Tag: risk perception

What Happens When You Research the Disease?

We know how anti-vaccine folks think.

Anti-vaccine math…

And now we know how they do their research

How Anti-Vaccine Folks Research Disease

If you’re like me, you are probably wondering why they picked 2016 as the year to research.

Why look just at 2016?

And, there you see it.

In the past 6 years, 2016 was the year with the fewest cases of measles. Why not choose 2017 or 2018 to do their research?

But let’s look at 2016, even though the information isn’t complete:

  • 86 cases
  • cases in 19 states, including Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon, Tennessee, Texas, and Utah
  • a large outbreak in Arizona (31 cases) linked to a private detention center and all that is known is that 7 of 9 staff members who got measles had received at least one dose of MMR, and 3 had received their dose very recently
  • a large outbreak in Shelby County, Tennessee, at least 7 cases, including 6 unvaccinated and one partially vaccinated child
  • a large measles outbreak (17 cases) in Los Angeles County and Santa Barbara County that was linked to the Los Angeles Orthodox Jewish community
  • two cases in Colorado, including an unvaccinated toddler and an unvaccinated adult – outbreaks which cost at least $68,192 to control

And of th cases in 2016, it seems that just 16% were vaccinated.

What about the claim that 26% were vaccinated?

That wasn’t 26% of the total number of cases, but rather 26% of the cases among US residents.

So if you do the math, that’s just 14 cases that were vaccinated, and out of 86 cases, that’s really just 16%. And a lot of those cases are skewed by the one outbreak at the detention center, in which they may have only received one dose of MMR and nearly half may have gotten vaccinated after the caught had already started!

What about the claim that “the odds of dying from the measles are like 0.00000013%” using numbers “before the vaccine was introduced in 1963?”

“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.

In the pre-vaccine era, your odds of getting measles were very high. Remember, everyone eventually got measles.

And looking at statistics of reported measles cases and reported measles deaths, we know that death occurred in about 1 to 3 in every 1,000 reported cases.

So everyone got measles, but not everyone survived having measles.

Even if you use a more liberal count of 1 death in 10,000 cases, when all kids get measles, that’s a lot of deaths. Remember, about 450 people used to die with measles each year.

What about your odds of dying with measles now?

If you are fully vaccinated, then they are extremely low.

They are pretty low if you are unvaccinated too, in most cases, because you are benefiting from herd immunity and the fact that most folks around you are vaccinated, reducing your risk of being exposed to measles. Still, the risk is much higher than most anti-vaccine folks expect, because they often make the mistake of using the entire population of the United States in their calculations. They should instead just use the folks who are unvaccinated and susceptible, a much smaller number.

Want to increase your risk?

  • travel out of the country
  • hang out in a cluster with other unvaccinated people
  • stay unvaccinated

The odds aren’t in your favor to avoid measles if you are unvaccinated. Eventually, your luck might run out.

Starting to see the mistakes anti-vaccine folks make when they say they have done their research?

“How do they know how many people would have gotten measles and how many of them would have died?!?”

It’s not rocket science.

It’s epidemiology.

“We constructed a state-space model with population and immunisation coverage estimates and reported surveillance data to estimate annual national measles cases, distributed across age classes. We estimated deaths by applying age-specific and country-specific case-fatality ratios to estimated cases in each age-country class.”

Simons et al on Assessment of the 2010 global measles mortality reduction goal: results from a model of surveillance data.

Unfortunately, after years of improvements, measles deaths increased in 2017. And they will continue to increase, as our risk of getting measles continues to increase if folks don’t get vaccinated and protected.

Lastly, why does it “sound like millions of people would have died without the measles vaccine?”

Maybe because millions of people died in previous years, before they were vaccinated and protected.

Indeed, do your research, but you will find that vaccine-preventable diseases aren’t as mild as anti-vaccine folks believe. That’s why it is important to get vaccinated and protected.

More on Researching Vaccine-Preventable Disease

Did a Top Cancer Scientist Suddenly Die After Getting a Yellow Fever Vaccination?

