Tag: deaths from vaccine-preventable diseases

Measles Propaganda from The Physicians for Informed Consent

Most people understand that measles can be deadly.

“Measles is a highly contagious, serious disease caused by a virus. Before the introduction of measles vaccine in 1963 and widespread vaccination, major epidemics occurred approximately every 2–3 years and measles caused an estimated 2.6 million deaths each year.”

WHO Measles Fact Sheet

In the United States alone, in the pre-vaccine era, “an average of 549,000 measles cases and 495 measles deaths were reported annually.”

That roughly translates into about one death for every 1,000 cases, or a case-fatality rate of about 0.1%.

That’s in line with the typical case-fatality rate of measles of 0.1 to 0.2%.

Just How Deadly Is Measles?

Not surprisingly, many others have reported a similar case-fatality rate for measles.

Not everyone though.

The ironically named Physicians for Informed Consent suggests that it should be much, much lower.

Why?

Because of a 1989 report that said that “Before measles vaccine was available, more than 400,000 measles cases were reported each year in the United States. However, since virtually all children acquired measles, the true number of cases probably exceeded 4 million per year (i.e., the entire birth cohort).”

Their idea is that if there were more cases (i.e., the entire birth cohort), then even if almost 500 people died each year, the extra cases would make the death rate lower.

There are a lot of problems with that reasoning though…

For one thing, 500 people dying each year of a now vaccine-preventable disease is a lot of people, no matter how you to frame it!

I fixed this graph from The Physicians for Informed Consent to more accurately represent measles mortality data in the pre-vaccine era.
I fixed this graph from The Physicians for Informed Consent to more accurately represent measles mortality data in the pre-vaccine era.

And the traditional stat about the measles fatality rate clearly mentions that this is about reported cases.

You can’t change the number of measles cases to a theoretical number, the entire birth cohort, and keep the number of deaths based on the number of reported cases, and think that you are still talking about the same thing. What if deaths from measles were under-reported too?

“Death from measles was reported in approximately 0.2% of the cases in the United States from 1985 through 1992.”

CDC Pink Book

And there are plenty of more recent statistics, when far fewer people were getting measles, that show a similar case fatality rate.

What Is the Measles Fatality Rate?

How else do we know that The Physicians for Informed Consent is misinforming people?

“…any parent who has seen his small child suffer even for a few days with persistent fever of 105 F, with hacking cough and delirium, wants to see this prevented…”

Alexander D Langmuir, MD on the Medical Importance of Measles

Their measles ‘information’ sheet, made by folks who have likely never treated a child with measles, say that “most measles cases are benign.”

That’s a bit different than Dr. Langmuir’s 1962 account of how the typical child suffered with measles and why he welcomed the new measles vaccine.

“Nevertheless, a resurgence of measles occurred during 1989–1991, again demonstrating the serious medical burden of the disease. More than 55,000 cases, 123 deaths, and 11,000 hospitalizations were reported”

Orenstein et al on Measles Elimination in the United States

What was the case fatality rate during the measles outbreaks in the late 1980s?

It was a little over 0.2%. Did we again under-count cases or was the case-fatality rate so high because most of the cases were in younger, preschool age children?

Anyway, whether the case fatality rate is 1 in 1,000 or 1 in 10,000 (the UK lists their measles case fatality rate at 1 in 5,000), it doesn’t mean that someone will die when you hit case number 1,000, 5,000, or 10,000. It could be the 1st case in an outbreak or the 15,000th.

Measles can be deadly. That’s why most of us choose to have our kids vaccinated and protected.

Do you know how many people had measles in the 2013 outbreak in Brooklyn when a pregnant woman developed measles and had a miscarriage? The outbreak that was started by an unvaccinated teenager included a total of 58 cases.

How about the 2015 outbreak in Clallam County, Washington in which an immunocompromised woman died of pneumonia due to measles? There were only five other cases, almost all unvaccinated.

