Tag: transverse myelitis

Why Do Some People Think That Vaccines Cause AFM?

So we know that vaccines don’t cause acute flaccid myelitis.

Consider a five-year-old in Maryland who recently came down with symptoms of AFM.

Was he recently vaccinated?

Nope. It had been some time since his four-year-old vaccines. Almost a year. And he had not gotten a flu vaccine yet.

What he did have were worsening symptoms about two weeks after he had seemed to get over a cold, something he has in common with most other kids with AFM.

“To try to pin a tragic yet uncommon neurological condition caused by enteroviruses on vaccines is dangerous and puts more kids at risk.”

Scott Krugman, MD

As with this case, the CDC reports no correlation with vaccines in the cases that they have investigated.

And remember, some of these kids have been unvaccinated!

That makes you wonder why some folks actually think that vaccines are associated with AFM, doesn’t it?

Why Do Some People Think That Vaccines Cause AFM?

That’s right, as you are likely suspecting, the usual suspects are pushing anti-vaccine propaganda and promoting the idea to scare parents away from vaccinating and protecting their kids.

“…there are many other reasons to suspect vaccine-related mechanisms of causation for AFM in the U.S., a primary one being that the scientific literature has documented paralysis as an adverse reaction to vaccination for decades!”

The Non-Polio Illness That “Looks Just Like Polio” by Lyn Redwood, RN, MSN, President, Children’s Health Defense

If any of these kids had recently gotten the oral polio vaccine, then sure, an adverse reaction to the vaccination would be at the top of the list of possible causes. After all, we know that VAPP can occur after OPV, but that vaccine hasn’t been used in the United States since 2000, when we switched to IPV.

Why do these folks think that they have it all figured out?

Vaccines are not causing AFM because of needle puncture wounds or tonsillectomies.
Vaccines are not causing AFM because of needle puncture wounds or tonsillectomies.

The AFM outbreaks happen at the beginning of the school year, when kids are all getting their shots, right?

Nope. They happen during the summer and early fall, peaking in August. And despite what some folks think, most parents don’t wait until the end of summer, just before school starts, to vaccinate their kids. Plus, most kids don’t even need vaccines before the start of the school year. Kids typically only get vaccines before starting kindergarten and middle school.

But the outbreaks do coincide with the when kids get their flu shots, right?

How many kids get flu shots in June and July?

If it was flu shots, the peak would be in October and November, when most kids get their flu shots and we would continue to see cases through December and January.

Many anti-vaccine websites and Facebook groups are pushing the idea that vaccines cause AFM.
Many anti-vaccine websites and Facebook groups are pushing the idea that vaccines cause AFM.

Of course, there is absolutely no evidence that flu vaccines, or any other vaccines, cause AFM.

What about the journal article that Brandy Vaughan posts as evidence?

“By reviewing vaccine-associated inflammatory diseases of the central nervous system, this study describes the current knowledge on whether the safety signal was coincidental, as in the case of multiple sclerosis with several vaccines, or truly reflected a causal link, as in narcolepsy with cataplexy following pandemic H1N1 influenza virus vaccination.”

Vaccine-associated inflammatory diseases of the central nervous system: from signals to causation

Even if you just read the abstract, as many folks do, you get a good idea where they are going with the article. It talks about how the claims of an association between multiple sclerosis and vaccines were proven to be purely coincidental.

Remember, correlation does not imply causation.

With AFM, you don’t even have much correlation to imply causation though!

Most cases occur just before we start giving flu vaccines and they don’t occur every year or in every state.

But doesn’t the article mention myelitis?

“Most of the published associations are based on individual case reports or small series of patients.”

Vaccine-associated inflammatory diseases of the central nervous system: from signals to causation

It does mention myelitis, just like it mentions MS – where an association has been shown to be purely coincidental.

Remember, case reports are not good evidence.

“…there are many other reasons to suspect vaccine-related mechanisms of causation for AFM in the U.S., a primary one being that the scientific literature has documented paralysis as an adverse reaction to vaccination for decades!”

The Non-Polio Illness That “Looks Just Like Polio” by Lyn Redwood, RN, MSN, President, Children’s Health Defense

But isn’t acute flaccid myelitis listed as a possible side affect in the package inserts for our vaccines?

