About a year ago, Meryl Dorey, Australia’s infamous American-born vaccine denialist and anti-science promoter, and her Australian anti-Vaccine Network (AVN) was ordered to change its misleading name or be shut down. The New South Wales (an Australian state) Office of Fair Trading left an order at the home of AVN president Meryl Dorey yesterday with a letter of action, “labeling the network’s name misleading and a detriment to the community.” Given Dorey’s, and by extension the AVN’s, well known antivaccination stance, this order wasn’t surprising.
Over the past few months I have written extensively about several whooping cough (Bordetella pertussis) outbreaks which had reached epidemic levels in areas like the Washington state, and has been considered one of the worst outbreaks in the USA during the past several decades. The outbreak has lead to several deaths here in the USA and in other countries such as the UK. Of course, these outbreaks and epidemics have lead to the “blame game” from the antivaccination gang, because they have claimed that since A) most kids are vaccinated, and B) we’re having this outbreak then C) either the vaccines are useless or are actually the cause of the outbreak. Seriously. They blame the vaccines.
So I decided to search the internet to find the most popular vaccine denialist arguments regarding pertussis vaccinations, and deconstruct and debunk them. Hopefully, it will be a useful tool for you when you’re engaging a ridiculous argument with one of those antivaccinationists. Of course, I could use the information too. Continue reading “Effectiveness of pertussis vaccines–science vs. lies”
For New Year’s Day, I’m republishing the top 10 articles I wrote in 2013. Well, actually top 9, plus 1 from 2012 that just keeps going.
#9. This article was published on 13 May 2013, and has had over 5000 views. A Federal court decided that refusing to vaccinate one’s children is not a constitutionally protected right covered by the First Amendment.
The US District Court for the Northern District of Ohio has ruled (pdf) that a parent’s refusal to vaccinate her children against diseases is not a “free exercise” of religion, and is tantamount to neglect.
In April 2010, the Tuscarawas County (Ohio) Jobs and Family Services (TCJFS) took custody of the children of Charity and Brock Schenker as a result of a domestic violence matter between the parents. TCJFS determined that the children were “neglected and dependent” and worked out case plans for the parents which included psychiatric evaluations, drug testing and supervised visitation of their children. When TCJFS asked about the children’s immunizations, according to Secular News Daily, “Mrs. Schenker claimed she had religious objections to immunizations. The court informed her that the immunizations would be ordered.”
As a result of recommendations of court-ordered psychiatric evaluations and positive random drug tests, Mrs. Schenker (who subsequently divorced her husband) visitations were terminated, and TCJFS filed a motion for permanent custody of her children in August 2011. According to the Secular News Daily, “the county laid out as evidence a number of instances in which Schenker did not comply with orders, refused home inspections, and more. But Schenker sued with eight claims, including conspiracy claims and, most significantly, claims that her First Amendment right to free expression of religion was violated.” Continue reading “Court decides parent’s refusal to vaccinate kids is not “free exercise of religion””
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
Even in adults, there are substantial complications, such as broken ribs from coughing, that can have a significant impact on the overall health of the individual.
One of larger concerns with recent outbreaks of pertussis has been that adults with lapsed immunity or unvaccinated older children may pick up the infection, then pass it to these unvaccinated or partially vaccinated infants (usually less than 1 year old).
In the real world of science-based medicine, the link between autism and vaccines (particularly, the MMR vaccine for measles, mumps and rubella) has been thoroughly debunked, quashed, and discredited. In the delusional world of the vaccine denialists, the link between autism and vaccines is based on Mr. Andy Wakefield‘s paper alleging a connection between MMR and autism that has been retracted by the Lancet medical journal.
