Tag: shedding

cVDPV

Circulating vaccine-derived polio virus or cVDPV are outbreaks of polio that are actually caused by the polio vaccine.

Very rarely, the attenuated (weakened) virus in the oral polio vaccine can revert to a form that can cause the person who was vaccinated or their close contact to actually develop polio.

It should not be confused with VAPP or vaccine-associated paralytic polio. With VAPP, the original strain of attenuated vaccine virus reverts to a form that can cause polio, but it does spread from one person to another, so does not lead to outbreaks.

cVDPV Outbreaks

Fortunately, both VAPP and cVDPV are rare.

How rare? VAPP only occurs in about 1 in every 1.27 million children receiving their first dose of OPV.

And according to the WHO, there had only been about 24 outbreaks of cVDPV over the past 10 years. Tragically, this has resulted in at least 750 cases of paralytic polio in 21 countries.

An outbreak of cVDPV in Syria will be controlled by 355 vaccination teams that will vaccinate up to 328,000 children.
The WHO reports that an outbreak of cVDPV in Syria will be controlled by 355 vaccination teams that will vaccinate up to 328,000 children.

A new outbreak of cVDPV in Syria adds to those numbers though.

After being polio free for 15 years, since 1999, Syria began having cases of wild type polio again in 2013 (35 cases) and 2014 (1 case). Those polio cases and the emergence of an outbreak of cVDPV2 (there are three strains of polio virus – this outbreak was caused by the type-2 strain) highlight the effects of years of poor immunization rates because of war.

While there are many challenges to getting kids vaccinated in Syria, up to 355 vaccination teams with 61 supervisors will be working out of five vaccine distribution centers to vaccinate 328,000 children to control the outbreak and get kids vaccinated.

Circulating Vaccine-Derived Polio Virus

Just like wild type polio, we can stop cVDPV by increasing vaccination rates and increasing access to improved sanitation facilities.

Why?

Although anti-vaccine folks routinely cry wolf about shedding, the oral polio vaccine really does shed – in the stool of people who have been recently vaccinated. You can then be exposed to the attenuated polio vaccine virus (which can help give immunity to others in the community by passive immunization) or a strain of cVDPV (which can, unfortunately, help give others, especially if they are not vaccinated, paralytic polio) if they are exposed to open sewage or can not practice proper hygiene, etc.

Can’t we just stop using the live, oral polio vaccine?

Although a serious side effect of the vaccine, the vaccine’s benefits clearly outweigh the risk of both VAPP and cVDPV while polio is endemic (lots of cases) in a region, after all, without the vaccine, hundreds of thousands of children would get polio and would be paralyzed.

In polio-free countries, the risks of VAPP and cVDPV becomes greater than the risk of polio though, and they move to the inactivated polio vaccine. That helps prevent a situation in which the polio vaccines actually causes more cases of polio than wild type polio viruses.

Eventually, all countries will move to the IPV vaccine as we move closer to polio eradication. We came one step closer to that point in April 2016 when all countries that were still using the oral polio vaccine switched from trivalent OPV (three strains) to bivalent OPV (two strains) for their routine immunization programs. This could eliminate up to 90% of cases of cVDPV (most are caused by the type-2 strain which is not in bOPV)!

What To Know About cVDPV

Circulating vaccine-derived polio virus outbreaks are a rare side effect of the oral polio vaccine.

More Information About cVDPV

10 Reasons to Not Vaccinate Your Kids

The Pontifical Academy for Life reaffirmed the
The Pontifical Academy for Life reaffirmed the “lawfulness” of using vaccines to protect children and those around them.

Parents often have their reasons for why their kids aren’t vaccinated.

But whether they have a medical exemption, personal belief exemption, or a religious exemption to getting vaccines, they often have the same reasons for not believing in vaccines.

What are some of them?

They might be scared of toxins.

They might think that vaccines don’t work.

They might think that vaccines aren’t necessary anymore and that they can just hide in the herd.

They are just trying to fit in at a Waldorf school…

10 Reasons to Not Vaccinate Your Kids

In addition to simply being scared about things they have heard on the Internet, some of the reasons that parents don’t vaccinate their kids include that:

