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#1 of 269 Old 03-23-2014, 05:26 AM - Thread Starter
 
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Several of the "worst outbreak in years thanks to the anti-vaccine nutjobs" articles say that measles were thought to be eradicated from the US in the year 2000, and now, it is back and we've had large outbreaks due to those crazies like Jenny McCarthy and all the idiots who blindly listen to her. I'm paraphrasing, but that's the gist.

 

After some research I found a few things worth noting. In the year 2000, there were 86 confirmed cases of measles in the US. In 2013, there were 189. I understand that percentage wise, that is a large increase. However, we are talking the difference of 103 cases in a country with over 300 million people. Do these numbers really constitute words like eradicated vs outbreak? There is a lot of hype over these cases, and a lot of blame on the unvaccinated, but when you look beyond the hype, you find things like:

 

"The largest outbreaks occurred in New York: one in Oswego/Onondaga counties involving nine persons and a second in Kings County involving eight persons. The Oswego/Onondaga outbreak occurred in a high school; the source of infection was unknown. Of the six high school students eligible for vaccination, five had been vaccinated." (from the year 2000)

 

Five out of six infected people were vaccinated (you could even say 5 out of 9 if you like). Using these figures you could make an argument that you are more likely to get the measles if you are vaccinated. Of course, several people will say that is by far too small a sample to make such a claim. And I agree. But doesn't that also mean it is too small a group to count as a large outbreak?

 

Another, more recent article that tries to instill fear and blame the unvaccinated says, "19 of the 32 cases of measles they have confirmed so far this year are in people who had not been vaccinated, and of that group, 14 were intentionally not vaccinated."

 

What that tells me is 40% of those infected were vaccinated.  How can there be so much blame on the unvaccinated when the vaccinated seem to be coming down with it either almost as much or more than the unvaccinated? Why aren't we questioning the effectiveness of the vaccine? Is it because it is easier to blame parents than the pharmaceutical industry?

 

Sources:

http://www.salon.com/2014/03/20/measles_outbreak_vaccine_trutherism_now_officially_a_public_health_crisis/

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5106a2.htm

http://www.scpr.org/news/2014/03/18/42870/majority-of-states-measles-cases-were-unvaccinated/

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#2 of 269 Old 03-23-2014, 05:59 AM
 
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I remember measles going around Douglas county, Co in 1996...as i heard about them the year before, too...i remember the health dept promoting mmr vaccines

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#3 of 269 Old 03-23-2014, 06:00 AM
 
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And the other excuse and blame game for measles outbreaks it to point fingers at foreigners now. 

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#4 of 269 Old 03-23-2014, 06:19 AM
 
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There was a measles out break in the early 1990s too. My niece and son had measles then - they were too young for the vax. The MMR was scheduled at the time for 18 months. Because of the outbreak, the MMR was moved up to 15 months and then to 12 months where it is now, I do believe.

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#5 of 269 Old 03-23-2014, 07:57 AM
 
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  Of course, several people will say that is by far too small a sample to make such a claim. And I agree. But doesn't that also mean it is too small a group to count as a large outbreak?

So true!


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#6 of 269 Old 03-23-2014, 08:13 AM
 
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'An outbreak of measles occurred in a high school with a documented vaccination level of 98 per cent. Nineteen (70 per cent) of the cases were students who had histories of measles vaccination at 12 months of age or older and are therefore considered vaccine failures...Vaccine failures among apparently adequately vaccinated individuals were sources of infection for at least 48 per cent of the cases in the outbreak.' Measles outbreak in a vaccinated school population: epidemiology, chains of transmission and the role of vaccine failures/B M Nkowane, S W Bart, W A Orenstein, M Baltier, American Journal of Public Health (Impact Factor: 3.93). 05/1987

An interesting thing to note was:

 

'Vaccine failures among apparently adequately vaccinated individuals were sources of infection for at least 48 per cent of the cases in the outbreak.'


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#7 of 269 Old 03-23-2014, 08:16 AM
 
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Saying a lot of vaxxed individuals got a disease does not mean much on its own.  We need to know what percentage of vaxxed, semi vaxxed and unvaxxed got the disease.

 

Example:  A school has 500 people and 480 are fully vaccinated, 20 are unvaccinated.

