Six Reason to Question Vaccinations

[Ivor the Engineer]

Apparently.... death from measles nowadays is caused by taking calpol for the fever...

http://gimpyblog.wordpress.com/2007...hens-observer-article-a-round-up/#comment-363

Have any studies been done comparing how quickly people recover from an illness with a mild to moderate fever when given an antipyretic, such as paracetamol, vs. placebo?

 

[kellyb]

I think the research is conflicting, but here's what the WHO has to say:


http://www.who.int/bulletin/volumes/81/5/ITMB0503.pdf

It is usually best not to suppress fever (pp. 367–374)
Antipyretics, including paracetamol, are commonly prescribed for children with pyrexia (fever) but there is no evidence that this is beneficial. Some studies, on the contrary, suggest that fever may have beneficial effects in infection, but this has not been proved. Paracetamol in therapeutic doses is generally safe, but hepatoxicity has occurred in children taking recommended dosages. There are not enough data to show whether it is safe to use paracetamol in situations where malnutrition is common. Treatment should only be given to children in obvious pain or discomfort. The question of whether fever represents a beneficial or harmful response to illness has been debated for hundreds of years, but the evidence to date suggests that in most circumstances it is beneficial.

 

[robinson]

Skeptigirl...This is a pretty pointless discussion, though.

No kidding.

 

[Skeptic Ginger]

Ironically, I think it is because they are so rare.

I ended up in a coma when I had the measles. There were a number of cases at the time, but I've never knowingly met anyone else who suffered as much. (Unknowingly, I did. Later I was told there were three of us on the ICU. I know one of the others didn't make it and I think I was also told that the other one never fully recovered if survived at all.)

My dad had polio as a young child and never walked again, yet I don't recall ever meeting anyone else who's had polio. (Possibly some of his friends or patients when I was younger, but I don't remember anything of the sort.)

There are probably a few more people, but you might not see them on the streets much, or if you do, you won't be able to tell.

FIW, I am mortified of these infections.

Sure but how many people know lots of folks harmed by vaccine side effects?

 

[Skeptic Ginger]

...However, I have my doubts over the risk to public health posed by meningitis. Why, exactly, do kids need to be vaccinated against bacteria that cause meningitis before they are allowed to go to school? There is a public health argument for compulsory vaccination for highly contagious diseases (though diseases such as chickenpox and mumps are pretty mild in the vast majority of children), but for rare and hard to transmit infections such as meningitis, what valid reason has the state got to deny public education to the children of parents who refuse those particular vaccinations?

ETA: http://www.vaccination.org.au/articles/article523.html

We have 3 vaccines for meningitis caused by 3 different organisms, H-flu, pneumococcal and meningococcal bacteria. You don't seem to know the facts about this one, Ivor.

The vaccines are recommended because for the first 2, they save a lot of lives. They are only given to young kids and I do not believe either are on the school vaccine requirements though I could be wrong and they may be included with preschool requirements. For meningococcal the vaccine is only recommended for certain higher risk groups. Recently teens were included again, because they were identified as specifically benefiting from the vaccine. Again however, meningococcal vaccine is not a school requirement to my knowledge.

Each state differs but for WA State:

Preschool vaccine requirements does include H-flu (HIb) but not pneumococcal or meningococcal.

School vaccine requirements does not include any of the three.

You are confusing recommendations with requirements.

 

[Skeptic Ginger]

Apparently.... death from measles nowadays is caused by taking calpol for the fever...

http://gimpyblog.wordpress.com/2007...hens-observer-article-a-round-up/#comment-363

This idiot believes one of the anti-vaxer lies:

You are kidding aren’t you. Measles deaths had been eradicated by 99% before vaccination even came along. Yet the medical profession ignorantly claim to be the protector of the nation when all evidence points to improved sanitation as the reason for infectious diseases not being the killers they used to be.

What a shame.

 

[kellyb]

You are confusing recommendations with requirements.

Here’s all the colleges with mandated Menactra:
http://www.immunize.org/laws/menin.htm


Here’s one state with a high school requirement for the meningcoccal conjugate vaccine:
http://www.bphc.org/bphc/pdfs/cdc_alerts/2005/Meningococcal-Disease-Vaccination_04-20-05 .pdf

Prevnar required for preschool and elementary:
http://www2a.cdc.gov/nip/schoolsurv/irPCV.htm

Hib's required in a lot of states, too.

