disease outbreaks show threat of undervaccination

[doggie]

well antivaxxer's strike out. this time they really got nailed. some have changed their minds but storm just say see some people that were vaccinated got it anyway. some people never learn.

http://www.mlive.com/news/index.ssf/201 ... ugh_o.html

TRAVERSE CITY, MI -- Over the past six weeks, the Traverse City area has become an unnerving, real-life example of the consequences of undervaccination.

Cases of whooping cough and measles have impacted hundreds of families, overwhelmed local doctors and public health officials, and put parents who don't vaccinate their children on the defensive.

"Nobody likes to be the person who says, 'I told you so,' " but what's unfolding now is exactly the scenario feared by those worried about the region's low immunization numbers, said Dr. Bradley Goodwin, a Traverse City family physician who is president of the Grand Traverse County Medical Society.

Grand Traverse County has one of Michigan's highest rates of schoolchildren opting out of vaccines -- twice the state average and six times the national rate for kindergartners in 2013-14.

In some schools, the rate is even higher. That includes Grand Traverse Academy, the 1,200-student charter school associated with the initial outbreak of whooping cough, also known as pertussis, an illness nicknamed "the 100-day cough."

[eh02]

http://www.cfr.org/interactives/GH_Vaccine_Map/#/intro

:( Wish we could say that's the first time this has happened. It's unfortunately just getting worse.

[doggie]

Yes though this one is one of the bigger ones and really out there

[August]

You can quite easily get Whooping Cough even though you've been vaccinated, and even if you've been vaccinated you can pass it to unvaccinated people without showing symptoms. It's a really shitty vaccine, about the only benefit is that if you catch it it's not as bad. Which is not to be sneezed at, because it's a really really horrible disease. But it circulates even in fully vaccinated populations.

As far as I could understand, this was accurate when my kids were younger, but I haven't read up on it since they reached the age of the 4/5 year old booster and are as immune as they're going to get between adult boosters (which I get, too). If there's new research, please correct me. And, why have they still not got a better vaccine?

The really crazy thing, though, about the DTaP refusers is that they're not vaccinating for diptheria or tetanus, which really really could kill a older child/adult, not just make you vomit a lot and sound like a smoker for the rest of your life.

ETA, looks like it's definitely still the case, but apparently they're working on an attenuated vaccine.

http://www.pnas.org/content/111/2/787

[warriorblade8857]

The main concern with whooping cough is that it does kill infants - especially newborns. But yes, it is a shitty vaccine in terms of its failure rate.

However, I think it's important to note that the herd immunity threshold (% of population needed to be vaccinated to prevent disease from spreading) for whooping cough is high compared to other diseases. It's ~93%, while it's ~80% for polio. So, just a small increase in antivaxxers throws the whole population off... and now not only are you more likely to fall sick (because the vaccine is shitty), you're more likely to catch it in the first place (because the threshold is so high, it's easy to dip below).

Long story short, the pertussis portion of the vaccine is still very important.

[warriorblade8857]

Sorry, didn't mean to sound like I'm lecturing, nerdy public health worker here.

[Coco]

That's where some of my quiverfull family live. So far they're okay. Maybe this will convince them to vax, but i doubt it. :angry-banghead:

[eh02]

The main concern with whooping cough is that it does kill infants - especially newborns. But yes, it is a shitty vaccine in terms of its failure rate.

...

Long story short, the pertussis portion of the vaccine is still very important.

Public health person here too! :banana-dance:

I think people not knowing much about what exactly a "shitty" vaccine entails is one of the biggest obstacles. The reproductive rate (which affects herd immunity) can drop significantly if you become infected when you've been vaccinated because you will be much less infectious vs. a non-vaccinated person, so it still makes a significant impact on your community to be immunized, EVEN if you still do manage to get ill. You'll be sick for a shorter period of time and your bacterial load will likely be much less.

And like you said, people really need to embrace the attitude that immunizations are a choice you make as an adult that is more beneficial to your community than necessarily to yourself. It's not really a big deal to get pertussis as an adult. You usually heal from it just fine with no complications. But if you give it to a child or senior or someone with significant healthy or immune system issues, it could easily kill them. Especially babies, obviously, because the ones who become the most ill are usually too young to receive the vaccine. It's kind of similar to men getting the HPV vaccine - men themselves likely have no ill health effects from HPV at all. But we still recommend they get the vaccine, because it saves women's lives. No difference with whooping cough!

[August]

I disagree that pertussis is no big deal for an adult. Give me a dozen doses of the flu a year over just one bout of whooping cough. But yes, nowhere near as bad as for a newborn.

