Even in the pre-vaccine era, when measles would kill 500 people a year in the United States, there is a very good chance that you wouldn’t have known anyone that died of measles. Of course, that doesn’t mean that nobody died of measles or chicken pox or any other now vaccine-preventable disease.
You likely know someone that plays football, right? Maybe on a youth football team or in middle school or high school? Do you know anyone that plays on a team in the NFL? While millions of kids might play football, only a few thousand play in the NFL.
Chicken pox was never a benign disease. It was considered a rite of passage because we all had to endure it, but it wasn’t something anyone looked forward to. You don’t die from a benign disease.
Part of that is actually true – “they keep you a customer for life” because you didn’t die from a vaccine-preventable disease!
Many countries don’t have the chicken pox vaccine on their routine immunization schedule because they don’t think it is cost-effective and they were concerned about what controlling chicken pox could do to rates of shingles.
“About 3 in every 1000 pregnant women in the UK catch chickenpox. Between 1985 and 1998, nine pregnant women died in the UK from chickenpox complications. Their unborn babies are also at risk from a rare condition called foetal varicella syndrome (FVS). This can result in serious long-term damage to the baby or even death, particularly if the mother catches chickenpox in the first 20 weeks of pregnancy.”
Vaccine Knowledge Project on Chickenpox (Varicella)
These countries have the same rates of shingles as countries that do use the chicken pox vaccine, but still have high rates of chicken pox and complications of chicken pox!
The UK does not vaccinate for chicken pox, but young, otherwise healthy kids die with chicken pox in the UK.
While you will be at higher risk for complications from chicken pox and most other diseases if you have a compromised immune system or are malnourished, if you are otherwise healthy, there is nothing you can do to boost your immune system to try and beat chicken pox – besides getting vaccinated.
Chicken pox parties kind of made sense in the pre-vaccine era. Since it was inevitable that your child would get chicken pox, you wanted them to get it at a young age, so they weren’t at increased risk for complications as an adult.
Does it sometimes seem like anti-vaccine folks are speaking a foreign language?
It definitely seems like they misunderstand and misuse a lot of scientific terms, like evidence, research, and toxin, doesn’t it?
The first step to understanding someone who is truly anti-vaccine and unnecessarily puts their kids at risk for vaccine-preventable diseases, might be to understand how they misunderstand most things about vaccines…
anything and everything bad that happens to you in the days, weeks, months, and years after you get vaccinated or in the days, weeks, months, and years before you were born because of the vaccines your parents or grandparents received
Every year we hear experts telling us to get vaccinated against the flu.
And more often than not, we hear critics telling us that the flu vaccine isn’t going to work that well because it isn’t a good match.
Is that because they just guess at which flu strains to put into the flu vaccine each year, as some folks say?
Do They Really Just Guess at Which Strain to Put in the Flu Vaccine?
Of course they don’t guess at which vaccine strain to put in the flu vaccine!
“Flu viruses are constantly changing, so the vaccine composition is reviewed each year and updated as needed based on which influenza viruses are making people sick, the extent to which those viruses are spreading, and how well the previous season’s vaccine protects against those viruses.”
CDC on Selecting Viruses for the Seasonal Influenza Vaccine
There are over 100 flu centers in over 100 countries that are involved in testing thousands of flu virus samples each year. Representative samples from these centers then go to the five major World Health Organization (WHO) Collaborating Centers for Reference and Research on Influenza.
The directors of these centers review these samples and other available information and make a recommendation on which vaccine strains to include in the flu vaccine for the next flu season. Each country then considers this recommendation and decides which flu strains to include in their flu vaccine.
“The influenza viruses in the seasonal flu vaccine are selected each year based on surveillance data indicating which viruses are circulating and forecasts about which viruses are the most likely to circulate during the coming season.”
CDC on Selecting Viruses for the Seasonal Influenza Vaccine
Although they don’t have a crystal ball and so can’t know exactly which flu strains will be making us sick each flu season, it is hardly a wild guess.
