Tag: coincidence

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

What Is Vaccine Injury Denial?

Few people deny that vaccine injury is real.

Vaccine injuries, while rare, are certainly real.

That’s why we have table injuries, the Vaccine Court, and the National Vaccine Injury Compensation Program.

What Is Vaccine Injury Denial?

Again though, vaccine injuries are rare.

“Vaccine Injury Denialism is rampant across the mainstream media, where child-abusing vaccine pushers like the New York Times, Washington Post and CNN deliberately contribute to the holocaust of vaccine injuries now devastating humanity’s children. Sadly, the same denialism about the alarming growth in medical injuries caused by vaccines is also endemic across universities, science journals and medical schools, where doctors are indoctrinated into a kind of “Flat Earth” denialism of vaccine injury reality.”

Mike Adams on Vaccine Injury Denialism is the denial of fundamental human dignity

Claims of vaccine injury denial come when we are skeptical or don’t believe that anything and everything is a vaccine injury.

Barbara Loe Fisher's NVIC even claims that Shaken Baby Syndrome can be a vaccine injury.
Barbara Loe Fisher’s NVIC even claims that Shaken Baby Syndrome can be a vaccine injury.

For example, in some circles, if you point out that vaccines do not cause asthma, ADHD, autism, Celiac disease, diabetes, eczema, food allergies, infertility, multiple sclerosis, POTS, SIDS, or transverse myelitis, etc., then claims of vaccine injury denial begin to fly.

That shouldn’t be surprising, as these and other so-called vaccine induced diseases make up the bulk of the vaccine injury stories that scare many parents.

“IMAGINE YOU LIVE IN A COUNTRY in which a minority of people are taken in the middle of the night, and beaten, kicked, poisoned, half-drowned… they are crippled for life, maimed, and they are expected to accept a doctor’s or a judge’s view that “It wasn’t the Gestapo” or “It’s not even an injury”.

Imagine that minority amounted to tens of millions of people.

Now imagine that these victims are lured into traps by their own doctors with promises of medicine that will prevent illness – but in reality the doctors are paid for every patient they manage to convince to show up – and the doctors determine which injuries they caused and which were just “coincidences”.

Now imagine the media is primed to tell the world that no such injuries ever occur. Now your neighbors are denying it, calling you crazy for thinking there is a link…”

James Lyons-Weiler on Should Vaccine Risk/Injury Denial Be Prosecutable Offenses?

But doctors and the media, and your neighbors for that matter, don’t deny that claims of vaccine injury are real because of some grand conspiracy or simply because they want to.

It is because of research and science, understanding the difference between correlation and causation, and more research. And we understand that vaccines are both passively and actively monitored for side effects.

Vaccine injuries, although real, are rare.

The only denialism about vaccines that is important, is among those who deny that vaccines work and that they are safe and necessary.

What to Know About Vaccine Injury Denial

Anti-vaccine folks like to claim that anyone who doesn’t believe that vaccines cause all of their vaccine-induced diseases are part of a conspiracy of vaccine injury denial.

More on Vaccine Injury Denial

Is It a Vaccine Reaction?

Why do anti-vaccine folks think that there are so many vaccine reactions?

It is mostly because they think that anything bad that happens after someone is vaccinated, even if it is weeks or months later, must have been caused by the vaccine.

“Differentiation between coincidence and causality is of utmost importance in this respect. This is not always easy, especially when an event is rare and background rates are not available.”

Heininger on A risk-benefit analysis of vaccination

Of course, this discounts that fact that most people have a basic risk, often called the background rate, for developing most of these very same conditions, and they can just coincide with getting vaccinated.

Put more simply, the “reaction” would have happened whether or not they had been vaccinated.

“…when a number of well-controlled studies were conducted during the 1980s, the investigators found, nearly unanimously, that the number of SIDS deaths temporally associated with DTP vaccination was within the range expected to occur by chance. In other words, the SIDS deaths would have occurred even if no vaccinations had been given.”

WHO on Six Common Misconceptions About Immunization

That doesn’t mean that everything automatically gets blamed on coincidence though.

Is It a Vaccine Reaction?

Vaccine adverse events can be reported to VAERS online or using a downloadable form.
Vaccine reactions can be reported to VAERS online or using a downloadable form.

When trying to determine if a child has had a vaccine reaction, experts typically go through a series of questions, looking at the evidence for and against :

  • How soon after the vaccine was given did the reaction occur? Was it minutes, hours, days, weeks, months, or years later?
  • Is there any evidence that something else could have caused the reaction?
  • Is there a known causal relation between the reaction and the vaccine?
  • Is the reaction a table injury?
  • Is there evidence that the vaccine does not have a causal association with the reaction?
  • Do any lab tests support the idea that it was a vaccine reaction?

