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What the Papers Don't Say About Vaccines
jamie tips an article in The Guardian's "Bad Science" column which highlights recent media coverage of the MMR vaccine. A story circulated in the past week about the death of a young child, which the parents blamed on the vaccine. When the coroner later found that it had nothing to do with the child's death, there was a followup in only one of the six papers who had covered the story.
"Does it stop there? No. Amateur physicians have long enjoyed speculating that MMR and other vaccinations are somehow 'harmful to the immune system' and responsible for the rise in conditions such as asthma and hay fever. Doubtless they must have been waiting some time for evidence to appear. ... Measles cases are rising. Middle class parents are not to blame, even if they do lack rhetorical panache when you try to have a discussion with them about it. They have been systematically and vigorously misled by the media, the people with access to all the information, who still choose, collectively, between themselves, so robustly that it might almost be a conspiracy, to give you only half the facts."
It's a societal issue. Once a critical portion of the population is not immunized against a disease, then a widespread epidemic is more possible and likely. This could have severe economic impacts that go far beyond the goals of individual parents. This is why most immunization is mandatory unless there is a specific religious or health related exception. People invoking these exceptions trivially are endangering the functioning civil order. These vaccines have proven to be quite safe -- and, even if there is a risk of infection (say for example, with live polio), if the negative side-effect rate in the population is low-enough, its still something that should be mandated in order to ensure that the population as a whole is resilient to some of the Big Nasties.
I know this is going to be viewed somewhat as flamebait, but to put it bluntly, doctors are mechanics for the human body.
It's funny you should say that. A friend of mine is toward the end of med school, and at her house I was leafing through one of the professional journals she gets. It reminded me a lot of a car mechanic's guide. Very little on the science or the why. She agreed.
Maybe that's the right thing, as being a family doctor you have to keep up with an awful lot of conditions. But I went through a lot of doctors before I found one who a) had at least a touch of humility, and b) made me feel like she understood the actual science involved.
most urticarias do start suddenly and the reason is never found.
"It's such a fine line between stupid and clever" -- David St. Hubbins, Spinal Tap
Recently here in NY we had a law passed to take the mercury out of vaccines (diff. kind of mercury used and not in dangerous amounts). The mother who they put on the news to hail the bill was, like me, a parent of an autistic child. However, the reason she gave for the bill was that "infants' immune systems are not well formed enough to fight the mercury". I was laughing so hard I nearly ripped something. That's what's wrong. You protest so hard you get a bill passed and go on the news to defend it, and you lack any basic understanding of the human body. If all these people think the vaccines are harmful, so be it. But I wish they would gain some basic understanding of the body first.
When parents of my pediatric patients say they're skipping vaccines, they talk more about what they read on the Internet than what they see on television or read in the newspaper. The second most common source of information cited about how vaccines are dangerous is "people [they've] talked to." Only a small percentage make a distinction about specific vaccines; most who refuse the MMR refuse everything. So, do I have to wait until we prove another negative - autism isn't caused by DTaP - to prevent common (and sometimes fatal) whooping cough? Proving that the MMR vaccine doesn't cause autism (NEJM 347:1477-1482) hasn't been enough for my vaccine refusers so far. This is a parental issue. I think the solution is basic education in the scientific method and statistics for everyone, beginning in elementary school.
The mercury was removed years ago because of people flipping over it. Kids feeling like crap after a vaccine will happen regardless of what you put in it, because of the very nature of what it does (it makes your immune system go nuts over it, which is what makes you feel like crap... like what happens when you a have a freagin cold). Oversimplifying here, but thats about it.
Spacing them out may or may not have benefits, I'm not arguing that, but its not the mercury or whatever that makes your kid go poof after a vaccine.
Usually, one can rely on the cock-up theory. However, in the case of the MMR vaccine there really was a conspiracy.
http://www.city-journal.org/2008/bc1114td.html
Because such self-reported anecdotes are not relevant in a proper statistical analysis.
