Posts Tagged ‘measles’
Give extra credit to Michelle Bachmann
Despite the successes of childhood immunizations, wrote Penn Nursing researcher Alison M. Buttenheim…controversy over their safety has resulted in an increasing number of parents refusing to have their children vaccinated and obtaining legally binding personal belief exemptions against vaccinations for their children.
People who cannot get immunizations because of allergies or compromised immune systems rely on “herd immunity,” the protection they get from a disease when the rest of the population is immunized or immune, explained Dr. Buttenheim. If a high number of children go intentionally unvaccinated because of personal belief exemptions, herd immunity is compromised, she said, giving a disease the chance to spread rapidly…
“Vaccines are one of the great public health achievements of the last couple of centuries,” Dr. Buttenheim said. “They protect us from diseases that used to routinely kill hundreds of thousands of children in the United States and still kill hundreds of thousands globally. It’s not just important for a child to be vaccinated, it’s important at a population level to have high rates of coverage.”
In 2008, a measles outbreak spread in California. It was traced to a child whose parents had decided not to vaccinate him. He brought the disease back from Europe, infecting other children at his doctor’s office and his classmates. The boy’s parents had signed a personal belief exemption affidavit stating that some or all of the immunizations were against their beliefs, thereby allowing their son to go unvaccinated before entering kindergarten. California is one of 20 states that allow such exemptions.
Dr. Buttenheim plans to test several interventions at the school level, including new incentive structures for schools to increase adherence rates. She believes the school nurse can play a key role in encouraging parents to get children immunized. “We know everyone is heavily influenced by social norms and pressure,” she explained, and school nurses can set the expectation that children get fully vaccinated. “I think the school nurse can really act as a gatekeeper here, and reset the norm in favor of immunization.”
One of the reason we have government – as opposed to libertarian anarchy – is to protect the overwhelming majority of the population from the ignorance and foolishness of a small number of citizens. We have traffic lights and rules for 4-way stops at intersections. We don’t leave the decision-making up to who has the biggest SUV on the street.
If Dr. Buttenheim’s well-intentioned plan is as ineffectusl as I think it will be – we need to have the Feds step in and provide oversight to the sillyass states that let parents decide it’s OK to place the children of others in danger. There is no shortage of stupid regulations like this around the nation. This is one of the dumbest.
Whooping cough, or pertussis, a highly infectious respiratory disease once considered doomed by science, has struck Washington State this spring with a severity that health officials say could surpass the toll of any year since the 1940s, before a vaccine went into wide use.
Although no deaths have been reported so far this year, the state has declared an epidemic and public health officials say the numbers are staggering: 1,284 cases through early May, the most in at least three decades and 10 times last year’s total at this time, 128.
The response to the epidemic has been hampered by the recession, which has left state and local health departments on the front lines of defense weakened by years of sustained budget cuts…
Did you think Republicans and Blue Dog Dems were going to cut funds for Naval Bases in Washington State?
Skagit county’s top medical officer, Dr. Howard Leibrand, who is also a full-time emergency room physician, said that in the crushing triage of a combined health crisis and budget crisis, he had gone so far as to urge local physicians to stop testing patients to confirm a whooping cough diagnosis.
If the signs are there, he said…doctors should simply treat patients with antibiotics. The pertussis test can cost up to $400 and delay treatment by days. About 14.6 percent of Skagit County residents have no health insurance, according to a state study conducted last year, up from 11.6 percent in 2008…
State health officials estimate that because of incomplete testing and the assumption that many people with mild cases are not seeking medical treatment, perhaps as few as one in five pertussis cases is being recorded and tracked, suggesting that the outbreak is far more widespread than the numbers indicate.
Pertussis was once a dreaded disease of childhood — killing 5,000 to 10,000 Americans a year from the 1920s through the 1940s — but is now a risk mostly to infants, to whom it is fatal in about 1 percent of cases. Most of the victims in Washington, as in previous outbreaks in other states, are between 8 and 12…
The pertussis vaccine is commonly given in childhood, and many states require it for children of school age. But Washington State, according to a federal study last year of kindergarten-age children, had the highest percentage of parents in the nation who voluntarily exempted their children from one or more vaccines, out of fear of side effects or for philosophical reasons…
Or sheer stupidity, ignorance compounded by religious blather.
Ms. Selecky said immunizations were meant to protect not only individuals but also the broader population: the so-called herd immunity threshold. If a large enough segment of the population is unprotected from a disease — generally considered 5 percent to 15 percent, depending on the disease — even people with some degree of immunity through vaccination can have an elevated risk, she said.
