Category: Vaccine Education

How Many People Die from Vaccine Preventable Diseases These Days?

People don’t often die from vaccine-preventable diseases these days.

At least not in industrial countries.

Deaths from Vaccine-Preventable Diseases Today

Well, they aren’t supposed to.

Dr. Bob Sears actually reassured parents that measles wasn't deadly in developed countries, neglecting to mention the dozens of people who have died in outbreaks in Europe - another well-nourished population with lower vaccination rates than the U.S.
Dr. Bob Sears actually reassured parents that measles wasn’t deadly in developed countries, neglecting to mention the dozens of people who have died in outbreaks in Europe – another well-nourished population with lower vaccination rates than the U.S.

Tragically, we are seeing more and more deaths from vaccine-preventable diseases every day in countries that once had these diseases under good control:

  • over 100 measles deaths across Europe and a measles death in the United States a few years ago
  • diphtheria deaths in Australia, Belgium, South Africa, and Venezuela
  • life-threatening tetanus cases in Australia, Canada, New Zealand, and Ukraine
  • a rabies death in the United States in a child who’s parents skipped the post-exposure rabies vaccine
  • pertussis deaths in the United States
  • influenza – a record number of deaths in the United States, with most kids unvaccinated
  • rotavirus – yes, unvaccinated kids still die of rotavirus in the United States in the 21st Century! In a recent outbreak in California, in which a child died, almost all of the kids were unvaccinated.

And not surprisingly, these deaths are almost always in unvaccinated children.

Deaths from Vaccine-Preventable Diseases in the Pre-Vaccine Era

While tragic, we are still fortunate that these deaths are no where close to the levels we once saw before we had vaccines to protect our kids.

In the pre-vaccine era, we used to see:

  • up to 15,000 deaths and 200,000 diphtheria cases each year until the 1940s
  • an average of 175,000 cases of pertussis each year in the early 1940s, with about 1,118 deaths from pertussis in 1950 and 467 deaths from pertussis in 1955
  • up to 20,000 cases of paralytic polio each year until the early 1950s
  • an average of about 186,000 cases of mumps each year before 1967, with an average of 40 deaths a year
  • up to 500 deaths and 500,000 measles cases each year until the early 1960s
  • a rubella epidemic in 1964-65 that caused 12.5 million rubella virus infections and “resulted in 11,250 therapeutic or spontaneous abortions, 2,100 neonatal deaths, and 20,000 infants born with congenital rubella syndrome”
  • up to 20,000 cases of invasive H. influenzae (Hib) disease each year, with more than half of them having meningitis, and about 300 to 600 deaths, mostly children under age 2 years. In 1980, 45 children died with epiglottitis and there were an additional 222 deaths from Hib meningitis.
  • up to 11,000 hospitalizations and 100 chicken pox deaths each year until 1995
  • up to 17,000 cases of invasive pneumococcal disease in children younger than 5 years each year (before 2000), including 13,000 cases of bacteremia (blood infection) and 700 cases of pneumococcal meningitis, with 200 deaths.
  • just over 400,000 visits to the doctor and up to 272,000 visits to the emergency room, 70,000 hospitalizations and 20 to 60 deaths each year in children under age 5 years because of rotavirus infections until 2006

But that deaths from vaccine-preventable diseases aren’t common is hardly a reason to skip or delay your child’s vaccines, as some might suggest. It is just testament to the fact that vaccines work.

That these deaths from vaccine-preventable diseases quickly rise as rates of vaccinations drop is a tragic reminder that vaccines are necessary.

As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks.
As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

And what makes it even more tragic is that this was all predicted and could have been prevented if folks didn’t listen to anti-vaccine propaganda that scares them away from vaccinating and protecting their kids.

Worldwide Deaths from Vaccine-Preventable Diseases

Of course, talk of deaths from vaccine-preventable diseases shouldn’t stop with the developed or industrial world.

