Tag: measles

Who Dies with Measles?

Measles is another of those diseases that some claim used to be mild and a rite of passage for kids.

That’s why there was an episode of the Brady Bunch about it, right?

An episode in which all of the kids got sick and they had to call two pediatricians to do house calls…

Who Dies with Measles?

While measles was a rite of passage for kids, it wasn’t the kind you looked forward to, because measles is rarely mild.

“Before a vaccine became available in 1963, measles was a rite of passage among American children. A red rash would spread over their bodies. They would develop a high fever. Severe cases could cause blindness or brain damage, or even death.”

CDC says measles almost eliminated in U.S.

Instead, most people develop 10 days of measles symptoms, including a high fever, cough, runny nose, watery eyes, and a rash. Photophobia, irritability, sore throat, headache, and abdominal pain are other symptoms that children with measles might have.

Many require hospitalization and some die.

But isn’t it just older people or those with immune system problems that die with measles?

“From 1964 through 1971, 16.7% of the death certificates reviewed noted some underlying pathologic condition.”

Roger Barkin, MD on Measles mortality. Analysis of the primary cause of death.

Nope.

It is most often children, typically young children, without any medical problems who die.

Before the routine use of vaccines, most measles deaths were young children without any medical problems.
Before the routine use of measles vaccines, most measles deaths were young children without any previous medical problems.

In the post-vaccination era, no one would be expected to die with measles, but those with immune system problems sometimes do, as most others are vaccinated and protected. As vaccinated rates drop though, even otherwise healthy children and adults can once again die of measles.

Remember the measles outbreaks at the end of the 1980s?

“Complications were reported in 672 (9.8%) cases, including otitis media in 318 (4.6%) cases, pneumonia in 178 (2.6%), diarrhea in 171 (2.5%), and encephalitis in five (0.1%). Nine hundred thirteen patients (13.3%) were hospitalized, and 10 measles-associated fatalities were reported (case-fatality rate: 1.5 deaths per 1000 reported cases). Eight of the deaths were reported in children less than 5 years of age, all of whom were unvaccinated. None had a reported underlying illness or immunodeficiency. Most deaths have been attributed to pneumonia.”

Measles — United States, First 26 Weeks, 1989

Probably not, but from 1989 to 1991 there were at least 123 measles deaths across the United States, even after measles had been declining for years with the introduction of the measles vaccine in the 1960s. Most of the deaths were otherwise healthy, without underlying medical problems.

They were unvaccinated and unprotected.

Because we don’t typically hear any details about measles deaths, including the almost 90,000 measles deaths that continue to occur around the world each year, most people likely assume that measles only kills in third world countries, where kids are already sick or malnourished. Of course, that wouldn’t explain how over one hundred people died with measles in Europe over the past few years…

Still think that measles isn’t deadly?

Tragically, there are plenty of stories (although most are never reported in the news and we don’t hear about them) and case reports that will prove you wrong:

  • Olivia Dahl died with measles when she was 7-years-old (1962)
  • an unvaccinated 3-year-old died in Maricopa County (1970)
  • a 13-year-old girl who had previously been vaccinated with one of the first inactivated measles vaccines which were found to be ineffective and were replaced with the newer live vaccines died in Michigan (1978)
  • a 9-month-old died in Chicago (1990)
  • an unvaccinated 13-year-old died in Kansas (1990)
  • Tammy Bowman, an 11-year-old unvaccinated girl died in Michigan (1990)
  • an unvaccinated 13-year-old became the first person in the UK to die with measles in 14 years (2006)
  • a 14-year-old died of Subacute Sclerosing Panencephalitis (SSPE), a late complication of a natural measles infection (2015)
  • an immunocompromised woman died after she was exposed in an outbreak in Clallam County, Washington (2015)
  • a 6-year-old boy with leukemia died in Italy caught measles from his intentionally unvaccinated sibling (2017)
  • an 11-month-old unvaccinated infant died in Greece (2017)
  • an intentionally unvaccinated 9-year-old girl with chromosomopathy, which is not a contraindication to getting vaccinated, died in Italy (2017)
  • a 10-month-old unvaccinated boy who likely caught measles when he had been hospitalized for an RSV infection, died in Italy (2018)
  • a 16-year-old who had received a heart transplant when she was 2-years-old died in France (2018)
  • an unvaccinated toddler in Jerusalem (2018)

Measles as a rite of passage?

