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History Is Destined To Repeat Itself With More Measles Outbreaks

March 31, 2016 2 comments

What Have We Learned From Last Year’s Measles Outbreak?

8QgmhZV.jpgLast year the United States experienced a large, multi-state measles outbreak that was largely responsible for 189 measles cases that spread across 24 states and the District of Columbia.  It’s believed that the outbreak started from a traveler who contracted measles overseas and then visited the Disneyland amusement park in California while infectious.  Widespread media coverage of the outbreak helped elevate public concerns related to the dangers of measles infection, the consequences of a growing number of school vaccine exemptions and the risks of disease among those who were too young or medically unable to be vaccinated.

At this time last year, it seemed as though we were experiencing a tipping point; a growing number of people were beginning to realize that vaccine refusal had consequences that could threaten our nation’s public health.  The fact that the personal decisions of a select few people was able to threaten herd immunity and the health of many unsuspecting families and communities was worrisome.

It was believed that more parents (including some who had previously refused vaccines) were seeking and accepting vaccination for their children as a direct result of the outbreak.  However, to determine whether clinicians were experiencing any real or lasting changes in vaccine acceptance, Medscape conducted a survey of vaccine providers to find out.

The survey, conducted in July of 2015, included 1577 physicians, nurse practitioners and physician assistants who worked in pediatrics, family medicine and public health.  Responses confirmed that the measles outbreaks induced more acceptance of the measles vaccine and vaccines in general.  The survey also indicated that, for some parents, a greater acceptance of vaccines was directly related to the fear of the disease, the consequence of being denied admission to schools, daycares or camps, and a greater knowledge about vaccines as a result of more reading on the subject.  However, in some cases there was no change.

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Results of Medscape Survey Conducted in July, 2015

 

Every Child By Two also experienced a heightened amount of interest in the months during and immediately following the outbreak with a record number of inquiries from parents.  Most were asking for information about the dangers of measles infection and for clarification of the MMR (measles, mumps and rubella) vaccine schedule.  There were many parents who were specifically inquiring as to the possiblity of vaccinating their children before the recommended age in order to protect them during the outbreak.  Shot of Prevention blog posts that included content specific to measles infection and MMR vaccination had record numbers of views in the early months of 2015, and personal stories relating to the outbreak, were widely shared on social media.

One story that drew a lot of attention was an open letter by Dr. Tim Jacks, whose two children had to be quarantined after they were both exposed to measles at a Phoenix Children’s Hospital clinic.  His 3-year-old daughter Maggie had a compromised immune system as a result of fighting acute lymphoblastic leukemia (blood cancer), while his 10 month old son Eli had received all his recommended vaccines, but was still too young for his first dose of MMR vaccine.  While neither of his children ended up contracting measles, the frustration he expressed in his letter entitled “To the parent of the unvaccinated child who exposed my family to measles” hit a nerve with a lot of people.

The Focus of Immunization Rates Fades as Cases Dwindle

In reaching out to Dr. Jacks this week, it appears that the attention on vaccinations that was raised during last year’s outbreak appears to have been rather short-lived.  He explained,

“As a pediatrician, I regularly discuss vaccines, exemptions, and last year’s outbreak.  The cold facts and data only reach so many, so my family’s story adds a personal angle to the issue that questioning parents rarely consider.  After the media exposure, many families were aware of our situation.  However today, the measles issue is not on as many people’s minds.  Vaccine exemption is however a hot issue in Arizona.  The Arizona political arena is considering avenues to encourage vaccination and I am hopeful that the coming year will produce progress in that regard.”

Today, a little over a year since the outbreaks began, the good news is that there have only been two reported measles cases so far in 2016.  However, it also appears that history may be destined to repeat itself.

Consider, for example, the reports out just this week about a California charter school student who tested positive for measles after returning home from traveling overseas.  With just 43% of kindergarteners at the Yuba River Charter School being up-to-date on their MMR vaccine, the California Department of Public Health has attempted to prevent a measles outbreak by first closing the school to all students, and then remaining closed to those without a measles vaccine until April 8 as long as no new cases are documented.

