Tag: morality

Is the MMR Vaccine Licensing Being Called into Question?

Why do some folks think that the MMR vaccine licensing is being called into question?

Yup. That’s what the usual suspects are trying to make you think.

Is the MMR Vaccine Licensing Being Called into Question?

Taking advantage of the fact that many sites publish all press releases, these folks want you to think that a major news site is following their latest bombshell, which of course is just another dud.

The MMR was licensed in 1971. The ICAN papers are from 1978…

You mean there really isn’t an FDA coverup?

“Clinical studies of 284 triple seronegative children, 11 months to 7 years of age, demonstrated that M-M-R II is highly immunogenic and generally well tolerated.”

MMR II Package Insert

Not only is the package insert very transparent about the studies used to approve the MMR II vaccine they are talking about, since only a minor change was made to the original MMR vaccine, which was approved in 1971, it isn’t surprising that larger trials weren’t required at the time.

So there were earlier, larger trials?

Yup.

But did they use a saline control group?

Nope.

A Vaccinated vs Unvaccinated Study - Stokes et al on Trivalent combined measles-mumps-rubella vaccine. Findings in clinical-laboratory studies.
A Vaccinated vs Unvaccinated Study – Stokes et al on Trivalent combined measles-mumps-rubella vaccine. Findings in clinical-laboratory studies

The control group was actually unvaccinated.

It is also important to keep in mind that this study, and a few other MMR studies, followed much, much larger studies of the individual measles, mumps, and rubella vaccines.

“The large majority of children in the United States have been vaccinated against measles and a sizable portion have been given mumps and rubella vaccines. It is estimated by us based on vaccination distribution that about 41 million children have received measles vaccine, 7 million mumps vaccine, and 21 million rubella vaccine. The combined triple vaccine provides a simple, safe, and effective immunization procedure using a single vaccine dose against three important diseases in children who have not yet been immunized.”

Stokes et al on Trivalent combined measles-mumps-rubella vaccine. Findings in clinical-laboratory studies.

Much larger double-blind, placebo-controlled studies of the individual measles, mumps, and rubella vaccines.

This is why you don’t routinely do vaccinated vs unvaccinated studies anymore. It is unethical to let kids get measles, mumps, rubella or other diseases.

The bottom line is that the measles (1968), mumps (1967), and rubella (1969) vaccines were safe when they were approved by the FDA.

The MMR (1971) was safe when it was approved by the FDA.

And MMR-II (1978) was safe when it was approved by the FDA.

Since then, there have also been studies showing that getting a second dose of MMR-II is safe and effective and that ProQuad, the combination measles, mumps, rubella, and chickenpox vaccine is safe and effective, although it is associated with a small increased risk of febrile seizures if given as a first dose.

There is no FDA coverup. No bombshell.

Just anti-vaccine folks continuing to try and scare you away from vaccinating and protecting your kids.

More on the Licensing of the MMR Vaccine

Why Should Medical Exemptions Be Based on CDC Contraindications?

Getting a medical exemption for vaccines isn’t controversial.

Or at least it shouldn’t be.

Why Should Medical Exemptions Be Based on CDC Contraindications?

As many people know though, some people have been taking advantage of the fact that medical exemptions weren’t clearly defined in California’s vaccine law.

Who are the doctors handing out fake medical exemptions in California?
Who are the doctors handing out fake medical exemptions in California?

Are there just a few doctors taking advantage of the California law?

“But at 105 schools in the state, 10% or more of kindergartners had a medical exemption in the school year that ended last month, according to a Los Angeles Times analysis of state data.”

Pushback against immunization laws leaves some California schools vulnerable to outbreaks

Is 10% a lot?

In one recent report, Vaccination Coverage for Selected Vaccines, Exemption Rates, and Provisional Enrollment Among Children in Kindergarten — United States, 2016–17 School Year, the median rate of medical exemptions in the US was just 0.2%, with a range of <0.1 to 1.5%.

In West Virginia and Mississippi, states that don’t allow non-medical exemptions and where criteria for medical exemptions are fairly strict, the rates were 0.1 and 0.3% respectively.

And that’s about what you would expect, as there are very few true contraindications or precautions to getting vaccinated.

