Vaccination Worries - Second in a Series
As I explained in my first post of this series, I am writing in response to an article that came out in a health organization’s newsletter. The original article was just one page long, but I’m afraid I have MUCH more than one page to say in response to it. The article was written in a “Q&A” format, with a small side bar box with a few “interesting facts.” In this post, I’ll address the first Q&A in the article. I will continue to answer them, then move on to the “interesting facts,” which will each have their own post of response.
Question 1: Haven’t whooping cough, measles, and mumps been wiped out? The answer explains that we are seeing more cases of these, even deaths, due to immigration patterns, global travel, and pockets of unvaccinated people. The answer is clearly intended to frighten people into choosing to vaccinate.
There have been some outbreaks of these diseases in recent years, though it is important to know that the CDC considers an “outbreak” of a disease to be 3 or more linked cases. Lets look at each of these diseases:
Measles: In 2007 there were a total of less than 130 cases of measles in the US, which resulted in some hospitalizations for….dehydration. One hospital worker had to be on a ventillator for a few days, but information is not available on what underlying conditions that person may have had. This was the highest number of cases in a single year since 1996, another article referenced an outbreak of 30 cases being the highest number in a single year since 1996. When I did a Google search on “measles death” I was unable to find any reports on recent measles deaths in the US, though one CDC documents mentions that an average of one person per year dies of measles in the US. And ironically, the most recent significant number of measles deaths were blamed–in a CDC document (page 7)–on vaccination–though it was an indirect link. Here is what the CDC said:
The mothers of many infants who developed measles were young, and their measles immunity was most often due to vaccination rather than infection with wild virus. As a result, a smaller amount of antibody was transferred across the placenta to the fetus, compared with antibody transfer
from mothers who had higher antibody titers resulting from wild-virus infection. The lower quantity of antibody resulted in immunity that waned more rapidly, making infants susceptible at a younger age than in the past.
Bottom line…there is some truth, and some untruth in the answer. Yes, measles cases are being brought to the US from abroad…but I could find no evidence that these cases are causing deaths, and infact found evidence that shows that it is actually immunization which is indirectly leading to an increase of deaths in the late 80’s/early 90’s. It is also interesting to note that the CDC acknowledges that prior to the introduction to the vaccine 90% of children developed natural life-long immunity (which mothers would then pass to their infants), and the vaccine given at 12 months offers just 95% immunity, which wears off with time.
Mumps: The CDC reports that an average of 265 cases of mumps are reported annually in the US. The CDC website reported an outbreak in the midwest of approximately 600 cases in 2005-2006, a National Institutes of Health reports updates this figure to 6584. I could not find any specific reports on the number of deaths, which leads me to believe that there weren’t more deaths due to mumps this year than in a “non-outbreak” year. The reports indicate that they did not know where the outbreak originated from, although another 2005 outbreak in New York was mentioned as coming from the UK–another country with a highly vaccinated population. The outbreak in the midwest spread mostly among college students. There were 85 hospitalizations, and no deaths. Most of the cases in these outbreak occurred in vaccinated individuals. The NIH abstract comments:
Despite a high coverage rate with two doses of mumps-containing vaccine, a large mumps outbreak occurred, characterized by two-dose vaccine failure, particularly among midwestern college-age adults who probably received the second dose as schoolchildren.
So yes, there was an outbreak. Not attributable to overseas travel, didn’t cause deaths, and it didn’t occur in an unvaccinated population.
Whooping Cough: Whooping cough deaths range from about 5 to less than 20 per year in the US. I could find news reports about several outbreaks, but nothing very definitive. Some details I did pick up on were:
- it is well known that whooping cough is under-reported, mostly because it just isn’t identified in older people that get it. Some people also speculate that when a Dr. has a patient that is fully vaccinated against whooping cough they are more likely to diaganose something like “chronic bronchitis” rather than whooping cough.
- when details about the transmission were shared, it was usually spread in an elementary school, or, ironically, in a health care setting. Yep…one toddler in Boston gave it to FIFTEEN medical personel. Guess they weren’t washing their hands very well. This is something I recall reading about before.
- one reason that health care providers are good sources of transmisson is that the effectiveness of the vaccine wanes, and since the disease is usually mild in adults, revaccination previously wasn’t happening (now adults are given DTaP rather than just a tetanus immunization). Infected adults then give it to children, who are much more susceptible to serious infections due to their smaller airways.
So again on this one, though I did find reports of outbreaks, I really didn’t find any evidence of an increase in cases/deaths in recent years, and certainly no evidence of this being associated with foriegn travel.
So, to wrap back around to that question, a more accurate answer would have been that the diseases have not been completely erradicated, but are rare. In the case of measles and mumps, the symptoms are typically very mild in children, and having the disease provides stronger immunity than receiving the vaccine.
Whooping cough is one that scares me personally. While it is still relatively rare, the disease does pose a more credible risk of death than some of the other diseases that children are vaccinated against. For this reason, I have chosen the DTaP vaccine as one that I “selectively” get for my children. I might have chosen differently though if it were still the DTP vaccine, which the CDC acknowledges has a higher risk of causing complications. It was actually complications from this vaccine that triggered the implementation of the system by which vaccine manufacturers are now free of any risk of being sued for vaccine reactions.
Next in the series, I will address the question “What would happen if we stopped vaccinating?”
