Can you explain why we will almost certainly have the second highest number of measles cases in one year since 1994, even though we see the devastation that high rates of measles is causing in Europe and other parts of the world?
How many people will get measles in the United States this year?
Although no one is reporting on this, with several large ongoing outbreaks still not under control – it will be another record year for measles in the United States.
“Robert F. Kennedy Jr., Chairman of Children’s Health Defense (CHD), and Rolf Hazlehurst, parent of a vaccine-injured child, petitioned the Department of Justice (DOJ) Office of Inspector General (OIG), and the Senate and House Judiciary Committees today to investigate actions taken by federal personnel during the “Vaccine Court” Omnibus Autism Proceedings (OAP).”
Kennedy and Hazlehurst claim to have evidence of “obstruction of justice and appallingly consequential fraud by two DOJ lawyers who represented the Department of Health and Human Services (HHS) in 2007.”
Kennedy and Hazlehurst claim that “that the leading HHS expert, whose written report was used to deny compensation to over 5,000 petitioners in the OAP, provided clarification to the DOJ lawyers that vaccines could, in fact, cause autism in children with underlying and otherwise benign mitochondrial disorders.”
Who is this expert?
It is Andrew Zimmerman, MD, a pediatric neurologist.
There is also a claim that Dr. Zimmerman, along with Dr. Richard Kelley, who was also an expert witness in the Vaccine Court Omnibus Autism Proceedings, served as expert witnesses in a medical malpractice case against a pediatrician who vaccinated a child, supposedly causing him to become autistic.
Yates Hazlehurst, who was the second test case in the Vaccine Court Omnibus Proceedings.
Dr. Zimmerman admits that there is no evidence that vaccines cause autism, but also believes that there are some exceptions, and that vaccines can cause regressive autism in some kids with mitochondrial disorders.
Dr. Zimmerman also clarified that it is not just immunizations, but infections, fever, and other inflammatory responses that can lead to regressive autism.
And Dr. Zimmerman would have testified to it in the Cedillo case (the first test case in the Vaccine Court Omnibus Proceedings), if he had been allowed to.
Except that upon review of the Cedillo case, Dr. Zimmerman had concluded that “there is no evidence of an association between autism and the alleged reaction to MMR and Hg, and it is more likely than not, that there is a genetic basis for autism in this child.”
Apparently, he had changed his mind later, even though he continues to say that all evidence points to the fact that vaccines don’t cause autism.
“Dr. Zimmerman subsequently submitted a second expert opinion on behalf of Hannah Poling, which in effect states that she suffers autism as a result of a vaccine injury. The same government officials, who submitted and relied upon Dr. Zimmerman’s first expert opinion as evidence in the O.A.P., secretly conceded the case of Hannah Poling and placed it under seal so that the evidence in the case could not be used in the O.A.P. or known by the public.”
Memorandum Regarding Misconduct By The United States Department Of Justice And The United States Department Of Health And Human Services During The Omnibus Autism Proceeding As To The Expert Opinions Of Dr. Andrew Zimmerman
But what about the “second expert opinion” from Dr. Zimmerman?
According to Poling’s mother, “Dr. Zimmerman was not an expert nor was he asked to be an expert on Poling’s case. The government conceded her case before ANY opinion was rendered or given.”
What about Dr. Richard Kelley?
“As noted above, an important consideration for treatment of AMD is that “normal” inflammation can impair mitochondrial function. Although most infections cannot be avoided, certain measures can limit the risk of injury during infection or other causes of inflammation… We believe it is much better to immunize with DTaP than risk infection with highly inflammatory and potentially damaging community-acquired pertussis.”
Dr. Richard Kelley on Evaluation and Treatment of Patients with Autism and Mitochondrial Disease
While he seems to believe that vaccines can trigger regressive autism in some kids with mitochondrial disease, he admits that other kinds of inflammation can do it too, including vaccine-preventable diseases.
“We believe it is much better to immunize with DTaP than risk infection with highly inflammatory and potentially damaging community-acquired pertussis.”