Despite overwhelmingly high vaccination rates across the country, with a mere 1.7% national vaccine exemption rate among kindergartener’s for the 2014-2015 school year, and a 90%+ coverage of MMR vaccine among 19-35 month old children, these small pockets of unvaccinated children continue to present a risk of future measles outbreaks. Read more…

Can Infants Really Handle 10,000 Vaccines At a Time? Dr. Harrison Explains

March 24, 2016 83 comments
journalsEvery Child By Two is pleased to launch another article in their Expert Commentary series featuring guest writer Joel A. Harrison, PhD, MPH, a retired epidemiologist who has worked in the areas of preventive medicine, infectious diseases, medical outcomes research, and evidence-based clinical practice guidelines. Dr. Harrison volunteers his time to provide in-depth and expert analysis of articles which ultimately make false claims about the safety of vaccines.  His articles are summarized here on Shot of Prevention with links to the full response on the Every Child By Two website.

Today we will feature Dr. Harrison’s latest paper,

by Joel A. Harrison, PhD, MPH

A recurrent concern among parents is that the mounting number of vaccines now administered to babies is a major challenge to the infantile immune system. Leading advocate of childhood immunizations, Dr. Paul Offit, has sought on numerous occasions to reassure parents by emphasizing how robust and effective babies’ immune systems are at responding to the daily threats from the enormous number of bacteria and viruses they are exposed to. He has illustrated this by showing how – in theory – a baby’s immune system could cope with the number of epitopes (parts of a microbe recognized by our immune system) represented by 10,000 vaccines at one time. While 10,000 seems like a lot, as Dr. Offit explains, even this number is small compared to the capacity of our immune system and, yet, it is exponentially greater than the epitopes represented by all the vaccines given to children.

Well-organized, well-funded groups have sprung up trying to persuade parents of the alleged dangers of vaccines. Their arguments are mistaken, confused, lacking in scientific rationale and logical cohesion. There is one claim, based on one statement/sentence made by Dr. Paul Offit, repeated umpteen times all over the blogosphere, that I think encapsulates their flawed thinking. This claim takes one sentence out of context, ignoring the entire lead in to it. However, even without the context, antivaccinationist’s use of it contradicts common sense. Rather than doing their homework, they amplify each other in a near hermetically sealed self-reinforcing closed circle.

I believe that there is not a single book or paper that I couldn’t find one or two sentences that I could take out of context in order to prove any point I wish to. The purpose of this paper is to once again explain how our  immune systems work, how vaccinations fit in the picture, and to show just how flawed antivaccinationist thinking is. Read more…

Questioning Whether To Get Your Child the HPV Vaccine? Read This

January 21, 2016 4 comments

iStock_000039978628_Double.jpgIn June 2006, the first human papillomavirus (HPV) vaccine was licensed for use in the U.S.  Rather than celebrate the development of a vaccine to prevent a deadly form of cancer, many parents have instead been misguided by fear.  As a result of persistent internet stories and inaccurate myths that question the safety of HPV vaccines, parents continue to refuse or delay HPV vaccines for their children, and one of the most effective ways to prevent cancer is being grossly underutilized.

Although millions of doses of HPV vaccines have been administered in the past 10 years, some parents still fear what may happen if their child gets an HPV vaccine. 

What they should fear is what may happen if they don’t.

I offer the following information about HPV because everyone should understand where their fears ought to be directed: at the disease, not the vaccine designed to prevent it.

1)  It’s not about sex, it’s about cancer.

Regardless of what parents choose to teach (or not teach) their kids about sex, abstinence or contraception, the HPV vaccine is vital to the health of our children because it protects them from cancer.

By preventing people from contracting certain strains of a highly prevalent infection, we can then prevent the possibility of HPV infections turning into cancerous cells. An HPV infection is often contracted shortly after sexual debut, and can eventually lead to cancers of the cervix, vulva, vagina, penis, anus or throat. Since the majority of these cancers have no formal screening measures, they often go undetected until they are well advanced.

2)  Nearly all sexually-active individuals will contract HPV at some point in their lives. 

HPV is the most common sexually transmitted infection in the United States and is often referred to as the common cold of the genitals. HPV is not a new virus, but many people are unfamiliar with how dangerous and prevalent it is. Consider these staggering statistics:

Not only is HPV infection common, but most people rarely know they’re infected because it typically occurs without any symptoms.  Since it’s possible to develop symptoms years after first being infected, it’s especially difficult to diagnose exactly when a person first became infected.

In about 90% of cases, an HPV infection will eventually clear in about a year or two. However, during that time, those infected with HPV are often unknowingly spreading the infection to others.

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3)  As many as 10% of those infected will eventually develop cancer. 

