Tag: pre-vaccine era

How Many Vaccines Did Kids Get in the 1960s?

You have likely heard about the explosion in vaccines and vaccine dosages for kids, right?

Although it is easy to see that today’s counts are inflated to scare folks, it is a little harder to figure out about the good old days, when folks still got measles, mumps, Hib, hepatitis B and meningococcemia.

Did they get 2 vaccines or 5 vaccines or what?

How Many Vaccines Did Kids Get in the 1960s?

Well, maybe it isn’t that hard to figure out…

We could look in some old issues of Pediatrics and see how we used to vaccinate and protect kids back then.

And what would we find?

Kids got multiple doses of DPT, DT, polio, and smallpox vaccines in 1960.
Kids got multiple doses of DPT, DT, polio, and smallpox vaccines in 1960.

Using the same anti-vaccine math that gets us to 72 doses today, these kids in 1960 got 31 doses!

Remember, with anti-vaccine math, each DPT shot counts as 3 vaccines…

Looks like they’re going to have to fix the ad on their truck!

And all of the propaganda they put out trying to scare folks into thinking kids get so many more vaccines than they used too.

More on Immunizations Schedules from the 1960s?

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

What is the Natural Immunity Model?

It’s becoming a little clearer why some folks think it is safe to not vaccinate their kids, leaving them at risk to get vaccine-preventable diseases.

Who's calling the measles outbreaks a national emergency?
Who’s calling the measles outbreaks a national emergency?

Their idea of a natural immunity model of getting disease simply involves hiding in the herd and any outbreaks they trigger magically stopping.

What is the Natural Immunity Model?

Bob Sears thinks he has exposed some big news, that not everyone who gets measles dies.

Fortunately, that’s very true and something folks have always known.

With a death rate of about 1 in 1000 cases, you wouldn’t expect to have had any deaths after just 50 or 60 cases. But you never know. It’s not like every 1000th case dies. It could be the second case, the 562nd, or the 3043rd.

The hospitalization rates work the same way. They are statistical averages of what typically happens when people get measles.

That’s why measles was once called a “harmless killer.” It is often harmless, if you call having a high fever and feeling miserable for a week harmless, but it is sometimes a killer.

So is what we are seeing in Washington “what an outbreak looks like with the natural immunity model,” when no one is vaccinated and protected?

Of course not!

In a natural immunity model, up to 90% of the people who are exposed to someone with measles get sick!

In the pre-vaccine era, everyone got measles. That's the natural immunity model.
In the pre-vaccine era, everyone got measles. That’s the natural immunity model.

In a natural immunity model, everyone gets measles.

Not everyone survives having measles though.

Remember, the last measles death in the United States was during a 2015 outbreak in Washington. A immunocompromised women got caught up in an outbreak of mostly unvaccinated people, got measles, and died.

That’s the natural immunity model.

This family didn't have a choice about their son getting sick - he was too young to be vaccinated when he was exposed to an unvaccinated child with measles.
This family didn’t have a choice about their son getting sick – he was too young to be vaccinated when he was exposed to an unvaccinated child with measles.

Not having a choice about getting measles.

That’s the natural immunity model.

Worry about your child with leukemia after an exposure to measles…

That’s the natural immunity model.

“Well, what does this mean? Much like the outbreak in 2014 in a large Amish community (around 400 cases), and the recent NY outbreak in an orthodox Jewish community (around 100 cases), these types of outbreaks are centralized and self-limiting—which means they don’t spread like wildfire. These cases are also almost exclusively in communities who are CHOOSING not to be vaccinated. In other words, they are not random people “victimized” by measles. #dontfeelsorryforthem”

Melissa Floyd

Do anti-vaccine folks really think that these outbreaks are self-limiting? That they just stop on their own?

Do they not understand that the only thing that keeps them from “spreading like wildfire” is the intensive work of the local and state health departments, efforts to get folks vaccinated, and quarantines?

The Disneyland measles outbreak, for example, was hardly centralized or self-limited. It spread to Arizona, Nebraska, Utah, Colorado, Washington, Oregon, Mexico, and Canada.

And like many other large outbreaks, it cost millions of dollars to contain.

“Measles outbreaks can be very costly to communities, a new report suggests. For example, the 2013 measles outbreak in New York City cost the city’s health department nearly $395,000 and more than 10,000 personnel hours, according to a report in JAMA Pediatrics. And there were other non-monetary costs, including the loss of a pregnancy, researchers reported.”

Measles outbreaks come with serious consequences

That hardly sounds like something that is harmless or self-limited.

“Now, the ACIP is preparing to add a 3rd dose for all college-age students to try to stop adults from getting and spreading measles—THAT’S how common adults cases are. Yet in Washington, there were only three??”

Melissa Floyd

Not only is there no call for a third dose of MMR to help stop the spread of measles, the CDC actually says a third dose isn’t necessary.

