Child vaccination rates hit record high levels

[mzmolly]

...

The CDC report, based on data on 17,017 children, found that fewer than 1 percent got no vaccines.

The immunization program's success hinges on parents' trust in vaccine safety, CDC Director Dr. Julie Gerberding said.

Public health officials have expressed concern in recent years that some parents fearful about vaccine safety were declining to get their children vaccinated, making them more apt to catch and spread preventable diseases.

"We really recognize that ultimately our program is dependent on trust -- trust of moms and dads, trust of caretakers and trust of the clinicians, pediatricians (and) family practice professionals who take care of our children," Gerberding told reporters in a conference call.

http://in.reuters.com/article/healthNewsMolt/idINCOL47185220080904?pageNumber=2&virtualBrandChannel=0">REUTERS

[mzmolly]

1. In other words, it is false to suggest that parents are not vaccinating and causing a resurgence

of disease. This talking point is promoted by the CDC in spite of their own evidence.

[mzmolly]

2. Meant to say "evidence to the contrary."

;)

[Hannah Bell]

3. and by many in this forum. over & over & over & over...

surprised they haven't shown up to repeat it here.

[mzmolly]

4. They've got their blinders

on tight I'm afraid. Waiting for the next official talking point before they forget that the "science" proves them (and the CDC) wrong on their assertions in this regard.

[Fire_Medic_Dave]

8. and since autism continues to increase it's false to say it's caused by vaccines.

[Jim__]

11. I'm curious as to how you arrive at that conclusion.

The statements I see are: vaccination rates are up; autism rates are up. And then your conclusion, therefore, vaccines don't cause autism. I really don't see how you get there.

[Fire_Medic_Dave]

12. Thimerosal was removed from routine childhood vaccines in the U.S. by 2001.

Yet autism rates have continued to climb.

David

[mzmolly]

16. Depends on which study you examine.

eom

[Fire_Medic_Dave]

17. Which study show thimerosal being used as a preservative in vaccines in the U.S.?

[mzmolly]

18. I'm pretty sure you know that some vaccines still contain mercury

and I was speaking about autism rates.

However, don't forget about the MMR jab regardless.

[Fire_Medic_Dave]

19. So which study shows thimerosal being used in routine childhood vaccines in the U.S.?

[mzmolly]

20. Off to ignore

with you. :hi:

[Fire_Medic_Dave]

21. So that would mean you have no studies to backup what you say?

[Fire_Medic_Dave]

22. Don't you just hate it when the facts get in the way?

[Jim__]

23. That's not even a plausible argument that thimerosal in vaccines is not a cause of autism ...

... never mind the more general conclusion that you stated.

[OnTheOtherHand]

25. oh, good golly

This thread apparently started as a spin-off from one about RFK Jr.'s Deadly Immunity -- an article that sniffs, "Some skeptics dispute that the rise in autism is caused by thimerosal-tainted vaccinations." Yes, indeed.

Fire_Medic_Dave's fact does give good reason to doubt that "the rise in autism is caused by thimerosal-tainted vaccinations." If you're demanding proof that thimerosal "is not a cause of autism," that's a different question.

If everyone is willing to make basic distinctions, communication might be possible.

[Jim__]

26. oh, good golly, try paying attention.

Your assertion: This thread apparently started as a spin-off from one about RFK Jr.'s Deadly Immunity ... makes no sense. This thread was created before that thread.

As to: Fire_Medic_Dave's fact does give good reason to doubt that "the rise in autism is caused by thimerosal-tainted vaccinations.". No, it doesn't. His claim needs to be quantified. Autism rates have been increasing for a number of years, and from everything I've read on the subject, for a number of different reasons.

If you are asserting that the claims that vaccines may cause autism are limited to claims about thimerosal in vaccines, that asserion would be incorrect. Rather than rehash dicussions that have been made on this board before, I'll refer you to a video of an interview with Dr. Healy, a former Director of the NIH. The first 30 seconds of the video, where Dr Healy discusses possible connections between vaccines and autism, should clarify that the discussion is broader than thimerosal. As the video continues, she provides more information.

[OnTheOtherHand]

27. OK, got me on the first point

I read them in the wrong order, so to speak. There's some overlap in the comments, but it's more that other discussions colonized this one.

No, it doesn't. His claim needs to be quantified. Autism rates have been increasing for a number of years, and from everything I've read on the subject, for a number of different reasons.

Your third statement actually undermines your first. Quantification could add precision, but there's no need to dispense with common sense. The ordinary-English meaning of "the rise in autism is caused by thimerosal-tainted vaccinations" is that vaccinations are the most important -- if not the sole -- cause of the increase.

If you are asserting that the claims that vaccines may cause autism are limited to claims about thimerosal in vaccines, that asserion would be incorrect.

I quite obviously asserted nothing of the sort.

Do you yourself think that vaccines are a major contributor to autism, and if so, how? If that question is too reductive, feel free to replace it with a more appropriate one.

[Jim__]

29. Getting your first point wrong, means you got the whole context wrong.

So, in the context of this thread, stating that the rate of vaccination continues to increase and the rate of autism continues to increase, is not saying anything about thimerosal. Then, stating that thimerosal was removed from vaccines in 2001 (BTW - an incorrect statement - it stopped being added to new vaccines, the already existing store continued to be used) as support for the first statement, is to incorrectly assume that the possible connection between thimerosal and vaccines was the only possible connection. Again, if you listen to Dr Healy, that is clearly wrong.

