Respectful Insolence

I’m with Kevin, M.D. on this one. Not giving required vaccinations is akin to child neglect:

CHICAGO – State laws that make it easy for children to skip school-required vaccinations may be contributing to whooping cough outbreaks around the country, a study suggests.

All states allow children to be exempted from school immunization requirements for medical reasons — because they might have a bad reaction, for example, or have weak immune systems — and 48 states allow exemptions for personal or religious beliefs.

To get non-medical exemptions, some states require documentation, notarized paperwork and even visits to a local health department. In other states, parents merely have to sign an exemption letter.

Compared with stricter states, those with easy exemption policies had about 50 percent more whooping cough cases, according to the study. Also, about 50 percent more people got whooping cough in states that allowed personal-belief exemptions, compared with those allowing only religious exemptions, the study found.

Here’s the study:

Nonmedical Exemptions to School Immunization Requirements: Secular Trends and Association of State Policies With Pertussis Incidence

Saad B. Omer, MBBS, MPH; William K. Y. Pan, DrPH, MS, MPH; Neal A. Halsey, MD; Shannon Stokley, MPH; Lawrence H. Moulton, PhD; Ann Marie Navar, MHS; Mathew Pierce, JD, MPH; Daniel A. Salmon, PhD, MPH

JAMA. 2006;296:1757-1763.

Context: School immunization requirements have played a major role in controlling vaccine-preventable diseases in the United States. Most states offer nonmedical exemptions to school requirements (religious or personal belief). Exemptors are at increased risk of acquiring and transmitting disease. The role of exemption policies may be especially important for pertussis, which is endemic in the United States.

Objective: To determine if (1) the rates of nonmedical exemptions differ and have been increasing in states that offer only religious vs personal belief exemptions; (2) the rates of nonmedical exemptions differ and have been increasing in states that have easy vs medium and easy vs difficult processes for obtaining exemptions; and (3) pertussis incidence is associated with policies of granting personal belief exemptions, ease of obtaining exemptions, and acceptance of parental signature as sufficient proof of compliance with school immunization requirements.

Design, Setting, and Participants: We analyzed 1991 through 2004 state-level rates of nonmedical exemptions at school entry and 1986 through 2004 pertussis incidence data for individuals aged 18 years or younger.

Main Outcome Measures: State-level exemption rates and pertussis incidence.

Results: From 2001 through 2004, states that permitted personal belief exemptions had higher nonmedical exemption rates than states that offered only religious exemptions, and states that easily granted exemptions had higher nonmedical exemption rates in 2002 through 2003 compared with states with medium and difficult exemption processes. The mean exemption rate increased an average of 6% per year, from 0.99% in 1991 to 2.54% in 2004, among states that offered personal belief exemptions. In states that easily granted exemptions, the rate increased 5% per year, from 1.26% in 1991 to 2.51% in 2004. No statistically significant change was seen in states that offered only religious exemptions or that had medium and difficult exemption processes. In multivariate analyses adjusting for demographics, easier granting of exemptions (incidence rate ratio = 1.53; 95% confidence interval, 1.10-2.14) and availability of personal belief exemptions (incidence rate ratio = 1.48; 95% confidence interval, 1.03-2.13) were associated with increased pertussis incidence.

Conclusions: Permitting personal belief exemptions and easily granting exemptions are associated with higher and increasing nonmedical US exemption rates. State policies granting personal belief exemptions and states that easily grant exemptions are associated with increased pertussis incidence. States should examine their exemption policies to ensure control of pertussis and other vaccine-preventable diseases.

Although one can quibble about its methodology, the results of this study, in which lax vaccination polices tend to correlate with higher rates of pertussis on a state-by-state basis, should come as no real surprise. The effectiveness of the pertussis vaccine depends upon herd immunity, where high levels of vaccination keep an infectious disease from spreading among the few unvaccinated and those in whom the vaccine is not offering adequate protection. (No vaccine is 100% effective; so there will always some percentage of even a vaccinated population that is susceptible to the disease vaccinated against. Antivaxers often distort, exaggerate, or misrepresent this fact to question whether vaccinations are efficacious at all.) As I’ve pointed out before, in places like Boulder, Colorado, where wealthy alties have refused to vaccinate their children in droves, pertussis has returned with a vengeance. And we may be seeing the same thing here, as the study found:

Children with nonmedical exemptions are at increased risk of disease and they increase community risk of disease transmission. From 1985 through 1992, exemptors in all states were 35 times more likely to contract measles than nonexempt children. In Colorado, exemptors were 22 times more likely to have had measles and 5.9 times more likely to have had pertussis than vaccinated children. Moreover, the incidence of measles and pertussis in nonexempt children in a county was associated with the frequency of exemptors in that county.

That’s an incredible difference.

