Tag: case reports

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?

Do Vaccines Cause HSP?

Have you ever heard of HSP?

Children with Henoch-Schonlein purpura (HSP) typically have a purplish rash (purpura), joint pain and swelling (arthritis), and severe stomach pains. They can also have blood in their urine (hematuria).

Palpable purpura in a toddler with HSP, likely after a Mycoplasma pneumoniae infection.
Palpable purpura in a toddler with HSP, likely after a Mycoplasma pneumoniae infection. (CC BY-NC-SA 4.0)

While those can all be very scary symptoms, fortunately, they typically go away without any treatment.

What Causes HSP?

HSP, also known as IgA Vasculitis, is an autoimmune reaction.

“Henoch-Schönlein purpura is caused by an abnormal immune system response in which the body’s immune system attacks the body’s own cells and organs.”

What is Henoch-Schönlein purpura (HSP)?

We don’t know why some kids have this abnormal immune reaction.

We do know that it most commonly occurs after a viral upper respiratory tract infection, although other infections, including chickenpox, measles, and hepatitis, can also trigger HSP.

Do Vaccines Cause HSP?

HSP has been associated with almost anything, from medications and foods, to insect bites and exposure to cold weather, so it is not surprising that some folks would think that vaccines could be a trigger too.

There are even some case reports of children developing HSP after receiving a vaccine. It is important to remember that a case report is basically a gloried anecdote though. It is not the kind of high quality evidence you really want if you are trying to make a case trying to prove causality.

One small study did suggest an increased risk following the MMR vaccine, but it only looked at hospitalized children with HSP. And of 288 hospitalized children with HSP, only eight had received a recent vaccine.

A more robust study, Vaccination and Risk of Childhood IgA Vasculitis, recently found that common childhood vaccines did not significantly increase the risk of HSP.

What to Know About Vaccines and HSP

Since some vaccine-preventable diseases can cause Henoch-Schönlein purpura, there is no evidence that vaccines can cause HSP beyond isolated case reports, and the most recent evidence shows that vaccines do not cause HSP, parents should vaccinate their kids, even if they have had a previous episode of HSP.

More on Vaccines and HSP

Can Vaccines Cause Kawasaki Disease?

Kawasaki disease is rare and there is a good chance that you have never even heard of it, even though the first case was diagnosed in 1961.

Kids with this condition are typically irritable and can develop high fever, swollen glands in their neck, red eyes, red, cracked lips, red, swollen hands and feet, and a rash.

If you have heard of it, there is a good chance it is because anti-vaccine folks are using Kawasaki disease to scare you away from vaccinating and protecting your kids. Lately, talk about Kawasaki disease and the meningococcal B vaccines have been going around.

What Causes Kawasaki Disease?

Kawasaki disease is a type of vasculitis.

Kids who develop Kawasaki disease, who are typically under age 5 years, develop inflammation of their blood vessels, which leads to many of the symptoms and complications we see.

What causes this inflammation?

“Evidence suggests that Kawasaki disease may be linked to a yet-to-be identified infectious agent, such as a virus or bacteria. However, despite intense research, no bacteria, virus, or toxin has been identified as a cause of the disease.”

AAP on Kawasaki disease

We don’t know.

Can Vaccines Cause Kawasaki Disease?

Ask about Kawasaki disease if your child has a fever for five days and other symptoms of Kawasaki disease.
Courtesy of the kdfoundation.org

Because the cause of Kawasaki disease is unknown, that leads some folks to think that it could be vaccines.

Could it?

That vaccine clinical trial data sometimes finds a higher, although not statistically significant risk for Kawasaki disease, gets some of those folks thinking about it even more, except they don’t seem to think about the fact that the risk is never statistically significant.

But aren’t there case reports of kids getting Kawasaki disease after getting a hepatitis A, yellow fever, hepatitis B, or flu vaccine?

Yes, but getting a case report published about one patient who you think got Kawasaki disease soon after getting a vaccine isn’t strong evidence that it wasn’t a coincidence.

“Childhood vaccinations’ studied did not increase the risk of Kawasaki disease; conversely, vaccination was associated with a transient decrease in Kawasaki disease incidence. Verifying and understanding this potential protective effect could yield clues to the underlying etiology of Kawasaki disease.”

Abrams et al. on Childhood vaccines and Kawasaki disease, Vaccine Safety Datalink, 1996-2006.

And not surprisingly, several studies have shown that there isn’t any extra risk for Kawasaki disease after routine vaccines.

