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Sharyl Attkisson and measles vaccine math – wrong in so many ways

One of the favorite tropes of the anti-vaccine religion is their odd reliance on the ridiculous anti-vaccine math, including some pushed by Sharyl Attkisson, a favorite nemesis of the old feathered dinosaur. Attkisson believes that kids who have been vaccinated against the measles are more likely to get measles than those who are not vaccinated.

Yes, the anti-vaxxers actually believe this nonsense and promote it across the internet as an “argument” against the measles vaccine, despite numerous measles outbreaks that have dire consequences for children.

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. 

Read More »Sharyl Attkisson and measles vaccine math – wrong in so many ways

Cocooning the family to protect infants from whooping cough

Infant being treated for pertussis infection. ©CDC, 2012.

Over the past year or so, there have been several outbreaks of whooping cough (Bordetella pertussis), including one that reached epidemic levels in Washington state, which has been considered one of the worst pertussis outbreaks in the USA during the past several decades. The disease lead to 18 infant deaths in the USA during 2012.

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.” 

Whooping cough is a serious disease that has significant complications for children:

  • 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

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). 

Read More »Cocooning the family to protect infants from whooping cough

Protecting infants from whooping cough by cocooning

Infant being treated for pertussis infection. ©CDC, 2012.

This year, 2012, was one of the worst whooping cough (Bordetella pertussis) outbreaks in the USA for the past 70 years, which included an outright epidemic in Washington state. Some of the reasons for the spread of the disease were a reduced whooping cough (Dtap) vaccination rate and reduced effectiveness of the Dtap (or TDaP) vaccine. Whooping cough is a serious disease, especially to children under the age of one year old, who have not been fully vaccinated. According to the Centers for Disease Control and Prevention, of those infants who are hospitalized with pertussis about:

  • 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 dieRead More »Protecting infants from whooping cough by cocooning

Washington state makes it harder to get an immunization exemption

Paul Offit, MD

After one of the worst whooping cough (Bordetella pertussis) epidemics in 70 years in Washington state, there is some good news. The New York Times has reported that the state, after passing a law that made it more challenging for a parent to get a personal exemption for a vaccination for their children, the exemption rate in Washington state has dropped by 25 percent. This is good news, because until recently Washington state was dead last in the immunization rate, or, if you like exemptions, it was number 1!

In 2011, the state’s legislature passed a law making exemptions a bit more difficult, by requiring parents to actually speak to a healthcare professional about the risks and benefits of vaccinations. That person then must sign off on the exemption. Parents who opted out of state immunization requirements for kindergartners peaked at 7.6 percent in the 2008-2009 school year, setting off alarms among public health experts in the state, according to the New York Times.Read More »Washington state makes it harder to get an immunization exemption

Vaccine denialism causes USA’s worst whooping cough epidemic in 70 years

Steven Salzberg, at Forbes Magazine, has reported that the USA is experiencing the worst whooping cough epidemic in 70 years. In addition, the CDC has stated that as of  August 4 2012 (pdf), there are 21,000 cases and 10 deaths in the United States from whooping cough(Bordetella pertussis) year-to-date. Wisconsin has the highest rate of infection, while Washington, as I have discussed on a number of occasions, has one of the highest total number of pertussis infections. 

Increases in pertussis outbreaks by state from 2011 to 2012.

Read More »Vaccine denialism causes USA’s worst whooping cough epidemic in 70 years

Whooping cough update: Washington state epidemic hits 3400 cases

The Washington State Department of Health is reporting  that as of August 4, 2012, the current whooping cough (Bordetella pertussis) epidemic has hit 3400 cases, over 15X more than the 214 cases reported at the same time last year. The epidemic has finally shown a big drop off in new reports this past week (pdf), although there are concerns that the numbers will increase against this fall as children return to school in the autumn.

Pertussis cases by week 2012 (red) vs 2011 (blue)

According to the Centers for Disease Control and Prevention, pertussis (whooping cough) can cause serious illness in infants, children and adults. The disease usually starts with cold-like symptoms and maybe a mild cough or fever. After 1 to 2 weeks, severe coughing can begin. Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks. In infants, the cough can be minimal or not even there. Infants may have a symptom known as “apnea.” Apnea is a pause in the child’s breathing pattern. Pertussis is most dangerous for babies. More than half of infants younger than 1 year of age who get the disease must be hospitalized. Approximately 1-2% of infants who are hospitalized from pertussis will die.Read More »Whooping cough update: Washington state epidemic hits 3400 cases

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.Read More »Whooping cough–effectiveness of pertussis vaccines

Whooping cough–Washington state epidemic is very scary thanks to vaccine denialism

The Washington State Department of Health is reporting that, as of July 30 2012, there have been 3,285 cases of whooping cough (Bordetella pertussis) in the state. This compares to just 253 through the same time period in 2011. If you want to be scared, look at it graphically.

Read More »Whooping cough–Washington state epidemic is very scary thanks to vaccine denialism

Whooping cough update: Washington state epidemic exceeds 2800 cases

The Washington State Department of Health has reported (pdf) that the current whooping cough (Bordetella pertussis) epidemic has hit 2883 cases, over 10X more than the 210 cases reported at the same time last year. The epidemic seems to have peaked a few weeks ago, although concerns will remain as children return to school in the autumn.

According to the Centers for Disease Control and Prevention, pertussis (whooping cough) can cause serious illness in infants, children and adults. The disease usually starts with cold-like symptoms and maybe a mild cough or fever. After 1 to 2 weeks, severe coughing can begin. Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks. In infants, the cough can be minimal or not even there. Infants may have a symptom known as “apnea.” Apnea is a pause in the child’s breathing pattern. Pertussis is most dangerous for babies. More than half of infants younger than 1 year of age who get the disease must be hospitalized. Approximately 1-2% of infants who are hospitalized from pertussis will die.Read More »Whooping cough update: Washington state epidemic exceeds 2800 cases