The ordinary-English meaning of "the rise in autism is caused by thimerosal-tainted vaccinations" is that vaccinations are the most important -- if not the sole -- cause of the increase.

Once again, you're not even arguing about what's been said in this thread. The statement was: and since autism continues to increase it's false to say it's caused by vaccines.. That's incorrect. Stating, incorrectly, that thimerosal was removed from routine childhood vaccines in 2001, doesn't say anything about other possible connections between vaccines and autism. So, the original claim does not follow from the subsequent claim.

The numbers that I've seen, indicate that less than 2% of overall autism cases have been directly connected to vaccine by parents. I would not consider that a major contributor. My main contention in this argument is that not enough research has been done on this topic. The empirical evidence that there could be a connection is very strong, roughly 5,000 cases where the parents see autism in the immediate aftermath of a vaccination.

However, given that number (2% of overall autism cases) versus the number of vaccines administered on an annual basis, it is clear that studies of the risk from vaccines to the general population are not going to show a statistically significant risk. But, as pointed out by Dr Healy, studies can be done to, at least try to, determine an at risk subgroup in the population.

As to the how, I will refer you, first to the interview of Dr Healy - she is an expert and lists possible connection.

Secondarily, I will refer you to to the discussion in the science forum. One way is fever. An article denying that a connection had been established in the Hannah Poling case, noted that the problem could have been brought on by fever. In the government document on the Hannah Poling case, Hannah gets a fever of 102.3 2 days after she received 9 immunizations. Her mother called the pediatrician who gave the shots and he said this is a normal reaction to the shots she had received. So, the article denying the connection, actually makes it appear stronger. The fever ran for 10 days, and after it, Hannah, who had been very healthy and aware (as attested to by her pediatrician on the day she received the shots) became withdrawn and after months of tests was finally diagnosed with autism. Her parents have offered to make her medical records public. The government, under grounds of their forfeiting any remuneration for the injury, refuses to allow that. The government had sealed the records on the entire case and we only know about it because someone leaked it to the press.

Also in that discussion in the science forum, there is reference to an article in Time, in which an immunologist states the number of immunizations given in Hannah's case can easily overwhelm an immature immune system resulting in unpredictable sickness (I'm paraphrasing because I don't want to go and read the article again).

Again, more research is needed. People who declare there is no connection, do not have the facts to support that.

[OnTheOtherHand]

35. oh?

The OP doesn't even mention autism. I think I'm as entitled to my context as you are to yours. But at least it helps to explain why we might talk past each other.

Fire_Medic_Dave's second post clarified the scope of his first. Even if it didn't, childhood vaccines have been around a lot longer than the autism epidemic. Obviously that doesn't prove that no childhood vaccine causes autism, but it's hardly immaterial.

The numbers that I've seen, indicate that less than 2% of overall autism cases have been directly connected to vaccine by parents. I would not consider that a major contributor. My main contention in this argument is that not enough research has been done on this topic.

OK, that seems reasonable. There's a big distance between arguing that childhood vaccines caused the autism epidemic, and arguing that childhood vaccines may cause or trigger some cases of autism.

[WillYourVoteBCounted]

46. Funny seeing you in these here parts

Nice to see you here, too, but beware this forum is a real hell hole.
I just stopped by today to see how awful it would be. (been busy with the election stuff ya know).

There seems to be an anecdotal relationship with the stepped up rate of vaccinations
and the increase in cases of autism. I didn't say proof, just "seems to be" and "anecdotal."

Before you say anything, know that a good friend of mine is an epidemiologist and has explained
VAERS etc. But he too is skeptical of products by big pharma as he has seen the damage done.

I think (think) that in the 80's the rate of vaccinations and number of vaccinations was increased.

This increase could mean that certain children were exposed to higher doses of the various crap
that is in vaccines.

This is one of the worst forums at DU, in that any posts that criticize any vaccine,for any reason, bring out major attacks and flame wars by certain individuals.

The same goes for criticizing big pharma here.

If you don't want to get flamed here, you have to blindly support any and all vaccines that
Big Pharma comes out with.

IOW, all vaccines are good and necessary and not to be questioned.

Trust the government, always.

[OnTheOtherHand]

48. I don't remember how it started

Oh, I sort of do: I was curious to see how people were arguing about Deadly Immunity.

I have no trouble believing that some vaccines' risks outweigh their benefits, at least as a live possibility. Given the history of medicine, it would hardly be surprising. At the same time, in various places I've encountered an anti-vaccination ideology that doesn't seem well tethered in reality (any more than blind trust of government 'experts' would be).

From what I've seen, it seems like the discussions here are polarized in a pretty familiar way.

[Fire_Medic_Dave]

30. So what's causing autism now?

[cosmik debris]

32. It's all part of a conspiracy by the same people

who faked the moon landing.

[Jim__]

34. Based on what I've read, the causes of autism are both genetic and environmental.

In other words, again, based on what I've read, there is no single cause. It's is entirely possible that thimerosal played a role; and that other components/effects of vaccine also play a role. Watch the video I cited above of Dr Healy. As far as possible causes from vaccine she cites: genetic, metabolic, immunological, mitochondrial susceptibility in specific, relatively small, subgroups that are triggered by vaccines. She also cites the type of research that should be done; and is being discouraged by certain public health officials because they fear that such an investigation will cause people to fear vaccines.

[Fire_Medic_Dave]

37. The ever moving goal post.

Although there is no evidence to conclude it, even if vaccines are causing autism the cost is still worth the benefit.

