Measles vaccine coverage stagnant – increased measles cases in 2017

measles vaccine coverage

According to new research published by the CDC and World Health Organization (WHO), worldwide measles cases have spiked in 2017. Multiple countries have reported severe and protracted measles outbreaks over the past year. Because of large gaps in measles vaccine coverage across the world, there were an estimated 110,000 worldwide measles-related deaths in 2017.

Let me repeat that – 110,000 measles-related deaths in 2017. This is a disease that the anti-vaccine religion will claim over and over that it’s not a very dangerous disease. Even in the USA, where it is estimated that 1-2 children will die out of 1,000 infected by measles, it is still a dangerous disease. Of course, anti-vaxxers dismiss that risk of death as “low,” showing little empathy for children that die of measles every year.

There are other serious complications of measles:

Measles is not trivial. And the only way to prevent the highly contagious disease is with two doses of the measles vaccineContinue reading “Measles vaccine coverage stagnant – increased measles cases in 2017”

Attacking SB277 with another lawsuit –Torrey-Love v. State of California

On 21 November 2016, a new lawsuit attacking SB277, the state’s statute removing the personal belief exemption from immunization requirements, was filed with a federal district court in Riverside (Central District of California, Eastern Division), assigned to Judge Dolly M. Dee. The complaint, like previous lawsuits, faces serious hurdles.

Continue reading “Attacking SB277 with another lawsuit –Torrey-Love v. State of California”

Flu vaccine cost – reason for some millennials to avoid it

flu vaccine cost

The 2016-2017 flu season has commenced in the Northern Hemisphere, and your best choice to avoid the effects of the flu is the seasonal flu vaccine. Despite the known dangers of the flu, even for healthy young adults, and the overall safety and effectiveness of the flu vaccine, the uptake of the flu vaccine has been stubbornly low. As we’ll see later, maybe some of the reasons may be the flu vaccine cost.

During the 2015-2016 flu season in the USA, the CDC estimated the flu vaccine uptake for children, 6 months to 17 years old, was around 59.3%. And for adults, greater than 18 years, the uptake was estimated to be 41.7%. Both numbers are well below the 80-90% uptake required for herd immunity against the flu.

There are a lot of excuses for not getting the flu vaccine, even amongst dumb ass health care workers, but most of them are complete nonsense. However, there might be one excuse that can be hard to criticize – the flu vaccine cost.

Flu vaccine cost – the millennials

 

In September, the Harris Poll found that 52% of millennials plan to avoid getting the flu shot during the 2016-17 flu season. The poll, done on the behalf of the CityMD urgent care center network, showed that the millennials (the generation born between the early 1980s and the early 2000s) gave the following reasons for not getting the flu vaccine:

  • 49% said they don’t trust that it will keep them from getting the flu
  • 29% said they think it could make them sick
  • 25% don’t want to spend the money
  • 23% don’t think they need it because they’ve never gotten the flu
  • 4% don’t know where to get the flu shot

Let me quickly debunk these reasons (except for the flu vaccine cost which we’ll examine later). First up, the flu vaccine does vary in effectiveness from year to year. However, given the seriousness of the flu, that most individuals probably can’t work for over a week, especially if you have one nanogram of concern about contaminating your co-workers – even if the flu vaccine’s effectiveness is only 50%, that reduces one’s risk by that amount. Remember, there are complications from the flu, even to healthy adults, that include death. And if you are in any risk group, such as a diabetic, complications from flu can be much worse.

Next on the hit parade is the belief that the flu vaccine causes the flu. This is one of the most inane, ignorant and thoroughly debunked myths about the flu vaccine. It is biologically implausible, if not completely impossible, for the inactivated, or attenuated, viruses in the vaccine to become infectious in a human. There is simply no evidence that the flu vaccine causes the flu.

The next point, that they have never gotten the flu, is also ridiculous. I suppose, by some random combination of events, someone may have avoided the flu, possibly because everyone around them got the flu vaccine. But as they say in those financial adverts on TV, past performance is not an indicator of future results. No one is inherently immune to the flu, so there is a strong random probability one will eventually catch it if they are not immunized. Every year brings new flu virus subtypes, and unless one is vaccinated against them, they are at risk of catching it.

The last point about not knowing where to get the flu shot is laughable. Just about every pharmacy chain in the USA provides the vaccine. Many health departments have flu clinics. Every physician gives the vaccine. That’s the lamest excuse ever.

Now let’s get back to the point I skipped – the flu vaccine cost. I know a lot of millennials are shouldering a huge amount of student debt, can’t find decent jobs, and probably living on handouts or “loans” from their parents. And maybe on the list of life’s necessities, a flu vaccine ranks down near the bottom. But are you millennials looking at these financials decisions in rational manner? I say not.

  • Generally, the flu takes 7-10 days for recovery and to be past the contagious stage. The cost of missing work, if you are hourly or don’t have sick leave, can reach hundreds of dollars.
  • Treating the flu, from prescription drugs like Tamiflu to over-the-counter flu symptom relievers of limited efficacy, probably costs more than your typical flu shot.
  • The risk of complications is high. If the flu develops into pneumonia, one might have to go to an emergency department somewhere, which will also cost more than the flu.

