The Vaccination Effect: 100 Million Cases of Contagious Disease Prevented
bits.blogs.nytimes.com
bits.blogs.nytimes.com
Yes I get vaccinated yearly for the flu, I also got one for H1N1 (?) a few years ago.
So many people across all age ranges it's sad, the comments in the NYT article are sad to see. A 20 something guy at work was telling me excitedly how "some guy" on YouTube "proved" writing the word hate and love on water bottles then freezing them makes the ice different. This same person is against vehemently against all GM foods and Big Pharma, the "some guy on YouTube" is the all-knowing answer.
Not sure what the treatment should be.
I have to take issue with some parts of the article. Lohr (the NYT article's Author) cites 38,000 cases of Pertussis in the US. It may just be a coincidence, but 38,000 is the number of cases recently reported in Australia. The CDC reports[1] 27,550 for 2010 (an awesomely precise estimate), so, 38k doesn't sound out of line, but I didn't find a source for that number. Going back to Australia where they have 95% compliance according to this news article[2], they suspect that mutation of the pathogen is responsible for the rise in cases. The NYT article OTOH, lays the blame on non-compliant parents. Additionally, the acellular Pertussis vaccine apparently doesn't always prevent illness, but lessens the severity and duration of infection. So, it could well be that most of the reported cases were vaccinated as was the case in Australia.
I wonder why authors feel the need to keep re-writing the standard pro-vaccination puff pieces. They don't seem to do anything to convince skeptics. I'd like to see a study of why people choose to refuse vaccines and apply those results to efforts to increase vaccination rates.
[1] http://www.cdc.gov/nchs/fastats/whooping.htm
[2] http://www.abc.net.au/health/thepulse/stories/2012/08/14/356...
Personally, I am for vaccination. I'm way over vaccinated due to trips to third world countries -- sometimes I would get 6 shots over 2 days. However the spacing for vaccinations in infants seems rushed, and the ingredients are something I wouldn't let my kid touch or eat. (kind of like how you wouldn't feed your kid honey until after they're one) I recently told our doctor we wanted an ingredient list of the vaccines they were planning to administer, so we could attempt to understand, before following their schedule in ignorance. I definitely don't want my kid to have the diseases our grand parents grew up with, and that means vaccinating.
I'm wondering if a doctor would balk at signing a document of liability for {x} resulting from vaccination. If she wouldn't put her career behind her belief, should I believe her?
Does herd immunity require herd mentality? Can one investigate, or at least try to be diligent without being vilified?
For one, there is a law in the US that removes vaccination liability from doctors.
A bigger problem with your suggestion is problematic math behind it - if vaccines killed one person for every ten saved it would still be worthwhile, but your suggestion would quickly ensure no doctors ever willing to give any vaccines to anyone, ensuring higher death rate among you and your relatives. The actual incident rate is much smaller - for example between 3000 and 49000 people die of flu each year, and only about a 100 people die of vaccine complications (most of them of egg allergy, totally preventable if treated right away).
It's precisely due such poor understanding of statistics is why there are large groups if people opposed to vaccination - they fixate on a smaller probability negative outcome in the immediate future and ignore large probability negative outcome three months down the road.
I don't think any professional can be blamed for not wanting to tie liability to client whimsey.
>It's precisely due such poor understanding of statistics is why there are large groups if people opposed to vaccination - they fixate on a smaller probability negative outcome in the immediate future and ignore large probability negative outcome three months down the road.
No, the probability of death or injury from all diseases (for people in the US) is small. It may be relatively large compared to the probability of death or injury from vaccination, but it is still small for each individual.
That's true. But I suspect that better sanitation and nutrition played a large part as well.
>so your analysis is correct for the individual, while still badly wrong for society as a whole.
I know. Which is why it is important to have safe and effective vaccines.
Not in every case. Polio, for example, became a more serious problem because of sanitation. http://www.pbs.org/wgbh/rxforsurvival/series/diseases/polio....
Why?
Also, there is a problem with the hypothetical, since there are other means of reducing disease than vaccination, e.g. aggressive quarantine and disinfection, trending toward telecommuting or smaller school classroom size, etc.
