Tag: shedding

Getting Vaccinated to Protect Those Who Can’t Get the Vaccines

Most people get vaccinated because those vaccines have the direct benefit of reducing their risk of getting a life-threatening vaccine preventable disease. Protecting those who can’t get vaccines is a secondary benefit.

Should you get vaccinated to protect those who can't get the vaccines?
Does rationalizing your decision in anti-vax Facebook groups help you feel better that you are putting kids with cancer at greater risk to get sick?

A secondary benefit that anti-vax folks go to great lengths to convince themselves isn’t real and justify their decision to leave their kids unvaccinated and unprotected..

Getting Vaccinated to Protect Those Who Can’t Get the Vaccines

Of course, none of their explanations really hold water.

None of the vaccines that are routinely used on the CDC immunization schedule are a risk if you are around kids with cancer or other immunodeficiencies, except for FluMist and those with severe issues, like being in a bone marrow transplant unit.

One of the biggest misconceptions though, is that in getting vaccinated, parents are putting their own kids at great risk to protect someone else.

Don't set your kid on fire to keep mine warm!
Don’t set your kid on fire to keep mine warm!

Of course, that’s not true.

Remember, vaccines are safe, with few risks.

That why the analogy of setting their own kids on fire to keep others warm doesn’t make any sense.

After all, unlike vaccinating their own child, setting their child on fire offers them no benefit!

And they should understand that the one and only reason that their kids don’t get more vaccine-preventable diseases in this dog eat dog world is because the vast majority of us vaccinate and protect our kids.

Herd immunity is indeed real. In addition to protecting those who can’t be vaccinated, it protects the free-riders, those who just don’t want to get vaccinated.

What about the idea that it is unrealistic for folks who are immunocompromised to expect that they can lead normal lives and avoid infections?

You can't avoid all risks of infection, but why not avoid those that you can?

While it is true that there are other infections out there besides those that are vaccine-preventable, wouldn’t you want to at least reduce those risks that you can?

But could it be, as much as they seem to believe in shedding, that they think they are being altruistic in not vaccinating their kids?

Anti-vax folks are all about the shedding...
Anti-vax folks are all about the shedding

They aren’t.

In most cases, there are no restrictions on vaccinating people who have contact with those with immune system problems.

What about the idea that vaccines cause cancer?

Vaccines prevent cancer!
Vaccines prevent cancer!

That isn’t true. In fact, there are several vaccines that prevent cancer!

What other misconceptions do they have?

Most of the reasons folks use to avoid vaccines have been refuted a thousand times.
Most of the reasons folks use to avoid vaccines have been refuted a thousand times.

Let’s look at those last few issues…

  • vaccines are not associated with autism
  • vaccines aren’t perfect, but they do work very well
  • vaccines do help those with immune system problems, sometimes directly and more often because of herd immunity
  • people who have cancer are often vaccinated before they have chemo, but that protection gets wiped out during treatment and they can’t get caught up until after they have completed all of their treatments
  • kids with cancer might get some vaccines, but typically don’t get live vaccines

What about the idea that your unvaccinated child isn’t sick, so can’t get anyone else sick?

While that is a very common argument among anti-vax parents, it is very important that if your child is unvaccinated, then they are at much greater risk to catch a vaccine-preventable disease. And since you are often contagious even before you show symptoms, they might unknowingly expose many other people before they even realize that they are sick.

Hopefully you now understand it was never really a question.

That's why you get vaccinated, to protect those who can't get the vaccines!

Vaccinate and protect your kids.

If you don’t, in addition to putting them at risk to get sick, you put everyone around them at risk, including some who are at very high risk for severe complications from vaccine preventable diseases.

More on Risks from Unvaccinated Kids

Measles Outbreaks in New Zealand

Just like other areas of the world, New Zealand has a problem with measles outbreaks. It shouldn’t be surprising then that they also have a problem with folks pushing anti-vax misinformation.

Where are the areas in New Zealand with 97% MMR vaccination rates?
Where are the areas in New Zealand with 97% MMR vaccination rates? Just askin…

Are they really seeing the most measles cases in the areas with the highest vaccination rates?

Measles Outbreaks in New Zealand

One thing is sure, there are a lot of measles cases in New Zealand.

“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

Do we know which parts of New Zealand have the most measles outbreaks?

We do!

