Four cases of measles have now been confirmed at a San Diego charter school--the first reported outbreak of measles in school-age kids in that city in 17 years. Unsurprising twist:
None of the children, including the one most recently reported with the disease, has been vaccinated.
New Scienceblogger Drugmonkey already hits the high (or low, such as it may be) points in this case in a much less restrained manner than I'm able to.
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Thanks again, antivaccine activists. Thanks for the measles. Again:
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They just thought they had it.
Hm. Surely this does not come as a surprise?
On only a semi-related note -- has anyone had a good look at this yet: http://www.cbc.ca/health/story/2008/02/12/antibody-study.html
--and what do people think?
What a twist!
The only people who care about this are scaremongering microbe-hunters hoping to capitalize (grants, tests, drugs, interviews, Time Magazine covers) on an outbreak.
Ain't gonna happen. 3 kids getting the measles is not a big deal.
...Except that,
(a) it's no longer "3 kids getting measles", it's 10 so far, including an 11-month old baby (http://www.upi.com/NewsTrack/Top_News/2008/02/12/measles_break_out_in_s…),
and
(b) measles can be fatal.
So why is it that kids catching a potentially fatal disease because of scaremongering by anti-vaxers, not a big deal?
Fleming, you are a prime, grade-a, nasty little idiot.
I thought charter schools had to observe state vaccination laws. In Kentucky, public schools are really insistent about kids having up-to-date vaccination records and won't let them stay in school if parents (umm, no one I know ...) procrastinate about getting those shots.
Forget about global warming. Our greatest challenge as a nation is to stop the US public's steady decline into idiocracy.
wheatdogg, the reporting on this claims that parents can get an exception from vaccination, even in the usual public school systems. In Cali, anyway. One imagines that this derives from religious objections but of course then it would be only fair for people of more, er, recent theological stances to object out as well.
http://www.nbcsandiego.com/health/15282223/detail.html?rss=dgo&psp=news
"More than 50 children who attend the San Diego Cooperative Charter School, a county-run charter school in the San Diego neighborhood of Linda Vista, and the Murray Callan Swim School and the Baldwin Academy day care center, both in Pacific Beach, are being quarantined as a precaution...The 10-month-old baby remained hospitalized Monday night but was expected to be released on Tuesday."
And the parents who caused all this in the first place should be treated as criminals and forced to pay any restitution to parents missing work with their quarantined children and the medical bills for the hospitalized 10 month old.
Parents who do things like that to their kids deserve to be kicked out of the gene pool. Assholes.
Evolved: I agree with your sentiment, but many parents are just uninformed. The people who deserve the blame are public health officials who allow exemptions for vaccinations and the buffoons who make it their job to lead credulous parents into foolish inaction and lobby for public health laxity.
Drugmonkey is right; many states in the USA allow exemptions for "religious" reasons.
It's worse than that. California and close to half of all states allow "personal belief" exemptions that include anything under the sun, including "I just don't feel like it."
Other states, like Indiana and Nebraska, take a parental signature as "proof" that the child was vaccinated.
Even in West Virginia and Missouri--the two states with no non-medical exemptions allowed--the vaccination requirement is only as strict as the local school district officials make it. Fortunately, they seem to do a very good job. Pertussis rates in WVa and Missouri are at or near the bottom of the pile.
I recall someone mentioning this paper before, but it bears repeating:
Nonmedical Exemptions to School Immunization Requirements.
Secular Trends and Association of State Policies With Pertussis Incidence
Omer SB et al, JAMA. 2006;296:1757-1763
http://jama.ama-assn.org/cgi/content/full/296/14/1757
Omer find that pertussis rates by state are correlated with the ease of obtaining a vaccination exemption. The longer these assinine policies are in place, the more kids are coming down with pertussis. Say what you want about West Virginia, but at least their health department doesn't trifle with fatal childhood diseases.
I had chicken pox as a kid. Probably missed a week of school. Got runny nose, itchy, red blotches all over my body. Nobody cared, nobody died, nobody gave me any medication, nobody wrote about it, nobody blogged it. Just rode it out, stayed away from my younger siblings, natural immunity conquered it, got better.
My, we were much smarter 30 years ago.
Fleming unequivocally self-identifies as a troll. Please do not feed the troll.
I had chicken pox as an adult. I was sick for four weeks, nearly broke a tooth with rigors and chills and I could have done without the pneumonia, too.
If I could have had the shot, I'd have taken it like a...shot.
It may be a harsh lesson, but perhaps some parents might get the message if their children end up hospitalized (or worse) if they continue to dodge immunizations. Unfortunately, most of these parents are too young (or clueless) to know about the epidemics of measles, pertussis, polio and other childhood diseases that took ten of thousands of children "out of the gene pool" a century or more ago.
Why do people risk their children's health on the say-so of some misinformed, dogmatic health "experts?" Would they also return to the time before flush toilets and sewers, doctors not washing their hands before surgery or childbirth, treated water supplies, and the toothbrush?
One of the infected San Diegoans brought the disease to Hawai'i: http://www.signonsandiego.com/news/metro/20080213-9999-1n13measles.html
I had chicken pox as a kid. ... Nobody cared, nobody died, nobody gave me any medication, nobody wrote about it, nobody blogged it. Just rode it out, stayed away from my younger siblings, natural immunity conquered it, got better.
Uh huh. See if you care sometime in the future when you get shingles. You know, that really nasty disease in adults that's caused by a resurgence of the virus that causes chicken pox in children and never leaves the body afterwards? My grandmother went blind in one eye from shingles, my grandfather went through six months of hell, and my father went through three days of agony because of lesions erupting in his mouth before the antiviral drugs he got kicked in and tamped it down. He only managed to get off relatively lightly because he got a very fast diagnosis and treatment.
Varicella pneumonia aside, it isn't the chicken pox that is the serious problem; it's what happens years and years (decades, usually) later. I heard somewhere that shingles is a leading cause of suicide among elderly people. If all that can be prevented with a vaccination, you'd be an idiot and an ass to oppose it.
Me, I managed to survive having rubella when I was a baby, with no ill effects. Lots of children don't. Just because I was lucky once doesn't mean that everyone will be, or that my luck will hold forever.
I had rubella when I was about one as well. Although I was fine, the problem was that a lot of my Mum's friends at the time were either pregnant or trying for a baby. I didn't give any of them rubella (Mum warned them away as soon as she realised what was wrong) but I shudder to think of what would have happened if she'd been slightly less on the ball.
As long as we're sharing sob stories, I really wish they'd had the varicella vaccine when I was a kid. I had chicken pox when I was about 14, and I have at least a half-dozen big scars on my face that'll be with me for the rest of my life. I caught my husband counting them just the other morning. I was no great beauty to start with, but I could do without the additional minor disfigurement.
I'm grateful I had all the vaccinations available during my childhood, and I'm glad kids will have even better protection in the future.
You guys are all screwy. Clearly, you lack balance and perspective.
It's a tragic thing if a 14-year old gets hit by a car.
It's a tragic thing if a 14-year old, say, gets shuffled off to two homes, after a divorce.
It's a tragic thing if a 14-year old, say, has an unresolved speech impediment.
Sorry, but chicken pox in a 14-year old ain't a big deal.
Some jerk above says: See if you care sometime in the future when you get shingles
Trust me, I'm not worried about shingles in the future, doofus.
One decent tidbit of wisdom from Wheatdogg:
Would they also return to the time before flush toilets and sewers, doctors not washing their hands before surgery or childbirth, treated water supplies, and the toothbrush?
Don't know who "they" are, but these are all very good common sense practices which almost entirely negate the irrational fear of microbes that some have in developed countries like ours.
Sorry, but chicken pox in a 14-year old ain't a big deal.
Itching is no big deal. Being quarantined is annoying, and, depending on the timing, may be detrimental to a child's academic achievement, but is more of an annoyance than anything else.
But not all cases are that light. Lifelong scarring. Disfigurement. Nerve damage. Paralysis. Blindness. Febrile seizures. Hospitalization. Death. I would not call any of those things "no big deal". A 14-year-old friend of mine, shortly after I had chickenpox (we were caught in the same outbreak), was very ill indeed. Infants are at a particularly high risk, and it causes a number of dreadful birth defects if pregnant women become infected.