Suppose a doctor vaccinates 20 kids a week, for 50 weeks of the year (1000 kids per year). Suppose each vaccination has an average of 3 different vaccines (i.e. against 3 different diseases). Suppose the average vaccine has a 1/10k chance of serious complication. So over the course of a year the doctor gives about 3000 vaccines each year with a 1/10k chance of serious complication. Suppose a single serious complication risks their career. This means the average doctor is risking their career over 1 incident just over every 3 years. I personally prefer a family physician with more than 3.3 years of experience.
Meanwhile over those 3 years 9000 cases of disease were eliminated. Sure your kid may mean everything to you (mine sure does) but having a doctor put their career on the line for something that only has a probability of success is silly considering how many times they roll the dice in their career.
My kids? We're cautious. Never more than one at a time. Didn't bother with Rotavirus (I suspect we paid for that). No Hep-B at birth. Oldest has had the MMR. So far the only out of the ordinary observation was with our youngest who had a horrible cough after receiving the DTaP. Would refuse Gardasil.
> I recently told our doctor we wanted an ingredient list of the vaccines they were planning to administer, so we could attempt to understand, before following their schedule in ignorance.
It is a shame that asking simple questions like that can get you labeled as a crank in some circles. Fortunately, most of that is published by the CDC, and other places. Childhood vaccination schedule for the convenience of anyone who is curious. http://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.h...
>I'm wondering if a doctor would balk at signing a document of liability
Even the companies that manufacture the vaccines want nothing to do with the legal liability for injury. https://en.wikipedia.org/wiki/Vaccine_court
[1] http://summaries.cochrane.org/CD001269/vaccines-to-prevent-i...
The EU has a vaccine schedule tool. Schedules are somewhat similar to the US but not the same.
http://vaccine-schedule.ecdc.europa.eu/Pages/Scheduler.aspx
Also women in France are filing lawsuits over Gardasil.
http://www.rawstory.com/rs/2013/11/25/frances-top-medical-ex...
I'm wondering if a programmer would balk at signing a document of liability for {x} resulting from their code submitted on a tight deadline. If they wouldn't put their career behind the belief in their code, should I believe them?
The time pressure on programmers due to business needs limits the amount of time they get to spend with their code, much like the time pressure on doctors due to business needs limits the amount of time they get to spend with each patient, researching the latest anti-vax theories, etc.
The tight deadline you refer to is entirely self-imposed due to profit models.
And/or a scarcity of doctors.
What? No. Please explain how "increased consultation time (over no consultation at all) would result in better outcomes and fewer injuries."
Is that pretty clear how a consultation would result in a better outcome and less injuries?
The sum of the studies and education (I assume they are both untainted and unbiased) is expressed in their application to their own kin.
What does that even mean?
I also don't have information saying spreading out the doses over time would be better or worse. What are other countries doing WRT infant vaccine schedules? What are some options that still get my child vaccinated against disease? Are the doses they take 1/20th the amount that I would take, since I'm 20 times their weight? Does scaling doses even work that way? Why didn't I take organic chemistry when I was in college? Does ethyl-mercury metabolize into anything? When the CDC says 'a tiny bit' what does that mean quantitatively? These are just some of the questions I'm asking, so that I don't remain ignorant.
It's no credit to remain ignorant, and it's no credit to be a belligerent fanatic on either side. If I can be bothered to wash my kid's grapes before they eat them, I could at least understand what the doctor is putting in them before following blindly.
Even if you're pro-vaccine but question the schedule and efficacy and necessity of some of the shots given exposure risk, you're called a crank.
If you can't do that, please don't blame us for it.
It means they don't have any information to back it up.
That is just one example, but vaccine schedules are impacted by exposure risk, but also by some level of convenience (based on the fact that we don't go to doctors every day, so "let's vaccinate you as much as we can in the few times we'll see you"). If you show up for a well visit and your child is not 100%, do you let the child get the vaccine or do you come back next week/month?
Vaccine safety is easier to test under very strict conditions and single vaccinations, but the topic is complicated by varying levels of child health as well as offering vaccines in combination.