We are seeing many reports that Professor Martin Gore, an oncologist at London’s Royal Marsden Hospital for more than 35 years, died suddenly after getting a yellow fever vaccine.

Could that be true?

Could someone really die after getting a routine vaccination?

Did a Top Cancer Scientist Suddenly Die After Getting a Yellow Fever Vaccination?

Of course, it could be true.

Although vaccines are very safe, they are not 100% risk free. And tragically, they do very rarely have life-threatening side effects.

To be fair, we don’t know the full story about what happened to Prof Gore, but the media reports do say that he suffered total organ failure shortly after getting his yellow fever vaccine.

What we don’t know is how shortly after getting the vaccine or if there is any evidence for another cause for his having organ failure.

Still, although most side effects are mild, it is reported that the yellow fever vaccine, which has been available for more than 80 years, can rarely cause:

How rarely?

About 1 in 55,000 for severe allergic reactions, 1 in 125,000 for severe nervous system reactions, and 1 in 250,000 for life-threatening severe illness with organ failure.

And the risks are likely higher if you are older than age 60 years, although YEL-AND and YEL-AVD are not reported to happen with booster doses of the yellow fever vaccine.

“People aged ≥60 years may be at increased risk for serious adverse events (serious disease or, very rarely, death) following vaccination, compared with younger persons. This is particularly true if they are receiving their first yellow fever vaccination. Travelers aged ≥60 years should discuss with their healthcare provider the risks and benefits of the vaccine given their travel plans.”

Yellow Fever Frequently Asked Questions

Why would you get the yellow fever vaccine if you were older than aged 60 years and you knew there was a higher risk of severe side effects?

Yellow fever itself is a life threatening disease without a cure and a case fatality rate of up to 50%, and again, YEL-AVD is not common, occurring in about 0.4/100,000 doses.

So you would typically want to get vaccinated if you were traveling to an area where yellow fever was a risk.

“Since January 2018, 10 travel-related cases of yellow fever, including four deaths, have been reported in international travelers returning from Brazil. None of the 10 travelers had received yellow fever vaccination.”

Fatal Yellow Fever in Travelers to Brazil, 2018

In addition to outbreaks, yellow fever is still endemic in forty-seven countries in Africa and Central and South America, leading to 170,000 severe cases and 60,000 deaths in recent years, including some deaths in unvaccinated travelers returning from these areas. Did you read about these deaths in the paper?

Although it is not on the routine immunization schedule, if you are traveling somewhere and yellow fever is a risk, you should get a yellow fever vaccine.

Professor Gore’s death, at age 67, is a tragedy, no matter the cause.

That we are having to talk about it because anti-vaccine folks are using his death to push their idea that vaccines aren’t safe is unconscionable.

More on Yellow Fever Vaccine Deaths

How to Become a Vaccine Advocate

Are you tired of reading about outbreaks that might put your family at risk, either because they are too young to be vaccinated, fully vaccinated, or because they have a true medical condition that keeps them from being vaccinated?

Brittney Kara, who once wondered why vaccines weren’t mentioned in the Bible, gets a lot of other things wrong too.

Are you especially tired of reading about these outbreaks while friends and family members post anti-vaccine propaganda on Facebook that you know isn’t true?

How to Become a Vaccine Advocate

It is time to speak up and speak out against anti-vaccine misinformation.

It’s time to become a vaccine advocate.

Most importantly, post and share stories when you or your family get a vaccine!

Share your #flushotselfie and let folks know you got vaccinated and protected.
Share your #flushotselfie and let folks know you got vaccinated and protected.

And be skeptical when you see or hear something that is anti-vaccine, especially when they are talking about toxins, vaccine-induced diseases, Big Pharma, vaccine choice, mandatory vaccination, the benefits of natural immunity, or when they are trying to sell you their books, videos, seminars, or supplements.

If nothing else, drop a link to the vaxopedia whenever someone posts something about vaccines that you just know isn’t true.