Because the rates of once-feared diseases like pertussis have fallen so low, thanks to vaccinations, people have forgotten how horrible these diseases could be. For an example of just how warped this thinking can become, I was made aware of a discussion on Mothering.com. In this discussion, a mother by the ‘nym of Momtezuma Tuatara is practically ebullient at reports from New Zealand claiming that the vaccine is a “dud,” when in fact that is not what the reports claim. For example, this 2004 report states about the latest epidemic of pertussis there:

Vaccination information was recorded for 2181 (62.5%) cases. A total of 34 cases had received all five doses of vaccine, 146 had received four doses and 285 were in receipt of three vaccine doses. Across all age groups, the proportion of cases vaccinated was 49.4% (1725/3489). Surveillance data show that only 47.5% (47/99) of those aged 4 months or less, had received the vaccines for which they were eligible (see Table 13).

In other words, the vast majority of the cases had not received all of the recommended doses of the vaccine, and it was noted that more adults were coming down with the disease:

The immunity provided by vaccination does not last through adulthood and is not 100% effective. Therefore it is important that children are immunised on time according to the immunisation schedule. The 2004 epidemic has highlighted the need for a strategy to control the persisting pool of infection in the adult population.

But in the woo world of antivaccination zealots, this sort of data is “validation” of their belief that vaccines don’t work:

I like seeing my ideas confirmed and that is that despite these vaccinations, all the diseases come and go as they please in frequency.

Of course, in this world, “natural” immunity is assumed without question to be better than any immunity induced by vaccine:

So I think that not only is the vaccine far less effective than widely claimed/considered, what we are seeing is the long-term result of replacing natural immunity with vaccine immunity, with a much larger percentage of adults and older children being non-immune and capable of transmitting the infection (which is often subclinical or milder in these age groups as compared to in the younger age groups in which it “prefers” to occur, and who more often exhibit clinical symptoms).

I also think there may be some maternal immunity which has been lost with the loss of widespread natural immunity, which also leaves infants more vulnerable to infection. JMO.

And:

Natural immunity to Pertussis is undoubtedly superior to anything produced by the vaccine. The aluminum in the killed vaccine stimulates an antibody response but not a cell-mediated response. Natural infection stimulates the entire immune system.

There it is again, the faith in the “natural” as being inherently and automatically superior to anything conventional medicine can do, which is viewed as “unnatural.” And, as is the case in alternative cancer therapies, for example, this belief in “natural immunity” leads to irresponsible and potentially dangerous practices. In the case of chickenpox, for example, some parents are holding “pox parties“:

It sounds like a plot line from The Simpsons. In fact, it is a plot line from The Simpsons. Who else but America’s favorite dunderhead, Homer Simpson, would do such a thing?

Surprisingly, pox parties are popping up in neighborhoods in several U.S. cities. On Internet bulletin boards and blogs, rumors spread that the chickenpox vaccine is somehow unsafe or ineffective. Parents worried by these rumors join email rings. When one of these parents’ children gets chickenpox, the parents invite others in the community to a pox party…

A “natural mothering” web site gives a recipe for spreading varicella zoster virus — the chickenpox germ. It advises parents to pass a whistle from the infected child to other children.

“It is absolute lunacy,” UCLA infectious disease specialist Peter Katona, MD, tells WebMD.

Adults who get chickenpox for the first time get a much more serious disease than do children. But even for children, chickenpox isn’t a walk in the park. And every once in a while, a child gets a very serious form of the disease. One in 50,000 kids gets a brain infection that causes retardation or death. And itchy chickenpox blisters can get infected with dangerous bacteria.

“Imagine losing a child because you were dumb enough to bring him to a pox party,” Gershon says.

Indeed. Back in the days before the availability of the chickenpox vaccine, pox parties were not quite as irrational as they sound now because there was no other way to achieve immunity to the varicella virus. Considering them in context of the times, they were somewhat understandable. Even so, that doesn’t mean they were a good idea, even then. Parents were still taking a chance, as fellow SBer Tara Smith pointed out several months ago:

Additionally, the wild virus just ain’t as benign as we’d like to think. It can cause severe pneumonia or encephalitis. Additionally, I mentioned here that deadly infections with the group A streptococcus are becoming more common. Guess what’s a major risk factor for these infections? Yep–chicken pox. Check out, for example, this manuscript on invasive group A strep disease in Alberta, Canada, which notes that “varicella virus infection preceded invasive GAS disease in 25% of children 8 years of age and under.” It has the potential to be much more than just an inconvenient itch.

And, I would add, in children with compromised immune systems, varicella infection can be deadly. Yes, the vast majority of children who get chickenpox recover uneventfully, but a number of these can suffer serious complications. Overall, the vaccine has minimal risk, and it prevents disease in children and the later development of shingles in adults.

This attitude that “natural immunity” is inherently “better” than permeates antivax websites. For example:

Exchange your faith in: Natural immunity only comes after a disease.
With faith in: Natural immunity comes with Health, a ‘clean blood stream that is well nurished’.

