Tag: causation

Mistaking Subsequence for Consequence

Most parents understand that vaccines are safe, with few risks, and necessary, but some are still scared to get their kids vaccinated and protected.

Some even get anxious at the idea of going to their next visit to their pediatrician, because it might mean their baby is going to get shots.

Why?

They have likely heard some of those vaccine injury stories and got to thinking – how could all of those parents be wrong?

Mistaking Subsequence for Consequence

It’s easy to make a hasty judgement about something.

We jump to conclusions and try to link things together when they occur at about the same time as each other.

It is incident to physicians, I am afraid, beyond all other men, to mistake subsequence for consequence.

That’s because we often mistake subsequence (the state of following something) for consequence (a result of an action).

For example, developing multiple sclerosis (the consequence) six weeks after (subsequent) getting a vaccine, doesn’t mean that the vaccine caused you to develop multiple sclerosis.

Although the source of the quote on subsequence and consequence is Dr. Samuel Johnson, an 18th century writer, it got new life when Justice Jeremy Stuart-Smith used it in a DTP vaccine trial verdict.

“Where given effects, such as serious neurological disease or permanent brain damage, occur with or without pertussis vaccination, it is only possible to assess whether the vaccine is a cause, or more precisely a risk factor, when the background incidence of the disease is taken into account. The question therefore is, does the effect occur more often after pertussis vaccination than could be expected by chance?”

Sir Jeremy Stuart-Smith

What about chance and coincidences?

Instead of thinking that things could simply be the result of chance or a coincidence, we typically want more of an explanation when something happens, and sometimes, we simply want someone or something to blame.

“Establishing or disproving cause and effect, particularly for events of major consequence, proved difficult. Although the original allegations of causation were largely anecdotal and based on the fallacious assumption that subsequences and consequences were synonymous, they raised great concern and stimulated the search for an improved vaccine.”

Vaccines (Seventh Edition)

That leads us to fallacious thinking – post hoc ergo propter hoc (after this, therefore, because of this).

It shouldn’t though.

“Most of you will have heard the maxim “correlation does not imply causation.” Just because two variables have a statistical relationship with each other does not mean that one is responsible for the other. For instance, ice cream sales and forest fires are correlated because both occur more often in the summer heat. But there is no causation; you don’t light a patch of the Montana brush on fire when you buy a pint of Haagan-Dazs.”

Nate Silver

Remember, “correlation does not imply causation.”

Because polio outbreaks often came in summer months, some folks thought the virus must be spread at swimming pools, so they were often closed. It didn't help... Correlation did not equal causation.
Because polio outbreaks often came in summer months, some folks thought the virus must be spread at swimming pools, so they were often closed. It didn’t help… Correlation did not equal causation.

That maxim becomes easier to understand when you see all of the things that correlate together, like ice cream sales and forest fires, but once you think about them, there is no way that one could cause the other.

  • the consumption of high fructose corn syrup and deaths caused by lightning
  • the divorce rate in Maine and the per capita consumption of margarine
  • autism rates and organic food sales
  • autism rates and Jenny McCarthy‘s popularity?!?

Correlation does not imply causation.

“It is incident to physicians, I am afraid, beyond all other men, to mistake subsequence for consequence.”

Dr Samuel Johnson

Fortunately, it is not as “incident to” (likely to happen to) physicians these days to “mistake subsequence for consequence.”

There are certainly some vaccine friendly pediatricians who pander to the fears of parents and push so-called alternative, non-standard, parent-selected, delayed protection vaccine schedules, who seem to believe in anecdotal evidence above all else, but most doctors understand that vaccines are safe and necessary.

They also know that because correlation can sometimes equal causation, we don’t ignore possible vaccine injuries. And that’s why we have strong vaccine safety systems that can detect and warn us of true vaccine risks.

More on Mistaking Subsequence for Consequence

Bob Sears on Ethan Lindenberger’s Senate Testimony

Not surprisingly, Bob Sears doesn’t seem to like that he was one of the folks who was called out by Ethan Lindenberger during his testimony before Congress.

Remember, Ethan Lindenberger was testifying at the Senate Health, Education, Labor, and Pensions Committee Hearing, Vaccines Save Lives: What Is Driving Preventable Disease Outbreaks?

