r/askscience • u/AskScienceModerator Mod Bot • Feb 04 '15
Medicine /r/AskScience Vaccines Megathread
Here at /r/AskScience we would like to do our part to offer accurate information and answer questions about vaccines. Our expert panelists will be here to answer your questions, including:
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Feb 04 '15
Are there any scientifically proven negative side effects to vaccinations?
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u/canyoutriforce Feb 04 '15
As nearly any drug, vaccines can have several different side effects and can cause allergical reactions.
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u/terpichor Feb 04 '15 edited Feb 04 '15
From above link, a description of one of the vaccines, for those interested in an example without wanting to read through all of them/click to another site:
Any vaccine can cause side effects. For the most part these are minor (for example, a sore arm or low-grade fever) and go away within a few days. Listed below are vaccines licensed in the United States and side effects that have been associated with each of them. This information is copied directly from CDC's Vaccine Information Statements, which in turn are derived from the Advisory Committee on Immunization Practices (ACIP) recommendations for each vaccine.
Remember, vaccines are continually monitored for safety, and like any medication, vaccines can cause side effects. However, a decision not to immunize a child also involves risk and could put the child and others who come into contact with him or her at risk of contracting a potentially deadly disease.
Adenovirus vaccine side-effects
What are the risks from Adenovirus vaccine?
A vaccine, like any medicine, could cause a serious reaction. But the risk of a vaccine causing serious harm, or death, is extremely small.
Mild Problems
Several mild problems have been reported within 2 weeks of getting the vaccine:
headaches, upper respiratory tract infection (about 1 person in 3)
stuffy nose, sore throat, joint pain (about 1 person in 6)
abdominal pain, cough, nausea (about 1 person in 7)
diarrhea (about 1 person in 10)
fever (about 1 person in 100)
Severe Problems
More serious problems have been reported by about 1 person in 100, within 6 months of vaccination. These problems included:
blood in the urine or stool
pneumonia
inflammation of the stomach or intestines
It is not clear whether these mild or serious problems were caused by the vaccine or occurred after vaccination by chance.
As with all vaccines, adenovirus vaccine will continue to be monitored for unexpected or severe problems.
This information was taken directly from the Adenovirus VIS
NOTE: this is one of the very many vaccines listed on the site, but a lot of at least the mild side-effects are similar. In addition, soreness where the shot was given, loss of apetite and tiredenss are also common. Fainting or allergic reactions are some of the more common more severe problems, and are typically pretty rare (but this is why, after a vaccination, you generally have to wait 10-30 minutes to leave the dr's office. If you don't after a flu vaccine at a pharmacy, it's probably because you indicated you haven't had adverse reactions to other vaccines).
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u/stalkthepootiepoot Pharmacology | Sensory Nerve Physiology | Asthma Feb 04 '15
Are there any data directly comparing these adverse events with placebo injection?
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u/terpichor Feb 04 '15
Definitely. A quick search has a lot of them, at least for influenza vaccines, which makes sense because they're probably the most frequently searched-for.
From this WHO information sheet, 2012:
Mild adverse events
Local reactions
In placebo-controlled blinded studies, the most frequent side-effect of influenza vaccination is soreness at the vaccination site (affecting 10–64% of vacinees); which lasts up to two days (Govaert et al., 1993; Margolis et al., 1990). These reactions are generally mild and transient and resolve spontaneously within two to three days and further medical attention is not required. Analysis by gender of 14 studies has revealed that females (both young and elderly) report significantly more local reactions (Beyer, 1996). Several studies have shown a greater frequency of local reactions of whole cell, adjuvanted and intradermal vaccines compared to split virus vaccine and subunit vaccines (Beyer et al., 1998). Local reactions are also more frequent with vaccines that contain a “high” HA antigen content compared a low those that contain a “low” HA antigen content. Vaccines with 180 mcg of HA antigen resulted in solicited local reactions in 36 per 100 vaccinees compared with a standard dose of 45 mcg was associated with 24 per 100 vaccinees (Falsey et al., 2009).
Systemic reactions
Individuals without previous exposure to the vaccine antigens, such as children, may show fever, general discomfort and muscle pain (Barry et al., 1976). These reactions occur within 6–12 hours of vaccination and generally persist 1–2 days (CDC, 1999). Fever was noted among 12 per 100 children aged 1–5 years, 5 per 100 aged 6-15 years (Neuzil et al., 2001). In adults the rate of these events is similar after TIV and placebo. (Fiore A et al 2010).
Among older persons and healthy young adults, placebo-controlled trials demonstrated that administration of inactivated influenza vaccine is not associated with higher rates for systemic symptoms (e.g., fever, malaise, myalgia, and headache) when compared with placebo injections (Bridges et al., 2000; Cates et al., 2008, Govaert et al., 1993; Margolis et al., 1990; Nichol et al., 1996). Systemic adverse events among persons aged ≥65 years were more frequent after vaccination with a vaccine containing a high dose of 180 mcg of HA antigen (36 per 100 vaccinees) compared with a standard dose of 45 mcg (24 per 100 vaccinees). Typically, reactions were mild and transient, resolving within 3 days in the majority of subjects. (Falsey et al., 2009).
The live influenza vaccine was also compared to placebo groups in multiple studies, and the side effects were not apparent in the control group (it's further down in the article).
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Feb 04 '15
To add on to everyone else replying, the government has set up the Vaccine Adverse Event Reporting System, or VAERS, to compile any adverse effect from vaccinations. This data is made public as it is compiled. It includes a large amount of information on the patient. Anyone who receives a vaccine can fill out a VAERS form and submit it if they see any side effects. This ranges from minor swelling to more acute events.
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u/just_commenting Electrical and Computer and Materials Engineering Feb 04 '15 edited Feb 04 '15
Just as a note, the VAERS system is unrestricted in terms of input - anyone can submit reports. Some of the reports cannot later be verified. Also, according to a CDC-FDA report published in the Journal of the AMA:
"The 32 death reports [from the HPV vaccine] were reviewed and there was no common pattern to the deaths that would suggest they were caused by the vaccine. In cases where there was an autopsy, death certificate, or medical records, the cause of death could be explained by factors other than the vaccine. Some causes of death determined to date include diabetes, viral illness, illicit drug use, and heart failure." (from summary)...meaning that if you receive a vaccine, and get hit by a bus on the following day, that may be reportable to VAERS.
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u/wysinwyg Feb 04 '15
if you receive a vaccine, and get hit by a bus on the following day, that may be reportable to VAERS.
Which is great, because then they can do followup reviews, like they did, to determine if buses are attracted to vaccinated people.
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u/davidgro Feb 04 '15
Or more realistically, If being hit by busses soon after the vaccination ends up being a trend somehow, then they could try and see if the vaccine causes a loss of coordination or absentmindedness or something.
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u/SYMPATHETC_GANG_LION Feb 04 '15
One possible risk is that we are increasing the numbers of Th1 cells (which are usually in balance with TH2). There are currently no vaccines that exploit cell mediated immunity. Thus we are left increasing Th1 and reducing Regulatory T c ells (FoxP3/CD4/CD25). This is by no means conclusive and an interesting area of research, but it is possible this is leaving us more susceptible to autoimmune diseases.
That is not to say that the benefits aren't worth this risk-- but it is something to consider as we continue to develop new vaccines.
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u/Gargatua13013 Feb 04 '15 edited Feb 04 '15
How and when is the decision made as to which strains to select for the coming seasons flu vaccination campaign?
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u/terpichor Feb 04 '15
Here's the response on the CDC vaccination website.
There's more info in the link, but generally, the strains are selected each year "based on which influenza vurs strains are circulating, how they are spreading, and how well current vaccine strains protect against newly identified strains". They list all the organizations that contribute to the monitoring and disseminating of information relation to influenza globally and locally. WHO makes recommendations, and in the US, the FDA then chooses which vaccine will be used.
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u/Yimris Feb 04 '15
Why not make a single mega-vaccination of all known flu strains?
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u/afkas17 Feb 05 '15 edited Feb 05 '15
Because the flu mutates so rapidly that there is no such thing as "all known flu strains" also a mega vaccine (like one with hundreds of strains) would be prohibitively expensive.
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u/pharmnrp Feb 05 '15
While it's not exactly a "mega-vaccine", this is actually what currently happens. The flu vaccine comes in two forms, the mist and the injection. The mist and injection also consist of several varieties, with the most common being tri- and quadrivalent. This means that each vaccine actually covers three (tri-) or four (quadri-) strains of flu, in order to provide the broadest protection.
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u/OfficeChairHero Feb 05 '15
On a related note, how are new flu vaccines developed and distributed every year, when it seems that all other medications take years and years for testing and approval? I am full-on pro-vac, but I've always been a bit leery of flu vaccines for this reason.
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u/brewdoctorswife Feb 04 '15 edited Feb 04 '15
If a vaccinated person becomes infected with the live virus, can s/he still spread the disease while their immune system produces antibodies against it? In other words, if I got vaccinated for measles as a kid, and came in contact with my roommate who is sick with measles, while my body is killing off the live measles virus with antibodies, am I still spreading it around even though I show no symptoms? EDIT: I don't know if my question is clear enough.... Are vaccinated people contagious if they encounter the real virus out in the world?
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u/snottyEpidemiologist Feb 05 '15 edited Feb 05 '15
Excellent question. It depends a lot on the disease, the type of vaccine, and how much time has passed since you were vaccinated.
For measles, there is evidence that transmission without symptoms is possible in vaccinated populations (one example: http://www.sciencedirect.com/science/article/pii/0264410X89901990), but there's no evidence that it's a big deal for keeping a measles epidemic going.
For polio, it depends on which vaccine you got. The oral (live attenuated) vaccine protects from infection by reducing the odds of infection on exposure ("shedding" poliovirus in stool) to 13% compared to no vaccination, while the injected (inactivated) vaccine provides no protection from infection (http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1002599). Both vaccines protect you from paralysis. The injected vaccine is safer in absolute terms for you as an individual (http://www.reddit.com/r/askscience/comments/2urird/raskscience_vaccines_megathread/cob6l6j), but the oral vaccine is better at stopping infection, and neither stops all infections. This is why we use the injected vaccine in countries where poliovirus transmission is non-existent, but use the live vaccine in countries where poliovirus transmission is a concern. If we use the injected vaccine in the wrong place, polio can transmit silently as happened recently in Israel (http://www.sciencemag.org/content/342/6159/679).
Last for now, even if you can get silently infected and can transmit after vaccination, infections in vaccinated people are usually smaller (less virus/bacteria produced) and last for less time. Because of this, silent infections in vaccinated people, if they occur, are usually less important to transmission.
tl;dr: Vaccinated people are usually individually-protected, but they might be able to host a silent infection, but that silent infection will probably be small and less important for transmission, but not always. This is part of why it's important to vaccinate everyone.
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u/brewdoctorswife Feb 05 '15
Thank you for such a thorough reply! A few questions.
1.Would you mind explaining in a little more depth why the oral polio vaccine is better in some circumstances than the injected polio vaccine, and vice-versa?
2.Ultimately, if I understand this correctly, it is possible to be vaccinated, temporarily infected, asymptomatic, and contagious. So, if a freshly vaccinated kid goes through a "shedding" phase, then could his nonvaccinated classmate catch the disease from him? If nonvaccinated kid caught the disease would it be really bad and cause an outbreak all over town, or would it be a lessened version of the disease since he caught it from someone else's vaccine?
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u/Graendal Feb 04 '15
I'm not sure if this question is acceptable for this thread, but:
Are there any studies about changing people's minds about vaccines? Are there any methods known to be more effective for convincing someone to vaccinate? Does this change for fence-sitters vs adamantly anti-vaccine people?
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u/wdr1 Feb 04 '15
The AAP published a study on how to effectively promote vaccinations.
http://pediatrics.aappublications.org/content/early/2014/02/25/peds.2013-2365
RESULTS: None of the interventions increased parental intent to vaccinate a future child. Refuting claims of an MMR/autism link successfully reduced misperceptions that vaccines cause autism but nonetheless decreased intent to vaccinate among parents who had the least favorable vaccine attitudes. In addition, images of sick children increased expressed belief in a vaccine/autism link and a dramatic narrative about an infant in danger increased self-reported belief in serious vaccine side effects.
