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The 2011 measles outbreak and vaccines in Nature

I was debating what to blog about last night, and it wasn’t easy. We’re in the midst of yet another embarrassment of riches, as far as topics relevant to this blog go. Then I noticed something that I considered to be quite appropriate, given that we are now right in the middle of the yearly autism quackfest known as Autism One in Chicago. This week, Nature published an issue with a special section devoted specifically to vaccines. The timing seemed just too deliciously appropriate to ignore. Think of it. In Chicago (well, Lombard), there is a collection of anti-vaccine cranks meeting to present fallacious “science” claiming that vaccines cause autism and all manner of chronic health problems. In contrast, one of the oldest and most distinguished scientific journals in existence publishes several articles in a single issue about vaccines.

Yep, karma, even more so, given that the CDC published a new Morbidity and Mortality Weekly Report (MMWR) last week discussing the status of measles in the U.S.

The Nature vaccine issue has a number of articles on the topic of vaccines, ranging from an editorial, to news items, to scientific articles. For my purposes, three articles caught my attention:

The article discussing the case of measles is particularly relevant today, as we are in the middle of a resurgence of measles cases, both here in the U.S. and a much worse outbreak in Europe. In the U.S. we have had thus far this year 118 cases of confirmed measles, the most cases since 1996. Of these cases, 47 resulted in hospitalization and 9 in pneumonia. Fortunately, none had encephalitis, and none died, but that’s only because the risk of encephalitis is between 1:1,000 and 1:5,000. In an outbreak of 118, there’s only around a 10% chance (at the most) of having a case of measles encephalitis among the children. However, the more children there are who are infected, the greater the chance of complications such as encephalitis, and let’s not forget that we already have an 8% pneumonia rate.

Fortunately, MMR vaccine uptake in the U.S. remains generally high, although there are increasingly pockets of low uptake susceptible to outbreaks. Indeed, that’s what appears to be happening. As reported in Nature and the MMWR report cited above, measles was in essence eliminated from the U.S. in 2000. This was not easy to do; measles is one of the most contagious viruses that exist. Indeed, it’s the contagiousness of the measles virus that has allowed it to find its way back into the U.S. from other countries, as described in the MMWR report:

Among the 118 cases, 105 (89%) were import-associated, of which 46 (44%) were importations from at least 15 countries (Table), 49 (47%) were import-linked, and 10 (10%) were imported virus cases. The source of 13 cases not import-associated could not be determined. Among the 46 imported cases, most were among persons who acquired the disease in the WHO European Region (20) or South-East Asia Region (20), and 34 (74%) occurred in U.S. residents traveling abroad.

More worrisome, of the 47 hospitalized patients, all but one were unvaccinated, and the statistics were:

Unvaccinated persons accounted for 105 (89%) of the 118 cases. Among the 45 U.S. residents aged 12 months−19 years who acquired measles, 39 (87%) were unvaccinated, including 24 whose parents claimed a religious or personal exemption and eight who missed opportunities for vaccination. Among the 42 U.S. residents aged ≥20 years who acquired measles, 35 (83%) were unvaccinated, including six who declined vaccination because of philosophical objections to vaccination. Of the 33 U.S. residents who were vaccine-eligible and had traveled abroad, 30 were unvaccinated and one had received only 1 of the 2 recommended doses.

Do you see the pattern here?

Leaving a child unvaccinated leaves that child at a greatly increased susceptibility to measles and therefore a highly elevated risk of catching the virus when exposed. This is particularly true when enough people refuse vaccines to compromise herd immunity, so that the unvaccinated can no longer rely on the herd, which they’ve gotten away with doing in the past. Nowhere is this more evident than in Europe, where more than 6,500 cases were reported in 2010, and we have Andrew Wakefield to thank for decreased vaccination rates that are only now starting to recover, as this story in–of all places–The Huffington Post describes:

To prevent measles outbreaks, officials need to vaccinate about 90 percent of the population. But vaccination rates across Europe have been patchy in recent years and have never fully recovered from a discredited 1998 British study linking the vaccine for measles, mumps and rubella to autism. Parents abandoned the vaccine in droves and vaccination rates for parts of the U.K. dropped to about 50 percent.

The disease has become so widespread in Europe in recent years that travelers have occasionally exported the disease to the U.S. and Africa.

Although overall vaccine uptake rates are high, thanks to Andrew Wakefield, there are pockets of children whose parents fear the vaccine more than measles and have therefore not vaccinated. These pockets have been enough to allow measles not just to come roaring back in Europe, but to allow Europe to export its measles to the U.S.

