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Infant mortality rates regressed against number of vaccine doses routinely given: Is there a...

post #1 of 29
Thread Starter 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170075/?tool=pubmed

 

 

 

Quote:
Despite the United States spending more per capita on health care than any other country,4 33 nations have better IMRs. Some countries have IMRs that are less than half the US rate: Singapore, Sweden, and Japan are below 2.80. According to the Centers for Disease Control and Prevention (CDC), “The relative position of the United States in comparison to countries with the lowest infant mortality rates appears to be worsening.”5
post #2 of 29
The limitations listed in that study are staggering and their rationales for not including these factors are weak. They didn't consider the heterogenity of the demographics per country (the amount of different races present). they didn't consider preterm birth rates (the Us ranks high here as well); they didn't consider how a country defines a live birth (some countries would count an infant born prematurely a miscarriage or stillbirth even if the child lives a few days the United States does not).

since those factors are not difficult to statistically consider in the analysis my guess is Mr. Miller did so, and found they account for most or all of his .7 correlation so he left them out and only discussed them this way as if they didn't because he would never publish something that showed vaccines not as a villian (Neil Miller is the director of an organizaiton that promotes not vaccinating).

Also, what other things could we compare and regress in this fashion without controlling for vital components? The number of internet users per capita and infant mortality? Number of cell phone towers? Number of cell phone users? Number of viewers of American football? All of those things would give you a high correlation if you don't control for demographics preterm birth rates and definition of live birth.
post #3 of 29
Quote:
Originally Posted by Dakotacakes View Post

they didn't consider preterm birth rates (the Us ranks high here as well); they didn't consider how a country defines a live birth (some countries would count an infant born prematurely a miscarriage or stillbirth even if the child lives a few days the United States does not)

 

"We" (the US) also generally try harder to save micropreemies, which doesn't always work out as well as we would like, and that increases our infant mortality rate.

post #4 of 29

This was discussed here before:  http://www.mothering.com/community/t/1358055/more-vaccines-equal-more-infant-deaths-study-documents

 

It is complete garbage.  There are many detailed posts in the other thread showing why, but in brief, from the last paragraph of my own previous post: 

 

 


Quote:
Originally Posted by pers View Post

So basically, to sum up, this study tried to boil down an incredibly complex subject down to one variable, completely ignoring (except to give a brief and flimsy reason why a few factors could be ignored) all other factors which could cause the rates to be as they are.  It uses a way of counting vaccines that doesn't make much sense scientifically, data from only one year, in which most of the countries with the lowest number of vaxes have lot of factors in common beyond vaccine schedule, and excludes all countries with a worse IMR than the US on order to find a correlation between vaccines and IMR.  Yeah, I think they are a loooooooooooooong way from even hinting at causation.  

 
post #5 of 29

Thanks for posting Emmy. 

 

I had no idea that most of the Scandinavian countries with socialized medicine require so few vaccines (12) as compared to the U.S. (26). Neither does Japan (12).

It appears that they are able to achieve good health without having to give so many vaccines (although I admit that there are a lot of other factors that are probably responsible besides lack of vaccines the U.S. considers "necessary"). 

post #6 of 29
Quote:
Originally Posted by Chicharronita View Post

Thanks for posting Emmy. 

 

I had no idea that most of the Scandinavian countries with socialized medicine require so few vaccines (12) as compared to the U.S. (26). Neither does Japan (12).

It appears that they are able to achieve good health without having to give so many vaccines (although I admit that there are a lot of other factors that are probably responsible besides lack of vaccines the U.S. considers "necessary"). 

 

Scandinavian countries do do a fewer vaccines than the US.  Timing also plays an important factor in these numbers as for some vaccines it is not that they are not given in Scandinavian countries but that they are given later.  The US gives infant vaccines at 2, 4, and 6 months.  Scandinavian countries give them at 3, 5, and 12 months.  Sweden, for instance, gives third doses for DTaP, IPV, Hib, Pneumo(6 vaccines, by their way of counting) at 12 months, and thus these doses are not included in their numbers as it is only for vaccine given before one year of age.  In the US, these vaccines are given at 6 months, and thus are included in the numbers.  

