What the Papers Don't Say About Vaccines 737
jamie tips an article in The Guardian's "Bad Science" column which highlights recent media coverage of the MMR vaccine. A story circulated in the past week about the death of a young child, which the parents blamed on the vaccine. When the coroner later found that it had nothing to do with the child's death, there was a followup in only one of the six papers who had covered the story.
"Does it stop there? No. Amateur physicians have long enjoyed speculating that MMR and other vaccinations are somehow 'harmful to the immune system' and responsible for the rise in conditions such as asthma and hay fever. Doubtless they must have been waiting some time for evidence to appear. ... Measles cases are rising. Middle class parents are not to blame, even if they do lack rhetorical panache when you try to have a discussion with them about it. They have been systematically and vigorously misled by the media, the people with access to all the information, who still choose, collectively, between themselves, so robustly that it might almost be a conspiracy, to give you only half the facts."
It's not actually a parental issue (Score:5, Informative)
It's a societal issue. Once a critical portion of the population is not immunized against a disease, then a widespread epidemic is more possible and likely. This could have severe economic impacts that go far beyond the goals of individual parents. This is why most immunization is mandatory unless there is a specific religious or health related exception. People invoking these exceptions trivially are endangering the functioning civil order. These vaccines have proven to be quite safe -- and, even if there is a risk of infection (say for example, with live polio), if the negative side-effect rate in the population is low-enough, its still something that should be mandated in order to ensure that the population as a whole is resilient to some of the Big Nasties.
Re:Doctors != Scientists (Score:5, Informative)
I know this is going to be viewed somewhat as flamebait, but to put it bluntly, doctors are mechanics for the human body.
It's funny you should say that. A friend of mine is toward the end of med school, and at her house I was leafing through one of the professional journals she gets. It reminded me a lot of a car mechanic's guide. Very little on the science or the why. She agreed.
Maybe that's the right thing, as being a family doctor you have to keep up with an awful lot of conditions. But I went through a lot of doctors before I found one who a) had at least a touch of humility, and b) made me feel like she understood the actual science involved.
Dr Sear's Vaccine Book (Score:1, Informative)
I highly recommend Dr Sear's vaccine book if you are a new parent. The doses of mercury and formaldehyde included in most vaccine is concerning to most parents. As most parents will tell you, your kid feels and looks like crap after getting a single vaccine. Dosing him with multiple ones really knocks 'em down for a week or more until they return to normal.
My wife and I chose to space out the vaccines we gave our child to 1-2 a month instead of 3-4 every two months. This keeps a "mostly normal" vaccine schedule while trying to avoid overburdening the kids body.
Re:Evidence does not get recorded (Score:3, Informative)
Many, many statistical analysis have been done. Repeatedly it has been proven there is no link.
But the press still print any trash story they can make up, leading to people like you being unsure.
Re:Evidence does not get recorded (Score:4, Informative)
most urticarias do start suddenly and the reason is never found.
Science knowledge (Score:4, Informative)
Re:That is impractical. I mean, impossible. (Score:5, Informative)
Re:Dr Sear's Vaccine Book (Score:4, Informative)
The mercury was removed years ago because of people flipping over it. Kids feeling like crap after a vaccine will happen regardless of what you put in it, because of the very nature of what it does (it makes your immune system go nuts over it, which is what makes you feel like crap... like what happens when you a have a freagin cold). Oversimplifying here, but thats about it.
Spacing them out may or may not have benefits, I'm not arguing that, but its not the mercury or whatever that makes your kid go poof after a vaccine.
This time there *was* a conspiracy .... (Score:3, Informative)
Usually, one can rely on the cock-up theory. However, in the case of the MMR vaccine there really was a conspiracy.
http://www.city-journal.org/2008/bc1114td.html
You don't understand evidence (Score:3, Informative)
Because such self-reported anecdotes are not relevant in a proper statistical analysis.
If there were a correlation to be found, then the epidemiologists would be able to find it just based on the fact that a significant number of children came in with cases of hives shortly after coming in for their MMRs. Your records would support that, based simply on the objective facts that you had the MMR on date x, and came down with hives on date x+n. That's all the evidence your son's case can provide.
