Tag: vaccine induced disease

Should I Blame the Vaccine If I’m Sick and I Just Got Vaccinated?

We all know the saying, correlation equals causation, right?

So if you get an MMR vaccine and get the measles a week later, it has to be the vaccine, right?

Should I Blame the Vaccine If I’m Sick and I Just Got Vaccinated?

Actually, no.

“Correlation does not imply causation.”

Although it would be very easy to blame the vaccine, if you keep in mind that the saying is actually “correlation does not imply causation,” maybe you will do a little investigating and see if something else is to blame.

Some things to consider and ask yourself:

  1. Do I really have measles? Remember that it is not uncommon to develop a fever and a rash about 7 to 12 days after getting an MMR vaccine. This is a very common, mild vaccine reaction. It doesn’t mean that you have measles or even a mild case of the measles.
  2. Was I recently exposed to someone with measles? If you were vaccinated because you were exposed to measles during an outbreak, then there is a good chance that the vaccine hasn’t had a chance to work yet and you actually developed measles from being exposed to the wild virus.
  3. Do I have the wild type or a vaccine strain of measles? Testing can be done to tell which strain of measles you have and to see if it is a wild type or vaccine strain.

Are there any examples of folks having wild type disease if they get sick shortly after being vaccinated?

Not surprisingly, there are a lot of these types of examples.

“Vaccine strains are poorly or not transmissible and prompt differentiation between wild-type and vaccine strains allows for optimal management and public health action.”

Pabbaraju et al on Simultaneous Detection and Differentiation between Wild-Type and Vaccine Measles Viruses by a Multiplex Real-Time Reverse Transcription-PCR Assay

What about examples of folks getting sick with vaccine strain measles and other diseases? Not so many.

The clinical diagnosis could just as easily have been wild type measles and not a vaccine strain, as there was a lot of measles in the the UK in 1988.
The clinical diagnosis could just as easily have been wild type measles, as there was a lot of measles in the the UK in 1988.

Most of the published examples are case reports without evidence of a vaccine strain.

What about the kid in Canada that got measles after her MMR vaccine?

“We describe a case of vaccine-associated measles in a two-year-old patient from British Columbia, Canada, in October 2013, who received her first dose of measles-containing vaccine 37 days prior to onset of prodromal symptoms.”

Murti et al on Case of vaccine-associated measles five weeks post-immunisation, British Columbia, Canada, October 2013.

She had symptoms of measles and a vaccine strain and was reported as “the first case of MMR vaccine-associated measles.” Well, at least the first case that occurred so long after getting vaccinated. Still, they note that “clinically significant vaccine-associated illness is rare.”

What about all of the people in California and Michigan who supposedly had vaccine-strain measles?

This is not vaccine strain measles! It is people with a rash or fever after being vaccinated. They don't have measles though.
This is not vaccine strain measles! It is people with a rash or fever after being vaccinated. They don’t have measles though.

Anti-vaccine folks made that up!

When It’s a Wild-Type Virus

What’s the most obvious evidence against the idea that vaccines and shedding are responsible for causing outbreaks?

For one thing, despite the recent uptick, cases of vaccine-preventable diseases are way down from the pre-vaccine era. That’s not what you would expect if vaccine-induced disease was common or if contacts of those who were recently vaccinated could easily get sick from shedding.

And we have evidence against vaccine induced disease.

When kids get chicken pox shortly after being vaccinated, they often have a wild strain. They don’t have breakthrough chicken pox.

“All of 57 vaccinees with breakthrough varicella, clinically diagnosed on the basis of a generalized maculopapular or vesicular rash, in which there was amplifiable DNA [corrected], had wild-type VZV infection based on analysis of viral DNA. “

LaRussa on Viral strain identification in varicella vaccinees with disseminated rashes.

Same thing with measles.

Want to avoid these situations in which you could get a wild strain of a vaccine-preventable disease?

Don’t skip or delay your child’s vaccines!

More On Wild-Type and Vaccine Measles Viruses

Side Effects and Adverse Events Following Immunizations

Vaccines are safe, but they do have some side effects, mostly mild, and they rarely cause some serious and severe adverse reactions.

Vaccine adverse events can be reported to VAERS online or using a downloadable form.
Vaccine adverse events can be reported to VAERS online or using a downloadable form.

