Tag: cost-effectiveness

Did Bobby Kennedy Admit That Chickenpox Kills People?

The usual talking point from folks who are anti-vax is that vaccine-preventable diseases are mild. Some even go so far to say that they are good for you! It isn’t too often that these folks admit that these diseases, from measles and polio to chickenpox, do indeed kill people.

Bobby Kennedy finally gets it right, admitting that chickenpox killed 100 people a year in the pre-vaccine era.
Having chickenpox doesn’t protect you from developing shingles – it’s why you develop shingles!

No, chickenpox doesn’t kill 1 in 100 people, but that doesn’t mean that people don’t die with chickenpox, especially if they are unvaccinated and unprotected.

Did Bobby Kennedy Admit That Chickenpox Kills People?

Do we want to go back to the days when more folks were dying with chickenpox?

“The total cost to theoretically save 50 children is approximately $900 million dollars or $17.5 million per life saved.”

Bobby Kennedy

What else does Bobby Kennedy say?

“Chickenpox can reactivate as shingles when an adult’s immunity wanes or is not boosted by periodic exposure to children with chickenpox. CDCs clinical studies predicted that widespread vaccination would double shingles rates among adults and children and precipitate a shingles epidemic. “

Bobby Kennedy

While it is true that chickenpox can reactivate as shingles, a bonus of getting vaccinated and protected with the chickenpox vaccine is that it actually decreases your risk of developing shingles later in life!

And those countries that didn’t vaccinate and protect their kids with the chickenpox vaccine, because they thought it might cause a later shingles epidemic if fewer kids were sick and boosting the immunity of adults who had already had chickenpox still saw a rise in shingles cases.

That’s probably why many of those countries are now considering adding the chickenpox vaccine to their schedule.

What else did Bobby Kennedy say?

“…chickenpox presents as a mild rash and slight fever and confers lifetime immunity to chickenpox and significant protection against shingles, heart disease, atopic diseases, and cancers including glioma, brain, and spinal tumors. “

Bobby Kennedy

The part about getting lifetime immunity to chickenpox is true.

Does chickenpox provide significant protection against heart disease, atopic disease, or cancer?

Nope.

And of course, if you have ever had chickenpox, you know that it is far more than “a mild rash and a slight fever.”

Unvaccinated kids with chickenpox typically have 250 to 500 blisters over their entire body.
Unvaccinated kids with chickenpox typically have 250 to 500 blisters over their entire body. Photo courtesy CDC/ Dr. John Noble, Jr..

In a routine case of chickenpox, the fever typically rises to at least 102°F and lasts for at least 2 to 3 days, with the rash persisting for up to a week.

Unfortunately, not all chickenpox cases are routine.

In addition to the deaths, there are plenty of reports of kids having complications with chickenpox and developing skin superinfections, pneumonia, encephalitis, or having strokes.

What else does Bobby Kennedy say?

“Merck’s vaccine is only 60% effective after 5 years, leaving adults vulnerable to shingles.”

Bobby Kennedy

Actually, it has been found that one dose of the chickenpox vaccine is 100% effective at preventing severe disease!

So why do we get two doses?

“This study confirmed that varicella vaccine is effective at preventing chicken pox, with no waning noted over a 14-year period. One dose provided excellent protection against moderate to severe disease, and most cases occurred shortly after the cohort was vaccinated. The study data also suggest that varicella vaccination may reduce the risks of HZ in vaccinated children.”

Baxter et al on Long-term effectiveness of varicella vaccine: a 14-Year, prospective cohort study.

Two doses of the chickenpox vaccine are up to 94% effective at preventing any chickenpox disease, even breakthrough cases.

And again, several studies have confirmed that getting vaccinated and protected with the chickenpox vaccine decreases your risk of developing shingles!

Do you really want your kids to be at risk to get chickenpox and have a higher risk to get shingles later in life?

Of course not. That’s why you hopefully don’t listen to folks like Bobby Kennedy and you vaccinate and protect your kids.

More on Chickenpox Deaths

About That 4 Billion Dollars Taxpayers Have Paid for Vaccine Injuries…

Why do some folks think that taxpayers have paid 4 billion dollars in vaccine injuries and deaths?

