immunocompromised, vaccine and numbers - Mothering Forums

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#1 of 33 Old 05-15-2014, 06:11 AM - Thread Starter
 
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What percentage of people are immunocompromised and thus have not been vaccinated?

 

A lot of the immunocompromised have cancer or developed a condition later in life. Unless you developed your condition under age 1 or 2, you probably did receive most of your vaccine.  Not everyone who is immunocompromised was always immunocompromised.

 

Many people who are immuno-compromised can receive vaccines if they want to.  It depends on whether the vaccine is live or not and the severity of the disease.  The vaccine might not take, but it might.  

 

http://www.phac-aspc.gc.ca/publicat/cig-gci/p03-07-eng.php

 

So…how many immunocompromised are there?  What percentage of those have not or can not be vaccinated?

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#2 of 33 Old 05-15-2014, 06:56 AM
 
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Most numbers I always see have to do with AIDS/HIV and do not factor in others conditions.

Factor in all those with certain disease that can not be vaccinated, I would loved accurate numbers! :lurk 

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#3 of 33 Old 05-15-2014, 01:33 PM
 
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The issue with immunocompromised is that for at least as long as that status lasts, it doesn't matter if you've been vaccinated.

Vaccines teach your immune system to recognize and fight off specific pathogens. If your immune system isn't working, it doesn't do that terribly well. The vaccine might afford you some protection, but you shouldn't assume that it will do much, and you certainly shouldn't assume it will do enough.

During my chemotherapy, I was advised to assume that I was, for all practical purposes, unvaccinated.
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#4 of 33 Old 05-15-2014, 01:45 PM - Thread Starter
 
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That is a good point, meepycat.  I assume it is just for the duration of the chemo?  

 

ETA:  thinking this through a bit more...

 

I would assume vaccine had during chemo would not work too well as you could not mount a good immune response to them

 

What about vaccines had in childhood - are you still prone if exposed?

 

What if you had the disease in childhood - are you still prone if exposed?


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#5 of 33 Old 05-15-2014, 02:01 PM
 
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AFAIK, I am not still prone to VPDs if I'm exposed.  My immune system is working fine again, I'm back on my feet, it should all be good.

 

One thing the docs were sure to cover specifically was chicken pox - I wasn't vaccinated for CP, I had it when I was 11.  I was considered vulnerable to it while on chemo, but I'm told I should not still be concerned now.  The chemo didn't wipe out my immune systems accumulated knowledge and experience, it just took the system response way down from its usual levels.

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AFAIK, I am not still prone to VPDs if I'm exposed.  My immune system is working fine again, I'm back on my feet, it should all be good.

 

One thing the docs were sure to cover specifically was chicken pox - I wasn't vaccinated for CP, I had it when I was 11.  I was considered vulnerable to it while on chemo, but I'm told I should not still be concerned now.  The chemo didn't wipe out my immune systems accumulated knowledge and experience, it just took the system response way down from its usual levels.

 

Very helpful information, meepycat, thanks for sharing it with us.

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#7 of 33 Old 05-16-2014, 03:01 PM - Thread Starter
 
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Still subbing.

 

I know I cannot make anyone respond - but I think it behooves anyone who says "I partly vaccinate for the immunocompromised" to have some idea of how many immuno-compromised there are and how immuno-compromise and vaccine status interplay.  I think it is especially relevent if they try to present the immuno-compromised as a reason  for others to vaccinate.  


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#8 of 33 Old 05-16-2014, 05:08 PM
 
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I think the key thing to know about the interplay of vaccine status and immune compromise is that it's irrelevant whether people who are immunocompromised are or were vaccinated.  If they were not vaccinated, they probably shouldn't be.  If they were vaccinated, they may still not be protected from VPDs.

 

I have no idea how many immunocompromised people there are, or how many I am in contact with on a regular basis (there are definitely some, as I still visit the oncology department every few weeks).  I do know how many people I was in contact with when I was immunocompromised- all of them.  I have children in my household, and those children went to daycare.  I'm married to someone who has a job and commutes by public transit.  I had a job and commuted by public transit.  Immune compromised people are not sequestered away in sanitariums. 

