Tag: side effects

Making a Better Pertussis Vaccine

So we know that we need a better pertussis vaccine.

DTaP and Tdap just aren’t doing the job that they should be doing.

Whooping Cough is back, again.
Whooping Cough is back, again.

So when will we get one?

Making a Better Pertussis Vaccine

Since anti-vaccine folks are always talking about the 300 new vaccines in the pipeline, you would think that we would have had several new pertussis vaccines by now…

Unfortunately, we don’t.

What we do have is some good candidates, including:

  • new acellular pertussis vaccines, either with more antigens or an adjuvant
  • a new live attenuated nasal vaccine, BPZE1
  • new whole-cell vaccines with reduced endotoxin contents (so should have fewer side effects that then original whole-cell pertussis vaccine – DTP)

Before you get too excited, keep in mind that none of these vaccines will be available in your pediatrician’s office any time soon. Developing a new vaccine takes a lot of time.

BPZE1 has started phase 2a trials though.

What do we do until we get new pertussis vaccines?

“We should be more vigilant than we have been in the past to recognize and treat pertussis in all age groups so that transmission to young infants is reduced. Most important (although not discussed in this review) is to ensure that all pregnant women receive the Tdap vaccine between 27 and 36 weeks’ gestation with each pregnancy. Also, we should consider routinely administering Tdap vaccine every 3 years to all adolescents and adults who were primed with a DTaP vaccine.”

James D. Cherry on The 112-Year Odyssey of Pertussis and Pertussis Vaccines—Mistakes Made and Implications for the Future

We should keep using the pertussis vaccines we have!

Vaccines work, even when they aren’t as effective as we would like.

More on Making a Better Pertussis Vaccine

Did 79.4% of the Reported Child Deaths to VAERS Get a Vaccine on the Day They Died?

We know that reports to VAERS are unverified.

“When evaluating data from VAERS, it is important to note that for any reported event, no cause-and-effect relationship has been established. Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.”

Guide to Interpreting VAERS Data

They can’t be used to prove causality or definitively say that an adverse reaction or side effect was caused by a vaccine.

Did 79.4% of the Reported Child Deaths to VAERS Get a Vaccine on the Day They Died?

Still, it might be surprising to learn that in the majority of reports to VAERS about deaths in children, most had been vaccinated on the day they died.

Did 79.4% of the Reported Child Deaths to VAERS Get a Vaccine on the Day They Died?
The study is easy to find…

Is that true?

It’s actually not.

The idea for the statistic comes from a report, Deaths Reported to the Vaccine Adverse Event Reporting System, United States, 1997–2013, that was published in the 2015 issue of Clinical Infectious Diseases.

“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

Wait.

How do we get to “no concerning pattern was noted” to 79.4% of the kids were vaccinated on the day they died?

“For child death reports, 79.4% received >1 vaccine on the same day.”

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

All the report is saying is that for kids who were vaccinated, 79.4% of them received more than one vaccine on the same day. It wasn’t the day they died though.

That kids would get more than one vaccine on the same day isn’t surprising. Few parents skip or delay vaccines so much that they just get one shot at a time.

“In our VAERS review, we did not detect any concerning patterns that would suggest causal relationships between vaccination and deaths.”

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

If anything, this report confirms that vaccines are safe and with few risks.

“The number of death reports in children exceeded those in adults in all years, and in both groups the number of reports has decreased in recent years.”

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

It is surprising that anti-vaccine folks would use it to try and scare folks away from vaccinating and protecting their kids.

More on Deaths Reported to VAERS

About Those Vaccine Strains in Measles Outbreaks…

A lot happens to control and contain a measles outbreak these days.

For one thing, you have to confirm that everyone with measles symptoms actually has measles. If you miss anyone, because measles is so contagious, then they could expose other people and the outbreak will keep getting bigger.

How do they confirm who has measles and who doesn’t?

While you could just make a clinical diagnosis, simply relying on the person’s history and pattern of symptoms, typically everyone just gets tested.