Uh, TRANSVERSE myelitis and ACUTE DISSEMINATED ENCEPHALOmyelitis are not the same as acute flaccid myeltitis.
Uh, TRANSVERSE myelitis and ACUTE DISSEMINATED ENCEPHALOmyelitis are not the same as acute flaccid myelitis.

While it should be clear that AFM isn’t the same as ADEM and TM, it is very important to understand that even when those other conditions are listed in a package insert, it is in the section that is marked “without regard to causality.”

This isn’t evidence that vaccines cause AFM!

But didn’t the BMJ publish a study about Vaccines and the U.S. Mystery of Acute Flaccid Myelitis?

BMJ seems to allow anyone to publish responses to their articles online...
BMJ seems to allow anyone to publish responses to their articles online…

Nope. What they did is let someone publish what is essentially an online letter to the editor. And anti-vaccine folks are spreading it around like it is an actual BMJ study…

Surprised?

You shouldn’t be.

This is how anti-vaccine propaganda works.

It’s no coincidence that anti-vaccine folks are trying so hard to associate the outbreaks of AFM with vaccines. What better way to scare folks and make them think that vaccines are dangerous?

AFM is all that anti-vaccine folks are talking about these days...
AFM is all that anti-vaccine folks are talking about these days…

How are ‘we’ working on a vaccine for AFM if we don’t even know what causes AFM???

But that’s how many anti-vaccine folks think. Everything is a vaccine injury. Everything is a conspiracy.

Don’t believe them. Vaccines are safe and necessary.

More on Anti-Vaccine Propaganda About AFM

 

Do Vaccines Cause Acute Flaccid Myelitis?

Breaking News – 62 cases of AFM in 22 states have been confirmed so far this year, and another 65 are under investigation.

Since 2014, we have seen several outbreaks of acute flaccid paralysis (the sudden onset of weakness in one or more arms or legs) across the United States.

Why?

We don’t know, except we do know that these folks don’t have polio, even though folks continue to get confused because the kids are described as having a “polio-like” disease. Every case undergoes extensive testing, including testing for polio and other viral infections.

Do Vaccines Cause Acute Flaccid Myelitis?

Tragically, like some other conditions of unknown cause, some people have grasped onto the idea that AFP could be caused by vaccines.

“Of 14 patients with available information, 12 had previously received polio vaccine; one child and one adult were unvaccinated because of personal belief exemptions.”

Acute Flaccid Paralysis with Anterior Myelitis — California, June 2012–June 2014

It shouldn’t be surprising that there is absolutely no evidence that this is any type of vaccine injury.

Of nearly 350 cases of the acute flaccid myelitis (AFM), or the subtype of AFP that we have been seeing since 2014, we know that:

  • most cases occur in children
  • they have a magnetic resonance image (MRI) showing spinal cord lesion largely restricted to gray matter and spanning one or more vertebral segments
  • AFM can be caused by viruses, environmental toxins, and genetic disorders, although no common etiology has been found in recent cases
  • cases are occurring sporadically – after 120 cases in 34 states in 2014, there were only 24 cases in 17 states in 2015, but then 149 cases in 39 states in 2016 and 33 cases in 16 states in 2017. And there have been at least 62 cases in 22 states in 2018.
  • most cases occur in the late summer and early fall
  • most had symptoms of a preceding viral illness, including respiratory symptoms or diarrhea
  • some were unvaccinated
  • the ages of affected children has ranged from 5 months to 20 years
  • some patients have recovered, while others have persistent paralysis
  • there has been at least one death
  • some, but not all, were positive for enterovirus D68
  • in Colorado this year, 9 of 14 cases were linked to EV-A71 infections
  • although there was a national outbreak of EV-D68 in 2014 that coincided with the first AFM cases, we didn’t see this kind of outbreak in the following years

So what’s causing these kids, with a median age of about 7 years, to develop acute flaccid myelitis?

We don’t know, but there is certainly no reason to think that it could be a vaccine, as some anti-vaccine folks suggest.

For one thing, several of the kids were completely unvaccinated!

And then, if it was a vaccine, why the seasonal pattern?

