Tag: herd immunity

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

Vaccine Analogies and Metaphors

Analogies and metaphors are a good way to explain things, including that vaccines are safe and necessary.

We are sunk if we stop vaccinating.
As the CDC explains, we are sunk if we stop vaccinating.

Here are some of my favorite vaccine analogies and metaphors.

Getting vaccinated is like:

  • applying sunscreen before going to the beach
  • applying insect repellent before going camping in the woods
  • making sure that your kids are wearing a seat belt or sitting in an age-appropriate car seat or booster seat when you get in the car
  • installing anti-virus software on your new computer

When do you put on your seat belt? When you get in the car, before you get in an accident. Just like a vaccine. You get it before you get sick. Yes, some vaccines do work after you have been exposed to an illness, but they don’t work after you are already sick.

There is a problem with these metaphors though; they don’t include the risks to other people.

These do:

  • taking driver’s ed and getting your license before driving
  • taking swimming lessons before going in the water without a life jacket
  • putting your gun in a locked safe
  • putting a fence around your backyard so that no one in your neighborhood can drown in your pool
  • making sure folks don’t text and drive

That’s right.

Vaccination equals protection.

And not just protection for the person getting vaccinated. Being unvaccinated puts others at risk too, as you might start an outbreak.

Getting your kids vaccinated is like taking them to swimming lessons instead of just throwing them in the lake. Either way they can learn to swim and have protection/immunity from drowning. But one method (throwing them in the lake) is much more dangerous than the other.

Analogies can also help explain how vaccines work.

“Vaccines are a like a wanted poster, they just show your body what the bad guys look like, so when faced with them for real you are ready, prepared, and able to stop them before they cause harm.”

Can vaccines overwhelm the immune system?

Are there analogies that explain the idea of free-riders – folks who intentionally don’t vaccinate their kids and attempt to hide in the herd?

“If all my child’s friends are vaccinated, won’t he be protected by herd immunity? Why should I put my child at risk for vaccine reactions if all the other children around him are already immune?

This is like riding in a carpool where everyone contributes each month to pay for gas, repairs and parking. One morning, a new neighbor shows up and says, “I think I’ll ride along with you. But I’m not going to pay, since you’re going downtown anyway and you have an empty seat.” If enough people choose to take a free ride on other children’s immunity, herd immunity will soon disappear.”

Why is herd immunity so important?

And to explain the idea of what some folks consider vaccine injuries.

“I have found that it sometimes helps to give parents an analogy. I ask them the following: If they were to put gas in their car and then later got a flat tire, would that mean putting gas in the car had caused the flat tire? No. The two events were just a coincidence.”

Karen Lewis on What Vaccine Safety Means

What are some good analogies to describe how some anti-vax folks think?

Since that bridge isn’t 100% safe (I Googled that some bridges have collapsed), I’m going to let my kids swim across this river with fast moving water.

Have you heard the bridge analogy?

There are also versions with crocodiles in the water…

In case it’s not clear, in this analogy, walking across the bridge is like getting vaccinated. Swimming across the river is like intentionally not vaccinating your kids.

There are plenty of other good analogies that help to explain the importance of vaccines.

“Clusters of unvaccinated people are like patches of dry grass that, with a single match, can start a wildfire that will burn not only dry material, but sometimes wet as well. The match could be a student who returns from a trip abroad with measles or a train commuter with whooping cough.”

Saad Omer

It’s also important to remember that anyone, even those who are well prepared, can get burned in a wildfire. That’s why the analogy works so well.

“Vaccinating one’s children is like paying taxes. We all have a moral and a legal duty to pay taxes because we have a moral and a legal duty to contribute to the upkeep of our society and to its public goods (e.g., a good public health system, national defence, etc.).”

Vaccine Refusal Is Like Tax Evasion

Why are we concerned about those who are unvaccinated if our own children are fully vaccinated?

“Think of camping as an analogy. If everyone at a campground properly stores their food, bears won’t be enticed to come around. If even one person leaves their food unprotected, it invites bears in to investigate all the campsites for opportunities to eat.”

How does choosing not to immunize affect the community?

These analogies help explain how unvaccinated folks put others at risk.

“Being intentionally unvaccinated against highly contagious diseases is, to carry Holmes’ analogy a bit further, like walking down a street randomly swinging your fists without warning. You may not hit an innocent bystander, but you’ve substantially increased the chances that you will.

