Tag: ITP

Are Fewer Than 1% of Vaccine Injuries Reported to VAERS?

It is a common anti-vaccine argument that fewer than 1% of vaccine injuries are reported to VAERS.

I've found that fewer than 1% of anti-vaccine signs are true...
I’ve found that fewer than 1% of anti-vaccine signs are true…

They even think that they have evidence from Harvard to support their claim!

Are Fewer Than 1% of Vaccine Injuries Reported to VAERS?

Do they?

Are fewer than 1% of vaccine injuries reported to VAERS?

It has long been suspected that reports to VAERS are under-reported, as it is a passive reporting system.

The original claims for under-reporting to VAERS were based on an old study about drug reactions and were not specific to vaccines though.

Is that the Harvard study?

Nope.

“Restructuring at CDC and consequent delays in terms of decision making have made it challenging despite best efforts to move forward with discussions regarding the evaluation of ESP:VAERS performance in a randomized trial and comparison of ESP:VAERS performance to existing VAERS and Vaccine Safety Datalink data. However, Preliminary data were collected and analyzed and this initiative has been presented at a number of national symposia.”

Electronic Support for Public Health–Vaccine Adverse Event Reporting System (ESP:VAERS)

They are talking about a report, Electronic Support for Public Health–Vaccine Adverse Event Reporting System (ESP:VAERS), that was conducted at Harvard Pilgrim Health Care, Inc.

“Preliminary data were collected from June 2006 through October 2009 on 715,000 patients, and 1.4 million doses (of 45 different vaccines) were given to 376,452 individuals. Of these doses, 35,570 possible reactions (2.6 percent of vaccinations) were identified.”

Electronic Support for Public Health–Vaccine Adverse Event Reporting System (ESP:VAERS)

It is very important to note that all the study found is that all possible reactions, including minor reactions, like pain and fever, are not common.

They didn’t actually finish the report to see how commonly those reactions were reported to VAERS.

But we already know that more serious reactions are reported to VAERS much more routinely.

“Sensitivities ranged from 72% for poliomyelitis after the oral poliovirus vaccine to less than 1% for rash and thrombocytopenia after the MMR vaccine.”

Rosenthal et al on The reporting sensitivities of two passive surveillance systems for vaccine adverse events

And there has even been a more recent report, Advanced Clinical Decision Support for Vaccine Adverse Event Detection and Reporting, which also used an ESP-VAERS system, that found great improvements in reporting of adverse events to VAERS.

Even more importantly, even with it’s limitations, VAERS works!

“Despite its limitations, VAERS effectively detected a possible problem soon after introduction of RRV-TV in the United States.”

Lynn R. Zanardi, et al on Intussusception Among Recipients of Rotavirus Vaccine: Reports to the Vaccine Adverse Event Reporting System

Although it would be ideal to have even more reports sent to VAERS, time and again, we have seen that VAERS works.

“On November 23, 2010, the combination of the coding term “febrile convulsion” and the Fluzone(®) TIV product exceeded a predetermined threshold in the VAERS database. By December 10, we confirmed 43 reports of febrile seizure following TIV in children aged 6-23 months. Clinical features of most reports were consistent with typical uncomplicated febrile seizures, and all children recovered. Further epidemiologic assessment of a possible association between TIV and febrile seizures was undertaken in a separate, population-based vaccine safety monitoring system.”

Leroy et al on Febrile seizures after 2010-2011 influenza vaccine in young children, United States: a vaccine safety signal from the vaccine adverse event reporting system.

As we have seen, for VAERS to work, we don’t need all side effects and reactions to be reported.

“VAERS is primarily a safety signal detection and hypothesis generating system. Generally, VAERS data cannot be used to determine if a vaccine caused an adverse event. VAERS data interpreted alone or out of context can lead to erroneous conclusions about cause and effect as well as the risk of adverse events occurring following vaccination.”

Shimabukuro et al on Safety monitoring in the Vaccine Adverse Event Reporting System (VAERS).

Also, VAERS is not the only safety system that we have to make sure that our vaccines are safe.