 

A disease affects 10% of the vaccinated and 50% of the unvaccinated.

 

50 vaccinated people could come down with the disease, while only 10 unvaccinated people would come down with the disease.

 

Simply by virtue of the fact that there are more vaccinators than non-vaccinators, there will frequently be more vaccinated who come down with the disease.  So, more vaccinated than non-vaccinated coming down with something does not really mean a heck of a lot.

 

Sorting out attack rates is not easy business, though.  

 

1.  Studies often group under-vaxxed and status unknown in with whom they see fit (usually the unvaxxed) which can skew numbers.

 

2.  It can often be extremely difficult to figure out how many people were exposed

 

Where I think such numbers are useful is when it help us determine vaccine efficacy.  

 

I also think it shoots a bit of an arrow in the whole "the unvaxxed are disease spreaders!"  Um, in my example above, and all things being equal,  I am more likely to get the measles from one of the 50 vaxxed than the 10 unvaxxed.  


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#8 of 269 Old 03-23-2014, 08:22 AM
 
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Originally Posted by littlec View Post
 Of course, several people will say that is by far too small a sample to make such a claim. And I agree. But doesn't that also mean it is too small a group to count as a large outbreak?

 

And too small to draw conclusions from.

 

I am not overly thrilled with the CDC 1-3/1000 mortality rate statistic.  They seem to be using very recent numbers, but there are not enough cases of measles in the USA to make a good sample size.  It is borderline deceitful.

 

Most recent stats out of a large outbreak in Europe (you know, the kind where there are enough numbers to create statistic) show the mortality rate to be about 1/2500 per reported case.  I can get the link later if anyone likes - gotta fly now!


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#9 of 269 Old 03-23-2014, 08:27 AM
 
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^^^^

 

The CDC's measles mortality rate for the 1950s and 1960s (pre-vaccination) was less than 1 in 100,000.  See page 85 here.

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#10 of 269 Old 03-23-2014, 08:33 AM
 
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#11 of 269 Old 03-23-2014, 09:25 AM
 
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Here's what doesn't make sense to me. If the unvaccinated are to blame for RECENT measles outbreaks, and if the narrative is that everything was fine and dandy until the Wakefield Incident, why do vaccination coverage levels for MMR follow this bizarre pattern? http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/coverage.pdf

If herd immunity requires 90-95% coverage, shouldn't measles have been RAMPANT in the late 60s and early 70s, when coverage hovered around 60% and with only a one-dose regimen? Instead, we're hearing the narrative that the introduction of the vaccine --poof!--wiped out measles.

At any rate, we're seeing MUCH higher vaccination rates in the early 2000s, a routine 2-dose regimen, and more reports of outbreaks.
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#12 of 269 Old 03-23-2014, 09:36 AM
 
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Here's what doesn't make sense to me. If the unvaccinated are to blame for RECENT measles outbreaks, and if the narrative is that everything was fine and dandy until the Wakefield Incident, why do vaccination coverage levels for MMR follow this bizarre pattern? http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/coverage.pdf

If herd immunity requires 90-95% coverage, shouldn't measles have been RAMPANT in the late 60s and early 70s, when coverage hovered around 60% and with only a one-dose regimen? Instead, we're hearing the narrative that the introduction of the vaccine --poof!--wiped out measles.

At any rate, we're seeing MUCH higher vaccination rates in the early 2000s, a routine 2-dose regimen, and more reports of outbreaks.

Once upon a time almost everyone had natural immunity to common vaccine-available diseases.  Vaccine acquired immunity does not seem to be as good as natural immunity.  It is not surprising we are seeing an upswing in disease as those with natural immunity die out.  (usual caveat:  disease and vaccine dependent)

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#13 of 269 Old 03-23-2014, 11:16 AM
 
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After some research I found a few things worth noting. In the year 2000, there were 86 confirmed cases of measles in the US. In 2013, there were 189. I understand that percentage wise, that is a large increase. However, we are talking the difference of 103 cases in a country with over 300 million people. Do these numbers really constitute words like eradicated vs outbreak? There is a lot of hype over these cases, and a lot of blame on the unvaccinated, but when you look beyond the hype, you find things like:

 

 

I think people sometimes confuse the word "outbreak" with "epidemic".  