Anti-vax protestors at the Neptune statute in Virginia with misinformation on the 4 billion dollars for vaccine injuries..
How many doses of vaccines have been given during the time that the $4 billion was paid out? How many lives were saved because they didn’t get polio, measles, and Hib, etc.?

Oh, these folks…

About That 4 Billion Dollars Taxpayers Have Paid for Vaccine Injuries…

So, is it true?

Have taxpayers paid 4 billion dollars for vaccine injuries and deaths, like their signs say?

Nope.

For one thing, these anti-vax protestors are mixing together a couple of separate anti-vaccine talking points that are used to scare parents away from vaccinating and protecting their kids.

  1. While the National Childhood Vaccine Injury Act of 1986 did set up a $0.75 vaccine excise tax to fund the Vaccine Injury Compensation Trust Fund, it is the vaccine manufacturers who pay the tax.
  2. And billions and billions of doses of vaccines (over 3.5 billion just since 2006) have been given since 1989, the time since the $4,060,857,713.42 has been paid by the Vaccine Court. The payment has been for 6,355 compensated claims over those thirty years, most of which are for vaccine injuries, not deaths. Fewer than 10% of Vaccine Court cases are for vaccine deaths.

Does that matter?

Now up to 4 billion dollars for vaccines injuries, the payout is after billions and billions of vaccines have been given.
That’s about 1 compensated claim, the majority of which are settled, in about 775 thousand doses. So not quite 1 in a million…

It does if you consider that many more kids would die if we didn’t routinely vaccinate and protect our kids!

“Analyses showed that routine childhood immunization among members of the 2009 US birth cohort will prevent ∼42 000 early deaths and 20 million cases of disease, with net savings of $13.5 billion in direct costs and $68.8 billion in total societal costs, respectively.”

Zhou et al on Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009

And it would be far more costly if we returned to an era when epidemics of vaccine preventable diseases became routine.

Too bad I can’t fit all of that on a sign…

More on Vaccine Court Payouts

10 Myths About Chicken Pox and the Chicken Pox Vaccine

You remember chicken pox, don’t you?

Is this really a disease that we need to vaccinate our kids against?

Obviously, the folks who posted the following comments don’t seem to think so.

It is just as obvious that they are wrong though.

That she doesn't understand survivorship bias doesn't mean that you shouldn't vaccinate your kids.
That she doesn’t understand survivorship bias doesn’t mean that you shouldn’t vaccinate your kids.

No one ever says that chicken pox, measles, mumps, and rubella kills everyone that gets them.

Even in the pre-vaccine era, when measles would kill 500 people a year in the United States, there is a very good chance that you wouldn’t have known anyone that died of measles. Of course, that doesn’t mean that nobody died of measles or chicken pox or any other now vaccine-preventable disease.

You likely know someone that plays football, right? Maybe on a youth football team or in middle school or high school? Do you know anyone that plays on a team in the NFL? While millions of kids might play football, only a few thousand play in the NFL.

Benign diseases don't kill kids.
Benign diseases don’t kill kids.

Chicken pox was never a benign disease. It was considered a rite of passage because we all had to endure it, but it wasn’t something anyone looked forward to. You don’t die from a benign disease.

Trying to scare people into thinking that vaccines are poison... Anti-vaccine propaganda is all about fear.
Trying to scare people into thinking that vaccines are poison… Anti-vaccine propaganda is all about fear.

Part of that is actually true – “they keep you a customer for life” because you didn’t die from a vaccine-preventable disease!

The UK doesn't haven't routinely vaccinate against chicken pox, but they do have chicken pox deaths...
The UK doesn’t routinely vaccinate against chicken pox, but they do have chicken pox deaths and the same rise in shingles rates…

Many countries don’t have the chicken pox vaccine on their routine immunization schedule because they don’t think it is cost-effective and they were concerned about what controlling chicken pox could do to rates of shingles.

“About 3 in every 1000 pregnant women in the UK catch chickenpox. Between 1985 and 1998, nine pregnant women died in the UK from chickenpox complications. Their unborn babies are also at risk from a rare condition called foetal varicella syndrome (FVS). This can result in serious long-term damage to the baby or even death, particularly if the mother catches chickenpox in the first 20 weeks of pregnancy.”

