s/o how the unvaxxed contribute to health

[kathymuggle]

Cyberfish mentioned in another thread that the unvaxxed can contribute to community health.  This is not an idea I had given much thought to, but it intrigues me.

I am specifically interested in whether having unvaxxed people (who are more likely to catch a disease) actually keeps the disease in existence in its current state and helps to keep it from morphing into something possibly more dangerous (at a minimum something we are less equipped to deal with).  

What do you think?  Am I out to lunch?  Does keeping a disease around through non-vaxxing (assuming diseases can be kept around through non-vaxxing - which is a leap, depending on the disease) actually help keep a disease from changing into something  else?    

Edited by kathymuggle - 3/9/13 at 8:00am

[cyberfish]

I will try to post more later but a few quick thoughts...

I think we need to do away with the idea that good community health means the absence of a select few diseases for which we have vaccines, to begin with.  I'm not entirely convinced that not vaccinating means keeping a disease around, either, a concept about which you seem to be skeptical as well.  Pertussis comes in cycles and they've found that it is not the unvaxed who are keeping it around.  Scarlet fever declined rapidly at the beginning of the 20th century and scientists are still not sure why.  There's never been a vaccine for it.  

As I mentioned before with pertussis, if you are not vaccinated and have a cough, you will (hopefully) stay in because you are ill.  If you are vaccinated, you may still be a carrier of pertussis because the vaccine reduces symptoms in the affected; it doesn't affect transmission.  So this argument may be tenuous, but it seems that in this case the vaccinated may be unwitting transmitters of an illness from which they are "protected."  So in this regard, cocooning newborns by having parents get the DTaP seems futile.   

Also, with HiB, as I also mentioned, we've paved the way for more lethal strains of this illness to fill the vacant ecological niche.  Had we left well enough alone this would not be an issue.  

[cyberfish]

Another quick thought and then I realllllly have to go....

Look at the problems caused by antibiotic overuse.  It's in everything -- soaps, even.  So now what do we have?  Resistant bacteria.  I think we're messing with things that we have no business messing with.  

[MamaMunchkin]

The first thing that came to mind was - natural boosting.   Not sure how this notion applies, if at all, to all VPDs though.  But for VPDs where this applies, I'd be interested to know if/how having some wild virus around would reduce the need for vax booster.  If so, given a VPD, what's the minimum number of unvaxed necessary to reduce, or eliminate, booster?

We have figures on minimum vax coverage needed for herd immunity.  Similarly, is it possible that there is some minimum - unvax - coverage that can reduce/eliminate booster?  What's the interplay between these 2 figures, if any?  Keep enough many people "safe" from VPD, while also maximizing how long vax immunity lasts.   

The other thing that came to mind was from an article from a few months ago about how getting sick from mumps have some protective effect against ... I don't remember which ... some cancer ... was it breast or ovarian ...??  It makes me wonder, do other VPDs have some protective effect against other diseases as well?

Given the current climate on vaccine, not sure we'll learn about any of these in the near future though.

[kathymuggle]

Originally Posted by cyberfish 

As I mentioned before with pertussis, if you are not vaccinated and have a cough, you will (hopefully) stay in because you are ill.  If you are vaccinated, you may still be a carrier of pertussis because the vaccine reduces symptoms in the affected; it doesn't affect transmission.  So this argument may be tenuous, but it seems that in this case the vaccinated may be unwitting transmitters of an illness from which they are "protected."  So in this regard, cocooning newborns by having parents get the DTaP seems futile.   

Agreed.

The burden of pertussis has shifted - from preschool and school age children to babies and older teens/adults.  I don't think anyone is overly concerned with the burden shifting to adults (if someone is going to get pertussis, a healthy adult might be the safest choice) - but babies are another story.  What is unclear to me is whether or not pertussis has increased or decreased in infants.  Do babies just seem to be getting pertussis more because older kids are not, so it looks bad in comparison? Or has the actual rate in babies increased?  

Also, with HiB, as I also mentioned, we've paved the way for more lethal strains of this illness to fill the vacant ecological niche.  Had we left well enough alone this would not be an issue.  

Good Point.  

