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#61 of 150 Old 07-01-2010, 07:18 AM
 
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INF-ß, I agree that the disease would look the same. My point is that VAPP and VDPV in circulation are not one and the same thing. They have different implications with regards to policy.

I also do not know if the immunity from a VDPV would be cross protective with the WPV's in circulation. I know that immunity to each of the 3 polio viruses is not cross protective. If you have immunity to polio virus 1, you would still be susceptible to polio virus 2 and 3. That is why there are all 3 viruses in the OPV.

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Originally Posted by heathergirl67 View Post
Except that you didn't offer any proof. You offered what you think you remembered from something you read somewhere. Even if it's true, the vast majority of the population is vaccinated. So of course the majority of those infected would be vaccinated. It's never been my understanding that vaccines were supposed to be guaranteed prevention from ever being affected by these diseases. They're going to offer some people total immunity and others will get the diseases, but feel the effects less. The herd immunity point is that fewer people total will be getting sick, meaning fewer to transmit the diseases, meaning fewer subsequently getting sick from them, etc. I don't know how one could look at the graphs of illnesses pre-vaccine versus post-vaccine and believe that they don't affect herd immunity.
My understanding on one point you made. Fewer people getting sick does not necessarily mean fewer people carrying the pathogen. As with the pertussis vaccine, you can still carry the bacteria and spread it around, even though you yourself do not develop full blown pertussis cough.

A graph does not always give the whole picture. In the instance of polio, it gives a tiny fraction of the picture.
Another problem with the graphs is that the numbers pre vaccine are often estimates. And the numbers post vaccine are more accurate, requiring lab work to diagnose, not just the clinical diagnosis. Diagnostic criteria can really mess with the numbers. Graphs of death rates will probably be more accurate than graphs of incidence.

This doesn't mean the graphs are completely useless, but the dramatic curves are most likely not quite that dramatic.

The awful heat seems to be making me a little more feisty than I usually am. Apologies if anyone finds my tone offensive.

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#62 of 150 Old 07-01-2010, 11:50 AM
 
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Weren't certain VPDs also redefined, making it difficult to determine whether or not vaccines prevented these illnesses? For example, polio: doctors had more strict standards, deeming what (pre vaccine introduction) would have been diagnosed as polio as either aseptic meningitis or coxsackie virus. I read this in Neil Z ******'s book (among many other things that throw the legitimacy of herd immunity out the window), and found it interesting/relevant to this discussion.

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#63 of 150 Old 07-01-2010, 01:26 PM
 
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Polio was 'redefined'. They changed the diagnostic criteria around the time the Salk vaccine was introduced, making it impossible to compare 'before' and 'after'. The polio graph from the 1950's in the USA is pretty meaningless.

Polio and Acute Flaccid Paralysis looks at some of the other causes of acute flaccid paralysis.

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#64 of 150 Old 07-01-2010, 04:46 PM
 
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But it's not just polio. It's every disease.
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#65 of 150 Old 07-01-2010, 05:15 PM
 
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Originally Posted by INF-ß View Post
Whoever did not get the disease (vaccinated or not) during an outbreak surely was not properly exposed to the disease.
How do you define "get the disease"? And how do you know if they actually got it? I'm also not sure what you mean by "properly exposed". What differentiates proper exposure from improper exposure?
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#66 of 150 Old 07-01-2010, 05:57 PM
 
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Originally Posted by heathergirl67 View Post
But it's not just polio. It's every disease.
The point is that you have to look at each illness and figure out what happened.

How were cases ascertained/counted before the vaccine? Was there a change?

Is the illness easy to diagnose? There was something about measles in the U.K. recently...they started requiring actual tests to make sure that it was all measles and it turned out doctors were wrong a lot of the time. Pertussis is a classic illness for misdiagnosis.

Is the illness always symptomatic? Polio and chickenpox can both be invisible due to the mildness of the symptoms in some cases.

So, there are some illnesses where the vaccine looks very good and others where the information is a mess.

I don't think the statement:
"Vaccines work and provide herd immunity" has any logical meaning. Throwing in the phrase "some of the time" would help.
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#67 of 150 Old 07-01-2010, 06:09 PM
 
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Originally Posted by ema-adama
INF-ß, I agree that the disease would look the same. My point is that VAPP and VDPV in circulation are not one and the same thing. They have different implications with regards to policy.

I also do not know if the immunity from a VDPV would be cross protective with the WPV's in circulation. I know that immunity to each of the 3 polio viruses is not cross protective. If you have immunity to polio virus 1, you would still be susceptible to polio virus 2 and 3. That is why there are all 3 viruses in the OPV.
Of course, that is what you expect when someone is given a live and mutated PV strain. It thrives!