Exchange your faith in: Disease is dangerous.
With faith in: Healing activity (typically called disease symptoms) is a process that is natural, beneficial, and far safer than generally recognized.

Personally, I think I’ll keep my view that vaccine preventable diseases like polio or pertussis are dangerous, thank you very much. One has to wonder, of course, if diseases aren’t “dangerous,” then why bother to try to prevent or treat them? That does seem to be the attitude behind a lot of this antivaccination lunacy. After all, those nasty symptoms that can result in paralysis in polio, for example, are nothing more than manifestiations of “healing activity.” Apparently it’s better to let your child suffer the horrendous symptoms of pertussis, with the risk of the need for hospitalization and even the possibility of death. And, make no mistake, pertussis can be a horrible disease, complicated by pneumonia and occasionally death.

Although antivaccination mania goes back a long time, I wonder if this this extreme faith in the natural and belief that the symptoms of disease are a healing crisis” whose symptoms shouldn’t be interfered with may be traceable, at least in modern times, back to Ryke Geerd Hamer, a German physician who developed a concept that diseases, especially cancers, aren’t dangerous in and of themselves but rather are manifestations of a mental conflict. Indeed, he formulated what became known as German New Medicine, complete with various “rules” and “laws” (in fact, total woo) based on this concepts, such as the First Biological Law: The Iron Rule of Cancer. The bottom line from Dr. Hamer’s and other altie doctors for antivaxers is that disease isn’t really as dangerous as doctors tell you that it is, that vaccines are an unnatural assault on the immune system, and that disease is due more to internal factors (such as mental stress or a tragedy) than it is to bacteria or viruses. Of course, Dr. Hamer didn’t originate such concepts himself, but he popularized them, at least in Europe.

The results of this study suggest that, the easier it is to get an exemption from vaccination for schools, the more an infectious disease like pertussis can spread and the more herd immunity can be compromised, thus endangering even the vaccinated. Worse, it is clear that attitudes such as those expressed on the Mothering.com forums and by utter loons like Dawn Winkler (there’s just no other word that describes her), the Libertarian candidate for Governor of Colorado, are on the increase. Yes, I’m very afraid that it will take a huge and deadly resurgence of vaccine-preventable diseases to remind people of the reasons that these vaccinations were developed in the first place. It wasn’t to “enrich the pharmaceutical companies.” It wasn’t to enrich doctors. It wasn’t because conventional medicine want’s to inject “filth” into your children. It was to protect children from epidemic diseases that caused incredible suffering and death until as recently as a few decades ago. And these diseases never went away, either. They are still there, waiting to return.

ADDENDUM: I’m sure the antivaxers will pull the “pharma shill” gambit on this particular study, because two of the researchers reported support from pharmaceutical companies. Just wait. Never mind that one of the two isn’t completely convinced that lax vaccination policies are associated with higher pertussis rates.

Comments

  1. #1 Prup aka Jim Benton
    October 24, 2006

    I grew up before the vaccinations were available and had the — for then — normal attacks of chicken pox and measles. Even if they had no long-range consequences, going through them is not fun, at all. I wonder how many kids, if they were unvaccinated deliberately, would thank their parents for the experience in later life.

  2. #2 Ruth
    October 24, 2006

    My parents generation gave pox parties, so we would get it over before we were school-age. I had the German measles as a kid, which weren’t too bad, but I worry about women in their first trimester exposed to this disease. That is a proven cause of neurological damage. Will the deaf kids sue the mercury parents for needlessly causing a drop in vaccination?

  3. #3 robopox
    October 24, 2006

    “And all the Woo’s down in Wooville,
    the tall and the small,
    fear their vaccines,
    and get none at all”.
    (with apologies to Dr. Suess).

    I teach microbiology at a communtiy college in
    central AZ. Since 2002, there have been over a thousand
    cases of pertussis in this county. approaching 2000, now.

    I’ve had 20-somethings Nursing students
    hacking up a lung in class,
    and then complaining of the hypoxia….

    …..bringing their spasmodically coughing kid to class
    because they are “too sick to go to pre-school”;

    …..students who work as Pharmacy Techs, who have 10
    people waiting in line, half of them coughing like a
    crackhead smoking strychnine, or with their kid in line,
    turning blue and puking on the floor after a ‘whoop’.

    the patients are either 20 somethings who were vaccinated
    with the whole cell vaccine 15 years ago and got exposed to
    a child with a primary case, or 20-30 and not vaccinated at all; or children like CindyLou Woo (who was no more than two), generally unvaccinated (often to everything).

    After having gone on erythromycin prophylaxis twice when
    some knucklehead coughed a blue-whistling streak all through class, I went and got the DTaP.

    Non-vaccination is not just abusive to kids.
    It’s a public health crime.

