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”

Measles epidemic in Europe is killing children – blame anti-vaccine religion

measles epidemic

Maybe some of you haven’t been following the reports about the European measles epidemic, but it’s scary news. The BBC News reported that more than 41,000 people have contracted measles in the first six months of 2018. Worse yet, 37 of those people have died of that virus.

Let me be blunt – nearly every one of those 41,000 cases and 37 deaths could have been prevented by the MMR vaccine (for measles, mumps, and rubella). Period. Full stop. End of story.

In case I wasn’t clear, let me repeat myself – indulge me, we’re talking about children dying of an entirely preventable disease. Every single case of measles could have been prevented. Every single death could have been prevented. This isn’t a complicated story.

Maybe you think that Europe is a big area with over a half billion people, so this might be expected. That would be incorrect. Measles was almost extinct in much of the developed world. In 2016, there were just 5,273 measles cases for the whole year. In 2008, there were only 3,575 cases and one death. Measles was almost eliminated.

Let’s take a look at how this happened, and place blame right where it belongs – in the misinformation, pseudoscience, and outright lies of the anti-vaccine religionContinue reading “Measles epidemic in Europe is killing children – blame anti-vaccine religion”

Tetyana Obukhanych – another anti-vaccine appeal to false authority

There are so many annoying issues about the antivaccination cult, that most of us can’t even keep up with it. If only they would provide evidence published in high quality, peer-reviewed journals (yes, a high standard, but if we’re talking about public health, a high standard is required), the fake debate would move into a real scientific discussion. One of their favorite feints against real evidence is to push people, like Tetyana Obukhanych, who appear to have great credentials, but once you dig below the surface, not much is there.

One of the most irritating problems I have with the anti-vaccination movement is their over-reliance on false authorities, where they trumpet the publications or commentary from someone who appears to have all of the credentials to be a part of the discussion on vaccines, but really doesn’t. Here’s the thing – it simply does not matter who the authority is or isn’t, all that matters is the evidence.

For example, Christopher Shaw and Lucija Tomljenovic, two researchers in the Department of Ophthalmology at the University of British Columbia, have, for all intents and purposes, sterling credentials in medicine and science. However, they publish nonsense research (usually filled with the weakest of epidemiology trying to show a population-level correlation between vaccines and adverse events) in low ranked scientific journals.

Now the anti-vaccine world has a new hero – Tetyana Obukhanych. Continue reading “Tetyana Obukhanych – another anti-vaccine appeal to false authority”

National Vaccine Injury Compensation Program facts

national vaccine injury compensation program

In this post I explain how one goes about proving a case in the  National Vaccine Injury Compensation Program (NVICP), and how that differs from proving a case in the civil courts, focusing on what it means to have a no-fault program and proving causation. I will use a case that started with the tragic death of a young child after a vaccine to illustrate the complexity and operation of the program, and also to address the idea of federal preemption, and how it limits the ability of those claiming vaccine injuries to use state courts for their claims.

Continue reading “National Vaccine Injury Compensation Program facts”

20th anniversary of the Andrew Wakefield vaccine fraud – no celebrations

andrew wakefield

I’m a couple of months late with this article because of life and reasons, but a bit over 20 years ago, in February 1998, Andrew Wakefield published his infamous article in Lancet, which was eventually retracted in 2010. He stated that “onset of behavioural symptoms was associated, by the parents, with measles, mumps, and rubella (MMR) vaccination in eight of the 12 children.” Because Wakefield claimed that most of the behavioral problems were autism, that became the rallying cry of the anti-vaccine religion for the past 20 years – the MMR vaccine, if not all vaccines, cause autism.

I actually remember getting that particular issue of Lancet 20 years ago, and I ran across that article. My first thought was, “why in hell would Lancet publish such a troublesome article with just 12 freaking (not the word I used) data points.” Then I wondered who that Wakefield character was – was he an expert on vaccines and childhood behavioral issues? Well, the internet in 1998 didn’t have search engines like we do today, so finding out anything about Andrew Wakefield was difficult at best. I just assumed that if the Lancet, one of the top medical journals in the world, published it, Wakefield must have some level of respect.

Even though the internet was as much a bastion of pseudoscience and conspiracists as it is now, you would never “do your research” on the internet. But our local newspaper had a blurb about the Wakefield study in a Sunday health section, and my wife read the article. She got panicked that our two young daughters, who were having upcoming MMR vaccines, would become autistic. That was my first experience in having to defend vaccines against nonsense (don’t tell my wife I called her worries were nonsense).