Perhaps the most interesting perspective this week on the issue of vaccine rejectionism is the second article I cited above, Vaccines: The real issues in vaccine safety by Roberta Kwok, who notes in the beginning of her article that “hysteria about false vaccine risks often overshadows the challenges of detecting the real ones.” She begins by citing the case of John Salamone. We’ve met him before in the context of my review of Paul Offit’s most recent book, Deadly Choices: How the Anti-vaccine Movement Threatens Us All. Salamone’s son is an example of a real adverse reaction to a vaccine. Basically, his son got polio from the live oral polio vaccine, a known complication. His son got that vaccine, even though an inactivated polio virus vaccine known to be safer was available at the time, because the oral polio vaccine was cheaper and more easily administered. As a result, Salamone became a real vaccine safety activist, in contrast to the anti-vaccine activists at Generation Rescue masquerading as “vaccine safety” activists. He and other parents worked together to effect change, and the U.S. shifted to the safer vaccine in the late 1990s.

Kwok’s overall point is that these fake vaccine safety scares, such as the widespread belief that vaccines cause autism, have made it more difficult to identify real vaccine safety issues:

Vaccines face a tougher safety standard than most pharmaceutical products because they are given to healthy people, often children. What they stave off is unseen, and many of the diseases are now rare, with their effects forgotten. So only the risks of vaccines, low as they may be, loom in the public imagination. A backlash against vaccination, spurred by the likes of Andrew Wakefield — a UK surgeon who was struck off the medical register after making unfounded claims about the safety of the measles, mumps and rubella (MMR) vaccine — and a litany of celebrities and activists, has sometimes overshadowed scientific work to uncover real vaccine side effects. Many false links have been dispelled, including theories that the MMR vaccine and the vaccine preservative thimerosal cause autism. But vaccines do carry risks, ranging from rashes or tenderness at the site of injection to fever-associated seizures called febrile convulsions and dangerous infections in those with compromised immune systems.

Serious problems are rare, so it is hard to prove that a vaccine causes them. Studies to confirm or debunk vaccine-associated risks can take a long time and, in the meantime, public-health officials must make difficult decisions on what to do and how to communicate with the public.

The article then goes on to describe how public health officials have become increasingly vigilant about vaccine side effects, setting up intensive surveillance systems, most recently and famously for the 2009 H1N1 pandemic. Specifically, scientists were looking above all for evidence of a link between the H1N1 vaccine and Guillain-Barré syndrome, based on studies that suggested a link between the 1976 swine flu vaccine and this debilitating neurological syndrome. Studies thus far have not shown a link between the latest H1N1 vaccine and Guillain-Barré, which is good, but vigilance continues, not just for H1N1 vaccines but for every vaccine. The result of this surveillance has been to find a link between a rotavirus vaccine and intestinal intussusception, as well as a link between the measles, mumps, rubella and varicella (MMRV) vaccine and febrile convulsions. As a result, use of these vaccines was halted.

Unfortunately, links are often not clear, and during the period of uncertainty between the first report of a possible vaccine complication and studies that either confirm or refute the link, public health officials are forced to make decisions on incomplete evidence. One current example is the possible link between the H1N1 vaccine Pandemrix and narcolepsy in young people. It is not yet clear whether this association is spurious or likely to indicate causation. Another aspect of this issue is whether there are genetic susceptibilities to adverse reactions due to vaccines. Contrary to what the anti-vaccine movement claims, scientists have never denied that there might be genetic factors resulting in increased susceptibility to vaccine injury. However, in science actual evidence is required, rather than speculation, and what we have now on this issue is, for the most part, speculation. It’s also not at all a straightforward issue to determine genetic determinants of increased risk for adverse reactions. Just as finding a genetic cause of autism has been difficult and full of dead ends, despite clear evidence of a strong heritable component, finding evidence of a genetic predisposition to vaccine injury is anything but a trivial task. Moreover, even in children who might have such a hypothetical predisoposition to vaccine injury, when the risk-benefit calculation is done it may well end up that the benefits of vaccines still outweigh the risks. Such would seem to be the case for children with mitochondrial disorders.

So how do we convince parents that the fear mongering by the anti-vaccine movement about vaccines and autism (or vaccines and all the other the movement tries to link with them, for that matter) is without basis in evidence and science and that it is safe to vaccinate? I agree with Julie Leask is at the National Centre for Immunisation Research and Surveillance, Discipline of Paediatrics and Child Health, School of Public Health, University of Sydney, New South Wales 2006, Australia, who wrote the last article that caught my interest, Target the fence-sitters. This is the way to go; the hard core anti-vaccine believers are not going to change their minds, no matter how much evidence you throw at them. We’ve seen this time and time again right here on this very blog, right here in the comments, stretching back over six years.