It might be a few years, but eventually Menactra will be a common requirement for HS/JH, I'm pretty sure.

http://209.85.165.104/search?q=cach...ndate"+meningococcal&hl=en&ct=clnk&cd=1&gl=us

Mandates for adolescent immunizations: Recommendations from the Adolescent Working Group of the National Vaccines Advisory Committee

Over the following decade, these adolescent vaccine recommendations remained the same; however since January 2005, three new vaccines have been licensed and recommended for adolescents: tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap); tetravalent meningococcal conjugate vaccine (MCV4); and human papillomavirus vaccine (HPV). The recommended age range for routinely administering these vaccines is also 11-12 years, and catch-up vaccination is recommended for previously unvaccinated older adolescents. [CDC, 2007a; CDC, 2006a; CDC, 2005a; CDC, 2007b] Additional vaccines currently in development will likely be added to the adolescent vaccination schedule in the future.

Target population
Understanding the target population for receipt of a vaccine will help guide policymakers to determine which students should be included in a school mandate. For example, a vaccine recommended for 11 and 12 year olds would call for a mandate for entry into 6th or 7th grade. If there are catch-up recommendations for older populations, which is typical for newly licensed vaccines, a state may want to implement a mandate that affects a wider school population (e.g. 6th – 12th grade) so that more students can benefit from the new vaccine. However, implementation may not be feasible on this large a scale. When a new mandate is being considered, data on current vaccine coverage levels in the target population can be used to assess the scope of implementation efforts needed to achieve desired public health outcomes.

A potential source of controversy may occur when a mandate is directed at only a segment of the student population. For example, the HPV vaccine is currently only licensed for females, although it may be licensed for males in the future. A vaccine mandate directed specifically at female students might have to go through the legislative or regulatory process a second time if the vaccine were later recommended for male students as well. Some policymakers may also find a school mandate directed toward females discriminatory in nature and may prefer not to enact a mandate until it can be implemented among the entire target population.

After ACIP recommendations are made, policymakers should allow for an adequate time to address the above considerations prior to determining whether or not to create and implement a mandate for any vaccine. As recommended by the Association of Immunization Managers (AIM), this implementation period would allow policymakers to consider and address critical elements related to vaccine introduction as well as seek the input of state and local health department personnel, thereby improving a school mandate’s potential effectiveness in increasing vaccination coverage. [AIM, 2006] The Washington State Board of Health has also developed guidelines for the adoption of state vaccine mandates, in an effort to outline locally-relevant criteria that can be applied by decision makers as new vaccines are licensed. [Washington State Board of Health, 2006] These criteria include, among others, review of vaccine effectiveness, disease burden, and implementation issues. Thorough consideration of such issues before moving forward with a school mandate will help ensure that the full public health benefit of vaccines recommended for adolescents is realized and that the U.S. immunization program is strengthened overall.

 

[Eos of the Eons]

However, I have my doubts over the risk to public health posed by meningitis.

I personally know two children that died of meningitis. One was my friend's nephew. Everybody in my city clamoured for the vaccine as soon as it became available. I stood in line 3 hours to make sure my kids got that shot.

 

[Ivor the Engineer]

I personally know two children that died of meningitis. One was my friend's nephew. Everybody in my city clamoured for the vaccine as soon as it became available. I stood in line 3 hours to make sure my kids got that shot.

Then there must be a lot of irrational people in your city. How does it feel to be controlled by fear?

ETA: http://www.meningitis.org/disease-info/whats-the-risk

Am I at risk?
The risk of getting the disease is very low. Although meningococcal disease is infectious and can cause outbreaks, 97 out of every 100 cases are isolated, with no link to any other cases.

The bacteria that cause the disease are very common: at any time about one in ten of us has them in our noses and throats without ever knowing they are there, and for most of us this is harmless. We pass the bacteria between each other by close contact (e.g. kissing).

Usually we have to be in very close or regular contact with someone for the bacteria to pass between us. Even when this happens, most of us will not become ill because we have natural immunity.

The bacteria cannot live longer than a few moments outside the human body, so they are not carried on things like clothes and bedding, toys or dishes.

 

[Skeptic Ginger]

That Boston law you are citing kelly refers to "residential schools". That is not all schools. And the colleges pretty much are going to be addressing living in the dorms for the memingococcal vaccine though I see a few which appear to apply to all kids.

