Vaccination & epidemic

[wolf]

Oh, how perfect!

[Aliantha]

I wish they had a vaccine for cancer

[orthodoc]

There's one - a vaccine against HPV (Human Papilloma Virus) - that protects against cervical cancer and cancers of the anus, vagina, and vulva that are due to HPV. See http://www.cdc.gov/hpv/vaccine.html.

And, thanks for the link, UT. The guy uses only US data from the CDC. Those numbers are reliable.

[lumberjim]

I was just looking at the 2013 vaccine schedule. polio is still on there. I thought that had been eradicated world wide. Why is that still on there?

Doc, if you were me, what vaccines would you consider having done for a 15 year old, and a 13 year old child?

[tw]

Originally Posted by lumberjim

I thought that had been eradicated world wide. Why is that still on there?

Polio has an interesting legacy from the cold war. Since it could be used as a weapon in a world that no longer needs that vaccine, then both the US and Russia have this disease in cold storage. So that vaccines can be created if needed.

[orthodoc]

Originally Posted by lumberjim

I was just looking at the 2013 vaccine schedule. polio is still on there. I thought that had been eradicated world wide. Why is that still on there?

Doc, if you were me, what vaccines would you consider having done for a 15 year old, and a 13 year old child?

You're right, LJ - smallpox has been eradicated as a 'wild-type' disease, although small samples still exist in laboratories. The WHO has been working hard to make polio the second infectious disease to be eradicated, and the program has been very successful - except in Nigeria, in some of the northern states like Kano State. Due to recent assassinations of community health workers and families bringing their children for vaccination, the WHO has temporarily halted immunization programs there.

If the 13 and 15 year old are completely vaccine-naive and they were my children, I would want them to receive the primary immunization series for tetanus/diphtheria/pertussis; a series for polio using the inactivated vaccine; meningococcal vaccine; two doses of MMR; the varicella vaccine; Hep A & B (this comes as a combination vaccine or can be separate); and the HPV vaccine. I've included a link: http://www.cdc.gov/vaccines/who/teens/for-parents.html that has information for parents on recommendations. If you google 'vaccine recommendations teens no previous immunizations', you can link to a pdf file that has the 'catch-up' schedule for 7 - 18 year olds who are naive or behind schedule. I couldn't get that link to work directly here, but it's the best one.

Polio has been eradicated in the US, but a visitor from Africa, or even possibly India or Afghanistan, where cases of polio have only just ceased and there may still be undocumented cases, could bring the virus here and infect susceptible people. Varicella is much more severe in older children and adults. Hep B is particularly nasty and there's a high rate of transmission. Hep A still pops up in foodborne outbreaks, and if your teens go on a school or other trip to Central American countries they will likely encounter it. Pertussis is milder in adults but the idea is to make adults less susceptible so that they don't pass it on to susceptible infants.

[lumberjim]

Oh. ..I was thinking of a small pox, wasn't I?

[orthodoc]

Hmm ... just thinking I should have prioritized that list. If I were going to get things done over a period of time rather than all at once, I'd go for the tetanus/diphtheria/pertussis series first. Tetanus is a direct, ongoing threat because it lives in soil, we all encounter it, and we have no treatment for it (we can give Tetanus Immunoglobulin at the wound site along with starting a tetanus series for those who are susceptible, but ... much better to be protected).

Then, depending on my kids' contacts and travel plans, I'd have them get the varicella vaccine, the MMR vaccine, the meningococcal vaccine. Then the Hepatitis vaccines and HPV. Polio could wait until the end if the kids aren't traveling outside the country and aren't in contact with visitors from abroad. I'd still do it, but the kids are more likely to run into the other diseases.

Eta ... even though polio is now rare, I'd still want my kids protected from it because 90% of infections are asymptomatic. That means that a contact could have the disease and be shedding virus/infectious and never know it. You wouldn't have to come into contact with someone who was ill with the disease. So many young people go abroad at some point - until polio is eradicated worldwide, I'd go for protection.

If the kids were going to travel abroad then I'd move the polio, Hep A and B, and any other specific immunization recommendations for the destination (like Yellow Fever) up the list.

[orthodoc]

The College of Physicians of Philadelphia has a nice web site on vaccines, how they work, their history, etc., here: http://www.historyofvaccines.org/con...ation-schedule.

Lots of interesting information.

Eta - all of the recommendations above are what I'd think about for my children, in consultation with our family doctor who knows the kids. Anyone considering pursuing this should do so in consultation with their own physician. I am not making specific recommendations or prescriptions for anyone.

