Study quashes vaccine anxiety

[Skeptic Ginger]

See, I'm still wondering why talk of pandemic influenza is being used to push regular ole' flu vaxes.

It isn't. At least not by CDC or anyone who actually works in the field. However, when the next pandemic does occur, one reason to get regular flu vaccine if it is the time for it is to prevent symptoms that may mimic H5N1. In other words if you get regular flu you won't know if it is H5 for a while and that could be stressful.

Which, interestingly, have been proven to be extremely ineffective (right around 0% effective for preventing flu death)...so ineffective in the age group they are most often given in and that the flu is most often fatal in, that now the plan is to require kids to get the vax, in hopes that maybe that will change things.

It is not as simple as you state here. There is evidence fewer vaccinated kids (flu vaccine) are hospitalized during flu season than unvaccinated kids. Not all of them have cultures but we can still see the vaccine is working. We also know older people have milder cases of flu if vaccinated. But studies show that flu vaccine, for whatever reason didn't appear to impact the death rates from pneumonia during flu season. On the other hand, I believe the studies looked at total use of vaccine over time, and no subsequent affect on death rates. They did not compare vaccinated persons death rates with unvaccinated persons. Still, the results were what they were.

So different strategies are being investigated. But that doesn't mean the vaccine doesn't work. Time will tell and we need more studies as well.

 

[kellyb]

It isn't. At least not by CDC or anyone who actually works in the field.

Yes it is!
That #7 was on the list of "Recipe for creating demand for, and interest in ,the flu vaccine".
And it was a presentation given by Glen Nowak, the Director of Communications for the CDC's national immunization program.

Still, the results were what they were.

Right, but it makes no sense that the vaccine prevents the flu, but not flu deaths.
If the vaccine worked at all, there should at least have been, say, a 30% decrease in flu related deaths.
Seriously, take this thought through to it's logical conclusion:
A)The flu vaccine prevents the flu, or flu related symptoms, but not flu related deaths-
B)Among those who recieve the vaccine, their chances of contracting the flu are lessened-
c) But among those who recieve the vaccine, but do contract the flu, their chances of dying from the flu are slightly increased.

Really, that's the only logical end to the claim that it does prevent the flu, but not death from the flu.

Time will tell and we need more studies as well.

Agreed.

 

[Eos of the Eons]

Well, I was going to let it drop...but the mood here seems to be "defend the old DPT, it was never bad, but let's not talk about it, unless you have something good to say."

I don't know how you read that into my posts. Antivaxxers typically go on rants about vaccines in general. I would like to get down to the bare bones and look at the facts. Thus, I want to talk about currently used vaccines. The ones we actually give our children. I'm not ignoring past vaccines, since they saved lives and were safer than the diseases they allowed us to build up immunity against. If you want to harp on them, fine. I just find it pointless.

Why, in the world, are any kids anywhere still recieving this vaccine?

They no longer make the old ones, so they are not available to use. Instead, you are reading too much into the article. The study is comparing children getting current vaccines to morbidity of children that previously received the old vaccines. You need to read the definitions they give for the study's terms.

In your own quote it states:

There have, though, been some periods without DTP

So the kids only got OPV. You hysterically interpret this to mean currently, and that DTP shouldn't have been used?? When in fact, the words actually say that using DTP at that time in the PAST saved more kids than just using OPV.

We thus propose to study, in a randomised controlled trial of measles vaccination taking place in Guinea-Bissau, the immunology of non-specific effects of vaccination, and their interaction with sex. Specifically, among children who have received the 3 recommended doses of DTP

They will be looking at children that got the old vaccine when it was being used, not giving them the old vaccine. They will not being giving the children DTP, they are looking at kids who at one time got DTP.

I would recommend not cherry picking studies with terms that you are misinterpreting. The study shows that current vaccines are more effective at protecting children when they encounter the diseases.
The simple fact of the matter is that building up immunity with vaccines saves lives, and that vaccines are getting more effective. So why waste all the time drudging up misinformation and using misquotes to bash them?

