Another herd immunity thread - Page 3 - Mothering Forums
Forum Jump: 
Reply
 
Thread Tools
#61 of 113 Old 02-24-2009, 01:58 PM
Banned
 
Join Date: Nov 2008
Location: Ohio
Posts: 722
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by carriebft View Post
Some also see a subclincal infection (having been exposed to wild type measles) acts as a natural booster to the vaccine. I don't see subclincal measles as much of an issue and I don't think it happens too often to the point where transmission is possible (or we would have a lot more measles cases and a lot more vaccinated measles cases-- as the case would have to have a high enough viral load to transmit, in which case it would not be too subclincal anymore)
I swear it took me an hour to find these again! I need a folder for all this stuff!

Detection of measles vaccine in the throat of a vaccinated child.
http://www.ncbi.nlm.nih.gov/pubmed/1...t=AbstractPlus
Quote:
Fever occurring subsequent to measles vaccination is related to the replication of the live attenuated vaccine virus. In the case presented here, the vaccine virus was isolated in the throat, showing that subcutaneous injection of an attenuated measles strain can result in respiratory excretion of this virus.

Detection of measles virus RNA in urine specimens from vaccine recipients.
P A Rota, A S Khan, E Durigon, T Yuran, Y S Villamarzo, and W J Bellini
http://www.pubmedcentral.nih.gov/pic...9&blobtype=pdf
Quote:
The changing epidemiology of measles, in the form of mild
measles cases in previously vaccinated individuals (1, 11, 20),
suggests that more asymptomatic or subclinical cases might be
occurring. ... In one previous
study, urine samples from 5 of 12 measles case contacts
were positive for measles virus antigen even though only 1 of
these 5 contacts developed clinical signs
PaigeC is offline  
#62 of 113 Old 02-24-2009, 02:01 PM
 
carriebft's Avatar
 
Join Date: Mar 2007
Posts: 6,947
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I am not sure what you are saying. I did not say subclincal infections don't happen, I said that they: possibly beneficial in acting as a booster when exposed to wild type measles and that I don't think subclinical measles are a big issue in creating outbreaks. the one case you noted there is a single case and i would have to see the whole study to really comment on it.

I would add that I don't think we all have subclincal measles either, but I think that is for another thread.

"Parents are simply trustees; they do not own the bodies of their children"-Norm Cohen  Martial arts instructor intactlact.gifhomebirth.jpgnak.gif and mom to 4: DD1 (1/05) DS (7/06) DD2 (5/08) DD3 (2/11)
carriebft is offline  
#63 of 113 Old 02-24-2009, 02:07 PM
 
carriebft's Avatar
 
Join Date: Mar 2007
Posts: 6,947
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Also, if subclincal infections were this big issue, why would outbreaks occur from importation in the USA. And if subclincal infections were an issue AND the vaccine didn't work AND the vaccine wanes (as is being said in this thread), wouldn't we be having a lot more measles cases NOT from importation?

"Parents are simply trustees; they do not own the bodies of their children"-Norm Cohen  Martial arts instructor intactlact.gifhomebirth.jpgnak.gif and mom to 4: DD1 (1/05) DS (7/06) DD2 (5/08) DD3 (2/11)
carriebft is offline  
#64 of 113 Old 02-24-2009, 02:09 PM
 
japonica's Avatar
 
Join Date: May 2005
Location: Canada-->Australia
Posts: 987
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 4 Post(s)
Quote:
Originally Posted by shuttlt View Post
@tmaue
Thanks for explaining that angle on herd immunity so succinctly.


I must confess, when I started looking at the herd immunity that was exactly the problem I had. But (and sticking to measles) I then found the following information from our good friends the CDC.

If you're born prior to 1957 you've probably been exposed to epidemic measles, people vaccinated prior to 1968 needed boosters because they were vaccinated with innactivated measles, post '68 vaccination was with live measles and is believed to be lifelong.
http://www.cdc.gov/vaccines/vpd-vac/...-vac-risks.htm
Just to muddy the waters a bit, here's the Canadian take on adults and measles and the question of immunity...

Quote:
Combined measles, mumps, rubella vaccine (MMR) is preferred for vaccination of individuals not previously immunized against one or more of these viruses. Adults born before 1970 may be considered immune to measles. Adults born in 1970 or later who do not have documentation of adequate measles immunization or who are known to be seronegative should receive MMR vaccine. One additional dose of vaccine should be offered only to adults born in 1970 or later who are at greatest risk of exposure and who have not already received two doses or demonstrated immunity to measles.
http://www.phac-aspc.gc.ca/im/is-cv/index-eng.php

I was born in 1970, right on fence so to speak (yes, I'm old). I have no idea if I was given the MMR but if I was, I know for certain the mumps portion did not confer "lifelong immunity" as I had full blown wild mumps at age 10. If I never received the MMR, as many in my age group might not have (even Health Canada says we may be considered immune, who knows), then I wouldn't think that as adults we're contributing to "herd immunity." One personal note, even though I have no idea about my measles status, I'm not worrying about it and running out to get a MMR.