How often are they right?
“During seasons when most circulating influenza viruses are closely related to the viruses in the influenza vaccine, the vaccine effectiveness estimate has ranged from 50-60% among the overall population.”
WHO on Vaccine effectiveness estimates for seasonal influenza vaccines
Actually, they are right in most years! So if it is a guess, than the folks who choose which strains to include in the flu vaccine are very good guessers!
There have actually only been a few times in recent years when we have had mismatched flu strains. And in one of those years, they picked the right strain, but then the strain changed or drifted before the start of flu season.
“One hundred fifty-six (22%) of the 709 influenza A(H3N2) isolates were characterized as antigenically similar to A/Wyoming/3/2003, which is the A/Fujian/411/2002-like (H3N2) component of the 2004-05 influenza vaccine, and 553 (78%) were characterized as A/California/7/2004-like.”
2004-05 U.S. Influenza Season Summary
Not surprisingly, flu vaccine effectiveness goes way down during a mismatch year. During the 2004-05 flu season, for example, the overall vaccine effectiveness of the flu vaccine was just 10%.
Of course, in most years, flu vaccine is typically much more effective than that.
How effective will flu vaccines be this season?
Will this year’s flu vaccine be a good match?
We won’t know until flu season is well under way, not that you should wait for an answer to get your flu vaccine. The benefits of the flu vaccine extend beyond preventing the flu, so it is a good idea to get vaccinated even in a year when there might not be a good match.
Many news organizations ran with a story about a multi-state measles outbreak recently.
They got something wrong though.
There is no ongoing, single, multi-state outbreak of measles this year.
Fake News About Measles Outbreaks?
Is it understandable that some media outlets would have been confused by recent CDC reports?
The CDC Measles Cases and Outbreaks page hadn’t been updated since late-July and is still reporting case numbers that are “current as of July 14, 2018,” so there really was no recent CDC report to generate all of this extra attention.
“From January 1 to July 14, 2018, 107 people from 21 states (Arkansas, California, Connecticut, Florida, Illinois, Indiana, Kansas, Louisiana, Maryland, Michigan, Missouri, Nevada, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, and Washington) and the District of Colombia were reported to have measles.”
CDC on Measles Cases and Outbreaks
Although it has been changed to say “107 individual cases of measles have been confirmed in 21 states,” there was nothing to indicate it was a single outbreak that the CDC was monitoring as many sites reported:
NBC2 – Measles outbreak spreads to 21 states, infecting more than 100 people
Unfortunately, many of these reports are still online.
How did it happen?
It’s likely because you have reports from organizations and websites that seem to want to push out content, but don’t have much of a budget to pay health or medical writers to make sure it is accurate.
2018 Measles Cases and Outbreaks
It’s also unfortunate that some of these sites, in trying to correct the idea of a single, nation-wide outbreak, are now trying to minimize this year’s measles outbreaks.
No, there isn’t one large outbreak that is spreading across the United States, but there are a lot of smaller outbreaks, some of which are still ongoing.
And these outbreaks are not something that should still be expected, as we have had a safe and effective measles vaccine for over 50 years and measles was declared eliminated in the United States in 2000!
There is also something very much different about 2018, that not surprisingly, no one is reporting about.
With over 107 cases, things seem very similar to last year right, when we had about 118 cases?
She even defends Andrew Wakefield and doesn’t believe that people died of measles once MMR vaccination rates went down after Wakefield’s study was published.
A Crazymother Visits Her Pediatrician to Talk About Vaccines
As someone who is mindful that language can promote stigmas and stereotypes, it is not a term that I chose.
It is the name of a parenting group.
Wait until you hear what this pediatrician has to say when a Crazymother informs her she will no longer be vaccinating!
“Ok, today is just a hepatitis vaccine.”
I have made the decision that I no longer want my kids to be vaccinated.