“We baby boomers were apparently the last generation whose doctors, and therefore parents, accepted the measles as just one more annoying rite of passage of childhood that also happened to prime the immune system and provide lifelong immunity. Medical texts prior to the advent of the vaccine described measles as a benign, selflimiting (sic) childhood infectious disease that posed little risk to the average well-nourished child.”

Darrerl Crain, DC on The Great Measles Misunderstanding

While early pediatric textbooks did a great job describing the symptoms of measles, they also did a great job of documenting that measles was never a benign disease, something anti-vaccine folks still misunderstand because vaccines can do such a good job controlling the disease.

Even as overall mortality improved in the mid-20th Century, measles still wasn't a benign disease.
Even as overall mortality improved in the mid-20th Century, measles still wasn’t a benign disease.

Do benign, self-limiting childhood infections diseases kill hundreds of children every year?

This toddler died of measles in 1955.
This toddler died of measles in 1955.

Measles as a rite of passage is something we don’t want to have to go back to. It was a rite of passage that was endured because there was no other choice.

We have a choice now.

Don’t be misled into making the wrong one.

Don’t help anti-vaccine folks bring back measles and other vaccine-preventable diseases.

Vaccines are safe, effective and necessary.

“Today, vaccination is a cornerstone of pediatric preventive health care and a rite of passage for nearly all of the approximately 11,000 infants born daily in the United States.”

Cohn et al on Immunizations in the United States: A Rite of Passage

Getting vaccinated and protected is a rite of passage that you can look forward to, thanks to the many benefits of vaccines, not one that you should dread or avoid.

More on Measles Deaths

Myths About Warnings and Adverse Reactions in the MMR Package Inserts

Have you heard that the MMR package insert “contains 42 paragraphs of warning and adverse reactions?”

And some of those warnings include “seizures, encephalitis, pneumonia, deafness, death and MEASLES?”

Measles? From the measles vaccine?

Myths About Warnings and Adverse Reactions in the MMR Package Inserts

Is that really in the MMR package insert?

Package inserts aren't so scary once you learn what's really in them.
Package inserts aren’t so scary once you learn what’s really in them.

Let’s see, 42 paragraphs of warning and adverse reactions???

Nope.

Anti-vaccine propaganda is not informed consent.
Anti-vaccine propaganda is not informed consent.

The Warning Section, which lists all adverse reactions and safety hazards that may occur after getting a vaccine and what you should do if they occur, actually only contains five paragraphs!

There are 23 more paragraphs in the Adverse Reactions section, but as most folks understand, this section includes clinical trials experience, postmarketing experience, and voluntary reports, so it is not always possible to establish a causal relationship to vaccination for the adverse effects listed here.

What does the MMR package insert say about seizures, encephalitis, hearing loss, and death?

“Measles is also known as rubeola. It is a serious illness. Measles virus can be passed to others if you have it. Measles can give you a high fever, cough, and a rash. The illness can last for 1 to 2 weeks. In rare cases, it can also cause an infection of the brain. This could lead to seizures, hearing loss, mental retardation, and even death.

Mumps can also be passed to others. This virus can cause fever and headache. It also makes the glands under your jaw swell and be painful. The illness often lasts for several days. Sometimes, mumps can make the testicles swell and be painful. In some cases, it can cause meningitis, which is a mild swelling of the coverings of the brain and spinal cord.

Rubella is also known as German measles. It is often a mild illness. Rubella virus can cause a mild fever swollen glands in the neck, pain and swelling in the joints, and a rash that lasts for a short time. It can be very dangerous if a pregnant woman catches it. Women who catch German measles when they are pregnant can have babies who are stillborn. Also, the babies may be blind or deaf, or have heart disease or mental retardation.”

So the package insert is telling folks to get vaccinated and protected to avoid seizures, encephalitis, and death. Why don’t anti-vaccine folks ever mention that part of the package insert?

Don’t listen to anti-vaccine propaganda about vaccine package inserts.