Where are the cases in the measles outbreaks in New Zealand?
The case count is now up to 1742…

Of course, this doesn’t really tell you anything about why some districts have more cases than others…

Is it because they have more unvaccinated people or simply because they have a lot more people?

Many of the measles cases in New Zealand are in infants too young to be vaccinated and in teens and young adults.
Many of the measles cases in New Zealand are in infants too young to be vaccinated and in teens and young adults.

Wherever they live, we know that like measles outbreaks in every other part of the world, few of the folks with measles in New Zealand are known to be fully vaccinated.

And while New Zealand had eliminated home grown-cases of measles just a few years ago, it wasn’t with vaccination rates of 97%.

“For immunisation from measles, rubella and mumps two doses of the vaccine called MMR are needed. Dr McElnay said among New Zealand’s children and infants, 95 percent had had the first dose and 90 percent the full vaccine.”

NZ eliminates NZ-origin measles

Unfortunately, while they were working to get younger kids vaccinated and protected, many older kids and adults are still not vaccinated.

“However, we must remain vigilant and improve our vaccination rates because these diseases can easily spread among unimmunised people from imported cases. In New Zealand, people aged 12 to 32 years have lower vaccination rates than young children so are less likely to be protected against these diseases.”

Measles and rubella officially eliminated in New Zealand

Only about 80% of teens and young adults are fully vaccinated against measles in New Zealand!

Combined with high numbers of folks who were never vaccinated and folks who travel to other parts of the world where measles is still endemic and you have a recipe for disaster.

“While there have been no measles deaths in this outbreak, there have been five pregnant women hospitalised and two fetal losses associated with these events.”

Report investigates high hospitalisation rates for measles in Auckland region

In addition to the two unborn babies who died, there are also reports of at least three hospitalisations for encephalitis.

Two doses of the MMR vaccine is your best protection against measles.

A disaster that could easily be prevented with two doses of a vaccine that is safe, with few risks, and obviously necessary.

More on Measles in New Zealand

Why Do Anti-Vax Folks Get Excited About Polio Outbreaks?

At least two things happen whenever we hear about a new polio outbreak. And yes, I said polio outbreak.

One is that many people assume it is wild polio and that we are moving further away from finally eradicating polio.

Hopefully folks understand that polio outbreaks wouldn't just stop if we stopped vaccinating...
Hopefully folks understand that polio outbreaks wouldn’t just stop if we stopped vaccinating…

And the other?

Anti-vax folks assume that it is an outbreak of vaccine strain polio and very wrongly use this as a reason to try and scare parents away from vaccinating and protecting their kids.

“The polio outbreak in the Philippines is confirmed to be from a circulating vaccine-derived poliovirus type 2. This is of particular concern, as wild poliovirus type 2 was certified as globally eradicated in 2015. Poorly conducted immunization activities, when too few children have received the required three doses of polio vaccine, leave them susceptible to poliovirus, either from vaccine-derived or wild polioviruses. Full immunization protects them from both forms of the virus.”

WHO, UNICEF and partners support Philippine Department of Health’s polio outbreak response

As expected, that’s the response we are seeing from anti-vax folks to news of the latest outbreak of polio in the Philippines.

Why Do Anti-Vax Folks Get Excited About Polio Outbreaks?

But isn’t bad that the polio vaccine can actually cause outbreaks?

Of course!

No one wants people to get sick after getting vaccinated. And that’s why we are moving towards stopping the use of the oral polio vaccine that causes vaccine derived polio.

It is also very important to consider the alternative. A lot more people getting wild polio!

“As recently as 30 years ago, wild poliovirus paralysed more than 350,000 children in more than 125 countries every year. In 2018 there were fewer than 30 reported cases in just two countries – Afghanistan and Pakistan.”

“Zero polio transmission and health for all”, WHO Director-General gives new year’s wish to the people of Afghanistan and Pakistan

We also need to remember the reason we typically see outbreaks of vaccine strain polio. It is because vaccination rates have dropped in an area!

Wait, what?

Yes, that’s right. The polio vaccine, in addition to protecting you from wild polio can prevent you from getting the vaccine strain polio too.

But isn’t the polio vaccine causing many more cases of polio than the actual polio virus?

Bob Sears recently shared an article that was two years old about mutant strains of polio causing outbreaks

It once was, but that’s simply because we are getting very close to eradicating polio and there were fewer cases of wild polio!

