Sorry it's taken so long to give a more researched
response to the vaccine issue, but here goes-
--- [EMAIL PROTECTED] wrote:
> > Sonja wrote-
> > Well that's just it. Some of the vaccinations can
> seriously debillitate a
> > child or even kill it. I'd like to know about
> those risks, _all_ the risks.
> > In the Netherlands the former minister of health
> Els Borst said that it
> > wasn't necesary for parents to have the full
> information as to what side
> > effects certain vaccines hold, because they only
> occur in few cases and too
> > much information would only make parents worry
> too much.
Ugh. Well, it's generally true that known vaccine
side effects are few, but if it happens to _your_
child, that 'less than 0.1%' just became 100% for
him/her. On the other hand, the truly debilitating
effects of the wild-type infection are much more,
percentage-wise, than the vaccine, in many cases. One
example, measles:
"Measles-related mortality, most often due to
respiratory and neurological complications, occurs in
0.1-0.3% of reported US cases.
Worldwide, measles causes approximately 880,000 deaths
each year. An estimated 85% of these deaths occur in
Africa and Southeast Asia. Case fatality rates are
higher among children younger than 5 years. Highest
fatality rates are among infants aged 4-12 months and
in children who are immunocompromised due to HIV
infection or other causes." {from a 2001 article}
"Measles encephalomyelitis is a complication in
1/1000-2000 wild-type cases in the US; some of these
will have permanent brain damage such as deafness.
Complications are more likely in unexposed adults or
debilitated (malnourished or immunocompromised)
children." {from a 2002 article}
"Moderate-severity vaccine complications from the MMR
(measles, mumps, rubella) vaccine: febrile seizures
(high fever from _any_ source can cause a seizure) 1
in 3000 doses; temporary joint pain/stiffness (more
prevalent in teen & adult women) 1/4 doses; temporary
decrease in platelet count that can lead to bleeding
problems 1/30,000 doses.
Severe allergic reaction (potentially fatal) less than
1/million doses; 'possible-related' deafness or brain
damage also ~ 1/million." {CDC data}
So, wild-type measles has a kill rate of
1-3/thousand(in the US); vaccine mortality is
1/million or less. (And the vaccine is for 3 viruses,
not just measles.)
There was an article on a recent outbreak of measles
in an undervaccinated population in The Netherlands,
with ~ 25% complication rate, which is higher than
usual (of 162 cases, 1 delirium, 9 pnemonia, 9 middle
ear infection).
http://www.cdc.gov/ncidod/eid/vol7no3_supp/vandenhof.htm#Figure%202
>[Sonja] I find that
> > insulting to my intelligence. As I found out it
> is rather difficult to find
> > any information as too side effects of vaccines.
I don't know what vaccines you're required to get in
The Netherlands, but a good site to start with in the
States is the CDC's immunization page; you can click
on the VIS (Vaccine Information Statement) to get
individual vaccine information. Many of the sites are
available in other languages.
http://www.cdc.gov/nip/
> At the moment I'm deciding
> > on whether or not to vaccinate Tom with a new
> vaccine, it is against
> > menigitis C. It hasn't been around for all that
> long (about year) and in
> > order to get all children vaccinated medics have
> been rather shady as to the
> > sort of side effects it can cause, that is side
> effects in the short term,
> > because they simply don't know about any long
> term effects. Also it is a
> > vaccine that only vaccinates against the much
> less common (although there
> > has been an increase in the number of cases over
> the past few years)
> > meningitis C not the much more feared meningitis
> B.
I think the 'B' you're refering to is _Haemophilus
influenzae_ type B; there isn't a decent vaccine
against _Neisseria menigitidus_ type B, but there is
one against _Nm_ type C.
Meningococcus has several variant types, one of which
is type C.
>From the CDC:
"Four vaccines protect against some, but not all, of
the bacteria that cause meningitis. The vaccines are:
7-valent pneumococcal conjugate (Prevnar�)
23-valent pneumococcal polysaccharide
(Pneumovax� 23 and Pnu-Imune� 23)
Haemophilus influenzae type b conjugate (Hib)
Quadrivalent A,C,Y,W-135 meningococcal polysaccharide
(Menomune�).
Two of the vaccines, pneumococcal conjugate and Hib
conjugate, are usually given to all infants and young
children.
"The pneumococcal polysaccharide vaccine does not work
well in children under 2 years old and is not
recommended for this age group. It is used in older
children and adults. Pneumococcal polysaccharide is
recommended for all adults 65 years of age and older
and for children and adults with certain medical
conditions.
