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#1 of 51 Old 04-08-2013, 12:05 PM - Thread Starter
 
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Why do we vaccinate for Polio and not tuberculosis (BCG) ?

 

Both disease are just a plane ride away ( a common response when people protest vaccinating for Polio, as it is eradicated in many countries)

 

Both have vaccines

 

Both can be serious, although the disease is latent in most of the population in both cases.


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#2 of 51 Old 04-08-2013, 12:34 PM
 
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I think BCG is quite 'adverse effecty' . . . But then so is OPV . . .
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#3 of 51 Old 04-08-2013, 01:07 PM
 
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I haven't researched it but a doctor told me the bcg strain isn't the one in circulation now making out obsolete. Since we're not considering it anyways.... Who knows. I had the Soviet version as baby.
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#4 of 51 Old 04-08-2013, 01:09 PM
 
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I was vaccinated for BCG in the UK along with most of my friends in school. So I wondered why it wasn't done in the US.

I went to a talk several years ago about the efficiency of testing for latent TB and asked at the end. They claimed the BCG has very low efficacy ("from one cow in 1920" was the quote I remember - I probably have the date wrong) so not worth doing.

Anecdote warning - I am immune though. I reacted to the skin test I had to have for my greencard application so ended up having to have a chest X-ray before I could get the document.

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#5 of 51 Old 04-08-2013, 01:23 PM
 
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Originally Posted by prosciencemum View Post

I was vaccinated for BCG in the UK along with most of my friends in school. So I wondered why it wasn't done in the US.

I went to a talk several years ago about the efficiency of testing for latent TB and asked at the end. They claimed the BCG has very low efficacy ("from one cow in 1920" was the quote I remember - I probably have the date wrong) so not worth doing.

Anecdote warning - I am immune though. I reacted to the skin test I had to have for my greencard application so ended up having to have a chest X-ray before I could get the document.

But if this is the case why do so many other countries still do it? I get that in areas where there is a heavy burden of TB it might be indicated, but lots of countries that still use it are comparable to the US in that regard. 


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#6 of 51 Old 04-08-2013, 01:27 PM
 
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I don't know if its true and haven't looked into it any more. Actually I don't know if the UK still does it.

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#7 of 51 Old 04-08-2013, 01:30 PM
 
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From the NHS website:


"Why do we no longer vaccinate teenagers with the BCG at school? How can I get my child vaccinated?

TB is a difficult disease to catch because it requires prolonged exposure to an infected person. For example, you are very unlikely to catch it by sitting or standing next to someone who is infected. Also, rates of TB in the UK population have fallen to very low levels over the past 15 years.

The BCG vaccination programme was changed to reflect this and is now only given to people in at-risk groups.

If your child does not come into one of the higher-risk groups, the current advice is not to give them the BCG vaccination on the NHS. There are private clinics that parents can approach for a BCG vaccination, but the NHS does not keep a list of these clinics."

http://www.nhs.uk/Conditions/vaccinations/Pages/bcg-tb-vaccine-questions-answers.aspx#teenagers

Looks like I might have been in one of the last groups of teenagers routinely given it in the UK.

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#8 of 51 Old 04-08-2013, 01:35 PM
 
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Same website explains its effective only against some strains of TB. So maybe the relative amount if different strains circulating changes the decision about if it should be used or not.

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#9 of 51 Old 04-08-2013, 02:10 PM - Thread Starter
 
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I went to a talk several years ago about the efficiency of testing for latent TB and asked at the end. They claimed the BCG has very low efficacy ("from one cow in 1920" was the quote I remember - I probably have the date wrong) so not worth doing.

 

 

"Clinical trials have demonstrated conflicting results regarding BCG vaccine efficacy. Meta-analytic reviews have estimated the vaccine efficacy in preventing any TB disease at approximately 51%. The protective effect of BCG vaccine against disseminated TB in the newborn is estimated to be 78%."

http://www.phac-aspc.gc.ca/publicat/cig-gci/p04-bcg-eng.php

so, not great efficacy, but I has seen similar rates in other vaccines.