Mother to DD#1  s/b @40w 2003 for unknown reasons; DD#2   9.5 years old; DS  6 years old 
  Why are daughters protected but not sons?
 
 
 
  
japonica is offline  
#65 of 113 Old 02-24-2009, 02:20 PM
 
MyBoysBlue's Avatar
 
Join Date: Apr 2007
Location: Alberta Canada
Posts: 1,116
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I'm Canadian and I was born in the later half of the 70's. I did get the one round of MMR as a baby. I also did end up with Mumps anyway at around at 11 or 12. So either I was one of the ones where the vax didn't confer immunity at all or it had worn off by that time.

Wife to DH, Mom to my Intact Boys DS1: Born 02 Pain Med Free Hospital Birth, BF'ed for 9 Months, Partially Vax'd DS2: Born 06 via UC, BF'ed 3 years 10 months, and UnVax'd
MyBoysBlue is offline  
#66 of 113 Old 02-24-2009, 02:23 PM
 
japonica's Avatar
 
Join Date: May 2005
Location: Canada-->Australia
Posts: 987
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 4 Post(s)
Hey, maybe we got a bad batch of mumps vaccine...so much for us protecting the herd. LOL.

Mother to DD#1  s/b @40w 2003 for unknown reasons; DD#2   9.5 years old; DS  6 years old 
  Why are daughters protected but not sons?
 
 
 
  
japonica is offline  
#67 of 113 Old 02-24-2009, 02:45 PM
Banned
 
Join Date: Nov 2008
Location: Ohio
Posts: 722
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by carriebft View Post
Also, if subclincal infections were this big issue, why would outbreaks occur from importation in the USA. And if subclincal infections were an issue AND the vaccine didn't work AND the vaccine wanes (as is being said in this thread), wouldn't we be having a lot more measles cases NOT from importation?
Perhaps we DO have a lot more measles cases but they are subclinical and/or not diagnosed by drs? When (if) subclinical infection is rampant then the source of outbreaks is difficult to determine.
PaigeC is offline  
#68 of 113 Old 02-24-2009, 03:48 PM
 
mamakay's Avatar
 
Join Date: Apr 2005
Location: in la la land, or so they say...
Posts: 8,995
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by carriebft View Post
Also, if subclincal infections were this big issue, why would outbreaks occur from importation in the USA. And if subclincal infections were an issue AND the vaccine didn't work AND the vaccine wanes (as is being said in this thread), wouldn't we be having a lot more measles cases NOT from importation?
What has me completely convinced that measles is really eliminated is the total and complete lack of measles death in infants. If an infant is deathly ill with a measles-like rash, they're going to test for measles. And in a "post vaccine society" it is infants who are most severely affected by measles when there's an epidemic.
mamakay is offline  
#69 of 113 Old 02-24-2009, 03:52 PM
 
ema-adama's Avatar
 
Join Date: Dec 2007
Posts: 2,392
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by shuttlt View Post
Surely all of these things effect whether or not you get new outbreaks of the disease (well maybe not the polluted air), and maybe how bad you are likely to get it, rather than the possibility of herd immunity?
Yes. This was in relation to epidemic theory, not herd immunity. I am not sure what they are factoring in when they try to figure out what causes an epidemic.


Quote:
Quote:
Originally Posted by ema-adama
What makes a susceptible host?
I assume from previous posts, it means 'not immune'. Anyone disagree?
Here something does not make sense to me. I do not think immune/not immune is the only part of the equation. For instance with the various bacteria that can cause meningitis, from what I understand they are in pretty much everyone's throats. But not everyone is coming down with meningitis. Why do some and not others? Why do 999 out of the infected 1000 not develop clinical polio? What makes that one person develop the clinical signs? What makes a person develop complications from measles, chickenpox, mumps?

Quote:
I think the lifelong immunity claim is only made for live virus vaccination.
Depends who you ask. I have heard the current polio (IPV) and DTaP aurgued as being important from a public health perspective.

Quote:
Quote:
Originally Posted by ema-adama
Each vaccine it would seem has a different percentage rate for providing life long immunity (factoring in whether it prevents transmission or only the clinical disease). I have by no means reached a final conclusion as to which vaccines actually do and do not have the potential to confer life long immunity, if any at all.
I'm curious what your reasons are for doubting that vaccines can confer immunity at all, or that the lifelong claim isn't true. Why wouldn't it be?
That was poor phrasing on my part. "if any at all" I meant that I am not sure than any vaccines confer lifelong immunity. I do think some vaccines are more effective than others. I also think that just because a vaccine confers immunity, does not mean that this is preferable to the disease - in light of the extras that come with the vaccine that you would not otherwise need to metabolise. And it does not mean that it is life long immunity.

