Too many falsehoods, too often

11 Oct

ResearchBlogging.orgThere are a number of falsehoods used in the vaccine-rejectionist arsenal. One, which we’ve discussed recently, is the idea that vaccine preventable diseases are in reality “not that bad.” Another is that deaths from vaccine preventable diseases were decreasing before vaccines were introduced, implying that the vaccines are getting credit for something that was already happening. Another is that somehow we are “overvaccinating” and that we can go back to an earlier schedule and be just fine. Another is that we vaccinate children too young.

We all know the current catch phrases. And that’s what they are, slogans, catch phrases…the efforts of marketing rather than science.

But, let’s take a look at a paper that covers a number of these falsehoods at once. This is an older paper, from 1994. The paper is National Trends in Haemophilus influenzae Meningitis Mortality and Hospitalization Among Children, 1980 through 1991.

As you can imagine, they were looking at the reduction in deaths and hospitalizations from meningitis caused by Haemophilus influenzae. This is what the Hib vaccine protects against. The first Hib vaccine licensed in the U.S. came out in 1985. However, it didn’t work for children >18 months of age, and had only moderate effectiveness for older children. A more effective vaccine was licensed in 1987 for children >18 months, and in 1990 for children >2 months.

Bottom line, good protection against Hib meningitis came to the U.S. in 1987.

So, if this actually worked, we should see trends changing about that time. Take a look at Figure 1 from the paper. (click to enlarge)

U.S. Hib deaths by year 1980 to 1991

The top trend is for Hib induced meningitis. The other two datasets are for Streptococcus pneumoniae and Neisseria meningitidis induced meningitis.

Note that the mortality was dropping with time before the introduction of the vaccine. Deaths declined by 40% from 1980 to 1987 (a span of 8 years) for Hib meningitis (with similar big drops in the other types). Dang. Good job, docs! But, that’s only part of the story. Take a look at what happens after 1988. Hib meningitis deaths drop at a much faster rate. After the introduction of the vaccine, Hib meningitis deaths dropped 90% in only 4 years.

But, you don’t have to geek out like me on the numbers, just look at that trend–in 4 years, Hib meningitis went from the highest cause of meningitis deaths, to tied with the lowest in this comparison.

That’s the sort of data that the mercury-causes-autism crowd were expecting to see in the autism rates starting a couple of years ago. (but, I digress…)

Note that there isn’t a change in the trends for the non Hib versions of meningitis graphed. It’s about as clear as data can get–introduce the vaccines, fewer people die. Note that the hospitalization rate is about 15x higher than the death rate. So, a lot of kids ended up in the hospital. I have to admit, I didn’t realize how really nasty this disease is. If about 1 in 15 of the people who go to the hospital die…well, dang, thank god there’s a vaccine.

I can already hear the response–but, why do we have to be so “aggressive” in giving these vaccines to such young children? Take a look at figure 3 from the paper.

Hib meningitis deaths for infants and young children 1980-1991

They broke the data down to infants (younger than 1 year old) and children 1-4 years old. Notice that the trend is the same for both age groups. More importantly, notice that the death rate is about 5x larger for the youngest children.

Yes, five times higher. But, protecting these young children is “aggressive”. If that’s aggressive, thank god for aggressive.

You may be wondering what prompted this little excursion to a paper from the 1990’s. Well, take another look at the citation:

Kenneth C. Schoendorf, John L. Kiely, William G. Adams and Jay D. Wenger (1994). National Trends in Haemophilus influenzae Meningitis Mortality and Hospitalization Among Children, 1980 through 1991 Pediatrics, 93 (4), 663-668

Note that one author, John L. Kiely? He recently wrote an Op-Ed for the Atlanta Journal Constitution on the importance of the MMR vaccine. Or, you may know him as EpiWonk.

But, to summarize:

Go back to the 1980 vaccine schedule? Had they not added Hib, thousands of kids would have died in the last 20 years. Many more would have suffered permanent injury.

We give too many vaccines? Based on what? Can we just do without the Hib?

Vaccines given too young? A 5x higher mortality rate for the youngest. Where’s the sense in delaying protection?

Vaccine preventable disease were becoming more manageable, so vaccines weren’t really doing anything. I guess if you believe in levitating dolphins, that argument works. For everyone else, the data are clear: vaccines work. They work well.

4 Responses to “Too many falsehoods, too often”

  1. Ms. Clark October 11, 2008 at 07:20 #

    http://jcn.sagepub.com/cgi/content/abstract/21/7/591

    “This report describes the brain autopsy of a boy who at age 4 1/2 years experienced an episode of fulminant Haemophilus influenzae type b bacterial meningitis, resulting in massive brain destruction and the clinical signs of brain death. However, medical intervention maintained him for an additional two decades. Subsequent autopsy revealed a calcified intracranial spherical structure weighing 750 g and consisting of a calcified shell containing grumous material and cystic spaces with no recognizable neural elements grossly or microscopically. ”

    I don’t know about you all, but I’m sure glad my children never had HiB disease. They were both too old to benefit from the vaccine by the time it came out.

    I remember one of the doctors from the AAP asked Jenny on the Larry King show which disease that they are currently vaccinating against in babies and young children would Jenny like to see a child get (as opposed to preventing with a vaccine) she and Dr. Jay whined that that wasn’t a fair question.

    It’s a very fair question. When asked which ones he thought needed to be skipped or delayed, Jenny’s dumb and dumber boyfriend, Jim Carey said “some parents” think the tetanus vaccine is unwarranted.

    The whole “too many too soon” thing is a sound bite comment that makes Jenny look concerned, I would guess that she wouldn’t lose any sleep if a baby is now not vaccinated for Hib because of her advice and later it dies a gruesome death. I wonder how many micrograms of how many different toxins it took to turn that 4 year old boy’s brain into a lump of calcified clotted blood and tissue.

    Well, at least they were “natural” toxins. I’m sure that comforted the boy’s parents no end.

  2. grenouille October 11, 2008 at 20:25 #

    It is important to remember that the Hib vaccine has led to a sharp decline in cases of orbital cellulitis in children. Orbital cellulitis can lead to blindness, meningitis, irreversible brain damage and death.

    http://linkinghub.elsevier.com/retrieve/pii/S0161642000001780

    This function of the vaccine is important to me personally because I nearly died of OC when I was 2 years old. There was one other child in the hospital with the same thing. Tragically, she died.

    I was so thrilled to get this vaccine for each of my children and I get really upset when I hear Hollywood “experts” calling it unnecessary.

Trackbacks/Pingbacks

  1. | Autism Library - October 11, 2008

    […] Insolence and LeftbrainRightBrain. While not on MMR or measles, this also inspired a post on the Hib vaccine, using a paper by EpiWonk that shows clearly how effective this vaccine is and how important it is […]

  2. Around the autism blogosphere October 11 2008 | Autism Library - October 11, 2008

    […] Insolence and LeftbrainRightBrain. While not on MMR or measles, this also inspired a post on the Hib vaccine, using a paper by EpiWonk that shows clearly how effective this vaccine is and how important it is […]

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