    In the town to the north, the haven for all things
    New-Age Vortexy, at least a third of all students in
    the primary school were unvaccinated (as reported by a
    student who worked there while going to Nursing school.)

    Since the outbreak hasn’t occurred there, I can only surmise
    that their crystals and chakra’s exert a powerful influence.
    (set sarcasm to ‘off’ now…re-set rant to ‘on’)

    “personal exemption” ends where your contagious phlegm
    enters my sinus (to paraphrase).

    On a separate rant…the director of the Nursing school has
    stated publically that she has “no respect for Western Medicine”. God knows what they are being taught about
    vaccines after they get out of the science dept.
    So we soldier on, hoping that “evidence based medicine” sticks for at least the next two years.

    sigh.

  4. #4 Catherina
    October 24, 2006

    well, in actual fact, even the vaccinated children are unprotected and do not contribute to herd immunity after age 5 to 8. The sad fact is that pertussis immunity, whether acquired through vaccination or disease, is not permanent. So unless we all start to boost pertussis vaccination along with tetanus and diphtheria (you are all doing that, right?!), there will be no herd immunity to speak of (apart from isolated settings like a pre-school group). Most babies contract pertussis from older relatives (mom, dad, etc.). This is the knowledge that needs to be spread so that vaccination rates especially in young families go up (for a cocooning strategy). For now, the increased rates in pertussis are probably mostly due to increased awareness about pertussis in juveniles and adults.

    “Momtezuma Tuatara” is Hilary Butler, btw.

    Catherina (got my dTaP/IPV booster last year)

  5. #5 eci
    October 24, 2006

    ‘Momtezuma’ is quite the piece of work. She’s got a nice little cult-like following going on on the MDC forums, where they eat up everything she says with nary a hint of critical thinking, and good luck arguing with them – anyone who dares to challenge her gets overrun with so much crappy pseudo-science it’s impossible to argue effectively unless you’ve got hours a day to devote to researching the faulty sources and complete misinterpretations of scientific evidence.

    She claims to have stopped fatal reactions to bee-stings with massive doses of vitamin C, among other things. She’s also a big proponent of homeopathy, which makes it pretty clear she doesn’t have the foggiest idea what’s she’s talking about, because anyone who looks seriously at homeopathy sure wouldn’t be advocating it!

  6. #6 Catherina
    October 24, 2006

    who can take a woman serious who is publishing a book with her husband and puts her own name in larger font than his onto the title page?!

    Hilary recently tried to stand up to a couple of anti-Hilary minded on another board – did not hold out for long and retreated to the safety of mothering.com.

  7. #7 anonimouse
    October 24, 2006

    Hilary Butler is clearly in the running for the stupidest person alive. I remember reading a sample chapter of her latest self-published anti-vax tome – I think the only thing she got right in the entire work was the spelling of her name.

  8. #8 clone3g
    October 24, 2006

    “Momtezuma Tuatara” is Hilary Butler, btw.

    Clever name. I hope she wears a hat to cover the third eye.

  9. #9 anonimouse
    October 24, 2006

    As for the study, it’s kinda like those studies that were done that showed that eating too much makes you fat or that drinking too much shortened life expectancy. It’s a no-brainer – the fewer people that vaccinate, the more people that get sick.

  10. #10 Stogoe
    October 24, 2006

    The victory of vaccination against these diseases was won so completely in the past that people have forgotten why they were fought for at all.

  11. #11 KeithB
    October 24, 2006

    How can you mention Hamer and not mention that his disciple is holding court at Aetiology here:
    http://scienceblogs.com/aetiology/2006/10/friday_kooky_komment.php

    160 comments and counting!

    Unless, you are staying quiet so he doesn’t show up!

  12. #12 Sastra
    October 24, 2006

    I’m just speculating here, but I wonder if the over-valuation of “natural” cures and even “natural” diseases might be the natural outgrowth of the popular belief that pain and suffering are not random accidents, but gifts from Higher Powers which are given to us for a purpose — which is to make us stronger, better people. From what I can tell, this theodicy seems to cut across both traditional and more New Age-ish variations of religion and spirituality. We need to experience evil, for without it we do not deserve or recognize the good. There are no accidents; everything happens for a reason. Nature/God is wiser than we are; we are being given a test, or a lesson, or an opportunity to build our character, or a demonstration that we must trust that God is in charge, and it will all turn out right … or something.

    Every time a bad thing happens to good people, these kinds of rationalizations come out of the woodwork. Perhaps that’s why this particular way of expressing what you call “extreme faith in the natural” sounds so familiar to me.

  13. #13 anonimouse
    October 24, 2006

    I kinda want Jan to show up. I need to release some stress and pathetic pseudointellectuals like him make easy targets.