Tags: DTaP, MMR, vaccination
Yes, I would much rather my kids get measles, mumps, and rubella naturally than by vaccination. It seems that vaxing kids leaves them invulnerable to getting the disease when it would be mildest yet provide lifelong protection against getting it when it would be dangerous. Do you remember the stories about smallpox wiping out indigenous American Indians when Europeans came in? It seems that a lot of adults and infants with no protection whatsoever contracted the disease and died, but the children up through adolescence got a milder form of the disease and lived. I wonder if we’re setting ourselves up for this scenario with these diseases that used to be considered just normal childhood diseases — measles, mumps, rubella, and now chicken pox. There are a couple of adults in my church who have never had chicken pox. But the twin brother of one of these people got chicken pox as an adult, and he had an absolutely horrendous time with it. We simply don’t know enough about the long-term effects of varicella vaccination. The current results of the MMR vax (namely, that many adolescents and young adults are left open and vulnerable to the disease — in my area about a decade ago, there was a measles outbreak at a university, and all students had to be revaccinated before they were allowed to attend — if the original vaccine were so good, why have to revax? if it’s not so good, why give it when kids could get lifelong immunity from getting the real disease at a very low risk of complications?) makes me question the wisdom of giving vaxes for low-risk diseases.
Yes Kathy, I have concerns similar to yours–that vaccination is creating a weaker “immunity” than would be gained by allowing our children to get sick, which ultimately leaves them at risk of getting sick when they are older and much more vulnerable.
This was the basis of my first vaccine rejection–which was Chicken Pox. At the time (1999), data was still iffy about how long the immunity from the vaccine would last–reports were that children would need to get a booster at about age 20-22. My fear was that my children might lack medical insurance at that time (as I did), and thus elect not to get the booster, thus leaving themselves open to getting the illness when older and more likely to develop serious complications. Now of course they are reporting that the vaccine immunity last much less time than 20 years, and children are supposed to get a booster around age 4-6.
Well how many boosters are going to end up getting added on? Its been accepted for a long time that tetanus boosters are supposed to be done every 10 years…now adults get “DTaP” rather than just “T” because of the rising pertussis risk. Are we going to come to a point where there are booster shots for a dozen different diseases that people are expected to get every 5 to 10 years?
Jenn,
Every time I bring up the statistics with my ped I’m told that you won’t find stats on deaths associated directly with these diseases since people don’t die from them, but the complications that arise from it. The example I remember was the flu - they said that not many people die directly from that but complications like pneumonia, etc. that stem from it. Since I don’t know every complication that arises from every disease, and of those, how many had Disease X before having the complication, it makes it hard to argue the point. It gets to be a really frustrating conversation. Many of my friends have given up on peds and are taking their children to their own family doctors who seem to be more open-minded about selective vaccination.
Wow Jen, that has got to be on the list of “crazy making Dr. excuses” to support vaccination! Somehow Dr. Offit has no trouble coming up with statements on how many people die, and the CDC publishes numbers on how many people are supposedly saved. And then there is that whole “36,000 flu deaths per year” number that gets floated every fall at the beginning of flu season (blech!).
I agree, the family practice Dr’s that I’ve used have been much more open on the vaccination issue than peds. Actually, it was a family practice Dr. who suggested to me that he didn’t think it was wise to give more than 2 shots at once (one in each thigh) so as to not overwhelm the baby’s immune system and to be able to pinpoint better which one caused a reaction.
Never fear though, I will address the “number of deaths” question. Just keep reading!
Just because people who have been vaccinated get an illness later in life does not mean that they did not have any immunity. It just means that they do not have full immunity. Without the childhood vaccine, the small number of cases may have been more severe. So using the argument of vaccinated people getting the disease anyway meaning the vaccines are not helpful is simply not valid. And I don’t understand the problem with needing boosters throughout your lifetime. I’m more than happy to get a shot every few years than come down with any of these diseases and possibly end up in the hospital.
The number of illnesses and deaths is also not a valid point to use to argue against vaccinating children because these numbers are for a highly-vaccinated population. If everyone stopped vaccinating their children, those numbers would definitely start to change.
I don’t think the CDC is trying to scare people, but instead educate them that these diseases do indeed still exist, hence the need to continue vaccinating (and therefore continue to keep these numbers small).
Also, I find it interesting that people say they would rather “naturally” immunize their children by letting them come into contact with the diseases. That’s really not much different than using injections to immunize, other than the fact that when my son receives injections I can be prepared to keep an eye on him for a few days. “Natural” vaccination can happen at any time, and probably when it is least expected.
That’s not saying there aren’t issues with vaccines, but controlled vaccines (and yes, probably boosters) still have many advantages to just leaving things up to chance.
Lisa–
Thank you for your comments! I really do need to get back to working on this topic.
I will be answering most of your arguements in coming posts…but I did want to address one right now…the issue of why I worry about the need for boosters. For me, this started with the Chicken Pox vaccine. Chicken Pox is a relatively benign disease in childhood, but is VERY serious when contracted as an adult (as is also true of most other diseases we vaccinate against). When my first four children were infants, the reccommendation was to get the infant vaccine, then a booster at age 21. I myself was uninsured when I was 21, and on a tight budget. There is no way I would have paid $60 to get a booster–as it was, even when I was in excruciating, mind numbing pain from a cyst, I refused to go to the hospital because “I can’t afford to pay the bill.” The pain was so intense I could barely speak coherantly–it was definitely worse than any pain I’ve ever experienced in birth. My foster father literally had to make a 3 hr drive to my apartment to force me to go to the hospital.
So I chose to skip the chicken pox vaccine–because I would rather that my children get the disease in childhood, and then have lifelong immunity, rather than take the risk that they contract it as adults when it is much more serious.