...more outbreaks of vaccine-preventable diseases like pertussis:
Erik Ferry thought little of the sniffles and cough his 12-year-old daughter came down with in February.
But the coughs became more frequent and violent, and the bug hung on for days, then weeks.
Concerned it was more than just a cold, Ferry took his daughter to the doctor, and a dose of antibiotics cleared things up. Only later did he learn that several of the girl's classmates at the East Bay Waldorf School in El Sobrante had the same symptoms.
And it was only this month that Ferry, who lives in Berkeley, learned that a bout of pertussis, or whooping cough, was sweeping through the school like a bad rumor: Sixteen students have been diagnosed, and health officials suspect many more are infected.
The outbreak was so severe that school officials had to shut down the school to control it. The reason for the outbreak? I think you know the answer to that one already:
Contra Costa Health Services temporarily shut down the private East Bay Waldorf School on Friday in an effort to control the outbreak, which health officials say spread quickly because fewer than half the students at the school are immunized.
Students and staff will be allowed to return to school Monday, Contra Costa Public Health Director Wendel Brunner said, but all parents must prove their children are on antibiotics.
What?
Screw antibiotics! They're at best a short-term measure. Make sure all the children are immunized against pertussis before they are allowed back! Antibiotics are a short term solution. (I'm also surprised that such lovers of "natural" cures will eschew vaccination but require its children to down three weeks worth of the evil, big pharma tool of antibiotics.) A 50% immunization rate is far too low to sustain herd immunity, leaving the population there vulnerable to outbreaks. Unless immunization rates top 90%, there's little to stop something like this from happening again:
School and health department officials said they have been trying to control the disease -- affecting mostly kindergartners -- since the first confirmed case in April. But Ferry said he believes the pertussis started making its way around the school in January, when several students initially got sick.
"Closing a school for an outbreak of pertussis is a very unusual action," Brunner said. "Normally, we're able to control pertussis cases in schools without closing the school; however, the situation in the East Bay Waldorf School is different. They have a very low rate of immunization among their students."
About 98 percent of students at other schools in the county -- public and private -- have been vaccinated. California law allows parents to opt out of immunizing their children for various reasons.
Waldorf Schools, of course, are well known for being places where parents tend to be very open to "alternative" health practices and antivaccination sentiments. However, they could well be the canary in the coal mine as vaccination rates fall. And what is one of the reasons, arguably the major reason, parents are afraid of vaccines and vaccination rates are falling? Well, I think you know the answer to that one too:
Contra Costa Health Immunization Coordinator Erika Jenssen, parent of an 11-year-old at the school who has been immunized, said some parents cite studies that indicate vaccinations may cause autism as a reason for opting out.
Another problem, of course, is that the unvaccinated tend to cluster in crunchy places like Waldorf schools, a nidus for infections that can provide a reservoir of disease that can spread to the rest of the community, endangering those who can't be vaccinated for medical reasons and the small percentage of the vaccinated who did not develop immunity. Contrary to the insinuations of antivaccinationists, who view diseases like pertussis as not a big deal, pertussis is a huge deal, particularly in infants. The WHO estimates that 294,000 infants died of pertussis worldwide, and in the prevaccination era there were on the order of 10,000 deaths a year from pertussis in just the U.S. alone. The usual causes of death from this disease are secondary pneumonia, dehydration, hypoxia, encephalopathy, or cerebral hemorrhage, the last of which occurs because of the paroxysmal coughing, which elevates intracranial pressure. Moreover, up to 25% of children under 4 and 4% of children over four develop a secondary pneumonia, which often requires hospitalization. Even leaving that aside, the unrelenting cough that the disease causes is horrible to behold and even more horrible for a child to endure.
I fear that this is the sort of story that we will be seeing more and more of in the future. I had thought that they had faded into the woodwork, but antivaccinationists are like cockroaches. They never really went away. They were always there, lurking under the floorboards, and now they've managed to get celebrity power in the form of D-list celebrity Jenny McCarthy who, despite being dumb as a rock when it comes to science and medicine (and that's actually an insult to rocks) while she spreads toxic myths about vaccines, nonetheless thinks her University of Google degree gives her the background and knowledge to tell physicians that they don't know what they're talking about. They've also been lucky enough to be able to take advantage of a confusing ruling in the Hannah Poling case that opens the door for them to spin it into a "concession that vaccines cause autism" when it is nothing of the sort.
Worse, on June 4, led by the ex-comedienne turned antivaccinationist Jenny McCarthy, hordes (or maybe dozens; it remains to be seen) of activists who disingenuously claim they are not "antivaccine" while attributing all manner of toxins and evils to vaccines, will descend upon Washington, D.C. to protest in a "Green Our Vaccines" rally. They'll likely get national news attention and scare even more parents about vaccine safety. It's true that the organizers of the march are trying to hide the more--shall we say?--vociferous of the antivaccinationists in their ranks in order to try to maintain the facade that they are not "antivaccine," but the rabid antivaccinationists will be there nonetheless. They'll be meeting with their--and your--legislators and doing their best to influence them.
What's likely to happen next if pro-science forces don't get their acts together is a sadly predictable phenomenon. The more vaccination rates fall, the more frequently outbreaks like this will occur. The more vaccination rates fall, the more children and adults will become ill with vaccine-preventable diseases. The more vaccination rates fall, the more deaths there will be. If antivaccinationists get their way, maybe even polio could make a comeback.
All of this leaves the question of what to do. What can those who understand the value of vaccines do to counter this well-financed, well-publicized effort? Three years ago, antivaccinationists were the gang that couldn't shoot straight. Now they're appearing on Larry King's and Oprah's TV shows to spew their fear to the masses. When the number of vaccine-preventable deaths per year skyrockets from the double digits to three, four, or even five digits, you'll know whom to blame, but it will be too late. As the U.K. experience over the MMR vaccine shows us, it can more than a decade or more for the damage from such campaigns to be repaired.
You know, it's things like this that really make me think that lying, especially in public over things that have been shown, and likely things about which one has been repeatedly corrected, should be a crime.
I wan to be there sometime when one of these people starts going off so I can extend my arm, unfurl an accusatory finger, and bellow, "LIAR! YOU ARE LYING! HOW DARE YOU!"
