Make anti-vaccine parents pay higher premiums

[princesspeach]

Not true at all. Don't take the 2010 California Pertussis outbreak and apply it to other outbreaks. Here's a perfect counter-example:I recall seeing similar stats in the recent California measles outbreaks too.

Measles, Whooping Cough, Tetanus, Reubella, Hib, etc. "Don't worry, be happy and take some Vitamin C!" Wow...

The only polio vaccine on the schedule in the US since 2000 is the IPV vaccine. Go Google it and learn what the "I" stands for.

You honestly have no clue how vaccines work, do you? If you had even a clue you wouldn't utter something like what you did on the end of that sentence

Why do feel the need to insult somebody just because they have a different opinion.

 

[Geoff_M]

Why do feel the need to insult somebody just because they have a different opinion.

People are certainly entitled to a different opinion, but they aren't entitled to their own set of facts.

 

[princesspeach]

along the lines of OP's article...it's been proven again and again that breastfeeding a child for AS LONG as possible,like well over a year,is best for their overall health.BEST.without question saves lives,cuts doctor bills improves lifelong health. so should those how choose not to BF/can't BF pay higher premiums for that? or is that a choice,while vaccinating is not?
Because starting down a slippery slope of mandating everything based on insurance companies and the bottom line, scary.
I know this isn't a popular thought on this thread, but I'm a big believer in safety for kids,personal choice for families,and the simple fact that articles like this are helping no one except the companies who create vaccines,and the insurance companies who contract their services.
I won't argue online over the truth/untruth of the statements of vaccine safety(or not) but I have real issues with not truly understanding the real motives behind much of our current medical 'knowledge' and where it originates from.
Whatever your personal belief on this subject,it is the same in my example above, and I personally loathe the idea that an insurance industry would have that much say in the life of individual families.

Money is a big motivator behind many vaccines. Hospitals get money(your tax dollars) from the fed gov if a certain number of employees get the flu vaccine. They do everything short of fire us to try to get us vaccinate ourselves. Fortuantely there is enough healthcare workers that refuse and a big enough shortage of workers that they can't push it too far. Flu vaccines are big money makers for the pharm companies. The pharm companies have a large number of lobbiest for each congressman. Many of the powers that be own stock in pharm companies. The money trail goes on and on. I am not completely anti vaccine, but the number of vaccines were giving to kids and adults is getting out of hand. The amount of medications and antibiotics people take is insane. I guess its easier to take a pill or a shot then take do the things that are necesary to stay healthy.

 

[princesspeach]

People are certainly entitled to a different opinion, but they aren't entitled to their own set of facts.

I agree so don't insult people with a differing opinion then yourself.

 

[npmommie]

Because starting down a slippery slope of mandating everything based on insurance companies and the bottom line, scary.
I know this isn't a popular thought on this thread, but I'm a big believer in safety for kids,personal choice for families,and the simple fact that articles like this are helping no one except the companies who create vaccines,and the insurance companies who contract their services.
I won't argue online over the truth/untruth of the statements of vaccine safety(or not) but I have real issues with not truly understanding the real motives behind much of our current medical 'knowledge' and where it originates from.
Whatever your personal belief on this subject,it is the same in my example above, and I personally loathe the idea that an insurance industry would have that much say in the life of individual families.

 

[Nancy]

Wow, actually, I want to thank you for this. Occasionally I've had recurrences of long-lasting coughs, and it never occurred to me that it might be whooping cough because I had the vaccine as a child, but I don't recall getting a booster for it. I'll speak to my doctor about this at my check-up next month. Appreciate the heads-up!

I was just thinking the same thing.


I've seen a few things about having the schools administer the vaccines and how people don't think they should. I am 52 and I remember lining up and getting vaccines in school and also getting the polio vaccine but not as a shot..they put it on sugar cubes and we ate those.

 

[snarlingcoyote]

People are certainly entitled to a different opinion, but they aren't entitled to their own set of facts.

Preach on Geoff_M!

This should be cast as a mantra and children should be forced to memorize it so that they will remember it and perhaps follow the dictates of it in their adult lives.

 

[Acklander]

I don't think to many unvaccinated kids are ending up in hospital. What they should do is make overweight people and smokers pay higher premiums. Those are the people that are ruining our healthcare system. The healthcare cost that go along with being obese are astronomical. If being unvaccinated makes you overeat than maybe there is a point to all this.

Or maybe you should pay a higher premium if you've never smoked and are at a healthy weight - smokers and overweight people die younger, but the healthy people can live for years and years with alzheimer's disease - that REALLY runs up the cost of health care. OR we could have a system where everyone chips in to help cover the costs of the medical expenses when you need it.
Lets face it - some people will go through life never needing health care beyond the basics, some people will be born with or develop conditions that need more than the average amount of health care and most of us will fall somewhere in the middle, where we may have one or two major crisis's during or at the end of our life.

 

[Ember]

People are certainly entitled to a different opinion, but they aren't entitled to their own set of facts.

This is a truly great line - and applicable in so many situations. Mind if I steal it for use in every day life?

 

[Deb in IA]

People are certainly entitled to a different opinion, but they aren't entitled to their own set of facts.

Exactly.

They also aren't entitled to spout off laughably ridiculous fantasy fairy tales and pseudoscience as medical advice.

Especially when they are asked repeatly to provide ANY sort of reference to their claims, and they NEVER HAVE.