I'm sorry but vaccines of any kind do not confer immunity whatsoever.

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My understanding on one point you made. Fewer people getting sick does not necessarily mean fewer people carrying the pathogen. As with the pertussis vaccine, you can still carry the bacteria and spread it around, even though you yourself do not develop full blown pertussis cough.
So where did the vaccinated get the pertussis bacteria from?
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#68 of 150 Old 07-01-2010, 07:10 PM
 
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Originally Posted by ammiga View Post
How do you define "get the disease"? And how do you know if they actually got it? I'm also not sure what you mean by "properly exposed". What differentiates proper exposure from improper exposure?
Just witness what kids and parents do during a chicken pox party.
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#69 of 150 Old 07-01-2010, 08:37 PM
 
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Originally Posted by INF-ß View Post
Just witness what kids and parents do during a chicken pox party.
I don't understand how that answers my questions. I have seen plenty of people exposed to plenty of diseases, but show no outwards signs of contracting the disease. So I am wondering how you interpret "getting" a disease, and what proper exposure is. I don't understand the term proper exposure at all.
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#70 of 150 Old 07-01-2010, 09:01 PM
 
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Originally Posted by ammiga View Post
I don't understand how that answers my questions. I have seen plenty of people exposed to plenty of diseases, but show no outwards signs of contracting the disease. So I am wondering how you interpret "getting" a disease, and what proper exposure is. I don't understand the term proper exposure at all.
So you have no idea why kids have to share snots and lollies in a pox party? What if school children and and teenagers do the same, will this practice lead to outbreaks?
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#71 of 150 Old 07-01-2010, 09:53 PM
 
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Originally Posted by INF-ß View Post
So you have no idea why kids have to share snots and lollies in a pox party? What if school children and and teenagers do the same, will this practice lead to outbreaks?
I'm not sure what you are getting at or how to respond to your comments and questions. To gain a better understanding of you and how to properly respond, I think I really need straightforward answers to my questions. Specifically, how to you define "getting a disease"? And how do you define "properly exposed"?

Do you define getting the disease as having outward symptoms of it, gaining immunity of the disease, or something else entirely?

Do you define "properly exposed" as the method of exposure, enough exposure to experience effects of the disease, exposure to gain immunity, or something else entirely?

ETA:
In response to your questions to me, are you asking if school children and teenagers who are actively infected with the disease and engage in those behaviors will lead to an outbreak or just those groups in general?
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#72 of 150 Old 07-01-2010, 10:09 PM
 
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Originally Posted by ammiga

ETA:
In response to your questions to me, are you asking if school children and teenagers who are actively infected with the disease and engage in those behaviors will lead to an outbreak or just those groups in general?
Yes. I do not expect responsible adults would be doing that thing but hey they can be MCs.
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#73 of 150 Old 07-01-2010, 10:27 PM
 
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Yes. I do not expect responsible adults would be doing that thing but hey they can be MCs.
Are you going to clarify the questions I've asked you? Your lack of answers to questions is making dialogue with you quite difficult.
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#74 of 150 Old 07-01-2010, 10:29 PM
 
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Originally Posted by ammiga
Specifically, how to you define "getting a disease"? And how do you define "properly exposed"?
Just get a shot of varicella vaccine, that's one way. It's not only specific but 100% guaranteed you are getting VZV into the tissues. Best method of exposure so far.

Otherwise, visit a pox party and lick some infected lollies or make contact with mucous and lesions.

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Do you define getting the disease as having outward symptoms of it, gaining immunity of the disease, or something else entirely?
The etiologic agent must be present. Immunity is breached when you have acquired the disease.

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Do you define "properly exposed" as the method of exposure, enough exposure to experience effects of the disease, exposure to gain immunity, or something else entirely?
Any method that will promote a successful infectious process.
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#75 of 150 Old 07-01-2010, 10:39 PM
 
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Originally Posted by INF-ß View Post

The etiologic agent must be present. Immunity is breached when you have acquired the disease.
So people are immune before they are exposed to the disease? And then are no longer immune once they have it?

What about after the disease has run its course? Assuming it is something like chicken pox, measles, or rubella and not the flu.

What is a successful infectious process? Showing symptoms of the disease or gaining immunity? Or both?
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#76 of 150 Old 07-01-2010, 11:05 PM
 
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So people are immune before they are exposed to the disease? And then are no longer immune once they have it?
Both are true.

