We shouldn’t forget that Samoa was on her International Tour.
You likely remember Samoa because of the vaccine tragedy that happened there. Two infants died after nurses mixed up the diluent for the MMR vaccine with a powerful anesthetic.
Vaccines were already halted in Samoa, but that didn’t keep Taylor Winterstein from planning to go and further scare folks away from vaccinating and protecting their kids.
And where are we now?
While Taylor Winterstein and her family were in California, meeting Andy Wakefield, there has been an epidemic of measles in Samoa, where at least one unvaccinated infant has already died.
“From 1 January 2019 to 10 October
2019 there have been 1742 confirmed cases of measles notified across
New Zealand. 1416 of these confirmed cases are in the Auckland region.”
2019 NZ measles outbreak information
There has also been an awful lot of measles in New Zealand, which was also on her little tour. Two unborn babies have died during these outbreaks, and there are also reports of at least three hospitalizations for encephalitis.
No one expects to hear stories of kids dying after being vaccinated. Fortunately, these types of tragedies are very, very rare.
Still, even one is too many when it might have been prevented. After all, that’s why we vaccinate our kids in the first place. To protect them from life-threatening vaccine preventable diseases.
A Toddler Has Died After Being Vaccinated in Cuba
The Ministry of Health in Cuba released a statement a few days after her death:
“Between October 7 and 8 of this year, three one-year-old children were diagnosed with an adverse event associated with vaccination with PRS, which protects against Mumps, Rubella and Measles, this is applied according to official scheme to children one and six years old.
All had been vaccinated on October 7 at the “Betancourt Neninger” Polyclinic in the municipality of Habana del Este, province of Havana, and immediately after symptoms appeared, they were admitted and received medical attention by professionals of high scientific level in the Pediatric Hospitals ” Borrás Marfán ”and Centro Habana.
Through the active research carried out on all children vaccinated in that Health Area, two more children were detected with symptoms, which motivated their admission.
Painfully on October 9 at night, the one-year-old girl Paloma Domínguez Caballero dies, admitted to the “Borrás Marfán” Hospital as a result of complications. The remaining four children remain admitted: one with intensive attention, which is stable and the others evolve favorably.
The system of active surveillance of the events associated with vaccination carried out in the country has not identified any other children with symptoms.
The PRS vaccine has been used for years in Cuba, imported from India, is endorsed by the World Health Organization and certified by the Center for State Control of Medicines, Equipment and Medical Devices (CECMED).
A Commission of the Ministry of Public Health investigates the causes that caused this unfortunate event.”
Official Note from the Ministry of Public Health on adverse event associated with vaccination with PRS (computer translation)
So what happened?
Tragically, either because of errors or contamination, vaccines can rarely cause people to get sick, either if:
a reconstituted vaccine was used much after six hours – live vaccines can quickly become contaminated if they are kept and used for too long a time
vaccine diluents were mixed up – some vaccines need to be mixed before use and vaccination tragedies can occur when a dangerous medication is used instead of a vaccine’s standard diluent
vaccines were improperly handled – breaking the cold chain – or allowed to expire
In Samoa, the recent tragedy in which two toddlers died, we know that the vaccine diluent was mixed up with a powerful anesthetic.
It doesn’t sound like a diluent mixup happened in Cuba though.
“The mother told the news portal CiberCuba that the daughter’s arm began to swell the same day she was vaccinated. Then the vomits arrived. Less than 24 hours later I was already in intensive care, from where I did not come out alive again.”
Vacuna en mal estado suministrada en Cuba podría haber dejado 25 niños en estado de gravedad
With reports that the vaccines were possibly expired and the child getting sick later in the day, with swelling in her arm, it is more likely that there was some contamination, maybe in a vaccine vial itself.
The report says that it was the PRS vaccine – Parotiditis, Rubéola, and Sarampion – or MMR, which is usually available in 5 or 10 multi-dose vials when one dose vials aren’t available.
It was imported from India, which makes many of the vaccines that are used throughout the world, but any contamination likely would have occurred well after it was manufactured and shipped to Cuba.
In all of these cases, there is typically nothing inherently wrong with the vaccine itself.
“Cuba, a relatively poor and small country (population 11.2 million), has managed to bring about remarkable achievements in health in the past 30 years despite difficult fiscal restraints and limited resources.”
MacDonald et al on Infectious Disease Management: Lessons from Cuba
Interestingly, Cuba actually makes most of their other immunizations.
So why would they be using expired vaccines?
Was it a mistake?
Did someone use a leftover vial that had become contaminated with bacteria? Were the vaccines not refrigerated properly? Is it an isolated issue or part of a bigger breakdown in their healthcare system?
With four other sick kids, the use of a contaminated leftover vial that was part of an original 10 dose vial becomes one possible scenario.
We might get some answers if the vaccine vials had not been thrown away after they were used, and are still available for testing.