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#14 of 269 Old 03-23-2014, 11:38 AM
 
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After some research I found a few things worth noting. In the year 2000, there were 86 confirmed cases of measles in the US. In 2013, there were 189. I understand that percentage wise, that is a large increase. However, we are talking the difference of 103 cases in a country with over 300 million people. Do these numbers really constitute words like eradicated vs outbreak? There is a lot of hype over these cases, and a lot of blame on the unvaccinated, but when you look beyond the hype, you find things like:

 

 

Measles was declared eradicated/no longer endemic because there were breaks in transmission/times when no measles could be found.  There were still outbreaks then, and the news today is just that the outbreaks have been a bit bigger than they were.  But each individual outbreak comes to an end.  Measles will be considered endemic again if we reach the point where the outbreaks don't really end, where measles is always occurring somewhere in the US. 

 

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 Originally Posted by littlec View Post

 

"The largest outbreaks occurred in New York: one in Oswego/Onondaga counties involving nine persons and a second in Kings County involving eight persons. The Oswego/Onondaga outbreak occurred in a high school; the source of infection was unknown. Of the six high school students eligible for vaccination, five had been vaccinated." (from the year 2000)

 

Five out of six infected people were vaccinated (you could even say 5 out of 9 if you like). Using these figures you could make an argument that you are more likely to get the measles if you are vaccinated. Of course, several people will say that is by far too small a sample to make such a claim. And I agree. But doesn't that also mean it is too small a group to count as a large outbreak?

 

 

Actually, while one very small outbreak would be too small to make a broad claim, the bigger issue is that we do not have enough information to make a claim.  We do not know anything about the overall vaccination status of the highschool. 

 

If there were 100 students in the highschool, and 50 were vaccinated and 50 unvaccinated, then knowing that 5 vaccinated kids got measles and only 1 unvaxed kid did, then that could actually indicate there was a problem and the vaccine made kids more likely to get it (though from this alone, yes, it would be too small to say for sure). 

 

If there were 56 kids in the school, 50 who were vaxed and 1 unvaxed, then 5 vaxed kids and 1 unvaxed getting it would be 10% of each population getting it, not showing the vaccine to have any effect, and vaccinated kids being just as likely as unvaxed kids to get it. 

 

If there were a 101 kids in the school and 100 of them were vaccinated, then 5 vaxed kids getting it and 1 unvaxed kid getting it would show a 5% attack rate for vaxed and 1% attach rate for unvaxed, indicating that clearly the vaccine was quite effective. (5% actually is the expected attack rate for people exposed after only 1 vaccine, but again, numbers in this case would be too small to reach any actual conclusions about general effectiveness of the vaccine). 

 

Without more information about the population and vaccination coverage of it, all that knowing that a few vaccinated kids got the disease tells us is that the vaccine is not 100% effective, but we already knew that. 

 

 

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 Originally Posted by littlec View Post

 

Another, more recent article that tries to instill fear and blame the unvaccinated says, "19 of the 32 cases of measles they have confirmed so far this year are in people who had not been vaccinated, and of that group, 14 were intentionally not vaccinated."

 

What that tells me is 40% of those infected were vaccinated.  How can there be so much blame on the unvaccinated when the vaccinated seem to be coming down with it either almost as much or more than the unvaccinated? Why aren't we questioning the effectiveness of the vaccine? Is it because it is easier to blame parents than the pharmaceutical industry?

 

 

It's largely about what could have been done to prevent the disease.  

 

What reasonably could have been done to prevent the cases in kids too young to be vaccinated?  Unless any of them were deliberately exposed, probably not much could be done to them directly, the only way to keep them from getting it is to keep them from being exposed. 

 

What can be done to 1 to 2% of people who are still not immune despite getting 2 doses of vaccine from getting it?  Again, not much besides preventing them from being exposed. 

 

What could be done to prevent the 14 cases in intentionally unvaxed?  Well, 98% or 99% of them could have been prevented by 2 doses of the vaccine - meaning likely 13 could have been prevented (even if exposed) and possibly even all 14.  That would not just protect those 13 or 14, but anyone who caught it from one of those 13 or 14 vaccine preventable cases would not have been exposed to it so not have gotten it. 

