For those of you who don’t know about Sharyl Attkisson, she’s a former CBS newsperson who has headed down the black hole of the anti-vaccine movement. She retreads old anti-vaccine tropes, like lame conspiracy theories – Attkisson, according to Orac, “through her promotion of antivaccine conspiracy theories, Sharyl Attkisson was, is, and will continue to be a danger to children and public health.”
So Attkisson’s anti-vaccine trope of the day is this pseudo-math (probably not a real word, but I’m going to use it for this article) about vaccines. Not only are her claims based on fake data, but those claims also rely upon the complete misuse of simple math and statistics.
We all know that outbreaks of preventable diseases cause (unnecessary) suffering and potentially devastating harms. This blog has a whole series dedicated to showing how vaccines save lives (examples here, here, here, here, and here).
But besides those harms, outbreaks also have direct monetary costs. They cost individuals money, when those people have to miss work or pay for medications, co-pays or costs associated with caring for a sick child or other family member harmed by a disease. Outbreaks also impose costs on health insurers covering the (often very high) costs of treating a preventable disease; and they impose costs on the public purse. Public health authorities have to contain the outbreak. If people depend on a public health insurance program, their health costs are also covered by the public. Public funding is limited. When agencies have to spend money on containing outbreaks, they are not using the money in other ways. As a result, other services and needs suffer.
Our paper argues that those whose decision not to vaccinate caused an outbreak should pay for the costs to public agencies of the outbreak. It then suggests options for achieving that goal. The blog post proceeds in three parts that shortly summarize the paper’s arguments: highlighting the costs of outbreaks, explaining the justifications for imposing costs of those who do not vaccinate, and mentioning how costs can be recovered. Continue reading “Recouping costs of vaccine preventable disease outbreaks”
On June 11, it was reported that the recent outbreak of whooping cough (Bordetella pertussis) in Johnson County, Kansas, has grown by 65 cases to a total of 175 cases since the beginning of the year. The Johnson County health department has issued a warning (pdf) about the outbreak, requesting that children and adults get the vaccine and to be aware of symptoms. To prevent the spread of the disease, the health department is requesting that people who are being treated for the disease with antibiotics stay home for 5 days, and those we are refusing to be treated, stay home for 3 weeks. Continue reading “Whooping cough: Kansas outbreak grows (update)”
Over the past few weeks, I’ve discussed numerous outbreaks of whooping cough, or Bordetella pertussis (or just pertussis) throughout the US, Canada, England and Australia. For those individuals who think that whooping cough has either disappeared or is not dangerous, well, it’s time to disabuse anyone of that particular notion.
These are just the more notable outbreaks. According to the CDC, there were over 27,000 whooping cough cases in the US in 2010 (and that number is going to be small compared to 2012’s numbers). And, worldwide, there are 30-50 million cases of pertussis and about 300,000 deaths per year. It is not a disease to be treated lightly.
Of infants younger than 1 year of age who get pertussis, more than half must be hospitalized. The younger the infant, the more likely treatment in the hospital will be needed. Of those infants who are hospitalized with pertussis about:
1 in 5 get pneumonia (lung infection)
1 in 100 will have convulsions (violent, uncontrolled shaking)
Half will have apnea (slowed or stopped breathing)
1 in 300 will have encephalopathy (disease of the brain)
1 in 100 will die
Teens and adults can also get complications from pertussis, though they are usually less serious than in children, especially if they had been vaccinated. Usually, complications in this age group are often caused by the cough itself. In one study, less than 5% of teens and adults with pertussis were hospitalized. Pneumonia (lung infection) was diagnosed in 2% of those patients. The most common complications in another study of adults with pertussis were:
Weight loss (33%)
Loss of bladder control (28%)
Passing out (6%)
Rib fractures from severe coughing (4%)
So if anyone thinks this is an innocuous disease, well they’d be wrong. It’s not without serious consequences, up to and including death.
It makes you wonder why there isn’t something we could do about this disease. You’d think that science would be able to prevent it. Oh wait, there is a way, and it’s called a vaccine. The DTaP vaccine (for diphtheria, tetanus and pertussis) is the way to prevent whooping cough (and diphtheria and tetanus, both dangerous in their own right).
