When Most People In An Outbreak Are Vaccinated

[Turquesa]

So first we had:

Mumps in the Midwest

Mumps in Korea

Pertussis in California

Pertussis on Long Island

Mumps in Australia

Mumps in New York and New Jersey

And even the measles outbreaks of 2008, (notwithstanding CDC spin), still had under half of the cases confirmed to be among the unvaccinated. 

And now, mumps in Berkeley, CA.

I get that vaccines for both mumps and pertussis are both really weak.  I also get that a lot of us only had one mumps vax as kids In fact for pertussis, the current vaccine as administered is probably doing next to nothing. 

But I decided that it was important to keep a running tally of these cases because I'm getting pretty sick of public health officials finger-wagging at those evil "pockets" of unvaccinated people... when they should just humbly admit that a vaccine--or how its administered--is actually to blame.  By the way, we vax for these two diseases.  We also don't get hysterical about herd immunity.

Does anyone else have another example to add?  Or thoughts?

[pers]

Originally Posted by Turquesa 

And even the measles outbreaks of 2008, (notwithstanding CDC spin), still had under half of the cases confirmed to be among the unvaccinated. 

Under half?  How do you figure that?

There were 131 reported cases, 123 of which were US residents.  

63 were not vaccinated due to religious or philosophical exemption.  16 were too young for the vaccine.  Another 17 were delaying vaccination or not vaccinated for unknown reasons.  One was not vaccinated and born before 1957, so assumed to have had the disease not need vaccination, but apparently never had measles or got it twice.  

So, 63+16+17+1=97.   That is 78% of the 123 US cases and 74% of the total 131 cases.  Well over half not vaccinated either way. 

In addition, there were 15 people who had unknown vaccine status, and 8 who were not US residents and so apparently the CDC didn't care abut their vaccination status.  Only 11 cases (8%) was confirmed to have been vaccinated, and of those only 6 (5% of the 131) had had both recommended doses.  
 

[kathymuggle]

Pers...I ran the numbers according to the CDC and came to a similar conclusion you did.  I wonder if the OP has different information or a different spin?

I also clicked on the first link, about mumps and vaccines and it said this:

In a study reported in last week's New England Journal of Medicine, researchers from the Centers for Disease Control and Prevention and several Midwestern state health departments examined the 6,584 cases in the Midwestern outbreak. They found that the incidence was four times higher among people 18 to 24 years old than in all other age groups combined. This was despite the fact that 84% of the mumps patients in that age group (and 63% of the patients overall) had received the recommended two doses of mumps vaccine.

So, while the numbers may not hold in the measles cases, they seem to be holding in the mumps scenario.  I will have to check out the other scenarios when I have time.

 

OP....There do seem to be more outbreaks lately. I wouId have to check this out before I would swear to it. However, working on the theory that there are more outbreaks,there may be several reasons as to why:

 

-vaccines are not as effective as they would like to think.  They did seem to keep certain disease at bay for a while - maybe the diseases are mutating (speculation on my part).  Diseases are cyclical, so maybe it is just time for a natural upswing - vax status or not we should expect to see more cases during an upswing.

 

-evil non vaxxers are to blame.....only vax rates are fairly high and relatively stable. I don't think a small, small minority of non-vaccinators can explain outbreaks.

 

http://children.webmd.com/vaccines/news/20080904/childhood-vaccination-rates-high

 

I think the intense anger at non-vaccinators is caused by the fact the finger pointers know vaccines are far from 100% effective.  If they were highly effective, pro-vaccinators would not give a rats a$$ that little Johnny is unvaccinated, as little Johnny would pose no threat.  I have serious issues with the thinking behind this arguement, but none-the-less I do think that is where the anger and blame is coming from.

 

Oh, and those who point fingers at evil non-vaxxers, particularly those in positions of power, dislike intensely that they cannot control non-vaxxers...how dare we not do as they say, lol. 

 

Interesting topic!

 

 

 

 

Edited by kathymuggle - 10/13/11 at 7:14am

[Jugs]

The thing is though, simply looking at what percent of the cases were vaccinated doesn't give an accurate picture. Since the overwhelming majority of people are vaccinated, its mathematically inevitable for more vaccinated people to get the disease. We need to look at the percentage of unvaxed or partially-vaxed who get the disease in an outbreak, versus the percentage of fully-vaxed who get the disease in an outbreak.

[kathymuggle]

Originally Posted by Jugs 

The thing is though, simply looking at what percent of the cases were vaccinated doesn't give an accurate picture. Since the overwhelming majority of people are vaccinated, its mathematically inevitable for more vaccinated people to get the disease. 

Agreed.

[lokidoki]

I would also venture to say that the unvaxed vs. the vaxed are more likely to be reported...which skews the stats even more.

[Turquesa]

The quote feature is failing me today, so here are my low-tech responses.

Pers, re: measles I only factored in the philosphical and religious exemptions, so I’ll stand corrected.

KathyMuggle, where pertussis is concerned, you’re not really speculating.  The mutated pertussis strain has been common knowledge for some time: http://www.bmj.com/content/316/7125/91.2.full

From that article: “Reports have been widespread, with no clustering in areas of low vaccination. Neither has evidence been found for a similar increase in whooping cough in Belgium near to the Dutch border.”