Bob Sears on Ethan Lindenberger’s Senate Testimony

So what did Ethan Lindenberger have to “say” about Bob Sears?

In his written testimony that was submitted to the Senate Health, Education, Labor, and Pensions Committee, he wrote:

“…the measles outbreak was made out to be a unfounded panic created by big pharmaceutical companies and meant to push legislative agendas. Del Bigtree, a celebrity in the anti-vaccine movement, spoke with “Dr. Bob Sears.” My mom and I sat down, watching this video so she could prove her beliefs were not unfounded. In this video, Dr. Bob Sears claims that in the past 15 years there hasn’t been a single death to the measles. In contrast, 449 people have had fatal reactions to the MMR vaccine.”

Testimony of Ethan Lindenberger Student at Norwalk High school Before the Senate Health, Education, Labor, and Pensions Committee March 5th, 2019

These and many other comments didn’t make it into his oral statements.

Why not?

“Although Ethan did not include this information in his verbal testimony, it was part of his original verbal statements (which were leaked), then edited out – for obvious reasons.”

Bob Sears

The obvious reason is that each witness only had five minutes to speak, not some conspiracy as Dr. Bob seems to be implying!

And his original, written statements weren’t leaked. Like the statements of every other witness, they were posted on the Senate Committee website.

After clearing up all of that, do we still need to discuss how Dr. Bob is trying to justify any of his statements about the MMR vaccine?

Even though you can guess where this is going, let’s go ahead and do it to be complete, especially since Dr. Bob really does seem to want folks to know where “the fact” of the 459 fatal reactions to the MMR vaccine come from.

You likely already know this, but they are simply reports to VAERS. And you likely also know that “inclusion of events in VAERS data does not imply causality.” That little fact is included in a disclaimer when you search the VAERS database, which is why anti-vaccine folks created their own search tool at MedAlerts – the reference Dr. Bob uses.

A report in VAERS – a death following the MMR vaccine that was found to be caused by meningococcal meningitis.

But just because we understand that these reports aren’t proof of causality doesn’t mean that we dismiss them. No one dismisses VAERS reports as unscientific, as Bob Sears claims.

“And if you are the type of doctor, or Legislator, who likes to dismiss VAERS reports as “unscientific,” then please explain why HHS even bothers to collect the data? Spend millions of dollars collecting scientific data, then do nothing with it? Who does that? And what type of scientist ignores data? Is that what Congress had in mind when it created the VAERS system as a Federal Law?”

Bob Sears

For a guy who wrote a book about vaccines, you would think he understood the purpose of VAERS…

“VAERS is used to detect possible safety problems – called “signals” – that may be related to vaccination. If a vaccine safety signal is identified through VAERS, scientists may conduct further studies to find out if the signal represents an actual risk.”

CDC on How VAERS is Used

VAERS works.

Remember, it was using VAERS data that CDC and FDA vaccine experts quickly discovered that the first RotaShield rotavirus vaccine was associated with an increased risk of intussusception.

“In addition, the American Academy of Pediatrics warned about this in a 1998 publication in Pediatrics that confirmed 48 cases of severe or fatal encephalopathy after Measles Vaccination in the 70s and 80s: 8 children died, and the rest survived but were neurologically devastated.”

Bob Sears

What about the AAP warning about encephalopathy and the measles vaccine?

Dr. Bob is talking about a 1997 paper, Acute Encephalopathy Followed by Permanent Brain Injury or Death Associated With Further Attenuated Measles Vaccines: A Review of Claims Submitted to the National Vaccine Injury Compensation Program, which concluded that “this clustering suggests that a causal relationship between measles vaccine and encephalopathy may exist as a rare complication of measles immunization.”

“Nevertheless, with a denominator of 75,000,000 vaccinees throughout 23 years, the incidence of acute encephalopathy caused by measles vaccine in this cohort can reasonably be described as very low.”

Weibel et al on Acute Encephalopathy Followed by Permanent Brain Injury or Death Associated With Further Attenuated Measles Vaccines: A Review of Claims Submitted to the National Vaccine Injury Compensation Program

Bob left that part out, didn’t he?

Considering how many children used to die and develop measles encephalitis each year, this small risk would still seem to greatly outweigh the risk of remaining unvaccinated and at risk to get measles.

Fortunately, even that risk is something we likely don’t have to worry about!