Quote:
There were some links to studies posted last night that I still need to read. The source of the lifelong immunity claim is important as so many people seem to doubt it.
One day I hope to have a neat tidy table with each vaccine and the studies done on duration of immunity. So far this eludes me. But this is central to the herd immunity aurgument. Can you imagine the confusion if pediatricians started trying to explain why some vaccines contribute to herd immunity and others do not? The number of times I have seen DTaP given as a vaccine for herd immunity just has my head :


Quote:
Shifting epidemiology is surely an argument for not having a sloppy vaccination program, rather than an argument about whether herd immunity is achievable, or meaningful. As for serotype/Th1 immune systems, I would need to read more in order to comment.
This is the second time I have read you writing this and it has me intrigued. Why would an optimal vaccination rate take care of shifting epidemiology?

Quote:
A lot of what you say strikes me as sensible. Vaccination most certainly isn't a substitute for clean drinking water. Having said that, are there figures for how bad these diseases (say measles) are in countries that do have clean drinking water etc...?
I have not done in depth reading on measles as it was never a question for me. I know there are other mama's who have lots of info for this. There was an outbreak in Switzerland that I read about and no one died. I can't remember the complications and I certainly cannot remember what the health profile of those who had complications were. I hope someone has the figures for this question.

Quote:
Originally Posted by tmaue View Post
One of the questions given above was about why I doubt antibodies, as far as vaccine protection goes. The reason I doubt antibodies is because you see over and over in studies and personal accounts where someone had sufficient antibody levels and still got the disease. You also get the reverse, where someone does not have antibodies and when exposed does not get the disease. There is something else that must be going on in the immune system to make this possible. They are starting to learn more but more info is needed. So, in my opinion, vaccine antibody level alone providing protection is just theory.
Don't say that too loudly Terribly blasphemous.

I think what I was trying to say is that herd immunity is part of epidemic theory as in an attempt at preventing epidemics.

But when you are dealing with infectious diseases that are not dangerous to most people who are healthy and have access to the things we know promote good health, then I find myself asking the question as to why the vaccine is needed to create herd immunity.

What was wrong with the model of children having illnesses that left them immune as adults when the diseases are more dangerous (mumps, measles, rubella, chickenpox)? And, if you were a woman, protecting your child through the placenta and breastmilk. What was not working there?
Surely this was also creating herd immunity?

Megan, mama to her little boy (Feb2008) and introducing our little girl (Dec 2010)
ema-adama is offline  
#70 of 113 Old 02-24-2009, 03:57 PM
 
mamakay's Avatar
 
Join Date: Apr 2005
Location: in la la land, or so they say...
Posts: 8,995
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by carriebft View Post
The 15 year study seemed to me to say that the projections we thought would happen did not hold and that the MMR continued to be effective. I know I have a 25 year one but I just cannot locate it at the moment.

Some also see a subclincal infection (having been exposed to wild type measles) acts as a natural booster to the vaccine. I don't see subclincal measles as much of an issue and I don't think it happens too often to the point where transmission is possible (or we would have a lot more measles cases and a lot more vaccinated measles cases-- as the case would have to have a high enough viral load to transmit, in which case it would not be too subclincal anymore)

I also think the outbreaks recently demonstrated that the MMR doesn't seem to wane or be waning yet (again, its only been around 40 years). If you look at switzerland and USA particularly, the infection remained isolated to unvaccinated and partially vaccinated populations.
For the measles component, yes. (for now...we did have a lot of measles floating around until the late 90's, and that's probably why those of us vaccinated in the 70's and 80's aren't having our own measles epidemic at the moment. Our vaccine immunity was regularly "boosted" by exposure to the wild virus from time to time in the 80's and 90's.)

The mumps part is different. Pretty much every country on earth that has used the Jeryll-Lynn strain for a long time has seen mumps epidemics in an older age group.

For this reason, the CDC is considering adding a third dose of MMR to the schedule, to be given to adults. Which probably won't hurt the continued elimination of measles, too.
mamakay is offline  
#71 of 113 Old 02-24-2009, 03:58 PM
 
carriebft's Avatar
 
Join Date: Mar 2007
Posts: 6,947
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Actually the Switzerland outbreak does now have a death associated with it. It happened this past month.

"Parents are simply trustees; they do not own the bodies of their children"-Norm Cohen  Martial arts instructor intactlact.gifhomebirth.jpgnak.gif and mom to 4: DD1 (1/05) DS (7/06) DD2 (5/08) DD3 (2/11)
carriebft is offline  
#72 of 113 Old 02-24-2009, 04:07 PM
 
carriebft's Avatar
 
Join Date: Mar 2007
Posts: 6,947
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
There was an outbreak in Switzerland that I read about and no one died. I can't remember the complications and I certainly cannot remember what the health profile of those who had complications were. I hope someone has the figures for this question.

outbreak in switzerland to date:

Quote:
Bern noted that since November 2006 Switzerland has seen 3,400 cases of measles, with one death last week in Geneva, 250 hospitalizations and 500 complications that included 143 cases of pneumonia and 8 cases of encephalitis
http://genevalunch.com/2009/02/06/me...erland-update/

outbreak in germany- 614 cases (some traced back to switzerland):

Quote:
All interviewed patients fulfilled the clinical case definition for measles. Otitis media was reported by 91 (19%) patients, pneumonia by 35 (7%), and encephalitis by three (0.6%), of whom two died. Measles-related complications were more common in younger children: otitis media (22% in infants, 21% in 1–14 year-olds, 10% in > 14 years; P = 0.008) and pneumonia (17% in infants, 7% in 1–14 years, 4% in > 14 years; P = 0.015). The two patients with encephalitis who died were aged 2 months and 2 years; the patient who survived was aged 19 years.

