Tag: vaccines work

Show Me the Vaccine Insert!

Have you ever wondered why anti-vaccine folks always ask about vaccine inserts?

It will soon be obvious that anti-vaccine folks don't really read vaccine inserts...
It will soon be obvious that anti-vaccine folks don’t really read vaccine inserts…

Would they really be happy if we handed them the entire vaccine insert before every visit?

Would they read the entire vaccine insert?

Which part of the vaccine insert do anti-vaccine even read?
Which part of the vaccine insert do anti-vaccine folks even read?

Or would they continue to only believe the parts that they think justify their decisions to leave their kids unvaccinated, unprotected, and at risk for getting life-threatening diseases?

Show Me the Vaccine Insert!

Let’s see what’s really in these package inserts…

“Measles, mumps, and rubella are three common childhood diseases, caused by measles virus, mumps virus (paramyxoviruses), and rubella virus (togavirus), respectively, that may be associated with serious complications and/or death. For example, pneumonia and encephalitis are caused by measles. Mumps is associated with aseptic meningitis, deafness and orchitis; and rubella during pregnancy may cause congenital rubella syndrome in the infants of infected mothers”

MMR II Package Insert

Wait a second!

How can anti-vaccine folks say that measles is a mild disease if the vaccine insert says that it “may be associated with serious complications and/or death.”

Have they really read this thing?

“The impact of measles, mumps, and rubella vaccination on the natural history of each disease in the United States can be quantified by comparing the maximum number of measles, mumps, and rubella cases reported in a given year prior to vaccine use to the number of cases of each disease reported in 1995. For measles, 894,134 cases reported in 1941 compared to 288 cases reported in 1995 resulted in a 99.97% decrease in reported cases; for mumps, 152,209 cases reported in 1968 compared to 840 cases reported in 1995 resulted in a 99.45% decrease in reported cases; and for rubella, 57,686 cases reported in 1969 compared to 200 cases reported in 1995 resulted in a 99.65% decrease”

MMR II Package Insert

Full stop!

How can they say vaccines don’t work when the package insert provides these stats showing it does and goes on to say that “M-M-R II is highly immunogenic and generally well tolerated.”

“The recommended age for primary vaccination is 12 to 15 months.”

MMR II Package Insert

Why are some of these folks delaying or skipping their child’s MMR vaccine? The package insert says to give it at 12 to 15 months!

“Individuals first vaccinated at 12 months of age or older should be revaccinated prior to elementary school entry.”

MMR II Package Insert

That’s the part of the package insert that says to give a second dose before kids enter kindergarten.

“There are no reports of transmission of live attenuated measles or mumps viruses from vaccinees to susceptible contacts.”

MMR II Package Insert

And that’s the part that says they can stop talking about shedding.

Maybe we should make anti-vaccine folks read these inserts…

“The following adverse reactions are listed in decreasing order of severity, without regard to causality, within each body system category and have been reported during clinical trials, with use of the marketed vaccine, or with use of monovalent or bivalent vaccine containing measles, mumps, or rubella:”

MMR II Package Insert

Do anti-vaccine folks understand that some of the things that are listed in the adverse reactions section of the package insert haven’t actually been proven to be caused by the vaccine? They are listed “without regard to causality.”

When you see them talk about SIDS and autism and package inserts, this is what they are talking about.

What about all of the “hidden” ingredients that are listed in the package insert?

Vaccine ingredients are not hard to find.

The ingredients that are so well hidden, they are listed right in the vaccine’s insert? Where does it mention all of the toxins that anti-vaccine folks are always talking about?

“…M-M-R II is highly immunogenic and generally well tolerated.”

MMR II Package Insert

The MMR vaccine works and it is safe.

It says so in the package insert.

Vaccinate your kids.

More on Vaccine Inserts

Did Better Hygiene and Sanitation Get Rid of Vaccine-Preventable Diseases?

Anti-vaccine folks, in addition to trying to argue that vaccines are full of poison, typically try to make a case that vaccines aren’t even necessary.

Why not?

They had good hygiene and sanitation in Brooklyn when my uncle got polio in 1950. What they didn't yet have was a polio vaccine.
They had good hygiene and sanitation in Brooklyn when my uncle got polio in 1950. What they didn’t yet have was a polio vaccine. If the wide use of indoor plumbing got rid of the plague in the early 1900s, why didn’t it get rid of all other infectious diseases at the same time?

Because, they claim, vaccines don’t even work. They claim that it was better hygiene and sanitation, not vaccines that helped get rid of smallpox, polio, and measles.

Did Better Hygiene and Sanitation Get Rid of Vaccine-Preventable Diseases?

On the surface, the idea that better hygiene and sanitation helped get rid disease makes a lot of sense.

“The 19th century shift in population from country to city that accompanied industrialization and immigration led to overcrowding in poor housing served by inadequate or nonexistent public water supplies and waste-disposal systems. These conditions resulted in repeated outbreaks of cholera, dysentery, TB, typhoid fever, influenza, yellow fever, and malaria.

By 1900, however, the incidence of many of these diseases had begun to decline because of public health improvements, implementation of which continued into the 20th century. Local, state, and federal efforts to improve sanitation and hygiene reinforced the concept of collective “public health” action (e.g., to prevent infection by providing clean drinking water).”

Achievements in Public Health, 1900-1999: Control of Infectious Diseases

It makes a lot of sense because better hygiene and sanitation did actually help control and eliminate many infectious diseases, including cholera, dysentery, and typhoid fever.

Others, like yellow fever and malaria, decreased because the mosquitoes that spread them were brought under control.

