Tag: pre-vaccine era

Do Kids Really Get 72 Doses of Vaccines?

Most parents vaccinate their kids according to the recommended immunization schedule.

They know that’s the best way to keep them protected.

Do Kids Really Get 72 Doses of Vaccines?

Saying kids get 72 doses of vaccines is a propaganda too to scare parents. — Saying kids get 72 doses of vaccines is a propaganda tool to scare parents.

While kids do get more vaccines than their parents did, that’s only because we have more vaccines available to protect them from more now vaccine-preventable diseases.

Do they get their kids 72 doses of vaccines?

That sounds like a lot…

It sounds like a lot because it is an inflated number that is meant to scare parents.

Kids today do routinely get:

13 vaccines, including 5 doses of DTaP, 4 doses of IPV (polio), 3 or 4 doses of hepatitis B, 3 or 4 doses of Hib (the number of doses depends on the vaccine brand used), 4 doses of Prevnar, 2 or 3 doses of rotavirus (the number of doses depends on the vaccine brand used), 2 doses of MMR, 2 doses of Varivax (chicken pox), 2 doses of hepatitis A, 1 doses of Tdap, 2 or 3 doses of HPV (the number of doses depends on the age you start the vaccine series), 2 doses of MCV4 (meningococcal vaccine), and yearly influenza vaccines
protection against 16 vaccine-preventable diseases, including diphtheria, tetanus, pertussis, measles, mumps, rubella, polio, chicken pox, pneumococcal disease, hepatitis A, hepatitis B, meningococcal disease, HPV, rotavirus, Hib, and flu
about 28 doses of those vaccines by age two years (with yearly flu shots)
about 35 doses of those vaccines by age five years (with yearly flu shots)
as few as 23 individual shots by age five years if your child is getting combination vaccines, like Pediarix or Pentacel and Kinrix or Quadracel and Proquad
about 54 doses of those vaccines by age 18 years, with a third of that coming from yearly flu vaccines

How do you get a number like 72?

You can boost your count to make it look scarier by counting the DTaP, MMR, and Tdap vaccines as three separate vaccines each, even though they aren’t available as individual vaccines anymore.

To boost the Vaccine Doses for Children a bit more, they add pregnancy doses too.

This trick of anti-vaccine math quickly turns these 8 shots into “24 doses.”

It’s not a coincidence.

Anti-vaccine folks want to scare you into thinking that vaccines are full of toxins, that kids get too many vaccines, that we give many more vaccines than other countries, and that this is causing our kids to get sick.

Can an unvaccinated child really get tetanus after a toe nail injury? Photo by Petrus Rudolf de Jong (CC BY 3.0)

None of it is true.

At age four years, when your preschooler routinely gets their DTaP, IPV, MMR, and chicken pox shots before starting kindergarten, how many vaccines or doses do you think they got? Two, because they got Kinrix or Quadracel (DTaP/IPV combo) and Proquad (MMR/chickenpox combo)? Four, because they got separate shots? Or Eight, because you think you should count each component of each vaccine separately?

Know that even if you do want to count them separately, it really just means that with those two or four shots, your child got protection against eight different vaccine-preventable diseases – diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, and chicken pox.

Vaccine-preventable diseases that have not disappeared, something that the “72 doses” sites don’t ever warn you about.

What to Know About Anti-Vaccine Math

Many websites use anti-vaccine math to inflate vaccine dose numbers and scare parents away from vaccinating and protecting their kids.

Can Vaccinated Children Be Asymptomatic Carriers of Pertussis?

Why do anti-vaccine folks like to talk about baboons so much?

“Did you know that a study showed that baboons injected with whooping cough vaccine became infected with whooping cough anyway – and silently spread the disease to other baboons for 35 days?”

Anti-vaccine Meme

Is it because baboons are used in the study of vaccines?

That’s part of it, at least when they can find a study where they can cherry pick the results to suit their needs.

The Baboon Study

Like most anti-vaccine talking points, this one about baboons, has some truth to it.

An adult male baboon. Photo by Elizabeth Miller

There was a baboon study with the pertussis vaccine and it found that previously vaccinated baboons could develop asymptomatic carriage of the pertussis bacteria after they were intentionally infected.