The other thing that folks should understand? Most reports to VAERS are not actually vaccine injuries

More on the Percentage of Reports to VAERS

Will SB276 Revoke Legitimate Medical Exemptions?

Bob Sears has already said that SB276 will eliminate medical exemptions and stop doctors from writing medical exemptions.

ITP after MMR is not a reason to get a medical exemption for all vaccines…

What is he saying now?

Will SB276 Revoke Legitimate Medical Exemptions?

Bob Sears is saying that SB276 will revoke legitimate medical exemptions from children who have had “seizures, nerve injuries, and severe allergic reactions after vaccines.”

He also says that they “will be forced to continue just to stay in school.”

To be clear, neither SB276 nor any other vaccine law in the United States forces anyone to get vaccinated.

Yes Bob Sears, what do you mean forced to stay in school?
Yes Bob Sears, what do you mean forced to stay in school?

Although implying forced vaccination is a common anti-vaccine tactic, even his own followers called him out on it…

What else can you see from reading the comments to Bob’s post?

Some medical exemptions might be revoked under SB276, but it isn’t because they are legitimate.

ITP would not be a reason to get a medical exemption to all vaccines.
ITP would not be a reason to get a medical exemption to ALL VACCINES.

A rash that turned in ‘purple blobs’ after the MMR vaccine sounds like it could be ITP, which is actually a table injury.

Since the ACIP lists that as a precaution to getting another dose of MMR, you would almost certainly get a medical exemption, but not to all vaccines!

While scary for parents, ITP typically goes away on its own without treatment in about two weeks to six months.

Anyway, SB276 doesn’t revoke legitimate medical exemptions.

If you actually read SB276, as amended, what it does do is trigger a review by medical professionals to “identify those medical exemption forms that do not meet applicable CDC, ACIP, or AAP criteria for appropriate medical exemptions” if:

  • a school’s immunization rate drops below 95%
  • a doctor writes five or more medical exemptions in a single year (although that doesn’t sound like a lot, keep in mind that true medical exemptions are not very common, so the average doctor who is only writing medical exemptions for their own patients likely won’t write that many each year)
  • a school doesn’t report it’s immunization rates

And once reviewed, inappropriate medical exemptions can be revoked, although that process can be appealed by a parent who thinks that their child does indeed have a legitimate medical exemption.

Keep in mind that just because a doctor writes more than 5 exemptions in a single year, that doesn’t mean that they will automatically be revoked. That simply triggers a review. Even if the doctor writes 10 or 20, if they are legitimate exemptions, then they will be allowed.

Again, SB276 doesn’t revoke legitimate medical exemptions.

Why does Bob Sears think that it does?

Maybe because many of things that Bob Sears considers to be legitimate medical exemptions actually aren’t, which is why he is already under investigation, even before SB276 is enacted…

More on Legitimate Medical Exemptions

How Long Do Side Effects of Immunizations Last?

Immunizations are safe, but they can have some risks and side effects.

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

Fortunately, most are fairly mild, like pain and fever.

How Long Do Side Effects of Immunizations Last?

And most vaccine side effects go away quickly.

For example, fever and fussiness, two of the most common vaccine reactions, typically only lasts a day or two.

Others can last a little longer, but still usually go away on their own:

  • when kids get a rash after their MMR vaccine, it might last three or four days
  • even when kids get swelling of an entire arm or leg after the DTaP shot is given, it might last for 1–7 days
  • pain at the injection site typically only lasts a few days
  • shoulder injury related to vaccine administration (SIRVA) can last months and sometimes doesn’t go away
  • arthritis after a rubella containing vaccine, which mostly occurs in adults, typically only lasts a few days
  • febrile seizures are usually brief and rarely lead to non-febrile seizures
  • immune thrombocytopenic purpura (ITP) after a measles containing vaccine resolves in two weeks to six months, typically without any treatment
  • intussusception after a rotavirus vaccine resolves with treatment, either an air contrast enema or surgery
  • Guillain-Barré Syndrome after a seasonal flu vaccine, which is very rare, resolves in the majority of people over a period of years

Do any have more long lasting effects?