Barring that, I keep my vaccines up to date just to spite these lunatics.
I am not a parent. It amazes me that they are so willing to gamble with their children's lives like this.
So is it god's will that the unvaccinationed children are most likely to be infected or selection (natural and socio-cultural). Must be those evil Darwinists.
Unfortunately, BA, many of the victims of the pertussis may be infants who were too young to be vaccinated or were under vaccinated. This is what makes the anti-vax fools so dangerous.
(due to a seizure disorder my son with health issues could not be vaccinated against pertussis, so we had to be very careful who he came in contact with, since our county was having a pertussis epidemic, hence my distaste for the anti-vax contingent)
This is not really news nor worth a great deal of anti-antivaccination bile. It has been long known that immunity from pertussis from the childhood series wanes by age 12 or so. In the past few years the schedule has been updated so that kids around that age get a booster (for the tetanus component as well). It seems a lot of clinics are not giving it though as I see a lot of teens in the Emergency Dept with cuts who haven't had the tetanus booster, so I know they aren't getting the pertussis component. However, even if they do get it, the pertussis immunity will wane again. Most adults have no resistance to pertussis and serve as a reservoir for the disease. It is estimated that most coughs in adults that last more than 2 weeks have an excellent chance of being due to pertussis.
This is not to downplay the seriousness of pertussis. It does cause some morbidity in adults due to the duration of symptoms (it is also known as the 100 day cough). This is of course in addition to the mortality in infants. I fortunately have never seen an infant with pertussis, but last time I took the Pediatric Advanced Life Support course the instructor had video of an infant with it. Watching her misery as she coughed to the verge of apnea just about made the class cry (the infant was on the verge of being intubated but fortunately pulled through without it).
So it is important to get this immunization, but outbreaks of this disease are less attributable to antivaccine nonsense than the natural patterns of the disease and the vaccine. And for anyone reading who needs a tetanus booster, or cuts themselves and is offered one at an ED or clinic, be sure to ask for the one with the pertussis component. Most of the time otherwise you will only be given the Td (Tetanus-diptheria) vaccine. You want the TdaP (Tetanus-diptheria-acellular Pertussis) vaccine instead.
I have been lucky to have never seen pertussis in person either, but I also saw the videos of kids who were just unstoppable...very heartbreaking. Must be just awful for the parents to witness, in addition to the trauma the kid is in.
Here are vidoes:
http://www.vaccineinformation.org/video/index.asp
It would be interesting to have known about adult pertussis a while back; when I was in my late twenties, I caught a bad cold that caused me to cough for well over a month. It hit a few other members of my circle of friends, too. I remember comparing cough-induced rib injuries with a few fellow victims of this bug, but my own took first prize: Towards the end of the illness, I reached up to put on my hat before going outside, and HEARD my weakened rib cartilage tear before I even felt it. Coughing afterwards felt like someone was swinging a sledgehammer into my side. I was on serious pain meds for three weeks after that, and couldn't do much of anything with my right arm for another month. I also missed something like eight days of work, which became a very bad start to a brand new job.
Most likely, it was just something viral and not pertussis, but I also have a lifelong problem with laryngospasm, and I NEVER want to experience a cough like that again. (Nor do I want to be responsible for transmitting a disease that nasty to someone else; I did get adult Tdap vaccine this year.) Anyone who thinks a month-long cough is trivial has obviously never had one.
Mary said "So it is important to get this immunization, but outbreaks of this disease are less attributable to antivaccine nonsense than the natural patterns of the disease and the vaccine. And for anyone reading who needs a tetanus booster, or cuts themselves and is offered one at an ED or clinic, be sure to ask for the one with the pertussis component. Most of the time otherwise you will only be given the Td (Tetanus-diptheria) vaccine. You want the TdaP (Tetanus-diptheria-acellular Pertussis) vaccine instead."
That is true, but the herd immunity is an important aspect of pertussis transmission. In states that permit more non-medical exemptions to vaccine requirements, the levels of pertussis are higher:
http://jama.ama-assn.org/cgi/content/full/296/14/1757
Also, in schools like the one in the article and the one written about above, and the one in Boulder, CO that was written about years ago:
http://www.theatlantic.com/doc/200209/allen_a ... and the one in Austria that is in the center of measles outbreak, tend to concentrate disease transmission.
By the way, my son who was denied vaccination against pertussis as an infant was given the Tdap last fall. My younger teenage children had the Tdap the year before. I wanted my older son to get it when they did, but the Tdap was not releases for those older than 18 until recently.
I think it's clear from the story that lack of immunization was the problem here, not wearing off of the initial immunizations...
but that said, are there recommended boosters for adults? I'm medically immuno-compromised, and therefore can't have live vaccines, but I often wonder (but never when I'm at the GPs) if I should have some boosters...
Canadian Chick,
Yes, it is now recommended that when an adult goes to renew their tetanus shot that they get the Tdap:
http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/DTaP-Td-DT/Tdap.htm
The handout given at the clinic:
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-tdap.pdf
If you cannot have the vaccine, perhaps you should hope all those around you get it.
Not to change the subject, but:
Screw antibiotics! They're at best a short-term measure. Make sure all the children are immunized against pertussis before they are allowed back! Antibiotics are a short term solution.
Orac, you're trying to my head explode, right? (to those unfamiliar with my blog, I regularly rant about the misuse of antibiotics). The DPH really didn't advocate antibiotic prophylaxis over a readily available vaccine, did they?
Anti-vax = murder.
Some of you may recognize me as the guy from Winona, MN. A small city which gained international recognition in this blog about a week ago with this entry about serious antivaccinationist stupidity in Winona, MN
Well today, there was a response in the Winona Post (a different newspaper) that was in support of the previous stupidity. At this point, it isn't available on line (I suspect it will be tomorrow). Anyway this 'letter to the editor' goes on claim that due to Homeland Security, Eli Lilly was given liability protection and could still manufacture vaccines with thirerosal and that the fda allows for trace amounts of thirerosal and blah blah blah. It goes on and on with impressive data that I would expect is mis representative of real life.
