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Please note first that I am pro-vaccination. Vaccinations are a risk, which are designed to mitigate another (larger) risk. With this in mind, we shouldn't lo

• dalke 13y ago
  "it's a shame that no numbers are mentioned on that side of the coin" Here you go: "The rates of virologically confirmed aseptic meningitis per 10,000 recipients were 16.6, 11.6, 3.2 and 0 for the standard MMR, Takeda MMR, Kitasato MMR and Biken MMR vaccines, respectively." There were 38,203 recipients, and the vaccines "were arbitrarily given". Source is "Adverse events associated with MMR vaccines in Japan", http://www.ncbi.nlm.nih.gov/pubmed/8741307 http://www.ncbi.nlm.nih.gov/pubmed/8741307 .
  • fnordfnordfnord 13y ago
    Shouldn't there be a _lot_ of very good data about this in the general case, not just for widely recognized anomalous events? I suspect adverse reactions are under-reported. A recent experience does nothing to dissuade me from that notion. (I know, confirmation bias). But the sheer number of vaccinations that take place would provide some very good data. Of course, that data would also probably show at least some occasional quality control problems with vaccines. No matter how much I may respect the science behind vaccination, I refuse to simply have faith that there are never any QC problems with the mass production of vaccines (or any product for that matter). Our youngest developed a _very_ bad cough in the days/weeks after receiving the DTaP. We called the pediatrician who gave us the standard advice, to monitor the baby and bring her in if it worsened. We later did take the baby in for the cough. The doctor began dissuading us from the idea that it was Pertussis or related to the vaccination, before seeing the baby, and despite local news reports indicating a local increase in Pertussis cases[1]. The doctor had a look at the baby, and told us again it probably wasn't Pertussis, everything was normal (except the cough and low grade fever), ran a blood test for Influenza (tests confirmed that it wasn't Influenza), and told us to use a humidifier. I asked what the procedure (WRT both treatment and reporting) would be if it had been a possible or suspected vaccine adverse reaction. The doctor said they had _never_ had any reportable cases of vaccine adverse reaction and indicated a general lack of knowledge of adverse event reporting requirements. The clinic where this occurred was right across the street from the hospital that baby was born in, in the Medical Center in Houston, Texas, and is part of a large and well respected practice. Considering the number of patients that clinic has (it is a busy practice, with several clinics), even considering the low expected rate of serious adverse vaccination events, it is not possible that this clinic has never had a reportable event, and very unlikely that there were no serious adverse events. Baby might not have had Pertussis and baby is fine now. But, the experience turned my skepticism into a lack of confidence, at least with that particular clinic. [1] http://www.chron.com/news/houston-texas/article/Whooping-cough-on-the-rise-in-Texas-U-S-3851973.php http://www.chron.com/news/houston-texas/article/Whooping-cou...
    • dalke 13y ago
      Umm, what makes you think there isn't a lot of very good data? Start with http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#dtap http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#dtap . I linked to DTaP but there are many others on that page. To report a problem, go to http://vaers.hhs.gov/index http://vaers.hhs.gov/index , which is the Vaccine Adverse Event Reporting System. Did you get any paperwork about the immunization? There should have been a flyer or handout like http://www.cdc.gov/vaccines/hcp/vis/vis-statements/dtap.pdf http://www.cdc.gov/vaccines/hcp/vis/vis-statements/dtap.pdf . This has information both about VAERS, as well as about the National Vaccine Injury Compensation Program. The "ap" in DTaP vaccine means "acellular Pertussis", which means it uses antigens of the pertussis pathogen rather than whole cells. There should be no infectious material that could cause a bad cough a week later. (It also has fewer side-effects than, but is also less effective than the whole cell vaccine.) I read that newspaper article you mentioned. It said "Infants under 2 months of age are at the highest risk, accounting for five of Texas' [six] deaths this year" and "80 percent of those were children under 2 months old, who are too young to be vaccinated against the disease." This is a very different situation than what you are describing, where a cough starts a week after the vaccination. I don't think you can make the inference that it's a side-effect of the vaccination itself based on that article. The article points out that the new vaccine formulation doesn't seem to be as effective for as long as the old one. What's likely happening is that adults whose immunity has worn off are acting as carriers for the disease, and infecting babies and children who haven't received any immunization for the disease. This is probably one of the reasons that the Td immunization (DTaP is for children) recommends "All adults should get a booster dose of Td every 10 years." (While it doesn't confer a life-long immunity, the goal is to prevent pertussis in children; they have the highest risk of death if infected.) I don't know what to say to you, other than that I, some anonymous person on the internet, agrees with your doctor that "it probably wasn't Pertussis." > "even considering the low expected rate of serious adverse vaccination events, it is not possible that this clinic has never had a reportable event" There are different styles of reporting. First off, 25% of the children who receive the DTaP vaccine get a fever, 25% get redness or swelling where the shot was given, and 25% get soreness or tenderness where the shot was given. Your doctor has almost certainly seen those side effects. But they aren't reported because they are expected. Again, they should be in the handout you got as part of the information about immunization. No doctor is going to report such mild problems. Then there are the "moderate problems", like seizure, non-stop crying, and a fever of over 105°F. These occur in less than 1:1000 children, which means there should have been a couple of children in your clinic who have had these reactions. However, it's up to the doctor to decide if this is severe enough to report. The VAERS guideline include "clinically significant adverse health events following vaccination", "vaccination error [that] may pose a safety risk", "or that the error would be preventable with public health action or education" but "accepts all reports." These moderate problems are likely not 'significant adverse.' The severe cases seem to happen in 1:1 million cases or rarer for the vaccinations I looked at. Even across all of the vaccinations, it's unlikely that your doctor's office would have had that happen to one of their patients. So, that's one style of reporting. Another style occurs when they get the above statistics in the first place. In that case, they enroll doctors into the program, and have the doctors report all problems that arise after the vaccination. This can be compared to a baseline reference from children who haven't yet had the vaccine. (Eg, the three weeks before the vaccine compared to the three weeks after.) That's used to weed out coincidental correlations. After all, kids do get sick even with vaccines. This second style of reporting is what's used to list the known risks of the vaccine, with the first style of reporting use to get information about the very rare cases. What should the doctor have done to improve your sense of confidence? Run a test for pertussis even though your child didn't have the symptoms for the disease? Make a report even though it wasn't a severe adverse effect? The information you wanted - what to do if there was a severe affect - should have been information you already had. I'm somewhat surprised that the staff didn't know that, since I (an anonymous stranger on the internet) knew it existed, but I also only know your side of the story.
• gnur 13y ago
  Your wording is one of the reasons people skip on vaccinations. > Vaccinations are a risk, which are designed to mitigate another (larger) risk. People don't understand risks, the lottery is one excellent example of people that don't understand basic probability. The difference between 1 in 10.000 chance of death vs 1 in 1.000.000 of sickness is huge, but when presented to most people the risk seems the same (very small).
  • ronaldx 13y ago
    > Your wording is one of the reasons people skip on vaccinations. Unfortunately, my choice of wording is not the problem... you are welcome to restate what I said, if you like. In the case of vaccinations, it is economically rational to skip a vaccination (from a selfish point of view) - you receive the majority of the benefit from herd immunity and don't have to take the risk of the vaccination. The fact that people almost always do choose to take vaccinations shows that we humans have a good altruism and excellent appreciation of the consequences in wider society. I don't think policy should undermine that by disguising the mathematical truth of the situation. In most cases, we trust that people can judge their own risks. Every medicine has a list of side-effects with their possible risk attached. Vaccinations should really be no different. (We can argue about your lottery example another time - there are several rational reasons to play)