You probably aren’t surprised to hear that Japanese encephalitis isn’t very common in the United States.
“Travelers who go to Asia are at risk for getting Japanese encephalitis (See map). For most travelers the risk is extremely low but depends on where you are going, the time of year, your planned activities, and the length of the trip. You are at higher risk if you are traveling to rural areas, will be outside frequently, or will be traveling for a long period of time”Japanese Encephalitis
Fortunately, if you are one of those travelers who will be at risk, a Japanese encephalitis vaccine is available.
Is the Japanese Encephalitis Vaccine the Stupidest Vaccine Known to Man?
So how many people get Japanese encephalitis in the United States?
Not many, but that doesn’t mean it isn’t important to have a Japanese encephalitis vaccine if you need it, right?
“Now correct me if I’m wrong, but no one seems to be complaining of the fact that we have two vaccines that
injuredhave injury ratesadverse events of over 100 people. Nine serious adverse events. When the disease itself has only infected 12 human beings in 24 years.
That means that both of these vaccines are six times more dangerous than the disease itself, yet no one on this panel seems to want to discuss that. I imagine that you all will pass whatever it is the Japanese encephalitis next – the stupidest vaccine known to man.
Remember 12 people infected in America – 4 million people visiting the Asia every single year – 24 years – 12 people been infected, and yet we are having this conversation. It is clear that this is a money making operation for the vaccine maker and has nothing to do with actual safety.”Del Bigtree at the ACIP Meeting
Del’s rant was in response to the Advisory Committee on Immunization Practices discussing Japanese encephalitis vaccines…
It is clear that he doesn’t understand how any of this works, so let’s correct him, since he did ask.
First things first.
Why does he think that only 12 people have been infected with Japanese encephalitis in the United States?
“In the United States, in 25-year period following licensure of JE vaccine in 1992, 12 travel-associated cases reported (< 1 case per year)”Review of Japanese encephalitis (JE) and JE Vaccine Work Group plans
That’s actually the data from the ACIP JE Vaccine Work Group…
Japanese encephalitis is more common in Asia, where it is endemic in 24 countries in the WHO South-East Asia and Western Pacific regions.
Still, since it isn’t on the list of National Notifiable Conditions, it is possible that a low number of cases have been reported to the CDC because few of the cases actually get reported.
It is also possible that there are few cases because folks who are high risk now get vaccinated and protected. Rates were higher in the pre-vaccine era.
But there is also the fact that most travelers are not at risk to get Japanese encephalitis, so maybe there really have only been 12 cases.
“However, given the large numbers of travelers to Asia (>5.5 million U.S. travelers entered JE-endemic countries in 2004), the low risk for JE for most travelers to Asia, and the high cost of JE-VC ($400–$500 per 2-dose primary series), providing JE vaccine to all travelers to Asia likely would not be cost-effective. In addition, for some travelers with lower risk itineraries, even a low probability of vaccine-related serious adverse events might be higher than the risk for disease. Therefore, JE vaccine should be targeted to travelers who, on the basis of their planned travel itinerary and activities, are at higher risk for disease.”Use of Japanese Encephalitis Vaccine in Children: Recommendations of the Advisory Committee on Immunization Practices, 2013
That doesn’t mean that we shouldn’t have these vaccines or that this is all part of a money-making operation, does it?
If it was a “money-making operation,” wouldn’t the ACIP recommend the Japanese encephalitis vaccines for all travelers?
Or to make even more money, wouldn’t they just add it to the routine immunization schedule and recommended it for all children?
“Travelers to JE-endemic countries should be advised of the risks for JE disease and the importance of personal protective measures to reduce the risk for mosquito bites. For some travelers who will be in a higher-risk setting based on season, location, duration, and activities, JE vaccine can further reduce the risk for infection. JE vaccine is recommended for travelers who plan to spend a month or longer in endemic areas during the JE virus transmission season.”Use of Japanese Encephalitis Vaccine in Children: Recommendations of the Advisory Committee on Immunization Practices, 2013
Instead, they make recommendations, even with the latest updates, that virtually guarantees a very low market for the vaccine.
But if the disease isn’t common, why have a vaccine at all?
“Although symptomatic Japanese encephalitis (JE) is rare, the case-fatality rate among those with encephalitis can be as high as 30%. Permanent neurologic or psychiatric sequelae can occur in 30%–50% of those with encephalitis.”Japanese encephalitis
Japanese encephalitis is deadly!
And since the Japanese encephalitis vaccines are safe, with few risks (Del is talking about VAERS reports when he talks about vaccine injury rates), why wouldn’t you get vaccinated and protected if you were going to be at risk?
“No safety concerns to date in post-licensure surveillance.”Review of Japanese encephalitis (JE) and JE Vaccine Work Group plans
After all, there is nothing stupid about wanting to reduce your risk of getting sick and dying.
More on Japanese Encephalitis
- VAXOPEDIA – How Many People Die from Vaccine Preventable Diseases These Days?
- VAXOPEDIA – Anti-Vaccine Points Refuted A Thousand Times
- CDC – Japanese Encephalitis Traveler’s Health
- CDC – Japanese Encephalitis FAQ
- WHO – Japanese encephalitis
- ACIP updates schedules for vaccines against Japanese encephalitis, anthrax
- CDC – Review of Japanese encephalitis (JE) and JE Vaccine Work Group plans
- MMWR – Inactivated Japanese Encephalitis Virus Vaccine Recommendations of the Advisory Committee on Immunization Practices (ACIP) – 1993
- MMWR – Japanese Encephalitis Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP) – 2010
- MMWR – Recommendations for Use of a Booster Dose of Inactivated Vero Cell Culture-Derived Japanese Encephalitis Vaccine — Advisory Committee on Immunization Practices, 2011
- MMWR – Use of Japanese Encephalitis Vaccine in Children: Recommendations of the Advisory Committee on Immunization Practices, 2013
- MMWR – Japanese Encephalitis Among Three U.S. Travelers Returning from Asia, 2003–2008
- MMWR – Japanese Encephalitis in a U.S. Traveler Returning from Thailand, 2004
- MMWR – Japanese Encephalitis in Two Children — United States, 2010
- Yellow fever and Japanese encephalitis vaccines: indications and complications.
- Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2017 on CDC WONDER Online Database, released December, 2018. Data are from the Multiple Cause of Death Files, 1999-2017, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Feb 28, 2019 8:53:52 PM