It ends by pointing out that in Minnesota we can request exemptions from school vaccination requirements on philosophical, conscientious or religious basis. It says that we should all educate ourselves at 909shot.com
Any help/ideas you can throw my way will be greatly appreciated.
It's going to take several major epidemics from "benign" childhood diseases like pertussis or, help us all, polio, with a fair number of children and adults dying from complications before the anti-vax crowd goes back into the woodwork.
Even chicken pox would do it; adults are more likely to get varicella pneumonia, and end up in MICU (or the morgue).
And I shudder to think what's going to happen when a large non-vaccinated contingent gets old enough to be getting pregnant. The MMR (measles, mumps, rubella) is one of the vaccines that is included in the anti-vax "hit list". We test pregnant women for rubella immunity, but because it's a live-virus vaccine it can't be given during pregnancy. All we need is one good rubella epidemic in an area with a high incidence of people whose parents "opted out" on vaccinations and fetal rubella syndrome will be back. Just to mention one possibility.
HCN, thanks for the info - looks like I can't have that combination though...apparently as a kid I had a reaction to the diptheria vax (no idea what, I just know that it's written on the cover of my chart, and there's no one alive to ask for details).
I haven't had a tetanus shot since the early 90s when I was attacked in a bar...
Yup, I'd better hope that the people aroundme have sufficient immunity...or else I'm screwed.
Hi RMP, what kind of info would be helpful? I think the best thing is just to present the facts rather than try to argue nonsense. Here are some websites with various factsheets and so forth:
http://www.vaccineinformation.org
http://www.vaccine.chop.edu
http://www.immunizationinfo.org
http://www.cispimmunize.org
http://www.cdc.gov/vaccines/spec-grps/parents.htm
The damage caused by the anti-science anti-vaccination fools is potentially far greater than the obvious damage to unvaccinated and other unprotected members of our society. Contrary to the lies put forward about big pharm, vaccines are not a high profit area. The number of companies willing to continue vaccine manufacture is down to the point it would be difficult to ramp up production in the event of an emergency.
I recently read Dr. Offet's book "Vaccinated". One thing I learned from the book was that there was great interest in the development of vaccines against bacterial infections. This was largely abandoned with the rise of antibiotics. Now we seem to be slowly slipping into the post-antibiotic era. Just when we need a backup defense against bacteria, the resources for a promising alternative are fading, and public and political support is being eroded.
Perhaps there will be an all natural herbal solution and maybe pigs will fly.
It is the kids that I feel sorry for. I caught a mild version of whooping cough when I was about eleven years old (I see from Mary's comment that is was probably caused by a waning of my immunization) and I was sick for about three months, with a very annoying cough that would not go away or be controlled.
I know the full version of the illness is much worse than what I went through.
Next time I need tetanus I will check that I get whooping cough vaccination too. But I am not due until 2011.
MMToole: "All we need is one good rubella epidemic in an area with a high incidence of people whose parents "opted out" on vaccinations and fetal rubella syndrome will be back."
- and another wave of children born with deafness and/or with blindness and/or with heart problems and/or mentally handicapped as happened in my country and elsewhere in '64 and '65. I believe rubella can also cause "natural" abortions (stillbirths)--?
Here's one "rubella" story with references and link (and not written by me!): http://deafness.about.com/cs/featurescauses/a/rubella.htm
"I am deaf because of maternal rubella. In 1963-1965, there was an epidemic of rubella in the United States. (Before a vaccine was developed, the United States had cyclical epidemics of rubella.) That 1963-1965 epidemic produced thousands of deaf babies like myself.
Rubella may have done other things to me too. It made my hands small, and it could be why I am under five feet tall. Rubella is a very damaging virus."
Has anyone confirmed the actuality of so-called "measles or chicken pox Parties" ? I'm not a parent, and doubt that I would resort to the internet for parenting advice if I were, but I have heard tales of such things.
My question for those who would support such idiotic ideas is: "why risk your child's life when a simple injection could prevent the possibility ?"
Yes, I know. People in the mercury militia will tell me that they're trying to keep their children safe. . . by risking their lives. The Stupid, It Burns.
Thanks isles. I've just checked out the cdc website I will definitely refer to them. Does anyone know a good site/post/article that specifically addresses the credibility of 909shot.com (National Vaccine Information Center).
The biggest problem with NVIC is that it never updates its information. From http://www.pathguy.com/antiimmu.htm it says.
Just taking a look at the NVIC site, I see they are not very good at updating with recent research. And it seems that have lots of opinion articles, and when they do include references they are cherry picked (just glanced at the HPV page, and it has nothing on the thousands upon thousands of people who it was tested on). Another red flag on that website is the tab on top labeled "Lawyers"
More on the founder of NVIC:
http://www.geocities.com/issues_in_immunization/fearmongers/barbara_loe…
Maybe some of you should aspire to go into show business.
It seems only natural that individuals that spend their lives pretending to be someone or something that they are not should feel comfortable pretending to be experts in a field of study with which they know nothing.
Uncle Dave, I believe one of the qualities of a good actor is that they can be good liars. They realistically exhibit emotions that they really don't feel.
While those of us who have trained in science and engineering, we need to show the evidence and be close to truth... or face the consequences if caught. And with engineering there are often many checks to catch those who are not quite honest (oh, and testing can usually show what is wrong).
I would never do well in show business.
Has anyone done a statistical analysis that correlates autism against breast implants? Just a thought...
BioinfoTools: yes, indeed, the whole spectrum of problems to which you refer is Congenital/Fetal Rubella Syndrome. It's hard to tell if it causes miscarriages (spontaneous loss before 20 weeks), since the natural background level is so high (one out of every four or five documented pregnancies miscarries anyway), but it is suspected as a cause of stillbirth (fetal loss after 20 weeks). Congenital deafness, cataracts/blindness, cardiac defects, and retardation/learning disablilities are all included. Chicken pox also can cause a congenital syndrome with some similarities.
MMOToole said " Chicken pox also can cause a congenital syndrome with some similarities."