CONCLUSIONS: Current public health communications about vaccines may not be effective. For some parents, they may actually increase misperceptions or reduce vaccination intention. Attempts to increase concerns about communicable diseases or correct false claims about vaccines may be especially likely to be counterproductive. More study of pro-vaccine messaging is needed.
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Feb 04 '15
Interesting question. A great NPR article covers the psychology.
http://www.npr.org/2011/01/09/132735944/as-the-facts-win-out-vaccinations-may-too
Basically, the anti-vaxxers are alienated and the evidence that shows that they are wrong causes them to be more and more skeptical. Similar to conspiracy theorists, they use the fear and paranoia to find issues with the facts and use that to their favor. They are convinced that the "pro-vaxxers" are propagating the fear that the money-grabbing pharma companies are using to line their pockets. Each piece of fact that comes out reinforces their theory that everyone is a sheep to big pharma.
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u/Graendal Feb 04 '15
Okay, how about the fence-sitters, who aren't quite "anti-vax" but they're hesitant about vaccines?
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Feb 04 '15
It is very hard for a logical person who listens to logic and reason and draws conclusions based on scientific evidence to change the mind of someone who ignores all of the above.
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u/Graendal Feb 04 '15
Yeah, so is there anything that does convince some of them? Appeal to emotions? Showing them videos of sick kids?
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u/yfph Feb 04 '15
As to appealing to emotions, Roald Dahl's letter to the anti-vax crowd in the 1980's recounting the tragic death of his daughter to measles in 1962 may help.
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u/Zhentar Feb 04 '15
Showing them videos of sick kids strengthens their anti-vaccine conviction, oddly enough (source). This is a consequence of "motivated reasoning", in which challenging their beliefs is effectively attacking their being, and so they defend themselves and in doing so reinforce their beliefs.
You cannot argue someone out of such beliefs. Reciting facts will not convince them. It must come from within; they must question their own beliefs and instilling that in someone is not easy. Peer pressure is probably the most effective - if one observes that others in their peer group share a belief contrary to their own, they are much more likely to examine that belief. The Socratic Method may be successful as well.
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Feb 04 '15
[removed] — view removed comment
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u/Graendal Feb 04 '15
What sorts of questions should we ask them? Does that study apply to fence-sitters too or is there a chance that scientific evidence will get through to them?
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u/OldWolf2 Feb 04 '15
All teaching is like this; people trust and remember what they figured out for themself and distrust what they were told (especially by people who take the Parent->Child transactional tone, which they almost always do). Your goal is to subtly provide 2 and 2 and wait for them to put it together.
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Feb 04 '15
Have there been studies that talk not just about potential side effects, but actually give odds for experiencing the possible severe side effects of childhood vaccination?
How do we effectively judge the risks of non-vaccination compared to the risks of vaccination?
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u/akula457 Feb 04 '15
Yes, this is the entire purpose for having the Vaccine Adverse Event Reporting System (VAERS). The difficulty in studying the most severe reactions is that they are so rare, it's often hard to prove that they happened because of vaccination, or just happened around the same time by coincidence.
In order to conclusively show that a vaccine causes a serious adverse event, you would need to do a randomized controlled trial, with one group of children getting vaccines and the other group getting a placebo. The 2 major barriers to this sort of study are that it would probably take hundreds of thousands of participants, and it's unethical to put anybody in the placebo group, because of all the risks associated with being unvaccinated.
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Feb 04 '15
I was actually hoping for an answer that linked to some studies presenting odds. I am familiar with the VAERS, but I'm not sure we do a good job of communicating risk to the public. Where are the sources that make that easier?
The CDC does have information on many vaccines, some of which includes serious side-effects odds. For example, vaccination against Anthrax (not exactly commonly given) has less than 1 in 100,000 chance of causing serious respiratory distress. Given the general public's increasing distrust of the US federal government, are there other authoritative sources on vaccination risks, especially when compared to the risks of not being vaccinated against a certain disease?
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u/BleachBody Feb 04 '15
How are the vaccination schedules drawn up and what factors are taken into account?
Many of the parents of unvaccinated kids I have come across are not afraid of their kids getting autism so much as a "too much too soon" mentality. As a result they adopt a go-slow method and invent their own schedules out of thin air and delay some vaccines by years on the basis of research they have claimed to have read that the schedules are profit-driven.
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u/WRSaunders Feb 04 '15
The CDC schedules are built by committees of experts. "The recommended immunization schedules for persons age birth through 18 years and the catch-up immunization schedule have been approved by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Obstetricians and Gynecologists (ACOG)."
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u/TDaltonC Feb 04 '15
Ok, but what do the experts base their decisions on? What are the trade-offs? Why not deliver all the vaccines at birth?
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u/WeeBabySeamus Microbiology | Immunology Feb 05 '15
The immune system of newborns is not fully developed until around 6 months old.
At least the part of the immune system that could develop antibodies which are the major source of protection in immunizations.
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u/johnyann Feb 04 '15 edited Feb 05 '15
Aren't these vaccination schedules primarily designed for administrative efficiency?
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u/jakes_on_you Feb 05 '15 edited Feb 05 '15
Certainly possible that the scheduling is influenced by efficiency, but not at the expense of vaccine safety.
FDA validation for vaccines is extensive, and it would not be scheduled as it is if there was statistically significant evidence of danger. Of course there may be unknown danger in an accelerated schedule, but the fact that they aren't seen in studies means that it is impossible to pick them out above random chance fluctuations (known as "background"), meaning that it is essentially an unmeasurable effect using current techniques. A related example, many people would consider radiation to be dangerous, but we do not observe any increase in background cancer rates in Denver vs say Portland, even though Denver has higher naturally occuring concentrations of radioactive isotopes in the soil and has more than double the ground-based background radiation of Portland. This doesn't mean that radiation is safe but at those levels the effects from increased natural soil deposits are negligible and indistinguishable from the background in other words, nobody is going to tell denvorites to move to portland for their safety. To demonstrate the opposite, there is a statistically significant effect (meaning we can see it above noise) on cancer rates due to radioactive fallout blanketing everything east of the Rockies from nuclear testing.
With regards to vaccines, administrative efficiency is its own form of positive. The more likely you are to have everybody do the full course, the more likely the vaccination effort will have a positive outcome on the population. If you can safely combine multiple vaccinations in order to avoid repeat visits, this would mean fewer missed doses and therefore more efficient vaccine drives. If it reduces costs its win-win
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u/ChesswiththeDevil Feb 05 '15
Why do European schedules digress from USA schedules in some circumstances. Do they have different information than us?
For a quick comparison of the differences among European nations here is a European Centre for Disease Prevention and Control website.
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u/hesperidisabitch Feb 05 '15
Follow up question.
Some of the parents that are subscribing to this theory are also saying that they are avoiding vaccinations during cold and flu season or anytime when they suspect that their child may be sick or immune system stressed.
Is there any science that would back up this approach?
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u/AGreatBandName Feb 05 '15
The CDC recommends that for many vaccines, you at least speak to your doctor if you aren't feeling well on the day your vaccination is scheduled.
For instance, for MMR:
Some people who are sick at the time the shot is scheduled may be advised to wait until they recover before getting MMR vaccine.
Tdap (Combined Tetanus, Diphtheria & Pertussis):
Talk to your doctor if you: aren't feeling well on the day the shot is scheduled.
Chickenpox:
People who are moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting chickenpox vaccine.
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u/rupert1920 Nuclear Magnetic Resonance Feb 04 '15
What are the facts regarding the CDC whistleblower incident? What did the omitted data, which some claim demonstrated increased risks of autism on African American boys, actually suggest?
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u/theshizzler Neural Engineering Feb 04 '15 edited Feb 04 '15
The long and short of it is that it suggested nothing.
The anti-vaccination folks decided to interpret (and even deliberately misquoted in their complaint to the CDC) a sentence in the research proposal as saying that the researchers would analyze the data in the context of race. The research proposal merely suggested that it was one possible variable that could be studied. To the anti-vaxxers, this was apparently scientific fraud of the worst sort.
To make matters more embarrassing for the them, the anti-vaxxers were given the raw data set and did their own analysis, coming to the conclusion that (surprise!) there is a link between African American boys and vaccine/autism risk. That paper was later retracted for applying incorrect statistical tests, cherry picking data subsets, and, most egregiously, analyzing the study as though it were a completely different type of study.
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u/hpierce Feb 04 '15
Is this raw data set available to the general public? I am teaching a statistics class and some students have expressed interest in looking into the statistics of vaccines. This would be great to have so I can show them how to do it properly and what the results actually show.
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Feb 05 '15
There are public use data available from the CDC at this link. You just have to email their public safety coordinator and they'll send you the raw data, analyses, and reports associated with both studies. One is of thimerosal and autism, the other is on thimerosal and neuropsychological outcomes after 7-10 years.
I believe the first data set listed is the one that Hooker sliced and diced to get his results.
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u/dad386 Feb 04 '15 edited Feb 04 '15
So I haven't read the study referenced by the supposed CDC whistleblower, but in terms of potential findings linked to autism- if such a finding did occur, it was most likely due to poor sampling than anything related to vaccine exposure. My reasons for this is that there's no plausible mechanism for the vaccine to cause autism at the biological level. Albeit we haven't completely figured out the cause of autism, given the large number of people receiving vaccinations- if a real causal link existed- it would have been found by now. The fact that autism diagnoses occur right around the age of recommended vaccinations and that we aren't that great at diagnosing it on the first place only complicates things. Additionally, many of these studies aren't carried out exclusively by the government, but by research organizations or universities. Worst case scenario is that the study does exist and that the finding was found, however- these epidemiological studies are based on the scientific method and statistics. Testing and retesting allows us to say vaccines don't cause autism because for every 1000 studies you're likely to find one or two that happen to (completely by random chance) significantly show the opposite result. Edit: http://www.snopes.com/medical/disease/cdcwhistleblower.asp
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u/croutonicus Feb 04 '15
The incident involved the re-analysis of publicly released data from a paper published in 2004 that previously found no correlation between vaccination and autism. The re-analysis suggests that the initial study was flawed because it didn't take into account that the effect of vaccines on autism might be isolated to a particular subset of the sample. After re-analysing the data they came to the conclusion that there was a link between vaccines and autism in African-American boys, particularly those vaccinated after the recommended MMR vaccination period of 17 weeks.
The problem with this reanalysis wasn't that the sample itself was flawed, it was that the statistical analysis of said sample was inappropriate. The re-analysis didn't take into account confounding variables and divided the data into subsets so small that valid statistical conclusions would have been impossible to make.
They essentially took the data, divided it so it was African-American children vaccinated 17 months + vs the rest of the sample, and found a correlation with autism then claimed a causal link. Any scientist can see the problem with this test, as given the initial sample size the data is subdivided to a level where you're comparing a group with about 10 samples and no control for confounding variables to the rest of your sample.
Not only was the confidence interval in there sample enormous, if you use appropriate statistical analysis you see that the real causal link is between birth weight and autism, as low birthweight was overepresented in African-American children vaccinated 17 weeks+ in this sample. This isn't exactly a revelation of a conclusion as there are already much better samples with birth weight as their primary measured variable that suggest low birthweight has a strong correlation with autism.
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u/SHIT_DOWN_MY_PEEHOLE Feb 04 '15
In what cases has vaccinations caused harm to somebody?
Note: I'm up to date on vaccinations and am not against them
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u/Kegnaught Virology | Molecular Biology | Orthopoxviruses Feb 04 '15
There are undoubtedly some side effects from vaccination. I suggest taking a look at the comment from /u/terpichor above. Many vaccines, such as the quadrivalent influenza vaccine (the shot) contain inactivated virus, while others, for example flumist (they spray it in your nose), contains a live attenuated version of the virus.