Here is where it is important to note that an infection is different than a disease.

The example that many people are familiar with is tuberculosis. It is common to have a TB infection without any signs or symptoms and to not feel sick. The only reason we know that they have TB is because they had a positive TB test.

Unfortunately, about 5 to 10% of these people with TB infections can eventually develop TB disease, with coughing, weight loss, night sweats, fever, and chest pain, etc.

It is kind of the same with the baboons in the study. Twenty-four hours after two previously vaccinated baboons were inoculated with pertussis bacteria in the back of their nose and trachea, an unvaccinated baboon was put in each of their cages.

The vaccinated baboons continued to have pertussis bacteria in their noses, which the researchers had put there, for up to 35 days. And they were able to eventually pass the pertussis bacteria to the unvaccinated baboons in their cages. Vaccinated baboons also became infected or colonized after they were put in a cage with an intentionally infected unvaccinated baboon.

“…animals did not cough and showed no reduction of activity, loss of appetite, or other outward signs of disease.”

Warfel et al on Acellular pertussis vaccines protect against disease but fail to prevent infection and transmission in a nonhuman primate model

The vaccinated baboons were infected, but they never did develop symptoms of pertussis.

What Does The Baboon Study Mean?

One thing that is for sure – the baboon study found that the pertussis vaccines work. Only unvaccinated baboons got sick with pertussis.

But does this study explain our current outbreaks of pertussis?

Are vaccinated people becoming colonized and then getting others sick?

I guess it is possible, but we are not baboons in a cage with other baboons. How would we spread a respiratory disease, even if we did become colonized with the bacteria, if we don’t have symptoms?

It may explain part of our outbreaks though.

If vaccinated people do commonly become colonized with pertussis bacteria, then they might very well test positive for pertussis even though they don’t have symptomatic pertussis disease. So when they develop a cold or bronchitis and are found to have a positive pertussis test, then couldn’t that test just indicate that they have a pertussis infection and not disease, even though something else is actually causing their symptoms?

That’s what we think happens with strep carriers, right?

That’s kind of what the baboon study found. All of the baboons tested positive, but only the unvaccinated baboons had symptomatic pertussis disease.

“Baboons vaccinated with wP vaccines exhibit a level of protection that is intermediate between convalescent animals and aP-vaccinated animals. They exhibit no outwards signs of disease and are initially colonized to the same high level as aP-vaccinated animals but clear the infection more rapidly.”

Pinto et al on Pertussis disease and transmission and host responses: insights from the baboon model of pertussis.

It is interesting to note that the baboon study also found that baboons who had received whole cell pertussis vaccines also became carriers. They just didn’t stay carriers for as long as the baboons who got the newer acellular pertussis vaccine. But since they were still carriers, if asymptomatic transmission is such a big problem, wouldn’t it have been a big problem back in the day when everyone got whole cell pertussis vaccines?

The Debate Over Asymptomatic Carriage

Most vaccines prevent the spread of disease.

Do the pertussis vaccines?

Most folks still think so.

“The baboon model pioneered by Warfel et al. is without question a game-changer, shedding light on the impact of vaccination on disease and infection. However, the view it affords is clearer with respect to immunity and pathology than with respect to transmission. We point out that the extrapolation of the possibility of transmission from vaccinated baboons in the laboratory to the probability of transmission from vaccinated humans in the population is unwarranted. More work is needed to elucidate the relative transmissibility of infections in vaccinated vs. unvaccinated hosts. The evidence adduced above suggests, however, that vaccination with aP must have a strong effect on transmission as well as disease.”

Matthieu Domenech de Cellès et al on Epidemiological evidence for herd immunity induced by acellular pertussis vaccines

Even the author of the baboon study has said that “We agree that these data should not be directly extrapolated to pertussis transmission in humans. Although baboons are >96% genetically similar to humans, there are likely differences in how the species respond to vaccination and infection. We also agree that aP-vaccinated infected people are likely less efficient at transmitting pertussis compared with unvaccinated infected people, although it is not clear to what extent.”