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The word immune is derived from the Latin stem immuno, meaning safe or free from. In a general sense, the term implies a condition under which an individual is protected from disease (not all but some specific disease).http://www.microbiologyprocedure.com...y/immunity.htm
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What about after the disease has run its course? Assuming it is something like chicken pox, measles, or rubella and not the flu.
What about it? The person is just recovering from the destructive effect of the infectious disease such as cellular and tissue damage. This process will happen again when re-infection is permitted.

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What is a successful infectious process? Showing symptoms of the disease or gaining immunity? Or both?
What is it with this 'immunity' thingy? Excuse me for my word, but it is really hard to discuss the essence of 'virginity' after a 'rape' scene.
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#77 of 150 Old 07-02-2010, 01:44 AM
 
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But it's not just polio. It's every disease.
Deborah already addressed this. You cannot lump all the diseases and vaccines together like that. Diagnostic criteria create a mess with all the diseases and all vaccines and the graphs that are used to show dramatic curves associated with the introduction of a vaccine. Polio is a particularly striking example. If you want to discuss each vaccine and each disease with regards to pre and post figures and how they are established, I am happy to take a closer look with you.

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Of course, that is what you expect when someone is given a live and mutated PV strain. It thrives!
I am not sure that VDPV in circulation were expected. VAPP was. I am also not sure I would define the OPV viruses as 'mutated'. It is my understanding they are attenuated wild viruses. The circulating VDPV are the mutated viruses (originally the attenuated wild virus - OPV). However we seem to splitting ever finer hairs. And I still do not understand what your point is.

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I'm sorry but vaccines of any kind do not confer immunity whatsoever.
If you would care to build on this point I would be interested to understand your reasoning.


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So where did the vaccinated get the pertussis bacteria from?
I guess there is more to this question than I understand at the moment. My answer would be that pertussis is endemic, so it's not that hard to come in contact with it.

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#78 of 150 Old 07-02-2010, 02:56 AM
 
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Originally Posted by ema-adama

I am not sure that VDPV in circulation were expected. VAPP was. I am also not sure I would define the OPV viruses as 'mutated'. It is my understanding they are attenuated wild viruses. The circulating VDPV are the mutated viruses (originally the attenuated wild virus - OPV). However we seem to splitting ever finer hairs. And I still do not understand what your point is.
Yes, the Sabin poliovirus vaccine is a product of mutation, it's called attenuating mutation. For without this mutation, basically you are just giving the original WT-poliovirus.

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A major determinant for this neuroattenuation is linked to a single mutation located in the IRES of the viral genome in the case of the three Sabin vaccine strains (21, 35, 49). This mutation is believed to disrupt the interaction of the IRES with a cellular factor, leading to poor translation of the viral polyprotein with subsequent attenuation of the virus.http://jvi.asm.org/cgi/content/full/78/20/11097
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Viruses constituting the Sabin oral polio vaccine (OPV) are inherently genetically unstable (2, 3). Upon reproduction in vaccinees and their contacts, they tend to lose attenuating mutations. http://jvi.asm.org/cgi/content/full/83/7/3402
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If you would care to build on this point I would be interested to understand your reasoning.
Physical barrier and isolation of an infected individual will confer immunity for the susceptible group thereby breaking the chain of infection.

Vaccination and intentional exposure to natural infection are the exact opposite.


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I guess there is more to this question than I understand at the moment. My answer would be that pertussis is endemic, so it's not that hard to come in contact with it.
And who are the carrier of the disease? The vaccinated or the nonvax.
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#79 of 150 Old 07-02-2010, 04:41 AM
 
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Physical barrier and isolation of an infected individual will confer immunity for the susceptible group thereby breaking the chain of infection.
I think we have a different understanding of what immunity is and is not. And I have the impression we are not going to come to an agreement.

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#80 of 150 Old 07-02-2010, 11:31 AM
 
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heathergirl67, on the issue of vaccination rate, I feel you're misjudging here. I'm not trying to be offensive, so don't take it that way. It's plastered all over numerous news articles that the CDC is unhappy with the adult vaccination rate, that most adults don't get boosters, and in some cases, there aren't any for that age group anyway. The numbers were posted here over a year ago that the population was around 33 million with only about 750,000 children. Children are in contact with adults much of the time, not just other children. Even if there was a 70% vaccination rate among children in this case--and the rate for adults is likely low since the CDC themselves complain about that though I can't find any specific percentages for us--then 30% of non-vaccinated people (children?) getting the disease really doesn't say anything since the non-vaccinated and non-boostered are the vast majority of the population. Herd immunity is a term constantly thrust around, but the only vaccination rate being quoted is that for children, a mere 2.27% of the entire US population. Even if we can say for sure that 90% of children are vaccinated, that only tells us that 2.05% of our total population is vaccinated. We really need to know the adult percentages before any mathematical conclusions are drawn about 'herd immunity.'
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#81 of 150 Old 07-02-2010, 12:21 PM
 
