Tag: benefits

Who Dies with Measles?

Measles is another of those diseases that some claim used to be mild and a rite of passage for kids.

That’s why there was an episode of the Brady Bunch about it, right?

An episode in which all of the kids got sick and they had to call two pediatricians to do house calls…

Who Dies with Measles?

While measles was a rite of passage for kids, it wasn’t the kind you looked forward to, because measles is rarely mild.

“Before a vaccine became available in 1963, measles was a rite of passage among American children. A red rash would spread over their bodies. They would develop a high fever. Severe cases could cause blindness or brain damage, or even death.”

CDC says measles almost eliminated in U.S.

Instead, most people develop 10 days of measles symptoms, including a high fever, cough, runny nose, watery eyes, and a rash. Photophobia, irritability, sore throat, headache, and abdominal pain are other symptoms that children with measles might have.

Many require hospitalization and some die.

But isn’t it just older people or those with immune system problems that die with measles?

“From 1964 through 1971, 16.7% of the death certificates reviewed noted some underlying pathologic condition.”

Roger Barkin, MD on Measles mortality. Analysis of the primary cause of death.

Nope.

It is most often children, typically young children, without any medical problems who die.

Before the routine use of vaccines, most measles deaths were young children without any medical problems.
Before the routine use of measles vaccines, most measles deaths were young children without any previous medical problems.

In the post-vaccination era, no one would be expected to die with measles, but those with immune system problems sometimes do, as most others are vaccinated and protected. As vaccinated rates drop though, even otherwise healthy children and adults can once again die of measles.

Remember the measles outbreaks at the end of the 1980s?

“Complications were reported in 672 (9.8%) cases, including otitis media in 318 (4.6%) cases, pneumonia in 178 (2.6%), diarrhea in 171 (2.5%), and encephalitis in five (0.1%). Nine hundred thirteen patients (13.3%) were hospitalized, and 10 measles-associated fatalities were reported (case-fatality rate: 1.5 deaths per 1000 reported cases). Eight of the deaths were reported in children less than 5 years of age, all of whom were unvaccinated. None had a reported underlying illness or immunodeficiency. Most deaths have been attributed to pneumonia.”

Measles — United States, First 26 Weeks, 1989

Probably not, but from 1989 to 1991 there were at least 123 measles deaths across the United States, even after measles had been declining for years with the introduction of the measles vaccine in the 1960s. Most of the deaths were otherwise healthy, without underlying medical problems.

They were unvaccinated and unprotected.

Because we don’t typically hear any details about measles deaths, including the almost 90,000 measles deaths that continue to occur around the world each year, most people likely assume that measles only kills in third world countries, where kids are already sick or malnourished. Of course, that wouldn’t explain how over one hundred people died with measles in Europe over the past few years…

Still think that measles isn’t deadly?

Tragically, there are plenty of stories (although most are never reported in the news and we don’t hear about them) and case reports that will prove you wrong:

  • Olivia Dahl died with measles when she was 7-years-old (1962)
  • an unvaccinated 3-year-old died in Maricopa County (1970)
  • a 13-year-old girl who had previously been vaccinated with one of the first inactivated measles vaccines which were found to be ineffective and were replaced with the newer live vaccines died in Michigan (1978)
  • a 9-month-old died in Chicago (1990)
  • an unvaccinated 13-year-old died in Kansas (1990)
  • Tammy Bowman, an 11-year-old unvaccinated girl died in Michigan (1990)
  • an unvaccinated 13-year-old became the first person in the UK to die with measles in 14 years (2006)
  • a 14-year-old died of Subacute Sclerosing Panencephalitis (SSPE), a late complication of a natural measles infection (2015)
  • an immunocompromised woman died after she was exposed in an outbreak in Clallam County, Washington (2015)
  • a 6-year-old boy with leukemia died in Italy caught measles from his intentionally unvaccinated sibling (2017)
  • an 11-month-old unvaccinated infant died in Greece (2017)
  • an intentionally unvaccinated 9-year-old girl with chromosomopathy, which is not a contraindication to getting vaccinated, died in Italy (2017)
  • a 10-month-old unvaccinated boy who likely caught measles when he had been hospitalized for an RSV infection, died in Italy (2018)
  • a 16-year-old who had received a heart transplant when she was 2-years-old died in France (2018)
  • an unvaccinated toddler in Jerusalem (2018)

Measles as a rite of passage?