WHAT! Everyone keeps telling me that chicken pox is harmless. Though when chicken pox went through my kids' school one kid ended up in the hospital with a nasty flesh-eating bacterial infection. Plus my 6-month old baby got it, and it was only later that I found out how dangerous it was for babies!
As an off the cuff observation, my oldest son went to special ed. preschool with a child whose disabilities were quite severe. It turns out that his mother was pregnant with him while his older sister had chicken pox. That is just an observation, it may have nothing to do with his disabilities.
MMToole,
Thanks, esp. the difference between miscarriages and stillbirth. The virtues of being lazy: someone else tells you what should look all this up yourself... ;-)
Excuse the mess, accidentally let that fly before I had finished editing it. The last sentence should, of course, read: "The virtues of being lazy: someone else tells you what you should look up for yourself... ;-)"
Regarding "measles parties", I (born 1964) can confirm that they existed when I was a child, because I was sent to them or was the "host" of them. But these were post-vaccination, not instead of vaccination.
As small children we got our vaccinations and then, as soon as a kid went down with the mild version of the illness all the other vaccinated kids would be sent round to play.
The theory was that the vaccination had trained the immune system to be prepared for the real thing so kids would only go down with a mild version of the illness, but nothing prepared the body like the real thing. So you were sent to play, get mildly ill and then be safe for the rest of your life.
BioinfoTools, good to see that I'm not alone in asking for help. I don't think you and I are lazy, it's just that there is SOOOO much info out there.
I had what I think was a mild case of pertussis when I was 9 or so; I came through it all right, but I remember being utterly miserable for about eight weeks or so. Whether or not a disease is "harmless" (and most actually aren't), being sick as a kid isn't any fun, and being very sick as a kid is just agonising. I don't get why these people are so quick to put their kids at risk of -- at best -- being in misery for weeks and weeks. That's nuts.
HCN -- Chicken pox isn't harmless, even if you recover from it completely with no ill effects. Ask anyone who's ever had shingles. The only way as far as I know that you get shingles is by having had chicken pox previously. And shingles is the leading cause of suicide amongst elderly people, at least where I live. It's that bad. Preventing your kids from ever getting the original disease prevents them from getting a horrible, nasty disease later on in life.
My grandmother went blind in one eye from shingles, my grandfather was in agony for six months, and my father got painful lesions in his mouth and only recovered quickly because of fast intervention with advanced antiviral drugs. I'm a little bit touchy on the subject of chicken pox.
Interrobang said "HCN -- Chicken pox isn't harmless, even if you recover from it completely with no ill effects."
I know that. In fact I believe I even said that:
"WHAT! Everyone keeps telling me that chicken pox is harmless. Though when chicken pox went through my kids' school one kid ended up in the hospital with a nasty flesh-eating bacterial infection. Plus my 6-month old baby got it, and it was only later that I found out how dangerous it was for babies!"
I am very aware of the misery caused by chicken pox, and the dangers. The year it went through my kids' school there were more stories of kids with the flesh-eating bacteria. Plus, as I mentioned in the following paragraph that fetal exposure to chicken pox may have been implicated in the rather severe disabilities of another child I know.
And, NO! I am not happy or glad that my kids all got chicken pox one year BEFORE the vaccine was available. They, along with myself, are now eligible for shingles as we get older.
Oh, and as far the the stupid "Western Medicine" label goes: the varicella vaccine was developed in Japan.
Interrobang said "Ask anyone who's ever had shingles. The only way as far as I know that you get shingles is by having had chicken pox previously. And shingles is the leading cause of suicide amongst elderly people, at least where I live. It's that bad. Preventing your kids from ever getting the original disease prevents them from getting a horrible, nasty disease later on in life. "
And yet the clueless anti-vax types are now claiming that the varicella vaccine does NOT prevent shingles. Like this clueless idiot here:
http://www.autismvox.com/at-least-72-measles-cases-in-the-us/#comment-3… who says "So it is scientifically correct to say that the reduction in exposure to Varicella zoster virus due to the chicken pox vaccine will not weaken any naturally obtained immunity and increase the likelihood of developing to more complicated Shingles later on in life?"
You have an uphill battle with that one (hey, I tried, but he is still being clueless). Though I would appreciate it if you did not direct your anger towards people (like me) who agree with you!
A few years ago one of my friends held her toddler in her arms and watched her almost choke to death from Whooping Cough. She said it was the first time she really, really understood that children can die from disease. That this is what the past was like.
She is strongly against vaccinations, and, as far as I know, none of her 6 kids has had any. She believes firmly in natural remedies, alternative medicine, homeopathy, "nutrition," home schooling, late breastfeeding, the Mormon Church, the power of prayer, government conspiracies, the John Birch Society, Armaggedon, Civil War reenactments, "courtship," and doing things the old-fashioned way.
I'm not sure, because I didn't want to push it, but I don't think her experience with her own baby has changed her mind on vaccinations. In her world, everything appears to be wound up tightly together, so that admitting that vaccinations are a good thing might end up meaning that later on she has to reject Jesus Christ.
I suspect that, for a lot of the anti-vaxers, it comes down to their self-identity. It's not the science. It's the entire package they've bought in to, and how they have framed their world into a narrative where they are the crusaders standing against the evil without.
Sastra, you have great comments. You should get a blog.
Sastra: your description of your friend's mind-set is scary. It's sad how some people's need for structure/emotional security lead them to those sorts of tightly-connected associations, to the point of endangering their own or their family's lives from things easily prevented or treated. Re-enactment (whether Civil War or Society for Creative Anachronism) is fun, but I for one have no interest in actually living under those conditions full-time: does your friend realize that twice as many soldiers died during the Civil War from "non-combat causes" (read: disease) as died in battle or from their wounds? I'm much too fond of things like modern concepts of hygiene, germ theory of disease, indoor plumbing, and the like.
Her mindset to me sounds more consistent with Christian Science than with the LDS; most Mormons I've met like modern medicine just fine. Ironically, when Christian Science was founded, Mary Baker Eddy had a valid point; medicine in the 1880's was still pretty medieval.
Sastra, how do you still remain friends with her? I ask because I have a friend who is very religious (Catholic in this case) and who is becoming increasingly tied to the alt-med world. It's putting a real strain on our friendship.