Your armchair analysis on a sample size of one is not evidence, and has no place in a medical record.
Re:Negative headlines sell better (Score:2, Informative)
I got the MMR as a kid, and din't get sick from it, my brother did though, but oddly enough he got well after a week or so. Does that mean that the vaccine is dangerous?
NO, of course not!
Vaccine is made of deactivated viruses, and the body reacts to those viruses as it is supposed to, some just reacts a bit more...effectively, than others, and immediately fires up the immune responses.
The MMR vaccine is clearly one of those cases where the "Better safe than sorry" approach of some misinformed parents REALLY risk hurting their child, when it later in life get into contact with the viruses they were supposed to be protected against through the MMR.
Re:Negative headlines sell better (Score:3, Informative)
Well if you're immune system is expressing large amounts of chitinase because of the vaccine, I wouldn't be surprised if it leads to things like asthma.
From http://en.wikipedia.org/wiki/Chitinase [wikipedia.org] :
As such, it is unsurprisingly related to allergies. What is surprising, perhaps, is that asthma in particular has been linked to enhanced chitinase expression levels.[14][15][16][17][18]
Jenny McCarthy needs to shut up (Score:3, Informative)
Has Jenny cured her sons supposed vaccine induced autism yet?
The media is eager as hell to hope on board whenever she opens her ignorant mouth.
Seriously, who the fuck in their right mind would take medical advice from this nutbar? And shouldn't spewing such nonsense somehow fall into the realm of practicing medice without a license?
http://www.stopjenny.com/ [stopjenny.com]
Re:Negative headlines sell better (Score:2, Informative)
My daughter got the MMR a month or two ago and she ended up with a week of 106F fever.
So the doctor told you that the fever was a result of the MMR or did you come up with the diagnosis yourself?
The doctor actually had us come in for an extra visit to verify that it was a result of the MMR - although high fever is a well-known and common side effect of the MMR vaccine. Incidentally, had the 106F fever been the result of infection, it would have been a serious cause for concern. Brain damage, due to the fever, only kicks in if the fever gets above 107F but, getting back to my original point, the whole business is very scary and it's only natural for parents to be interested in the question of whether vaccines sometimes cause permanent damage.
Re:Negative headlines sell better (Score:5, Informative)
Yellow fever vaccine is a live virus (though it is attenuated).
Re:Lack of Interest in Science (Score:2, Informative)
My supermarket stocks dozens of brands of bar soaps that are not antibacterial (er, that do not contain antibiotics) and at least 3 brands of liquid soap that are not antibacterial.
You are full of it.
It is certainly disappointing that so many soaps include antibiotics, but hyperbole isn't going to help that situation any.
Re:Parents ARE to blame (Score:5, Informative)
But a little more seriously, I think many people are getting suspicious of doctors who are too quick with the prescription pad, and don't spend much time actually doing preventative, or even curative, medicine.
As a doctor, I agree wholeheartedly. There are a number of reasons for this, but, honestly, the biggest reason is this is just not paid for. The biggest insurers in this country - medicaid and medicare do not pay for annual preventative health visits except for children. Also, they pay per visit, not what you did or how good a job you did as a doctor. I can spend 30 minutes discussing stuff with my patents about non-medicine treatments, about vaccines or whatever (and I do because I consider it my job to do what is best for my patients), but I won't get paid a dime to do it by their insurance for all that extra time with them or for many of the preventative health visits. That costs me quite a bit of money actually. I have to pay staff and office cost so it comes straight out of my families pocket. Many docs, are understandably (to a certain degree) not willing to make that sacrifice.
This also might lead you to understand why docs get upset with the Jenny McCarthy types. If we spend more time talking about why vaccines are safe, we either have less time to talk about stuff that might be more important or just sacrifice and lose more money ourselves and at the same time make other patients wait longer.