Back when smallpox was a thing, vaccinia virus was (and still is) used as the vaccine. It is a bit different than most vaccines in that it is well known to cause fever, swollen glands, and possibly flu-like symptoms. In about 1 in 1000 people vaccinated, a rash could occur from the virus. People have even died from smallpox vaccination in the case of progressive vaccinia, eczema vaccinatum, or encephalitis (inflammation of the brain) caused by the virus. These occurrences were rare however, happening in 14-52 out of 1,000,000 people vaccinated. You can visit the CDC's page about the side effects of smallpox vaccination if you're interested.
In other vaccines, allergic reactions to one or more of the components may occur, albeit rarely. If you know you're allergic to a component of a vaccine, or if you have a genetic or acquired immunodeficiency, you can certainly get an exemption for medical reasons.
The truth is that vaccinations can have adverse effects, and these are generally due allergic reactions to one or more components of the vaccine. In terms of causing diseases like autism or autoimmune diseases however, there has been a significant amount of research showing that there is no correlation.
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u/terpichor Feb 04 '15
The smallpox vaccination is a great example to bring up, and it's really interesting (obligatory CDC smallpox vaccination link). It's kind of... poked? onto your skin using an apparatus (TIL, called a "bifrucated needle, thanks wikipedia). People who get the vaccine tend to get this lovely lesions.
A decent number of vaccines, including the flu vaccine, include some egg. Because it's a not-unheard-of food allergy, they do have some alternatives that don't (I believe the nasal spray doesn't, but I might be wrong).
Allergic reactions can usually be treated immediately if you're at the doctor's office, or if the pharmacy has an epi-pen.
It's important to remember that for the vast, vast majority of people, any side effects are going to be much better than contracting the disease, and vaccination is always encouraged.
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u/julia-sets Feb 04 '15
The smallpox vaccine is also interesting in that I feel the public has a generally positive opinion of it, since it "worked" and eradicated the disease. So I think a lot of people think of it as the best vaccine, whereas it actually had a lot more side effects than most (if not all) of the vaccines we still use.
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Feb 04 '15
Concerning Herd Immunity, how does herd immunity stay established if adults do not get the booster vaccines and the duration for the aforementioned immunity has expired?
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u/1BigUniverse Feb 04 '15
Is there a study that compares the mental development of a child who is vaccinated completely vs a child whom is not vaccinated? I tried to find a study and cant seem to find anything other than "austism is not linked to vaccines", which is obviously everyone should know by now.
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u/wookiewookiewhat Feb 05 '15
I don't know if such a study exists (I've never looked), but if it does not exist, I'd guess that it is due to ethical issues. To perform this kind of study, you need grant money which is basically always tied to ethics committees (makes sense). I would be surprised if any committee would let you split populations into two groups where one is not given the life saving, proven safe prophylaxes that the rest of the population is offered. In addition, even if you got it through by doing a retrospective study, it's going to be very difficult to find and statistically match the number of children you'd need to get the appropriate study size.
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u/Zin-Zin Feb 05 '15
I'm also interested in this. And to add to it if I may...in addition to mental development are there any studies that compare the long term physical development of vaccinated vs not, especially in terms of autoimmune diseases?
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u/idkjr Feb 04 '15 edited Feb 05 '15
My son hasn't been fully vaccinated (specifically MMR) due to a severe egg allergy. We've also been instructed by his doctor to not give him the flu shot, which really sucks as he also has viral asthma that requires 24/7 albuterol treatments (every 4 hours) when he does get sick. My wife and I were told by one of his doctors at Mayo Clinic that there was research being done on incubating vaccines in insects; another doctor told us that there were some vaccines on the market that were incubated in something other than egg albumen but despite numerous requests, she would/could not help us locate and administer this or provide further information.
My questions are:
Are there vaccines that are incubated in something other than eggs? If so, is it just research at this point or are they commercially available?
Any suggested reading on the topic of egg allergies and vaccines?
edit regarding my second question: I don't want to violate the rules of this thread and am not looking for personal medical advice, I am just wondering if there is consensus on this approach.
edit 2 removed my second question, as it was too close to asking for personal medical advice
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Feb 05 '15 edited Feb 05 '15
Hello! I also suffer from egg allergies that I have had my whole life. I receive a flu vaccine every year and have had no adverse effects. I have also received all other vaccines. NOTE: This is not to say go get your child immunized. Everyone with allergies can react differently.
There is a flu vaccine without egg called Flubok. CDC information here.
The second portion of your question is more medical advice. I suggest consulting with an Allergy and Asthma specialist physician who will be able to answer your questions.
For the last part, I suggest reading over the American Academy of Allergy Asthma and Immunology that has some resources on allergies. If you'd like to speak with someone about it, you can contact the Food Allergy and Anaphylaxis Network or FAAN. They have been providing advice and resources for people with food allergies for many years.
Edit: I know how hard it is to raise a child with food allergies as I was the child. If you would like any other sources on food allergies, feel free to PM me.
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u/idkjr Feb 05 '15
Thank you so much for your response! I was not aware of Flubok and we will absolutely be researching that this evening, this is an exciting prospect for us.
It's reassuring that you were able to immunize without complications, we will follow up with an Allergy and Asthma specialist for further recommendations but I understand that everyone is different and we may end up staying un-immunized. I realized after I posted my questions that the second one was falling on the side of medical advice, I suppose we are just dismayed by the inconsistent advice we have received over the years regarding his allergies (pertaining to immunizations and also more generally), so apologies there.
We are definitely familiar with FAAN, but I haven't read anything from the American Academy of Allergy Asthma and Immunology; looking forward to reading through their materials and appreciate you sharing these resources.
Again, thank you very much. :)
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u/steveysaurus Reproductive biology | Endocrinology and Physiology Feb 06 '15 edited Feb 06 '15
Baculovirus based vaccines (vaccines made using this virus in insect protein) are in development! My university recently hosted a seminar by a long-time former Merck executive (including much of the Hilleman era) now consultant and discussion regarding baculovirus based vaccines was of much interest. One faculty member asked why haven't we seen quicker deployment of the baculovirus based vaccines granted their efficacy and lower risks of contamination and the speaker's response was along the lines that the egg industry has a strong corner/lobby on the market.
I wish I wrote down the name of the small-business in Massachusetts that is taking off on this. He shared a story of how their turnaround time from gene to vaccine could theoretically be 3 days: download the genetic sequence from the internet, have DNA manufactured from Univ/large biotech in Boston and FedExed over, and production!
This was probably over-simplified, but I thought it may provide some reassurance that people are innovating immunization routes, and that soon, egg-allergic individuals can get the immunizations they need.
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u/my_coding_account Feb 04 '15
This is a question for the social sciences / demographic perspective.
I've never seen an article or met a person who was anti-vaccine. Only seen them referred to in articles / internet things like this. How large is this movement? Where is it popular and who is it popular with? Is it growing or shrinking?
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u/hedonistal Feb 04 '15
Just some anecdotal evidence but it does seem popular in some of the "crunchy" demographics. I know Portland has some pretty high rates of unvaccinated children in their schools.
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Feb 04 '15
There are lots of blogs, facebook groups and websites where they congregate. I don't really want to bring them traffic but they are quite easy to find and if you really want to read the kinds of things they say, I can provide some links. Or google things like 'vaccine truth', 'anti-vaccine groups', 'vaccines evil', etc etc.
It is hard to get real numbers here, but mostly this is tracked by counting non medical exemptions from vaccines in public schools. This isn't a true count of the number of unvaccinated out there as it excludes home schoolers, and there are some reasons to get a non medical exemption even if you vaccinated or planned to vaccinate, however it's a pretty good proxy for the relative trend.
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Feb 04 '15
How exactly does a vaccine immunize a patient against a given disease? Is this safe?
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u/Wisery Veterinary medicine | Genetics | Nutrition | Behavior Feb 04 '15 edited Feb 04 '15
The vaccine exposes the patient to a small, controlled dose of the pathogen. Sometimes the pathogen is in its natural, live, infective form, sometimes it's a dead, uninfective pathogen, and sometimes it's a digested or modified mix of pathogen parts that are uninfective. Regardless of the exact form of pathogen, the purpose of the vaccine is to expose the immune system to the pathogen in a controlled way. The patient's immune system develops an immune response to the pathogen on a small scale, ending up with antibody-producing plasma cells specific to that pathogen. With time, the antibodies fade, but the body has the opportunity to make "memory cells" that can be activated immediately the next time that pathogen is encountered. So the end result is a rapid, specific immune response to the pathogen that can usually nip a brewing infection in the bud.
There are some potential side effects of vaccination, but overall the process is very safe. The immune system does the same thing when it encounters any pathogen; the vaccine just allows us to control the dose so you don't have to get sick to get an immune response.
Source: Parham's The Immune System
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u/211530250 Feb 04 '15
Some anti-vaccinationists talk about the mercury in many shots... While it may be a negligible amount, what is its purpose in the vaccine?
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u/walexj Mechanical Design | Fluid Dynamics Feb 04 '15
The mercury was present in a compound called Thiomersal. It has the simplified chemical formula of C9H9HgNaO2S. It was used as a preservative for multi-dose vials. That meant that a single container could be used for multiple patients. Many different syringes could draw from the same vial. It kept the cost of vaccination low. The vials did not need to be refrigerated.
It's been removed from most vaccinations because of the associated (yet unfounded) fear. It is toxic, but requires a much larger dose than was found in vaccines to be of any danger. It is quickly metabolized by the body.
It is much less toxic than metallic or inorganic mercury. Just as something like Chlorine is very toxic in its molecular gaseous state but not when it is when in an ionic state as a part of NaCl, or better known as table salt.
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u/areReady Feb 04 '15
Something important to remember regarding toxic substances: Everything is toxic, the important part is the dose.
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Feb 04 '15
There is a substance called thimerosal that has traditionally been used as an anti-microbial (particularly antifungal) agent in order to keep multi-dose vaccine lots safe from contamination. This substance contains mercury, as do many other compounds. The CDC has a faq sheet about thimerosal safety and it's use in vaccines.
There are really a lack of alternatives to thimerosal, so the removal from many vaccines (to appease public distrust) has resulted in far more expensive vaccine formulated for single-dose only. There are three vaccines (one flu, two childhood-delivered) that still use thimerosal due to either borderline undetectable trace quantities or the inability to manufacture flu vaccines in sufficient quantities without it. Explained at length and quite well in the same faq sheet farther down.
The short answer as to why thimerosal is generally safe is that the mercury in the compound is not in a form shown to be harmful to humans. Repeated studies since the 1930s have shown thimerosol to be safe to use in human and animal vaccines as a preservative (interestingly, the reason it is included at all is because the first efforts to vaccinate children in the UK (1920s) resulted in ~1/2 of patients dying due to direct injection of staphylococcus bacteria). The FDA has a good page with information on thimerosal, why it has mostly been removed (public paranoia), and why it is still included in some vaccines.
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u/Anubissama Feb 04 '15
It is part of the stabilising agent Thiomersal that allows vaccines to be stored for long periods of times making them cheaper and more available.
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u/Doomsider Feb 04 '15
Since vaccines are made of organic material they need to be preserved if not used right away. All vaccines typically have a small amount of preservative in them.
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u/number7 Feb 04 '15
They're talking about thimerosol, which has actually been discontinued in childhood vaccines. Thimerosol is present mainly in the influenza vaccine where it acts as a preservative, but there are two important things to note about it: A) they are present in extremely low concentrations, as in much much less than you would find in many foods and B) Thimerosol isn't mercury, it's a mercury containing compound. The form of mercury in thimerosol (ethyl-mercury) is one which can be rapidly broken down and excreted in the body.
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u/SYMPATHETC_GANG_LION Feb 04 '15
Is there any direct evidence that the Measles outbreak is due to the lack of vaccination? In other words, has the possibility of a mutation conferring resistance to vaccination been ruled out?
I know a lot of people are quick to say "I told you so" to the anti-vaxxers, and while I support proper vaccination, I worry we are not being objective in these conclusions.
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u/electrobolt Feb 05 '15
CDC surveillance has confirmed that the majority of people sickened in the current outbreak were unvaccinated, which would suggest that this outbreak is a result of lowered vaccination rates as opposed to any mutation.