  14. #14 rrt
    October 24, 2006

    Obviously I dunno if this is due to undervaccination or not, but my co-worker and his infant son both contracted pertussis over a year ago. He was miserable, and his son was hospitalized several times.

  15. #15 Common Sense
    October 24, 2006

    I’m with Kevin, M.D. on this one. Not giving required vaccinations is akin to child neglect

    Well, isn’t that wonderful for Dr. Kevin (and you). He sounds like a typical MD with all the FACTS (not). First, he would need to prove to me that vaccinations are as safe as they claim. Otherwise his claims of child neglect are quite comical. I will say this… it would be fair if this “Dr.Kevin” were kind enough to give his suggestions for those parents who are concerned about the schedule and/or the safety of certain vaccinations. I would listen to someone who was understanding to the concerns and repectful of anyone who questioned the need for certain vaccinations. Otherwise, the rhetoric means squat.

  16. #16 shot_info
    October 24, 2006

    Good to CS makes a reappearence to sprout off her misunderstanding of math and science.

    Hey CS, get the hint disease kills more people than vaccines ever will. Given that you think others better educated that your lack of basic high school knowledge suggests, it YOU who doesn’t have the facts.

    Although it is possible that FACTS <> facts in your little part of the world.

  17. #17 anonimouse
    October 24, 2006

    Well, isn’t that wonderful for Dr. Kevin (and you). He sounds like a typical MD with all the FACTS (not).

    Considering you present zero facts at any time, having any facts at one’s disposal would be an improvement.

    First, he would need to prove to me that vaccinations are as safe as they claim.

    The scientific consenseus is that vaccines are generally quite safe and effective. It is up to you, you ignoramus, to prove otherwise. Too bad you can’t.

    Otherwise his claims of child neglect are quite comical.

    Too bad the WHO doesn’t think so. I tend to think that non-vaccination, in the absence of any other red flags, shouldn’t merit a call to child protective services. But it is a legitimate warning flag – sorry to burst your “informed choice” bubble.

    I will say this… it would be fair if this “Dr.Kevin” were kind enough to give his suggestions for those parents who are concerned about the schedule and/or the safety of certain vaccinations. I would listen to someone who was understanding to the concerns and repectful of anyone who questioned the need for certain vaccinations.

    Bull. True believers like yourself really don’t care about meaningful dialogue about vaccines. You want someone to pat you on the head and make you feel ok for your choice to leave your kids (and others) at risk for potentially serious diseases.

    The evil organizations you talk about, like the CDC and FDA, are always debating the need for certain vaccines and the current schedule. Unbeknownst to you, there are a whole boatload of vaccines that aren’t on the current schedule that could be. They’re not there because reasonable people in these organizations decided that the risks (however small) outweighed the benefits. That is how real public health entities work, not the black helicopter/evil empire ones that exist only in your pathetic fantasy world.

  18. #18 Orac
    October 24, 2006

    You know, I haven’t posted about vaccination in quite a while; I was wondering if ol’ “Common Sense” would show up again when I decided to go back to the topic today. Apparently “Common Sense” can’t get enough of Orac’s special brand of Respectful Insolence™.

  19. #19 Loony Basoony
    October 24, 2006

    “First, he would need to prove to me that vaccinations are as safe as they claim.”

    Easily done. There are plenty of clinical studies, including the trials specifically done to satisfy the FDA, which you can use to make the risk/benefit analysis. You will find sufficient data to make an informed judgement, if you take the time to read them and really analyze the data. They are not light reading; they are very dense and written for a technical audience. So be careful not to merely skim, and make sure you understand how words are properly used in the context of clinical trials. (There are specific meanings used to avoid misunderstandings, but a layperson may not be aware of this.)

    Then, before you criticize doctors who throw up their hands in despair at parents who refuse to vaccinate even when a layperson-friendly synopsis of the information is provided, make sure you spend an equivalent amount of effort looking at the effects of pertussis: morbidity and mortality rates in particular, as well as severity of the symptoms.

    I’m not sure I’d use the term “child abuse” in this context, because I don’t know what the parents’ motivation is. However, I fear a lot of parents are avoiding vaccines not out of informed opinion but out of misinformation found on the Web and through other sources. If one child dies of the vaccine, is that a bad thing? Yes! Is it a reason to not give it to your child? Think carefully; you must be sure that the alternative is better.

    A lot of people used to die of pertussis. Those who didn’t suffered terribly. It’s not a pleasant disease, and it is very contagious. Consider also that if you choose not to vaccinate your child for a non-medical reason, you are not only exposing your child to this dreadful illness, but also any unvaccinated or undervaccinated child who may meet your child while your child is contagious. I wouldn’t use the phrase “child abuse” personally for this, but I have to admit that I can’t find a good reason for saying it isn’t harmful to all our children to specifically and intentionally refuse to vaccinate one’s own children. At best, it’s selfishness: sparing one’s child a momentary pain and perhaps a day of fever on the assumption that everybody else will vaccinate, allowing one to benefit from herd immunity. I find myself comparing it to buying one’s way out of a draft card on the assumption that others will be able to serve in one’s stead if the country is in need.