About Those Vaccine Strains in Measles Outbreaks…

What kind of testing?

“Laboratory confirmation is essential for all sporadic measles cases and all outbreaks. Detection of measles-specific IgM antibody and measles RNA by real-time polymerase chain reaction (RT-PCR) are the most common methods for confirming measles infection. Healthcare providers should obtain both a serum sample and a throat swab (or nasopharyngeal swab) from patients suspected to have measles at first contact with them. Urine samples may also contain virus, and when feasible to do so, collecting both respiratory and urine samples can increase the likelihood of detecting measles virus.”

Measles For Healthcare Professionals

It depends, but often a throat swab or a throat swab and urine are collected for PCR testing, especially if it has been 7 or fewer days since the patient came down with their rash.

If it has been longer than 7 days, then testing using urine and blood specimens can be performed.

“Molecular analysis can also be conducted to determine the genotype of the measles virus. Genotyping is used to map the transmission pathways of measles viruses. The genetic data can help to link or unlink cases and can suggest a source for imported cases. Genotyping is the only way to distinguish between wild-type measles virus infection and a rash caused by a recent measles vaccination.”

Measles For Healthcare Professionals

Because many people get vaccinated during an outbreak and a rash and fever is a side effect of the MMR vaccine, testing becomes very important in those who were recently vaccinated.

Statistics from the 2015 Disneyland measles outbreak...
Statistics from the 2015 Disneyland measles outbreak. Anti-vaccine folks, this slide doesn’t mean what you think it means.

After getting vaccinated, testing helps confirm that someone has vaccine strain measles and not wild type, a vaccine reaction, and don’t actually have measles.

“Here, we describe a real-time reverse transcription-PCR (RT-PCR) method that detects the vaccine genotype (MeVA RT-quantitative PCR [RT-qPCR]) and that can provide rapid discrimination between wild-type-virus infections and vaccine reactions.”

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

An no, the vaccine reaction is not that they developed measles! They developed a rash and/or fever, a common side effect of the MMR vaccine.

“During outbreaks, measles vaccine is administered to help control the outbreak, and in these situations, vaccine reactions may be mistakenly classified as measles cases.”

CDC on Genetic Analysis of Measles Viruses

So the reports that you might have seen that 31 people in the California measles outbreak had a vaccine strain of measles aren’t true. There were at least 31 people who were recently vaccinated during the outbreak and had a rash and/or fever, and they tested positive for the vaccine strain, proving that they weren’t actually part of the outbreak. None of them actually had measles though.

Has anyone ever gotten the measles after being vaccinated?

“Vaccine‐associated measles is a possible, but extremely rare event.”

Sood et al on Vaccine‐associated measles in an immunocompetent child

Yes, there are a few case reports.

Very rare case reports.

Who's to blame for low immunization rates and continuing outbreaks?
Who’s to blame for low immunization rates and continuing outbreaks?

We know who’s responsible for the rise in measles outbreaks and no, it ain’t folks who have recently been vaccinated. Vaccines are safe and necessary.

Get vaccinated. Stop the outbreaks.

More on Vaccine Strains in Measles Outbreaks

When You Ask for Vaccine Advice in an Anti-Vaccine Facebook Group…

Can you guess what happens when you ask for advice about vaccines in an anti-vaccine Facebook Group?

Meningitis is not a side effect of vaccines.

What could go wrong?

When You Ask for Vaccine Advice in an Anti-Vaccine Facebook Group…

While most of us are used to hearing about meningococcal meningitis being a big risk for teens and young adults, it is important to realize that rates of disease are also high for infants, with a second peak during adolescence.

The highest rates of meningococcal disease occurs during infancy and adolescence.

So why don’t we routinely vaccinate infants against meningococcal disease?

Many countries do, including Australia and the UK, and in the United States, high risk infants are vaccinated against meningococcal disease.

If you were on the fence but were advised by your paediatrician (Australian spelling) to get vaccinated and protected because a child in your town had just died, would you get vaccinated?