 

So I disagree with Kathy's suggestion that it behooves you to understand how many immune compromised people there are if you vaccinate partly because of them.  ONE vulnerable individual is enough to move a lot of people to vaccines, if that individual is close to them.  From there, it's a very small exercise in empathy to consider whether getting a few shots might help some strangers avoid some suffering.

 

I don't think vaccinating or not vaccinating is a decision that boils down to a single factor for most people.  However, I think it's unproductive to head down the road it looks to me like Kathy is currently surveying - at the end of that road, we declare any concern for the immune compromised to be a ridiculous pose, held by people who haven't bothered to understand the true prevalence of immune compromise. 

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#9 of 33 Old 05-16-2014, 06:41 PM
 
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I think an important part of the discussion is what percentage of the population is immunocompromised, and, for that matter, how we even define "immunocompromised."

I am grateful that meepycat gave us information on the those undergoing chemotherapy, but what about people who have autoimmune disorders?  Both illness AND vaccines can have severe, even deadly consequences.  Many people with autoimmune disorders are not properly diagnosed for years; in the meantime, they continue to take vaccines; how many of them become significantly worse because of those vaccines?

And how many are unable to mount the expected immune response  to the vaccine because of autoimmune problems (whether they have too strong or too weak a reaction)--and doesn't that kind of destroy "herd immunity?"

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#10 of 33 Old 05-16-2014, 06:50 PM - Thread Starter
 
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I think the key thing to know about the interplay of vaccine status and immune compromise is that it's irrelevant whether people who are immunocompromised are or were vaccinated.  If they were not vaccinated, they probably shouldn't be.  If they were vaccinated, they may still not be protected from VPDs.

 

I have no idea how many immunocompromised people there are, or how many I am in contact with on a regular basis (there are definitely some, as I still visit the oncology department every few weeks).  I do know how many people I was in contact with when I was immunocompromised- all of them.  I have children in my household, and those children went to daycare.  I'm married to someone who has a job and commutes by public transit.  I had a job and commuted by public transit.  Immune compromised people are not sequestered away in sanitariums. 

 

So I disagree with Kathy's suggestion that it behooves you to understand how many immune compromised people there are if you vaccinate partly because of them.  ONE vulnerable individual is enough to move a lot of people to vaccines, if that individual is close to them.  From there, it's a very small exercise in empathy to consider whether getting a few shots might help some strangers avoid some suffering.

 

I don't think vaccinating or not vaccinating is a decision that boils down to a single factor for most people.  However, I think it's unproductive to head down the road it looks to me like Kathy is currently surveying - at the end of that road, we declare any concern for the immune compromised to be a ridiculous pose, held by people who haven't bothered to understand the true prevalence of immune compromise. 

On an individual basis, it is entirely fine to vaccinate or not vaccinate yourself for any reason.

 

From a public health perspepctive it certainly does matter how many people are currently at risk of xyz due to being immunocompromised.  If more people are harmed by a vaccines than immuno-compromised are helped by vaccines, then that is an issue.  

 

Of course, figuring out the comparative risks will be quite difficult and will have to be done on a vaccine by vaccine basic.  If vaccines were 100% safe, then yes, one could argue everyone should vaccinate to protect the vulnerable, no matter how few the immunocompromised number.   Vaccines are not 100% safe, so as a society we need to know if more people are hurt than immunocompromised are help, and that takes numbers.  


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#11 of 33 Old 05-16-2014, 06:57 PM
 
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People with autoimmune disorders might genuinely need to forgo vaccination. However, these individuals not being effectively vaccinated shouldn't damage herd immunity for the general population.

Herd immunity occurs when *most* of a population is vaccinated. It doesn't mean that no one ever gets the disease, but it does mean that individuals in that population are unlikely to be exposed to a VPD, and if a case of the VPD occurs, it is unlikely to spread. There are two major threats to herd immunity now: easy, rapid travel, and a growing population of people who don't vaccinate. So a disease that's been eradicated in a particular poulation can easily be brought back by a traveller, and there are enough susceptible individuals for the disease to spread, and possibly remain active in the population.
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#12 of 33 Old 05-16-2014, 07:04 PM - Thread Starter
 
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. There are two major threats to herd immunity now: easy, rapid travel, and a growing population of people who don't vaccinate. 