 

Originally Posted by MamaMunchkin 

The first thing that came to mind was - natural boosting.   Not sure how this notion applies, if at all, to all VPDs though.  But for VPDs where this applies, I'd be interested to know if/how having some wild virus around would reduce the need for vax booster.  If so, given a VPD, what's the minimum number of unvaxed necessary to reduce, or eliminate, booster?

Some of this may be disease specific.  We know with chicken pox that we do not have enough wild chicken pox floating around to reduce the need for boosters.  We know this because of the shingles uptake.  the vaccination rate for varicella is around 90%  (per CDC) so at least where chicken pox is concerned, we need a rate higher than 10% unvaxxed to induce immune boosting properties.

We have figures on minimum vax coverage needed for herd immunity.  Similarly, is it possible that there is some minimum - unvax - coverage that can reduce/eliminate booster?  What's the interplay between these 2 figures, if any?  Keep enough many people "safe" from VPD, while also maximizing how long vax immunity lasts.

I wonder this as well.   

Given the current climate on vaccine, not sure we'll learn about any of these in the near future though.

No, we probably won't.  It is too bad - with pertussis and chicken pox, I think looking at big picture alternate methods of disease control might be wiser than just throwing more vaccines at it.  

[pek64]

Originally Posted by kathymuggle 

Cyberfish mentioned in another thread that the unvaxxed can contribute to community health.  This is not an idea I had given much thought to, but it intrigues me.

I am specifically interested in whether having unvaxxed people (who are more likely to catch a disease) actually keeps the disease in existence in its current state and helps to keep it from morphing into something possibly more dangerous (at a minimum something we are less equipped to deal with).  

What do you think?  Am I out to lunch?  Does keeping a disease around through non-vaxxing (assuming diseases can be kept around through non-vaxxing - which is a leap, depending on the disease) actually help keep a disease from changing into something  else?    

I question whether unvaxxed are more likely to catch a disease. Without a sense of security from vaccinations, they may be more proactive regarding their personal and family health. They seem to place higher value on good nutrition and habits than vaxxers. But that may be too far off topic for what you want to explore here.

[sassyfirechick]

Originally Posted by pek64 


I question whether unvaxxed are more likely to catch a disease. Without a sense of security from vaccinations, they may be more proactive regarding their personal and family health. They seem to place higher value on good nutrition and habits than vaxxers. But that may be too far off topic for what you want to explore here.

I do think this is a component.  In my group of friends and even acquaintances, I'm the only non-vaxxer.  There's one or 2 delay vaxxers, and then a good 3 dozen that 'vax to the max'!  My self and my family, we do take a lot of what some would call extra steps to ensure a strong natural immune system, and I can say that the 2 delayed vax families follow a similar lifestyle.  The others, well we're talking full on SAD, antibiotics for every sniffle, chemicals in the house and yard....any one of them might decide to "go heathy" and make a dietary change - but that consists of skim milk and weight watchers meals with a diet soda. 

Back to the OP, I think that if non-vaxxers do follow healthier living choices because they have educated themselves in not only vaccines but in the basics of the immune system then yes, they can play an integral part in ensuring that viruses don't mutate to a point where the natural immune system can no longer handle them.  It's silly to try and eliminate certain diseases when so many more are out there, and many of the ones we focus on can be fairly benign anyways.

All of my co-workers dutifully got their flu vax, I did not.  So far 2 have been positive for the flu over the course of the season, and the rest, while they haven't had the flu they've each had multiple illnesses ranging from stomache bugs to coughing fits to month long sniffles - all coming to work with these issues only to leave early.  Now where I work it can't be argued that sick time isn't available - it's a town job, cushy benefits, lots of time off.  Now I'm part time so none of that even applies to me, but the one cold I had I did stay home, on my own dime, to recoup and care for my DD who also got sick (it was following a well baby visit - so we caught something at the pedi's, of course). 

[MissCee]

Originally Posted by MamaMunchkin 

The first thing that came to mind was - natural boosting.   Not sure how this notion applies, if at all, to all VPDs though.  But for VPDs where this applies, I'd be interested to know if/how having some wild virus around would reduce the need for vax booster.  If so, given a VPD, what's the minimum number of unvaxed necessary to reduce, or eliminate, booster?

We have figures on minimum vax coverage needed for herd immunity.  Similarly, is it possible that there is some minimum - unvax - coverage that can reduce/eliminate booster?  What's the interplay between these 2 figures, if any?  Keep enough many people "safe" from VPD, while also maximizing how long vax immunity lasts.   

