Tag: Cochrane Collaboration

Everything You Need to Know About the Measles Vaccine

The measles vaccine is one of the most effective vaccines we have.

It is also one of the safest, having very few serious side effects.

Everything You Need to Know About the Measles Vaccine

So why are some parents still afraid to allow their kids to get vaccinated and protected, putting them at risk to get measles, a life-threatening disease?

“Existing evidence on the safety and effectiveness of MMR vaccine supports current policies of mass immunisation aimed at global measles eradication and in order to reduce morbidity and mortality associated with mumps and rubella.”

Cochrane Systematic Review on Vaccines for measles, mumps and rubella in children

Let’s see if you still are after we get all of your questions about the measles vaccine answered…

Schools in California were closed for at least two weeks in 1917 because of measles epidemics.
Schools in California were closed for at least two weeks in 1917 because of measles epidemics.
  1. How long has the measles vaccine been around? The very first measles vaccine was licensed by John Enders in 1963. An improved measles vaccine was developed by Maurice Hilleman and licensed in 1968, and that is the measles vaccine that we still use today, at least in the United States. It was combined into the MMR vaccine in 1971.
  2. How effective is the measles vaccine? A single dose of the measles vaccine is about 93% effective at preventing a measles infection. Two doses (the second dose was added to the routine immunization schedule in 1994) are up to 97% effective. That’s why almost all of the people who get measles in an outbreak are unvaccinated.
  3. How long does immunity from the measles vaccine last? Immunity from the measles vaccine is thought to be life-long. It is important to understand that the second dose isn’t a booster dose, but is instead for those few folks who don’t respond to the first dose.
  4. Who should get the measles vaccine? Everyone without a true medical contraindication should get the measles vaccine (MMR), with the first dose at 12-15 months and a second dose at 4-6 years.
  5. Can my kids get their measles vaccine early? An advanced immunization schedule is available for kids in an outbreak or if they will be traveling out of the country. The first dose can be given as early as age 6-months, but is repeated when the child is 12 months because of concerns of interference with maternal antibodies. The official second dose can be given early too, as early as 4 weeks after the first dose, as long as the child is at least 12 months old.
  6. Do I need a booster dose of the measles vaccine? People who are fully immunized do not need a booster dose of the MMR vaccine, but it is important to understand whether or not you are really fully immunized to see if you need a second dose. Some adults who are not high risk are considered fully vaccinated with only one dose, while others should have two doses. Are you at high risk to get measles? Do you travel, live in an area where there are measles outbreaks, go to college, or work as a health care professional?
  7. Should I check my measles titers? In general, it is not necessary to check your titers for measles. If you haven’t had two doses of the MMR vaccine, then get a second dose. If you have had two doses of the MMR vaccine, then you are considered protected. Keep in mind that there is no recommendation to get a third dose of MMR for measles protection, although it is sometimes recommended for mumps protection during a mumps outbreak.
  8. If my child gets a rash after getting his MMR, does that mean that he has measles? No. This is a common, very mild vaccine reaction and not a sign of measles.
  9. Can the measles vaccine cause seizures? The MMR vaccine can cause febrile seizures. It is important to remember that without other risk factors, kids who develop febrile seizures after a vaccine are at the same small risk for developing epilepsy as other kids. And know that vaccines aren’t the only cause of febrile seizures. Vaccine-preventable diseases can cause both febrile seizures and more serious non-febrile seizures.
  10. Why do people think that that the measles vaccine is associated with autism? It is well known that this idea originated with Andrew Wakefield, but the real question should be why do some people still think that vaccines are associated with autism after so much evidence has said that they aren’t?
  11. What are the risks of the measles vaccine? Like other vaccines, the MMR vaccine has mild risks or side effects, including fever, rash, and soreness at the injection site. Some more moderate reactions that can rarely occur include febrile seizures, joint pain, and a temporary low platelet count. More serious reactions are even rarer, but can include deafness, long-term seizures, coma, or lowered consciousness, brain damage, and life-threatening allergic reactions.
  12. Why are there so many reports of measles vaccine deaths? There are extremely few deaths after vaccines. The reports of measles vaccine deaths you see on the Internet are just reports to VAERS and are not actually reports that have been proven to be caused by a vaccine. As with other vaccines, the risks from having a vaccine-preventable disease are much greater than the risks of the vaccine. The only reason that it might not seem like that now is because far fewer people get measles now than they did in the pre-vaccine era, when about 500 people died with measles each year.
  13. When did they take mercury out of the measles vaccine? Measles vaccines, including the MMR, have never, ever contained mercury or thimerosal.
  14. Why do we still have outbreaks if we have had a measles vaccine since 1963? In the United States, although the endemic spread of measles was declared eliminated in 2000, many cases are still imported from other countries. As measles cases increase around the world, that is translating to an increase in outbreaks here. Even though overall vaccination rates are good, because there are many pockets of susceptible people in areas that don’t vaccinate their kids, they get hit with outbreaks.
  15. Can we eradicate measles? Because measles is so contagious, the vaccine does have failures, and some folks still don’t get vaccinated, there is some doubt that we can eradicate measles without a better vaccine. That doesn’t mean that the current measles vaccines can’t prevent outbreaks though…