“We baby boomers were apparently the last generation whose doctors, and therefore parents, accepted the measles as just one more annoying rite of passage of childhood that also happened to prime the immune system and provide lifelong immunity. Medical texts prior to the advent of the vaccine described measles as a benign, selflimiting (sic) childhood infectious disease that posed little risk to the average well-nourished child.”

Darrerl Crain, DC on The Great Measles Misunderstanding

While early pediatric textbooks did a great job describing the symptoms of measles, they also did a great job of documenting that measles was never a benign disease, something anti-vaccine folks still misunderstand because vaccines can do such a good job controlling the disease.

Even as overall mortality improved in the mid-20th Century, measles still wasn't a benign disease.
Even as overall mortality improved in the mid-20th Century, measles still wasn’t a benign disease.

Do benign, self-limiting childhood infections diseases kill hundreds of children every year?

This toddler died of measles in 1955.
This toddler died of measles in 1955.

Measles as a rite of passage is something we don’t want to have to go back to. It was a rite of passage that was endured because there was no other choice.

We have a choice now.

Don’t be misled into making the wrong one.

Don’t help anti-vaccine folks bring back measles and other vaccine-preventable diseases.

Vaccines are safe, effective and necessary.

“Today, vaccination is a cornerstone of pediatric preventive health care and a rite of passage for nearly all of the approximately 11,000 infants born daily in the United States.”

Cohn et al on Immunizations in the United States: A Rite of Passage

Getting vaccinated and protected is a rite of passage that you can look forward to, thanks to the many benefits of vaccines, not one that you should dread or avoid.

More on Measles Deaths

Vaccine Analogies and Metaphors

Analogies and metaphors are a good way to explain things, including that vaccines are safe and necessary.

We are sunk if we stop vaccinating.
As the CDC explains, we are sunk if we stop vaccinating.

Here are some of my favorite vaccine analogies and metaphors.

Getting vaccinated is like:

  • applying sunscreen before going to the beach
  • applying insect repellent before going camping in the woods
  • making sure that your kids are wearing a seat belt or sitting in an age-appropriate car seat or booster seat when you get in the car
  • installing anti-virus software on your new computer

When do you put on your seat belt? When you get in the car, before you get in an accident. Just like a vaccine. You get it before you get sick. Yes, some vaccines do work after you have been exposed to an illness, but they don’t work after you are already sick.

There is a problem with these metaphors though; they don’t include the risks to other people.

These do:

  • taking driver’s ed and getting your license before driving
  • taking swimming lessons before going in the water without a life jacket
  • putting your gun in a locked safe
  • putting a fence around your backyard so that no one in your neighborhood can drown in your pool
  • making sure folks don’t text and drive

That’s right.

Vaccination equals protection.

And not just protection for the person getting vaccinated. Being unvaccinated puts others at risk too, as you might start an outbreak.

Getting your kids vaccinated is like taking them to swimming lessons instead of just throwing them in the lake. Either way they can learn to swim and have protection/immunity from drowning. But one method (throwing them in the lake) is much more dangerous than the other.

Analogies can also help explain how vaccines work.

“Vaccines are a like a wanted poster, they just show your body what the bad guys look like, so when faced with them for real you are ready, prepared, and able to stop them before they cause harm.”

Can vaccines overwhelm the immune system?