    I can understand religious objections. Okay, I don’t understand, but I see where it is unfair to ask a person to violate their deeply held beliefs. But frankly, most anti-vaxers I know are not anti-vaxers because of faith, so they do not have the excuse of deeply held beliefs.

  20. #20 TheProbe
    October 24, 2006

    A post by CS is like a breath of 2-chlorobenzalmalononitrile.

  21. #21 Common Sense
    October 24, 2006

    All your responses just prove to me that the system as it stands now is broken. Anyone who questions any vaccinations (in total or certain ones) becomes a crazy person and a person who of course is “neglecting their children”. Good luck with that mentality. You are only fooling the uniformed and the nitwits.

  22. #22 clone3g
    October 24, 2006

    As nutty as Common Sue is, she doesn’t come close to that Jan Spleen person.

    “Anyone who questions any vaccinations (in total or certain ones) becomes a crazy person and a person who of course is “neglecting their children”.

    Sue, the medical and pharmaceutical industries question the safety of vaccines and drugs every day. They actually keep an eye out for adverse reactions and catch most. It’s bad for business you know.

  23. #23 khan
    October 24, 2006

    I had a tetanus/diptheria booster in ’03.

    Is there a pertussis booster for adults, and (if so) can I just go to the local walk-in clinic and get such?

  24. #24 Hyperion
    October 24, 2006

    **He sounds like a typical MD with all the FACTS (not).**

    Fellow of the American College of Tautological Sciences? Sorry, couldn’t resist.

    Anyways, you want your doc to sit there and take the time to listen to your concerns about vaccinations and walk you through why you should do it and generally make you feel better about it. There’s nothing wrong with asking for that, of course, and I do think that part of what draws people to altie quacks is that they make more of an effort to connect emotionally to the patient.

    But here’s the thing, you want your doc to take all that time to counsel you? Ok, then pay him for it…call your congressman and tell him to reverse the pending 5.1% across the board cut to Medicare payments to physicians. But you don’t use Medicare, you say? Of course not, but your doc almost certainly takes Medicare patients, and in order to make up for the money he’s losing by doing so, he has to see more patients, which means less time with each of them.

  25. #25 HCN
    October 24, 2006

    Yes, there is now an adult booster:
    http://www.cdc.gov/nip/vaccine/tdap/tdap_adult_recs.pdf

    You would have to call the clinic to see if they have any. My kids (who are 12 and older) have been getting it this fall during their annual well-child check ups.

  26. #26 Brian X
    October 24, 2006

    Hell, I’m two weeks from my 31st birthday and I’m thinking of getting a flu shot. And if there had been a chickenpox vaccine when I was a kid, I wouldn’t have three scars on my face (two on the forehead, one on the temple) that look like .22 bullet wounds.

  27. #27 shot_info
    October 24, 2006

    “system as it stands now is broken.”

    Of course this is the typical us v. them response of those infected by conspiracy theories. Too bad that there isn’t a vaccine against that.

    Or prehaps LackofCS is vaccine damaged by her direct example.

    She could be onto something there…

  28. #28 Inquisitive Raven
    October 25, 2006

    Okay, that adult pertussis vaccine looks to have been available a couple of years at most. So… what did I get one fine August morning in 2001 when I went to a Philly ER to get a rabies vaccine (yech) and ended up getting a tetanus shot as well? The paperwork I got handed by the ER seemed to indicate that I’d gotten a DPT.

    BTW, when I was at a pediatric inservice for EMS personnel about 10-11 years ago, I remember the speaker expressing concerns about rising rates of pertussis then.

  29. #29 Nomen Nescio
    October 25, 2006

    Anyone who questions any vaccinations (in total or certain ones) becomes a crazy person

    considering the risks involved with the diseases you’d be toying with but for those vaccines, i’m not convinced you haven’t confused your cause and your effect, there.

    i had the chicken pox as a child. a quarter century later, i can still remember being utterly miserable from it. good thing kids today don’t have to deal with that… unless their playmates’ parents are irresponsible boobs who fail to vaccinate, that is.

    (one of my great-aunts, a few years dead now, spent her entire adult life in a wheelchair. polio. i remember being told about the risks of the oral vaccine my whole school was given against that, and thinking of her, then eagerly swallowing it.)