And again, so does Dr. Zimmerman, to the point that in many cases, he thinks that even kids with mitochondrial disorders should be vaccinated.
“…the MMR vaccine has been temporally associated, if rarely, with regressions — with regression in AMD and other mitochondrial disease when given in the second year. Doubtless some of these regressions are coincidental, since the usual age for giving the MMR falls within the typical window of vulnerability for AMD regression.”
“The undersigned has reviewed and considered the filed reports from these experts and finds that the opinions of the experts lend support to the conclusions reached in this decision. In reaching the conclusions set forth in this decision, however, the undersigned relies more heavily on the testimony and reports of the experts who were observed and heard during the hearings.”
Hazlehurst v. Secretary of HHS
So where is the fraud in the Vaccine Court Omnibus Proceedings?
Is it that the Poling case files have been kept under seal and hidden from public view?
“Finally, and perhaps for purposes of Rolf’s request that Poling’s records be released to the public, Jon and I have not allowed the release of Hxxxx’s records nor will we ever willingly allow third parties to tear apart her medical history which includes other close family members as well as things that should have never been in the record to begin with.”
While we should all care about fraud in our court system, we should all also care about folks who push misinformation about vaccines and try to scare parents away from vaccinating and protecting their kids, especially when they use autistic kids to do it.
“I do think that — that there was much information — misinformation brought about by Dr. Wakefield and it’s — this has set the field back. I think that — that we — we have worked very hard to try to reassure the public and I agree with doing that because I am very supportive of vaccinations, immunizations in general.”
While Dr. Zimmerman truly believes that future research might find a way to identify a very small subset of kids with mitochondrial disorders that worsen after they get their vaccines (or infections or other types of inflammation), this doesn’t apply to the great majority of autistic kids or even the great majority of kids with regressive autism.
Even Dr. Zimmerman only seems to speak of an “uncommon relationship” that “is not evident in studies that have been done to date.”
And none of the researchers he mentions, including Richard Frye, Shannon Rose, Joe (Jill?) James, or Dmitriy Niyazov seem to have actually studied vaccines, only possible relationships between autism and mitochondrial conditions.
“The claims by RFK Jr. and Handley draw on something that was not, in fact, a fraud, that is misrepresented as having a dramatic impact on the Omnibus Autism Proceedings when it had little to no effect.”
Plus ça change – anti-vaccine activists revive the Hannah Poling case
With billions of doses of vaccines being given each year, it is likely not surprising that we see some problems. But when many of those vaccines are being given to kids, even one mishap, especially if it leads to life-threatening complications, is too many.
That’s why many safe guards have been put in place in the manufacturer and distribution of modern vaccines, so that we don’t see these types of vaccine tragedies:
the Cutter Incident, when, in 1955, at least 56 people developed polio and 5 children died after being vaccinated with inactivated polio vaccine that was poorly manufactured by Cutter Laboratories and still contained live polio virus
hepatitis-contaminated yellow fever vaccines – some lots of yellow fever vaccines used in the military in 1942 were unintentionally contaminated with the hepatitis B virus
the Lubeck Disaster – 75 children died and others got tuberculosis in 1929 Germany after there was a mixup between the BCG vaccine and the strain of Mycobacterium tuberculosis that causes tuberculosis. The BCG vaccine was supposed to be made with a weakened strain of Mycobacterium bovis bacteria instead.
the Bundaberg incident – 12 children died in Australia in 1928 after being given contaminated diphtheria vaccine from a multidose vial without preservative
tetanus contaminated smallpox vaccine in the 1890s and early 20th century
Although vaccines are much safer now, some rare incidents still occur.
Fifteen infants died and 75 children got sick in Syria in 2014 after they received a neuromuscular blocking agent, atracurium, instead of the measles vaccine they were supposed to get. How? The measles vaccine that was being used is mixed with a diluent, but instead of using the proper diluent, the health worker unintentionally used a bottle of atracurium instead.