Then why is there even a debate about this manufactroversy (a manufactured or invented controversy)? Well, researchers actually examined this false controversy in a recently published article, by Graham Dixon and Christopher Clarke of Cornell University, in Health Education Research. They investigated how the news media and journalists try to “falsely balance” their reporting about the debunked link between vaccines and autism. The journalists create this false balance, “despite a strong medical and scientific consensus backed by rigorous epidemiological studies indicating no link between autism and vaccines.” Dixon and Clarke also state that “research suggests that journalists in the United Kingdom and United States often report this controversy by presenting claims both for and against a link in a relatively ‘balanced’ fashion. In some cases, so-called ‘falsely balanced’ reporting fails to mention which claim is supported by a scientific consensus.” An overwhelming scientific consensus, by the way. Continue reading ““False balanced” reporting of autism-vaccine manufactroversy”
A new article published this week in the Journal of the American Medical Association (JAMA) by Misegades et al. analyzed a recent whooping cough (Bordetella pertussis) outbreak in California children. Misegades determined that those who had not been vaccinated against the disease were nine times more likely to get pertussis than those who had received the entire five-shot series. However, among children who were fully vaccinated, the longer it had been since their final dose of the DTaP vaccine (which protects against diphtheria, tetanus and pertussis), the higher the risk of contracting whooping cough. This is in line with the decrease in effectiveness of the vaccine that has been discussed here and elsewhere. Continue reading “Whooping cough vaccine–facts about waning immunity”
If you spend any time reading the antivaccination rants, you will hear about all kinds of conspiracy theories, pseudoscience, and scaremongering. Given that there is little scientific evidence that supports their beliefs, they have little choice but invent strawman arguments to make their point. One of the more amusing strategies of antivaccine cult is to claim that diseases were going away before vaccinations. These people believe, without any evidence whatsoever, that diseases like polio, measles, and chickenpox were disappearing because of better sanitation. Or better nutrition. Or something other than what really ended these diseases–vaccines. It’s a historical revisionism of a legendary level.
Admittedly, part of this belief is that people lack the cultural memory of some of these diseases. Few parents born after 1970 would remember classmates who had been stricken with polio. Few would have remember measles, mumps, or other epidemics sweeping through a school. They just don’t remember it, because vaccines introduced in the 50’s and 60’s reduced, and in the case of smallpox, eliminated the disease. Of course, there is evidence that support the theory that vaccines end diseases. But we don’t have to go back 40 or 50 years to show this happens, but we can talk about a disease that has been drastically reduced in the last few years, just because of a new vaccine.
A recent study, published in TheNew 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”
A couple of days ago I reported that the flu vaccination not only prevents the flu itself, but it may also reduce risk of certain types of heart disease and death from cardiovascular events. In another study presented at the Canadian Cardiovascular Congress meeting in Toronto, the authors stated that the flu vaccination may have a critical benefit to patients who have implantable cardiac defibrillators (ICD), a small battery-powered device that automatically detects cardiac arrhythmias, then corrects it by delivering an electrical shock that can revert ventricular fibrillation, and that has been extended to include both atrial and ventricular arrhythmias.
According to study author Dr. Ramanan Kumareswaran, physicians have known that patients tend to need more ICD shocks during flu season, and wanted to investigate ways of reducing this need to rely on the device.
The study surveyed 229 patients who had come in for appointments related to their ICD care from September through November 2011. Of those patients, 179 (78%) reported that they had received the influenza vaccination in the previous year. Patients who received the influenza vaccine were older than those who did not (70.8 vs. 64.8 years, P=0.0005). Finally, there was no difference in the prevalence of coronary artery disease, diabetes, renal disease, and prior stroke in patients the vaccinated and un vaccinated patients.
Some of the results of the survey were:
Patients who received the flu vaccine were more likely to reject statements such as, “The Flu shot is not effective” and “The Flu shot will make me sick” compared to individuals not receiving the influenza vaccine.
Vaccinated individuals also planned to obtain the influenza vaccine in the upcoming year.
Thirty nine (17.0%) individuals in the overall cohort received at least one ICD therapy during the two pre-defined periods – 10.6% who received the influenza vaccine received at least 1 ICD therapy during influenza season compared to 13.7% who did NOT receive the influenza vaccine (P=NS).
About 13.7% of the unvaccinated patients experienced at least one ICD therapy (meaning that the ICD device had to adjust the heart rate) during the flu season compared to the 10.6% of patients who were vaccinated. This wasn’t a significant difference. However, the average number of ICD therapies per person during influenza season was greater in individuals not receiving the influenza vaccination (0.45 therapies) compared to individuals who did receive the influenza (0.14 therapies).
“What is interesting is that if this is consistent over time, it could be of significant benefit to our patient population who already have compromised survival to start with,” wrote Dr. Sheldon Singh, one of the study’s authors.
The authors concluded:
A large proportion of patients with ICDs receive the influenza vaccine. Receipt of the influenza vaccine may be associated with a reduction in ICD therapies during influenza season.