The vaccine is over 85% effective in preventing a serious infectious disease. Since the introduction of the vaccine, diphtheria and tetanus cases have dropped by 99%. And whooping cough has dropped by 92%. And even then, people don’t want to vaccinate their kids. But why?
Antivaccine lunatics think that vaccines are harmful
All medical procedures, whether taking an over-the-counter pain reliever or having surgery to remove a tumor, has some amount of risk or side-effects. For the DTaP vaccine, there are some side effects, mostly minor, and even those may not be a result of the vaccine itself.
An extremely large study, with over 13,000 patients, it can find even small effects, “found no evidence for an increased risk for neurologic, hematologic, allergic events, or new onset of chronic illnesses among adolescents vaccinated with Tdap.”
In a Korean clinical trial, published in a high impact peer-reviewed journal, found that “No serious adverse effects were noted, and most adverse effects resolved without treatment. The immunogenicity against each antigen was high in patients who were interchangeably vaccinated for DTaP.”
There are a lot more, but those are the most recent, and pretty much shut the door on the old “vaccines cause XYZ” myth.
So what can we can conclude here. First, there are more outbreaks of whooping cough because fewer people are getting vaccinated or updating vaccinations. Second, whooping cough can be dangerous to adults and children. Third, DTaP vaccine prevent whooping cough. Fourth, aside from a very few and minor side effects, there is nothing dangerous about the vaccine.
Sadly, whooping cough (Bordetella pertussis) has killed an infant in San Miguel County, New Mexico. According to the New Mexico Department of Public Health said that it was the first time that an infant in the state has died from pertussis since 2005. The infant was two months old, and had been given the first of three doses of the DTaP vaccine, which immunizes children against diphtheria, tetanus and pertussis. The vaccine doesn’t induce a sufficient immune response until the third dose, which is given at around 6 months, so infants are at risk from being infected by the bacteria. The only way the infant could have contracted whooping cough was from another infected person, like an adult (whose immunity has lapsed) or an unvaccinated child.
In the same report, the state’s Department of Health say that New Mexico experienced more whooping cough cases in 2011 than any time since the 1980’s. They also state that they have confirmed 110 cases of the disease s0 far in 2012, ahead of the rate in 2011. Of those 110, 13 have been in infants, and of those eight required hospitalization.
This case is very sad, because the parents were responsible, and got their child vaccinated. But someone else, who was not immune or a child whose parents refused to vaccinate them, passed this dangerous infection on to the dead child.
A nine week old Idaho girl died Friday of complications from whooping cough according to Reuters. She was being treated for the disease at a hospital in Pocatello, Idaho; however, her situation worsened, and she was flown to the University of Utah medical center for further treatment as her condition worsened.
There appears to be a significant outbreak of whooping cough in the Northwest US since the beginning of the year. Washington state has had 1132 cases so far this year, a pace running far ahead of last year, when the state had 961 cases for the whole year. Montana has had nearly 100 cases in 2012, while Idaho has had 31 cases.
According to Emily Simnit, a spokeswoman with the Idaho Department of Health and Welfare, “when you have something as tragic as the death of an infant, it underscores the fact that there are really nasty, severe illnesses that vaccines can prevent.”
The whooping cough immunization is a component of the DPT (diphtheria, pertussis and tetanus) vaccine, which is typically given at the age of 2 months. So the infant probably was not immunized against the disease, and probably got it from an unvaccinated individual, or possibly from someone with lapsed immunity. It could have even been a sibling or another adult. However, there is no indication that the parents were opposed to vaccinating the infant, so this is probably just horrible luck, though the prevalence of the disease in those areas increased the chances of any infant contracting whooping cough.
Idaho and Washington are two of about 20 states that allow for philosophical exemptions to vaccinations. Because of the drop in vaccination rates, herd immunity, where enough people are vaccinated that the disease has little possibility of being transmitted from an infected person to an susceptible one, has probably developed some cracks that allow the diseases to start spreading more quickly.
There are few legitimate reasons to refuse to get vaccinated. There should be medical reasons for not being vaccinated. However, refusing to get children vaccinated because of unscientific, unproven, and ridiculous reasons should stop. Children shouldn’t die of diseases that can be eliminated. One preventable death is unacceptable and unconscionable.