Learn the risk of misinformed consent and following bad advice – leaving your kids unvaccinated and unprotected.

More on Myths About Warnings and Adverse Reactions in the MMR Package Inserts

Did an Islamic Council in Indonesia Issue a Fatwa Against the Measles Vaccine?

A fatwa against a vaccine?

That’s one of those things that can’t be true right?

Did you know that there are Fatwas that support immunizations?
Did you know that there are fatwas that support immunizations?

After all, it was just a few years ago that the Islamic Advisory Group for Polio Eradication met and stated that it “reiterates its trust in the safety and effectiveness of polio and other routine childhood vaccinations as a life-saving tool which protects children; and acknowledge that it fully conforms to Islamic rulings.”

A Fatwa Against the Measles Vaccine

Unfortunately, it’s true.

The Indonesian Ulama Council (MUI), in a Fatwa Commission Meeting on August 20, established that it is illegal (haram) to use vaccines that utilize pigs and their derivatives, including the MR (measles-rubella) vaccine.

Importantly though, they also stated that the use of the MR vaccine is permissible (mubah), because there is no alternative vaccine and measles and rubella are dangerous diseases. So it is still not a good reason to seek a religious exemption to getting vaccinated.

What’s the concern?

Some vaccines use gelatin as a stabilizer. And the gelatin in those vaccines typically comes from pigs.

This isn’t a new issue though.

In 1995, Islamic legal scholars met at a seminar convened by the Islamic Organization for Medical Sciences on the topic The Judicially Prohibited and Impure Substances in Foodstuff and Drugs.

“Transformation which means the conversion of a substance into another substance, different in characteristics, changes substances that are judicially impure or are found in an impure environment, into pure substances, and changes substances that are prohibited into lawful and permissible substances.”

The seminar concluded that “The gelatin formed as a result of the transformation of the bones, skin and tendons of a judicially impure animal is pure…”

So even though Muslims can’t eat pork, they can take medicines packaged in gelatin capsules and they can get vaccines that contain gelatin.

Fortunately, although although some immunization programs ordered a temporary delay when the fatwa was first issued, MR vaccination has resumed in Indonesia. That’s good news, as measles outbreaks are still common in the region.

But why has this become an issue again?

More on the Fatwa Against the Measles Vaccine

 

Who is Alexander Langmuir?

Alexander Langmuir is typically described as a hero or titan of public health.

Then why do some folks think he was against the flu and measles vaccines?

Who is Alexander Langmuir?

Dr. Alexander Langmuir has been called the father of infectious disease epidemiology.

Why?

In 1949, he established the CDC’s Epidemiology Program. Actually, at the time, the CDC was still called the Communicable Disease Center.

Dr. Alexander Langmuir and his Polio Surveillance Unit at the EIS in 1955.
Dr. Alexander Langmuir and his Polio Surveillance Unit at the EIS in 1955.

Dr. Langmuir, as Chief Epidemiologist at CDC for 21 years, also:

  • founded the Epidemic Intelligence Service (EIS)
  • instituted a malaria surveillance system
  • established national disease surveillance system for the United States
  • was involved in resolving the Cutter incident
  • brought the Morbidity and Mortality Weekly Report to CDC
  • investigated the swine influenza virus vaccine incident, when it was thought that some people developed GBS after getting the new swine flu vaccine in 1976

His work saved the lives of hundreds of thousands of people.

Don't believe any propaganda or quotes without sources attributed to Alexander Langmuir.
Don’t believe any propaganda or quotes without sources attributed to Dr. Alexander Langmuir.

Did he ever tell folks to not get a flu shot?

Was he ever concerned about mercury in flu shots?

Considering that Dr. Langmuir died in 1993, before folks became concerned about thimerosal in vaccines, that’s unlikely. That’s especially so considering that the only place you can find these types of quotes are on anti-vaccine websites.

Still, Langmuir was critical of flu shots.

“From this appraisal of the experience in the past three and one-half years, it is apparent that progress in the control of influenza has not been impressive.”

Langmuir et al. on The Epidemiological Basis For The Control Of Influenza

He didn’t think that they worked well enough. Or more importantly, he didn’t think we had enough information about how well they worked.

