Tag: pre-vaccine era

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

What Is the Morbidity/Mortality Rate of the Polio Vaccine vs the Wild Virus?

Some anti-vaccine folks still think that the risks of vaccines are far greater than the risks of the vaccine-preventable diseases they keep you from getting.

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

They aren’t, but you can kind of understand why they might think that with a disease like polio, when they might never actually have known anyone to have the disease.

What Is the Morbidity/Mortality Rate of the Polio Vaccine vs the Wild Virus?

Still, even though polio is under good control and close to being eradicated, the risk/benefit ratio clearly favors getting vaccinated and protected.

That’s because the polio vaccines are very safe and if we stopped vaccinating, polio could come back.

In fact, morbidity/mortality from polio vaccines are decreasing, as we are using much less oral polio vaccine (OPV) in the transition (OPV cessation) to just using inactivated polio vaccine (IPV).

“Over the past ten years, more than 10 billion doses of OPV have been given to nearly three billion children worldwide. More than 16 million cases of polio have been prevented, and the disease has been reduced by more than 99%. It is the appropriate vaccine through which to achieve global polio eradication.”

OPV Cessation

And while most developed countries already use IPV, those that are still using OPV recently switched from a trivalent (tOPV) to a bivalent (bOPV) form of OPV. We could do this because type 2 poliovirus has already been eradicated (2015)!

Of course, the issue with the OPV vaccines is that they rarely cause vaccine-associated paralytic polio (VAPP) and circulating vaccine-derived polioviruses (cVDPV).

Fortunately, this is even less common with bOPV.

As this chart from the WHO shows, polio vaccines are very safe.
As this chart from the WHO shows, polio vaccines are very safe.

So morbidity (getting sick)/mortality (dying) from polio vaccines is low.

There were only 31 cases of wild polio in 2018, in Afghanistan and Pakistan, and an additional 102 cases of cVDPV in 7 countries.

What about morbidity/mortality from polio?

“As recently as 30 years ago, wild poliovirus paralysed more than 350 000 children in more than 125 countries every year. In 2018 there were fewer than 30 reported cases in just two countries – Afghanistan and Pakistan.”

“Zero polio transmission and health for all”, WHO Director-General gives new year’s wish to the people of Afghanistan and Pakistan

With a 99.9% drop in polio cases since 1998, your risk of getting polio in most parts of the world is very low, but you still have to consider both the morbidity/mortality of polio in the pre-vaccine era and the risk of polio returning if we stop vaccinating before it is eradicated.

What about the idea that you don’t have to worry about polio because only 1% of kids with polio developed paralysis?

“The mortality rate for acute paralytic polio ranges from 5–15%.”

Disease factsheet about poliomyelitis

Well, when everyone gets polio, even 1% is a lot.

With such a safe vaccine, why put your kids at risk of getting polio?

Do you even understand what the risks are?

No, it isn’t just the risk of wild polio in Afghanistan and Pakistan.

Since the oral polio vaccines shed, if you are unvaccinated, in addition to the risk of wild polio, there is a small risk of getting circulating vaccine-derived polioviruses (cVDPV) if you are not vaccinated and protected. No, it is not a big risk, as there were only 102 cases of cVDPV in 7 countries in 2018, but it isn’t zero either.

And the other big risk is that if enough folks stop getting vaccinated, taking their chances hiding in the herd, polio will come back and our chance to eradicate another vaccine-preventable disease will fail.

More on the Morbidity and Mortality Rates of Polio

Propaganda Busting Confirms Anti-vaccine Sites Photoshop Images

Spend a few minutes going through our list of anti-vaccine PRATTs, and you will quickly realize that they just push misinformation and propaganda.

Propaganda Busting Confirms Anti-vaccine Sites Photoshop Images

How easy is it to refute their claims?

Consider this “article” about measles outbreaks…

It shows an infant with chicken pox.

While that could be a simple mistake, it is actually a Photoshopped stock image of an infant with chicken pox that adds a big scary needle and syringe, that I guess is supposed to represent a vaccine.

