Tag: travel vaccines

Risks and Benefits of Vaccines – Anti-Vax Edition

Anti-vax folks like to say that they are doing their research, even collecting that research into handy binders. And they like to think that they are looking at both the risks and benefits of vaccines when they make their decision to skip or delay their child’s vaccines.

When anti-vax folks look at the risks and benefits of vaccines, they see lots of risks and few benefits.
When anti-vax folks look at the risks and benefits of vaccines, they see lots of risks and few benefits.

Like their research, their method of considering the risks and benefits of vaccines is very flawed

Risks and Benefits of Vaccines – Anti-Vax Edition

What’s the first thing you notice when you look at Ashley Everly‘s chart?

She doesn’t have a column for when a child Should Be Vaccinated!

Although there are no optional vaccines, there are some situations in which getting vaccinated and protected is truly essential, including:

  • a child bitten by a dog, coyote, or bat with rabies
  • a completely unvaccinated teen who gets a deep puncture wound while playing in a field
  • a baby born to a mother with hepatitis B
  • an unvaccinated older teen living in a dorm on a college campus where there is an ongoing outbreak of meningococcemia
  • a preschooler with a cochlear implant
  • an unvaccinated 1st grader who’s sibling is starting chemotherapy for leukemia
  • unvaccinated kids traveling out of the country to parts of the world where vaccine-preventable diseases are still endemic
  • a child with asplenia

Does she really think that the benefits of the rabies vaccine don’t outweigh the risks? Does she understand what happens if you get rabies, even if your child has access to nutritious food, clean drinking water, and emergency medical care?

Who Should Not Be Vaccinated?

What else is wrong with Ashley Everly‘s risk and benefit chart?

Most of the things on her list of who should not be vaccinated are not true contraindications.

Of course, the one about having a “previous vaccine injury or serious reaction” would likely be a reason to not get that vaccine again, as long as the injury or reaction was really caused by the vaccine.

Are there situations in which the potential benefit of vaccination might not outweigh the vaccines risks?

“Events or conditions listed as precautions should be reviewed carefully. Benefits of and risks for administering a specific vaccine to a person under these circumstances should be considered. If the risk from the vaccine is believed to outweigh the benefit, the vaccine should not be administered. If the benefit of vaccination is believed to outweigh the risk, the vaccine should be administered. Whether and when to administer DTaP to children with proven or suspected underlying neurologic disorders should be decided on a case-by-case basis.”

ACIP Contraindications and Precautions

Those situations are called precautions.

Fortunately, most are temporary, such as having a “moderate or severe acute illness with or without fever.”

These precautions do not include having a family history of cancer or autoimmune disease.

When Vaccination May Be Unnecessary

Are there any situations in which vaccination may be unnecessary?

There are a few, including:

  • when a disease is eradicated
  • when you aren’t at risk to get a disease and there is little risk that there will be an outbreak in your community or a return if folks stop vaccinating – that’s why we don’t routinely vaccinate against yellow fever, cholera, and typhoid fever, etc. in the United States
  • when you get sick and develop natural immunity

Vaccination is still necessary if a child’s mother is breastfeeding (which doesn’t protect against most vaccine-preventable diseases), has natural immunity to wild type infections (passive immunity quickly wears off), and even if the child has access to nutritious food and clean drinking water.

Nearly two months in the ICU vs getting a tetanus shot… How do the risks and benefits stack up now?

And yes, getting vaccinated and protected is even necessary if a child has access to emergency medical care.

What to Know About the Risks and Benefits of Vaccines

While you should certainly consider the risks and benefits of getting vaccinated, understand that vaccines are safe, with few risks, and very necessary.

More on the Risks and Benefits of Vaccines

Are the Measles Outbreaks in New York a Hoax?

Wait, why do some folks think that the measles outbreaks in New York are a hoax?

There were no confirmed cases in the measles outbreaks in New York, except the 654 measles cases that were confirmed… Some hoax!
There were no confirmed cases in the measles outbreaks in New York, except the 654 measles cases that were confirmed… Some hoax!

Oh, the usual suspects

Are the Measles Outbreaks in New York a Hoax?

Brooklyn, New York had 654 measles cases in the largest measles outbreak in 27 years.

There have been 312 confirmed cases in the measles outbreaks in Rockland, County, New York.

There have been an additional 312 confirmed, reported cases in Rockland County, New York, the longest measles outbreak since the endemic spread of measles was declared eliminated in 2000.

Were they a hoax?