At all. So, I know that’s not what you want to hear.
“It isn’t. It scares me. It scares me a lot.”
I know. I hear that, but I also have to do what I feel is best.
“Is there a specific concern that you have?”
Oh, there is a lot of things.
“What are they?”
There’s a lot. I’m worried about a lot. I wasn’t planning on having this conversation today. I didn’t know he was getting a shot. I wasn’t prepared. I thought he coming in for a blood test today. There’s a lot of reached out and met a lot of other moms who just have a lot of really sad stories and I just kind of started doing my own research and I just don’t feel like it is best for my kids and … I’m very concerned for his health and him getting vaccinated with all of these problems that he already has isn’t going to benefit him right now so I may change my mind down the road.
That last paragraph says an awful lot about why some parents are choosing to delay or skip their children’s vaccines:
“So my job at every visit is to let you know what you are declining and what we’re trying to protect against. It’s also very important if you decide not to immunize to remember that he’s at risk for a lot of other things so if he gets a fever its going to mean something different to mean than a child who is fully immunized as a fever… so if you call us after hours and he has a fever, make sure you tell us, oh by the way, he isn’t immunized…”
How does it mean something different if a child is intentionally not vaccinated?
While a vaccine-preventable disease should be in the back of your mind for any kid if their symptoms fit the disease, since vaccines aren’t 100% effective, they move higher up your list of possibilities if you know the child is unvaccinated and unprotected.
“I also just want to tell you that there’s a very big difference between anecdotal evidence and population based evidence, so just because someone has a sad story doesn’t mean that what happened to them is truly related to the vaccine.”
Crazymothers – OMG, I can’t even with this… She said that children didn’t get the MMR and many died. That’s not true. If you look at the cases of measles after 1998 when the Lancet study was published the measles cases actually went down. Nobody died. Nobody has died in America for years and years from the measles. It is completely silly.
Measles cases went down?
“Between 2001 and 2013 there was a sharp rise in the number of UK measles cases, and three people died.”
Current measles risks in the UK and Europe
As most folks now, before Wakefield was stripped of his medical license, he practiced in the United Kingdom, and not surprisingly, that’s where we saw a big effect on MMR rates. They went down and measles cases went up.
But even as measles cases and deaths have gone down globally, measles outbreaks and measles deaths have been much worse in the rest of Europe.
Even in the United States, cases have gone way up since we hit a record low of 37 cases in 2004 and there have been deaths, with the last in 2015.
“Again, this was very contentious and you would not get consensus from all members of the group on this, but that is my feeling, that the, the risk of this particular syndrome developing is related to the combined vaccine, the MMR, rather than the single vaccines.”
It is amazing how many times you hear the phrase “that’s not true” in this video about things that are so easy to confirm as facts.
“Continue to give it some thought because to me vaccines are modern miracles and it scares me to death to have people not getting vaccinated… He’ll probably be okay, but that’s because I’ve vaccinated my kids the other day, so we’re protecting your kid… The more people who stop doing it, forget about it, it’s going to go back to the old days where people are dying all of the time.”
Crazymothers – There’s that herd immunity myth. She says that your kid is going to be okay because I’m doing the right thing. I’m vaccinating my child. And anybody who studies this knows that’s not true! Herd immunity is a myth. Go outside and talk to a 30-year-old, 40-year-old, 50-year-old, who hasn’t been recently vaccinated and you can clearly see, plain as day…
As far as I know, we have indoor plumbing, we have sewage systems, we have clean water, and we have access to whole foods, we have ways to supplement with vitamins and minerals, we have all of these amazing things and that is what actually brings disease rates down.
Proper sanitation, sewage systems, all of the modern things that we take for granted – that is what is actually bringing the disease down, because clearly, in under-developed countries, we still see the diseases rampant, right?