 

[Deb in IA]

http://www.cdc.gov/mmwr/preview/mmwrhtml/00056803.htm

Achievements in Public Health, 1900-1999 Impact of Vaccines Universally Recommended for Children -- United States, 1990-1998
At the beginning of the 20th century, infectious diseases were widely prevalent in the United States and exacted an enormous toll on the population. For example, in 1900, 21,064 smallpox cases were reported, and 894 patients died (1). In 1920, 469,924 measles cases were reported, and 7575 patients died; 147,991 diphtheria cases were reported, and 13,170 patients died. In 1922, 107,473 pertussis cases were reported, and 5099 patients died (2,3).

In 1900, few effective treatment and preventive measures existed to prevent infectious diseases. Although the first vaccine against smallpox was developed in 1796, greater than 100 years later its use had not been widespread enough to fully control the disease (4). Four other vaccines -- against rabies, typhoid, cholera, and plague -- had been developed late in the 19th century but were not used widely by 1900.

Since 1900, vaccines have been developed or licensed against 21 other diseases (5) (Table_1). Ten of these vaccines have been recommended for use only in selected populations at high risk because of area of residence, age, medical condition, or risk behaviors. The other 11 have been recommended for use in all U.S. children (6).

During the 20th century, substantial achievements have been made in the control of many vaccine-preventable diseases. This report documents the decline in morbidity from nine vaccine-preventable diseases and their complications -- smallpox, along with the eight diseases for which vaccines had been recommended for universal use in children as of 1990 (Table_2). Four of these diseases are detailed: smallpox has been eradicated, poliomyelitis caused by wild-type viruses has been eliminated, and measles and Haemophilus influenzae type b (Hib) invasive disease among children aged less than 5 years have been reduced to record low numbers of cases.

Information about disease and death during the 20th century was obtained from the MMWR annual summaries of notifiable diseases and reports by the U.S. Department of Health, Education, and Welfare. For smallpox, Hib, and congenital rubella syndrome (CRS), published studies were used (2,3,7-14).

Current Delivery and Use of Vaccines

National efforts to promote vaccine use among all children began with the appropriation of federal funds for polio vaccination after introduction of the vaccine in 1955 (5). Since then, federal, state, and local governments and public and private health-care providers have collaborated to develop and maintain the vaccine-delivery system in the United States.

Overall, U.S. vaccination coverage is at record high levels. In 1997, coverage among children aged 19-35 months (median age: 27 months) exceeded 90% for three or more doses of diphtheria and tetanus toxoids and pertussis vaccine (DTP), three or more doses of poliovirus vaccine, three or more doses of Hib vaccine, and one or more doses of measles-containing vaccine. Coverage with four doses of DTP was 81% and for three doses of hepatitis B vaccine was 84%. Coverage was substantially lower for the recently introduced varicella vaccine (26%) and for the combined series of four DTP/three polio/one measles-containing vaccine/three Hib (76%) (15). Coverage for rotavirus vaccine, licensed in December 1998, has not yet been measured among children aged 19-35 months. Coverage among children aged 5-6 years has exceeded 95% each school year since 1980 for DTP; polio; and measles, mumps, and rubella vaccines (CDC, unpublished data, 1998).

Vaccine Impact

Dramatic declines in morbidity have been reported for the nine vaccine-preventable diseases for which vaccination was universally recommended for use in children before 1990 (excluding hepatitis B, rotavirus, and varicella) (Table_2). Morbidity associated with smallpox and polio caused by wild-type viruses has declined 100% and nearly 100% for each of the other seven diseases.

Smallpox. Smallpox is the only disease that has been eradicated. During 1900-1904, an average of 48,164 cases and 1528 deaths caused by both the severe (variola major) and milder (variola minor) forms of smallpox were reported each year in the United States (1). The pattern in the decline of smallpox was sporadic. Outbreaks of variola major occurred periodically in the first quarter of the 1900s and then ceased abruptly in 1929. Outbreaks of variola minor declined in the 1940s, and the last case in the United States was reported in 1949. The eradication of smallpox in 1977 enabled the discontinuation of prevention and treatment efforts, including routine vaccination. As a result, in 1985 the United States recouped its investment in worldwide eradication every 26 days (1).

Polio. Polio vaccine was licensed in the United States in 1955. During 1951-1954, an average of 16,316 paralytic polio cases and 1879 deaths from polio were reported each year (9,10). Polio incidence declined sharply following the introduction of vaccine to less than 1000 cases in 1962 and remained below 100 cases after that year. In 1994, every dollar spent to administer oral poliovirus vaccine saved $3.40 in direct medical costs and $2.74 in indirect societal costs (14). The last documented indigenous transmission of wild poliovirus in the United States occurred in 1979. Since then, reported cases have been either vaccine-associated or imported. As of 1991, polio caused by wild-type viruses has been eliminated from the Western Hemisphere (16). Enhanced use of the inactivated polio vaccine is expected to reduce the number of vaccine-associated cases, which averaged eight cases per year during 1980-1994 (17).

Measles. Measles vaccine was licensed in the United States in 1963. During 1958-1962, an average of 503,282 measles cases and 432 measles-associated deaths were reported each year (9-11). Measles incidence and deaths began to decline in 1965 and continued a 33-year downward trend. This trend was interrupted by epidemics in 1970-1972, 1976-1978, and 1989-1991. In 1998, measles reached a provisional record low number of 89 cases with no measles-associated deaths (13). All cases in 1998 were either documented to be associated with international importations (69 cases) or believed to be associated with international importations (CDC, unpublished data, 1998). In 1994, every dollar spent to purchase measles-containing vaccine saved $10.30 in direct medical costs and $3.20 in indirect societal costs (7).

