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In Calif. Study, Most Kids With Whooping Cough Were Fully Vaccinated
An anonymous reader writes with this extract from a Reuters article: "In early 2010, a spike in cases appeared at Kaiser Permanente in San Rafael, and it was soon determined to be an outbreak of whooping cough — the largest seen in California in more than 50 years. Witt had expected to see the illnesses center around unvaccinated kids, knowing they are more vulnerable to the disease. 'We started dissecting the data. What was very surprising was the majority of cases were in fully vaccinated children. That's what started catching our attention,' said Witt."
So... either their was something wrong with the vaccine, there was a mutation, or else this particular vaccine is less effective than most other vaccines. Unfortunately, most people will take this and generalize it to "vaccines don't work!!!"
No, the vaccine worked. The reason most of the children who got infected also had the vaccines, was that 81% of all children had recieved the vaccine. The risk of getting the infection was still greater for the children who newer got the vaccine.
So the correct headline would be "Vaccine not as effective as previously thought".
Let's put it this way. When you have a vaccine that works 95% of the time, and 99% of the kids are vaccinated. You'll have ~5% of the population contracting the disease despite being vaccinated. And the 1% of the population will contract the disease because they weren't vaccinated. You end with way more students that are vaccinated with the disease than those who are not vaccinated (absolute number wise). But it also ignored the fact that 94% of the population was protected against the disease.
Don't feed the troll.
This actually makes perfect sense. Consider the following:
1. Most children -are- vaccinated.
2. Vaccinations do not really make you "immune" to catching a disease, they train your body to more efficiently fight it off.
So, what happens is that the small percentage on unvaccinated children are bringing Whooping Cough back into contact with the rest of us, and those vaccinated children who perhaps don't have their immune system running at full capacity (tired, stress, fighting other illnesses, etc) catch it. Since there are statistically so many more of the latter available, it makes perfect sense that there are more cases in vaccinated children than unvaccinated.
A more interesting statistic would be if every outbreak could be traced back to an unvaccinated "patient zero". I strongly suspect this is the case.
I know it's slashdot, so you can't be bothered to RTFA, but the article says the kids most vulnerable were ages 8-12. It then when on to address why there was a sharp cutoff at age 12, and points out that at age 13, kids are eligible for a booster shot. So it seems the vaccines DO work, and we just need to readjust the booster schedule.
Whether you get chicken pox from another person or shot, it's still the same virus. Except the vaccine virus is already dead, so it's harmless. I don't know why you would be opposed to doing it.
BTW thanks for the reminder. I need to get my adult vaccinations. (It's been 20 years since last time.)
My AC stalker: " I personally agree with your posts most of the time, but that won't keep me from modding you troll"
Consider: Allowing them to choose to be unvaccinated significantly increases the risk for you and your children.
Diseases like this only vanish when everyone is vaccinated, otherwise local outbreaks can still spread from the unvaccinated into the general population.
Chicken pox vaccine is a live virus vaccine, but it's a weakened form of it. It likely gives some amount of protection for life, but due to relatively low amounts of data they recommend boosters for now. Even so, since your body now forever hosts the weakened virus, it's hoped that later episodes of shingles will also be less severe and prevalent. Hopefully once everyone vaccinates we can eliminate this painful and sometimes disfiguring, debilitating or deadly disease from humanity forever.
E pluribus unum
Where do you think shingles came from before there was a CP vaccine? "Shingles" is the reactivation of the same freaking virus you had long ago -- because herpes is forever.
The vaccine, unlike the wild virus, does not take up residence in nerve roots and does not have the potential to cause shingles later. However, both the wild immunity and the vaccine immunity wane with age, so if you're not routinely exposed to the wild virus you need a booster to prevent shingles.
Which, thank you, I will be getting along with my pertussis booster in about two years. Both I and my (now adult) children have had the wild flavor of chicken pox, and I can do without another round with it. Unlike some, I can read the medical literature on this stuff. I even talk to my doctor, believe it or not.
Now, get off my lawn.
Lacking <sarcasm> tags,
Personal choice only goes so far. If your personal choice puts my family at risk, then it ceases to become a personal choice. You do realize that there is a compromise between "ALL HAIL THE GOVERNMENT OVERLORD" and "FUCK THE FED", right?
Perhaps vaccinations aren't bad? If they're properly researched and proved effective, they might even be good?
Thimerosol hasn't been in childhood immunizations for over 10 years (except seasonal flu, and even there it's available thimerosol-free). No corresponding drop in autism rates.