 

[Eos of the Eons]

And onto Raven:

HERE is some info, straight from the horses mouth, on DTaP in this regard, which fully supports what I stated, which was that certain vaccines, INCLUDING those in use today, CAN cause seizures, and that such events are STILL recognized reactions as a result:

So? They "cause" far less seizures than the disease. I never said the vaccines don't ever cause fevers that might lead to the far less damaging seizures than the disease causes, in fact I already posted the rates. The fevers can even be prevented, lowering the risk further. You keep ignoring the fact that the diseases cause far more seizures, and the diseases even kill children.

So, in a world without any vaccination, we would see FAR more seizures and actual deaths. Is that preferable?

In a world with vaccination we see far less seizures and NO deaths. Is that not preferable?

Instead of ranting:

I did NOT come here to “bash vaccines”. I came here to see what was being said and found something I found to be erroneous and challenged it and was attacked by several people as some kind of proselytizing, rabid freak or something. Esp. interesting considering that this is the stereotype a few have presented regarding that other board (“don’t bother trying to post anything which disagrees with their belief or you will be attacked/booted”, to paraphrase the general sentiment)

then address the questions. Especially those above. I've pointed out stereotypes on that other board. The stereotype is that vaccinated kids are dumber, sicker, and "less natural". What stereotypes exist here? You say we have stereotypes here, then what are they?

Heck, I'll help you. The stereotype I have of antivaxxers are that they rant on about vaccines using misinformation and misquotes. I keep seeing that demonstrated here. You have done nothing to quell that stereotype, and instead keep on using misinformation and misquotes while ignoring the facts presented by myself and numerous others here. Argue the facts, and stop posting what I've already posted on seizure rates.

You've not been attacked, and most definitely not been booted. Unless you call being asked questions and for clarification "attacked". You're doing the same, but I don't feel attacked.

 

[kellyb]

They will be looking at children that got the old vaccine when it was being used, not giving them the old vaccine. They will not being giving the children DTP, they are looking at kids who at one time got DTP.

Read the study, Eos.

Purpose
OBJECTIVES
General: To investigate the immunological background for the non-specific effects of diphtheria-tetanus-pertussis (DTP) and measles vaccines on child mortality
Specific: Examine the cytokine responses and possible association with morbidity in a study of DTP vaccinated children who will be randomised to receive a measles vaccine or no vaccine at 4½ months of age. (All children will receive a measles vaccine at 9 months of age)

They're talking about 4 1/2 month old babies.

Further study details as provided by Bandim Health Project:
Primary Outcomes: Cytokine levels in the randomised groups
Expected Total Enrollment: 400
Study start: January 2006

Exactly how long ago did these 4 month old babies recieve the DTP?

And just in case anyone is confused, the new vaccine is called the DTaP.

 

[Eos of the Eons]

I read the study proposal IN CONTEXT. Something you clearly have failed to do, and even misread the very quote you put on these boards. They are using a measles vaccine.


Let's go over this again. In context.

We thus propose to study, in a randomised controlled trial of measles vaccination taking place in Guinea-Bissau, the immunology of non-specific effects of vaccination, and their interaction with sex. Specifically, among children who have received the 3 recommended doses of DTP, we will be able to compare the cytokine and antibody profiles of children who receive an early dose of measles vaccine at 4½ months of age with children who receive no additional vaccine at this age.

It states that kids will get the measles vaccine and be compared to kids who at one time got DTP. They won't be administering DTP, they will be administering measles vaccines.

 

[Eos of the Eons]

Exactly how long ago did these 4 month old babies recieve the DTP?

Oy, my turn to learn something. Where in the blazes is Guinea-Bissau? And what 4 1/2 month old gets 3 doses of DTP within 4 1/2 months?

