Home > General Info, Preventable Diseases, Science & Research > Wrapping Up the Year with Our Most Popular Posts

Wrapping Up the Year with Our Most Popular Posts

When I was first approached to contribute to this blog, I wasn’t sure I would have enough material to contribute on a regular basis.  Since then, I’ve recognized that when it comes to immunization issues, there is just so much to discuss.  Now, as I reflect on the past year, I realize that one of the greatest gifts I’ve received has been becoming part of this special community.  

Throughout the past year, we have seen continuous growth among the readers of this blog and the participants on our Vaccinate Your Baby Facebook page.  We continue to attract a caring community of parents, medical professional, health care workers and public health advocates who actively participate in immunization discussions by offering their thoughts, opinions, experiences and expertise.  We hope that we can continue the momentum, and ask that you suggest your family, friends and work colleagues join us for more lively conversations in the new year. 

As we “wrap” up 2011, we will be highlighting our most popular posts of the year.  If you’ve read them before, you can now share them with others and encourage them to join us for more immunization discussions.  If you’ve yet to see these posts, than you may be interested in seeing what issues have captured the attention of our regular participants.   

Today I’ll be highlighting a post that addresses a recurring question I hear from parents; “Why Worry About the Unvaccinated?”  Without the proper understanding of both the benefits and limitations of vaccines, it’s difficult to understand how the unvaccinated population could ever pose a threat to anyone but themselves.  However, this post encourages readers to consider the unintended consequences for all.  

Why Worry About the Unvaccinated?

Time and again, we hear this from parents who choose not to vaccinate their children.

“If your child is vaccinated, why are you worried about them catching anything from my child?”

This is a common response from parents when it is suggested that a purposely unvaccinated child poses a threat to others.

One thing that many parents may not understand is that while vaccinations are highly effective, and greatly decrease the chance of contracting preventable diseases, no vaccine is 100% effective.    According to CDC reports, “most routine childhood vaccines are effective for 85% to 95% of recipients.   For reasons related to the individual, some will not develop immunity.”

This explains why, during an outbreak of a vaccine preventable disease, an unvaccinated child can increase the risk of disease for everyone that may be exposed, even if the people who have been vaccinated vastly outnumber those who have not.  It is not uncommon for a small portion of the vaccinated population to be infected, However, that does not prove that vaccinations are not effective.  To truly understand the risks, you need to know more than just the number of vaccinated vs. unvaccinated who have become infected.  You have to appreciate the percentages that are involved.  For instance, this example offered on the CDC website, explains this concept quite clearly:

“In a high school of 1,000 students, none has ever had measles. All but 5 of the students have had two doses of measles vaccine, and so are fully immunized. The entire student body is exposed to measles, and every susceptible student becomes infected. The 5 unvaccinated students will be infected, of course. But of the 995 who have been vaccinated, we would expect several not to respond to the vaccine. The efficacy rate for two doses of measles vaccine can be higher than 99%. In this class, 7 students do not respond, and they, too, become infected. Therefore 7 of 12, or about 58%, of the cases occur in students who have been fully vaccinated.

As you can see, this doesn’t prove the vaccine didn’t work – only that most of the children in the class had been vaccinated, so those who were vaccinated and did not respond outnumbered those who had not been vaccinated. Looking at it another way, 100% of the children who had not been vaccinated got measles, compared with less than 1% of those who had been vaccinated. Measles vaccine protected most of the class; if nobody in the class had been vaccinated, there would probably have been 1,000 cases of measles.”

When we consider this in relation to what is currently happening in our own communities today, we see why there is reason for the vaccinated to be concerned.  (To continue reading this blog post, click here.)

  1. cia parker
    December 21, 2011 at 1:06 pm

    Just remember that Europe has had 266, 074 cases of measles this year as of October 26, and only nine deaths. The VAERS received reports of 3,427 adverse reactions to the MMR last year, 2010, and fifteen deaths. Measles is usually a harmless disease, conferriing permanent immunity and strengthening the immune system. Women who recover from measles and breast feed their babies give the babies their antibodies, which protect them when they are most vulnerable to severe damage from measles. Women who have gotten the MMR have no immunity which is passed on in breast milk. The disease is usually relatively mild (and vitamin A and avoidance of fever reducers prevent most complications), while the vaccine is extremely dangerous. I, like thousands of other parents, refused the MMR for my daughter, because I am much more afraid of autism, bowel disease, seizure disorders, or death from the MMR, than I am of measles, mumps, or rubella.