 


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#10 of 51 Old 04-08-2013, 02:18 PM
 
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And by other vaccines you mean pertussis?

It's a trade off between how common and serious the disease is and how effective and safe the vax is. How common are reactions to bcg compared to dtap? How common is the disease in the us? I certainly hope acip does a lot more than just recommend everything over a certain percent efficacy.
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#11 of 51 Old 04-08-2013, 02:31 PM - Thread Starter
 
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Bolding mine.  I am not quite sure this holds.  They are saying lack of contagiousness and rarity are the reasons they have decided to not offer it as a standard vax.  Tetanus both lacks contagiousness and is rare.  

 

Hep. B is not overly contagious (it is blood born) and rare in some demographics (it is found in about 1.7/100 000 female Canadians).  

 

Quote:

Originally Posted by prosciencemum View Post


"Why do we no longer vaccinate teenagers with the BCG at school? How can I get my child vaccinated?

TB is a difficult disease to catch because it requires prolonged exposure to an infected person. For example, you are very unlikely to catch it by sitting or standing next to someone who is infected. Also, rates of TB in the UK population have fallen to very low levels over the past 15 years.


http://www.nhs.uk/Conditions/vaccinations/Pages/bcg-tb-vaccine-questions-answers.aspx#teenagers
 

 

 

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There is a battle of two wolves inside us.  One is good and the other is evil.  The wolf that wins is the one you feed.

 

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#12 of 51 Old 04-08-2013, 02:45 PM - Thread Starter
 
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FYI =  there is an  average of  1600 cases of tuberculosis in Canada per year and 650 cases of Hep. B (although they think it is under-reported).  Tetanus has  0-6 cases per year.

 

Both tetanus and Hep. b are more effective vaccines than BCG - so maybe therein lies the difference.  


There is a battle of two wolves inside us.  One is good and the other is evil.  The wolf that wins is the one you feed.

 

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#13 of 51 Old 04-08-2013, 03:13 PM
 
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Are those Pre vaccine era rates?

And yes hep b is very under reported. Several times ver, I think like ten times is the estimate but I can't remember for sure.
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#14 of 51 Old 04-08-2013, 04:27 PM - Thread Starter
 
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Are those Pre vaccine era rates?

And yes hep b is very under reported. Several times ver, I think like ten times is the estimate but I can't remember for sure.

no - current.

 

tetanus:  http://www.phac-aspc.gc.ca/im/vpd-mev/tetanus-eng.php

hep b:  http://www.ccohs.ca/oshanswers/diseases/hepatitis_b.html

tuberculosis:  http://www.phac-aspc.gc.ca/tbpc-latb/pubs/tbcan09pre/index-eng.php#t3


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#15 of 51 Old 04-08-2013, 05:10 PM
 
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So you're comparing rates of tb with no vaccine to rates of hep b and tetanus with a vaccine?
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#16 of 51 Old 04-08-2013, 05:13 PM
 
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There is a Vax program 4 TB still @ work in the world & some Canadians have the Vax (travel, immigration) But that is a technical point.

My BFF has latent TB. She got it in India. We live in different states tho . . .
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#17 of 51 Old 04-08-2013, 06:14 PM
 
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Germany hasn't vaccinated for bcg in ages. I'm surprised the UK does.
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#18 of 51 Old 04-08-2013, 06:55 PM - Thread Starter
 
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So you're comparing rates of tb with no vaccine to rates of hep b and tetanus with a vaccine?

Well, tetanus at most is 1/250 000 (that is pre-vaccine era when many more people lived on farms).  4 people per million getting tetanus at 35 million people is 140 cases.

 

So - without vax tetanus would be 140 at the most and without vax tb is 1600  

 

I am not going to bother looking up hep B stats - I am more interested in discussion than debate or proving a point.  I am trying to sort out why something like Tb is not vaccinated while certain other diseases (that share similar characteristics) are.  


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#19 of 51 Old 04-08-2013, 07:00 PM - Thread Starter
 
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Germany hasn't vaccinated for bcg in ages. I'm surprised the UK does.

