"The diseases are coming back thanks to unvaccinated kids." - Page 6

[heathergirl67]

Originally Posted by Sileree

What if adults don't want to take the risk of getting an MMR shot every ten years? Why is it our obligation to use a product over and over that is not performing as it should?



Serotype replacement is not a "what if". It has happened already, and this is demonstrated in the medical literature.

Adults shouldn't take the risk of getting an MMR shot if they don't want to. I've never been a fan of the idea of taking away someone's right to their own health care. Just because the immunity wears after a period of time doesn't mean that it isn't performing as it should. That's the nature of the beast. It's a weaker version of the illness. Therefore the resulting immunity doesn't last as long the immunity for the illness would, in most cases.

Serotype replacement has happened, but not to the degree people were worried about. Other strains have had room to thrive and take their place. And the incidence of invasive disease due to Hib or any serotype of it is much lower than before the vaccine was introduced.

[heathergirl67]

Buttercupmama- I don't think of antecdotal stories as a scientific measure of anything, but I like hearing them anyway. Thank you for telling me about how life on Trinidad was for you. A good friend of mine was raised there, lived here for about three years, and recently got married and moved back. He had nothing but wonderful things to say about his childhood there. (I don't think we ever discussed vaccinations or communicable diseases, so I can't comment on what he thought of that) I'm glad that you and your family remained in good health. FWIW, Trinidad's current vaccine schedule is different from what you described. So I guess they thought the diseases were a big enough problem to impliment a nation-wide vaccination program. Or maybe they were just trusting the CDC or WHO. Who knows?
http://www.health.gov.tt/sitepages/default.aspx?id=155

[buttercupmama]

I already looked it up after posting my response. You have to keep in mind that nothing Trinidad's government has done is based on any kind of logic. They have an unhealthy obsession with following America in everything it does. This does not generally bode well with the public, but it's seen as 'progress' all the same. Regardless, you never needed an exemption in Trinidad and I'm sure a lot of people, having grown up as I did, don't bother with getting their kids vaccinated. The rate of the diseases has no relevance since that never had anything to do with it.

[ema-adama]

Originally Posted by heathergirl67

Serotype replacement has happened, but not to the degree people were worried about. Other strains have had room to thrive and take their place. And the incidence of invasive disease due to Hib or any serotype of it is much lower than before the vaccine was introduced.

I would like to see evidence to support the claim that the overall incidence of all types of Hi (typable and non typable) being lower since HiB vaccination was introduced. If you have it handy, I would appreciate you posting it.

[Deborah]

Heathergirl,
Mumps numbers you presented are certainly interesting.

What you left out: how many of the cases with complications were in teens and adults.

I've never seen such an evaluation of pre-vaccine deaths and complications where the numbers weren't distorted or manipulated in some way to make things look worse than they actually were. And I've looked through a number of them.

Thanks for the research.

[Sileree]

I have a few problems with your numbers, heathergirl67.

30,000 cases of brain involvement, including aeseptic meningitis on average

I use a quote from the CDC's The Pink Book to clarify this:

http://www.cdc.gov/vaccines/pubs/pin...oads/mumps.pdf

"Central nervous system (CNS) involvement in the form of aseptic meningitis (inflammatory cells in cerebrospinal fluid) is common, occurring asymptomatically in 50% to 60% of patients. Symptomatic meningitis (headache, stiff neck) occurs in up to 15% of patients and resolves without sequelae in 3 to 10 days. Encephalitis is rare (less than 2 per 100,000 mumps cases)."

100 cases of permanent deafness on average

Hearing loss is stated as 1 in 20,000 cases by the CDC in The Pink Book. If there were 200,000 cases per year pre-vaccine, how were there 100 cases of deafness? According to my calculator 200,000 / 20,000 = 10, not 100.

Considering the population increase, if people were still infected with mumps at the same rate we would have...