“We did not identify any association between MMR vaccination and encephalitis, aseptic meningitis, or autism.”

Mäkelä et al on Neurologic disorders after measles-mumps-rubella vaccination.

Although encephalopathy or encephalitis is still a table injury, studies have shown it is likely not associated with getting the MMR vaccine.

“For encephalitis and aseptic meningitis, the numbers of events observed within a 3-month risk interval after vaccination were compared with the expected numbers estimated on the basis of occurrence of encephalitis and aseptic meningitis during the subsequent 3-month intervals. “

Mäkelä et al on Neurologic disorders after measles-mumps-rubella vaccination.

And then there is the 2012 IOM report, Adverse Effects of Vaccines: Evidence and Causality, which found inadequate evidence to be able to conclude that encephalitis was caused by vaccines.

“The last child to die from measles infection in the United States was back in 2003. Since then, over 100 fatal VAERS reports have been filed for the MMR vaccine. At what point would mandating this no longer be considered in the interest of the greater good? “

Bob Sears

Bob ignores those reports and ignores the fact that a woman died in 2015.

He also ignores the fact that you don’t even have to go all of the way back to 2003 to find the last child who died of measles.

  • a 17-year-old died of SSPE in 2004
  • a 1-year-old died of measles in 2005
  • an 11-year-old died of SSPE in 2005
  • an 8-year-old and a 12-year-old died of SSPE in 2006
  • a 19-year-old died of SSPE in 2007
  • a 13-year-old died of SSPE in 2008
  • a 17-year-old died of SSPE in 2011
  • an infant died of SSPE in 2012

More importantly though, he ignores that fact that the only reason that there aren’t even more measles deaths these days is because most people are vaccinated and protected! Even Bob used to understand this…

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”

Bob Sears in The Vaccine Book

Unfortunately, people shared their fears with their neighbors… And we are seeing the consequences of what happens when folks scare parents away from vaccinating and protecting their kids.

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

More on Bob Sears’ Response to Ethan Lindenberger’s Senate Testimony

More About Measles Deaths in the United States

Anti-vaccine folks like to talk about death and measles, as long as they can talk about vaccine deaths, something they seem to think happens commonly.

“Over the past ten years in the U.S., there has been one reported death from the measles, and it is unclear based on the medical history of the patient whether and how measles played a role in their death. During the same time period (based on Vaccine Adverse Event Reporting System (VAERS) reports), there have been 105 reported deaths associated with the MMR or MMRV vaccinations.”

Measles Madness: Dr. Brian Hooker’s Statement to WA Legislators

There are two big problems with this statement, that is so often repeated that it is clearly a PRATT – a point refuted a thousand times.

The reports in VAERS about deaths after MMR are not proof of a cause-and-effect relationship.

“Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.”

Guide to Interpreting VAERS Data

In fact, studies have shown that most of the reports of deaths submitted to VAERS are coincidental and not causally associated with a vaccine.

But what about deaths following a natural measles infection?

There are plenty of those that anti-vaccine folks love to ignore.

Wide-ranging Online Data for Epidemiologic Research = WONDER
Wide-ranging Online Data for Epidemiologic Research = WONDER

Where are they?

There were actually 5 SSPE deaths and 2 measles deaths in 1999, but I started the list from 2000, as that was when the endemic spread of measles was eliminated in the United States.
There were actually 5 SSPE deaths and 2 measles deaths in 1999, but I started the list from 2000, as that was when the endemic spread of measles was eliminated in the United States.

These deaths are all in the CDC Wonder database.

Before the death of the woman in Washington in 2015, the CDC caused a lot of confusion by stating that “the last verifiable death in the United States from acute measles infection occurred in 2003 when there were 2 reported deaths.”

Does that mean that the measles deaths in 2005, 2009, 2010, and 2012 didn’t happen?

Of course not!

The information in the CDC Wonder database comes from death certificates that are sent in from all over the United States to the National Vital Statistics System. The system isn’t like VAERS though, where just anyone can send in a report. Still, they are unverified, which is why the CDC doesn’t mention them all.

Still, if anti-vaccine folks are going to push VAERS reports that we know are likely coincidental, then they shouldn’t ignore these measles deaths.