I think the UK stopped routine BCG in 2005.

 

If you are interested in such things, you can click on the different European countries to see what they vax for and when.

http://www.euvac.net/graphics/euvac/vaccination/ireland.html


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#20 of 51 Old 04-08-2013, 07:37 PM - Thread Starter
 
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Same website explains its effective only against some strains of TB. So maybe the relative amount if different strains circulating changes the decision about if it should be used or not.

Wikipedia also said the shots efficacy varies from region to region:

 

"The most controversial aspect of BCG is the variable efficacy found in different clinical trials, which appears to depend on geography. Trials conducted in the UK have consistently shown a protective effect of 60 to 80%, but those conducted elsewhere have shown no protective effect, and efficacy appears to fall the closer one gets to the equator.[4][5]"

 

http://en.wikipedia.org/wiki/BCG_vaccine

 

The article speculates on reason why as well - it is an interesting read.

 

It does make me wonder if other vaccines have efficacy rates that differ from region to region. 


There is a battle of two wolves inside us.  One is good and the other is evil.  The wolf that wins is the one you feed.

 

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#21 of 51 Old 04-08-2013, 08:45 PM
 
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Also why is BCG the only vax named that way? The rest are named for the disease . . . I was just reading about the different strains of mumps, like Urabe . . .
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#22 of 51 Old 04-09-2013, 05:30 AM
 
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Its definitely interesting that the US has never implemented a mass BCG immunisation (from the wikipedia page: http://en.wikipedia.org/wiki/BCG_vaccine). 

 

 

Also this I find interesting: 

Quote:
The UK introduced universal BCG immunization in 1953, and until 2005, the UK policy was to immunize all school children at the age of 13, and all neonates born into high-risk groups. [] Routine immunization with BCG was withdrawn in 2005 because of falling cost-effectiveness: whereas in 1953, 94 children would have to be immunized to prevent one case of TB, by 1988, the annual incidence of TB in the UK had fallen so much, 12,000 children would have to be immunized to prevent one case of TB.

 

BCG stands for "Bacillus Calmette–Guérin" (also wikipedia).

 

Calmette and Guerin were the French scientists who developed the technique to attenuate the tubercle bacillus to make the first TB vaccination in the early part of the 20th century. So I guess Bacillus Calmette-Guerin is the name for the attenuated version of the tubercule bacillus (TB) bacterium which made the first vaccine... 

 

Is this the oldest vaccine still in routine use? Maybe that explains the different name (using an older convention?). 


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#23 of 51 Old 04-09-2013, 06:35 AM
 
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Also I don't have my laptop until tomorrow but I remember being told that the Soviet tuberculosis vaccine was different from the western supply. It was touted more effective but more reactive. In east Germany, newborns received one dose and then never again. My same aged peers on the other side didn't get it. Tb never was a big issue in my lifetime home. They did say they are seeing an increase in card from very poor eastern European immigrants who probably lived in not so great conditions and are promptly treated.
As for the green card you are lucky not to have to take antibiotics. An au pair friend of mine was forced to take them or leave. Her skin test was positive did to the vaccine. Xray clear, blood test showed healthy,us doctors refused to acknowledge that her vaccine could illicit a false positive. She rather went home. That was in NYC. Crazy one must wonder where that doctor got his license from. Btw since I had a work visa a skin test was all they wanted. Again it hurt since they stay in your skin layer but was negative. Btw routine skin tests are not performed home. I had to go to the institute of tropical medicine to obtain one.
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#24 of 51 Old 04-09-2013, 07:05 AM
 
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Yeah. I think I agreed I might take the drugs to treat latent TB at a later date, but as I was planning to become pregnant imminently I was able to defer that (and just never brought it up again!). The doctors were convinced I must have latent TB and very keen to treat me for it. No thanks to those drugs.... 


