Response to [...] measles vaccine: fourteen things to consider.

I haven't checked for a while, so I was rather surprised when I looked at the views - almost 1400 now.

I wanted to thank everyone reading and sharing these posts - they're written with the goal to look at things, to elaborate and illuminate; contributors to that should be thanked. And really, don't be shy to point out mistakes in this - I am not an expert in these topics, nor am I an accomplished writer.


Response to [...] measles vaccine: fourteen things to consider.

So, holiday season. I have a lot of time on my hands and there's another one of these vaccine posts.
Time to look at one:
m
Measles and measles vaccines: fourteen things to consider. ~by Roman Bystrianyk (co-author Dissolving Illusions: Disease, Vaccines, and the Forgotten History) [vaccinecouncil.org, http://goo.gl/RTFi5E]

 The measles. Let us consider what we know about it. To be honest, I really don't know much about it - so let's turn to wikipedia:

  • Four day fevers
  • Coughs
  • Head cold
  • Red eyes
  • Rashes
  • Complications
Among complications, there are simpler ones such as diarrhea and serious ones such as Pneumonia, i.e. inflammatory condition of the lung].

And lastly that between 1987 and 2000, the case fatality rate in the USA was 3 per thousand cases. That's the USA. I find this rather large - that period is rather large, but it is a period with modern healthcare.

Let's read the article!
Measles – it’s a highly infectious disease we don’t think much about today. After all, a vaccine was developed 50 years ago that “defeated” the problem. [1] But wait… despite a measles vaccine being around for half a century, measles is still considered a major threat by health authorities.
Diseases with reasonably high death rates and complications are often considered a major threat.
At its fifty year anniversary there were universal positive accolades in the media. Anyone who questions the value of measles vaccines or any vaccine is quickly pilloried because the science of the measles vaccine is supposedly beyond reproach. Proponents say that only conspiratorialists and lunatics would question it.
Ah, framing. This paragraph will make anybody criticising it a 'proponent'. Maybe it's far simpler - maybe most people defer to authority, and authority defers to data. Let's put a little quote here. The annual number of reported measles cases in the United States has declined from between 3 million and 4 million in the prevaccine era to <100 cases in association with the highest recorded immunization rates in history. [Official journal of the american academy of pediatrics, http://goo.gl/WFIOYC].

You'll note that I put in this little link telling you where it came from. They just put down an implication that it doesn't work, while this sentence and the source clearly state it does work.

Well, it turns out there are fourteen things we haven't been told.

1. Measles death rate had declined by almost 100% before the use of a measles vaccine.

They start with early death rates; then state that:
[...] The death rate from measles in the United States had already dropped by approximately 98%. 
I wanted to check the source for that statement - it's number three on their list. Looking at that, I find some mishmash of things, not a clear source for one of them. Based on the source they reported they used, I find the following data for 1950-1981  [CDC, Reported Cases and Deaths from Vaccine Preventable Diseases, United States, 1950–2008]:


I made this with gnuplot, by the way - a very neat tool. The styling is done using gnuplotting.

Anyway, this is logarithmic on the y-axis. As you can see, a drop starts around 1963, and by the time we've reached 1967, we have a reduction in both cases and deaths of nearly two tiles. You might be interested to learn that this means that 4 years after reduction, there was something of an 80% reduction in both death rate and the number of cases. We see a small resurgence, after which the second dose is introduced - after that,the decline continues and we go to an actual near 100% reduction of both cases and deaths.

So what's up with that graph? I have no idea. I'm going to suppose they made a typo in Excel or something; they disagree with one of their sources - I literally copy-pasted the table into a text file and used it as a data file. I have no Idea what they did. In fact, they disagree hugely with the wikipedia graph as well [http://goo.gl/7ySDjD].

Moving on, it might be the next claim has some truth:

Some New England states had no deaths at all from measles. During this year, the whole of New England (Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, and Connecticut) had only 5 deaths attributed to measles. Deaths from asthma were 56 times greater, accidents 935 times greater, motor vehicle accidents 323 times greater, other accidents 612 times greater, and heart disease 9,560 times greater.

By now you realise I'm going to first compare their claims with their sources. It's a thing called scepticism - and it is interesting to do when we're talking conspiracy-theory posts.

The new england claim is true. Is that surprising? Not so much. In the USA, 1963 - as we can see at the top of table I-18, we see that 364 people died due to the measles. That's exactly the same number as before [http://goo.gl/PYzoqM].

Does that mean the disease is not dangerous? Not really. Recall from earlier that the disease causes all kinds of things, including pneunomia. Death isn't really a thing in there; in fact, the disease is listed as highly infectious - not as highly deadly.
In England the measles vaccine was introduced in 1968. By this point measles deaths were extremely rare. The actual death rate from measles in England had fallen by an almost full 100%.  
I can't find the source they say they used; it is apparently a book. Luckily, we have other bloggers; He did find the source [http://goo.gl/WLndMN]. He clearly states and refers to the sources, and also explains what that data says; he also points out that measles death isn't measles incidence - the latter was most greatly reduced by vaccines.

As the measles in a modern society - that is, a society with proper nourishment, sanitation and healthcare - isn't a mortal disease, the fact the antivaxxers _only_ show you the death graphs is rather illuminating. It's a red herring. Look at the graph I included. It's the raw data. In that 31 year period, the population grew, but incidence lowered from 319124 to 3124. And as is _clearly_ illustrated in that graph, the biggest drop is after the vaccine.

