago.
Death went down a lot before, but only the vaccine has impacted incidence of infection with the virus.

The graph is useful because it shows both the incidence (which appears to stabilize at 235/100,000 just before the vaccine was introduced) and mortality(0.2 ish/100,000). It confirms that before vaccination, about 1 (or fewer) in 1000 died from measles.

ETA: I like this little snippet under the graph:

At the time of the introduction of the vaccine in 1963 the chances of death from measles was close to two in a million

 

[Skeptic Guy]

Fair enough.
Lets assume 1 million kids are born in the USA each year.
Without vaccination, all will get measles at some point, and 1000 will therefore die.
But since there is near-universal vaccination in the US, out of the birth cohort in any given year, lets say 98% are vaccinated. Then only 2000 cases of measles will occur in that birth cohort, of whom 2 will die.
Vaccination has prevented 998 deaths. Each year.

ETA to say the case fatality rate for measles in the US is actually less than 1/1000, but I am using your figures to illustrate the point.

Only 998 deaths prevented? You're right, it's all scare-mongering.

 

[Ivor the Engineer]

Only 998 deaths prevented? You're right, it's all scare-mongering.

Have you purchased your Kevlar vest yet?

998 deaths a year. Heck, we manage to kill over 3 times that many on the roads in the UK each year. Measles-Smeashles

 

[kellyb]

ETA: I like this little snippet under the graph:

That can't be right, though. I know the chart itself is accurate (well, you can email the CDC and ask them and they say it's right) but 2 in a million can't be right at all. The lowest estimate that could be squeezed out of anything would be closer to 100 out of a million.

 

[Ivor the Engineer]

That can't be right, though. I know the chart itself is accurate (well, you can email the CDC and ask them and they say it's right) but 2 in a million can't be right at all. The lowest estimate that could be squeezed out of anything would be closer to 100 out of a million.

300 million Americans / 500,000 = 600 deaths / year from measles.

Seems about right to me.

ETA: It also points to a much lower death rate than 1 in 1000 (closer to about 1 in 4000), which is consistent with other figures from around the world.

 

[kellyb]

300 million Americans / 500,000 = 600 deaths / year from measles.

Seems about right to me.

Well...yeah...if everyone in the US caught measles at the same time in one year at a rate of 2 per million.

Birth cohort! Birth cohort!

The US has about 4 million babies born a year...would be/was 4 millionish measles cases a year. No way we only had 8 measles deaths a year, you know? We had more cases of SSPE (rare but horrific measles complication)than that, I think.

On a somewhat related note to risk perception and whatnot, though...

http://www.cdc.gov/ncidod/EID/vol10no11/04-0624_11.htm

RSV is a major cause of respiratory infections in infants and young children; lower respiratory infections are the second most common cause of deaths worldwide, causing an estimated 2 million deaths per year in children <5 years of age. More than 4,000 infant deaths per year in the United States are attributable to RSV.

And this one includes deaths in the elderly:
http://www.cdc.gov/od/oc/media/pressrel/r030107.htm

In addition, about 11,000 people die per year from respiratory syncytial virus (RSV), a virus that causes upper and lower respiratory tract infections primarily in young children and older adults.

 

[Ivor the Engineer]

The figure is misleading because as you say, it is mainly members of the (much smaller) birth-cohort that would die.

The other way to look at it is picking a random American, of any age, and calculating the risk they would die of measles that year, based on the number of deaths of "all" Americans from measles per year.

 

[kellyb]

The figure is misleading because as you say, it is mainly members of the (much smaller) birth-cohort that would die.

The other way to look at it is picking a random American, of any age, and calculating the risk they would die of measles that year, based on the number of deaths of "all" Americans from measles per year.

Oooohhh...I see what you were saying now. Duh.

Sorry 'bout that. Ok. I see what you mean. That's the whole population risk. Gotcha'.

 

[Ivor the Engineer]

OK, how about this explanation model:

For every 100 000 cases of chicken pox in kids, 200 are admitted to hospital (=2/1000)

For each 100 000 children under 16 in any given year there will be 0.82 with severe complications from chicken pox they have contracted. This is the annual incidence of severe complications from chicken pox within the defined population (kids under 16).

Children will only be at risk at one point in time during their 16 years (or whatever the chosen limit is) rather than continuously, and this is where the discrepancy Ivor is getting at appears to come from.