I do make this sacrifice and build it into my schedule, but I make about 30-50% of most my colleuges for it and I spend more time than most of them working because of it. Most of my patients would agree I'm a much better doctor than most for it. Other than knowing I do a good job, I am essentially punished for it. Our system in the US is screwed. My only recourse to maintain this type of care and make a competitive salary is to do boutique medicine. I'm not sure I'm willing to do that because it would exclude all of my poorer patients.
Re:Parents ARE to blame (Score:2, Informative)
Perhaps you should read back through Ben Goldacre's blog and see what else he's written about the MMR scare - this is something he most definitely does know about. Oh yeah, and if you read his biography you'll see he is also a medical doctor.
John
I know that and I wasn't talking about him. I was talking about the writers in the newspapers and other places that scare parents - you know, the ones without MDs. Of course the article's author knows what he's talking about. Geeze!
Re:Science knowledge (Score:2, Informative)
No, that's not true at all. The FDA recommended that thiomersol be removed from children's vaccines only in 2001. It's still routinely used in multi-dose bottles of vaccines in the US.
Which isn't to say it's particularly harmful - it's a very small amount of mercury and the mercury in thiomersol is ethylmercury rather than methylmercury. The latter is what you find in industrial pollution that winds up in fish. It seems to be more biologically toxic, pooling in tissues and taking significantly longer to be eliminated from the body.
Re:That is impractical. I mean, impossible. (Score:5, Informative)
IAAP (I am a physician - specifically pediatrics). First off, "you" may have been "fine" when you "got measles," but the population of England wasn't. Measles isn't chicken pox - it's a LOT worse. It's pretty rare to die of pox, but measles will kill you, give you encephalitis, make you go deaf, or a lot of horrible, horrible things. It's not just a bunch of itchy spots for a month.
And second, as for your reaction to the DTaP vaccine, there is a widely known side effect of the vaccine (specifically the "P" part against Pertussis, aka Whopping Cough). We are well aware of the side effect and it is known. That is not the same as speculation about an unproven side effect believed by the public and rejected by most of the scientific community. Hmm, sounds a *lot* like the Global Warming denier community. Oh wait, but those guys are kooks, right? *You're* just being skeptical, right?
That being said, your physician is either an idiot, or to be fair, maybe this wasn't known in 1960s UK - the solution to the DTaP reaction you describe is to administer just the D and T portions and not adding the Pertussis part. Congratulations, you were not immunized against Tetanus or Diptheria.
Re:Lack of Interest in Science (Score:3, Informative)
There is no resistance danger from products that physically rip the cells apart (this is bleach, alcohol, etc.). Those products are capitalizing on emotionally manipulating people, but they aren't causing difficulty for people trying to treat infections.
Consumer soaps that are marketed as antibacterial generally contain triclosan, full stop. Hand sanitizers are indeed often alcohol based, but they are marketed as killing germs, not as being antibacterial.
most childhood diseases happens after vaccination (Score:2, Informative)
Re:Actually.... (Score:3, Informative)
Funny, the fillings I had last year were still amalgam fillings, and when I had to have some work done on the same fillings back in September the dentist used amalgam again to fill in the work he had done. I also was advised and I also signed a consent form before I received a flu vaccine shot back in October that the vaccine contained thimerosal. I am fairly certain that this was the same vaccine given to children needing resistance to the flu. In any case, these days, many of the wild caught ocean fish, certain tuna species fall under this category, have significant amounts of mercury. Don't even get me started on the natural background levels of asbestos in the air. The asbestos is mainly liberated from the erosion of naturally exposed deposits.
Sure, any amount of asbestos, mercury, or radiation is dangerous, but determining what an acceptable level above background has been difficult. It is even more difficult when there are weirdos are out there actively interfering. So think about acceptable levels of risk the next time you go for a drive in you car.
Re:Helminthic Therapy to the Rescue (Score:3, Informative)
Given the number of food allergies you have, it sounds like you ALREADY have a parasite. Both my wife and I picked up giardia somewhere, and it's caused all kinds of health problems, along with a list of food sensitivities. I did an IgG food sensitivity panel and my test results make me look like an AIDS patient (although I am HIV negative). I've taken Tinidazole for the giardia, but that didn't work so I'm on Metronidazole right now.