More About Measles Deaths in the United States

Did 79.4% of the Reported Child Deaths to VAERS Get a Vaccine on the Day They Died?

We know that reports to VAERS are unverified.

“When evaluating data from VAERS, it is important to note that for any reported event, no cause-and-effect relationship has been established. Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.”

Guide to Interpreting VAERS Data

They can’t be used to prove causality or definitively say that an adverse reaction or side effect was caused by a vaccine.

Did 79.4% of the Reported Child Deaths to VAERS Get a Vaccine on the Day They Died?

Still, it might be surprising to learn that in the majority of reports to VAERS about deaths in children, most had been vaccinated on the day they died.

Did 79.4% of the Reported Child Deaths to VAERS Get a Vaccine on the Day They Died?
The study is easy to find…

Is that true?

It’s actually not.

The idea for the statistic comes from a report, Deaths Reported to the Vaccine Adverse Event Reporting System, United States, 1997–2013, that was published in the 2015 issue of Clinical Infectious Diseases.

“No concerning pattern was noted among death reports submitted to VAERS during 1997–2013.”

Moro et al on Deaths Reported to the Vaccine Adverse Event Reporting System

Wait.

How do we get to “no concerning pattern was noted” to 79.4% of the kids were vaccinated on the day they died?

“For child death reports, 79.4% received >1 vaccine on the same day.”

Moro et al on Deaths Reported to the Vaccine Adverse Event Reporting System

All the report is saying is that for kids who were vaccinated, 79.4% of them received more than one vaccine on the same day. It wasn’t the day they died though.

That kids would get more than one vaccine on the same day isn’t surprising. Few parents skip or delay vaccines so much that they just get one shot at a time.

“In our VAERS review, we did not detect any concerning patterns that would suggest causal relationships between vaccination and deaths.”

Moro et al on Deaths Reported to the Vaccine Adverse Event Reporting System

If anything, this report confirms that vaccines are safe and with few risks.

“The number of death reports in children exceeded those in adults in all years, and in both groups the number of reports has decreased in recent years.”

Moro et al on Deaths Reported to the Vaccine Adverse Event Reporting System

It is surprising that anti-vaccine folks would use it to try and scare folks away from vaccinating and protecting their kids.

More on Deaths Reported to VAERS

Who Is Mark Green?

Have you heard of Mark Green?

For those of us who grew up watching ER, Mark Green is a household name.

But that’s not the Mark Green I’m talking about…

Who Is Mark Green?

Mark Green is a soon-to-be congressman, recently elected for Tennessee’s Seventh Congressional District.

A Republican, he is also a doctor. Specifically, he became a Army special operations flight surgeon after completing a residency in emergency medicine.

Dr. Hotez was one of the many people who called out Rep Mark Green for his anti-vaccine comments.

Of note, Dr. Green has also made horrible statements about transgender people, saying that they have a disease and that they are an evil that must be crushed.

Although his previous statements led him to withdraw as Trump’s pick for Army Secretary, that didn’t keep folks in Tennessee from sending him to Congress.

And now we have his comments about vaccines and autism…

At a recent town hall meeting in Tennessee, Green said:

“Let me say this about autism,” Green said. “I have committed to people in my community, up in Montgomery County, to stand on the CDC’s desk and get the real data on vaccines. Because there is some concern that the rise in autism is the result of the preservatives that are in our vaccines.

“As a physician, I can make that argument and I can look at it academically and make the argument against the CDC, if they really want to engage me on it,” Green said.

Has he apologized?

Mark Green's statements will hurt autistic families.
Mark Green’s statements will hurt autistic families.

Despite some saying that he has walked back those claims, his main response has been that his comments had been “misconstrued” and that “I’ve vaccinated my kids and let others know they need to vaccinate theirs too.”

Nothing about vaccines and autism.

“There appears to be some evidence that as vaccine numbers increase, rates of autism increase,” Green said. “We need better research, and we need it fast. We also need complete transparency of any data. Vaccines are essential to good population health. But that does not mean we should not look closely at the correlation for any causation.”

Except for when he doubled down on his statements trying to associate vaccines with autism…

So just what did Rep Mark Green mean to say about vaccines and autism?
So just what did Rep Mark Green mean to say about vaccines and autism?

Statements which seemed to cause the Tennessee chapter of the AAP and the Tennessee Department of Health to issue statements of their own.