So yes, 10% is an awful lot and that’s a good sign that it is more than just a few doctors taking advantage of the law.

“If a child has a medical exemption to immunization, a physician licensed to practice medicine in New York State must certify that the immunization is detrimental to the child’s health. The medical exemption should specify which immunization is detrimental to the child’s health, provide information as to why the immunization is contraindicated based on current accepted medical practice, and specify the length of time the immunization is medically contraindicated, if known.”

Dear Colleague letter regarding guidelines for use of immunization exemptions

Why do most other states have so few medical exemptions?

Mostly because there are very few true medical reasons to skip or delay a child’s vaccines!

They include, but aren’t limited to, the contraindications and precautions listed in the package insert for each vaccine (the contraindications and warnings sections…) and by the Advisory Committee on Immunization Practices.

They don’t include many other things that are “incorrectly perceived as contraindications to vaccination,” such as things in the family medical history of the child, eczema (unless they are getting the smallpox vaccine), colic, sleep apnea, or being a picky eater.

Is everything a vaccine injury?
Is everything a vaccine injury?

It should be obvious.

Medical exemptions for vaccines should be based on CDC criteria because some folks think that everything is a vaccine injury.

More on Medical Exemptions

What’s the Worst That Can Happen If You Lie About Vaccinating Your Child?

We have heard about anti-vaccine parents forging their unvaccinated children’s vaccine records to get them in school.

What’s the harm, right?

What’s the Worst That Can Happen If You Lie About Vaccinating Your Child?

Most of us can think of an awful lot of things that can go wrong in this scenario and we know exactly who’s going to be harmed!

An immunocompromised child got chicken pox after her mom lied about getting her vaccinated.

Yeah, if you lie about getting vaccinated, your kid can get sick.

They can also get other people sick…

We found that out last year when an unvaccinated teen returned from a trip overseas and developed measles.

“Although patient A’s parents had chosen not to vaccinate him, his immunocompromised brother, an organ transplant recipient, had received intravenous immunoglobulin to protect him against measles before traveling overseas. When patient A’s illness was reported, SCCPHD recommended that his brother receive additional intravenous immunoglobulin and be quarantined 7 additional days; the family followed both recommendations. Patient C’s unvaccinated sister, aged 17 years, received parental permission to choose to receive MMR vaccine when her brother was quarantined; she opted to receive the vaccine.”

Notes from the Field: Measles Outbreak in an Era of Stricter Immunization Requirements — California, March 2018

While that isn’t so surprising, it is that instead of cooperating with health department investigators, so that they can find and quarantine contact, several people lied. That led to more people getting sick and the outbreak going on longer than it should have.

It is also amazing that they hadn’t already vaccinated their kids, having a high risk, immunocompromised child in the house who couldn’t receive the MMR vaccine!

More on the Worst of the Anti-Vaccine Movement

About those Stanley Plotkin Videos…

Stanley Plotkin is typically described as “a prominent figure in the history of vaccinology, whose work on vaccine development has led to a significant reduction in morbidity and mortality from infectious diseases in the second part of 20th century. “

Why?

For one thing, he developed the rubella vaccine that we still use today.

He also worked on vaccines against CMV, polio, chicken pox, rabies, and rotavirus.

What Did Stanley Plotkin Say While He Was Under Oath?

That’s not why anti-vaccine folks are talking about him these days, or maybe it is…

Mostly, they are misinterpreting comments he made during a videotaped deposition.

“Lori Matheson is fighting her ex-husband, Michael Schmitt, for the right to decide if their two-year-old daughter should be vaccinated.”

Michigan anti-vaccination case to goes to court

A videotaped deposition in a case involving parents who disagreed about vaccinating their daughter…

Even though it isn't his exact quote and anti-vaccine folks don't give you the full context of what he was talking about, it is clear that Dr. Plotkin simply meant that you can't prove a negative.
Even though it isn’t his exact quote and anti-vaccine folks don’t give you the full context of what he was talking about, it is clear that Dr. Plotkin simply meant that you can’t prove a negative.

What do anti-vaccine folks think he said?

“I would say it is logically true that you cannot say, you cannot point to proof that it doesn’t cause autism. ”

Stanley Plotkin, M.D.

No, he isn’t saying that vaccines are associated with autism.