Are you ready to get your kids their MMR vaccine so that they are vaccinated and protected against measles, mumps, and rubella?

If not, what other questions do you have?

While you are thinking, here is a question for you – Do know why they used to call measles a harmless killer?

More on the Everything You Need to Know About the Measles Vaccine

Crisis or Crossroads at the Cochrane Collaboration?

Not surprisingly, Peter Gøtzsche has had some defenders.

“A scandal has erupted within the Cochrane Collaboration, the world’s most prestigious scientific organisation devoted to independent reviews of health care interventions. One of its highest profile board members has been sacked, resulting in four other board members staging a mass exodus.”

Maryanne Demasi, PhD on Cochrane – A sinking ship?

Who is Maryanne Demasi?

“DISCLOSURE: Maryanne Demasi is a science reporter and a researcher working with Prof Peter C. Gøtzsche, the Nordic Cochrane Centre, and was present in Edinburgh at the time of the meeting, but not present in the discussion room.”

Oh…

Someone who works with Peter Gøtzsche is defending him. That doesn’t sound too surprising.

It is also not surprising the way that some folks are describing Peter Gøtzsche’s expulsion, saying that it was only about his behavior and not his work.

Did Peter Gøtzsche get expelled because of his work or behavior?
Did Peter Gøtzsche get expelled because of his work or behavior?

But the problem wasn’t that he wrote a critique of a Cochrane HPV meta-analsysis, but that his critique was so poorly done!

“I think it’s a hatchet job by people with several axes to grind, that needed better editorial peer review. I would be surprised if Cochrane’s investigation and update resulted in changed conclusions.”

Hilda Bastian on The HPV Vaccine: A Critique of a Critique of a Meta-Analysis

A hatchet job by people with several axes to grind…

Not the kind of work you would expect from a member of the Governing Board of the Cochrane Collaboration, especially after most of the same charges were refuted when they were made against the European Medicines Agency.

Did Peter Gøtzsche allow a bias against screening for cancer harm the Cochrane Collaboration?
Did Peter Gøtzsche allow a bias against screening for cancer harm the Cochrane Collaboration?

And it wasn’t even the first time that he was accused of harming the Cochrane Collaboration .

“Cochrane wishes to state unequivocally that the views Professor Gøtzsche has expressed on the benefits and harms of psychiatric drugs are not those of the organization. As primarily a research organization Cochrane does not make clinical recommendations and we have not done so on this issue.”

Statement from Cochrane

How many times has the Cochrane Collaboration had to distance itself from the views of its Board Members?

How many times has the Cochrane Collaboration had to distance itself from the views and work of Peter Gøtzsche and the Nordic Cochrane Collaboration?