“In the event that a HCP who has 2 documented doses of MMR vaccine is tested serologically and determined to have negative or equivocal measles titer results, it is not recommended that the person receive an additional dose of MMR vaccine. Such persons should be considered to have presumptive evidence of measles immunity.”

Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

Any talk about a third dose of MMR has to do with outbreaks of mumps…

“Is this all a coincidence my friends? Is the panic generated because of motive rather than data? In other words, could the media actually be encouraged to shift public beliefs on an issue to help pass legislation with a vested interest? #HerdImmunityDoesntApplyToVaccines”

Melissa Floyd

It’s not a coincidence that we are seeing so much anti-vaccine measles panic and propaganda these days. Outbreaks always bring it out.

Why?

It becomes harder to justify your decision to leave your kids unvaccinated and unprotected when you actually start to see that intentionally unvaccinated kids are getting sick.

More on the Natural Immunity Model

Remembering When Everyone Had Measles

In the pre-vaccine era, everyone got measles.

What was that like?

Remembering When Everyone Had Measles

Although the first measles vaccine was licensed in 1963, an improved version wasn't available until 1968.
Although the first measles vaccine was licensed in 1963, an improved version wasn’t available until 1968.

Well, for one thing, before we had a measles vaccine, having measles was considered a rite of passage for kids, but only because they had no choice except to eventually get it!

And when measles came to town, as it inevitably did, most folks got it, leading to missing weeks of school, play, and work, etc.

But it wasn’t all fun and games.

At best, measles left you feeling miserable.

Tragically for some, they didn’t survive having measles.

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

CDC says measles almost eliminated in U.S.

It should be clear that when measles was everywhere and everyone had measles, it could affect every aspect of your life.

Quarantines for measles were once very common, although everyone still ended up getting measles eventually.
Quarantines for measles were once very common, although everyone still ended up getting measles eventually.
In 1959, the Los Angeles Times reported that 80% of the kids in this school’s lower grades would be absent in an outbreak that had been ongoing since the previous month
Could you imagine your child’s college shutting down for two weeks because kids were getting sick? This was in 1956.
If measles was so mild, why were colleges shutting down for two weeks?
Quarantines were common to control outbreaks in 1949.
Too bad they didn’t have laptops in 1947, although even if they did, Will Jones would have been too sick to have worked from home when he had measles…
Remember the Lassie episode when Timmie had measles...
Remember the Lassie episode when Timmie had measles… When everyone got measles, measles was every were, even on TV.
Delaying a movie isn’t so bad…
But what about almost delaying a trip to the moon? Remember Apollo 13?
Measles deaths were common in 1952.

When everyone got measles, everyone had problems with measles.

We know what happens when immunization rates drop…

That’s why most of us are very glad to vaccinate and protect our kids. We don’t want them to get measles or any other vaccine-preventable diseases.

More on Remembering When Everyone Had Measles

Is January Usually a Big Measles Month?

This year is just getting started, but we already have reports of 86 92 94 measles cases in 7 states, and we haven’t even reached the end of January.

Is that a lot?

Well, let’s compare to previous years…

Is January Usually a Big Measles Month?

Classically, in the pre-vaccine era and in parts of the world that still have endemic measles, rates of this vaccine-preventable disease are highest:

  • during the late winter and early spring (temperate climates, like the United States)
  • after the rainy season (tropical climates)

In the post-vaccine era, measles season seemed to shift a little later, to the spring and early summer. In 1994, for example, when we had 963 cases of measles in the United States, 79% of those cases occurred between April and July.

January is not typically a big month for measles.
January is not typically a big month for measles.

Similarly, in 2011, we had only seen 15% of the year’s total measles cases by April 1. By August 1, that was up to about 70%.

We do see measles cases year round though, we just seem to see more of them in the spring and early summer months. Since most measles outbreaks in the United States are imported from other parts of the world, you might expect that we would see more cases when folks are traveling more and when there are big outbreaks in other parts of the world.

Unfortunately, measles is on the rise in many parts of the world right now.

And that is likely why we have already seen more cases this month than in the entire year of 2000 (86 cases), 2002 (44 cases), 2003 (55 cases), 2004 (37 cases), 2005 (66 cases), 2006 (66 cases), 2007 (55 cases), 2009 (71 cases), 2010 (61 cases), and 2016 (86 cases).

YearJanuary Measles CasesTotal Cases
19915969,643
1992492,200
199317312
19946963
199522309
19962508
20081140
20118220
20137187
201415667
2015108188
20188355
201994?

As you can see from the above table, January is not typically a big month for measles.

But what happened in 2015? There were a lot of measles cases in January, but we ended the year with only a moderate amount of cases.

That January spike was the California outbreak that had begun in December 2014. By February 2015, there were at least 125 cases, but fortunately no other large outbreaks the rest of the year.