You should also be checked for problems with neuraltransmitters and hormones, including adrenal, thyroid, dopamine, etc. Defficiencies of some of these things (as well as several key vitamins) can also result in flaky immune systems and food sensitivities.
Re:Too many coincidences (Score:3, Informative)
'post hoc ergo propter hoc'
Its a classic logical fallacy.
Humans are very good in finding 'connections' where there are none.
Its probably some trait we got a long time ago when being a paranoid critter with an overactive imagination gave you a better change not to be eaten by a predator.
Re:Negative headlines sell better (Score:2, Informative)
Re:Negative headlines sell better (Score:2, Informative)
You are a moron. Doctors have spent years learning about disease and microbiology. Parents get fancy articles in pretty magazines that use a lot of top 10 lists. Doctors do have the ability to determine EXACTLY what is causing the disease in the vast majority of cases. Symptoms are actually less important in diagnosis than signs. Parents get media scares written to induce them to buy the stupid magazine.
Before you ask, yes I do work in health care.
Re:That is impractical. I mean, impossible. (Score:3, Informative)
Not really, because it only takes one case to generate an epidemic among unvaccinated subjects. So the very low odds of catching it in the first place only apply to the first case.
In a given population, about 85% must be vaccinated to achieve a "herd immunity" effect for unvaccinates (that is, a *lack of opportunity to be exposed* to active disease). But when the vaccinates drop below about 85%, you have conditions conducive to an epidemic.
So yes, the very occasional unvaccinate is not really at risk. However, if they become the norm, then the risk of infective exposure becomes very high, and the associated risk of death becomes everyone's problem, rather than a rare few's problem.
We have already seen this principle at work with several localized lepto epidemics since vaccinating dogs against lepto fell out of favour due to fear of imaginary "reactions" -- and lepto had previously been pretty well vaccinated out of existence.
Re:Dr Sear's Vaccine Book (Score:2, Informative)
The mercury has been reduced, not removed from many vaccines. It is still present in measurable amounts.
Remember, you always have the right to ask to see what is in the vaccines that the doctor is giving your child!
Re:Negative headlines sell better (Score:1, Informative)
The Function of Fever
If you raise temperature a few degrees above normal body temperature, enzymes become hyperactive. The enzymes in the immune system are activated and powered up to fight infection by acceleration of the activity of certain white cells which literally eat and digest bacteria. This process is called "phagocytosis," which means literally "eating cells." At 104 degrees Fahrenheit, enzymes and phagocytic cells are at their maximum state of activation. Therefore, a fever should not be artificially brought down unless it exceeds 104 degrees Fahrenheit. At 106 degrees, brain damage (i.e., enzyme destruction) begins. When there is a fever it should be monitored every thirty minutes and treated if it exceeds 104.
Close, but not quite.
Re:Negative headlines sell better (Score:2, Informative)
# 39C (102.2F) - Severe sweating, flushed and very red. Fast heart rate and breathlessness. There may be exhaustion accompanying this. Children and people with epilepsy may be very likely to get convulsions at this point.
# 40C (104F) - Fainting, dehydration, weakness, vomiting, headache and dizziness may occur as well as profuse sweating.
# 41C (105.8F) - (Medical emergency) - Fainting, vomiting, severe headache, dizziness, confusion, hallucinations, delirium and drowsiness can occur. There may also be palpitations and breathlessness.
So yeah, if she had a 106F fever for a solid week she should have been hospitalized. I hope for your sake the next time she has a fever like this you take her to the ER after no more than 24 hours or there will likely be permanent damage.
Re:Negative headlines sell better (Score:3, Informative)
The real issue for concern out of the childhood vaccines is the suspension solution they are delivered in. This contains preservatives to provide shelf-life and enhance the vaccine's effectiveness since we don't have Just-In-Time medical vaccination infrastructure. Some of the happy ingredients you'll find in common vaccines are formaldehyde (poison) and thimerosal (poison) which breaks down into ethylmercury (poison) and also raw mercury (poison).