More on How to Become a Vaccine Advocate

The Latest Anti-Vaccine Bombshell on Infanrix Hexa is Just Another Dud

There are a lot of things about the latest anti-vaccine bombshell that won’t surprise you

For one thing, the “bombshell” isn’t recent. Anti-vaccine folks are just re-posting it now because a new hexavalent vaccine just got FDA approval.

The Latest Anti-Vaccine Bombshell on Infanrix Hexa is Just Another Dud

What about the 1,271 page confidential GSK document that was leaked to the press?

It was actually a document that was submitted as part of an Italian court case.

What about the idea of “missing deaths” and under-reporting of vaccine deaths?

“Before specifically addressing your analysis, it’s important to note that the issue of whether there is an increased risk of Sudden Infant Death following vaccination generally and following vaccination with DTP-containing vaccines more specifically is one that has been considered and thoroughly evaluated not only by GSK but also by a number of world-renowned regulatory agencies and public health authorities, including the European Medicines Agency, the US Centers for Disease Control and Prevention and the World Health Organization. The clear consensus amongst such agencies and authorities is that one cannot reasonably conclude, based on available data and information, that there is a causal relationship between vaccination generally or vaccination with Infanrix hexa and Sudden Infant Death.”

Dr. Norman Begg, Chief Medical Officer, GSK Vaccines on Infanrix hexa and sudden death: a review of the periodic safety update reports submitted to the European Medicines Agency

It’s no bombshell that this is all propaganda and these issues have been thoroughly investigated. Or that someone got a “study” that manipulated and misinterpreted data published in a predatory journal.

The idea that the hexavalent vaccines could be causing unexplained cases of sudden infant death shortly after vaccination began after a few case reports from Germany in 2003. Further studies, including a large study in Italy, found no risk.

What about the idea of “missing deaths” in safety reports from the manufacturer?

If there are so many "missing deaths," then why is the cumulative number of deaths higher in the latest report?
If there are so many “missing deaths,” then why is the cumulative number of deaths higher in the latest report?

Of course, there are no missing deaths.

I found the “missing deaths” that Puliyel talks about in his Infanrix hexa paper – in the GSK report he used to write his “study.”

The GSK report explains that twelve deaths were excluded from analysis, apparently eight from the first year (101 cumulative) and three from the second year (five cumulative), which is why the cumulative deaths dropped from eight to five.

Why?

“A cumulative review of Sudden Death (SD) since launch has been performed. Follow-up information received for older cases was taken into account. Design of the below observed to expected analysis was revisited in view of comments EMA expressed in the assessment report of PSUR 15-16 (dated 26 April 2012).”

GlaxoSmithKline Biological clinical safety and pharmacovigilance’s confidential report to the EMA: PSUR 19, page 440

Keep in mind that these are cumulative deaths since they began using the vaccine in 2000, and which are below the expected background rates of SIDS.

Vaccines are safe.

Hexavalent vaccines are safe.

Do your research before buying into the next anti-vaccine bombshell that try to throw at you to scare you away from vaccinating and protecting your kids.

More on the Latest Anti-Vaccine Bombshell

Seven New Year’s Vaccine Resolutions for 2019

If you’re making New Year’s resolutions, here’s one for the top of your list:

  1. I won’t complain about my kids being kept out of school during an outbreak, if I intentionally didn’t vaccinate them.

Yes, apparently that was a thing this past year…

Not surprisingly, parents lost their challenge to get their unvaccinated kids back into their Waldorf school during a chicken pox outbreak.
Not surprisingly, parents lost their challenge to get their unvaccinated kids back into their Waldorf school during a chicken pox outbreak.

It is an important reminder that there are consequences if you choose to not vaccine your kids.

In addition to the risk of getting a vaccine-preventable disease, the risk of getting a vaccine-preventable disease and getting someone else sick, there is the chance that your kids will be quarantined and kept out of daycare or school until the outbreak is over.

Six More New Year’s Vaccine Resolutions for 2019

Need some more?