Are there analogies that explain the idea of free-riders – folks who intentionally don’t vaccinate their kids and attempt to hide in the herd?

“If all my child’s friends are vaccinated, won’t he be protected by herd immunity? Why should I put my child at risk for vaccine reactions if all the other children around him are already immune?

This is like riding in a carpool where everyone contributes each month to pay for gas, repairs and parking. One morning, a new neighbor shows up and says, “I think I’ll ride along with you. But I’m not going to pay, since you’re going downtown anyway and you have an empty seat.” If enough people choose to take a free ride on other children’s immunity, herd immunity will soon disappear.”

Why is herd immunity so important?

And to explain the idea of what some folks consider vaccine injuries.

“I have found that it sometimes helps to give parents an analogy. I ask them the following: If they were to put gas in their car and then later got a flat tire, would that mean putting gas in the car had caused the flat tire? No. The two events were just a coincidence.”

Karen Lewis on What Vaccine Safety Means

What are some good analogies to describe how some anti-vax folks think?

Since that bridge isn’t 100% safe (I Googled that some bridges have collapsed), I’m going to let my kids swim across this river with fast moving water.

Have you heard the bridge analogy?

There are also versions with crocodiles in the water…

In case it’s not clear, in this analogy, walking across the bridge is like getting vaccinated. Swimming across the river is like intentionally not vaccinating your kids.

There are plenty of other good analogies that help to explain the importance of vaccines.

“Clusters of unvaccinated people are like patches of dry grass that, with a single match, can start a wildfire that will burn not only dry material, but sometimes wet as well. The match could be a student who returns from a trip abroad with measles or a train commuter with whooping cough.”

Saad Omer

It’s also important to remember that anyone, even those who are well prepared, can get burned in a wildfire. That’s why the analogy works so well.

“Vaccinating one’s children is like paying taxes. We all have a moral and a legal duty to pay taxes because we have a moral and a legal duty to contribute to the upkeep of our society and to its public goods (e.g., a good public health system, national defence, etc.).”

Vaccine Refusal Is Like Tax Evasion

Why are we concerned about those who are unvaccinated if our own children are fully vaccinated?

“Think of camping as an analogy. If everyone at a campground properly stores their food, bears won’t be enticed to come around. If even one person leaves their food unprotected, it invites bears in to investigate all the campsites for opportunities to eat.”

How does choosing not to immunize affect the community?

These analogies help explain how unvaccinated folks put others at risk.

“Being intentionally unvaccinated against highly contagious diseases is, to carry Holmes’ analogy a bit further, like walking down a street randomly swinging your fists without warning. You may not hit an innocent bystander, but you’ve substantially increased the chances that you will.

One might usefully analogize the risk of disease to a crapshoot. A person’s chance of being infected is, as Dr. Singer acknowledges, a matter of luck. But is it really OK for the unvaccinated to load the dice to increase the odds against other people? If so, by how much?”

Ronald Bailey on Vaccines and the Responsibility To Not Put Others at Risk

Of course, there are plenty of bad vaccine analogies and metaphors that anti-vaccine folks push:

  • getting vaccinated is like rape
  • getting vaccinated is like the Holocaust
  • “genes load the gun but the vaccines pull the trigger”
  • vaccine manufacturers are like tobacco manufacturers
  • I won’t set my child on fire to keep yours warm (this doesn’t work as a vaccine analogy, mostly because there is no benefit to setting your child on fire. Would an anti-vaxxer let their child start a campfire to keep their friends from dying in the cold?)
  • getting a vaccine is like eating a handful of M&Ms out of a big bowl when you know that a few have been poisoned
  • getting a child  vaccinated is like giving 1,000 kids 1,000 cupcakes, telling them to pick one and eat it, knowing that one of the cupcakes is poisoned (it’s maybe like letting a child with a severe peanut allergy choose a cupcake, knowing that there is a one in a million chance that the cupcake he chooses has been made with peanuts…)
  • I want safer cars, but that doesn’t make me anti-car

You understand why the anti-car one is a bad analogy, right? Folks who want safer cars generally still drive and ride in cars!