In 2015, at least two kids died and 29 got sick in Chiapas, Mexico, among 52 children who were vaccinated. The children were reportedly given a BCG vaccine, the rotavirus vaccine, and/or a hepatitis B vaccine that day. However, the only vaccine that all of the sick children received in common was the hepatitis B vaccine. Since 130,000 doses from the same batch of vaccines had been given in the area, it was not thought to be a manufacturing problem or widespread issue. It was instead bacterial contamination of hepatitis B vaccine vials at that one clinic.
Fifteen children died in 2017 in a village in South Sudan after a poorly trained team that wasn’t adhering to WHO immunization safety standards used the same syringe to reconstitute measles vaccines over a four day period. They also didn’t keep the vaccine vials refrigerated.
“A single reconstitution syringe was used for multiple vaccine vials for the entire four days of the campaign instead of being discarded after single use. The reuse of the reconstitution syringe causes it to become contaminated which in turn contaminates the measles vaccine vials and infects the vaccinated children.”
Statement regarding findings of joint investigation of 15 deaths of children in Nachodokopele village, Kapoeta East County in South Sudan
As you can imagine, the conditions that led to these tragedies aren’t present when most kids get vaccinated.
Even in developing countries, most children get vaccinated by people adhering to WHO immunization safety standards. Why did they happened then? Both Syria and South Sudan have been rocked by war for years, leading to a breakdown in the ability to provide routine health care, even as basic as getting kids vaccinated. And Comunidad La Pimienta, Simojovel, Chiapas is a very poor part of southern Mexico.
These kinds of tragedies aren’t going to happen at your pediatrician’s office, as they don’t even have drugs like atracurium.
What Happened in Samoa?
In Samoa, four years after the deaths of the children in Syria, we are once again hearing about reports of deaths after kids were vaccinated with the MMR vaccine.
Two children in Samoa, both one-year-olds, died within minutes of being vaccinated on the same day in the same hospital on the island of Savai’i.
Not surprisingly, as health officials investigate the cause, use of the MMR vaccine had been suspended in Samoa.
So what happened?
“Until the investigations have been completed and reported on we cannot say what did happen.
However, given the batch of vaccine involved had been in use in that country since August last year, and given the same batch of vaccine has been used in South American countries and the Caribbean island nations without incident, it seems unlikely that there was anything wrong with the vaccine.
The reports from the parents of the children affected on Friday indicate the reactions occurred within minutes after vaccination. This would preclude a response to the vaccine viruses as this takes at least a week. While anaphylaxis occurs within minutes and can be fatal when not treated the odds of seeing this twice in a day at the same place, given a chance of 1 in a million doses, is literally astronomical.”
Dr. Helen Petousis Harrison on What happened in Samoa?
Since it happened so quickly, it sounds like it could have been a mix-up with the diluent, as happened in Syria. A five dose vial of MMR is used in Samoa, which means that unlike premixed vaccines, it does have to be mixed with a diluent.
What about contamination? It is known that vaccine vials can be contaminated with Staphylococcus bacteria if they are mishandled. Although Staphylococcus bacteria can directly cause infections, they can also release a toxin that can cause toxic shock syndrome (TSS).
Considering how quickly these children got died though (within minutes), it isn’t likely that the vaccines became contaminated with Staphylococcus toxins. There have been reports of TSS following vaccination in the past, usually with vaccines that don’t use preservatives, but symptoms typically develop over four to 24 hours.
“This particular vaccine batch lot arrived to Samoa in August 2017 and has been in use since then. The same vaccine batch lot used in Samoa is also in use in a number of South American and Caribbean countries (Belize, Ecuador, St. Vincent, Trinidad Tobago, Chile, Aruba, Dutch Antilles, St. Kitts & Nevis and Cuba) with no reports of adverse events from those countries.”
Could this be related to what happened to two other children in Samoa who had died after getting their MMR vaccines?
Almost certainly not. Those children, siblings, died years earlier, one in 2015 and the other in 2017. Neither died immediately after being vaccinated and there are reports that they may have had some kind of an immunodeficiency syndrome that contributed to their deaths.
“A number of media outlets are already covering these tragic events, speculating on the cause of death before the investigation is completed, and the stories have been picked up by the anti-vaccination movement.”