More on Peter Gøtzsche

 

Crisis at the Nordic Cochrane Centre

This could be it for the Nordic Cochrane Centre.

“I regret to inform you that I have been expelled from membership in the Cochrane Collaboration by the favourable vote of 6 of the 13 members of the Governing Board. No clear reasoned justification has been given for my expulsion aside from accusing me of causing “disrepute” for the organization.”

Peter Gøtzsche on A moral governance crisis: the growing lack of democratic collaboration and scientific pluralism in Cochrane

Or at least for Peter Gøtzsche and his association with the Cochrane Collaboration, which he co-founded in 1993.

I’m not sure how he thinks that there was no clear justification for his being expelled though.

Crisis at the Nordic Cochrane Centre

Most folks understand why Peter Gøtzsche was expelled from the Cochrane Collaboration…

They remember that he recently published a poorly done analysis in BMJ Evidence-Based Medicine, The Cochrane HPV vaccine review was incomplete and ignored important evidence of bias that was critical of a Cochrane Review on the HPV vaccine, Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors, which concluded that the HPV vaccines work and that they are safe.

While Gøtzsche’s analysis prompted the Cochrane Collaboration to initiate an investigation, they concluded that his analysis “substantially overstated its criticisms” and that the allegations were “not warranted and provided an inaccurate and sensationalized report of their analysis.”

Is that it?

Nope.

Many people are also familiar with the Nordic Cochrane Centre because of their involvement in continued complaints about the HPV vaccine. Complaints that were not approved by the Cochrane Collaboration and that were not an official Cochrane viewpoint!

“…we highlight here how academic colleagues, under the purported banner of a respected authority, raise concerns about the HPV vaccine but they cite an evidence base of small and poor quality studies and ignore the extensive wealth of global literature that vividly demonstrate the excellent efficacy and safety record of the vaccine.”

Head et al on Inadvisable anti-vaccination sentiment: Human Papilloma Virus immunisation falsely under the microscope

Complaints that had already been investigated and dismissed by the European Medicines Agency and refuted by many other studies.

“This week at its meeting in Edinburgh, Cochrane’s Governing Board considered, as planned, the findings of an independent review and additional complaints related to the conduct of a Member. The Board’s conclusion was communicated to the individual concerned and is part of an ongoing process. The Co-Chairs of the Board will provide further details once this process is complete.

Following this, four Board members (Gerald Gartlehner, David Hammerstein Mintz, Joerg Meerpohl and Nancy Santesso) decided to resign as Cochrane trustees with immediate effect.”

Message from the Governing Board

Unfortunately, Gøtzsche’s being expelled led to others leaving the Cochrane Governing Board, including two appointed trustees who volunteered to step down to to comply with Cochrane’s Articles of Association.

Although they may not have been defending Gøtzsche's opinions or behaviors, four other board members resigned in solidarity.
Although they may not have been defending Gøtzsche’s opinions or behaviors, four other board members resigned in solidarity.

We can hope that this is the end of the matter, as Cochrane will soon have an election for new board members.

Peter Gøtzsche is out at the Cochrane Collaboration.
Peter Gøtzsche is out at the Cochrane Collaboration.

Will he be kept on at the Nordic Cochrane Centre, which he founded? Will the Nordic Cochrane Centre be allowed to keep ‘Cochrane’ in their name?

The Nordic Cochrane Centre is primarily funded by the Danish Government, and what do they get besides all of the anti-HPV vaccine stuff?

“Antidepressant drugs are another major killer that people could do well without.”

Peter C Gøtzsche: Prescription drugs are the third leading cause of death

Peter Gøtzsche seems to be against cancer screening, psychiatric drugs, and thinks that Big Pharma has corrupted health care. Is that the “plurality of opinions, views, and perspectives” that folks want at Cochrane or anywhere else in medicine?

Unfortunately, I bet this isn’t the last that we have heard from him.

More on the Crisis at the Nordic Cochrane Centre