Hib. The first Hib vaccines were polysaccharide products licensed in 1985 for use in children aged 18-24 months. Polysaccharide-protein conjugate vaccines were licensed subsequently for use in children aged 18 months (in 1987) and later for use in children aged 2 months (in 1990). Before the first vaccine was licensed, an estimated 20,000 cases of Hib invasive disease occurred each year, and Hib was the leading cause of childhood bacterial meningitis and postnatal mental retardation (8,18). The incidence of disease declined slowly after licensure of the polysaccharide vaccine; the decline accelerated after the 1987 introduction of polysaccharide-protein conjugate vaccines for toddlers and the 1990 recommendation to vaccinate infants. In 1998, 125 cases of Hib disease and Haemophilis influenzae invasive disease of unknown serotype among children aged less than 5 years were provisionally reported: 54 were Hib and 71 were of unknown serotype (CDC, unpublished data, 1998). In less than a decade, the use of the Hib conjugate vaccines nearly eliminated Hib invasive disease among children.

Future Direction

Vaccines are one of the greatest achievements of biomedical science and public health. Despite remarkable progress, several challenges face the U.S. vaccine-delivery system. The infrastructure of the system must be capable of successfully implementing an increasingly complex vaccination schedule. An estimated 11,000 children are born each day in the United States, each requiring 15-19 doses of vaccine by age 18 months to be protected against 11 childhood diseases (6). In addition, licensure of new vaccines is anticipated against pneumococcal and meningococcal infections, influenza, parainfluenza, respiratory syncytial virus (RSV), and against chronic diseases (e.g., gastric ulcers, cancer caused by Helicobacter pylori, cervical cancer caused by human papilloma virus, and rheumatic heart disease that occurs as a sequela of group A streptococcal infection). Clinical trials are under way for vaccines to prevent human immunodeficiency virus infection, the cause of acquired immunodeficiency syndrome.

To achieve the full potential of vaccines, parents must recognize vaccines as a means of mobilizing the body's natural defenses and be better prepared to seek vaccinations for their children; health-care providers must be aware of the latest developments and recommendations; vaccine supplies and financing must be made more secure, especially for new vaccines; researchers must address increasingly complex questions about safety, efficacy, and vaccine delivery and pursue new approaches to vaccine administration more aggressively; and information technology to support timely vaccinations must be harnessed more effectively. In addition, the vaccine-delivery system must be extended to new populations of adolescents and adults. Each year, thousands of cases of potentially preventable influenza, pneumococcal disease, and hepatitis B occur in these populations. Many of the new vaccines will be targeted at these age groups. The U.S. vaccine-delivery system must routinely include these populations to optimally prevent disease, disability, and death.

Despite the dramatic declines in vaccine-preventable diseases, such diseases persist, particularly in developing countries. The United States has joined many international partners, including the World Health Organization and Rotary International, in seeking to eradicate polio by the end of 2000. Efforts to accelerate control of measles, which causes approximately one million deaths each year (5), and to expand rubella vaccination programs also are under way around the world. Efforts are needed to expand the use of existing vaccines in routine childhood vaccination programs worldwide and to successfully introduce new vaccines as they are developed. Such efforts can benefit the United States and other developed countries by decreasing disease importations from developing countries.

Reported by: National Immunization Program, CDC.


References

Fenner F, Henderson DA, Arita I, Jezek Z, Ladnyi ID. Smallpox and its eradication. Geneva, Switzerland: World Health Organization, 1988.

US Department of Health, Education, and Welfare. Vital statistics -- special report, national summaries: reported incidence of selected notifiable diseases, United States, each division and state, 1920-50. Washington, DC: US Department of Health, Education, and Welfare, Public Health Service, National Office of Vital Statistics, 1953:37.

US Department of Health, Education, and Welfare. Vital statistics rates in the United States, 1940-1960. Washington, DC: US Department of Health, Education, and Welfare, Public Health Service, National Center for Health Statistics, 1968.

Duffy J. The sanitarians: a history of public health. Urbana, Illinois: University of Illinois Press, 1990.

Plotkin SA, Orenstein WA. Vaccines. 3rd ed. Philadelphia, Pennsylvania: WB Saunders Co., 1999.

CDC. Recommended childhood immunization schedule -- United States, 1999. MMWR 1999;48:12-6.

Batelle Medical Technology Assessment and Policy Reserach Program, Centers for Public Health Research and Evaluation. A cost benefit analysis of the measles-mumps-rubella (MMR) vaccine. Arlington, Virginia: Batelle, 1994.

Cochi SL, Ward JI. Haemophilus influenzae type b. In: Evans AS, Brachman PS, eds. Bacterial infections of humans. New York, New York: Plenum Medical Book Co., 1991

CDC. Annual summary 1980: reported morbidity and mortality in the United States. MMWR 1981;29.

CDC. Reported incidence of notifiable diseases in the United States, 1960. MMWR 1961;9.

CDC. Reported morbidity and mortality in the United States, 1970. MMWR 1971;19.

CDC. Provisional cases of selected notifiable diseases, United States, cumulative, week ending January 2, 1999 (52nd week). MMWR 1999;47:1125.

CDC. Provisional cases of selected notifiable diseases preventable by vaccination, United States, weeks ending January 2, 1999, and December 27, 1997 (52nd week). MMWR 1999;47:1128-9.