A few years back, she began working for a chiropractor as a receptionist and I swear it was like she joined a cult. We lived in N.Alberta at the time and most breastfed babies simply do not get enough vitamin d up there--with winter lasting about 8 months or so. When I mentioned that I had purchased the supplements on the ped's advice, she tried to convince me not to give my baby the drops. Because rickets is just something doctors use to scare new moms into using formula, man! I kinda blew it off at the time, but it was a harbinger of things to come.
Now she is a trained doula, ranting about epidurals and c-sections each time we talk. Of course, she has begun spacing out her toddlers' vaccines because it's more natural that way. And all those shots are not really necessary. They are just for convenience... I can't agree with her and I am getting tired of circular arguments.
I do seriously wonder how you deal with the situation. Do you try to change her mindset or do you just try to be there for her when the inevitable comes?
OK, let me get this straight:
The school preferred overprescribing antibiotics (and possibly helping the pertussis bugs learn how to fight these antibiotics) to actually prescribing something that in a one-time usage would stop the pertussis plague in its tracks, never to return (at least not to that group of kids)?
Pardon me while I scream.
Any fellow DCers out there want to start up a counter-protest with me?
wackyvorlon "I am not a parent. It amazes me that they are so willing to gamble with their children's lives like this."
Then you're part of the problem.
We're approaching this wrong. Instead of saying "move on, nothing to see here", we've got to stump up to the problem of increasing autism, and find out what's causing it.
Many of these parents think that vaccination is the gamble, and are frightened out of their wits by autism.
They've seen autism, they haven't seen whooping cough. The devil they fear is more powerful than the ghost they've never seen.
We should be saying "Yes, autism is a problem, we don't know what's causing it, but we know it isn't vaccines"
"We're approaching this wrong. Instead of saying "move on, nothing to see here", we've got to stump up to the problem of increasing autism, and find out what's causing it."
Ignorance like this is the real problem. Would you care to provide evidence of any real increase in autism itself JM?
If so, please be clear about the distinction between "autism" and "ASDs".
Provide appropriate descriptive epidemiology.
Address diagnostic substitution.
Address the changes in diagnostic criteria.
Address the changes in diagnostic practices and provision of services.
Address socioeconomic factors that may influence the situation, etc.
"Many of these parents think that vaccination is the gamble, and are frightened out of their wits by autism."
I wonder what's responsible for that?
"They've seen autism, they haven't seen whooping cough. The devil they fear is more powerful than the ghost they've never seen."
Nice, autistic people as the metaphorical devil.
And more..
http://news.bbc.co.uk/1/hi/health/7259338.stm
And for the anti-vax wingnuts reading, explain this:
http://news.bbc.co.uk/1/hi/health/7120495.stm
Half a million less child deaths a year because of vaccines.
By the way, abcnews.com has a story on the latest cases in the vaccine court attempting to prove an "autism-vaccine link":
http://abcnews.go.com/Health/MindMoodNews/wireStory?id=4831736
It's getting a bigger play than the whooping cough outbreak.
My prediction: Eventually, some famous person (a genuine star, unlike celebrity-level Jenny McCarthy) is going to have a child die or become severely disabled from a disease that could have been prevented through vaccination. That star is then going to become a tireless advocate of vaccinations, and we'll have competing camps in Hollywood.
MMOToole: You're reminding me of _The Mirror Crack'd_ by Agatha Christie. Unless you loathe mysteries, you might want to check it out.
Do'C: As the parent of an autistic child, I didn't find JM's comment offensive at all. He wasn't referring to autistics as the devils, he was referring to autisim itself as the known devil as opposed to the unknown ghost of epidemic disease. In this reference, I heartily concur. If autism had a body, and my chest were a cannon, I would shoot my heart out at the beast.
Don't get me wrong: if somehow every student at some Waldorf school getting pertussis would magically make my child neurotypical, I'd be handing out infected popsicles. (Yes, I am that selfish.) However, it wouldn't. The vaccines might, maybe, possibly, have aggravated some condition in some ASD patients. However, there is no proof that they are causing any significant amount of ASD. None. Nada. Zip.
There is much MORE proof that people with unknown immunodeficiencies or other sensitivities are injured or killed by the vaccines *as vaccines,* but nobody argues we shouldn't use them on that basis because it's patently ridiculous. Someday this "vaccines made my kid autistic" argument, barring new and revolutionary data, will be looked at the same way.
M
How scary is this? I've never completed the series of infant TDP shots (born in 1987), since I had a pretty severe allergic reaction. I had Td shots as an older child, but I was deadly afraid of catching the whooping cough. If I was allergic to the vaccine (which, as far as I knew then, was basically dead or weakened cells of the target disease), what would happen if I got the disease for real? Fortunately, when I got a job on post as a janitor at a daycare, I got all my vaccinations updated, and no allergic reaction this time! :)
As far as chicken pox, though, none of my pediatricians could agree on if I actually got it. When my older brother had it, I got one "pock." I've not (re) contracted it since, but I think I'm going to have a talk with my physician next time I see him. Shingles are scary indeed.
there's a vaccine for shingles recommended for people 60 and older:
http://www.cdc.gov/vaccines/vpd-vac/shingles/vac-faqs.htm
"Ignorance like this is the real problem."
No BS arrogance like this is the problem. My sons best friend - his next door neighbour - is autistic.
You have no idea the pain his parents go through, and this solipsistic "you're ignorant" pose verges on the inhumane.
"Address ..."
Are you a doctor, or a researcher? Why don't you? That's my point you fool.
Yes, vaccination is an issue, but so long as parents don't even get sympathy, but get ululated at, they are *not* going to pay attention.
JM: This is Do'C: http://www.autismstreet.org/weblog/?page_id=2
Unlike you, it is not his neighbor's child who is autistic. It is his own.
Now what about some of the other parents, like me. My kid is also disabled due to seizures. Because of his seizures he was denied protection from pertussis (only got the DT vaccine), at a time when our county was going through a pertussis epidemic. He also has a severe genetic heart condition, for which he is first in line in the fall for a flu shot.
