To HIB or not to HIB - Mothering Forums

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Old 11-02-2005, 12:35 AM - Thread Starter
 
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Hello everyone,
I have not yet vacinated by 6.5 months old. I'm planning on doing so selectively. But I'm not sure what my plan of action is. It seems that HIB is not very reactive and may protect from menigitis - something that's dangerous and you can't aquire natural immunity to it. What are your thoughts?
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Old 11-02-2005, 12:40 AM
 
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I agree and did so after talking to my ped. My dd is 10 mo old and got it 9 days ago. She still has a large lump at the injection site. I am still deciding how to handle it.
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Old 11-02-2005, 12:53 AM
 
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Quote:
Originally Posted by B'shert
It seems that HIB is not very reactive and may protect from menigitis - something that's dangerous and you can't aquire natural immunity to it. What are your thoughts?
That if I, as a non-vaccinated adult, couldn't acquire immunity to it, in the face of the fact that we all incubate meningitis types at least three times a year, not only do I wonder why I am still alive, but why I've got a family tree at all.

“I want to sell drugs to everyone. I want to sell drugs to healthy people. I want drugs to sell like chewing gum.” former Merck CEO, Henry Gadsden

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Old 11-02-2005, 02:19 AM
 
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I'm not scared of Hib at all. We weren't vaxed for it and we didn't worry about it. What's changed? Someone figured out how to make money off of it...

-Angela
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Old 11-02-2005, 03:50 AM
 
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That's not exactly true. You *can* acquire natural "immunity" to Hib. Why do you think the vaccine isn't recommended for anyone over age 5? Because people over age 5 just don't get Hib meningitis. Most people carry the bacteria in their respiratory tract all the time. It's a normal part of the flora in your body. It only causes illness under the right (or should I say wrong) conditions.
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Old 11-02-2005, 05:58 AM
 
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I think my resons for not, were that I read if you exclusively B-feed, your baby is low-risk for HIB infection, and also read that getting the DTaP can actually increase the risk of HIB infection...hmmm.

I haven't even worried about it since.
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Old 11-02-2005, 08:22 AM
 
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Quote:
Originally Posted by alegna
I'm not scared of Hib at all. We weren't vaxed for it and we didn't worry about it. What's changed? Someone figured out how to make money off of it...

-Angela
I think what has also changed is that Hib bacteria has become resistant to treatment with antibiotics. This does worry me.
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Old 11-02-2005, 09:45 AM
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From what I've read the meningitis strains that Hib may or may not "protect" against are very limited. There are many types of meningitis and the Hib does not protect against them all. Run a forum search and you'll see what I am talking about.

Also of interest:http://www.mothering.com/discussions...ght=meningitis

http://www.chron.com/cs/CDA/ssistory.mpl/health/3380789

http://www.cdc.gov/nip/publications/pink/hib.pdf Of special interest to me in this article was that after 6-7 mo of age the incidents of Hib disease declines markedly.

"The most striking feature of Hib disease is age-dependent
susceptibility. Passive protection of some infants is provided by
transplacentally acquired maternal IgG antibodies and breastfeeding
during the first 6 months of life. Peak attack rates occur at 6–7
months of age, declining thereafter. Hib disease is uncommon
beyond 5 years of age. The presumed reason for this age distribution
is the acquisition of immunity to Hib with increasing age."


It sounds like since the majority of American mothers stop breastfeeding at or before 6 mo. they no longer pass on antibodies and the babies are unprotected at their most vulnerable age. So if you plan on breastfeeding IAW WHO reccomendations you should be just fine.

"Epiglottitis is an infection and swelling of the epiglottis, the tissue
in the throat that covers and protects the larynx during swallowing.
Epiglottitis may cause life-threatening airway obstruction."
This is what the ER doctor scared me with when DS was in for croup. Once the Dr found out he wasn't vacced he had them test for this. I was really upset and conflicted about my decisions, but the test was negative and I am back to weighing pro's and con's. Ironically (sp?) the Ped's never mentioned this possibility to me when trying to get me to vax. They were much more into the meningitis scares.

http://www.mothering.com/discussions...ght=meningitis I love this post because she breaks it down in number of cases for you.