“Our information regarding the occurrence of influenza is largely qualitative. Schools close, absenteeism increases, medical services become taxed, virus isolations and serological identifications are made in great numbers, and daily accounts appear in our newspapers and on television. We know we have an epidemic and we know its specific cause, but we have few quantitative measures of incidence, age- and sex-specific attack rates, and character and severity of complications. Further- more, we have only crude data regarding mortality. We do not know what proportion of excess deaths occurs among reasonably active and productive citizens in contrast to deaths among persons who are already invalids suffering from severely debilitating pre-existing disease. Despite this serious deficiency we base our recommendations for vaccine use largely on mortality experience. We undertake major efforts to produce influenza vaccine in large amounts, but we have no meaningful information regarding its actual distribution. We do not know to what extent it actually reaches persons at highest risk.”

Langmuir et al. on A Critical Evaluation of Influenza Surveillance

But he wasn’t anti-vaccine.

And he never said that flu shots weren’t safe.

“The availability of potent and effective measles vaccines, which have been tested extensively over the past 4 years, provides the basis for the eradication of measles in any community that will raise its immune thresholds to readily attainable levels.”

Langmuir et al. on Epidemiologic Basis For Eradication Of Measles In 1967

And concerning all that he did in the field of public health, he is certainly not someone that anti-vaccine folks should be quoting.

More on Alexander Langmuir

Measles on a Plane, Train, and a Cruise Ship

What to most folks worry about when they go on a cruise?

That’s right. Norovirus…

While it isn’t as common as most folks think, norovirus is still often thought of as the cruise ship disease.

Measles on a Plane, Train, and a Cruise Ship

Not surprisingly, many of the same conditions that put you at risk for getting norovirus, including that it is very contagious and you are in close quarters with a lot of other people on a ship, puts you at risk for getting other diseases.

Even measles?

Especially measles.

In 2014, 136 people got measles after an unvaccinated person developed measles on a cruise ship, including 28 people on the cruise.

More recently, an unvaccinated teenager exposed others to measles on a Norwegian Cruise Lines ship while visiting Alaska. It seems like the same person also exposed folks to measles on a few planes and trains too.

How did they get measles? In Thailand.

This is almost certainly the same person who arrived at Vancouver International Airport from Tokyo on an Air Canada flight (July 30), leaving for Portland on Air Canada Jazz that same day.

While in Portland, they exposed people to measles at multiple locations:

  • Leno Medoyeff Bridal, 710 NW 23rd Ave., Portland, 3:30—5:30 p.m. (July 31)
  • Tom’s Pancake House, 12925 SW Canyon Rd., Beaverton, 7—9:30 a.m. (Aug. 1)
  • Max Red Line, Beaverton Transit Center to Pioneer Square, 12:30—1 p.m. (Aug. 2)
  • Max Red Line, Pioneer Place to Beaverton Transit Center, 5:30—6 p.m. (Aug. 2)
  • Verde Cocina, 5515 SW Canyon Ct., Portland, 2—4:30 p.m. (Aug. 5)

They weren’t done yet though.

You really shouldn't have to worry about measles when you board a plane, train, or cruise ship with your kids.
You really shouldn’t have to worry about measles when you board a plane, train, or cruise ship with your kids.

They then traveled back to Vancouver International Airport on an Alaska Airlines flight (August 6) and boarded a Norwegian Jewel cruise ship to Alaska.

Fortunately, the teen was placed in medical isolation shortly after boarding the ship and may have left the typically 7 day cruise early, as they were transferred to PeaceHealth Ketchikan Medical Center on August 8.

How can you protect yourself?

Get vaccinated. You never know when someone who is unvaccinated is going to expose your family to measles or put them at risk for other vaccine-preventable disease.

More on Measles on a Plane, Train, and a Cruise Ship

How Anti-Vaccine Are You? Take Our Quiz.

It’s easy to be anti-vaccine when you are hiding in the herd. You don’t get vaccinated and you don’t vaccinate your kids, and instead, you simply rely on the fact that everyone else around you is vaccinated to protect you from vaccine-preventable diseases.

Would you vaccinate your high-risk child?
Would you vaccinate your high-risk child? Photo by Janko Ferlic.