To help keep our vaccines safe, it is important that all “clinically important adverse events that occur after vaccination of adults and children” be reported to VAERS, not just the ones that are known to be side effects.

Wait.

Isn’t an adverse event the same as a side effect?

Adverse Events Following Immunizations

To better understand that, let’s first look at how we define an adverse event following immunization (AEFI):

“An Adverse event following immunization (AEFI) is any untoward medical occurrence which follows immunization and which does not necessarily have a causal relationship with the usage of the vaccine. The adverse event may be any unfavourable or unintended sign, abnormal laboratory finding, symptom or disease.”

Classification of AEFIs

So it should be clear that not all adverse events are actually caused by vaccines.

Many are coincidental events that simply occur after a vaccine is given.

What’s the Difference Between Side Effects and Adverse Events Following Immunizations?

Others are true vaccine reactions though, including fever, pain, fainting, and allergic reactions, etc.

“A side effect is any health problem shown by studies to be caused by a vaccine. Like any medication, vaccines can cause side effects. Usually vaccine side effects are minor (for example, a sore arm where a shot was given or a low-grade fever after a vaccine) and go away on their own within a few days.”

Understanding Side Effects and Adverse Events

These are the reactions that we call side effects or adverse reactions of the vaccine.

Still, just because a sign or symptom can be a side effect of a vaccine doesn’t mean that it always will be.

“A vaccine reaction is an individual’s response to the inherent properties of the vaccine, even when the vaccine has been prepared, handled and administered correctly.”

Vaccine reactions – WHO Vaccine Safety Basics

Here are some other definitions:

  • adverse event – Medical occurrence temporally associated with the use of a medicinal product, but not necessarily causally related.
  • adverse reaction/side effect – A response to a drug which is noxious and unintended, and which occurs at doses normally used in man for the prophylaxis, diagnosis, or therapy of disease, or for the modifications of physiological function.
  • unexpected adverse reaction – Not consistent with applicable product information or characteristics of drug.
  • severe adverse event or reaction – are rarely life-threatening and usually do not result in long-term problems
  • serious adverse event or reaction – Any untoward medical occurrence that at any dose is life-threatening, results in death, requires inpatient hospitalization or prolongation of existing hospitalization, or results in persistent of significant disability or incapacity

Does understanding those definitions make it easier to see why you should be skeptical when folks try to scare you with VAERS reports and data from package inserts?

“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 both can include reports about adverse events, not just side effects. So they both include events that can very well be coincidental, and not caused by a vaccine.

So when doing your research about vaccines, focus on real side effects, or things that are known to be caused by vaccines. You will find that most vaccine side effects are mild and that more serious or severe side effects are very rare.

More on Side Effects and Adverse Events

Vaccine Induced Measles

Why are anti-vaccine folks still pushing the idea that vaccine induced measles is a thing?

This study is not about vaccine induced measles.
This study is not about vaccine induced measles.

In yet another example of anti-vaccine folks inappropriately using a real vaccine study, the ironically named Physicians for Informed Consent continues to push the idea that many measles cases are caused by the MMR vaccine.

Vaccine Induced Measles

They aren’t…

The study they are citing, Rapid Identification of Measles Virus Vaccine Genotype by Real-Time PCR, simply talks about how to “distinguish between measles cases and vaccine reactions.”

“During measles outbreak investigations, rapid detection of measles vaccine reactions is necessary to avoid unnecessary public health interventions.”

Rapid Identification of Measles Virus Vaccine Genotype by Real-Time PCR

While many of these people do test positive for a vaccine strain, they do not actually have measles. They typically just have a rash and/or fever, with a concern that they might have measles because they are in the middle of a measles outbreak.

But if they have a rash and fever and test positive for measles, even if it is a vaccine strain, why shouldn’t we just say that they have measles?

Because measles isn’t just about having a rash and fever. It is having a specific pattern of a high fever for 3 or 4 days, then developing a rash, and continuing to have a fever. People with measles also typically have other symptoms, including irritability, cough, coryza, and conjunctivitis.

Confirmed Case Counts in Measles Outbreaks

Still, since these measles vaccine reactions can get confused with real measles cases, do they inflate the measles case counts in our outbreaks?