[FiddleDD]

You can quite easily get Whooping Cough even though you've been vaccinated, and even if you've been vaccinated you can pass it to unvaccinated people without showing symptoms. It's a really shitty vaccine, about the only benefit is that if you catch it it's not as bad. Which is not to be sneezed at, because it's a really really horrible disease. But it circulates even in fully vaccinated populations.

As far as I could understand, this was accurate when my kids were younger, but I haven't read up on it since they reached the age of the 4/5 year old booster and are as immune as they're going to get between adult boosters (which I get, too). If there's new research, please correct me. And, why have they still not got a better vaccine?

The really crazy thing, though, about the DTaP refusers is that they're not vaccinating for diptheria or tetanus, which really really could kill a older child/adult, not just make you vomit a lot and sound like a smoker for the rest of your life.

ETA, looks like it's definitely still the case, but apparently they're working on an attenuated vaccine.

http://www.pnas.org/content/111/2/787

I actually wish they'd make a separate Pertussis only vaccine. I'm someone who's more comfortable with separate vaccines and the closest they have is Pertussis with Tetanus. It would annoy me if I had kids, because Tetanus is a vaccine that can wait a little (there's like zero chance of them getting it until they're at least mobile). As for Diptheria, the last time I'd checked there had been an average of one case a year in the past ten years or so. Unless that case had been in my state or things changed I would feel comfortable skipping that part of the vaccine because in that case I do think the rare chance of a dangerous vaccine related incident is more likely than encountering the disease. (JMO)

It really is a terrible vaccine, results wise anyway. The only vaccine less effective is the flu vaccine and that relies on guessing which strains will be active that season. It also bothers me that a child under two months old is the most likely to die from Pertussis and yet they can't get the vaccine until they're two months old. Yet they can get HepB at birth even if the mother tests negative for the disease. :roll:

(note, I am NOT anti vaccine. I like to think of myself as vaccine cautious. I think they are important, but I also think people should be educated and give them a little thought. I also wish it was easier to get information that wasn't biased in either direction. If I ever have kids they will be vaccinated, I'll probably just be the annoying parent that insists on not getting them all in one visit. :lol: )

[apple1]

Part of the reason the CDC and the pediatricians' academy supports combined vaccines is because - from a public health standpoint - there is more overall vaccine compliance that way. Even as it is with the current vaccines/recommendations, multiple visits are required and at those visits a child may be "stuck" as many as 3 times. (Again, from a public health, not necessarily individual viewpoint) the more separate vaccines, and separate sticks, that are required, the less likely it will all happen.

[apple1]

As for pertussis in newborns -

All pregnant women are recommended to receive TDaP vaccine (so the newborn should have the antibodies passed on), as are the adults that will interact closely with the newborn.

Not saying this is perfect, but it sure helps.

[FiddleDD]

I understand combined vaccines as a public health measure, I just think there should be an option for people who would prefer to split them up. I'm inclined to think it would improve vaccination rates among people who aren't totally anti-vaccine but might consider skipping some just because they are combined. That's just my personal opinion though.

I know they recommend TDaP vaccine for pregnant women, but honestly my knee jerk reaction is hell no. I 100% understand and support women who do, but it just doesn't feel right. I'd be more comfortable keeping an infant fairly isolated and staying home for much of the first 6-8 weeks.

However, it isn't an issue for me at this point in my life. I read a lot about vaccines when I was looking into natural health because it's such a hot button issue and comes up a lot, but I don't see myself having kids anytime soon, maybe never. If it did happen, I'd read up on the studies and most likely change my mind once I can see the benefits in a concrete scientific explanation, I'm just being honest and saying it just doesn't feel right to me.

BTW I'm loving the calm and logical manner in which this discussion is taking. I'm someone who usually gets jumped on by both sides on this issue. :lol: And yet, it something I find interesting and enjoy talking about.

[Jana814]

This is really sad that this has happened.

[apple1]

I understand combined vaccines as a public health measure, I just think there should be an option for people who would prefer to split them up. I'm inclined to think it would improve vaccination rates among people who aren't totally anti-vaccine but might consider skipping some just because they are combined. That's just my personal opinion though. I agree. It may, however, be a practical matter of getting some manufacturer to see this option as having enough demand to be worth doing (just saying)

I know they recommend TDaP vaccine for pregnant women, but honestly my knee jerk reaction is hell no. I 100% understand and support women who do, but it just doesn't feel right. I'd be more comfortable keeping an infant fairly isolated and staying home for much of the first 6-8 weeks. Statistics don't bear this out as being practical and effective. Also, statistically, TDaP in pregancy has be demonstrated as safe.