Even as a lot of progress is being made, as more and more people get vaccinated, worldwide, there were:

  • about 89,780 measles deaths, mostly young children
  • about 215,000 deaths from rotavirus infections
  • at least 1 million deaths from hepatitis B
  • almost 200,000 deaths from Hib
  • over 4,200 deaths from chicken pox
  • about 50,000 deaths from meningococcal infections
  • about 160,000 deaths from pertussis
  • about 826,000 deaths from pneumococcal infections
  • almost 60,000 deaths from rabies
  • just over 70,000 deaths from tetanus
  • about 222,000 deaths from typhoid
  • between 30,000 to 60,000 deaths from yellow fever

As you can see, most of these diseases are still big killers around the world.

“You hear about people who don’t like to vaccinate their kids in the Western world, which I suppose is a personal choice, but when you’re out there, the result of your children not being vaccinated is that they’ll likely die, or be horribly maimed. So yes, I saw a real desire to have their children protected, and also a real understanding of it – I didn’t seem to come across anybody who went ‘What is it?’ Or ‘What does it do?’ They all seemed to know about it.”

Ewan McGregor on Cold Chain Mission

In most of these countries, the problem is access to vaccines though, not parents refusing to get their kids vaccinated.

What to Know About Deaths from Vaccine Preventable Diseases

Unvaccinated kids are still dying from vaccine-preventable diseases.

More on Deaths from Vaccine Preventable Diseases

Why Does the FDA Warn About Mercury in Fish, but Not Mercury in Flu Shots?

The FDA and EPA began to warn certain high risk groups about eating fish that might be contaminated with high levels of mercury in 2004.

Although it was known that “nearly all fish and shellfish contain traces of mercury,” this wasn’t thought to be a health concern for most people. Higher levels of mercury in certain fish could be though, especially for young children, nursing mothers, pregnant women, and women who might become pregnant.

That’s why the EPA and FDA recommended that those high risk groups not eat Shark, Swordfish, King Mackerel, or Tilefish (have highest levels of mercury) and limit eating other fish that are lower in mercury.

Why Does the FDA Warn About Mercury in Fish, but Not Mercury in Flu Shots?

So why do experts warn about mercury in fish, but don’t warn about mercury in vaccines?

Trace Amounts on “Ten Lies” Told About Mercury in Vaccines
Trace Amounts thinks that they have uncovered “Ten Lies” about mercury in vaccines

While that is a good question, the most obvious answer is that there are a very limited number of vaccines that you can get that contain any mercury (thimerosal), while if there was no warning, you could theoretically eat a ton of fish that are contaminated with at least some mercury.

And since 2001, thimerosal-free versions of non-flu vaccines have been available. There has also been an increasingly large supply of thimerosal-free flu vaccines available since 2003.

So how much mercury from vaccines could pregnant women and young children really be getting?

Remember, the only routine vaccines that pregnant women get are Tdap (never contained thimerosal) and the flu vaccine. And all of the routine vaccines young children receive are now thimerosal-free, including DTaP, Hib, IPV, Rotavirus, and Prevnar. All children should also get a flu vaccine once they are six months old, but like the flu vaccines for pregnant women, thimerosal-free flu vaccines are available.

Still, if they didn’t get a thimerosal-free flu shot, it would mean that they got the amount of mercury from one flu shot each year, or 25mcg. Some children could get up to 50mcg if it was their first season getting a flu vaccine, as they might need two doses of the flu vaccine.

The FDA and EPA offer very specific recommendations on how much fish to eat to avoid mercury.
The FDA and EPA offer very specific recommendations on how much fish to eat to avoid mercury.

How much mercury do you ingest when you eat fish? It depends on the fish, which is why the recommendations on which fish to eat and avoid are so specific. In general, it can range from 4mcg for salmon, 60mcg for canned albacore tuna and 170 mcg for swordfish.