Would a vaccine injury have such a seasonal pattern – even skipping a year?
Would a vaccine injury have such a seasonal pattern – even skipping a year?

And why don’t cases occur in all states and at the same rates each year?

Also, why the big range in ages? After all, what vaccines do a 5 month old and a 20 year old have in common?

And the CDC has been looking at all possible causes.

“Our medical team has been reviewing vaccine records when available during this year’s investigation and do not see a correlation.”

Kristen Nordlund, CDC spokeswoman

Acute flaccid myelitis is not caused by vaccines. Hopefully we will soon find out what really is causing it and can figure out how to prevent it.

Want to prevent a type of acute flaccid paralysis right now?

Get vaccinated!

While AFM is a type of non-polio AFP, we have long had a vaccine that can prevent polio, which also causes acute flaccid paralysis.

More on Vaccines and Acute Flaccid Paralysis

Updated October 17, 2018

The Myth That Polio Only Went Away Because They Changed the Way It Was Diagnosed

Have you heard this one?

“Before the vaccine was developed, the diagnosis of polio required 24 or more hours of paralysis. After the vaccine release, the diagnosis changed to at least 60 days of paralysis. As you can imagine, cases of polio dropped significantly.”

So that’s why polio went away?

It wasn’t the vaccine?

The Myth That Polio Went Away Because They Changed the Diagnostic Criteria

In 1952, there were 21,000 cases of paralytic polio in the United States.

But were there really?

Didn’t they change the way they diagnosed polio a few years later, right after the first polio vaccines came out, making it less likely that folks would be diagnosed with polio?

The original diagnostic criteria for polio came from the World Health Organization and included:

“Signs and symptoms of nonparalytic poliomyelitis with the addition of partial or complete paralysis of one or more muscle groups, detected on two examinations at least 24 hours apart.”

It changed in 1955 to include residual paralysis 10 to 20 days after onset of illness and again 50 to 70 days after onset.

Why?

“In the past children’s paralysis was often not correctly diagnosed as polio. Stool samples need to be analyzed to be able to distinguish paralytic symptoms from Guillain-Barré Syndrome, transverse myelitis, or traumatic neuritis.”

Polio – Data Quality and Measurement

But you coulld’t just use stool samples, as many kids might have recently had non-paralytic polio, and could test positive for polio (false positive test), but have another reason to have paralysis.

“Isolation of poliovirus is helpful but not necessary to confirm a case of paralytic poliomyelitis, and isolation of poliovirus itself does not confirm diagnosis.”

Alexander et al. on Vaccine Policy Changes and Epidemiology of Poliomyelitis in the United States

Since polio causes residual paralysis, the new diagnostic criteria helped to make sure that kids were diagnosed correctly.

Did We Overestimate the Number of Kids with Polio?

Some folks think that since we changed the criteria, we overestimated the number of kids with polio in the years before the vaccine came out.

Most of this idea seems to come from a panel discussion in 1960 by critics of the original polio vaccine, The Present Status of Polio Vaccines, including two, Dr. Herald R. Cox and Dr. Herman Kleinman, who were working on a competing live-virus vaccine.

None in the group were arguing against vaccines, or even really, that the Salk polio vaccine didn’t work at all though. They just didn’t think that it was effective as some folks thought.

“I’ve talked long enough. The only other thing I can say is that the live poliovirus vaccine is coming. It takes time. The one thing I am sure of in this life is that the truth always wins out.”

Dr. Herald R. Cox on The Present Status of Polio Vaccines

Dr. Cox did talk a lot about the oral polio vaccine. He talked about successful trials in Minneapolis, Nicaragua, Finland, West Germany, France, Spain, Canada, Japan, and Costa Rica, etc.

When anti-vaccine folks cherry pick quotes from The Present Status of Polio Vaccines discussion panel, they seem to leave out all of the stuff about how well the oral polio vaccine works.

That’s how they work to scare parents and hope that their anti-vaccine myths and misinformation can win out over the truth that vaccines work and that they are safe and necessary.

“Since nothing is available, there seems to be no alternative but to push the use of it. I don’t think we should do so in ignorance, nor too complacently, believing that as long as we have something partially effective there is no need to have something better.”

