Vaccine Safety Curriculum for Medical Residents - American Academy of Pediatrics

[Mirzam]

What a joke!

http://therefusers.com/refusers-newsroom/vaccine-safety-curriculum-for-medical-residents-american-academy-of-pediatrics/

[stik]

That's not really a training guide about vaccine safety.  It's a training guide about communicating with concerned parents about an important public health initiative.  Doctors undergo a lot of training about effective patient communication at a number of points in their education.  The information included in this training is consistent with the published research.  

[slmommy]

I don't have time or energy to even start on this one. I hope it is a joke, but I doubt it, or not far from reality anyway.

People, if your dr. is a condescending $*#@&*%$ who you think has stock lines to "challenge" you instead of respecting your concerns or decision, find a new dr. You pay them, they work for you. 

(NO, I am not suggesting that drs do anything patient wants, before anyone brings that up. And plenty of pedis are exercising their right to fire their patients over vax compliance too. I don't think dr. patient relationships should continue where one or both sides have absolutely no respect for the other). 

On a side note, I wonder if pedis from older generation are more likely to be ok with sel/del/non vaxing. They remember prior schedules, have probably seen some reactions, aren't fresh out of med school, and have probably eaten humble pie a few times. 

[stik]

They also remember pre-vax outbreaks.  

[slmommy]

Originally Posted by stik 

They also remember pre-vax outbreaks.  

yeah, and that argument can go both ways........ chicken pox.

Or those accounts from drs. pre-mmr who asserted those vpds are well tolerated by healthy children (and back in the days moms had antibodies to pass along to infants)...

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1919891/pdf/pubhealthreporig00027-0069.pdf

Quote:

(Measles)

Complications are infrequent, and, with adequate medical care, fatality is rare.

I won't even bring up Dr. Mendelsohn again. 

[Mirzam]

Originally Posted by stik 

They also remember pre-vax outbreaks.  

So do I, and no one was afraid of measles. Revisionist history at its finest. 

[Taximom5]

Originally Posted by stik 

That's not really a training guide about vaccine safety.  It's a training guide about communicating with concerned parents about an important public health initiative.  Doctors undergo a lot of training about effective patient communication at a number of points in their education.  The information included in this training is consistent with the published research.  

It's too bad pediatricians don't undergo a lot of training on how to recognize a vaccine reaction.

Looks like time is instead spent teaching doctors that intelligent, well-educated parents who research vaccines are conspiracy theorists who need "special handling."

Too many of us have had the horrifying experience where our children had severe adverse reactions to vaccines that initially went unrecognized by medical personnel. We were treated like we were crazy and/or stupid, while our children suffered, all because the doctors and nurses had been taught that such reactions were not possible.

[stik]

Historically, measles has a good record of terrifying parents.

[Taximom5]

Originally Posted by stik 

Historically, measles has a good record of terrifying parents.

That's just not true.

Historically, measles has been considered a routine childhood disease--annoying, uncomfortable, and contagious, but with only rare complications, and those in children with underlying health problems.

Before vaccination, parents weren't terrified of it--they expected it. It was common practice to put children to bed with an infected sibling so they would get it and be done with it, according to many, including author and historian John Fitzgerald, author of "The Great Brain" children's books.

[Rrrrrachel]

Measles is one of the leading causes of death of children worldwide. Almost 140,000 children die a year from the measles. Yes, those are mostly in developing countries where they don't have access to the vaccine or proper supportive care, but I don't think it's fair to say that measles isn't a serious illness. Before we had the vaccine here there were 450 or so deaths and around 4,000 cases of encephalitis a year.

[slmommy]

Originally Posted by Rrrrrachel 

Before we had the vaccine here there were 450 or so deaths and around 4,000 cases of encephalitis a year.