While you are supposed to avoid the fish with the highest mercury levels, you might be eating the other fish each week, so unless you don’t like to eat fish, it is almost certainly going to quickly add up to much more than you get from your yearly flu vaccine, which you likely avoided anyway by getting a thimerosal-free flu shot.

And with fish, the mercury is in the form of methymercury, 95% of which is absorbed into your bloodstream. In contrast, thimerosal in vaccines breaks down to ethylmercury and is eliminated from your body quicker than methylmercury.

But if fish contains mercury, why not just tell people to avoid eating fish?

“Most fish are an excellent source of high quality protein. Fish are also important sources of selenium, zinc, iodine, iron, and other minerals needed by the body. Fish are natural sources of many B vitamins, and oily fish provide vitamins A and D. Studies with pregnant women have found that the nutritional benefits of fish, like other protein-rich foods, are important for their children’s growth and development during pregnancy and childhood. Most fish are low in fat, and most of the fat that is present in fish is healthy polyunsaturated fat. The polyunsaturated omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are also present in many types of fish. Research is still underway to determine the health benefits of omega-3 fatty acids.”

Questions & Answers from the FDA/EPA Advice on What Pregnant Women and Parents Should Know about Eating Fish

Fish have a lot of important nutrients, so are good to eat. So you balance the benefits of eating fish with the risks of mercury contamination and we get the sensible advice to limit the amount of fish you eat.

When you do the same kind of analysis of the risks and benefits of vaccines, even those with thimerosal, the benefits are still greatly in favor of getting vaccinated to prevent life-threatening infections. Remember, thimerosal was removed from vaccines as a precautionary measure and not because it was proven to be dangerous. In fact, many studies have shown that thimerosal in vaccines is not harmful.

What to Know About Mercury in Fish and Vaccines

Comparing mercury in fish and vaccines is like comparing conventionally grown apples and pears, at least it would be if someone figured out how to make an edible vaccine in the form of a pear.

More on Mercury in Fish and Vaccines

When a Vaccine Doesn’t Count and Needs to Be Repeated

Of course, anti-vaccine folks are wrong when they say that vaccines don’t work.

Vaccines work and they work well to protect us from many different vaccine preventable diseases.

At least they do when you get the right vaccine at the right time and it is given properly. If an error is made, sometimes a vaccine dose needs to be repeated.

When a Vaccine Doesn’t Count and Needs to Be Repeated

While it would be unfortunate to have to repeat a vaccine dose, in most cases, if you didn’t, it would leave the child without full protection.

Why might a vaccine dose not count?

The Menomune vaccine has been discontinued, but this label is a good example of things to check before giving a vaccine.
The Menomune vaccine has been discontinued, but this label is a good example of things to check before giving a vaccine.

Although it doesn’t happen often, it is possible that:

  • the wrong vaccine was given
  • the vaccine was given too early, either before the next dose was due or when the child was too young. Although there is some leeway for when most vaccines can be given, there are still some specific rules to follow, especially the minimum time between doses, the earliest age you can get a dose, and the age requirement for booster doses. (sticking to the standard immunization schedule can help avoid these types of errors)
  • the vaccine was mixed improperly (many vaccines are now premixed, making this error less likely to occur)
  • part of the vaccine leaked out when it was being injected, which can happen when kids move, if they aren’t being held well as the shot is being given (rotavirus doses aren’t repeated if a child spits up though)
  • the vaccine had expired or had not been stored properly
  • two live vaccines (except for the typhoid vaccine) were given on separate days, but less than 28 days apart (again, sticking to the standard immunization schedule can help avoid this types of error)
  • the vaccine was given by the wrong route, although depending on the vaccine, this dose might still be valid (most vaccines, except hepatitis B and rabies)

Still, instead of a vaccine dose not counting, the much more common reason for a vaccine dose to be repeated is for folks to lose their vaccine records.

Do You Really Have to Repeat That Vaccine Dose?