However, it isn't an issue for me at this point in my life. I read a lot about vaccines when I was looking into natural health because it's such a hot button issue and comes up a lot, but I don't see myself having kids anytime soon, maybe never. If it did happen, I'd read up on the studies and most likely change my mind once I can see the benefits in a concrete scientific explanation, I'm just being honest and saying it just doesn't feel right to me. fair enough

BTW I'm loving the calm and logical manner in which this discussion is taking. I'm someone who usually gets jumped on by both sides on this issue. :lol: And yet, it something I find interesting and enjoy talking about.

My comments in red above

[eh02]

I would feel comfortable skipping that part of the vaccine because in that case I do think the rare chance of a dangerous vaccine related incident is more likely than encountering the disease. (JMO)

(note, I am NOT anti vaccine. I like to think of myself as vaccine cautious. I think they are important, but I also think people should be educated and give them a little thought. I also wish it was easier to get information that wasn't biased in either direction. If I ever have kids they will be vaccinated, I'll probably just be the annoying parent that insists on not getting them all in one visit. :lol: )

I think all people try to make decisions that are best for their families, but most people just don't have the training on this subject matter to totally understand why exactly vaccine rates need to stay very high. When it comes down to it, these outbreaks are happening exactly because parents have thought what you do - that while vaccines have prevented outbreaks in the past, they're just not as important anymore because the diseases are more rare.

Vaccinating even when a disease isn't that common is what prevents it from ever becoming common again. That's been shown historically again and again and again. In the US and all over the world. It is important. It saves lives. Until the diseases are GONE - 100% gone, smallpox-level gone - healthy, non-immune compromised people need to stay vaccinated.

I really urge people to trust professionals who dedicate their entire lives to researching the safety of these things. If you think pro-vaccine research is biased, you probably have not seen the size of the body of research that is pro-vaccine compared to the anti-vaccine research, and I would encourage you to look at it and look at the sources as you go. And for a personal account or opinion...the Surgeon General maybe should be weighted a little heavier than, say, Jenny McCarthy. Would you rather get on an airplane designed by an aerospace engineer or an airplane model hobbyist? Why should public health and medical issues be any different?

Also, a HUGE amount of research goes into the decisions to combine or separate vaccines. The choices are made on very thorough investigation into which choices maximize positive health outcomes. NOBODY would be vaccinated for diphtheria if it was a separate vaccine, because nobody gives a sht about diphtheria anymore. And then kids would be popping up left and right with diphtheria all the sudden. Just as a reminder, diphtheria can have up to a 20% fatality rate in small children and middle-aged or elderly adults and is as contagious as polio or smallpox. I know I don't want to see children in my community dying of diphtheria if we can help it.

[RandomTrivia]

I know they recommend TDaP vaccine for pregnant women, but honestly my knee jerk reaction is hell no. I 100% understand and support women who do, but it just doesn't feel right. I'd be more comfortable keeping an infant fairly isolated and staying home for much of the first 6-8 weeks.

I'm not sure 6-8 weeks of isolation is feasible, honestly. My son is 8, and at least when he was born (things may have changed since), he had pediatric checkups at, I think, 1 or 2 weeks, and again at a month, plus a bonus visit for a MRSA infection. Which meant (at least) 3 different exposures to the pediatric waiting room. At least one of the recent measles outbreaks was complicated by the infected child exposing everyone in the waiting room at his/her pediatrician's office. Even with separate "sick" and "well-child" sections, things happen.

And honestly, I was home for just over a week with the baby before I was so stir-crazy it wasn't even funny anymore. It didn't help that I couldn't lift the baby and carrier (c-section), so I couldn't go anywhere when DH wasn't around.

[FakePigtails]

I actually wish they'd make a separate Pertussis only vaccine. I'm someone who's more comfortable with separate vaccines and the closest they have is Pertussis with Tetanus. It would annoy me if I had kids, because Tetanus is a vaccine that can wait a little (there's like zero chance of them getting it until they're at least mobile). As for Diptheria, the last time I'd checked there had been an average of one case a year in the past ten years or so. Unless that case had been in my state or things changed I would feel comfortable skipping that part of the vaccine because in that case I do think the rare chance of a dangerous vaccine related incident is more likely than encountering the disease. (JMO)

It really is a terrible vaccine, results wise anyway. The only vaccine less effective is the flu vaccine and that relies on guessing which strains will be active that season. It also bothers me that a child under two months old is the most likely to die from Pertussis and yet they can't get the vaccine until they're two months old. Yet they can get HepB at birth even if the mother tests negative for the disease. :roll:

(note, I am NOT anti vaccine. I like to think of myself as vaccine cautious. I think they are important, but I also think people should be educated and give them a little thought. I also wish it was easier to get information that wasn't biased in either direction. If I ever have kids they will be vaccinated, I'll probably just be the annoying parent that insists on not getting them all in one visit. :lol: )

Presumably research showed that pertussis vaccines aren't as effective as early as hepatitis B vaccines. I trust that if earlier pertussis vaccines were possible that the CDC would have changed the recommendation since their whole purpose is to avoid preventable deaths. The vaccine schedule is designed to give children immunity as early and effectively as possible. Unfortunately, different vaccines work in different ways and can't always be given (and actually be effective) as early as we'd like.

edit: I found this from Oxford University (http://www.ovg.ox.ac.uk/pertussis-vaccine-in-pregnancy)

Vaccinating babies at birth does not offer them the best protection against pertussis, for two reasons. Firstly, newborn babies’ immune systems do not respond well at this age to the first dose of pertussis vaccine. Secondly, vaccination does not offer immediate protection. It takes several days to respond to the vaccine, and at least two doses of vaccine are needed to give high levels of protection.