Why are you assuming that the complication and death rate would remain the same as it was in the mid-1960s?

200,000 cases per year / 30 deaths = a death rate of 1 in 6,666.

Compare that to this study, which found 0 deaths in almost 90,000 cases in Poland in the year 2003:

http://www.ncbi.nlm.nih.gov/pubmed/16190522

So in reality, every year pre-vaccine we had:
- 200,000 cases reported
- Up to 4 cases of encephalitis
- 30,000 cases of symptomatic aseptic meningitis in the form of a stiff neck and headache, with no long-term sequelae
- 10 cases of permanent deafness
- 20-30 deaths

Nowhere near the numbers of combined morbidity and mortality your website claimed.

[Sileree]

Originally Posted by ema-adama

I would like to see evidence to support the claim that the overall incidence of all types of Hi (typable and non typable) being lower since HiB vaccination was introduced. If you have it handy, I would appreciate you posting it.

Me too.

[heathergirl67]

Sileree- I based those numbers off of the page I linked at the bottom of my post. I'll link it again. I know that different places have different numbers, so I just chose one. I got the current numbers based on the 1967 levels. The population has increased in America by 1.56% since then, so I multiplied those rates by 1.56. I figured the disease rates would be the same since sanitation is about the same since then and nutrition is about the same, if not worse. Please note that I was sure to say "on average" since I acknowledge that it's an extrapolation of numbers, and just a rough estimate. Also that same link gives information on Japan. They don't currently vaccinate for mumps and have permanent deafness occuring in 1 out of every 1,000 cases.

http://www.immunizationinfo.org/vaccines/mumps

Oh yeah, and here's a link about Hib:

http://www.mdch.state.mi.us/pha/epi/.../HFLUGRAPH.HTM

[mama2soren]

Originally Posted by heathergirl67

The population has increased in America by 1.56% since then, so I multiplied those rates by 1.56.

I'm severely short on sleep today, but wouldn't multiplying the rates by 1.56 be the equivalent of the population increasing by 156%, not 1.56%?

[ammiga]

Originally Posted by mama2soren

I'm severely short on sleep today, but wouldn't multiplying the rates by 1.56 be the equivalent of the population increasing by 156%, not 1.56%?

Yes. The numbers should be multiplied by 1.0156 to get the equivalent of the population.

But like others have already pointed out, a lot has changed since then, and it is inaccurate to assume that the rates of complications would remain the same. They might fair better in some populations (non-vaccinated, healthy eaters, no fever reducers, etc.) and worse in others (vaccinated on schedule, typical American eaters, use of OTC and prescription drugs, use of fever reducers, etc.). Too much has changed across to just assume rates would be the same. And there are too many factors to take into account that influence potential outcomes that are never documented.

[heathergirl67]

LOL. Okay, here comes the shocking admission: math is not my strong point. Sorry about that. But when I added up what the totals would be, it was all just basic multiplication. So I think that part was correct. ::Hangs head in shame:: I really need to brush up on my math skills!

[TerraNoelle]

Originally Posted by Chicharronita

Is this one like other mainstream magazines, where every other page is an ad for some Big Pharma concoction?

Perhaps I'm picky, but I'd rather not take advice from magazines that feel no compunction about placing "health" articles between pharmaceutical ads.

For whatever reason I started suddenly getting Parents magazine. I have always hated it. It looks lovely lying in my recycle bin though

[Sileree]

Originally Posted by heathergirl67

Also that same link gives information on Japan. They don't currently vaccinate for mumps and have permanent deafness occurring in 1 out of every 1,000 cases.

That website you provided did not give a direct source for that number, but I was curious so I did some digging around. The following isn't really to argue with you personally, I am just doing some thinking aloud and sharing some information I found for those who might be interested.

I think this is probably the study the 1 in 1,000 stat for Japan was based on:

http://www.ncbi.nlm.nih.gov/pubmed/19209100

It looked at the incidence level for 40 pediatric practices in Japan between 2004 and 2006.

