5 ms·

The issue is not black and white - and laying the entire issue at the feet of non-vaccinated is blatant propaganda. For example, the recent whooping cough outbr

by jen_h 13y ago

The issue is not black and white - and laying the entire issue at the feet of non-vaccinated is blatant propaganda. For example, the recent whooping cough outbreaks are due to the fact that the newer (safer!) acellular vaccines are just not as effective as the older (less safe) vaccines. Vaccinated populations are falling victim to whooping cough, as the current vaccines are not long-lasting enough. Reuters published a pretty good explanation of the issue in August of last year: http://www.reuters.com/article/2013/08/01/us-whooping-cough-booster-idUSBRE9700XK20130801 http://www.reuters.com/article/2013/08/01/us-whooping-cough-... tl;dr: We need a new vaccine. Tilting at small populations of anti-vaxxers may feel satisfying, but it is ultimately counterproductive, especially in this case.

joosters 13y ago
It's interesting that the whooping cough outbreaks seem to be concentrated in the US. In the rest of the world, measles dominates.
- jen_h 13y ago
  I remember reading somewhere that some of the whooping cough in the States was actually being transmitted by the vaccine itself in some cases - but Google isn't returning any unbiased search results right now on that one.
  - tptacek 13y ago
    That is an extraordinary claim. Does someone else have a source to back that up? This argument would appear to vindicate the antivax movement, at least vis a vis whooping cough. That would be a shocking development.
    - jen_h 13y ago
      Here we go - it's another strain one can still be colonized by, not pertussis, but parapertussis: http://www.cidd.psu.edu/research/synopses/acellular-vaccine-enhancement-b.-parapertussis http://www.cidd.psu.edu/research/synopses/acellular-vaccine-... ("An acellular whooping cough vaccine actually enhances the colonization of Bordetella parapertussis in mice; pointing towards a rise in B. parapertussis incidence resulting from acellular vaccination, which may have contributed to the observed increase in whooping cough over the last decade.") tl;dr: "We missed a spot." Which is going to happen. I don't think it validates being anti-every-vaccine, but it does validate asking questions and furthering research (and ceasing the vilification of the population that does ask questions!).
    - kyro 13y ago
      The most reputable source I could find that touches on pertussis vaccinations and disease spread is http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376937.htm http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/uc..., particularly this part: This research suggests that although individuals immunized with an acellular pertussis vaccine may be protected from disease, they may still become infected with the bacteria without always getting sick and are able to spread infection to others, including young infants who are susceptible to pertussis disease. The study, conducted on animals, does not, however, suggest that the vaccine increases rate of disease spread, rather that vaccinated individuals can serve as unaffected and unsuspecting nodes of transmission. This can happen with the acellular type of vaccine, not the whole-cell.
  - d4vlx 13y ago
    It sounds like you may have been reading the anti-vaccination propaganda.
    - rosser 13y ago
      Without commenting either way on the veracity of the GP comment's claim, it sounds like you're asserting something on the basis of your own bias, here, too. EDIT: particularly so, given the follow-ups to your comment's sibling, citing animal studies demonstrating exactly the thing claimed: that even vaccinated individuals can transmit the disease.
      - wglb 13y ago
        actually being transmitted by the vaccine (claimed in the post in question) and that even vaccinated individuals can transmit the disease are very different things.
        rosser 13y ago
        Oops, you're right. Good catch, thanks.
- Fomite 13y ago
  The U.S. hasn't had quite the same drops in measles vaccinations as Europe has.
pit 13y ago
Thanks for explaining that. I wasn't sure why it it would matter to Kid #1 if Kid #2 had the mumps, as long as Kid #1 was vaccinated.
- Fomite 13y ago
  Partial immunity in Kid #1. More pressingly, Kid #3 could have any number of pressing medical issues that mean they cannot be vaccinated, and are thus vulnerable.
- rz2k 13y ago
  What was explained? The understanding of the effects of vaccinating kid #1 isn't all about kid #1 being immune to the infection. Instead it is that kid #1 is x% less susceptible to contracting the infection if exposed. So you might wonder, how could Small Pox be much extinct if the vaccine is only about 95% effective, and how have we wiped out an enormous number of diseases that caused immense suffering in the 20th century using vaccines that were not 100% effective in protecting the vaccinated from infection on an individual level? The lesson is that common sense can be a terrible guide for even the roughest approximations of the dynamics of a system. Dispersion models explain the limits to how far water will trickle down through soil or the conditions under which wild fires will burn themselves out. The models for infectious diseases involve variables for the likelihood of transmission, mortality rates, how long you're contagious until you show symptoms, the percentage of population that is susceptible etc. While even common sense will tell you that the best way to avoid a disease is to avoid contact, it might not tell you that vaccinating populations is largely about reducing exposure. Assume our hypothetical situation has kids one through eight living on a street and they only play with their immediate neighbor. Then let's assume that the kids have a natural resistance of 20%, but 60% if they are vaccinated. If kid #8 has the disease, what is kid #1's risk of exposure if everyone is vaccinated vs no one is vaccinated? (1-20%)^6 = 26% (1-60%)^6 = 0.4% I think those numbers are astonishing and beat the tar out of what common sense has to say. Of course more realistic models would show many more links between nodes as well as lower transmission rates, but differences of even a hundredth of a percent in a population of 320 million is 32 thousand people. The conversation begins with: "The issue is not black and white — and laying the entire issue at the feet of non-vaccinated is blatant propaganda." If we're going to use extreme language, then it is "blatantly wrong" to say it is "blatant propaganda". The portion of people who defect from or cooperate with vaccination programs does matter. It isn't much of a problem if there is one Jenny McCarthy, but it becomes a problem if she advocates on behalf of defection to everyone else in her playgroup, or worse to other parents around the country. While it is a good instinct to assume that issues aren't simple, it is tempting to see issues as having "two sides" and that the middle ground must be reasonable. I don't understand why newer/safer vaccines being less effective is being presented as a middle ground. If the "two sides" are not vaccinating and vaccinating, then this argument would not be in between the two, but instead it should be an argument that is more extreme than a mere decision to vaccinate. And yet, I think it serves to create uncertainty instead, and ultimately fewer vaccinations and lower resistance in the population.
xherberta 13y ago
Thank you. "An analysis of 32000 Californians over 11yrs. found the a cellular pertussis VAX to be 53-64% effective."-NY times
sureshv 13y ago
Ultimately unvaccinated people put the whole community at risk by reducing herd immunity. For pertussis the threshold is over 90% for prevention assuming that 100% of the population is immunized. If 10% are not immunized then your already behind for a disease with high transmission rates.
tokenadult 13y ago
the recent whooping cough outbreaks are due to the fact that the newer (safer!) acellular vaccines are just not as effective as the older (less safe) vaccines You have one historical fact misreported there. It is clear that the current acellular vaccines were adopted because of safety concerns about former cellular pertussis vaccines. What's actually NOT clear is whether those safety concerns really necessitated changing the vaccine formula. It appears that anti-vaccine activists may have exaggerated the risk profile of cellular vaccines and understated their effectiveness while campaigning to reduce vaccine use in general.
- jen_h 13y ago
  Billions of dollars aren't spent to modify a vaccine just to mollify a small community of questioners, who weren't even that great in number at the time of conversion. If anything, it would benefit the vaccine makers - fewer side effects to impede sales, and more sales because more boosters are needed (though I doubt there's anything that nefarious at play in this specific case). Here's a post-marketing study about the increased safety profile of the acellular vaccines vs. the cellular vaccines: http://www.ncbi.nlm.nih.gov/pubmed/8620224 http://www.ncbi.nlm.nih.gov/pubmed/8620224
  - tokenadult 13y ago
    Thanks for the link, but that study was very soon after the change and ignores the issue of whether vaccine effectiveness was the same (as history appears to be showing it was not). And that is the point. A small reduction of minor reported adverse effects for a large reduction of immunization effectiveness is usually not counted as a good trade-off by epidemiologists.