David

[Jim__]

41. What goal post? What are you talking about?

[Fire_Medic_Dave]

45. Sorry not really directed at you.

Your post makes sense, it's just that in many of these discussions the goal posts seem to move in regards to vaccines and autism.

[Fire_Medic_Dave]

31. I was pointing out the fallacy in Mz Molly argument by making a similar sweeping statement.i

[depakid]

13. Low vaccination rates tend to appear in clusters

where anti-vaccination types reinforce one anothers' dysfunctional beliefs.

Such as here:

"Two of every three kindergartners at downtown Portland's Cedarwood Waldorf and Milwaukie's Portland Waldorf attended class last year missing at least one state-required vaccination, a rate 17 times higher than Oregon's average."

http://www.oregonlive.com/health/index.ssf/2008/10/clusters_of_unvaccinated_stude.html

[mzmolly]

15. This is not

the talking point used by the CDC to sell vaccines ie "Clusters of small groups of parents are not vaccinating..."

Instead the propaganda generally looks like this: http://blogs.wsj.com/health/2008/03/21/more-parents-refuse-to-vaccinate-kids/

Public health officials are adamant that there’s no solid evidence linking vaccines to autism or other neurological disorders. But that’s apparently not enough to persuade growing numbers of parents who are refusing to vaccinate their children because they believe vaccines may cause health problems, the NY Times reports.

Growing numbers of parents? This kind of statement is misleading considering we have an ALL TIME HIGH RATE OF VACCINE COMPLIANCE.

Further, where is the ranting and raving when this happens: http://www.ajph.org/cgi/content/abstract/77/4/434

Lastly no one really knows how long an MMR vaccine confers any protection in a given individual. I was fully vaccinated and titers taken while I was pregnant showed no immunity to measles. So in spite of my being vaccinated, I was not "protected" from measles. In addition, my husband was fully vaccinated and had a bad case of measles a short time later.

Edited to add working link.

[semillama]

5. Good news that most parents realize the importance of vaccination schedules

Like the article states:

"Childhood vaccinations save an estimated 33,000 lives per year in the United States, the CDC's Dr. Anne Schuchat said."

another interesting tidbit in the article:

"The Centers for Disease Control and Prevention issued its report on vaccination rates for ages 1-1/2 through 3 years just a day after another study came out showing no link between autism and the vaccine given to guard against measles, mumps and rubella."

[mzmolly]

6. Bad news that the CDC continues to promote false

assertions, however.

According to the CDC, we have record high vaccine compliance rates and have had "good" coverage since the 1990's. In fact, the CDC tracks coverage levels annually and the trend has been showing an increase in compliance. Under the circumstances, the only conclusion to be made is that they knowingly mislead people when they continue to assert that parents are refusing to vaccinate, thus bringing a resurgence of disease? Yet at the same time, they note the importance of trust:

"We really recognize that ultimately our program is dependent on trust -- trust of moms and dads, trust of caretakers and trust of the clinicians, pediatricians (and) family practice professionals who take care of our children," Gerberding told reporters in a conference call.

I'm not saying that the CDC can't scrounge one kid in a school of 1000 who hasn't been fully vaccinated (or has an unknown status) to scapegoat, but that does not excuse their continued campaign of fear and smear to sell vaccines while they ask for our trust.

As to the MMR study, I'll consider the source. It's the same source that blamed parents for an outbreak of measles in spite of record high vaccination rates. Yet when we have outbreaks in highly vaccinated populations there is no mass effort to inform and/or place blame. Unless of course, as I stated, they can scrounge up one "*non-vaccinated" child in a bundle.

As to their assertion about lives saved, unless they track those who's lives are lost to vaccination, that figure is erroneous. Until we know the cost, we can't accurately weigh the benefit.

*non vaccinated may also mean a child hasn't had the latest booster, may be too young to vaccinate or may have an unknown status.*

In spite of my reservations, I'm glad you take some comfort in the article. :hi:

[Name removed]

7. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[OnTheOtherHand]

9. "they knowingly mislead people when they continue to assert..."

Example, please?

[mzmolly]

14. Read the thread please.

The CDC asserts that "growing numbers of parents are not vaccinating" and as such we're seeing a resurgence of diseases like measles. It's simply not true.

[OnTheOtherHand]

24. I've searched the thread for that quotation

Then, for good measure, I Googled it.

I did find, in this thread, a similar phrase attributed to a WSJ blog, which cited the New York Times. The Times article doesn't appear to cite the CDC at all. The WSJ post credits the CDC for a statistic on measles mortality.

I will invite you once more to support your allegation.

[mzmolly]

28. Good point.

Here are a few articles on the subject that better illustrate my position - (edited to add my original statement for clarity)

According to the CDC, we have record high vaccine compliance rates and have had "good" coverage since the 1990's. In fact, the CDC tracks coverage levels annually and the trend has been showing an increase in compliance. Under the circumstances, the only conclusion to be made is that they knowingly mislead people when they continue to assert that parents are refusing to vaccinate, thus bringing a resurgence of disease? Yet at the same time, they note the importance of trust.

Note the opening paragraphs in the following articles:

http://www.dbtechno.com/health/2008/08/25/cdc-reports-on-measles-outbreak-parents-to-blame/

Washington (dbTechno) - The U.S. Centers for Disease Control and Prevention (CDC) has come out and stated that the number of measles cases in the U.S. has reached its highest point since 1996, and parents are to blame.

http://www.reuters.com/article/topNews/idUSN2146685120080821?feedType=RSS&feedName=topNews

From Reuters: WASHINGTON (Reuters) - Parents refusing to have their children vaccinated against measles have helped drive cases of the illness to their worst levels in a dozen years in the United States, health officials reported on Thursday.

