Tag: smallpox

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

Origins of a Name – Chickenpox

We know how a lot of diseases got their names, and it’s not always the kind of association that you might think.

For example, Fifth disease got its name because it was literally the 5th disease known to cause a fever and a rash!

“Measles is, he says, derived from the Dutch maseln (measles); the disease is also called in Holland mczsel-sucht, the measle-sickness; so translated by an old English writer. The literal sense is “small spots.”

Sykes On the Origin and History of Some Disease Names

And measles likely comes from the Dutch word for “small spots.”

So Why Do They Call It Chickenpox?

While that all makes perfect sense, one name that you likely don’t give much thought to, maybe because we don’t see it much anymore, is the name chickenpox.

How did we end up with the name chickenpox?

Did you ever think it was spread from chickens?

That it is caused by the varicella-zoster virus doesn’t really help understand the nickname. Nor does the fact that reactivation of chickenpox leads to shingles or herpes zoster.

“In 1767, an English doctor, William Heberden, realized two important things. First, he showed that chickenpox is different from the more deadly disease, smallpox. Second, he showed that once a person has had chickenpox, that person usually never gets it again (In other words, they’re immune for life). “

Case file: Blister Sisters

William Heberden wasn’t the first to study chickenpox though.

Was he the first to name it, in his paper, On the Chicken-Pox?

William Heberden doesn't provide any clues to how chickenpox got its name.
William Heberden doesn’t provide any clues to how chickenpox got its name.

Probably not…

  • the Charaka Samhita, an ancient Ayurvedic text describes chickenpox
  • Giovanni Filippo Ingrassia – described chickenpox in the 16th Century
  • Dawud al-Antaki – talks about chickenpox in his book Tadhkirat Dawud in 1599, but considers it a benign form of smallpox
  • Richard Morton – also describes chickenpox as a mild form of smallpox in 1694
  • Thomas Fuller – wrote about chickenpox in his Exanthemologia in 1730
  • Samuel Johnson – described chickenpox in 1755 in his dictionary

So none of that really tells how why we ended up with the name chickenpox though, does it?

One big clue?

In 1886, Thomas Fagge claimed that the origin of the term chickenpox came from the word “chickpease,” because the early chickenpox rash looks like a chickpea…

One thing is clear though. Chickenpox has been around a long time, but fortunately can now be easily prevented with the chickenpox vaccine.

More on Chicken Pox

Would Osler Stand for Anti-Vaccine Folks Using His Famous Quote?

I often find myself having to reset my irony meter after reading some of the anti-vacccine memes and posts that people send me.

Like when anti-vaccine folks quote the Founding Fathers…

Would Osler Stand for Anti-Vaccine Folks Using His Famous Quote?

Or they quote William Osler…

You remember William Osler, don’t you?

In 1910, as smallpox outbreaks continued and anti-vaccine folks made it harder to get folks vaccinated, he wrote:

“I would like to issue a Mount-Carmel-like challenge to any ten unvaccinated priests of Baal. I will go into the next severe epidemic with ten selected, vaccinated persons and ten selected unvaccinated persons – I should prefer to choose the latter – three members of Parliament, three anti-vaccination doctors (if they can be found), and four anti-vaccination propagandists.

And I will make this promise – neither to jeer nor jibe when they catch the disease, but to look after them as brothers, and for the four or five who are certain to die, I will try to arrange the funerals with all the pomp and ceremony of an anti-vaccination demonstration.”

William Osler on Man’s Redemption of Man

Want to vote on whether Osler would pick Jim Meehan to be one of the anti-vaccination doctors for his challenge?

Anyway, the Osler quote that Meehan posted, about not taking medicine, doesn’t mean what he thinks it means.

Osler wasn’t telling folks to not take any medicines.

“Osler himself prescribed relatively few drugs, his basic armamentarium consisting of quinine for malaria, digitalis for heart failure, opiates for pain and coughs, and iron and arsenic for anemia.”

Would Osler stand by his famous quote today?

He just meant that folks should avoid medicines that weren’t necessary and had no chance of working. Medicines, at the time, which often did more harm than good.

While you likely could apply his statement to the overuse of antibiotics, he certainly wasn’t talking about vaccines!

More on Would Osler Stand for Anti-Vaccine Folks Using His Famous Quote?

Vaccines and Mother’s Day

Last year, we found several connections between Father’s Day and vaccines, especially that Maurice Hilleman has often been called the father of modern vaccines.

Is there a mother of modern vaccines?

Vaccines and Mother’s Day

Does it have to be modern vaccines?

Of course, the first person that comes to mind is Lady Mary Wortley Montagu, who learned about smallpox inoculation in Turkey and used it to protect her own children, also advocating for more general use in England.

But that involved variolation, not vaccination.

So who could be the mother of vaccines?

How about the person who “has done more for immunizations that any one person in this whole country?”

Betty Bumpers was a champion in our efforts to reduce the burden of vaccine-preventable diseases among children in the United States.  She played a major leadership role as 1st Lady of Arkansas in improving immunization in that state and was inspirational in launching the first major Presidential Initiative on Immunization during the late 1970s.  She continued to be a major immunization advocate through much of her life launching “Every Child By Two (ECBT)” which she chaired along with Mrs. Rosalyn Carter, now “Vaccinate Your Family”.

Walter Orenstein

And to honor her, let’s continue her work…

Before vaccines, this mother and all of her kids got polio...
Before vaccines, this mother and all of her kids got polio…

For as Betty Bumpers said, “only when every child has completed his or her series of immunizations will our job be completed.”

More on Vaccines and Mother’s Day