Batelle Medical Technology Assessment and Policy Research Program, Centers for Public Health Research and Evaluation. A cost benefit analysis of the OPV vaccine. Arlington, Virginia: Batelle, 1994.

CDC. National, state, and urban area vaccination coverage levels among children aged 19-35 months -- United States, 1997. MMWR 1998;47:547-54.

CDC. Certification of poliomyelitis eradication -- the Americas, 1994. MMWR 1994;43:720-2.

CDC. Paralytic poliomyelitis -- United States, 1980-1994. MMWR 1997;46:79-83.

Yeargin-Allsopp M, Murphy CC, Cordero JF, Decoufle P, Hollowell JG. Reported biomedical causes and associated medical conditions for mental retardation among 10-year-old children, metropolitan Atlanta, 1985-1987. Developmental Medicine and Neurology 1997;39:142-9.



Table_1
Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.


TABLE 1. Vaccine-preventable diseases, by year of vaccine development or licensure
-- United States, 1798-1998
===================================================================================
Disease Year
----------------------------------------------
Smallpox* 1798+
Rabies 1885+
Typhoid 1896+
Cholera 1896+
Plague 1897+
Diphtheria* 1923+
Pertussis* 1926+
Tetanus* 1927+
Tuberculosis 1927+
Influenza 1945&
Yellow fever 1953&
Poliomyelitis* 1955&
Measles* 1963&
Mumps* 1967&
Rubella* 1969&
Anthrax 1970&
Meningitis 1975&
Pneumonia 1977&
Adenovirus 1980&
Hepatitis B* 1981&
Haemophilus
influenzae type b* 1985&
Japanese
encephalitis 1992&
Hepatitis A 1995&
Varicella* 1995&
Lyme disease 1998&
Rotavirus* 1998&
----------------------------------------------
* Vaccine recommended for universal use in U.S. children. For smallpox, routine vaccination
was ended in 1971.
+ Vaccine developed (i.e., first published results of vaccine usage).
& Vaccine licensed for use in United States.
=========================================================================================


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Table_2
Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.


TABLE 2. Baseline 20th century annual morbidity and 1998 provisional morbidity from
nine diseases with vaccines recommended before 1990 for universal use in children
-- United States
===============================================================================================
Baseline 20th century 1998 Provisional %
Disease annual morbidity morbidity Decrease
--------------------------------------------------------------------------------------
Smallpox 48,164* 0 100%
Diphtheria 175,885+ 1 100%&
Pertussis 147,271@ 6,279 95.7%
Tetanus 1,314** 34 97.4%
Poliomyelitis (paralytic) 16,316++ 0&& 100%
Measles 503,282@@ 89 100%&
Mumps 152,209*** 606 99.6%
Rubella 47,745+++ 345 99.3%
Congenital rubella 823&&& 5 99.4%
syndrome
Haemophilus 20,000@@@ 54**** 99.7%
influenzae type b
--------------------------------------------------------------------------------------
* Average annual number of cases during 1900-1904 ( 1 ).
+ Average annual number of reported cases during 1920-1922, 3 years before vaccine
development.
& Rounded to nearest tenth.
@ Average annual number of reported cases during 1922-1925, 4 years before vaccine
development.
** Estimated number of cases based on reported number of deaths during 1922-1926
assuming a case-fatality rate of 90%.
++ Average annual number of reported cases during 1951-1954, 4 years before vaccine
licensure.
&& Excludes one cases of vaccine-associated polio reported in 1998.
@@ Average annual number of reported cases during 1958-1962, 5 years before vaccine
licensure.
*** Number of reported cases in 1968, the first year reporting began and the first year after
vaccine licensure.
+++ Average annual number of reported cases during 1966-1968, 3 years before vaccine
licensure.
&&& Estimated number of cases based on seroprevalence data in the population and on the
risk that women infected during a childbearing year would have a fetus with congenital
rubella syndrome ( 7 ).
@@@ Estimated number of cases from population-based surveillance studies before vaccine
licensure in 1985 ( 8 ).
**** Excludes 71 cases of Haemophilus influenzae disease of unknown serotype.
================================================================================================

 

[Deb in IA]

Here's another article written in lay language.
http://www.sciencebasedmedicine.org/?p=516

Herd Immunity
Published by Mark Crislip under Public Health,Science and Medicine,Vaccines
Comments: 43
Some infections can be eradicated from the face of the planet. Smallpox is the one example of disease eradication to date. Smallpox still exists in US and Russian labs, but there has been no wild cases since 1977. It is, like the Dorothy, history.

Why were we able to eradicate smallpox? Three reasons:

1) There is only one form of smallpox. Unlike influenza that changes from year to year. So only one vaccine needed.
2) By what appears to be a once in a universe miracle, every county cooperated with the WHO (much like we all cooperate with the IRS) so the entire planet received the vaccine. Once enough people were vaccinated, the disease was unable to perpetuate itself and spread and so died out.
3) Unlike bacteria, there are no asymptomatic smallpox carrier states. Eradicable viruses usually cause symptomatic disease and do not result in asymptomatic, infectious carrier states that serve as a reservoir for infecting others. HIV and Herpes cause chronic asymptomatic infections and will probably never be eradicated.

There are other diseases that are theoretically eradicable, like measles and polio. They have one antigenic type, have no carrier state and, if the entire world could be vaccinated, the disease would cease to exist in the wild. I am sure there would be biologic weapons labs that would always carry a vial or 2 of every infection. Just to be safe.