  30. #30 Nomen Nescio
    October 25, 2006

    my, but that “german new medicine” woo seems fascinating.

    on one of the pages our good host linked to, a miniature image of a CT scan shows artifacts the alties claim as real effects and radiologists claim as CT machine glitches. the altie web author has thoughtfully superimposed a dark arrow on the image to point out the center of the artifact, which seems to cover the brain section imaged in the CT scan in concentric circles.

    that superimposed arrow appears to be a semi-transparent computer graphic. which apparently also happens to reduce the contrast in the mini-CT scan to the point where the same concentric arrows show up, not only in the imaged brain tissue, but in the imaged cranial bone, too; elsewhere in the scan, that bone is too bright to make out these artifacts.

    boy, but i’d be interested in seeing a full-size, good-quality scan of that CT image, so i could mess with the contrast and brightness for myself. not that that would ever convince the alties, of course.

  31. #31 Common Summoner
    October 25, 2006
  32. #32 Dunc
    October 25, 2006

    A few years back, I and one of my friends both contracted chickenpox from someone’s unvaccinated kids. I was 26 at the time, and had a really nasty time of it. My friend nearly died.

    People have forgotten just how serious these diseases can be.

  33. #33 anonimouse
    October 25, 2006

    All your responses just prove to me that the system as it stands now is broken. Anyone who questions any vaccinations (in total or certain ones) becomes a crazy person and a person who of course is “neglecting their children”.

    You’re not crazy. That would give you an out and an excuse.

  34. #34 Common Sense
    October 25, 2006

    But here’s the thing, you want your doc to take all that time to counsel you? Ok, then pay him for it…call your congressman and tell him to reverse the pending 5.1% across the board cut to Medicare payments to physicians.

    Ah, no, I’m not calling anyone to force my doctor to sit down and talk with me for 5-10 minutes (max) on which vaccinations are the most important and which ones could be scheduled out? Or for me to explain that my child won’t be getting the Hep B vaccine for Cripes sake? Or, for me to explain that no matter what schedule he/she has I would only consider getting one vaccine per visit. The way that I figure it, he owes me a ton of time. No need for well-baby visits for my third (since 4 months) – due to no vaccinations. Also, no “sick visits” due to adverse vaccine reactions. Trust me, he owes me…

  35. #35 clone3g
    October 25, 2006

    CS: Trust me, he owes me…

    Maybe you should Sue ‘em!

  36. #36 Common Sense
    October 25, 2006

    Maybe you should Sue ‘em!

    For what?

  37. #37 khan
    October 25, 2006

    Just a data point:

    Three years ago a 53 year old coworker got chicken pox (he and his brothers never had it as children).

  38. #38 Common Sense
    October 25, 2006

    Just a data point:

    Three years ago a 53 year old coworker got chicken pox (he and his brothers never had it as children).

    Oh, my God, no….

  39. #39 anonimouse
    October 26, 2006

    On a semi-related note, the flu vaccine is safe for kids after all.

    http://news.yahoo.com/s/ap/20061024/ap_on_he_me/flu_vaccine_safety_6

    But of course, some of the researchers had the audacity to take drug company money at some point in their life. That makes the study bogus for anti-vaxers. Never mind.

  40. #40 Common Sense
    October 26, 2006

    Good link, Mouse.

    Linus had a security blanket, and this is a huge security blanket…

    Cool. Feeling much better now.

  41. #41 Andrew Wade
    October 26, 2006

    “Common Sense”:
    First, he would need to prove to me that vaccinations are as safe as they claim.

    Just how is he supposed to do that? The matter has been studied, but are you competent to critique the studies? Would you be willing to do so? For the record, this is what “they” claim:

    TABLE 6. Adverse events * occurring within 48 hours after vaccination with diphtheria
    and tetanus toxoids and pertussis vaccine (DTP)
    =======================================================================================
    Event Frequency of event +
    —————————————————————————–
    Local reaction
    – Pain 1 per 2 doses
    – Swelling 2 per 5 doses
    – Redness 1 per 3 doses

    Systemic reaction
    – Fever >=100.4 F (>=38 C) 1 per 2 doses
    – Fretfulness 1 per 2 doses
    – Drowsiness 1 per 3 doses
    – Anorexia 1 per 5 doses
    – Vomiting 1 per 15 doses
    – Persistent, inconsolable crying (i.e., for >=3 hrs) 1 per 100 doses
    – Fever >=105 F (>=40.5 C) 1 per 330 doses
    – Collapse (hypotonic-hyporesponsive episode) 1 per 1,750 doses
    – Convulsions (with or without fever) 1 per 1,750 doses
    —————————————————————————–
    * Adapted from Cody CL, Baraff LJ, Cherry JD, et al., 1981 (60).
    + Rate per total number of doses, regardless of dose number in DTP series.
    =======================================================================================

    “… the National Childhood Encephalopathy Study (NCES) and other controlled epidemiologic studies have provided evidence that DTP can cause acute encephalopathy (64-68). This adverse event occurs rarely, with an estimated risk of zero to 10.5 episodes per million DTP vaccinations (68). A detailed follow-up of the NCES indicated that children who had had a serious acute neurologic illness after DTP administration were significantly more likely than children in the control group to have chronic nervous system dysfunction 10 years later.”