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buttercupmama- I see what you're saying. I've heard that before. I've also heard that the diagnostic criteria of some diseases changed after the vaccines came out. I've heard all of those things. But the fact remains that before vaccination these diseases were floating around. They were something that people got commonly. And now you just don't see them anymore. So for those adults who haven't had boosters, babies who are unvaccinated, etc, they don't get it because the diseases aren't in circulation anymore, thanks to vaccines. It seems so plain to see to me, but I understand that many don't see it that way. I'm afraid that this is something that we're going to disagree on.
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#82 of 150 Old 07-02-2010, 12:43 PM
 
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Well, yes and no, heathergirl.

For example, polio was floating around for thousands of years. But paralytic polio was not. It is a disease of modernity.

Mumps keeps popping up, in spite of the vaccine. Unfortunately, it is popping up in teens and young adults, where it is a much more dangerous and painful illness.

Pertussis, as has been widely discussed on this board, circulates like mad, despite the vaccine.

Hib and Prevnar both create issues of serotype replacement, another topic which has been discussed many times on this board.

I'll agree that some vaccines, some of the time, do seem to create herd immunity.

But the statement that vaccines create herd immunity, as I said earlier, is nonsense.

The discussion only makes sense if you go vaccine by vaccine and illness by illness. Blanket statements don't work.
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#83 of 150 Old 07-02-2010, 12:47 PM
 
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Originally Posted by INF-ß View Post
So where did the vaccinated get the pertussis bacteria from?
the answer is they get it from anywhere - the vaccinated or the unvaccinated because the vaccine does not confer immunity to the bacteria. It confers protection against the pertussis toxin (PT) which is the toxin produced by the bacteria. The vaccinated have some protection from developing symptoms to the toxin - they do not have protection from the bacteria that produces the toxin. If you look at pertussis deaths in infants - there were, on average, 17 deaths for infants under 6 months in the years 2001-2003: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5450a3.htm

what's defining the so-called pertussis 'epidemic' is the increase in diagnosis for the teen and adult populations. However, since adults and teens have ALWAYS been carrying and spreading this bacteria and have always had prolonged coughs (just undiagnosed or written off as allergies), they can't be a reason for increases in infant deaths (if there WERE an increase in infant deaths -there isn't) There is an increase in diagnosed cases. Not the same thing - but boy the media sure thinks something is different this year because there is now a vaccine for teens and adults.

oh - and vaccinating teens and adults will again, only protect teens and adults from the pertussis toxin - thereby further masking any symptoms they might have if they are carrying the bacteria. the vaccine does not make them immune, it does not stop them from carrying the bacteria.
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#84 of 150 Old 07-02-2010, 02:01 PM
 
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the answer is they get it from anywhere - the vaccinated or the unvaccinated because the vaccine does not confer immunity to the bacteria.
You answered for the vaccinated but how about the unvaccinated? Are you saying that the unvaccinated (newborns/adults) are carriers of B. pertussis bacteria by default?

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It confers protection against the pertussis toxin (PT) which is the toxin produced by the bacteria. The vaccinated have some protection from developing symptoms to the toxin - they do not have protection from the bacteria that produces the toxin.
That is demonstrably false. The term 'protection' applies to the protective antigens of the pathogen known as the virulence factor. It aids the pathogen in invasion and colonization of the host thus initiating the disease. This neither confer any advantage nor protection to the individual at all. Toxoids are just weakened pertussis toxins.

The pertussis vaccine (acellular) also contains filamentous hemagglutinin (FHA), another virulence factor which are proteins found at the surface of B. pertussis bacteria. Like the toxins, they are also immunogenic. So you have made two false and misleading assumptions so far.


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what's defining the so-called pertussis 'epidemic' is the increase in diagnosis for the teen and adult populations. However, since adults and teens have ALWAYS been carrying and spreading this bacteria and have always had prolonged coughs (just undiagnosed or written off as allergies), they can't be a reason for increases in infant deaths (if there WERE an increase in infant deaths -there isn't) There is an increase in diagnosed cases. Not the same thing - but boy the media sure thinks something is different this year because there is now a vaccine for teens and adults.
I am curious where did you hear that myth?