Now, as I’ve said with the other study, from the same Canadian Cardiovascular Congress meeting, that showed that a link between getting the flu vaccination and reduced cardiovascular events, these studies are not peer reviewed. They aren’t published yet in journals. They haven’t been repeated by other researchers. But the study seems to be sound, and it is a very sound argument for getting the flu vaccination if you have serious cardiovascular issues.
In addition to preventing the disease, the flu vaccination may have a more important benefit to those who get the shot. Dr. Jacob Udell, a cardiologist at Women’s College Hospital and the University of Toronto, looked at published clinical trials on flu vaccinations, dating back to the 1960s, examining the vaccine’s effect on cardiovascular events. Dr. Udell presented his meta-review results at the 2012 Canadian Cardiovascular Congress on October 28 2012.
The combined studies examined a total of 3227 patients, with an equal split between patients with and without heart disease. Half of the patients were randomly assigned to receive flu vaccine, and those that did not received a placebo. Four randomized controlled trials of moderate quality conducted between 1994-2008 met inclusion criteria. Here are some of the most important results:
An approximate 50 per cent reduction in the risk of a major cardiac event (heart attack, stroke, or cardiac death) compared with placebo after one year of follow-up.
A similar trend was seen for the flu vaccine reducing death from any cause (approximately 40 per cent).
The influenza vaccine reduced cardiovascular events and cardiovascular death in people with or without heart disease.
The study concluded:
Influenza vaccine reduced non-fatal CV events and may reduce sudden CV death in patients with and without CVD. However, the very low number of observed CV events and important design limitations among these RCTs strongly limit their validity and make it challenging to draw a definitive conclusion. A large, adequately powered, international multicenter RCT testing the efficacy of influenza vaccine to reduce incident and recurrent CV events is prudent to confirm these findings.
According to a report by Jennifer Nelson at NBC News, “The flu vaccine could be an important way to maintain heart health and ward off strokes and heart attacks, the researchers said.” Nelson also quoted Dr. Udell as proclaiming that “perhaps that the flu vaccine is a heart vaccine.” Well, maybe that’s overstating the case, but who knows.
But why would the flu vaccine reduce cardiovascular events? Nelson’s report suggested a couple of very plausible reasons:
“Udell said it may be that when people develop heart disease, some factor ‘tips them over the edge,’ such as plaque clogging arteries, or lower levels of oxygen as a result of the flu.” This is entirely possible, since those with atherosclerosis do have reduced blood flow to heart muscle. And the flu, being much more dangerous than most people believe, could just push someone over the line from having just enough oxygen for their heart muscle, to not enough.
“Dr. Sarah Samaan, a cardiologist and director of the Women’s Cardiovascular Institute at Baylor Heart Hospital in Plano, Texas, said the key to the link may be in reducing inflammation. When someone gets the flu, blood levels of inflammatory substances rise, and inflammation of the blood vessels can trigger heart attacks. ‘This happens because inflammation can make cholesterol plaques in the blood vessels unstable,’ Samaan explained. Unstable plaques are more likely to develop tiny cracks, which can cause blood clots to form. Such clots can block blood flow within arteries, causing a heart attack (if the blood vessel supplies the heart) or a stroke (if the artery feeds the brain), she said.” Again, entirely plausible.
Now, a couple of caveats about this study. First, it’s presented at a conference. Second, it’s not peer-reviewed. I’ll assume that it’s good work, but until it’s peer-reviewed and published in a great journal, it’s at the level of highly provocative. And it’s intensely interesting. But the great thing about meta-reviews is that they are easily repeated, and easily criticized if there’s a problem with the statistical analysis, so in light of that, I have high confidence in the quality of these results.
The 50% reduction in cardiovascular events is both clinically relevant, and may be higher than what will be seen in future randomized trials. But even if it’s 40%, 30%, or even 10%, that’s an amazing benefit of the flu vaccine for individuals at risk for cardiovascular events. The thing is that although a lot of people know that they are at risk, they have diabetes or are overweight, many people are unaware of their cardiovascular risks. They may have untreated hypertension. Or atrial fibrillations. Or any number of diseases where the risks of cardiovascular events are high, and can reduce the risk by a significant amount just by a simple and safe flu vaccination. And don’t listen to those myths about the flu vaccine, they just aren’t true. No, they aren’t true.
Vaccines save lives. And they might keep you from getting a heart attack!
