## Hey vaccine deniers–it’s just simple math. Part deux.

A few days ago, I wrote an article discussing how antivaccination trope inventors could not understand the most basic elements of mathematics in reading a vaccine label. They misinterpreted some simple math like that the toxic level of a substance is several million times higher than what is injected. I suppose in the minds of vaccine deniers, 1=1 billion. Or 1 trillion. Or 4783.2226. It just depends.

And if they can’t understand the simplest of math principles, assuming that they would understand population level statistics might be a really bad assumption.

Recently, I was pointed to an antivaccination article, on the Political Blindspot website, which is dedicated to finding news articles swept under the rug by mainstream media. My skeptical radar always goes into full energy mode whenever I see the word “mainstream.” Continue reading “Hey vaccine deniers–it’s just simple math. Part deux.”

## Student Nurse Perspective: The Flu Vaccine.

Ingvar Árni Ingvarsson, a student nurse in the UK, wrote an excellent perspective on vaccines from his nursing eyeballs, which he graciously allowed me to re-post here.

Little intro might be handy for this. This post has been on my mind for a long time now and finally I decided to pull my finger out and actually write it. What is to follow will be a mixture of factual, scientific and anecdotal writings. Because that is the way I roll. I have been itching to write something, anything about vaccinations for a little bit now, but so far decided not to because there are so many out there who do it and do a better job of it then I would dream of, so I’ll list some. Skeptical Raptor, Respectful Insolence, Red Wine & Apple Sauce, Just The Vax and many many more.

Prior to starting my nursing course I was very much into my slightly alternative medicine. I was on the fence regarding vaccines, not just the flu vaccine but all vaccines. Now that I think back on it I’m not really sure why. It was never really something that I thought about properly until I started my university course. What was probably a turning point for me was the amount of patients over 70 I came across who had to use callipers and wheelchairs because they contracted polio when they were kids. I have never come across a patient under 70 who has had polio. Never. This sort of got me thinking about the importance of vaccination, and if there is one thing that I have learned since starting uni is that evidence is the key. Continue reading “Student Nurse Perspective: The Flu Vaccine.”

## 2-dose varicella vaccine regimen – decline of chickenpox

The varicella vaccine for chickenpox was introduced in the mid-1990’s in the USA and has been associated with substantial and statistically significant declines in incidence, hospitalizations and deaths attributable to chickenpox.

Despite the beliefs of vaccine refusers, who  have stated emphatically that chickenpox is not dangerous, the real complications from a varicella infection are numerous and serious:

• dehydration
• pneumonia
• bleeding problems
• infection or inflammation of the brain (encephalitis, cerebellar ataxia)
• bacterial infections of the skin and soft tissues in children including Group A streptococcal infections
• blood stream infections (sepsis)
• toxic shock syndrome
• bone infections
• joint infections

Let’s take a look at the facts – the varicella vaccine has actually lead to a significant reduction in the incidence of chickenpox in children.

## Vaccine exemptions contribute to outbreaks of preventable diseases

Once again, a new study is published in a peer reviewed journal that shows that exemptions to proper and recommended levels of vaccination for children before entering public school are harming the general population. I’ve talked about the issue of exemptions causing outbreaks or epidemics previously in New York, Washington, and other places

Over the past few years, there have been several outbreaks of whooping cough (Bordetella pertussis), including one that reached over 9000 individuals in California in 2010, considered one of the worst pertussis outbreaks in the USA during the past several decades

The original DTP vaccine (diphtheriatetanus and pertussis) became available in the USA in 1948 and was critical to dropping the number of cases of whooping cough from 260,000  in 1934 to less than a few thousand per year in the 1990′s. The Advisory Committee on Immunization Practices (ACIP) recommends (pdf) that children should get 5 doses of DTaP (the replacement for the original DTP vaccine), one dose at each of the following ages: 2, 4, 6, and 15-18 months and 4-6 years. Those children who are not completely vaccinated according to these ACIP recommendations for pertussis are considered to be “undervaccinated.”

• 1 in 4 (23%) get pneumonia (lung infection)
• 1 or 2 in 100 (1.6%) will have convulsions (violent, uncontrolled shaking)
• Two thirds (67%) will have apnea (slowed or stopped breathing)
• 1 in 300 (0.4%) will have encephalopathy (disease of the brain)
• 1 or 2 in 100 (1.6%) will die. In 2012, pertussis killed 18 infants in the USA.

Even in adults, there are substantial complications from whooping cough, such as broken ribs from coughing, that can have a significant impact on the overall health. Continue reading “Vaccine exemptions contribute to outbreaks of preventable diseases”

## Repeated contact with mumps may overwhelm immunization

A recent study, published in The New England Journal of Medicine, concluded that after an intense face-to-face educational technique, used among Orthodox Jews, apparently led to an outbreak of mumps in 2009 and 2010, despite high vaccination rates in the group. In a one-year period, from June 28, 2009, through June 27, 2010, 3,502 cases of mumps were reported in New Jersey, New York City and New York’s Orange and Rockland counties. The study examined 1,648 of those cases, 97% were Orthodox Jews, and found 89% had received two doses of the vaccine and 8% received one dose, a relatively high rate of vaccination.