One might usefully analogize the risk of disease to a crapshoot. A person’s chance of being infected is, as Dr. Singer acknowledges, a matter of luck. But is it really OK for the unvaccinated to load the dice to increase the odds against other people? If so, by how much?”

Ronald Bailey on Vaccines and the Responsibility To Not Put Others at Risk

Of course, there are plenty of bad vaccine analogies and metaphors that anti-vaccine folks push:

  • getting vaccinated is like rape
  • getting vaccinated is like the Holocaust
  • “genes load the gun but the vaccines pull the trigger”
  • vaccine manufacturers are like tobacco manufacturers
  • I won’t set my child on fire to keep yours warm (this doesn’t work as a vaccine analogy, mostly because there is no benefit to setting your child on fire. Would an anti-vaxxer let their child start a campfire to keep their friends from dying in the cold?)
  • getting a vaccine is like eating a handful of M&Ms out of a big bowl when you know that a few have been poisoned
  • getting a child  vaccinated is like giving 1,000 kids 1,000 cupcakes, telling them to pick one and eat it, knowing that one of the cupcakes is poisoned (it’s maybe like letting a child with a severe peanut allergy choose a cupcake, knowing that there is a one in a million chance that the cupcake he chooses has been made with peanuts…)
  • I want safer cars, but that doesn’t make me anti-car

You understand why the anti-car one is a bad analogy, right? Folks who want safer cars generally still drive and ride in cars!

Have you heard any good or bad analogies or mataphors about vaccines?

More on Vaccine Analogies and Metaphors

Why Are the DPT and OPV Vaccines Still Used in Some Countries?

As most folks know, neither the DPT nor OPV vaccines are used in the United States.

Pope Francis helped launch a polio vaccine campaign when he visited Mexico in 2016.
Pope Francis helped launch a polio vaccine campaign when he visited Mexico in 2016.

That they are still used in other countries likely raises some questions for those folks that get them.

Why Are the DPT and OPV Vaccines Still Used in Some Countries?

As I am sure you have guessed, there is no conspiracy about the continued use of these vaccines in other parts of the world. We aren’t getting rid of old stocks of vaccines or using cheaper vaccines in poorer parts of the world.

So what’s the reason?

To understand why they are still used in other countries, it helps to understand why they aren’t used here.

Remember that the DPT vaccine, which protects folks against diphtheria, pertussis, and tetanus, came under attack in the 1970s and 80s as some folks blamed the vaccine for causing vaccine injuries, including seizures and encephalopathy. It didn’t, but we still got a new vaccine, DTaP, which doesn’t seem to work as well.

“Although concerns about possible adverse events following their administration have led to the adoption of acellular pertussis vaccines in some countries, whole-cell pertussis vaccines are still widely produced and used globally in both developed and developing countries. Whole-cell pertussis vaccines that comply with WHO requirements, administered according to an optimal schedule have a long and successful record in the control of whooping cough. Furthermore, the excellent efficacy of some currently available whole-cell pertussis vaccine has also been shown, not only in recent clinical trials, but also on the basis of the resurgence of disease where vaccination has been interrupted or when coverage has markedly decreased. Therefore, WHO continues to recommend whole-cell pertussis vaccines for use in national immunization programmes.”

WHO on Recommendations for whole-cell pertussis vaccine

The WHO now recommends that if countries do switch to DTaP,  the acellular pertussis vaccine, they should be prepared to add additional periodic booster doses and immunizations during pregnancy, which may still “may not be sufficient to prevent resurgence of pertussis.”

The OPV vaccine, on the other hand, was replaced because it can rarely cause vaccine-associated paralytic polio (VAPP) and circulating vaccine-derived polio virus (cVDPV). Of course, it does it at much lower rates than wild polio virus, so until polio is well controlled, the benefit of using OPV outweighs the risk. In addition to being less expensive and easier to use, OPV has the benefit over IPV of providing better herd immunity.

At some point, as we did in the United States in 2000, countries make a switch to the IPV vaccine.

In 2016, remaining countries that use OPV switched from trivalent OPV to bivalent OPV, because wild polio virus type 2 was eradicated in 1999. Once the remaining two types are eradicated, we can stop using the OPV vaccine altogether.

Until then, countries either use:

  • OPV plus one dose of IPV
  • sequential IPV-OPV schedules – high vaccine coverage and low risk of wild polio importation
  • IPV only schedules – sustained high vaccine coverage and very low risk of wild polio importation

So there is no conspiracy. These vaccines are safe and they work.

