Tag: case reports

Can Vaccines Cause Rhabdomyolysis?

The urine is dark because of myoglobinuria secondary to muscle break down. Hemoglobinuria, from blood, is the other thing that makes urine dark.
The urine is dark because of myoglobinuria secondary to muscle break down. Hemoglobinuria, from blood, is the other thing that makes urine dark. Photo Kumar et al (CC BY-NC-SA 3.0 US).

You have probably never heard of rhabdomyolysis.

Children with rhabdomyolysis have severe muscle pain, muscle weakness, and dark urine.

It is classically caused by exercising too much (really overdoing it or exercising a lot more or a lot longer than you typically do) and damaging your muscles, leading to a breakdown of muscle cells and the release of creatine kinase, which in addition to muscle symptoms, can lead to kidney failure.

In addition to exercise, rhabdomyolysis can be caused by seizures, drugs, toxins, insect stings, snake bites, metabolic disorders, infections (viral myositis), and trauma.

“The most common causes of pediatric rhabdomyolysis were viral myositis (38%), trauma (26%), and connective tissue disease (5%).”

Mannix et al on Acute Pediatric Rhabdomyolysis: Causes and Rates of Renal Failure

Keep in mind that rhabdomyolysis is rare. You won’t confuse the aches and pains that most kids get, and which often get blamed on growing pains, with rhabdomyolysis. Although younger kids don’t always have dark urine when they have rhabdo, the pain and weakness is severe. Seek immediate medical attention if you think that your child might have rhabdomyolysis.

Can Vaccines Cause Rhabdomyolysis?

It is well known that rhabdomyolysis can be caused by infections.

“Rhabdomyolysis has been reported to be associated with a variety of viral infections, including influenza, [15,16] Coxsackie virus, human immunodeficiency virus (HIV), echovirus and cytomegalovirus [17]. In our series, the definite viral infection was identified in 5 patients (influenza type B in 4, Coxsackie A10 in 1)”

Chen et al on Clinical spectrum of rhabdomyolysis presented to pediatric emergency department

So if a natural influenza virus infection can cause rhabdomyolysis, does that mean that the flu vaccine can too? What about other vaccines?

Not necessarily, but there are a few case reports that associate vaccines with rhabdomyolysis.

“Influenza A infection has been described as a major viral cause of infection-induced rhabdomyolysis, but to date, only one reported case was described as having been induced by influenza vaccine.”

Callado et al on Rhabdomyolysis secondary to influenza A H1N1 vaccine resulting in acute kidney injury.

In several of the reports, patients already had chronic medical problems for which they were being treated. Still, no signal was found to suggest that the flu vaccine is a problem for these patients.

It is important to note that reports of post-vaccination rhabdomyolysis in healthy people are even rarer.

So while it is could be possible that vaccines are rarely associated with rhabdomyolysis, we know that many infections, including many vaccine-preventable diseases, are a more common cause.

Don’t skip or delay a vaccine because you might have heard that vaccines cause rhabdomyolysis.

Vaccines are safe, with few risks, and are obviously necessary.

More on Vaccines and Rhabdomyolysis

Is Ocular Palsy a Vaccine Injury?

Now why would anyone think that an ocular palsy could be caused by vaccines?

There is no real evidence that a cranial nerve six palsy, which causes strabismus or esotropia, is a common vaccine injury, even though Dr. Bob focused on it recently.

Is Ocular Palsy a Vaccine Injury?

What is Dr. Bob’s evidence?

A vaccine injury story from a vaccine hesitant mom who was giving her child one vaccine at a time and who became cross-eyed five days after getting the MMR vaccine.

“It is an absolutely, 100% well known vaccine reaction to live virus vaccines as you eventually discovered, it’s called ocular palsy.”

Bob Sears

Is that true?

Not exactly.

It is true that there are a handful of case reports of toddlers developing a cranial nerve six palsy after a live virus vaccine, but that doesn’t make it an “absolutely, 100% well-known vaccine reaction.”

Why not?

The story Dr. Bob tells could be published as a case report. But that wouldn’t be proof that it was caused by the MMR vaccine, as other causes weren’t ruled out, and it is easy to overlook that the child had just had a double ear infection.