My son who is living in the dorm this year had to document his 2 doses of MMR or positive titers or he couldn't start college. They never even mentioned the meningococcal vaccine which I found negligent on their parts. I made sure my son and his friends got theirs. And I contacted the school and reminded them of the CDC recommendations. I hope to see notices going out to dorm residents by next quarter or I will contact the school again.

The pneumococcal vaccine list notes "age appropriate" in all cases where it is required except the Marianas Islands. That would mean preschool only.

 

[Ivor the Engineer]

That Boston law you are citing kelly refers to "residential schools". That is not all schools. And the colleges pretty much are going to be addressing living in the dorms for the memingococcal vaccine though I see a few which appear to apply to all kids.

My son who is living in the dorm this year had to document his 2 doses of MMR or positive titers or he couldn't start college. They never even mentioned the meningococcal vaccine which I found negligent on their parts. I made sure my son and his friends got theirs. And I contacted the school and reminded them of the CDC recommendations. I hope to see notices going out to dorm residents by next quarter or I will contact the school again.

The pneumococcal vaccine list notes "age appropriate" in all cases where it is required except the Marianas Islands. That would mean preschool only.

LOL!

How small does a risk have to be before failure to inform someone about it is *not* negligent in the US?

 

[Ivor the Engineer]

Calls for the UK to introduce the varicella vaccine as standard for all children.

http://news.scotsman.com/health.cfm?id=1772922007

...

During a 13-month period between 2002 and 2003, 188 cases of chickenpox complications leading to hospitalisation were reported to the British Paediatric Surveillance Unit. Of these, 112 children met the criteria to be included in the study - a rate of 0.82 cases per 100,000 children. The average age of those suffering complications was three.

...

The researchers wrote: "Universal vaccination would be the only realistic option to prevent severe complications and deaths as few, if any, could be identified as potentially preventable under current UK policy."

In an accompanying editorial, Professor Adam Finn, and colleagues from Bristol University, argued immunisation against chickenpox should be introduced in the UK.

...

Getting chickenpox is probably one of the safest things you could ever do in this life.

I'm starting to think public health researchers are just an extension of pharmaceutical companies' lobby groups when they come out with crap like this.

 

[Physiotherapist]

I couldn't agree more!!!

 

[Rolfe]

Calls for the UK to introduce the varicella vaccine as standard for all children.

http://news.scotsman.com/health.cfm?id=1772922007



Getting chickenpox is probably one of the safest things you could ever do in this life.

I'm starting to think public health researchers are just an extension of pharmaceutical companies' lobby groups when they come out with crap like this.

I just heard a very thoughtful radio discussion of this by a paediatric epidemiologist. He was talking about the need to balance the actual risk of harm and the degree of harm caused by chickenpox, with the costs of the vaccine - principally financial costs. He was clear that it was a balanced judgement call, but that the arguments in favour of vaccination were stronger than might be percieved by the casual observer.

Forgive me, and call it argument from authority if you like, but I'm more inclined to give weight to the considered opinion of an expert in the field who has himself given great thought to the matter, than to a knee-jerk opinion about chicken pox being safe and paediatric epidemiologists being pharmaceutical lobbyists.

Rolfe.

 

[Ivor the Engineer]

I just heard a very thoughtful radio discussion of this by a paediatric epidemiologist. He was talking about the need to balance the actual risk of harm and the degree of harm caused by chickenpox, with the costs of the vaccine - principally financial costs. He was clear that it was a balanced judgement call, but that the arguments in favour of vaccination were stronger than might be percieved by the casual observer.

Forgive me, and call it argument from authority if you like, but I'm more inclined to give weight to the considered opinion of an expert in the field who has himself given great thought to the matter, than to a knee-jerk opinion about chicken pox being safe and paediatric epidemiologists being pharmaceutical lobbyists.

Rolfe.

I'd have two questions for him:

1) Does the immunity provided by the vaccine wane?

2) Will people who have already had chickenpox be more likely to get shingles if mass vaccination takes place?

ETA: How the figures are fudged:

http://www.slate.com/id/2114797/

...the pharmaceutical industry charges my pediatric practice about $46 per dose to recoup its research and development costs and to turn a substantial profit. Because the illness is mostly mild, it's hard to make a good economic case for it based on medical savings. But the ledger balances in favor of vaccination when you take into account another potential savings: parental work time. Itchy, infectious kids often have to stay home from school for five or six days, and someone has to stay home with them. Six days multiplied by almost-every-child comes to a whole lot of lost time at the office—a significant drain on the economy.