Vaccine Knowledge Project on Chickenpox (Varicella)

These countries have the same rates of shingles as countries that do use the chicken pox vaccine, but still have high rates of chicken pox and complications of chicken pox!

The UK does not vaccinate for chicken pox, but young, otherwise healthy kids die with chicken pox in the UK.

Don't trust the CDC, but do trust anyone with a website or Facebook page that says what you want to believe.
Don’t trust the CDC, but do trust anyone with a website or Facebook page that says what you want to believe…

Most folks should understand that when anti-vaccine folks say “do your research,” they mean look at their websites and Facebook groups that regurgitate misinformation and anti-vaccine propaganda.

Natural immunity is not better than vaccine induced immunity when you consider the risks of a natural infection, which can include death.
Natural immunity is not better than vaccine induced immunity when you consider the risks of a natural infection, which can include death.

We don’t need disease.

There is no diet that will help you beat chicken pox.
There is no diet that will help you beat chicken pox.

While you will be at higher risk for complications from chicken pox and most other diseases if you have a compromised immune system or are malnourished, if you are otherwise healthy, there is nothing you can do to boost your immune system to try and beat chicken pox – besides getting vaccinated.

Homeopathic vaccines do nothing.
Homeopathic vaccines do nothing.

There is also no homeopathic remedy or homeopathic vaccine that can help you avoid chicken pox.

Adults don't need boosters to most vaccines, so actually are up-to-date and immune to most diseases.
Adults don’t need boosters to most vaccines, so actually are up-to-date and immune to most diseases.

The chicken pox vaccine provides long lasting protection. Ironically, anti-vaccine folks often misunderstand how herd immunity works, the one thing that can protect their unvaccinated kids as they try to hide in the herd

Chicken pox parties were never as common as folks think they were, but when done, it was out of necessity, as we didn't have a vaccine.
Chicken pox parties were never as common as folks think they were, but when done, it was out of necessity, as we didn’t have a vaccine.

Chicken pox parties kind of made sense in the pre-vaccine era. Since it was inevitable that your child would get chicken pox, you wanted them to get it at a young age, so they weren’t at increased risk for complications as an adult.

But intentionally exposing your child to a life-threatening infection when a safe and effective vaccine is available?

Do your research. Get vaccinated and protected.

More on Chicken Pox Myths

Costs of a Measles Outbreak

The endemic spread of measles was eliminated in the United States in 2000, but unfortunately, that hasn’t stopped us from having outbreaks of measles each year.

Since reaching a record low of just 37 cases of measles in 2004, other milestones in the measles timeline we should all know about include that there were:

  • 220 measles cases in 2011, a 15-year record and the highest number of cases since 1996 at least until 2014, when we had at least 667 cases
  • 58 cases in the 2013 New York City measles outbreak and for a short time, the largest outbreak since the endemic spread of measles was eliminated in the United States
  • 382 cases in the 2014 measles outbreak in Ohio and now the largest outbreak since the endemic spread of measles was eliminated in the United States
  • 170 measles cases in the first few months of 2015, including a large outbreak in California that was linked to Disneyland.
  • 188 cases and a measles death in 2015
  • an outbreak in Rockland County, New York that has been going on since September 2018, making it the longest outbreak since the endemic spread of measles was eliminated in the United States
  • an outbreak in Brooklyn, New York, which at 654 cases, became the largest outbreak since 1992

That’s still far below where we used to be though, especially when you consider that before the first measles vaccine was licensed, there was an average of about 549,000 measles cases and 495 measles deaths in the United States each year.

Containing a Measles Outbreak

Several factors help to limit the measles outbreaks that we continue to see in the United States. Most important is that fact that despite the talk of personal belief vaccine exemptions and vaccine-hesitant parents not getting their kids vaccinated, we still have high population immunity.

In the United States, 90.8% of children get at least one dose of the MMR vaccine by the time they are 35 months old and 91.1% of teens have two doses. While not perfect, that is still far higher than the 81% immunization rates the UK saw from 2002 to 2004, when Andrew Wakefield started the scare about the MMR vaccine. Instead of overall low immunization rates, in the U.S., we have “clusters of intentionally under-vaccinated children.”

It also helps that the measles vaccine is highly effective. One dose of a measles vaccine provides about 95% protection against measles infection. A second, “booster” dose helps to improve the effectiveness of the measles vaccine to over 99%.