Dr. Bernard Greenberg on The Present Status of Polio Vaccines

And of course, they did, fairly soon, switch to something better – the Sabin live-virus oral polio vaccine.

Interestingly, using the idea that we changed the diagnostic criteria to make polio go away in an argument about vaccines is known as the Greenberg Gambit.

It tells you something about anti-vaccine arguments, that these folks are misinterpreting something someone said about vaccines almost 60 years ago.

In pushing the idea that polio hasn’t been eliminated, but rather just redefined, they also miss that:

But isn’t polio still around and just renamed as transverse myelitis, Guillain-Barré syndrome (GBS), and aseptic meningitis?

Let’s do the math.

Using the adjusted numbers in the The Present Status of Polio Vaccines discussion, there were at about 6,000 cases of paralytic polio in the United States in 1959.

While 3,000 to 6,000 people in the United States develop Guillain-Barré syndrome each year, the risk increases with age, and it is rare in young kids. Remember, paralytic polio mostly affected younger children, typically those under age 5 years.

“Transverse myelitis can affect people of any age, gender, or race. It does not appear to be genetic or run in families. A peak in incidence rates (the number of new cases per year) appears to occur between 10 and 19 years and 30 and 39 years.”

Transverse Myelitis Fact Sheet

Similarly, transverse myelitis is uncommon in younger children, and there are even fewer cases, about 1,400 a year.

What about aseptic meningitis? That doesn’t usually cause paralysis.

So do the math.

You aren’t going to find that many kids (remember, the incidence was 5-7 per 1,000) under age 5 years who really have “polio,” but instead, because of a worldwide conspiracy about vaccines, are getting diagnosed with transverse myelitis, Guillain-Barré syndrome (GBS), or aseptic meningitis instead.

Anyway, kids with acute flaccid paralysis are thoroughly tested to make sure they don’t have polio. And both transverse myelitis and Guillain-Barré syndrome have different signs and symptoms from paralytic polio. Unlike polio, which as asymmetric muscle atrophy, the atrophy in transverse myelitis and Guillain-Barré syndrome is symmetrical. Also, unlike those other conditions that cause AFP, with polio, nerve conduction velocity tests and electromyography testing will be abnormal. Plus, polio typically starts with a fever. The other conditions don’t.  So while these conditions might all be included in a differential diagnosis for someone with AFP, they are not usually that hard to distinguish.

“Each case of AFP should be followed by a diagnosis to find its cause. Within 14 days of the onset of AFP two stool samples should be collected 24 to 48 hours apart and need to be sent to a GPEI accredited laboratory to be tested for the poliovirus.”

Polio – Data Quality and Measurement

But why be so strict on following up on every case of AFP?

It’s very simple.

If you miss a case of polio, then it could lead to many more cases of polio. And that would tmake it very hard to eradicate polio in an area.

If anything, until the establishment of the Global Polio Eradication Initiative (GPEI) in 1988, it is thought that cases of polio and paralytic polio were greatly underestimated in many parts of the world!

And now polio is almost eradicated.

“DR. SABIN: Let us agree, at least, that things are not being brushed aside. Let us say that we might disagree on the extent to which certain things have received study. But I hope that Dr. Bodian realizes that nobody is brushing things aside. I would not have taken the trouble of spending several months studying viremia with different strains in chimpanzees and human volunteers, and viremia produced by certain low temperature mutants to correlate it with their invasive capacity, if I were merely brushing it aside.”

Live Polio Vaccines – Papers Presented and Discussions Held at the First International Conference on Live Poliovirus Vaccines

There is no conspiracy.

Think about it.

If they redefined how paralytic polio was diagnosed in 1955 as part of a conspiracy to make it look like the polio vaccines were working, then why did the number of cases continue to drop into the 1960s?

Shouldn’t they have just dropped in 1955 and then stayed at the same lower level?

After the switch to the Sabin vaccine, polio was on its way to being eliminated in the United States.
After the switch to the Sabin vaccine, polio was on its way to being eliminated in the United States, although there was an uptick in 1959, before we made the switch.