Are you worried now that your kids might get a vaccine dose that has to be repeated?

Don’t be. It doesn’t happen very often.

It helps that we don’t actually have a one-size-fits-all immunization schedule and

  • there is a range of recommended ages for most vaccines
  • there is a range of recommended ages for catch-up immunization, which is basically an accelerated immunization schedule, which is why infants can typically start getting their vaccines as early as age 6 weeks and get the first few sets as early as 4 weeks apart

Also, you typically have a grace period, during which early vaccine doses will still count.

“…administering a dose a few days earlier than the minimum interval or age is unlikely to have a substantially negative effect on the immune response to that dose. Known as the “grace period”, vaccine doses administered ≤4 days before the minimum interval or age are considered valid…”

AICP on Timing and Spacing of Immunobiologics

The grace period doesn’t count for the rabies vaccine and while it is an ACIP guideline, it might be superseded by local or state mandates. The grace period also can’t be used to shorten the interval between two live vaccines, which must be at least 28 days.

One last way to get away without repeating an invalid dose would be checking your child’s titers.

When Do You Repeat the Invalid Vaccine Dose?

The next question that comes up after you realize that you have to repeat a dose of a vaccine is when should you repeat it?

It depends.

  • give the correct vaccine as soon as possible if the problem was that the wrong vaccine was given
  • repeat the dose as soon as possible if the problem was an expired, improperly stored, or a dose that had leaked out
  • if the dose was given too early, then you need to wait for the appropriate interval or when your child is old enough to get the dose. Keep in mind that when you repeat the dose, you would generally restart counting your interval from the invalid dose, not from the previous dose. That’s because the invalid dose might interfere with mounting a good immune response.

And in all cases, report the error to the ISMP National Vaccine Errors Reporting Program (VERP) or VAERS.

What to Know About Vaccine Errors

Although they aren’t common, vaccine errors sometimes lead to the need to repeat your child’s vaccines.

More on Vaccine Errors

Why Are We More Careful About Introducing Baby Food Than Giving Vaccines?

The rules about introducing baby food have changed a lot over the years.

Believe it or not, instead of rice cereal, when your baby is ready for solid foods, you can now give her fruits, veggies, meat, or even peanut butter. That’s right, infants can have peanut butter!

baby boy cake child
Let them eat cake, but don’t let that be your baby’s first food… Photo by Henley Design Studio on Pexels.com

In fact, if your baby has eczema, your pediatrician will likely encourage you to introduce peanut butter early, by four to six months, as a way to hopefully avoid peanut allergies later in life.

Why Are We More Careful About Introducing Baby Food Than Giving Vaccines?

Those are some big changes, aren’t they.

Still, a lot of other things stayed the same, including that parents should:

  • wait until at least four months, and often until six months, before they think about starting solid foods
  • only give one new food at a time

So while there are few restrictions on which foods to give now (still no honey before age 12 months and no choke foods), you still want to introduce one new food every three or four days to watch for a reaction.

Why is that different than for vaccines?

It’s because reactions to foods are more common, especially non-allergic type reactions (diarrhea, gas, and fussiness, etc), but also because there is basically no risk to delaying the introduction of new foods by this slow method.

There is also no real benefit to going much faster. Do you really want to introduce your baby to multiple new foods a day?

In addition to allergies and intolerances, there is another type of reaction you are watching for too – your baby simply not liking the food. For example, if one of your baby’s first foods is an apple, strawberry, beet combo puree and he spits it out at the first taste, how are you going to know which flavor he didn’t like? Isn’t it better to go through all of the single ingredient first foods before mixing them up?

Now if you did the same thing with vaccines, your baby would be getting a shot every four days! And it would leave them unprotected for a lot longer period of time.

Considering that serious vaccine reactions are rare, it is easy to understand that there is no benefit to only giving one vaccine at a time and we recommend that folks stick to the standard immunization schedule.