“I could not say that as a, as a scientist or a logician. But I can say as a physician that, no, they do not cause autism, because as a physician, I have to take the whole body of scientific information into consideration when I make a recommendation for a child.”

Stanley Plotkin, M.D.

All he is saying is that you can’t definitively prove a negative.

One of the different things in communicating the fact that there is no link is that science and English are not really the same language. So when a scientist says, “We have no evidence that there’s a link between vaccines and autism,” what they’re really saying is, “We are as positive as someone can humanly be that there’s no link.”
Seth Mnookin explain it well – One of the different things in communicating the fact that there is no link is that science and English are not really the same language. So when a scientist says, “We have no evidence that there’s a link between vaccines and autism,” what they’re really saying is, “We are as positive as someone can humanly be that there’s no link.”

For example, just because I have never seen a black swan, I can’t use that as proof that black swans don’t exist somewhere. After all, I haven’t been everywhere.

“…scientists can be at a real disadvantage in this debate because they, by their nature, are careful in how they present their conclusions.”

Vaccines: Last Week Tonight with John Oliver (HBO)

What else do anti-vaccine folks have a problem with?

Remember the rubella vaccine he developed?

“After a detour to obtain credentials as a pediatrician, I returned to Wistarto work on rubella. Those years were fraught with advances and reverses, controversy and eventually vindication. The pandemic of CRS babies in 1964-65 was an important stimulus to research on the vaccine. “

Stanley Plotkin’s On the Occasion of the Presentation Of The 2002 Albert B. Sabin Gold Medal

During the rubella epidemic of 1964-65, there were 12.5 million rubella virus infections, which “resulted in 11,250 therapeutic or spontaneous abortions, 2,100 neonatal deaths, and 20,000 infants born with congenital rubella syndrome.”

And that’s just in the United States.

The controversy?

“There were only two fetuses involved in making vaccines. When fetal strains of, fibroblast strains were first developed, I was involved in that work trying to characterize those cells; but they were not used to make vaccines.”

Stanley Plotkin, M.D.

It is well known (this isn’t some shocking truth as some are trying to push) that some vaccines are made with fetal embryo fibroblast cells (the WI-38 and MRC-5 cells) from cell lines that are derived (they can replicate infinitely) from two electively terminated pregnancies (abortions) in the 1960s.

Those two fetuses weren’t the only two fetuses ever used in research though, they were just the only ones used to actually make vaccines.

“Human diploid cell strains (HDCSs) are batches of cells that are currently used for different purposes, including culturing viruses for the manufacturing of vaccines”

A brief history of human diploid cell strains.

They had to get to the point where they knew how to make vaccines in human cell lines though and that’s what he is talking about in the deposition.

“Q. In any event, so we have 76 in this study. Would you approximate it’s been a few hundred fetuses?


A. Oh, no, I don’t think it was that many. Probably not many more than in this paper. And I should stipulate that we had nothing to do with the cause of the abortion.”

It took some experimentation to find the right kind of cells and the right methods, but ultimately, they found that fetal embryo fibroblast cells were the best to use to grow many viruses.

Copies of those same cells are still used today.

What about the other “issues” brought up in the deposition?

Did he experiment on orphans, people who were mentally handicapped, or those who lived in third world countries?

“I don’t remember specifically, but it’s possible. And, again, I repeat that in the 1960s, that was more or less common practice. I’ve since changed my mind. But those were, that was a long time ago.”

Stanley Plotkin, M.D.

Those were different times, but Dr. Plotkin’s vaccine studies weren’t unethical and weren’t like what was done at Willowbrook, in which children were purposely exposed to hepatitis, with the justification that most of them ended up getting it anyway.

Surprisingly, in the early 1970s, there was still some debate about the ethics of doing experiments on children, and as you can see, using ableist language to describe children with a disability.
Surprisingly, in the early 1970s, there was still some debate about the ethics of doing experiments on children, and as you can see, using ableist language to describe children with a disability.

And from those times, experts developed the rules for how things are now done.

Ironically, anti-vaccine folks are pushing this stuff about Plotkin, but don’t understand why leaving kids completely unvaccinated and unprotected in a study is unethical.