But herd immunity is disease specific, so when we talk about herd immunity for measles, it doesn’t matter if someone has immunity against hepatitis A or Hib. Also, some vaccines, like Hib and Prevnar, have indirect effects, protecting adults even though they aren’t vaccinated, because vaccinated kids are less likely to become infectious.
There is only clearly one modern thing that that anti-vaccine folks take for granted – vaccines.
My uncle got polio around 1950, in Brooklyn, just before the first polio vaccine was developed.
You know what?
They had indoor plumbing, sewage systems, clean water, whole foods, vitamins and minerals, and medicine – he was hospitalized for six months – yet many people still died of polio.
At that time, during the pre-vaccine era, many people also died of measles, tetanus, pertussis, chicken pox, and many other diseases that are now prevented with vaccines.
And unfortunately, many under-developed countries still don’t have proper sanitation, sewage systems, or good nutrition, but do you know what they also don’t have?
We are very close to eradicating polio all over the world. Only two countries, Afghanistan and Pakistan still have cases of wild polio today. And so far this year, there have only been 11 cases. Did every other country in the world suddenly get proper sanitation, sewage systems, and good nutrition? Is that why we are so close to eradicating polio?
Of course not. It’s the polio vaccine.
Vaccines work. Vaccines are safe and necessary. They have few risks and many benefits. You won’t learn any of that from the Crazymothers group and that’s likely why you have made the decision that you no longer want your kids to be vaccinated.
What to Know About Crazymothers Propaganda
Don’t let Crazymothers propaganda scare you away from vaccinating and protecting your kids.
Wait, why would anyone think that the polio vaccine could be linked to outbreaks of hand, foot, and mouth disease?
“Scientific researchers have discovered that the infectious disease Hand,Foot and Mouth Disease is vaccine-induced and then spread to others through shedding from the Polio Vaccine. Enterovirus 71 (EV71) causes Hand, Foot, and Mouth Disease. The polio vaccine (OPV and IPV) is contaminated with EV71. It, along with EV-D68 and several other enteroviruses and coxsackie viruses are used in the manufacturing of the polio vaccines, which are given to children three times in the first year of life, and again between 4-6 years of life. Bottom line: children recently vaccinated with the polio vaccine are shedding the EV71 that causes the most serious complications of HFMD. ”
Is the Polio Vaccine Linked to Outbreaks of Hand Foot Mouth Disease?
Health Freedom Idaho makes some very serious claims and even links to a research article, which in most cases, you would expect to support their claims.
Not surprisingly, the article, A Dominant EV71-Specific CD4+ T Cell Epitope Is Highly Conserved among Human Enteroviruses, says absolutely nothing about contamination of vaccines and nothing about shedding.
“Recognizing disingenuous claims made by the anti-vaccination movement is essential in order to critically evaluate the information and misinformation encountered online.”
Anna Kata Anti-vaccine activists, Web 2.0, and the postmodern paradigm – An overview of tactics and tropes used online by the anti-vaccination movement
What about a link between polio vaccines and hand, foot, and mouth disease?
Well, hand, foot, and mouth disease is typically caused by the coxsackievirus A16 and EV71, which are enteroviruses. So is the polio virus. In fact, the Enterovirus genus is made up of 15 different species and 100s of different viruses. And they are all in the same Picornavirus family.
And that’s likely why researchers have found that “the most dominant epitope is highly conserved among enterovirus species, including HFMD-related coxsackieviruses, HFMD-unrelated echoviruses and polioviruses.”
“An epitope refers to the specific target against which an individual antibody binds.”
What is an Epitope?
So basically, this research isn’t saying that the polio vaccines are contaminated or that they cause hand, foot, mouth disease.
What it is saying, is that if you have been vaccinated with the polio vaccine, then you might have some protection against other enteroviruses!
“As shown here, poliovirus vaccination may have an impact on subsequent severity of HFMD disease. Cross-reactivity between EV71 A3 epitope and the A3v epitope of poliovirus 3 Sabin strain, may lead to the stimulation of protective, cross-reactive T cell responses, limiting the severity of subsequent HFMD.”