And in many European countries last year, many of the deaths are in countries with few cases. When the 17-year-old unvaccinated girl in Portugal died, there were just 31 cases. In Switzerland, a vaccinated man with leukemia died in an outbreak with just 69 cases. There were only 163 cases when an unvaccinated 10-month-old died in Bulgaria. And there were fewer than 1,000 cases in Germany when a partially vaccinated mother of three children died.

More Myths About Measles

The Physicians for Informed Consent pushes a lot of other myths and misinformation about measles:

  • about using vitamin A to treat measles – where this works, in developing countries, untreated measles has a case fatality ratio of 5 to 40% because of malnutrition! It isn’t usually thought to be very helpful in an industrial country without malnutrition. And no, simply having a picky eater or one who eats a lot of junk food doesn’t mean that he will be helped by vitamin A if he gets measles
  • about using immunoglobulin to treat measles – the MMR vaccine and immune globulin can be used for post-exposure prophylaxis, but it is not a treatment once you have measles!
  • they misuse VAERS data to try and say the MMR vaccine is more dangerous than getting measles
Not surprisingly, the information that The Physicians for Informed Consent provides rarely matches that of the references they cite.
Not surprisingly, the information that The Physicians for Informed Consent provides rarely matches that of the references they cite.

The Physicians for Informed Consent even talks about benefits of getting measles, but somehow leaves out any talk about the risk of getting SSPE after a natural measles infection.

What else do they leave out? The idea that people who survive a measles infection can have some immunosuppression for up to two to three years! This measles-induced immune damage puts them at risk of dying from other diseases and helps explain why kids who are vaccinated against measles are also less likely to die from other childhood infections.

They even published a press release claiming that they “recently reported in “The BMJ” that every year about 5,700 U.S. children suffer seizures from the measles, mumps and rubella (MMR) vaccine.”

Their report? It was a  “letter to the editor” that anyone can submit online…

Get educated so that you aren’t fooled by this kind of propaganda and anti-vaccine talking-points.

What to Know About Measles Propaganda from The Physicians for Informed Consent

The Physicians for Informed Consent push propaganda to make you think that vaccine-preventable diseases, like measles, aren’t that bad and that vaccines are really, really dangerous.

More on Measles Propaganda from The Physicians for Informed Consent

Vaccines Statistics and Numbers

To help you get better educated about vaccines, it can help to learn some vaccine statistics and some other numbers behind vaccines.

Vaccine Statistics

For all of the talk of some folks delaying or skipping vaccines, do you know how many vaccines are given each day?

According to the CDC, from 2006 to 2016, at least 3,153,876,236 doses of vaccines were distributed in the United States. These are the vaccines that are covered by the National Vaccine Injury Compensation Program, such as DTaP, MMR, Hepatitis A and B, HPV, and flu, etc.

That’s over 286 million doses each year!

The WHO reports that 85% of infants around the world receive vaccines against DTP, polio, measles, and hepatitis B.
The WHO reports that 85% of infants around the world receive vaccines against DTP, polio, measles, and hepatitis B.

How about worldwide?

That’s harder to know, but consider that the World Health Organization reports that 85% of infants worldwide, or almost 100 million infants, get at least:

  • 3 doses of DTP
  • 3 doses of hepatitis B
  • at least one doses of measles
  • 3 doses of polio

Plus, an increasing number are getting vaccines to protect them against Hib, pneumococcal disease, rotavirus, HPV, meningitis A, mumps, rubella, tetanus, and yellow fever.

“UNICEF supplies vaccines reaching 45 per cent of the world’s children under five years old as part of its commitment to improving child survival.”

How many vaccine doses are we talking about?

A lot. UNICEF alone buys 2.8 billion doses of vaccines each year! Those vaccines are then distributed to children in over 100 countries.