Big pharma also keeps pushing cocktail shots, multiple vaccinations in one single shot, whereas before you would take multiple visits and each time it would be a separate vaccine.
This is not some push by the "pharma" bogeyman. It's a push by doctors to reduce the chance that a child fails to complete his or her vaccination series.
If the probability of missing a visit is, say, 0.05, then the probability of missing a shot in a series of 3 is (1 - 0.95^3) ~= 14%, as opposed to 5% if you can actually do it all at once.
OK, so what's their motive? Surely Big Pharma in cahoots with Big Doctor would love lots of visits and lots of separate billable injections?
The real reason is more likely to be that plenty of people only take their kids to the pediatrician once in a while, because they don't have insurance or they work a lot (particularly amongst the poor, where things like transportation can be an issue), so getting them all in in a few combination shots means higher vaccination levels across the board.
"GlaxoSmithKline agreed to plead guilty to criminal charges and pay $3 billion in fines for promoting its best-selling antidepressants for unapproved uses and failing to report safety data about a top diabetes drug, federal prosecutors announced Monday. The agreement also includes civil penalties for improper marketing of a half-dozen other drugs."
http://www.nytimes.com/2012/07/03/business/glaxosmithkline-a...
"Glaxo chief: Our drugs do not work on most patients
A senior executive with Britain's biggest drugs company has admitted that most prescription medicines do not work on most people who take them. Allen Roses, worldwide vice-president of genetics at GlaxoSmithKline (GSK), said fewer than half of the patients prescribed some of the most expensive drugs actually derived any benefit from them.
It is an open secret within the drugs industry that most of its products are ineffective in most patients but this is the first time that such a senior drugs boss has gone public.
"The vast majority of drugs - more than 90 per cent - only work in 30 or 50 per cent of the people," Dr Roses said. "I wouldn't say that most drugs don't work. I would say that most drugs work in 30 to 50 per cent of people. Drugs out there on the market work, but they don't work in everybody."
http://www.independent.co.uk/news/science/glaxo-chief-our-dr...
I'm baffled by the "omg!" attitude towards the second part. Anyone who's had antidepressant treatment has likely experienced the need to try a couple different meds before finding the right one. Everyone seems to respond differently to different ones - the same med that works for one person may be totally ineffectual for another. If you're in the 50% that a med doesn't work for, you switch.
Ever heard of the Gardasil vaccine ?
"Amid questions about the safety of the HPV vaccine Gardasil one of the lead researchers for the Merck drug is speaking out about its risks, benefits and aggressive marketing... The risks of serious adverse events including death reported after Gardasil use in (the JAMA article by CDC's Dr. Barbara Slade) were 3.4/100,000 doses distributed. The rate of serious adverse events on par with the death rate of cervical cancer.
http://www.cbsnews.com/news/gardasil-researcher-speaks-out/
Over a hundred young girls have died after taking the vaccine, and many others have been left suffering horrible illnesses. Here, look at some of the victims.
Debate the causal link all you want, I'm not taking a stance on this either way, but what I object to is people being labelled cranks for simply asking questions and pointing things out.
This is why I strongly prefer the term "community immunity" over "herd immunity".
Can one investigate, or at least try to be diligent without being vilified?
Yes, absolutely. If you stick to actual reputable provable science, you'll wind up in the "vaccines are safe" camp. If you follow crackpots who don't understand science, you'll wind up somewhere else.
As for the ingredients, that goes for most medicine. Medicine is often stuff you wouldn't want to be eating or touching routinely, but that's because it's for non-routine use. I wouldn't give my kid a big bottle of acetaminophen to chow down on, but I will give some of it to her when it's medically indicated.
As for signing a document of liability, would you sign one if you thought that the procedure was generally safe, but there was a one-in-a-million chance that, through no fault of your own, the procedure could go wrong and leave you bankrupt because of what you signed?
How likely are any of these events for a newborn? Would waiting a week, a month, etc put an infant at risk?