Two problems I have with this study:

"The study population consisted of patients < or = 20 years old"

I wish I could see a full-text version and try to find how many cases in this study were in those over 15. The risk of complications are higher for older teens and adults.

"Clinical diagnosis of mumps was made by experienced pediatricians"

So according to the CDC only 30-40% of cases present with the classic mumps symptoms. These forty pediatric groups found 7,400 symptomatic cases. So what is the true number of people who get deafness out of so many total infections, both symptomatic and asymptomatic?

This link says that the in 1 in 20,000 stat that the CDC is using is from a study from the year 1957:

http://www.ncbi.nlm.nih.gov/pubmed/3767776

Why then would mumps have caused a HIGHER rate of morbidity as time went on? It doesn't make a lot of sense.

One reason could be it occurs in age groups for which there are more complications (older teens and adults). This happened with measles. I found a study that stated that measles caused death in 1 in 10,000 cases in 1954. Since the introduction of the vaccine, more young babies and adults get the disease (and again they have higher complication rates), so nowadays 1 in 1,000 reported cases result in death. Mumps is endemic in Japan now, but they did vaccinate for it at one time (one article stated they stopped the vaccine in 1993). Did that screw up the pattern of who gets the disease?

Is it how we treat mumps now vs. 50 years ago? Tylenol/acetaminophen usage increases the death rate for measles. Could it increase the complication rate for mumps as well? All the websites I googled for "treatment of mumps" recommended it for the fever.

[littlec]

Originally Posted by Sileree

That website you provided did not give a direct source for that number, but I was curious so I did some digging around. The following isn't really to argue with you personally, I am just doing some thinking aloud and sharing some information I found for those who might be interested.

I think this is probably the study the 1 in 1,000 stat for Japan was based on:

http://www.ncbi.nlm.nih.gov/pubmed/19209100

It looked at the incidence level for 40 pediatric practices in Japan between 2004 and 2006.

Two problems I have with this study:

"The study population consisted of patients < or = 20 years old"

I wish I could see a full-text version and try to find how many cases in this study were in those over 15. The risk of complications are higher for older teens and adults.

"Clinical diagnosis of mumps was made by experienced pediatricians"

So according to the CDC only 30-40% of cases present with the classic mumps symptoms. These forty pediatric groups found 7,400 symptomatic cases. So what is the true number of people who get deafness out of so many total infections, both symptomatic and asymptomatic?

This link says that the in 1 in 20,000 stat that the CDC is using is from a study from the year 1957:

http://www.ncbi.nlm.nih.gov/pubmed/3767776

Why then would mumps have gotten MORE deadly as time went on? It doesn't make a lot of sense.

One reason could be it occurs in age groups for which there are more complications (older teens and adults). This happened with measles. I found a study that stated that measles caused death in 1 in 10,000 cases in 1954. Since the introduction of the vaccine, more young babies and adults get the disease (and again they have higher complication rates), so nowadays 1 in 1,000 reported cases result in death. Mumps is endemic in Japan now, but they did vaccinate for it at one time (one article stated they stopped the vaccine in 1993). Did that screw up the pattern of who gets the disease?

Is it how we treat mumps now vs. 50 years ago? Tylenol/acetaminophen usage increases the death rate for measles. Does it for mumps as well? All the websites I googled for "treatment of mumps" recommended it for the fever.

Does anyone know why that happens? I give DD tylenol or motrin when she has a high fever (102ish)- should I not? Is there anything else I can do to help her fever- or is it not even something to worry about. (sorry, I know this is off topic..if someone would message me with the info or something, I would really appreciate it!)

[heathergirl67]

Sileree- Great research and questions. I would be interested to know the answers to those questions, too.