If there were a correlation to be found, then the epidemiologists would be able to find it just based on the fact that a significant number of children came in with cases of hives shortly after coming in for their MMRs. Your records would support that, based simply on the objective facts that you had the MMR on date x, and came down with hives on date x+n. That's all the evidence your son's case can provide.
Your armchair analysis on a sample size of one is not evidence, and has no place in a medical record.
Yellow fever vaccine is a live virus (though it is attenuated).
But a little more seriously, I think many people are getting suspicious of doctors who are too quick with the prescription pad, and don't spend much time actually doing preventative, or even curative, medicine.
As a doctor, I agree wholeheartedly. There are a number of reasons for this, but, honestly, the biggest reason is this is just not paid for. The biggest insurers in this country - medicaid and medicare do not pay for annual preventative health visits except for children. Also, they pay per visit, not what you did or how good a job you did as a doctor. I can spend 30 minutes discussing stuff with my patents about non-medicine treatments, about vaccines or whatever (and I do because I consider it my job to do what is best for my patients), but I won't get paid a dime to do it by their insurance for all that extra time with them or for many of the preventative health visits. That costs me quite a bit of money actually. I have to pay staff and office cost so it comes straight out of my families pocket. Many docs, are understandably (to a certain degree) not willing to make that sacrifice.
This also might lead you to understand why docs get upset with the Jenny McCarthy types. If we spend more time talking about why vaccines are safe, we either have less time to talk about stuff that might be more important or just sacrifice and lose more money ourselves and at the same time make other patients wait longer.
I do make this sacrifice and build it into my schedule, but I make about 30-50% of most my colleuges for it and I spend more time than most of them working because of it. Most of my patients would agree I'm a much better doctor than most for it. Other than knowing I do a good job, I am essentially punished for it. Our system in the US is screwed. My only recourse to maintain this type of care and make a competitive salary is to do boutique medicine. I'm not sure I'm willing to do that because it would exclude all of my poorer patients.
I was born in the UK in 1961, and so grew up in the era where we weren't vaccinated against things like measels and chicken pox, and so of course we caught them, and we were fine. There may be rare side effects of these diseases, but the coincident rise in autism coupled with the rise in vaccination at least doesn't indicate autism as one of the side effects. As it happened I also almost died as an infant as a result of the DTP vaccine, and consequently wasn't given the 2nd shot of the series. I did subsequently catch whooping cough, and although it was unpleasant, it's sure better than being dead.
IAAP (I am a physician - specifically pediatrics). First off, "you" may have been "fine" when you "got measles," but the population of England wasn't. Measles isn't chicken pox - it's a LOT worse. It's pretty rare to die of pox, but measles will kill you, give you encephalitis, make you go deaf, or a lot of horrible, horrible things. It's not just a bunch of itchy spots for a month.
And second, as for your reaction to the DTaP vaccine, there is a widely known side effect of the vaccine (specifically the "P" part against Pertussis, aka Whopping Cough). We are well aware of the side effect and it is known. That is not the same as speculation about an unproven side effect believed by the public and rejected by most of the scientific community. Hmm, sounds a *lot* like the Global Warming denier community. Oh wait, but those guys are kooks, right? *You're* just being skeptical, right?
That being said, your physician is either an idiot, or to be fair, maybe this wasn't known in 1960s UK - the solution to the DTaP reaction you describe is to administer just the D and T portions and not adding the Pertussis part. Congratulations, you were not immunized against Tetanus or Diptheria.
There is no resistance danger from products that physically rip the cells apart (this is bleach, alcohol, etc.). Those products are capitalizing on emotionally manipulating people, but they aren't causing difficulty for people trying to treat infections.
Consumer soaps that are marketed as antibacterial generally contain triclosan, full stop. Hand sanitizers are indeed often alcohol based, but they are marketed as killing germs, not as being antibacterial.
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