From CDC site: "Babies and children can get hepatitis B in the following ways:
At birth from their infected mother. From bites from an infected person. By touching open cuts or sores of an infected person. Through sharing toothbrushes or other personal items used by an infected person. From food that was chewed (for a baby) by an infected person. From ear piercing needles that were not cleaned well."
Source - http://www.cdc.gov/vaccines/vpd-vac/hepb/fs-parents.html Edit - added CDC info
If you wait a week, that's a week-long window for infection. It's small, certainly, but what's the gain? Is there any advantage to waiting?
The gain comes when the safety of vaccinations comes up into question. The CDC doesn't advocate giving every available vaccine on day one, in a single massive cocktail form, for this very reason. This would be the cheapest and most efficient way to vaccinate (all at once, one shot for all vaccines), but obviously that is not how it is done due to safety of the newborn.
Your reasoning seems to boil down to anti-vaccination people thinking it's worse, and this is some small concession to them. Which is essentially saying, it's rushed because I say it's rushed.
There are a number of vaccines to give, and if there were no concerns about safety they could all be given at birth. However, there obviously are concerns by manufacturers and the CDC (and of course elsewhere) so the CDC created a schedule. People that question the schedule often question the Hep first, based on the incredibly small chance an infant would come into contact with the virus.
Part of the reasoning behind the schedule being the way it is relates to doctor visits. The CDC wants children vaccinated, so accelerating the schedule and giving multiple vaccinations at once isn't due to fear of exposure at certain ages as much as the logic of "while you're here, let's take care of these vaccines as well." Kind of like the reasoning behind topping off your fluids during a car's scheduled maintenance. No need to bring the car in when you are more likely to run dry on fluids, we'll just fill you up while you're here.
Part of the CDC's concern is making sure kids are vaccinated, so the more vaccinations at once mentality makes sense to increase the likelihood of vaccination. Parents would surely be less likely to visit a doctor 15 times in a year than say 2-3 or less.
The link below shows the number of vaccines recommended in the first 6 years. Bundling them and accelerating the schedule helps guarantee higher vaccination rates, but can complicate matters when safety of vaccines is harder to test and compare in a multitude of combinations.
http://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch...
The vaccine court has paid out individuals for vaccine injury. The results of the court are generally not widely publicized, but defining safe is somewhat key to these points.
I really would like to know what, if any, reasons there are to delay vaccines and why one might consider any given schedule to be "rushed". But so far I only get handwaving.
This is only one specific case, but the point is that the more we know about a person, the more likely we are to make informed decisions about their safety and health.
Only some kids are allergic to peanuts, but we don't give kids peanuts until they are two or so. We know more about them at two, and they are less vulnerable.
Vaccines are good against a known thing, such as Hepatitis B or Polio. So you would want your kids to be vaccinated against things like that. However the flu vaccine is not really effective.
Side effects? If you take a Flu vaccine shot or Whooping cough shot you get a different one from that given to pregnant women and babies. Think about that. One contains mercury, the other doesn't. So why doesn't everybody get the safer one? Manufacturer cost.
Which leads to a third issue which I didn't mention - money. Corporations abuse whenever they can, why wouldn't it be the same in the pharma industry? Take the flu vaccine, the effectiveness is not proven, yet we are bombarded everyday with marketing/propaganda that flu shots are available and they only cost 60 bucks.
The Andrew Wakefield MMR-Autism paper has been discredited but it did make a lot of people ask questions. Why are kids today getting so many more vaccinations than before? Why are more kids getting diagnosed with autism? Is there a causal link? Why instead of single shots are different shots getting combined into one super cocktail - to save money, cut corners?
If you read Ben Goldacre's books on the pharma and health industry, you will quickly understand that most big pharma medical trials are poorly controlled experiements and mainly used as marketing tools for new products. They will sponsor/allow dozens of tests confirming a positive result, to crowd out one or two better controlled tests which produce a negative result.
Obviously citations needed, but this is from memory.
At the end of the day, parents have tough decisions, use common sense and understand that medicine evolves.
The last few years, doctors recommended kids take Tylenol before vaccinations to help pain management. Now doctors say take Advil, because Tylenol in young infants and children may be linked to asthma and exczema - and some research indicates Tylenol reduces the effectiveness of the vaccine shot itself!