Not true.  While vaccine rates do have minor fluctuations from year to year, vaccintion rates are high and stable.  


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#13 of 33 Old 05-16-2014, 07:06 PM
 
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Do you have a link for the vaccination rates?
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#14 of 33 Old 05-16-2014, 09:32 PM
 
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People with autoimmune disorders might genuinely need to forgo vaccination. However, these individuals not being effectively vaccinated shouldn't damage herd immunity for the general population.

Herd immunity occurs when *most* of a population is vaccinated. It doesn't mean that no one ever gets the disease, but it does mean that individuals in that population are unlikely to be exposed to a VPD, and if a case of the VPD occurs, it is unlikely to spread. There are two major threats to herd immunity now: easy, rapid travel, and a growing population of people who don't vaccinate. So a disease that's been eradicated in a particular poulation can easily be brought back by a traveller, and there are enough susceptible individuals for the disease to spread, and possibly remain active in the population.


Here is a link for the percentage of the population that has autoimmune disorders.
http://www.newswise.com/articles/growing-number-of-autoimmune-disease-cases-reported
"Approximately 50 million Americans, 20 percent of the population or one in five people, suffer from autoimmune diseases. Women are more likely than men to be affected; some estimates say that 75 percent of those affected--some 30 million people--are women."

So 20% not being effectively vaccinated shouldn't damage herd immunity for the general population?
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#15 of 33 Old 05-16-2014, 09:58 PM
 
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Not true.  While vaccine rates do have minor fluctuations from year to year, vaccintion rates are high and stable.  

 

Maybe in children.  But adult rates aren't that great.  High rates in only 25% of the population can't possibly be enough to generate supposed herd immunity.

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#16 of 33 Old 05-17-2014, 05:53 AM - Thread Starter
 
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Maybe in children.  But adult rates aren't that great.  High rates in only 25% of the population can't possibly be enough to generate supposed herd immunity.

 

Agreed.

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Do you have a link for the vaccination rates?

 

http://www.cdc.gov/vaccines/imz-managers/coverage/nis/child/figures/2012-map.html


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#17 of 33 Old 05-17-2014, 06:41 AM
 
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Why are people saying that there is a growing number of people not vaccinating? CDC shows percentages of vaccinated have increased, not decreased.
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#18 of 33 Old 05-17-2014, 07:12 AM
 
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Why are people saying that there is a growing number of people not vaccinating? CDC shows percentages of vaccinated have increased, not decreased.

Vaccine coercionists believe that by lying about this data, they can raise panic and get everyone to vaccinate compliantly.

http://culturalcogniton.net/blog/2014/1/28/the-logic-of-reciprocity-and-the-illogic-of-empirically-unin.html

eta-Ugh! I had to 2-thumb that link in. I'll correct it later, or you can go to my recent thread in this forum, "Lies and Exaggeration in the Media."
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#20 of 33 Old 05-19-2014, 10:53 PM
 
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This story just ran in our newspaper about a father who feels everyone should be vaccinating because his immunocompromised son got CP from an unvaccinated child at school.

http://www.vancouversun.com/touch/story.html?id=9846252
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#21 of 33 Old 05-20-2014, 10:15 AM
 
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Varicella is a live virus vaccine which sheds and can be given to an immunocompromised person after vaccination.


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#22 of 33 Old 05-20-2014, 02:47 PM
 
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This story just ran in our newspaper about a father who feels everyone should be vaccinating because his immunocompromised son got CP from an unvaccinated child at school.

http://www.vancouversun.com/touch/story.html?id=9846252

So this took place 4 years ago when the child was six.  This dad is so pro-vaccine but he didn't vaccinate his own son with the varicella vaccine?  Or was the child vaccinated but it didn't work for him?  Why is it we know (rather, that's what we read) that he caught it from an unvaccinated kid but we don't know whether the child had the vaccine?

 

A child down the street got chickenpox twice, once from his own vaccine and again from a buddy who was just vaccinated.

As long as shedding can take place, there is no security in knowing everyone has been vaccinated.

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#23 of 33 Old 05-20-2014, 07:03 PM
 
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 A child down the street got chickenpox twice, once from his own vaccine and again from a buddy who was just vaccinated.