Or would you listen to folks in an anti-vaccine Facebook group who tried to convince you that meningitis was actually a side effect of getting vaccinated?

Folks who insist that deaths from vaccine-preventable disease aren’t real and that instead, they are actually vaccine-injuries?

This is the modern anti-vaccine movement.
This is the modern anti-vaccine movement.

We know what happens when you ask for vaccine advice in an anti-vaccine Facebook group. The members push their propaganda to scare you away from vaccinating and protecting your kids.

Don’t listen to them. Vaccines are safe and necessary.

More on When You Ask for Vaccine Advice in an Anti-Vaccine Facebook Group…

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

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

What Are the Side Effects of the Flu Vaccine?

Like other vaccines, flu vaccines can have side effects.

Fortunately, most of those side effects are mild.

What Are the Side Effects of the Flu Vaccine?

Not surprisingly, a lot of things that get blamed as being caused by flu vaccines are not actually side effects.

Did you actually get the flu in the days or weeks after your flu vaccine?

That’s not a side effect of your flu vaccine. Neither the inactivated flu shot, nor the attenuated FluMist can actually cause a flu infection.

Did you get a little sore at the site where you got your flu shot?

That’s a common side effect to getting a flu shot.

So is having some redness and swelling at the site, all of which begin soon after getting the shot and go away in a few days. You can also get a headache, fever, nausea, and muscle aches or signs and symptoms of an allergic reaction.

Do you have a runny nose or a cough? Side effects of the nasal spray flu vaccine can include a few days of runny nose, wheezing, headache, vomiting, muscle aches, fever, sore throat and cough.

Again, a bad cough and cold after a flu shot isn’t a side effect of the vaccine though.

Remember, correlation does not imply causation.

If you found out you were pregnant shortly after getting a flu shot, you wouldn’t think they were associated, would you?

What about narcolepsy?

“An increased risk of narcolepsy was found following vaccination with Pandemrix, a monovalent 2009 H1N1 influenza vaccine that was used in several European countries during the H1N1 influenza pandemic.”

Narcolepsy Following Pandemrix Influenza Vaccination in Europe

Although the focus has been on the Pandemrix flu vaccine as a trigger for narcolepsy in some countries (the vaccine wasn’t used in the United States), interestingly, several countries that weren’t using the vaccine also saw a spike in narcolepsy cases as the 2009 H1N1 pandemic hit.

Doctors and pharmacies rarely give away flu shots for free. They might not charge a copay sometimes because they are getting paid by your insurance company!
Doctors and pharmacies rarely give away flu shots for free. They might not charge a copay sometimes because they are getting paid by your insurance company!

What about all of the reports of severe reactions and deaths after getting a flu shot that you might hear about? In addition to vaccine injury stories, those reports are to VAERS and typically are not causally related to getting a vaccine.

Why are there so many reports to VAERS and the NVICP about flu vaccines? Since 2006, over 1.6 trillion doses of flu vaccine have been distributed in the United States, which equals about the total of all other vaccines we use.

What Are the Side Effects of This Year’s Flu Shot

Even when folks understand that flu vaccines don’t typically cause serious side effects, the question always comes up whether or not this year’s flu shot is causing more side effects than usual.

That’s actually not unreasonable, even when you consider that the biggest change in most flu vaccines from year to year is the strain of flu viruses they include, and not any of the other ingredients.

In addition to the Pandemrix flu vaccine, in 2010, the use of one brand of flu vaccines in Australia was suspended because they were causing more side effects (fever and febrile seizures) in young children than expected.

“The studies flesh out preliminary findings from CSL in June 2012, which said that the manufacturing process retained more virus component than that of other manufacturers and that the 2010 virus components triggered an excessive immune response in some young kids.”

CSL studies shed light on 2010 flu vaccine seizures

So are there any more side effects this year?

No, there is no evidence of increased side effects from this year’s flu vaccines

More on Flu Vaccine Side Effects