Measles: To Disneyland and Beyond

[jjenny]

Don’t Let the Measles Destroy Parental Rights

https://unitedfamiliesinternational...dont-let-the-measles-destroy-parental-rights/

Fairly preventable disease (that's what the author calls it)? As far as I can tell measles is only preventable by vaccination. If concern about parental rights is going to help spreading highly infectious disease around, what are we supposed to do about it? Nothing?

 

[LinasK]

I would have thought the opposite, if anything. The vaccination puts stress on your immune system making you more susceptible to other infections. What do our medical folk think?

That was three weeks ago I got the shot, and although I think it might have prolonged the cold I had at the time, I think it shortened this stomach virus compared to my friend, who didn't get the flu shot.

 

[chlban]

Exactly. Not a single reputable study showed that vaccinations cause regressive autism.

So maybe people should reconsider taking medical advice from Jenny McCarthy?

 

[chlban]

We do quarantine people with communicable diseases. Right now there are people sitting at home with their children because these children were exposed to measles. They are in quarantine.
Why should we waste valuable resources because some people refuse to vaccinate their healthy children?
And for child with cancer, measles could be a death sentence.
They can't be vaccinated so they depend on "herd immunity." But because not all people are vaccinating, we are losing our "herd immunity."

I can see the argument about personal or religious freedom, so I would say if you don't want to vaccinate your child, then don't. However they will not be allowed in the public school system without being vaccinated, for the protection of the other children.

 

[jjenny]

I can see the argument about personal or religious freedom, so I would say if you don't want to vaccinate your child, then don't. However they will not be allowed in the public school system without being vaccinated, for the protection of the other children.

The problem is, they are still allowed in public places such as Disneyland.

 

[Ellmau]

The time I worry most about unimmunized people is when a woman who wasn't immunized becomes pregnant. Being exposed during pregnancy can cause serious damage to the fetus, and there isn't anything that can be done to correct it once the damage is done. (I have no links for that, it's just knowledge from books, pamphlets and video I saw years ago about it.) Avoiding people with measles isn't enough to prevent it since they are contagious before they show any signs of illness. I don't understand gambling with your child's life that way, but others probably say the same thing about me and some of the things I've done in my life.

MOO

If you want to see the result of what happens when a pregnant woman gets rubella (German measles, the R in the MMR combined vaccine) the gentleman in this story has various disabilities as a result of his motehr getting the disease in a pre-vaccine era:

http://www.dailymail.co.uk/news/art...fund-raising-money-total-reaches-329-000.html

http://www.**************/1805154/fund-for-attacked-disabled-pensioner-alan-barnes-passes-300000/

http://www.**************/1805154/fund-for-attacked-disabled-pensioner-alan-barnes-passes-300000/

 

[MyBelle]

The problem is, they are still allowed in public places such as Disneyland.

Aren't the non-immunized also the only ones at risk? I'm not seeing what the big deal is all about.

 

[Curiosum]

Yes, that's true. There have been two studies that found no increase. And one was a sizeable population in Denmark. But here's a study that found a link: http://www.ncbi.nlm.nih.gov/pubmed/21058170

