Originally Posted by Taximom5
Funny you mention diphtheria in the former Soviet Union during 1989-1994.
There were many reasons for the resurgence of diphtheria during that time.
"The reasons for the reemergence of epidemic diphtheria in countries where immunization programs had nearly eliminated diphtheria in the 1970s are not fully understood but are thought to include the introduction of toxigenic strains into the general population, low coverage with diphtheria toxoid-containing vaccines among children in the 1980s and early 1990s, and a large gap of immunity among adults.
The spread of the epidemic throughout the former Soviet Union was facilitated by six factors:
Large-scale population movements, including the return to Russia and Ukraine of hundreds of thousands of ethnic Slavs from Central Asian and Caucasian countries, and the flight of refugees from fighting in Georgia, Armenia, Azerbaijan, Tajikistan, and the northern Caucasus
Partial deterioration of the health infrastructure
Delay in implementing aggressive measures to control the epidemic
Inadequate information for physicians and the public
Lack of adequate supplies for prevention and treatment in most of the countries"
Not mentioned is the fact that, except for cabbage, food was terribly scarce during that time, leaving most of the population vulnerable to all kinds of infections. But also mentioned in the article is one of the reasons why vaccination rates were lower in the 1980's: it was because the doctors there realized that patients were having adverse reactions to the vaccines, and were reluctant to push an increased schedule. Unfortunately, that got kind of whitewashed over, and instead, doctors were chastised for believing that vaccines were causing reactions when doctors in other countries weren't believing this. And it didn't apparently occur to anybody that maybe the cause for increased vax reactions was the same cause for vulnerability to diphtheria and other diseases: malnutrition and lack of adequate medical care.
Also see http://missinglink.ucsf.edu/lm/russia_guide/russianhealth2.htm
"However, after the 1960s quality began to decline as did the general standard of living in Russia. This decline sped up after the collapse of the Soviet Union. In the first four post-Soviet years, that decline was typified by significant increases in infant and maternal mortality and contagious diseases and by decreases in fertility and life expectancy. The life expectancy of men fell from 64 to 57 from 1990 to 1994, and throughout the 1990s alcohol-related deaths increased 60% and infectious and parasitic diseases increased by 100%."
Food for thought, indeed.
So when someone who is passionately defending vaccines tries to put sole blame of illness on lack of diphtheria vaccination in a country such as the former Soviet Union, we know that they are missing most of the picture. (Funny how they tell us to "listen to the experts," but they don't listen to the experts who say that reemergence of epidemic diphtheria during this time is not fully understood, but instead try to convince us that it's 100% the fault of not vaccinating.
Are you trying to say that the article somehow implied that a low rate of vaccines was not the major cause of the diptheria epidemic? Or that a mass vaccination campaign during the epidemic did not result in an almost immediate drop of diptheria?
"Outbreaks of diphtheria among military units, especially those with new recruits, were reported throughout the 1980s in the Soviet Union. New recruits were not routinely revaccinated against diphtheria, and military bases mixed large numbers of individuals, both susceptible and possibly infected, from throughout the Soviet Union in crowded living conditions."
"The decreased intensity of childhood vaccination caused increased susceptibility to clinical diphtheria among children. The incidence of diphtheria was higher among unvaccinated persons than among vaccinated persons in Moldova and Russia [19, 31]; in addition, in almost all affected countries, severe disease was more commonly documented among unvaccinated cases than vaccinated cases."
"A critical factor in permitting this epidemic was the accumulation of large numbers of susceptible adults as a consequence of the waning of vaccine-induced immunity and the decreased opportunity for naturally acquired immunity."
"In countries that quickly achieved high coverage among adults, incidence rates also decreased quickly. For example, in Moldova following a successful mass campaign in the summer of 1995, no winter peak occurred and the epidemic was stopped (figure 3) ."
After a MASS vaccine campaign that literally had vaccines set up at jails, market places, had people going door to door, upping the requirement for children to go to school it began to be controlled.
"By the end of 1995, most countries began reporting decreased numbers of diphtheria cases compared with the same period in 1994. In 1996, all countries in the NIS and Baltic States reported fewer cases, for a total of 20,215 cases, 60% less than the 50,425 cases reported in 1995. Reported cases have continued to decrease, with 7196 cases reported from all NIS and Baltic States in 1997 and 2720 cases in 1998."
So the number of diptheria cases dropped by 60 percent in 1 year. "Coincidentally" after a mass vaccine campaign.
"Although proper management of cases and contacts is of increasing importance for the consolidation phase of epidemic diphtheria, the most important goal of control measures remains achieving the highest possible immunization coverage for the whole population."
Also, "not fully understood" does not equal "we have absolutely no idea" They absolutely know the major cause of the epidemic.
Is the fact that the epidemic was controlled after a mass vaccination campaign that targeted millions and millions of adults and children just a coincidence to you then?
Edited by teacozy - 7/25/13 at 10:53am