Testing helps to make sure that only real cases of measles are included in outbreak case counts.
Testing helps to make sure that only real cases of measles are included in outbreak case counts.

They don’t.

While we occasionally do see a “confirmed” case later change as further testing is done, it is important to realize that most cases are thoroughly evaluated to see if they are in fact really measles.

Most case counts are made up of confirmed cases and don’t include suspected cases that might be someone who has a rash after their MMR vaccine or some other viral infection.

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

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

Anyway, vaccine induced or vaccine associated measles is extremely rare.

What about the fully vaccinated woman in New York who developed measles, getting four other people sick in 2011?

Didn’t she have vaccine induced measles?

Nope.

“This is the first report of measles transmission from a twice-vaccinated individual with documented secondary vaccine failure. The clinical presentation and laboratory data of the index patient were typical of measles in a naive individual. “

Rosen et al on Outbreak of Measles Among Persons With Prior Evidence of Immunity, New York City, 2011

She had the D4 strain of measles – not a vaccine strain.

Who Gets Measles?

Most people who get measles are unvaccinated, often intentionally unvaccinated.

Trying to get you to think that many people in an outbreak have a vaccine strain is just another propaganda technique to scare you away from vaccinating and protecting your kids.

Don’t fall for it!

Two doses of MMR are the best protection against measles.

Vaccines are safe, with few risks, and they are obviously necessary.

More on Vaccine Induced Measles

Vaccine Injuries vs Coincidences

Believe it or not, some folks don’t think that coincidences are real.

Not believing in coincidences is a well known trope of the anti-vaccine movement.
Not believing in coincidences is a well known trope of the anti-vaccine movement.

Is it a coincidence that these folks are the ones who are the most likely to believe that vaccines cause a lot of injuries and vaccine induced diseases?

Vaccine Injuries vs Coincidences

Thinking about vaccine side effects and coincidences is not new.

“When I undertook the study with the current vaccine strain on my own two triple-negative children and their three playmates, also triple- negatives, I thought: “I am going to do this very carefully now,” and, like Dr. Gear, I set up certain time schedules. I said: “I am going to start to give the vaccine now.” Every time I said “I am going to start to give it” and did not give it, two to three or four days later they came down with either pharyngitis, vomiting and abdominal pain, or a little fever.

I waited for approximately six weeks for those children to stop having some sort of febrile episode. I finally gave up. It so happened that after they got the vaccine they did not have any such episode.”

Albert Sabin on Recent Studies And Field Tests With A Live Attenuated Poliovirus Vaccine

When Albert Sabin was first researching his oral polio vaccine, he understood the problem. How could he really know if any signs or symptoms that occurred after he gave someone his vaccine were really caused by the vaccine, or just a coincidence?

“However, a report later to be given by Dr. Smorodintsev will deal with approximately 7,500 children who had received the vaccine and were carefully followed, as compared with another group, in similar number, who had not, for various types of illnesses which were occurring during the period.”

Albert Sabin on Recent Studies And Field Tests With A Live Attenuated Poliovirus Vaccine

The solution? They studied kids who had not gotten his vaccine.

But you don’t need an unvaccinated group to uncover coincidences.

You can just look at the background rate of a symptom or condition, and compare the periods before and after you start using a vaccine.

For instance, consider this study from Australia about using the HPV vaccine in boys, in which they made some predictions of what would happen after introducing the HPV vaccine.

Assuming an 80% vaccination rate with three doses per person — which equates to about 480 000 boys vaccinated and a total of 1 440 000 doses administered nationally per year in the first 2 years of the program — about 2.4 episodes of Guillain-Barré syndrome would be expected to occur within 6 weeks of vaccination. In addition, about 3.9 seizures and 6.5 acute allergy presentations would be expected to occur within 1 day of vaccination, including 0.3 episodes of anaphylaxis.

Clothier et al. on Human papillomavirus vaccine in boys: background rates of potential adverse events.

Wait. Are they saying that the HPV vaccine is going to cause Guillain-Barré syndrome, seizures, allergic reactions, and anaplylaxis?

Of course not. When the study was done, the kids hadn’t gotten any vaccines yet!

That was the background rate of those conditions.

They happened before the vaccine was given, and you can expect them to continue to happen after these kids start getting vaccinated – at that same rate.