Of course, this is a terrible strategy, as we are seeing with the increase in cases of measles and pertussis, etc. It is much better to learn about the importance and safety of vaccines, get fully vaccinated, and stop these outbreaks.

This hasn’t seemed to have deterred most anti-vaccine “experts” yet, as they continue to spout their anti-vaccine myths and misinformation and push their anti-vaccine talking points.

But as they continue to tell you that vaccines don’t work, how about asking what they would do in these ten high-risk situations?

Amazingly, some folks continue to try and justify skipping vaccines and accept the risk of disease, even when that risk is much higher than usual and they could be putting their child’s life in immediate danger!

How will you do with our quiz?

Would you choose to vaccinate in these situations?

1. Baby born to mother with hepatitis B.

You are pregnant and have chronic hepatitis B (positive for both HBsAg and HBeAg). Should your newborn baby get a hepatitis B shot and HBIG?

Background information:
Many anti-vaccine experts tell parents to skip their baby’s hepatitis B shot, saying it is dangerous, not necessary, or doesn’t work (typical anti-vax myths and misinformation).

However, it is well known that:

  • from 10 (HBeAg negative) to 90% (HBeAg positive) of infants who are born to a mother with chronic hepatitis B will become infected
  • 90% of infants who get hepatitis B from their mother at birth develop chronic infections
  • 25% of people with chronic hepatitis B infections die from liver failure and liver cancer
  • use of hepatitis B immune globulin (HBIG) and hepatitis B vaccine series greatly decreases a newborn’s risk of developing a hepatitis B infection (perinatal transmission of hepatitis B), especially if HBIG and the first hepatitis B shot is given within 12 hours of the baby being born

Would your newborn baby get a hepatitis B shot and HBIG?

2. Your child is bitten by a rabid dog.

Your toddler is bitten by a dog that is almost certainly rabid. Several wild animals in the area have been found to be rabid recently and the usual playful and well-mannered dog was acting strangely and died a few hours later. The dog was not vaccinated against rabies and unfortunately, the owners, fearing they would get in trouble, disappeared with the dead dog, so it can’t be quarantined. Should your child get a rabies shot?

Background information:
Although now uncommon in dogs, rabies still occurs in wild animals, including raccoons, skunks, bats, and foxes. These animals can then expose and infect unvaccinated dogs, cats, and ferrets, etc.

To help prevent rabies, which is not usually treatable, in addition to immediately cleaning the wound, people should get human rabies immune globulin (RIG) and rabies vaccine.

The rabies vaccine is given as a series of four doses on the day of exposure to the animal with suspected rabies and then again on days 3, 7, and 14.

Although rare in the United States, at least 1 to 3 people do still die of rabies each year. The rabies vaccine series and rabies immune globulin are preventative, however, without them, rabies is almost always fatal once you develop symptoms. A few people have survived with a new treatment, the Milwaukee protocol, without getting rabies shots, but many more have failed the treatment and have died.

Would your child get a rabies shot? What if he had picked up a rabid bat?

3. Traveling to Romania.

You are traveling to the Romania to see family with your 9-month-old baby. Neither of you have had the measles vaccine. Should you both get vaccinated before making the trip?

Background information:

Over the past few years, over 100 people have died in measles outbreaks across Europe, with many in Romania.

Although the first MMR vaccine is routinely given when children are 12 months old, it is now recommended that infants get vaccinated as early as age six months if they will be traveling out of the country.

Since the endemic spread of measles was stopped in 2000, almost all cases are now linked to unvaccinated travelers, some of whom start very large outbreaks that are hard to contain.

Would you both get vaccinated before making the trip?

4. Tetanus shot.

Your unvaccinated teen gets a very deep puncture wound while doing yard work. A few hours later, your neighbor comes by to give you an update on his wife who has been in the hospital all week. She has been diagnosed with tetanus. She had gotten sick after going yard work in the same area and has been moved to the ICU. Do you get him a tetanus shot?

Background information:
Most children get vaccinated against tetanus when they receive the 4 dose primary DTaP series, the DTaP booster at age 4-6 years, and the Tdap booster at age 11-12 years.

Unlike most other vaccine-preventable diseases, tetanus is not contagious. The spores of tetanus bacteria (Clostridium tetani) are instead found in the soil and in the intestines and feces of many animals, including dogs, cats, and horses, etc.