Could we ever eradicate bacterial diseases? No way. Not ever. Bacteria will often colonize people, not causing disease. Neisseria meningitis, for example, will, depending on the season and the population studied, will be found asymptomatically in the throat of up to 35% of people (1). The asymptomatic carriers serve as a source of bacteria that can subsequently be passed on to others, who, for reasons of genetics or bad luck, develop invasive disease.

Asymptomatic carriage can be important to developing immunity to bacteria. Like vaccines, carriage exposes the immune system to small amounts of antigen and can lead to immunity. Unlike vaccines, there is the small, but real, chance that the bacteria will become invasive and kill the patient. Or jump to another and kill them.

The meningococcal vaccine is not one of the stellar vaccines. It has modest efficacy, but may make the difference between life and death in some patients. The meningococcal vaccine can decrease the chance of an individual having invasive disease or dying from the disease, but perhaps more importantly, the vaccine can markedly decrease the asymptomatic carriage rates in a population (2).

The decrease in the number of disease carriers is vital to the prevention of bacterial infections. Vaccines are never 100% effective. Some people are genetically unable to respond to the vaccine, some have immunodeficiencies that preclude receiving vaccines or developing a response to the vaccine, some haven’t gotten around to vaccination or are too young to receive a vaccine. If you vaccinate a large number of people, besides preventing disease in an individual, it helps protect the vulnerable in a population. Vaccines prevent disease propagation.

A recent example of beneficial effects of the vaccine mediated decrease in carriers occurred with the conjugate pneumococcal vaccine that is given to children. The conjugated pneumococcal vaccine is directed against the 7 most common disease causing strains. Pneumococcus is a nasty bacteria, causing pneumonia, sepsis, and meningitis.

The use of the vaccine lead to a decrease in the incidence of meningitis of 64% for the vaccine strains in children less than 2 years old, but, due to a general decrease in the carriage rates in the community, the rates of meningitis also dropped in the greater than age 65 group by 54% and a decrease in meningitis for all ages by 73% (4). The use of the vaccine in children has also lead to the decrease in invasive pneumococcal disease in adults (3).

Herd immunity at work. Part of herd immunity functions to decrease the number of people in a population who carry the disease so that an at risk population are not exposed. Part of herd immunity functions by preventing the spread of some, especially viral, diseases. If there are not enough vulnerable people in a population, the disease cannot spread and perpetuate. However this mechanism for herd immunity is less helpful with bacteria, which can colonize or cause less obvious disease.

Like pertussis.

Pertussis, whooping cough, is caused by a bacteria, Bordetella pertussis. It infects the upper airway of children, causing obstruction and intractable coughing and vomiting after coughing. Kids can cough themselves to death, unable to stop coughing to take in a breath. The whoop of whooping cough occurs when the kids cough themselves blue and rapidly suck in air so they do not suffocate. If you vomit while trying to inhale, as occurs with pertussis, the child can suck vomit into their lungs, a bad thing as Eric ‘Stumpy Joe’ Childs proved.

There is a vaccine against Pertussis and it has been effective in helping to almost eradicate the disease in the US. World Wide disease there are about 294,000 deaths from pertussis. In the US disease “the rate of pertussis peaked in the 1930s, with 265,269 cases and 7518 deaths reported in the United States. This rate decreased to a low in 1976, when 1010 cases and 4 deaths occurred (9)”. Before the vaccine pertussis killed about 8000 children a year, a death rate of about 1 in 500 (10).
Pertussis cases have been climbing. There were, in 2007, 10,000 cases of pertussis in the US, a new record.
USA. USA. USA.

Those numbers are all well and good, but a moving picture is worth thousands of words.
Warning: children are suffering in this video.
http://www.youtube.com/watch?v=dZ5jf-5MobE.

This is what the vaccines prevent. This what will come back as vaccination rates fall.

The vaccine is good, but not perfect. Vaccine efficacy is 64% for cases defined by mild cough, 81% for paroxysmal cough, and 95% for severe clinical illness (11). Note the vaccine is good for attenuating the disease, not preventing it entirely. Patient with a cough are very infectious. Cough is a great way to spread disease (15). The reason the doctor asks you to turn your head and cough when testing for a hernia is not that turning the head improves the hernia exam, it is so you do not cough on the doctor, a remnant of the age of Tb. And immunity wanes with time, so older populations are at increased risk for having asymptomatic disease (8)

Pertussis persists in the adult population, due to declining immunity over time and primarily presents as a prolonged cough, not whooping cough. Adults have enough immunity to avoid the severe manifestations of the disease. And pertussis is common.

“From September 1986 through February 1989, we studied UCLA students with cough that lasted 6 days or more . During this 2.5-year period, we found that 26% of the evaluated students had pertussis and that illness was endemic throughout the study period. Similar studies done in adults in the United States, Australia, and Germany have had generally similar findings. Twelve percent to 32% of persons with prolonged cough have been found to have pertussis. In our study, important clinical findings in persons with pertussis were that the median duration of cough illness before seeking care was 21 days, productive cough was rare, the most common clinical diagnosis was bronchitis, and in no case was the diagnosis of pertussis entertained (9).”

So there is a huge potential source of pertussis, omnipresent, presenting atypically, at least as far as whooping cough is concerned, ready to kill. Maximizing immunity in children and boosting immunity in adults is the only way to control pertussis: Herd immunity.