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#15 of 269 Old 03-23-2014, 12:06 PM
 
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 'An outbreak of measles occurred in a high school with a documented vaccination level of 98 per cent. Nineteen (70 per cent) of the cases were students who had histories of measles vaccination at 12 months of age or older and are therefore considered vaccine failures...Vaccine failures among apparently adequately vaccinated individuals were sources of infection for at least 48 per cent of the cases in the outbreak.' Measles outbreak in a vaccinated school population: epidemiology, chains of transmission and the role of vaccine failures/B M Nkowane, S W Bart, W A Orenstein, M Baltier, American Journal of Public Health (Impact Factor: 3.93). 05/1987

 

An interesting thing to note was:

 

'Vaccine failures among apparently adequately vaccinated individuals were sources of infection for at least 48 per cent of the cases in the outbreak.'

 

I'm a little confused by this... if I am reading this right, 70% of cases were vaccine failures in a school with 98% vaccine rate (would have been a single vaccine at the time, so 5% expected failrue rate).  Meaning the 2% of the population which had not had a single vaccine made up 30% of the measles cases? That part seems clear.

 

But since 70% of the cases were themselves vaccine failures, I am a little confused about the 48% which you copied in bold - do they mean that 48% of the cases caught them from someone who had a vaccine failure?  I'm really not sure how they would even try to figure out who caught them from who in a school.  But if that is what they mean, would that indicate that the 2% of the population which was unvaxed was the source of infection for 52% of the cases?

 

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Originally Posted by Turquesa View Post

Here's what doesn't make sense to me. If the unvaccinated are to blame for RECENT measles outbreaks, and if the narrative is that everything was fine and dandy until the Wakefield Incident, why do vaccination coverage levels for MMR follow this bizarre pattern? http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/coverage.pdf

If herd immunity requires 90-95% coverage, shouldn't measles have been RAMPANT in the late 60s and early 70s, when coverage hovered around 60% and with only a one-dose regimen? Instead, we're hearing the narrative that the introduction of the vaccine --poof!--wiped out measles.

At any rate, we're seeing MUCH higher vaccination rates in the early 2000s, a routine 2-dose regimen, and more reports of outbreaks.

 

Are we seeing a much higher vaccination rate?  I thought it was fairly stable/slightly higher in some areas with pockets where it is lower, but will stand corrected if that is true. 

 

But Emmy526 has it right above - let's point the finger at foreign travel!

 

Most travel in/out of the US is too and from Canada.  Next is Mexico.  Both have higher vaccine rates than the US and neither have a lot of measles. 

 

Third on the list of travel too/from US is the United Kingdom.  While Wakefield may not have had much influence on the measles vaccine rate in the US, the release of his research in the UK did cause a drop in vaccine rates there down in to the low 80% percents for several years.  This predictably did cause some large outbreaks of measles.  Is there really any surprise that outbreaks of measles in the country third on the list for travel in/out of the US would cause a few (much smaller) outbreaks there?

 

We hear  "poof wiped out measles" because even a single dose of the vaccine with less than full coverage caused the numbers to drop dramatically and quickly from a time when virtually every child got them to most children not getting them just a few months later.  But yes, measles rates were still much higher then with only a single dose and lower coverage, and cases were still counted in the tens of thousands in the years after the vaccine where now a couple hundred cases a year is considered an unusually high amount. 

 

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Once upon a time almost everyone had natural immunity to common vaccine-available diseases.  Vaccine acquired immunity does not seem to be as good as natural immunity.  It is not surprising we are seeing an upswing in disease as those with natural immunity die out.  (usual caveat:  disease and vaccine dependent)

 

But.. the point is that I would rather my kids not get measles.  Yes, natural immunity is more effective, but... to get it requires having measles.  

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#16 of 269 Old 03-23-2014, 01:50 PM
 
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Pers, yes, that it was the link in my post shows. The U.S. has increased by a staggering 40% in measles vaccination coverage. But gee, don't take the CDC's word for it. How about an emotive, pro-vax personal blog post? http://io9.com/despite-anti-vaxxer-rhetoric-vaccination-rates-are-hig-1510028898

It's unusual, too, that we're seeing the outbreaks in NYS, with its draconian vaccine laws and high coverage rates.

