Why we vaccinate–103 million cases of diseases averted since 1924

vaccines-vs-microbes

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.

#10. This article was published on 3 December 2013, and has had over 5000 views. It’s one of my favorite because it shows, with scientific evidence, that the trope pushed by the vaccine deniers that better sanitation, food, and medicine reduced the mortality from these diseases. But we know it’s the vaccines, and we have brilliant science to support that fact.

One of the tropes of the antivaccination world is that vaccines didn’t stop diseases. They give credit to everything from modern medicine to better food to better sanitation. Some of the credit they give is ironic since many vaccine deniers hate most aspects of modern medicine and believe that food was better 100 years ago. You can never get enough of the contradictions and hypocrisy of the antivaccine crowd.

I think it becomes easy to dismiss the value of vaccines in ending widespread disease because almost anyone writing today about vaccines has no memory of ubiquitous and deadly epidemics of diseases. We’re almost at a point in our culture that if Twitter doesn’t report it, it didn’t happen, so infectious diseases are something that happened back when humans lived in caves, prior to the advent of social media. I happen to have been born right near the end of widespread epidemics of infectious diseases, so I don’t remember any epidemics personally, though I recall a few classmates in high school who had a few effects from polio and other diseases. Culturally, we have forgotten our past with respect to diseases. Continue reading “Why we vaccinate–103 million cases of diseases averted since 1924”

Why we vaccinate–protecting babies from pertussis

tdap-vaccineRecently, 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 Advisory Committee on Immunization Practices (ACIP) recommends (pdf) that children should get 5 doses of DTaP (the vaccine for (diphtheriatetanus and pertussis), 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.”  Continue reading “Why we vaccinate–protecting babies from pertussis”

Vaccine exemptions contribute to outbreaks of preventable diseases

vaccines-religious-exemptionOnce 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.” 

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. 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”

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). 

Continue reading “Cocooning the family to protect infants from whooping cough”

Infant in North Carolina dies of whooping cough

whooping-cough-coccoonThe North Carolina Department of Health and Human Services reported that a three-week old child died of whooping cough (Bordetella pertussis) last week.

As the report states, a child cannot be vaccinated with DTaP (the vaccine for diphtheriatetanus and pertussis) until they are about 2 months old. However, because infants are susceptible to whooping cough, all adults, children, friends, relatives, everyone, who is in contact with that child should be vaccinated against pertussis, a process called cocooning.

When an antivaccination militant says “my unvaccinated child won’t hurt your child”, this is where their lies are uncovered. For example, an unvaccinated older child may have whooping cough, and the parent take him or her to a pediatrician for the horrible cough, and that infected child passes it to other children.

In this case, the NC Department of Health and Human Services has not reported how the child may have contracted the deadly disease, so we can only speculate. Continue reading “Infant in North Carolina dies of whooping cough”

Vaccination coverage in US children,19-35 months–uptake still high

The United States Centers for Disease Control and Prevention (CDC) has reported in the 2012 National Immunization Survey (NIS) that the majority of children, age 19-35 months, remained extremely high from 2008 through 2012, although there was a small, but statistically significant drop in uptake of some vaccines from 2011 to 2012. In addition, the CDC specified a substantial concern about clusters of unvaccinated children in widespread communities that are at risk from vaccine preventable diseases, and may pose a health risk to the community at large.

The study results were based upon a survey (cell and land-line phone calls with follow-up details from the health care provider) of about 16,000 children (an extremely large sampling for a survey). The data was then adjusted for racial/ethnic, income, and other population factors. Even though the CDC provided data from 2008-2012, the current method of polling was started in 2011, and only results from 2011 and 2012 are mathematically comparable.

vaccine-uptake-2013-2012

 

 

Continue reading “Vaccination coverage in US children,19-35 months–uptake still high”