 

Also interesting is that the Scandinavian countries are not in complete agreement as to which vaccines are most important.  Sweden, Norway, and Denmark all give three doses of pneumo vaccines (only two of which are included in these numbers for each, since the third is at 12 months). Iceland does not, but has the same number of vaccines since it gives MenC, which the others do not  Finland does not give either MenC or pneumo, but does give three doses of rotavirus vaccine.  The US, of course, gives all three.  

 

Point of interest, British Columbia may not be it's own country, but it has a population similar in size to that of Iceland and it's own vaccine schedule.  It's routine immunization schedule would be counted as 25 vaccines, if counted as they were in this paper, only one less than the US.   British Columbia's infant mortality rate for 2009 (the year used in this paper) was 3.6.  If it were it's own country, it would have been at number 8 on the list ordered by IMR, having almost exactly the same rate as Norway (12 vaccines).   If the vaccine schedule in the US was contributing to the high infant mortality rate there, then why wouldn't it be doing the same in British Columbia, Canada?    

post #7 of 29

I agree with some vaxxers that vaccines may not  be overly relevant to infant mortality rates.  There are so many variables and factors that play into infant mortality rates.  It does make me wonder, though, why people are so zealously pro-vaccine when vaccines apparently have little to do with broad health indicators in developed countries - such as infant mortality.

post #8 of 29

Yes, the vaccine stats don't hold water but the premature factor in U.S. is no excuse for our miserable IMR. CDC says "The U.S. 'does a good job of saving babies when they are born preterm,' Marian F. MacDorman, PhD, of the CDC’s National Center for Health Statistics, tells WebMD. 'The problem we have is prevention, preventing that preterm birth, and that’s where we are in trouble, I think.' "   That we have more preterm births (and thus more infant losses) doesn't make us any better at bringing fetuses into healthy children. Blaming it on races or education or other factors doesn't make us look any better either. Supposedly, apparently, according to U.S. medical standards, all a baby needs is lots of spending, lots of birth interventions, induced labors, c-sections, lots of vaccines, drugs, scheduled feedings and the like; then U.S. should be way ahead. Attention to factors of reduced stress, better nutrition/less junk food for moms, exclusive breastfeeding for babies, natural onset of labor, better support for moms, ample togetherness for mother and baby, and other influences are not considered needed factors by U.S. medicine but do have large impacts. The micropreemie aspect has been shown/admitted in past to have very slight statistical impact.

post #9 of 29
Thread Starter 
Quote:
Originally Posted by lfpalmer View Post

Yes, the vaccine stats don't hold water but the premature factor in U.S. is no excuse for our miserable IMR. CDC says "The U.S. 'does a good job of saving babies when they are born preterm,' Marian F. MacDorman, PhD, of the CDC’s National Center for Health Statistics, tells WebMD. 'The problem we have is prevention, preventing that preterm birth, and that’s where we are in trouble, I think.' "   That we have more preterm births (and thus more infant losses) doesn't make us any better at bringing fetuses into healthy children. Blaming it on races or education or other factors doesn't make us look any better either. Supposedly, apparently, according to U.S. medical standards, all a baby needs is lots of spending, lots of birth interventions, induced labors, c-sections, lots of vaccines, drugs, scheduled feedings and the like; then U.S. should be way ahead. Attention to factors of reduced stress, better nutrition/less junk food for moms, exclusive breastfeeding for babies, natural onset of labor, better support for moms, ample togetherness for mother and baby, and other influences are not considered needed factors by U.S. medicine but do have large impacts. The micropreemie aspect has been shown/admitted in past to have very slight statistical impact.

Well said

post #10 of 29
Quote:
Originally Posted by kathymuggle View Post

I agree with some vaxxers that vaccines may not  be overly relevant to infant mortality rates.  There are so many variables and factors that play into infant mortality rates.  It does make me wonder, though, why people are so zealously pro-vaccine when vaccines apparently have little to do with broad health indicators in developed countries - such as infant mortality.

 

 

Not really, when you consider which vaccine preventable diseases are most likely to contribute to infant mortality and then look at the similarities and differences in the vaccine schedules.

 

All countries in the paper give DTaP, though a few give it at 3, 5, and 12 months (meaning the 12 month one isn't counted for this paper) instead of 2, 4, and 6 months.  All countries give polio vaccine (again, on different schedules, but still given, whether oral or injected).  Most countries give HIB. MMR wouldn't show up in this paper as most countries give it after 12 months, but I'm pretty sure all countries give at least measles and rubella (mumps is optional in Japan), and while infants aren't given it, this helps infant mortality by preventing congenital rubella syndrome and by herd immunity preventing infants from being exposed to measles. 