Where's the syringe and needle?
Where’s the syringe and needle?

The thing is, neither the chicken pox nor MMR vaccine look like that and neither would be given with such a long needle!

In fact, that needle is about twice the size as any needle that would be used on an infant or toddler, which is why they had to Photoshop a separate photo of a big syringe and needle onto the infant with chicken pox.

It's just a stock image of a big syringe and needle...
It’s just a stock image of a big syringe and needle…

Now that you know that the photo is make-believe, you shouldn’t be surprised that their “article” is too.

This erroneous thinking has led the public, media and government alike to attribute the origin of measles outbreaks, such as the one reported at Disney in 2015 (and which lead to the passing of SB277 that year, stripping vaccine exemptions for all but medical reasons in California), to the non-vaccinated, even though 18% of the measles cases occurred in those who had been vaccinated against it — hardly the vaccine’s two-dose claimed “97% effectiveness.”

Government Research Confirms Measles Outbreaks Are Transmitted By The Vaccinated

By itself, the number of cases in an outbreak doesn’t exactly tell you a vaccine’s effectiveness. You also have to know something about how many people were vaccinated and unvaccinated and the attack rate, etc.

“Among the 110 California patients, 49 (45%) were unvaccinated; five (5%) had 1 dose of measles-containing vaccine, seven (6%) had 2 doses, one (1%) had 3 doses, 47 (43%) had unknown or undocumented vaccination status, and one (1%) had immunoglobulin G seropositivity documented, which indicates prior vaccination or measles infection at an undetermined time.”

Measles Outbreak — California, December 2014–February 2015

Anyway, in the Disneyland outbreak, if you do the math correctly, you can see that only 8 of 110 were fully vaccinated, or about 7%.

What does that tell you about vaccine effectiveness?

Not much!

Again, we don’t know how many vaccinated vs unvaccinated folks were exposed and didn’t get measles.

We can guess though…

Most folks are vaccinated, even in California. So the fact that only 7% of the people that got measles in the outbreak were fully vaccinated actually says quite a lot about how effective the MMR vaccine really is.

What about the idea that vaccinated people are starting outbreaks and spreading measles?

While the vast majority of measles outbreaks are in fact traced to someone who is unvaccinated, there was one outbreak in 2011 that was “started” by someone who was vaccinated.

“She had documentation of receipt of MMR vaccination at 3 years and 4 years of age. There was no travel during the incubation period and no known sick contacts. However, the index patient worked at a theater frequented by tourists.”

Outbreak of Measles Among Persons With Prior Evidence of Immunity, New York City, 2011

Since even the MMR vaccine isn’t 100% effective, is it really so surprising that occasionally, someone who received two doses of the vaccine could get measles and pass it to others, especially considering that around 220 people got measles in the United States that year?

“During 2011, a provisional total of 222 measles cases were reported from 31 states… Most patients were unvaccinated (65%) or had unknown vaccination status (21%). Of the 222, a total of 196 were U.S. residents. Of those U.S. residents who had measles, 166 were unvaccinated or had unknown vaccination status, 141 (85%) were eligible for MMR vaccination, 18 (11%) were too young for vaccination, six (4%) were born before 1957 and presumed immune, and one (1%) had previous laboratory evidence of presumptive immunity to measles.”

Measles — United States, 2011

Is the MMR vaccine a failure because there were some still some outbreaks in the 1980s, before we started to give kids a second dose? The attack rate in many of these school outbreaks, in which many kids had one dose of MMR, was still only about 2 to 3%.

It is safe to blame a failure to vaccinate and intentionally unvaccinated kids for most of the recent measles outbreaks.

Is the MMR vaccine a failure because we still have outbreaks among intentionally unvaccinated kids and every once in a while, in someone who is fully vaccinated who gets caught up in an outbreak?

Of course not!

It is easy to do a little research, consider what disease rates looked like in the pre-vaccine era, and know that vaccines work and that they are necessary.

More on Propaganda Busting Confirms Anti-vaccine Sites Photoshop Images