With pertussis, while herd immunity may help prevent disease spread, because it is a bacteria and can be present without causing illness, the herd immunity rates required to prevent the spread of disease are much higher than needed for viruses. Immunity rates needed to protect the population from pertussis are about 94%, while virus spread is decreased if immunity rates are only 80% or so. More of the population can be vaccine slackers and not be at risk for a viral illness, but not pertussis.

As discussed in this blog, there are pockets of non-vaccination in California. According to the LA times, over 10,000 kindergartners had vaccine exemptions and some schools had very high no vaccine rates, many over 20%.

So far, no big outbreaks, but pertussis is the one I would expect to hit first. As it requires the highest herd immunity rates and the has the biggest source of potential sources, California is primed for a resurgence of pertussis. All you would need to infect, say, an entire Waldorf school, is one adult who comes to work with a cough.

Published in Pediatrics this month is a paper that looked at the effect of vaccine refusers on laboratory confirmed (PCR or cultures) pertussis in Colorado (13). They had 158 cases of pertussis in the Kaiser system between 1996 and 2007.

Infected children were significantly more likely to have parents who refused vaccinations (11.5%) than the controls (0.5%). The difference translated to a 22.8-fold increased risk of pertussis in the unvaccinated children.

At the time in Colorado, vaccination refusal was less than 1%, but they accounted for 11% of the cases of pertussis. That’s not surprising. With a bacterial disease like pertussis, a small slip in the vaccine rate can lead to a big jump in disease.

The vaccine is not 100%. So there will be cases in vaccinated children as well. What is striking is ALL the cases in the unvaccinated group could be attributed to not having the vaccine.

Oh, that’s Colorado. I don’t need to worry. Doesn’t apply to my community.

There have been natural experiments in the world where diseases that were rare due to immunization came back with a decline in vaccination rates. Like Sweden. Watch as immunity in the population falls, watch as pertussis comes back. On the count of three, everyone say duh.

“Immunization against pertussis was introduced in Sweden in the 1950s and discontinued in 1979. This was followed by a low endemic level of pertussis for 3 years. Thereafter the incidence gradually increased and there were two outbreaks in 1983 and in 1985. In the period 1980 to 1985 pertussis was confirmed by culture or serology in 36,729 patients of which 11% were younger than 12 months of age and 69% were ages 1 to 6 years. An estimate of the total frequency of pertussis in preschool children was made from reports from a sample of the child health centers. The annual incidence rate per 100,000 population ages 0 to 6 years increased from the 700 cases in 1981 to 3200 in 1985. The ratio of total cases to those reported from the laboratories was 3:1 in 1981 and 2:1 in 1985. The cumulative incidence rate by the average age of 4 years was estimated at 16% of the unimmunized cohort born in 1980 compared with 5% of the immunized cohort born in 1978. The seriousness of pertussis was evaluated by studying the 2282 pertussis patients hospitalized from 1981 to the end of 1983. Forty-eight percent were infants younger than 12 months of age. Neurologic complications were noted in 4% and pneumonia in 14% of the hospitalized patients. Eleven children received assisted ventilation. Fatal outcomes were reported in 3 children (0.1%), 2 of whom had severe congenital disabilities (8).”

Ready?
One.
Two.
Three.

Hey. I heard that all the way in Portland.

Similar outbreaks of diphtheria, a bacterial disease that requires viral herd immunity rates of about 85% to prevent spread. When the Soviet Union fell apart, the vaccinations levels fell due to no health coverage, poor economics and a fear of vaccines perpetuated by anti vaccination proponent.

Part of the problem was

“changes in the immunization schedule during this period encouraged less intensive vaccination of children. Use of an alternative schedule of fewer doses of lower antigenic content (adult formulation) vaccine was allowed beginning in 1980.”

Good thing that doesn’t describe anyone in this country. Who would be nuts enough to think that we give too may vaccines too soon? Certainly no MD. That’s a path down which lies huge epidemics with horrific morbidity and mortality.

The old USSR went from 3,000 diphtheria cases to 50,000 cases in 5 years as vaccination rates fell from almost universal coverage to 69% (7). Diphtheria was not controlled until vaccination rates were pushed back into the low 90’s using the old schedule.

Vaccination rates are drifting down in some parts of the US. The bacteria and viruses are not gone and never will be. As the vaccination rates fall, the herd loses its immunity and can no longer provide protection. The risk is slowly building and there will be more outbreaks. The reason to get vaccinated becomes increasingly compelling. And only Jenny McCarthy will be satisfied if the epidemics return (6).
———
References

1) FEMS Microbiol Rev. 2007 Jan;31(1):52-63.C Lessons from meningococcal carriage studies. PMID: 17233635

2) J Infect Dis. 2008 Mar 1;197(5):737-43 Impact of meningococcal serogroup C conjugate vaccines on carriage and herd immunity. PMID: 18271745
3) Clin Infect Dis. 2009 Jan 1;48(1):57-64. Epidemiology of invasive pneumococcal disease among adult patients in barcelona before and after pediatric 7-valent pneumococcal conjugate vaccine introduction, 1997-2007. PMID: 19035779

4) Effect of pneumococcal conjugate vaccine on pneumococcal meningitis. N Engl J Med. 2009 Jan 15;360(3):244-56. PMID: 19144940

5) http://www.metrokc.gov/health/immunization/compare.htm

6) http://www.time.com/time/health/article/0,8599,1888718,00.html

7) http://www.cdc.gov/ncidod/eid/vol4no4/vitek.htm

Pediatr Infect Dis J. 1987 Apr;6(4):364-71. Pertussis in Sweden after the cessation of general immunization in 1979.