Have you heard any good or bad analogies or mataphors about vaccines?

More on Vaccine Analogies and Metaphors

Who Dies from the Flu?

While some folks still believe that the flu is a mild infection, most people understand that the flu is a very dangerous disease.

A dangerous disease that kills hundreds of children and tens of thousands of adults each year in the United States.

Who Dies from the Flu?

In addition to thinking that the flu isn’t dangerous, some folks misunderstand just who is at risk for dying from the flu.

While it is certainly true that some people at higher risk than others, including those who are very young, very old, and those with chronic medical problems, it is very important to understand that just about anyone can die when they get the flu.

Just consider the 2017-18 flu season, in which 181 children died.

As in most years, half of the kids who died of flu during the 2017-18 flu season had no underlying medical condition. Of those who did, the most common were neurologic and pulmonary conditions.
As in most years, half of the kids who died of flu during the 2017-18 flu season had no underlying medical condition. Of those who did, the most common were neurologic and pulmonary conditions.

In addition to the fact that half of the kids who died were otherwise healthy, without an underlying high risk medical condition, it is important to realize that up to 80% were unvaccinated.

That’s a good clue that flu vaccines work and that everyone should get vaccinated and protected each year.

“Influenza vaccination during the 2015-2016 influenza season prevented an estimated 5.1 million illnesses, 2.5 million medical visits, 71,000 hospitalizations, and 3,000 P&I deaths.”

Estimated Influenza Illnesses, Medical Visits, Hospitalizations, and Deaths Averted by Vaccination in the United States

Flu vaccines aren’t perfect, but even when they are less effective than we would like, they have many benefits, including reducing your risk of dying from the flu.

Who dies from the flu?

Consider that one of the first flu deaths of the season was a 29-year-old Raleigh lawyer.

And the first pediatric flu death was an unvaccinated child in Florida without any underlying medical conditions.

Anyone can die from the flu.

Get your flu vaccine now.

More on Flu Deaths

The National Vaccine Injury Compensation Program Payouts Prove that Vaccines are Dangerous

Have you heard this argument?

Misinformation about the NVICP, like from this Focus for Health article, likely helps confuse and scare many parents.
Misinformation about the NVICP, like from this Focus for Health article, likely helps confuse and scare many parents.

Apparently, some folks think that because we have a National Vaccine Injury Compensation Program that compensates those who have serious problems after a vaccine, even deaths, then it must mean that vaccines are dangerous.

Do the National Vaccine Injury Compensation Program Payouts Prove that Vaccines are Dangerous?

To most other people, that argument doesn’t hold water.

Why?

Because we know that:

  • the National Vaccine Injury Compensation Program is a no-fault alternative to the traditional legal system for resolving vaccine injury petitions
  • of over 3.1 billion doses of vaccines that were distributed in the United States between 2006 and 2016, there were 3,749 compensated claims through the NVICP
  • almost 80% of all compensated awards by the NVICP come as a “result of a negotiated settlement between the parties in which HHS has not concluded, based upon review of the evidence, that the alleged vaccine(s) caused the alleged injury.”
  • the NVICP settlements are funded by an excise tax on vaccines
  • the NVICP cases are published by the U.S. Court of Federal Claims, so all information is disclosed to the public and no safety concerns are hidden

So what does the National Vaccine Injury Compensation Program (VICP) really prove?

It proves that true vaccine injuries are very rare – about 1 in a million rare.

It proves that while vaccines are not 100% safe, they are very safe.

Certainly safer than the complications of a vaccine-preventable disease.

And it proves that anti-vaccine arguments are very easy to refute

More on the NVICP and Vaccine Safety

Three Reasons to Skip a Flu Shot This Year

We sometimes hear that folks are going to skip their yearly flu vaccine because they don’t believe in flu shots, they never get sick, or they think that flu shots don’t work or are dangerous.