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  2. December 21, 2011 at 1:48 pm

    How many doses of MMR were given in 2010? Without that data there is no way to compare the relative risk even if we assume (and I don’t) that every single VAERS report was a complication due to MMR. The vaccine is NOT extremely dangerous, and measles is not a mild disease. Ever read Little House on the Prarie? Mary Ingalls (and countless others) lost her sight to that disease. Rubella causes horrible birth defects when a pregnant woman becomes infected. One of my cousins was born hydrocephalic because of rubella and died at the age of 14. He was blind, never spoke or walked and had to be fed by bottle his whole life.

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  3. publichealthgal
    December 21, 2011 at 1:54 pm

    Cia, you are not alone in your fears. If you were, there wouldn’t be so much to worry about. Unfortunately, your reasoning is not based on science. MMR has been found in multiple studies to have nothing to do with autism or any other developmental disability. Autism, according to experts in the field like researcher Dr. Eric Courchesne have shown that autism changes in the brain start in prenatal development and are not related to vaccines. Measles disease still kills many children around the world in places where they are not routinely vaccinated. VAERS data reports any reactions that happen in the hours, days or weeks following a vaccination. Data may include coincidental illness. Investigators work to track trends and look at case reports to see if reactions are actually related to the vaccine and if they are severe enough to cause a serious problem. But with millions of vaccinated children each year, even 3,000 reports is not that much. Those that have witnessed measles will line-up for hours, walk many miles to get the live-saving protect of the MMR. We are lucky that most of us will never have to see our child hospitalized with measles. And I hope this will not change.

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  4. Kelly
    December 21, 2011 at 2:25 pm

    Your numbers are a little off there, cia parker.

    From: The November Measles Report: http://ecdc.europa.eu/en/publications/Publications/1112_European_monthly_measles_monitoring_Nov_2011.pdf

    During the period January to October 2011, 27 970 officially validated cases of measles were reported to TESSy by the 29 contributing EU and EEA countries. There were eight measles-related deaths and 24 patients developed acute measles encephalitis. The highest incidence was among infants below one year of age (38.0 cases per 100 000 population).

    From the same report:

    Vaccination status was known for 83% (23 112 cases) of the reported cases. Of these, 82% (18 927) were unvaccinated and 13.5% (3 114) had only received one dose.

    You are also misrepresenting VAERS data. VAERS is a passive reporting system and does not indicate causation.

    Measles is usually a harmless disease, conferriing permanent immunity and strengthening the immune system.

    You must have a pretty screwed up definition of harmless. Measles killed 8 people in Europe (CDC MMWR from Dec. 2/2011, link below, cites 9 deaths). Table 2 of the Measles Report also shows that there were 24 cases of encephalitis and 979 cases of pneumonia.

    Women who recover from measles and breast feed their babies give the babies their antibodies, which protect them when they are most vulnerable to severe damage from measles. Women who have gotten the MMR have no immunity which is passed on in breast milk.

    This is wrong. Passive immunity is via the placenta, not breastmilk and vaccinated women still pass on this immunity, but at lower levels compared to the wild virus. This is a complicated issue because the presence of maternal antibodies interferes with vaccination (http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=728), however allowing wild measles to circulate is unreasonable because even though the highest incidence of measles is in those 10 years old. (“Nine measles-associated deaths were reported, including six in France, one in Germany, one in Kyrgyzstan, and one in Romania. Seven deaths occurred among persons aged >10 years. Four decedents were unvaccinated, and the vaccination histories of the remaining five, all adults, were unknown. ” http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6047a1.htm)

    I, like thousands of other parents, refused the MMR for my daughter, because I am much more afraid of autism, bowel disease, seizure disorders, or death from the MMR, than I am of measles, mumps, or rubella.

    Well, you can put your fears to rest cia parker, because the MMR doesn’t autism or seizure disorders and the risk of bowel disease and death is much greater from measles than the vaccine.

    The MMWR editor notes (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6047a1.htm):

    Principal factors contributing to decreased demand for measles vaccination in EUR include lack of knowledge of the seriousness of the disease, resulting in a reluctance to be vaccinated; skepticism about the benefits of vaccination; fear of adverse effects from being vaccinated; and limited health-care access for some underserved populations (6). Religious or philosophical objections to vaccination are serious barriers to increasing population immunity in certain communities in EUR, particularly in WE (6).

    Pretty much sums up cia parker’s post.

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  5. Nathan
    December 21, 2011 at 11:54 pm

    Just remember that Europe has had 266, 074 cases of measles this year as of October 26, and only nine deaths.