In other words, avoiding the cost of the flu vaccine may actually cost you more in the long run. I know that many of us make short-term economic choices, but in this case, the risk of spending much much more far exceeds the relatively low cost of the vaccine.

In general, the flu shot runs from $14.99 to around $30 at many places in the USA (and now, the 4% of you millennials who don’t know where to get the flu shot, here you go):

  • Costco Flu Shots: Costs $14.99 for standard trivalent (protection against 3 strains of flu). No quadrivalent (protection against 4 strains). If you don’t have health insurance, Costco is, by far, the cheapest. So when you’re picking up a case of Cheetos, get your flu short for less than a six pack of craft beer.
  • CVS Flu shots: No trivalent (though possibly they will later). Costs $39.99 for quadrivalent. You get a 20% off one-time coupon valid on non-sale merchandise and non-pharmacy purchases up to $50 (maximum value $10).
  • Walgreen’s Flu Shots: Costs $31.99 for standard trivalent. $39.99 for quadrivalent.
  • Rite Aid Flu Shots: Costs $32.99 for standard trivalent. $39.99 for quadrivalent.
  • Meijer Flu Shots: Costs $27.99 for standard trivalent. $50 for quadrivalent.
  • Wal Mart Flu Shots: Costs $27.88 for standard trivalent. $32.54 for quadrivalent.
  • Sam’s Club Flu Shots: Costs $15 for standard trivalent. $25 for quadrivalent.
  • Kroger Flu Shots: Costs $30 for standard trivalent. $40 for quadrivalent.
  • Target Flu Shots: No trivalent (as of now). $39.99 for quadrivalent. Note that CVS now runs Target pharmacies (prices are the same), but you do get a $5 Target gift card if you get a flu shot at a Target CVS pharmacy.

But you really can get these vaccines for free. If you have health insurance, especially under Obamacare, you can get the vaccine for free, or for a small co-pay. Like I mentioned previously, most county health departments give away the vaccine for free, so contact them. Even if they have rules which say they’ll only vaccinate kids or the elderly, most will make exceptions if it’s hard to afford.

Yes, there might be a reason to fear the flu vaccine cost, but really, there are no excuses. It might take some work, go get the flu vaccine, and maybe save your life.

 

Citation

California SB277 vaccine law preliminary injunction hearing

SB277 vaccine law

Today I attended the hearing for a preliminary injunction in the Whitlow suit, one of the lawsuits against California’s SB277 vaccine law. I arrived early to try and get an impression of the judge, and because I was worried that there would be no room in the court (in the end, everyone who wanted got in). I sat in the court from 11am, and after the courtroom was cleared for lunch break stood in line until it was opened, around 1:15.

Below are my impressions. Since Judge Sabraw ordered that all electronic devices be off during the hearing, and I did not bring a legal pad, I could not take notes, so this is based on my recollections – and I apologize to the lawyers on either side if I misremembered their points. I’ll be happy to be corrected on any details.

In this hearing, the question was whether plaintiffs should get a preliminary injunction, an order putting the SB277 vaccine law on hold until the case is decided.

The standard for a preliminary injunction is a four part standard that looks at:

  1. chances of winning on the merits;
  2. whether there will be irreparable harm to the plaintiffs without the injunction;
  3. how the balance of equities falls – whether the harm to the plaintiffs is larger than the harm to the defendants from granting the injunction;  and
  4. whether an injunction is in the public interest. In the hearing, most of the focus was on the legal merits, though there was some discussion about the potential harm to the plaintiffs.

I admit that my impression was that on almost every issue the state had a better argument, with stronger case law supporting it. However, I am – obviously – a supporter of the SB277 vaccine law, and that may bias my views. It was a long hearing, and I’m no doubt not covering every detail.  Continue reading “California SB277 vaccine law preliminary injunction hearing”

HPV vaccine lowers cancer risk and healthcare costs

HPV vaccine lowers cancer risk

If you overlook the plain ignorance of junk medicine pushers on the internet, it’s clear that there’s only a few things that you can do to lower your risk of cancer.  Quitting tobacco is probably the biggest one. But right up there is the fact that the HPV vaccine lowers cancer risk – and as a consequence, lowers health care costs generally.

Despite it’s clear benefit to human health, the HPV cancer preventing vaccine, also known as Gardasil, is under utilized in the USA. There seems to be a lot of reasons why HPV vaccine uptake is low, but the evidence is clear that it is safe, it reduces cancer risk, and it lowers the costs of healthcare.

So, let’s take a look at some of the data.

Continue reading “HPV vaccine lowers cancer risk and healthcare costs”

California’s vaccine exemption laws – clustering effects

All 50 US states (along with several territories and DC) require mandatory vaccination for children entering public (and frequently, private) schools. This system has essentially ended most vaccine preventable diseases in the USA, including measles, polio, chickenpox, and many others.