Chickenpox is also associated with a number of very nasty secondary infections which are much more dangerous, such as group A streptococcus.
Trust me, I'm not worried about shingles in the future, doofus.
Then you may have a very nasty surprise waiting for you. I hope you are one of the lucky ones. (I hope I am too; I also have had chickenpox.) You probably don't realize that shingles can kill -- and it can do worse as well. Would you like to live your last few decades in constant pain? Or partial paralysis? What about blindness? Must be nice not to worry about those kinds of things. It must be bliss.
Fleming you really are a myopic moron and a troll. Measles can be fatal. Chickenpox is more than just an itchy problem for many. Avoiding these problems is pretty simple yet people such as yourself think that your anecdotal experience with one thing or the other is evidence for how the rest of the world will operate. This is simply not the case.
Your continued defense of your stance shows that you're either a complete idiot or a troll or more than likely both.
Both. D. David Steele has been trolling since his days as Wavy Davy on evolution blogs and Hank Barnes on here. The idiocy is lifelong.
Wow Tara, as a citizen in the community of San Diego, I have also been monitoring the situation. Two more kids have come down with measles here bringing the total to 8 cases. I don't think it will be an "epidemic" as most kids do indeed have their vaccinations.
It is however, not so surprising that so many people do have a mistrust of modern medicine to the point that some are reluctant to trust current science and medicine at all. After all, the recent HIV vaccination ended up with more people testing as positive to HIV in the group that was given the vaccine than the group who received a placebo.
And speaking of San Diego, the REALLY BIG NEWS the other day, on Feb 14th: Sexually transmitted diseases HAVE RISEN SINCE 2003 IN SAN DIEGO BY 800%!!! This rise in infections was seen in Syphillis, Gono, and Chlamydia. And 80% of this rise in std infections was in the group of Men who have Sex with Men (MSM).
However, I went to the San Diego County Health site, to look at what HIV infections have done in the exact same time period of 2003 to current in the identical group of MSM's. To my utter amazement, HIV has defied the laws of gravity and has not gone up at all, but actually went down in the very same time period of 2003 to 2007 when all other std's in the MSM community have been skyrocketing!
Clearly something is wrong with this picture, as this clearly INDICATES that whatever is causing HIV tests to show positive simply CANNOT BE A SEXUALLY TRANSMITTED DISEASE!
Dear Tara, can YOU, as an "acclaimed" aetiologist please explain to us why HIV is defying the "laws of gravity" and going down in the MSM community when all other std's are rising?
I certainly hope you can, before even more of us lose "faith" in modern science and medicine.
Dear Tara,
Now that we have all had a chance to vent our righteous spleen on all those dirty anti-vaccine hippies, perhaps we could get back to the epidemiology. You ARE an epidemiologist right?
In 1920 the incidence of measles was around 470,000. Deaths were estimated at 7,575.
In 1962,the year before introduction of the measles vaccine, incidence of measles was around 500,000. Deaths were 432. Less than one in a thousand
This is illustrative of a long declining trend, which of course continued after 1963. The measles vaccine had, inother words, minimal to zero impact on hospitalization and deaths due to measles in the US.
Now it's 2008, 45 years more of advances in medical and nutritional science, meaning that the risk of dying or becoming seriously damaged by measles should be very, very small for most Americans.
On the other hand: "vaccinating 540,000 children, would result in:
Up to 81,000 cases of rash and fever.
Up to 5,400 cases of parotid (mumps) swelling
Up to 216 cases of febrile seizures
Up to 18 cases of thrombocytopenia (red-blood cell destruction)
Up to [figure missing] cases of chronic thrombocytopenia.
Up to 5 cases of Aseptic Meningitis.
Up to 1 case of Central Nervous system damage.
Up to 15,420 cases of transient joint arthralgia some of these becoming chronic. (pg 95, H. Dept Handbook)"
This, Tara, is quite apart from the question of (denied) effects such as autism.
In view of this, maybe, just maybe, a case could be made that there are worse criminals in the world than those damned dirty anti-vaccine hippies that make it so difficult for those who just want to protect America to control all those terroristic germs sneaking in from Third World countries such as Switzerland?
Or is it against your mainstream academic oath and the subsequent AIDStruth Initiation Rite Booster Shot to view any case from both sides?
PS. don't let me distract you from that interesting epidemiological conundrum brought up by Creepers just above, namely the fact that HIV is rather poorly correlated with other STIs
Paramyxos,
I'm not an anti-vax dude -- I've been vaccinated as have my kids. I just really haven't thought much about the issue.
But, this is a devastating fact:
In 1920 the incidence of measles was around 470,000. Deaths were estimated at 7,575.
In 1962,the year before introduction of the measles vaccine, incidence of measles was around 500,000. Deaths were 432. Less than one in a thousand
If true, to me, this shows that vaccines are real late to the party, and don't deserve many, if not most, of the medical accolades they have received.
Is this trend true for polio and small pox, too?
Fleming,
The measles statistics I've presented are the bona fide, official NIH approved ones. Rest assured. The incidence of measles in the US may have been lowered considerably by the vaccine - I'm aware of no alternative explanation - but its "deadly effects" have not. To the contrary, when measles does strike, it's more deadly now because there's little natural immunity among adults.
Polio (I'll skip smallpox since it requires even more extensive discussion with quotes)is a different and more complicated story. It's one of the numerous Central Nervous System diseases which were discussed briefly in the rabies thread on this blog not long ago. That makes polio fairly easy to relabel as, for instance, meningitis.
Here's a few more facts easily found on wikipedia:
1. Around 90% of polio infections have no symptoms at all.
2. In fewer than 1% of cases the virus enters the central nervous system, preferentially infecting and destroying motor neurons, leading to muscle weakness and acute flaccid paralysis.
3. Major polio epidemics were unknown before the 20th century. By 1910, much of the world experienced a dramatic increase in polio cases and frequent epidemics became regular events, primarily in cities during the summer months.
If you have problems spotting the red flags here, these articles will provide all the clues you need.
http://www.whale.to/vaccine/polio7.html
You can use this graph (with references especially to the correlation with DDT) for easy overview:
http://www.vaclib.org/intro/present/pol_all.jpg
Most major medical inter- and innovations are hyped, and the real facts grotesquely distorted. That's simply the nature of "free market" competition for the hearts and minds (and bodies) of the consumers. I'm no anti-vax fanatic myself: who can say for sure what the real story is? The only thing that's not difficult to detect is the crude and totalitarian nature of the propaganda.
Paramyxos states:
According to the surveillance statistics compiled by the CDC, measles infections in the United States were associated with the following complication rates from 1993-2004:
Complication----------------Percent Reported
_______________________________________
Diarrhea------------------------------8%
Otits Media--------------------------7%
Pneumonia---------------------------6%
Encephalitis-------------------------0.1%
Seizures------------------------------0.6%
Death---------------------------------0.2%
Widespread immunization has reduced the reported cases of measles from ~500,000 cases per year to less than 200 cases per year. Maintaining this low incidence of measles leads to a decrease in the complications of measles.
At the current incidence of less than 200 cases/year, deaths from measles have been reduced from ~1000 deaths/year to less than 0.04 deaths per year (that is to less than one death every 25 years).
Encephalitis as a complication of measles has been reduced from ~500 cases/year to less than 0.02 cases per year (less than one case of measles encephalitis every 50 years).
Pneumonia as a complication of measles has been reduced from ~30,000 cases/year to less than 12 cases/year.
Paramyxos concedes that:
Is this true? Has vaccination made measles more deadly?
Or is Paramyxos wrong?
Can we observe the beneficial effects of the vaccine?
Yes, the beneficial effects become apparent every time there is a measles outbreak in this country. For example, an outbreak of 34 cases of measles were linked to an index case in Indiana in 2005.
So, in this outbreak 88% of the infected people were old enough to be eligible for vaccination but had not been vaccinated.
In contrast, the population-wide immunization rates for measles in Indiana are 92% for preschoolers and 98% for sixth graders. (NEJM 355:447-455).
The unvaccinated account for ~2-8% of the population of the state but 88% of the people infected in this outbreak.
About 9% of the infections in this outbreak required hospitalization.
The immunization program prevents measles, prevents hospitalization due to measles, and prevents the dangerous complications of measles.
Paramyxos is wrong when he claims that the vaccine has not lowered the "deadly effects" of measles.