“Vaccines do not cause autism.”

Tennessee Department of Health Statement on Immunizations

So, is he going to really apologize for his comments, and perhaps learn a bit more about vaccines, vaccine-preventable disease, and autism?

More on Mark Green

Diagnosing Vaccine Injuries

Vaccines are often described as one of the greatest public health achievements of the 20th century.

That great benefit also leaves no doubt for most people that getting vaccinated and fully protected far outweighs the very small risks that vaccines might have.

Vaccine Injuries vs Vaccine Side Effects

Vaccines can certainly have side effects.

Fever, pain at the injection site, and redness and swelling where the shot was given are all common, mild problems that can be associated with almost any vaccine.

Some vaccines might also commonly cause fussiness, tiredness or poor appetite, and vomiting within 1 to 3 days of getting the vaccine. Others can cause a rash, headache, or muscle and joint pain for a few days.

Even syncope or fainting can commonly occur within 15 minutes of teens getting a vaccine.

Other vaccine side effects can include persistent crying, nodules at the injection site, limb swelling, and febrile seizures, etc.

These are well known vaccine side effects that are often minor and temporary though.

Is It a Vaccine Injury?

Although the term is typically associated with the anti-vaccine movement, as they tend to think everything is a vaccine injury, it is important to understand that vaccine injuries, although rare, are indeed real.

After all, vaccines are not 100% safe.

In addition to the milder side effects listed above, vaccines can very rarely cause more serious types of adverse events or injuries, including:

  • life threatening allergic reactions
  • brachial neuritis (shoulder pain and then weakness) following a tetanus containing vaccine
  • encephalopathy/encephalitis following a measles, mumps, or rubella, or pertussis containing vaccine
  • chronic arthritis following a rubella containing vaccine
  • thrombocytopenic purpura (ITP) following a measles containing vaccine
  • vaccine-strain measles viral infection in an immunodeficient recipient following a measles containing vaccine
  • intussusception – following a rotavirus vaccine
  • shoulder injury related to vaccine administration – SIRVA

Keep in mind that some of these are just table injuries and are not necessarily proven as being caused by vaccines.

And while vaccines are associated with some serious adverse events, the research is clear that vaccines are not associated with autism, SIDS, and shaken baby syndrome, type 1 diabetes, multiple sclerosis, inflammatory bowel disease, or other so-called vaccine induced diseases.

Or Is It Just a Coincidence?

Dr. Samuel Johnson once said that “It is incident to physicians, I am afraid, beyond all other men, to mistake subsequence for consequence.”

How does this apply to diagnosing vaccine injuries?

Too often we forget that just because one event is subsequent (happens after) another, it does not mean that it was a consequence (was caused by) the first event. It is another way of saying that correlation does not imply causation.

This is also highlighted by missed vaccine stories, events that would surely be blamed on a vaccine injury, except that a vaccine was never actually given for one reason or another.

Most pediatricians have these types of missed vaccine stories, such as:

  • an infant who begins vomiting on the way home from a well appointment and is diagnosed with intussusception (9 month old visit and didn’t get any vaccines)
  • a 4 year old who developed encephalitis just one week after his well check up (no vaccines – DTP had been deferred to his 5 year old visit)
  • a 2 month old who died of SIDS on the night of his scheduled well child visit (no vaccines as they had forgotten to go to the appointment)
  • a 4 month old who had a seizure at his well child visit (no vaccines were given yet as they were still being drawn up)

Or they have kids who begin to have symptoms or are diagnosed with a condition right around the time of a check up when they would routinely get one or more vaccines, but haven’t yet. From diabetes and POTS to transverse myelitis, some parents would have blamed their child’s vaccines if they had actually been vaccinated at that time and subsequently got diagnosed.

My own son started getting migraines when he was 12 years old and about to start 7th grade. Should I blame his headaches on his middle school booster shots? While it would be convenient, it is more likely that genetics are to blame. I started getting migraines at about the same age, and he began getting them just before he got his booster shots.

Diagnosing Vaccine Injuries

How do you know if your child had a true vaccine injury?

Does the reaction fit into the vaccine injury type AND “time period for first symptom or manifestation of onset or of significant aggravation after vaccine administration” as described in the NVICP vaccine injury tables?

