Tag: shedding

Inappropriate Use of Vaccine Studies

Have you ever wondered how anti-vaccine do their vaccine research?

These types of binders of anti-vaccine information are typically filled with vaccine studies that folks end up misusing to scare parents away from vaccinating and protecting their kids.
These types of binders of anti-vaccine information are typically filled with vaccine studies that folks end up misusing to scare parents away from vaccinating and protecting their kids.

While they used to have to rely on Google University for their vaccine research, they now have folks making them ready made binders chock full of misinformation!

Misusing Vaccine Studies

As with their misuse of Google and Pubmed, a lot of the problems with these binders is that anti-vaccine folks cherry pick studies that support what they want to hear.

And in many cases, they read things into studies, thinking they support their views against vaccines, when they really don’t.

You're not gonna catch measles from someone's urine....
You’re not gonna catch measles from someone’s urine….

Is this 1995 study, Detection of Measles Virus RNA in Urine Specimens from Vaccine Recipients, a warning about shedding?

Anti-vaccine folks would sure like you to think so, but the thing is, measles is a respiratory illness.

“In this systematic review, we have determined that there have been no confirmed cases of human-to-human transmission of the measles vaccine virus.”

Greenwood et al on A systematic review of human-to-human transmission of measles vaccine virus

Detecting vaccine strain measles in urine isn’t something to be concerned about because it can’t lead to an infection.

Anyway, you’re not going to get measles from shedding after someone was vaccinated. If you do, you will be the first!

Misusing MTHFR Tests

Have you wondered why anti-vaccine are so concerned about their MTHFR test results?

“In conclusion, the invalid interpretation that the determination of the MTFHR variant is an acceptable reason for vaccine exemptions is not based on the precepts of replication and rigorous clinical testing. It is unfortunate that the loose application of our exploratory report has been misinterpreted and used to inappropriately justify exemption of children from medically indicated vaccines.”

David M Reif, Ph.D. on the Inappropriate Citation of Vaccine Article

Turns out it is because a few anti-vaccine doctors misinterpretated an old study about the smallpox vaccine.

Now that the author of that study has called them out, will they stop?

Other Vaccine Studies That Are Misused

Of course, there are more…

The article totally misinterpretated the study...
The article totally misinterpretated the study…

Remember when anti-vaccine folks thought that the polio vaccine was causing outbreaks of hand, foot and mouth disease?

“Well, that’s actually totally backwards. Our article suggests that FAILURE to get vaccinated with polio vaccine might set you up for Hand Food Mouth disease (EV71).”

It wasn’t…

And then there is the study that had anti-vaccine folks thinking that 38% of the kids in the Disneyland measles outbreak were vaccinated.

This isn't a study about vaccine-associated measles...
This isn’t a study about vaccine-associated measles…

The study was about new ways to detect measles vaccine reactions.

“During measles outbreak investigations, rapid detection of measles vaccine reactions is necessary to avoid unnecessary public health interventions.”

Roy et al on Rapid Identification of Measles VirusVaccine Genotype by Real-Time PCR

These are folks with a fever and a rash after their MMR vaccine.

This is not people with vaccine-associated measles.

Misusing Scientific Research

Remember when they thought that the study, Deaths Reported to the Vaccine Adverse Event Reporting System, United States, 1997–2013, reported that 79% of deaths in VAERS occurred on the day a child received a vaccine?

Did they read the study?
Did they read the study?

That’s not what the study said…

The study simply said that “For child death reports, 79.4% received >1 vaccine on the same day.”

It wasn’t the same day they died though.

“No concerning pattern was noted among death reports submitted to VAERS during 1997–2013.”

Moro et al on Deaths Reported to the Vaccine Adverse Event Reporting System

In fact, the study “did not detect any concerning patterns that would suggest causal relationships between vaccination and deaths.”

What about when anti-vaccine folks say that only 1% of vaccine side effects are reported to VAERS? That has to be true, right?

Not exactly.

That claim is based on an old study about drug reactions and was not specific to vaccines.