[sexobon]

Tw made a statement:

Originally Posted by tw

Jenny McCarthy, at a minimum, owes us all an apology for causing death to so many infants. ...

Clod asked him for supporting facts:

Originally Posted by Clodfobble

Can you give me numbers, tw, on exactly how many infants have died in the developed world of vaccine-preventable diseases since Jenny McCarthy started speaking out? For I know you would not just use some indefinable quantity like "so many," without numbers to back it up.

Tw didn't giver Clod supporting facts claiming they were elusive:

Originally Posted by tw

There is no actual number since many other factors apply - including all vaccine effectiveness. However numbers start in the hundreds. May be higher.

Clod identified his evasiveness and gave him a chance to redress her question:

Originally Posted by Clodfobble

... Effectiveness is irrelevant in this case, since you weren't talking about infection rates, you were talking about death rates. ...You said that Jenny McCarthy was responsible for "so many dead infants." I ask again: do you have numbers to back up this claim,

Lamp acknowledged the context of the conversation and gave statistics:

Originally Posted by Lamplighter

... If death is the insisted criterion, then the data for only one year (2012) includes 18 deaths:

Sexobon pointed out that those statistics weren't entirely attributable to Jenny McCarthy:

Originally Posted by sexobon

Childhood Pertussis vaccination doesn't begin until 2 months of age; so, you can eliminate the <3 mos. category (13 deaths) as having been influenced by anyone's anti-childhood vaccination rhetoric. The information you provided here doesn't say whether or not they where vaccinated either, as vaccinations is not 100% effective. You can also eliminate the adult category (55+ years, 1 death) as childhood vaccination and first booster does not confer lifetime immunity; rather, lasting only 3-6 years. The potential influence a Jenny McCarthy type may have had in 2012 is 4 deaths (you didn't specify them as non-immunized versus failed immunization either), not 18 deaths as the tw-lamplighter school of spin doctoring would propagandize.

Originally Posted by Lamplighter

...A significant portion of the discussion in this thread has included herd immunity. ...

Not that portion.

Originally Posted by Lamplighter

"spin doctoring" and "propagandize" here are the sorts of emotional word-usage that TW has been talking about all along. ...

You drew that erroneous conclusion; because, you forgot to first ask (which you do a lot) which camp I fall into. I'm all for childhood vaccinations; so, obviously emotion doesn't attach. No, my assessment was based on the contents of the posts, in the context of the flow of the conversation as acknowledged by the users within their own posts. The responses to Clod's question were evasive, misleading, and not by accident. The assessment is logical and accurate. With friends like that, the cause doesn't need enemies.

[xoxoxoBruce]

Originally Posted by sexobon

I'm all for childhood vaccinations...

Me too... stab all the children, shoot 'em too.

[Lamplighter]

Originally Posted by sexobon

...You drew that erroneous conclusion; because, you forgot to first ask (which you do a lot) which camp I fall into....

The "blame the reader" tactic when found wanting is called obscurantisme terroriste,
as in ... you misunderstood me/my... it's your fault you forgot to ask ... etc.

If it's important to know your position, put it in your posts.
For me, it's a minor issue which camp you're in.

The "spin doctoring" and "propagandize" and now with:
"With friends like that, the cause doesn't need enemies."
These are your emotional word usages, not mine or TW's.

[tw]

Originally Posted by sexobon

Clod identified his evasiveness and gave him a chance to redress her question:

Was answered. Actual numbers are complicated by factors such as some vaccines are not 100% effective and recent discoveries that some vaccines might be losing effectiveness. Apparently uncertainty exists. Lamplighter's numbers confirm that bottom line. Numbers so one sided as to be obvious. To not vaccinate was irresponsible (ill informed) reasoning. To be angry and offensive because those mistakes were exposed is simply an adult acting like a child. His tirade (and not one fact) confirms even he knows it.

Assumed was that mothers will always nurse their children. Protection does not transfer when mothers do not nurse.

[sexobon]

Originally Posted by tw

Described are more examples of why medicine recommends all kids be vaccinated. Even infants who cannot yet be vaccinated are at significantly greater risk due to others who deny their responsibility to society. That 'screw everyone else' attitude exists. ...

The mothers can be vaccinated shortly before giving birth to help protect infants <2 mo.

[orthodoc]

Just to clarify, while that is true of the DTaP vaccine it is not true of the MMR or any other live attenuated virus vaccines. (I know tw was referring to your quote about pertussis; just didn't want people to incorrectly suppose that all vaccines can be given shortly before birth to protect a young infant.)