My own hypothesis is that we may be have a weaker vaccine in circulation. Time will tell, but it wouldn't hurt health care consumers to start demanding some answers.
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#17 of 269 Old 03-23-2014, 02:15 PM
 
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Those "eradicated in the US" claims bug me, partly because "just a plane ride away" keeps getting spouted as a reason to vaccinate.  The two ideas seem contradictory to me.  Personally, I think that claiming that measles was eradicated in the US was about as honest as saying urine had been eliminated from one particular end of the swimming pool.  I think the claims were mostly a marketing ploy to inflate people's confidence in vaccines.

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#18 of 269 Old 03-23-2014, 02:26 PM
 
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Most travel in/out of the US is too and from Canada.  Next is Mexico.  Both have higher vaccine rates than the US and neither have a lot of measles. 

 

FYI - I am almost positive the vaccination rate in Canada is below that of USA.  We cannot know for certain as Canadian stats can be a bit tricky to figure out, but there was some sort of mini scandal a little bit ago about Canada having the lowest vaccination rate of affluent countries.

 

http://www.theglobeandmail.com/life/health-and-fitness/health/are-canadian-kids-undervaccinated-or-is-it-that-we-just-dont-know/article11477965/

 

That being said, no, we do not have much measles.  We occasionally have outbreaks  - and Quebec in particular seems prone, despite high vax rates.  

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#19 of 269 Old 03-24-2014, 07:49 AM
 
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That being said, no, we do not have much measles.  We occasionally have outbreaks  - and Quebec in particular seems prone, despite high vax rates.  

 

Quebec outbreak:

 

Major measles epidemic in the region of Quebec despite a 99% vaccine coverage

 

Abstract

The 1989 measles outbreak in the province of Quebec has been largely attributed to an incomplete vaccination coverage. In the Quebec City area (pop. 600,000) 1,363 confirmed cases of measles did occur. A case-control study conducted to evaluate risk factors for measles allowed us to estimate vaccination coverage. It was measured in classes where cases did occur during the outbreak. This population included 8,931 students aged 5 to 19 years old. The 563 cases and a random sample of two controls per case selected in the case's class were kept for analysis. The vaccination coverage among cases was at least 84.5%. Vaccination coverage for the total population was 99.0%. Incomplete vaccination coverage is not a valid explanation for the Quebec City measles outbreak.

 
 

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#20 of 269 Old 03-24-2014, 07:57 AM
 
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So much for herd immunity. The 1% did not infect all 563 cases.

 

No one died.  All have lifetime immunity.

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#21 of 269 Old 03-24-2014, 08:08 AM
 
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The usual measurement of death from measles (or anything else) is the ratio of fatalities to the number of diagnosed patients. For pre-vaccine measles in the USA, that was about 1/1000. (In the Third World, where kids with measles can't be rushed to the ER and ICU, it is much, much higher.) At least that many survived with sever permanent damage like deafness. Mirzam's 1/100000 number comes from using a denominator not of those who got sick, but of the entire population of the United States.

 

You might as well say that the death rate from AIDS at the height of the epidemic was 1/6000 (as measured by Mirzam), so what was the big deal? The big deal, among other things, is that at that time the fatality rate for those who became ill was almost 100%, with survivors being studied individually to try to determine the source of their resistance.

 

All numbers from anti-vax sources need the most careful scrutiny. [UPDATE: typo fixed]

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"So much for herd immunity. The 1% did not infect all 563 cases."

 

In the literal sense, the second claim (only) is true. However, we can not conclude that the outbreak would have occurred or been almost as bad without that 1%. First, it is often the case that a member of the 1% (here in California, it is 5%) introduces the illness into the community; the recent outbreak here came from the return to California of an unvaccinated university student from vacation at his home in the Philippines, where measles remains endemic. Second, the math behind herd immunity is "chaotic", i.e., it is subject to The Butterfly Effect. A small increase in the size of the susceptible (unvaccinated or unsuccessfully vaccinated) population can translate into large increase in the number of cases of illness. Differential equations, I regret to inform you, don't care about organic food.

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Who cares what you thing about organic food?  Then don't eat it!