"Parents are simply trustees; they do not own the bodies of their children"-Norm Cohen  Martial arts instructor intactlact.gifhomebirth.jpgnak.gif and mom to 4: DD1 (1/05) DS (7/06) DD2 (5/08) DD3 (2/11)
carriebft is offline  
#73 of 113 Old 02-24-2009, 04:16 PM
 
mamakay's Avatar
 
Join Date: Apr 2005
Location: in la la land, or so they say...
Posts: 8,995
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by carriebft View Post
Actually the Switzerland outbreak does now have a death associated with it. It happened this past month.
It sounds like the "completeness of reporting" in Switzerland is very poor if their reported cases make it look like it's just an outbreak. The CDC now thinks it might have been only 3% of measles cases that were being reported here during the early and mid 90's. If you see a measles death, you have to figure that there are thousands of infections (usually about 5-7 thousand) happening, reported accurately or not.
mamakay is offline  
#74 of 113 Old 02-24-2009, 04:18 PM
 
carriebft's Avatar
 
Join Date: Mar 2007
Posts: 6,947
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
well, it's 3,600 or something so far so they are getting up there in numbers reported. i am not sure they are still calling it that

"Parents are simply trustees; they do not own the bodies of their children"-Norm Cohen  Martial arts instructor intactlact.gifhomebirth.jpgnak.gif and mom to 4: DD1 (1/05) DS (7/06) DD2 (5/08) DD3 (2/11)
carriebft is offline  
#75 of 113 Old 02-24-2009, 04:20 PM
 
anewmama's Avatar
 
Join Date: Feb 2007
Posts: 1,530
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
So what does that say about the alleged 90% drop in measles from 1966- 1968? How many cases were erroneously reported then?
anewmama is offline  
#76 of 113 Old 02-24-2009, 04:56 PM
 
mamakay's Avatar
 
Join Date: Apr 2005
Location: in la la land, or so they say...
Posts: 8,995
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
This is an interesting article, relevant to the question of waning immunity:

http://toronto.ctv.ca/servlet/an/loc...05?hub=Toronto

Quote:
The end result of the investigation into the durability of immunity in the vaccine age could be a recognition that adults need booster shots to prevent outbreaks of what we now consider childhood diseases. Osterholm, for one, thinks that's likely.
mamakay is offline  
#77 of 113 Old 02-24-2009, 05:38 PM - Thread Starter
 
shuttlt's Avatar
 
Join Date: Feb 2009
Posts: 516
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by ema-adama View Post
Yes. This was in relation to epidemic theory, not herd immunity. I am not sure what they are factoring in when they try to figure out what causes an epidemic.
On one level it's got to be somebody wandering around with an infectious disease meeting enough people who aren't immune. Everything else is detail

Quote:
Originally Posted by ema-adama View Post
Here something does not make sense to me. I do not think immune/not immune is the only part of the equation. For instance with the various bacteria that can cause meningitis, from what I understand they are in pretty much everyone's throats. But not everyone is coming down with meningitis. Why do some and not others? Why do 999 out of the infected 1000 not develop clinical polio? What makes that one person develop the clinical signs? What makes a person develop complications from measles, chickenpox, mumps?
I assume this is a question that has an answer. Is there a Doctor in the house?

Quote:
Originally Posted by ema-adama View Post
Depends who you ask. I have heard the current polio (IPV) and DTaP aurgued as being important from a public health perspective.
I'd have to recheck the numbers to be sure that that was bogus. Does it have the same kind of herd immunity ratio as measles. I'm kind of myopically focused on measles right now.

Quote:
Originally Posted by ema-adama View Post
That was poor phrasing on my part. "if any at all" I meant that I am not sure than any vaccines confer lifelong immunity.
OK

Quote:
Originally Posted by ema-adama View Post
I do think some vaccines are more effective than others. I also think that just because a vaccine confers immunity, does not mean that this is preferable to the disease - in light of the extras that come with the vaccine that you would not otherwise need to metabolise. And it does not mean that it is life long immunity.
OK, but a vaccine might be preferable it just isn't necessarily preferable, and vaccines don't necessarily need life long immunity for herd immunity - surely they only need to last long enough.