Others think that asymptomatic carriage of pertussis might behind a lot of our recent outbreaks. Or at least what helps them grow so large.

Still, it is important to remember that unvaccinated folks do play a role in these outbreaks too. In a pertussis outbreak at a Florida preschool, in which most kids were vaccinated, the outbreak was started by a vaccine-exempt toddler.

And we have seen this in many other areas and it has been confirmed by many studies. Whatever else is contributing to pertussis outbreaks, like waning immunity, they are also associated with vaccine refusal.

“Counties with higher exemption rates had higher rates of reported pertussis among exempted and vaccinated children when compared with the low-exemption counties.”

Imdad et al. on Religious exemptions for immunization and risk of pertussis in New York State, 2000-2011.

But what if the DTaP and Tdap vaccines do cause folks to be asymptomatic carriers?

Even if that is true, understand that these vaccines don’t actually infect you, making you a carrier. They just might not prevent you from becoming a carrier if you are exposed to someone else with pertussis. While that might be a good reason to develop a new and better pertussis vaccine, it certainly isn’t a reason to skip or delay your child’s vaccines now.

Remember that even with our current outbreaks, rates of pertussis were much higher in the pre-vaccine era.

What to Know About Vaccines and Asymptomatic Carriers of Pertussis

The role of asymptomatic carriers and pertussis is controversial, but it certainly isn’t a reason to skip or delay your child’s vaccines.

Why Do We Only Worry About Measles?

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.

And health officials don’t just worry about measles. They work to control outbreaks of mumps, pertussis, hepatitis A, and all other diseases too.

Why We Worry About Measles Outbreaks

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

In the late 1980s, when we had large outbreaks between 1989 to 1991, with 55,622 cases and 123 deaths, it meant that we weren’t vaccinating enough kids because Federal support for vaccine programs had dropped.

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.

How do you fix that?

Hopefully with education.

Why You Should Worry About Measles Outbreaks

Did you know that after the measles outbreaks of 1989, we also saw outbreaks of rubella and congenital rubella syndrome?

396 cases of rubella, 4 deaths, and 2 cases of congenital rubella syndrome in 1989
1,125 cases of rubella, 8 deaths, and 32 cases of congenital rubella syndrome in 1990
1,401 cases of rubella, 1 death, and 34 cases of congenital rubella syndrome in 1991

Did you know that because they have overall lower vaccination rates, measles outbreaks in Europe grow far larger, into the tens of thousands of cases, with dozens of deaths?

“We must not tolerate a world in which a child dies from a disease that can be easily prevented with a low-cost vaccine.”

Dr Tedros, WHO Director-General on World Immunization Week 2018

We worry about measles outbreaks, because we don’t want to go back to anti-vaccine folks push us back to pre-vaccine era levels of disease and deaths.

We know what happens when vaccine levels drop too low.

A measles epidemic hit New York City in 1951, as this front page NYTimes article reports. — A measles epidemic hit New York City in 1951, as this NY Times article reports.

We know that vaccines are safe and necessary.

You should know that anti-vaccine propaganda that scares parents away from vaccinating and protecting their kids is rooted in myths and misinformation. They often get away with it because most parents today ahve never seen how devastating measles and other diseases can really be, so they believe stories about the Brady Bunch, instead of the advice of real experts.

You hopefully understand that’s a mistake.

Comparing Lightning Strikes to Measles Deaths

Have you ever heard that your child has more of a chance of getting hit by lightning than getting measles?

Since getting struck by lightning is rare, folks like to use it in comparisons to other things that they also think are low risk when trying to make a point.

There are problems with this type of argument though.

Understanding Risk Perception

In an age when many folks are overly anxious about things, it is important to understand the difference between real and perceived risks. Unfortunately, our biases often lead us to worry about the wrong things, sometimes with tragic consequences.

“No intervention is absolutely risk free. Even the journey to a physician’s office with the intention to receive a vaccination carries the risk of getting injured in an accident. With regards to risks of vaccination per se, one has to distinguish between real and perceived or alleged risks.”