 

Any evidence for that measles shedding, unvaccinated Philipine student, or should we take your word for it? You checked his titres or you have his immigration and vaccine records?

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Measles is a reportable disease. He was the first patient. As to whether he was unvaccinated and had just returned from the Philippines, where there is a lot of measles, I suppose that the doctors could all have lied to the news media about it. And they could have faked the moon landing, too, if we want to go down that path.

 

Luckily, there seems to have been only one other case, also an unvaccinated Filipino who had been overseas.

 

It's not that hard, in many cases, to backtrack through medical records and find the first patient in a community. There was also an outbreak when I was at Berkeley, and the first two patients were identified. I think 11 were sick in total. The second patient was a foreign student. I never learned who the first was.

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Measles transmission for twice vaccinated person as index case.

 

Outbreak of Measles Among Persons With Prior Evidence of Immunity, New York City, 2011

 

Results. The index case had two doses of measles-containing vaccine. Of 88 contacts, four secondary cases were confirmed that had either two doses of measles-containing vaccine or a past positive measles IgG antibody. 

 

 

Conclusions. This is the first report of measles transmission from a twice vaccinated individual. The clinical presentation and laboratory data of the index were typical of measles in a naïve individual. Secondary cases had robust anamnestic antibody responses. No tertiary cases occurred despite numerous contacts. This outbreak underscores the need for thorough epidemiologic and laboratory investigation of suspected measles cases regardless of vaccination status.


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Quote:

Originally Posted by Mirzam View Post
...The index case had two doses of measles-containing vaccine. Of 88 contacts, four secondary cases were confirmed that had either two doses of measles-containing vaccine or a past positive measles IgG antibody. 
 

 

So the measles titers were unreliable, too?

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Hmm, one one my recent posts seems to have been deleted. Guess that's a good way to keep the argument unbalanced! The less offensive part was this graph:

Where did all the measles go, and why? Someone wants to argue that we had a sanitary revolution over three years that knocked measles out, at just the same time as the vaccine was released??

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#28 of 269 Old 03-24-2014, 11:52 AM
 
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Quote:
Originally Posted by ss834 View Post
 

Quote:

Originally Posted by Mirzam View Post
...The index case had two doses of measles-containing vaccine. Of 88 contacts, four secondary cases were confirmed that had either two doses of measles-containing vaccine or a past positive measles IgG antibody. 
 

 

So the measles titers were unreliable, too?

Antibodies do not necessarily mean immunity and you can have immunity without antibodies.

 

http://www.ncbi.nlm.nih.gov/pubmed/1565228

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359130/

 

Antibody Theory: The Fatal Flaw in the Vaccination Agenda

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#29 of 269 Old 03-24-2014, 11:54 AM
 
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Originally Posted by Andrew Lazarus View Post
 

Hmm, one one my recent posts seems to have been deleted. Guess that's a good way to keep the argument unbalanced! The less offensive part was this graph:

Where did all the measles go, and why? Someone wants to argue that we had a sanitary revolution over three years that knocked measles out, at just the same time as the vaccine was released??

Lol.

 

Right.  You made some highly offensive comparisons - that is why that post got deleted.  It has nothing to do with keeping an argument "unbalanced" The deletion is all on you.


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#30 of 269 Old 03-24-2014, 11:57 AM
 
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FYI - I am almost positive the vaccination rate in Canada is below that of USA.  We cannot know for certain as Canadian stats can be a bit tricky to figure out, but there was some sort of mini scandal a little bit ago about Canada having the lowest vaccination rate of affluent countries.

 

 

 

The WHO, which I was going off of, lists us as having a higher rate than the US, but I'm not sure what they base their numbers on since, yes, Canada does have tricky stats, and different sources give different numbers.  So that could be wrong, but I am pretty certain Wakefield's report didn't cause a big drop here the way it did in the UK.

 

Quote:
Originally Posted by Turquesa View Post

Pers, yes, that it was the link in my post shows. The U.S. has increased by a staggering 40% in measles vaccination coverage. But gee, don't take the CDC's word for it. How about an emotive, pro-vax personal blog post? http://io9.com/despite-anti-vaxxer-rhetoric-vaccination-rates-are-hig-1510028898

It's unusual, too, that we're seeing the outbreaks in NYS, with its draconian vaccine laws and high coverage rates.