by jen_h 13y ago

joosters 13y ago

It's interesting that the whooping cough outbreaks seem to be concentrated in the US. In the rest of the world, measles dominates.

jen_h 13y ago
I remember reading somewhere that some of the whooping cough in the States was actually being transmitted by the vaccine itself in some cases - but Google isn't returning any unbiased search results right now on that one.
- tptacek 13y ago
  That is an extraordinary claim. Does someone else have a source to back that up? This argument would appear to vindicate the antivax movement, at least vis a vis whooping cough. That would be a shocking development.
  - jen_h 13y ago
    Here we go - it's another strain one can still be colonized by, not pertussis, but parapertussis: http://www.cidd.psu.edu/research/synopses/acellular-vaccine-enhancement-b.-parapertussis http://www.cidd.psu.edu/research/synopses/acellular-vaccine-... ("An acellular whooping cough vaccine actually enhances the colonization of Bordetella parapertussis in mice; pointing towards a rise in B. parapertussis incidence resulting from acellular vaccination, which may have contributed to the observed increase in whooping cough over the last decade.") tl;dr: "We missed a spot." Which is going to happen. I don't think it validates being anti-every-vaccine, but it does validate asking questions and furthering research (and ceasing the vilification of the population that does ask questions!).
  - kyro 13y ago
    The most reputable source I could find that touches on pertussis vaccinations and disease spread is http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376937.htm http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/uc..., particularly this part: This research suggests that although individuals immunized with an acellular pertussis vaccine may be protected from disease, they may still become infected with the bacteria without always getting sick and are able to spread infection to others, including young infants who are susceptible to pertussis disease. The study, conducted on animals, does not, however, suggest that the vaccine increases rate of disease spread, rather that vaccinated individuals can serve as unaffected and unsuspecting nodes of transmission. This can happen with the acellular type of vaccine, not the whole-cell.
- d4vlx 13y ago
  It sounds like you may have been reading the anti-vaccination propaganda.
  - rosser 13y ago
    Without commenting either way on the veracity of the GP comment's claim, it sounds like you're asserting something on the basis of your own bias, here, too. EDIT: particularly so, given the follow-ups to your comment's sibling, citing animal studies demonstrating exactly the thing claimed: that even vaccinated individuals can transmit the disease.
    - wglb 13y ago
      actually being transmitted by the vaccine (claimed in the post in question) and that even vaccinated individuals can transmit the disease are very different things.
      - rosser 13y ago
        Oops, you're right. Good catch, thanks.
Fomite 13y ago
The U.S. hasn't had quite the same drops in measles vaccinations as Europe has.

pit 13y ago

Thanks for explaining that. I wasn't sure why it it would matter to Kid #1 if Kid #2 had the mumps, as long as Kid #1 was vaccinated.