“One is morally free to use the vaccine regardless of its historical association with abortion. The reason is that the risk to public health, if one chooses not to vaccinate, outweighs the legitimate concern about the origins of the vaccine. This is especially important for parents, who have a moral obligation to protect the life and health of their children and those around them.”

National Catholic Bioethics Center FAQ on the Use of Vaccines

Or why it’s immoral to push anti-vaccine propaganda or put others at risk to get a vaccine-preventable disease.

“Results indicate that the total number of cases of poliomyelitis, measles, mumps, rubella, varicella, adenovirus, rabies and hepatitis A averted or treated with WI-38 related vaccines was 198 million in the U.S. and 4.5 billion globally (720 million in Africa; 387 million in Latin America and the Caribbean; 2.7 billion in Asia; and 455 million in Europe). The total number of deaths averted from these same diseases was approximately 450,000 in the U.S., and 10.3 million globally (1.6 million in Africa; 886 thousand in Latin America and the Caribbean; 6.2 million in Asia; and 1.0 million in Europe).”

Olshansky et al on The Role of the WI-38 Cell Strain in Saving Lives and Reducing Morbidity

Dr. Plotkin’s work has helped save millions of lives.

“His achievements in vaccinology are on a scale that truly can be measured in lives saved and lives restored.”

On the Occasion of the Presentation Of The 2002 Albert B. Sabin Gold Medal

And that’s why anti-vaccine folks are attacking him.

More on Stanley Plotkin

The Pacific Northwest Measles Outbreak of 2019

Breaking News – There are 2 new cases in Clark County (70 cases), bringing the total case count to 75 cases.

It started with a confirmed case of measles in a child in late December.

The Pacific Northwest measles outbreak on 2019 started when a child exposed others in the area in late December.

There were soon reports of more cases.

The Clark County measles outbreak quickly grew.

And more cases.

The Pacific Northwest Measles Outbreak of 2019

But the measles cases didn’t stay in Clark County.

Two of the unvaccinated kids from Clark County traveled to Hawaii while they were contagious.
Two of the unvaccinated kids from Clark County traveled to Hawaii while they were contagious.

As with other recent large measles outbreaks, cases soon spread to neighboring counties.

As of late January, there are now measles cases linked to this ongoing outbreak in Clark County and King County (Washington) and Multnomah County (Oregon).

The rapid growth of the outbreak led Clark County to declare a local public health emergency and Washington’ governor to declare a State of Emergency in all counties in the state of Washington.

“The measles outbreak and its effects impact the life and health of our people, as well as the economy of Washington State, and is a public disaster that affects life, health, property or the public peace.”

Governor Jay Inslee on proclaiming a State of Emergency

Why so much concern?

Are you familiar with the immunization rates in this part of the country? About the only good thing you can say about Washington’s immunization rates are that they are better than Oregon‘s…

Washington has one of the highest rates of exemptions in the United States.

That’s right.

High non-medical vaccine exemption rates and low vaccination rates. A recipe for very large outbreaks of vaccine-preventable diseases, especially measles which is so highly contagious.

Immunization rates by county in Washington.

And a recipe for disaster. These outbreaks are getting harder to control, are lasting longer, and are getting bigger and bigger.

Also remember that the last measles death in the United States, in 2015, was a woman who got caught up in a measles outbreak in Clallam County. Why didn’t that trigger folks in the area to get Vaccinated?

Pacific Northwest Measles Outbreak of 2019
Clark County (WA)70 cases
King County (WA)1 case
Multonomah County (OR)4 case
 75 cases

How many of them are vaccinated? Anti-vaccine folks are pushing hard to convince folks that everyone in the outbreaks are vaccinated. Don’t believe them!

As in most outbreaks, almost all of the people in this outbreak are unvaccinated.

How many people will get sick in the Pacific Northwest Measles Outbreak of 2019 before it ends?

You will have to make an extra appointment if you followed his immunization plan and left your kids unvaccinated and at risk during this outbreak.
You will have to make an extra appointment if you followed his immunization plan and left your kids unvaccinated and at risk during this outbreak.

Are parents going to keep listening to anti-vaccine folks who push the idea that measles isn’t that bad and make you think that it is riskier to get vaccinated?

Are they going to realize that unless they are malnourished or have a vitamin deficiency, that taking extra vitamin A that you order from someone’s online store will not reduce their risk of severe complications if their unvaccinated child gets measles?