Why is it important to consider these and other questions?

Because most of us are very good at jumping to conclusions, are quick to place blame, and like to know the reasons for why things happen.

We don’t like to think that things are just caused by coincidence.

Post hoc ergo propter hoc (after this, therefore, because of this).

We are especially good at linking events and often automatically assume that one thing caused another simply because it occurred afterwards.

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

Dr Samuel Johnson

But we also know that correlation does not imply causation. And because of the great benefits of vaccines, it is important to find strong evidence for a correlation before we blame vaccines for a reaction.

Too often though, the opposite happens. Despite strong evidence against a correlation, parents and some pediatricians still blame vaccines for many things, from SIDS and encephalitis to autism.

Background Rates vs Vaccine Reactions

Although anti-vaccine folks are always calling for vaccinated vs unvaccinated studies to further prove that vaccines are indeed safe, much of that work is already done by looking at the observed rate of possible reactions and comparing them to the background rate of reactions and conditions.

We often know how many people are expected to develop certain conditions, from seizures and type 1 diabetes mellitus to acute transverse myelitis and juvenile and rheumatoid arthritis.

“On the basis of the reviewed data, if a cohort of 10 million individuals was vaccinated in the UK, 21.5 cases of Guillain-Barré syndrome and 5.75 cases of sudden death would be expected to occur within 6 weeks of vaccination as coincident background cases. In female vaccinees in the USA, 86.3 cases of optic neuritis per 10 million population would be expected within 6 weeks of vaccination. 397 per 1 million vaccinated pregnant women would be predicted to have a spontaneous abortion within 1 day of vaccination.”

Black et al on Importance of background rates of disease in assessment of vaccine safety during mass immunisation with pandemic H1N1 influenza vaccines

Intussusception is a good example of this.

This might surprise some folks, but we diagnosed and treated kids with intussusception well before the first rotavirus vaccines were ever introduced. And then, it was only after the risk of intussusception after vaccination exceeded the background rate that experts were able to determine that there was an issue.

Background rates also explain why unvaccinated kids develop autism. It’s not a coincidence.

“Knowledge of the background incidence rates of possible adverse events is a crucial part of assessing possible vaccine safety concerns. It allows for a rapid observed vs expected analysis and helps to distinguish legitimate safety concerns from events that are temporally associated with but not necessarily caused by vaccination.”

Gadroen et al on Baseline incidence of intussusception in early childhood before rotavirus vaccine introduction, the Netherlands, January 2008 to December 2012

Fortunately, studies have never found an increased risk above the background rate for SIDS, non-febrile seizures, and other things that anti-vaccine folks often blame on vaccines. So when these things happen on the same day or one or two days after getting vaccinated, it almost certainly truly is a coincidence. It would have happened even if your child had not been vaccinated, just like we see these things happen in the days before a child was due to get their vaccines.

For example, using background incidence rates in Danish children, one study found that if you vaccinated a million children with a new flu vaccine, you could expect that naturally, after seven days, you would see:

  • facial nerve palsy – one case
  • seizures – 36 cases
  • multiple sclerosis – one case
  • type 1 diabetes – three cases
  • juvenile and rheumatoid arthritis – three cases

After six weeks, those numbers of course go up. In addition to 4 kids developing MS, 20 develop diabetes, 19 develop arthritis, and 218 have seizures, and there would have been at least two deaths of unknown cause.

Would you blame the flu shot for these things?

What flu shot?

This was a “hypothetical vaccine cohort” that used 30 years of data from the Danish healthcare system to figure out background rates of each condition.

“In addition, the expected number of deaths in Japan following an estimated 15 million doses of H1N1 vaccine administered would be >8000 deaths during the 20 days following vaccination, based on the crude mortality rate.”

McCarthy et al on Mortality Rates and Cause-of-Death Patterns in a Vaccinated Population

Looking at background rates is especially helpful when folks report about vaccine deaths.

Using the Japan example that McCarthy studied, if they had looked at background rates, then all of a sudden, the 107 deaths they found after 15 million doses of H1N1 vaccine were given in 2009 would not have been so alarming. Background rates would have predicted a much, much higher number of deaths to naturally occur in that time period simply based on crude mortality rates.

Again, none of this means that possible vaccine reactions are dismissed as being coincidences. They just aren’t immediately assumed to have been caused by vaccines, because vaccines are necessary and a lot of research has already gone into demonstrating that vaccines are safe and vaccines continue to go through routine safety monitoring to make sure they stay safe.

What to Know About Evaluating Vaccine Reactions

Vaccines are safe and many of the things that folks think are vaccine reactions can be explained by looking at the background rates for these conditions and understanding that they would have happened anyway.

More on Evaluating Vaccine Reactions