The other thing that came to mind was from an article from a few months ago about how getting sick from mumps have some protective effect against ... I don't remember which ... some cancer ... was it breast or ovarian ...??  It makes me wonder, do other VPDs have some protective effect against other diseases as well?

Given the current climate on vaccine, not sure we'll learn about any of these in the near future though.

This was a study done between mumps and reducing the risk of ovarian cancer! I have it bookmarked and I've read through it a few times ...it's super thought provoking I think! 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951028/

[fruitfulmomma]

[ma2two]

Kids who get chickenpox help protect others against shingles, from the natural booster effect.

[MamaMunchkin]

Originally Posted by MissCee 

This was a study done between mumps and reducing the risk of ovarian cancer! I have it bookmarked and I've read through it a few times ...it's super thought provoking I think! 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951028/

That's the one - thanks!

Now, where are all those risk-benefit analyses of getting mumps vs getting ovarian cancer, esp. for women?  I know, I know ... it's a rhetorical question ...

[kathymuggle]

Originally Posted by MissCee 

This was a study done between mumps and reducing the risk of ovarian cancer! I have it bookmarked and I've read through it a few times ...it's super thought provoking I think! 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951028/

That is one interesting study!

A few of my favorite lines:

"In eight observational studies addressing the association, the summary odds ratio was <snip> suggesting a 19% decrease in risk of ovarian cancer associated with history of mumps parotitis."

"Despite the epidemiologic evidence that mumps might reduce the risk of ovarian cancer, this association has largely been ignored, probably due to the lack of a plausible biologic explanation. "

Gotta love this ^ one^    Researchers did not understand how a pattern they observed could be possible, so they ignored it.  

"Understanding the scope of and basis for the potential benefits of childhood infections may allow immunologists to duplicate the beneficial effects at the same time that vaccination provides the means for avoiding a natural infection and its possible immediate consequences."

I like that they acknowledge there might be some benefit to childhood infections.  Of course, rather than look at whether or not it might be Ok for mumps to circulate among healthy children, they suggest building a better vaccine to duplicate the effects of mumps (it reminds me of trying to make formula duplicate breast milk…I am skeptical it can happen).  Of course, to the best of my knowledge, this study has not resulted in people  trying to build a better mumps vaccine.  

Go to:

 

[kathymuggle]

More later, with sources if people like,

I looked up the number of deaths from ovarian cancer in the USA and it is about 15 000 per year.  If mumps prevents 19% of cases (we could then assume 19% of deaths), getting the mumps would prevent about 2850 deaths per year.  

According to the CDC pink book, the height of mumps deaths was in the early 60's prior to vaccination.  Around 53 people died of mumps, and the USA population was around 179 million.  So, if we had the same death rate today, with the population being double, we might have around 106 deaths.  Of course only women get ovarian cancer, so half the mumps deaths do not count (we need to compare women to women)…and we are back at 53.

So - in the ovarian corner, we have 2850 deaths yearly that could have been prevented through getting the mumps.

In the mumps corner, we have 53 deaths from mumps.

 

I get the above is simplistic.  My math may be very slightly off (not everyone who gets ovarian cancer dies from it - although most do).  The mumps survival rate might be higher now that the 1960's - although probably not.  The numbers of death  (2850 versus 53) are so far apart though, that even nitpicking my math is unlikely to change things in a huge way.

I also know that death is not the only complication that parents worry about with mumps.  Death is not the only complication with ovarian cancer either.

Lastly, I know that mumps can kill children - and I would prefer a dead 60 something from ovarian cancer than a dead 4 year old from mumps.  However, I am not sure I would prefer 2850 dead 60-somethings to 53 dead children.  I would certainly prefer my children got mumps and reduce (fairly significantly) their chances of ovarian cancer.  

All this is moot, though, isn't it?  You probably could not get the mumps now even if you tried.  

[LiLStar]

I remember reading once several years ago about a hospital in...Switzerland? Sweden? I think it started with an S, used to (decades ago) deliberately infect children with certain chronic illnesses (kidney related comes to mind?) with measles because after they recovered from measles, they would be cured. I haven't been able to find a source for that, and its hard to look because there's too many details I have muddled. Has anyone heard of that?