“Please contact your pediatrician or doctor if your child is scary sick, struggling to breathe or unable to eat or very lethargic or otherwise seriously ill. Let them know you are worried they may have measles so they can arrange not to contaminate the waiting room or the whole office.”

Paul Thomas, Integrative Pediatrician

Getting vaccinated can help keep your kids from getting “scary sick” from measles…

“The above recommendations are informational only. Please consult with your doctor before implementing anything you might learn here.”

Paul Thomas, Integrative Pediatrician

The only good advice he gives.

Anti-vaccine misinformation has gotten us to the place where these outbreaks are becoming more common. Vaccinate your kids so they don’t get measles and don’t expose anyone else.

And for the anti-vaccine folks who are asking:

  • it isn’t going to be shedding or a vaccine strain that caused the outbreak
  • everyone or almost everyone in the outbreak is going to be unvaccinated
  • the measles vaccine does work against all the different genotypes of measles
  • more people don’t die from getting the MMR or any other vaccine than from the diseases they protect us against
  • whether the death rate of measles is 1 in 1000 or 1 in 10,000 cases, remember that just before the measles vaccine came out, in the early 1960s, nearly 500 people would die of measles each year. And it isn’t that a person dies after 1,000 or 10,000 cases. With more cases, there is just a higher chance that someone will eventually die.

And you are still worried about the MMR vaccine because anti-folks are still scaring you away from vaccinating and protecting your kids.

Vaccines are safe and necessary with few risks. There is no good reason that we should still have outbreaks like this.

More on The Pacific Northwest Measles Outbreak of 2019

Updated March 3, 2019

But Did Anyone Die?

Anti-vaccine folks don’t seem to like that they are getting more attention these days.

Why are they getting more attention?

More unvaccinated folks are getting sick.

But Did Anyone Die?

Is that really such a big deal though?

Hillary Simpson doesn't think measles outbreaks are a big deal because she doesn't think that anyone has died....
Hillary Simpson doesn’t think measles outbreaks are a big deal because she doesn’t think that anyone has died….

It’s not like anyone has died in all of these outbreaks, is it?

Actually, they have…

Most anti-vaccine folks conveniently seem to not be aware of her, but an immunocompromised woman died after she was exposed to measles during a 2015 outbreak in Clallam County, Washington.

“New details about the first confirmed measles death in the U.S. since 2003 show that the victim, a 28-year-old woman with underlying health problems, was likely exposed to the virus at a Port Angeles tribal health clinic.

Nearly three dozen other people also were potentially exposed to the highly contagious germ on Jan. 29, 2015, at the Lower Elwha Health Clinic by a 52-year-old man who became the first case of measles confirmed in Clallam County in two decades.”

Fatal measles case linked to exposure at tribal clinic, records show

So yes, someone did die during the recent measles outbreaks.

A 28-year-old woman died in Clallam County, Washington.

Not everyone is all better.

And during the 2013 measles outbreak in Brooklyn, a pregnant woman with measles was hospitalized and had a miscarriage.

But it isn’t just measles…

There are also deadly outbreaks of hepatitis A and as everyone knows, pediatric flu deaths are mostly in kids who are unvaccinated.

So, did anyone die?

Yes, tragically people have died because of the anti-vaccine movement.

And tragically, unless folks stop believing this kind of anti-vaccine propaganda and start vaccinating and protecting their kids, even more people will die unnecessarily.

More on Vaccine Preventable Disease Deaths

Believe It or Not, Chicken Pox Parties Are Still a Thing

Do you remember having chicken pox?

Oh boy, I sure do!

I was about six or seven years old and it was bad. Still, I’m not sure if I remember because I had such a bad case or because it made me miss Halloween that year.

It was almost certainly both, as I remember being covered in spots from head to toe.

What I don’t recall is having many visitors. Why didn’t my mom throw me a chicken pox party!

I also don’t remember going to a chicken pox party to get sick.

Believe It or Not, Chicken Pox Parties Are Still a Thing

Whether or not chicken pox parties were ever that popular, the approval of the chicken pox vaccine in 1995 should have put an end to the practice.

After all, why intentionally expose your child to a potentially life-threatening disease, when a safe and effective vaccine is readily available?