That’s why it’s a waste of time and effort to try to change the mind of the likes of J.B. Handley, Jenny McCarthy, Barbara Loe Fisher, Ginger Taylor, and others. There was a time when I thought that I could, but six and a half years of beating my head against the wall has taught me that I’m about as likely to succeed in changing their minds as I am to convince the Pope to become an atheist. It’s just not going to happen; these people are true believers in what, for all intents and purposes, can be considered a religion. The bottom line is that I don’t really care about changing, for example, J.B. Handley’s mind; I only care about countering his influence whenever possible. The fence-sitters can still be reached. They haven’t (yet) fallen down the rabbit hole of pseudoscience, autism “biomed,” and conspiracy mongering. There’s still hope to reach them, and reach them I try to do, using a variety of techniques ranging from pure sarcasm and full frontal assault to humor to dispassionate discussions of scientific papers. What works the best? I really don’t know, because I have no way of measuring. I do, however, keep trying.

In the meantime, as the MMWR report on the 2011 measles outbreak in the U.S. and the articles in Nature demonstrate, the anti-vaccine movement is doing real damage as it reverses hard-won gains made against measles over the last four decades.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

492 replies on “The 2011 measles outbreak and vaccines in Nature”

And, what won’t be in the MMWR that you quoted are the new cases in Charlottesville, VA that my daughter told me about yesterday. An woman contracted measles in India, was infectious on her plane trip home and, the day she finally was diagnosed, had spent most of her time at a local shopping mall. Currently, (as of yesterday’s news), she has infected 2 other people who have been confirmed to have measles. News reports are telling people who have any symptoms of measles to stay at home and contact their doctors. Hopefully, vaccine levels are high enough that the outbreak is contained.

Yay for unvaccinated persons who don’t worry about others.

MI Dawn

I was gonna bring up the Charlottesville cases, the first here in 20 years apparently, but MI Dawn beat me to it.

This sort of thing makes me feel better, from a local school where an exposure occurred: “Parents of non-vaccinated children who were in attendance on May 20 have been told that their children are to stay off school grounds for the rest of the school year, except to attend today’s clinic.”

http://www2.dailyprogress.com/news/2011/may/26/7/measles-case-ar-1066570/

At the end of the day yesterday while I was taking the bus from the lab back to the parking lot I saw a big sign about measles vaccinations outside of the emergency room, so the UVA hospital at least is taking this seriously.

And just to nitpick (and a bit of good news) the downtown mall the person was at is an outdoor place, a closed off road with boutiques, bars and restaurants, so it could have been worse if it was a real shopping mall.

@MI Dawn

Read about that. I believe there is a Waldorf school connection, so I think we may be seeing more cases.

@Orac

Great article. Regarding how to reach the fence-sitters, I don’t think there is any single way that works for all, so using multiple techniques is probably best.

I do wonder what it will take to get some of these non-vaccinators to take the risk seriously. We’re (you’re?) fortunate that there have been no deaths in the US outbreaks, but it’s just a matter of time. Deaths are a statistical inevitability if a growing portion of the population is left vulnerable to outbreak.

I’m not sure how many were unvaccinated, but so far in Massachusetts this year, we’re up to 17 confirmed cases. The normal number in this state, annually, is 2 to 3.

My daughter, at age 20, got rubella from the vaccine–confirmed by lab tests after much initial disbelief of attending physician.

Interesting anomaly, but we all still vaccinate.

My approach involves examining and revealing the underlying motives of anti-vaxxers to fence-sitters. I believe that we must clearly differentiate between distraught parents caught in the daily struggles of post-institutional society ( heart-rending stories at AoA lately) from the leaders of the movement *whatever* their motives including those who may also be parents and using the movement as avenue toward fame and recognition as well. Additionally, the movement as a means to monetary compensation should be highlighted.

Anti-vaccinationism is a strong component of natural health advocates’ agenda : vaccines are anathema as they are decisively *not* a natural product *and* they have improved public health vastly thus strongly supporting SBM’s position. I often hear woo-meisters state how vaccines are *neither* safe nor effective. Speculative connections between vaccines and serious illnesses are recounted as though they were Holy Writ; charts are displayed “proving” how the introduction of vaccines did *not* lead to a decrease in deaths ( often with missing sections of data). It was “improved sanitation” or suchwhat. You know the drill.

Truly, vaccines are a threat to the health of woo-meisters’ *enterprises*: since they have been used by pseudo-science as a means to discourage faith in SBM, if they are shown to be relatively safe and even ( gulp!) useful, it may serve to illustrate the untrust-worthy and mercenary nature of those who are selling the bill of goods. I’d love to see woo done in by its own *bete noire*. Jabbed!

Anthro –

Was this a mild case of rubella (sometimes referred to a bit vaguely as a ‘vaccine reaction’)? Or something full-blown enough to cause the attending’s disbelief? If the latter, then perhaps she would want to see if there are any potential signs of immunodeficiency.

That’s the same outbreak we’ve got here, the measels from the trip to India.