Although the tetanus spores are common in soil, they need low oxygen conditions to germinate. That’s why you aren’t at risk for tetanus every time your hands get dirty. A puncture wound creates the perfect conditions for tetanus though, especially a deep wound, as it will be hard to clean out the tiny tetanus spores, and there won’t be much oxygen at the inner parts of the wound.

These types of deep wounds that are associated with tetanus infections might including stepping on a nail, getting poked by a splinter or thorn, and animal bites, etc. Keep in mind that some of these things, like a cat bite, might put you at risk because you simply had dirt/tetanus spores on your skin, which get pushed deep into the wound when the cat bites you.

Symptoms of tetanus typically develop after about 8 days and might include classic lockjaw, neck stiffness, trouble swallowing, muscle spasms, and difficulty breathing. Even with treatment, tetanus is fatal in about 11% of people and recovery takes months.

Would you get your teen a tetanus shot?

5. Cocooning to protect baby from pertussis.

Both of your unvaccinated teens go to school with a personal belief vaccine exemption. You are due in a few months and are a little concerned about the new baby because there have been outbreaks of pertussis in the community, especially at their highschool. Should everyone in the family get a Tdap shot?

Background information:
Pertussis, or whooping cough, classically causes a cough that can last for weeks to months.

While often mild in teens and adults, pertussis can be life-threatening in newborns and infants. In fact, it is young children who often develop the classic high-pitched whooping sound as they try to breath after a long coughing fit.

In a recent outbreak of pertussis in California, 10 infants died. Almost all were less than 2 months old.

Since infants aren’t protected until they get at least three doses of a pertussis vaccine, usually at age 6 months, experts recommend a cocooning strategy to protect newborns and young infants from pertussis. With cocooning, all children, teens, and adults who will be around the baby are vaccinated against pertussis (and other vaccine-preventable diseases), so that they can’t catch pertussis and bring it home.

There is even evidence that a pregnancy dose of Tdap can help protect infants even more than waiting until after the baby is born to get a Tdap shot.

Would everyone in your family get a Tdap shot?

6. Nephew is getting chemotherapy.

Your nephew was just diagnosed with leukemia and is going to start chemotherapy. Your kids have never been vaccinated against chicken pox and haven’t had the disease either. Your brother asks that you get them vaccinated, since they are around their cousin very often and he doesn’t want to put him at risk.

Do you get your kids vaccinated with the chicken pox vaccine?

Background information:
Kids with cancer who are getting chemotherapy become very vulnerable to most vaccine-preventable diseases, whether it is measles, flu, or chicken pox.

According to the Immune Deficiency Foundation, “We want to create a ‘protective cocoon’ of immunized persons surrounding patients with primary immunodeficiency diseases so that they have less chance of being exposed to a potentially serious infection like influenza.”

Would your get your kids vaccinated with the chicken pox vaccine?

7. Outbreak of meningococcemia at your kid’s college.

Your child has just gone off to college. There is an outbreak of meningococcemia in her dorm (8 cases already). It is the strain that is included in the Menactra and Menveo vaccines, although she has not been vaccinated. Do you encourage her to get vaccinated?

Background information:
Neisseria meningitidis is a bacteria that can cause bacterial meningitis and sepsis (meningococcemia).

Depending on the type, it can occur either in teens and young adults (serogroups B, C, and Y) or infants (serogroup B).

Although not nearly as common as some other vaccine-preventable diseases, like measles or pertussis, it is one of the more deadly. Meningococcemia is fatal in up to 40% of cases and up to 20% of children and teens who survive a meningococcal infection might have hearing loss, loss of one or more limbs, or neurologic damage.

Meningococcal vaccines are available (Menactra and Menveo) and routinely given to older children and teens to help prevent meningococcal infections (serogroups A, C, Y and W-135). Other vaccines, Bexasero and Trumenba, protect against serogroup B and are recommended for high risk kids and anyone else who wants to decrease their risk of getting Men B disease.

Would you encourage her to get vaccinated against meningococcemia?

8. Cochlear implants.

Your preschooler has just received cochlear implants. Should he get the Prevnar and Pneumovax vaccines?