Heininger on A risk–benefit analysis of vaccination

Vaccines have risks, but they are small risks, as we know that vaccines are safe and necessary and the decision to skip or delay your child’s vaccines carries with it a much greater risk.

Comparing Lightning Strikes to Vaccine Preventable Diseases

How common or rare do you think it is to get hit by lightning?

odds of being hit by lightning – 1 in 1,171,000 (each year)
odds of ever being hit by lightning – 1 in 14,600 (lifetime risk)
on average, 26 people die after being struck by lightning each year (since 2007), which is down from a recent historical average of 45 deaths per year (30 year average) and way down from when we used to see 400 lightning strike deaths each year before 1950
on average, 252 people are injured after being struck by lightning each year

Actually, just since 2000, at least 5 people have died of measles in Canada. — Actually, just since 2000, at least 6 people have died of measles in Canada.

Although 26 people dying after lightning strikes sounds like way too many to me, especially since one recent death was a 7-year-old boy in Tennessee playing under a tree, with 1 in 1,171,000 odds of getting hit, it sounds like we are pretty safe.

But is it fair to use those odds to justify your decision to keep your kids unvaccinated?

Of course not!

Why is our risk of getting struck by lightning so low?

What happens when we hear thunder or see lightning?

When Thunder Roars, Go Indoors!

What happens when a thunder storm approaches and you are at your kids soccer or baseball game?

“Postpone or suspend activity if a thunderstorm appears imminent before or during an activity or contest (irrespective of whether lightning is seen or thunder heard) until the hazard has passed. Signs of imminent thunderstorm activity are darkening clouds, high winds, and thunder or lightning activity.”

UIL on Lightning Safety

Many ball fields now have lightning detectors to alert officials of nearby storms. And just about everyone has access to weather apps on a smart phone that can alert them to an approaching thunder storm or nearby lightning strikes.

The point is that most of us understand that lightning is dangerous, so we go far out of our away to avoid getting hit. The risk of getting hit by lightning isn’t 1 in 1,171,000 with folks running around outside waving golf clubs in the air during thunder storms or sitting on their roofs under an umbrella watching the storm.

The risk of getting hit by lightning is 1 in 1,171,000 because most of us go inside once we know lightning is nearby.

“Based on the media reports of the fatal incidents, many victims were either headed to safety at the time of the fatal strike or were just steps away from safety. Continued efforts are needed to convince people to get inside a safe place before the lightning threat becomes significant. For many activities, situational awareness and proper planning are essential to safety.”

A Detailed Analysis of Lightning Deaths in the United States from 2006 through 2017

And the same is true with measles and other vaccine-preventable diseases. They aren’t as common as they once were because most of us are vaccinated and protected.

If you skip or delay your child’s vaccines, you will increase the risk that they will get one of these vaccine-preventable diseases. And you will increase the risk that they will get someone else sick.

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”

Dr. Bob Sears in The Vaccine Book

And if enough people don’t get vaccinated, herd immunity fails, and we will see a return of pre-vaccine era levels of disease.

What to Know About Vaccines and Risk Perception

Folks often misuse lightning strikes when they think about risks, not understanding that the risk of getting hit by lightning is low because we take a lot of precautions to avoid getting hit by lightning.

How Many People Die from Vaccine Preventable Diseases These Days?

People don’t often die from vaccine-preventable diseases these days.

At least not in industrial countries.

Deaths from Vaccine-Preventable Diseases Today

Well, they aren’t supposed to.

Dr. Bob Sears actually reassured parents that measles wasn't deadly in developed countries, neglecting to mention the dozens of people who have died in outbreaks in Europe - another well-nourished population with lower vaccination rates than the U.S. — Dr. Bob Sears actually reassured parents that measles wasn’t deadly in developed countries, neglecting to mention the dozens of people who have died in outbreaks in Europe – another well-nourished population with lower vaccination rates than the U.S.