“Benign isolated 6th nerve palsy of childhood is rare, and recurrences are rarer. By definition, it is not due to a threatening cause, such as an underlying intracranial lesion, and recovery is expected. This condition typically occurs following viral illnesses, infections, and immunization involving attenuated live vaccinations. In general, prognosis for benign recurrent 6th nerve palsy is excellent, and majority of patients recover full muscle function.”

Gonçalves et al on Benign Recurrent Sixth Nerve Palsy in a Child

Could the child that Dr. Bob talks about have had a viral infection causing their sixth nerve palsy?

Sure. The child even had a double ear infection the previous month.

Considering that in most of the case reports, the children developed symptoms later, between 7 or 21 days to as late as 6 weeks to 6 months after their vaccine, then the previous ear infection starts to look like a more likely cause, not the MMR vaccine.

“A previously healthy four-year-old girl was presented to our emergency room with complaints of binocular horizontal diplopia of sudden onset and strabismus.”

Gonçalves et al on Benign Recurrent Sixth Nerve Palsy in a Child

What’s different about the four-year-old girl discussed above and the child Dr. Bob talks about?

“One week prior to the event, the child had a history of fever and productive cough, and she was under treatment with amoxicillin. There was no history of live attenuated vaccine administration in the previous days.”

Gonçalves et al on Benign Recurrent Sixth Nerve Palsy in a Child

This child wasn’t recently vaccinated.

There are also case reports of children developing recurrent 6th nerve palsy without any obvious trigger – no immunization and no recent infection.

And cases from the 1950s and 60s and earlier, before we had an MMR vaccine.

“This syndrome is not a new entity, and experienced clinicians recall cases in which the combination of only fever and VI nerve palsy cautioned them against other diagnostic measures. Sir Charles Symonds, in a discussion recorded in the proceedings of the Royal Society of Medicine, makes reference to his observations of patients in whom VI nerve palsy followed febrile illness and was of no consequence. In the same discussion he also mentions instances in which VI nerve palsy followed otitis media, and yet there was no pain and little constitutional disturbance. The palsy he considered to be the result of an aseptic thrombosis of the inferior petrosal sinus, adjacent to the VI nerve as it passes through Dorello’s canal.”

Knox et al on Benign VI Nerve Palsies in Children

Also consider that if a live attenuated vaccine is causing such a vaccine injury, then wouldn’t you expect kids with natural measles infections to develop these 6th nerve palsies at equal, or more likely, greater rates.

What about those case reports from the 1950s and 60s and earlier? No, those early case reports weren’t about kids with measles.

The bottom line is that if you want to consider this type of ocular palsy a vaccine injury, you should also explore the possibility that it was caused by an infection or by chance. And the only folks who would say 100% that these incidents are a vaccine injury, when there is just as much, if not more, evidence saying they aren’t, are those who think that everything is a vaccine injury

More on Medical Exemptions

The Dunning-Kruger Awards

Bob Sears posted his pic wearing Mickey Mouse ears a month before the big Disneyland measles outbreak...
This was posted a month before the big Disneyland measles outbreak…

Most folks understand, or think they understand, the Dunning-Kruger effect.

“Poor performers—and we are all poor performers at some things—fail to see the flaws in their thinking or the answers they lack.”

We Are All Confident Idiots

Not surprisingly, there are plenty of great examples of the Dunning-Kruger effect among vocal vaccine deniers.

The Dunning-Kruger Awards

But who leads the pack?

Smarter than the entire New York Public Health Department?

I don’t think so…

Yes, Forrest Maready, who came up with the Crooked Face Theory of vaccine injury, now considers himself to be an expert on polio.

Robert F. Kennedy, Jr. thinks that he is cursed with too much knowledge about vaccines…

Kelly Brogan, a holistic psychiatrist, got her case study published in the Advances in Mind-Body Medicine journal. History making? That’s about as history making as her vaccine paper that was published in the journal, Alternative Therapies in Health and Medicine.

Full stop. There is a lot of good information on the Internet, but most folks who say they did their research about vaccines on Google choose “to accept only information that supports his or her position, and ignores or dismisses information in conflict with it.”