But on the bright side, no one blew up the plane! (And maybe some of the airport security guys were infected.)

Maybe it’s time to update passports with vaccination records. After all, your dog has to have them, so why not you and your kids?

This is basically a derail but, sine immunity to rubella was brought up:

I grew up when DPT, smallpox and polio was basically it. I got rubeola (regular measles) and supposedly rubella (“German measles”) twice! We were told that my first case was too mild and “didn’t take”. Is this a real thing? Is there a third ailment that could be mistaken for rubella? Haven’t thought about it for 50 years, but that just triggered the question in my mind. Sorry for the diversion.

The MMWR article is quite alarming. In France, where many of the cases in the USA were imported from, there is a large outbreak of measles with over 10,000 cases reported so far this year. Of note, 89% of the 118 reported cases for the USA occured in individuals who were not vaccinated against with the MMR vaccine. The largest outbreak in the USA occured in a community that was fearful of the MMR vaccine due to it’s fraudulent link to autism. Thirteen years after Dr Wakefield’s inaccurate Lancet article, we are still seeing the negative effects on humanity. We need to make a stronger effort to reverse this effect, or smallpox will be the last disease that we will be able to say has been eradicated from the earth.

Dr Sam Girgis
http://drsamgirgis.com

Actually Dr. Sam, it was announced today that Rinderplast was eliminated as well (think I spelled that right….).

@DaveD

Yeah. I tried to find some info on the Boston cases, but the Boston and MA Dept. of Public Health web sites aren’t very informative. The last BPH news release was back when there were only 2 confirmed and 3 suspected.

Really wish they were more like the MN DoH site.

I’ve been so alarmed by this “outbreak,” I too had to do several posts on it this week. It seems West Virginia, due to their stringent vaccine laws, remains one of the few safe places left in America. I suggest we all make our way there with great haste.

Thanks, TBruce. They all seemed pretty much the same to me at the time, but I know (now) I really lucked out on the severity scale.

Lets see, in the first months of 2011, there have been (according to the WHO-CISID) 380 cases of measles* in the UK and 7,380 cases of measles in France. For comparison, there were 397 cases in the UK and 5,139 in France in all of 2010.

[*Note: laboratory-confirmed cases – 377 in the UK and 2,139 in France so far in 2011.]

That’s impressive work! I wonder if they’ll be touting this success at the “Autism One” conference (where Andy Wakefield is giving a talk on “Munchausen’s disease by proxy”).

People have asked why there has been such a problem with measles outbreaks recently, when the vaccines uptake hasn’t declined by much. Well, there are two reasons.

First, a decline in vaccine uptake from 96% to 92% – which doesn’t seem like much – means a doubling in the number of unvaccinated people (4% to 8%).

Second, people who refuse to vaccinate their children tend to be socially inter-related; they hang about together, socialise and have “play dates” with each other and attend the same private schools. This facilitates the spread among the unvaccinated by putting them in close contact. The people who don’t vaccinate because they are too busy, too poor or just don’t like needles don’t cluster together as much.

So, where there are groups of vaccine “refuseniks”, expect to find measles outbreaks. Previously, this was limited to certain religious groups, but Dr. Wakefield and others, like “Dr. Bob” Sears and “Dr. Jay” Gordon, have made vaccine refusal non-denominational. Now anybody can take part in a measles outbreak, no matter what their religious beliefs might be!

What a brave new world we live in!

Prometheus

Putting together two pieces of information:

1) Prometheus says 92% are vaccinated against the measles (does the non-vaccinated rate include those too young?)
2) 89% of the measles cases are for non-vaccinated people.

So non-vaxxed people make up 8% of the population, but 90% of those who get the measles.*** And there are people who still claim that vaccination doesn’t work? The reduction of measles was due to sanitation? We can avoid measles by not letting ourselves get exposed? (that’s Th1Th2, btw) Apparently, it is just a coincidence that non-vaccinated folks are either extremely unsanitary or incapable of avoiding infection.

***By my math, that means that non-vaccinated people are 100 times more likely to become infected than the vaccinated, right?

vaccines are anathema as they are decisively *not* a natural product

I always thought they were delightfully natural. Just a little poke to get your own immune system to do the work it’s all set up to do already.

Heck, the original vaccine was a pefectly natural cowpox infection…

@ Todd W. I found a measles alert from the Massachusetts Department dated May 10, 2011 discussing the 10 cases YTD that had been reported in the State.

I also located the newest case of measles in the article:

Vaccinated Boston Toddler Gets Measles (May 26, 2011) and the Massachusetts Department of Health now reports 17 cases of measles YTD.

The “vaccinated toddler” referred to in the article had received only one measles vaccine…health officials state that the child is among the ~ 5 % of children who don’t get immunized against the measles virus with just one of the two shot series. Following completion of the two-shot series, close to 100 % of vaccine recipients are immune.