Yet, according to CDC data, parents are complying at record high levels.

Even more misleading are the following comments:

From a http://seattletimes.nwsource.com/html/nationworld/2004387288_measles02.html">Seattle Times Article: While the numbers seem small, two developments could set the stage for a major resurgence in this country: an increase in the numbers of people choosing not to get vaccinated and outbreaks of the disease in Israel and Europe, CDC officials said.

And this from the Reuters article: "Increases in the proportion of the population declining vaccination for themselves or their children might lead to large-scale outbreaks in the United States," the CDC said.

Perhaps you'll have a different take?

[Fire_Medic_Dave]

33. So it could be the press misleading people and not the CDC?

[OnTheOtherHand]

36. thanks

I like to know what people are arguing about. ;)

That dbTechno article is awful. The second link is more useful. But I don't see any contradiction between that Reuters article and the one you cited in the OP. Actually, I can't tell from the OP what the rate of measles vaccination is, but even if it is higher than 99%, that still leaves daylight for over 100 measles cases, most of whom weren't vaccinated.

I don't know why you find the last two statements very misleading. Are you asserting that the measles vaccination doesn't prevent measles? If not, then why is it wrong to speculate that an increase in the proportion of the population declining vaccinations might lead to large-scale outbreaks? You seem to be assuming that CDC officials made some wild assertion about an actual increase, but actually, who knows what the CDC officials said?

[mzmolly]

38. To answer your questions...

I don't know why you find the last two statements very misleading. Are you asserting that the measles vaccination doesn't prevent measles?

I'm suggesting that we had lower compliance rates in years in which we saw a great decline in measles cases. For example, compliance in the late 1960's and early 1970's was at about 60%. Also, according to studies like http://jama.ama-assn.org/cgi/content/abstract/267/6/823">THIS "Coverage of 80% or less may be sufficient to prevent sustained measles outbreaks in an urban community." It is not possible to have 100 coverage as not everyone can be vaccinated.

If not, then why is it wrong to speculate that an increase in the proportion of the population declining vaccinations might lead to large-scale outbreaks? You seem to be assuming that CDC officials made some wild assertion about an actual increase, but actually, who knows what the CDC officials said?

According to the article(s) in question, the CDC did not speculate in the manner you suggest, they indicated that we were seeing a decline in coverage leading to a resurgence of disease. If there were a single article in which such assertions were being made, I might chalk it up to error on the part of reporters, however this is not the case.

[Fire_Medic_Dave]

40. They could always quote the CDC officials and name them.

[OnTheOtherHand]

42. as it turns out, we can go to the transcript

http://www.cdc.gov/media/transcripts/2008/t080501.htm

From the prepared statement:

The third issue I want to mention is about the unimmunized population. In the United States, we're very fortunate to enjoy very high levels of immunization. When we look at our toddler population around the country, more than 92 percent of toddlers are immunized with the MMR vaccine.

When we look at kindergarten entry, about 96 percent of kindergartners have gotten their measles immunizations. They're supposed to get a second dose by kindergarten.

But that doesn't mean that there aren't pockets of unimmunized children and adults around the country. And we know that measles can make its way to those communities.

In the outbreaks so far this year, two-thirds of children who are old enough to be immunized but are not turned out to not be immunized because of personal belief or religious exemption....

From the Q&A:

RON LYNN (ph), LOS ANGELES TIMES: I just wanted to ask you two questions. Are there signs that these pockets of unimmunized people are growing? And do you feel that health officials are struggling to convince the public that the MMR vaccine is safe?

SCHUCHAT: Thank you for that question. You know, we don't have data for every community, but we do know from our national surveys that there is clustering of unimmunized or underimmunized persons.... (N)ow I think we're seeing a different trend, with communities or pockets of unimmunized or underimmunized children that are more closely linked to exempt from immunization, either religious or personal beliefs.

I am concerned that those communities may be growing. And I think it's very important for parents to have good information to make decisions, to discuss with their doctor the risks and benefits of vaccines, and the ongoing risk of vaccine-preventable diseases.

I could keep going, but there's a lot of it. It all seems pretty reasonable to me. As Reuters notes, she clearly states that she thinks the "princip(al) difference this year is the extent of outbeaks in Europe...."

[mzmolly]

44. Interesting transcript from the Reuters article. However I don't see how it refutes the overall

point.

[OnTheOtherHand]

47. maybe I haven't grasped the overall point

I thought the overall point, in your view, was that CDC is contradicting itself about vaccination rates. I think the transcript shows CDC being consistent and measured.

[mzmolly]

49. Provided a single transcript encompassed every CDC statement made to every reporter perhaps? However

here are my original remarks:

According to the CDC, we have record high vaccine compliance rates and have had "good" coverage since the 1990's. In fact, the CDC tracks coverage levels annually and the trend has been showing an increase in compliance. Under the circumstances, the only conclusion to be made is that they knowingly mislead people when they continue to assert that parents are refusing to vaccinate, thus bringing a resurgence of disease? Yet at the same time, they note the importance of trust.

Though my statement was made after reading press similar to what I noted above, I'll attempt to address my point further using your singular example ...