One even showed that getting vaccinated could be protective! Another benefit of vaccines and another reason you shouldn’t skip or delay your child’s immunizations.

What to Know About Vaccines and Kawasaki Disease

While anti-vaccine folks often list Kawasaki disease among their vaccine-induced diseases, several studies have shown that vaccines are not associated with Kawasaki disease, except to maybe have a protective effective if you are fully vaccinated.

More on Vaccines and Kawasaki Disease

Can Vaccines Cause POTS?

Have you ever heard of POTS?

“In POTS, the lightheadedness or fainting is also accompanied by a rapid increase in heartbeat of more than 30 beats per minute, or a heart rate that exceeds 120 beats per minute, within 10 minutes of rising.”

NIH Postural Tachycardia Syndrome Information Page

POTS or postural orthostatic tachycardia syndrome was first identified in the early 1990s and can cause many debilitating symptoms, such as dizziness, headaches, and fatigue.

What Causes POTS?

We don’t know what causes POTS.

“The term “POTS” was coined in 1993 by a team of researchers from Mayo Clinic, led by neurologist Dr. Philip Low. However, POTS is not a new illness; it has been known by other names throughout history, such as DaCosta’s Syndrome, Soldier’s Heart, Mitral Valve Prolapse Syndrome, Neurocirculatory Asthenia, Chronic Orthostatic Intolerance, Orthostatic Tachycardia and Postural Tachycardia Syndrome.”

Dysautonomia International on POTS

Well, we know that POTS is caused by a malfunction of the patient’s autonomic nervous system (dysautonomia), but we don’t know always know what causes or triggers that malfunction.

Sometimes we do though, as POTS has been associated with other types of dysautonomia, like Ehlers-Danlos Syndrome and Mast Cell Disorders.

And genetics may play a role in some people with POTS.

Can Vaccines Cause POTS?

It shouldn’t be surprising that some folks think that vaccines could be associated with POTS.

“Anyone at any age can develop POTS, but the majority of individuals affected (between 75 and 80 percent) are women between the ages of 15 to 50 years of age.”

NIH Postural Tachycardia Syndrome Information Page

That’s right.

As more people were becoming aware of POTS, some of them were getting vaccinated for HPV.

But that correlation certainly doesn’t mean that vaccines cause POTS.

“POTS is a condition that causes lightheadedness or fainting and a rapid increase in heartbeat upon standing. The cause is unknown, but doctors think POTS may be associated with a number of risk factors and syndromes, including: a recent viral illness, physical deconditioning, chronic fatigue syndrome and nervous system problems.”

CDC on Can HPV vaccines cause POTS?

And studies have confirmed that, including:

  • In 2015, the European Medical Association confirmed evidence that HPV vaccines do not cause complex regional pain syndrome (CRPS) and postural orthostatic tachycardia syndrome (POTS)
  • A review of VAERS reports that “did not detect any unusual or unexpected reporting patterns that would suggest a safety problem” with HPV vaccination, including extra cases of POTS
  • A study in the UK using the MHRA’s Yellow Card passive surveillance scheme found no increase in reports of chronic fatigue syndromes following the introduction of Cervarix
  • A large, nationwide register-based study from Norway found no indication of increased risk of chronic fatigue syndrome/myalgic encephalomyelitis following HPV vaccination
  • A large cohort study of over 2 million young girls in France found no risk for autoimmune diseases (including neurological, rheumatological, hematological, endocrine, and gastro-intestinal disorders)
  • A large cohort study of girls in Sweden with pre-existing autoimmune diseases found that HPV vaccination was not associated with increased incidence of new-onset autoimmune disease (49 types of autoimmune diseases)

Contrast those large studies that are evidence against any association between vaccines and POTS with the case reports, anecdotal evidence, and vaccine scare stories that say there is.

“There is currently no conclusive evidence to support a causal relationship between the HPV vaccine and POTS. It is of utmost importance to recognize that although temporal associations may be observed, conclusions of causality cannot be drawn from case reports and case series due to the small sample size and lack of control population inherent to this type of scientific literature. If POTS does develop after receiving the HPV vaccine, it would appear to do so in a small subset of individuals and would be difficult to distinguish from the normal prevalence and incidence of the disorder.”

Butts et al on Human Papillomavirus Vaccine and Postural Orthostatic Tachycardia Syndrome: A Review of Current Literature

What about other vaccines? Could they cause POTS?

Folks should remember that a case report is basically a gloried anecdote and is not the kind of evidence you should use to make decisions about vaccinating and protecting your kids.
Folks should remember that a case report is basically a gloried anecdote and is not the kind of evidence you should use to make decisions about vaccinating and protecting your kids.