What about these kids:
http://www.timesonline.co.uk/tol/news/uk/article1055533.ece
Anyway, you are complaining about parents of autistic kids not getting any sympathy? What about the boys in the above article? What about the parents of the dozen or so babies who die of pertussis each in the USA? What about the parents of the child in the UK who just died from diphtheria? What about the babies who got measles while in the doctor's waiting room when an unvaccinated kid with measles came to that same doctor (after getting measles from a trip to Switzerland)?
Here's an idea: You show us the real and actual data that vaccines are worse than the disease. If you say the MMR is worse than measles, mumps or rebella: give us the evidence (remembering that measles tends to cause permanent neurological damage in between 2 to 3 out of 1000, and kills about 1 in 1000 who get the actual disease). If you claim that the DTaP is worse than diphtheria, tetanus or pertussis, just give us the evidence.
Let me address my point in a little more detail.
The whole thing is about fear. When vaccines were introduced the diseases they innocculate against were real and visible. That visibility enabled the medical community to persuade parents to infect - live virus vaccines remember - their own children with the very diseases they mortally feared.
Those diseases are no longer visible, but autism is. And for some reason it is rising.
So the fear factor - the very thing that got vaccines accepted in the first place - is now working in reverse.
The standard appeal to herd immunity and community safety _is_ _not_ _going_ _to_ _work_.
And a lot of smug chatter about "how stupid can people be" is not going to work either. In fact, my retort to this smug chatter is exactly that - how stupid are you being.
The smug chatter is in fact, a negative stance. We need a positive one. Every time this comes up we need to mention not just the benefits of vaccines, not just the lack of association with autism, but very importantly have something to say about autism
Because autism is visible in every suburb and it frightens people. The fear is what gives people like Jenny McCarthy a hook, and we need to take it away from her.
Doc "You show us the real and actual data that vaccines are worse than the disease"
I never said they were. You're not listening to me, you're mistaking me for someone else.
Read my previous comment.
JM said "Those diseases are no longer visible, but autism is. And for some reason it is rising."
The reason is perhaps because the diseases are no longer visible. Perhaps because parents are no longer going to funerals for their children that there has been more attention to child development. Plus, disabled children are no longer warehoused in institutions, but are kept at home.
JM said "Doc "You show us the real and actual data that vaccines are worse than the disease"
I never said they were. You're not listening to me, you're mistaking me for someone else."
I believe you are the one mistaking Do'C for me. Okay, I'm sorry... I looked at your first post where you say:
"We should be saying "Yes, autism is a problem, we don't know what's causing it, but we know it isn't vaccines""
But that is a problem, because the relationship between autism and vaccines (from thimerosal to MMR) have been studied over the past ten years in several countries and several continents. It does not matter how many of these studies come out: the true believers will not be swayed.
The don't care that Wakefield was not qualified to work with children or that he was paid by a lawyer for specific results... or that he willfully ignored being told his data was worthless. He is a hero, and even though the MMR has been used in the USA since 1971 and has never contained thimerosal --- you will still have those who claimed it caused their child's autism.
Or even that paper that claimed autism is mercury poisoning was written by a nurse, a financial advisor, a chemical engineer and other people with limited medical background and was printed in a journal that will print anything as long as you pay them... You tell them over and over and over again that the paper is crap, that the journal is crap and that the authors do not know what they are talking about. They are still not swayed, and will continue to claim that autism is mercury poisoning. Even though children are now exposed to much less mercury than just a few years ago.
It is not fear: it is willful ignorance.
HNC (sorry, yes I did mistake you for DoC)
"It is not fear: it is willful ignorance."
It is fear. Autism is real and visible, polio etc no longer.
Full disclosure: Both of my children were innoculated, in the UK, with MMR, at the height of the scare. I have no problem with vaccination at all. You're mistaking me for someone else.
Please try and pay attention to what I'm saying.
The fear of disease was once enough to push parents to infect (innoculate) their children with the very diseases they were terrified of.
Today it is fear of autism, improperly associated with vaccination, that is pushing them in the reverse direction.
Unless we deal with that fear, all smug chatter about "ignorance" will not make a blind bit of difference.
We have to deal with the fear, and rising rates of autism are real.
Which is my point, the stance of "I don't care about your worries about autism, but you're stupid and/or a social monster if you don't innoculate" is not going to work.
The last part might be true (is true), but the first part is where you lose people. We have to care about autism, and we have to acknowledge it in these discussions.
grenouille wrote:
A little of both, I think, with more emphasis on the latter. My situation seems to be easier than yours because my friend does not try to convince or persuade me on the subject of alternative medicine, and we seldom bring that topic up. At least, not on purpose. Every now and then she'll mention some remedy she thought was perfectly mainstream (vitamin C for colds, for example), and I'll mention that there's no good evidence backing it, and, if she's not emotionally connected to the remedy, she considers not bothering with it anymore because of that. She really can't tell what is, and is not, mainstream science, so I'm her official "rationalist, skeptic, atheist" woo-free reference point.
In her particular case, I think giving as little unasked advice as possible has more impact than if I were constantly telling her what she should be doing (she's got plenty of that in her life already.) Since she told me how scared she was when her toddler had whooping cough -- and is already aware of my stance on the importance of vaccinations -- my rubbing it in with any variation of "I told you so" would have added nothing. She seems to be gradually wavering off the hard line anti-vax; no reason to force a choice too soon by confronting her. How could anything I say have more impact than watching her baby daughter turn blue and barely make it to the emergency room?
JM said "Which is my point, the stance of "I don't care about your worries about autism, but you're stupid and/or a social monster if you don't innoculate" is not going to work.
The last part might be true (is true), but the first part is where you lose people. We have to care about autism, and we have to acknowledge it in these discussions."
What you say is true... but really for a very small vocal minority. If you look around, there are several parents of autistic kids who do not beat the "vaccines cause autism" drum. You will find them here:
http://www.autism-hub.co.uk/
The main problem is this small vocal minority includes some people with money who go an buy full page ads in newspapers. Then there are so-called journalists that like to fuel the fire with misinformation. Then there are "experts" that make their money as professional witnesses, and the lawyers behind them. If you want to read about their shenanigans try Kathleen Seidel's Neurodiversity blog.