Anyway, good luck! It can be a really tough choice either way.
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Old 11-02-2005, 01:43 PM
 
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This vaccine was not around when my first two children were getting routine vaccines. When it was licensed, (by the time my 3rd child was born) a VIS hadn't even been issued yet, and our drs office gave me a hand typed version of a VIS, and it stated this vaccine was recommended for children in daycare. My child was a stay at home breastfed baby. Yet the dr recommended the shot anyway.

I never even heard of HIB until the shot was recommended for my son born in 1995.

If it was such a dangerous disease, why hadn't I heard more about it? My first two did just fine w/out the shot.

Also, a wise immunologist told me he's been warning them for years about the mercury and aluminum in the shots.

I no longer give my consent for any vaccines for any of my children, my youngest, born 3 years ago as of 9/3/2005, is unvaccinated.
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Old 11-02-2005, 01:44 PM
 
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Quote:
Originally Posted by buff
I think what has also changed is that Hib bacteria has become resistant to treatment with antibiotics. This does worry me.
An EXCELLENT reason to avoid hospitals and avoid giving antibiotics.

-Angela
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Old 11-02-2005, 02:20 PM
 
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And speaking of antibiotics and Hib, here is small snippet from vaccine injury compensatioin case regarding the Hib vaccine:

ALEXANDER CAMERLIN, by his Mother and Next Friend, KIMBERLY CAMERLIN

FACTS
Alexander was born on April 23, 1990.

On January 5, 1991, he went to the doctor with left otitis media and was prescribed Augmentin.

Eleven days later, at nine months of age, he received HiB vaccine on January 16, 1991. On January 18, 1991, he was back to the doctor, having developed a fever of 105° that morning. He was twitching and sent to the ER. He was floppy and toxic-appearing. An MRI showed slightly enlarged lateral ventricles. He had some swelling in the C1-C8 sections of his spinal cord with increased signal on T2-weighted MRI. His Babinskis were upgoing with slightly increased tone. Alexander was diagnosed with cervical TM.

TESTIMONY
Dr. Elizabeth C. Dooling testified first for petitioner. She is a board-certified pediatric neurologist, an Associate Professor of Neurology at Harvard, and a staff neurologist and staff pediatrician at Massachusetts General Hospital. Her specialty is developmental anomalies and brain tumors.

Dr. Dooling saw Alexander for a second opinion in April 1991. He had been fussy the evening of his HiB and given Tylenol. Eleven days previously, he had otitis media (OM) and was on antibiotics. At 4:30 a.m., the morning after the vaccination, he was spread-eagled and moaning.

He was taken to the Emergency Room at Bay State Hospital. His fever reached 105° and he was very irritable, lethargic and toxic. Id. His spinal fluid tap showed an elevated white blood cell count (36 white cells of which 51% were polys, and a mildly elevated protein of 36). His glucose was normal as were his cultures.

The diagnosis was an acute encephalitic process. He had no movement of
his legs and arms. He was irritable and somnolent. The MRI showed swelling and a postinfectious process.

Dr. Dooling’s opinion is that the HiB was a substantial factor in this process. Alexander had been vaccinated three times before his HiB vaccination without any adverse event. Medical literature shows that vaccines, including HiB vaccine, can lead to demyelinating disorders. It is very uncommon for a child under one year of age to have an acute encephalomyelitis or a transverse

Dr. Dooling also opined that Alexander’s OM (Otis Media/ear infection) was another substantial factor in his TM. He was recovering from the OM when he received HiB vaccination which affected his immune responses, making him more vulnerable.

Dr. Dooling opined that if Alexander had not received HiB vaccine, he would not have contracted TM subsequent to his ear infection. Alexander had finished his antibiotic regimen when he received HiB. On January 16, 1991, Dr. Nordstrom checked his ears. In the hospital, all of Alexander’s mucous membranes were inflamed and his ears were red. Dr. Dooling said that, even though the ears may have been clear when he received his HiB vaccination, we do not know if his immune system had recovered completely. Any upper respiratory tract infection, including OM, can lead to TM. She would not vaccinate someone who had recently recovered clinically from a prior infection.