Will Jim Meehan ever understand vaccines better?

Will anyone that listens to these folks?

Don't let Goop's mistake become your mistake.

Gwyneth Paltrow and Goop made one mistake – thinking that they could give health advice.

The creator of the PEACH anti-vaccine safety manual that has been distributed in Orthodox Jewish communities spent years gathering anti-vaccine propaganda...
The creator of the PEACH anti-vaccine safety manual that has been distributed in Orthodox Jewish communities spent years gathering anti-vaccine propaganda…

While the average pediatrician doesn’t actively investigate vaccine safety, do you know who does? Real scientists and researchers…

Whether they put all of the anti-vaccine propaganda they gather into a binder or a vaccine guide on the Internet, these folks are simply misinformed about vaccines.

Don’t look to them to help get you educated about vaccines.

Dunning Kruger Awards

Do Vaccines Cause Bell’s Palsy?

We don’t usually know what causes Bell’s Palsy, so that makes it a perfect candidate for some people to think it’s a vaccine injury.

Mercola cites a study that looked at VAERS reports, so none of the cases were verified to see if they were actually caused by a vaccine. And he fails to mention all of the real studies that found no association between vaccines and Bell's Palsy!
Mercola cites a study that looked at VAERS reports, so none of the cases were verified to see if they were actually caused by a vaccine. And he fails to mention all of the real studies that found no association between vaccines and Bell’s Palsy!

And for anti-vaccine folks to use in their propaganda to scare you away from vaccinating and protecting your kids.

What Causes Bell’s Palsy?

Although we may not always know what causes it, Bell’s Palsy is fairly easy to diagnose.

“Bell’s palsy is a nerve problem that affects the muscles of your face. It causes weakness or partial paralysis of the muscles on one side of your face. With Bell’s palsy, your eyelid may not close properly and your smile may seem uneven.”

What Is Bell’s Palsy?

So what causes it?

“Bell’s palsy occurs when the nerve that controls the facial muscles is swollen, inflamed, or compressed, resulting in facial weakness or paralysis. Exactly what causes this damage, however, is unknown.”

Bell’s Palsy Fact Sheet

Most experts think that Bell’s Palsy is caused by a viral infection, which leads to swelling and inflammation of the facial nerve. That’s likely why steroids and antiviral medications, like acyclovir, are often helpful treatments.

“The prognosis for individuals with Bell’s palsy is generally very good. The extent of nerve damage determines the extent of recovery. Improvement is gradual and recovery times vary. With or without treatment, most individuals begin to get better within 2 weeks after the initial onset of symptoms and most recover completely, returning to normal function within 3 to 6 months.”

Bell’s Palsy Fact Sheet

Fortunately, most people with Bell’s Palsy, which mainly affects adults, get better.

Do Vaccines Cause Bell’s Palsy?

Bell’s Palsy was first described by Sir Charles Bell in 1821.

There are reported cases before that though, with the earliest by Cornelis Stalpart van der Wiel (1620-1702) from The Hague, The Netherlands in 1683.

And no, we didn’t have any vaccines in 1683.

That’s not to say that vaccines couldn’t cause Bell’s Palsy.

One vaccine, an inactivated intranasal influenza vaccine that was only used in Switzerland during the 2000-01 flu season, was associated with an increased risk of Bell’s Palsy.

Why? It was likely because of the enzymatically active Escherichia coli Heat Labile Toxin (LT) adjuvant that was used in the vaccine, which is not something you find in any of the vaccines we now use.

While you might find an occasional case report about a vaccine and Bell’s Palsy, remember that a case report published about one patient isn’t strong evidence that it wasn’t a coincidence.

It should be reassuring to everyone that plenty of studies have been done confirming that other vaccines we use do not cause Bell’s Palsy. And even in the case of that flu vaccine, the association was quickly discovered and the vaccine was discontinued.

In fact, since vaccines, especially the chicken pox vaccine and Tdap, can prevent infections that actually cause Bell’s Palsy, if you are worried about Bell’s Palsy, get vaccinated!

More on Bell’s Palsy?