Wei et al. on A Dominant EV71-Specific CD4+ T Cell Epitope Is Highly Conserved among Human Enteroviruses
Yay for cross-reactivity!
“Cross-reactivity between antigens occurs when an antibody directed against one specific antigen is successful in binding with another, different antigen. The two antigens in question have similar three-dimensional structural regions, known as epitopes, which allow the antibody for one antigen to recognize a second antigen as being structurally the same antigen.”
Stephen J. Chadwick, MD
So you get antibodies from the polio vaccine and these antibodies cross react with the viruses that cause hand, foot, and mouth disease, which could lead to milder symptoms, because it is like you already have some antibodies to that virus too!
“HFMD outbreaks could occur where polio vaccination has failed, due to lack of refrigeration or other breaks in the cold chain that (might) go unreported.”
Exploring the Link between Polio Vaccination and Hand Foot Mouth Disease
In China, where outbreaks of hand, foot, and mouth disease are much more severe than they are in the United States, often leading to life-threatening disease, there has been a concern that the increased number of outbreaks could be linked to a failure of their polio vaccines, since getting vaccinated could be protective.
That’s the link the research is talking about…
I actually asked one of the researchers about what anti-vaccine folks were saying about their study and they told me:
“Well, that’s actually totally backwards. Our article suggests that FAILURE to get vaccinated with polio vaccine might set you up for Hand Food Mouth disease (EV71).”
Bottom line: polio vaccines are not contaminated and children recently vaccinated with the polio vaccine are not shedding the EV71 that causes the most serious complications of HFMD. Health Freedom Idaho made the whole thing up.
More on Linking the Polio Vaccine to Hand Foot Mouth Disease
Anti-vaccine folks often claim that health officials only worry about measles and measles outbreaks.
They can’t understand why anyone gets concerned by a few measles cases here and there, not understanding that a lot of work goes into containing measles outbreaks and making sure that they don’t grow beyond a few cases.
We do get concerned about measles outbreaks though.
“Whenever measles strikes, it’s more than just an outbreak of a single disease, or an indication that children aren’t receiving their measles shots; it’s also a warning that immunization coverage in general, for all vaccine-preventable diseases, is lower than it should be.
To put it another way: When rates of routine vaccination—children receiving all their shots on schedule, as a preventive measure rather than a reaction to an outbreak—start to fall, the first sign is usually a measles outbreak.”
Seth Berkley on Measles Outbreaks Are a Sign of Bigger Problems
The measles vaccine is among the most effective vaccines we have, so if we are seeing outbreaks, even though measles is very contagious, it means there is a problem.
“A focus on measles surveillance can help detect populations unreached by immunization systems and, by extension, program weaknesses. Measles serves as the ‘canary in the coal mine’ for detecting problems with immunization programs, a characteristic whose importance has recently been highlighted in the context of global health security.”
Orenstein et al on Measles and Rubella Global Strategic Plan 2012–2020 midterm review
As much as anti-vaccine folks like to try and minimize how serious measles can be, it is easy to see that measles is indeed a serious, life-threatening disease. We had good nutrition, proper sanitation, and modern health care in 1990, and still, a lot of people died with measles. Rates of subacute sclerosing panencephalitis (SSPE), a late complication of measles, went up too, in the years after these outbreaks.
“Measles is a wholly preventable disease, and it was almost eradicated from the country in 1983, when only 1,497 cases were reported. But by 1990, after Federal budget cuts and the end of the Government’s monitoring of immunization programs, more than 30,000 cases of measles and more than 60 deaths were reported.”
Panel Ties Measles Epidemic to Breakdown in Health System
Those outbreaks were fixed, as we improved access to help kids get vaccinated and protected. Unfortunately, the issue with outbreaks today isn’t about access to vaccines, at least not in the developed world. It is about parents intentionally skipping or delaying vaccines.