Please answer my stupid question about vaccination

Dolly Welsh

Tue, Mar 10 2015, 11:24 pm

amother wrote:

That is so heartbreaking and sad. That poor family. Sad

But please remember the flip side, many babies have died due to receiving vaccines. Sad

All we can do as parents is make the best, most informed decision we can possibly make (in the case of vaccines that means reading and researching BOTH sides of the debate) and daven to Hashem that He should help us and protect our children.

This equivalence is false.

It isn't an equal number of deaths on both sides.

There is a great deal of likely danger on one side, but only a real but very unusual danger on the other side. That doesn't mean vaccines never cause problems. Vigilance is needed around a recently vaccinated infant or child, and you might space them if a child is low body weight or generally not strong. But you get your vaccines. They are bundled because that hurries the transition to protected status, and makes it more likely that the infant or child will actually get everything. Not everybody has time to come back. Well meaning people with busy families may intend to come back and get delayed by other events.

Any non-professional should keep her fingers off Google about this issue. A non-professional has no idea how to "research" this, only the ability to read the nonsense of which there is plenty on the internet.

With google and a modem I can prove to you that the moon is made of green cheese, if you give me a few hours. I can call it "research" as well as anybody else.

How do you know the moon isn't made of green cheese? It's white and blotchy.

People are going to be maimed and die and have already, from this pernicious nonsense.

Cheese smells better and is better for you.

Hashem_Yaazor

Wed, Mar 11 2015, 9:00 am

black sheep wrote:

Didn't you say in a previous post that pertusis is spread by vaccinated people?

Yes.

That does not mean it is spread post-vaccination by obtaining the vaccine itself!

What I mean is that should a vaccinated person (vaccinated any time in the past) be exposed to the bacterium, have it enter his or her body and start colonizing, that person can then go and transmit it to someone else. A key point that led me to asking these questions and researching this point actually was when I saw my local health department's brochure about period of contagion (one is most contagious before the telltale cough appears, when the symptoms are most like a regular cold). Just because we want something to be true, it doesn't mean it is. I definitely wanted my babies to be protected by others' vaccinations when they were still young and fragile, but I found out that I can't really rely on that at all, and I can only do what I can for their personal benefit and daven.

(While I have explained why Barbara's post is irrelevant, I figured I might as well add that her post is also discussing the time of the DTP vaccine which, while more effective, was taken off the market later on due to the rates of reactions. So even though it did nothing to disprove my point, it would be non-applicable anyway.)

chaiz

Wed, Mar 11 2015, 10:07 am

Hashem_Yaazor wrote:

Yes.

What I mean is that should a vaccinated person (vaccinated any time in the past) be exposed to the bacterium, have it enter his or her body and start colonizing, that person can then go and transmit it to someone else. A key point that led me to asking these questions and researching this point actually was when I saw my local health department's brochure about period of contagion (one is most contagious before the telltale cough appears, when the symptoms are most like a regular cold). Just because we want something to be true, it doesn't mean it is. I definitely wanted my babies to be protected by others' vaccinations when they were still young and fragile, but I found out that I can't really rely on that at all, and I can only do what I can for their personal benefit and daven.

But why would it be spread more by vaccinated individuals than non vaccinated?

Barbara

Wed, Mar 11 2015, 10:07 am

Hashem_Yaazor wrote:

black sheep, you are mixing up live virus vaccines with pertussis, which DTaP is not -- it cannot be spread post vaccination and does not shed. I stand by what I said. The only objection amother had was with the subjective word 'easily' which is not quantifiable.

Barbara was only showing how it confers individual protection; less people will get sick if they are vaccinated effectively. Not that it didn't spread.

No. My post was countering your suggestion that pertussis can never be eredicated. Look at how quickly the incidence was reduced in Japan. Eradication, or near-eradication, is possible.

Moreover, even if vaccinated people can spread the disease (and others have provided research that disputes your conclusion that it can), there is little question that, with vaccination, there is less of it to spread, protecting the vulnerable population.

Hashem_Yaazor

Wed, Mar 11 2015, 10:29 am

Barbara wrote:

Not according to the CDC. http://www.cdc.gov/pertussis/about/faqs.html (note no mention of lower vaccination rates, because that has little to do with its incidence, only in amount of sickness and severity of it)

Q: Why are reported cases of pertussis increasing?

A: Since the early 1980s, there has been an overall trend of an increase in reported pertussis cases. Pertussis is naturally cyclic in nature, with peaks in disease every 3-5 years. But for the past 20-30 years, we've seen the peaks getting higher and overall case counts going up. There are several reasons that help explain why we're seeing more cases as of late. These include: increased awareness, improved diagnostic tests, better reporting, more circulation of the bacteria, and waning immunity.