Undervaccinating against pertussis puts children and community at risk

whooping_cough-babyOver 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 original vaccine contained what was called “whole-cell” pertussis, which includes all of the antigens of the pertussis bacterium, partially because it wasn’t understood (and to some extent still not fully understood) which antigens on the bacteria actually induce the proper immune response to have the body destroy a pertussis infection. In the late 1990’s, the Advisory Committee on Immunization Practices (ACIP) recommended that the USA switch to the acellular form of the vaccine, known as DTaP (a pediatric vaccine to immunize against diphtheria, tetanus and pertussis) or Tdap (the older children/adult version of same vaccine). Continue reading “Undervaccinating against pertussis puts children and community at risk”

Easy vaccine exemption rules lead to lower vaccination rates–shocking

exemption mapRecently, there have been a few peer-reviewed articles published analyzing the effects of non-medical vaccines exemptions. There are usually two types of non-medical exemptions, philosophical, where the parents just don’t like vaccines because they’ve bought into the pseudoscience of vaccine denialism, or religious, where they use the cover of fake religions (only one tiny mainstream religion is opposed to vaccinations) to deny the huge health benefits of vaccinating their children. I reviewed one article that described that as a result of these exemptions, rates have increased quickly in whooping cough infections, is non-trivial disease. 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.

Inconvenience (that is, the parents can’t be bothered to get their children immunized), bogus religious beliefs, and increased concerns, based on little actual evidence, about the risks of vaccination, are leading more US parents to refuse to vaccinate their children. A recent article, which investigated the rates of vaccination by state (while analyzing the ease of obtaining non-medical exemptions), showed that parents are increasingly able to refuse vaccination in states that have relatively simple procedures for immunization exemption. Some states, fearing a public health crisis, have responded by putting in place more burdensome procedures for parents of school-aged children to opt-out. Continue reading “Easy vaccine exemption rules lead to lower vaccination rates–shocking”

Religious exemptions to vaccines elevates whooping cough rates

 

©Centers for Disease Control and Prevention, 2012
©Centers for Disease Control and Prevention, 2012

According to a new study published in Pediatrics, the number of New York state parents who skipped at least one required vaccine for religious reasons has increased over the past decade. And New York counties that had this increase in religious exemptions to vaccinations also had more  whooping cough (Bordetella pertussis, or simply pertussis) cases, even among children that had been fully vaccinated.

For this study, the researchers tracked data from the New York State Department of Health on both religious exemptions and new whooping cough cases. Children were reported as having a religious exemption if they had been allowed to skip at least one required vaccine for non-medical reasons. 

The key results from the study were:

  • The overall state annual mean rate of religious exemptions increased significantly from 0.23 % in 2000 to 0.45% in 2011, almost doubling the rate over the decade.
  • The prevalence of religious exemptions varied greatly among counties with no obvious trends, although all of the counties around New York City showed large increases in religious exemptions.
  • Counties with mean religious exemption rates of >1% reported a higher incidence of pertussis. For counties with higher exemption rates, the rate of pertussis was 33 per 100,000 compared to counties with lower exemption rates, which had a pertussis infection rate of 20 per 100,000. The researchers determined that this difference was statistically significant.
  • In addition, the risk of pertussis among vaccinated children living in counties with high exemption rate increased with increase of exemption rate among exempted children, also statistically significant.

The increase in whooping cough rates is particularly troubling since unvaccinated children not only put themselves at risk, but also those who have been vaccinated (as result of the lower effectiveness of the currently available pertussis vaccine). Also, as the exemption rate increases and there is a lower than expected effectiveness of the vaccine, the herd immunity becomes weaker. Continue reading “Religious exemptions to vaccines elevates whooping cough rates”

Vaccine denier – diseases eliminated by sanitation, not vaccines

And here we go again. Over the Memorial Day weekend, I was catching up on some reading, which sometimes leads me to reading pseudoscience claims of some random vaccine denier. In this case, it was an article that claimed that it had “irrefutable evidence” that diseases were eliminated by better sanitation rather than vaccination.

Well, I am always one to read up on “irrefutable evidence”, but it’s possible that my standard for “irrefutable evidence” is different than most others. And in fact, real science assumes that most evidence can be scientifically refuted, so it never speaks in such absolutes. So that’s hint #1 that I’m going to be disappointed. Continue reading “Vaccine denier – diseases eliminated by sanitation, not vaccines”