Without them, there would be over:

  • 1.3 million pertussis related deaths each year
  • 600,000 cases of paralytic polio each year

With most of these cases affecting young children.

More on the Continued Use of DPT and OPV Vaccines

How Contagious Is Measles?

Did you hear about the folks in New York who got quarantined isolated on the Emirates plane from Dubai?

Turns out that about 10 passengers had the flu or other cold viruses.
Although the worry was likely about MERS, it turns out that about 19 passengers had the flu or other cold viruses.

News like that and folks getting exposed to other infectious diseases, probably has them wondering just how contagious these diseases are. Do you have to be sitting next to someone to get them? In the same row? On the same floor?

Understanding Your Risk of Catching a Disease

Fortunately, most diseases are not terribly contagious.

We worry about some things, like SARS and Ebola, because they are so deadly, not because they are so contagious or infectious.

Wait, contagious or infectious? Aren’t they the same thing?

To confuse matters, some infectious diseases aren’t contagious, like Lyme disease. And some vaccine-preventable diseases are neither infectious nor communicable. Think tetanus. You may have never thought of it that way, but you aren’t going to catch tetanus from another person. Of course, that’s not a good reason to skip getting a tetanus shot!

To understand your risk of getting sick, you want to understand a few terms, including:

  • infectious disease – a disease that can be transferred to a new host
  • communicable – an infectious disease that can be transferred from one host to another
  • non-communicable – a non-infectious disease which can not be transferred from one host to another
  • contagiousness – an infectious disease that is easily transferred from one person to another
  • infectivity – the ability of an infectious agent to cause an infection, measured as the proportion of persons exposed to an infectious agent who become infected. Although this doesn’t sound much different from contagiousness, it is. The Francisella tularensis bacteria is highly infectious, for example, to the point that folks exposed to a culture plate are given antibiotics or put on a fever watch. Few of us get tularemia though, because transmission is through tick bites, hunting or skinning infected rabbits, muskrats, prairie dogs and other rodents, or inhaling dust or aerosols contaminated with F. tularensis bacteria. So if you get exposed, you will probably get sick, but there is a low probability for getting exposed.
  • incubation period – the time it takes to start having symptoms after you are exposed to an infectious disease. A longer incubation period increases the chances that someone will get exposed to a disease and travel home before getting sick. A shorter incubation period, like for influenza, means that a lot of people can get sick in a short amount of time.
  • contagious period- the time during which you can spread the illness to other people and may start before you have any symptoms
  • quarantine – used to separate people who have been exposed to a contagious disease and may become sick, but aren’t sick yet
  • isolation – used to separate people who are already sick with a contagious disease
  • transmission – how the disease spreads, including direct (direct contact or droplet spread) vs indirect transmission (airborne, vehicleborne, or vectorborne)
  • R0 (r nought) – the basic reproductive number or the number of new infections originating from a single infectious person among a total susceptible population
  • Rn – the net reproductive number, which takes into account the number of susceptibles in a community
  • infectious period – how long you are contagious

Got all that?

How Contagious Is Measles?

If not, understanding how easily you can get measles should help you understand all of these terms.

Measles is highly contagious, which is likely why all of the Brady kids got sick.
Measles is highly contagious, which is likely why all of the Brady kids got sick.

Measles is highly contagious, with a very high R0 number of 12 to 18.

That’s because:

  • the measles virus can live for up to two hours on surfaces and in the airspace where an infected person coughed or sneezed
  • infected people are contagious for up to four days before they have a rash and even know that they have measles, so expose lots of people even if they get put in isolation once they get diagnosed
  • infected people continue to be contagious for up to four days after the rash appears, so can continue to expose people if they aren’t put in isolation

So you don’t need to have someone with measles coughing in your face to get sick. If they coughed or sneezed at the grocery store, on the bus, or at your doctor’s office and then you entered the same area within two hours, then you could be exposed to the measles virus and could get sick.

Why don’t we see at least 12 to 18 people in each measles outbreak anymore?

That’s easy. The definition for R0 is for a total susceptible population. Most folks are vaccinated and protected, so even if they are around someone with measles, they typically won’t get sick.

Still, up to 90% of folks who aren’t immune and are exposed to measles will catch it. That includes infants too young to be vaccinated, kids too young to be fully vaccinated, and anyone who has a true medical exemption to getting vaccinated.