In Chapias, Mexico, after two infants died in 2015 after getting multiple vaccines, a vial was found to be contaminated with the Staphylococcus hominis bacteria.
A few years later, in 2017, 15 children died in South Sudan when unrefrigerated vaccine was mixed with a syringe that was reused over and over for four days and given to kids by untrained workers.
Again, these are very rare and isolated cases. Remember that billions of doses of vaccines are given each year without problems, saving millions of lives.
Hopefully we will soon learn what really happened to these children in Cuba, especially as that will hopefully help to make sure it doesn’t happen again.
Most importantly, don’t let these very rare tragedies scare you away from vaccinating and protecting your kids.
“The Cuban government has confirmed that five children suffered severe reactions and one of them — a 1-year-old girl — died after receiving a vaccine. The serum came from the same company in India that produced vaccines linked to the deaths of three other children following inoculations administered in Cuba in 2002.”
Child dies in Cuba after receiving vaccine made in India. It’s not the first time
We should remember what happened following the tragedy in Samoa. All vaccinations were unnecessarily suspended in the country for a time and MMR vaccinations were suspended for nine months!
The death of the girl in Cuba is a terrible tragedy, but folks shouldn’t make it any worse. There is almost certainly nothing wrong with the vaccines from India or any other vaccines in Cuba or anywhere else.
Remember the two young children who died in Samoa in early July 2018, shortly after getting an MMR vaccine?
In addition to the tragic deaths of those two children, it led to the suspension of all vaccinations in the country.
The Tragedy in Samoa Was Not Caused by the MMR Vaccine
Fortunately, that suspension was eventually reversed, but they did continue to hold MMR vaccinations.
How long did they suspend MMR vaccinations?
They didn’t restart until April 15.
And while the trial for the two nurses involved in the tragedy is delayed until June, the Director General of Health, Leausa Take Naseri, has said that their deaths were a mistake caused by human error.
“On 4 June 2019, both nurses pleaded guilty to negligence causing manslaughter. On 2 August, both nurses were sentenced to five years in prison. During the sentencing hearing, it was confirmed that one of the nurses mixed the MMR vaccine powder with expired muscle relaxant anaesthetic instead of water for injection supplied in a vial with the vaccine.”
Infant deaths in Samoa a tragic outcome from error preparing MMR vaccine
With measles outbreaks in many nearby countries, health experts and parents are eager to get vaccinations restarted and to get kids caught up.
Hopefully, they get vaccinated before anti-vaccine folks head to Samoa to try and scare folks away from getting vaccinated.
So what can we say about 2018 when it comes to vaccines?
Well, we did get some new ones!
approved by the FDA in late 2017, a new hepatitis B vaccine for adults, Heplisav-B, the formal recommendation for its use from the ACIP came on February 21, 2018
although it was both approved by the FDA and formally recommended by the ACIP in late 2017, Shingrix, the new shingles vaccine, became more widely available in 2018 – well kind of – there have been a lot of shortages due to high demand for the vaccine
Vaxelis, a hexavalent vaccine that combines DTaP-IPV-Hib-HepB into one shot was FDA approved on December 21, 2018, but likely won’t be available for a few more years
And we lost one… Last year was the first full year that Menomune, an older meningococcal vaccine, was no longer available. It was discontinued because of low demand, as we began to use the newer vaccines, Menactra and Menveo instead.
a shortage of monovalent pediatric hepatitis B vaccine will continue into 2019 (doesn’t affect combination vaccines with hepatitis B)
Gardasil 9 received an expanded recommendation – women and men between the ages of 27 and 45 years can now get vaccinated and protected with this HPV vaccine
the hepatitis A vaccine got a lower age recommendation – at least in special situations – “HepA vaccine be administered to infants aged 6–11 months traveling outside the United States when protection against HAV is recommended.”
the recommendation to use a third dose of MMR to control outbreaks of mumps was formally approved
the WHO updated its recommendations for use of the dengue fever vaccine (Dengvaxia) to makes sure that only dengue-seropositive persons are vaccinated, as they found an increased risk of severe dengue in seronegative people who were vaccinated
Of the 163 million to 168 million doses of flu vaccine that will be distributed in the United States for the 2018-2019 season, more than 80% will be thimerosal free.
China had an issue with substandard DTaP vaccines made by one company in one part of the country
India had an issue with contaminated polio vaccines made by one company in one part of the country – bivalent oral polio vaccines (two strains) still contained all three strains of polio vaccine virus
If you didn’t hear about any of those things in the news, you may have heard about the death of two young children in Samoa after they received an MMR vaccine. That tragedy almost certainly was caused by an error in administering/mixing the vaccines, and not because there was anything wrong with the vaccines themselves.
Need help getting educated about vaccines? Despite continued outbreaks, 2018 was a good year for vaccine advocates and vaccine education.