In the August Press Conference a reporter from CNN posed the following question:

And, also, you mentioned that 96 percent of kindergartners are vaccinated. Then why are we – why is it such a risk, if only four percent of the children in that age group haven't gotten the vaccine?

The reporter asks the same question I do.

I feel it is contrary to suggest that "clusters of unimmunized or underimmunized persons may be growing" thus placing us "at risk" in spite of record high vaccination rates and an "extremely effective" vaccine. Feel free to disagree.

Edited for grammar.

[OnTheOtherHand]

50. hardly

If you're committed to the view that the CDC contradicts itself regardless of evidence, then you are free to believe that. But I'm not. I'll need to see some evidence. I didn't choose this transcript out of the ether; I found it when looking for material support for the articles you cited. It isn't my example; it was yours.

In fact, the CDC tracks coverage levels annually and the trend has been showing an increase in compliance.

That depends. The CDC reported a change of 0.0 plus-or-minus 0.9 in MMR coverage of 19-35-month-olds from 2006 to 2007. The only statistically significant changes nationwide were increases in PCV coverage. (Here.) But the 2006 and 2007 figures are higher than the 2005 estimate of 91.5.

None of this rebuts the suggestion that clusters of unimmunized or underimmunized children may be growing. And a coverage rate of 92.3 leaves plenty of room for an increase in measles from current levels of under 200 cases per year.

If the doctor had perfect knowledge, then it might make sense to accuse her of being inconsistent. But it makes sense to me that she would be genuinely unsure how far anti-vaccination arguments might be catching on in certain communities -- and a dataset based on about 17,000 interviews nationwide can't answer that question.

I feel it is contrary to suggest that "clusters of unimmunized or underimmunized persons may be growing" thus placing us "at risk" in spite of record high vaccination rates and an "extremely effective" vaccine.

To refer to something that the doctor actually said: "And so the final points I want to make are that measles is extremely infectious and can be severe, that cases of measles are increasing in the United States, mostly related to importations from Europe and Israel, and that our communities with many unimmunized persons are at risk for ongoing transmission of the virus" (emphasis added).

What's your gripe with that? Because it's the only time the phrase "at risk" appears in the entire transcript.

[mzmolly]

51. Rebut a "suggestion?"

It's up to the CDC to prove what they "suggest" when they call a Press Conference to express concern regarding "clusters of un-vaccinated people growing..." I see you failed to help them out in that regard.

I have examined national data from the pink book that shows an overall increase in vaccination rates over the last two decades.

http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/coverage.pdf

Further, at your request I posted a few articles from an isolated issue that helped to demonstrate my point. You attempted to source the Reuters article and suggested that was my entire case. Let me assure you my opinion comes from years of examining various statements made by the CDC.

We do agree that some of what has been promoted in the media (credited to the CDC) is inaccurate it seems? What we don't agree on is where the skewing of public opinion in this regard begins.

I am off to a class this evening, but I look forward to our continued conversation.

[OnTheOtherHand]

52. hang on there

What makes you think that CDC called a press conference "to express concern regarding 'clusters of un-vaccinated people growing...'"?

The subject of the press conference is a matter of record:

I want to speak with you today about a concerning situation. We have had more cases of measles this year than in any year since 2001.

Your preoccupation with vaccination rates isn't necessarily hers. In fact, the record indicates that it isn't hers.

I have examined national data from the pink book that shows an overall increase in vaccination rates over the last two decades.

Right. That has no bearing on her speculation about clusters. I don't think this distinction is very subtle.

For that matter, her speculation about clusters has little bearing on her take-home message: "...we want to make sure that parents who are making decisions about immunizing their children are aware of the measles risk that's ongoing around the country and make sure that they have a chance to talk with their provider about opportunities for protection."

"Let me assure you my opinion comes from years of examining various statements made by the CDC."

I'm sure that's true, but don't you think it would be irresponsible of me to adopt an intellectual critique of health care professionals based upon the representation of a pseudonymous DU poster? I would rather wait for supporting evidence.

[mzmolly]

53. Since we're being particular, the subject of the press conference

is titled "CDC Update on Measles Outbreaks in United States." One of the areas touched on was the seemingly unfounded "concern" I noted above. Again, I used your documentation to give you an example of some of the rhetoric I take issue with.

Also, I don't suggest you adopt my critique of the CDC. In fact, you are free to suggest the burden of proof for my assertions is greater than it is for "health care professionals" if you wish.

Regarding the "take home message" it's always the same sales pitch. I've seen it before. Ultimately it amounts to, buy the vaccine... Speaking of which, I hope you've had your adult booster shot? I'd hate to see you become part of a potential "growing cluster" or anything. ;)

[OnTheOtherHand]

54. OK, that's why I linked to it

So, apparently, you can read it one way and I can read it another. (Would you agree that there is a difference between touching on what you regard as a seemingly unfounded concern and calling a press conference about the concern, which is what you seem to have stated in the comment before this one?)

By the way, I think it would be interesting to map exposure and adherence to anti-vaccination arguments and see whether they cluster or not.

you are free to suggest the burden of proof for my assertions is greater than it is for "health care professionals" if you wish.

Rather, I think the CDC has already met a higher standard of proof for their vaccine recommendations than you have for your assertions about their rhetoric. Doesn't mean I assume that every word out of a doctor's mouth deserves deference.

Regarding the "take home message" it's always the same sales pitch. I've seen it before. Ultimately it amounts to, buy the vaccine...