[August]

Diptheria has a mortality rate of 5-10%, with full medical care, and is endemic in multiple parts of the world. Remember the doctor who caught the subway in NY with ebola? It is only a plane ride away and way way way way too dangerous to not vaccinate based on your local disease rate, which is incidentally based on high vax rates.

I've neveer heard of a pertussis and tetanus vaccine. Why do they make it, and in which countries is it sold? It's not available in the US according to the CDC.

Hepatitis vaccines at birth are only necessary when a family member is hep B +. Since it's awkward to ask grandma, they just vaccinate all babies on the off chance there's a Hep B + family member. Public health wise, it's a great idea, but for my family, no way. My kids had it when starting school or having surgery.

[Trynn]

I don't think I got my hep B shots till high school...

[FiddleDD]

Diptheria has a mortality rate of 5-10%, with full medical care, and is endemic in multiple parts of the world. Remember the doctor who caught the subway in NY with ebola? It is only a plane ride away and way way way way too dangerous to not vaccinate based on your local disease rate, which is incidentally based on high vax rates.

I've neveer heard of a pertussis and tetanus vaccine. Why do they make it, and in which countries is it sold? It's not available in the US according to the CDC.

Hepatitis vaccines at birth are only necessary when a family member is hep B +. Since it's awkward to ask grandma, they just vaccinate all babies on the off chance there's a Hep B + family member. Public health wise, it's a great idea, but for my family, no way. My kids had it when starting school or having surgery.

[Deist woman]

I can't believe that people are not talking about the "R" part of the MMR vaccine. This is a quote from CDC, giving a before and after picture of the Rubella vaccine.

""An epidemic of rubella (German measles) in 1964-65 infected 12½ million Americans, killed 2,000 babies, and caused 11,000 miscarriages. In 2012, 9 cases of rubella were reported to CDC.""

Rubella can be such a mild illness that it is often mistaken for a cold. A pregnant woman is tested for Rubella titres during pregnancy, and if she does not have active immunity, she is vaccinated after delivery. She and her baby are vulnerable all through the pregnancy. Teachers are highly at risk, because of all the little germ factories in their classrooms. The life of a woman's child can depend on the vaccination decisions of people she has never even met.

[Rebelwife]

I can't believe that people are not talking about the "R" part of the MMR vaccine. This is a quote from CDC, giving a before and after picture of the Rubella vaccine.

""An epidemic of rubella (German measles) in 1964-65 infected 12½ million Americans, killed 2,000 babies, and caused 11,000 miscarriages. In 2012, 9 cases of rubella were reported to CDC.""

Rubella can be such a mild illness that it is often mistaken for a cold. A pregnant woman is tested for Rubella titres during pregnancy, and if she does not have active immunity, she is vaccinated after delivery. She and her baby are vulnerable all through the pregnancy. Teachers are highly at risk, because of all the little germ factories in their classrooms. The life of a woman's child can depend on the vaccination decisions of people she has never even met.

[Terrie]

what drives me nuts is people who claim "It should be a personal choice." That's like saying drunk driving is a personal choice, because you're endangering not just yourself, but those around you. :cry:

[August]

I can't believe that people are not talking about the "R" part of the MMR vaccine. This is a quote from CDC, giving a before and after picture of the Rubella vaccine.

""An epidemic of rubella (German measles) in 1964-65 infected 12½ million Americans, killed 2,000 babies, and caused 11,000 miscarriages. In 2012, 9 cases of rubella were reported to CDC.""

Rubella can be such a mild illness that it is often mistaken for a cold. A pregnant woman is tested for Rubella titres during pregnancy, and if she does not have active immunity, she is vaccinated after delivery. She and her baby are vulnerable all through the pregnancy. Teachers are highly at risk, because of all the little germ factories in their classrooms. The life of a woman's child can depend on the vaccination decisions of people she has never even met.

A friend of mine can't become immune to rubella (apparently not uncommon). She was terrified through her pregnancies.

Antivaxxers avoid discussing rubella like the plague. It makes it too obvious that they do not care a jot for other people.