CONCLUSION
Petitioner is entitled to reasonable compensation
.
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Old 11-02-2005, 03:52 PM
 
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yep, i agree about avoiding antibiotics - but the fact still remains i think that hib is more dangerous now than it was because it is now fairly untreatable. This still worries me.
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Old 11-02-2005, 04:03 PM
 
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HIB was the one disease I read about where the disease itself worried me more than the reaction from the shot. It's the one vax I've had ds get. He had it at age 1 (and thus didn't need any further boosters). He's had no other vaxes.
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Old 11-02-2005, 04:03 PM
 
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The average number of Hib cases reported in the United States is about 2,000. I don't have mortality rates, but I will post it when I find it.

2,000 reports of Hib out of 300 million people. This disease is not what most would consider a killer, nor a threat and certainly not enough to warrant universal vaccination. Particularly since, according to the CDC, the majority of cases are not "covered" by the vaccine. Most cases are of an unknown serotype.
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Old 11-02-2005, 04:35 PM
 
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pumpkinsmama - just a note that there were not "under 5" cases of Hib meningitis in 2003....the stats are for children under the age of 5!
the stats are:
seropositive for Hib - 20 cases
not seropositive for Hib - 80 cases
unknown seropositivity - 178 cases

So that's 278 cases in kids under 5, only 20 of which were definitely Hib related.

A writer/runner/thinker/wife with two daughters (11/02 and 8/05), one dog, three cats, seven fish, and a partridge in a pear tree... in Vermont.
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Old 11-02-2005, 04:35 PM
 
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Quote:
Originally Posted by Plummeting
Most people carry the bacteria in their respiratory tract all the time. It's a normal part of the flora in your body. It only causes illness under the right (or should I say wrong) conditions.
what are the circumstances that will make one to be more prone to get it?

Valeria
dd 05.17.2005
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Old 11-02-2005, 04:51 PM
 
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Quote:
Originally Posted by nancy926
pumpkinsmama - just a note that there were not "under 5" cases of Hib meningitis in 2003....the stats are for children under the age of 5!
the stats are:
seropositive for Hib - 20 cases
not seropositive for Hib - 80 cases
unknown seropositivity - 178 cases

So that's 278 cases in kids under 5, only 20 of which were definitely Hib related.

I'm not sure where the above stats originated, but according to the CDC in 2003, the numbers of reported cases of Hib for children <5 are:

seropositive b: 32 cases
non-sero b: 117
unknown: 227

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5254a1.htm
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Old 11-02-2005, 04:56 PM
 
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Here are the 2003 reported cases of Hib for other age groups:

AGE (Cases)

5-14 (97)
15-24 (94)
25-39 (114)
40-64 (476)
>65 (802)
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Old 11-02-2005, 05:00 PM
 
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Quote:
Originally Posted by LongIsland
Here are the 2003 reported cases of Hib for other age groups:

AGE (Cases)

5-14 (97)
15-24 (94)
25-39 (114)
40-64 (476)
>65 (802)
so what are the conclusions?

Valeria
dd 05.17.2005
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Old 11-02-2005, 05:02 PM
 
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Quote:
Originally Posted by valeria_vi
so what are the conclusions?
Conclusions for . . . ?
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Old 11-02-2005, 05:06 PM
 
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Quote:
Originally Posted by LongIsland
Conclusions for . . . ?
why do the numbers increase with age? what do we learn from this?

I am just starting to research the vax issue, so I'm trying to understand.

Valeria
dd 05.17.2005
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Old 11-02-2005, 05:38 PM
 
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Quote:
Originally Posted by valeria_vi
what are the circumstances that will make one to be more prone to get it?
Well, not being breastfed and being in daycare situations are the two main things, apparently. Beyond that, I would imagine that it's all about your immune function, nutritional status, etc. Look at the stats LI provided - the number of cases increase again for the elderly. Of course, nowadays I think they just make up a larger percentage of the population, but it also has to do with the fact that their immune systems just aren't up to par anymore and they're probably on all kinds of drugs.

As far as Hib being untreatable, the fatality rate is 5%. Of those who recover, about 20% will have some sort of permanent damage, such as hearing loss, mental retardation, etc. The one you should really be worried about WRT antibiotic resistance is pneumoccocal meningitis. It makes no sense to vaccinate for Hib and not do Prevnar. None at all.
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Old 11-02-2005, 07:36 PM
 
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Quote:
Originally Posted by valeria_vi
what do we learn from this?
The first Hib vaccine was licensed in 1985. Hib was put on the childhood recommended schedule of immunizations in 1993. Prior to 1991, Hib was not a notifiable disease.