9) http://www.annals.org/cgi/content/full/128/1/64

10) http://www.metrokc.gov/health/immunization/compare.htm

11) http://jama.ama-assn.org/cgi/content/abstract/267/20/2745

12) http://www.cdc.gov/mmwr/preview/mmwrhtml/00046738.htm

13) Glanz J, et al “Parental refusal of pertussis vaccination is associated with an increased risk of pertussis infection in children” Pediatrics 2009; DOI: 10.1542/peds.2008-2150.

14) http://www.cdc.gov/ncidod/eid/vol4no4/vitek.htm

15) Only sex is as efficient a way to spread infection. If someone coughs on you during sex, it’s all she wrote. Make sure your affairs are in order.

 

[Geoff_M]

Oh, Deb, now you've done it! Prepare for the cut-n-paste barrage that plays the "Vaccines Didn't Really Save Us" gambit by pointing out that the mortality rates of most preventable diseases were on the decline before the associated vaccines were introduced. While true due to things like advancements in supportive care (ex. the "iron lung" that allowed polio victims to not suffocate to death) and advancements in public health efforts, it also completely ignores the fact that cases of the diseases plummeted with vaccine up-take rates and that "death" is hardly the only long-term negative consequence of many of those diseases. Yes, thanks to advancements children may have lived after contracting the disease, but might be left with hearing loss (my grandfather), blindness, mental retardation, paralysis, or other serious life-long conditions.

And here's another interesting thought. I wonder if the people that describe vaccine content as "crap" realize the corner they may be painting themselves into. Those greedy Pharma companies currently have a problem on their hands. Up until not too long ago, drug R&D's lifeblood was finding new pharmaceutical products that are in essence chemical molecules. However, it appears more and more that this well is starting to dry up as it's becoming harder and harder to find new "blockbusters". One new promising area for new discoveries is that of "biologicals" that are derived from living cells. Vaccines are "biologicals". Last year the FDA approved a "vaccine" for the treatment of prostate cancer. I put vaccine in quotes because it's not really a traditional vaccine, but instead a biotherapeutic treatment. "Biologicals" will need many of the same components and such used in vaccines to keep them sterile and potent. This is the "crap" that people refer to. So wouldn't it be ironic if the first effective treatment for autism were in fact a biological and suddenly people would be faced with the decision to use the "crap", "toxins", etc. that they have long derided to treat their child?

 

[Deb in IA]

Hmmm.


Potentially, a "vaccine" to prevent autism!!!

 

[WeLoveLilo05]

I'm sorry, but a cold takes 7-10 days to completely run it's course. Do you really think I should keep my child home those 7-10 days each time she gets a cold? And I should stay home from work too? If it's just a cold, people need to build up their immunity, not hide in the closet like they have the plague. I don't mean this to be snarky, but are you a stay-at-home parent? Anyone who works for a living knows it is impossible to stay home with your kids when they have a cold, then stay home when you're sick. If the sickness is also accompanied by a rash, fever, etc., then by all means stay home, but for just the common cold, I think this is a bit over the top.

Yes but on the flip side, (and I am not saying you do this,I am just kind of seeing where there other poster was coming from). I had a little girl who constantly came in sick. One day she came in looking awful, felt her head to find she was burning up! Sent her down to the nurse (literally this kid just walked in the building and I was sending her back up to the nurse) and the nurse called her mom and said she had a fever, mom came in with some Tylenol, administered it, and said "OK, go back to class". The nurse stepped in and said the policy is 24 hour fever free w/o tylenol. Mother huffed and puffed about having to take her sick child home. Poor thing was only in kindergarten! Ended up, she had strep throat!

 

[WeLoveLilo05]

I have not seepnany anivax people trying to get anybody not to vaccinate. I do think the provaccine people really try to push it on the non vax people who just want to be left alone to make their own descisions.

agreed! Anytime this comes up (and o boy its been a few times here on the DIS I really try and stay out, but they just pull me back in )! I feel like I have to come on here and defend why I didn't want my DD to get certain vaccines and why I have to agree with parents who opt not to have their child vaccinated. Honestly...autism is the last thing on my mind when it comes to vaccines.
People who are pro vax feel the need to bash parents who have made the choice not to and thats what gets me mad. I am not trying to get people to not vaccinate, you do what you want with your child, I would never tell you how to parent or raise a child, I am just clearly saying why I decided not to have certain vaccines done to my child (a previous reaction and HOURS AMONG HOURS of research).

 

[Geoff_M]

People who are pro vax feel the need to bash parents who have made the choice not to and thats what gets me mad. I am not trying to get people to not vaccinate, you do what you want with your child, I would never tell you how to parent or raise a child, I am just clearly saying why I decided not to have certain vaccines done to my child (a previous reaction and HOURS AMONG HOURS of research).

Please understand that I (and others including people like Deb) are not reacting primarily to someone's decision not to vaccinate their children, but instead it's that the decision is often reached on the basis of accepting (and often times passing on) really, really bad and/or misleading information. We would also be the first ones to admit that there are legitimate reasons for some parents not to vaccinate their child... such as your experience with a bad reaction.

I don't do this...
DIS'er Parent: "I'm not vaccinating my child."
Geoff_M: "You're an idiot!"

I do this...
DIS'er Parent: "I'm not vaccinating my child because vaccines contain ground up puppies!"
Geoff_M: "That's completely false, and here's why..."
(Now perhaps I was a bit harsh on bumbershoot, but if you've been around here enough you'll understand... as Deb hinted at above.)