Vaccine-Preventable Disease Statistics

As impressive as the number of vaccines that are given each year are the numbers about what happens when we give vaccines:

  • there are 2 to 3 million fewer deaths in the world each year because people are vaccinated and protected
  • in the Unites States, every $1 spent on vaccines provides $3 in direct benefits and up to $10 in benefits if you include societal costs
  • in developing countries, every $1 spent on vaccines provides $16 in direct benefits, but that goes up to $44 when you take “into account the broader economic impact of illness”
  • for children born in the United States during “1994–2013, routine childhood immunization was estimated to prevent 322 million illnesses (averaging 4.1 illnesses per child) and 21 million hospitalizations (0.27 per child) over the course of their lifetimes and avert 732,000 premature deaths from vaccine-preventable illnesses,” and it also “will potentially avert $402 billion in direct costs and $1.5 trillion in societal costs because of illnesses prevented”
  • only two countries continue to have wild polio – Afghanistan and Pakistan – and together, they only had 21 cases in 2017

Still, only one vaccine-preventable disease, smallpox, has been eradicated.

And worldwide, more than 3 million people still die from vaccine-preventable diseases every year, many of them young children.

Other Vaccine Numbers

There are some other numbers about vaccines and vaccine-preventable diseases folks should know:

  • the number of pediatricians who got a $3 million vaccine bonus – zero
  • the number of vaccines that contain antifreeze as an ingredient – zero
  • the number of vaccines that contain peanut oil as an ingredient – zero
  • the number of studies that link vaccines to autism – zero
  • the number of diseases that homeopathic vaccines can prevent – zero
  • the number of anti-vaccine sites that mention any benefits of vaccines – zero
  • the number of VAERS reports that are thought to be unrelated to a vaccine – 53%
  • the number of VAERS reports that are thought to be definitely caused by a vaccine – 3%
  • the number of definite VAERS reports that were serious – 1 (anaphylaxis)
  • the number of myths about vaccines that can scare you away from vaccinating and protecting your kids – 100s

Vaccines work. Vaccines are safe. Vaccines are necessary.

Get vaccinated and protected.

What’s the biggest number you should be thinking about? Way too many people are still getting and dying from vaccine-preventable diseases.

What to Know About Vaccine Statistics

Although more work needs to be done to protect more people, vaccine statistics clearly show that vaccines work and that they are safe and necessary.

More on Vaccines Statistics

Pertussis Outbreaks

Like measles and mumps, pertussis, or whooping cough, is another vaccine-preventable disease that has been increasing in recent years.

Pre-Vaccine Era Pertussis Outbreaks

Pertussis has been known since at least the Middle Ages, although the bacteria that causes pertussis, Bordetella pertussis, wasn’t discovered until 1906.

Like measles, pertussis was a top killer of young children in the pre-vaccine era.
Like measles, pertussis was a top killer of young children in the pre-vaccine era.

That discovery led to the later development of the first pertussis vaccines, but before then, pertussis was a big killer, with epidemic cycles every 2 to 5 years.

During one of these cycles in the United States, from 1926 to 1930, there were:

  • 909,705 cases, and
  • 36,013 deaths

Unfortunately, even natural infection doesn’t provide life-long immunity, so adults would get pertussis and give it to susceptible kids, who were most likely to die during these epidemics.

But even in non-epidemic years, a lot of folks got pertussis. The number of reported cases ranged from “just” 161,799 in 1928 to 202,210 in 1926. And during one of the biggest years, 1934, there were 265,269 cases!

Post-Vaccine Era Pertussis Outbreaks

That changed in the vaccine era.

The first pertussis vaccines were developed in the 1930s and became more widely used in the 1940s when it was combined into the whole-cell DTP vaccine.

This was replaced with the acellular DTaP vaccine in 1997, with the Tdap vaccine being added to the vaccine schedule in 2006.

These vaccines helped to greatly reduce how many people got pertussis and how many people died from pertussis:

  • 1940 – 183,866 cases
  • 1950 – 120,718 cases and 1, 118 deaths
  • 1960 – 14,809 cases and 118 deaths
  • 1970 – 4,249 cases and 12 deaths
  • 1980 – 1,730 cases and 11 deaths
  • 1990 – 4,570 cases and 12 deaths
  • 2000 – 7,867 cases and 12 deaths
  • 2010 – 27,550 cases and 26 deaths

They never eradicated pertussis though, and as you can see, recently, pertussis cases have started to rise again.