Quote:
Originally Posted by ema-adama
Quote:
Originally Posted by shuttlt
Shifting epidemiology is surely an argument for not having a sloppy vaccination program, rather than an argument about whether herd immunity is achievable, or meaningful. As for serotype/Th1 immune systems, I would need to read more in order to comment
This is the second time I have read you writing this and it has me intrigued. Why would an optimal vaccination rate take care of shifting epidemiology?
OK. This is probably just me not explaining myself properly. Clearly shifting epidemiology is a bad thing IF you haven't reduced the occurrence of the illness you are vaccinating against sufficiently. It might be sufficient if you just end up with fewer negative outcomes. It would certainly be sufficient if the number of older people coming down with the illness post epidemiological shift is less than the number before you started vaccinating. I assume that at least the former case must be true given that we vaccinate. Where the average is doesn't matter in and of itself.

Quote:
Originally Posted by ema-adama View Post
But when you are dealing with infectious diseases that are not dangerous to most people who are healthy and have access to the things we know promote good health, then I find myself asking the question as to why the vaccine is needed to create herd immunity.
But is good nutrition enough to stop children dying of all these diseases if you ended vaccination? Sure it would help, but you would still have a bunch of dead children.

Quote:
Originally Posted by ema-adama View Post
What was wrong with the model of children having illnesses that left them immune as adults when the diseases are more dangerous (mumps, measles, rubella, chickenpox)?
You might have to accept a bunch of dead children to avoid a small number of dead adults if this was implemented. Also, in the unvaccinated world, most adults would be immune, but some wouldn't be. I would be interested in seeing numbers, but you might end up with more adults with measles as well.

Quote:
Originally Posted by ema-adama View Post
And, if you were a woman, protecting your child through the placenta and breastmilk. What was not working there?
Surely this was also creating herd immunity?
Not in the same sense since measles and mumps etc.. were still freely circulating.
shuttlt is offline  
#78 of 113 Old 02-24-2009, 06:21 PM
 
ema-adama's Avatar
 
Join Date: Dec 2007
Posts: 2,392
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by mamakay View Post
This is an interesting article, relevant to the question of waning immunity:

http://toronto.ctv.ca/servlet/an/loc...05?hub=Toronto
Nice article. I should be using more google scholar

Quote:
Originally Posted by shuttlt View Post
On one level it's got to be somebody wandering around with an infectious disease meeting enough people who aren't immune. Everything else is detail
OK, I think I am starting to understand where the differences in our approach come from. From what I understand you would be happy with a world where diseases were wiped out one after another leaving the population safer.
I do not think everything else is detail. I think it is very significant as to just who is at risk of developing complication and/or dying. Disease is a part of life and I am not sure that it can just be eradicated with vaccination (articificially - which I know is a difficult word, but I can't think of another).
I just do not think it is that simple. I still think that when addressing epidemiology and trying to figure out how best to protect a population, there are factors which doctors do not think are essential. It is almost as if some magic wand with no side effects is waved and voila, the disease is eradicated and we are a safer, healthier population. But is this really so?



Quote:
I assume this is a question that has an answer. Is there a Doctor in the house?
Well, there are a couple of questions. To the first one, you do not need to be a doctor to answer it. Look up serotype replacement and the history of HIB and Prevnar. To the others, I do not have the links, but the info is there. If I have time, I will track them down.


Quote:
I'd have to recheck the numbers to be sure that that was bogus. Does it have the same kind of herd immunity ratio as measles. I'm kind of myopically focused on measles right now.
As neither pertussis nor polio transmission are prevented (although pertussis is a hotly debated one), these vaccines protect the individual, and not the community. (OPV prevent transmission, but it also causes polio)


Quote:
OK, but a vaccine might be preferable it just isn't necessarily preferable, and vaccines don't necessarily need life long immunity for herd immunity - surely they only need to last long enough.
When life long immunity is required for herd immunity, what else is long enough? Under what circumstances is a vaccine preferable?
Quote:
OK. This is probably just me not explaining myself properly. Clearly shifting epidemiology is a bad thing IF you haven't reduced the occurrence of the illness you are vaccinating against sufficiently. It might be sufficient if you just end up with fewer negative outcomes. It would certainly be sufficient if the number of older people coming down with the illness post epidemiological shift is less than the number before you started vaccinating. I assume that at least the former case must be true given that we vaccinate. Where the average is doesn't matter in and of itself.
My understanding of shifting epidemiology is that babies are no longer protected by maternal antibodies and older people are more at risk for the diseases - the two segments of the population that you do not want sick with the diseases are now more at risk. I have to admit that this is more theoretical for me, as I do not have the numbers. This has been discussed here before (of course). If I have time I will try and dig it up.

Quote:
But is good nutrition enough to stop children dying of all these diseases if you ended vaccination? Sure it would help, but you would still have a bunch of dead children.
Oi, who said stopping vaccination?
What do you know about the nutritional needs of a child sick with measles and the recommended treatment? I have to assume you are thinking, please correct me if I am wronge, that it seems complete quackery to believe that something as simple as nutrition, clean water, clean (not disinfected) home environement etc can make that big of a difference in a healthy child. That it can mean the different between life and disability/death. Especially when there is so much science telling us that vaccines and modern drugs are saving so many millions. I certainly do not expect you to take my word on it.

