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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."
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.
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!!!"
Not so. If the anonymous reader had read the entire article from which he or she posted, s/he would have seen that what was found is that researchers had overestimated how long the whooping cough vaccine was effective. So if a kid had gotten the original shot or booster shot fairly recently (didn't say how many years out it was good for), that kid did not develop the disease.
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.
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,
The story point to the vaccine schedule in California needs to be updated to the CDC recommendations. Nothing more.
The Kruger Dunning explains most post on
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.
There's another possibility. I did not RTFA, so I don't know if the absolute numbers were in there, but if the number of unvaccinated kids is small relative to the number of vaccinated kids, then it could just be an artifact of the small numbers. There is a theorem in probability about this IIRC, but I forget the name. It's often mentioned with respect to false positives in blood tests, for example.
If a blood test for a disease is 90% accurate for both positive and negative results (for simplicity we use the same value), but only 3% of the population truly has the disease, then the following can occur:
Of the 3% that have the disease, 10% (0.3% of the total population) will show negative
Of the 97% that don't have the disease, 10% will show positive - more than three times as many as the number who actually have the disease. This is the key fact - the results may be purely due to this kind of imbalance.
Only the 2.7% that have the disease will correctly show positive. In the total population about 12.7% will show positive, of which over 3/4 will be false.
Substitute vaccination for blood test - some small percentage of vaccinations will fail, but if the incidence of the disease is relatively quite small, that failure will show as a majority of those who have the disease.
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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.
If it was herd immunity, you would still expect to see a significantly higher number of infected amongst the unvaccinated.
That's not necessarily true.
Say the vaccine is 96% effective and we're studying a population of 1000 kids. If they were all vaccinated, and they all come in contact with the virus, you'd expect roughly 40 of them to still get sick. If 30 of those do not get vaccinated, and all 1000 were exposed to the virus, you'd have a cap of 30 non-vaccinated kids getting sick, but still roughly 39 of the vaccinated kids will be sick, simply because there are more of them.
The total amount of people with the disease goes up significantly, but most of the people coming down with the disease are still people who were vaccinated. If you stop assuming all those people came in contact with the virus, the fact that there are now 30 kids who weren't vaccinated increases the chance of 39 kids for whom the vaccine didn't work to come in contact with the disease, so there's a larger proportion of vaccinated kids getting sick.
> 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.
Bingo!
Not only that: the non-immune kids, once you break past herd immunity numbers, become the incubators of the mutations that break out of the vaccination wall.
Of the 132 patients under age 18, 81 percent were up to date on recommended whooping cough shots and eight percent had never been vaccinated. The other 11 percent had received at least one shot, but not the complete series.
So:
81% fully vaccinated.
11% incomplete.
8% unvaccinated.
Threshold for herd immunity: generally considered to be at 92% minimum for pertussis.
In other words: the unvaccinated/incompletely-vaccinated 19% broke herd immunity. Once that happens, you have an incubation dish for mutations, you have transmission vectors to those for whom the vaccine is out of date or has not worked as well as hoped.
The rate of cases for each age, two through 18 years old, peaked among kids in their pre-teens. Among fully immunized kids, there were about 36 cases for every 10,000 children two to seven years old, compared to 245 out of every 10,000 kids aged eight to 12. "The longer you went from your last vaccine, the greater your risk of disease," Witt told Reuters Health. At age 13, the number of cases dropped, presumably because that's the age when children are eligible for their booster shot.
Aha! The REAL pattern begins to emerge:
Broken herd immunity lets the disease in: those with incomplete vaccinations begin to be affected at higher rates than those who have received the booster shot. In essence, age 12 - due to the pacing of the booster shots - is effectively a risk zone.
This is why "religious objections" for booster shots are such fucking bullshit: being unvaccinated DOES cause societal risk. We need 92% minimum coverage for herd immunity and we do not have it.
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).