@ Todd W. I found a measles alert from the Massachusetts Department dated May 10, 2011 discussing the 10 cases YTD that had been reported in the State.

I also located the newest case of measles in the article:

Vaccinated Boston Toddler Gets Measles (May 26, 2011) and the Massachusetts Department of Health now reports 17 cases of measles YTD.

The “vaccinated toddler” referred to in the article had received only one measles vaccine…health officials state that the child is among the ~ 5 % of children who don’t get immunized against the measles virus with just one of the two shot series. Following completion of the two-shot series, close to 100 % of vaccine recipients are immune.

Lilady

Following completion of the two-shot series, close to 100 % of vaccine recipients are immune.

So what do you care if someone chooses to not vaccinate. It’s their choice they take responsibility for their choices.

And I know what you’re going to say next. But, but that .1% makes up a lot of children, and, and they don’t have a choice. They rely on herd immunity. Our precious mathematically flawed misinterpreted vague theory.

So is this what the crux of the vaccine argument has come down to? You do it for the medically fragile? The theoretical ones for whom the vaccine fails?

Well why don’t you just state that from the beginning? Let the public and all of the mothers know what your true intentions are. Them vaccinating is not really for them it’s for the idea of supposedly protecting medically damaged children. If they(vaccine recipient) so happen to benefit also, then great but it’s not really about them it’s for the others who have co-morbidity issues.

BTW, does how are you going to stop all of the other microbes from infecting and killing them? How are they going to survive the common cold and other viruses? More vaccines for the public? When will your control psychosis stop.

.health officials state that the child is among the ~ 5 % of children who don’t get immunized against the measles virus with just one of the two shot series.

So if 100% of the people get 1 shot and do not get the 2nd shot.95% “immunity”. Will measles be wiped out?

@ Augustine: Your (too) obvious dig at my deceased son who was medically labile…not medically damaged…is a new low even for you. My son received his immunizations against measles in infancy. Tell us again how your two (imaginary) healthy children are un-immunized.

Medically labile (not medically damaged) children include children who are undergoing treatment for cancer or have an immuno-suppressive disorder or disease. Children and adults who have undergone stem cell therapy and those who are on immuno-suppressive treatments following organ transplants are also at great risk. “Healthy” infants, who are too young to have received MMR vaccine depend on the herd immunity in their community to protect them from this potentially deadly virus.

BTW:

Where did you go to school?

Are you gainfully employed?

I’ll take unsubstantiated assertions by trolls for $300, Alex.

“So what do you care if someone chooses to not vaccinate. It’s their choice they take responsibility for their choices.”
Augustine, there is a small problem with your thinking. It is the PARENT who decides not to vaccinate, it is the KID who gets sick.
Most States do not allow parents to refuse medical treatment for their kids on religious or other grounds. Or maybe I should reword that – they can refuse treatment, but when the kid dies they get prosecuted and sent to jail. Why should it not the the same for vaccination?

“So is this what the crux of the vaccine argument has come down to? ”

No. It has already been explained to you what the mutliple convergent lines of pro-vaxx reasoning are. The good people here have expended significant effort and time trying to teach you what those lines of reasoning are.

How very dare you have the arrogance and insolence to throw all that away just to concentrate on one small part and misrepresent it.

Your attempt at creating a simplistic strawman in order to accuse others of mental illness and sociopathy has been noted.

Your attempts at using the memories of other people’s late children has been noted.

You are a vile, malicious, vicious, vindictive and mercurial little shit. As long as you continue to mistreat people this way, your reputation will be to shit.

Kindly leave these kind people alone and take your evil elsewhere.

You are not worthy, and would have been banned ages ago, if it were not for Oracs exremely forgiving policy.

It is the PARENT who decides not to vaccinate, it is the KID who gets sick.

Oh, you would rather the state to decide? Nice political ideology there, patriotic, liberty defending, sailor. You mix your politics with your science very well.

Most States do not allow parents to refuse medical treatment for their kids on religious or other grounds.

My kids are not sick. Why would they need medical “treatment”?

Or maybe I should reword that – they can refuse treatment, but when the kid dies they get prosecuted and sent to jail. Why should it not the the same for vaccination?

Deal. Only if the doctor, nurse, receptionist, pharmacist, pharmacy, pharmaceutical company, CDC,that HHS lady with the cocked head, and local health department can be sued into oblivion every time a vaccine causes injury AND every time the vaccine fails to prevent the disease that it is advertised for.

BTW, is this stuff in a science handbook somewhere? Do you just make this stuff up as you go along developing your philosophy and politics?

“Healthy” infants, who are too young to have received MMR vaccine depend on the herd immunity in their community to protect them from this potentially deadly virus.