My daughters eventually got that vaccine (and received all subsequent vaccines up to and including the HPV vaccine), although even I monitored my children for a few weeks for any behavioral changes. Knowing what I know now, I should have just a fun dad, but I admit to worrying.

Let’s remind everyone about the frauds and lies of Andrew Wakefield because it has led to the return of vaccine-preventable diseases. Continue reading “20th anniversary of the Andrew Wakefield vaccine fraud – no celebrations”

Jenny McCarthy, with help from Oprah Winfrey, lies about vaccines

jenny mccarthy vaccines

Jenny McCarthy was once the MTV drunk college dating game hostess and former “journalist” on The View. I remember when she joined The View – there was widespread condemnation of her hiring from scientists, journalists, and yours truly because of her loud and annoying antivaccine rhetoric. Clearly, no one of any note supported her being hired on the View, except for websites like the Age of Pushing Nonsense To Harm Children. Continue reading “Jenny McCarthy, with help from Oprah Winfrey, lies about vaccines”

The myth of Big Pharma vaccine profits – it’s not what they say it is

Several of the ongoing memes, tropes and fabrications of the vaccine deniers is somehow, somewhere, in some Big Pharma boardroom, a group of men and women in suits choose the next vaccine in some magical way, and foist it upon the world just to make billions of dollars through vaccine profits. Of course, while magically concocting this vaccine brew, these pharmaceutical execs ignore ethics and morals just to make a profit on hapless vaccine-injured victims worldwide.

The Big Pharma vaccine profits conspiracy trope ranges across the junk medicine world. Homeopathy, for example, claims that Big Pharma suppresses the data that shows water cures all diseases. Like Ebola.

But the Big Pharma vaccine profits conspiracy is still one of most amusing myths of the antivaccination world.

Continue reading “The myth of Big Pharma vaccine profits – it’s not what they say it is”

It’s simple math – vaccines saved 700,000 children’s lives

In 1994, the Vaccines for Children program (VFC) was created by a Federal budget authorization in direct response to a measles resurgence in the United States that caused tens of thousands of cases and over a hundred deaths, despite the availability of a measles vaccine since 1963. The net effect of the VFC program was that it provided (and continues to provide) vaccines to children whose families or caregivers couldn’t otherwise afford them, such as those who are uninsured or Medicaid eligible. These are vaccines that have saved 700,000 children’s lives.

It was one of America’s great social healthcare programs in the history of the USA. VFC had an immediate and positive effect on the health of America’s children. Continue reading “It’s simple math – vaccines saved 700,000 children’s lives”

Anti-vaccine statistics – back to simple math again

anti-vaccine statistics

One of the age-old tropes of the anti-vaccine statistics world is that kids who have been vaccinated against the measles are more likely to get measles than those who are not vaccinated. I squashed this myth several times; unfortunately, those are old articles with broken links and such.

Now, the anti-vaccine statistics monsters persevere with their alternative facts. So, once more unto the breach, dear friends, once more. We will take down this trope. Continue reading “Anti-vaccine statistics – back to simple math again”

Measles infections prevent heart disease – an anti-vaccine trope

measles infections prevent heart disease

Here we go again, another anti-vaccine trope based on one paper without adequate scientific criticism of said paper. What is this trope? Mumps and measles infections prevent heart disease and stroke. Let me jump right to the conclusion – wrong.

Although I’ve seen this story before, like most zombie tropes in the anti-vaccine world, this one has come back from the dead. In the pseudoscientific website, Health Impact Newsthe author writes:

By my calculations, natural infection with the measles and mumps will prevent millions of heart attacks and strokes. Why is this information not all over the TV and internet? I will tell you why. Because mainstream media is in bed with Big Pharma who pay their bills. The politicians are slaves to their corporate masters. Our children should be exposed to every virus and bacteria for which a vaccine exists.

The author’s shrill claim is based on a 2015 article published in the lower impact factor journalAtherosclerosis. The authors concluded that “measles and mumps, especially in case of both infections, were associated with lower risks of mortality from atherosclerotic CVD (cardiovascular disease).”

Now, it’s time to turn a critical and skeptical eye towards that article.

 

Mumps and measles infections prevent heart disease – the paper

The study evaluated lifestyle questionnaires from 43,689 men and 60,147 women who were aged 40-79 years at the baseline period of 1988-1990. Individuals of that age probably were not vaccinated against measles or mumps, since that vaccine wasn’t available for children until the late 1960s, when the individuals in the study would have been 20-50 years old. The questionnaire included history of measles and mumps, and were followed until 2009.