My dear Franklin,
I'm not quite sure what you are trying to prove. I said when measles does strike the victims are not so well protected as they were before. Short speech will suffice:
1962 - 432 deaths out 520,000 cases
1989-1991 - 120 deaths out of 55,000 cases
Although medical and nutritional science had advanced 25-30 years (supposedly), and although the authorities had to deal with less cases over a longer period of time, the relative death toll in 1989-1991 was more than double that of 1962.
Paramixedup,
From Acute Measles Mortality in the United States,
1987-2002
"From 1987 to 2002, reports of acute measles mortality in the United States declined by 199%, from 165-184 reported deaths during 1987-1992 to 1 reported death during 1993-2002."
Of those deaths, 90% were in unvaccinated people. Any increase in CFR is a reflection of the increased number of patients with HIV and other immunocompromising conditions, who are much more likely to die if they acquire measles. Those deaths could be prevented if immunization rates were higher.
Correction 520,000 should have been 502,000 cases in 1962
Sister Howitzer,
Either you are kidding me or you are kidding me AND you are Adele.
The host of this blog is an epidemiologist and none of you apologists understand the concept of a continually declining trend over the whole century or number of deaths relative to number of cases.
And now measles deaths are blamed on HIV too?
To quoute Bill Clinton, give me a break!
Did you even bother to look at the article?
"Early in the 20th century, measles was a universal childhood illness. The annual number of measles deaths in
the United States fluctuated between 2000 and 10,000,
and the death-to-case ratio (DCR; the number of reported
deaths per 1000 reported cases) generally exceeded
10 (figure 1). The number of deaths and the
DCR began to decline significantly in the 1930s, most
probably as a result of treatments for secondary infections
[1-4], improved nutrition [5], and reduced
crowding [6]. In the 1950s, the annual DCR declined
to â¼1; however, measles remained a common illness,
with an average of 550,000 reported cases and 495 deaths reported each year. The introduction of measles
vaccine in 1963 led to a precipitous drop in measles
cases and measles deaths; however, the DCR did not
change substantially (figure 1)."
No one is denying that measles cases and mortality decreased dramatically prior to the availability of vaccination. It's common knowledge.
And I'm not Adele.
Paramyxos Says:
What Paramyxos actually said:
Can Paramyxos come up with another plausible explanation for the dramatic decrease in "hospitalization and deaths due to measles in the US" other than the vaccination program?
I still think Paramyxos has conveyed the most important fact that is probably unknown to most people:
In 1920 the incidence of measles was around 470,000. Deaths were estimated at 7,575.
In 1962,the year before introduction of the measles vaccine, incidence of measles was around 500,000. Deaths were 432. Less than one in a thousand
If mortality rates were decreasing substantially over a 42-year period BEFORE the measles vaccine, this means something. What is it?
Sister Howitzer makes the glib statement:
No one is denying that measles cases and mortality decreased dramatically prior to the availability of vaccination. It's common knowledge.
If this fact is common knowledge, then tell us what you conclude from this data.
Is this meant to be a rhetorical question?
There were considerable advances in the treatments for the complications from measles in this time period.
You currently have a much better chance of surviving severe trauma from a car accident than you did several decades ago. According to your convoluted logic there is no point in wearing seat-belts or stopping people from driving drunk because modern medicine will probably save you anyway. You might be crippled, you might lose a few limbs but what does that matter because the mortality rate is down.
I had a shingles outbreak 3 years ago when I was 38, I had chicken pox as a child. It was the single most painful thing I've ever had happen to me. Much worse than breaking an elbow or a lower leg bone, worse even than 2nd degree burns over 20% of my body and it went on for months with virtually no let up, long after the rash disappeared. Morphine barely took the edge off the pain and I can quite easily believe that suicide might become attractive after a while, I was told at the time that for some people the pain was permanent and basically untreatable. I'm told that it is unlikely to recur but I almost have a panic attack anytime I get any sort of red spot or rash. Anyone who has had chicken pox who is not concerned about shingles is a fool.
Get your kids vaccinated and save them the agony. I've gotten the shingles vaccine and I recommend talking over getting it with your doctor if you've had chicken pox. It's not recommended for those under 60 but it is possible to have shingles before then and I had no problem from the vaccination.
"I'm not quite sure what you are trying to prove. I said when measles does strike the victims are not so well protected as they were before.
What Paramyxos actually said:
The measles vaccine had, in other words, minimal to zero impact on hospitalization and deaths due to measles in the US."
My dear Franklin, if this were an election campaign I'd say your base was the lazy voters with the short memory, which means you would probably win the presidency of this particular blog in a landslide. But I am still happy with the votes of the few that can actually read what it says on the ballot.
What Paramyxos said was this:
"when measles does strike, it's more deadly now because there's little natural immunity among adults."
Sorry but there's no way around it; everybody can check for themselves just a few Comments up. By "little natural immunity" is meant the quality of vaccine induced immunity is not as good as the immunity one gets from actually having had measles.
Then, Franklin, you ask me to explain the "dramatic drop" from 432 anual deaths to around zero in a good year. Why even Chris Noble has grasped that by now! It's the combined effects of medical and nutritional advances.
Now try to concentrate and listen to Fleming: The question is not how did measles deaths drop dramatically from 400 to almost zero in the 40 years since the introduction of the vaccine. Neither is the final question how did measles deaths drop from 7,500 to 400 in the 40 years before the introduction of the vaccine.
The question is, if deaths dropped by 7,000 in a continual fashion over 40 years from 1920 to 1962, what makes you think it wouldn't have dropped by the remaining 400 cases in another 40 years also without the benefit of the vaccine?
i too had chicken pox as a kid. i vaguely remember being miserable for days, and all the adults seeming a lot more worried than i was. plus, as mentioned, now i get to worry about shingles in another few decades --- the notion of some damn virus joyriding on my genome through all my life only to come haunt me later is more than mildly creepy.
kids these days don't know how lucky they are for the chance to miss out on all that, IMO.
(i've been told, but cannot remember, that i had the mumps as an infant. apparently sent my older brother's school into a tizzy, or some such story. i'm sure that could've been done without, too.)
Paramyxos,
You have done the blog world a great service by providing lucid insight on the question of measles.
The question is, if deaths dropped by 7,000 in a continual fashion over 40 years from 1920 to 1962, what makes you think it wouldn't have dropped by the remaining 400 cases in another 40 years also without the benefit of the vaccine?
That is the ultimate question, no? But, the alarmists will likely dodge this ultimate question, since they are wedded to the notion, a priori, that vaccines work and are good.
I would ask a sub-question:
Given that mortality from measles decreased substantially WITHOUT A VACCINE, why do we need a vaccine?
More Denialist Propaganda
As we breathlessly await an answer to Para's question (presumably now sufficiently clarified beyond the tipping point of caricature for our resident medical experts) let me be another wet blanket at the glorious biotech party.
By that I mean medical journal articles that document measles epidemics in vaccinated populations.
Tara, once again I'm sorry about spoiling the happy-talk without the requisite references, but alas my retrieval system is inefficient as usual.
So I'll propose more convoluted logic to make Chris' day: the hypothesis, based on horizontal gene transfer in evolution, elevated cortisol (TH1 to TH2 shift) from vaccinations, etc. and my childhood memories; that those childhood diseases, measles mumps and chicken pox were the very "extended development" processes that provided natural immunity. And just to make it really exciting, a corollary. Respiratory syncitial virus, which didn't "exist" in my early no-autism-was-ever-heard-of years, is a recombined agent from multiple childhood vaccinations - unpredictable but determined as the chaos theorists would put it.
Realize this gang, before the 1980's recombination between "species" of RNA viruses was said to be "impossible" by "experts"; a textbook example of denialism, par excellance.
And for those who think I'm just blowing smoke out of my ass, I do have an excerpt handy from (the great) Richard Lewontin's "Biology as Ideology", (1991) pg 39 "Causes and Effects" that speaks to the very subject at hand. It starts out "Modern biology is characterized by a number of ideological prejudices that shape the form of its explanations and the way its researches are carried out. One of those major prejudices is concerned with the nature of causes."
It gets better, but only a teaser for now ...