While 90% of people may clear the infection, the other 10% end up developing cancerous cells years, or even decades, after initial exposure.  Since there is no way to determine which cases will clear and which will lead to cancer, universal vaccination is the most effective means of prevention.

The following data reveals just how many cancer cases are linked to HPV each year:

Cervical cancer: Almost all cervical cancer cases are caused by HPV and more than 11,000 women in the U.S. alone get cervical cancer each year.  When looking at the bigger picture, 528,000 new cases of cervical cancer were diagnosed worldwide in 2012.

Anal cancer: About 91% of anal cancers are caused by HPV and there are approximately 4,300 anal cancers diagnosed each year.

Oropharyngeal cancers(cancers of the head, neck, throat, mouth, tongue, and tonsils) About 72% are caused by HPV and an estimated 8,400 of these cancers are diagnosed each year.

Vaginal cancer: HPV causes about 75% of vaginal cancers and there are about 500 vaginal cancers diagnosed each year.

Vulvar Cancer: HPV causes about 50% of vulvar cancers and an estimated 2,100 vulvar cancers are diagnosed each year.

Penile Cancer: About 63% of penile cancers are linked to HPV and there are about 600 penile cancers diagnosed each year.

Genital Warts: There are more than 40 types of HPV that specifically affect the genital area. However, 90% of genital warts are caused by HPV types 6 or 11 and about 360,000 people in the U.S. get genital warts each year.

Since there is no test to check one’s overall HPV status, and no standard screening to detect HPV in the mouth or throat, getting an HPV vaccine is an effective way to prevent illness rather than leave people vulnerable to infections that can lead to cancer.

Some argue that since there is a test to screen for cervical cancer that this eliminates the need for vaccination among women.  While cervical cancer screenings are vitally important, they don’t prevent infection.  Instead, they help identify precancerous lesions. Once lesions are discovered, women may then need to endure various invasive and painful procedures.  These may include cone biopsies used to help diagnose precancerous or cancerous cells, and a loop electrosurgical excision procedure (LEEP) often used to burn off precancerous lesions.  Additionally, cervical cancer screenings don’t help identify other HPV related cancers or help screen of men or adolescents for HPV.  With the vaccine we can prevent cancers before they exist.

4)  Surprise…you don’t have to have sex to get HPV.

Read more…

Debunking John Stone’s “DeStefano Rides Again” and the CDC “Whistleblower”

January 12, 2016 2 comments
journalsEvery Child By Two is pleased to launch another article in their Expert Commentary series with links to in-depth articles available on the Every Child By Two website.  This series features guest writer Joel A. Harrison, PhD, MPH, a retired epidemiologist who has worked in the areas of preventive medicine, infectious diseases, medical outcomes research, and evidence-based clinical practice guidelines. Dr. Harrison volunteers his time to provide in-depth and expert analysis of articles which ultimately make false claims about the safety of vaccines.  Today we will feature Dr. Harrison’s latest paper, Debunking Antivaccinationist John Stone and the CDC “Whistleblower”: A Review of John Stone’s “DeStefano Rides Again: GSK Rotavirus Vaccine Study Loses 80% Of Cases And 18 Deaths”

by Joel A. Harrison, PhD, MPH

I’ve written several articles for Every Child By Two. Each of them shows clearly the poor scholarship, deficient science, and often lack of common sense contained in articles written by antivaccinationists. The bottom line is they don’t know what they are talking about. If people are to decide on whether to vaccinate their children or not, it should be based on scholarly, well-grounded science, and reflect basic common sense, not claims made by people who are deficient in these.

John Stone is the UK editor for the online blog, Age of Autism. In a recent article, Stone writes: 

Frank DeStefano, the CDC’s Director of Immunization Safety and the lead author at the centre of CDC whistleblower William Thompson’s allegations about destroying MMR/autism data, is involved in another case of apparently hiding data, this time involving intussusception and death, in a newly published paper concerning the safety of GSK’s rotavirus vaccine, Rotarix.

Last month, Representative Posey revealed to Congress that Thompson told Dr Brian Hooker in a taped telephone conversation regarding the DeStefano MMR paper that:

Sometime soon after the meeting, we decided to exclude reporting any race effects, the co-authors scheduled a meeting to destroy documents related to the study. The remaining four coauthors all met and brought a big garbage can into the meeting room and reviewed and went through all the hard copy documents that we had thought we should discard and put them in a huge garbage can.