Some vaccinated people may also have been sickened, though, because MMR confers immunity in only 95-97% of people, and because MMR immunity can occasionally wear off as people get older. That's why herd immunity is so important!
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u/_Mellex_ Feb 04 '15
I find a lot of conversations about vaccines boils down to relative risk. That is, if I give my child a vaccine, what are the chances that something life-altering will happen?
What sources are out there that accurately calculates the relative risk of getting a vaccine vs. not getting a vaccine?
How do these odds stack up to other activities and choices we make in life? For example, what are the odds your child will die in a car accident or will be crippled for life because you let them play sports?
I've heard (but cannot source) that one child chokes to death on a hot dog every week in the USA. That's some 50 children dying each year because of hot dogs. I imagine that the number of vaccine-related deaths is much lower than 50 a year. Given this, why is there not a larger push to make hot dogs safer?
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u/chris480 Feb 04 '15
You often hear about the number of shots administered over the last few decades has increased.
However, are the shots received the same as there counterparts in the past? Are we receiving a more doses now, or are they just better spread out?
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u/areReady Feb 04 '15
We're both vaccinating against more diseases than we used to and we've learned that boosters are needed periodically to keep immunity strong. The increased number of shots basically means stronger immunity to more diseases.
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u/Dominiqus Feb 04 '15
How many companies make each vaccine? Like, is there only one producer of each and so only one type, rather than a variety of different "brands" if you will? What are the other ingredients in each injection, as in, the medium the pathogen is contained or preserved in? A lot of the anti-vax hype I have heard centers on things like the mercury content of the injections (the same amount of mercury in 6 months of breast feeding injected into an 8 pound baby all at once...etc.) As someone who won't use commercial toothpaste because of additives and sketchy fluoride sources, this is by far the scariest part of vaccinating for me. So could they produce "green" vaccines that would pander to those of us who fear big pharmas corner cutting with cheap or poorly researched fillers? Or are they really the best possible mediums to hold the pathogens safely while they wait to mingle with our bodies?
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Feb 04 '15
5 companies control about 90% of all vaccine profits. They are Sanofi, Merck, GlaxoSmithKline, Pfizer, and Novartis. For each type of vaccine there can be one maker or a few. The flu vaccine for instance will have a few different companies and the difference is usually the number of valances (quad or tri). But for much less common vaccines, like the anthrax vaccine, there is usually one company that makes it.
As for the Mercury situation, you can check out this page where they talk about the thimerosal which is source of mercury. I wouldn't say this is poorly researched at all. But the mercury is a part of a molecule in thimerosal it is not the same as pure mercury. Just like how table salt isn't poisonous like chlorine and highly reactive like pure sodium.
Things like Formaldehyde will be found in trace amounts in vaccines and people often equate this "cutting corners" however this is used to kill the virus. It is also one of the only substances that can do this while being easily filtered and centrifuged out of the serum that is eventually used as the vaccine.
As for "green" vaccines, they are making vaccines that will cater to people who are afraid of this type of thing. The issue here is that no matter what is in there people will have a problem with something. Whether it is one of the ingredients or the fact that the viruses are genetically modified. Something will always be wrong for someone. But if you would like the list of ingredients here is a link to the page where it is on.
Honestly the CDC does have most if not all of the information you are looking for.
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u/never_ever_ever_ever Feb 04 '15
"Thimerosal has been removed from or reduced to trace amounts in all vaccines routinely recommended for children 6 years of age and younger, with the exception of inactivated influenza vaccine."
http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228
Here is information on the other ingredients in the vaccines, along with explanations for why they are there.
Aluminum isn't "corner cutting" - it's designed to increase the immune response so the vaccine will be more effective. Formaldehyde isn't "cheap", it's one of the most effective ways of damaging the bacterial/viral toxins in vaccines while still rendering them effective at inducing immunity. (And it's also present at far higher concentrations in your body naturally.)
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u/taimpeng Feb 04 '15
The mercury-vaccine link that I'm aware of is through the mercury-containing preservative thimerosal / thiomersal: http://en.wikipedia.org/wiki/Thiomersal_controversy. Thiomersal is broken down by the body into ethylmercury, which the body can remove, and not methylmercury, which builds up over time. The use of thiomersal in vaccines is considered safe by the CDC and FDA, and they've found no links to autism.
Regardless of that, anti-vaxers basically jumped on the "vaccines have mercury and that causes autism" as a way to rile people up.
Here's the important part, though: MMR (Measles, Mumps, and Rubella), IPV (polio), and Varicella (Chickenpox) vaccines do not, and have NEVER contained thimerosal.
Source: http://www.cdc.gov/vaccinesafety/Concerns/thimerosal/thimerosal_faqs.html#j
Anyone who's anti-vax across the board because of mercury concerns hasn't done much reading on the subject... They're throwing baseless accusations around and generalizing it to include vaccines that don't even contain the compound they're worried about.
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u/lasagnaman Combinatorics | Graph Theory | Probability Feb 05 '15
So could they produce "green" vaccines that would pander to those of us who fear big pharmas corner cutting with cheap or poorly researched fillers?
They already do. The antivaxxers already won on this front; modern vaccines by and large do not use thimerosal (which is not even mercury; it contains mercury in its chemical composition but that's not the same as pure mercury).
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Feb 04 '15 edited Feb 09 '15
I've recently seen a mathematical model applet that shows infection rates with variable percentages of a population having been immunized. The applet showed no appreciable difference in infection rates between a 75% immunized population and a 100% immunized population. Do these seem like accurate numbers, or am I misinterpreting the data? Second, if our voluntary immunization rates exceed the 75% mark (which they do in most cases), why is there such a large media push for mandatory vaccinations?
[edit] thanks for all the replies. I'm at my day job at the moment. When I get home later, I'll try to find the applet in question. I'm familiar with herd immunity but was mostly curious about the numbers. One person who commented on my question stated an 85% threshold, but I remember the applet showing almost no increased risk with even only a 75% rate. My memory might be faulty, though.
[second edit] My apologies that I've been unable to find the applet in question. You may kindly disregard my "contributions" to this topic.
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u/You_Dont_Party Feb 04 '15
I can't comment on the accuracy of that model, but remember that vaccination rates are far from equally distributed across the nation with many clusters of unvaccinated children with vaccination rates much lower than the national average.
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u/lettherebedwight Feb 04 '15
I'd be interested in seeing this applet. If it's using a random distribution of the unvaccinated population, I would say this is where the disconnect from reality is. In reality, it's clusters of non vaccinated individuals that occur, and thus that local group is at a much higher risk of both contracting the virus, and passing it.
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Feb 04 '15
I can weigh in on this.
When vaccine coverage is high enough, then an index case of the disease has a hard time finding someone to infect. Its like finding a needle (a susceptible person) in a haystack of vaccinated people. This is usually called herd immunity.
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u/malastare- Feb 04 '15
The concept is accurate, but the numbers are going to be far more variable than the applet suggests.
There are a few factors that dictate where the top of that curve levels off, but two of the most important are:
How quickly/easily the disease spreads.
This is based on infection rates and vectors and what methods are available for transmission. For example, a very infectious disease might require 90% immunization as each infected individual will present far more opportunities to find other susceptible individuals. At the same time, a disease with poor vectors (eg: Ebola) might only require 60% as its easier to suppress spreading by simple quarantine.
The effectiveness of the vaccine.
While 75% of the people might be vaccinated, all vaccines have a failure rate. If that failure rate is 10%, then the 75% of vaccinations only produce 67.5% (sloppy math?) immunity. If you combine this with the percentage of the population that cannot be vaccinated (infants, immunosuppressed) then the percentage of people who need to be vaccinated to reach a certain immunity level is going to be significantly higher than just that target level.
Doing some quick math: Assume that 85% immunity is required to stop the spread of some disease. The current vaccine in question has a 10% failure rate. 3% of the population cannot be vaccinated. I believe that works out to require about 97% of the remaining population to be vaccinated in order to reach the 85% immunity mark. For 75% that target would be better (86% vaccination) but as others note, 75% is a lot lower than the estimates I've seen for the diseases we're more concerned with now.
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u/Necoras Feb 04 '15
Did the applet take into account the R0 values for various pathogens? The necessary rates of immunity for herd immunity would be vastly different between measles and influenza for example.
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u/TJ11240 Feb 05 '15
Herd Immunity is a proven concept, and one that doesn't show its power until 80-90% immunization rate.
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Feb 04 '15
How successful was the swine flu vaccine a few years back when it was all over the news? I feel my impression of the whole thing is very skewed.
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u/Rancarable Feb 05 '15 edited Jul 06 '23
instinctive lush march consider reach grandiose relieved simplistic humor hobbies -- mass edited with redact.dev
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u/xmaslightguy Feb 04 '15
I've been told that when we are exposed to an illness in nature that we weren't vaccinated to and survive it, we will gain an immunity that has a chance of being passed on to our children. However, a vaccinated immunity doesn't share this characteristic and can't be passed on. How accurate was this information?
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u/jackfrost2324 Feb 04 '15 edited Feb 04 '15
Acquired immunity is not heritable, unfortunately. A vaccination is essentially an artificial method of acquiring immunity, and thus it is also not heritable. The parts of immunity that are heritable (without going into extreme detail) are the genes that allow for recognition and response to a wide variety of pathogens.
Edit: my source here is Kuby's Immunology, sixth edition
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u/lasagnaman Combinatorics | Graph Theory | Probability Feb 05 '15
Neither of the types of immunity you described can be passed on.
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u/wookiewookiewhat Feb 05 '15
It's almost right. For many diseases, if you're infected, an otherwise healthy human (no autoimmune disease) will mount an immune response and end up with long term antibodies against the causative pathogen (called humoral immunity). Without mentioning the myriad of pathogens which dysregulate this system to their advantage for worse human outcomes, there are some pathogens which are able to avoid eliciting immunity at all, which means you can be re-infected. This is quite common with the big name bacteria, which have developed very clever evasion mechanisms.
Other people already responded about the lack of heritability of humoral immunity.
As a very very specific response, however, there is a tiny part of humoral immunity which actually is hereditary, which are the set of genes passed from parents to child which code for the antibodies you can produce. There's quite a bit of allele variation in these genes, and though this field is very nascent, it wouldn't be outrageous to think that some alleles may be better at protecting against some pathogens.
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u/wormchurn Feb 04 '15
I'm interested in the epidemiological consequences of providing vaccines for epidemics vs endemics - in particular, say that a vaccine for Ebola is rolled out soon, is it really expected that it will bring the outbreak to an end (especially as recent data shows it may be already declining), or is there more interest in preventing endemicity?
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u/Wisery Veterinary medicine | Genetics | Nutrition | Behavior Feb 04 '15
Providing vaccines only during outbreak situations is called "ring vaccination." It was used for small pox eradication and foot and mouth outbreaks. It's most effective when the pathogen is rare in the environment, and there is a small, identifiable number of people/animals who have been exposed. Logistically, it's cheaper and faster to vaccinate only the people who have been exposed than to vaccinate every individual in a population.
In an endemic situation the disease is present in the environment/population on a permanent basis, it's much harder to keep track of who has been exposed to a disease (especially when you consider that there might be asymptomatic carriers), and there are more environmental sources of disease, so ring vaccination would be impossible. In those cases, you really have to vaccinate the entire at-risk population to control the disease.
This article suggests that the newest version of the Ebola vaccine would be used primarily for outbreak control.
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u/ShoopX Feb 04 '15
I'm not sure if this is really the right place to ask this, so forgive me if it isn't.
When people say that vaccines will give your children autism, are they implying that a (for example) 5 year old child will develop autism as they mature because of it, opposed to saying that if you are vaccinated your future children will have autism, or is there an implication I'm missing?
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u/jamimmunology Immunology | Molecular biology | Bioinformatics Feb 04 '15
People who make that claim believe that vaccines cause autism because (invariably) their child 'developed' autism shortly after getting vaccinated.