Paramyxos:
Paramyxos suggests that measles is now deadlier because vaccine-induced immunity is inferior to the immunity induced by a measles infection, and he points to the mortality rate of measles between 1989-1991 in support of his hypothesis:
One prediction of the Paramyxos hypothesis that a "low-quality immunity" induced by the vaccine is to blame for the mortality of measles between 1989-1991 is that these deaths are a reflection of vaccine-failure.
Well, according to the paper linked to by Sister Howitzer, this prediction is not borne out (Jacqueline Gindler et al (2004). Acute Measles Mortality in the United States, 1987-2002. The Journal of Infectious Diseases 189:S69-S77).
This paper reported on 184 deaths due to measles in the United States between 1987 and 1992.
The vaccination status of these measles victims is of interest to Paramyxos' claim that modern mortality from measles is because "the quality of vaccine induced immunity is not as good as the immunity one gets from actually having had measles."
90% of these victims had not been vaccinated.
Only 19 of these 184 deaths occurred among individuals who had been vaccinated.
Paramyxos blames the mortality rate from measles between 1989-1991 on the "low quality" of vaccine-induced immunity, but only 10% of the measles deaths occurred in individuals who had been vaccinated.
Paramyxos is wrong.
If more of these measles victims had been vaccinated, fewer of them would have developed measles and even fewer of them would have died.
And here I thought the AIDS Denialists were stupid.
I'll spell it out for you in small sentences.
Let's say that in 1920 there were 470,000 car accidents 7,575 of which were fatal.
In 1962 there are still around 500,000 car accidents but only about 432 are fatal because we are better at getting people into ER and keeping them alive.
Now just because the people are dying at the same rate from car accidents does not mean that they don't suffer significant complications and they also have to spend a long time in hospital.
Imagine if virtually all car accidents could be prevented in the first place by a safety device. Only an idiot would say there is no point in preventing car accidents if the mortality rate is already decreasing.
I'll buy you a beer if at least one of the ant-vaccination kooks isn't one of the familiar HIV Denialists with a new pseudonym.
Shots-R-Us sounds eerily like Gene Semon.
haha more "taboo reactions" from a bunch of government can't tell a lie sycophants. I hate to do this again, but I've gotta post the brilliant mathematicians Dr. Darin Browns post again on what this is all really about. This gives me a total boner.
SLC,
Your comments, even from someone "with a PhD in elementary particle physics", remind me of the central sociological fact surrounding the reaction you embody:
This has nothing to do with the HIV hypothesis. Nothing to do with the pros vs. cons of vaccine administration. Nothing to do with whether global warming is human-caused. Nothing to do with the cause of the 9-11 attacks. Nothing to do with the issues.
It's all about "joining the anti-crankery club". It's all about getting patted on the back for "being skeptical". It's all about wearing "Skeptical Inquirer" t-shirts and throwing around terms like "whackjob" (implying that anyone who doubts a consensus viewpoint is akin to ejaculate fluid) and "denier" (implying that anyone who doubts a consensus viewpoint is akin to Holocaust deniers). It's all about having your ego stroked for helping in the fight against "scientific illiteracy" and "the cult of irrationality". It's all about the "taboo reaction" so eloquently and prophetically expressed by Feyerabend in Against Method years ago:
"Science [relating another person's characterization] ... is characterised by an essential scepticism; 'when failures start to come thick and fast, defence of the theory switches inexorably to attack on it'.' This is possible because of the 'openness' of the scientific enterprise, because of the pluralism of ideas it contains and also because whatever defies or fails to fit into the established category system is not something horrifying, to be isolated or expelled. On the contrary, it is an intriguing 'phenomenon' - a starting-point and a challenge for the invention of new classifications and new theories. We can see that Horton has read his Popper well. A field study of science itself shows a very different picture... Such a study reveals that, while some scientists may proceed as described, the great majority follow a different path. Scepticism is at a minimum; it is directed against the view of the opposition and against minor ramifications of one's own basic ideas, never against the basic ideas themselves. Attacking the basic ideas evokes taboo reactions which are no weaker than are the taboo reactions in so-called "primitive societies." Basic beliefs are protected by this reaction as well as by secondary elaborations, as we have seen, and whatever fails to fit into the established category system or is said to be incompatible with this system is either viewed as something quite horrifying or, more frequently, it is simply declared to be non-existent."
Read over the responses generated at this blog in reaction to HIV, vaccines, global warming, 9-11, etc. REGARDLESS OF THE MERITS OF THE DOUBTERS ON ANY OF THESE ISSUES, can anyone doubt that the "taboo reaction" expressed by the defenders of the faith here is any weaker than that in so-called "primitive societies"??
darin
Posted by: Darin Brown | January 13, 2008 6:57 PM
For those interested in more details about this outbreak...it highlights the communicability of measles. Some of the kids became infected after sitting in a doctor's waiting room for a few minutes. The county has an overall vaccination coverage very close to 90% and many of the kids in the charter school were probably vaccinated. Parents occasionally use the personal belief exemption as a convenience (they have either lost or can't find the vaccination record). Hopefully none of these kids will become seriously ill...
Franklin, get out of the gene pool. Thanks!
Gene writes,
Respiratory syncitial virus, which didn't "exist" in my early no-autism-was-ever-heard-of years, is a recombined agent from multiple childhood vaccinations - unpredictable but determined as the chaos theorists would put it.
Here (http://news.nationalgeographic.com/news/2006/02/photogalleries/newguine…)
is a picture of the golden-mantled tree kangaroo, discovered in 2005 in Indonesia, but which of course did not exist before Gene first read about it. As "the chaos theorists" would say, the inherently unstable trajectories of a squirrel and a wombat oscillated in non-periodic fashion sometime in late 2005 and recombined into this delightful new mammal. Something about fractals, too. The zoologists said it couldn't happen, so they must be wrong about everything.
The Reverend Dodgson had nothing on Semon, apart, that is, from a semblance of literary style.
Re cooler
I see that the Scienceblogs favorite moron and denier has migrated back over to here from Dr. Oracs' blog to post more of his crap. Mr. cooler hasn't got sufficient intelligence to grab his, I suspect considerable posterior with both appendages.
Since it is plainly obvious Tara, the epidemiologist in residence does not have an answer to the question concerning the role of vaccine in the steady decline in measles deaths over the century, perhaps we should look at some more facts:
One novel feature of the 1898-1991 US measles outbreak was that,
"incidence rates for infants were more than twice as high as those in any other age group. 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."
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf
The number of cases in which no antibodies are transferred is also higher among vaccinated mother to infant cases. That means the quality of vaccine induced immunity is not only limited to the parent, but affects also the pre-vaccine age infants of the previous generation.
Moreover, when comparing the death to case ratio in vaccinated and unvaccinated parts of the 1989-1991 population, one has to be aware that it was not the middle-class and up, dirty yet mostly white, anti-vax hippies that made up the later group. It was as always predominantly the poor, in particular the poor black and hispanic populations, that were not vaccinated. Incidentally, these are also the ones with highest number of other infections such as pneumonia, lowest level of nutrition, lowest quality health care etc. These are the real determinants of measles death, therefore more cases will occur among these populations regardless of
vaccination status of the patient or the patient's mother.
Again, it would be so much more interesting to have a real and balanced professional assessment including all of these factors instead of the usual lazy linked-newsflash- selected-for-propaganda-value approach from the blog host, who is even afraid of delivering the slander herself and therefore has to link to some other clown's rant.
http://scienceblogs.com/drugmonkey/2008/02/vaccination_woo_nutz_are_get…
The self-professed NIH-funded simian whose authority Tara is deferring to could do no better than begin by returning the compliment:
Around here at SciBlogs, people who know what the heck they are talking about like Tara, Orac, revere and Abel Pharmboy usually handle the dissection of the anti-sciencenauts who insist on not vaccinating their children against measles and the consequences thereof. Today however a specific, if anonymous, set of anti-vaccine parents are pissing me off.
Following this cute little session of reciprocal back slapping, our "biomedical research scientist" instantly verifies his claim that he doesn't know what the heck he, and by extension Tara, is talking about:
Except, oops. Children only receive the vaccine at 12-18 months. So for kids under a year, we're talking nearly 100% naked to infection.
Feel free to compare this with the CDC quote I gave above.
Re cooler
I see that the Scienceblogs favorite moron and denier has migrated back over to here from Dr. Oracs' blog to post more of his crap. Mr. cooler hasn't got sufficient intelligence to grab his, I suspect considerable posterior with both appendages.