    Did you add an extra “6” there? The WHO reports around 26,000 cases of measles in Europe.

    http://www.telegraph.co.uk/health/healthnews/8932117/WHO-Europe-must-act-on-measles-outbreak.html

    Along with over 7,000 hospitalizations, twice the amount of all the VAERS reports you claim (which are often mild reactions). So, far more adverse reactions to measles than to VAERS, and far, far more serious reactions to wild measles than the vaccine.

    Then there are the proportions. Nine deaths out of 26,000 cases of measles is far worse than fifteen deaths out of around 6 million doses of MMR vaccine (2 doses per kid with a birth cohort of around 3 million kids). And again, that’s assuming that the VAERS reports of deaths are actually caused by the vaccine. Which is not necessarily the case. VAERS reports are not reports of reactions.

    Even nine deaths out of 260,000 cases (wherever you got that number from) is worse than fifteen deaths from six million doses of vaccine. And remember, prior to the vaccine, everyone got measles. Like chickenpox. So there would be roughly three or four million cases of measles annually in the US without the vaccine.

    I absolutely fail to see how your numbers support concern for the vaccine over the disease.

    P.S. Do you have a reference for the following statement? I keep seeing people say this without evidence. I’m hoping you have it.

    Women who have gotten the MMR have no immunity which is passed on in breast milk.

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  6. Nathan
    December 22, 2011 at 12:08 am

    Sorry, Kelly, I had not read down far enough to see that you had already addressed most of what I had addressed in Cia’s post. I would add that immunity to measles is also passed to infants through breastfeeding as well as transplacentally; at least that is what I gather from studies like this:

    http://www.ncbi.nlm.nih.gov/pubmed/8886155

    As you can see from the study, the passing of this immunity is far from guaranteed. But I am interested in Cia’s claim that this does not happen with MMR vaccine at all. Even if this is true, you have done a nice job of pointing out how it is not a cut and dried issue.

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  7. Kelly
    December 22, 2011 at 1:35 am

    I admit I haven’t read the complete study, Nathan, so please correct me if I’m mistaken. From the abstract, I’m seeing that breast milk can contain antibodies to measles, but I’m not seeing how that is protective to the baby.

    Here is a more recent study (http://www.ajtmh.org/content/79/5/787.long) that mentions in the discussion that

    A PRN titer of 120–200 mIU/mL has been widely accepted as the correlate of protection in serum antibody but there is no known correlate of protection for breast milk antibodies. It is possible and perhaps likely that the presence of measles-specific neutralizing activity in breast milk contributes to protection. However, it is unknown what titer of neutralizing activity in breast milk is necessary to exert a protective effect per se.

    The above paper cites this study: http://www.ncbi.nlm.nih.gov/pubmed/15601649, which notes that maternal antibody very quickly declines in infants.

    So while breastfeeding can contribute to passive immunity in the infant, cia parker’s statement is misleading in implying that breastfeeding is enough to protect an infant from measles for the first year of life. As you have mentioned, the available data certainly doesn’t support such a statement. Perhaps cia parker will return and provide the evidence to support that claim.

    I’m very interested in the mechanism of protection that breastmilk would offer for an inhaled pathogen like measles. I can understand protection for GI pathogens with the sIgA blocking adherence, but I’m not sure how sIgA in the mouth and GI tract would protect against measles and how that antibody would survive digestion.Transplacental antibody would most certainly help in preventing the systemic spread of measles virus in the infant’s body, so that’s why I think transplacental antibody transfer is way more important than antibodies in breastmilk. This is just my opinion, of course, and I’m very open to correction if I’m mistaken.

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  8. Sandy
    December 26, 2011 at 9:58 pm

    It doesn’t matter whether the baby was immunized or not if it is your baby who dies! The only thing that matters then is your loss! It also doesn’t matter how many kids survive the disease vs how many survive being vaccinated. If the deceased child is your child or grandchild it puts everything in a different light!

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  9. December 27, 2011 at 5:51 pm

    You know what I want for 2012? For anti-vaccination fearmongers to cease citing VAERS data (” The VAERS received reports of 3,427 adverse reactions to the MMR last year, 2010, and fifteen deaths”) as if it were true, factual and accurate.

    Putting it another way, what I want for 2012 is for the general public to understand that VAERS is more like a poll (anybody can vote without any reason or justification whatsoever) than an accurate indication of vaccine reactions.

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  10. cia parker
    December 27, 2011 at 9:12 pm

    Lizditz:
    Unfortunately, VAERS is the only way for damaged individuals to get their injury officially tallied. The reports made are heart-rending, but I’m afraid it is not your feelings of shock and dismay at so much needless suffering that make you dislike it.

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