Questions about Vaccines

[Sumayyahs Mommy]

1) How thoroughly are vaccinations tested on humans prior to being recommended?
After understanding how Genetically Modified Organisms are handled/tested prior to being introduced into our food supply, I am curious how it is done for vaccines.

 

2) Why are vaccinations recommended for ALL kids, versus just ones that have weaker immune systems or are in an otherwise high-risk area/family/activity (like traveling)? There doesn't seem to be a way to truly eradicate a disease from a country, not while there are travelers nor while diseases are evolving.

 

3) Is there a vaccination quota that doctor offices must meet?

 

4) How is insurance related to vaccinations? (Both patient's insurance and doctor's insurance)

 

5) What vaccinations would you expose your kids to? Why or why not?

[prosciencemum]

Hello Sumayyahs Mommy. Welcome to mothering.

1. Vaccines go through several rounds of testing before entering the schedule. I think the most recently added in the USA was rotavirus, so you might consider looking up details of how that was tested. Because vaccines are routinely given to healthy children they are held to higher safety standards than most other drugs.

2. The idea behind a public health decision to vaccinate the vast majority of the population is to provide herd immunity. It's been demonstrated that once more than some large fraction of the population are immune to a disease even if someone enters with the disease it will not spread far so the small numbers of non immune people in the population will be protected.

3/4 are very us specific, so I don't have much to offer.

5. We follow the recommended schedule because I feel convinced it's been developed to be the best for the location its recommended. Having moved countries between kids I have seen how these recommendations change though, so i'm relatively relaxed about delayed schedules, and skipping some vaccines (e.g HepB if there's no high risk factors, varicella, and flu shots).

I'm not sure if you want to debate these points (although I'm pretty sure that will happen on this board). If you're not looking for debate you might want to request the moderators move it to the "Beginning research" board, or start a new thread there.

[WildKingdom]

There is not a vaccine quota that doctor offices have to meet. I believe some insurances give bonuses if a certain percentage of their subscribers are vaccinated, although none of the ones that I contract with do. There are no negative consequences to a doctor for not meeting a "quota."

I'm not sure what you are asking regarding insurance and vaccines. Could you be more specific? Some insurance pays for vaccines, some doesn't. I'm not sure what you mean by "doctors insurance"

[pek64]

Perhaps "doctors insurance" means malpractice insurance.

[Rrrrrachel]

Vaccines are tested extensively before they are licensed.  They have more stringent testing requirements than a typical drug, because they are used on healthy people.  There is also extensive testing that goes on after they are licensed to monitor safety.

You can read about vaccine testing in general here:

http://www.cdc.gov/vaccines/resdev/test-approve.htm

and you can read about the studies required for a particular vaccine by looking it up on the FDA website and looking at the approval letters.  Here's an example for gardasil

http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM094042

The reason they try to encourage everyone to vaccinate and not just high risk populations is to induce herd immunity.  When a high enough proportion of the population is vaccinated it makes it difficult for a disease to get a foothold if there is an outbreak.  Herd immunity is why when someone went to the super bowl with the measles there wasn't a massive outbreak.  Herd immunity protects the people for who the vaccine didn't induce immunity, for whatever reason, as well as people who, for medical reasons, can't be vaccinated.

[kathymuggle]

Originally Posted by Sumayyahs Mommy 

1) How thoroughly are vaccinations tested on humans prior to being recommended?
After understanding how Genetically Modified Organisms are handled/tested prior to being introduced into our food supply, I am curious how it is done for vaccines.

 

These are my concerns wrt to vaccine safety testing.

 

1.  A lot of the testing is done by the vaccine manufacturers themselves.  I think they have a vested interest in portraying vaccines favourably.

2.  A lot of vaccine tests are not done against a non-vaccinated control.  They test one vaccine against another or do a test where one vaccine has an ingredient (say thimerosal) and the other doesn't.  

3.  Most vaccines are not tested on children. I understand why, ethically, it does not change the fact that vaccine are not tested on children.

 

2) Why are vaccinations recommended for ALL kids, versus just ones that have weaker immune systems or are in an otherwise high-risk area/family/activity (like traveling)? There doesn't seem to be a way to truly eradicate a disease from a country, not while there are travelers nor while diseases are evolving.

 

They do it for herd immunity.  I don't doubt profit is involved as well.  With regards to herd immunity, you have to decide how you feel about it, and if you believe in it (and which vaccines it applies to).  No one can say boo to the fact I do not vaccinate for tetanus, for example, as tetanus is not contagious.  

 

There is a big ethical debate around herd immunity and vaccines - but at the end of the day I believe it is my job to protect my kids.  I am not going to have them assume the risks of a vaccine if I believe the risks of the vaccine are higher than the risks of the disease for them. 

 

 

 

3) Is there a vaccination quota that doctor offices must meet?

 

I think some of them get bonuses for high vaccination rates.

 

4) How is insurance related to vaccinations? (Both patient's insurance and doctor's insurance)

 

5) What vaccinations would you expose your kids to? Why or why not?