Among those measles deaths in Europe, there have been at least twelve measles deaths in Italy (five in 2017 and seven in 2018, among just 7,697 cases), all either unvaccinated or partially vaccinated, including:
If you haven’t guessed yet, as in other countries in Europe, we are seeing more deaths from measles simply because folks aren’t vaccinated and more people are getting measles.
Measles is a life-threatening disease, even in an age of modern medicine, indoor plumbing, sewage systems, clean water, whole foods, vitamins and minerals, etc.
Italy, with about 1/5 the population of the United States, but about equal to the size of California, has had over 600 times as many cases of measles as we have had in the United States over the last few years. To put it in perspective, that would be like having 33,000 cases of measles in the United States.
But shouldn’t folks have a choice about getting vaccinated?
Even with the new vaccine laws, parents have a choice. As with vaccine laws in the United States, Italy’s new vaccine mandates had nothing to do with forced vaccination.
That’s unlike most of the people who died of measles in Italy. Most of them didn’t have a choice about being vaccinated and getting measles. Some were immunocompromised and couldn’t be vaccinated and at least one was too young to be vaccinated.
Parents had been set a July 10th deadline to provide schools with the relevant documentation, but it will now be possible for parents to simply submit their own confirmation that the child has been vaccinated, according to Giulia Grillo, Italy’s Health Minister, who was speaking at a press conference on Thursday.
Mandatory vaccinations: Italian parents will no longer need to provide doctor’s note
And that’s why it’s unfortunate that the a newly elected government severely watered down a vaccine law that had made getting vaccinated mandatory to go to school.
And it’s unfortunate that people continue to push misinformation about vaccines and vaccine-preventable diseases.
What to Know About the Measles Deaths in Italy
A drop in vaccination rates has led to measles outbreaks and a number of measles deaths in Italy.
It is not news that we have been seeing more cases of mumps in recent years.
It is also isn’t news that many of these folks are vaccinated.
“Long Beach has been hit with a mumps outbreak that is vaccine-resistant. According to health officials in the Long Island town, almost two dozen individuals are believed to have contracted the virus, with four confirmed cases and at least 14 suspected ones.”
“We are actually to the point that we are worried that this vaccine may indeed not be protecting against the strain of mumps that is circulating as well as it could.”
Dr. Dirk Haselow, Arkansas State Epidemiologist
Of course, to say that the vaccine may not be protecting folks “as well as it could” doesn’t mean it doesn’t work because the wild type mumps virus has evolved or mutated enough to surmount our current MMR vaccine.
Is Mutating Mumps More Than the MMR Can Manage?
Although anything is possible, we fortunately have plenty of research that says that the mumps virus hasn’t mutated and that the MMR still works.
In fact, although the MMR vaccine is made from the A strain or genotype of mumps, it provides good protection against all 12 known strains of wild mumps viruses, including genotype G that has been causing most of the recent outbreaks.
But how can it cover a different strain of virus that isn’t in the vaccine?
Because not all viruses and vaccines are like influenza.
“The genotyping of the mumps virus is based on the Small Hydrophobic (SH) protein, a nonstructural protein and genetically the most variable one. Based on the SH-protein 12 different mumps viruses were detected up to now. In recent epidemics in Western countries the genotype G was mainly detected, while the mumps viruses used in the live attenuated mumps vaccines belong to genotype A (Jeryl Lynn) and to a lesser extent to genotype B (Urabe). However, antibodies against the SH protein have not yet been observed in human serum. It is, therefore, unlikely that antibodies against the SH protein play an important role in antibody-mediated virus neutralization.”
Sabbe et al. on The resurgence of mumps and pertussis
It is well known that you need a very specific match of the flu vaccine to the wild flu virus that is going around to get good protection, but for many other viruses, the differences that determine the strain or genotype have nothing to do with how antibodies will recognize the virus.
“Since mumps virus is monotypic, vaccine from any strain should provide lifelong protection against subsequent infection.”