Here are the number of reported Hib cases:

1991 (2,764)
1992 (1,412)
1993 (1,419) Hib placed on childhood schedule, resulting in universal immunization and state-by-state mandates for entry to daycare/school

1994 (1,174)
1995 (1,180)
1996 (1,170)
1997 (1,162)
1998 (1,194)
1999 (1,309)
2000 (1,398)
2001 (1,597)
2002 (1,743)
2003 (2,013)

Speaks volumes doesn't it?

Historical reporting data from the CDC:
http://www.cdc.gov/mmwr/preview/mmwrhtml/00035381.htm
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Old 11-02-2005, 07:53 PM
 
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You asked what we learn from this. I just learned something new today actually. I learned that the number of reported adverse events associated with Hib vaccine outnumber the actual reported cases of the illness (even before it was universally recommended):

VAERS Data (go to page 16):
http://www.cdc.gov/mmwr/PDF/ss/ss5201.pdf
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Old 11-02-2005, 08:48 PM
 
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Quote:
Originally Posted by Plummeting
As far as Hib being untreatable, the fatality rate is 5%. Of those who recover, about 20% will have some sort of permanent damage, such as hearing loss, mental retardation, etc.
Actually probably less than that. Those rates are the rates for *meningitis* from HIB.
http://www.cdc.gov/nip/publications/pink/hib.pdf
Quote:
Meningitis is infection of the membranes covering the brain and is
the most common clinical manifestation of invasive Hib disease,
accounting for 50%–65% of cases in the prevaccine era. Hallmarks
of Hib meningitis are fever, decreased mental status, and stiff neck
(these symptoms also occur with meningitis caused by other bacteria).
Neurologic sequelae occur in 15%–30% of survivors. The mortality
rate is 2%–5%, despite appropriate antimicrobial therapy.
So, the fatality rate is 2-5% OF 50-65%. kwim? Although, I couldn't find the mortality rate for HIB overall. So, maybe Plummetting's rates ARE the overall rates???

Becky, partner to Teague, SAHM to Keagan (7yo), Jonah (2yo)
 

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Old 11-02-2005, 09:43 PM
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You guys were right, I must have had a brain fart. I edited the post to avoid confusion. To avoid further confusion for those who just started reading, I had posted a comment that there were under five reported incidents of hib in 2003.

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Old 11-02-2005, 10:50 PM
 
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Quote:
Originally Posted by valeria_vi
what are the circumstances that will make one to be more prone to get it?
Just a side note Valeria.... are you the same Valeria Vi who was/is at Babycenter.com? If so, do you feel like introducing yourself and telling the board a bit about yourself?

In part answer to your question... (at least this way you get educated as to some of the other meningitises as well....) Most of the research into risk factors was done before any vaccines came onto the market, and with vaccines, you don't see a continuation in risk research unless there is something financially productive likely to come out of it. There are a couple of recent reviews, but even then, the facts they mention come from quite old medical literature so it pays to go right back to the original references to make sure they have quoted it accurately.

The following relates mainly to Neisseria Meningitides, but some of the risk factors will be the same, certainly the infection to silent carriage is identical:

6)Reviews of Infectious Diseaes, Volume 5, No 1 January-February 1983 "Meningococcal Disease: Still with Us” Heikki Peltola
Quote:
“Hedrich has estimated that meningococcal infection during epidemics may be as prevalent as the common cold, but that only one in every 1,000 infections culminates in disease. Niklasson, has calculated that only one of every 5,000 carriers will develop disease.”
Other things mentioned in this same Lancet article are:
1)Overcrowding. Yet two pages before, he says “Crowded conditions per se, may be of little importance.” There are many other studies, in very highly populated communities, such as Vietnam, that dispute that overcrowding is a factor. However, New Zealand authors do consider it an issue.
2)Poor general health.
3)Poor living conditions.
4)Acute respiratory disease.
5)Meningococcemia is often preceded by symptoms of upper respiratory tract infection.
6)Chronic severe alcoholism.
7)Gonorrhea 8 ( 8)Biomedicine and Pharmacotherapy 1985, 39:168) and gonorrhea carriage. 9(9)Wistanly et al, Lancet 1983 ii, 1134)
8)Abnormal immunological function i.e. antibdies made in Ig A, or a deficiency of IgG2, specific for meningo 2 ( 2)Microbiology review, Volume 46, June 1982, I.W. Devoe)
9)susceptibility of Blood Group B to meningitis 8(as above)