Wakefield was a swindling crook.
http://tallguywrites.livejournal.com/148012.html
> but it did make a lot of people ask questions.
Easily answered questions
> Why are kids today getting so many more vaccinations than before?
Because we now have vaccinations that are safe and effective. The alternative is dead, or crippled, people.
> Why are more kids getting diagnosed with autism?
Because we have more doctors able to diagnose; we have diagnostic criteria; we have parental awareness.
> Is there a causal link?
No.
> Why instead of single shots are different shots getting combined into one super cocktail - to save money, cut corners?
Vaccines that are cheaper and more effective are a good thing. Someone would have to be some kind of fucking half-wit to think otherwise.
EDIT:
> If you read Ben Goldacre's books
... and came away thinking there's any serious risk from vaccinations then you need to re-read the books.
http://www.cdc.gov/flu/about/qa/vaccineeffect.htm?mobile=noc...
The problem is not your ignorance (we're all ignoran of many things), it's the combination of ignorance, willingness to hold a strong opinion on the subject, and simultaneous lack of curiosity to explore the subject.
"The current flu shot is only 9% effective for the elderly and only 56% effective in general, according to CDC figures. CDC officials are baffled why the vaccine is so ineffective in the elderly." NYT
And from the Lancet:
"Background: No published meta-analyses have assessed efficacy and effectiveness of licensed influenza vaccines in the USA with sensitive and highly specific diagnostic tests to confirm influenza.
Findings (Interpretation): Influenza vaccines can provide moderate protection against virologically confirmed influenza, but such protection is greatly reduced or absent in some seasons. Evidence for protection in adults aged 65 years or older is lacking. LAIVs consistently show highest efficacy in young children (aged 6 months to 7 years)."
http://www.thelancet.com/journals/laninf/article/PIIS1473-30...
Heck, if the flu vaccine is so good for you why is it that health-care workers and doctors can't be bothered to get it?
http://www.thelancet.com/journals/lancet/article/PIIS0140-67...
The elderly having a weaker immune system is hardly new knowledge. It's one of the reasons the people they come into contact need vaccinations, so the elderly and young children benefit from herd immunity.
> Influenza vaccines can provide moderate protection against virologically confirmed influenza, but such protection is greatly reduced or absent in some seasons.
Hardly surprising or new info. They put a couple strains in the vaccine based on what they think will crop up that flu season. Sometimes it's wrong and the vaccine doesn't do much good. Sometimes a new threat like H1N1 come up mid-season and they make an additional one.
> Heck, if the flu vaccine is so good for you why is it that health-care workers and doctors can't be bothered to get it?
Because there are just as many idiot doctors and nurses as in the general population? You'll find people who don't believe in evolution as doctors and nurses, too. Hell, my wife's nursing textbook had analyzing auras as a possible care component.
By contrast the post I replied to was asserting that flu vaccine is not effective at all, which is demonstrably false.
The 9% represents elderly people, a target group for the vaccine. I think what's more important is that anyone considering the vaccine should be told that they still need to take precautions with basic hygiene.
The marketing/sales pitch implies too much that getting the shot means they're going to be immune ("be covered this Winter!"). It might result in them getting careless, not washing hands after being on public transport, touching their nose, etc. and getting sick.
What is your evidence that there are unsafe vaccines currently on the market that are being promulgated over safer vaccines due to manufacturer cost?
See, you can't even get that right. Setting aside for a moment the fact that autism rates have continued to increase despite the removal of thimerosal from nearly all vaccines (and that you get a lot more mercury from coal power plant emissions)...
The version of the flu shot that's contraindicated for pregnancy is the nasal spray, which lacks thimerosal because it's a single-dose variant. People at Walgreens/Safeway love the nasal spray.
http://www.cdc.gov/vaccines/hcp/vis/vis-statements/flulive.h... "LAIV may be given to people 2 through 49 years of age, who are not pregnant. LAIV does not contain thimerosal or other preservatives."
Pregnant women have to get the shot, which in multi-dose vials contains the preservative.
http://www.walgreens.com/marketing/library/contents.jsp?doci...