 

[robinson]

The effect of vaccination on the epidemiology of varicella zoster virus.
The Journal of infection
Edmunds WJ, Brisson M.

Immunisation Division, Colindale, London NW9 5EQ, UK.

Varicella zoster virus (VZV) causes chickenpox (varicella) on primary exposure and can reactivate later in life to cause shingles (zoster). As primary infection is more serious in adults than children, and exposure to the virus might boost the immune response to both chickenpox and shingles, there are two main concerns regarding infant VZV vaccination: that it could lead to an increase in adult disease; and/or that it could lead to a temporary increase in the incidence of shingles. This paper reviews the evidence for such outcomes. The consensus view of mathematical modelling studies is that the overall varicella associated burden is likely to decrease in the long term, regardless of the level of vaccine coverage. On the other hand, recent evidence suggests that an increase in zoster incidence appears likely, and the more effective vaccination is at preventing varicella, the larger the increase in zoster incidence. Targeted vaccination of susceptible adolescents and/or the contacts of high-risk individuals can be effective at preventing disease in these individuals with minimal risk to the community. However, targeted strategies would not prevent most disease (including most severe disease), and will not lead to a long-term reduction in the incidence of zoster. Understanding the mechanisms for maintaining immunity against varicella and zoster is critical for predicting the long-term effects of vaccination. Meanwhile sensitive surveillance of both chickenpox and shingles is essential in countries that have implemented, or are about to implement, varicella vaccination.

 

[kellyb]

I'd have two questions for him:

1) Does the immunity provided by the vaccine wane?

2) Will people who have already had chickenpox be more likely to get shingles if mass vaccination takes place?

1)In the US, the CDC has said we'll basically just keep adding as many additional doses as is needed. (We're at two doses now, there's been talk of a third...yes, it wanes fairly quickly in the absence of wild circulation. )

2) Quite possible, but Merck has a new vaccine for all the rest of us now called "Zostavax" that prevents shingles.

 

[Deetee]

Calls for the UK to introduce the varicella vaccine as standard for all children.

http://news.scotsman.com/health.cfm?id=1772922007.

Just love the comment by "Rab C Nesbitt" - came over all homesick like....

I am uncertain as to the benefits of universal vaccination. There are many things to consider including the need for boosters, the likelihood of up to 10-15% non-response and these people being susceptible as adults to more severe presentations of chicken pox.

Also, I understood that you could not give other live vaccines like varicella at the same time as MMR, since the response is blunted. So why are they calling for a "4 in 1"?

One thing no-one seems to have mentioned is the option of treating chicken pox in childhood with appropriate antivirals (e.g. aciclovir) to render the illness less severe - there is no reason why one should not do this, and it would avert the cases of severe chickenpox/complications, whcih as Ivor points out are rare anyway.


ETA: Here is the varicella / MMR stuff

 

[kellyb]

I am uncertain as to the benefits of universal vaccination. There are many things to consider including the need for boosters, the likelihood of up to 10-15% non-response and these people being susceptible as adults to more severe presentations of chicken pox.

The effectiveness of the first dose in the US is now considered to be closer to 70-80% after secondary vaccine failure is taken into account. (Lack of wild circulation, etc.) So we've had a bit of an explosion here in an older age group in the past couple of years.

Also, I understood that you could not give other live vaccines like varicella at the same time as MMR, since the response is blunted. So why are they calling for a "4 in 1"?

We have a MMRV (called ProQuad) now...they just put a super-high varicella load in there, and Merck self-reports a slightly higher seroconversion rate to all 4 components with that one. This has never, to my knowledge, been tested/affirmed outside of Merck labs, but that's what they're saying when Merck is allowed to use what they refer to as an 'appropriately sensitive tests". (These same "appropriately sensitive tests", whatever that means, say the first mumps dose seroconverts 99% of people, too.)

 

[Professor Yaffle]

I think the risk of increased shingles has been the main reason e haven't had the hickenpox vaccine in the UK so far. It would be interesting to see how much of an increase might result. Are there any figures on shingles for the US pre/post chickenpox vaccine introduction. And what is the uptake of the vaccine like?