“To counter the propaganda by anti-vaccine activists, the research and public health communities have to adjust their communication.”

Stephan Guttinger on The anti-vaccination debate and the microbiome

Does any of this surprise you?

Can we counter this type of anti-vaccine propaganda and keep it from scaring parents away from vaccinating and protecting their kids?

Sure.

But first we all have to recognize that they are doing it!

More on Misusing Vaccine Studies

How Much Shedding Would a Vaccine Shed…

Are you still confused about vaccine shedding?

You should be worried about wild diseases, not shedding from vaccines.
You should be worried about wild diseases, not shedding from vaccines.

As this infographic describes, it really isn’t that complicated…

What Does Vaccine Shedding Really Mean?

To clear up some things:

  • yes, some vaccines do actually shed, but it is rarely a reason to avoid getting vaccinated and protected
  • of the vaccines that we use routinely, shedding is limited to the rotavirus vaccines, FluMist, and the chickenpox vaccines
  • some other vaccines that can shed include the oral polio vaccine and the smallpox vaccine
  • the rubella component of MMR may very rarely shed, but only in breastmilk

If vaccines do shed, why shouldn’t we be more concerned about it?

Well, for one thing, most vaccines don’t shed.

DTaP, hepatitis A, hepatitis B, Hib, flu, IPV, HPV, meningococcal, pneumococcal, and Tdap shots – none of them shed.

And then there is the fact that:

  • when a vaccine sheds, it is the weakened or attenuated vaccine strain, not the wild strain that would cause more serious disease. Putting it another way, if the vaccine strain doesn’t make the person who is getting immunized sick, then why would it get someone else sick if they got it through shedding? Of course, there is a situation in which even a vaccine strain could be dangerous, and that’s for those who are severely immunosuppressed. Still, natural disease would be bad for these kids too!
  • even with oral polio vaccines, the problem isn’t really shedding, which actually provides a type of passive immunization in areas where polio is still not well controlled. The problem is that very rarely, the attenuated virus in the oral polio vaccine can revert to a form that can cause the person who was vaccinated to actually develop polio (VAPP). Now, shedding of this strain would be a problem, but only if the other person wasn’t immune.
  • rotavirus vaccines only shed in stool. You can avoid it by washing your hands when you change your child’s diapers, which you hopefully do anyway.
  • FluMist is attenuated and cold-adapted, which means that it won’t replicate well in our warmer nasal passages and respiratory tracts.
  • you have to actually get a rash, which is rare, for the chickenpox vaccine to shed.
  • it is only kids with eczema that usually get sick if they are exposed to someone who recently had the smallpox vaccine. Since the smallpox vaccine causes skin reactions, even the attenuated vaccine strain can cause severe reactions if a child’s skin is already broken down, like with eczema.

Are you still concerned about shedding?

Can a Vaccinated Person Transmit Measles Through Shedding?

To put your mind at ease, understand that you are not going to get measles from shedding.

“In this systematic review, we have determined that there have been no confirmed cases of human-to-human transmission of the measles vaccine virus.”

Greenwood et al on A systematic review of human-to-human transmission of measles vaccine virus

Well, at least not from someone who was recently vaccinated shedding a vaccine-strain of measles…

If you aren’t vaccinated and protected, you could easily get it from someone who has measles and who is shedding the wild type virus though. Measles is so contagious, you just have to be in the same room as someone with measles and you will likely get sick. In fact, you can enter a room a few hours after they have left and sill catch measles!

And in theory, if someone developed vaccine-associated measles – they got sick with a vaccine-strain of measles after getting vaccinated – then they could spread the virus to someone who wasn’t immune. That’s just because they would be contagious though, not anything specific to vaccines and shedding. Also, it is basically unheard of for this to happen.

Dectecting vaccine strain measles in urine isn't something to be concerned about because it can't lead to an infection. Measles is spread through respiratory secretions, not urine.
Dectecting vaccine strain measles in urine isn’t something to be concerned about because it can’t lead to an infection. Measles is spread through respiratory secretions, not urine.