“Chickenpox (varicella) is generally a much milder illness in children than in adults, with considerably lower rates of severe disease and death. Varicella is also virtually universal in many populations, meaning that very few individuals escape infection over a lifetime. Thus, a sound logic underlies the idea of chickenpox parties, at which susceptible children can acquire the contagious causative pathogen, varicella zoster virus (VZV), from their peers. However, chickenpox is not without risks, even for children of this age; severe, complicated, and occasionally fatal varicella occur in previously healthy children, as well as the immunocompromised (who are at very considerable risk).”

Hambleton et al on Chickenpox Party or Varicella Vaccine?

Most folks understand that. They get their kids vaccinated and have helped get chicken pox under very good control, with outbreaks of chicken pox declining over 95%.

“Each year, more than 3.5 million cases of varicella, 9,000 hospitalizations, and 100 deaths are prevented by varicella vaccination in the United States”

CDC on Monitoring the Impact of Varicella Vaccination

Apparently, not everyone has gotten the message though.

Remember when CPS had to investigate the mom who was having chicken pox parties in Plano, Texas a few years ago?

“On the page, parents post where they live and ask if anyone with a child who has the chicken pox would be willing to send saliva, infected lollipops or clothing through the mail.”

CBS 5 Investigates mail order diseases

Or when anti-vaccine folks were selling and mailing lollipops contaminated with chicken pox to folks so that they could skip the trouble of finding a chicken pox party?

And then there’s that time that a family served chicken pox contaminated punch at their chicken pox party. Oh wait, that was The Simpsons…

Chicken pox party - The Simpsons did it.
Chicken pox party – The Simpsons did it in the Milhouse of Sand and Fog episode in Season 17.

So what are they up to now?

Folks are still advertising chicken pox parties in anti-vaccine Facebook groups.
Folks are still advertising chicken pox parties in anti-vaccine Facebook groups.

More of the same…

Does she know that the chicken pox vaccine likely decreases your risk of getting shingles later in life?
Does she know that the chicken pox vaccine likely decreases your risk of getting shingles later in life?

Apparently, there are still plenty of folks looking for chicken pox parties to infect their kids.

Why?

It is easy to see a lot of cognitive biases at play in the decision to host or bring a child to a chicken pox party, including ambiguity aversion (prefer what they think are the known risks of getting the disease), bandwagoning (they think everyone else is doing it, because in their echo chambers of anti-vaccine propaganda, everyone might), and optimism bias, etc.

There is also a very poor perception of risks, as the risks from a natural chicken pox infection are far, far greater than any risk from the vaccine.

Don't forget to tent!!!
Don’t forget to tent and share breath!!!

In bigger news, Facebook has groups who’s mission is “finding pox,” so that parents can get their kids sick!

The mission of PX Colorado is finding pox!
The mission of PX Colorado is finding pox!

How many other PoX type groups are there on Facebook?

How many other parents are intentionally not vaccinating their kids and intentionally exposing them to chicken pox?

Do any of them quarantine or isolate their kids for 10 to 21 days after the chicken pox party, so as to not expose anyone who is too young to be vaccinated, too young to be fully vaccinated, or has a true medical exemption to getting vaccinated, including those who are immunocompromised?

Do they understand the consequences of having these pox parties?

The latest chicken pox party hostess is apparently a nurse - at least for now...
The latest chicken pox party hostess is apparently a nurse – at least for now…

Of course, an investigation from CPS, the health department, or a medical board isn’t the most serious consequence that should discourage folks from hosting or attending a chicken pox party.

Chicken pox can be a serious, even life-threatening infection. Sure, many kids just get a mild case, but others get more serious cases and have bad complications, including skin infections, encephalitis, sepsis, or stroke.

And some people do still die from chicken pox, which is supposed to be a mild, childhood illness.

“This report describes a varicella death in an unvaccinated, previously healthy adolescent aged 15 years.”

Varicella Death of an Unvaccinated, Previously Healthy Adolescent — Ohio, 2009

Fortunately, these deaths have been nearly eliminated thanks to the chicken pox vaccine.

And that’s why parents who are on a mission for “finding pox” should rethink things and switch to a mission to get their kids vaccinated and protected.

More on Chicken Pox Parties