When it comes to waning immunity, it seems that the acellular pertussis vaccine (DTaP) we use now may not protect for as long as the whole cell vaccine (DTP) we used to use. Throughout the 1990s, the US switched from using DTP to using DTaP for infants and children. Whole cell vaccines are associated with higher rates of minor and temporary side effects such as fever and pain and swelling at the injection site. Rare but serious neurologic adverse reactions including chronic neurological problems rarely occurred among children who had recently received whole cell vaccines. While studies have had inconsistent results that the vaccine could cause chronic neurological problems, public concern in the US and other countries led to a concerted effort to develop a vaccine with improved safety. Due to these concerns, along with the availability of a safe and effective acellular vaccine, the US switched to acellular pertussis vaccines.

Hashem_Yaazor

Wed, Mar 11 2015, 10:39 am

Regarding research that disputes what I said, where is that? And it's a logical fallacy to say "there is little question that, with vaccination, there is less of it to spread" -- because that is not true. It's around and the vaccination gives individual benefit to make someone less sick, but it exists in the same amount in the air, regardless of vaccination rates. I am going to make up an example to try to show it in a different way.

Germ SicklyX is in the air.

LocationSquare has a 50% vaccination rate for SicklyX. Yankel, who is vaccinated, breathes in SicklyX which starts to multiply. He sneezes next to his friend Moishy who is not vaccinated. Yankel doesn't really have many symptoms 2 weeks later, while Moishy gets very sick. Moishy still got it from Yankel. There is a high sickness rate in the 50% of LocationSquare's population that are not vaccinated.

LocationCircle has a 97% vaccination rate for SicklyX. Frumie, who is vaccinated, breathes in SicklyX which starts to multiply. She sneezes next to her friend Yenty who is vaccinated. Neither come down with symptoms 2 weeks later. In the meantime, Yenty sneezed next to Goldy who was also vaccinated, and Goldy sneezed next to Suri. Suri was not vaccinated, and 2 weeks later, the telltale signs of SicklyX are apparent. There is a low sickness rate in LocationCircle due to the vaccine, but it was still spread by the vaccinated.

(In addition, keep in mind there is ongoing study and changes in recommendations to the vaccine because of waning immunity, which means that there are likely more adults walking around not protected than kids, so please stop blaming people who are really not at fault! This is from the same FAQ page.

"Pertussis vaccines are effective, but not perfect. They typically offer high levels of protection within the first 2 years of getting vaccinated, but then protection decreases over time. This is known as waning immunity. Similarly, natural infection may also only protect you for a few years.

In general, DTaP vaccines are 80-90% effective. Among kids who get all 5 doses of DTaP on schedule, effectiveness is very high within the year following the 5th dose – at least 9 out of 10 kids are fully protected. There is a modest decrease in effectiveness in each following year. About 7 out of 10 kids are fully protected 5 years after getting their last dose of DTaP and the other 3 out of 10 kids are partially protected – protecting against serious disease.

Our current estimate is that Tdap vaccination protects 7 out of 10 people who receive it. Since Tdap vaccines were only licensed in 2005, we don't yet have results on long-term vaccine protection. We're still working to understand how that protection declines over time or might differ based on which vaccine was received during early childhood (I.e., DTaP or DTP). CDC will be conducting an evaluation in collaboration with health departments in Washington and California to better understand how long Tdap vaccines protect from pertussis. The data from these evaluations will help guide discussions on how best to use vaccines to control pertussis.")

Scrabble123

Wed, Mar 11 2015, 11:24 am

amother wrote:

So I'm not well researched/educated in the subject. However I do firmly believe in vaccination because that is what is the right thing to do according to DRs or professionals, and I am not one so I follow the experts.

My best friend on the other hand does not vaccinate and it really bothers me, for the sake of her children and other's health.

But can you please explain to me, how is not vaccinating harmful to those of us who do vaccinate? If we are protected then there is nothing to worry about. Is all the concern about those with low immunity or babies not yet vaccinated/elderly etc? Is this the whole concern? I'm not clear?

But if everyone did have the vaccine, then surely the diseases would die out and there'd be no need for these vaccines in the year to come?

Also does someone who doesn't vaccinate warn everyone that they don't in case they are around someone vulnerable?

TIA

National Geographic magazine had a decent article about how people distrust science and don't believe.
The moon landing was a hoax.
Vaccines cause autism.
GMOs are bad.
Etc. etc.