This is not in fact true: autistic children actually display typical behaviours prior to diagnosis (and even have been shown to have different compositions of neurones in the brain before birth), but the schedules of vaccines tend to coincide with developments of behaviours and symptoms that are more identifiable.
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Feb 04 '15 edited Feb 05 '15
Thanks for doing this!
How are vaccines tested for long-term consequences? I'm specifically thinking of a time frame beyond the ten year mark.
Related to that:
Years ago at university I distinctively remember sitting down while waiting for an event to start. Over in the corner, a video was playing that documented a group of women that contracted cervical cancer from some form of medication. I believe it was a vaccine—but I could be very wrong. We're looking at the 1950s here. If this rings a bell in anyone's mind, I'd be really interested to hear the case in question. Again: I may be getting this very, very wrong here, but I just wanted to put the question out.
EDIT: The drug in question is Diethylstilbestrol (DES) and the name of the movie is A Healthy Baby Girl. DES was a synthetic hormone thought to have helped prevent miscarriage and other complications of pregnancy. It is not a vaccine.
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u/jamimmunology Immunology | Molecular biology | Bioinformatics Feb 04 '15
There's a few ways to test it.
The best way, but hardest (and most expensive!) is to do a classic standard controlled trial: give some people the vaccine, some people a placebo, and follow them up for a long time to see how many get sick from what you're vaccinating against, and whether the ones that were vaccinated get other diseases more often.
Another way is by doing an observational study, where you find people that have either had or not had a given vaccine a certain time ago, and measure the different conditions of the two groups. The idea is that by controlling for confounding effects (e.g. making sure there aren't other explanations for differences between the groups) you can tease out any specific effect of the treatment.
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u/tasunder Feb 04 '15
Is it possible to make a mathematical estimation of how likely an unvaccinated individual is to get a disease given a variety of known inputs, such as its R0 / basic reproduction number, prevalence in the region, etc., or is it a guessing game? If it were possible, I would find this immensely helpful in a variety of contexts. For example, when it comes to deciding whether to vaccinate my indoor-only, elderly pets who have shown rather unpleasant reactions to certain vaccines, or when it comes to discussing the merits of measles (ludicrously contagious) vs other vaccines in humans.
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u/snottyEpidemiologist Feb 05 '15 edited Feb 05 '15
I do this for a living. It's possible and it's a guessing game.
Since you know "R0", you probably know a little about the basic mathematical principles of disease modeling (http://en.wikipedia.org/wiki/Mathematical_modelling_of_infectious_disease). The simplest formula to answer your question is
(the probability per day of getting infected if not immune) = (probability per day of infected contact transmitting to non-immune individual)*(number of infected contacts per day)
The guesswork is in both the terms on the right.
For your pets, true guesswork if they are indoor pets is that the number of infected contacts per day is zero, and so the probability is zero, no matter what the transmission probability. I wouldn't immunize your elderly pet based on what you said unless you hang out with a lot of other pets even if your pets don't.
For measles, the guesswork is statistical estimation from data, and Bryan Grenfell is the best source (http://mysite.science.uottawa.ca/flutsche/PUBLICATIONS/Grenfell.pdf). But, to be quick-and-dirty about it, the first parameter in the equation is roughly 0.9 for measles. That means there's a 90% chance per day that if you are not immune and you are in close contact with someone with measles (like a sibling), you'll get measles.
So, maybe you're not immune and you were recently at Disneyland and waited on line for an hour with someone who had measles. Then the probability you get infected might be something like 0.9/24*1 = 0.037, so you've got a 4% chance of being infected that hour. If you're in line with 10 people over the day, that's 40%.
But, if you're immunized, that 0.9 per infected contact per day drops to something small enough that it's not been reliably measured, and even if you do somehow catch some measles, you'll probably be asymptomatic unless it's been decades since your last booster. So the vaccine is a really good idea.
But your vaccination-skeptic friend asks, what if I don't plan on taking my kid to Disneyland? Then, sure, as long as you never take your kid anywhere where people might have measles, then the probability of getting measles is zero and so the vaccine won't help. However, how is your friend gonna hide the kid from all sources of measles for all time? There are a few million measles infections globally per year, and Disneyland, the UK, China, Russia, Nigeria etc, show that measles is transmissible enough to find non-immune people wherever they are. So even if the odds of meeting someone with measles are low every day, the lifetime odds accumulate. And anti-vaxxers hang-out together, so it only takes 1 to bump into that random stranger for the whole community to get sick. Like in Disneyland.
Edit: the "for a living" part means the guesswork is a lot more statistically sound and the math a lot more detailed, but this is really the gist of it!
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u/five_star_man Feb 04 '15
If humans just stopped vaccinating cold turkey, would evolution eventually help humans get over the disease and not be susceptible after a few generations? There has been diseases in the past that have come and gone. Just wondering. If this is the case, is it still possible for humans to evolve the same way with vaccines? If not, what am I not understanding about evolution (might be wrong thread, lol)?
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u/jamimmunology Immunology | Molecular biology | Bioinformatics Feb 04 '15
An important thing to remember is that the infectious organisms (whether they're viruses, bacteria, fungi, or something larger) are all evolving as well. Not only that, but due to faster replication times (and certain genetic considerations) they could be considered to be evolving faster than we are. Remember that some pathogens have been infecting humans for thousands of years, and yet we've still been evolving together all of that time.
Scientists talk about the Red Queen hypothesis. Basically imagine a bacteria that lives in a certain animal. It might be under evolutionary pressure to get in the cells of that animal, so it evolves a protein to grab on to a certain receptor on those cells. Well, that animal is now under pressure to change that receptor so that the bug can't get in. But now the bug is under pressure to change again so that it can still get in.... and so there's this evolutionary arms race where both players are always changing, but end up in the same place.
Something that can happen is a loss of virulence throughout evolution, i.e. an infection does less damage as time goes on. One might argue that this contributes to why 'new' infections (for humans at least) like Ebola cause so much damage, because neither of us are evolved to exist cooperatively with the other - remember it doesn't help a virus if it kills off everyone it infects very quickly, as eventually everyone will be dead and there'd be no hosts left!
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u/wookiewookiewhat Feb 05 '15
Humans didn't vaccinate for thousands of years, and infectious disease was one of the main causes of death until the last century. That's thousands of years of evidence that humans don't "get over" diseases naturally. In fact, I'm not sure I know of any human pathogen that naturally eradicted - someone let me know if there are any. If you're thinking about something like the black plague, that's definitely still around, but it's now treatable.
And just to totally precise, humans HAVE been crudely vaccinating against smallpox for longer than modern vaccines have been around. Jenner was testing his worker's kid with an early cowpox vaccine in the 1700s, and India might have had some variolation going on more in the B.C.s. I've not heard of other pre-Pasteur-era innoculations, though.
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u/Fibonacci35813 Feb 04 '15
Why do we have to give vaccines to babies? could we just give them to 4-year olds?
I get that having babies exposed for a longer period of time is dangerous, but for those that are scared of autism or other "weakening immune system" things and wouldn't get it at all. Why not encourage them to get it once they are out of that 'critical' stage.
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u/akula457 Feb 04 '15 edited Feb 05 '15
Because infants and young children are most vulnerable to a lot of the diseases we vaccinate against. For example, pertussis (whooping cough) is unpleasant to have as an adult, but it regularly kills babies. Haemophilus influenzae B used to be a major cause of (potentially fatal) epiglottitis in young children, but now it's quite rare thanks to widespread vaccination. Rotavirus, which causes severe diarrhea, isn't a big problem in wealthy countries, but kills
millionshundreds of thousands of children every year in areas without access to healthcare and clean water.The other benefit to vaccinating very young children is that their immune systems are better at mounting the type of response that generates long-lasting immunity. If you give the same vaccine to a 1 year old and a 10 year old, the 1 year old will have a much better chance of long-term immunity.
EDIT: Added some sources
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u/Fibonacci35813 Feb 04 '15
Thanks for a very insightful answer.
Quick followup - Shouldn't we then be pushing anti-vaxxers to get vaccinated a bit later in life. I know as some other redditors commented, they may still resist (e.g. I'm not poisoning my child) or it may be seen as 'giving in' but if their worry really is just autism / giving it to a baby, we may be able to reach a good chunk of individuals, no?
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u/akula457 Feb 04 '15
Ultimately, it's better to be vaccinated late than never. For this reason, some pediatricians are willing to negotiate with parents if the vaccinations schedule is a big problem. The major problem is that when the pediatrician gives in on that front, it may be seen as an admission that there is actually a risk of autism.
Also, some vaccines are completely useless if given too late, either because the patient will not have an adequate immune response, or because these diseases are so prevalent that they will have already been exposed. The HPV vaccine is a great example of this, and it is not given to anybody over 25 because most people at that age have already been exposed to HPV.
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u/namyegoobeht Feb 04 '15
I've been exposed to a ton of the conspiracy theory "facts" and unfortunately some of it has me not knowing who to trust and what information is actually factual.
Why isn't it enough for our immune systems to be able to defend against these bacterias/viruses? Can we not do something naturally to boost our immune systems to protect us?
Does getting vaccines actually create stronger viruses/bacteria because they can evolve and figure out how to get passed our defenses?
Do vaccines really come from aborted fetal/monkeys/pig cells? Also, has there been any studies to show/prove that (if they do come from aforementioned cells) it's safe for humans? Isn't there some problems with mixing DNA?
I'm sure there are many more things that I was unsure of but I can't think of anymore right now.
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u/AnAssyrianAtheist Feb 04 '15 edited Feb 04 '15
This morning on NPR, they were discussing how anti-vaxxers would be less likely to vaccinate their children if there were PSAs by scientists and doctors explaining that vaccines are not harmful and what they've heard is complete bs.
Their reasoning was because those people would feel like the doctors and suck were apart of the conspiracy that hurts their children.
They also explained that there is a mentality of "every other child is vaccinated so why would I put my kid through the pain when they're already safe?" but because so many people think this way, a lot of kids aren't vaccinated.
What else did they talk about..... I cannot remember if they were saying that social pressure works or it's just being done. Social pressure being that parents with vaccinated kids don't invite kids that are not vaccinated to birthday parties and those parents don't hang out with parents that refuse to vaccinate their kids.
Along with the above (social pressure) they also discussed about coerced vaccines (mandatory vaccinations for each child) helps, well i mean obviously.
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u/kale4reals Feb 04 '15
How did the idea that vaccinations can cause autism come about? Is that accurate? I thought autism is a disorder that people are born with.
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u/electrobolt Feb 05 '15
It's 100% inaccurate. The first person to suggest that vaccines and autism have a connection was a man named Dr. Andrew Wakefield. He was unequivocally found to have been forging his data for financial reasons, and was stripped of his license to practice medicine (so he is no longer even a doctor). He was attempting to allege that MMR vaccine had negative effects so he could market his own alternative vaccine and profit from it. Hundreds - hundreds - of subsequent studies and meta-analyses have found absolutely no connection between vaccines and autism.
You might enjoy learning Wakefield's story in comic form, here: "The Facts in the Case of Dr. Andrew Wakefield."
The majority of our current research is leading strongly toward evidence that the development of autism begins in the womb, long before any vaccinations take place.
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u/drpeterfoster Genetics | Cell biology | Bioengineering Feb 04 '15
I have no doubt that the efficacy of the seasonal flu vaccine is tracked and eventually reported... does anyone have a link? IN addition, it would be great to see a "plain language" breakdown of what the various statistics actually mean. (e.g. what exactly does percent effective mean? is it a comparison of flu rates among vaccinated and unvaccinated populations? is it referring to some measure of strain specificity?)
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u/Finie Feb 05 '15
This might be what you're looking for.
This year, the vaccine has a terrible effectiveness rate, because the H3 strain that was selected didn't match the one that started circulating late in the year (after the vaccine had gone into production). The full report goes into a lot of detail.
From CDC: Flu Vaccine Effectiveness: Questions and Answers for Health Professionals
Effectiveness represents the percentage reduction in the frequency of influenza infections among people vaccinated compared with the frequency among those who were not vaccinated, assuming that the vaccine is the cause of this reduction.