A few thoughts about this study:
-Lets begin by considering that this is a limited population (i.e. US boys) so generalizability is a bit limited.
-Validity concerns exist because the study is based on a self reported diagnosis without confirmation (because the data was taken from NHANES), and is retrospective in nature.
-Although the total study population was a decent size the autism group had only 33 children. Of those 9/31 had received Hep B in the first month of life. Meanwhile among children without autism 1,258 out of 7,455 received Hep B in the first month.
-I do find it interesting that the prevalence of autism is actually technically lower in the group of kids who received the vaccine (1/241) than those who didn’t (1/238). The differences between the groups are not significant.
-I also find it interesting that although their adjusted OR was 2.94 (so boys who received Hep B in the first month of life were 2.94 times more likely to go on to be diagnosed with Autism later) but their 95% CI was very wide (1.10-7.9) and I suspect their 99% CI would have actually eclipsed one. This fits with prevalence data shared above and causes me to question what exactly they did to get the OR they are reporting. It is also interesting that their subset OR for non-hispanic white boys was actually 0.385 meaning that in this group the Hep B birth dose would be presumed to be protective against autism—ok?
-Honestly, if I look at this as an epidemiologist (and I do have a MPH in Epidemiology so I can do this), I have to wonder if this was really just a "data fishing expedition” looking for some vaccine/autism association and the Hepatitis B association stuck out the most so the authors just kept manipulating their logistic regression until they got a decent odds ratio and then backtracked to come up with a methodology which would yield the data set they wanted to work with. For the record, I am not stating this is what the authors did and it would go against the ethics of the field if they had so perhaps they just didn’t put sufficient effort into their introduction and methods section and they really were only interested in looking at the association between boys who received hep B as neonates and autism. That doesn’t really explain why they included kids born way before Hep B was added to the routine immunization schedule and it is things like that and the vagueness about how they used logistic regression to control for confounders (which would be a great opportunity for a less ethical researcher to do some data massaging) which make me question. *For the record, I am not against established data set use studies. My honors thesis involved the first cohort look at C. jejuni infection and Guillain Barre Syndrome and it used the SPARCs data. At the time the association was suggested but a true cohort study had not been done and we realized that we had an opportunity to do this. What was important was that our methodology (including population, controlling variables, etc) was clearly defined before we ever touched the data and we didn’t change our plan to get a stronger association.*

**Also please note that Thimerosal (which was never shown to be causative for Autism anyway just for the record) was removed from Hep B (and all other vaccines except multi dose vials of seasonal influenza) in 2000. This is just FYI information for any parents out there making immunization decisions in the here and now.**

 

[MsFacetious]

Aren't the non-immunized also the only ones at risk? I'm not seeing what the big deal is all about.

If your kid gets cancer they can't be immunized.
If your child has an immune system issue, they may not be able to be immunized.
If your child is allergic to the vaccine, they may not be able to be immunized.

They would be "non-immunized" but not by choice.
And Disneyland is a common place for "Make A Wish" which is often kids who can't be immunized. :twocents:

 

[MyBelle]

If your kid gets cancer they can't be immunized.
If your child has an immune system issue, they may not be able to be immunized.
If your child is allergic to the vaccine, they may not be able to be immunized.

They would be "non-immunized" but not by choice.
And Disneyland is a common place for "Make A Wish" which is often kids who can't be immunized. :twocents:

If children are ill such as with cancer, shouldn't they wear masks in crowded places to protect them from not just measles but also viruses such as flu and common cold?

 

[blue22]

I can see the argument about personal or religious freedom, so I would say if you don't want to vaccinate your child, then don't. However they will not be allowed in the public school system without being vaccinated, for the protection of the other children.

But personal opinions don't really matter while there is legal exemptions that public schools have to honor.

I don't see states like mine (Texas) getting rid of these exemptions anytime soon.

 

[blue22]

Something I've found really interesting in this debate (not necessarily here, but in the population at large,) is how no one is talking about adults. I know VERY few adults who are fully vaccinated for anything. There are parents themselves who aren't fully vaccinated calling for forced vaccination of all children. I think adults should also be focused on. More children in our country are fully vaccinated, than adults. The adult vaccinated rate is very low. Adults are passing on diseases and it's not being talked about. Yet, I don't hear anyone talking about suing adults who don't vaccinate themselves. Ironic.

 

[chlban]

The problem is, they are still allowed in public places such as Disneyland.

Yes, but it goes back to the "herd" theory. Far less chance of it spreading if the majority is immunized. You will always have certain portions of the population, such as a child that has been undergoing Chemotherapy, or some other type of genuine medical reason that needs to be exempt. That has been true for decades, yet measles was gone fom the US. What brought it back was this nonsense about vaccines and autism.