[ema-adama]

Originally Posted by heathergirl67

Oh yeah, and here's a link about Hib:

http://www.mdch.state.mi.us/pha/epi/.../HFLUGRAPH.HTM

The latest data in that slide is from 1998. I am curious if the trend has remained stable in the last 12 years.

I like to see the raw data and look into the details of how it was collected, and how the figures were calculated. I could not find that with this slide. I would also like to see a break down of the different types of invasive disease.....

[ema-adama]

Abstract

In addition to the proportional increase in cases of non-type b Haemophilus influenzae disease in the post-H. influenzae type b vaccine era, the incidence of invasive H. influenzae disease was found to be approaching the rates of H. influenzae type b disease that were documented in the prevaccine period. Fifty-six percent of invasive disease now occurs in individuals aged >10 years.

Characterization of Invasive Haemophilus influenzae Disease in Manitoba, Canada, 2000–2006: Invasive Disease due to Non–Type B Strains
I have not read the full text, but the abstract certainly seems to be pointing to the trend in the slide not being stable. Yes, this is a different population, but I think this at least raises the question of whether the net effect of mass HiB vaccination is actually as effective as it was being presented in 1998.

[Sileree]

I found this website:

http://www.cdc.gov/abcs/reports-find...v-reports.html

It only goes back to 1997, but it has some interesting information.

This is invasive disease for the total population:

1997 - 0.1 per 100,000 of Hi type B, 0.3 per 100,000 of non-B serotypes, 0.6 per 100,000 of non-typeable Hi

National projection for invasive disease: 1.3 per 100,000

2008 - 0.04 per 100,000 of Hi type B, 0.39 per 100,000 of non-B serotypes, 0.94 per 100,000 of non-typeable Hi

National projection for invasive disease: 1.55 per 100,000

For children under 1 specifically:

1997 - 1.7 per 100,000 of Hi type B, 0.0 per 100,000 of non-B serotypes, 3.2 per 100,000 for non-typeable Hi

2008 - 0.40 per 100,000 of Hi type B, 2.18 per 100,000 of non-B serotypes, 6.53 per 100,000 for non-typeable Hi

[amnesiac]

Originally Posted by Sileree

I found this website:

http://www.cdc.gov/abcs/reports-find...v-reports.html

It only goes back to 1997, but it has some interesting information.

1997 - 37 cases of Hi type B (0.1 per 100,000), 64 cases of Hi other serotypes (0.3 per 100,000), 150 cases of non-typeable Hi (0.6 per 100,000)

National projection for invasive disease: 3,400 cases (1.3 per 100,000)

2008 - 15 cases of Hi type B (0.04 per 100,000), 143 cases of Hi other serotypes (0.39 per 100,000), 343 cases non-typeable (0.94 per 100,000)

National projection for invasive disease: 4,700 cases (1.55 per 100,000)

For children under 1 specifically:

1997 - 1.7 per 100,000 for Hi type B, 0.0 per 100,000 for other Hi serotypes, 3.2 per 100,000 for non-typeable

2008 - 0.20 per 100,000 for Hi type B, 2.18 per 100,000 for other serotypes, 6.53 per 100,000 for non-typeable

Any idea how ABCs data compares with numbers for the US as a whole?

[Sileree]

Originally Posted by amnesiac

Any idea how ABCs data compares with numbers for the U.S. as a whole?

According to the most recent Morbidity and Mortality Report (2008), which looks at all collected data for diseases in the U.S. for that year:

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5754a1.htm

For children under 1:

- 0.42 per 100,000 for serotype B
- 3.43 per 100,000 for non-B serotypes
- 2.28 per 100,000 for unknown serotypes

It doesn't tell us about non-typeable strains. But the ABC data was fairly close for group B serotype (0.40 vs. 0.42 per 100,000) and similar for non-B serotypes (2.18 vs. 3.43 per 100,000) in the year 2008.

For the national projection of invasive disease (4,700 cases) it was higher than what was reported: 2,886 cases of invasive Hi disease (all ages and all serotypes)