“Strategic vaccination campaigns have virtually eliminated diseases that previously were common in the United States, including diphtheria, tetanus, poliomyelitis, smallpox, measles, mumps, rubella, and Haemophilus influenzae type b meningitis.”

Achievements in Public Health, 1900-1999: Control of Infectious Diseases

That still left a lot of work for vaccines.

After all, we had good hygiene and sanitation in the United States when kids were routinely dying of polio, measles, Hib meningitis, pneumococcal meningitis, and rotavirus, etc.

Any way, if better hygiene and sanitation can get rid of so many diseases, why has each vaccine-preventable disease been controlled at a different time – yellow fever (1905), polio (1979), smallpox (1980), measles (2000), neonatal tetanus (2000), congenital rubella syndrome (2004), respiratory diphtheria (2009)?

What about the infectious diseases which don’t have vaccines? Why hasn’t better hygiene and sanitation helped control those diseases yet, like RSV, norovirus, Ebola, and Zika, etc.?

“Perhaps the best evidence that vaccines, and not hygiene and nutrition, are responsible for the sharp drop in disease and death rates is chickenpox. If hygiene and nutrition alone were enough to prevent infectious diseases, chickenpox rates would have dropped long before the introduction of the varicella vaccine, which was not available until the mid-1990s. Instead, the number of chickenpox cases in the United States in the early 1990s, before the vaccine was introduced in 1995, was about four million a year. By 2004, the disease incidence had dropped by about 85%.”

Misconceptions about Vaccines

And why does better hygiene and sanitation only work for chicken pox in countries that routinely use the chicken pox vaccine?

Do you want to believe that vaccines don’t work to justify skipping or delaying your child’s vaccines and leaving them unvaccinated and unprotected?

Be more skeptical, learn more about vaccines, and make the right choice to get your kids vaccinated.

More on the Hygiene and Sanitation Anti-Vaccine Theory

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

Has the United States’ Infant Mortality Rate Ranking Been Dropping as We Vaccinate More Kids?

Of all of the myths about vaccines that confuse and scare some parents, those about infant mortality rates can be especially hard to easily put aside.

After all, why doesn’t the United States rank better for infant mortality rates since most parents do vaccinate and protect their kids?

Vaccines and Infant Mortality Rates

That’s actually fairly easy to answer.

“Globally, the infant mortality rate has decreased from an estimated rate of 64.8 deaths per 1000 live births in 1990 to 30.5 deaths per 1000 live births in 2016.”

WHO on Infant Mortality Situation and Trends

Vaccine-preventable diseases don’t have much effect on infant mortality rates in the United States these days.

What does?

  • birth defects
  • premature births
  • SIDS
  • maternal complications of pregnancy
  • injuries

Think about it… If vaccines did increase infant mortality rates, then why would infant mortality rates be dropping as we vaccinate more kids?

Has the United States’ Infant Mortality Rate Ranking Been Dropping as We Vaccinate More Kids?

Do you know what has been dropping?

The Wisconsin Coalition for Informed Vaccination is pushing myths about SIDS and vaccines.
The Wisconsin Coalition for Informed Vaccination is pushing myths about infant mortality rates and vaccines.

The infant mortality rate.

In fact, infant mortality rates continue to drop and are now at their lowest levels ever.

While it is good news that the rate is dropping, most folks think they can be better.

For one thing, some states, like Mississippi, Louisiana, Alabama, Arkansas, and West Virginia, etc., have much higher infant mortality rates than others. Why? Much of those differences, can be explained by socio-economic factors. That’s also though to explain much of the differences in infant mortality rates between the U.S. and other developed countries, most of which have universal health care.

New Jersey, although they have ranked high for autism rates, has lower than average rates of infant mortality.
New Jersey, although they have ranked high for autism rates, has lower than average rates of infant mortality.

Another big difference is that many countries count infant mortality rates using different criteria than the United States.

For example, it is estimated that at least 40% of the differences between infant mortality rates in the United States and other countries is due to those countries not counting extremely preterm births among their statistics.

But why has the United States’ infant mortality ranking fallen relative to other developed nations?

Most European Countries had much higher infant mortality rates than the US in the 1960s and 70s, which affected relative rankings, even as all countries saw infant mortality rates fall.
OECD data shows that most European Countries have historically had much higher infant mortality rates than the US, which have affected relative rankings, even as all countries have seen infant mortality rates fall.

Although anti-vaccine groups try to tie this to ‘routine vaccination,’ it is easy to see that other countries have historically had much higher infant mortality rates than the United States. As they have caught up, the United States’ ranking has dropped relative to theirs, even though all have seen infant mortality rates drop.

Infant Mortality Rates in the Pre-Vaccine Era

But if you really want to understand the relationship of vaccines to infant mortality rates, you just have to look back to the pre-vaccine era. Back then, now vaccine-preventable diseases did have a big effect on infant mortality rates in the United States and elsewhere.

In 1910, for example, the most common causes of death for infants under 1 year were:

  1. diarrhea and enteritis
  2. premature birth
  3. congenital debility
  4. bronchopneumonia
  5. pneumonia
  6. malformations
  7. bronchitis
  8. convulsions
  9. injuries at birth
  10. whooping cough
  11. tuberculosis
  12. meningitis
  13. measles
  14. accident
  15. diphtheria

Although advances in modern medicine would help decrease the mortality from many of those diseases, it was vaccines that truly worked to make sure they were no longer a big part of our infant mortality statistics.

How will we continue to decrease our infant mortality rates?

Most experts think that it will require better access to health care for all members of society.

What to Know About Infant Mortality Rate Rankings

Infant mortality rates are not linked to vaccines.

More Infant Mortality Rate Rankings