Palacios et al. on Molecular Identification of Mumps Virus Genotypes from Clinical Samples: Standardized Method of Analysis
“Studies have demonstrated that blood sera from vaccinated persons cross-neutralizes currently circulating mumps strains.”
CDC on Mumps for Healthcare Providers
And like measles, the mumps vaccine (MMR), protects against all strains of wild mumps viruses.
“Compared with attack rates of 31.8%–42.9% among unvaccinated individuals, attack rates among recipients of 1 dose and 2 doses of the Jeryl Lynn vaccine strain were 4%–13.6% and 2.2%–3.6%, respectively.”
Dayan et al. on Mumps Outbreaks in Vaccinated Populations: Are Available Mumps Vaccines Effective Enough to Prevent Outbreaks?
And like other vaccines, the mumps vaccine (MMR) works.
That’s still far below where we used to be though, especially when you consider that before the first measles vaccine was licensed, there was an average of about 549,000 measles cases and 495 measles deaths in the United States each year.
Containing a Measles Outbreak
Several factors help to limit the measles outbreaks that we continue to see in the United States. Most important is that fact that despite the talk of personal belief vaccine exemptions and vaccine-hesitant parents not getting their kids vaccinated, we still have high population immunity.
In the United States, 90.8% of children get at least one dose of the MMR vaccine by the time they are 35 months old and 91.1% of teens have two doses. While not perfect, that is still far higher than the 81% immunization rates the UK saw from 2002 to 2004, when Andrew Wakefield started the scare about the MMR vaccine. Instead of overall low immunization rates, in the U.S., we have “clusters of intentionally under-vaccinated children.”
It also helps that the measles vaccine is highly effective. One dose of a measles vaccine provides about 95% protection against measles infection. A second, “booster” dose helps to improve the effectiveness of the measles vaccine to over 99%.
To further help limit the spread of measles, there are a lot of immediate control measures that go into effect once a case of measles has been suspected, from initiating contact investigations and identifying the source of the measles infection to offering postexposure prophylaxis or quarantining close contacts.
That’s an awful lot of work.
A 2013 measles outbreak in Texas required 1,122 staff hours and 222 volunteer hours from the local health department to contain.
Costs of a Measles Outbreak
In addition to requiring a lot of work, containing a measles outbreak is expensive.
A study reviewing the impact of 16 outbreaks in the United States in 2011 concluded that “investigating and responding to measles outbreaks imposes a significant economic burden on local and state health institutions. Such impact is compounded by the duration of the outbreak and the number of potentially susceptible contacts.”
We still don’t know what it cost to contain many big outbreaks, like the one in Ohio, but we do know that it cost:
over $2.3 million to contain the 2017 outbreak in Minnesota – 75 people got measles, 71 were unvaccinated, and more than 500 people were quarantined over a 5 month period
up to an estimated $3.91 million (but likely much more) to contain the 2015 outbreaks in California
$394,448 and 10,054 personnel hours in total personnel time and total direct cost to the New York City Department of Health and Mental Hygiene responding to and controlling the 2013 outbreak in NYC
two unrelated cases in Colorado in 2016 cost $49,769 and $18,423, respectively to investigate
$50,758.93 to contain an outbreak at a megachurch in Texas
$150,000 to contain (13 cases) an outbreak in Cook County, Illinois
$223,223 to contain (5 cases, almost all unvaccinated) to contain another outbreak in Clallam County, Washington, an outbreak that was linked to the death of an immunocompromised woman.
more than $190,000 of personnel costs in Alameda County, with 6 cases and >700 contacts, it is estimated that over 56 staff spent at least 3,770 hours working to contain the outbreak
$5,655 to respond to all of the people who were exposed when a 13-year-old with measles was seen in an ambulatory pediatric clinic in 2013
$130,000 to contain a 2011 measles outbreak in Utah
$24,569 to contain a 2010 measles outbreak in Kentucky
$800,000 to contain (14 cases, all unvaccinated) a 2008 measles outbreak at two hospitals in Tuscon, Arizona
$176,980 to contain a 2008 measles outbreak in California
$167,685 to contain a 2005 measles outbreak in Indiana – unvaccinated 17-year-old catches measles on church mission trip to Romania, leading to 34 people getting sick, including an under-vaccinated hospital worker who ends up on a ventilator for 6 days
$181,679 (state and local health department costs) to contain a 2004 measles outbreak in Iowa triggered by a unvaccinated college student’s trip to India
It is important to keep in mind that these costs are often only for the direct public health costs to the county health department, including staff hours and the value of volunteer hours, etc. Additional costs that come with a measles outbreak can also include direct medical charges to care for sick ($14,000 to $16,000) and exposed people, direct and indirect costs for quarantined families (up to $775 per child), and outbreak–response costs to schools and hospitals, etc.