Flu shot by injection does contain thimerosal, unless you get the special version which doesn't. Walgreens and Safeway have a limited supply of it and people have to call ahead to get this special version.
Given that an OB confirmed the above to me and I watched the OB's nurse administer a single shot without thimerosal, I think I'm more right than you on these matters.
Not at all. Sometimes medicines are contraindicated simply because there isn't enough study in the population at question. If the flu shot is known to be safe and the nasal, while believed to be safe, still needs more study in pregnant women, they'll recommend the shot.
> Flu shot by injection does contain thimerosal, unless you get the special version which doesn't.
Some of it does, some of it doesn't. It's a red herring - the safety of thimerosal is long since stablished, attempts from fraudsters like Wakefield notwithstanding.
> Given that an OB confirmed the above to me
Many OBs will spout the American theory that a single glass of red wine is bad for a baby, too. I'll trust the CDC over anecdotes from individual OBs.
If the objective is to do good and save lives, why not give everybody the same "safer" flu shot as given to pregnant women?
Why not eliminate the risk that a few people wander into Walgreens, not knowing they have a weakened immune system, and then get seriously ill or worse, drop dead?
You generally know if you're undergoing chemo, have AIDS, are pregnant, are over 50, etc. The provider administering will jog your memory, too.
> If the objective is to do good and save lives, why not give everybody the same "safer" flu shot as given to pregnant women?
According to Wikipedia, there's evidence it's more effective in young children. As with most medical treatments, there are risks and benefits that must be considered. The fact that it doesn't require a needle also has significant benefits, as fear of needles can be a barrier to vaccination.
By all means, continue the argument from ignorance and personal incredulity, though.
Yes, I do find it quite incredible that questioning the efficacy of vaccines is like a red flag to a bull for some people.
Even though the Lancet has published research examining the flu vaccine's effectiveness, it appears any kind of discussion is strictly forbidden.
I don't want to use the word "fascist" but this discussion has clearly shown that the people who are truly ignorant are those who fail to consider dissenting viewpoints.
I have little patience for the "explain this... oh... well, explain THIS! oh... well..." game vaccine doubters play.
"If this gravity stuff worked like you said, then cars would all be stuck to the ground."
"Well actually, they are."
"Sure, usually, but I saw a picture of a car that landed on top of another car. Clearly there are some flaws in this gravity thing."
"It's true that there are ways to get cars off the ground, but they don't stay off the ground for long, and their behavior still fits entirely within the theory of gravity. This is pretty basic stuff and you should really research it."
And then they call you a "fascist" for "not tolerating dissenting views".
But if you don't want to take the risk, by all means, go for the injection. In fact, my provider has never offered the nasal spray. It's only there because people find it to be more convenient or don't like needles.
Do I get to pose random questions without research? I can only assume you were referring to my question "how much do we know about whether a newborn has a compromised immune system or not?" That seems like a pretty legitimate question, does it not? Do I need a medical degree to pose a question regarding how much medical history we have about your average newborn baby?
Am I crossing some line into medical 'research' by asking that question? When babies are born, do they have clear documented medical histories that I'm unaware of?
You also asked if there were "any vaccines given to newborns that are contraindicated for immune-compromised people".
First we need to define newborns. Wikipedia says hours days or a few weeks old. I couldn't find how the CDC defines newborns.
In the first couple days, the only scheduled vaccine per the CDC is usually Hep B. Whether others are given in the first couple days probably depends on doctors, the baby's health, the parents, the country we're in, etc.
From the CDC: "Hepatitis B vaccination is contraindicated for persons with a history of hypersensitivity to yeast or to any vaccine component (92,189--191). Despite a theoretic risk for allergic reaction to vaccination in persons with allergy to Saccharomyces cerevisiae (baker's yeast), no evidence exists that documents adverse reactions after vaccination of persons with a history of yeast allergy."
So assuming you consider an allergy to be compromising to the immune system (which, by definition, an allergy is), it appears your answer is "yes, there is a vaccine given (or at least recommended) to newborns that is contraindicated for certain immune-compromised people".