Broad vaccination is considered one of the 10 greatest achievements in public health. Vaccines should probably be number 1 on the list. Overall, the immunization mandate has established a strong herd effect, which has generally ended transmission of these diseases.

Even though vaccinating children before they enter school is mandatory, there are ways around it, if you choose. Every state allows medical exemptions, which is based on a proven risk for a child to not be vaccinated with one or more vaccines. For example, some vaccines are produced in chicken eggs, and a tiny percentage of children are allergic. Medical exemptions are absolutely critical to the well being of the child, and no pro-science (pro-vaccine) writer or researcher would be opposed to those types of exemptions.

Furthermore, most states have vaccine exemption laws which allows personal belief exemptions (PBE). These PBEs fall into one of two groups–religious exemptions, that is, the parent “claims” that their religion is opposed to vaccines; or personal exemptions, which are simply based on the fact that the parents are opposed to vaccination for whatever reason that hits their brain after 20 minutes of Googling “facts.”

Most states allow both types of exemptions, some only allow religious exemptions, and one state, Mississippi, allows only medical exemptions. As a progressive, there is little positive I can say about Mississippi, but this is a major positive. So congrats Mississippi for caring about children, at least in this one important way. Continue reading “California’s vaccine exemption laws – clustering effects”

Yes, herd immunity works

Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), is a frequent contributor to this and many other blogs, providing in-depth, and intellectually stimulating, articles about vaccines (generally, but sometimes moving to other areas of medicine), social policy and the law. Her articles usually unwind the complexities of legal issues with vaccinations and legal policies, such as mandatory vaccination and exemptions, with facts and citations.

Professor Reiss also writes extensively in law journals about the social and legal policies of vaccination. Additionally, Reiss is also member of the Parent Advisory Board of Voices for Vaccines, a parent-led organization that supports and advocates for on-time vaccination and the reduction of vaccine-preventable disease.

This piece is a summary of Herd Immunity and Immunization Policy: The Importance of Accuracy, soon to be published in v. 94 of Oregon Law Review.

In an article that was published in the Oregon Law Review in 2014, authors Holland and Zachary claimed that school immunization mandates are inappropriate because they reject the concept that herd immunity works.

This piece will explain  why Holland and Zachary’s analysis is simply incorrect. And let’s be clear–there is a legitimate debate about  whether school immunization mandates are appropriate, policy wise, as a response to non-vaccination.

Unlike vaccine science, the appropriate policy to handle non-immunization is not agreed upon, and the data on what is the right way to get people to vaccinate is anything but clear (though some things are clear: for example, harder to get exemptions lead to higher vaccination rates). But the debate needs to be premised on accurate facts – not on misuse of legal terms and incorrect scientific data. Holland and Zachary’s article does not provide that. Continue reading “Yes, herd immunity works”

Anti vaccine cult – violent threats against California Senator

The anti vaccine cult has hit another low, sending out violent death threats against California Senator Richard Pan, who introduced SB 277, the bill that would repeal the personal belief exemption to school vaccine mandates. The bill still allows for legitimate medical exemptions (like immunocompromised children who need to be protected through the herd effect).

Although Sen. Pan is the leader of the legislators who are attempting to make this bill into law, many other lawmakers are championing mandatory vaccines for children to protect the general population have withstood intense and illogical criticism from the anti vaccine cult.

Continue reading “Anti vaccine cult – violent threats against California Senator”

Why we vaccinate–to protect our children from pertussis

 

tdap-mother-pertussis

During this past week, a 25 day old baby in Santa Barbara, CA died from pertussis, commonly known as whooping cough (caused by the Bordetella pertussis bacteria). The disease can be easily prevented by the DTaP or Tdap vaccines (also protect against tetanus and diphtheria), which can be given to infants as early as 6 weeks to 2 months old.

According to the California Department of Public Health, infants who are too young to be fully immunized or those who are not vaccinated are most vulnerable to severe and fatal cases of pertussis. In 2014, 66 of the pertussis hospitalizations cases were children four months of age or younger. Two infants have died of pertussis in California during 2014. Continue reading “Why we vaccinate–to protect our children from pertussis”

Infant T cells don’t remember pathogens–causes weaker immunity

active-immunityIf you hang out in various vaccine discussions, you will hear all kinds of odd, unscientific ideas about the immune system of infants. One of the major issues is a substantial oversimplification of the immune system (of adults and infants), mostly thinking it’s one “thing,” ignoring the complex physiology of the immune system which is an almost infinite number of interactions between cells, proteins and factors, organs, blood, fluids, and other physiological systems.

Generally, the popular assumption is that the infant immune system is weak, making those children more prone to viral or bacterial infections. The antivaccine crowd uses this belief to either state that vaccines won’t work or might actually harm the immune system, along with some overstated magical properties of human breast milk to prevent infection.

But according to a new study, led by Dr. Brian Rudd of the Department of Microbiology and Immunology at Cornell University, published in the Journal of Immunology, the immune system of newborns and infants is actually stronger than an adult’s immune system. Unfortunately, it has a short “memory.” Continue reading “Infant T cells don’t remember pathogens–causes weaker immunity”