Some nurses and doctors are refusing to get a flu shot and have to wear masks at work.
Some nurses and doctors are refusing to get a flu shot and have to wear masks at work.

Of course, none of those are good reasons.

Three Reasons to Skip a Flu Shot This Year

Flu vaccines are safe and have many benefits, even if they aren’t any where near 100% effective.

So are there any legitimate reasons to skip a flu shot?

Of course.

In fact, three very good reasons to skip a flu shot include:

  1. being younger than 6 months of age
  2. having a severe allergic reaction (e.g., anaphylaxis) after a previous dose of flu vaccine or to any component of the flu vaccine
  3. and, uh…

Actually, although folks might have many of bad excuses, there are only two good reasons to skip a flu shot…

So, infants who aren’t old enough to be vaccinated yet, and anyone who has had a life-threatening reaction to a previous dose.

Additional precautions, but not true contraindications, do including having had Guillain-Barré syndrome <6 weeks after a previous dose of influenza vaccine and having a moderate or severe acute illness with or without fever when you are planning to get vaccinated.

What about egg allergies?

Even if you have had a severe reaction to eggs, you can still get a flu shot. Just get it get it in an inpatient or outpatient medical setting (such as a hospital, clinic, health department, or physician’s office), so that you can be supervised by a health care provider who is able to recognize and manage severe allergic reactions.

Bad Reasons to Skip a Flu Shot

Are you scared of shots? Flumist is back.

Are you skipping the flu shot because you never get sick? How lucky do you feel this year? Don’t continue to gamble that you won’t get the flu. Increase your chances of staying well by getting a flu shot, the best way to avoid the flu.

There aren’t any natural alternatives that work better, no matter how hard you want to believe that going to a chiropractor, using essential oils, or homeopathic remedies might be helpful.

The flu vaccine doesn’t weaken your immune system.

There are no hidden or harmful ingredients in flu vaccines.

The flu vaccine is not going to give you the flu.

And the flu is definitely not a mild disease! There were 176 pediatric flu deaths last flu season, and as in most years, most were unvaccinated.

Don’t wait. Get your flu shot.

More on Flu Vaccine Contraindications

How Can I Get Vaccinated If My Parents Are Anti-Vaccine?

What do kids do when their parents are anti-vaccine?

    Most teens do know what's in a vaccine and they want to get vaccinated and protected.
Most teens do know what’s in a vaccine and they want to get vaccinated and protected.

Whether or not they know it, they hide in the herd, at least until they understand what’s going on.

And then they often make a choice to either continue with their parents beliefs and remain unprotected or they get caught up.

Can Minors Consent to Getting Vaccinated?

Since getting vaccinated is a medical procedure, in most cases, you are still going to need the consent of a parent, guardian, or other adult family member if you are still a minor, which leaves out simply going out and getting caught up.

“State law is generally the controlling authority for whether parental consent is required or minors may consent for their own health care, including vaccination.”

Abigail English, JD on  the Legal Basis of Consent for Health Care and Vaccination for Adolescents

Are you still a minor?

“In most states, age 18 is the age of majority and thus, before treating a patient under the age of 18, consent must be obtained from the patient’s parent or legal guardian.”

Ann McNary, JD on Consent to Treatment of Minors

When it comes to immunizations and health care, in addition to what state you live in, that likely depends on whether or not you are an emancipated minor (court order), married minor, pregnant minor, or minor parent (situational emancipation). It also can depend on the type of health care you are seeking, like if a minor is seeking birth control or treatment for an STD.

“States Parties shall assure to the child who is capable of forming his or her own views the right to express those views freely in all matters affecting the child, the views of the child being given due weight in accordance with the age and maturity of the child.”