My own hypothesis is that we may be have a weaker vaccine in circulation. Time will tell, but it wouldn't hurt health care consumers to start demanding some answers.
 
Sorry, totally read your first post wrong, you said "gone up in the early 2000's" and was linking that to your first paragraph about Wakefield and what has happened since and somehow misinterpreted it and thought that you were saying that measles vaccine rate had gone up dramatically in the US following Wakefield. 
 
But you were still talking about since the 60's and 70's, right?  Then yes, as I said before, measles vaccine rates have gone up dramatically since then, and measles rates have gone down.  In the late 60's and the 70's, measles cases were still counted in the tens of thousands, which was a huge drop from how they were counted in decades prior to that.  In the 80's they were mostly counted in the thousands. There was a brief upswing back in to tens of thousands, after which they added the second dose.  and the numbers dropped again until soon they were being measured in the low hundreds per year.  
 
Now a couple hundred cases, a number which not even have been noticed in with the tens of thousands of cases in the 70's, is considered an unusually large outbreak.  Just look how far we've come. 
 
The US vaccination rate is still high enough that unless it drops, measles won't return to sweep across the nation again. But the size of the outbreaks we are seeing (and while some vaccinated people do get measles, the great majority of cases have been in unvaxed people in the last few years, and thus most of them preventable, despite unvaxed only being a small percentage of the population), shows just how ready measles is to jump back into being a normal part of our children's lives if we were to quit vaccinating. 
 

Quote:

Originally Posted by Mirzam View Post
 

 

Quebec outbreak:

 

Major measles epidemic in the region of Quebec despite a 99% vaccine coverage

 

Abstract

The 1989 measles outbreak in the province of Quebec has been largely attributed to an incomplete vaccination coverage. In the Quebec City area (pop. 600,000) 1,363 confirmed cases of measles did occur. A case-control study conducted to evaluate risk factors for measles allowed us to estimate vaccination coverage. It was measured in classes where cases did occur during the outbreak. This population included 8,931 students aged 5 to 19 years old. The 563 cases and a random sample of two controls per case selected in the case's class were kept for analysis. The vaccination coverage among cases was at least 84.5%. Vaccination coverage for the total population was 99.0%. Incomplete vaccination coverage is not a valid explanation for the Quebec City measles outbreak.

 

The full paper is here http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2271410/.  It is quite interesting.  They learned a lot from that outbreak.    Mostly: 

 

Quote:
 Vaccine efficacy rose from 85% in children vaccinated at 12 months of age to > or = 94% in those vaccinated at 15 months and older. Even for children vaccinated at or after 18 months of age, the RR of measles was reduced when compared with children vaccinated between 15 and 17 months of age (RR 0.61, CI 95% 0.33-1.15). Small changes in the timing of initial measles vaccination can have a major impact on vaccine efficacy.

 

Most kids had only received 1 dose of measles.  Those who had 2 were less likely to get measles than those who had 1.  Those who were most likely to experience vaccine failure were those vaccinated with a single dose given within a couple weeks of their first birthday.  

 

While this outbreak was larger than would have been expected in a highly vaccinated population, it still was limited in scope did still fizzle out rather than continuing endlessly.  That is herd immunity. That incidents like this are so rare we have to go all the way back to 1989 to look at one so large is also thanks to herd immunity. 

 

Quote:
Originally Posted by rachelsmama View Post
 

Those "eradicated in the US" claims bug me, partly because "just a plane ride away" keeps getting spouted as a reason to vaccinate.  The two ideas seem contradictory to me.  Personally, I think that claiming that measles was eradicated in the US was about as honest as saying urine had been eliminated from one particular end of the swimming pool.  I think the claims were mostly a marketing ploy to inflate people's confidence in vaccines.

 

Eradicated means there is no longer sustained transmission in the US, not that there can never be outbreaks.  Basically, it doesn't live here any more, but it can still visit, and would like to move back in.  
 
About 4 million or so children born each year, each of which would have had measles in the next 10 years or so if born prior to the vaccine, and yet a few hundred cases is an alarmingly bad year for measles.  We could be doing better, but we are still doing a pretty good job at keeping it from coming back to take root. 
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