 

The differences? Well, one of the vaccines the US gives that many countries do not is rotavirus.  Rotavirus is deadly in developing nations, but in the US, death from it is quite rare. It has, however, put a lot of babies in the hospital with severe illness.  Death is not the only thing vaccines are intended to prevent. Other differences are the US and some others give the hepatitis B series during infancy for all babies.  Many other countries only give it to babies deemed at risk.  Hepatitis B does not, to my understanding, typically kill infants so wouldn't contribute to infant mortality, but hepatitis B in infants/young children can result in chronic infection with long term complications that may kill them later.  Also I suspect that it may be standard for everyone in the US because the US has had a bigger problem with Hep b in infants than countries that do not - on the other hand, some countries still vaccinate for tubercolosis because it is a bigger problem in them than it is in the US.  MenC and Pneumo are two others that the US gives that some others do not, though more countries are starting too.  How much do these disease contribute to infant mortality?    

post #11 of 29
Quote:
Originally Posted by pers View Post


 Death is not the only thing vaccines are intended to prevent.    

That. smile.gif
post #12 of 29
The fact that preterm babies are vaccinated BEFORE they reach the previously expected due date, and continue to receive vaccinations well before the correlating dates if they had been born at full term cannot be discounted here.

My oldest received hep B at 4 hours old, even though he was only 4 1/2 pounds. He received all other recommended vaccines either on schedule or early, even though he was extremely small, hade other health issues, and had a documented severe reaction at 2 months.

I've heard similar stories from other moms of preterm babies.
post #13 of 29
Quote:
Originally Posted by prosciencemum View Post


That. smile.gif

Except this is a thread on infant mortality.

post #14 of 29
Quote:
Originally Posted by pers View Post

 

 

Not really, when you consider which vaccine preventable diseases are most likely to contribute to infant mortality and then look at the similarities and differences in the vaccine schedules.

 

All countries in the paper give DTaP, though a few give it at 3, 5, and 12 months (meaning the 12 month one isn't counted for this paper) instead of 2, 4, and 6 months.  All countries give polio vaccine (again, on different schedules, but still given, whether oral or injected).  Most countries give HIB. MMR wouldn't show up in this paper as most countries give it after 12 months, but I'm pretty sure all countries give at least measles and rubella (mumps is optional in Japan), and while infants aren't given it, this helps infant mortality by preventing congenital rubella syndrome and by herd immunity preventing infants from being exposed to measles. 

 

The differences? Well, one of the vaccines the US gives that many countries do not is rotavirus.  Rotavirus is deadly in developing nations, but in the US, death from it is quite rare. It has, however, put a lot of babies in the hospital with severe illness.  Death is not the only thing vaccines are intended to prevent. Other differences are the US and some others give the hepatitis B series during infancy for all babies.  Many other countries only give it to babies deemed at risk.  Hepatitis B does not, to my understanding, typically kill infants so wouldn't contribute to infant mortality, but hepatitis B in infants/young children can result in chronic infection with long term complications that may kill them later.  Also I suspect that it may be standard for everyone in the US because the US has had a bigger problem with Hep b in infants than countries that do not - on the other hand, some countries still vaccinate for tubercolosis because it is a bigger problem in them than it is in the US.  MenC and Pneumo are two others that the US gives that some others do not, though more countries are starting too.  How much do these disease contribute to infant mortality?    

  You said "not really" and then said nothing that disproved my point. 

post #15 of 29

 

Quote:
Originally Posted by kathymuggle View Post

  You said "not really" and then said nothing that disproved my point. 

 

 

Well, apparently I failed to make my point.  So to break it down a little better, you said:  

 

Quote:

Originally Posted by kathymuggle View Post

I agree with some vaxxers that vaccines may not  be overly relevant to infant mortality rates.  There are so many variables and factors that play into infant mortality rates.  It does make me wonder, though, why people are so zealously pro-vaccine when vaccines apparently have little to do with broad health indicators in developed countries - such as infant mortality.

 

Firstly, I responded to the idea that "vaccines have little to do with broad health indicators in developed countries." 