Tragically, we are seeing more and more deaths from vaccine-preventable diseases every day in countries that once had these diseases under good control:

over 100 measles deaths across Europe and a measles death in the United States a few years ago
diphtheria deaths in Australia, Belgium, South Africa, and Venezuela
life-threatening tetanus cases in Australia, Canada, New Zealand, and Ukraine
a rabies death in the United States in a child who’s parents skipped the post-exposure rabies vaccine
pertussis deaths in the United States
influenza – a record number of deaths in the United States, with most kids unvaccinated
rotavirus – yes, unvaccinated kids still die of rotavirus in the United States in the 21st Century! In a recent outbreak in California, in which a child died, almost all of the kids were unvaccinated.

And not surprisingly, these deaths are almost always in unvaccinated children.

Deaths from Vaccine-Preventable Diseases in the Pre-Vaccine Era

While tragic, we are still fortunate that these deaths are no where close to the levels we once saw before we had vaccines to protect our kids.

In the pre-vaccine era, we used to see:

up to 15,000 deaths and 200,000 diphtheria cases each year until the 1940s
an average of 175,000 cases of pertussis each year in the early 1940s, with about 1,118 deaths from pertussis in 1950 and 467 deaths from pertussis in 1955
up to 20,000 cases of paralytic polio each year until the early 1950s
an average of about 186,000 cases of mumps each year before 1967, with an average of 40 deaths a year
up to 500 deaths and 500,000 measles cases each year until the early 1960s
a rubella epidemic in 1964-65 that caused 12.5 million rubella virus infections and “resulted in 11,250 therapeutic or spontaneous abortions, 2,100 neonatal deaths, and 20,000 infants born with congenital rubella syndrome”
up to 20,000 cases of invasive H. influenzae (Hib) disease each year, with more than half of them having meningitis, and about 300 to 600 deaths, mostly children under age 2 years. In 1980, 45 children died with epiglottitis and there were an additional 222 deaths from Hib meningitis.
up to 11,000 hospitalizations and 100 chicken pox deaths each year until 1995
up to 17,000 cases of invasive pneumococcal disease in children younger than 5 years each year (before 2000), including 13,000 cases of bacteremia (blood infection) and 700 cases of pneumococcal meningitis, with 200 deaths.
just over 400,000 visits to the doctor and up to 272,000 visits to the emergency room, 70,000 hospitalizations and 20 to 60 deaths each year in children under age 5 years because of rotavirus infections until 2006

But that deaths from vaccine-preventable diseases aren’t common is hardly a reason to skip or delay your child’s vaccines, as some might suggest. It is just testament to the fact that vaccines work.

That these deaths from vaccine-preventable diseases quickly rise as rates of vaccinations drop is a tragic reminder that vaccines are necessary.

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

And what makes it even more tragic is that this was all predicted and could have been prevented if folks didn’t listen to anti-vaccine propaganda that scares them away from vaccinating and protecting their kids.

Worldwide Deaths from Vaccine-Preventable Diseases

Of course, talk of deaths from vaccine-preventable diseases shouldn’t stop with the developed or industrial world.

Even as a lot of progress is being made, as more and more people get vaccinated, worldwide, there were:

about 89,780 measles deaths, mostly young children
about 215,000 deaths from rotavirus infections
at least 1 million deaths from hepatitis B
almost 200,000 deaths from Hib
over 4,200 deaths from chicken pox
about 50,000 deaths from meningococcal infections
about 160,000 deaths from pertussis
about 826,000 deaths from pneumococcal infections
almost 60,000 deaths from rabies
just over 70,000 deaths from tetanus
about 222,000 deaths from typhoid
between 30,000 to 60,000 deaths from yellow fever

As you can see, most of these diseases are still big killers around the world.

“You hear about people who don’t like to vaccinate their kids in the Western world, which I suppose is a personal choice, but when you’re out there, the result of your children not being vaccinated is that they’ll likely die, or be horribly maimed. So yes, I saw a real desire to have their children protected, and also a real understanding of it – I didn’t seem to come across anybody who went ‘What is it?’ Or ‘What does it do?’ They all seemed to know about it.”

Ewan McGregor on Cold Chain Mission

In most of these countries, the problem is access to vaccines though, not parents refusing to get their kids vaccinated.

What to Know About Deaths from Vaccine Preventable Diseases

Unvaccinated kids are still dying from vaccine-preventable diseases.