 

[kellyb]

Examine the cytokine responses and possible association with morbidity in a study of DTP vaccinated children who will be randomised to receive a measles vaccine or no vaccine at 4½ months of age. (All children will receive a measles vaccine at 9 months of age)

It never mentions a group of older children. It's studying 2 groups of 4 1/2 month old babies.
Both get DTP. One gets the measles vax, and the other doesn't.

 

[kellyb]

And here are 2 manufacturers who still make the whole cell vaccine.
http://www.biofarma.co.id/vaccines.htm
http://www.seruminstitute.com/content/products/product_vac.htm

 

[Eos of the Eons]

I think the 4 1/2 month olds will be following some vaccine schedule, and by 6-9 months will have 3 doses DPT. They are studying it in conjunction with the measles vaccination. The measles vaccination starts at 4.5 months old.

Thank you for showing me that DTP is still used in some parts of the world.
I was WRONG to say it is no longer manufactured.

And do feel free to note my condescending tone, but also my willingness to admit I was WRONG about the manufacture of DTP, and use of DTP where these kids will get the measles vaccine, (will check before making such a blasse assertion again, my apolgies, plus gratitude for showing me where I was wrong).

My next question, is why use DTP when DTaP is available?
Is it cheaper, easier to store? They only differences is that DTaP contains parts of, rather than the whole pertussis cell. So why still use DTP?

Then, is it better to offer something like DTP, rather than nothing at all? I feel it is better to use DTP than nothing. I just don't know why they use it in this African area instead of DTaP.

*bows to kellyb*

Thank you for your presentation of information and patience.

 

[kellyb]

It's cool, Eos.

I'd imaging making an "antigen only" vaccine is a LOT more expensive/difficult than making a vaccine with whole-celled, killed bacteria.
But that's just a guess.

As to what's better, DTP or nothing at all...well, it apparently depends on a lot of factors...some of which this clinical trial is trying to sort out, it appears.
Those are the sorts of questions there aren't any easy answers for, but scientists are trying to figure it out, I guess.
I'm still shocked by the 3 fold decrease in mortality during times of DTP shortage. But there very well could have been lots of different factors at play, and the observed effect could have just been coincidence.
So, I dunno.

 

[SteveGrenard]

Oy, my turn to learn something. Where in the blazes is Guinea-Bissau?

It's on the west coast of Africa between Senegal and Guinea.

 

[Eos of the Eons]

I'd imaging making an "antigen only" vaccine is a LOT more expensive/difficult than making a vaccine with whole-celled, killed bacteria.
But that's just a guess.

Thank you again.

I get quite appalled at the lack of proper health care in some countries nowadays. We have so much we take for granted nowadays. The availablility of safer and more effective vaccines is one of them. This realization keeps me humble.

 

[Eos of the Eons]

It's on the west coast of Africa between Senegal and Guinea.

Thanks Steve

How many countries use DTP and how many use DTaP? In the countries that use DTP, who gets to decide? Is it a choice between cheap or nothing, or is someone just being cheap? How do you justify cheap over safe if that is what is happening?
Maybe I'll just be glad something is being used. I think the measles study is redundant. Why spend money on the study instead of using DTaP? Or, is the decrease in adverse events not significant enough to justify increased costs of DTaP? Allergic reactions are treatable, and risk of seizure is minimal with no long lasting effects in most cases, especially compared to the disease. Variables to consider.

Further, if there were a DTP/asthma association we should be seeing exceptionally high asthma incidence in just those countries with high levels of DTP immunization. This is clearly not the case. China, as just one of several examples that could be cited, has consistently high levels of DTP immunization, typically well above 90%,(18) but its incidence of asthma is among the lowest on earth.

http://www.geocities.com/issues_in_immunization/safety/Hurwitz_review.htm

Hmm, risk, benefit, costs. Weigh them all, and the countries that still use DTP can hardly be looked down on.