Re SLC
Perhaps you should suck on Shyh Ching Lo's balls, or Duesbergs for that matter to get some real intelligence in your life, just a suggestion, hugs,
Cooler.
Nice Claus so what your saying is, let's just give everyone measles that way babies under a year are more immune!!
You are a smart dood!!
BTW Claus I am loving your new name!! Molecular entry clap was real old.
I see that in one instance I have written "1898" instead of "1989". More importantly, further down, I have written "previous" instead of "next". The passageshould read
That means the quality of vaccine induced immunity is not only limited to the parent, but affects also the pre-vaccine age infants of the NEXT generation.
Re cooler
I prefer to associate with folks like Owen Chamberlain, Emilio Segre, Julian Schwinger, and Steven Weinberg, all Nobel Prize winning physicists whom I have taken courses from.
All cranks by definition because they believe the 9/11 lie.
Bingo! Adele, you've almost got it. The argument that everybody knows about except epidemiologists and professional vaccination enthusiasts is that childhood measles serves to build up our immune system in general and makes us better prepared to deal with a number of issues besides measles itself.
I don't suppose the professional epidemiologist or her new parallel blogging Drug Pet,would be interested in a fair and balanced look at that aspect, seeing it doesn't easily resolve into propagandistic sound bites.
Re cooler
Since both Prof. Segre and Prof. Schwinger died prior to 9/11, they could hardly have had any opinion relative to 9/11.
Re cooler
By the way, Mr. cooler failed to respond to my query on Dr. Oracs' blog as to whether he agrees with Prof. Singer that cigarettes don't cause lung cancer and that CFCs' aren't responsible for ozone depletion.
Paramyxos says Forced measles innoculation!! and Yes and lets take our kids and get them bit by rabied dogs. And get leprousy! And Ebola! And shoot ourself in the knee! What doesn't kill us makes us stronger we can deal with other issues better. People who die from it are because they are just dumb druggies and scaredycats.
Wait Para how can you get measles if viruses arent real??
Re cooler
By the way, Mr. cooler failed to respond to my query on Dr. Oracs' blog as to whether he agrees with Prof. Singer that cigarettes don't cause lung cancer and that CFCs' aren't responsible for ozone depletion.
Re SLC,
Whats next, do you want to find how many boners I get in a given day?
That's great Elkie; I like your satire of chaos theory, which I find instructive because I don't know a helluva lot about it.
But certainly there are no applications of chaos theory to biology and no one has ever published about such applications.
Of course.
"Nice Claus so what your saying is, let's just give everyone measles that way babies under a year are more immune!"
Adele, please try to grasp the basic argument here. Surely you understand that if ontogeny recapitulates phylogeny (a rough first approximation of course) then we still have "imbedded" horizontal gene transfer within the biosphere effecting the development of living creatures.
Thus, the acquisition of measles "naturally" would be a birthright of humans in a healthy environment thanks to all the refinements of civilization. Why there were "measles parties" for kids in a land of a long time ago and very far away ...
Re cooler
"Whats next, do you want to find how many boners I get in a given day?"
I suspect that the answer to that is 1 per week.
"Surely you understand that if ontogeny recapitulates phylogeny (a rough first approximation of course) then we still have "imbedded" horizontal gene transfer within the biosphere effecting the development of living creatures."
I really do wonder what you think this "werd salid" means?
"Perhaps you should suck on Shyh Ching Lo's balls...Whats next, do you want to find how many boners I get in a given day?"
Cooler, you might be taken more seriously if you refrained from writing like a twelve year old who's just learned a bunch of new words for pee pees.
Why Roy, do you think the Lord created viruses only to give vaccinologists something to do? In that case they've hung around a long time waiting to be put to use considering they're several days older than Adam and Eve.
Paramyxos started by claiming that:
and that:
In support of these claims he compared the mortality rate from measles in 1962, before introduction of the measles vaccine, to that of an epidemic in 1989-1991, after widespread immunization for measles in the US:
We pointed him to data showing that only 10% of the 184 deaths from measles in 1987-1992 occurred in individuals who had been vaccinated, inconsistent with his claim that measles is "more deadly now because there's little natural immunity among adults."
He has ignored that information, and instead he now seems to be claiming that the deaths from measles in 1989-1991, reflect a decreased passive transfer of immunity from mother to infant, providing a link to a CDC publication that noted a relatively high incidence of measles in infants less than 1 year of age during the 1989-1991 outbreak.
The maternal antibodies that are transferred to the baby help protect infants from measles during the first year of life and interfere with a strong response to measles vaccination, so the recommended immunization schedule calls for the first dose to be given after the first birthday.
Does a decreased passive transfer of immunity from mother to infant lead to an increased mortality from measles in modern outbreaks compared to the pre-vaccination era?
Let us examine the available data to test Paramyxos' latest hypothesis.
Table 1 of the Gindler paper summarizes the mortality of measles by age groups between 1987-1992, shown below for the more completely ascertained National Immunization Program (NIP) Database.
Age Group-----------------------# of Deaths--------------------Percentage of Deaths
Less Than 1 Year---------------------37-----------------------------------------20%
1 - 4 Years------------------------------65-----------------------------------------35%
5 - 19 Years----------------------------29-----------------------------------------16%
20 or More Years---------------------53-----------------------------------------29%
________________________________________________________________
Total 1987-1992----------------------184----------------------------------------100%
The data indicate that 20% of the deaths from this measles epidemic occurred in infants less than 1 year old, the population dependent on maternal antibodies for protection from measles.
How does this compare to the situation in 1962, before the introduction of the vaccine and the year that Paramyxos insists had a lower measles mortality rate because of a superior "natural immunity" to the virus.
Mortality data from measles in 1962 are available in the Vital Statistics of the United States, 1962. Volume II, Mortality, Part A. 1964. (WARNING: BIG PDF FILE).
Table 1-23 (on pages 104-105 of the PDF file) shows the following mortality for measles according to age group in 1962:
Age Group----------------------------------# Deaths-------------------------Percentage of Deaths
Less Than 1 Year------------------------------93------------------------------------------23%
1 - 4 Years-------------------------------------204------------------------------------------50%
5 - 19 Years-------------------------------------93------------------------------------------23%
20 or More Years------------------------------18--------------------------------------------4%
_____________________________________________________________________
Total 1962--------------------------------------408----------------------------------------100%
Infants less than one year of age accounted for 23% of measles deaths in 1962, slightly more than the 20% of measles deaths among infants in 1987-1992.
Paramyxos is wrong.
A decreased passive transfer of immunity from mother to child had no significant effect on the mortality rate.
Rather, the big increase in mortality is seen in adults age 20 years or greater who accounted for only 4% of deaths in 1962 but 29% of deaths in 1987-1992. Gindler et al. note that only 3 of the 53 adults who died of measles in 1987-1992 had been vaccinated.
If more of those unfortunate individuals had been vaccinated, fewer of them would have developed measles and even fewer of them would have died.
I'm sorry Shots,
It must be difficult to learn the meanings of words if you can't even spell them to look them up. Keep trying.
Maybe someday you'll express a thought.
Franklin, I'm sorry if you feel overlooked. I shouldn't have since you ( and who else makes up the royal "we" you are using) are taking the trouble to provide real arguments and statistics. To tell you the truth, I didn't answer, firstly because it was not the main question and I didn't find it that important. Secondly, because I thought you were correct: I couldn't simply use the death/case ratio to speculate on cause of death, vaccine vs. no vaccine, and so there was nothing to add.
I take it, the same thing goes for you guys. When you ignore point after point, it's because you've ceded them and want to move on, right?
The other half of my argument, that natural immunization is better than vaccine, was self-evident, so I didn't feel the need to repeat that. Instead I expanded it by pointing out that maternal vaccination also affects the quantity of transferred antibodies and duration of infant immunity, which, according to the CDC, was the explanation for the higher among young infants in 1989-1991.
In concession to your previous point, I took specific care not to make any claims regarding death relating to vaccinated vs. unvaccinated children in my next Comments. On the contrary, I said that because of other factors, such as relative poverty, such a straight forward argument could not be made from these statistics.
Having said that, the numbers you present seem to fit nicely with my main line of argument. Although relative incidence among children was the highest ever in 1987-1991, the death/case ratio was lower compared to 1962, which is to be expected from another 30 years of a steadily declining trend.