Is it a coincidence that whooping cough came back as more folks began to skip and delay vaccines for their kids?
Is it a coincidence that whooping cough came back as more folks began to skip and delay vaccines for their kids?

In 2012, there were 48,277 cases of pertussis in the United States, the most since 1950, when we had 68,687 cases. Unfortunately, with the rise in cases, we are also seeing the tragic consequences of this disease – 20 deaths in 2012, mostly infants under age 3 months.

Pertussis cases remained steady, but high, in 2013 and 2014, at around 30,000 cases in the United States.

In California, pertussis reached epidemic levels. The California Department of Public Health reported at least 11,114 cases in 2014 – the highest numbers of pertussis cases in the state in 70 years!

And as expected with the rise in cases, there were 3 pertussis related deaths in California that year – all infants who had contracted pertussis when they were less than 8 weeks old. Two of the infants became sick in 2013, but the third, a 5-week-old baby, got infected in 2014.

Another baby, only 25 days old died in early 2015, but will be counted as the 2nd death of 2014 since that is when the illness started. About 383 patients, mostly infants who are less than 4 months old, were hospitalized in California that year, including 80 who required intensive care. And according to the California Department of Public Health, about 82% of the cases in infants were born to mothers who did not receive a dose of Tdap during their third trimester of pregnancy.

What’s happened since then?

Pertussis cases are continuing to fall each year! In fact, with about 16,000 cases in the United States, 2017 may have ended with the lowest number of pertussis cases since 2008.

Still, with just 1,830 pertussis cases in California in 2016, there were two deaths – both infants who were younger than 3 months of age when they got sick. And there was at least one death in 2017, with similar rates of disease, although reports are still preliminary.

Why So Many Pertussis Outbreaks?

Ever since a 2010 California pertussis outbreak, in which there were 9,154 cases of pertussis, the most in 63 years, and 10 infants died, many people, especially parents, began wondering why we were seeing more pertussis these days.

Is it because the pertussis vaccines simply don’t work, as the anti-vaccine movement would have you think?

Or is it because there are higher rates of unvaccinated kids these days and parents using alternative immunization schedules, instead of the standard immunization schedule from the CDC?

James Cherry, MD is an expert on pertussis and pertussis vaccines.
James Cherry, MD is an expert on pertussis and pertussis vaccines.

A commentary, Why Do Pertussis Vaccines Fail?, by James Cherry, MD, gave us some answers.

While the title of the article might have you think that all of the blame lies with the pertussis vaccines, that certainly isn’t the case. While there can be vaccine failures with the pertussis vaccines, just like any other vaccine, that doesn’t mean that the vaccine doesn’t work for most children.

One of the problems is that the DTaP vaccine likely isn’t as effective as the older DTP vaccine. So instead of efficacy of 84 to 85%, as was once believed, it is likely closer to just 71 to 78%.

Other issues, including waning immunity, the possibility of an incorrect balance of antigens in the vaccine that could create a blocking effect, and genetic changes in the B. pertussis bacteria, could also possibly lead to increased vaccine failure rates.

So it isn’t that the pertussis vaccines don’t work.

That should be easy to see when you look at the pertussis rates in California, when the highest rates by far were in infants less than 6 months of age (434 per 100,000 people). In contrast, children who were 6 months to 6 years old had a rate of only 62 per 100,000.

And the results of a study that were presented at the 49th annual meeting of the Infectious Diseases Society of America in Boston show just how important the pertussis vaccine is, as:

  • vaccine effectiveness was 98.1 percent among children who received their 5th dose within the past year
  • long term effectiveness – children who were five or more years past their last DTaP dose – was about 71 percent
  • children who had never received any doses of DTaP (unvaccinated children) faced odds of having whooping cough at least eight times higher than children who received all five doses

It is also important to note that the high rates seen in 2010 in California are still well below the rates that were seen in the pre-vaccination era, when the attack rate of pertussis in the United States was as high as 157 per 100,000 people, with about 200,000 cases a year.