 

[SteveGrenard]

Thanks Steve

How many countries use DTP and how many use DTaP? In the countries that use DTP, who gets to decide? Is it a choice between cheap or nothing, or is someone just being cheap? How do you justify cheap over safe if that is what is happening?

Maybe I'll just be glad something is being used. I think the measles study is redundant. Why spend money on the study instead of using DTaP?

Hmm..I don't think this is a readily available statistic. Many poor small countries in Africa, and Guinea-Bissau is way down there, don't have much of a reporting health infrastructure and are lucky to have any health infrastructure at all. It could very well be a financial consideration and you're right, DTP is better than nothing at all. Who knows why they do what they do? All it takes is one well connected medical/politician on the ground there to inflict his preferences on the population. Trying to figure out why such decisions are made is a whole other set of politics. Am I also so naive not to think money isn't involved? No. Did you see
the film The Constant Gardener? It will make you jaded quick. Of course this is fiction.

http://www.toxicuniverse.com/review.php?rid=10005957

The Constant Gardener starts out a routine murder mystery, but like all the best mysteries, turn into something quite a bit more significant before it's done with us. Justin Quayle (Ralph Fiennes) is a diplomat with the British High Commission in Kenya, and his wife, Tessa Quayle (Rachel Weisz) has just died in a car wreck along with her colleague, Arnold Bluhm (Hubert Koundé), a Kenyan doctor whom local gossip held she was having an affair with. Lengthy flashbacks lay out Justin and Tessa's courtship, playing only slowly back up to the present, where Justin is quick to have suspicions about her death, and its connection to government collusion in ethically dicey experiments being run on the Kenyan populace by a massive pharmaceutical concern eager to develop a vaccine against the coming tuberculosis crisis.

 

[kellyb]

Well, it looks like it's extremely complex. I had no idea there would be this many variables to consider.
http://www.who.int/vaccines-documents/DocsPDF99/www9911.pdf

Dr Milstien noted that there were currently 33 countries where whole cell pertussis vaccines were produced, compared to eight producing acellular pertussis vaccines.
Any decision by WHO to recommend use of acellular vaccines would have impact on both the quantity and the quality of available pertussis vaccines. She agreed with the concept of joint ventures for transfer of technology for production of acellular vaccines by local producers, if done with total involvement of the relevant national
regulatory authority. Dr Mehta commented on the difficulties of theoretical application of methodologies in production of acellular vaccines in India. The issues are not only the costs of licensing fees, but government regulations in vaccine production and the application of intellectual property rights.

This next one is interesting, as it almost pertains to this thread right here, in a round about way.

Several participants indicated that public support for immunization programmes depends on trust in the overall efficacy and safety of the products used. Mr Holst and Dr Schild stated that the continued use of whole cell DTP vaccines of high quality is desirable and appropriate in developed and developing countries.
Drs Kane and Widdus reminded participants that there are occasions in which events can suddenly erode public confidence in vaccines, and the circumstances allowing such rapid erosion in public support exist in most countries; therefore, there must be constant monitoring of public confidence as well as disease burden and adverse events following immunization.

It also mentions patent issues, and the possibility that the acellular one might not work as well, among other things.

 

[Eos of the Eons]

Awesome link, thank you, very in depth.

In the United States, there is a clear transition to total use of DTaP vaccine
following infant immunization with three vaccines which began in 1996-97.
With fewer physician visits for adverse events following immunization, the use
of the acellular vaccine is only slightly less cost-beneficial than use of the whole...

China has effected pertussis control using whole cell DTP, and has recently
explored limited use of locally-produced DTaP vaccines. Currently, the crude
incidence of pertussis is below 1 per 100 000 and the surveillance of disease was
said to be estimated at 30-40% efficient in reporting of diagnosed pertussis.
Safety concerns have not been raised about the whole cell vaccine. The current
cost of acellular vaccines, accounting for under 0.5% of all pertussis vaccines
used in China, prevents any consideration of wider use.