And I'll put the same scenario to you that I mentioned earlier: Would you feel the same way if a pregnant HIV+ friend told you that after doing a lot of "research" she'd concluded that HIV didn't cause AIDS, and she didn't plan on taking antiretroviral drugs to try and prevent passing HIV on to her child? Would you merely smile and say that you "support" her decision if you know that there are significant medical errors and misinterpretations made in the case that she presents for her decision? Would trying to point out her errors be tantamount to "forcing" AZT on her? Would you be "bashing" her?

Anytime this comes up (and o boy its been a few times here on the DIS I really try and stay out, but they just pull me back in )!

You know, the good news is that these threads seem to be dying out here. I think that it's a sign that the anti-vaccine hysteria has long passed it high-water mark. I also see other evidence of that. The media seems to have lost interest in the scare stories, and in fact seem more fixated on reporting on things like the final exposure of Andrew Wakefield's Lancet hoax. And recently I found a news article about the fact that childhood vaccination rates in our part of the state have steadily risen since hitting a low in 2002 (during the height of the hysteria). Some county's whose rates of kids that were up-to-date on all their shots were at 45% are now about 70%. Still not up to the levels health care professionals would like, but a big jump in the right direction.

 

[PrincessKsMom]

Yes but on the flip side, (and I am not saying you do this,I am just kind of seeing where there other poster was coming from). I had a little girl who constantly came in sick. One day she came in looking awful, felt her head to find she was burning up! Sent her down to the nurse (literally this kid just walked in the building and I was sending her back up to the nurse) and the nurse called her mom and said she had a fever, mom came in with some Tylenol, administered it, and said "OK, go back to class". The nurse stepped in and said the policy is 24 hour fever free w/o tylenol. Mother huffed and puffed about having to take her sick child home. Poor thing was only in kindergarten! Ended up, she had strep throat!

As I said it my post, if the child has a fever or a rash than it's obviously more than just the common cold and they should be seen by a doctor. However, I know in the case of my DD, whenever she gets upset she vomits. If someone is bullying her, she vomits. If she's nervous, she vomits. I have fought with school to keep her there because this is more her way of having a panic attack, and I don't feel she should be allowed to "run away" from whatever is bothering her (in certain situations). Once I explained the situation to the teacher, nurse, principal...they agreed it would be best to allow her the time she needs, and then send her back to class. Sometimes I do take the tough love approach. To other people they might think she has a stomach virus or the flu, but I know the difference. No chance of anyone catching her nervous stomach.

I do agree there are parents who try to avoid their child coming home or missing school at all costs. I feel sorry for those children and I also feel sorry for their parents. I am fortunate in that I have plenty of paid time off from work and a very understanding employer. Not everyone is as fortunate. I remember being the sick child who was sent to school. My parents were divorced and if my mom missed 1 day of work she would be fired. It's a horrible situation to be in -- send your sick child to school or be unable to provide for them. Not everyone has someone who they can turn to for help. And then there are the other students/parents to consider. It's really a no win situation for everyone.

 

[princesspeach]

Oh, Deb, now you've done it! Prepare for the cut-n-paste barrage that plays the "Vaccines Didn't Really Save Us" gambit by pointing out that the mortality rates of most preventable diseases were on the decline before the associated vaccines were introduced. While true due to things like advancements in supportive care (ex. the "iron lung" that allowed polio victims to not suffocate to death) and advancements in public health efforts, it also completely ignores the fact that cases of the diseases plummeted with vaccine up-take rates and that "death" is hardly the only long-term negative consequence of many of those diseases. Yes, thanks to advancements children may have lived after contracting the disease, but might be left with hearing loss (my grandfather), blindness, mental retardation, paralysis, or other serious life-long conditions.

And here's another interesting thought. I wonder if the people that describe vaccine content as "crap" realize the corner they may be painting themselves into. Those greedy Pharma companies currently have a problem on their hands. Up until not too long ago, drug R&D's lifeblood was finding new pharmaceutical products that are in essence chemical molecules. However, it appears more and more that this well is starting to dry up as it's becoming harder and harder to find new "blockbusters". One new promising area for new discoveries is that of "biologicals" that are derived from living cells. Vaccines are "biologicals". Last year the FDA approved a "vaccine" for the treatment of prostate cancer. I put vaccine in quotes because it's not really a traditional vaccine, but instead a biotherapeutic treatment. "Biologicals" will need many of the same components and such used in vaccines to keep them sterile and potent. This is the "crap" that people refer to. So wouldn't it be ironic if the first effective treatment for autism were in fact a biological and suddenly people would be faced with the decision to use the "crap", "toxins", etc. that they have long derided to treat their child?

Maybe its dying out because people don't wan't to discuss something with people who are arrogant and condescending to anyone that disagrees . Go ahead and give your children the crap toxins. Take your drugs. Feed them the ritalin. Its your right. Its all good. Honestly I could care less what you do with your kids. If you have them. Just don't try to force it on mine. What made you the judge and jury on whats good and bad information. I don't mean to be rude, but arrogance and a know it all attitiude just irritate people.

 

[rie'smom]

Unless and until everyone who chooses to smoke, overeat, not exercise, drive 1 mile over the speed limit, texts while driving, texts while walking in the mall, has a pet, drinks diet drinks, is born to parents who give them the gene that causes disease, jaywalks, etc pays higher premiums, then no one should.