There are websites with the real information on them. They included Immunize. org (putting space in to avoid spam filter), pkids. org, meningitis-angels. org, pathguy.com/antiimmu. htm, and a whole list here:
ratbags.com/rsoles/gl/vaccines1. htm
How can it not be willful ignorance, if all that information is out there --- and it is being ignored. Many countries had reduced or removed thimerosal from vaccines before the USA (much of Europe and Canada), but their autism rates are still going up. Japan actually made measles vaccinations voluntary, and even STOPPED using their version of the MMR... yet autism still went up, and they have had to close university campuses because of measles outbreak.
Personally, having dealt with my kid's health being endangered by those who choose to ignore the science for over 16 years... I'm a bit worn out. I find it exasperating (became acquainted with Orac on Usenet, misc.health.alternative years ago). That is why my patience is a bit thin with the "it is fear" canard. I'm sorry, I'm afraid my fear of my son dying from respiratory ailments (after four hospital stays due to croup, and now with his heart condition that has a real possibility of "sudden death" outweighs any imaginary fear of autism.
Anyway, you are at a blog called "respectful insolence", what did you expect? If you want a more scholarly analysis of the issues go to http://www.sciencebasedmedicine.org/ ... you might find the "vaccines do not cause autism" articles there more to your liking.
HCN: "why my patience is a bit thin with the "it is fear" canard"
We're talking past each other, I have not disputed any of your points re. the invalidity of the vaccine "hypothesis"
What I am pointing to is the danger of an insoucient "you're dumb" response to fear.
Let me ask you - what causes autism? Don't know? Neither do I.
In case you don't recognize it, that is ignorance, on both of our parts. And ignorance causes fear.
And fear causes people to react in strange, even stupid ways.
If we don't acknowledge fear and try and deal with it, we will simply get stupid and ignorant responses.
(And don't pull the parent-concerned-for-his-kids emotional claptrap on me. Coincidentally, my son just came out of surgery about an hour ago and I'm just off to see him. It's a cheap trick that works both ways sunshine)
"Address ..."
Are you a doctor, or a researcher? Why don't you? That's my point you fool.
I'll assume that your ad-hominem retort signifies that you are unwilling, or more likely, unable to address the points requested in support of your claim.
I'm not going to address them for you, because I did not make any claim of a "problem of increasing autism".
DoC " in support of your claim."
I think I have supported my claim, perfectly adequately. I doubt however, you recognize what it is.
It is a fact - although disputed by the most recent post here - that measured autism rates are increasing. It is also a fact - undisputed by that post - that concern in the community is increasing.
Fear in other words, with some dispute as to whether the fear is misplaced or not.
My claim, should you not recognize it, is that the "you're dumb" stance has exactly zero chance of preventing the stampede away from vaccination programs. In the absence of explanation people will grab hold of whatever naive belief seems plausible.
In order to work we need both the negative "no vaccines don't cause autism" *and* a more positive one "but this is what we think might, or this is what we're working on" or even the 'denialist' position of "we don't think it's real, it's just diagnostic change"
Although I think the last has poor prospects unless it is really true and a consensus, and not just a few isolated papers.
It is a fact - although disputed by the most recent post here - that measured autism rates are increasing.
Then you will have absolutely no problem
Providing appropriate descriptive epidemiology.
Addressing diagnostic substitution.
Addressing the changes in diagnostic criteria.
Addressing the changes in diagnostic practices and provision of services.
Addressing socioeconomic factors that may influence the situation, etc.
to substantiate that "fact".
In order to work we need both the negative "no vaccines don't cause autism" *and* a more positive one "but this is what we think might, or this is what we're working on" or even the 'denialist' position of "we don't think it's real, it's just diagnostic change".
I'll agree that positive is needed, although the straw denialist you built will definitely never adequately address your evidence-free claim of "fact". You make the claim of a "problem of increasing autism" - you bring the proof.
There is no doubt that ASD diagnoses are increasing. This is not the same thing as "autism rates". To claim that autism rates are increasing without providing a shred of scientific evidence to support that claim as "fact", simply adds more fear to the equation.
DoC
Don't be pedantic. You say "ASD diagnoses", I say "autism rates". You're also stating a position there, that it is simply diagnosis that is changing. That is disputable but is not important to my point.
Perception in the community is having a harmful effect on vaccination rates. That perception creates fear.
That fear must be dealt with.
This issue is unlike creationism. In that case, we can poke the anti's with sticks because we have knowledge on our side. Ridicule works because we can encourage the stupid to make themselves look stupid.
In this case - causes of autism - we don't have knowledge, we only have ignorance. Ridicule is inappropriate because when asked "so what does cause autism?" we have no answer, and we make ourselves look stupid.
So poking parents with sticks is not only cruel, it is actively harmful to real knowledge that we do possess - vaccines. Our ignorance of the causes of autism, and our refusal to engage with those fears is just creating room for woo-woo.
For the You Think You're Badly Off file:
I arrive in London, pick up The Guardian, and find this:
http://education.guardian.co.uk/schools/story/0,,2279399,00.html
Some crazy socialist MP (Mary Creagh from Wakefield) says the UK should adopt the kind of strong pro-vaccination measures the US has! Forcing little children to be vaccinated in order to get into school! (Unless, of course, the parents don't want it, a point not mentioned in the story)
Naturally, both the Tories and the British Medical Association just hate the idea, far outweighing any distaste they might have for vaccination rates of 11% in inner London. (And observed increases in Usual Suspect diseases, per the story)
Never fear, the lefty Labour Party is also against it. Sadly, I don't suppose the long-suffering RINO Orac will take comfort in that.
As a scientist and a parent, I think parents would be more willing to follow doctors' advice if
1) doctors treated parents, and especially mothers, as human beings, instead of as dimwits (my pediatrician eventually got it, but it took about one year).
2) the medical establishment hadn't made severely bad, not evidence-backed decisions in the relative recent past. Mothers my age now see their mothers getting breast cancer - the same mothers that were told not to breastfeed because formula is better.
3) the level of scientific education in most of the western world would be better. Most of my fellow mothers, even those with a humanities degree, are terribly ignorant in this respect (eg, there's a desperate lack of probability understanding).