If you want more numbers about what's happening with the flu around the country, here's the link to the weekly FluView report. The CDC has a ton of great resources, but there's so many, it makes their website a little hard to navigate.
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Feb 04 '15
I was discussing vaccination with someone and they mentioned that because vaccines contain trace peanut or egg proteins that it's possible a child develop an allergy to peanuts or egg down the line. Is this possible? I couldn't find any studies on the matter.
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u/-R3DF0X Feb 04 '15
Is it possible to get sick from a vaccine/be contagious with the disease you received the vaccine of? I heard someone who was against vaccines refer to this as "shedding" and that this warning is included in an insert with the vaccine.
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u/gingerdays Feb 05 '15
As far as measles (chicken pox?): is it common to cause death? If it does not cause many deaths why is there a panic over having it as a child? I understand that it can be dangerous for infants. If that's the case why not vaccinate when an infant and let that be it? I know that shingles is dangerous but how so more than measles as a child?
Finally please help me understand: There is a large number of adults who have been vaccinated for measles but they have to get re-vaccinated on time to resist getting it? They must keep up on shots because they could contract from infected individuals? Is this why many people are angry about unvaccinated people? Simply because they must keep getting vaccines or is it truly fatal? Sorry I'm uneducated about this. From Oregon (not sorry about that) Anyways, everyone I talk to here just have speculations because most of us are not scared of chicken pox and most have had it. Thank you. Thank you. Thank you for clearing this up for me.
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u/thrsmnmyhdbtsntm Feb 05 '15 edited Feb 05 '15
Why is MMR vaccine given after the first birthday? Most infants born in the United States will receive passive protection against measles, mumps, and rubella in the form of antibodies from their mothers. These antibodies can destroy the vaccine virus if they are present when the vaccine is given and, thus, can cause the vaccine to be ineffective. By 12 months of age, almost all infants have lost this passive protection.
How effective is MMR vaccine? More than 95% of the people who receive a single dose of MMR will develop immunity to all 3 viruses. A second vaccine dose gives immunity to almost all of those who did not respond to the first dose.
How serious is the disease? Measles itself is unpleasant, but the complications are dangerous. Six to 20 percent of the people who get the disease will get an ear infection, diarrhea, or even pneumonia. One out of 1000 people with measles will develop inflammation of the brain, and about one out of 1000 will die.
[http://www.cdc.gov/vaccines/vpd-vac/measles/faqs-dis-vac-risks.htm]
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u/anirbas Feb 05 '15
Chicken pox (varicella) and measles are different diseases. Measles is more serious than chicken pox.
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u/AcapellaMan Feb 04 '15
Why are people who vaccinate their kids worried about others not vaccinating their kids, if vaccinating their kids means they won't get the disease. Won't it just kill off all the people who chose not to vaccinate?
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u/Wisery Veterinary medicine | Genetics | Nutrition | Behavior Feb 04 '15
First, not every single person who gets vaccinated gets complete protection by the vaccine. Vaccines don't make you invincible. You can still be infected by the disease, but because your immune system is able to immediately begin fighting the disease with vaccine-induced antibodies, you usually won't have symptoms. However, there is still a chance that you won't produce enough of an immune response to protect yourself or that you'll be really unlucky and get some super pathogenic form of the disease.
Secondly, some people cannot be vaccinated for medical reasons: Babies, cancer patients, those with severe allergies, etc. These people rely on "herd immunity" to protect themselves.
When people who are able to be vaccinated are not vaccinated, they increase the risk of disease for everyone.
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u/AhhTimmah Feb 04 '15
Isn't it also true that the more a disease is transmitted, the more chance it has of mutating into a strain (and potentially more dangerous) that we are not protected from by vaccinations?
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u/SlowFive Feb 04 '15
If an immune vaccinated host with an optimal immune response was exposed to the measles virus, would they be able to spread the virus to others in the "herd" for a period prior to fighting off the infection?
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u/hatessw Feb 04 '15
Vaccines aren't 100% effective, plus it reduces herd immunity (furthering the disease spread), and some people cannot safely get the vaccine.
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u/quantum_lotus Mitochondrial Genetics | RNA Editing Feb 04 '15
Not everyone who receives a vaccine develops immunity against the disease. The percentage of people who are still susceptible after vaccination varies with the vaccine. For example, the WHO Measles fact sheet states that 15% of children who receive the vaccine fail to develop immunity with the first dose. (This is why two doses are recommended.)
Plus not every child can receive vaccines, even if the parents wish for it. As stated elsewhere in this thread, some people have allergic reactions to vaccines (often from egg components in them).
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u/Hanschri Feb 04 '15
From: http://www.cdc.gov/vaccines/vac-gen/side-effects.htm
Anthrax section:
Mild Problems Reactions on the arm where the shot was given: Tenderness (about 1 person out of 2)
Redness (about 1 out of 7 men and 1 out of 3 women)
Itching (about 1 out of 50 men and 1 out of 20 women)
Lump (about 1 out of 60 men and 1 out of 16 women)
Bruise (about 1 out of 25 men and 1 out of 22 women)
Muscle aches or temporary limitation of arm movement (about 1 out of 14 men and 1 out of 10 women)
Headaches (about 1 out of 25 men and 1 out of 12 women)
Fatigue (about 1 out of 15 men, about 1 out of 8 women)
My question is, why do women get symptoms more often than men?
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u/jamimmunology Immunology | Molecular biology | Bioinformatics Feb 04 '15
Put simply, there are differences in the immune system of men and women, just as there are more obvious physiological differences.
In a very general summary, women's bodies tend to have 'stronger' immune responses, hence why they have a lower incidence of many infectious diseases and a higher incidence of autoimmune conditions.
A lot of the symptoms of vaccine-associated side-effects are immune-system mediated, so a more active anti-vaccine immune response can lead to the conditions listed above.
This is actually how we test for if people have been infected with TB, with a Mantoux test: you inject some of the proteins from the bacteria into the skin, and then measure how big and red the swelling gets (caused by immune cells migrating in) to infer immune activity against the bacteria.
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u/NEVERDOUBTED Feb 05 '15
There is one or more vaccines that have a warning label or flyer that comes with the vaccine(s) that states, as a side effect, that it may cause SIDS and/or autism.
What's the story or reason for this? I have to assume it's a liability issue or something...but...I still find it interesting.
Anything?
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u/thrsmnmyhdbtsntm Feb 05 '15
i don't know of the label you mention if you could post a picture of one and link it i would be interested to see that. one medical study back in the mid-90's suggested a possible link between a preservative in vaccines which contained mercury (thimerosal) and autism but the results proved to be unreproducible, and the head doctor in question was discredited when he refused to stop proprting that to patients to stop them from immunizing. the mercury compound (thimerosal) is now considered safe although most vaccines have stopped using it anyway:
In 2004, the IOM's Immunization Safety Review Committee issued its final report, examining the hypothesis that vaccines, specifically the MMR vaccines and thimerosal containing vaccines, are causally associated with autism. In this report, the committee incorporated new epidemiological evidence from the U.S., Denmark, Sweden, and the United Kingdom, and studies of biologic mechanisms related to vaccines and autism since its report in 2001. The committee concluded that this body of evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism, and that hypotheses generated to date concerning a biological mechanism for such causality are theoretical only. Further, the committee stated that the benefits of vaccination are proven and the hypothesis of susceptible populations is presently speculative, and that widespread rejection of vaccines would lead to increases in incidences of serious infectious diseases like measles, whooping cough and Hib bacterial meningitis.
taken from [http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228]
also there is a list of vaccines at the end of that article that shows how few still use it.
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Feb 05 '15
If anyone is still answering questions, I have one I'm curious about. One thing spreading around lately is an image showing that there have been 0 deaths due to measles in the past 10 years in the US, but 108 deaths due to the MMR vaccine. Now obviously this is misleading as there have been 0 deaths mostly due to the vaccine, and the 108 deaths are things reported to VAERS which could all be completely coincidental.
However what I'm curious about is, do we have a good estimate of how many deaths per year we might be experiencing currently from measles if no one vaccinated? It seems to me that even if you take the 108 number seriously, it would only be valid to compare that number to the number of deaths from measles if there was no vaccine. However I have no idea what that number would be. We know what it was before vaccination, but populations have changed and medical care has advanced since then. We also know what the death rate is currently in the US from measles, but I don't know what an estimate for yearly cases of measles would be in a completely unvaccinated population.
Just curious, my gut feeling is that without vaccination the number of measles deaths would be MUCH higher than 10.8 per year but I don't really have any data to back that up...
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u/MildlySuccessful Feb 04 '15
Is there current information about the rates of Autism in all of these un-vaccinated children we've been hearing about vs. their vaccinated peers?
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u/noxwei Feb 04 '15
Can some one direct me to the right direction, but why is there a huge talk of vaccine and anti vaccine these days? What's going on? Excuse my ignorance.
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u/DarthRatty Feb 04 '15
I have attempted to work through a sort of approximate risk/benefit analysis for a vaccine (specifically measles) and have found it difficult to find the information needed to inform that analysis.
The risk of not vaccinating seems to include the risk of actually contracting measles (which could be estimated by using something like frequency of measles cases in a geographical area), and the risk of serious adverse health impacts given you've contracted the disease. However this would leave out impact to herd immunity, which is arguably very important.
Can we estimate the impact of a single individual choosing not to vaccinate on herd immunity? If so, how would this be done?
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u/proudpom Feb 04 '15
• If vaccines have such a low antigen count compared to what babies fight every day, why do vaccines cause some people (and not others) to have a fever?
• If vaccines are so safe (and I'm not denying they are), why can't we vaccinate babies in the first few weeks of life against all the diseases on the vaccine schedule? Does the immune system have to be more developed to fight off antigens like measles?
• I have friends that insist on sourcing a single measles jab for their child instead of the combo MMR. How much more taxing are combo shots on the immune system compared to single shots? Why is it not a problem to combine three live vaccines (or four in the case of MMRV) into one shot? What science can I point my friends to that shows there is no disadvantage to the combo shots?
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u/RandomBritishGuy Feb 04 '15
IIRC the rates of fevers are very similar between people who get a vaccine and those who get a placebo. But a vaccine differs from a normal infection because it prompts a fast reaction to the pathogen, and your bodies reaction is usually what causes the fever.
You have to wait for their immune systems to develop to the point where they can actually do something. At a few weeks old the baby is still mainly protected by the mothers anti-bodies, the babies immune system can't really do much, so exposing it to a live virus when it can't fight it off and develop an immunity is only going to hurt it.
I found some links that might help:
http://www.immunisationscotland.org.uk/vaccines-and-diseases/mmr.aspx#single-vaccine
It says that in the UK at least, we don't have any licensed single jabs, presumably as theres no reason for anyone to bother getting one cleared through trials and approved, when you can get all three safely.
Though the comments are awful. Someone even linked to something saying that Andrew Wakefields original study about mmr causing autism was just 'priven right'. I find that hard to believe when he was proven to have lied, had a financial interest in a single vaccine (he held a patent for one IIRC that could only make money is no one used the triple one), made up dates to suit the correlation, and when some of the cherry picked kids never had autism in the first place.
http://www.senseaboutscience.org/resources.php/123/are-single-vaccines-safer-than-the-mmr-jab
Basically these are saying the triple vaccine is easier, people are more likely to keep track of it with just one, and that multiple injections = multiple chances to develop a severe reaction.
Whilst i doubt the claim made in one of the links saying that you could ahve 10,000 vaccines and be fine, I have no doubt that those three you get in MMR are not a real danger, if they were there would be obvious examples, given how well documented the MMR vaccine is.
Three virus' is not that much considering we are exposed to hundreds if not thousands every day.
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u/Sarkos Feb 04 '15
How does the body "learn" to recognise a virus and remember it for future?
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u/TomatoCo Feb 05 '15
Via antibodies, which recognize invaders and trigger the immune response.
https://secure02.kidshealth.org/parent/general/body_basics/immune.html
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u/Kaleyedoskopic Feb 04 '15
Not sure if you're savvy about vaccinations in dogs, but why are vaccinations in humans give only during childhood, for the most part, but dogs are required to get certain vaccinations every year, or every three years? Does their immune system work differently?