Megan, mama to her little boy (Feb2008) and introducing our little girl (Dec 2010)
ema-adama is offline  
#79 of 113 Old 02-24-2009, 06:48 PM
 
mamakay's Avatar
 
Join Date: Apr 2005
Location: in la la land, or so they say...
Posts: 8,995
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
I'd have to recheck the numbers to be sure that that was bogus. Does it have the same kind of herd immunity ratio as measles. I'm kind of myopically focused on measles right now.
No. The DTaP and IPV are nothing like the measles vaccine. Neither the pertussis vax nor IPV have any significant effect on making the vaccinated non-infectious.

http://www.polioeradication.org/vaccines.asp

Quote:
Inactivated polio vaccine (IPV) needs to be injected and works by producing protective antibodies in the blood (serum immunity) - thus preventing the spread of poliovirus to the central nervous system. However, it induces only very low levels of immunity to polivirus locally, inside the gut. As a result, it provides individual protection against polio paralysis but, unlike OPV, cannot prevent the spread of wild polio virus.
Pertussis:

http://www.mothering.com/discussions....php?t=1042918

But measles is different. The theory of herd immunity DOES work perfectly (more or less) with the measles vaccine.
mamakay is offline  
#80 of 113 Old 02-24-2009, 06:53 PM
 
mamakay's Avatar
 
Join Date: Apr 2005
Location: in la la land, or so they say...
Posts: 8,995
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
My understanding of shifting epidemiology is that babies are no longer protected by maternal antibodies and older people are more at risk for the diseases - the two segments of the population that you do not want sick with the diseases are now more at risk. I have to admit that this is more theoretical for me, as I do not have the numbers. This has been discussed here before (of course). If I have time I will try and dig it up.
It's all true, but that's actually a compelling reason to NOT stop vaccinating against measles. Measles is "more deadly" (though less common) in societies that vaccinate.
We've reached a point of no return there with maternal antibodies and infants.
mamakay is offline  
#81 of 113 Old 02-24-2009, 07:01 PM
 
mamakay's Avatar
 
Join Date: Apr 2005
Location: in la la land, or so they say...
Posts: 8,995
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Here something does not make sense to me. I do not think immune/not immune is the only part of the equation. For instance with the various bacteria that can cause meningitis, from what I understand they are in pretty much everyone's throats. But not everyone is coming down with meningitis. Why do some and not others? Why do 999 out of the infected 1000 not develop clinical polio? What makes that one person develop the clinical signs? What makes a person develop complications from measles, chickenpox, mumps?
Nobody really knows what all is going on there, but a lot of it is bad luck. Some is "host factors".
With polio, sometimes there was an injury that allowed the virus to gain access to the nervous system where it then caused paralysis. With meningitis, sometimes it's probably catching catching a nasty virus right at the same time they're newly colonized with a bacteria they've never been colonized with before. With chickenpox, a lot of times the severity of the illness is related to the "dose" of the virus the kid was exposed to.
But a lot of it is still just a mystery.
mamakay is offline  
#82 of 113 Old 02-24-2009, 07:09 PM - Thread Starter
 
shuttlt's Avatar
 
Join Date: Feb 2009
Posts: 516
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by ema-adama View Post
OK, I think I am starting to understand where the differences in our approach come from. From what I understand you would be happy with a world where diseases were wiped out one after another leaving the population safer.
Sure, assuming it were possible, wouldn't everybody?

Quote:
Originally Posted by ema-adama View Post
I do not think everything else is detail.
Ironically I've been running a fever all day and it's making me flippant. More what I mean is that there are arguments about herd immunity were those things are irrelivant... is herd immunity theoretically possible, for example. There are then arguments where those things are much more important.... what place should herd immunity play in the fight against epidemic disease. My initial interest in this was people claiming that herd immunity was a myth. In answering that, it seems to me, nutrition isnt important.

Quote:
Originally Posted by ema-adama View Post
I think it is very significant as to just who is at risk of developing complication and/or dying.
Are you saying that if there was an outbreak in an industrialized, first world country nobody would die? In which case, surely one can have an argument about herd immunity without getting derailed by nutrition?

Quote:
Originally Posted by ema-adama View Post
Disease is a part of life and I am not sure that it can just be eradicated with vaccination (articificially - which I know is a difficult word, but I can't think of another).
There is no obvious way to eradicate disease in general, I agree. Equally, that doesn't mean there is no difference between now and 100 years ago.

Quote:
Originally Posted by ema-adama View Post
I just do not think it is that simple.
Neither do I.

Quote:
Originally Posted by ema-adama View Post
I still think that when addressing epidemiology and trying to figure out how best to protect a population, there are factors which doctors do not think are essential. It is almost as if some magic wand with no side effects is waved and voila, the disease is eradicated and we are a safer, healthier population. But is this really so?
Like what. Don't doctors say "eat healthily and take regular exercise". What aren't they addressing?

Quote:
Originally Posted by ema-adama View Post
When life long immunity is required for herd immunity, what else is long enough?
Sure. But is lifelong immunity required for herd immunity (I'm always focused on measles, but take your pick).