I’ve told this tale before – to people too ignorant to know what life in this land was like before widespread availability of vaccines. Every year, at the end of winter, you could look around the urban neighborhood where I grew up and ask – “Who died this winter?”
There would be other school-age kids who died of scarlet fever, measles, diphtheria, whooping cough, German measles – all the ailments these vaccines fight against. Then, we could look forward to summer vacation – and polio.
The “traditional” alternative
An analysis of more than 1,000 research articles concluded that few health problems are caused by or clearly associated with vaccines. A committee of experts convened by the Institute of Medicine to review the scientific literature on possible adverse effects of vaccines found convincing evidence of 14 health outcomes — including seizures, inflammation of the brain, and fainting — that can be caused by certain vaccines, although these outcomes occur rarely. It also found indicative though less clear data on associations between specific vaccines and four other effects, such as allergic reactions and temporary joint pain. In addition, the evidence shows there are no links between immunization and some serious conditions that have raised concerns, including Type 1 diabetes and autism…
The majority of these problems have occurred in individuals with immunodeficiencies, which increase individuals’ susceptibility to the live viruses used in MMR and varicella. Six vaccines — MMR, varicella, influenza, hepatitis B, meningococcal, and the tetanus-containing vaccines — can trigger anaphylaxis, an allergic reaction that appears shortly after injection. And, in general, the injection of vaccines can trigger fainting and inflammation of the shoulder, the committee noted.
The evidence suggests that certain vaccines can lead to four other adverse effects, although the data on these links are not as convincing, the report says. The MMR vaccine appears to trigger short-term joint pain in some women and children. Some people can experience anaphylaxis after receiving the HPV vaccine…
The committee’s review also concluded that certain vaccines are not linked to four specific conditions. The MMR vaccine and diphtheria-tetanus-acellular pertussis (DTaP) do not cause Type 1 diabetes, and the MMR vaccine does not cause autism, according to the results of several studies. The evidence shows that the flu shot does not cause Bell’s palsy or exacerbate asthma. Suggestions that vaccines can lead to these serious health problems have contributed to parental concerns about immunization for their children.
Establishing a cause-and-effect relationship between an agent and a health outcome requires solid evidence. The committee’s conclusions are based on the strengths and weaknesses of several types of evidence, including biological, clinical, and epidemiological research. In many cases of suggested vaccine-related adverse outcomes, there is too little evidence, or the available evidence offers conflicting results or is otherwise inadequate to draw conclusions…
Which won’t mean much to those suffering from the most notable American disease – irrational, spooky conspiracy theories relying on gossip for decision-making.
Computational analysis comes to the aid of modern medicine once again. I know it won’t touch the fears of the conspiracy crowd – but, it’s a delight to have a sufficient level of readily-available computing horsepower at hand nowadays to throw at a task like this one.
Given the success of vaccines in preventing a long list of diseases, why is opposition to vaccination gaining hold? Decision-making expert Valerie Reyna contends that it’s because anti-vaccination messages tell a compelling story compared to official sources, and they meet people’s need to understand rare adverse outcomes.
“In the era of Web 2.0, the contagion of ideas, transmitted rapidly through social media, is as concerning as the contagion of diseases because of their power to reduce vaccination rates, leaving populations vulnerable to preventable death and disability,” said Reyna…
This spring, the Centers for Disease Control reported that the United States is experiencing the highest number of measles cases in more than a decade. According to the alert, measles was declared eliminated in the United States in 2000 due to a high vaccination rate. This could change should vaccination rates decline…
Since most people don’t understand how vaccines work, the Internet, which facilitates users across the globe to sharing personal experiences and ideas about health care, fills the vacuum.
According to Reyna, anti-vaccination messages are expected when people don’t understand how vaccination works and when adverse events that are difficult to explain appear to be connected. Autism, for example, is diagnosed in children during the same time period that children receive a battery of vaccinations. Despite research to the contrary, anti-vaccination messages have claimed vaccines are to blame. Official sites, on the other hand, tend not to provide a convincing narrative story line that helps people connect the dots.
Under these circumstances, how do people approach the decision to vaccinate? In Reyna’s model, the decision to get a flu shot, for example, could be a seen as a decision between feeling OK (by not getting the vaccine) or taking a chance on not feeling OK (due to a vaccine side effect). Without better information, most people would choose not to get a vaccine.
In a culture as anarchistic as ours here in the United States, the misreading can be deliberate. There is a pundit I know who considers rejecting flu vaccination a point of libertarian ethics – and he stores/replenishes his supply of anti-virals at a cost of hundreds of dollars every flu season as appropriate “protection”. I guess if you can afford such lengths to satisfy rejecting one of medical history’s best solutions to recurrent illness – rock on!.