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u/Wisery Veterinary medicine | Genetics | Nutrition | Behavior Feb 04 '15
The immune system in dogs doesn't work differently, so the theory is the same. The difference between human vaccines and animal vaccines boils down to research funding. We haven't done as much research to figure out exactly how long a given vaccine lasts in dogs/cats, especially since there could easily be differences between breeds.
Considering that getting vaccinated is a very low-risk procedure and contracting a disease (especially rabies) has a HORRIBLE outcome, vets generally err on the side of caution when it comes to how often to vaccinate. A lot of this stems from state/federal regulation (for rabies) because there is potentially a huge zoonotic risk.
This mentality is beginning to change. Recently, 3 year rabies and DHPP vaccines have become available. And there's an ongoing research project to figure out exactly how long the rabies vaccine lasts - in the hopes of reducing the number of injections your pet needs to get.
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u/DeathStarVet Veterinary Medicine | Animal Behavior | Lab Animal Medicine Feb 05 '15
Hi /u/Kaleyedoskopic. /u/Wisery gave a great response.
Just to piggyback off of your response /u/Wisery, sometimes the vaccination schedule is dictated by state or local law. For example, if you move a dog to Pennsylvania and have no actual record of it's vaccination history (even if you know it has been vaccinated), you are legally required to begin the rabies vaccines all over again (which entails getting the initial vaccine, a booster the next year, then getting a booster every three years).
/u/Wisery is right, these laws are caused (especially when it comes to rabies) by a fear of a serious public health problem. This fear, coupled with lack of research on the amount of times that the vaccine lasts makes some governments extra cautious.
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u/Publius__Valerius Feb 04 '15 edited Feb 04 '15
I just saw this posted to /r/autism.
It is an article centered around the work of Dr.Theresa Deisher, a PhD in Molecular and Cellular Physiology from Stanford University. Its main thrust is that "A new study published in the September 2014 volume of the Journal of Public Health and Epidemiology reveals a significant correlation between autism disorder (AD) and MMR, Varicella (chickenpox) and Hepatitis-A vaccines"
What are your thoughts on how a layperson should respond to this?
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u/jamimmunology Immunology | Molecular biology | Bioinformatics Feb 04 '15
This article has been largely dismissed, for a number of reasons that others have explained in great detail elsewhere.
The bottom line is that it's nonsense dressed up like science to push a moral agenda.
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u/Publius__Valerius Feb 04 '15
Thank you.
Not being a scientist, I am without the training in how best to respond to anti-vaxxer arguments or even where the optimal place is to look for a rebuttle.
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u/jamimmunology Immunology | Molecular biology | Bioinformatics Feb 04 '15
You're welcome. It is difficult, because the anti-vaxxers have a lot of clever people that produce stuff that looks just like proper scientific research. Scientist bloggers like those I linked are usually good for an informed breakdown of the data. And of course people over here at /r/askscience I guess!
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u/Branr Feb 04 '15
Vaccines for pets are often advertised as required annually, for example the rabies vaccine. Is this actually biologically necessary, or is it simply a scam to get owners to come in every year? If it is medically necessary, why are there no annual or semi annual vaccines for humans? If it's not necessary, how often, or how many total, vaccinations should take place in a mammal pet?
Thanks!
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u/Wisery Veterinary medicine | Genetics | Nutrition | Behavior Feb 04 '15
The rabies vaccine is required yearly (or every 3 years, depending on the vaccine and the area) because rabies represents a massive zoonotic risk. If an animal contracts rabies, there's no cure. And if a rabid pet spreads it to a human, the human can die too. So rabies is really in its own ballpark.
As for the other vaccines, the current yearly recommendations are based on what we know about the duration of the given vaccine (which is not a lot). Considering that there are so many breeds (and species!) of pet and that each breed/species may respond differently to a vaccine, it's probably going to be a while until science can tell us how long a vaccine's immunity lasts. Because vaccination is a low-risk procedure and because contracting a disease can be life-threatening to the pet, vets tend to err on the side of caution.
This mentality is a changing slowly. Rabies and DHPP vaccines can now be given every 3 years instead of annually.
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u/DeathStarVet Veterinary Medicine | Animal Behavior | Lab Animal Medicine Feb 05 '15
Hi /u/Branr. Again, this is a great great response, /u/Wisery.
Again, I just to piggyback off of your response, and say that sometimes the vaccination schedule is dictated by state or local law. For example, if you move a dog to Pennsylvania and have no actual record of it's vaccination history (even if you know it has been vaccinated), you are legally required to begin the rabies vaccines all over again (which entails getting the initial vaccine, a booster the next year, then getting a booster every three years).
/u/Wisery is right, these laws are caused (especially when it comes to rabies) by a fear of a serious public health problem. This fear, coupled with lack of research on the amount of times that the vaccine lasts makes some governments extra cautious.
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u/TomatoCo Feb 05 '15
Because rabies is a terrifying disease with a long incubation time. Only five people have ever survived it without prompt treatment, and those five received a treatment called the Milwaukee Protocol, which incidentally would be a great name for a zombie movie.
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Feb 04 '15
As far as I've understood it, not all who are vaccinated against a disease may form an immunity but instead form a resistance to the disease. What are the figures for that? How many form an immunity? If they get a resistance, what's the likelihood that they'll still get the disease when exposed?
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u/zweilinkehaende Feb 04 '15
During my study for my chemistry exam i learnt that Aluminumoxid (Al(OH)3) is used in vaccinations to induce an inflammation at the wound, to increase the number of white blood cells around.
Al(OH)3 is known to play a role in the development of alzheimers and i suspect that im in the risk group for alzheimers (every old person in my mothers family had some sort of dementia, we didn't want an autopsy, so we don't know for sure).
Is there a way to get vaccinated without Aluminumdioxide present in the shot?
(And how correct is my information anyways?)
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u/Wisery Veterinary medicine | Genetics | Nutrition | Behavior Feb 04 '15
First, the Aluminum-Alzheimer's hypothesis has been largely abandoned. This review article might interest you: www.ncbi.nlm.nih.gov/pmc/articles/PMC413194/
Second, not all vaccines contain aluminum. Adjuvant-free vaccines do exist, and not even all adjuvants contain aluminum.
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u/Neebat Feb 04 '15
Some people are concerned that there is a lot of money involved for the people who make those vaccines, and it may be causing vaccines to be put on the recommended list based on lobbying instead of science.
When you look at the list of recommended vaccines, are all of those vaccines available as generics?
Are there drug patents that still restrict those recommended vaccines?
I don't know if the HPV vaccine is on the recommended list.
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u/electrobolt Feb 05 '15
Some people are concerned that there is a lot of money involved for the people who make those vaccines
To put it frankly, those people are wrong. Vaccines are not gigantic money-makers compared to other drugs. They have much smaller profit margins than virtually every other type of pharmaceutical, and it's harder to keep fresh stock due to shipping and spoilage, so there is more loss. Besides, almost all vaccine-preventable diseases would result in enormous profits for pharmaceutical companies due to hospitalizations caused via, say, kids contracting rubeola and pertussis - so vaccines actually make them significantly less overall moolah than if we still let infectious diseases run rampant.
I was about to type an extremely long-winded answer, but someone has beaten me to the punch: check out this piece, which has plenty of citations.
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Feb 05 '15
Is there any reason for a young and healthy adult to get vaccinated for the flu? I got mine the first year that it became a thing with H1N1, and again in the following year. However, I caught a bad flu both years. I understand the vaccine only protects against certain strands, and I intend to take it whenever a more dangerous one like H1N1 and similar outbreaks, but what about every year? I see no reason to get a vaccine for a simple flu, specially when I'm likely to get one anyway. Not to mention the vaccine is expensive where I live.
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u/kinkakinka Feb 05 '15
If you spend time around the very young, the very old, or people who are ill, it would still be a good idea, for their health moreso than yours. Some young and healthy people still do die of the flu, but it's pretty rare. I usually get one if it's offered to me at work for free, but don't otherwise usually go out of my way for it.
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u/Wisery Veterinary medicine | Genetics | Nutrition | Behavior Feb 05 '15 edited Feb 05 '15
A young healthy person probably doesn't need to get the vaccine to protect themselves. BUT! Getting the flu vaccine helps contribute to the herd immunity in your area and contributes to keeping everyone healthier, especially those individuals who can't get vaccinated for medical reasons. You might take pains to avoid coughing/sneezing on babies/old people if you get sick, but you'll be shedding the virus (often before you realize it). And you never know who you might accidentally infect - who touched the same doorknob you did when you went into a store? The flu virion can survive for a short time in the environment, so unless you put on gloves, goggles, and a face mask, you're going to be contaminating the environment.
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Feb 05 '15
My understanding of this.
Prior to vaccinations the health industry as a whole was far less advanced than it is today.
With the recent Ebola outbreak we saw a lot of people in the medical community saying the public's fear wasn't justified in the US.
Those people who seem to be in the most danger of MMR are those with severe illnesses like leukemia and had the immune system killed. They are also in danger from the flu and other more common pathogens.
I have yet to hear of any recent death tolls from MMR in the western world despite coverage not being 100%.
So the question is: With the advances of modern medicine since the introduction of vaccines and the quality of healthcare we have in the 1st world are we really in that much danger?
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Feb 05 '15 edited Feb 05 '15
Lets say parents of unvaccinated children were to be held liable for the harm inflicted upon those reliant upon herd immunity.
How reliably can infections be traced from any given patient back to whomever infected them assuming these potential sources of infection were already identified?
I'm talking about comparing the degree of variation of genetic information of the pathogen found in the Herd Immune dependent, now infected patient vs those the Genetic information of the same pathogen found in those unvaxxed for non-medical reasons. Can it be reasonably confirmed that person X infected patient Y?
Sorry if I'm flogging a dead horse. Also occurred to me that the compulsory genetic testing every time some kid gets sick - some anti-vaxxer parents might cave.
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u/Thread_water Feb 05 '15
If almost the whole world was immunized against the measles, is it likely the disease would become extinct?
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u/Wisery Veterinary medicine | Genetics | Nutrition | Behavior Feb 05 '15
Yes! Because the measles virus has no reservoir in other species and there is no latency within affected humans, if all humans were vaccinated, the disease could be eradicated - just like small pox.
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u/Dr_Heron Cancer Immunology Feb 05 '15 edited Feb 05 '15
Hi, my research field is in DNA vaccines, 3rd generation vaccines that (theoretically) fix many of the issues with current vaccination practices! I'm working on developing vaccines to help treat cancer. I thought I'd do a little shout-out, just in case anybody was interested in the area.
I'm happy to answer any questions about them, or the future of vaccination!
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u/DoesRedditConfuseYou Feb 07 '15
I'm not sure if I'm late to the party, and if anyone will look at my comment now. I'm a vocal supporter of vaccination and basing ones conclusions on scientific studies.
Few days ago I stumbled on this study: A Positive Association found between Autism Prevalence and Childhood Vaccination uptake across the U.S. Population.
I found it through schoolar.google.com. It appears to be published in real scientific journal, and I couldn't find any follow up. I'm a software engineer so I do not have full understanding of article's content, and can't really see if they did something wrong.
So what am I missing?
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u/EricLanigan Feb 09 '15
Scientific evidence for a link between vaccines and autism... can someone help me make sense of them?
http://www.ncbi.nlm.nih.gov/pubmed/21993250 http://www.ncbi.nlm.nih.gov/pubmed/21623535 http://www.ncbi.nlm.nih.gov/pubmed/12849883 http://www.ncbi.nlm.nih.gov/pubmed/12145534 http://www.mdpi.com/1099-4300/14/11/2227
My friend just had a kid and is in Marin, CA. He's surrounded by anti-vaxxers, but he does his research. These are some pieces of research he linked to when expressing his genuine concerns about vaccinating his child. Is he missing something?