We should also consider what happens when our state and local health departments have to divert so much time and resources to deal with these types of vaccine-preventable diseases instead of other public health matters in the community. Do other public health matters take a back seat as they spend a few months responding to a measles outbreak?
There were 220 cases of measles in the United States in 2011. To contain just 107 of those cases in 16 outbreaks, “the corresponding total estimated costs for the public response accrued to local and state public health departments ranged from $2.7 million to $5.3 million US dollars.”
In contrast, it will costs about $77 to $102 to get a dose of the MMR vaccine if you don’t have insurance. So not only do vaccines work, they are also cost effective.
What to Know About the Costs of a Measles Outbreak
Containing a measles outbreak is expensive – far more expensive than simply getting vaccinated and protected.
Well, there have been studies warning people about giving Tylenol before vaccines. It had nothing to do with side effects though. They suggested that a vaccine might be less effective if the child got Tylenol before his vaccines. It is important to note that they never really found that the vaccines didn’t work as well, as all of the kids in the study still had protective levels of antibodies, they were just a little lower than kids who didn’t get Tylenol.
Other studies have found the same effect if Tylenol was given after a child got his vaccines. Although interestingly, other studies have found that giving Tylenol after vaccines does not affect antibody titers.
“Antibody titres to diphtheria and tetanus toxoids and pertussis bacteria of the placebo (n = 25) and acetaminophen (n = 34) groups did not differ significantly from each other. It is concluded that acetaminophen in a single dose schedule is ineffective in decreasing post-vaccination fever and other symptoms.”
Uhari et al on Effect of prophylactic acetaminophen administration on reaction to DTP vaccination
The only thing that this had to do with side effects though, is that the kids who got Tylenol had a little less fever.
What about the association of MMR, Tylenol and autism? Although one study did suggest that to be true, the study, a parental survey, was found to be “fatally flawed.”
Can I Give My Kids Tylenol When They Have Their Vaccines?
So, can you give your kids Tylenol when they get their vaccines?
The better question is, should you give your kids Tylenol either before or after they get their vaccines?
Notwithstanding the very small chance that giving Tylenol might cause decreased immunogenicity (lower antibody production) if you give it before your kids get their vaccines, since there is a good chance that they won’t have any pain or fever and won’t even need any Tylenol, then why give it?
Skip the “just in case” dose and wait and see if they even need it.
What about afterwards?
If your kids have pain or fever and are uncomfortable, then you should likely give them something for pain or fever control, such as an age appropriate dose of either acetaminophen or ibuprofen. Will that cause lower antibody production? Maybe. Will that mean that their vaccines won’t work. That’s doubtful. It certainly won’t lead to increased side effects though, unless they a reaction to the dose of Tylenol itself.
Should you give a pain or fever reducer after a vaccine “just in case?” Again, there is a good chance that your kids might not need it, so it is likely better to wait and see if they do, instead of giving a dose automatically after their shots.
There is even some evidence that giving acetaminophen or ibuprofen before vaccines, or as a routine dose right after, especially with booster shots, doesn’t really prevent side effects that well anyway. They work better if given on an as needed basis instead, and these kinds of doses are less likely to be associated with decreased antibody production.
What to Know About Tylenol and Vaccines
Giving a pain or fever reducer either before or after your child’s vaccinations likely won’t affect how it works, but since it often isn’t necessary, it is likely best to only given one, like Tylenol or Motrin, if it is really needed.