  1. they are vegan – many vegans vaccinate their kids
  2. they are Catholic – most Catholics vaccinate their kids – Pope Francis even led an oral polio vaccination drive recently
  3. their child is on antibiotics – having a mild illness is not usually a good reason to skip or delay getting vaccines
  4. their child had an allergic reaction to a vaccine – a severe, anaphylactic reaction to one vaccine or vaccine ingredient wouldn’t mean that your child couldn’t or shouldn’t get all or most of the others
  5. they are Jewish – most Jews vaccinate their kids
  6. a doctor wrote them a medical exemption – there are actually very few true contraindications to getting vaccinated and a permanent exemption to all vaccines would be extremely rare, which casts doubt on the ever growing rate of medical exemptions in many areas
  7. they are Muslim – most Muslims vaccinate their kids and most Islamic countries have very good immunization rates.
  8. someone at home is immunocompromised – since we stopped giving the oral polio vaccine, shedding from vaccines is not a big concern and contacts of those who are immunocompromised are usually encouraged to get vaccinated
  9. they are Buddhist – most Buddhists vaccinate their kids – the Dalai Lama even led an oral polio vaccination drive recently and Buddhist countries have very good immunization rates.
  10. someone in their family had a vaccine reaction – a family history of a vaccine reaction is not a good reason to skip or delay getting vaccinated, as it has not been shown to increase your own child’s risk of a reaction. And yes, this has even been shown for siblings of autistic children, which makes sense, since vaccines don’t cause autism.

What about other religions?

Whether you are Hindu, non-Catholic Christians, Amish, or Jehovah’s Witnesses, etc., remember that all major religions believe in vaccines. Of course, the Amish are a little more selective of when and which vaccines they will get, but as we saw in the Ohio measles outbreak, they do get vaccinated.

On the other hand, Christian Scientists don’t vaccinate, along with some small Christian churches that believe in faith healing and avoid modern medical care.

Still, most people understand why it is important to vaccinate their kids.

What to Know About These Reasons to Not Vaccinate Your Kids

What do you think about these reasons to not vaccinate your kids? Since they aren’t really absolute reasons to not get vaccinated, are you ready to get your kids vaccinated now?

More About Reasons to Not Vaccinate Your Kids

Johns Hopkins Hospital Warns Patients about Vaccine Shedding

The original Johns Hopkins Hospital Patient Guide did warn immunocompromised patients about contact with those who were recently vaccinated.
The original Johns Hopkins Hospital Patient Guide did warn immunocompromised patients about contact with those who were recently vaccinated.

Are recently vaccinated people causing outbreaks of vaccine-preventable diseases?

Should kids be put in quarantine after they get their vaccines?

Of course not, but some anti-vaccine folks continue to push outdated information that hospitals, including Johns Hopkins, warn cancer patients to avoid children who were recently vaccinated.

Although vaccine shedding is a concern with some live vaccines, like the oral polio vaccine and the small pox vaccine, it is important to keep in mind that neither has been used in the United States for some time now.

Hospitals no longer warn patients about restricting exposure to people who have recently been vaccinated.

Were websites scrubbed of information about shedding as part of some conspiracy?

Of course not.

They were simply updated to keep up with the latest guidelines.

Can Immunocompromised Patients Have Visitors?

These guidelines about kids with cancer aren’t that new though.

As far back as 2001, an article in the journal Pediatrics & Child Health, “Practical vaccination guidelines for children with cancer,” recommended that household contacts of immunosuppressed children should receive:

  • all routine, age-appropriate vaccines, including DTaP, IPV, Hib, MMR, and Tdap,  and that no special precautions are necessary because transmission of disease from these vaccines does not occur.
  • the varicella vaccine and that even in the event of a vaccine-associated vesicular rash, the transmission risk is low and the consequences of infection are limited by the attenuated nature of the vaccine virus.
  • an annual flu vaccine

These recommendations for household contacts of immunosuppressed children are based on the 2000 Red Book: Report of the Committee on Infectious Diseases.

The recommendations in latest (2012) edition of the Red Book  state that household contacts of people with an immunologic deficiency should also:

  • receive the rotavirus vaccines if indicated
  • receive either the inactivated influenza vaccine or live attenuated influenza vaccine, giving preference to the inactivated influenza vaccine only if the immunosuppressed person is a hematopoietic stem cell transplant (HSCT) recipient in a protected environment.
The revised Johns Hopkins Hospital Patient Information Guide no longer warns about contact with children who were recently vaccinated.
The revised Johns Hopkins Hospital Patient Information Guide no longer warns about contact with children who were recently vaccinated.

So hospitals should no longer be warning patients about restricting exposure to people who have recently been vaccinated.

In fact, the latest guidelines from the Immune Deficiency Foundation Advisory Committee state that except for the live oral poliovirus vaccine, close contacts can receive other standard vaccines because viral shedding is unlikely and these pose little risk of infection to a subject with compromised immunity.

The Immune Deficiency Foundation also warns that, “The increased risk of disease in the pediatric population, in part because of increasing rates of vaccine refusal and in some circumstances more rapid loss of immunity, increases potential exposure of immunodeficient children.”