The new CDC based study of GSK’s Rotarix vaccine by Haber et al., of which DeStefano is senior author and therefore responsible for research integrity, admits a small association with the serious condition of intussusception (an intestinal obstruction secondary to the inversion of one portion of the intestine within another). The paper states that from February 2008 to December 2014 the Vaccine Adverse Event Reporting System (VAERS) “received 108 confirmed insusceptible reports after RV1” (Rotarix). However, a careful review of the database reveals no less than 565 cases for the period. The paper claims to have excluded only 4 reports as unconfirmed (making a total of only 112). (Stone, 2015a; reposted 2015b)

In an Addendum posted a day after the reposting of his article, Stone writes:

I took this article down for 24 hours to consider the points made by “n davis” and “n davis is correct”. I had overlooked the fact that the paper selects US cases only – that there are only a trickle of cases from the US against a relative flood from abroad – and this is basis of massive selection bias, particularly in relation to deaths. It also shows that the US reporting system while always vastly inadequate is wilting. Pharmaceutical companies are required by law to forward reports from abroad where they come to their attention: there is nothing in n davis’s claim that these reports were unavailable to DeStefano – anyone interested in the safety of the vaccine to US children or any other would have considered all of the reports. (Stone 2015c)

Summary

Read more…

Afraid of an Allergic Reaction to Vaccines? Chances are One in a Million

October 22, 2015 4 comments

It’s a fairly common concern.  What are the chances that I will have an allergic reaction to a vaccine?  And if so, how dangerous could it be?  What about my kids?

schoolvaccinationsAt the onset of almost every doctor’s visit, patients are asked to identify what, if anything, they are allergic to.  For some, it’s a long list of food, environmental allergens, or even medications.  For others, who don’t have allergies, there is always the concern that an unknown allergy may exist, and the fear is heightened by not knowing when, or how, that allergy may reveal itself.

When it comes to vaccinations, parents and children can breathe a little easier now.  A study that was recently published in the Journal of Allergy and Clinical Immunology determined that the odds that a vaccine will trigger a serious or potentially fatal allergic reaction is very slim.  In fact, it’s about one in a million (or 1.31 in a million to be exact).

According to the American Academy of Allergy Asthma & Immunology (AAAAI), researchers from the U.S. Centers for Disease Control and Prevention (CDC) searched the Vaccine Safety Datalink (VSD) databases to identify potential anaphylaxis cases following any vaccine. After reviewing 25 million vaccines administered between the years of 2009 to 2011, they found that just 33 people had a serious or potentially life-threatening allergic reaction known as anaphylaxis.

After reviewing the records from more than 17 million visits, researchers identified the following:

  • 380 cases of anaphylaxis, possible anaphylaxis, or allergy of which only 135 involved children 5 years old or younger
  • no cases of vaccine induced anaphylaxis in children less than 4 years old
  • none of the people who had anaphylaxis died, and only one had to be hospitalized
  • pre-existing allergies, asthma or past anaphylaxis, which are known risk factors for anaphylaxis, were a factor in as many as 85% of these cases
  • epinephrine (the first-line treatment for anaphylaxis) — was only given in 15 cases, whereas antihistamines and corticosteroids were the preferred treatment by caregivers in the remaining cases
  • only 9% of those who had a serious allergic reaction had a documented prescription for an epinephrine auto-injector
  • only 15% were known to have been referred to an allergist for follow-up after the reaction occurred

Anaphylaxis is a serious and life-threatening allergic reaction, so it’s understandable to be concerned about the risk of allergic reaction to vaccines, especially among children with known allergies.  However, while most common anaphylactic reactions are to foods, insect stings, medications and latex, this study helps identify that there is a very low risk of anaphylaxis as a result of vaccination. Read more…

Why Delay Vaccines For Your Child?

October 8, 2015 56 comments

I hear this often.  

“I plan to vaccinate, but I’m going to wait until my child is a bit older and better able to handle the vaccines.”  

And this.

“I’ll vaccinate my child.  I just prefer to space them out for my child and only do one at a time.”

Parents who choose to delay vaccines, or design their own vaccination schedule, do so because they believe it will be safer for their baby.

They typically want their children to be protected from preventable diseases, but they’re not convinced they need to follow the CDC’s recommended schedule in order to do that.

Some parents find it hard to accept that one schedule can be suitable for all children and so they feel more comfortable with a schedule that they design themselves – one which gives them the freedom to administer their children’s vaccines one at a time, or maybe even when the child is older.  Some parents make these decisions because they’re concerned that the recommended schedule somehow puts their child at risk of suffering some adverse event or reaction.  Essentially, parents who delay vaccines, or space them out, believe they’re providing a safer option for their child.