“A total of 654 cases were confirmed, with rash onsets between September 30, 2018 and July 15, 2019. Serious complications included hospitalization (52), intensive unit care (19) and pneumonia (34). Multiple international importations of measles introduced into a community with prevalent delays in vaccination among young children propagated this outbreak.”

2019 Health Alert #26: Update on Measles Outbreak in New York City

Of course not!

The New York State Department of Health advises that on all suspected measles cases, “Viral specimens (nasopharyngeal swaband urine) and serology (IgM and IgG) should be obtained for diagnostic testing and confirmation.”

Were these cases all caused by vaccine strain measles, as Larry Palevesky suggests?

Of course not!

A vaccine strain has never before caused a measles outbreak. And NYC Health Commissioner Dr. Oxiris Barbot, in a press conference, stated that “Yeah, it’s, you can’t get the measles from the vaccine.”

Although anti-vax folks often focus on the measles strain when there is an outbreak, all it really helps you do is figure out where the imported cases came from.

Even though health officials didn’t tell us the specific strains involved in the outbreaks, guess what, they did tell us the sources of the outbreak, so it is basically the same thing.

The cases were imported from Israel, UK, and Ukraine.

And the CDC has told us that “All measles cases this year have been caused by measles wild-type D8 or B3.”

“We have to stop blaming, accusing, targeting, ostracizing, condemning unvaccinated children as a health risk, which would then make this subject completely moot.”

Larry Palevsky

What else do we know about the measles outbreak in Brooklyn?

  • it began in October 2018 “with an unvaccinated child from Brooklyn who acquired measles in Israel”
  • it included 15 neighborhoods in Brooklyn, with most concentrated in Williamsburg, Borough Park, and Sunset Park
  • the majority of cases were in children, including at least 91 cases in infants less than 12 months old
  • the great majority of cases were unvaccinated, with only 27 cases fully vaccinated with two doses of MMR
  • there were 52 hospitalizations, including 16 ICU admissions

And the outbreak cost over $6 million to control!

The Rockland County measles outbreak is still ongoing.

At a gathering for the New York Alliance for Vaccine Rights and First Freedoms Community, these folks, including Larry Palevsky (left) are discussing the "alleged" measles outbreaks that New York spent $6 million and 500 staff to contain.
At a gathering for the New York Alliance for Vaccine Rights and First Freedoms Community, these folks, including Larry Palevsky (left) are discussing the “alleged” measles outbreaks that New York spent $6 million and 500 staff to contain.

So why do they think they are a hoax?

“There were over 800 kids who the New York State and New York City Department of Health have said were confirmed cases of measles. The real question is, were these really confirmed as per the CDC recommendations. We do not have that data. In fact, anecdotally, New York State told the physicians not to do the tests.”

Larry Palevsky

Is this about the strains again? Is this about the fact that once you know you are in the middle of a huge measles outbreak, you might be able to start diagnosing kids clinically?

“New York State lied when they said that there were confirmed cases. We don’t know what kind of illnesses the kids had. And there’s a set of papers in the literature that specifically state that if the children are found by analysis to have a measles virus infection that is consistent with a side effect of the vaccine, it is important for the Department of Health to alert the public that it was a vaccine strain that caused the outbreak, because a vaccine strain illness should not be equated with a public health emergency. [Applause]”

Larry Palevsky

Yes, it is about the strains…

“So the reality is that when there is a vaccine strain measles outbreak, meaning that the vaccine itself was not properly attenuated, meaning it was more active and virulent than just simply giving an antibody response in the body, when that occurs an outbreak is almost always very very close to the vest, meaning that would explain why it was only seen in two communities out of 62. And if New York state had done the proper testing of the vaccine to see if it was too virulent and of the children who had the measles infection to see what type of measles virus they had, then in all likelihood this was a vaccine strain measles infection which is known to be a side effect of the vaccine and not a public health emergency.”

Larry Palevsky

Is any of that true?

Since we have never had an outbreak of measles from an MMR vaccine that wasn’t properly attenuated, I’m guessing no, it isn’t. Also remember that to control the outbreak, they gave lots and lots of MMR vaccine to unvaccinated folks in those communities…

What about his explanation for why we only saw outbreaks in Brooklyn and Rockland Counties? Well, for one thing, we didn’t. Other areas of New York and of course, around the country have seen a rise in measles. And the outbreaks in Brooklyn and Rockland Counties were caused when unvaccinated folks traveled to Israel, UK, and Ukraine and returned to an area with low immunization rates. They weren’t caused by a bad batch or mutant strains of measles in the MMR vaccine.