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#25 of 51 Old 04-09-2013, 07:44 AM
 
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My eldest was born in Hong Kong and had the BCG birth dose. I had it as a teen in the UK, and thereafter had chronic sore throats and enlarged lymph glands until my early twenties. I also had to get the skin test for my green card, I reacted, but the NP didn't seem concerned.


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#26 of 51 Old 04-09-2013, 09:04 AM
 
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Anecdote: I had no side effects other than the classic itchy bump. The scar is still just about visible on my upper arm. 


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#27 of 51 Old 04-09-2013, 01:33 PM
 
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I had obvious adverse effects from the BCG, but I hardly have a mark on my arm from the vaccination.


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#28 of 51 Old 04-11-2013, 07:02 PM
 
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I was born and raised in the region where tuberculosis of bone and lung is endemic and I can testify to the fact (and WHO agrees with that) that effectiveness of the vaccine is very low.

However the vaccine is still given to all newborn in the region with TWO additional boosters. The rationale for it is that is protects children under five years of age from dying from the most serious forms of tuberculosis. But not from the lung TB, which is  the most common form of the disease in my region.

In 2007, in the country where I am from, 164 000 people received treatment from TB and 25 000 died from the TB!!! These people were vaccinated on the schedule when young. The rates of infection among vaccinated people are steadily rising and the health authorities, doctors and WHO all testify that BCG is highly ineffective vaccine with low efficacy rates.

Literally, few days ago our head of the Epidimeology Dept. declared that BCG is highly reactive  vaccine and not at all effective but there is NO alternative. IF there was more effective alternative, he would immediately suggest dropping BCG from the vaccine schedule.

From what I remember, the WHO issued a report few years ago stating the geographic region has a lot to do with the vaccine effectiveness. For example, massive BCG vaccination in India completely failed and resulted in increased TB infection in children. However, BCG seemed to be VERY effective in some parts of Africa where people has developed natural immunity to that infection.

I know many people (close relatives, friends)_ who contracted TB in childhood and were treated for that. I also know several adults with TB. Each of them were vaccinated against TB.

This is an epic failure of the vaccine:

1. It does not protect children or adults from lung TB

2. It does not prevent transmission.

3. It carries high rate of side effects in malnourished population (which is not aproblem in UK but is a severe problem in my region)

4. It is not effective in regions with endemic forms of TB

5. The immunity is short lived.

 

All BCG really does is lessen severity of miliarniy (?) tuberculosis that has high death rates in young population.

 

Thanks to BCG I have three huge ugly scars on my arms and constantly enlarged lymph nodes (common sideeffect of vaccine). In addition to BCG, we had to undergo annual Mantu tests and annual chest X-rays for many, many years.

 

 

Not all vaccines are effective, some are downright ineffective and are harmful. That is the fact that is freely acknowledged by the people in my country. And I totally do not get the vicious debates on this forum where pro-vaxxers refused to acknolwedge that. I think it is time we wake up and face reality.

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#29 of 51 Old 04-11-2013, 07:04 PM
 
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The links to the stats, I can post them but probably nobody in this forukm will be able to read them:)

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#30 of 51 Old 04-12-2013, 04:41 AM
 
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Quote:
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Not all vaccines are effective, some are downright ineffective and are harmful. That is the fact that is freely acknowledged by the people in my country. And I totally do not get the vicious debates on this forum where pro-vaxxers refused to acknolwedge that. I think it is time we wake up and face reality.

 

I'm curious where you get this idea from. The CDC has never recommended the BCG vaccine, and the NHS stopped routine immunization with it in 2005. Isn't that a pretty good acknowlegement by two undeniably pro-vax organizations that not all vaccines are worth deploying in large scale programs, and that where the evidence points at a low benefit or a high risk the recommendations change.

 

I think it's a strawman to claim that the entire "pro-vax" side ignores evidence of poor effectiveness and unacceptable side effects. I do not agree that I do that for example, and I think the above demontrates that the US CDC and the UK NHS do not either.

 

 But neither will I accept with blind faith all the suggestions on anti-vax websites which are commonly repeated on this forum that most (if not all) vaccines are worthless and have frequent harmful side effects. 


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