While the focus has been on the HPV vaccines, an issue with other vaccines causing POTS would have been picked up with our current vaccine safety systems.

But why has the focus been on the HPV vaccines?

It is an easy association to notice, after all POTS begins to occur right around when the HPV vaccines are given (teen years) and the HPV vaccines are given in many different countries. Most other vaccines that we give to teens in the United States, including Tdap and the meningococcal vaccines, aren’t as widely used in other countries.

But remember, POTS isn’t a new diagnosis. That anti-vaccine groups are latching onto it to scare parents away from vaccinating and protecting their kids is.

What to Know About Vaccines and POTS

There is no evidence that vaccines, especially the HPV vaccines, cause POTS.

More on Vaccines and POTS

Can Vaccines Cause Transverse Myelitis?

Transverse myelitis is not common, so most people probably haven’t heard of it.

“The term myelitis refers to inflammation of the spinal cord; transverse refers to the pattern of changes in sensation—there is often a band-like sensation across the trunk of the body, with sensory changes below.”

Transverse Myelitis Fact Sheet

The symptoms of transverse myelitis depend on where the inflammation occurs and sometimes, on the cause. They can include back pain, weakness or paralysis of the legs and arms, paresthesias (sensory alterations in the neck, arms, or legs), and bowel and bladder dysfunction.

What Causes Transverse Myelitis?

An MRI of a teen with transverse myelitis.
An MRI of a teen with transverse myelitis that resolved after total body irradiation therapy was stopped.

Many things can cause transverse myelitis.

Possible triggers can include:

  • infections – following bacterial, viral, fungal, and parasitic infections
  • immune system disorders
  • inflammatory disorders
  • vascular disorders

Unfortunately, it isn’t usually known what causes someone to develop transverse myelitis.

There are treatments though and many people with transverse myelitis have at least a partial recovery, although it may take months to years.

Transverse myelitis is not thought to be genetic and rates are highest in two age groups – those between 10 and 19 years (when many preteens and teens get vaccinated) and those between 30 and 39 years.

Can Vaccines Cause Transverse Myelitis?

Have you heard that vaccines can cause transverse myelitis?

“Vaccines currently routinely recommended to the general population in the U.S. have not been shown to cause transverse myelitis.”

Institute for Vaccine Safety on Do Vaccines Cause Transverse Myelitis?

While there are some case reports that tell of a temporal association between getting a vaccine and later developing transverse myelitis, the evidence does not support any association.

Why do we see these case reports?

Just like SIDS, autism, type 1 diabetes, and many other conditions, transverse myelitis has a background rate of disease or a number of cases that you can expect to occur in a given population. Once you know this background rate, you can then predict how many people will coincidentally develop transverse myelitis within one, seven, forty-two, or more days after they are vaccinated.

With a background rate of about 0.36 per 100,000 people, if one million get a vaccine, you would expect:

  • at least 1 to 2 of them to develop transverse myelitis coincidentally after 1 day
  • at least 1 to 2 of them to develop transverse myelitis coincidentally after 7 days
  • at least 2 to 4 of them to develop transverse myelitis coincidentally after 42 days

If the rate is higher than that, it could indicate a problem.

Let’s do the math.

There are about 1,400 new cases of transverse myelitis in the United States each year.

How many vaccines are given? About 286 million doses – each year. Some of those are given on the same day, but that would still mean that 100s of people should be getting transverse myelitis within 1 to 7 days if vaccines were a cause.

They aren’t.

“Correlation does not imply causation.”

In fact, an Institute of Medicine report, Adverse Effects of Vaccines: Evidence and Causality, dismissed most of the evidence for an associated between vaccines and transverse myelitis as insufficient and lacking.

And further studies found no association:

  • A Vaccine Safety Datalink study, Acute Demyelinating Events Following Vaccines: A Case-Centered Analysis, looked at nearly 64 million vaccine doses of vaccines and also “found no association between TM and prior immunization.”
  • Another study, Maternal safety of trivalent inactivated influenza vaccine in pregnant women, used “a large, geographically diverse, retrospective cohort of pregnant women” and found no cases of transverse myelitis.

Not only do vaccines not cause transverse myelitis, but many vaccine-preventable diseases can. So vaccines can likely protect you from developing transverse myelitis by protecting you from these diseases!

What to Know About Transverse Myelitis

Vaccines do not cause transverse myelitis, although many vaccine-preventable diseases can.

More on Transverse Myelitis