Just more fear/disease mongering. In your “humans need medicine to survive because they are just weak animals” bias you left out the fact they they should have maternal fetal antibodies which protect them. When this happens they are in fact NOT relying on herd immunity.

MMR Vaccine is a must i feel. I understand people feeling worried over the link with autism and the vaccine, but as far as i am aware, it has never been proven and research has been done.

MMR outbreak could potentially harm hundreds… if not more.

Roadstergal,

Heck, the original vaccine was a pefectly natural cowpox infection…

Yeah, thanks for promoting vaccinia.

Leaving a child unvaccinated leaves that child at a greatly increased susceptibility to measles and therefore a highly elevated risk of catching the virus when exposed.

Oh the drama.

If the shortest distance between two points is a straight line then the shortest distance between an uninfected child and measles infection is the live measles vaccine.

Th1Th2 – what percentage of children infected with the vaccine die? How does that compare to the percent who die of the actual full strength disease?

@39

Obviously sanitary standards have been decreasing in France since 2007.

@ Roadstergal: Well, the part you describe is natural _however_ do you seriously believe that our pristine woo-meisters will accept *anything* made in a *lab*(( shudder)) if it is not one of their own brand of supplements, superfoods, or dried vegetable powders? ‘Fraid not!

I really enjoy Orac’s writing, and I greatly appreciate the information provided by the commentators. I’ve learned a lot. But sweet Jesus do I get tired of the trolls.

@Sid- Your blog would be way more interesting if you just chronicled your life as a guy who still thinks having a mullet is cool.

Christopher @42 — Exactly my thoughts.

Cranks and crackpots abound, everyone’s an expert on the internet, and deep knowledge and expertise (as exemplified by our esteemed host) just mean you’ve been brainwashed by the establishment. Science would be so much easier if we were allowed to just make shit up!

Mephistopheles,

Th1Th2 – what percentage of children infected with the vaccine die? How does that compare to the percent who die of the actual full strength disease?

Are they supposed to die of measles? And what is a “full strength disease”?

Mephistopheles,

Th1Th2 – what percentage of children infected with the vaccine die? How does that compare to the percent who die of the actual full strength disease?

Are they supposed to die of measles? And what is a “full strength disease”?

Excuse me if I’ve missed mention of this elsewhere on RI, but there are two good current articles on autism thanks to Psychology Today.

Both are authored by physicians, and both cast serious doubt on the assertion that there is an “autism epidemic” and that any environmental toxin (i.e vaccines and/or substances in them) is driving an increase in autism.

Allen Frances M.D. (who chaired the DSM-IV Task Force) had this to say in his blog article:

DSM IV gave autism purchase by introducing a milder form close to the populous boundary to normality. Then autism took flight on the wings of definitional diffusion, internet contagion, financial incentive, and naïve interpretation of epidemiological results. The overall rate of autistic symptoms is probably the same as it always has been since time immemorial- only the naming of them has changed.

These are the sorts of articles that provide an excellent and vital complement to scientific journal studies, utilizing the popular press to clarify critical issues that antivaxers love to obfuscate.

The other Psychology Today article I referred to appears in the current print issue of the magazine.

@DB
The increase in autism cases tracks pretty much perfectly with the decrease in mental retardation cases. By gum, we’ve won the war on mental retardation. By calling it something else.

@ Dangerous Bacon: Terrific Link you provided to Dr. Frances’ blog. I also located another article written by the doctor in this month’s issue of Psychology Today, available by keying in:

Will DSM-5 Contain or Worsen the “Epidemic” of Autism

I think Dr. Frances nailed down the “epidemic”, succinctly.

You mentioned how anti-vax can be compared to its own religion, so I had to add this to the comments.

When I was first exposed to the existence of people who opposed vaccines, I had a sneaking feeling of familiarity about the ‘arguments’ I was hearing at a fairly regular interval. They sounded familiar, but I couldn’t quite put my finger on what it was.. exactly.

So…
I decided to wander over to the trusty google, and searched for ‘the origins of anti-vaccine’. Then I read it;
Wow.
I sat there stunned.

You could write an entire article about this.

Doesn’t it seem strange for a science article to have such a suggestive tone? But I guess if your focus is pointed in a direction it’s near impossible to be aware of much else. And yes, I would have my children vaccinated if I had any.

I’m just waiting for someone to decide to sue whoever they contracted measles or similar from. I’m not saying they’d win, but it would be interesting to watch.

In the UK/ NHS where I work,in our local Strategic Health Authority area,we have had 12 confirmed cases in the past week from a school camp.In addition I have seen 2 cases already this year in my own practice.

Patanjali Sutra 3:17
“A word, its meaning, the idea behind it, and it’s effect on the body are normally confused because of superimposition upon one another. By concentrating on the word [or sound] produced by any being, knowledge of its meaning is obtained.”