That time period, also known as a risk interval, is when “individuals are considered at risk for the development of a certain adverse event following immunization (AEFI) potentially caused by the vaccine.”

For example, did your child develop an anaphylactic reaction within four hours of getting the DTaP vaccine? While a reaction 14 hours after the vaccine would be much less likely to be caused by the vaccine, if it occurred within 4 hours, that could certainly be a vaccine injury.

How about a child who developed thrombocytopenic purpura 90 days after getting his MMR vaccine? That is unlikely to be a vaccine injury, as the MMR vaccine typically causes TTP within 7 to 30 days.

If you think that your child has had a vaccine injury, be sure to talk to your pediatrician. You should also report any vaccine reaction to Vaccine Adverse Event Reporting System (VAERS) and if you truly believe that your child has been injured by a vaccine, you can file a claim with the National Vaccine Injury Compensation Program (VICP).

“You may file a claim if you received a vaccine covered by the VICP and believe that you have been injured by this vaccine.”

What You Need to Know About the National Vaccine Injury Compensation Program (VICP)

How will your pediatrician figure out if it is a vaccine injury? Among the things that they will consider when evaluating a reaction after a vaccine will be the answers to some key questions, including:

  • Is there any evidence that something else caused the reaction? While getting a vaccine could cause an anaphylactic reaction, so could the fact that your child just eat a peanut butter and jelly sandwich.
  • Is there a known causal association between the reaction and the vaccine?
  • Is there strong evidence against a causal association between the reaction and the vaccine?
  • Is there a laboratory test that implicates the vaccine as a cause of the reaction?
  • If the reaction is an infection, did it have a vaccine or wild type origin?

Your pediatrician will also consider other factors when making a decision, including whether other patients were affected (might implicate a contaminated vaccine), and will make sure that the original diagnosis is correct.

Being able to answer all of these questions often puts pediatricians in the unique position of correctly evaluating potential vaccine injuries. There is even a standardized algorithm that can help your pediatrician collect and interpret all of the data they will get when evaluating a possible vaccine injury.

Another algorithm can help evaluate and manage suspected allergic reactions, including immediate or type 1 hypersensitivity reactions and delayed type 3 hypersensitivity reactions. If the reaction is consistent with an allergic reaction and additional doses of the vaccine are still needed, possible next steps in this algorithm include serologic testing for immunity and skin testing with the vaccine or vaccine components.

For extra help, your pediatrician can consult an allergist or immunologist before considering giving your child another vaccine, if necessary. Experts at the Clinical Immunization Safety Assessment (CISA) are also available for consults about suspected vaccine injuries.

Over-Diagnosing Vaccine Injuries

In addition to vaccine side effects and vaccine injuries, it is much more common for children and adults to develop health problems and symptoms after getting a vaccine that have nothing to do with the vaccine. These are events, sometimes tragic, that would have happened even if they had not been vaccinated.

Anytime we see a post about vaccines and SIDS, we know what happened, an anti-vaccine Facebook group is taking advantage of a grieving family.
Anytime we see a post about vaccines and SIDS, we know what happened, an anti-vaccine Facebook group is taking advantage of a grieving family.

Despite the evidence against it, some parents may still think that their child has been injured or damaged by a vaccine, especially if they:

  • believe all of the vaccine injury stories they hear on the Internet
  • misuse vaccine package inserts
  • believe that VAERS reports have all been confirmed to be true
  • think that vaccine injuries can occur months or years after getting a vaccine
  • find a case report in PubMed and think that is convincing evidence of causality, even though it is really nothing more than a glorified anecdote
  • have found their way into a Facebook group where folks think vaccines always injure kids
  • go to a homeopath, chiropractor, or holistic practitioner who told them the child was injured

For example, studies have repeatedly shown that “vaccination does not increase the overall risk of sudden infant death (SIDS),” and that “the risk of SIDS in vaccinated cases and controls is neither increased nor reduced during the early post-vaccination period.”

What should you do if you really think that your child has a vaccine injury?
Just what a parent needs when their baby dies of SIDS, someone to reach out and tell them it was because they had him vaccinated… 

So a VAERS report of SIDS on the night that an infant received his 4 month vaccines, while tragic, would likely not end up being classified as a true vaccine injury.