Quote:
Originally Posted by ema-adama View Post
Under what circumstances is a vaccine preferable?
If the harm of not vaccinating is juged to be greater than the harm of vaccinating. If you end up with fewer deaths total even if you shift them around a bit, it might be preferable. If you move the average age of getting the disease, but even for that age group you have fewer deaths.

Quote:
Originally Posted by ema-adama View Post
My understanding of shifting epidemiology is that babies are no longer protected by maternal antibodies and older people are more at risk for the diseases - the two segments of the population that you do not want sick with the diseases are now more at risk. I have to admit that this is more theoretical for me, as I do not have the numbers. This has been discussed here before (of course). If I have time I will try and dig it up.
But without numbers, all we know is that the average has moved. I don't care what the average is. It could be that the number of adults getting the illness has fallen as well, even though they now make up a greater proportion of people getting sick.

Quote:
Originally Posted by ema-adama View Post
What do you know about the nutritional needs of a child sick with measles and the recommended treatment? I have to assume you are thinking, please correct me if I am wronge, that it seems complete quackery to believe that something as simple as nutrition, clean water, clean (not disinfected) home environement etc can make that big of a difference in a healthy child.
I don't think it's quackery to say it can make a difference, how big, I don't know. Once they're sick I would presume it's a bit late for worrying about whether they are getting enough zinc. I don't see that saying this stuff can help means that herd immunity can't be important.

Quote:
Originally Posted by ema-adama View Post
That it can mean the different between life and disability/death.
If it makes any difference at all then I'm sure it can make the difference between life and death, sometimes. The question is how often.
shuttlt is offline  
#83 of 113 Old 02-24-2009, 08:07 PM
 
alegna's Avatar
 
Join Date: Jan 2003
Posts: 44,408
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by mamakay View Post
What has me completely convinced that measles is really eliminated is the total and complete lack of measles death in infants. If an infant is deathly ill with a measles-like rash, they're going to test for measles. And in a "post vaccine society" it is infants who are most severely affected by measles when there's an epidemic.
I agree. It's either not around, OR infants are getting some passive immunity from mom prenatally.

-Angela
alegna is offline  
#84 of 113 Old 02-25-2009, 12:09 AM
 
Marnica's Avatar
 
Join Date: Oct 2008
Posts: 5,585
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)
This is an interesting thread that has made me wonder. I was vaccinated as a child with the MMR. I was born in 1972...if immunity is believed to be lifelong why was I required to receive a booster mmr at the age of 19 for college entry???

If the people let government decide what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as are the souls of those who live under tyranny." Thomas Jefferson.

Marnica is offline  
#85 of 113 Old 02-25-2009, 12:18 AM
 
carriebft's Avatar
 
Join Date: Mar 2007
Posts: 6,947
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Marnica View Post
This is an interesting thread that has made me wonder. I was vaccinated as a child with the MMR. I was born in 1972...if immunity is believed to be lifelong why was I required to receive a booster mmr at the age of 19 for college entry???
I don't know about your school, but the college I went to required an MMR booster if you had only had one dose or had no vaccination record.

"Parents are simply trustees; they do not own the bodies of their children"-Norm Cohen  Martial arts instructor intactlact.gifhomebirth.jpgnak.gif and mom to 4: DD1 (1/05) DS (7/06) DD2 (5/08) DD3 (2/11)
carriebft is offline  
#86 of 113 Old 02-25-2009, 01:46 AM
 
alegna's Avatar
 
Join Date: Jan 2003
Posts: 44,408
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by shuttlt View Post
Sure, assuming it were possible, wouldn't everybody?
Nope. We're fooling with things we don't begin to understand. There is interesting research that shows that some childhood diseases prevent other chronic conditions. I also read an interesting article about how intestinal parasites prevent other chronic conditions. We don't know nearly enough about how the immune system works to start eliminating such huge factors.

-Angela
alegna is offline  
#87 of 113 Old 02-25-2009, 01:56 AM
 
amnesiac's Avatar
 
Join Date: Dec 2001
Location: at the end of the longest line
Posts: 4,984
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Marnica View Post
This is an interesting thread that has made me wonder. I was vaccinated as a child with the MMR. I was born in 1972...if immunity is believed to be lifelong why was I required to receive a booster mmr at the age of 19 for college entry???
The 2nd dose isnt considered a booster dose. But it was something that was paid a lot of attention to at that time beause of the measles outbreak that would have been wrapping up at the time you entered college.
amnesiac is offline  
#88 of 113 Old 02-25-2009, 03:27 AM - Thread Starter
 
shuttlt's Avatar
 
Join Date: Feb 2009
Posts: 516
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by alegna View Post
Nope. We're fooling with things we don't begin to understand. There is interesting research that shows that some childhood diseases prevent other chronic conditions. I also read an interesting article about how intestinal parasites prevent other chronic conditions. We don't know nearly enough about how the immune system works to start eliminating such huge factors.