Convention on the Rights of the Child

Are you a mature minor? In some states, you can also give consent for medical procedures, including getting vaccinated, if you are a mature minor – someone who is old enough to understand and appreciate the consequences of a medical procedure.

In Washington, for example, minors may get immunizations without their parents consent after their health care provider evaluates the minor’s “age, intelligence, maturity, training, experience, economic independence or lack thereof, general conduct as an adult and freedom from the control of parents.”

Fourteen other states, including Alabama, Alaska, Arkansas, Delaware, Idaho, Illinois, Kansas, Louisiana, Maine, Massachusetts, Montana, Nevada, Oregon, Pennsylvania, South Carolina, Tennessee, and West Virginia have laws that allow mature minors to consent to general medical treatment either in all or a range of restricted circumstances.

How Can I Get Vaccinated If My Parents Are Anti-Vaccine?

Believe it or not, this question comes up a lot more than you can ever imagine.

If you are old enough to consent to getting vaccinated on your own, then you are all set and can start to get caught up on your immunizations.

If not, then your options are more limited, but might include:

  • talking to your parents about your concerns
  • asking someone, like your pediatrician, to be an advocate and talk to your parents with you
  • petitioning the court for emancipation ( you may get a whole lot more than the ability to get consent to get vaccinated though…)
  • waiting until you are old enough to consent to get vaccinated without your parent’s permission

While waiting is likely the easiest option, since that leaves you at risk for getting a vaccine-preventable disease, you should probably think about talking to your parents.

Why don’t they want you to get vaccinated? Do they have specific concerns about side effects? Do they have a religious objection?

Vaccines are safe and necessary. Hopefully you can help your parents understand that and they will allow you to get caught up on all of your vaccines.

More on Getting Vaccinated If Your Parents Are Anti-Vaccine

Can Flu Shots Cause the Flu?

Most folks get a flu shot each year.

Most, but not all.

Some people still think that getting a flu shot will cause them to have the flu.
Some people still think that getting a flu shot will cause them to have the flu.

Why do some people skip it?

Can Flu Shots Cause the Flu?

Yes, some people think that getting a flu shot will actually cause them to get the flu.

It’s not hard to see why though.

The flu vaccine is not the most effective vaccine we have, so it is certainly possible that you can still get sick with the flu even though you have had your flu vaccine. Of course, that’s not a good reason to skip getting a flu vaccine, as they have lots of benefits.

Some other reasons you might still think that the flu vaccine can cause the flu include that:

  • side effects after a flu shot can include a soreness, low-grade fever, headache and muscle aches, which some people might confuse with a mild case of the flu
  • many other respiratory viruses can make you sick during cold and flu season, none of which the flu vaccine protects you against
  • since the flu vaccine takes about two weeks to work, if you got sick shortly after being vaccinated, you may have already been exposed and developed the flu before the vaccine became effective

But why can’t the flu shot cause the flu?

That’s easy.

It’s because the flu shot is an inactivated vaccine. The influenza virus is killed or inactivated, the viral particles are purified and split up, with only the HA and NA surface glycoproteins remaining. Those glycoproteins can not cause a natural flu infection.

What about Flumist, the nasal spray flu vaccine?

While Flumist is a live virus vaccine, it is made with attenuated or weakened strains of the flu that are cold-adapted, unable to replicate at the warmer temperatures that are found in the lungs and other areas of our bodies.

So Flumist doesn’t cause the flu either.

Hopefully this is one vaccine myth that folks will stop spreading. Remember, flu vaccines don’t cause you to get sick with the flu. Get vaccinated. Flu vaccines are your best protection against the flu.

What about those folks who say that they are going to skip the flu shot because they never get sick with the flu?

They are gambling.

It is estimated that about 5 to 20% of people get the flu each year. Unless you are rarely around other people during flu season, the chances are that you will eventually get the flu, especially if you are unvaccinated and unprotected.

More on the Myth that Flu Shots Cause the Flu