While there were far more cases of vaccine derived polio than wild polio last year, there were more cases of wild polio earlier in 2019 and it is now about even.

Tragically, we are starting to see more and more cases of wild polio.

Science event in Washington, D.C. reminding folks that Vaccines Work.
Pediatricians at the March for Science event in Washington, D.C. reminding folks that Vaccines Work.

Still, we are no where near the numbers of cases of polio and kids getting paralyzed when polio was epidemic in most countries.

And the outbreaks of vaccine derived polio?

They demonstrate what happens when we don’t keep up our immunization rates. And how anti-vax folks either don’t understand or intentionally try to misinform parents about how vaccines work.

More on Polio Outbreaks

About That Johns Hopkins Protocol of Immunocompromised Kids…

We know that immunocompromised kids are especially at risk from vaccine preventable diseases, both because they are immunocompromised and because they often can’t get vaccinated or fully vaccinated.

That why herd immunity is important and there are immunization protocols for immunocompromised kids.

About That Johns Hopkins Protocol of Immunocompromised Kids…

One of the most commonly followed protocols, 2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host, was recently published by the Infectious Diseases Society of America.

“Healthy immunocompetent individuals who live in a household with immunocompromised patients should receive the following live vaccines based on the CDC annual schedule: combined measles, mumps, and rubella (MMR) vaccines; rotavirus vaccine in infants aged 2–7 months; varicella vaccine (VAR); and zoster vaccine (ZOS). Also, these individuals can safely receive the following vaccines for travel: yellow fever vaccine and oral typhoid vaccine.”

2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host

There are also guidelines from the Medical Advisory Committee of the Immune Deficiency Foundation, the ACIP, and the American Academy of Pediatrics.

All of the protocols support kids getting vaccinated and protected, unless they have a medical exemption, and that their contacts get vaccinated and protected.

Is it any wonder that some parents are scared to vaccinate their kids after listening to these folks speak at these rallies?

That’s why it is surprising to hear what Robert F. Kennedy, Jr had to say about the protocol he reviewed from Johns Hopkins.

“So I went to the Johns Hopkins protocols for immunocompromised children. And I read it. And when I read it, it’s a long, dense document, but there’s no place in that entire document that said immunocompromised children should be kept away from unvaccinated children. Do you know what there is? Ah! It says that the real danger to immunocompromised children is vaccinated children, because, whatever you do, don’t let your immunocompromised child near a child who has recently, meaning six weeks, had a chickenpox vaccine. Don’t let your child anywhere near a child who has had a polio vaccine. Or a pertussis vaccine. And that’s the worst one. Because the child with pertussis has no knowledge that he has pertussis. He is an asymptomatic carrier. But he can pass it to your child. And he is more likely to pass it to your child if he is vaccinated!”

Robert F. Kennedy, Jr

Where is this Johns Hopkins protocol that Kennedy read?

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.

He can’t be referring to the old version of the Johns Hopkins Hospital Patient Information Guide for the Immunocompromised Patient, can he? The revised Johns Hopkins Hospital Patient Information Guide no longer routinely warns about contact with children who were recently vaccinated.

Although anyone with a severe immunodeficiency should avoid those who have recently received the oral polio vaccine, that vaccine hasn’t been used in the United States since 2000. Also, you don’t have to avoid folks who have received the chickenpox vaccine, unless they get a rash and it is uncovered. And you certainly don’t have to avoid anyone who has received the pertussis vaccine, as it is not a live vaccine.

The Johns Hopkins Hospital Patient Information Guide does warn those who are immunocompromised to “Tell friends and family who are sick not to visit.”

Who’s more likely to get sick with things like measles, chickenpox, and pertussis?

Folks who are unvaccinated!

“The threat of pertussis and other childhood communicable diseases to children with immunodeficiency is particularly alarming. 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. The immunosuppressed subject is particularly at risk in crowded living conditions because of the spread of these diseases by aerosol droplets or through the oral-fecal route.”

Medical Advisory Committee of the Immune Deficiency Foundation on Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts

Has Kennedy read the protocols from the Immune Deficiency Foundation? They do warn of the risk from intentionally unvaccinated kids!

Has he read the Johns Hopkins Hospital Patient Information Guide, which was updated at least two years ago?

Have you, especially if you are thinking about skipping or delaying your child’s vaccines?

More on the Johns Hopkins Protocol of Immunocompromised Kids…