Yes, many many people in public health strongly support the MMR vaccine, so naturally at every opportunity they urge people to take it.

Chances are, when this doctor read "Deadly Immunity" (I'll assume she did that not long after it came out), she wondered how many people's lives would be ruined by it -- while other people read it and wondered how many people's lives had been ruined by the vaccines. This is a sharply polarizing issue, as you know.

[mzmolly]

55. I read the link as indication that vaccination rates fluctuate slightly from year to year,

which I why I look at overall trends in the CDC Pink Book. As I've indicated a few times in this conversation we've had outbreaks of measles in highly vaccinated populations, here is one example:

Editorial Note: This outbreak demonstrates that transmission of measles can occur within a school population with a documented immunization level of 100%. This level was validated during the outbreak investigation. Previous investigations of measles outbreaks among highly immunized populations have revealed risk factors such as improper storage or handling of vaccine, vaccine administered to children under 1 year of age, use of globulin with vaccine, and use of killed virus vaccine (1-5). However, these risk factors did not adequately explain the occurrence of this outbreak.

http://www.cdc.gov/mmwr/preview/mmwrhtml/00000359.htm">CDC.GOV

And another -

http://aje.oxfordjournals.org/cgi/content/abstract/129/1/173">OXFORDJOURNALS.ORG

In 1985, 69 secondary cases, all in one generation, occurred in an Illinois high school after exposure to a vigorously coughing Index case. The school's 1,873 students had a pre-outbreak vaccination level of 99.7% by school records. The authors studied the mode of transmission and the risk factors for disease in this unusual outbreak. There were no school assemblies and little or no air recirculatlon during the schooldays that exposure occurred. Contact interviews were completed with 58 secondary cases (84%); only 11 secondary cases (19%) of these may have had exposure to the index case in the classrooms, buses, or out of school. With the use of the Reed-Frost epidemic model, only 22–65% of the secondary cases were likely to have had at least one person-to-person contact with the index case during class exchanges, suggesting that this mode of transmission alone could not explain this outbreak.

Yet in the information below and in the recent press conference, the CDC promotes the notion that we're in a special situation today because it's possible growing "clusters" of people aren't vaccinating? Pardon me for not buying it.

Here is another example of what I take issue with - http://www.cdc.gov/Features/MeaslesUpdate/

From January through July 2008, CDC received reports of 131 measles cases from 15 states and the District of Columbia—the highest year-to-date number since 1996. More than 90% of those infected had not been vaccinated, or their vaccination status was unknown. Many of these individuals were children whose parents chose not to have them vaccinated. Fifteen of the patients, including four infants, were hospitalized.

Note that the http://iier.isciii.es/mmwr/preview/mmwrhtml/00049048.htm">1996 outbreak they mentioned appears to have occurred in a "highly vaccinated population."

During April 9-July 7, 1996, a total of 107 confirmed measles cases were reported from Washington County, Utah -- one of five counties in the Utah Southwest Health District (USHD). Fourteen cases associated with this outbreak were reported from other counties in Utah and from Arizona, California, and Nevada. This report summarizes the epidemiologic investigation of the outbreak in Washington County (1995 population: 65,885) and demonstrates the potential for measles to spread in a school-aged population despite a high coverage rate for at least one dose of measles vaccine.

Draw your own conclusions on the failure of the CDC to note this in the article above. Perhaps after picking it apart you'll feel that the information I've provided does not erode trust among parents or point to contrary rhetoric. However as a parent I disagree. The CDC "sells" one side of the story, one that often contradicts other data they provide (and logic) if one digs a bit deeper.

You said ~ Rather, I think the CDC has already met a higher standard of proof for their vaccine recommendations than you have for your assertions about their rhetoric. Doesn't mean I assume that every word out of a doctor's mouth deserves deference.

I wasn't attempting to change your mind, I was simply sharing my perspective. You're certainly entitled to different opinion. However, as you know the CDC indicates that the benefits of various vaccines outweigh the risks. It seems you http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=222&topic_id=47521&mesg_id=48119">disagree on some level? Or at the very least don't feel they've met the "standard of proof" in various situations? May I ask which vaccines you are concerned about and why?

As you note, indeed this is a very polarizing issue. My guess is that the CDC Press Conference was desirable in response to the http://www.time.com/time/health/article/0,8599,1721109,00.html">Hannah Poling ruling in 2008 and not the 2005 RFK Jr. article? Though they came out with various "concerns" at that time as well. Either way it would appear that we both feel the reason for the Press Conference was more about damage control and maintaining high vaccination levels than an actual heightened concern over a so called Measles outbreak?

Regarding your interest in "cluster" studies, did you know that the CDC promotes the gathering of various data at times? For example the CDC noted early in the press conference that health care professionals are not as familiar with measles as they once were. Do you feel that a timely reminder (just after the ruling I noted above) http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00273">such as this might impact reporting in a given year? In other words, could any so called "clusters" be more about a current, heightened awareness and the following investigation than an actual increase?

I think part of the reason the issue is polarizing is because the CDC promotes one side of the story, and creates an environment in which choice is not respected. Doctors don't generally consult with patients about family history and the risk of contracting a various disease, they're not encouraged to. They're taught to sell vaccines so that we can all be "safe." And, rather than examine as individuals the choice to take part in a particular vaccine program, we're to swallow the "benefits outweigh the risks" language. So, we keep vaccinating without question because as you know the disease can come back if an unvaccinated child gets X. However, if a vaccinated child in a highly vaccinated population gets X ?