You are right, the numbers are here for the deaths, pages 3 and 4, (also interesting to see the other #s and vpds)

http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/cases&deaths.pdf

about 400,000-700,000 cases per year and 300-600 deaths per year, (measles in 1950s and 60s)

[Rrrrrachel]

Never mind, need to practice my careful reading this morning

[Super~Single~Mama]

Originally Posted by Taximom5 

Originally Posted by stik 

Historically, measles has a good record of terrifying parents.

That's just not true.

Historically, measles has been considered a routine childhood disease--annoying, uncomfortable, and contagious, but with only rare complications, and those in children with underlying health problems.

Before vaccination, parents weren't terrified of it--they expected it. It was common practice to put children to bed with an infected sibling so they would get it and be done with it, according to many, including author and historian John Fitzgerald, author of "The Great Brain" children's books.

And now vaxes are routine, annoying, slightly uncomfortable, and only cause problems in those with underlying health problems? Your point?

[slmommy]

Originally Posted by Super~Single~Mama 

And now vaxes are routine, annoying, slightly uncomfortable, and only cause problems in those with underlying health problems? Your point?

Well, two points would be that 1. natural infection gives lifetime immunity, vax no, and 2. natural infection improves ability of mother to pass measles antibodies to her baby (via placenta and breastmilk) which protects them in the early months of life, vaxed moms not so much. 

http://news.bbc.co.uk/2/hi/health/503025.stm

This article also mentions Measles parties in UK, which I have also heard about being more common in Germany and Austria.

http://www.pediatricsdigest.mobi/content/104/5/e59.full

Quote:

Women born in the United States after measles vaccine licensure in 1963 transfer less measles antibody to their infants than do older women. This may result in increased susceptibility to measles among infants.

[Rrrrrachel]

Natural immunity also fades with time. Herd immunity is also effective at protecting an unvaccinated infant, and without the risks associated with the measles.

Vaxxed moms still pass on antibodies, although not as much.

[slmommy]

The first thing I posted, this

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1919891/pdf/pubhealthreporig00027-0069.pdf

from 1967? puts herd immunity level at 55%. I guess that's why they thought they could eradicate measles in a year. Nowadays I believe they think we need at least low 90s for herd immunity.

I wonder how many adults who received MMR as kids no longer have immunity. 

I wonder what will happen when baby boomer generation is out of the picture, the last generation with significant natural immunity.

[Rrrrrachel]

I don't know, because to my knowledge mmr is not one they've had a problem with fading overtime (like pertussis, for example.). You could just as easily ask how many adults that had measles have had their immunity fade, since natural immunity also fades, though ore slowly.

Rubella can be caught more than once, so even natural immunity isn't perfect.

[slmommy]

I'm guessing that more boosters will need to be added after that chunk of population with natural immunity is no longer around. There are a lot of vaxed women who have lost immunity to rubella and find out during pregnancy. I haven't seen any numbers for measles, but I'm guessing there are quite a few adults who had MMRs as kids and it has worn off. 

Paul Offit says:

Quote:

 natural infection with 'systemic' viruses such as measles, mumps, rubella, or varicella often confers life-long protection against mild disease associated with reinfection.

http://www.ncbi.nlm.nih.gov/pubmed/11444023?dopt=Abstract

[Rrrrrachel]

You can get rubella more than once, the vaccine isn't perfect (no vaccine is) and natural infection does not necessarily prevent you from getting it again.

There is no evidence that measles or mumps immunity fades significantly over time. Mir you have some data on fading titers I'd love to see it, but otherwise guessing is exactly what you're doing.

[Rrrrrachel]

Natural infection OFTEN offers lifelong protection against MILD disease. It's certainly true that natural infection provokes a much stronger response from the immune system (since you actually get sick,) resulting in higher titer levels, but that natural immunity still fades over time. That's why people who had chicken pox get shingles. Their natural immunity fades and it allows the virus to reactivate.

Vaccine based immunity does fade more quickly (again, since you don't actually have to get sick in the first place this seems like a fair trade off, to me), but as vaccination programs effectively eliminate more diseases that becomes less of an issue.