The measles has a very high R0 is easier to see when you compare it to those of some other diseases

 

Infection R0
Diphtheria 6-7
Ebola 1.5-2.5
Flu 1.4-4
MERS 2-8
Mumps 4.7
Pertussis 5-17
Polio 2-20
RSV 3
SARS 2-5
Smallpox 5-7
Varicella 8-10

Why such a big range for some diseases?

These are estimates and you are more or less contagious at different stages of each illness.

Fortunately, in most cases you can just get vaccinated and protected and don’t have to worry too much about them.

More on the Contagious Periods of Diseases

Catch-Up Immunization Plans for Adults

It isn’t hard to figure out how to catch-up kids when they fall behind on their vaccines.

After all, the CDC publishes catch-up immunizations schedules for both younger kids and teens.

Catch-Up Immunization Plans for Adults

What happens when an unvaccinated adult needs to get caught up?

Adults need vaccines too, especially if they have never been vaccinated before.
Adults need vaccines too, especially if they have never been vaccinated before.

They essentially follow the catch-up immunization plan for teens, with a few exceptions:

Are you an adult that needs to get caught up because you have never been vaccinated, your parents skipped or delayed some vaccines, or you lost your immunization records?

Get caught up! It’s likely easier than you think.

More on Catch-Up Immunization Plans for Adults

Vaccine Signs You Might See at Your Pediatricians Office

Does your pediatrician have any signs or posters up on the doors or walls?

If they do, it is probably just a sign alerting you that flu vaccines are available or a reminder to cover their cough when they are sick.

Or maybe they have some educational posters up to educate parents about the overuse of antibiotics, how to wash your hands, or when to call poison control.

Vaccine Signs You Might See at Your Pediatricians Office

Some pediatricians also have signs and posters about vaccines and vaccine preventable diseases:

Do your kids get a lollipop after their vaccines, or just protection against life-threatening diseases?
Do your kids get a lollipop after their vaccines, or just protection against life-threatening diseases?
Thank vaccines and herd immunity.
Thank vaccines and herd immunity.
Skipping some vaccines? Are you going to say sorry if your kids get a vaccine-preventable disease?
Skipping some vaccines? Are you going to say sorry if your kids get a vaccine-preventable disease?
Does your pediatrician have separate waiting rooms for unvaccinated kids?
Does your pediatrician have separate waiting rooms for unvaccinated kids?
There is no benefit, just extra risks, if you delay your child's vaccines.
There is no benefit, just extra risks, if you delay your child’s vaccines.
Vaccine preventable diseases are just a plane ride away.
Vaccine preventable diseases are just a plane ride away. Get vaccinated before you travel.
Parents of Earth, are your children fully immunized?
Long ago, everyone vaccinated their kids.
Unvaccinated children exposed to measles are quarantined for at least 21 days.
Hopefully you will never see a quarantine sign at your pediatrician’s office.

Got questions about vaccines?

Get your answers before your pediatrician puts up a sign that they are firing all unvaccinated kids.

More Vaccine Signs and Posters

Vaccine Movies and Videos

All of the attention that Robert De Niro gave the movie Vaxxed has many people realizing that there are anti-vaccine movies out there.

Promoted as documentaries, they mostly include the same anti-vaccine ‘experts’ that scare parents away from vaccinating their kids on the Internet.

These types of movies include:

  • Vaxxed
  • The Greater Good
  • Trace Amounts
  • Who Killed Alex Spourdalakis?
  • Bought
  • Man Made Epidemic
  • Sacrificial Virgins
  • The Truth About Vaccines

Most are propaganda, without even a trace amount of truth in them, and should not be used as a research tool to help you make a decision about vaccines.

Vaccine Movies and Documentaries

What about movies to actually help you get educated about vaccines?

Every Last Child takes a look at the fight to end polio in Pakistan.
Every Last Child takes a look at the fight to end polio in Pakistan.

Watch these movies and documentaries:

Have you seen or heard about any of these movies about vaccines?

Vaccine Videos

Just as bad as so-called vaccine documentaries, many of the vaccine videos that you find on You-Tube are also filled with misinformation and propaganda, including many vaccine scare videos.

Where are you Jon Stewart? Measles is still around...
Where are you Jon Stewart? Measles is still around…

Watch the following vaccines videos instead:

Still have questions?

More on Vaccine Movies and Videos