Unfortunately, as many here can tell you I could discuss vaccination for hours on end. However, I'm preparing to entertain for the coming holiday so as difficult as it is to pry myself away (provided you don't have any questions for me or ask for more commentary) the last word is yours. ;)

Pardon the lengthy reply and thanks for the respectful discussion. We'll likely have to agree to disagree as is often the case. I've yet to change one mind and I've yet to have mine changed.

Peace

[OnTheOtherHand]

56. this seems pretty straightforward

Unless you have evidence that the MMR vaccine actually doesn't protect against measles at all, then your arguments here seem somewhat akin to arguing against seat belt use on the basis that people who wear seat belts can still be killed. That isn't to say that it's impossible to muster plausible arguments against vaccinations; surely it would depend on all the facts.

Why do you "take issue with" the assertion that in the first seven months of 2008, more than 90% of individuals infected with measles had not been vaccinated or their vaccination status was unknown? Do you think that was coincidental?

Your choice of quotation from the Washington County case study is remarkably partial. Here are some of the points you left out:

Of the 99 case-patients eligible for measles vaccination *, 64 (64%) had not been vaccinated, 34 (34%) had received one dose of a measles-containing vaccine (MCV), and one (1%) had received two doses of an MCV....

A vaccine effectiveness study was conducted at the high school where the outbreak was initially reported.... The measles attack rate among unvaccinated students was 33% (nine cases) and among recipients of one dose of MMR was 1% (eight cases). No cases of measles were diagnosed among any of the recipients of two doses of MMR in this high school....

Back in post #38, you cited evidence that "Coverage of 80% or less may be sufficient to prevent sustained measles outbreaks in an urban community." Now you cite evidence that coverage of 80% or more may not be sufficient to prevent a measles outbreak. Your main conclusion in each case seems to be that vaccination isn't especially helpful, but I suspect that that opinion precedes these particular data.

However, as you know the CDC indicates that the benefits of various vaccines outweigh the risks. It seems you disagree on some level? Or at the very least don't feel they've met the "standard of proof" in various situations? May I ask which vaccines you are concerned about and why?

Certainly. I know of no evidence to challenge the CDC's current assessment of the benefit/risk balance of any vaccine. "Standard of proof" isn't the right frame, in my opinion: it is incumbent upon CDC and FDA to continue to gather data on benefits and risks of these and other medical treatments. I don't single out one vaccine for concern.

Either way it would appear that we both feel the reason for the Press Conference was more about damage control and maintaining high vaccination levels than an actual heightened concern over a so called Measles outbreak?

No, not at all, and I don't understand the basis for your inference that the CDC doctor was misrepresenting the reason for the press conference. I do think that the CDC is consistently concerned with promoting MMR vaccination. It doesn't follow that the reason for the press conference was something other than what the doctor said it was.

Do you feel that a timely reminder (just after the ruling I noted above) such as this might impact reporting in a given year?

Sure, although that "reminder" was reporting on cases that had already been reported. I'm not sure why CDC would be less worried about the number of reported cases in 2008 if it concluded that cases in 2007 had been underreported, which could be the case.

...the CDC promotes one side of the story, and creates an environment in which choice is not respected. Doctors don't generally consult with patients about family history and the risk of contracting a various disease, they're not encouraged to. They're taught to sell vaccines so that we can all be "safe." And, rather than examine as individuals the choice to take part in a particular vaccine program, we're to swallow the "benefits outweigh the risks" language.

Well, I'm partly sympathetic to that description of the issue and partly not, but I'll leave it there for now.

So, we keep vaccinating without question because as you know the disease can come back if an unvaccinated child gets X. However, if a vaccinated child in a highly vaccinated population gets X ?

Apparently, based on the evidence that you yourself linked to, that is a lot less likely (but not impossible). It interests me that you linked to such evidence apparently without noticing.

I get the impression that you think the balance weighs against MMR vaccination, and I can't tell why (if so). So it goes.

If I don't catch you in the interim, have a lovely Thanksgiving!

[mzmolly]

57. I must not

be making myself clear as you're not understanding. For example, I didn't overlook what you note in the Washington case. I posted the information as it contains another example demonstrating the fact that outbreaks of disease also occur in highly vaccinated populations. I went on to say that the CDC, while selling the vaccine, and noting we had an outbreak in a given year, failed to state that it appears to have occurred at least initially in such a population.

Here is a snip ~

A vaccine effectiveness study was conducted at the high school where the outbreak was initially reported. Review of school vaccination records of the 879 students attending the school at the time of the outbreak indicated that 780 (89%) students had received one dose of measles-mumps-rubella vaccine (MMR), 72 (8%) had received two doses of MMR, and 27 (3%) were unvaccinated. Seventeen unvaccinated students had philosophic exemptions, and 10 had no record of measles vaccination in their school health files. The measles attack rate among unvaccinated students was 33% (nine cases) and among recipients of one dose of MMR was 1% (eight cases).

According to these stats one could argue that the attack rate in the *vaccinated was 66%. About equal to the rate you chose to focus on above.

While I'd enjoy responding to the remaining areas of confusion (restoring context in some cases) it appears such an attempt would be futile. So, rather than rehash point after point continuing the cycle of babbling without communicating, I'll refrain from attempting to clarify and let the record of conversation stand as is.

As for my opinion on the measles vaccine, I think what the evidence indicates is that the vaccine offers protection in some individuals, under the right conditions, for an undetermined period of time. However, I don't think we, as a society, have accurately/honestly measured the cost for such protection. Interesting to note that those born before 1957 are considered "probably immune" for a lifetime due to natural immunity.

(I must say, I think your seatbelt comparison is outrageous.)

Interesting to note, I've actually had my http://www.cdc.gov/vaccines/recs/schedules/downloads/adult/06-07/adult-schedule.pdf">adult MMR booster. Though, I would not do it over again given the same choice.

By the way, I am not anti-vaccine, I'm pro-choice and pro-green vaccine.

You have a nice holiday as well. :hi:

Edited because I'm dog tired and frankly incoherent. ;)

[OnTheOtherHand]

58. ?

I don't know why you find the seatbelt example outrageous. Insisting that CDC should have pointed out that the 1996 measles outbreak started in a high school with a high vaccination rate seems remarkably like complaining that someone failed to mention all the cases where people fail to wear seat belts but die in car crashes anyway -- especially since the cases very disproportionately occurred among people who hadn't had even one MMR dose. And seat belt use poses its own controversies of choice. Of course car crashes are not contagious, so the analogy can't be taken very far. (ETA: If anything, the argument against requiring seat belt use seems much more compelling from a 'choice' perspective than the argument against strongly promoting MMR vaccination.)

Actually, in this case the analogy breaks down further because the school had a high one-dose vaccination rate but a low two-dose vaccination rate. The data reported suggest that a single dose greatly improves the individual's chances of avoiding infection in an outbreak, but doesn't suffice to stop the spread. (ETA: So, CDC plausibly presents the case study as underscoring the importance of obtaining two doses. You seem to prefer to interpret it as evincing the relative inefficacy of vaccination.)

According to these stats one could argue that the attack rate in the *vaccinated was 66%. About equal to the rate you chose to focus on above.

Huh? How would one argue that? If the attack rate in the vaccinated or *vaccinated were anything like 66%, there would have been many hundreds of cases at the high school alone. What rate are you reckoning here?

Indeed, I don't know that we can talk meaningfully about the costs of MMR vaccination if, in a fairly simple case study, we can't agree on attack rates within an order of magnitude. But if you want to direct me to a source that plausibly estimates adverse event rates, cool.

[mzmolly]

59. It seems

that you came into the thread misunderstanding context and it appears to have continued? I think you assigned a motive that did not exist, and that along with perhaps my communication style, (and a chronic lack of sleep on my part) has lent itself to ongoing confusion? But, in spite of it all, I'll attempt a quick clarification on a few things again. ;)

In response to the one v. two dose point you made. At one time the recommendation was one dose. One was considered vaccinated if they had one jab depending upon date of birth. This system was in place for decades. Then we had a handful of outbreaks in highly vaccinated communities and the CDC said essentially we better suggest a booster and so on ...

Regarding the 66% attack rate. If we begin with the nearly 900 students as you suggest it seems to me 33% of cases in non-vaccinated persons would account for close to 300 cases, not nine. Though in all fairness to both of us, I realize the term 'attack rate' is used in varied context depending upon the situation.

I will touch on your seatbelt analogy and give you my own analogy:

I don't know why you find the seatbelt example outrageous. Insisting that CDC should have pointed out that the 1996 measles outbreak started in a high school with a high vaccination rate seems remarkably like complaining that someone failed to mention all the cases where people fail to wear seat belts but die in car crashes anyway --

While this again was one example of the bias I take issue with I'll use your analogy to paint the larger picture. I believe it's closer to suggesting we're having an increase in auto deaths while reminding people to wear their flawed seat belts. While at the same time, failing to mention all the cases where people wore said seat belts and died as a result of not knowing they were flawed. Keep in mind, all we have is the flawed version of the seat belt because questioning injuries as a result of wearing them is simply not allowed. In fact we mustn't strive to improve the current version of the seat belt or everyone will stop wearing them! Seat belts are good, questioning a design flaw = bad. Why, if everyone stopped wearing their seat belts we'd be in serious peril! Why do you want children to die from not having a seat belt on!? You must be anti-seat belt! :sarcasm:

Again, we have a different view.

You requested plausible estimations of adverse event rates in relation to the MMR jab we don't have a system of tracking that is considered "plausible." We have a passive reporting system known as VAERS. And what we're told is essentially "of course we track adverse events" but "the information is not reliable." This is why I indicated we are not accurately measuring the cost of our success.

Here is the disclaimer at the VAERS website:

When evaluating data from VAERS, it is important to note that for any reported event, no cause and effect relationship has been established. VAERS is interested in all potential associations between vaccines and adverse events. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.

So you see, we know how many reported auto related deaths have been reduced by the flawed seat belt (we take great care in gathering and analyzing that information.) But we don't know how many people die or are injured as a result of the design flaw.

Should you respond, I'll get back to you after the holiday. :hi:

CHEERS!

Edited to add link to http://vaers.hhs.gov/">VAERS

[Fire_Medic_Dave]

39. My point exactly.

The press says the CDC says. Sounds like here say to me.

david

[OnTheOtherHand]

43. you may be interested in the transcript I just linked to

Here's a cute excerpt:

(ARTHUR) ALLEN (WASHINGTON INDEPENDENT): OK, one follow-up question. I think many of us are probably looking for the story that this is caused by these sort of expanding pockets of unimmunized children....

Yep, seems like many of us are. (I'll let you read the doctor's responses for yourself.)

[LeftishBrit]

10. Good news!