For the records, my children were vaccinated a bit later as compared to the suggested calendar, and they all got chicken pox with no particular side effects (or discomfort, actually). At that time my country didn't offer varicella vaccine. Let's hope they make a good shingles vaccine before they (and I) get old.
Now, I want to tell you about a much bigger lie that you've been fed. I want to talk to you about polio, because polio is a disease that most people think was the great success story of vaccinations. Let me read again from Walene James' book. Jonas Salk, the discoverer of the Salk polio vaccine has been called the 20th century miracle maker, and the savior of countless lives. We read glowing reports of the dramatic decrease in polio in the u.S. as a result of the Salk vaccine.
For instance, the Virginia State Department of Health distributes a folder which tells us that polio vaccines reduced the incidence of polio in the u.S. from 18,000 cases in 1954 to fewer than 20 in 1973-78. A recent article in Modern Maturity states that in 1953 there were 15,000 some odd cases of polio in the u.S. and by 1957 due to the Salk vaccine, the number had dropped to 2499.
However, during the 1962 Congressional hearings on HR10541, Dr. Bernard Greenberg, head of the Department of Biostatistics at the university of North Carolina, School of Public Health, testified that not only [now listen to this, folks...] not only did polio increase substantially after the introduction of mass and frequently compulsory immunization programs, but statistics were manipulated and statements made by the Public Health Service to give the opposite impression.
You have been lied to folks. The polio vaccine caused more polio than it protected people from. Moving on...
For instance, in 1957, the North Carolina Health Department made glowing claims for the efficacy of the Salk vaccine, showing how polio steadily decreased from 1953 to 1957. These figures were challenged by Dr. Fred Klenner who pointed out that it wasn't until 1955 that a single person in the state even received the polio vaccine injection.
Even then, the injections were administered on a very limited basis because of the number of polio cases resulting from the vaccine. It wasn't until 1956 that polio vaccinations assumed inspiring proportions. The 61% drop in polio cases in 1954 was credited to the Salk vaccine, when it wasn't even in the state yet. Nevertheless, by 1957, when the massive vaccination program had taken place, polio was again on the increase.
Other ways polio statistics were manipulated to give the impression of Salk vaccine success follow:
1. Redefinition of an epidemic. More cases were required to refer to polio as an epidemic after the introduction of the Salk vaccine. In other words, you needed 20 cases per hundred thousand to have an epidemic before the vaccine was introduced, and after the vaccine they changed that number to 35 cases per hundred thousand per year to require the definition of epidemic.
2. Redefinition of the disease. In order to qualify for classification as paralytic polio mytolitis, the patient had to exhibit paralytic symptoms for at least 60 days after the onset of the disease.
Now that's after they started the vaccination programs, folks. Before the vaccination program started in 1954, the patient had to exhibit paralytic symptoms for only 24 hours. What this means folks, is that if you walked into a doctor's office before the vaccine was introduced, and you said, "Oh, I have paralytic symptoms here. I've had them for about 2 weeks." They'd say, "Oh, that's polio. You've had it for more than a day." But after the vaccine, if after the vaccine, you walked into that same doctor's office, and you say, "Oh, I've had these symptoms for 2 or 3 weeks, now." They'd say, "Oh, wait two months, then we can call it polio." That's how the statistics get manipulated, folks.
Doctor Greenberg said, "This change in definition meant that in 1955 we started reporting a new disease, namely paralytic poliomyelitis, with a longer lasting paralysis.
The third way statistics were manipulated was mislabeling. After the introduction of the Salk vaccine, cocsacci virus and aseptic meningitis have been distinguished from paralytic poliomyelitis," explained Dr. Greenberg, "and in 1954 large numbers of these cases were undoubtedly mislabeled as paralytic polio." Now, another way of reducing the incidence of disease by way of semantics or statistical artifacts, as Dr. Greenberg calls it, is to simply reclassify the disease.
I worked at a Schweitzer hospital in the Amazon years ago when a whooping cough epidemic broke out on a river and killed many Indians. It's a horrible, horrible disease.
To me, anti-vax'er are terrorists. I think a fair argument can be made that they are abusing free speech -- i.e. their freemongering is the equivalent of falsely yelling "Fire!" in a crowded theater. Perhaps the ACLU would have an opinion on this?
uhhuh. suuure it did.
incidentally, polio is nowadays largely unknown in the world, with the few remaining pockets persisting only in backwaters that haven't yet been reached by comprehensive vaccination programs. why would you say that might be the case, pray tell?
Mark said: ".... blah blah in 1953 blah blah by 1957 due to the Salk vaccine, blah blah blah However, during the 1962 blah blah blah...Nevertheless, by 1957, ...blah blah blah started in 1954, ..."
Just a bunch of stuff taken from someone's antivax handbook, using such timely quotes (most that are older than me!).
What caused polio to return to Nigeria?
Don't answer until you read:
http://www.amazon.com/Polio-American-David-M-Oshinsky/dp/0195307143/
Cain:
"Any fellow DCers out there want to start up a counter-protest with me?"
I'm in central VA, but if a counter-protest is organized, I will take a road trip!
Orac, thanks for your excellent and informative blog, I've recently become a reader and I so appreciate the content.
Mark, have ever seen polio? I doubt it, for you had you'd know you're talking complete tripe.
My "uncle" - cousin really, contracted it at the age of 11 (he died about 20 years ago as a very broken old man) and it destroyed his life.
He didn't have paralysis in the FDR confined-to-wheelchair-but-still-coherent sense. He had it in the unable-to-walk-barely-able-to-speak-and-frighten-small-children sense.
Polio was not "redefined", it was (virtually) eradicated with vaccines.
Actually test the vaccines.
Make sure they are safe and effective.
Quell the fears of autism and the raft of autimmune diseases which occur from an overly aggressive vaccine schedule.
Make sure that hazardous waste levels of mercury are out of the flu vaccine (0.01% by weight thimerosal).
Vaccinate on a more rational, rule of reason basis.
Allow informed consent.
Have honest vaccine injury databases and rational compensation approaches.
This entire problem goes away.