    “Rarely, immediate anaphylactic reactions (i.e., swelling of the mouth, breathing difficulty, hypotension, or shock) have been reported after receipt of preparations containing diphtheria, tetanus, and/or pertussis antigens. However, no deaths caused by anaphylaxis following DTP vaccination have been reported to CDC since the inception of vaccine-adverse-events reporting in 1978, a period during which more than 80 million doses of publicly purchased DTP vaccine were administered. While substantial underreporting exists in this passive surveillance system, the severity of anaphylaxis and its immediacy following vaccination suggest that such events are likely to be reported.”

    http://www.cdc.gov/MMWR/preview/mmwrhtml/00046738.htm

    (This is for the older DTP vaccine, it is thought that the newer DTaP vaccine has fewer serious side-effects, but I couldn’t find large-scale studies on the web).

    So not completely safe. (What is?) But neither is not vaccinating. (Especially for Tetanus in the case of the DTP vaccine, as herd immunity will offer some protection from diphtheria and pertussis. But without vaccination the other two would be fairly dangerous as well; as it is pertussis does still kill about ten people a year in the United States).

  42. #42 Rebecca
    October 30, 2006

    Here’s my take on Vaccines: either they work or they don’t work. If they work, then people whose children are vaccinated have nothing to worry about from children who aren’t vaccinated. But what about the children who aren’t vaccinated, wont they potentially get sick? Yes. But, vaccines do have side effects. Vaccines do wear off. Hence, in the case of minor illnesses, it isn’t our deal to force parents to vaccinate their children. An example being chicken pox: what’s a few scars compared to a lifetime of immunity, when the older you are the more dangerous a chicken pox infection becomes. Also, in the case of chicken pox, you can’t make the argument that if everyone is inoculated, then there wont be any of the virus floating around. I got one word for you= Shingles!

  43. #43 HCN
    October 30, 2006

    Rebecca, you need to do a bit more research on vaccines. You can start on the concept of “herd immunity”… and for several children chicken pox is NOT a mild disease (and is literally deadly). Here is a start:
    http://www.cdc.gov/nip/publications/pink/varicella.pdf

  44. #44 anonimouse
    October 30, 2006

    Here’s my take on Vaccines: either they work or they don’t work. If they work, then people whose children are vaccinated have nothing to worry about from children who aren’t vaccinated.

    Typical lame anti-vax argument. Vaccines don’t always work. That’s why it’s important that the few who are left unprotected have a buffer of those who are. When people fail to vaccinate their kids for no good reason other than their paranoia, it reduces that buffer and leaves more kids at risk.

    But what about the children who aren’t vaccinated, wont they potentially get sick? Yes. But, vaccines do have side effects. Vaccines do wear off. Hence, in the case of minor illnesses, it isn’t our deal to force parents to vaccinate their children.

    Yes it is, because parents live in a society with other people, and intentionally putting other people at risk is pathetic. The reality is that the side effects of vaccines are generally mild and temporary. The side effects of many of these diseases can be permanent.

    An example being chicken pox: what’s a few scars compared to a lifetime of immunity, when the older you are the more dangerous a chicken pox infection becomes.

    All the more reason to vaccinate. After all, not everyone gets the chicken pox, wouldn’t it be better to expose everyone the disease uniformly? Of course, if you hate vaccines as you clearly do, then that argument doesn’t work.

    I got one word for you= Shingles!

    Which still exists when you get the disease naturally. Why would vaccination make that any worse?

    Please, Rebecca. If you’re going to espouse anti-vaccine sentiment, do a better job of hiding your views or come clean from the get go like (No) Common Sense.

  45. #45 Catherina
    October 30, 2006

    Rebecca,

    nothing in biology/in a body is 100%. This holds true for immunity as well (irrespective of whether this immunity is disease or vaccine acquired). Community immunity plays a big role in protecting those, who for some reason or other (their own inadequate immune response to vaccine or disease, to young/sick to be vaccinated) cannot be protected by vaccination.

    As for “a few pox” – the daughter of a friend of mine spent 6 weeks in a hospital with osteomyelitis due to chicken pox, 4 weeks on IV antibiotics. It wasn’t clear whether she would keep her leg (she did, luckily) – the scars were their smallest worry.

    The daughter of an acquaintance had a varicella stroke.

    The daugther of another friend had literally over 1000 pox *everywhere* (including in her vagina, in her throat, her ear canals, under her eyelids). She could not eat and hardly drink for 2 weeks. Granted, the scars are ugly, too, but compared to the 2 week ordeal, they are no issue.

    A playmate of my son spent a week in the hospital due to seizures with chicken pox.

    My son *had* chicken pox twice (so much for “lifetime of immunity”).

    I’d take vaccine over disease any day – in fact, I did with my daughter!

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