The word ‘vaccine’ was coined recently, but the sound of the word itself has been in use, almost certainly, for thousands of years.

It can be found in the Koran, in the form ‘Backsheen’, meaning ‘Boy of little worth’.

Going back to unattested darker times where the word itself is not found, we find much reference to Baks, Vax, Baccus etc.. The god of you-know-what?

The ‘Baksheen’, would have been the masculine form of the word for ‘Male sacrifice to Baccus’.

Clearly the circumstances under which this word was used would have been extremely memorable circumstances and, if you are familiar with the TEEM hypothesis (trauma-encoded-emotional-memory), would certainly be passed down to our children through our genetic memory (the one that recognises the sound and shape and threat/food potential of a bear even though you’ve never been around a bear).

The ‘Anti-Bakseen’ movement would have been the very first human rights movement. Certainly male sacrifice would have been phased out before female sacrifice. Or so the story goes.

So really we are fighting against the descendants of people who were vehemently opposed to feeding little boys to god.

That’s why, when they talk about ‘Big Pharma poisoning our kids’ what they really *feel* is ‘Stop feeding our kids to God!’

Sometimes you have to dig a little deeper than ‘from cows’. Sometimes you have to dig the bullshit too.

DB- thanks for the link

lilady – you’re one of the ‘stand out’ commenters here, who always have something thoughtful to say. I’m sorry that trolling little fuckwit decided to stoop so low.

The thing that bothers me most about Augustine is not his opposition to vaccines, but his manifest lack of care for anyone outside of his own family. It’s as if the rest of the world didn’t exist – he and they are existing on their own little island, unable to be affected by (or to affect) anyone else. Compassion and caring for other people don’t seem to be part of his mental vocabulary.

Being a good citizen, on the other hand, requires caring for other people as well as for oneself and one’s family. When I was a child I got measles and spent two weeks in bed. I never got German measles (rubella) and a few years ago it occurred to me that I should get the vaccine – not because I was so afraid of the illness for myself, but because I didn’t want to run the risk of getting it and unknowingly infecting a pregnant woman. What we do, how we live our lives, does affect other people, and we should do our best to care for them as well.

@Rebecca:

Augie consistently underestimates the risk of vaccine-preventable diseases by orders of magnitude. He’s in denial about the possible consequences of his family contracting one of these illnesses. I don’t think he gives a shit about his own family (whoever they may be, poor souls). He’s only interested in sticking it to all the experts to boost his own pathetic ego. He is addicted to the warm slimy feel of contempt for humanity.

@Th1Th2 – Your questions are:

Are they supposed to die of measles? And what is a “full strength disease”?

Per the CDC web site: “MMR is an attenuated (weakened) live virus vaccine. This means that after injection, the viruses grows (sic) and causes a harmless infection in the vaccinated person with very few, if any, symptoms.”
Note that this is a live virus vaccine. It causes an infection according to commonly accepted definitions of the words “live” and “infection”.
By contrast, the wild measles strains do typically cause noticeable symptoms and complications in a significant percentage of cases. These strains which are communicated naturally through the air are the ones I colloquially referred to as the full strength version.
Your other question of predestination is a philosophical one that I do not choose to respond to in this forum as it is irrelevant to the discussion.
Based on that, can you answer my question?

[Admittedly veering off topic from measles etc.]

Dangerous Bacon, re Dr. Frances’s views on autism.

Back in December 2010, NPR ran a piece on Dr. Frances in which he said, (I’ve added emphasis)

It’s not that Frances doesn’t think that Asperger’s exists and is a real problem for some people; he does. But he also believes the diagnosis is now radically overused in a way that he and his colleagues never intended. And why, in his view, did Asperger’s explode? Primarily, Frances says, because schools created a strange unintentional incentive.

“In order to get specialized services, often one-to-one education, a child must have a diagnosis of Asperger’s or some other autistic disorder,” he says.

“And so kids who previously might have been considered on the boundary, eccentric, socially shy, but bright and doing well in school would mainstream [into] regular classes,” Frances says. “Now if they get the diagnosis of Asperger’s disorder, [they] get into a special program where they may get $50,000 a year worth of educational services.”

Parents of children with autism were….not pleased.

Kristina Chew at Care2: Did the DSM create an epidemic of Aspergers?
Emily Willingham at Biology Files: NPR’s Asperger’s Fail
NPR’s Asperger’s piece: all things not considered (more personal reflections on asperger’s in childhood)

Sarah Schneider at Shift Journal:

…Asperger’s is a “fad diagnosis?” Have you actually met any parents who are willing to go through the grueling, soul-crushing process of getting our kids evaluated and diagnosed — not because our children are truly suffering, but because we are greedy for some undeserved taxpayer-financed services? I know I haven’t, and I cordially invite Allen Frances to produce those parents before continuing to run off his mouth about them.