Hopefully those contraindicated infants are not given that vaccine, but as I posed earlier, how much do we know about an individual infant's immune system within hours of birth? This probably depends on a lot of things as well - doctors, hospital (or home birth), availability of testing and results, etc.
The RV vaccine is usually given in the first couple months, where the 'newborn' label could still apply depending on how you use the word. RV is contraindicated for SCID.
Below is a full list of contraindications for several vaccines, listed on the CDC website.
http://www.cdc.gov/VACCINES/recs/vac-admin/contraindications...
An allergic reaction is an overreaction of the immune system to a normally harmless material. "Immune compromise" is a weakening of the immune system. These are, you might note, almost exact opposites. People with weak immune systems won't generally suffer allergic reactions, because an allergic reaction requires the immune system to overreact, and "weak" generally precludes an overreaction. At worst, they wouldn't suffer anything worse than a normal person.
Now, this does raise an interesting question, namely: are newborns ever allergic to this stuff? Could it cause a problem? The answer to the second would seem to be "no" given your CDC quote that there's no evidence for adverse reactions, and that would render the first moot. However, it's still an interesting question, but you'll notice that it's a completely different question from what you asked.
Is your question legitimate? Of course. My point is that mine was legitimate too, but when I posed it, I got a stupid "GIYF" response from you. Apparently you think you have the right to ask questions without research, but I don't. That double standard annoys me.
Worse, you don't even know what you don't know. You get the relationship between allergies and weakened immune systems completely wrong, yet you state that wrongness as fact, so obvious that you call it "by definition".
And then, when I call you out on this bad behavior, I imagine you'll call me a "fascist" and say that I'm "suppressing dissenting views" or some such crap. The reality is, I welcome dissent, but only intelligent dissent. You're not providing it.
Edit - I'm not sure how far you got in my last post, but if we're going to pick about allergies not being a compromised immune system, SCID is the reason for contraindication for RV.
And to be honest, no, I did not read the end of your post. I stopped at the moment I got to that completely ludicrous statement that an allergic reaction qualifies as an immune system compromise. This is not some obscure detail, this is an extremely basic fact about how the immune system works.
Agreed that it's not nitpicking to know why vaccines cause a potential danger - overactive or underactive immune systems obviously react (or don't) in different ways, but I understood the nature of the question to be much less specific (are vaccines contraindicated in the sick, instead of are vaccines contraindicated in this specific group of sick people).
What you point out is not an obscure detail, but if the spirit of the conversation were how I had interpreted it, the detail wouldn't be relevant. I focused more on the vaccine being recommended to sick people and not people sick with x.
This whole thing got started when I replied to a comment you made stating "A weakened immune system is not a condition you can really have without realizing it."
My response was a rhetorical question about how we don't know about a newborn's immune system. If it wasn't clear that "how much do we know about whether a newborn has a compromised immune system or not" was a rhetorical question, I apologize for not making that more clear, but I think the question has an obvious answer and I didn't ask it to get your opinion. If you feel that question has an answer other than "very little", feel free to elaborate.
The reason I asked that question is that your statement that one cannot have a weakened immune system without knowing only applies to adults, as baby in the first moments does not have a medical history. So yes, someone can have a weakened immune system without anyone knowing it, but likely that would be at birth and in the earliest days of lives - when some vaccinations take place. As one gets older, weakened immune systems might become more evident, but they would be least evident at birth. I'm not sure we can debate that as anything but fact, but I'm certainly willing to listen to dissenting views on that.
So I ask a rhetorical question, and your response is to pose a question to me - "Are there any vaccines given to newborns that are contraindicated for immune-compromised people? That strikes me as rather unlikely."
Your question clearly wasn't a rhetorical question, and was something that someone could just look up (thus, the Google comment). I could have said 'I believe there are but don't care to look them up', but I figured you'd just look them up yourself and that would be the end of it. I was aware that there were some vaccines that were contraindicated for certain allergies and other conditions, mainly because I wasn't able to get certain vaccines as a child.