 

I think measles and polio may have some merit.  The high contagiousness rate plus high degree of nasty side effects if one were to catch the VAD play into this.  I am non-vax - but I do understand why people may vax for the above two diseases.  I wish MMR were availible separately for those who wanted it.

[Chicharronita]

Hello and welcome! 

Originally Posted by Sumayyahs Mommy 

1) How thoroughly are vaccinations tested on humans prior to being recommended?
After understanding how Genetically Modified Organisms are handled/tested prior to being introduced into our food supply, I am curious how it is done for vaccines.

 

I think testing is for the most part done with the best information that researchers have on hand, but one of my concerns is that there may be things that they don't know about and therefore can't screen for. 

An example from the past: SV40 (simian virus #40; named because it was the 40th one discovered in polio vaccines).

SV40 was in the injected form of polio vaccines that were manufactured between 1955 and 1961.

 

It probably came from the kidney cells of infected monkeys, which were used to "grow" the polio virus.

 

Unfortunately at the time it was nearly impossible to detect small quantities of the virus.

 

Regular detection became possible around 1983 with the advent of PCR technology. PCR stands for polymerase chain reaction, and it is a biochemical technology used in molecular biology.

 

Although many deny that there's a connection between cancer and SV40 in vaccines, I don't feel comfortable being injecting with something that can have (at the present) unknown undetectable (with current technology) particles.

 

I also think it's extremely telling how one of the discoverers of SV40, Dr. Berenice Eddy, was demoted and lost her laboratory for exposing what she found to the public. I fear that even now, scientists who discover problems in vaccines face the possibility of the same kind of blackballing.

 

You can read more about this in an old Atlantic Monthly article:

 

The Virus and the Vaccine

[Marnica]

Originally Posted by prosciencemum 

Hello Sumayyahs Mommy. Welcome to mothering.
1. Vaccines go through several rounds of testing before entering the schedule. I think the most recently added in the USA was rotavirus, so you might consider looking up details of how that was tested. Because vaccines are routinely given to healthy children they are held to higher safety standards than most other drugs.
2. The idea behind a public health decision to vaccinate the vast majority of the population is to provide herd immunity. It's been demonstrated that once more than some large fraction of the population are immune to a disease even if someone enters with the disease it will not spread far so the small numbers of non immune people in the population will be protected.
3/4 are very us specific, so I don't have much to offer.
5. We follow the recommended schedule because I feel convinced it's been developed to be the best for the location its recommended. Having moved countries between kids I have seen how these recommendations change though, so i'm relatively relaxed about delayed schedules, and skipping some vaccines (e.g HepB if there's no high risk factors, varicella, and flu shots).
I'm not sure if you want to debate these points (although I'm pretty sure that will happen on this board). If you're not looking for debate you might want to request the moderators move it to the "Beginning research" board, or start a new thread there.

They are routinely given to ALL children healthy or not. 

Vaccines are TESTED on healthy subjects only. Trials do not include children/people with underlying health issues for the most part yet they are mandated for all children. I would think that is a fairly large number of children that are told they HAVE to have certain vaccines yet in reality there is NO safety data for those subgroups that have other chronic health issues. In fact, the fact that they have underlying health issues is often used as a reason why vaccinating is so important for that child. 

[Cynthia Mosher]

Rrrrachel, I've removed your post where you ask Kathy what percentage of trials actually are tested against a placebo vs a non placebo control. While it's nice that you acknowledge that Kathy knows more than you about that topic and that you want benefit from her knowledge, I think it would be best for that to be a separate thread of discussion so that the OP can have her specific questions addressed and discussed without the conversation veering off into that subtopic. 

[Rrrrrachel]

Ok, I thought it went to the op question about how thoroughly vaccines were tested, but I guess not.

[prosciencemum]

I can't understand how it was OT either when the OP was asking about how vaccines are tested. Surely understanding how placebos and other controls work in the tests is part of that.

What is OT I suppose is discussing if the thread is OT so sorry about that!

SummayahsMummy - I hope the responses so far have been helpful to you.

[kathymuggle]

"2.  A lot of vaccine tests are not done against a non-vaccinated control.  They test one vaccine against another or do a test where one vaccine has an ingredient (say thimerosal) and the other doesn't."  kathymuggle

I was asked about my sources for this statement, and I think it was a genuine question, so I will answer it. I think it is "on topic" as long as no huge debate erupts.  It relates to the OP's first point.

Op:  This statement was based on observations I have made from the studies I have seen.  I remember 2 recent ones (threads from last week) one compared Hep A to HPV, one report looked at 7 studies - only one of which compared a vaccine to saline.  

Based on my observations, I suspect a lot of vaccines are not tested against saline.  I do not have a study to back up my observation, but I only looked for 10 minutes or so.  I think the take home message for someone new to vaccine research is to be aware that not all studies compare vaccinated individuals to those injected with saline….and to figure out how that impacts what they are looking at.

Edited by kathymuggle - 12/1/12 at 4:24pm

[Rrrrrachel]

Thanks for clarifying, Kathy. Fair enough.