Right. Now let's work on improving the adjuvants used. For example during the swine flu scare a few years ago, Germany used a quality adjuvant that could not cause guillain-barre syndrome. In the US we used a worse adjuvant that caused various incidents of guillain-barre syndrome, narcolepsy, and death? Why? So the pharma companies could save a few cents per vaccine?
Pointing out the inevitable consequences of not vaccinating isn't "bashing".
Not everyone can be vaccinated, and many (such as the elderly) don't develop a strong immunity when vaccinated. For example, in my son's kindergarten class, there's a kid who have to have a liver transplant, and hence is on immunosuppressive drugs. Having my kids vaccinated helps protect that kid's life.
You don't understand how vaccines work.
They expose the adaptive immune system to the virus/bacterium in question. The adaptive immune system develops (in a pretty much evolutionary way) a response. It's unique to every individual - no two people produce the same antibodies. Some of them are more effective than others (hence the differing strength of immunity people display after being vaccinated, and why some rare people get really lucky and develop robust immune responses even to outliers like HIV) but there's such a variety that disease organisms can't "evolve immunity" in the way you're talking about.
Some fast-mutating viruses - like the flu, or even more, the cold viruses - can change enough to require new vaccines periodically, sure. But (a) that's not 'evolving immunity to a vaccine' and (b) the old vaccine remains just as effective against the old variants.
PHEM - party like it's 1997-2003!
I used to expect a Slashdot poster to have either properly read or at least fairly summarize the article posted. This is the third time in a month period in which the title/summary has been misleading. It is this type of practice that assists the viral spread of the misleading headline/summary which eventually becomes the whole story for less discerning news sources. The Reuters headline itself is much more accurate "Whooping cough vaccine fades in pre-teens: study", based on the content of the article itself. The statistics seem to say (correctly) that an unvaccinated child is disproportionally more likely to be infected with whooping cough. The discovery was that the vaccine used on children did not appear to be as effective over time as the booster shot schedule expected. The length of time from the last booster shot is correlated to the an increased chance of infection, which was larger than expected in later years. The conclusion being this booster shot cycle should adjusted so booster shots occur more frequently. What would be more interesting is to discover whether it was the loss of herd immunity due to unvaccinated children which led to the outbreak. Vaccines are known to often be only effect 95-99% of the time and often fade over time requiring booster shots. As herd immunity levels decrease the chance of propagation throughout a population every time individuals are in contact increases. It possible and even likely that it was this loss of herd immunity that exposed the larger than expected "fading" in strength of the vaccine's effects, which otherwise would have remained relatively unrealized and unimportant.
You are using hyperbole to state your case. That is rarely an effective conversational tool (although I do love it, and regularly use it).
There is always compromise. I am a firm believer in the 2nd amendment. I personally own several firearms, and am an avid hunter. I also firmly believe in concealed carry laws. What I don’t believe in is that any idiot should be allowed to own and carry a firearm without training. There should be a strict licensing procedure, training series, and background check (kind of like the ones we currently have in most states). To conceal carry, YES, you should have to register. If I am a cop, and I’m pulling you over, I don’t want a gun to surprise me. What if I try to grab that gun, because it surprised me, and it harms you or myself? Who is at fault there? I was protecting myself in a shitty situation (in my head) you were simply exercising your right.
It's not always black and white, anonymous internet person called wisnoskil. Most of life is shades of gray. I do not have the solutions, you are correct there. BUT, I'm not willing to discount immunizations because of a random article that says that maybe this immunization isn't going to last as long as we previously thought, and therefore we need to re-evaluate our SPACING IN TIME that the shots happen.
In other words, please don't leap to conclusions that aren't stated. Again, my original post simply called for compromise and rational thought.
> that could not cause guillain-barre syndrome ... n the US we used a worse adjuvant that caused
> various incidents of guillain-barre syndrome
Considering that no one knows exactly what causes GBS, I think what you meant was: "that caused less GBS than the adjuvant used in the US vaccine".
> Why?
Presumably because no one knew that there would be increased incidence of GBS?
> So the pharma companies could save a few cents per vaccine?
Sounds like you've been wearing that tin-foil hat for too long.
GBS is a very rare side effect of vaccination. AFAICS, you don't show me any evidence that it was the adjuvant rather than, for example, a mismatch between the adjuvant and the flu antigens.
Right. Now let's work on improving the adjuvants used. For example during the swine flu scare a few years ago, Germany used a quality adjuvant that could not cause guillain-barre syndrome. In the US we used a worse adjuvant that caused various incidents of guillain-barre syndrome, narcolepsy, and death? Why? So the pharma companies could save a few cents per vaccine?