Put another way, take 100 000 under 16 year olds and study them for a year. How many might get chicken pox in that time? Ivors assumption is that it is close to 100 000, but it is not, it will be less than 1/16th of this (say arbitrarily 1/20th)
This is 5000 children.
Out of these 5000 children, we know that 2 in each 1000 will be admitted to hospital (ie 10 children).
But we know the hospitalisation rate with severe complications of chicken pox is 0.85 per 100 000 of the relevant population - lets call it 1/100 000 for simplicity).
This means that of the 10 hospitalised cases, one will have severe complications.

That seems to kind of work out about right, doesn't it Ivor?

Yep. My misunderstanding. Given that there is about 12 million children in the UK, that works out to about 100 severe complications per year and 1000-2000 hospital admissions. Tiny numbers. What's next? Stomach bugs?

 

[Chris Haynes]

Wait, I thought we were talking about chicken pox?

Okay, measles.

What is interesting in a kind putting chicken pox together with measles is the story of the nurse in the UK who blamed the MMR for the death of her baby, when it turned out that the child had been exposed to chicken pox (and should not have been vaccinated to begin with, just like my oldest son's influenza and Dtap vaccine has been delayed until he recovers from a cold). In her grief she endangered a friend's baby by injecting the child with insulin:
http://news.scotsman.com/health.cfm?id=1699782007

... snip...
For a valid comparison, you'd need to compare the rate in the U.S. to the rate in an area with a similar standard of living/access to health care, that does not force the vaccination. You need to have indications of what a voluntary (rather than madatory) program would do to uptake rates for the vaccine, and in turn what that would do to the incidence of disease among the unvaccinated.

That would be Japan. Last spring several universty campuses were closed due to a measles outbreak. There are between 5000 to 10000 cases per year. According to the second link, double MMR vaccination has introduced in April 2006. According to the first link it says that in 1994 laws requiring mandatory vaccination were repealed. If you look at this table from WHO you can see the results:
http://www.who.int/vaccines/globals...series/TSincidenceByCountry.cfm?country=Japan

 

[Rolfe]

998 deaths a year. Heck, we manage to kill over 3 times that many on the roads in the UK each year. Measles-Smeashles

Don't you think that's a bit callous? Just pass up on the chance to save nearly 1,000 children's lives just because more are killed some other way?

What's the downside to the vaccination programme that you want to continue letting these children die? And don't come this "coercion" claptrap. Actual, concrete harm to offset these children's lives.

Rolfe.

 

[Skeptic Guy]

Have you purchased your Kevlar vest yet?

998 deaths a year. Heck, we manage to kill over 3 times that many on the roads in the UK each year. Measles-Smeashles

And what is the magic threshold at which we should start to care?

3,000 people?

10,000 people?

 

[Hellbound]

Just to point out something regarding the traffic death/measles analogy:

We regulate traffic, as well. Seat belt laws are common, speed limits, various safe driving praqctices, DUI laws, etc, etc, etc.

Why?

Because of the numbers they kill, and the numbers we can prevent with these laws. Are you likely to kill someone by doing "rolling stops" at a stop sign, or going 5 or 10 miles above the speed limit? Probably not, on an individual basis. DOes that mean these laws are not needed? Is the threat of traffic accidents "scare-mongering" and the threat of fines and penalties "coersion"?

 

[Chris Haynes]

Just to point out something regarding the traffic death/measles analogy:

We regulate traffic, as well. Seat belt laws are common, speed limits, various safe driving praqctices, DUI laws, etc, etc, etc.

...

Also automobiles have changed over the past several decades to reduce death and injury. The glass no longer breaks into sharp daggers, the frames are designed absorb crash forces and even steering wheels have been changed for safety reasons.

In the same way a vaccine helps change the human body's immune system to deflect infections like measles, mumps, etc.

 

[Ivor the Engineer]

Don't you think that's a bit callous? Just pass up on the chance to save nearly 1,000 children's lives just because more are killed some other way?

Only if spending the money on prevention or treatment for 'that some other way' would not save more lives using a similar amount of money. MMR is probably worth it. Varicella vaccine, no way! E.g, let's save 100's of kid's lives in the third world before we save 7 in the UK.

What's the downside to the vaccination programme that you want to continue letting these children die? And don't come this "coercion" claptrap. Actual, concrete harm to offset these children's lives.

Rolfe.

It's not the harm to 'these children's lives', it's all the other kids (and adults) who don't get treated (as well as they could) because there's less money and resources left to spend and use on them. Try explaining to a mother's children that she's going to die soon because we spent all the money vaccinating them against chickenpox, meningitis and flu.