To further help limit the spread of measles, there are a lot of immediate control measures that go into effect once a case of measles has been suspected, from initiating contact investigations and identifying the source of the measles infection to offering postexposure prophylaxis or quarantining close contacts.

That’s an awful lot of work.

A 2013 measles outbreak in Texas required 1,122 staff hours and 222 volunteer hours from the local health department to contain.

Costs of a Measles Outbreak

In addition to requiring a lot of work, containing a measles outbreak is expensive.

A study reviewing the impact of 16 outbreaks in the United States in 2011 concluded that “investigating and responding to measles outbreaks imposes a significant economic burden on local and state health institutions. Such impact is compounded by the duration of the outbreak and the number of potentially susceptible contacts.”

We still don’t know what it cost to contain many big outbreaks, like the one in Ohio, but we do know that it cost:

  • over $6 million to contain the 2018-19 measles outbreak in Brooklyn, with more than 500 staff dedicated to the response
  • at least $1.6 million to control the 2019 measles outbreak in Clark County, Washington
  • over $2.3 million to contain the 2017 outbreak in Minnesota – 75 people got measles, 71 were unvaccinated, and more than 500 people were quarantined over a 5 month period
  • up to an estimated $3.91 million (but likely much more) to contain the 2015 outbreaks in California
  • $394,448 and 10,054 personnel hours in total personnel time and total direct cost to the New York City Department of Health and Mental Hygiene responding to and controlling the 2013 outbreak in NYC
  • two unrelated cases in Colorado in 2016 cost $49,769 and $18,423, respectively to investigate
  • $50,758.93 to contain an outbreak at a megachurch in Texas
  • $150,000 to contain (13 cases) an outbreak in Cook County, Illinois
  • $223,223 to contain (5 cases, almost all unvaccinated) to contain another outbreak in Clallam County, Washington, an outbreak that was linked to the death of an immunocompromised woman.
  • more than $190,000 of personnel costs in Alameda County, with 6 cases and >700 contacts, it is estimated that over 56 staff spent at least 3,770 hours working to contain the outbreak
  • $5,655 to respond to all of the people who were exposed when a 13-year-old with measles was seen in an ambulatory pediatric clinic in 2013
  • $130,000 to contain a 2011 measles outbreak in Utah
  • $24,569 to contain a 2010 measles outbreak in Kentucky
  • $800,000 to contain (14 cases, all unvaccinated) a 2008 measles outbreak at two hospitals in Tuscon, Arizona
  • $176,980 to contain a 2008 measles outbreak in California
  • $167,685 to contain a 2005 measles outbreak in Indiana – unvaccinated 17-year-old catches measles on church mission trip to Romania, leading to 34 people getting sick, including an under-vaccinated hospital worker who ends up on a ventilator for 6 days
  • $181,679 (state and local health department costs) to contain a 2004 measles outbreak in Iowa triggered by a unvaccinated college student’s trip to India
Ending with 667 cases, 2014 became the worst year for measles in the United States since 1994.
Ending with 667 cases, 2014 became the worst year for measles in the United States since 1994. How much did these outbreaks cost to contain?

It is important to keep in mind that these costs are often only for the direct public health costs to the county health department, including staff hours and the value of volunteer hours, etc. Additional costs that come with a measles outbreak can also include direct medical charges to care for sick ($14,000 to $16,000) and exposed people, direct and indirect costs for quarantined families (up to $775 per child), and outbreak–response costs to schools and hospitals, etc.

We should also consider what happens when our state and local health departments have to divert so much time and resources to deal with these types of vaccine-preventable diseases instead of other public health matters in the community. Do other public health matters take a back seat as they spend a few months responding to a measles outbreak?

There were 220 cases of measles in the United States in 2011. To contain just 107 of those cases in 16 outbreaks, “the corresponding total estimated costs for the public response accrued to local and state public health departments ranged from $2.7 million to $5.3 million US dollars.”

In contrast, it will costs about $77 to $102 to get a dose of the MMR vaccine if you don’t have insurance. So not only do vaccines work, they are also cost effective.

What to Know About the Costs of a Measles Outbreak

Containing a measles outbreak is expensive – far more expensive than simply getting vaccinated and protected.

More on the Costs of a Measles Outbreak