And why don’t any of the folks with other conditions that cause paralysis, like transverse myelitis and Guillain-Barré syndrome (GBS) ever have polio virus in their system when they are tested?

Also, if the renaming theory explains why the polio vaccine didn’t work, then why do anti-vaccine folks also need to push misinformation about DDT and polio?

What to Know About Polio Myths and Conspiracies

The near eradication of polio from the world is one of the big success stories of the modern era, just as those who push the idea that has all been faked is a snapshot of society at one of our low points.

More on Polio Myths and Conspiracies

Can Vaccines Cause Transverse Myelitis?

Transverse myelitis is not common, so most people probably haven’t heard of it.

“The term myelitis refers to inflammation of the spinal cord; transverse refers to the pattern of changes in sensation—there is often a band-like sensation across the trunk of the body, with sensory changes below.”

Transverse Myelitis Fact Sheet

The symptoms of transverse myelitis depend on where the inflammation occurs and sometimes, on the cause. They can include back pain, weakness or paralysis of the legs and arms, paresthesias (sensory alterations in the neck, arms, or legs), and bowel and bladder dysfunction.

What Causes Transverse Myelitis?

An MRI of a teen with transverse myelitis.
An MRI of a teen with transverse myelitis that resolved after total body irradiation therapy was stopped.

Many things can cause transverse myelitis.

Possible triggers can include:

  • infections – following bacterial, viral, fungal, and parasitic infections
  • immune system disorders
  • inflammatory disorders
  • vascular disorders

Unfortunately, it isn’t usually known what causes someone to develop transverse myelitis.

There are treatments though and many people with transverse myelitis have at least a partial recovery, although it may take months to years.

Transverse myelitis is not thought to be genetic and rates are highest in two age groups – those between 10 and 19 years (when many preteens and teens get vaccinated) and those between 30 and 39 years.

Can Vaccines Cause Transverse Myelitis?

Have you heard that vaccines can cause transverse myelitis?

“Vaccines currently routinely recommended to the general population in the U.S. have not been shown to cause transverse myelitis.”

Institute for Vaccine Safety on Do Vaccines Cause Transverse Myelitis?

While there are some case reports that tell of a temporal association between getting a vaccine and later developing transverse myelitis, the evidence does not support any association.

Why do we see these case reports?

Just like SIDS, autism, type 1 diabetes, and many other conditions, transverse myelitis has a background rate of disease or a number of cases that you can expect to occur in a given population. Once you know this background rate, you can then predict how many people will coincidentally develop transverse myelitis within one, seven, forty-two, or more days after they are vaccinated.

With a background rate of about 0.36 per 100,000 people, if one million get a vaccine, you would expect:

  • at least 1 to 2 of them to develop transverse myelitis coincidentally after 1 day
  • at least 1 to 2 of them to develop transverse myelitis coincidentally after 7 days
  • at least 2 to 4 of them to develop transverse myelitis coincidentally after 42 days

If the rate is higher than that, it could indicate a problem.

Let’s do the math.

There are about 1,400 new cases of transverse myelitis in the United States each year.

How many vaccines are given? About 286 million doses – each year. Some of those are given on the same day, but that would still mean that 100s of people should be getting transverse myelitis within 1 to 7 days if vaccines were a cause.

They aren’t.

“Correlation does not imply causation.”

In fact, an Institute of Medicine report, Adverse Effects of Vaccines: Evidence and Causality, dismissed most of the evidence for an associated between vaccines and transverse myelitis as insufficient and lacking.

And further studies found no association:

  • A Vaccine Safety Datalink study, Acute Demyelinating Events Following Vaccines: A Case-Centered Analysis, looked at nearly 64 million vaccine doses of vaccines and also “found no association between TM and prior immunization.”
  • Another study, Maternal safety of trivalent inactivated influenza vaccine in pregnant women, used “a large, geographically diverse, retrospective cohort of pregnant women” and found no cases of transverse myelitis.

Not only do vaccines not cause transverse myelitis, but many vaccine-preventable diseases can. So vaccines can likely protect you from developing transverse myelitis by protecting you from these diseases!

What to Know About Transverse Myelitis

Vaccines do not cause transverse myelitis, although many vaccine-preventable diseases can.

More on Transverse Myelitis