Is there anything like this that is more current? I would hope the WHO has some follow up on the subject, but maybe they are not published. I will continue to look. For example, are they using more DTaP in China now?

It's the same with the polio vaccine. One may be safer, but less effective. In countries where the disease persists, you want the the more effective vaccine. Then, in countries where you no longer have the disease threat (thanks to vaccination), then you want safer.

Note that we don't have these comparisions with smallpox vaccinations. Eradicate the disease, and you don't even need to vaccinate.

Comparison testing for
immunogenicity and safety has indicated higher anti-PT and anti-FHA responses
following DTaP than after the whole cell vaccine studied. Fever following DTaP
occurred at the same frequency in placebo recipients (and up to 13% in whole cell
DTP recipients). Local erythema and induration were found in recipients of <2% of
doses administered. Use of DTaP as a booster was also associated with a lower
frequency of local reactions and higher anti-FHA and anti-PT. The cost of the vaccine
is ten times that of whole cell DTP...

...Current costs of DTaP vaccines imported for special purposes are almost 100 times the price of whole cell DTP, but Dr Homma believes DTaP vaccines could be used in the future if appropriate technology transfer were applied.

Ah, there we go. Thank you again for the link.

 

[Beth]

And onto Raven:

You've not been attacked, and most definitely not been booted. Unless you call being asked questions and for clarification "attacked". You're doing the same, but I don't feel attacked.

Actually, I think she has been attacked. Some people have only asked questions and asked her to clarify things, but others have accused her of holding extreme opinions she doesn't hold, advocating things she hasn't advocated, and then asked her to defend those looney positions. Her posts are consistently misread and always to her denigration as an intelligent thinking person.

She has not responded in kind, but been polite, rational and reasonable asking questions to clarify other people's position and where they got their information. She's also provided cites and has NOT engaged in wholesale denigration of other peoples sources of information due solely to the conclusions derived from that information.

The issue is, indeed complex, and there are room for dissenting opinons like hers. I hope she sticks around. I've learned a lot from her posts.

 

[Eos of the Eons]

Actually, I think she has been attacked. Some people have only asked questions and asked her to clarify things, but others have accused her of holding extreme opinions she doesn't hold, advocating things she hasn't advocated, and then asked her to defend those looney positions. Her posts are consistently misread and always to her denigration as an intelligent thinking person.

She has not responded in kind, but been polite, rational and reasonable asking questions to clarify other people's position and where they got their information. She's also provided cites and has NOT engaged in wholesale denigration of other peoples sources of information due solely to the conclusions derived from that information.

The issue is, indeed complex, and there are room for dissenting opinons like hers. I hope she sticks around. I've learned a lot from her posts.

Examples please. Especially of the extreme, and of the misreading.

Raven has indicated that she would prefer to take on the risks of disease. While that is a personal choice, there still has not been a good reason why.

Pointing out the risks of disease (particularly death) is not an attack.

I've quoted some rather impolite responses on Raven's behalf, but if you do not percieve them as such, then that is your perogative.

Some of her "cites" were not accurate, as I've already pointed out, but please continue to ignore that if you wish.

 

[kellyb]

...Current costs of DTaP vaccines imported for special purposes are almost 100 times the price of whole cell DTP, but Dr Homma believes DTaP vaccines could be used in the future if appropriate
technology transfer were applied

Yup. There it is.
The "technology transfer" is where it get's sticky. Patent issues.
Seems like there should be some kind of international law about that.

Discussion centred on the implication of patents on local production of acellular
vaccines in developing countries. Dr Olin stated that it appears that the patent and
proprietary issues are more important in the current use of available acellular vaccines
than the results of scientific studies. In the future, however, the primary question of
local production of acellular vaccines in developing countries may likely be one of
expense in production. This is possible since the production methodologies are
published and patents may have limited applicability; many patents for acellular
products/methods have less than 12 years to expiration.