Has the United States’ Infant Mortality Rate Ranking Been Dropping as We Vaccinate More Kids?

Of all of the myths about vaccines that confuse and scare some parents, those about infant mortality rates can be especially hard to easily put aside.

After all, why doesn’t the United States rank better for infant mortality rates since most parents do vaccinate and protect their kids?

Vaccines and Infant Mortality Rates

That’s actually fairly easy to answer.

“Globally, the infant mortality rate has decreased from an estimated rate of 64.8 deaths per 1000 live births in 1990 to 30.5 deaths per 1000 live births in 2016.”

WHO on Infant Mortality Situation and Trends

Vaccine-preventable diseases don’t have much effect on infant mortality rates in the United States these days.

What does?

birth defects
premature births
SIDS
maternal complications of pregnancy
injuries

Think about it… If vaccines did increase infant mortality rates, then why would infant mortality rates be dropping as we vaccinate more kids?

Has the United States’ Infant Mortality Rate Ranking Been Dropping as We Vaccinate More Kids?

The Wisconsin Coalition for Informed Vaccination is pushing myths about SIDS and vaccines. — The Wisconsin Coalition for Informed Vaccination is pushing myths about infant mortality rates and vaccines.

Do you know what has been dropping?

The infant mortality rate.

In fact, infant mortality rates continue to drop and are now at their lowest levels ever.

While it is good news that the rate is dropping, most folks think they can be better.

For one thing, some states, like Mississippi, Louisiana, Alabama, Arkansas, and West Virginia, etc., have much higher infant mortality rates than others. Why? Much of those differences, can be explained by socio-economic factors. That’s also though to explain much of the differences in infant mortality rates between the U.S. and other developed countries, most of which have universal health care.

New Jersey, although they have ranked high for autism rates, has lower than average rates of infant mortality.

Another big difference is that many countries count infant mortality rates using different criteria than the United States.

For example, it is estimated that at least 40% of the differences between infant mortality rates in the United States and other countries is due to those countries not counting extremely preterm births among their statistics.

But why has the United States’ infant mortality ranking fallen relative to other developed nations?

Most European Countries had much higher infant mortality rates than the US in the 1960s and 70s, which affected relative rankings, even as all countries saw infant mortality rates fall. — OECD data shows that most European Countries have historically had much higher infant mortality rates than the US, which have affected relative rankings, even as all countries have seen infant mortality rates fall.

Although anti-vaccine groups try to tie this to ‘routine vaccination,’ it is easy to see that other countries have historically had much higher infant mortality rates than the United States. As they have caught up, the United States’ ranking has dropped relative to theirs, even though all have seen infant mortality rates drop.

Infant Mortality Rates in the Pre-Vaccine Era

But if you really want to understand the relationship of vaccines to infant mortality rates, you just have to look back to the pre-vaccine era. Back then, now vaccine-preventable diseases did have a big effect on infant mortality rates in the United States and elsewhere.

In 1910, for example, the most common causes of death for infants under 1 year were:

diarrhea and enteritis
premature birth
congenital debility
bronchopneumonia
pneumonia
malformations
bronchitis
convulsions
injuries at birth
whooping cough
tuberculosis
meningitis
measles
accident
diphtheria

Although advances in modern medicine would help decrease the mortality from many of those diseases, it was vaccines that truly worked to make sure they were no longer a big part of our infant mortality statistics.

How will we continue to decrease our infant mortality rates?

Most experts think that it will require better access to health care for all members of society.

What to Know About Infant Mortality Rate Rankings

Infant mortality rates are not linked to vaccines.

More Infant Mortality Rate Rankings

CDC – Mortality Statistics: 1910
OECD (2018), Infant mortality rates (indicator). doi: 10.1787/83dea506-en (Accessed on 26 May 2018)
CDC – Recent Declines in Infant Mortality in the United States, 2005–2011
International Comparisons of Infant Mortality and Related Factors: United States and Europe, 2010
CDC – Infant Mortality
WHO – Infant Mortality Situation and Trends
Vaccines and infant mortality rates : A false relationship promoted by the anti-vaccine movement
Infant mortality and vaccines
Childhood mortality and vaccines
Properly evaluating vaccine mortality
Vaccines and infant mortality rates: A false relationship promoted by the anti-vaccine movement
Study – Socioeconomic status and risk of infant death. A population-based study of trends in Norway, 1967–1998
Study – Socio-economic factors associated with infant mortality in Italy: an ecological study

Why Didn’t Everyone Die with Our 1980s Level of Vaccination Rates?