Why the death rate was so high among adults I cannot say, though, since in the usual propagandistic style all the reports focus on the "large number of infant deaths", and my first explanation (lowered quality of adult immunity) apparently was wrong. Do you have the explanation for this apparent discrepancy?
Devolution of discussion is so hip right now.
Paramyxos First: "...none of you apologists understand the concept of a continually declining trend over the whole century or number of deaths relative to number of cases."
Neither do you, or at least you don't posit a legitimate hypothesis about said declining trend. Yet, you insist that this unexplained phenomenon is somehow relative to a decision to immunize now. Why should we take this into account when we have evidence that immunization works as it is expected to? Do you have some compelling reason to insist that we assume these trends, like life expectancy, death by infection and other medical improvements made merely by making common sense improvements to hygiene, understanding of quarantine, general living conditions and procedure, be used ta gauge the efficacy of immunization? No, you merely have historical data. Compelling it may be, but it by no means refutes the effectiveness of immunization. Why not do a comparison study of deaths in countries with greater immunization programs versus countries with little or no such programs?
Secondly: Cooler, what are you trying to say? If a dog barks it is always aggressive? If posters on a science blog sound like they don't want to hear a bunch of pseudo-science they are just merely denying the truth? While your quote may be ear candy to your ears it is mere punditry to mine. I respect mathematicians because they can do math, but not as scientific philosophists. If you are trying to make the case that anyone who argues against random hypotheses is merely wrong, that's illogical. If you are arguing that all hypotheses that counter status quo are right, that's illogical. Either way, your entry is purposeless. Stop it.
B8ovin,
Do you realize that Dr. Darin Browns post was so articulate and mindfucking I had to post it, because he broke you guys down like the little name calling idiotic santa claus worshipping sycophants you are. Anytime you guys are confronted with a point of view thats not supported by the government, you have the taboo reaction described in his magnum opus.
Government says hiv causes aids in 1984, provides no evidence, anyone that disagrees is a "crank"
Government says mercury in vaccines is harmless, no original toxicology studies proving it's safety yet anyone that disagrees is a "woo"
Government says al queda carried out 9/11, provides terrorists passports found in an empty ditch in Shankesville, while the plane dissapeared. Straigh out of Orwells 1984.
I suggest you watch the most viewed films in internet history about the 9/11 fraud etc. Loose change and Zeitgeist. Get your popcorn ready.
http://video.google.com/videorankings?type=viewed&range=d2008-02-19&cr=…
Paramyxos,
Your argument is not simply that "natural immunization is better than vaccine" but that, because the "quality of vaccine induced immunity is not as good as the immunity one gets from actually having had measles," measles vaccination leads to a greater mortality rate for measles infection.
We--Sister Howitzer and I--have shown that the available data do not support this argument.
When your argument is refuted and you simply continue making new bogus arguments, there is no reason for anyone to assume that you are conceding that your original argument is dead.
You seem to think that you are making an additional argument that has not yet been refuted and that is being ignored.
When I seem to ignore one of your arguments, it is generally because the argument is so poorly constructed that I can find no testable predictions--i.e., it is not a scientific argument--or because I feel that the argument has already been refuted by someone else.
You seem to be arguing that the trend for a decrease in the death-to-case-ratio (DCR) for measles in the decades preceding the development of the vaccine indicates that the vaccine has had no impact.
Sister Howitzer has already directly quoted the data from Gindler that refutes this argument.
Figure 1 of Gindler illustrates that although the DCR declined steadily during the first half of the twentieth century, it reached a plateau at ~1 death per 1000 cases in the 1950's. Gindler refers to papers arguing that this decline was due to treatments for secondary infections, improved nutrition, and decreased crowding.
Given that the incidence of measles was in the hundreds of thousands of cases per year, a DCR of ~1 translated to hundreds of deaths per year.
Figure 1 shows that this pattern persisted for about a decade--hundreds of thousands of cases of measles per year, a DCR of ~1, and a 2-3 year cycle of epidemics.
The figure also shows that a dramatic change occurred in the 1960's when vaccination for measles became widespread. At that point the incidence of measles dropped precipitously, and the 2-3 year cycle of epidemics was broken--but the DCR stayed about the same.
You seem to be arguing that the decline in measles deaths is simply a continuation of the trend of declining DCR that occurred in the first half of the 20th century.
However, the data show that the decline in measles deaths that has occurred after the 1950's was not a continuation of the pre-existing pattern. The decline in deaths was due to the decline in the incidence of measles to just a few cases per 100,000 population--a decline that represents a complete change in the pattern of measles infection from the preceding decades.
A decline that was the direct result of the immunization program.
By preventing measles, the immunization program prevents deaths caused by measles, even though the DCR has remained about the same since the 1950s.
As an Emergency Physician,in the last 4 weeks alone I have seen: the first documented case of Diphtheria in Australia since 1991,a case of Pertussis,and 2 cases of TB,and ALL those people were not vaccinated.
Case closed.
Franklin,
I guess the civil tone can't be maintained long since you guys always take it as a sign of weakness.
So I guess I have to resume pointing out that repeated clarifications seem to have minimal to zero impact on your read and understand abilities.
When your argument is refuted and you simply continue making new bogus arguments, there is no reason for anyone to assume that you are conceding that your original argument is dead.
My original argument is neither refuted, nor conceded. It was simply not answered.
The argument that was "ceded" was that I could simply cite the death/case ratio to show that vaccination renders the vaccinated person more likely to die if (s)he contracts measles anyway. That's it. The reason why it was so readily "ceded" was that it wasn't really the argument I had been making. But since you can't just let it go, let me recap to show exactly what little you're hanging your hat on. The argument was this:
"when measles does strike, it's more deadly now because there's little natural immunity among adults."
There is little natural immunity among adults because a large majority also of the unvaccinated one's hadn't had exposure to wild measles virus at the appropriate age. The assumption here is that Measles is more serious = more deadly in an adult.
You chose to read it as saying simply that, when vaccinated people get the measles, they are more likely to die than when unvaccinated people get the measles, leaving out the bit about the large part of unvaccinated people making it to adulthood before they get measles in a heavily vaccinated population.
Your reading of this single paragraph has been the bread and butter of every single long winded Comment from you.
I later tried, to point to the qualitative difference between natural and vaccine-induced immunity
By "little natural immunity" is meant the quality of vaccine induced immunity is not as good as the immunity one gets from actually having had measles.
It goes as we have seen to the incidence: In every major outbreak, there is a large percent of measles infections among already vaccinated people and their infants. I guess we can agree ceteris paribus that incidence affects mortality, yes? But you simply persisted in interpreting this as me saying (again ceteris paribus) that vaccinated people died more readily than unvaccinated people when they got the measles.
The fact is, at no time have I tried to push that point. You made it up. The point I have ceded in detail is that one cannot make any such argument merely from the death/case ratios.
Lastly I admitted that upon reading all the alarmist reports from government agencies about the huge infant mortality in 1989 I had been assuming that, like the measles incidence for this group, it was relatively high. In view of the obvious vaccine propaganda motivating the reports, I can only say that if you wish to push your line about the "new bogus argument" that decreased quantity and longevity of transplacental antibodies were a cause for the record high incidence of infant measles in 1989-1991, take it up with the CDC - You have my blessings. But that doesn't touch on my main argument one way or the other.
One fact remains: death/case ratio 1989-1991 was more than double 1962. Relative mortality from measles was higher in the heavily vaccinated population than in the unvaccinated population.
You have usefully shown that the whole difference is to be found in the adult unvaccinated category in spite of the unprecedentedly high incidence in the infant category. I am simply asking how that is accounted for. You have chosen not to answer but instead devoted yet another Comment to celebrating your "victory" on a point that was never contended in the first place.
Apparently you were pretty pleased with yourself about that and so thought, "Heck I'm on a roll here so why not go back to the real original argument and misrepresent that as well - again, again?:
You seem to be arguing that the decline in measles deaths is simply a continuation of the trend of declining DCR that occurred in the first half of the 20th century.