I care about the decision to not vaccinate because:
1. It is against halacha according it almost all opinions.
2. I care about public health as well as individual (which is not my business, but public health is).
3. I care about the emotional implications of what is taught to many children who are not vaccinated. These children will grow up and actually have to be involved in society: it will impact politics, science, tolerance, fear, etc. (As in some people make decisions because it makes them feel safe and base those decisions on factors which are misguided an untrue. There is an amount of risk that is considered not only acceptable, but essential to survival both physically and emotionally. There is also an amount of bitachon that should be a given. There is an amount of responsibility and trust that is a must.)
4. I care about disregarded accepted science. Science is not just fact spewing and opinion spewing. Science is tested, retested, and retested again and again. When science says something, it doesn't say that because it "feels like doing so." Science changes, but that is only because it is always put under a microscope. With more knowledge we come to be aware of more nuances that were not before. Science does not mind saying "science does not know" when it is "does not know." Human beings have issues feeling that things may be random or that they do not know the cause of things, but science does not.
5. In certain populations, anti-vaccination views have a power to spread like fire.
6. IRL, vaccination is not a regular part of my conversation. I let people do as they please with everything. I mean literally. I'm the neighbor who doesn't even know the names of the people on my block. I wouldn't share my child rearing opinions or admonish my Shabbos desecrating frum friend. I don't care what people wear, how they think, what they do, and just about anything else. When something is being discussed, and many people have the ability to hear it and hear sick, dangerous comments I will respond. I'll respond because it's not longer just about my neighbor next store, but potentially about the entire world. It's like if someone tells me a disturbing view on a subject, I'll ignore it, but if a speaker shares that view in a room of people and I know that Torah, science, and everything shows that that person is wrong, I will be the one to raise my hand and make that speaker for a fool for the greater good of society because that speaker is not just harming himself and those around him, but potentially all of the individuals in the room and those who are in contact with them.

Scrabble123

Wed, Mar 11 2015, 11:27 am

chaiz wrote:

It seemed like you were laying the blame on the vaccinated. So if we cannot blame the unvaccinated, why would the vaccinated be implicated here?

She's implicating no one. She's saying that the acellular vaccine is imperfect and needs improvement. Meanwhile, the un vaccinated have been at the forefront of the highest infections of pertussis. You may argue that the vaccinated may be asymptomatic or have atypical symptoms so if there is an outbreak between vaccinatied children, it is less likely to be tested and confirmed as pertussis because healthy kids or kids with slight colds do not go to the doctor have have sputum testing done; however many researchers in 2013 did test populations of apparently healthy vaccinated children in areas of high vaccination rates v. apparently healthy vaccinated children in areas with low vaccination rates: and guess which group was more likely to be "healthy carriers"? Yep, those in the areas with lower vaccination rates..... (I cannot source this, because I read it a few years ago and am not sure of the specifics as in which scientists performed the testing and who reviewed it, but you can try and research it yourself). It's not a perfect study, and the acellular vaccine is not perfect, but not vaccinating is not an option.

Last edited by Scrabble123 on Wed, Mar 11 2015, 11:32 am; edited 1 time in total

amother

Wed, Mar 11 2015, 1:34 pm

Hashem_Yaazor wrote:

My objection is to more than the word 'easily.' (And, sorry if I didn't explain myself well yesterday --it was a hard day.) Let's first define colonize. Colonize means bacteria is attached and growing however the growth is below the limit of infection. If the colony were to grow, infection would follow. So, a colonized individual has an immune system that is controlling the growth of pertussis and preventing disease. Eventually, the likelihood is that it will be cleared and not a permanent colonizer.

To spread B. pertussis, B. pertussis must be aerosolized. Infection effectively aerosolizes B. pertussis. Colonization usually does not do this effectively. In order to aerosolize, bad coughing is usually required. Also, low CFUs is enough to cause disease. So, someone colonized has few CFU and an ineffective means of 'spreading.' So, yes, it is possible. But, to say vaccinated people spread pertussis is a jump. If they would it is to someone with very close and regular contacts. Entirely possible, but they are not walking around spreading pertussis.

The people who are probably spreading that are vaccinated are people who are just a few days post vaccination and the people whose immunity is waining. When the immunity wains, colonization can occur and the immune system will only mildly control the growth. Then, B. pertussis grows and mild symptoms will show. These symptoms are when the biggest risk of spreading from a vaccinated individual occurs. But, the disease does not get bad in these people. The immune system quickly regains due to memory and stimulation.

Yes, aP has problems. The immunogenicity needs to be increased. Colonization is not desired in vaccinated people.

amother

Wed, Mar 11 2015, 2:51 pm

Hashem_Yaazor wrote:

" Baboons vaccinated with aP were protected from severe pertussis-associated symptoms but not from colonization, did not clear the infection faster than naïve animals, and readily transmitted B. pertussis to unvaccinated contacts"
That is why I used the word easily.

The literature I have read from the CDC seems to lump together colonization and infection, with the catarrhal stage following incubation being the most contagious, not the paroxysmal stage, which is what I understood the vaccine is most effective at preventing. Am I wrong? I am finding it nearly impossible to learn at what stage enough antibodies kick in to stop the infection.

Ahh, I understand now. Baboons require (I think) 10^9 to 10^10 CFU to infect. Humans require a whole lot less -humans with bacterial loads that high are very sick. So, monkeys can be colonized at 10^7 without disease. 10^7 is a lot! 10^7 can be more readily transmissible. People don't tend to be colonized without infection with such a bacterial burden. Yes, people with aP can transmit but probably not with high efficiently. This is purely hypothesis driven based on evidence. Little to nothing has been shown in humans.

Antibodies and T-cell function in prevention of colonization has not been worked out. A person I work with sees antibodies in combination with T-cells can prevent colonization.