Neither should a case report or package insert about SIDS influence your thinking about SIDS being associated with a vaccine injury.

Still, it is easy to understand why many like to blame vaccines.

Vaccines are an easy target, especially as most vaccine-preventable diseases are under fairly good control compared to the pre-vaccine era. And in some cases of SIDS, a new case of diabetes, or the sudden death of an older child, etc., it may happen soon after the child was vaccinated, and that correlation is hard to ignore for some folks.

At least it is hard to ignore and easy to be influenced by anti-vaccine folks if you don’t understand the background rate of these diseases – or the fact that a certain number of children will be affected no matter what, and because many kids get vaccinated, it is only a matter of chance that the two get correlated together. 

Vaccines are safe.

They don’t typically cause serious vaccine injuries.

If you do think that your child has a vaccine injury, talk to your pediatrician. Don’t get diagnosed in a Facebook forum…

More on Diagnosing Vaccine Injuries

Do Vaccines Cause Strabismus?

Vaccines can do a lot of things.

They can prevent you from getting a life-threatening disease, sometimes even after you have been exposed. And if you do get sick when vaccinated, the vaccine can often help to make sure the disease isn’t as severe as it might have been if you were unvaccinated. They can also keep you from getting sick and exposing others, including those who are at extra risk for severe disease.

Vaccines also get blamed for doing a lot of other things, namely for causing vaccine injuries.

These types of vaccine injury stories often scare other parents away from vaccinating and protecting their kids.
These types of vaccine injury stories often scare other parents away from vaccinating and protecting their kids.

While, of course, vaccines aren’t risk free, they don’t actually cause most of the bad things you read about on the Internet.

What Causes Strabismus?

Strabismus isn’t a disease. It is simply a term that describes a misalignment of your child’s eyes.

“At birth, an infant’s eyes cannot always focus directly on objects. They may appear to move quite independently at first, sometimes crossing, and sometimes wandering outward. But by the age of three to four months, an infant’s eyes should have the ability to focus on small objects and the eyes should be straight or parallel. A six-month-old infant should be able to focus on both distant and near objects.”

Prevent Blindness America on Is Strabismus Present at Birth?

To be more specific, children with strabismus can have:

  • esotropia – the eye turns inward
  • exotropia – the eye turns outward
  • hyertropia – the eye turns upward
  • hypotropia – the eye turns downward

And we get especially concerned when strabismus leads to amblyopia – decreased vision in the affected eye.

Some specific things that cause strabismus include:

  • third nerve (III) palsy
  • fourth nerve (IV) palsy – superior oblique muscle
  • sixth nerve (VI) palsy – lateral rectus muscle
  • Brown syndrome
  • Duane syndrome

Often, we don’t know why kids have strabismus, although it is thought that at least 50% of them are born with it, even if it isn’t recognized until they are older.

“Most strabismus is the result of an abnormality of the neuromuscular (including brain) control of eye movement. Our understanding of these control centers in the brain remains incomplete. Less commonly, a problem with the actual eye muscle may cause strabismus.”

AAPOS on What causes strabismus?

Kids with cerebral palsy, Down syndrome, hydrocephalus, and brain tumors are thought to be at higher risk for developing strabismus.

Do Vaccines Cause Strabismus?

And because we don’t always know what causes strabismus, that leads some folks to want to blame vaccines.

Interestingly, one study, Prevalence of Amblyopia and Strabismus in White and African-American Children Aged 6 through 71 Months: The Baltimore Pediatric Eye Disease Study, found that strabismus was rare in infants and that while higher in older kids, “there was no clear trend for increasing or decreasing prevalence after age 12 months.”

If strabismus was caused by vaccines, wouldn’t you expect to see more infants with strabismus and a consistent rise in cases as kids continued to get vaccines until they go to kindergarten?

Do any studies support the idea that vaccines do cause strabismus?

No.

There are a few case reports, but it is important to remember that a case report is basically a gloried anecdote. It is not the kind of high quality evidence you really want if you are trying to make a case trying to prove causality.

The biggest evidence against vaccines causing strabismus?

Strabismus isn’t new.

The first cases were reported over 3500 years ago and the first surgical repairs were being done in the early 19th Century.

So why do some folks think that strabismus is a vaccine injury? Mostly it is because some folks think that everything is a vaccine injury.

More on Strabismus