 

[nrdsb4]

If children are ill such as with cancer, shouldn't they wear masks in crowded places to protect them from not just measles but also viruses such as flu and common cold?

Absent from that list are healthy babies under one year of age. The vaccine is not recommended until one year old because younger than that, not all of them will seroconvert. Don't think healthy babies should have to be masked every time they are in public because others won't vaccinate, hoping to cruise in on herd immunity. JMO

 

[gitana1]

This thread has been a pleasure to read. Truly.

Thanks to everyone on both sides of the debate for your eloquent posts, informative links and opinions.

I have been vaccinated and so have my children. (now adults). I think it was the right (and smart!) thing to do.

CoolJ: I used to be like you wrt medications. In so many ways, I still am. Whether anyone likes it or not, some doctor's (and big pharma) are "drug-pushers".....DON'T throw stuff at me for saying that because we all know it's true, in some instances. (not for life threatening illnesses)

I won't derail the thread though but it would be nice to have a meaningful discussion about this in the basement.

Off to take my inhalers now. I like breathing. Without them, I'd be dead.

Ha ha. I'm with you. I wouldn't hsve made it past 12 if not for modern medicine. (Also need inhalers here!)

Fairly preventable disease (that's what the author calls it)? As far as I can tell measles is only preventable by vaccination. If concern about parental rights is going to help spreading highly infectious disease around, what are we supposed to do about it? Nothing?

Ive been pretty vocal about what can be done. Vaccines became widespread and commonly accepted due to rational education. Not telling those with fears that they are stupid, selfish or criminal.

I think need to back off the panicked vitriol against people opposed or concerned and begin calm and simple education programs like we used to have in the 50's etc. PSA's explaining the studies- who was tested an what the results were. Repeatedly.

Also, no religious exemptions for those who go to public schools or work in government jos, the medical ie
field, etc. I think that's already the case with hospitals. Religious freedoms can be restricted when the greater good outweighs the right being taken away. In this case, workers who work with populations who are often sick (emergency calls for police, fire and paramedics often involve sick people), means their risk of being exposed or spreading a disease to fragile populations, is huge. As actually, besides Christian science, I don't think any religion is against vaccines. No philosophical exemptions for those people either.

The problem is, they are still allowed in public places such as Disneyland.

As to Disneyland, they are a private business and and have great grounds for excluding unvaccinated people when there are outbreaks. I doubt this outbreak is considered serious enough for that though.

But children with compromised immune systems should not be going to busy public places anyhow. Flus, colds, and a million other diseases are easily spread in such places. I see newborns at airports and casinos, malls and Disney. Insane. Those are all cesspools of bacteria and viruses. Lots of foreigners at those places, some bringing diseases we don't typically see, as well.

 

[gitana1]

A few thoughts about this study:
-Lets begin by considering that this is a limited population (i.e. US boys) so generalizability is a bit limited.
-Validity concerns exist because the study is based on a self reported diagnosis without confirmation (because the data was taken from NHANES), and is retrospective in nature.
-Although the total study population was a decent size the autism group had only 33 children. Of those 9/31 had received Hep B in the first month of life. Meanwhile among children without autism 1,258 out of 7,455 received Hep B in the first month.
-I do find it interesting that the prevalence of autism is actually technically lower in the group of kids who received the vaccine (1/241) than those who didn’t (1/238). The differences between the groups are not significant.
-I also find it interesting that although their adjusted OR was 2.94 (so boys who received Hep B in the first month of life were 2.94 times more likely to go on to be diagnosed with Autism later) but their 95% CI was very wide (1.10-7.9) and I suspect their 99% CI would have actually eclipsed one. This fits with prevalence data shared above and causes me to question what exactly they did to get the OR they are reporting. It is also interesting that their subset OR for non-hispanic white boys was actually 0.385 meaning that in this group the Hep B birth dose would be presumed to be protective against autism—ok?
-Honestly, if I look at this as an epidemiologist (and I do have a MPH in Epidemiology so I can do this), I have to wonder if this was really just a "data fishing expedition” looking for some vaccine/autism association and the Hepatitis B association stuck out the most so the authors just kept manipulating their logistic regression until they got a decent odds ratio and then backtracked to come up with a methodology which would yield the data set they wanted to work with. For the record, I am not stating this is what the authors did and it would go against the ethics of the field if they had so perhaps they just didn’t put sufficient effort into their introduction and methods section and they really were only interested in looking at the association between boys who received hep B as neonates and autism. That doesn’t really explain why they included kids born way before Hep B was added to the routine immunization schedule and it is things like that and the vagueness about how they used logistic regression to control for confounders (which would be a great opportunity for a less ethical researcher to do some data massaging) which make me question. *For the record, I am not against established data set use studies. My honors thesis involved the first cohort look at C. jejuni infection and Guillain Barre Syndrome and it used the SPARCs data. At the time the association was suggested but a true cohort study had not been done and we realized that we had an opportunity to do this. What was important was that our methodology (including population, controlling variables, etc) was clearly defined before we ever touched the data and we didn’t change our plan to get a stronger association.*