“So the New York State Department of Health failed to do their job and instead they lied and said the cases were confirmed and they didn’t do their due diligence to actually evaluate all the possible reasons that an outbreak could have occurred. It’s very strange that two communities where there are lots of people moving through those communities that are non-Jewish, that are outside of the state that are coming through and why just those communities got the illness. That should have raised the red flag that something else was going on and your state failed us.”

Is it possible that those other people moving in and out of those communities in Brooklyn and Rockland County were vaccinated and protected against measles?!?

One thing should be very clear.

Brooklyn may have stopped their measles outbreak, but New York still has a public health emergency on their hands.

Well, not just New York. We need to stop this kind of propaganda if we want to keep parents from being scared to immunize and protect their kids.

More on Measles in NY

The Myth That Measles Never Left

Measles cases are on the rise. Where? Pretty much everywhere. But some folks are still pushing the myth that measles never left.

The highest number of measles cases in over 25 years? Don't call it a comeback?
Don’t call it a comeback? Cases in the US average 283 cases per year over the past 12 years (if you don’t skip 2019…)

It is easy to see that measles myth, like most AV myths, isn’t true.

The Myth That Measles Never Left

In the pre-vaccine era, everyone would get measles.

That translates into about 500,000 reported cases each year. Technically, it was likely closer to about 4 million cases in the United States each year, but either way, we know that lots of people got measles.

Then we got a measles vaccine and not surprisingly, cases of measles dropped. Except for a small uptick from 1989 to 1991, we were on our way to eliminating measles.

And we did, in 2000, when the endemic spread of measles was eliminated in the United States. From then on, all measles cases were imported.

In 2004, we had an historic low of just 37 measles cases in the United States!

Will we ever have fewer than 37 cases in a year?
Will we ever have fewer than 37 cases in a year?

And from 2000 to 2012, we averaged just 87 measles cases each year, which is far below the US average of 283 cases we are now seeing.

No, measles never completely left. It was not eradicated.

But it is certainly making a comeback and soaring to levels that we haven’t seen since 1992!

Just think about it… We had 37 cases of measles in 2004 and this year, we often had 37 cases in a single week!

Get vaccinated and protected so that you don’t get caught up in the next outbreak.

More on Measles Cases

Why Are Vaccinated Australians Now Catching Measles?

Measles is on the rise in Australia, like many other places. But why are vaccinated Australians now catching measles?

More vaccinated Australians are catching measles because there is more measles in Australia.
More vaccinated Australians are catching measles because there is more measles in Australia.

And has this got folks thinking it is because the disease is evolving?

Why Are Vaccinated Australians Now Catching Measles?

Well, apparently it has some folks thinking that.

Remember, Andrew Wakefield has also been talking about mutant measles.

Is that what this story in Australia was about?

No.

“In recent years, 13 Victorians have been hospitalized with measles despite having one or two vaccinations that should have made them immune. Why? Well, experts believe that because measles is so rare in Australia, we pretty much never come into contact with it, so our immune systems are starting to let their guards down and wane a little bit.”

Nathan Templeton on Measles Immunity Concerns

What is he talking about?

It’s the idea of exogenous boosting from being around natural infections. In other words, after you become immune from being vaccinated, you could get a boost in your immune protection if you are around someone with the disease.

“The exogenous boosting (EB) hypothesis posits that cell-mediated immunity is boosted for individuals reexposed to varicella-zoster virus (VZV).”

Talbird et al on Understanding the role of exogenous boosting in modeling varicella vaccination.

While this is thought to happen with chickenpox, we aren’t sure if it happens with measles.

It might, but the “problem” is that it is known that folks can have an amnestic response, so can be immune even though they have low antibody levels.

Mostly though, it is important to keep in mind that most of the people who get measles are unvaccinated, often intentionally unvaccinated.

“The key to measles elimination is increasing vaccination coverage and monitoring of measles antibody status for all ages, as well as enhancing surveillance of both domestic and overseas incidences.”

Inaida et al on Measles elimination and immunisation: national surveillance trends in Japan, 2008-2015.

So how many vaccinated Australians are getting measles?

Overall, there are 154 cases of measles in Australia so far this year.

“In Australia, the majority of measles cases are due to unvaccinated individuals becoming infected while travelling to countries in which measles is either common or there are outbreaks occurring. As measles is highly contagious, these people can then spread the disease to others, causing outbreaks, often before they are aware that they have the virus.”

Australia’s Measles Outbreaks 2019

And just as in the United States and most other countries, most of their outbreaks are started by folks who are unvaccinated.

More on Measles in Australia