 

Okay, if you want to show this is true, then find developed nations who don't vaccinate for diptheria, tetanus, pertussis, polio, and hib in infancy.  Also find countries that don't use vaccines in older kids/adults that protect infants such as rubella to prevent congenital rubella syndrome and measles vaccine which helps avoid exposing infants to measles.  

 

You won't, because aside from a few Asian countries not giving HIB, every country involved in the paper vaccinates for these things.  They may do it on a bit different schedule, in which case you are not considering the case of vaccinating for pertussis vs. not vaccinating for pertussis is going to have a noticeable impact on infant mortality but rather whether when six months old babies in both countries have had two doses, whether giving the third dose at six months or delaying it two twelve months prevents/allows enough pertussis deaths to show up in overall infant mortality figures.  

 

You are also looking a the difference vaccines that the US uses that other countries may or may not make such as rotavirus, penumo, menc, and hep b.  

 

That brings me to my second point, which was addressing  your implication that vaccines were pointless if they didn't prevent infant mortality.  That's like saying that there is no point in testing infant's hearing because this screening hasn't been shown to reduce infant mortality either.  Rotavirus kills a lot of children in developing nations, but only a few dozen a year in the US - not nearly enough to make a blip in overall infant mortality when compared to the over 25,000 deaths in an average year.  However, rotavirus also put over 50,000 infants in the hospital each year, and the number of rotavirus hospitalizations have decreased significantly since the vaccine.  Severe illness is also worthy of trying to pevent.

 

Hepatitis B doesn't generally kill infants, I believe.  It can make them pretty sick though.  And infants/young children who get hepatitis B are more likely than adults to develop chronic infections which can kill them eventually, though those deaths wouldn't be included in infant mortality since they happen later. 

 

So we are down to pneomo and menc.  Pneumo only kills a couple hundred infants a year, and MenC far less event than that, so again they wouldn't show up in overall infant mortality numbers - does that mean these deaths aren't worth trying to prevent?  However, again both result in more hospitalizations than deaths and can have serious long term complications.  


Edited by pers - 12/30/12 at 10:32pm
post #16 of 29
Quote:
Originally Posted by pers View Post

 

Firstly, I responded to the idea that "vaccines have little to do with broad health indicators in developed countries." 

 

Okay, if you want to show this is true, then find developed nations who don't vaccinate for diptheria, tetanus, pertussis, polio, and hib in infancy.  Also find countries that don't use vaccines in older kids/adults that protect infants such as rubella to prevent congenital rubella syndrome and measles vaccine which helps avoid exposing infants to measles.  

 

I don't have to.  I said infant mortality is a broad health indicator.   I have not mentionned getting rid of vaccines altogether.  Therefore I do not have find developed countries that do not vaccinate.  More vaccines clearly do not equal better infant mortality when you compare IMR and number of vaccines in developed nations.

 

You won't, because aside from a few Asian countries not giving HIB, every country involved in the paper vaccinates for these things.  They may do it on a bit different schedule, in which case you are not considering the case of vaccinating for pertussis vs. not vaccinating for pertussis is going to have a noticeable impact on infant mortality but rather whether when six months old babies in both countries have had two doses, whether giving the third dose at six months or delaying it two twelve months prevents/allows enough pertussis deaths to show up in overall infant mortality figures.  

 

You are also looking a the difference vaccines that the US uses that other countries may or may not make such as rotavirus, penumo, menc, and hep b.   You are pretty much saying this yourself.  These vaccines do not impact infant mortality rates in a big way.  

 

That brings me to my second point, which was addressing  your implication that vaccines were pointless if they didn't prevent infant mortality.

You said this, not me.  This thread is about infant mortality.

 

 

That's like saying that there is no point in testing infant's hearing because this screening hasn't been shown to reduce infant mortality either.  Rotavirus kills a lot of children in developing nations, but only a few dozen a year in the US - not nearly enough to make a blip in overall infant mortality when compared to the over 25,000 deaths in an average year.  However, rotavirus also put over 50,000 infants in the hospital each year, and the number of rotavirus hospitalizations have decreased significantly since the vaccine.  Severe illness is also worthy of trying to pevent.

 

See above.  I can define infant mortality for you if you like. wink1.gif  If you have a vent about how vaccines do more than save lives, you might want to start another thread.  If the babbling in this post is in answer to the question "why are some people so zealously pro-vax" it would have been clearer to say "because some people are concerned with more than just mortality rates."  I think this is a fair point, but let's face it - mortality rates are the most important thing, and the fact that vaccines do not seem to impact mortality rates does take the zip out of "accept all our vaccines and on schedule or your babies will die!!!" scenario.  