What if they start happening more often after kids get vaccinated?

Then it makes it less likely to be a coincidence and more likely that the vaccine is actually causing an increase in the background rate. And vaccine safety studies look for that, which is how we know that vaccines don’t cause SIDS, transverse myelitis, multiple sclerosis, and many other conditions.

Most of you will have heard the maxim “correlation does not imply causation.” Just because two variables have a statistical relationship with each other does not mean that one is responsible for the other. For instance, ice cream sales and forest fires are correlated because both occur more often in the summer heat. But there is no causation; you don’t light a patch of the Montana brush on fire when you buy a pint of Haagan-Dazs.

Nate Silver on The Signal and the Noise

Of course, when we are talking about coincidences, we are also talking about correlation and causation.

When correlation doesn’t equal causation, then it’s probably a coincidence. Or it’s at least caused by some other factor.

And coincidences happen all of the time.

Is It a Vaccine Injury or a Coincidence?

That something could be a coincidence is not typically want parents want to hear though, especially if their child has gotten sick.

What does it mean that something happens coincidentally?

“Most sudden cardiac deaths that remain unexplained after necropsy are probably caused by primary cardiac arrhythmias.”

Sudden death in children and adolescents

Often it just means that it is unexplained. And that it is chance alone that it occurred as the same time as something else.

“In the absence of a specific etiology for ASDs, and a tendency among parents of children with a disability to feel a strong sense of guilt, it is not surprising that parents attempt to form their own explanations for the disorder in order to cope with the diagnosis.”

Mercer et al on Parental perspectives on the causes of an autism spectrum disorder in their children

Again, when folks blame vaccines, it is often because they have nothing else to blame.

“In some fraction of the American population, however, the belief in a link remains. One reason is a coincidence of timing: children are routinely vaccinated just as parents begin to observe signs of autism. Most vaccines are administered during the first years of life, which is also a period of rapid developmental changes. Many developmental conditions, including autism, don’t become apparent until a child misses a milestone or loses an early skill, a change that in some cases can’t help but be coincident with a recent vaccination.”

Emily Willingham on The Autism-Vaccine Myth

Think that it is too big of a coincidence that some infants develop spasms shortly after their four month vaccines?

Dr. William James West first described these types of infantile spasms in the 1840s!

And the “Fifth Day Fits,” seizures that began when a newborn was five days old, was described in the 1970s, well before we began giving newborns the hepatitis B vaccine.

But SIDS was only discovered after we began vaccinating kids, right?

“But, with millions upon millions of doses given each year to infants in the first 6 months of life across industrialized countries and with sudden infant death syndrome being the most common cause of infant death among infants 1 month or older, the coincidence of SIDS following DTP vaccination just by chance will be relatively frequent. When the two events occur, with SIDS following vaccination, well-meaning and intelligent people will blame the vaccine. They seek order out of randomly occurring events.”

Jacobson et al. on A taxonomy of reasoning flaws in the anti-vaccine movement

Of course not.

Cases of SIDS have been described throughout recorded history and have been well studied to prove that they are not associated with vaccines.

“Some events after immunisation are clearly caused by the vaccine (for example, a sore arm at the injection site). However, others may happen by coincidence around the time of vaccination. It can therefore be difficult to separate those which are clearly caused by a vaccine and those that were going to happen anyway… Scientific method is then used to determine if these events are a coincidence or a result of the vaccine.

Vaccine side effects and adverse reactions

It is easy to blame a vaccine when something happens and a child was recently vaccinated. That is especially true now that anti-vaccine folks turn every story of a child’s death or disability into a vaccine injury story.

“Autism was known well before MMR vaccine became available.”

Chen et al. on Vaccine adverse events: causal or coincidental?

Blaming vaccines when it is clear that vaccines aren’t the cause doesn’t help anyone though. It scares other parents away from vaccinating and protecting their kids. And it doesn’t help parents who need support caring for a sick child or help coping with the loss of a child.

What to Know About Vaccine Injuries vs Coincidences

While all possible adverse events after getting a vaccine should be reported to VAERS and your pediatrician, remember that just because something happened after getting vaccinated, it doesn’t mean that it was caused by the vaccine.

More on Vaccine Injuries vs Coincidences