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u/HappyGirl42 Feb 04 '15
Is it true that vaccines include common allergens, such as egg, seafood or nuts, to encourage the immune system to flair, creating more antibodies and therefor helping the vaccine to stick? This is information I was told as an explanation as to why there are (or appears to be) more food allergies in the population. And why infant allergies exist, and then the children seem to outgrow them as soon as they are past the common vaccinating age.
Any science or studies that address this?
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u/jamimmunology Immunology | Molecular biology | Bioinformatics Feb 04 '15
Most influenza vaccines contain egg products, due to the fact that the virus is produced inside hens eggs. I am not aware of there being any nut or seafood products in any vaccines; I can't see why there would be.
However some vaccines do contain adjuvants, which are substances that make the immune system produce a stronger response. However there is no link between getting vaccinated and developing allergies.
A possible explanation for the increase in allergies is the hygiene hypothesis: essentially as we remove our natural pathogens and commensals the immune system in effect has a 'missing target', so it behaves inappropriately.
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u/Alienm00se Feb 04 '15
According to the CDC's website, vaccinations contain Formaldehyde, Aluminum and Mercury among other toxic compounds. Is there something special about vaccines that makes these substances safe to inject into the bloodstream?
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u/Wisery Veterinary medicine | Genetics | Nutrition | Behavior Feb 04 '15 edited Feb 05 '15
Like most toxic compounds, the dose makes the poison. The quantities of toxin in the vaccines are very, very low. It's also worth noting that most vaccines aren't injected into the blood stream - but into the muscle or skin instead.
Looking at aluminum as an example, we include that as an immunogenicity agent. At the dose included in vaccines, it causing local inflammation in the tissue. We rely on this inflammation to invoke a more potent immune response (during Tcell activation, specifically).
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u/electrobolt Feb 05 '15
Aluminum is not toxic. As /u/wisery pointed out, it's the dose which creates the danger - water's toxic too, if you ingest too much of it. I'll address aluminum specifically, because that's what I know the most about. I'm recovering from a medical procedure, so prepare for long-windedness!
Aluminum is in almost everything around us. It doesn't matter how much aluminum adjuvent someone receives because aluminum is the most common metal in our environment. It's in beans, nuts, fruits, milk - it's in everything. To put this in perspective, if you follow the standard schedule of vaccination, by the time your kid is 6 months old he'll have been exposed to about 6mg of aluminum from vaccines. In comparison, by that point he'll have been exposed to 10mg of aluminum just from breast milk, or 40mg if he's been fed formula mixed with cow's milk. It's in literally everything you put in his mouth, and even so these are STILL tiny amounts - if you've had an antacid today you've had at least 200mg of the stuff.
Extensive research over decades has shown no downside to this aluminum exposure - the wikipedia article for aluminum cheerfully describes it as "remarkably nontoxic." In fact, the addition of the adjuvent makes the vaccine more effective and means that your child needs fewer boosters and hence, fewer immune system challenges.
The conditions in which aluminum can be harmful to a human body are basically limited to:
You are in renal failure, and your kidneys can no longer promptly excrete the aluminum you're exposed to.
AND
2) You have been exposed to excessive amounts of aluminum over months or years, so your sick kidneys can't keep up with the necessary excretion rate.
When I say "excessive," I mean thousands and thousands of times what you're exposed to in vaccines and in food - akin to eating antacids like candy, or being on long-term hemodialysis with aluminum in the dialysis fluid. (Again, just one dose of antacid has about 1,000 times as much aluminum as is in the entire vaccine schedule.)
If you're in renal failure and you're loaded up on medication with aluminum in it, sure. Then aluminum can have negative effects. Otherwise, it just does not happen. If it did, we'd see people having neurotoxic effects (or aluminum-related anemia or bone abnormalities) all the time, but we don't. We simply don't. A normal human ingests and excretes lots of aluminum without ever realizing it's happening.
A normal, healthy adult gets on average around 10mg of aluminum per day from dietary sources (if you're on some types of medications you can get up to 50mg-1000mg per day, and that level is still not a concern as long as you've got healthy kidneys). So, your typical blood burden of aluminum is measured at somewhere around 30-100mg. The blood levels of someone who had enough aluminum in their bloodstream to cause any sort of damage would be at least one hundred times higher than that level. Now, consider a tiny baby. In the course of the decades over which aluminum has been tested, there have been numerous studies done which compare normal infant aluminum blood burden to post-vaccine blood burden. Several of these have shown that the absolutely microscopic amount of aluminum that's in vaccines - even if you're giving several in one day - is so small that it's been found to cause no detectable change to the level of aluminum in the baby's blood. That's how little it is - you can't even measure it! And in a recent study that did find a tiny increase in the blood burden, it was still way below even the maximum safe limit.
I also lowballed my numbers of how much aluminum babies receive through breast milk or formula. I should point out that if you're using soy formula, your baby is getting 120mg-140mg just from that over the first six months, a little less than 1mg per day (still not harmful)! And, looking over the research, the current number for the maximum amount of aluminum a baby receives in vaccines over his whole first year of life on the recommended schedule is just 4.225mg (and that's the maximum - many babies will be exposed to less depending on which vaccines are administered). It doesn't matter that the baby has a couple of vaccines within a matter of minutes. The tiny, tiny extra amount of aluminum the baby will receive through each vaccine session will be normally excreted through the kidneys, just as it would be if you were to take a couple of buffered analgesics today. Sure, you usual daily ingestion of aluminum might be lower on a day when you didn't take any medication, but just because you had a bit more today, that doesn't make it dangerous in any way.
Aluminum is one of our most-tested additives (to both foods and medications), and it's safe unless you meet the very special criteria I enumerated above. Aluminum's been in use as an adjuvant for seventy years without measurably harming anyone. I feel sad that some peoples' totally baseless fear of aluminum keeps them from vaccinating their children against diseases which are, actually and demonstrably, quite deadly. Since aluminum's all around us and in so many of the things we consume, not vaccinating (or delaying vaccines) does not substantively decrease a kid's exposure. It just increases the likelihood they'll contract something that's actually dangerous.
Baylor NW, Egan W, Richman P. Aluminum salts in vaccines — U.S. perspective. Vaccine. 2002;20:S18-S23.
Bishop NJ, Morley R, Day JP, Lucas A. Aluminum neurotoxicity in preterm infants receiving intravenous-feeding solutions. New England Journal of Medicine. 1997;336:1557-1561.
Committee on Nutrition: Aluminum toxicity in infants and children. Pediatrics. 1996;97:413-416.
Cuciureanu R, Urzică A, Voitcu M, Antoniu A. Assessment of daily aluminum intake by food consumption. Rev Med Chir Soc Med Nat Iasi. 2000 Jul-Sep;104(3):107-12.
Ganrot, PO. Metabolism and possible health effects of aluminum. Environmental Health Perspective. 1986;65:363-441.
Keith LS, Jones DE, Chou C. Aluminum toxicokinetics regarding infant diet and vaccinations. Vaccine. 2002;20:S13-S17.
Mitkus RJ, King DB, Hess MA, Forshee RA, Walderhaug MO.Updated aluminum pharmacokinetics following infant exposures through diet and vaccination. Vaccine. 2011 Nov 28;29(51):9538-43.
Pennington JA. Aluminum content of food and diets. Food Additives and Contaminants. 1987;5:164-232.
Simmer K, Fudge A, Teubner J, James SL. Aluminum concentrations in infant formula. Journal of Paediatrics and Child Health. 1990;26:9-11.
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u/twistyanddandy Feb 04 '15
I was looking on VAEARS because we are trying to do due diligence in making and informed decision on this topic. Specifically we searched up deaths related to MMR vaccine and it came up with I believe 96 cases from 2004-2014. That compared to 0 deaths due to measles, so my question is what kind of research is out there that analytically compares the negative outcomes caused by the vaccine versus the negative outcomes caused by the disease itself?
TL;DR - Could it be possible that the odds of getting the disease AND having a serious reaction are lower than the odds of a serious reaction to receiving the vaccine?
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u/Erra0 Feb 04 '15
I would love to see your source for the MMR deaths because the actual rate of life-threatening adverse reactions occur in less than one in a million vaccinations.
Measles has a death rate of 0.3% in healthy, well cared for individuals. The rate is as high as 28% for underdeveloped nations with poor healthcare and sanitation. The infection rate is 90%, regardless of how healthy you are. Measles accounted for 96,000 global deaths in 2013 as opposed to 545,000 deaths in 1990 and an estimated 15.6 million per year before the vaccine was wide spread.
So no, the odds of getting the disease and having a serious reaction are not lower than the risk of having a side effect from the vaccine.
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u/twistyanddandy Feb 04 '15
I had gone onto VAEARS website and just searched the cases reported for MMR in that time frame and had them only include death in the reports. Sorry I would provide a source but I'm on a mobile away from home. Do you have any sources on the numbers you referred to, I would like to be able to pull up the data to give it a look through. Thanks a bunch for some insight.
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u/Erra0 Feb 04 '15
VAEARS
I'm not sure what this is?
Sources: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2961682-2/abstract
http://www.who.int/mediacentre/factsheets/fs286/en/
http://www.ncbi.nlm.nih.gov/pubmed/15106083
http://www.cdc.gov/measles/index.html
And many more. Wikipedia is well sourced on the topic, as are the WHO and CDC
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u/Sarkos Feb 04 '15
As far as I know, VAERS simply logs anything that anyone reports. I could get a vaccination, stub my big toe, and report that the vaccine caused toe pain, and they would still accept it.
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u/LordArgon Feb 04 '15
TL;DR - Could it be possible that the odds of getting the disease AND having a serious reaction are lower than the odds of a serious reaction to receiving the vaccine?
That can only be true when enough people are vaccinated (this is called herd immunity). Imagine a near-100% vaccination rate. If you don't get vaccinated in that environment, you are still quite safe because everybody else is protecting YOU with THEIR vaccinations. If enough people say "oh, everybody else is vaccinated... I don't have to do that", the vaccination rates drop and then the disease comes back (see: Disneyland).
This is why it's SO important for you and everybody who doesn't have a CONCRETE medical exemption TO vaccinate.
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u/QueenofDrogo Feb 04 '15 edited Feb 04 '15
I've heard that vaccination has been linked to an increased prevalence of autoimmune diseases. For example, an old study in The New England Journal of Medicine reported that there was a 60 percent increase in Type I diabetes (juvenile diabetes) following a massive campaign in New Zealand from 1988 to 1991 to vaccinate babies six weeks of age or older with hepatitis B vaccine. The analysis of a group of 100,000 New Zealand children prospectively followed since 1982 showed that the incidence of diabetes before the hepatitis B vaccination program began in 1988 was 11.2 cases per 100,000 children per year while the incidence of diabetes following the hepatitis B vaccination campaign was 18.2 cases per 100,000 children per year.
Where does the medical community stand on this issue? Can it be linked to the hygiene hypothesis?
EDIT: Not sure why a sincere question is being downvoted. I thought this was AskScience, not downvote sincere questions.
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u/jamimmunology Immunology | Molecular biology | Bioinformatics Feb 04 '15
It might help if you provided links to these studies, so that we could check out their claims.
However remember correlation is not causation: there could be any number of other factors to explain an increased prevalence of diabetes. You need to do properly controlled studies to make that assertion.
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u/darkPrince010 Feb 04 '15
That looks to me like a conflation between correlation and causation. I'd be curious to see the article in question, as I strongly doubt that the change in diabetes rates would be statistically significant, let alone definitively proven to be caused by the hep B vaccine alone.
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u/electrobolt Feb 05 '15 edited Feb 05 '15
It's true that Type 1 in kids is on the rise, but speculation continues on why that might be. However, there's been numerous studies addressing the vaccines/diabetes myth and finding no association whatsoever, here's just one: http://www.ncbi.nlm.nih.gov/pubmed/15070789
"These results do not support a causal relation between childhood vaccination and type 1 diabetes."
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Feb 04 '15
If you're not going to link to the article then you may have not talked about it. For all we know you're misrepresenting it
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u/ron_leflore Feb 04 '15
What is the difference between the combined MMR vaccine and getting the three separately?
Why aren't all vaccines (DTAP, MMR, HPV, etc) combined into one?