VAPP or vaccine-associated paralytic polio after the oral polio vaccine might not resolve. Fortunately, it only occurs in about 1 in every 1.27 million children receiving their first dose of OPV. It is even less common after bOPV, which is oral polio vaccine that is now being used. And won’t happen at all once we stop using oral polio vaccines.

Encephalitis or encephalopathy after a pertussis or a measles, mumps, and rubella virus containing vaccine might also lead to long lasting effects.

And some, like anaphylaxis, are life-threatening.

Fortunately, most long-term vaccine studies have shown that immunizations are safe, rarely causing severe reactions, and don’t have many long term side effects.

What to Know About How Long Immunization Side Effects Last

Most vaccine side effects are mild and only last a few days.

More on Immunization Side Effects

Autoimmunity as a Contraindication to Getting Vaccinated

Can your kids get vaccinated if they have an autoimmune disease?

Can your kids get vaccinated if you or another family member have an autoimmune disease?

Folks shouldn't be using 23andMe DNA testing to justify their not wanting to vaccinate their kids.
Folks shouldn’t be using 23andMe DNA testing to justify their not wanting to vaccinate their kids.

Can your kids get vaccinated if you did one of those 23andMe genetic risk type tests?

“Risks associated with use of the 23andMe GHR tests include false positive findings, which can occur when a person receives a result indicating incorrectly that he or she has a certain genetic variant, and false negative findings that can occur when a user receives a result indicating incorrectly that he or she does not have a certain genetic variant. Results obtained from the tests should not be used for diagnosis or to inform treatment decisions. Users should consult a health care professional with questions or concerns about results.”

FDA allows marketing of first direct-to-consumer tests that provide genetic risk information for certain conditions

Not surprisingly, in almost all cases, the answer is yes.

Autoimmunity as a Contraindication to Getting Vaccinated

That doesn’t mean that there aren’t some true medical reasons that kids shouldn’t be vaccinated.

“Contraindications (conditions in a recipient that increases the risk for a serious adverse reaction) and precautions to vaccination are conditions under which vaccines should not be administered. Because the majority of contraindications and precautions are temporary, vaccinations often can be administered later when the condition leading to a contraindication or precaution no longer exists. A vaccine should not be administered when a contraindication is present; for example, MMR vaccine should not be administered to severely immunocompromised persons. However, certain conditions are commonly misperceived as contraindications (i.e., are not valid reasons to defer vaccination).”

Vaccine Recommendations and Guidelines of the ACIP

Which autoimmune diseases are listed as contraindications to get vaccinated?

None.

Which autoimmune diseases are listed as precautions to get vaccinated?

There are just a few, including Guillain-Barré syndrome (DTaP, Tdap, and flu vaccines) and thrombocytopenic purpura (MMR), but they typically don’t mean that you can’t still get vaccinated. And the general precaution to avoid getting a vaccine during “moderate or severe acute illness with or without fever” would apply to a time when you are acutely sick with your autoimmune disease, but you would get vaccinated once your symptoms were under better control.

Other things about autoimmune diseases are simply misperceived as being contraindications or precautions to getting vaccinated. Or they are pushed as anti-vaccine propaganda to scare you away from getting vaccinated and protected or to help you get a fake medical exemption.

“…vaccines are able to prevent some infections in MS patients known to accelerate the progression of the disease and increase the risk of relapses.”

Mailand et al on Vaccines and multiple sclerosis: a systemic review

For example, not only do vaccines not cause multiple sclerosis, they are recommended because they can prevent vaccine-preventable diseases that can make the disease worse for many people.

And flu shots and other vaccines are highly recommended for kids with diabetes, as they are at high risk for flu complications.

Vaccines are safe and necessary, even, and sometimes especially, if you have an autoimmune disease.

And having a predisposition for an autoimmune disease, either because of your child’s family history, or because of the results of some genetic testing kit you ordered on the internet, certainly isn’t a reason to skip or delay your child’s vaccines and leave them unprotected. You’re not avoiding any of the triggers that can cause autoimmune disease and simply increase the risk that they will get a vaccine-preventable disease and get others sick.

More on Autoimmunity as a Contraindication to Getting Vaccinated