In Calif. Study, Most Kids With Whooping Cough Were Fully Vaccinated 293
An anonymous reader writes with this extract from a Reuters article: "In early 2010, a spike in cases appeared at Kaiser Permanente in San Rafael, and it was soon determined to be an outbreak of whooping cough — the largest seen in California in more than 50 years. Witt had expected to see the illnesses center around unvaccinated kids, knowing they are more vulnerable to the disease. 'We started dissecting the data. What was very surprising was the majority of cases were in fully vaccinated children. That's what started catching our attention,' said Witt."
Re:So... (Score:5, Informative)
So... either their was something wrong with the vaccine, there was a mutation, or else this particular vaccine is less effective than most other vaccines.
Or the booster given at 11-12 should be given at 8-9.
Unfortunately, most people will take this and generalize it to "vaccines don't work!!!"
Yeah, there is that. Though there really isn't enough detail in the article to make that conclusion.
Of the whooping cough cases, 81% were fully vaccinated, 11% were partially vaccinated, 8% were not vaccinated. If more than 8% of the population was not vaccinated, then you could start down the path to building a case against vaccination.
Re:So... (Score:5, Informative)
So... either their was something wrong with the vaccine, there was a mutation, or else this particular vaccine is less effective than most other vaccines. Unfortunately, most people will take this and generalize it to "vaccines don't work!!!"
Not so. If the anonymous reader had read the entire article from which he or she posted, s/he would have seen that what was found is that researchers had overestimated how long the whooping cough vaccine was effective. So if a kid had gotten the original shot or booster shot fairly recently (didn't say how many years out it was good for), that kid did not develop the disease.
Re:Here we go (Score:4, Informative)
I know it's slashdot, so you can't be bothered to RTFA, but the article says the kids most vulnerable were ages 8-12. It then when on to address why there was a sharp cutoff at age 12, and points out that at age 13, kids are eligible for a booster shot. So it seems the vaccines DO work, and we just need to readjust the booster schedule.
Re:Here we go (Score:5, Informative)
Whether you get chicken pox from another person or shot, it's still the same virus. Except the vaccine virus is already dead, so it's harmless. I don't know why you would be opposed to doing it.
BTW thanks for the reminder. I need to get my adult vaccinations. (It's been 20 years since last time.)
Re:I doubt it's the vaccine (Score:5, Informative)
Re:Here we go (Score:5, Informative)
Chicken pox vaccine is a live virus vaccine, but it's a weakened form of it. It likely gives some amount of protection for life, but due to relatively low amounts of data they recommend boosters for now. Even so, since your body now forever hosts the weakened virus, it's hoped that later episodes of shingles will also be less severe and prevalent. Hopefully once everyone vaccinates we can eliminate this painful and sometimes disfiguring, debilitating or deadly disease from humanity forever.
Re:Here we go (Score:0, Informative)
Re:So... (Score:5, Informative)
The story point to the vaccine schedule in California needs to be updated to the CDC recommendations. Nothing more.
Re:Here we go (Score:5, Informative)
Thimerosol hasn't been in childhood immunizations for over 10 years (except seasonal flu, and even there it's available thimerosol-free). No corresponding drop in autism rates.
Re:So... (Score:5, Informative)
There's another possibility. I did not RTFA, so I don't know if the absolute numbers were in there, but if the number of unvaccinated kids is small relative to the number of vaccinated kids, then it could just be an artifact of the small numbers. There is a theorem in probability about this IIRC, but I forget the name. It's often mentioned with respect to false positives in blood tests, for example.
If a blood test for a disease is 90% accurate for both positive and negative results (for simplicity we use the same value), but only 3% of the population truly has the disease, then the following can occur:
Of the 3% that have the disease, 10% (0.3% of the total population) will show negative
Of the 97% that don't have the disease, 10% will show positive - more than three times as many as the number who actually have the disease. This is the key fact - the results may be purely due to this kind of imbalance.
Only the 2.7% that have the disease will correctly show positive. In the total population about 12.7% will show positive, of which over 3/4 will be false.
Substitute vaccination for blood test - some small percentage of vaccinations will fail, but if the incidence of the disease is relatively quite small, that failure will show as a majority of those who have the disease.
Misleading (Score:5, Informative)
Re:Here we go (Score:5, Informative)
> that could not cause guillain-barre syndrome ... n the US we used a worse adjuvant that caused
> various incidents of guillain-barre syndrome
Considering that no one knows exactly what causes GBS, I think what you meant was: "that caused less GBS than the adjuvant used in the US vaccine".
> Why?
Presumably because no one knew that there would be increased incidence of GBS?
> So the pharma companies could save a few cents per vaccine?
Sounds like you've been wearing that tin-foil hat for too long.
GBS is a very rare side effect of vaccination. AFAICS, you don't show me any evidence that it was the adjuvant rather than, for example, a mismatch between the adjuvant and the flu antigens.
Re:Here we go (Score:4, Informative)
Right. Now let's work on improving the adjuvants used. For example during the swine flu scare a few years ago, Germany used a quality adjuvant that could not cause guillain-barre syndrome. In the US we used a worse adjuvant that caused various incidents of guillain-barre syndrome, narcolepsy, and death? Why? So the pharma companies could save a few cents per vaccine?
This is not right at all.
In some countries in Europe they primarily used the ASO3 adjuvant (produced in Germany I believe), which was 10x more powerful than other adjuvants. This means they could reduce the amount of virus in each vaccine 10x, and thus treat more people in less time and with less costs. It seems very likely that this is involved with a dramatic increase in the incidence of narcolepsy (now believed to be an auto-immune disease). Germany might have used the other new adjuvant MF59 adjuvant, I don't know, which wasn't as associated with an increase in narcolepsy.
