Tag: nutrition

Risks and Benefits of Vaccines – Anti-Vax Edition

Anti-vax folks like to say that they are doing their research, even collecting that research into handy binders. And they like to think that they are looking at both the risks and benefits of vaccines when they make their decision to skip or delay their child’s vaccines.

When anti-vax folks look at the risks and benefits of vaccines, they see lots of risks and few benefits.
When anti-vax folks look at the risks and benefits of vaccines, they see lots of risks and few benefits.

Like their research, their method of considering the risks and benefits of vaccines is very flawed

Risks and Benefits of Vaccines – Anti-Vax Edition

What’s the first thing you notice when you look at Ashley Everly‘s chart?

She doesn’t have a column for when a child Should Be Vaccinated!

Although there are no optional vaccines, there are some situations in which getting vaccinated and protected is truly essential, including:

  • a child bitten by a dog, coyote, or bat with rabies
  • a completely unvaccinated teen who gets a deep puncture wound while playing in a field
  • a baby born to a mother with hepatitis B
  • an unvaccinated older teen living in a dorm on a college campus where there is an ongoing outbreak of meningococcemia
  • a preschooler with a cochlear implant
  • an unvaccinated 1st grader who’s sibling is starting chemotherapy for leukemia
  • unvaccinated kids traveling out of the country to parts of the world where vaccine-preventable diseases are still endemic
  • a child with asplenia

Does she really think that the benefits of the rabies vaccine don’t outweigh the risks? Does she understand what happens if you get rabies, even if your child has access to nutritious food, clean drinking water, and emergency medical care?

Who Should Not Be Vaccinated?

What else is wrong with Ashley Everly‘s risk and benefit chart?

Most of the things on her list of who should not be vaccinated are not true contraindications.

Of course, the one about having a “previous vaccine injury or serious reaction” would likely be a reason to not get that vaccine again, as long as the injury or reaction was really caused by the vaccine.

Are there situations in which the potential benefit of vaccination might not outweigh the vaccines risks?

“Events or conditions listed as precautions should be reviewed carefully. Benefits of and risks for administering a specific vaccine to a person under these circumstances should be considered. If the risk from the vaccine is believed to outweigh the benefit, the vaccine should not be administered. If the benefit of vaccination is believed to outweigh the risk, the vaccine should be administered. Whether and when to administer DTaP to children with proven or suspected underlying neurologic disorders should be decided on a case-by-case basis.”

ACIP Contraindications and Precautions

Those situations are called precautions.

Fortunately, most are temporary, such as having a “moderate or severe acute illness with or without fever.”

These precautions do not include having a family history of cancer or autoimmune disease.

When Vaccination May Be Unnecessary

Are there any situations in which vaccination may be unnecessary?

There are a few, including:

  • when a disease is eradicated
  • when you aren’t at risk to get a disease and there is little risk that there will be an outbreak in your community or a return if folks stop vaccinating – that’s why we don’t routinely vaccinate against yellow fever, cholera, and typhoid fever, etc. in the United States
  • when you get sick and develop natural immunity

Vaccination is still necessary if a child’s mother is breastfeeding (which doesn’t protect against most vaccine-preventable diseases), has natural immunity to wild type infections (passive immunity quickly wears off), and even if the child has access to nutritious food and clean drinking water.

Nearly two months in the ICU vs getting a tetanus shot… How do the risks and benefits stack up now?

And yes, getting vaccinated and protected is even necessary if a child has access to emergency medical care.

What to Know About the Risks and Benefits of Vaccines

While you should certainly consider the risks and benefits of getting vaccinated, understand that vaccines are safe, with few risks, and very necessary.

More on the Risks and Benefits of Vaccines

How Do Anti-Vaccine Folks Respond to New Information?

Ever wonder why most anti-vaccine folks don’t change their mind and get their kids vaccinated and protected when they “do their research” and “get educated” about vaccines?

You would think that they would, considering that anti-vaccine talking points are all based on myths and misinformation.

How Do Anti-Vaccine Folks Respond to New Information?

While some do change their mind, even before they are faced with an outbreak or their child getting sick, the biggest reason that others don’t is that they are stuck in an echo-chamber of like-minded folks.

This discussion is a good example of how this works.

The original poster wasn’t aware that measles was on the rise all over the world and that people are dying.

How do you respond to the fact that people are dying of measles?