This is actually a real question that someone recently asked:

“Can someone please explain how we survived the 1980s with vaccination rates well below “herd immunity” thresholds and far fewer vaccines? Why didn’t everyone die?”

J.B. Handley

Mr. Handley even provides a nice chart to give his question some context.

Vaccination rates for 2 year old children in 1985. — The chart shows vaccination rates for 2 year old children in 1985.

So why didn’t everyone die?

That’s easy.

While vaccine-preventable diseases can be life-threatening, they certainly don’t kill everyone who gets them. They are not 100% fatal. Well, rabies usually is, but not surprisingly, rabies wasn’t on his little chart…

Deaths from Vaccine-Preventable Diseases, 1985

What else does Mr. Handley miss?

“Comparisons between rates obtained from immunization records versus the total sample (records and recall) conducted on data collected between 1979 and 1983 showed that the USIS, which accepted parental recall, underestimated the true vaccination rate in preschoolers by as much as 23% for some antigens.”

Simpson et al on Forty years and four surveys: How does our measuring measure up?

The vaccination rates he is citing were based on a phone survey that wasn’t thought to be very accurate, underestimating true vaccination rates. It was last used in 1985.

While vaccination rates weren’t great at the time, they just weren’t as horrible as he makes it seem, but we still had some deaths from vaccine-preventable diseases. Not as bad as the pre-vaccine era though, when hundreds of people died with measles each year.

Here’s the data from the CDC for 1985:

https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/E/reported-cases.pdf

23 deaths from tetanus
4 deaths from pertussis
4 deaths from measles
1 death from rubella
2 cases of congenital rubella syndrome

Unfortunately, it got worse. This was just before the large measles outbreaks from 1989 to 1991, when 123 people died. During those three years, there were also 28 deaths from pertussis, 6 deaths from mumps, 13 deaths from rubella and 77 cases of congenital rubella syndrome!

But then we learned our lesson and we got kids vaccinated. But most of the problems then were about access to vaccines, not parents who intentionally skipped or delayed vaccines for their kids.

Deaths from non-Vaccine-Preventable Diseases, 1985

The CDC Morbidity and Motality Weekly Report includes summaries of notifiable diseases in the United States. Many of the diseases on J.B. Handley’s chart weren’t yet vaccine-preventable in 1985. They were quite deadly though, which is why vaccines were being developed and were eventually added to the schedule to protect our kids from getting them.

But in 1985 (*or in the years before the vaccine was introduced), tragically, the CDC lists:

80 deaths from hepatitis A
490 deaths from hepatitis B
68 deaths from chicken pox
219 deaths from Hib meningitis in children and about another 45 deaths from Hib epiglotittis
at least 200 deaths from pneumococcal disease in children*
257 deaths from meningococcal infections
20 to 60 deaths each year from rotavirus infections*

Want us to Turn Back the Clock and go back to an immunization plan (the Jenny McCarthy schedule) that didn’t include vaccines against any of these diseases? We would end up back to when kids still died of meningitis, pneumonia, blood infections, severe dehydration, epiglottitis, and cancer from Hib, pneumococcal disease, rotavirus, hepatitis B, hepatitis A, chicken pox, HPV, and meningococcal disease.

And the answer to Mr. Handley’s question becomes even more obvious.

How did we survive the 1980s with vaccination rates well below “herd immunity” thresholds and far fewer vaccines?

Many people didn’t.

What to Know About Deaths and Vaccination Rates

Poor vaccination rates and fewer vaccines led to more deaths from now vaccine preventable diseases in the mid-1980s.

VAXOPEDIA

Do Kids Really Get 72 Doses of Vaccines?