Could that happen this year?

Could the ongoing outbreaks in New York and the Pacific Northwest stop and we then end up with only a moderate amount of cases?

Let’s hope so.

Let’s hope that having the second highest number of measles cases in January since 1991 ends up being the only record we set this year.

More on Measles Season

Did the Measles Vaccine Have Only a Meager Effect on Deaths?

Anti-vaccine folks seem to think that they found another big bombshell report!

As you will see, the “meager effect” of the measles vaccine prevented over 500 measles deaths in the United States each year!

They are talking about an article from 2001, The Role of Public Health Improvements in Health Advances: The 20th Century United States, by David Cutler, which found that “clean water was responsible for nearly half of the total mortality reduction in major cities, three-quarters of the infant mortality reduction, and nearly two-thirds of the child mortality reduction.”

The article even included mortality graphs for anti-vaccine folks to misuse!

Did the Measles Vaccine Have Only a Meager Effect on Deaths?

What are they missing?

“In the early 20th Century, mortality in the United States declined dramatically. Mortality rates fell by 40% from 1900 to 1940, an average decline of about 1% per year”

Cutler on The Role of Public Health Improvements in Health Advances: The 20th Century United States

Most of the decline the article talks about came at the beginning of the 20th Century, before these vaccines were developed.

What about the vaccines for whooping cough, diphtheria, and tetanus, which were developed in the earlier part of the 20th Century? They weren’t routinely used until much later. Remember, the individual diphtheria, tetanus, and pertussis vaccines didn’t even become combined into a single DTP vaccine until 1948.

Clean water and sanitation only had so much effect on mortality rates and much of it was in the early part of the 20th Century. Vaccines and other medical interventions took us the rest of the way!

But, all of these diseases that are now vaccine preventable were still very deadly in the 1940s and 1950s, even with clean water and sanitation.

Sure, mortality rates had declined already by this time, just like they had for most other things, but the effects of clean water eventually plateaued and a lot of people were still getting measles and a lot of people were still dying.

Why so many deaths in 1950 if they had been eliminated by clean water and sanitation?

At least they were until the measles vaccine was discovered and more and more people started getting vaccinated and protected.

You can even ask the author of the article in question…

“Dear Lord.  The fact that vaccines aren’t the only reason why mortality declines in no way means that vaccines are not an important reason why mortality declines.”

David M Cutler, Harvard College Professor, Otto Eckstein Professor of Applied Economics

The idea that the measles vaccine had only a relatively meager effect on deaths due to measles infections is silly. It’s also dangerous if you believe it and leave your kids unvaccinated and at risk to get measles, which is clearly a deadly disease.

More on Anti-Vaccine Mortality Graphs

Are Infants More Likely to Die from Vaccines Than the Natural Diseases They Prevent?

Someone made a chart about vaccine deaths, saying it came from the CDC, and is using it to compare to an infant’s risk of natural death from vaccine-preventable disease.

Need help fact checking this image about vaccine deaths that anti-vaccine folks like to post?
Need help fact checking this image that anti-vaccine folks like to post?

Do you see any problems?

Are Infants More Likely to Die from Vaccines Than the Natural Diseases They Prevent?

Yes, that’s right.

They are misusing VAERS reports and claiming that they are vaccine deaths.

“When evaluating data from VAERS, it is important to note that for any reported event, no cause-and-effect relationship has been established. Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.”

Guide to Interpreting VAERS Data

They are also leaving out the fact that deaths from vaccine-preventable diseases are low because most people are vaccinated and protected. Remember, one of the benefits of vaccines is that they got us out of the pre-vaccine era, when a lot of people died of these diseases. And most of us don’t want to go back!

As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks.
As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

If they scare enough people with this type of propaganda though and more people skip or delay their vaccines, then the diseases will come back and the risk of death increases.

“In a review of reports of death following vaccination submitted to the Vaccine Adverse Event Reporting System (VAERS) from the early 1990s, the Institute of Medicine concluded that most were coincidental, not causally associated.”

Moro et al on Deaths Reported to the Vaccine Adverse Event Reporting System, United States, 1997–2013

That’s not even all that’s wrong with their little chart though.

They clearly say that they are talking about infants, but their chart says that it includes data for vaccines from birth to 18 years.

That should be evident when you realize that infants get neither hepatitis A nor MenB vaccines and there weren’t even any VAERS reports of deaths for infants for the hepatitis A vaccine in 2014. In fact, there has never been a report of a MenB vaccine death in VAERS for an infant.

So basically, these folks used inflated reports of deaths from VAERS that are likely coincidental and not associated with getting a vaccine and compared them to deaths that were reduced by the fact most folks are vaccinated and protected.

Don’t believe them. Vaccines are safe and necessary, with few serious side effects.

More on Misusing VAERS Reports