"The meningococcal polysaccharide vaccine is
recommended only for persons with certain medical
conditions and for persons who may come into contact
with the bacteria that cause meningococcal meningitis.
It also does not work well in children under age 2
years."
Currently, meningococcal vaccines are not _routinely_
used for children in the US (although that may change
for children with cochlear implants); here is the 2002
schedule:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5102a4.htm
This is the CDC paper on meningococcal vaccine (from
March, 2000):
http://www.cdc.gov/nip/publications/VIS/vis-mening.pdf
However, recent use in the UK has proven effective
against _Nm_ type C:
"Conjugate vaccine for group C meningococci... appears
to be immunogenic in young children and was
administered to all children during 1999-2000 in the
United Kingdom. In January 2001, the short-term
effectiveness of this vaccine in England was reported
to be 97% for teenagers and 92% for toddlers. These
early results confirm the superiority of this vaccine
compared with plain C polysaccharide vaccines, which
are ineffective in young children. Conjugate vaccine
is not yet available in the US."
{from a 2002 paper}
When I did a Medline search for side effects with _Nm_
group C vaccine, the only relevent article that
returned was from 1994:
"During an outbreak caused by group A Neisseria
meningitidis in March 1992 [in Saudi Arabia], groups A
and C meningococcal polysaccharide vaccine was
administered to 1,168 children aged from 2 to 18
years. Parents were surveyed to ascertain reactions of
children to the vaccine and development of invasive
group A meningococcal disease after immunization. The
most common reactions were mild local pain (21.9%),
erythema (12.2%), and swelling at the injection site
(7.2%). Only 1.7% of the children experienced fever
and 3.7% displayed irritability. The vaccine was well
tolerated and all adverse reactions disappeared within
24-48 hours of immunization. No cases of meningitis or
sepsis caused by group A meningococci were seen in the
1st 12 months of observation among the vaccinated
children." This is a small number of children.
Searching for "adverse effects" only added a Dutch
2002 article:
"The Health Council of the Netherlands
(Gezondheidsraad) assessed the vaccination of infants
against both group-C meningococci and pneumococci in
terms of general criteria and basic principles for
inclusion in the national vaccination programme.
Vaccination against meningococci C in the Netherlands
is expected to prevent about 300 cases of
meningococcal disease (meningitis or sepsis), 22
deaths and 12 cases of severe lasting problems
(neurological problems or amputations) per year."
Later there is mention of the need to monitor for
potential adverse effects...
[Dee wrote]
<snippage>
> (I still don't even think about the supposed
> anthrax vaccine they give the military/DOL/etc)
And it is difficult to find reliable information on
that one; this is from the CDC's 2000 paper:
http://www.cdc.gov/nip/publications/VIS/vis-anthrax.pdf
Because relatively few people get this vaccine, side
effects may not be 'tagable' as such; I certainly
would not get it without extremely good reason. One
of the other problems with the 'shotgun' approach for
military personnel is that no good studies have been
done on the effects of getting multiple vaccines
_plus_ the anti-chemical-warfare drugs; one theory
holds that this was a/the cause of Gulf War Syndrome.
> The recent movement in this state is mandatory
> chicken pox vaccine over the
> next 3 years. (I recently heard this vaccine can
> only be given once- not so
> sure about that, but looks like we move from
> uncomfortable kids to
> uncomfortable adult chicken poxers :-)
The vaccine, only in use since 1995 in the US
(although considerably longer elsewhere - Japan and
India, for example, for ~ 2 decades), is supposed to
confer permanent immunity, much as the wild infection
does, but in infants it may have greatly decreased
effect, and so perhaps there will have to be a booster
shot... here is the abstract from a 2002 article:
"Although varicella vaccine is recommended for
infants, many physicians and parents have withheld
vaccination from infants because of concerns about the
vaccine's long-term efficacy. We used a
decision-analytic Markov model to examine the effects
of decreasing vaccine efficacy on individuals and
society. The model incorporated published data on
age-specific incidence, morbidity, and mortality
rates, as well as data on shifting disease burden from
childhood to adulthood as vaccine compliance
increases. The effects of 2 vaccination
strategies---vaccinating infants at age 12 months and
waiting to vaccinate until children are 10 years of
age---were compared with the effects of no
vaccination. If the efficacy of the vaccine were to
decrease by 75%, then 50% compliance with vaccination
at age 12 months would save 1800 life-years and 12,800
quality-adjusted life-years annually in the United
States. The quality-adjusted life expectancy of
individuals vaccinated at age 12 months would be 63 h
longer than that of nonvaccinated individuals and
would increase to 79 h as vaccination compliance
increases and the burden of chickenpox shifts to
adulthood. Varicella vaccination of infants at age 12
months appears to be beneficial, even if the efficacy
of the vaccine declines substantially."