 

Hepatitis B doesn't generally kill infants, I believe.  It can make them pretty sick though.  And infants/young children who get hepatitis B are more likely than adults to develop chronic infections which can kill them eventually, though those deaths wouldn't be included in infant mortality since they happen later. 

 

and again with the off topic stuff...

 

So we are down to pneomo and menc.  Pneumo only kills a couple hundred infants a year, and MenC far less event than that, so again they wouldn't show up in overall infant mortality numbers - does that mean these deaths aren't worth trying to prevent?  However, again both result in more hospitalizations than deaths and can have serious long term complications.  

 

Italics.  Nice to know!  My own off topic point (or on, as it deals with mortality) have you seen Mizrams link showing the deaths reported from the a pneumo vaccine?  I know it is from AoA, but it might be worth pursuing to see if they are on to something…I digress.  You are absolutely correct.  Pneumo and Men C do not save very many lives, and therefore do not impact in any significant way the infant mortality rates.  


Edited by kathymuggle - 12/31/12 at 6:58am
post #17 of 29

Quote:

Originally Posted by kathymuggle View Post

I agree with some vaxxers that vaccines may not  be overly relevant to infant mortality rates.  There are so many variables and factors that play into infant mortality rates.  It does make me wonder, though, why people are so zealously pro-vaccine when vaccines apparently have little to do with broad health indicators in developed countries - such as infant mortality.

 

 

In agreement with graphs from CDC and NIH data on all kinds of infectious diseases, Dr. Nelson, in representation of leading John Hopkins School of Public Health makes a statement to the same effect as kathymuggle's statement. He writes: "It is frequently assumed that the ... development of vaccines and antibiotics are the reasons that mortality has changed, but this is not quite true for most infectious diseases."
 

Look carefully at frame 11 at this link:  http://ocw.jhsph.edu/courses/EpiInfectiousDisease/PDFs/EID_lec1_Nelson.pdf   The same is seen for other diseases. Reductions in mortality can always be reported over a period of time coinciding with the introductions of vaccination programs in developed countries as basic hygiene and understanding of infectious processes and improved nutritional knowledge have led to steady drops in infectious diseases over a long period of time. In recent decades, as you can also see from this link, overall infectious disease mortality has actually grown in the U.S. despite our vast number of vaccinations. These are attributed largely to HIV and to MRSA, while the epidemic of MRSA can be contributed to two factors:  excessive use of antibiotics, and meningitis vaccines that have created voids of traditional opportunistic bacteria, allowing niches for replacement with far more virulent MRSA bacteria.

In terms of the rotavirus you mention, see this story on my site where I present that "Exclusive breastfeeding cuts diarrhea in Brazil by 90%, versus 40% cut by vaccination in Mexico.":  http://thebabybond.com/    Early introduction of solid foods or formula supplements greatly impair breastmilk's ability to protect. Maybe vaccination is best reserved for those who do not have availability of exclusive breastmilk.

post #18 of 29

Here is more relevant info on the rotavirus vaccine (though maybe it should go to new thread):  http://pharmabiz.com/NewsDetails.aspx?aid=72845&sid=1

This paper describes the "debt trap" created by pharmaceutical industries where early subsidies for new vaccination programs are later dropped, and it discusses the unlikeliness of this vaccine having much value India. It also demonstrates how twisting of figures occur to provide initial supportive data for a vaccine's efficacy (and remember, from post above, that they only even claimed 40% reduction).

post #19 of 29
Quote:
Originally Posted by lfpalmer View Post

 


In terms of the rotavirus you mention, see this story on my site where I present that "Exclusive breastfeeding cuts diarrhea in Brazil by 90%, versus 40% cut by vaccination in Mexico.":  http://thebabybond.com/    Early introduction of solid foods or formula supplements greatly impair breastmilk's ability to protect. Maybe vaccination is best reserved for those who do not have availability of exclusive breastmilk.

Then there was also the bit last year about breastmilk essentially making the vax useless, and I was really surprised that the study didn't hit the mainstream more:

 

http://www.ncbi.nlm.nih.gov/pubmed/20442687

post #20 of 29
That study was blown out of proportion enough as it was.
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