What to Know About Giving Vaccines and Introducing Baby Food

Although it is like comparing peas with peach mango and oatmeal cereal, stick to your pediatricians advice about vaccines and introducing baby food.

More on Giving Vaccines and Introducing Baby Food

Why Do Some Vaccines Need Boosters?

Vaccines work.

They aren’t perfect though, which is why some vaccines need booster doses to help them provide long lasting protection.

Why Do Some Vaccines Need Boosters?

To be clear, just because you get more than one dose of a vaccine, that doesn’t make it a booster dose.

For example, infants get multiple doses of the DTaP, polio, Hib, hepatitis B, Prevnar, and rotavirus vaccines, but those are part of the primary series for those vaccines. They aren’t boosters.

“A “classical” prime-boost immunization schedule is, thus, to allow 4 to 6 months to elapse between priming and booster doses, hence the generic “0-1-6 month” (prime-prime-boost) schedule. Secondary antigen exposure thus results in the production of higher-affinity antibodies than primary responses.”

Plotkin’s Vaccines (Seventh Edition)

Getting the booster shot in a vaccine series is important to get full protection.
Getting the booster dose in a vaccine series is important to get full protection.

Classic booster doses are the:

But why do we need these booster doses?

While one or more doses of the primary series of the vaccine leads to the production of plasma cells and protective antibodies, the booster dose then causes a secondary immune response and the production of more long-lived plasma cells. That’s how we get higher levels of protective antibodies that will last longer.

Which Vaccines Don’t Need Boosters?

In general, live vaccines don’t need booster doses.

So why do we get a second dose of MMR?

This isn’t a classic booster dose. It protects the small percentage of people who don’t respond to the first dose.

Some folks may need a booster dose of the MMR vaccine in certain circumstances though, specifically if they are caught up in a mumps outbreak.

What to Know About Vaccine Booster Doses

Some vaccines need booster doses to help you get full protection. Don’t skip them.

More on Vaccine Booster Doses

Are You Too Scared to Vaccinate Your Kids?

These days, if a parent suggests to their pediatrician that they might want to skip or delay their child’s vaccines, it is typically not because they are afraid of any association with autism, or because they have been influenced by Jenny McCarthy or Andrew Wakefield, or even because they have done a lot of research.

It is mostly because they are scared.

Are You Too Scared to Vaccinate Your Kids?

What are they scared of specifically?

“In today’s world, smallpox has been eradicated due to a successful vaccination program and vaccines have effectively controlled many other significant causes of morbidity and mortality. Consequently, fear has shifted from many vaccine-preventable diseases to fear of the vaccines.”

Marian Siddiqui et al on the Epidemiology of vaccine hesitancy in the United States

Surprisingly, there often isn’t anything specific that they are scared of. That’s unfortunate, as it makes it harder to offer reassurance when they don’t have specific questions or concerns.

Still, something is scaring these parents, sometimes to the point that they have panic attacks if they even think about vaccinating their kids.

“…many parents are inundated with horror stories of vaccine dangers, all designed to eat away at them emotionally while the medical and scientific communities have mounted their characteristic response by sharing the facts, the data, and all of the reliable peer-reviewed and well-cited research to show that vaccines are safe and effective.”

Federman on Understanding Vaccines: A Public Imperative

What has them so scared?

Could it be:

Whatever it is, it builds up to the point to where these parents fear the risks of vaccines more than they fear the risks and complications of vaccine-preventable diseases.

As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks.
As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

That’s not surprising.

After all, why fear polio, measles, diphtheria, or tetanus, etc., if you have never had or known anyone that has had one of these now vaccine-preventable diseases? Why fear them, if you have never known anyone who has died with one of these now vaccine-preventable diseases?

And why trust that you should vaccinate your kids when you are likely inundated with messages about vaccines being poison, a Big Pharma conspiracy, or that you can just heal your child with some garlic and essential oils if they get sick?