If readers would like a different view of “the epidemic”, I have two recommendations:

Steven Novella at Science-Based Medicine on et al.’s new study on autism in South Korea, Autism Prevalence Higher than Thought (by the way, in his blog post, Frances rubbishes this study).

Jon Brock’s latest, Cracking the Enigma: What is PDD-NOS? .

Mephistopheles,

Th1Th2 – what percentage of children infected with the vaccine die?

Hold on a minute. Isn’t that a classic moving the goalpost fallacy? Whatever happened to the putative Vaccine-Preventable Disease slogan? If the measles vaccines cause measles infection (actually it is a MUST), how many people have you deceived by proclaiming the measles vaccine will protect them from measles? How could vaccine apologists say the measles vaccines have reduced measles incidence when they are among the leading infection-promoter? I always knew vaccination is a big joke more so the claim that it saves lives.

@65:

Thingy must think that jumping off the low board at a swimming pool is the same as jumping off the Golden Gate Bridge.

Th1Th2

Isn’t that a classic moving the goalpost fallacy?

No, it’s not. The goal of a public health initiative such as vaccinations is (it seems to me, as a layman) the reduction of serious disease and the complications of that disease. Per the CDC site quoted above, the vaccine does cause an infection but does not cause symptoms (for most people) – yet does confirm immunity to the wild virus.

Forgive me, but I am actually going to post an on-topic comment about the Nature articles:

Look at the map on the first link that shows the trouble spots. Zoom in on Europe (click on the pdf version), now find the three major countries that have less than 90% vaccine coverage. Which one is associated with an outbreak in San Diego? Which one is associated with large epidemiological studies? And which one started it all?

Now I want to see a version with the separate areas of France. It has over 90% coverage, but is experiencing a major outbreak. There should be some reports of pockets of low compliance. Well, what do you know, it is actually linked to in the references. Unfortunately it is map of the outbreaks, not of vaccine compliance. It does say:

Of the notified cases in 2010, almost 30% were hospitalised. A higher severity of the disease was observed in infants under one year of age and adults above 20 years, with respective proportions of hospitalised cases of 38% and 46%. In 2011, more than 300 people were hospitalised with acute encephalitis for eight of them. One measles-related death was reported.

And yes, I meant “confer” instead of “confirm”.

Mephistopheles,

Per the CDC web site: “MMR is an attenuated (weakened) live virus vaccine. This means that after injection, the viruses grows (sic) and causes a harmless infection in the vaccinated person with very few, if any, symptoms.”Note that this is a live virus vaccine. It causes an infection according to commonly accepted definitions of the words “live” and “infection”.

Symptomatic or not, it is still a diagnostic case of measles infection and you are proudly promoting the disease.

By contrast, the wild measles strains do typically cause noticeable symptoms and complications in a significant percentage of cases. These strains which are communicated naturally through the air are the ones I colloquially referred to as the full strength version.

Except that a typical measles is benign and uncomplicated but still highly infectious. So calling it “full strength version” is redundant.

Based on that, can you answer my question?

What question?

TBruce,

Thingy must think that jumping off the low board at a swimming pool is the same as jumping off the Golden Gate Bridge.

It does not matter. A suicidal man will do anything to kill himself.

@ Chris: Excellent link to the measles outbreaks. I think I have some vaccination history for the measles cases reported in 2010 in France. (Your un-techie buddy went through the back door…for you to link) I “googled”

Vaccine Status French Measles Cases

The second article from the top of the Google search page “Spotlight on Measles 2010…..” has the measles vaccine status, broken down by age for each confirmed measles case
in France. See Figure 4 Bar Chart for breakdowns.

lilady, here it is:
http://www.eurosurveillance.org/images/dynamic/EE/V15N36/art19656.pdf

According to the article the vaccine coverage is just about at 90%, not quite the level that is sufficient for herd immunity. And it says:

It had already been predicted in 1998 that countries like France or England and Wales, where vaccine coverage had remained around 80% to 85% for many years with insufficient catch-up programmes, have built up large cohorts of susceptible people, becoming prone to large outbreaks with an increase of the average age of cases [12] .

Mephistopheles,

No, it’s not. The goal of a public health initiative such as vaccinations is (it seems to me, as a layman) the reduction of serious disease and the complications of that disease. Per the CDC site quoted above, the vaccine does cause an infection but does not cause symptoms (for most people) – yet does confirm immunity to the wild virus.

So the CDC neither control the disease nor prevent infection. Instead they promote the disease and spread the infection through vaccination. Great. At least, their goal is still based on science of acquired immunity called infection-induced immunity.

So much for vaccines protect and save lives.

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