**Also please note that Thimerosal (which was never shown to be causative for Autism anyway just for the record) was removed from Hep B (and all other vaccines except multi dose vials of seasonal influenza) in 2000. This is just FYI information for any parents out there making immunization decisions in the here and now.**

You've made some though provoking, very logical points. We need more of this kind of explanation publicized, without accompanying rhetoric that I hear from some angry doctors. Just quiet, rational explanations. I think that would really help. You've educated me.

 

[gitana1]

But personal opinions don't really matter while there is legal exemptions that public schools have to honor.

I don't see states like mine (Texas) getting rid of these exemptions anytime soon.

I dont either. But it could happen if outbreaks became widespread and clearly deadly.

 

[MyBelle]

Absent from that list are healthy babies under one year of age. The vaccine is not recommended until one year old because younger than that, not all of them will seroconvert. Don't think healthy babies should have to be masked every time they are in public because others won't vaccinate, hoping to cruise in on herd immunity. JMO

Shouldn't the decision about wearing a mask rest with the parent?

If a parent takes their baby out into crowds, that's always their choice. There is no vaccine for RSV or the common cold.

 

[gitana1]

Well, it's in multiple sources, but from the CDC:



http://www.cdc.gov/vaccines/pubs/pinkbook/meas.html#measles

Measles is highly contagious among unvaccinated individuals:

Oh. That's a bit different from what I was saying. Which is that I think an unvaccinated person has a 100% chance of contracting the measles if someone with a nose full of it, sneezed directly in the unvaccinated person's face. I don't know how anyone could fight off infection under that scenario no matter how many supplements they take.

 

[K_Z]

Just so we're all clear here, disposable paper face masks are not sealed "respirator" masks. There are a variety of masks available, and there is a lot of research out there discussing effectiveness of various types of masks, against various vectors of infection. Some are not very effective at all at preventing droplet transmission.

In many Asian countries it is considered polite to wear a cloth or disposable mask all day if you have a cold or cough, so you see a lot of people wearing them out and about in society.

Here in the U.S., people with vulnerable immune systems don a mask when they have to go out into crowds. Some clinics and hospitals urge people with a respiratory illness or cough to wear a mask in the waiting room.

Masks are not a "panacea" against spreading disease by the infected, or exposure for the immunologically vulnerable. They are probably better than nothing at all, but by no means are most simple "ear loop" paper masks a complete barrier to transmission or infection. I don't want to get into a big discussion about particle size, filtration, droplets, mask varieties, etc. But just know that most disposable masks are probably more of a physical barrier than a true respiratory barrier, and that they are a good visual reminder to take precautions, avoid crowds and obviously sick people, and wash hands more often. They don't guarantee the wearer will not transmit disease, or prevent exposure to someone with a weak immune system.