What’s the answer?

“The present “resurgence of pertussis” is mainly due to greater awareness and the use of PCR for diagnosis. There are also many other factors which have contributed to the “resurgence.” New vaccines are clearly needed; with our present vaccines (DTaP and adolescent and adult formulated tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap)), if used correctly, severe pertussis and deaths in infants can be prevented.”

James D. Cherry, MD on The History of Pertussis (Whooping Cough); 1906 – 2015: Facts, Myths, and Misconceptions

It certainly isn’t for more kids to follow non-standard, parent-selected, delayed protection vaccine schedules or to simply skip vaccines all together. Since natural immunity isn’t going to keep newborns and infants from getting pertussis, the ages which are most at risk for life-threatening infections, they can catch pertussis from people around them, including those working on their natural immunity. Natural infections don’t even provide life-long protection against pertussis, as some people believe. That natural immunity wanes fairly quickly too.

Not Vaccinated? No Kisses!
Not Vaccinated? No Kisses!

The future of pertussis control is more likely going to be in maximizing our current vaccination program, including getting more teens and adults to get the Tdap vaccine, especially when women are pregnant.

That’s the best strategy, at least until new pertussis vaccines are developed. It provides a lot of benefits. According to the CDC, like with the flu vaccine, when you get a pertussis vaccine, in addition to protecting yourself and those people around you, “people who do catch whooping cough after being vaccinated are much less likely to be hospitalized or die from the disease.”

Unfortunately, not everyone has gotten the message. And because of waning immunity, children who aren’t vaccinated against pertussis can’t “hide in the herd” and rely on the rest of us who do vaccinate our children to provide them with protection. Instead, since they are at a higher risk, they get pertussis and get even more people sick.

This slogan, during a whooping cough epidemic, reminded parents to get their kids vaccinated now.
This slogan, during a whooping cough epidemic, reminded parents to get their kids vaccinated now.

In one study, Parental refusal of pertussis vaccination is associated with an increased risk of pertussis infection in children, researchers found that “vaccine refusers had a 23-fold increased risk for pertussis when compared with vaccine acceptors, and 11% of pertussis cases in the entire study population were attributed to vaccine refusal.” The highly contagious nature of pertussis then means every primary case is probably going to infect as many as 17 other people. That’s why it makes sense that higher rates of children using vaccine exemptions could be at least one of the factors in these outbreaks.

In fact, several studies, including, Geographic Clustering of Nonmedical Exemptions to School Immunization Requirements and Associations With Geographic Clustering of Pertussis, found that “geographic pockets of vaccine refusal are associated with the risk of pertussis outbreaks in the whole community.”

Get educated. Vaccines are safe and as you can see with the rise in outbreaks, vaccines are necessary.

What to Know About Pertussis Outbreaks

Many factors are responsible for the rise in pertussis outbreaks in recent years, but it is clear that being unvaccinated and unprotected put you at greatest risk for getting pertussis and passing it on to others.

More on Pertussis Outbreaks

What Are the Benefits of Natural Immunity?

In the pre-vaccine era, we had outbreaks of polio, and other, now vaccine-preventable diseases.
What are the benefits of getting polio?

Is natural immunity – the kind of immunity you get from actually getting a disease – better than immunity from a vaccine?

All things being equal, sure.

Unfortunately, all things aren’t equal when it comes to the question of natural immunity vs ‘artificial’ or vaccine induced immunity.

Vaccines are safe and have few serious side effects, while vaccine-preventable diseases can be life-threatening and can leave survivors with serious disabilities.

What Are the Benefits of Natural Immunity?

There are benefits of natural immunity.

If you get a disease, like measles or rubella, you typically have life-long immunity and won’t get it again.

That immunity comes at a price though.

In addition to being sick for a few days or weeks with the symptoms of the disease, many vaccine-preventable diseases can have serious complications. Most are life-threatening.

“…the high price of natural immunity, that is, occasionally severe and fatal disease, is a risk not worth taking.”