In other words, they are concerned about the risk of disease from intentionally unvaccinated kids and not from those who were recently vaccinated!

So, what about visitors?

“Tell friends and family who are sick not to visit.  It may be a good idea to have visitors call you first.”

The Johns Hopkins Hospital Patient Information Guide

Although you can’t prevent every cough and cold that might keep you from visiting a friend or family member who is being treated for cancer or has another immune system problem, keeping up to date on all vaccines can help to make sure that you don’t spread a vaccine-preventable disease, like measles or chickenpox, to them.

What To Know About The Johns Hopkins Vaccine Warning

Not only is Johns Hopkins Medical Center not telling cancer patients to avoid contact with children who recently received vaccines, they have gone out of their way to correct that misinformation from anti-vaccine websites.

Johns Hopkins Medicine, which includes the Johns Hopkins University School of Medicine and the The Johns Hopkins Hospital and Health System went out of their way to correct this anti-vaccine misinformation.
Johns Hopkins Medicine, which includes the Johns Hopkins University School of Medicine and the The Johns Hopkins Hospital and Health System went out of their way to correct this anti-vaccine misinformation.

Some folks haven’t gotten the message though and continue to push the idea that Johns Hopkins and other Hospitals warn cancer patients to avoid contact with recently vaccinated children.

Who Is at Risk If You Don’t Vaccinate Your Kids?

Passive immunity doesn't last until 12 months, when infants get their first dose of the MMR vaccine, so they are at risk for disease.
Passive immunity doesn’t last until 12 months, when infants get their first dose of the MMR vaccine, so they are at risk for disease. Photo by Jamie Beverly (CC BY-SA 2.0)

Whenever there is a discussion about folks who intentionally choose to not vaccinate themselves or their kids, one of their arguments invariably is ‘why are you so worried if you and your kids are vaccinated?”

Here is an example:

“My argument is simple. If you are vaccinated, you should not have to fear an outbreak of any preventable disease. That’s what the vaccine is supposed to prevent, right? Therefore, why should anyone butt into someone else’s business and tell them they should vaccinate? If one and one’s dependents are vaccinated, why should they have to worry about my personal decision to not vaccinate?”

I personally don’t believe in vaccines

As most people understand, the argument is far from simple.

Who Is at Risk If You Don’t Vaccinate Your Kids?

There are many people who are at risk from those who are unvaccinated, including those who:

  • are too young to be vaccinated or fully vaccinated – remember, with the latest immunization schedule, kids don’t typically get their first MMR until age 12 months and their second until they are 4 to 6 years old
  • can’t be fully vaccinated and have a true medical exemption – this includes children and adults with some immune system problems, vaccine allergies, or other contraindications to getting one or more vaccines
  • were vaccinated, but later developed an immune system problem and their immunity has worn off – might include children with cancer, AIDS, those receiving immunosuppressive therapy after a transplant, or a condition that requires immunosuppressive doses of steroids, etc.
  • were vaccinated, but their vaccine didn’t work or has begun to wear off (waning immunity) – vaccines work well, but no vaccine is 100% effective

These are the children and adults that can be, and should be, protected by herd immunity. At least they can be when most folks are vaccinated.

“We want to create a ‘protective cocoon’ of immunized persons surrounding patients with primary immunodeficiency diseases so that they have less chance of being exposed to a potentially serious infection like influenza.”

Medical Advisory Committee of the Immune Deficiency Foundation

So while some folks who are against vaccines try to scare others about shedding, those who take care of kids with immune system problems and their families go out of the way to get everyone around them vaccinated so their kids aren’t at risk of getting a vaccine-preventable disease!

“…the increased risk of disease in the pediatric population, in part because of increasing rates of vaccine refusal and in some circumstances more rapid loss of immunity, increases potential exposure of immunodeficient children.”

Medical Advisory Committee of the Immune Deficiency Foundation

Tragically, not everyone has gotten the message, and we continue to see and hear about kids who are too young to be vaccinated or who couldn’t be vaccinated get exposed to those who got sick because they simply chose to not get vaccinated.

What to Know About Risks from the Unvaccinated

Intentionally unvaccinated children and adults put others at risk for vaccine-preventable diseases.

More Information on Risks from the Unvaccinated

Live Vaccines

Although people usually think in terms of live vs inactivated vaccines, there are actually many other types of vaccines, including those made up of subunits of a virus or bacterial antigen, toxoid vaccines, conjugate vaccines, DNA vaccines, and recombinant vector vaccines.

Unlike those other vaccine types, live vaccines included a weakened version of a virus or bacteria.

For more information about live vaccines, see: