Vaccines

[Aphos]

An immunologist fed up with vegans and what they say about vaccines responds...

[Sibling Zono (anon1mat0)]

He forgot to mention that most people has mercury in their own teeth, as not all cavities can be covered with composite nor it is economical (or even feasible in some cases) to use gold, so amalgam is used and the main metal there is Mercury...

Sure, it would be great to avoid Hg at all, but as with all medicines, there is a cost benefit analysis, and the minuscule effects Hg can have in vaccines is greatly outweighed by the benefit of said vaccine.

[Aphos]

The thing is, the size of the dose is very important in determining the harmful effect of a substance.  Small doses are benign while large doses can be harmful or even fatal.

My favorite example is potassium.  A certain dosage of potassium is lethal.  However, NO potassium is also lethal.  A small amount of potassium is required in our diet.  Without it, our nerves cease to function..and death will result.

As for mercury, which is poisonous in large enough dosages, the human body is able to eliminate small amounts such as what you would find in a vaccine.  It is in larger amounts that problems occur.

[Griffin NoName]

Polio cases in Pakistan are increasing because the Taliban prevent vaccination. They think, because the vaccines are produced in the West, they have some secret detremental ingredient; I can't remember exactly what the ingredient is supposed to do, maybe kill instead of protect.

[Sibling Zono (anon1mat0)]

Wrong contaminant: large doses of lead, as in the subtle DNA test to Bin Laden's children that allowed to kinetically poison him with heavy metals...

[Swatopluk]

In Africa the final stage of the anti polio campaign failed for the same reason. Fundamentalists claimed that the vaccine was actually a drug causing infertility. The assumed plan was to exterminate Muslims (and Blacks) by preventing their women from bearing children under the disguise of medical help. That Osama bin Laden was found and identified by guys disguising themselves as part of the Pakistan vaccination campaign was seen as supporting evidence.

The basic idea is not as insane as it may sound. In the past there were ideas to lace food support for 3rd world countries with contraceptives or making support dependent on the use of the same. To my knowledge it never came to pass but the mere fact that it got discussed in the West justifies a certain degree of suspicion. Not to forget that there are people that actually would support such a scheme for religious and/or racist and have access to big megaphones (and cf. the secret reasearch for 'racist' bugs that was at times part of the US bioweapons program).

Idiots/fanatics/Ideologues (almost) always find something real to latch their mad theories onto.

[Opsa]

I have met people out in the hill country who will not allow their children to be vaccinated. It seems to me that really they are very scared and mistrustful of just about everything outside of their own family. They also tend not to vote, pay taxes, or allow their kids to go to school with other kids. I can't imagine how it must be to live like that.

[Aggie]

He forgot to mention that most people has mercury in their own teeth, as not all cavities can be covered with composite nor it is economical (or even feasible in some cases) to use gold, so amalgam is used and the main metal there is Mercury...

Some of the composites in use also contain some suspicious chemicals as well, so they're not necessarily a safe bet.

To fuel a bit of the discussion on vaccines, for which diseases is widespread vaccination really desirable?  Is it always desirable to vaccinate if the statistical occurrence of similar-severity complications for the vaccine (in a vaccinated population) are lower than statistical occurrence of the disease in the general unvaccinated population? Should we target anything that we can throw a vaccine at?

That makes sense to me for high-impact diseases like polio and smallpox, but does it necessarily follow that we should aim for 100% vaccination rates for less fatal diseases such as chicken pox and HPV?

There's also two separate arguments to be made from the perspective of public health and individual health.  To be selfish (which is our bloody biological right as a naturally evolved intelligent species, IMHO), in a widely-vaccinated population there is a disincentive to get yourself or your offspring vaccinated, simply because the chances of encountering the target pathogen are quite low. If herd immunity has reduced the statistical occurrence of a disease to a point where the statistical occurrence of complications from the vaccine is many times greater than actually contracting the disease, where's the individual motivation for getting vaccinated and thereby actually putting one's health at greater risk? (other than acting for the greater good)


I personally find that any public discussion of the merits of widespread vaccination for any of the "grey area" pathogens is going to be biased by the fact that vaccines are a profitable product of a very powerful industry body.  I'm personally biased against them as a default simply by the fact that there's a strong financial interest in creating acceptance for widespread vaccination, and in downplaying any potential side effects.  While the anti-vaccine side too often runs their mouth off with a alarming lack of reference to solid scientific data and established knowledge, the vaccine producers that stand to profit from unquestioning acceptance of vaccines too often (always?) are the ones funding and overseeing the creation, interpretation and in some cases non-release of the data in question.  One side has a distorted perception of reality, the other side has the ability to significantly distort reality as it's perceived by the people who are actually interested in making decisions based on objective information.

[Griffin NoName]

That makes sense to me for high-impact diseases like polio and smallpox, but does it necessarily follow that we should aim for 100% vaccination rates for less fatal diseases such as chicken pox and HPV?

At least two types of HPV cause cancer.

[Swatopluk]

For some years Germany abandoned polio vaccination when the 'alive' vaccine's inherernt risk approached that of an infection (due to the latter dropping to insignificance). When after the end of the Cold War polio threatened to get reintroduced from Eastern Europe vaccination was taken up again but this time with a 'dead' and therefore less risky vaccine (but with a higher failure rate too). Doctors around here get official recommendations from the Vaccine Commission (Impfkommission) what vaccinations are considered useful for what type of patient and the insurers do not cover all of them (e.g. one has to pay for Hepatitis B vaccination oneself, if one is not part of a risk group like e.g. people working in hospitals)

[Aggie]

That makes sense to me for high-impact diseases like polio and smallpox, but does it necessarily follow that we should aim for 100% vaccination rates for less fatal diseases such as chicken pox and HPV?

At least two types of HPV cause cancer.

Yes, but at what rates, and how is this comparable to the occurrence of side effects from the vaccine?

A study that covered 100% of the U.S. population during 2004–2008 estimated that about 33,300 HPV-associated cancers occur each year. About 21,300 HPV-associated cancers occur each year among females, and about 12,100 occur each year among males. Cervical cancer is the most common HPV-associated cancer among women, and oropharyngeal cancers are the most common among men. The following counts are from this study.

From June 2006-March 2013, approximately 57 million doses of HPV vaccines were distributed  and VAERS received approximately 22,000 adverse event reports occurring in girls and women who received HPV vaccines; 92% were classified as "non-serious" Reports received by VAERS peaked in 2008 and decreased each year after that; the proportion of female HPV reports classified as "serious" (reports are classified as "serious" if they contain information that the event resulted in hospitalization, prolongation of an existing hospitalization, permanent disability, life-threatening illness, or death) peaked in 2009 at 12.8% and decreased after that to 7.4% in 2013

Based on these numbers, it appears that the vaccine does more good than harm, at least in terms of acute side effects. The missing piece of data is the effectiveness of the vaccine... does it work 100% of the time? (likely not). That's almost irrelevant with these numbers; even a 60% immunity rate would overcome the number of serious side effects.

Incidentally, the rates for cancers (not necessarily all deaths) above are a bit lower than US motor vehicle deaths for the same years; think of how many people you've know of that have been in a traffic fatality (one of my acquaintances was a statistic in the US during those years), and you'll get an idea of how many people are affected  Then again, prevalence in the general population is probably similar to vehicle use:

HPV is estimated to be the most common sexually transmitted infection in the United States. Most sexually active men and women will probably acquire genital HPV infection at some point in their lives.The American Social Health Association reported estimates that about 75-80% of sexually active Americans will be infected with HPV at some point in their lifetime. By the age of 50 more than 80% of American women will have contracted at least one strain of genital HPV.

The unofficial rule of thumb that I've heard is that if you've had 4 or more partners, you've very likely contracted at least one strain of HPV. Not all cause cancer. 


The numbers get a little more complex on a personal level when behavioural aspects are considered. Certain demographics and sub-groups may be more likely to contract certain diseases than the general population, so the general numbers do not necessarily tell the whole risk/benefit story for a given individual.  For example, we have a perfectly good rabies vaccine, but don't vaccinate the general population.  Rabies isn't a significant public health (person-to-person) issue, and most people will not come into contact with a potentially rabid animal.  Likewise, based on my demographic group and behavioural patterns, I'd not likely take a vaccine for HIV if one was developed. The vaccine risk would (probably) outweigh my actual chances of contracting the disease, even though it's a serious disease. If I became a paramedic or intravenous drug user, I'd probably want the vaccine.