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oh - and vaccinating teens and adults will again, only protect teens and adults from the pertussis toxin - thereby further masking any symptoms they might have if they are carrying the bacteria. the vaccine does not make them immune, it does not stop them from carrying the bacteria.
Because you said so.
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#85 of 150 Old 07-02-2010, 03:03 PM
 
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You answered for the vaccinated but how about the unvaccinated? Are you saying that the unvaccinated (newborns/adults) are carriers of B. pertussis bacteria by default?
That's not what she said


That is demonstrably false. The term 'protection' applies to the protective antigens of the pathogen known as the virulence factor. It aids the pathogen in invasion and colonization of the host thus initiating the disease. This neither confer any advantage nor protection to the individual at all. Toxoids are just weakened pertussis toxins.

The pertussis vaccine (acellular) also contains filamentous hemagglutinin (FHA), another virulence factor which are proteins found at the surface of B. pertussis bacteria. Like the toxins, they are also immunogenic. So you have made two false and misleading assumptions so far.

from the dtap package insert " The role of the different components produced by B. pertussis in either the pathogenesis of, or the immunity to, pertussis is not well understood. There is no well established serological correlate of protection for pertussis" http://www.associatedcontent.com/art...rs.html?cat=71



I am curious where did you hear that myth? It's not a myth, it's a pattern



Because you said so.
Just read the insert.

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#86 of 150 Old 07-02-2010, 03:43 PM
 
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Both are true.





What about it? The person is just recovering from the destructive effect of the infectious disease such as cellular and tissue damage. This process will happen again when re-infection is permitted.



What is it with this 'immunity' thingy? Excuse me for my word, but it is really hard to discuss the essence of 'virginity' after a 'rape' scene.
Hmmm, I think I'm going to have to agree with another poster here. We have completely different understandings of immunity and how illnesses affect the body.
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#87 of 150 Old 07-02-2010, 04:00 PM
 
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Just read the insert.
I recommend you not to use the package insert as your only source of information. You will be misguided. The acellular pertussis vaccine was approved in the US in 1992 but still somehow the vaccine was able to 'protect' the individual from the disease that is 'not well understood' hitherto (?) and what's even more surprising is that the vaccine still confers immunity. Well, I call that a miracle!

Your source is incomplete, therefore unreliable.

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Molecular aspects of Bordetella pertussis pathogenesis

The molecular mechanisms of Bordetella virulence are now well understood, and many virulence factors have been identified and characterized at the molecular level. These virulence factors can be grouped into two major categories: adhesins, such as filamentous hemagglutinin, pertactin and fimbriae, and toxins, such as pertussis toxin, adenylate cyclase, dermonecrotic toxin and tracheal cytotoxin.....The adhesins and toxins act in concert to establish infection.http://revistes.iec.cat/index.php/IM...File/6144/5684
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#88 of 150 Old 07-02-2010, 04:16 PM
 
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If there were peer reviewed studies showing better efficacy of a vaccine, it would be in the best interest of pharmaceutical companies to put it on the insert. Considering the fact that they are trying to sell their product, if it's not on the insert by now (that articles is from '99) then I'll have to assume that it's not valid.

The insert does site several studies and uses qualifying words such as "WHO defined pertussis." The package insert is not from 1992. It was updated February of 2010.

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#89 of 150 Old 07-02-2010, 04:19 PM
 
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Fortunately for me, heathergirl67, I grew up in a third world country which didn't administer almost any vaccines. My mother was the worrying type and the only two vaccines available were, of course, given to me. This was in the 80s, again, in a third world country, with a dirty (and easily contaminated) water supply--the tanks at the water plant weren't even covered. Meanwhile, the incidence of these diseases was almost nil. People weren't getting sick and dying all around me without the vaccines. So it might be so plain for you to see that vaccines work, but it's just as plain to me that we don't need vaccines. The diseases are interesting in that they take their own course. I believe we're better off teaching parents how to manage them--definitely no more administering tylenol--rather than continuing to pretend we can outsmart mother nature. I think our species' biggest mistake was the invention of currency.
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#90 of 150 Old 07-02-2010, 04:21 PM
 
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Bolding mine
Quote:
Originally Posted by INF-ß View Post
Of course, that is what you expect when someone is given a live and mutated PV strain. It thrives!

I'm sorry but vaccines of any kind do not confer immunity whatsoever.



So where did the vaccinated get the pertussis bacteria from?
Quote:
Originally Posted by INF-ß View Post
I recommend you not to use the package insert as your only source of information. You will be misguided. The acellular pertussis vaccine was approved in the US in 1992 but still somehow the vaccine was able to 'protect' the individual from the disease that is 'not well understood' hitherto (?) and what's even more surprising is that the vaccine still confers immunity. Well, I call that a miracle!

Your source is incomplete, therefore unreliable.
Which is it?

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