This is not right at all.
In some countries in Europe they primarily used the ASO3 adjuvant (produced in Germany I believe), which was 10x more powerful than other adjuvants. This means they could reduce the amount of virus in each vaccine 10x, and thus treat more people in less time and with less costs. It seems very likely that this is involved with a dramatic increase in the incidence of narcolepsy (now believed to be an auto-immune disease). Germany might have used the other new adjuvant MF59 adjuvant, I don't know, which wasn't as associated with an increase in narcolepsy.
There was another variant of the ASO3 adjuvant that was produced in Quebec that seems to not be as related to the incidences of narcolepsy. I think there might have also been a difference between the use in Canada and Europe, in regards to whether they did 1 dose or 2 doses.
The US did not use these new adjuvants (at least now ASO3 not sure about MF59), and didn't see the increased incidence as much in narcolepsy. US healthcare is also kind of a hodgepodge of actions, so we tend not to do the same thing to everyone even if we wanted to. That's not the case in Europe.
You can read the FDA transcipt from the time-period evaluating the use of the new adjuvants.
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/BloodVaccinesandOtherBiologics/VaccinesandRelatedBiologicalProductsAdvisoryCommittee/UCM167162.pdf
IMO, I do think it's essential to create better adjuvants, the only problem being is that I don't think we understand the immune system well enough yet to do that. I mean I think we can find adjuvants that are more "powerful", but that's not necessarily what you want. You don't want the immune system to get overly broad in its response. You'd like it to stay specific to the virus and its potential variants. And I think if you use a more powerful adjuvant you might need to reduce the inherent contaminants in your provided dead virus even further.
And if you continued to read you would see that the CDC did not think this was necessarily a good idea because the vaccine is not tested in the younger age group, the infection rate is lower than this author says (they probably have more/better data) and note that severity is lower for vaccinated people.
Thanks to this article, I now understand why care givers for newborns need to get a booster right before they have their child (or, in the case of mothers, shortly after birth b/c it is not approved for pregnant women)--the vaccine loses potency rather rapidly and so you have to weigh vaccine risks against the level protection provided. In the case of new borns, the herd is the family/care givers, and they all need to protect the little one. In other cases, some infections are okay so long as outbreaks are relatively small.
From what I understand adjuvants are used so that less viral material is needed. Why not use more viral material and eliminate adjuvants? Is this feasible? How much more cost would it add for the vaccine manufacturer?
Today, there is a significant disagreement on how to improve vaccince safety. One large camp advocates the use of acellular approach (using non-living chemical compounds) that the immune system can learn on to attack the real virus, instead of having dead viral material. The reason for going to the acellular approach is that it is deemed safer, and easier to manage quality control (e.g., effectiveness from batch to batch, odds of residual live active virus contaminatio). Unfortunatly, our immune systems aren't trained as well on this acellular bootstrapping immunity boost technique and the reasnon appears to be that it is "too-clean". This "too-clean" effects was initially found in early standard vaccine production: researching why some batches were more effective than others, they found the batches with fewer contaminants actually produced a weaker immune response. You might think of it as an analogy to the immune system having "book" knowledge or "real-world" knowedge of how to do something (okay, maybe that's a poor analogy). Or having some extra "dirt" helps build the immunity.
To combat this, the adjuvants are added which amp-up the immune response. This allows for more control of effectiveness across batches (rather trying to control the contamination levels to small, but non-zero amounts) and this makes the production costs lower for virus based vaccines and is probably required to make acellular vaccines as effective as dead-virus vaccines.
The WHO (world health organization) and the makers of acellular vaccine technology are the biggest advocates of adjuvants as it allows for cheaper vaccines to be made. So the right question to ask is not how much cost it would add for the vaccine manufacturer, but how much cost it would add to vaccination programs administered by the WHO? and how those economics that affect what is available on the market? (vaccine makers don't want to trial too many variants, so if a big customer wants something one way, the rest of the market pretty much has to live with their choice).
Of course there is still the problem of quick response production (like flu vaccines). Sometimes there isn't enough wall clock time to even mass produce the viral material you need (this happened in the H1N1 epidemic, but in other cases, certain strains of viruses were found to be hard to culture in eggs). So in these situations, you have a choice: Innoculate fewer folks, or spread out the viral material that you do have and augment the immune response with adjuvants. Of course for H1N1, we know now that they did the latter in many cases (and in all the acellular production it was pretty much required anyhow).