There was another variant of the ASO3 adjuvant that was produced in Quebec that seems to not be as related to the incidences of narcolepsy. I think there might have also been a difference between the use in Canada and Europe, in regards to whether they did 1 dose or 2 doses.
The US did not use these new adjuvants (at least now ASO3 not sure about MF59), and didn't see the increased incidence as much in narcolepsy. US healthcare is also kind of a hodgepodge of actions, so we tend not to do the same thing to everyone even if we wanted to. That's not the case in Europe.
You can read the FDA transcipt from the time-period evaluating the use of the new adjuvants.
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/BloodVaccinesandOtherBiologics/VaccinesandRelatedBiologicalProductsAdvisoryCommittee/UCM167162.pdf
IMO, I do think it's essential to create better adjuvants, the only problem being is that I don't think we understand the immune system well enough yet to do that. I mean I think we can find adjuvants that are more "powerful", but that's not necessarily what you want. You don't want the immune system to get overly broad in its response. You'd like it to stay specific to the virus and its potential variants. And I think if you use a more powerful adjuvant you might need to reduce the inherent contaminants in your provided dead virus even further.
Re:Dead bass ackwards (Score:4, Informative)
Where's the moderation option for WRONG when you need it?
How can you blame the tin foil heads with so many errors made by the pro crowd? First, from cpu6502's post:
Except the vaccine virus is already dead, so it's harmless.
This is false. The chicken pox vaccine is an attenuated vaccine, meaning it is weakened but very much still alive.
From the parent post:
The vaccine, unlike the wild virus, does not take up residence in nerve roots and does not have the potential to cause shingles later.
This is false. Either version can cause shingles later in life. In fact, early research is bearing out predictions that mass chicken pox vaccinations will lead to increased shingles rates.
Unlike some, I can read the medical literature on this stuff. I even talk to my doctor, believe it or not.
The hospital where I used to work routinely provided chicken pox boosters to employees. I was advised not to get the booster because I did not have chicken pox as a child. The doctors told me that I had an increased risk of contracting shingles from the vaccination and that I'd be better off taking my chances without the booster. In my research of the literature, I've found nothing to support this. In fact, the CDC recommends the vaccine specifically to adults who never had chicken pox as a child.
Re:Here we go (Score:5, Informative)
And if you continued to read you would see that the CDC did not think this was necessarily a good idea because the vaccine is not tested in the younger age group, the infection rate is lower than this author says (they probably have more/better data) and note that severity is lower for vaccinated people.
Thanks to this article, I now understand why care givers for newborns need to get a booster right before they have their child (or, in the case of mothers, shortly after birth b/c it is not approved for pregnant women)--the vaccine loses potency rather rapidly and so you have to weigh vaccine risks against the level protection provided. In the case of new borns, the herd is the family/care givers, and they all need to protect the little one. In other cases, some infections are okay so long as outbreaks are relatively small.
Re:So... (Score:4, Informative)
Say the vaccine is 96% effective and we're studying a population of 1000 kids. If they were all vaccinated, and they all come in contact with the virus, you'd expect roughly 40 of them to still get sick. If 30 of those do not get vaccinated, and all 1000 were exposed to the virus, you'd have a cap of 30 non-vaccinated kids getting sick, but still roughly 39 of the vaccinated kids will be sick, simply because there are more of them.
The total amount of people with the disease goes up significantly, but most of the people coming down with the disease are still people who were vaccinated. If you stop assuming all those people came in contact with the virus, the fact that there are now 30 kids who weren't vaccinated increases the chance of 39 kids for whom the vaccine didn't work to come in contact with the disease, so there's a larger proportion of vaccinated kids getting sick.
I wish I had some mod points from you because this is the critical piece that most people miss. Vaccines aren't 100% effective, and small number of unvaccinated kids can be the tipping point to infecting the kids with responsible parents.
Re:So... (Score:5, Informative)
Bingo!
Not only that: the non-immune kids, once you break past herd immunity numbers, become the incubators of the mutations that break out of the vaccination wall.
Of the 132 patients under age 18, 81 percent were up to date on recommended whooping cough shots and eight percent had never been vaccinated. The other 11 percent had received at least one shot, but not the complete series.
So:
81% fully vaccinated.
11% incomplete.
8% unvaccinated.
Threshold for herd immunity: generally considered to be at 92% minimum [wikipedia.org] for pertussis.
In other words: the unvaccinated/incompletely-vaccinated 19% broke herd immunity. Once that happens, you have an incubation dish for mutations, you have transmission vectors to those for whom the vaccine is out of date or has not worked as well as hoped.
The rate of cases for each age, two through 18 years old, peaked among kids in their pre-teens. Among fully immunized kids, there were about 36 cases for every 10,000 children two to seven years old, compared to 245 out of every 10,000 kids aged eight to 12. "The longer you went from your last vaccine, the greater your risk of disease," Witt told Reuters Health. At age 13, the number of cases dropped, presumably because that's the age when children are eligible for their booster shot.
Aha! The REAL pattern begins to emerge:
Broken herd immunity lets the disease in: those with incomplete vaccinations begin to be affected at higher rates than those who have received the booster shot. In essence, age 12 - due to the pacing of the booster shots - is effectively a risk zone.
This is why "religious objections" for booster shots are such fucking bullshit: being unvaccinated DOES cause societal risk. We need 92% minimum coverage for herd immunity and we do not have it.