I'm honestly not sure why you didn't just look it up, unless you were more interested in my response than what you would have found on your own. But I did answer it, yet you chose to pick apart the one answer
Your response to that was "So you get to pose random questions without research, but I don't? How's that work?" I wasn't posing a random question, and my rhetorical question really shouldn't require research. Again, I think the answer was pretty obvious - if someone has a very brief lifespan, the person would likely have little medical history. There is a double standard about being expected to answer rhetorical question vs answering a factual question that you could also look up.
The answer to your question was clearly something you could have found on your own, but you asked me instead. Were you looking for an answer, or just looking to see how I'd answer it?
So I write out a longer reply, which you find some flaws with. You don't reference the part about RV/SCID in your reply, which seems to be the most relevant part of my response. That was the question you asked, yet you didn't even acknowledge the answer.
An allergy is not indicative of a weakened immune system, and I could have worded that a bit better. The person with allergies is 'compromised', and having an overactive immune system does compromise an individual. Having incredibly low blood pressure is dangerous, and having incredibly high blood pressure is dangerous too. Both indicate a compromised system that is not in balance, just as severe allergy and a condition such as SCID are impairments.
Whether or not an immune system is overactive (allergy) or weakened, I think using the term 'compromised' might have been the issue. Instead of "assuming you consider an allergy to be compromising to the immune system ", I could have left off at 'compromising'.
I did reference RV and SCID in the post as well, but you didn't reference those in your reply. I think your question, as asked literally, would be answered by RV being contraindicated in SCID cases. I answered the question as if you'd asked if vaccines were contraindicated in people with 'immune system irregularities' instead of 'immune system deficiencies'. The difference is, in my opinion, splitting hairs for the purpose of our dialogue, but that was what you chose to go with.
So yes, RV is contraindicated in SCID patients, and RV is recommended for newborns if you use the term newborns to indicate weeks instead of days. Hep B is not contraindicated for infants with weakened immune systems, but is contraindicated for infants with irregular immune systems that might be overreactive to yeast.
Regarding the calling out on bad behavior, I don't think I've behaved badly unless you somehow feel that my failure to clarify the difference between a weakened immune system and an overreactive one is a sin. What we are discussing here are mostly facts, not really opinions, and there really isn't much room for actual dissent. I have not problem with your opinions, as you haven't really provided any other than your opinions on my comments. I don't think you're suppressing any views. I'm not really providing opinions here, just facts for the most part (with the obvious clarification necessary to define allergy as irregular immune system instead of weakened).
Speaking of cost, my HMO gives my family flu vaccines for free. The only reason they would do this is if they think it's cheaper for them overall, because the campaign reduces doctor visits. They may be motivated solely by profit, but in this case, their desire for profit lines up with my desire for health.
I can't believe you seriously ask why kids are getting so many more vaccinations than before. You might as well ask why kids are getting so many more surgeries than before. Kids get more vaccines today because more vaccines are available. Obviously, kids weren't getting flu vaccines before the flu vaccine was actually developed.
"The current flu shot is only 9% effective for the elderly and only 56% effective in general, according to CDC figures. CDC officials are baffled why the vaccine is so ineffective in the elderly." NYT
And from the Lancet:
"Background: No published meta-analyses have assessed efficacy and effectiveness of licensed influenza vaccines in the USA with sensitive and highly specific diagnostic tests to confirm influenza.
Findings (Interpretation): Influenza vaccines can provide moderate protection against virologically confirmed influenza, but such protection is greatly reduced or absent in some seasons. Evidence for protection in adults aged 65 years or older is lacking. LAIVs consistently show highest efficacy in young children (aged 6 months to 7 years)."
http://www.thelancet.com/journals/laninf/article/PIIS1473-30...
Heck, if the flu vaccine is so good for you why is it that health-care workers and doctors can't be bothered to get it?
http://www.thelancet.com/journals/lancet/article/PIIS0140-67...
That's a shitty analogy.
If an aftermarket add-on made old people 9% less likely to get in a car accident, and the general public 56% less likely to, I'd consider that pretty awesome.
Brake failure sends you into the car in front of you. Flu shot failure means you might wind up with the flu - but if everyone else around you got their shot, you're going to be better off.