Rejecting a solution, a methodology – on the basis of the statistically-tiny number of long-term reversals or, worse, products demeaned by sleazy profiteers on occasion [as are all products], is illogical. I don’t mean to sound too much like Mr. Spock; but, the Age of Reason took our species past this sort of rationale a century-and-a-half ago.
I know my choice of words may offend good people; but, I grew up before most childhood vaccines were commonplace. My neighborhood in that New England factory town extended to 3 or 4 elementary schools, public and Catholic. When we finished winter and schoolkids gathered together again for the new season of sandlot baseball, one of the first things we sorted out was who died over the winter. Who had scarlet fever, who had diphtheria, who had whooping cough or mumps, who had measles, who died from the flu – la grippe. The only exception was the summer special, polio.
I know what it feels like to count up who was missing from a smallish community on just one side of a small city. Who died before we had access to vaccines. Those numbers were a hell of a lot more than the fears and trembling of people who don’t really look at statistics. Or have my memories.
Young parents in America are holy and not to be messed with. If they say something is correct, we all acquiesce. And is there any man, woman or canine who doesn’t leap out of the way when one of those giant, all-terrain Bugaboo strollers comes barreling down the sidewalk..?
Yet there’s one smug subgroup whose sense of entitlement endangers the rest. No, not poor Medicaid moms or Social Security grannies. The treacherous group is those parents, predominately those of some financial means, who refuse to vaccinate their children…
General worry became specific controversy in 1998, when the Lancet, a respected medical journal, published a paper by U.K. physician Andrew Wakefield and others saying that the standard vaccine for measles, mumps and rubella might cause autism. Later studies couldn’t confirm Wakefield’s findings, and the Lancet retracted the paper in 2010.
More recently, Wakefield has been barred from practice because of his phonied study.
Yet many parents still won’t vaccinate their kids. Some people in the U.S. have made an avocation of trying to secure a so-called personal belief waiver to allow their children to attend school without vaccines. Parents of autistic youngsters turned to the courts to blame drugmakers…
An unvaccinated boy from New York contracted mumps while in the U.K., then traveled home and attended summer camp. Within six months, hundreds of cases of mumps were counted, including some that led to pancreatitis, deafness and meningitis, Dr. Paul Offit wrote. A child in Minnesota died of Haemophilus B influenza after his parents opposed vaccinations. In January 2008, an unvaccinated child flew home to San Diego following a trip to Switzerland, and gave the gift of measles to dozens of others, including three children in a doctor’s waiting room.
Marin County, known for the fitness of its citizens, endured 15 percent of California’s whooping cough cases in 2010, even though it accounts for less than 1 percent of the state’s population. Ten children died, none of whom had been vaccinated…
Crowdsourcing medical care is about the dumbest thing parents can do. Relying on word-of-mouth myth and conspiracy theories is worse. People who endanger their kids – end up endangering everyone else.
The Web is an amazing tool for accumulating information. Try to remember that some of that information is crap. Science rarely has overnight revelations. It takes years of peer-reviewed publication and – more important – debate and more testing within those peer circles to move discovery forward.
Daylife/Reuters Pictures used by permission
Researchers long ago rejected the theory that vaccines cause autism, yet many parents don’t believe them. Can scientists bridge the gap between evidence and doubt?
This week, the open-access journal PLoS Biology investigates why the debunked vaccine-autism theory won’t go away. Senior science writer/editor Liza Gross talks to medical anthropologists, science historians, vaccine experts, social scientists, and pediatricians to explore the factors keeping the dangerous notion alive—and its proponents so vitriolic.
Pediatrician Paul Offit has made it his mission to set the record straight: vaccines don’t cause autism. But he won’t go on Larry King Live—where he could reach millions of viewers—or anyplace celebrity anti-vaccine crusaders like Jenny McCarthy appear. ”Every story has a hero, victim, and villain,” he explains. ”McCarthy is the hero, her child is the victim—and that leaves one role for you.”
When she read that hecklers were issuing death threats to spokespeople who simply reported studies showing that vaccines were safe, anthropologist Sharon Kaufman dropped her life’s work on aging to study the theory’s grip on public discourse. To Kaufman, a researcher with a keen eye for detecting major cultural shifts, these unsettling events signaled a deeper trend. ”What happens when the facts of bioscience are relayed to the public and there is disbelief, lack of trust?” Kaufman wondered. ”Where does that lead us?”