Fomite 13y ago
Partial immunity in Kid #1. More pressingly, Kid #3 could have any number of pressing medical issues that mean they cannot be vaccinated, and are thus vulnerable.
rz2k 13y ago
What was explained? The understanding of the effects of vaccinating kid #1 isn't all about kid #1 being immune to the infection. Instead it is that kid #1 is x% less susceptible to contracting the infection if exposed. So you might wonder, how could Small Pox be much extinct if the vaccine is only about 95% effective, and how have we wiped out an enormous number of diseases that caused immense suffering in the 20th century using vaccines that were not 100% effective in protecting the vaccinated from infection on an individual level? The lesson is that common sense can be a terrible guide for even the roughest approximations of the dynamics of a system. Dispersion models explain the limits to how far water will trickle down through soil or the conditions under which wild fires will burn themselves out. The models for infectious diseases involve variables for the likelihood of transmission, mortality rates, how long you're contagious until you show symptoms, the percentage of population that is susceptible etc. While even common sense will tell you that the best way to avoid a disease is to avoid contact, it might not tell you that vaccinating populations is largely about reducing exposure. Assume our hypothetical situation has kids one through eight living on a street and they only play with their immediate neighbor. Then let's assume that the kids have a natural resistance of 20%, but 60% if they are vaccinated. If kid #8 has the disease, what is kid #1's risk of exposure if everyone is vaccinated vs no one is vaccinated? (1-20%)^6 = 26% (1-60%)^6 = 0.4% I think those numbers are astonishing and beat the tar out of what common sense has to say. Of course more realistic models would show many more links between nodes as well as lower transmission rates, but differences of even a hundredth of a percent in a population of 320 million is 32 thousand people. The conversation begins with: "The issue is not black and white — and laying the entire issue at the feet of non-vaccinated is blatant propaganda." If we're going to use extreme language, then it is "blatantly wrong" to say it is "blatant propaganda". The portion of people who defect from or cooperate with vaccination programs does matter. It isn't much of a problem if there is one Jenny McCarthy, but it becomes a problem if she advocates on behalf of defection to everyone else in her playgroup, or worse to other parents around the country. While it is a good instinct to assume that issues aren't simple, it is tempting to see issues as having "two sides" and that the middle ground must be reasonable. I don't understand why newer/safer vaccines being less effective is being presented as a middle ground. If the "two sides" are not vaccinating and vaccinating, then this argument would not be in between the two, but instead it should be an argument that is more extreme than a mere decision to vaccinate. And yet, I think it serves to create uncertainty instead, and ultimately fewer vaccinations and lower resistance in the population.

xherberta 13y ago

Thank you. "An analysis of 32000 Californians over 11yrs. found the a cellular pertussis VAX to be 53-64% effective."-NY times

sureshv 13y ago

Ultimately unvaccinated people put the whole community at risk by reducing herd immunity. For pertussis the threshold is over 90% for prevention assuming that 100% of the population is immunized. If 10% are not immunized then your already behind for a disease with high transmission rates.

tokenadult 13y ago

the recent whooping cough outbreaks are due to the fact that the newer (safer!) acellular vaccines are just not as effective as the older (less safe) vaccines You have one historical fact misreported there. It is clear that the current acellular vaccines were adopted because of safety concerns about former cellular pertussis vaccines. What's actually NOT clear is whether those safety concerns really necessitated changing the vaccine formula. It appears that anti-vaccine activists may have exaggerated the risk profile of cellular vaccines and understated their effectiveness while campaigning to reduce vaccine use in general.

jen_h 13y ago
Billions of dollars aren't spent to modify a vaccine just to mollify a small community of questioners, who weren't even that great in number at the time of conversion. If anything, it would benefit the vaccine makers - fewer side effects to impede sales, and more sales because more boosters are needed (though I doubt there's anything that nefarious at play in this specific case). Here's a post-marketing study about the increased safety profile of the acellular vaccines vs. the cellular vaccines: http://www.ncbi.nlm.nih.gov/pubmed/8620224 http://www.ncbi.nlm.nih.gov/pubmed/8620224
- tokenadult 13y ago
  Thanks for the link, but that study was very soon after the change and ignores the issue of whether vaccine effectiveness was the same (as history appears to be showing it was not). And that is the point. A small reduction of minor reported adverse effects for a large reduction of immunization effectiveness is usually not counted as a good trade-off by epidemiologists.