So do they understand that reason behind the deaths is because those folks were unvaccinated?

Why didn’t “extreme poverty, poor nutrition, and a lack of sanitation” cause more measles deaths in Ukraine, Philippines, and Brazil before now?

Nope.

It’s always the vaccine with these folks…

It is anything and everything except that they weren’t vaccinated!

According to whom? You can actually go to the national health sites for each of these countries and find the data for yourself, if you were really interested in doing research.

And that they aren’t in America!

That’s not America… yet. Our measles cases are rising though and sooner or later we will start seeing measles deaths.

So what’s wrong with their thinking?

To start, these countries aren’t underdeveloped!

Brazil and the Philippines are newly industrialized countries and while Ukraine is considered a developing country, it is hardly the developing country without sanitation and nutrition that these folks make it out to be.

The problem in all of these countries isn’t a lack of nutrition, clean water, or health care. It is that too many folks are unvaccinated!

That becomes easier to see when you look at where else we are seeing a lot of measles deaths – the rest of Europe.

In the past 12 months, there have been 22 deaths from measles in Romania, Italy, France, and Greece.

Are folks in Italy suffering from malnutrition? Do they not have clean water?

There have been 64 deaths in Romania since there outbreaks started a few years ago.

Although Romania is a developing country, it isn’t a lack of clean water and sanitation that is causing measles deaths. It is that too many people in Romania are unvaccinated!

And too many people are listening to anti-vaccine propaganda.

Vaccines are safe, with few risks, and are obviously necessary.

More on How Anti-Vaccine Folks Respond to New Information

We Know Vaccines Work

We know vaccines work.

How well do they work?

In addition to eradicating smallpox, did you know that vaccines have helped eliminate four other now vaccine-preventable diseases?

  1. diphtheria
  2. neonatal tetanus
  3. polio
  4. congenital rubella syndrome

And unlike measles, which was declared eliminated in 2000, we really don’t see these diseases anymore.

We Know Vaccines Work

How well do vaccines work?

Let’s look at the disease counts (morbidity data), how many kids got sick, just before we developed a vaccine and where we are now:

DiseasePre-Vax EraNow% Decrease
Smallpox110,672last case 1977 100%
Diphtheria30,508199.9%
Pertussis265,26913,43994.9%
Tetanus6012096.7%
Neonatal Tetanus1,000+0100%
Polio21,269last case 1993100%
Measles763,094372 99.9%
Mumps212,9342,25198.9%
Rubella488,796599.9%
Congenital Rubella Syndrome20,0000100%
Hib invasive18,0002799.9%
HepB300,0002,79999.1%
Perinatal HepB16,20095294.1%
Pneumococcal invasive64,40098698.5%
HepA254,51811,16695.6%
Varicella5,358,5956,89299.9%

Sandra Roush and Trudy Murphy provided us with pre-vaccine baselines for 13 vaccine-preventable diseases in their article, Historical Comparisons of Morbidity and Mortality for Vaccine-Preventable Diseases in the United States.

“A greater than 92% decline in cases and a 99% or greater decline in deaths due to diseases prevented by vaccines recommended before 1980 were shown for diphtheria, mumps, pertussis, and tetanus. Endemic transmission of poliovirus and measles and rubella viruses has been eliminated in the United States; smallpox has been eradicated worldwide. Declines were 80% or greater for cases and deaths of most vaccine-preventable diseases targeted since 1980 including hepatitis A, acute hepatitis B, Hib, and varicella. Declines in cases and deaths of invasive S pneumoniae were 34% and 25%, respectively.”

Roush et al on Historical Comparisons of Morbidity and Mortality for Vaccine-Preventable Diseases in the United States.

Their study, which came out in 2007, used morbidity (2006) and mortality (2004) data that was recent at the time. The data has held up very well since then, looking at 2018 statistics in the National Notifiable Infectious Diseases Weekly Tables (see below), even with talk of waning immunity for some vaccines.

But can’t you explain all of this decline away by talking about better hygiene, sanitation, and nutrition?

Of course not!

“…for those trained in pediatrics in the 1970s, Hib (Haemophilus influenzae type b) was a horror.”

Walter Orenstein, MD

The pre-vaccine era for Hib was just before 1988, when the first Hib vaccine came out. We had good hygiene, sanitation, and nutrition in the 1980s and yet, a lot of kids died from Hib meningitis and epiglottitis. At least they did until he got a vaccine to prevent it.