One of the chief scientists studying this strain, Dr. Fritz Mooi, holds that this is still the case with the more recent outbreaks. http://www.ocregister.com/news/whooping-102691-ocprint-cough-cases.html

Jugs, you’re addressing my point, at least indirectly.  If percentage-wise, so many vaccinated individuals are getting these diseases (100% on Long Island!), the guilt trips against non-vaxxers don’t hold much water.  We really DON’T know that they are to blame, do we?  To take it a step further, it's a slap in the face to the argument that non-vaxxers are putting others in danger; with these diseases, it's the ineffective vaccines that are endangering the public.  I actually wonder if the public health community is so worried about maintaining its credibility that so many of its apologists won’t fess up to how ineffective these vaxes and/or their dosing schedules truly are.   

[Jugs]

Originally Posted by Turquesa 
Jugs, you’re addressing my point, at least indirectly.  If percentage-wise, so many vaccinated individuals are getting these diseases (100% on Long Island!), the guilt trips against non-vaxxers don’t hold much water.  We really DON’T know that they are to blame, do we?  To take it a step further, it's a slap in the face to the argument that non-vaxxers are putting others in danger; with these diseases, it's the ineffective vaccines that are endangering the public.  I actually wonder if the public health community is so worried about maintaining its credibility that so many of its apologists won’t fess up to how ineffective these vaxes and/or their dosing schedules truly are.   

The thing is, though, even if a vaccine were to be 99% effective, the more people that opt out, the more susceptible hosts there would be. Without those breaks in the chain of infection, the vaccine has more opportunity to fail because of the increased exposure to circulating disease.

[Turquesa]

Jugs, so how do you explain the case of the new mutated strain of pertussis that the current vaccine doesn't even go after?  As for mumps, I'm still skeptical.  The bottom line is that vaccinated or not, people who can get it can spread it.  And there's no telling in recent outbreaks whether a vaxed or unvaxed person "started it."  I imagine that the vaxed population in NYS is pretty dang high, considering their draconian vaccination laws. 

(This bears repeating: I'm vaccinating my kids against both diseases.  I hold this tiny prayer inside that at least they'd be safe from the older pertussis strain and that at least they ARE less likely to get measles and rubella). 

[kathymuggle]

Originally Posted by Jugs 

The thing is, though, even if a vaccine were to be 99% effective, the more people that opt out, the more susceptible hosts there would be. Without those breaks in the chain of infection, the vaccine has more opportunity to fail because of the increased exposure to circulating disease.

Assuming you (general you) believe in herd immunity and assuming you believe a tiny percentage of the population is responsible for outbreaks:

There are always going to be people who do not vaccinate their kids.  Always.  My grandmother did not vaccinate her kids (and yes, some vaccines existed).  Instead of pointing fingers (not saying you do this, but some do) at the rather tiny percentage of people who do not vaccinate, it might make more sense for vaccine manufactures to work on increasing the effectiveness of vaccines so a tiny percentage of the population does not bring about an outbreak.  

[Jugs]

Originally Posted by Turquesa 

Jugs, so how do you explain the case of the new mutated strain of pertussis that the current vaccine doesn't even go after? 

Bacteria mutate in an attempt to survive; that's simply what they are biologically driven to do. Fortunately, bacteria mutate rather slowly (this pertussis mutation was identified more than a decade ago), which buys some time to determine if the current vaccine protects against this mutated strain and, if not, reformulate the vaccine with more antigens. 

Originally Posted by kathymuggle 

Assuming you (general you) believe in herd immunity and assuming you believe a tiny percentage of the population is responsible for outbreaks:

There are always going to be people who do not vaccinate their kids.  Always.  My grandmother did not vaccinate her kids (and yes, some vaccines existed).  Instead of pointing fingers (not saying you do this, but some do) at the rather tiny percentage of people who do not vaccinate, it might make more sense for vaccine manufactures to work on increasing the effectiveness of vaccines so a tiny percentage of the population does not bring about an outbreak.  

Of course, which is why mathematical models for herd immunity allow for the fact that no vaccine is 100% effective and not everyone can or will be vaccinated.

[Turquesa]

Originally Posted by Jugs 

Bacteria mutate in an attempt to survive; that's simply what they are biologically driven to do. Fortunately, bacteria mutate rather slowly (this pertussis mutation was identified more than a decade ago), which buys some time to determine if the current vaccine protects against this mutated strain and, if not, reformulate the vaccine with more antigens. 

Of course, which is why mathematical models for herd immunity allow for the fact that no vaccine is 100% effective and not everyone can or will be vaccinated.

Yup.  I know how evolution and adaptation work.    The newer B. pertussis strain was identified over a decade ago, but as recently as 2010, the DTaP vaccine in use wasn't addressing it.  The chief researcher has a theory about why this is:

Much money has been invested in the current vaccine, Mooi said, and if he is right about a new strain, a different vaccine would need to be developed

Keeping in mind that it is impossible to force vaccination on others to attain ANY percentage--as history has unequivocally taught us--it's high time that we see a new and more effective vaccine developed.  To repeat, energy would be far better spent on this effort than on speculative and highly erroneous finger-wagging at disobedient Americans.