Many of the individuals attended a religious school where they practiced an intense training technique called chavruta, which involves close contact with a partner across a narrow table. Partners change frequently, and he discussion is often loud and may involve shouting since a larger group may be close to each other, all trying to make an argument or point. This prolonged contact overwhelmed the immunity, from the mumps vaccination (part of the MMR vaccine), for individuals. The study did find high rates of two-dose coverage reduced the severity of the disease and the transmission to people in settings of less exposure. Also, the study found that mumps did not spread outside of the Orthodox Jewish community in the area, further supporting the overall effectiveness of the mumps vaccine in the broader community. Continue reading “Repeated contact with mumps may overwhelm immunization”

## New research shows vaccine denialists put others at risk

In a recent article published in the American Journal of Public Health, Exposure of California Kindergartners to Students With Personal Belief Exemptions From Mandated School Entry Vaccinations, by Alison Buttenheim, Malia Jones, and Yelena Baras, parents worried about the safety of vaccinations have caused a new problem in the comeback childhood diseases that haven’t been seen in a couple of generations. Buttenheim et al. wrote that a greater number of parents are refusing to get their children vaccinated through legally binding person belief exemptions, and explained that this increases the risk of infection for those with compromised immune systems and those who cannot get vaccinations. Traditionally, these individuals relied upon herd immunity, which describes a form of immunity that occurs when the vaccination of a significant portion of a population (or herd) provides a measure of protection for individuals who have not developed immunity. Continue reading “New research shows vaccine denialists put others at risk”

## Whooping cough–effectiveness of pertussis vaccines

This year has been a bad one for whooping cough (Bordetella pertussis) throughout the world. There have been large outbreaks of pertussis in the United States, England and Australia in 2012. There have been some hypotheses as to why it has been happening. For example, there is some speculation that a subtype (or genotype) of pertussis was responsible for the Australian outbreak, but the evidence is complicated and equivocal. I think there is some evidence that the epidemic in Washington state results from the much lower vaccination rates in the area as a result of the anti-vaccination lunacy.

But the story may be much more complicated, and may need a more open discussion amongst those responsible for protecting us from these infectious diseases. These pertussis outbreaks may be a result of the reduced performance of the pertussis vaccine currently being used. The problem with an open discussion regarding the current vaccine is that the vaccine denialists will make an absolute claim that the pertussis vaccine does not work (of course, a complete fabrication, typical of the anti-vaxxers), instead of the more accurate position that the pertussis vaccine might not have the high level of effectiveness that was originally thought. Ironically, the current vaccine, the acellular pertussis version, replaced the older and more effective whole pertussis vaccine because critics believed the older version had too many side effects. Continue reading “Whooping cough–effectiveness of pertussis vaccines”

## Sharp increase in vaccination delays in Oregon

Recently, an article was published in PediatricsFrequency of Alternative Immunization Schedule Use in a Metropolitan Area by Steve G. Robison, Holly Groom,  and Collette Young, that studied the vaccination rate of children in the Portland area. It found that between 2006 and 2009, the number of children consistently delaying vaccinations in the Portland area increased more than three times.

In 2009, approximately 9.5% of Portland-area parents (out of a study population of nearly 98,000 children) consistently did not follow the recommended vaccine schedule for children from birth to nine months of age. Parents were considered “shot limiters” if they would not allow their children to be vaccinated with more than one or two shots at a time. The study noted that many who limit shots may be following an alternative schedule and plan to eventually complete the schedule, many do not follow through. Shot limited children also had more physician visits, presumably to complete the course of vaccinations.

According to Robison, an epidemiologist with the Oregon Sentinel Immunization Surveillance region, “There is no benefit to spacing out shots or getting fewer shots per visit. It is a very carefully constructed schedule intended to provide the most benefit when these kids need it.”

It remains unknown if the Oregon observations are applicable to the nation as a whole. However, if children haven’t received the proper vaccinations, it may reduce herd immunity leading to increased risks of outbreaks.

## Measles outbreak in Ireland

Preventable childhood disease epidemics keep breaking out throughout the world. Whooping cough has spread throughout the USA, and measles cases have risen dramatically in the UK. Now 17 new cases of measles have been reported during the last week in Southern Ireland bringing the total number of confirmed cases in West Cork to 42. Physicians in that part of Ireland are urging parents to vaccinate their children

According to Dr. Fiona Ryan, a consultant in public health medicine, “At the moment, the best way to ensure safety is to ensure that babies are not exposed to older children who may not be vaccinated and who are incubating the disease. Some cases have unvaccinated brothers and sisters, so they are very likely to become infected. Unfortunately the symptoms are very non-specific before they get the rash.” Continue reading “Measles outbreak in Ireland”

## Whooping cough: Washington State lacks funds to fight epidemic

The New York Times is reporting that the State of Washington has been hit by a whooping cough (pertussis) epidemic that has hit 1,284 individuals in 2012, 10 times the 128 seen at this point in 2011. At this rate, there could be over 3000 cases by the end of 2012. Of those infected so far in 2012, 86 infants (under age of 1 year) required hospitalization, including 19 of whom were under 2 months. Pertussis immunization, with the DTaP vaccine, does not confer full immunity to the child until the third vaccination at 6 months of age, during which the infant is susceptible to catching the disease from adults with lapsed immunity or other children who are not vaccinated. However, even children with the first vaccination have some immunity, so the infection could be milder than in a child without any vaccination. Continue reading “Whooping cough: Washington State lacks funds to fight epidemic”