also
Quote:
“ Iron anemia, with a low ph (6.6) increases the virulence factor of meningitis bacteria, 1,200 fold, from a 50% lethal dose of 3,600 organisms, to one of 4 organisms.” 2 Microbiology review, Volume 46, June 1982, I.W. Devoe
and
Quote:
“While meningococcal disease has been attributed to the virulence of the organism, this premise alone is not consistent with the data presented here and by others. These data suggest that virulence does not appear to be the “decisive” factor, but the host may be.” 7)Scand J Infect Dis 9: 105 – 110, 1977 “Immunological Investigations of meningococcal Disease” Edwards E. A. et al


Vaccine 19 (2001) 1327 - 1346.

the interesting parts were these.
Quote:
N. Menigitidis is a gram negative encapsulated diplococcus that is carried in the human nasopharynx by 10% of adults, but the organism rarely colonizes the proximal airways of healthy young children
then....
Quote:
More recently the central role of complement in preventing meningococcal infection in vivo has become apparent from study of individuals with complement deficiency providing important insight into the role of complement in immunity to N. Meningitidis. Over half the individuals with a later complement component deficiency (C5 - C9) will develop meningococcal disease and half of these will have recurrent attacks.... (these data) also suggest other factors are important in immunity to the common serogroups of the organism B and C. Of note there is a relative deficiency of late complement components in infancy, which may add to the susceptibility of meningococcal infections in this age group. In contrast to those with terminal complement component deficiency, individuals with either properdin or factor D deficiency have a case fatality of over 50% and recurrence is rare in survivors. clearly the alternative complement pathway, which does not use antibody is crucial in protection from meningococcal disease. It is not clear how important alternative pathway activation is in resisting group B infection in vivo...
and
Quote:
the surface charge and hydrophobicity of the nasal mucosa has a bearing on bacterial adhesion and changes in charge and thus adhesion, may result from exposure to tobacco smoke, which is associated with an increased risk of invasive disease.
and
Quote:
, immunity to N. Meningitidis is probably acquired through intermittent nasal carriage of other neisseriae and antigenically cross-reacting enteric flora during the first two decades of life.
If you want to go deeply into the immunological deficiencies normally found in someone with meningitis, read this:

http://www.pubmedcentral.nih.gov/art...i?artid=137398

It's technical and its important.

Other med article URLs:

http://www.ncbi.nlm.nih.gov/entrez/q...t_uids=3933588

http://www.ncbi.nlm.nih.gov/entrez/q...t_uids=2570968

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=10906015

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=11811858

http://www.ncbi.nlm.nih.gov/entrez/q...t_uids=9818472

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=10658342

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=10070414

http://www.ncbi.nlm.nih.gov/entrez/q...t_uids=2323355

http://www.ncbi.nlm.nih.gov/entrez/q...t_uids=1601077

http://www.ncbi.nlm.nih.gov/entrez/q...t_uids=8150006

http://www.ncbi.nlm.nih.gov/entrez/q...t_uids=6676682

pneumococcal meningitis, notice the risk factors are the same:

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=10706897

Men C similar risks:

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=11811858

http://www.ncbi.nlm.nih.gov/entrez/q...t_uids=8610679

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=10722132

One vaccine leads to other types coming in and taking over:

http://www.cdc.gov/ncidod/eid/vol5no3/lipsitch.htm
Quote:
"...Herd immunity may explain why the reduction in invasive Hib disease in some populations has exceeded the fraction of the population that received the vaccine and why Hib invasive disease declined even in age groups that had not yet received the vaccine...no evidence of increased carriage of non-b H. influenzae as a result of vaccination. Although increases in
invasive disease from other nasopharyngeal bacteria have been reported since Hib vaccination began... pneumococcal conjugate vaccine studies show considerable evidence of serotype replacement...Serotype replacement may take either of two forms: an increase in prevalence of a type already present in the population or the appearance and spread of types previously absent from the population because they were unable to compete with the vaccine type (s)...serotype replacement would be more likely to occur in areas where the prevalence of Hib is higher or for vaccination against other organisms whose prevalence is higher."
and
Quote:
"If used by a large fraction of the human population in a community, a conjugate vaccine may alter the composition of the bacterial population, not only in vaccinated, but also in unvaccinated persons in that community. Vaccination may reduce the prevalence of serotypes included in the vaccine, thereby protecting unvaccinated persons against exposure to these serotypes (herd immunity). Similarly, if serotype replacement occurs and vaccinated persons become more likely to carry nonvaccine serotypes, the exposure of unvaccinated persons to these serotypes will increase. As a result of these indirect effects, strain replacement will be magnified in communities where large numbers of persons are vaccinated...replacement will be most easily observed in communities where the level of vaccine coverage is high. Therefore, one would expect that the extent of serotype replacement when vaccines enter widespread use in a community may be much greater than that observed in clinical trials where a relatively small fraction of the community is immunized."

Other useful articles:

http://news.bbc.co.uk/hi/english/hea...00/1015154.stm

http://www.eurekalert.org/pub_releas...-tss042403.php
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Public release date: 28-Apr-2003
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Contact: Jason Bardi
[email protected]
858-784-9254
Scripps Research Institute
TSRI scientists show that rare genetic mutations increase susceptibility to sepsis
A group of researchers from The Scripps Research Institute (TSRI) have discovered rare genetic mutations in a subset of people who come down with a particular kind of severe sepsis, an acute and often deadly disease.
These rare mutations in a human gene called TLR4 lend susceptibility to meningococcal sepsis, which strikes over 2,500 people a year in the United States. About half of those who contract meningococcal sepsis are younger than the age of two, and the disease has an overall case fatality rate of 12 percent.
Just a few of many...

“I want to sell drugs to everyone. I want to sell drugs to healthy people. I want drugs to sell like chewing gum.” former Merck CEO, Henry Gadsden

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Old 11-03-2005, 02:34 AM
 
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Originally Posted by Plummeting
It makes no sense to vaccinate for Hib and not do Prevnar. None at all.

Plummeting,

do you have a source for this? i just read stephanie cave's book and some websites and haven't come across anything about it yet. i just checked out a new book called The Vaccine Controversy and am going to go read it right now.

it kinda scares me that i have read so much and there is still so much that i don't know. i feel so overwhelmed by this decision at times. downright scared of doing the wrong thing, either way.
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Old 11-03-2005, 02:47 AM
 
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Originally Posted by nichole
Plummeting,

do you have a source for this? i just read stephanie cave's book and some websites and haven't come across anything about it yet. i just checked out a new book called The Vaccine Controversy and am going to go read it right now.

it kinda scares me that i have read so much and there is still so much that i don't know. i feel so overwhelmed by this decision at times. downright scared of doing the wrong thing, either way.
It is scary, but we all feel that way sometimes.

Actually, if you read the last post by Momtezuma Tuatara, you'll see a quote in there that says:

Although increases in invasive disease from other nasopharyngeal bacteria have been reported since Hib vaccination began... pneumococcal conjugate vaccine studies show considerable evidence of serotype replacement...Serotype replacement may take either of two forms: an increase in prevalence of a type already present in the population or the appearance and spread of types previously absent from the population because they were unable to compete with the vaccine type (s)...

Serotype replacement just means that a different strain of the same bacteria is now replacing the bacteria the vaccine prevent. (I'm sure there's a better way to say that, but you get what I mean?)
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Old 11-03-2005, 04:03 AM
 
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And then, see, they will bring a new vaccine in for the Staph and that will go away, and into the vacuum will spring another bacteria to take advantage of the host weaknesses, and so it will go on ad nauseum... one vaccine after another.

“I want to sell drugs to everyone. I want to sell drugs to healthy people. I want drugs to sell like chewing gum.” former Merck CEO, Henry Gadsden

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