What about all of those folks who test positive for vaccine-strain measles during an outbreak?

That’s not about shedding either.

They aren’t even people with measles. Instead, they typically have a vaccine reaction, a rash and/or fever after getting their MMR and they test positive for the vaccine strain of measles because they just got a live virus vaccine.

Is Vaccine Shedding a Threat?

Shedding isn’t the threat that anti-vaccine folks make it out to me.

Think about it. If it really was a big problem, then why don’t more intentionally unvaccinated kids with exemptions get sick when they are around kids who are vaccinated?

“Health officials should require a two-week quarantine of all children and adults who receive vaccinations. This is the minimum amount of time required to prevent transmission of infectious diseases to the rest of the population, including individuals who have been previously vaccinated.”

Sally Fallon Morell, president of the Weston A. Price Foundation

We don’t actually quarantine anyone after they are vaccinated, so why don’t more kids with immune system problems get sick via shedding?

Or just think about what happens in a typical daycare or school. All of the kids don’t get vaccinated on the same day, so if shedding was an issue, wouldn’t the kids who had gotten their vaccines first shed on the ones who weren’t yet vaccinated, getting them sick?

Of course, this doesn’t happen. Again, shedding isn’t the threat that anti-vaccine folks make it out to be.

More on Vaccine Shedding

Is Measles Really Airborne?

As we reach record numbers of measles cases, what are anti-vaccine folks concerned about?

Anti-vaccine folks trying to do research about measles and miss dozens of articles describing how measles is indeed airborne.
Anti-vaccine folks trying to do research about measles and miss dozens of articles describing how measles is indeed airborne.

Making sure their kids get caught up on their vaccines so that they don’t catch measles, since it is so contagious? Nope. They are still trying to find reasons to justify their decision to leave their kids unvaccinated and unprotected.

Is Measles Really Airborne?

Guess what?

Measles really is airborne!

Surpised?

Are you thinking that I am relying on a single experiment from 1964 or do you think I found some more evidence when I did my research?

Is this something folks really doubt, after all, if measles isn’t airborne, how would it be so contagious? How would people get sick after simply being in the same room as someone else with measles, even if the sick person had already left?

“During the past decade, increasing attention has been giving to the theory that indoor air is a vehicle of respiratory infection and to the logical sequence of such a theory, that the transfer from person to person of such infection can be reduced by increasing ventilation.”

Wells et al on Ventilation in the flow of measles and chickenpox through a community

In fact, even before the measles virus was actually discovered in the 1950s, it was known that measles was airborne. Wells did her experiments in the 1940s.

“It is far from clear to me yet whether measles is solely an airborne infection, as I think Wells believed, or whether contact and airborne routes both play roles in different circumstances. It is clear however that airborne infection is sufficiently common and important to be a dertermining factor in the continuance of measles at the present time. It must receive due respect and weight in planning the future steps necessary for eradication.”

Langmuir on Changing concepts of airborne infection of acute contagious diseases: a reconsideration of classic epidemiologic theories.

And those experiments were revisited in the 1970s, when measles wasn’t eradicated as quickly as expected. Alex Langmuir was Chief Epidemiologist at CDC at the time.

Did you ever hear about the story of the folks who got measles International Special Olympics Games in the Minneapolis-St. Paul metropolitan area during July 1991? It’s not a story the anti-vaccine groups would tell you. It’s a published case report, An outbreak of measles at an international sporting event with airborne transmission in a domed stadium.

“…the dynamic airborne transmission of measles illustrates the potential for transmission in the absence of a recognized exposure.”

Ehresmann et al on An outbreak of measles at an international sporting event with airborne transmission in a domed stadium

Several people at the Games got measles simply because they were in the domed stadium, even though they had no direct contact with anyone who had measles.

There are also reports of kids getting measles at their pediatrician’s office, simply because another kid with measles had been seen a little earlier.

Airborne Transmission of Measles in a Physician's Office

The kids described at the Michigan pediatrician’s office didn’t have any direct contact with the child with measles. They simply showed up in the same office an hour later.