[Sibling Zono (anon1mat0)]

To be selfish (which is our bloody biological right as a naturally evolved intelligent species, IMHO), in a widely-vaccinated population there is a disincentive to get yourself or your offspring vaccinated, simply because the chances of encountering the target pathogen are quite low.

Selfish, rational and willing to gamble.

There are a number of questions there, like:
- What are the chances of dying of the targeted disease (likely > 0) and what are the chances of dying of complications from the vaccine (if the FDA and related agencies did their job ~ 0).
- Do you prefer certainty? If you have the vaccine there is a higher certainty you won't get the disease and there is a low chance you get complications, in which case you'll likely get them right away, as opposed to the disease which can strike at any time.

And then we have the rational aspect of the equation, what is the probability of getting something vs the desire to be protected? Imagine they finally figure out a vaccine against HIV, what are your chances of getting it? Would you get the vaccine (assuming is reasonably effective and safe)?

Personally, I did get Gardasil for my son not that long ago (no side effects BTW), and he still isn't sexually active, who knows when will he start and even then there is a lower risk for a man than a woman, yet if I can protect him, why not do it? Am I irrational on that decision?

[Bob in a quantum-state-of-faith]

Well, I've been considering getting the shingles vaccine.  Some preliminary research shows that people in my age bracket can seriously benifit from it (~60% reduction in infection) and there does not appear to be serious side-effects.  

They have now expanded the recommended age group to include mine (50-59), from the original group (60+).

I don't know how expensive it is, but a college got it, and it only cost him $50US, more than worth it, IMO.

Here's the info I found the most informative:  http://www.cdc.gov/vaccines/vpd-vac/shingles/hcp-vaccination.htm

Edit:

This is interesting:  

http://www.immunize.org/askexperts/experts_zos.asp

Can you catch zoster from a person with active zoster infection?
Zoster is caused by reactivation of a latent varicella virus infection (from having chickenpox in the past). Zoster is not passed from one person to another through exposure to another person with zoster. If a person who has never had chickenpox or been vaccinated against chickenpox comes in direct contact with a zoster rash, the virus could be transmitted to the susceptible person. The exposed person would develop chickenpox, not zoster.

So is this:

To whom should zoster vaccine be given?
ACIP recommends a single dose of zoster vaccine for all adults age 60 years and older whether or not they report a prior episode of herpes zoster. Persons with chronic medical conditions may be vaccinated unless a contraindication or precaution exists for their condition. For a copy of the ACIP recommendations on zoster vaccine, go to www.cdc.gov/mmwr/PDF/rr/rr5705.pdf.

Zoster vaccine is approved by the FDA for people age 50 years and older. Does ACIP recommend that clinicians vaccinate people in their 50s?
At its October 2013 meeting, the ACIP reviewed the current status of zoster vaccine licensure and the burden of herpes zoster (HZ) disease. ACIP declined to vote to expand the recommendations for the use of zoster vaccine to include people age 50 through 59 years for the following reasons: (1) though the burden of HZ disease increases after age 50, disease rates are lower in this age group than they are in persons age 60 years and older; (2) there is insufficient evidence for long term protection provided by the vaccine; and (3) persons vaccinated at younger than age 60 years may not be protected when the incidence of zoster and its complications are highest. However, zoster vaccine is approved by the FDA for persons age 50 through 59 years and clinicians may vaccinate persons in this age group without an ACIP recommendation.

And finally:

How safe is zoster vaccine?
In the pre-licensure clinical trial involving more than 38,000 adults, zoster vaccine was administered to about half of the study participants. The other half received a placebo. The occurrence of possible side effects was similar in the vaccine and placebo groups (1.9% and 1.3%, respectively). The incidence of serious medical events, hospitalization and death was the same among people who received zoster vaccine and those who received a placebo vaccination. As with all vaccines, the manufacturer, CDC, and the FDA will continue to monitor the vaccine to provide additional safety information.

[Griffin NoName]

Not only is Shingles often very nasty, it has been linked (note linked, not causal) with ME/CFS which I can tell you, you don't want. I got Shingles but very mild and only vaguely ill, when I was 40'ish. More likely Glandular Fever, which got very badly at age 45'ish implicated in my ME/CFS - but there are so many candidates for my ME/CFS who can tell. Now, a vaccine against ME/CFS..........that would be something to write home about.

[Bob in a quantum-state-of-faith]

I'm still doing research, but I'll likely get it soon.