Reducing Anxiety from Vaccinations

Have any ideas on how to get over your anxiety about vaccinations?

To start, learn that vaccines are safe, necessary, and they work to protect your kids and that all of the messages you are hearing about vaccines that have been scaring you aren’t true. You have probably already realized that on some level, but there are cognitive biases, heuristics, and logical fallacies that work together to change our perception of risk, keep us believing things aren’t true, and in this case, can keep you from vaccinating and protecting your kids.

It can also help to learn to think critically and be more skeptical about the things you see and read about vaccines, especially if you aren’t sure about the source of the information.

“The Internet has been identified as an important source for parents to seek and share vaccine information. There are concerns that parental fears or hesitancy on childhood immunizations are increasing due to the popularity of social media and exposure to online antivaccination sentiment.”

Tustin et al on Internet Exposure Associated With Canadian Parents’ Perception of Risk on Childhood Immunization: Cross-Sectional Study

Don’t let a small, yet vocal anti-vaccine minority scare you into a poor decision about your child’s vaccines.

What to Know About Being Too Scared to Vaccinate Your Kids

Parents who are inundated with anti-vaccine messages and misinformation sometimes get too scared to vaccinate their kids, fearing vaccines more than they fear the diseases they prevent.

More on Being Too Scared to Vaccinate Your Kids

When Parents Disagree About Vaccines

Parents likely aren’t going to agree on every single decision about their kids.

This is especially true when parents actually have different parenting styles.

Whether it is about discipline techniques, what time the kids should go to bed, or how much allowance they should get, disagreements are bound to come up at some point if both parents are actively involved in parenting.

What Does Your Significant Other Think About Vaccines?

What happens if you disagree about vaccines?

Do you even know what your SO thinks about vaccines?

  • Does your SO ever talk about a Big Pharma conspiracy?
  • Do they buy into the myths that vaccines are full of toxins or that they don’t even work?
  • Are they afraid that vaccines will damage your baby in some way?
  • Instead of going to the doctor when they are sick, do they instead grab some essential oils and head to their chiropractor, acupuncturist, and a naturopath?

Ideally, like most other parenting issues, you would have had a talk about vaccines way before you started planning a family and you would know what your significant other thinks.

Unfortunately, we often hear about disagreements about vaccines after a couple already has a baby.

In some cases, they not only have kids, but have already split up. Then, in addition to fighting about child support, visitation schedules, and who gets the house, you might have separated or divorced parents trying to convince a judge that only one of them should be allowed to make vaccination decisions.

That could mean that an unvaccinated child gets vaccinated over one parent’s objections or that a child stays unvaccinated, even though the other parent wants him to be vaccinated and protected.

When Parents Disagree About Vaccines

While it is hard to know the best thing to do in this situation, there is one thing that you absolutely shouldn’t do.

Don't get your child secretly vaccinated if your SO is opposed to vaccines.
Don’t get your child secretly vaccinated if your SO is opposed to vaccines.

Don’t vaccinate your child behind the other parent’s back.

Instead, help them understand that vaccines work and are safe and necessary.

What if they still don’t agree?

Ask what exactly they are worried about and make sure to get them answers for those specific concerns. It might also help to have them come to your next appointment and talk to your doctor.

Can you just agree to disagree about vaccines? I guess, as long as the one who didn’t get their way is going to agree to not be upset about it. If that’s the parent who wanted their child vaccinated, then that also means their is child is left at risk for getting a vaccine-preventable disease while they try to “hide in the herd.”

Can they just compromise?

While there is no benefit to skipping or delaying any vaccines over being fully vaccinated and protected, it is better than being unvaccinated. Hopefully, learning to compromise and lots of counseling can get you both to where you aren’t in a situation when a judge makes your vaccination decisions for you.

What to Know When Parents Disagree About Vaccines

It is best to know what your partner thinks about vaccines before you start planning on having kids.

More on When Parents Disagree About Vaccines