Are you sure about this? My understanding is that mercury-based vaccine preservatives were done away with at least five years ago, if not longer. I believe it was done in large part to allay parents fears about giving their children vaccines.
A good resource to research this issue (Score:2, Informative)
Also, see Dr. Sears' blog with a lot of current information http://www.askdrsears.com/thevaccinebook/ [askdrsears.com]
The author has spent may years of his practice (he is a pediatrician) to study in detail how each vaccine is made, what variants are available, which ingredients are present, what are the side effects, and when does the vaccine need to be administered. For each vaccine, he summarizes the reasons to take it, reasons to avoid it, and then gives his own recommendation.
Overall, I feel he provides a great overview of the available information to allow parents to make an informed choice.
PS: (Score:3, Informative)
BTW: It's not compulsory to be educated to be a skeptic but it is cumpulsory to be skeptical [wikipedia.org] to be properly educated.
Re:Lack of Interest in Science (Score:1, Informative)
Urine is sterile when it comes out of a healthy body.
It is not antiseptic at all.
Moreover, once out of the body and into the environment it can be colonized by all sorts of bacteria which can metabolize human metabolites carried in urine (urea -> ammonia is a common pathway). These bacteria (and their metabolites) in turn can feed other bacteria which are infectious pathogens in humans.
More importantly, not all humans are healthy; some will pee out pathogens that are infecting them (or that they simply carry in their urinary tract). These pathogens can survive in damp environments, and can thrive in the presence of bacteria which like to metabolize urine.
A small amount of splashback is almost inevitable, and in busy public toilets you are practically guaranteed to come into contact with substantial numbers of pathogens. Although they won't last long on the hands, they last long enough that if you touch your nose, lips, eyes, or food after using such a public toilet, you will be introducing pathogens into your body. In many cases your body will eliminate the pathogens, but not always, often resulting in mild GI upset and fever, and occasionally an outright infectious disease.
Also, fecal matter is pretty pervasive in enclosed spaces with toilets, and human feces is far from sterile, and typically contains hardy infectious pathogens on its own that will quite happily infect you if introduced into your digestive system.
Some of these pathogens aren't even microbial: almost 30% of people in North America have at some time been infected with Enterobius vermicularis. Enterobiasis is not terribly pleasant, even if it's not particularly likely to be harmful.
Handwashing dramatically reduces the chance of infection by microbes and by many internal parasites.
Soap itself is antimicrobial and can dislodge or disrupt parasite eggs. Real soap lingers for some time; some liquid hand cleaning solutions aren't soap but are also antimicrobial (by virtue of disrupting the lipids in bacterial cellular membranes) and antiparasitic (by virtue of being slippery enough to let running water or shaking dislodge them), and tend to linger even longer, even without considering antibacterial additives like triclosan.
You may not notice the low level discomfort of successfully fighting off regular innoculations that come from not washing your hands. If not, good for you, do whatever you like. However, you are not in any meaningful way "being better at it" than any other healthy human would be, since unless you are directly injecting microbes into your blood stream you are not engaging your (trainable) primary active immune system very much in eliminating things you swallow.
In fact, if you do happen to accidentally cause stuff on your dirty hands to enter your circulatory system (through common small capillary injuries in the eye or nose, for example) you are likely to fare worse than someone who has not been spending substantial amounts of energy coping with the same organisms that stay constrained within the digestive system. Why? Because that containment takes a substantial amount of energy that could be spent in other ways (from making fat (disease is great for losing weight!) to engaging the primary active immune system in fighting off an internal infection).
Re:That is impractical. I mean, impossible. (Score:1, Informative)
Chances of death if the child contracts whooping cough: about 1 in 4 with modern hospitalization, or 1 in 2 without.
Can you please cite your source for these statistics? The Wikipedia article on Whooping Cough (http://en.wikipedia.org/wiki/Pertussis) states that the worldwide death rate from this disease is in the range of 0.6 to 1%. One would assume that a lot of these cases did not have "modern hospitalization".
Re:Parents ARE to blame (Score:3, Informative)