The authors then determined hazard ratios (HR, see Note 1) for mortality from cardiovascular disease (CVD) between groups with history of measles and/or mumps infection versus those who did not have those infections. Here are some of the results of the analysis:

  • Men with history of measles had an HR for all CVD deaths of 0.92.
  • Men with history of both measles and mumps had an HR for CVD deaths of 0.80.
  • Women with both infections had an HR for all CVD deaths of 0.85.

The researchers also looked at comparisons between infected and non-infected groups for various types of CVD, but these data probably are the most important.

The study also attempted to show that there was no difference in infected and non-infected groups for a series of confounding variables. They include:

  • Age
  • Body mass index
  • Hypertension
  • Diabetes
  • Previous history of CVD
  • Smoker
  • Exercise level
  • Education
  • Stress level

Taken at face value, the research does seem to support the contention that we shouldn’t get the MMR vaccine to protect ourselves against measles and mumps, because catching those diseases may protect us against cardiovascular disease when we get older. But really, does it really gives us evidence to quit vaccinating? Let’s take look.

 

The critique

  1. This is a one-off primary study that has not been confirmed by any other researchers. This places it at the lower end of the hierarchy of scientific research.
  2. The authors did not propose a biologically plausible explanation. If one is to propose a correlation between two events, especially when the temporal difference is over 50-70 years, one must also propose a plausible reason why you might assume there is correlation. Is there a plausible reason for anyone to believe that a mumps or measles infection will protect someone from cardiovascular disease? I have a scientific bias towards plausibility, otherwise we can propose inane scientific hypotheses that waste the time of everyone involved.
  3. There is simply little evidence that measles or mumps is correlated with CVD –  a review of PubMed for any articles that might establish a relationship between mumps and/or measles with CVD provided me with two articles. The first is the one we are discussing herein. The second, also published in Atherosclerosis, seems to indicate that mumps and measles is related to higher rates of CVD. This is why cherry picking is bad – you seek out articles that support your pre-conceived conclusion rather than let all of the evidence lead you to a conclusion.
  4. The use of questionnaires for epidemiological studies is frowned upon by many researchers. The reasons for this are many, but they include a reliance upon the memory of the participant for events that may be 50 or 60 years in the past. For a highly infectious disease like measles, it’s hard to believe that 50% of the participants in this survey caught neither mumps or measles as a child. It’s more likely that they actually had caught the disease but forgotten about it. A properly designed study would have measured measles and mumps antibodies then determined the HR. Or used actual medical records (like a lot of vaccine studies use for case control studies of vaccine effectiveness and safety).
  5. The hazard ratios were tiny. Yes, it appears that mumps and measles infections prevent heart disease – the data seem to show a 8-20% reduction in CVD risk. But is that clinically significant? If being vaccinated against measles and mumps showed a 200-300% increase in the risk of CVD, I would be impressed and troubled by the results. But such a tiny reduction in the risk could be explained by anything. A missing confounder. Other infectious diseases. Nutritional levels. In fact, I can go on and on. Furthermore, is an 8% reduction in risk of CVD, if it is valid, worth the risk of death or disabling conditions from contracting measles or mumps? Although the question is rhetorical, it’s actually necessary to come to a conclusion based on the results provided.
  6. Speaking of vaccines, why wasn’t vaccine status asked (although the same memory issues that would plague this questionnaire would still bother me here)? Even though most of the participants probably would have missed the vaccine, some may have gotten it.
  7. The results also showed a 5-20% increase in risk of CVD for women who had either mumps or measles. That result alone throws into question the whole study, because the results are all over the place.

Can one use this article to claim that mumps and measles infections prevent heart disease and stroke? Not really. The best I can say, and I’m doing this with a lot of trepidation, is that this study provides us with observational data, not a confirmation or refutation of a hypothesis about mumps and measles infections. It certainly does not give us any reason whatsoever to change public health priorities in vaccinating against mumps and measles despite the anti-vaccine tropes.

 

Notes

  1. A hazard ratio describes a ratio of hazard rates between two events. In the case of this study, if the rate of cardiovascular disease mortality for the mumps infected group is 1.0 and it’s 2.0 for the non-infected group, then the hazard ratio is 0.5. That is the mumps infected group is only 50% as likely to have died of cardiovascular disease as the non-infected group.

 

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