  1. I will not travel out of the country without getting caught up on my vaccines. Remember, most outbreaks are started when an intentionally unvaccinated person travels out of the country, gets exposed to a vaccine-preventable disease, comes home while they are still in the incubation period and not showing symptoms, and then eventually get sick, exposing others.
  2. I won’t let a small, yet vocal anti-vaccine minority scare me into a poor decision about my child’s vaccines
  3. I will not lie to get a religious vaccine exemption. Is your religion really against vaccinating and protecting your child?
  4. I will avoid anti-vaccine echo chambers when doing my research about vaccines.
  5. I will learn about the cognitive biases that might me keeping me from vaccinating and protecting my kids.
  6. I will not repeat an anti-vaccine point that has already been refuted a thousand times.

Vaccines are safe, effective, and necessary.

This year, resolve to make the right choice and get your kids vaccinated and protected.

More on Seven New Year’s Vaccine Resolutions for 2019

Are the Risks Greater Than the Benefits for Any Vaccines?

The only reason some folks question the risk-benefit ratio of vaccines is because most of them have never had or even known anyone with a vaccine-preventable disease.

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

Of course, that’s simply because most people are vaccinated and protected. But if enough folks decide to skip or delay their vaccines, then we will have outbreaks and a higher risk of getting sick.

We shouldn’t have to wait for outbreaks for anyone to understand that the benefits of vaccines far outweigh their risks though.

Are the Risks Greater Than the Benefits for Any Vaccines?

Vaccines are safe, effective, and necessary.

Unless you have a true contraindication to getting vaccinated, until a disease is eradicated, the benefits of a vaccine will typically be far greater than its risks.

The switch from the live, oral polio vaccine to the inactivated vaccine is a good example of when this wasn’t the case though. Since OPV could rarely cause vaccine-associated paralytic polio (VAPP), once polio was well controlled in the United States, the risk of this side effect became greater than the benefit of continuing to use the vaccine, but only because we had an alternative polio vaccine that didn’t cause VAPP.

Similarly, the original rotavirus vaccine was withdrawn because the extra risk of intussusception, even though it was small, was thought to be greater than the benefits of the vaccine.

In the great majority of cases though, to think that getting vaccinated is a bigger risk than getting a vaccine preventable disease, you have to buy into the anti-vaccine hype:

Of course, none of that is true. These, and other anti-vaccine talking points have been refuted time after time.

Don’t put your kids at risk.

Don’t put others at risk from your unvaccinated child.

Get them vaccinated and protected.

More on Risks and Benefits of Vaccines

Who Dies with Measles?

Measles is another of those diseases that some claim used to be mild and a rite of passage for kids.

That’s why there was an episode of the Brady Bunch about it, right?

An episode in which all of the kids got sick and they had to call two pediatricians to do house calls…

Who Dies with Measles?

While measles was a rite of passage for kids, it wasn’t the kind you looked forward to, because measles is rarely mild.

“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.

Instead, most people develop 10 days of measles symptoms, including a high fever, cough, runny nose, watery eyes, and a rash. Photophobia, irritability, sore throat, headache, and abdominal pain are other symptoms that children with measles might have.

Many require hospitalization and some die.

But isn’t it just older people or those with immune system problems that die with measles?

“From 1964 through 1971, 16.7% of the death certificates reviewed noted some underlying pathologic condition.”

Roger Barkin, MD on Measles mortality. Analysis of the primary cause of death.

Nope.

It is most often children, typically young children, without any medical problems who die.

Before the routine use of vaccines, most measles deaths were young children without any medical problems.
Before the routine use of measles vaccines, most measles deaths were young children without any previous medical problems.

In the post-vaccination era, no one would be expected to die with measles, but those with immune system problems sometimes do, as most others are vaccinated and protected. As vaccinated rates drop though, even otherwise healthy children and adults can once again die of measles.

Remember the measles outbreaks at the end of the 1980s?

“Complications were reported in 672 (9.8%) cases, including otitis media in 318 (4.6%) cases, pneumonia in 178 (2.6%), diarrhea in 171 (2.5%), and encephalitis in five (0.1%). Nine hundred thirteen patients (13.3%) were hospitalized, and 10 measles-associated fatalities were reported (case-fatality rate: 1.5 deaths per 1000 reported cases). Eight of the deaths were reported in children less than 5 years of age, all of whom were unvaccinated. None had a reported underlying illness or immunodeficiency. Most deaths have been attributed to pneumonia.”