Again, I wonder if getting the vaccine and then getting the disease from the live virus vaccine and then getting it again from shedding bestows adequate immunity. No one knows. We are just fooling around with the immune system, that is all.


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#24 of 33 Old 07-09-2014, 09:29 AM
 
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What I keep wondering is if vaccination makes a significant difference in protecting the immune-compromised due to the large number of illnesses that are not vaccine related AND the problem of vaccine failure and the problem of vaccines wearing off AND the problem of most adults not having gotten vaccinated again AND a large part of the current childhood schedule not applying to adults.

Some examples of widespread illnesses for which vaccines are unavailable:
influenza-like illnesses
colds
all infectious gastro illnesses except rotavirus
hundreds of infectious viral illnesses

Examples of vaccine failure:
pertussis
mumps
any vaccine given to any person whose immune system for any reason is unable to respond

Examples of vaccines wearing off:
measles
mumps
chickenpox
pertussis
influenza

The CDC has just started pushing vaccines on adults and so far compliance is not spectacular.

I just don't see that given all that, vaccine compliance is going to make a big difference and make it safe for people with serious immune problems to wander around in public without risk. Slightly lowered risk has some benefit, but...
and many more
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#25 of 33 Old 07-09-2014, 09:31 AM
 
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Oh, and I forgot to mention the problem of vaccines still allowing carriage and transmission of the bacteria or virus. This is a big one with pertussis, but it may also occur with other vaccines.

Has anyone seen any research that shows that the influenza vaccine, for one major example, actually prevents carriage and transmission?
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#26 of 33 Old 07-09-2014, 09:56 AM
 
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Samaxtics- the child was probably not vaccinated b/c it is recommended that immune compromised people not receive live/attenuated virus vaccines (such as CP).
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#27 of 33 Old 07-09-2014, 10:27 AM
 
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We all have a lifetime risk of any cancer of about 40%. Each year in the US there are 1,600,000 new cases of cancer. Not all of those people will be treated with chemo. In kids under 14, in the us about 0.24% will develop cancer, at a rate of about 10,000 kids per year, and because of the types they are very likely to undergo chemo. There are 1.1 million people in the US with HIV, many of whom are doing well immune-wise, and a little less than half have AIDS, and thus are immune compromised. Autoimmune diseases like lupus, celiac, etc are not contraindications to vaccines, but they are often treated with meds that make it a contraindication( and bring up a whole host of other issues im not addressing here- just trying to find some of the stats OP asked about), and that's about 25 million people with the Dx (no info on treatments). I would imagine that's the bulk of immune compromised ppl in the US. I think it's harder to get too much closer to actual stats about "how many people are actually immune compromised." Data is from American cancer society, cdc, and American autoimmune related disease association.
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#28 of 33 Old 07-09-2014, 10:38 AM
 
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I was trying to ballpark this and initially came up with maybe 0.5-1%, but then I realized I was mixing stats of people with the DX vs people who were newly diagnosed. So it all feels very nebulous, but it's less than 1in 10 but more than 1/1000, probably, in any given year.
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#29 of 33 Old 07-09-2014, 08:29 PM
 
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Samaxtics- the child was probably not vaccinated b/c it is recommended that immune compromised people not receive live/attenuated virus vaccines (such as CP).
I just re-read the first paragraphs of that article again. It states that the chemo rendered his shots useless. As long as the immunocompromised person has not undergone treatment for, IIRC, 3 months they can be vaccinated.

It would also appear that they sent the child to school whilst he was having chemo treatments. I don't understand that logic given that there are many other non-vaccine available viruses.

This story took place in 2010. They added a booster in 2012 because one shot apparently wasn't conferring the lifetime immunity they claimed earlier.

Like I stated in an earlier post, the kid down the street had chickenpox twice even though he was vaccinated.
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#30 of 33 Old 07-10-2014, 05:19 AM
 
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Oh, and I forgot to mention the problem of vaccines still allowing carriage and transmission of the bacteria or virus. This is a big one with pertussis, but it may also occur with other vaccines.

Has anyone seen any research that shows that the influenza vaccine, for one major example, actually prevents carriage and transmission?
The Cochrane Group looked at all available studies on whether vaccinating health care workers for influenza protects patients, and concluded that there is no benefit.
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