We know that herpes zoster can occur in vaccinated
people (herpes zoster, aka shingles, is the
reactivation of chickenpox virus, which has been
'hiding out' in the spinal cord for years/decades);
whether it is less or as severe is unknown at this
time. From a 2000 article abstract:
"Since its licensure in 1995, the extensive use of
varicella vaccine and close surveillance of the
associated anecdotal reports of suspected adverse
effects provide the opportunity to detect potential
risks not observed before licensure because of the
relatively small sample size and other limitations of
clinical trials. OBJECTIVES: To detect potential
hazards, including rare events, associated with
varicella vaccine, and to assess case reports for
clinical and epidemiological implications. DESIGN AND
SETTING: Postlicensure case-series study of suspected
vaccine adverse events reported to the US Vaccine
Adverse Event Reporting System (VAERS) from March 17,
1995, through July 25, 1998. MAIN OUTCOME MEASURES:
Numbers of reported adverse events, proportions, and
reporting rates (reports per 100,000 doses
distributed). RESULTS: VAERS received 6574 case
reports of adverse events in recipients of varicella
vaccine, a rate of 67.5 reports per 100,000 doses
sold. Approximately 4% of reports described serious
adverse events, including 14 deaths. The most
frequently reported adverse events were rashes,
possible vaccine failures, and injection site
reactions. Misinterpretation of varicella serology
after vaccination appeared to account for 17% of
reports of possible vaccine failures. Among 251
patients with herpes zoster, 14 had the vaccine strain
of varicella zoster virus (VZV), while 12 had the
wild-type virus. None of 30 anaphylaxis cases was
fatal. An immunodeficient patient with pneumonia had
the vaccine strain of VZV in a lung biopsy. Pregnant
women occasionally received varicella vaccine through
confusion with varicella zoster immunoglobulin.
Although the role of varicella vaccine remained
unproven in most serious adverse event reports, there
were a few positive rechallenge reports and
consistency of many cases with syndromes recognized as
complications of natural varicella. CONCLUSION: Most
of the reported adverse events associated with
varicella vaccine are minor, and serious risks appear
to be rare. We could not confirm a vaccine etiology
for most of the reported serious events; several will
require further study to clarify whether varicella
vaccine plays a role."
Wild-type versus vaccine data: {from a 2002 article}
"In the US: Before varicella vaccine use became
widespread, 4 million cases of chickenpox were
reported annually. The disease was responsible for
11,000 hospitalizations each year and approximately
50-100 deaths.
Internationally: Varicella affects nearly all children
who do not have immunity. Annual incidence is
estimated at 80-90 million cases.
Mortality/Morbidity: In otherwise healthy children
aged 1-14 years, the mortality rate is estimated at 2
deaths per 100,000 cases.
Most deaths in the United States before universal
vaccination were from associated encephalitis,
pneumonia, secondary bacterial infection, and Reye
syndrome."
"Risk factors for severe varicella include the
following:
A neonate's first month of life, especially if the
mother is seronegative. Delivery before 28 weeks of
gestation also renders a baby susceptible because
transplacental transfer of immunoglobulin G (IgG)
antibodies occurs after this time.
Adolescence and adulthood
Steroid therapy: High doses for 2 weeks or more are
definite risk factors for severe disease. Even
short-term therapy at these doses immediately
preceding or during the incubation period of varicella
can cause severe or fatal varicella.
Malignancy: All children with cancer have an increased
risk for severe varicella, highest for children with
leukemia. Almost 30% of patients who are
immunocompromised and who have leukemia have visceral
dissemination of varicella; 7% may die.
Other immunocompromised state eg, malignancy,
antimalignancy drugs, HIV, other congenital or
acquired immunodeficient conditions.
Pregnancy: Pregnant women have high risk of severe
varicella, especially pneumonia."
So, if I were/had a teen or adult who had never had
chicken pox, I would definitely get the vaccine.
Some diseases clearly are worse or have potentially
much worse outcomes than the vaccine: polio and
measles, frex.
Some vaccines are not worth the risk of general
exposure at this time, because of the low probability
of it occuring in the population, like anthrax and
smallpox. (Of course, in case of biological warfare,
that would change.)
It's a calculated risk, either way.
Debbi
__________________________________________________
Do you Yahoo!?
Faith Hill - Exclusive Performances, Videos & More
http://faith.yahoo.com
_______________________________________________
http://www.mccmedia.com/mailman/listinfo/brin-l