Measles — United States, First 26 Weeks, 1989

Probably not, but from 1989 to 1991 there were at least 123 measles deaths across the United States, even after measles had been declining for years with the introduction of the measles vaccine in the 1960s. Most of the deaths were otherwise healthy, without underlying medical problems.

They were unvaccinated and unprotected.

Because we don’t typically hear any details about measles deaths, including the almost 90,000 measles deaths that continue to occur around the world each year, most people likely assume that measles only kills in third world countries, where kids are already sick or malnourished. Of course, that wouldn’t explain how over one hundred people died with measles in Europe over the past few years…

Still think that measles isn’t deadly?

Tragically, there are plenty of stories (although most are never reported in the news and we don’t hear about them) and case reports that will prove you wrong:

  • Olivia Dahl died with measles when she was 7-years-old (1962)
  • an unvaccinated 3-year-old died in Maricopa County (1970)
  • a 13-year-old girl who had previously been vaccinated with one of the first inactivated measles vaccines which were found to be ineffective and were replaced with the newer live vaccines died in Michigan (1978)
  • a 9-month-old died in Chicago (1990)
  • an unvaccinated 13-year-old died in Kansas (1990)
  • Tammy Bowman, an 11-year-old unvaccinated girl died in Michigan (1990)
  • an unvaccinated 13-year-old became the first person in the UK to die with measles in 14 years (2006)
  • a 14-year-old died of Subacute Sclerosing Panencephalitis (SSPE), a late complication of a natural measles infection (2015)
  • an immunocompromised woman died after she was exposed in an outbreak in Clallam County, Washington (2015)
  • a 6-year-old boy with leukemia died in Italy caught measles from his intentionally unvaccinated sibling (2017)
  • an 11-month-old unvaccinated infant died in Greece (2017)
  • an intentionally unvaccinated 9-year-old girl with chromosomopathy, which is not a contraindication to getting vaccinated, died in Italy (2017)
  • a 10-month-old unvaccinated boy who likely caught measles when he had been hospitalized for an RSV infection, died in Italy (2018)
  • a 16-year-old who had received a heart transplant when she was 2-years-old died in France (2018)
  • an unvaccinated toddler in Jerusalem (2018)

Measles as a rite of passage?

“We baby boomers were apparently the last generation whose doctors, and therefore parents, accepted the measles as just one more annoying rite of passage of childhood that also happened to prime the immune system and provide lifelong immunity. Medical texts prior to the advent of the vaccine described measles as a benign, selflimiting (sic) childhood infectious disease that posed little risk to the average well-nourished child.”

Darrerl Crain, DC on The Great Measles Misunderstanding

While early pediatric textbooks did a great job describing the symptoms of measles, they also did a great job of documenting that measles was never a benign disease, something anti-vaccine folks still misunderstand because vaccines can do such a good job controlling the disease.

Even as overall mortality improved in the mid-20th Century, measles still wasn't a benign disease.
Even as overall mortality improved in the mid-20th Century, measles still wasn’t a benign disease.

Do benign, self-limiting childhood infections diseases kill hundreds of children every year?

This toddler died of measles in 1955.
This toddler died of measles in 1955.

Measles as a rite of passage is something we don’t want to have to go back to. It was a rite of passage that was endured because there was no other choice.

We have a choice now.

Don’t be misled into making the wrong one.

Don’t help anti-vaccine folks bring back measles and other vaccine-preventable diseases.

Vaccines are safe, effective and necessary.

“Today, vaccination is a cornerstone of pediatric preventive health care and a rite of passage for nearly all of the approximately 11,000 infants born daily in the United States.”

Cohn et al on Immunizations in the United States: A Rite of Passage

Getting vaccinated and protected is a rite of passage that you can look forward to, thanks to the many benefits of vaccines, not one that you should dread or avoid.

More on Measles Deaths