Background information:
Cochlear implants can put your child at increased risk for bacterial meningitis caused by the Streptococcus pneumoniae bacteria (pneumococcus).

Would he get vaccinated with Prevnar and Pneumovax, as he is no at high risk for pneumococcal disease?

9. Splenectomy

Your child is going to have his spleen removed to prevent complications of hereditary spherocytosis. Should he get the meningococcal and pneumococcal vaccines first?

Background information:
Without a spleen, kids are at risk for many bacterial infections, including severe infections caused by Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis bacteria.

In addition to their routine vaccines, kids with asplenia might need Menveo or Menactra, Bexsero or Trumenba (Men B), and Pneumovax 23.

Would your child get these vaccines that are recommended for kids with asplenia?

10. Ebola

Ebola is returning, but this time an experimental vaccine is available.

Background information:
There were nearly 30,000 cases and just over 11,000 deaths during the 2014-16 Ebola outbreak in West Africa.

You are in an area that is seeing an increasing number of Ebola cases and there is still no treatment for this deadly disease. An experimental vaccine is being offered.

Do you get the vaccine?

How Anti-Vaccine Are You?

It’s easy to be anti-vaccine when you are hiding in the herd – seemingly protected by all of the vaccinated people around you.

Would you still delay or skip a vaccine in a high-risk situation?

More on The Anti-Vaccine Quiz

Can Vaccines Cause ITP?

ITP is an abbreviation for idiopathic thrombocytopenic purpura.

It is a condition in which our platelets get destroyed, leading to excessive bruising and bleeding, since platelets are needed for normal blood clotting.

What Causes ITP?

To understand what causes ITP, it is important to know it is also often referred to as immune thrombocytopenic purpura, because it is typically the cells of our own immune system that destroys our platelets.

Why?

Well, that’s where the idiopathic part comes in.

We don’t know why people develop ITP, although classically, ITP is thought to follow a viral infection, including Epstein-Barr virus (mono), influenza, measles, mumps, rubella, and varicella (chicken pox). ITP has also been associated with many other viral infections, from Dengue fever to Zika.

“Often, the child may have had a virus or viral infection approximately three weeks before developing ITP. It is believed that the body’s immune system, when making antibodies to fight against a virus, “accidentally” also made an antibody that can stick to the platelet cells. The body recognizes any cells with antibodies as foreign cells and destroys them. Doctors think that in people who have ITP, platelets are being destroyed because they have antibodies.”

Pediatric Idiopathic Thrombocytopenia Purpura (ITP)

These children with ITP, usually under age 5 years, develop symptoms a few days to weeks after their viral infections. Fortunately, their platelet counts usually return to normal, even without treatment, within about 2 weeks to 6 months. Treatments are available if a child’s platelet count gets too low though.

Can Vaccines Cause ITP?

The measles vaccine is the only vaccine that has been clearly associated with ITP.

“The available data clearly indicate that ITP is very rare and the only vaccine for which there is a demonstrated cause-effect relationship is the measles, mumps and rubella (MMR) vaccine that can occur in 1 to 3 children every 100,000 vaccine doses.”

Cecinati on Vaccine administration and the development of immune thrombocytopenic purpura in children

Even then though, the risk of ITP after a measles containing vaccine, like MMR or ProQuad, is much less than after getting a natural measles infection, so worry about ITP is a not a good reason to skip or delay getting vaccinated.

What about other vaccines?

There is no good evidence that other vaccines, including the chicken pox vaccine, DTaP, hepatitis B vaccine, or flu vaccine, etc., cause ITP.

What about Gardasil? ITP is listed in the package insert as an adverse reaction for Gardasil, but only in the postmarketing experience section, so it does not mean that the vaccine actually caused the reaction, just that someone reported it.

Although ITP is listed in the PI for Gardasil, studies have shown that there is no association.
Although ITP is listed in the PI for Gardasil, studies have shown that there is no association.

Several large studies have actually been done that found no increased risk for ITP after getting vaccinated with Gardasil.

What to Know About Vaccines and ITP

Although measles containing vaccines can rarely cause ITP, vaccines prevent many more diseases that can cause ITP.

More on Vaccines and ITP