Paul Offit, MD

So instead of just getting a vaccine, you have to earn your natural immunity by surviving the disease and hoping that you don’t have any of these serious complications:

  • chicken pox can be associated with meningitis, encephalitis, secondary pneumonia, skin infections, and sometimes death, and folks who have had chicken pox are thought to be at higher risk for shingles than those who have had a chicken pox vaccine
  • diphtheria can cause myocarditis, neuritis, and diaphragmatic paralysis, and death in 5 to 20 percent of people
  • about 50 percent of children (and 90 percent of infants) with hepatitis B develop chronic hepatitis B infections and can later develop scarring of the liver (cirrhosis), liver failure, and liver cancer
  • Hib can cause hearing impairment, neurologic sequelae, and death in 2 to 5 percent of cases
  • measles can cause pneumonia, seizures, and encephalitis, and death in about 1 in 1000 cases and Subacute Sclerosing Panencephalitis (SSPE) is a fatal, late complication of natural measles infections and which might occur in as many as 1:1700 people who have had measles.
  • mumps can cause orchitis (testicular inflammation), oophoritis (ovarian inflammation), pancreatitis, meningitis, encephalitis, deafness, and sometimes death
  • pertussis can cause pneumonia, seizures, and encephalopathy, and death in 0.2 percent of cases.
  • polio can cause meningitis, flaccid paralysis, and death in 2 to 5 percent of children and 25 to 40 percent survivors are at risk for Post-Polio Syndrome, with new symptoms of pain, fatigue, and weakness developing later
  • rotavirus can cause severe diarrhea and dehydration and used to cause 20 to 60 deaths a year.
  • rubella can cause arthritis, thrombocytopenic purpura, and encephalitis, but the bigger concern is pregnant women who get rubella, which can lead to spontaneous abortions, neonatal deaths, and congenital rubella syndrome.
  • tetanus can cause generalized muscle spasms and death in 11 percent of cases. Neonatal tetanus is also a concern.

That’s why for most of us, there is no question.

Our kids are fully vaccinated and we are very glad that they have artificial immunity against measles, Hib, pneumococcal disease, and hepatitis B, etc.

Myths About Natural Immunity

And people shouldn’t get confused about “natural” immunity.

It doesn’t mean that you just wake up and have immunity against a disease one day naturally. Again, you have to earn that immunity, by getting sick with the disease and hoping you don’t have any complications, some of which can be life-threatening. That’s why it is silly to think about checking titers if you haven’t been vaccinated or had a disease already, even though some anti-vaccine people propose doing that.

Even the idea that getting an infection provides life-long immunity isn’t always true. It certainly isn’t for some diseases, like pertussis or tetanus.

And getting one type of an infection doesn’t always mean that you will be protected against others. There are three serotypes of polio, for example, and immunity is serotype-specific. You would have to get all three serotypes of polio to equal the protection of the polio vaccine!

Other myths about natural immunity you may hear include that it is good to have childhood diseases, like measles or diphtheria.

That is of course ridiculous.

“Vaccination has greatly reduced the burden of infectious diseases. Only clean water, also considered to be a basic human right, performs better. Paradoxically, a vociferous antivaccine lobby thrives today in spite of the undeniable success of vaccination programmes against formerly fearsome diseases that are now rare in developed countries.”

Andre et al on Vaccination greatly reduces disease, disability, death and inequity worldwide

In fact, we now know that people who survive a measles infection can have some immunosuppression for up to two to three years! This measles-induced immune damage puts them at risk of dying from other diseases and helps explain why kids who are vaccinated against measles are also less likely to die from other childhood infections.

That’s not a benefit that you can get without a vaccine. And since the risks from vaccines are so small, there is no benefit of seeking natural immunity over getting vaccinated.

What to Know About the Benefits of Natural Immunity

The benefit of natural immunity, developing life-long immunity, comes at such a high price that it is not worth skipping or delaying your child’s vaccines to get it.

More on the Benefits of Natural Immunity