And if it was better hygiene and sanitation, etc., why did it affect every disease at a different time? And why hasn’t better hygiene and sanitation stopped RSV, HIV, norovirus, Zika, and all of the other non-vaccine-preventable diseases?

Although there was a decline in mortality rates at the beginning of the 20th Century for all diseases thanks to better hygiene, sanitation, and nutrition, that effect plateaued by the mid-1930s. And since a lot of people were still getting sick, remember everyone used to get measles, even if a small percentage would die, it would add up to a lot of deaths!

Vaccines aren’t perfect, but they are safe, with few risks, and work well. Get vaccinated and protected if you want to keep from getting and bringing back these now vaccine-preventable diseases.

More on We Know Vaccines Work

Behind the Curtain of the Anti-Vaccine Movement

Ever wonder what anti-vaccine folks talk about?

How they do their research?

Behind the Curtain of the Anti-Vaccine Movement

Here you go!

How do you argue the point that vaccines killed off all of the diseases?
That seems like a reasonable question…

There is a good reason that folks have a hard time arguing this point.

Vaccines work.

But let’s see how they do…

It is with her summary that says you can treat cancer naturally and without chemotherapy.
It is with her summary that says you can treat cancer naturally and without chemotherapy.

The idea that we simply renamed diseases to make them disappear has to be the silliest anti-vaccine claim that you will hear. If that’s true, why not come out with an RSV vaccine or an HIV vaccine and rename those diseases?

If smallpox was renamed to monkey pox, then where are all of the kids with monkey pox?
If smallpox was renamed to monkey pox, then where are all of the kids with monkey pox?

The idea that better hygiene, sanitation, and good nutrition made now vaccine-preventable diseases go away is a very good theory, because those things did actually improve the mortality rates for most things in the early part of the 20th century. Unfortunately, those effects plateaued by the 1930s.

When my uncle got polio in Brooklyn in the early 1950s, our family and access to very good hygiene, sanitation and nutrition. It didn’t help. Remember, a lot of people were still dying at the time from polio, pertussis, diphtheria, and measles.

It was vaccines.

Actually, it’s the charts and graphs with declining mortality rates from better hygiene and sanitation in the early 20th century that anti-vaccine folks can use to fool folks into thinking that vaccines don’t work. If they actually look at disease rates, with a few exceptions, they will see that they were mostly unchanged.

Charts with mortality rates won't prove their point, but are their only chance to fool folks. They have no chance if they use disease rates...
Charts with mortality rates won’t actually prove their point, but are their only chance to fool folks. They have no chance if they use disease rates

This is actually an interesting idea. Do viruses and bacteria become attenuated or less dangerous over time? Considering that smallpox was around for thousands of years and was still deadly right up until it was eradicated, in general, there is plenty of evidence against this idea. You can also look at polio, which still paralyzing people.

Scarlet fever has become less dangerous, but no evidence that many other diseases have over time.
Scarlet fever has become less dangerous, but no evidence that many other diseases have over time.
Sanitation, plumbing, clean food, hygiene worked to get rid of diseases - anything but vaccines...
Anything but vaccines…

This is another silly idea. It implies that vaccines actually cause outbreaks of vaccine-preventable disease. If this were true, then as we have been vaccinating more and more people, wouldn’t rates for all of these diseases have been going up over the years? And how did we eradicate smallpox? How are we so close to eradicating polio?

Then why do we see outbreaks in clusters of folks who are mostly intentionally unvaccinated.

Instead, we see outbreaks in clusters of folks who are mostly intentionally unvaccinated and no, it’s not just during “shedding season.”

Witch's brew of vaccines?
Again, anything but vaccines…

Do you really believe that ‘they’ are purposely “releases (sic) these diseases again, to cause hysteria, to get people back in their corner vaccinating again?”

It's a conspiracy! Big Pharma!!!
It’s a conspiracy! Big Pharma!!!
Vaccines are not killing people.
And yet, life expectancy and infant mortality rates are going up…

We know why they are coming back… It ain’t magic.

Are you prepared to argue their point now?

Did they convince you that we renamed diseases, flushing toilets and clean water got rid of all diseases, vaccines cause outbreaks, or that all of the diseases we developed vaccines for just naturally got milder and went away?

Or did they convince you to go out and vaccinate and protect your kids?

More on Behind the Curtain of the Anti-Vaccine Movement