However, the data show that the decline in measles deaths that has occurred after the 1950's was not a continuation of the pre-existing pattern. The decline in deaths was due to the decline in the incidence of measles
No, Franklin, I have not, repeat, repeat not said that the decline in measles incidence and therefore of deaths after 1962 was not a result of the vaccination program, to the contrary. If your problem is remembering, rather than reading skills let me repeat both arguments as conveyed in my response to Fleming:
The incidence of measles in the US may have been lowered considerably by the vaccine - I'm aware of no alternative explanation - but its "deadly effects" have not. To the contrary, when measles does strike, it's more deadly now because there's little natural immunity among adults.
Does it look like I'm denying the vaccine reduced incidence? Does the phrase, "when measles does strike", indicate that I believe there can be measles deaths in the absence of measles infections?
What I'm saying is:
1. The much vaunted feat of the measles vaccine was to reduce mortality by 400 cases, and that's only if we generously attribute every single case to the vaccine.
2. Since improvements in living standard, medical care nutrition etc. had already reduced measles incidence by thousands, what makes you think 40 years of further progress couldn't have accomplished the same as the vaccine? what makesyou think a medical-industrial complex and a policy devoted to exploring and pursuing these forms of advances wouldn't be more beneficial overall than the the drug development and pushing approach?
3. The part about measles being more deadly now because of lack of natural immunity in adults still holds. Only I shouldn't say "now", I should say 1963-1993 or something like that. Moreover, you have helpfully pinpointed the group where the death/case ratio has soared as "adults lacking natural immunity as well as vaccinations". I have ceded to you and commended you no end for those clarifications, but alas to no avail it seems.
For the rest, misrepresenting the original argument... well at least you are addressing it.
"As an Emergency Physician,in the last 4 weeks alone I have seen: the first documented case of Diphtheria in Australia since 1991,a case of Pertussis,and 2 cases of TB,and ALL those people were not vaccinated.
Case closed."
From 1985 through 1988, 42% of cases occurred in persons
who were vaccinated on or after their first birthday. During these years, 68% of cases in school-aged children (5-19 years) occurred among those who had been appropriately vaccinated. (CDC)
Just as well not everybody closes "the case" nearly as quickly as you, eh moron?
Para-man,
do you have any numbers more recent than 20 years ago,or is that when you last read anything?
I didnt insult you,so why are you calling me a moron? Its your way of debating obviously....
Now,of course 4 isolated cases dont constitute a trial or anything etc,i actually realize that you know,but its a nice trend nevertheless,and it is contributing to what started this thread by Tara in the first place,like it or not,i dont really care.
For Paramyxos, a reduction of 400 deaths in the United States does not justify a simple vaccination program.
I would prefer vaccination to myself or my child being one of those 400. But move the focus off of the United States for a moment, and consider the millions of lives lost to measles, especially in Africa.
The WHO's Weekly Epidemiological Record No 48, 11-30-2007, Table 1:
As measles vaccine coverage in Africa rose from half to three quarters, measles deaths dropped by an entire order of magnitude, from an estimated 396,000 to 36,000 (per year), even as population increased.
Outbreaks can still occur at this (still too low) level of immunization. After coverage dropped to near the current African level in Ireland in the late 1990s (due at least in part to denialist propaganda about MMR safety), measles incidence soared.
To the denialist, measles (and AIDS, rabies, etc.) is due to poverty. He is right, in a way, but only indirectly. The poor generally receive inadequate medical care, including vaccination. This lack of protection and treatment, not the factors fostering it, whether poverty (Africa) or effete denialist cynicism (Ireland, California), allows measles to spread.
Paramyxos,
How confused are you?
You seem to be unable to remember your own arguments. Therefore I will reproduce your original argument from your first post on this thread:
Franklin that would not only be uncivil but also proof that you can't read.
However, I think the facts are now out there. If you want to call max. 400 out of 7,500 more than minimal, or if you want to fault me for not being able to gaze into my crystal bowl and provide precise statistics for an historical alternative that never happened, instead of answering my questions, then I guess the end is a happy one since we can both feel victorious each according to his measure.
I think the problem is that you spending your time gazing into your porcelain bowl.
Paramyxos,
Prior to widespread vaccination for measles, each year in the United States there were hundreds of thousands of cases of measles and hundreds of deaths from measles.
In 2003, there were 42 cases of measles in the United States.
According to the CDC Surveillance Manual published in 2002:
"no acute deaths from measles in the United States have been documented since 1992"
Given the above data, please explain how these two statements made by you are logically compatible:
No "crystal bowl" is necessary. Just explain how those statements are logically compatible.
It's a "crystal ball" you're looking for, "Paramyxos." Not understanding science and reality is expected from denialists, but we have become accustomed to a slightly higher linguistic facility in your writing than what you have demonstrated of late.
Please beware the descent from denialism into pure obfuscation.
Are you assuming that the vaccine is 100% effective in conferring immunity? I know that my son had all his childhood vaccinations and when we tested him a year ago for immunity to measles, he had none. He was promptly revaccinated. If he had been exposed to measles, he would have gotten the disease. The last I remember, measles in an adult has a tendency to run a more severe course.
Noble, Elkie, Frankie,
I see now, and so does everybody else I'm sure. I wrote "bowl" instead of "ball" in my last Comment, therefore you don't have to answer any of the hard questions and Tara doesn't have to know what she is writing about. . . well what somebody else is writing about.
The "science" is clear as anything made from crystal now.
By the way, Tara, is it true that the measles clinical syndrome has a low predicitve value and that a history of immunization is part of the criteria for distinguishing
between the various viral rashes?
Paramyxos,
We still await your explanation of the logical conundrum.
Doublethink: The power of holding two contradictory beliefs in one's mind simultaneously, and accepting both of them.
--George Orwell, 1984
I warned about "obfuscation" not because Para confused "bowl" and "ball" but because his posts on this thread are uncharacteristically muddled.
It would be easier to answer Para's "hard questions" if he made an effort at clarity. Nevertheless, with some effort I think I may understand his point:
If we compare 1962 stats with 1987-91 stats (all USA), measles deaths are "only" about 400 fewer per year during the latter period, while the DCR is lower in children and higher in adults.
Of course, this is a classically Duesbergian comparison of the "worst" data from the vaccine era with the "best" data from pre-vax times. 1962 in the States was a low water mark for measles cases in the pre-vax years. Over the previous decades, only a few years had seen case numbers as low. Previously dramatic year-to-year fluctuation (Gindler, Figure 1) suggests that 1962 numbers could not have been maintained indefinitely.
1989-91 witnessed a measles epidemic, with deaths almost exclusively among the unvaccinated and fueled partly by immune deficiency from HIV infection (a fifth of adult cases).
Representative? No. In the decade before vax intro, cases hovered in the 2-400,000 range. In the decade after, they dropped into the tens of thousands. Deaths did about the same thing. See http://aje.oxfordjournals.org/cgi/reprint/102/4/341, Figure 1 (contemplate the reductions on this log scale plot). Since then, cases have dropped into thousands or even hundreds, with very few deaths. So few deaths that, except during epidemic years like 1990, a DCR is hard to nail down.
Even if we ignored the contribution of HIV to DCR and assume that the adult DCR is higher in some post-vax years than in some pre-vax years, what would it mean? Unless the DCR increases by a factor greater than that by which cases decrease, vaccination is desirable.
pre vax: avg of, say, 300,000 cases/yr with a DCR of 1/1000 yields 300 deaths/yr (and, of course, this was often much higher).
post vax: 1000 cases/yr (more than usually reported) with a DCR of 10/1000 (I exaggerate about 10 to 100x to help Para) would give about ten deaths per year (although in most years, none is reported).
Paramyxos makes the assumption that measles cases and therefore measles deaths will dwindle to nothing, even if vaccination was stopped.
Measles is highly contagious, and prevaccine era is estimated to have affected 90% of children by the age of 15. Without a vaccination programme, cases (and deaths) would merely increase once more. Proportionately fewer kids would die than in the 1920s, because of better management of complications, but the deaths would climb back to levels not far off those seen in the 60s just prior to introduction of measles vaccination.
Lol Elkie,
With a strained mental effort you seem to have succeeded where Franklin keeps sliding back. I applaud you.
Here was the question:
The much vaunted feat of the measles vaccine was to reduce mortality by 400 cases, and that's only if we generously attribute every single case to the vaccine.