Unfortunately, the opposite can be true.

Deviating from the well-tested and recommended schedule can actually put a child at greater risk of disease, without ever reducing their risk of adverse events.  Parents often fail to see the harm in spacing out vaccines, but they also fail to acknowledge the increased risk of disease and the data that supports the safety of the recommended schedule.

How can it be safe for such a small child to receive so many vaccines at a single visit?

Some parents worry that too many vaccines administered at such a young age may overwhelming a baby’s immune system.  Some might even believe that this could lead to injury or developmental delay.  It’s understandable that parents have these fears, but a good hard look at the science indicates that there is simply no evidence to support those fears.

Vaccines are designed to facilitate a baby’s own immune system, not overload it like the diseases have been known to do.  From the moment a baby is born they grow and thrive in a largely unsterile environment. Every day a baby’s immune system is bombarded with trillions of new threats in the air they breathe, on the hard surfaces they touch, and in everything they put in their mouths.

While children today receive more immunizations than their parents did, today’s vaccines are safer and contain less antigens.  Antigens are the elements of the vaccine that contain the weakened or killed versions of the germs that cause the disease.  They are the critical part of the vaccine that stimulate the immune response.  A child who receives all the recommended vaccines based on the 2014 childhood immunization schedule may be exposed to up to 315 antigens through vaccination by the age of 2However, in 1980, that figure was as high as 3,041 antigens.  So the argument that today’s schedule is more dangerous simply because there are more vaccines is simply not supported. Read more…

Dr. Harrison Exposes Anne Dachel’s Inept Evidence on Age of Autism

journalsEvery Child By Two is pleased to launch another article in their Expert Commentary series which will be referenced here on Shot of Prevention with links to the in-depth articles available on the Every Child By Two website.  This series features guest writer Joel A. Harrison, PhD, MPH, a retired epidemiologist who has worked in the areas of preventive medicine, infectious diseases, medical outcomes research, and evidence-based clinical practice guidelines. Dr. Harrison volunteers his time to provide in-depth and expert analysis of articles which ultimately make false claims about the safety of vaccines.  Today we will feature Dr. Harrison’s latest paper, Deficient Science, Hypocrisy & Bogus Arguments: Two Articles by Age of Autism’s Anne Dachel.

by Joel A. Harrison, PhD, MPH

Over the past several decades, a number of bloggers and organizations have claimed that vaccines and/or their ingredients cause a number of disorders, foremost among these is autism. The results of their efforts have been a decline in vaccine coverage and a rise in previously rare childhood diseases resulting in unnecessary suffering, hospitalizations, long-term disabilities, and even death.

Anne Dachel is a regular contributor and Media Editor for Age of Autism.

In two recent Age of Autism articles, “Dachel Media Update: Willingham Wanders Into Waldo” and “Dachel Media Update: Forbes’ Emily Willingham Has Made Up Your Mind”, Dachel criticizes several articles by Emily Willingham, a science writer at Forbes. As this paper will show, from Dachel’s own articles it is clear:

  1. Dachel literally doesn’t understand epidemiology and causal inference.
  2. Dachel displays poor scholarship in claiming that vaccine supporters rely solely on epidemiological studies, missing the numerous references to animal and other research types.
  3. Dachel is hypocritical in criticizing epidemiological studies while promoting/advocating for an epidemiological study comparing never vaccinated to vaccinated.
  4. Dachel resorts to a typical logical fallacy, ad hominem attacks.
  5. Dachel is hypocritical to imply, with NO credible evidence, that Emily Willingham is a “pharma shill“ by stating “Emily Willingtoworkforpharmaaham’s version is below” while she proudly refers to her own for-profit sponsor.
  6. Dachel’s approach is great propaganda for the uninformed; but not a valid scholarly approach. In neither of her articles does Dachel actually address what Willingham writes. Dachel could have directly critiqued each of the points Willingham made, including specific information from the writings she mentions; but she didn’t. Instead, Dachel refers to writings that Willingham may or may not have read. Using Dachel’s approach one could critique just about any article by throwing in a reference to another article or book without giving any details.
  7. Dachel, like many antivaccinationists, takes the approach that people are guilty until proven innocent or, perhaps, guilty with no possibility of proving innocence. However, it is a basic American principle to be considered innocent until proven guilty.

Read more…