“Four children had transient contact with the source patient as he entered or exited through the waiting room; only one of the four had face-to-face contact within 1 m of the source patient. The three other children who contracted measles were never in the same room with the source patient; one of the three arrived at the office one hour after the source patient had left.”

Block et al on Measles outbreak in a pediatric practice: airborne transmission in an office setting

Researchers described a similar situation at a pediatrician’s office in DeKalb County, Georgia at around the same time.

“Airflow studies demonstrated that droplet nuclei generated in the examining room used by the source patient were dispersed throughout the entire office suite. Airborne spread of measles from a vigorously coughing child was the most likely mode of transmission.”

Block et al on Measles outbreak in a pediatric practice: airborne transmission in an office setting

And increasing, we are seeing that airborne transmission means more folks are at risk on airplanes.

There is no doubt that measles is contagious and that measles really is airborne. Just like there is no doubt that vaccines are safe, with few risks.

More on Is Measles Really Airborne?

Who Is ‘Patient Zero’ in the 2019 Measles Outbreaks?

As we climb to ever higher case counts in the 2019 measles outbreaks, you might be wondering who to blame?

Who started the outbreaks?

How Does ‘Patient Zero’ Start a Measles Outbreaks?

As you have likely guessed, there is no one person who started all of this year’s outbreaks. Well, maybe there is. After all, who is responsible for so many folks not getting vaccinated?

In most cases though, we do know who started the outbreak – the “patient zero.”

And it is almost always an unvaccinated traveler, typically a US resident, who got measles abroad and brought it back into the U.S.

What happens next? If they expose a lot of people in an area with low vaccination levels, then you can expect a big outbreak. On the other hand, if most people are vaccinated and protected, you might not see any more cases in that area.

Who Is ‘Patient Zero’ in the 2019 Measles Outbreaks?

So who are these folks?

This year's measles cases are spread out in outbreaks in 26 different states. So there isn't only one patient zero...
This year’s measles cases are spread out in outbreaks in 26 different states. So there isn’t only one patient zero…

They aren’t people who had been recently vaccinated are giving others vaccine strain measles through shedding! That doesn’t happen.

Instead, at least 44 people triggered separate outbreaks after traveling from the Philippines, Ukraine, Israel, Thailand, Vietnam, Germany, Algeria, France, India, Lithuania, Russia, and the United Kingdom.

The 2019 measles outbreaks include the:

  • Rockland Outbreak – an unvaccinated teenager brought measles to Rockland County in September 2018 from Israel.
  • Brooklyn Outbreak – the initial case in Brooklyn was unvaccinated and got measles in October 2018 on a visit to Israel. Measles was reintroduced into the community at least six other times though, four cases were also acquired on visits to Israel, while two people got measles from the U.K., and one from Ukraine.
  • Pacific Northwest Outbreak – a child who had traveled from Ukraine to Washington was the first confirmed case and likely source of the Pacific Northwest measles outbreak.
  • Michigan Outbreak – a traveler from Brooklyn started the Michigan measles outbreak.
  • Northern California Outbreak – a “cluster” of cases in Butte, Tehama, and Shasta counties that was started by a traveler who had recently been to the Philippines.
  • Puget Sound Outbreak – triggered by a Canadian resident who traveled to Seattle, after completing a trip to Japan and New York, where he likely became infected.

Why is it important to find patient zero and know who started an outbreak?

Mostly, it helps you find everyone who was exposed to measles and hopefully limit and quickly control the outbreak.

Make sure you are fully vaccinated and protected, with two doses of MMR, before your next trip so that you're not the next patient zero.
Make sure you are fully vaccinated and protected, with two doses of MMR, before your next trip.

It should also remind everyone that the easiest way to avoid getting measles and avoid triggering an outbreak, is to get vaccinated and protected, especially if you plan on traveling out of the country.

More on Who Is ‘Patient Zero’ in the 2019 Measles Outbreaks?