What makes the two halfs of Franklin's brain cell bounce around and collide helplessly is that antivax-people consider measles a part their children's natural growth process. This issue has not been discussed here, we therefore bracket off the question of measles incidence and consider only the cases of death or lasting serious damage. Thus the question, which admittedly requires that you let go of the statistics you are desperately twisting and turning all the time to make that graph tell a different story than is plainly obvious:
Since improvements in living standard, medical care nutrition etc. had already reduced measles deaths by thousands, what makes you think 40 years of further progress couldn't have accomplished further reduction in deaths without the vaccine? what makes you think a medical-industrial complex and a policy devoted to exploring and pursuing these forms of advances wouldn't have made measles a harmless process for American children, and more beneficial overall than the drug development and pushing approach?
It may be that I have restated these simple points sloppily along the way. For that I beg your pardon,but I do tend to get bored with repeating what was plainly stated long, for instance last paragraph here
http://scienceblogs.com/aetiology/2008/02/san_diego_measles_outbreak.ph…
And for the alternative view of measles here:
http://scienceblogs.com/aetiology/2008/02/san_diego_measles_outbreak.ph…
If you and Franlin lost sight of what everybody else had understood were the main points, there's only your own obfuscations to blame, as well as the blog host who delivers misinformed one-sided propaganda borrowed elsewhere, then disappears - what they call a hit and run piece in politics.
Paramyxos states that "antivax-people consider measles a part their children's natural growth process." It is not clear whether Paramyxos also holds that belief, or offers it as an example of a boneheaded attitude that some other people hold. Either way, it's wrong. A damaging and often fatal disease is not part of anyone's natural growth process.
And the role of childhood immunization in reducing measles incidence is not open to debate. It was the vaccination that did it. Period.
That's "halves", not "halfs", just so you all don't get distracted again by this important detail.
Paramyxos,
So which is it? Which statement represents your belief?
Your original claim:
Or your later clarification?
Or do you really believe both of these statements?
Your typo was just amusing. I make typos too. The real problem is not that you are asking hard questions but that you won't listen to the answers you are given.
It is also not clear what you are saying anymore because you keep on changing your position.
I was dropped on my head when I was a baby and I'm OK. It was just part of the natural growth process. It made my skull thicker to protect me from future impacts. Every baby should go through this natural process!
Franklin and Sister Howitzer have already covered this ground, but I will repeat. Further reductions in measles deaths and death rates were not forthcoming from non-vaccine measures from the late 1940's until mass vaccination began. Para writes,
Since improvements in living standard, medical care nutrition etc. had already reduced measles deaths by thousands, what makes you think 40 years of further progress couldn't have accomplished further reduction in deaths without the vaccine?
Not only further reduction: Para is far too conservative. Draw a trend line through the 1920 to 1940 death rate data in Ginder, et al., Fig. 1. Zero deaths per measles case should have been achieved before the introduction of vaccines in the United States. Today, we should have negative death rates, i.e., brand-new people spontaneously appearing every time someone contracts a paramyxovirus.
Of course, by this logic, a falling body, accelerating at 9.8 metres per second squared, would ultimately reach faster-than-light speeds. Nonsense. Air resistance, the Earth's surface, and the inconvenient universal speed limit prevent that from happening.
Para should take one more look (or a first look) at Figure 1 from Barkin, 1975, linked in my last post, and at Figure 1 of J. Ginder, et al., 2004. While pre-vaccination cases of measles were relatively constant, and could be expected to remain so on average at about 400,000 per year in the United States, deaths from measles and the death rate roughly leveled off in the decade or more before mass vaccination. Cases, deaths, and death rates dropped again only after vaccinations began, dropped further with multiple dosing, and dropped again with strict school entrance requirements.
PM:
You fail to understand that the absolute number of measles deaths have declined because measles cases have declined. What on earth makes you think that if there were several million cases of measles annually (which there would be without vaccination)that no-one would die from it?
Para parrots the data-free VaxDenial websites' view that modern medicine (which they otherwise revile) could have reduced absolute deaths (and thus the DCR, too) to zero were it not for the distracting waste of resources (in their view) of vaccination programs. How, exactly, is the question. They give no good answer, stating only that prevention and drugs are not solutions.
Some fringe vax denialists believe that "natural immunity" is mystically better than the vaccine-induced sort. Following, their problem with measles is that there was never enough of it. Their solution? Give everyone measles at a young age, conferring "natural immunity" on all: Measles Parties.
That is, they've taken prevention off the table.
Of course, when infected, without total medical intervention some children would inevitably die, so how to bring the death count to zero? Next-generation post-measles party drugs? But Para ridicules the drug development and pushing approach. Answer two off the table.
What's left? Better nutrition, perhaps? No, even the well-nourished can die of measles. Anyway, the biggest problem with nutrition in developed countries these days is too much of it, in all income categories, not too little. No evidence that progress could be made with nutrition interventions. Third "solution" on the floor.
We are down to an institutionalized version of the measles party: by mandatory government policy, every child is checked into hospital, tested for potential complications, then exposed to measles, preferably getting infected, since going through with the disease is surely more edifying than just fighting it off. The child is monitored intensively during the course of disease so that death can be avoided. (Ironically, this "solution" goes against the anti-vaxxers' opinion that medical mistakes are the biggest issue in health care today.)
In an ideal world, it could work. The hospital stay would only cost say, $50,000 to $100,000 per child for cases with no complications. Less or more depending on how seriously our alternative reality friends take their no death goal. And more for the cases with complications. Total: just a few hundred billion dollars annually in the USA, plus billions more in lost productivity.
Contrast with the vaccine approach. The same goal (no deaths in most years), with the upside of no extended hospital stays and other disease-related suffering, has been achieved at a vaccine cost of a few dollars per child and the time investment of several quick doctor visits.
Para, try telling one of the anti-vax moms she has to spend a week in the hospital watching her red-eyed, coughing child run a disturbingly high fever (wouldn't want to use drugs!) and develop an itchy whole-body rash---all to avoid the low probability of a vaccine side effect. Of course, if she doesn't vaccinate, she may end up doing it anyway.
ElkMM,
You forgot to mention the distinct possibility that a number of these kids who intentionally contract measles may not die but instead end up blind due to corneal scarring. Sounds like a party that every party would be dying to have their child attend!
There really must be something perverse in human nature, to have it result in such strange denialism.
If every medical advance is just a plot to make people sick or kill them while the pharmacists and doctors get rich, why don't we restrict ourselves to Roman medical knowledge? We'd save a ton on medical schools as well as eliminating evil HMOs and the like.
Think how much healthier the survivors of the plagues and epidemics would be. We'll just have to ignore the crippled, blind, deaf and brain damaged as a necessary price.
So much misinformation has been posted on this thread that I don't know where to start, but Shots R Us's comments that respiratory syncytial virus (RSV) didn't exist before vaccines and is somehow due to vaccines is just too much.
I was a young children's hospital emergency room nurse in the 1970s and we saw hundreds of cases of what now is called RSV each winter. We didn't have that name for it back then, but the cases were still there and they were identified as bronchiolitis or infant asthma.
Also, in my career I saw the virtual disappearance of Haemophilus infuenzae type b (Hib) disease after the vaccine was introduced. In the 1970s there could be several cases of Hib meningitis a week in one ER. Some infants would die and some would be brain damaged. Not to mention the most feared disease in a pediatric ER - Hib epiglottitis. Nothing terrified us more and this disease has also virtually disappeared.
Vaccines are nothing short of a miracle. Ask anyone who was crippled by polio.
Vaccines are a miracle. But let us not forget that not all potentially (vaccine) preventable diseases are necessarily worth preventing, in cost-benefit terms.
There is a law of ever diminishing returns in vaccine medicine - the diseases which have major mortality/morbidity have had the highest priority, but when these have been prevented, one comes down to more marginal decisions regarding other less lethal or less common diseases. For instance, Gardasil prevents most carcinogenic HPV infections, but at great cost, and there are other ways to prevent cervical cancer (STI prevention, cervical screening).
If there was a vaccine produced to prevent Coxsackie B infections, would its universal implementation be supported? I doubt it would be worthwhile, but to someone who developed life-threatening myocarditis that reasoning would not hold water. They would say "I got myocarditis - why did you not give me the vaccine?" - an argument by anecdote that could almost parallel the antivaxers stance of "My child got autism, why did you vaccinate him?"