-Angela
Is there any evidence that this is the case for stuff we vaccinate against? How man people might be effected if this is true? What chronic conditions are measles and mumps felt to protect against? Could you point me in the direction of information on this.
shuttlt is offline  
#89 of 113 Old 02-25-2009, 05:14 AM
 
ema-adama's Avatar
 
Join Date: Dec 2007
Posts: 2,392
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by shuttlt View Post
Sure, assuming it were possible, wouldn't everybody?
Alegna addressed this nicely. When so little is understood, I have to say that mass vaccination could turn out to be a mass experiment.

Quote:
what place should herd immunity play in the fight against epidemic disease. My initial interest in this was people claiming that herd immunity was a myth. In answering that, it seems to me, nutrition isnt important.
I personally do not think herd immunity is a myth. I think it is an extavagant idea to try to eliminate disease with vaccine induced herd immunity. Especially with waning immunity and the fact that the herd immunity argument is used to promote vaccines that are not producing herd immunity. These two things are red flags to me. Nutrition does not have anything to do with herd immunity. But it has everything to do with a healthy immune system. And the health of a population. And it is only relevant when looking at the foundations for promoting mass vaccination programmes. I guess I am challenging the assumption that only vaccination can make a society healthier and safer.

Quote:
Are you saying that if there was an outbreak in an industrialized, first world country nobody would die? In which case, surely one can have an argument about herd immunity without getting derailed by nutrition?
No. There are people who are immune compromised. Even in the 1st world there are malnourished people. Am I understanding that you see the benefit of vaccine induced immunity as offering protection to those who do not look after the health of their families and those who are immune compromised?

Quote:
Like what. Don't doctors say "eat healthily and take regular exercise". What aren't they addressing?
No. I was saying that when factoring in all the parametres for host, environment and pathogen to predict an epidemic, I do not know if such things are accurately factored in. Having a disease and being maimed/killed by the disease is not the same thing. Why was it assumed that vaccine induced immunity would result in herd immunity?

Quote:
Sure. But is lifelong immunity required for herd immunity (I'm always focused on measles, but take your pick).
Just according the epidemic theory. What has made you think that anything less than life long immunity could contribute to herd immunity? I guess I should ask what you understand herd immunity to be.

Quote:
If the harm of not vaccinating is juged to be greater than the harm of vaccinating. If you end up with fewer deaths total even if you shift them around a bit, it might be preferable. If you move the average age of getting the disease, but even for that age group you have fewer deaths.
This is where it gets interesting. Who can tell you what the harm is for vaccinating? Where is the honest discussion that any harm can happen? How do we know who is at risk of being harmed? Surely we need to have this information to make a risk/benefit analysis? But we are drifting from herd immunity again.

Quote:
But without numbers, all we know is that the average has moved. I don't care what the average is. It could be that the number of adults getting the illness has fallen as well, even though they now make up a greater proportion of people getting sick.
Agreed, without the numbers this is a bit sensless to discuss.


Quote:
I don't think it's quackery to say it can make a difference, how big, I don't know. Once they're sick I would presume it's a bit late for worrying about whether they are getting enough zinc. I don't see that saying this stuff can help means that herd immunity can't be important.
No, but once they are sick it might be worth while holding off on the paracetamol and look at vit C and A.

Quote:
If it makes any difference at all then I'm sure it can make the difference between life and death, sometimes. The question is how often.
The studies are there.... time permitting I will try and track them down.

Quote:
Originally Posted by alegna View Post
Nope. We're fooling with things we don't begin to understand. There is interesting research that shows that some childhood diseases prevent other chronic conditions. I also read an interesting article about how intestinal parasites prevent other chronic conditions. We don't know nearly enough about how the immune system works to start eliminating such huge factors.

-Angela
:

Megan, mama to her little boy (Feb2008) and introducing our little girl (Dec 2010)
ema-adama is offline  
#90 of 113 Old 02-25-2009, 06:34 AM - Thread Starter
 
shuttlt's Avatar
 
Join Date: Feb 2009
Posts: 516
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by ema-adama View Post
No. There are people who are immune compromised. Even in the 1st world there are malnourished people. Am I understanding that you see the benefit of vaccine induced immunity as offering protection to those who do not look after the health of their families and those who are immune compromised?
I'll address the rest of your post when I have a minute, but the above interested me. First off, I guess we can all agree that there are a large number of people who aren't going to give their children the nutrition that you are talking about. In some circumstances that can be to do with poverty, but I suspect in the UK/US it has more todo with 'choice'.

Second of all, is it the case that if your child is well nourished and isn't already sick with something else that these diseases are harmless? This seems to be an important question to have a definitive answer to. It clearly isn't true of smallpox for example, is it true of measles. If you infected 100,000 kids (who gave every outward sign of being healthy) with measles, would there be no deaths or serious complications? If this was the case, it would certainly cause me to reconsider my stance a little.
shuttlt is offline  
Reply

Quick Reply
Message:
Drag and Drop File Upload
Drag files here to attach!
Upload Progress: 0
Options

Register Now

In order to be able to post messages on the Mothering Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
If you do not want to register, fill this field only and the name will be used as user name for your post.
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may post new threads
You may post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off