2. The 1963 measles vaccine caused a severe disease called atypical measles.



The original Killed Measles Vaccine (KMV) could indeed interact with the 'wild' measles vaccine to cause atypical measles. 
The early vaccine that was experimented with was a weakened, live measles vaccine. This vaccine resulted in a much higher fever in about half the children that received it. Meaning, they had a 106 degree fever as opposed to the 103 degree fever they might have had with natural measles. 
It's called the KMV - Killed Measles Vaccine. They back this up with a quote/reference to the New York Times - which is not a scientific journal or whatsoever. It is also not accessible on the web.
The next claim is that someone wrote:

To temper this problem, measles-specific antibody was given in the form of immune serum globulin alongside the live vaccines. This practice blunted the obvious reactions (fever and rash) to the live virus in the vaccine, but had serious potential consequences. 
 Given that they try to put references at multiple places, why doesn't this specific assertion have a reference?
I have  no problem accepting the next lap of text - they've already setup this assertion, and the second immediately tells you that this is a bad thing. But it's an assertion - why did they not back this up?

Wait a moment
 - it says "alongside the live vaccines". But the vaccine in question is KILLED measles vaccine. That's not a live vaccine.


Time to hit google again. Let me quote you the following:
Atypical measles occurs only in persons who received inactivated (“killed”) measles vaccine (KMV) and are subsequently exposed to wild type measles virus. Modified measles occurs primarily in patients who received immune globulin (IG) as post-exposure prophylaxis and in young infants who have some residual maternal antibody.  [http://goo.gl/0Z2Nup]
What is said here is that it can happen in patients that received IG after they came in contact with the pathogen, which is rather rare, and infants - infants! - that have some residual maternal antibody. If you're reading this with me, this tells you that infants are a high-risk group for atypical measles - aren't you glad with the extreme decrease in measles incidence and herd immunity? 
In other words, suppressing the measles rash and fever, which may have seemed like a good idea at the time, interfered with the normal immune response. Interfering with the body’s immune response, in attempt to compensate for a worse vaccine reaction, may have resulted in future problems in the adults that received this treatment. The use of immune serum globulin was recommended to be discontinued in 1968, but continued long after that. This practice continues to this day. 

 I can't access the Lancet, so I really can't check their source material. I can find no evidence of severely high incidence rates of atypical measles in populations receiving the immune globulin - I can find several references to it being normal practise after exposure to the pathogen:
As per guidelines, post-exposure prophylaxis was provided within six days of exposure. [http://goo.gl/02ljNY]

 So apparently, the risk isn't as high as they want you to believe. In fact, it seems quite obvious; in those rare  cases where post-exposure prophylaxis is encountered, the chances of you encountering someone with the pathogen again are extremely small; the chance that that causes atypical measles is rare - using whatever I can find - or 50%, using what they said.

They go on about atypical measles being bad for a bit - but we understand. Atypical measles is bad. Measles is bad. That's the reason for vaccines. Assertions won't help you there.

3. Measles was supposed to be eradicated in 1967

Wouldn't it be nice if each and every of our plans would be realised?

In the year 2000, cases had declined, and measles was finally declared eliminated from the United States – 33 years after the original elimination target date. However, in 2012 the CDC pulled back from that declaration, stating that measles reappeared and was spreading. Of the total number of cases, 200 were attributed to foreign travel, but the source for 22 cases was never determined. 
Let me get this straight: 222 cases of the measles were reported, and 200 were attributed to foreign travel. The source for 22 cases was never determined.

Okay, sure. It wasn't determined. But the other 90% were foreign travel - is it hard to believe these cases were due to contact with people travelling to foreign countries, or even something such as inproper hygiene or animal exposure?

From 385156 cases in the year of the first vaccine, we went to 222 today. You know for sure that 200 of those are foreign. And you're still, somehow, finding something to say against the vaccine. The numbers are weak with this one.

 4. A single shot was said to provide lifelong immunity  

So? Scientists can be hopeful as well, right?
However, unlike natural measles infection, the measles vaccine does not appear to provide such long lasting protection. Protection afforded by vaccination appears to wane in number of years. Length of protection is estimated in this study to be approximately 25 years. 
Guess why.
These observations suggest that even in mothers who experienced natural measles in childhood, recurrent exposure to natural measles is necessary in order to maintain adequate antibody levels for effective passive immunity of their infants. [http://goo.gl/LmqYL1].

Your body doesn't often carry along waste. If it's not used, it can be removed; it gets trashed. If you do not encounter the measles for 25 years - that's more than a single generation, as humans are fertile from the onset of puberty - then it is obviously not a threat and the antigen isn't needed. If you have the immunity - even at low levels - then the response is quicker, harder and your body knows the disease is around.

The fact that lifelong protection isn't afforded is a celebration of the efficacy of the vaccine; the reduction in incidence and herd immunity.

5. Large epidemics still occur in highly vaccinated populations

Let me start by saying I once did a simulation. We're talking extremely contageous disease in a possibly crowded environment. Even with high-vaccination rates, there is a chance that a second person is infected. If so, the third person has a higher chance - and it snowballs.  This occurs for any population with lower than 100% immunity rate.
 In the pre-vaccine era, measles freely circulated providing for natural boosting in the population. After natural measles infection during childhood, reoccurrence of measles was rare. The solid, lifelong protection afforded by natural infection has been replaced with a vaccine-induced immunity that wanes with time. Waning immunity among the vaccinated, combined with lower natural disease boosting will create substantial numbers of measles-susceptible people in highly vaccinated populations.
Indeed, life was better when most children died before school-age.
Dr. James Cherry, commented that, in the post-vaccine era, measles had become a “time bomb.” [29] Is this why the CDC and health officials go into a state of panic when measles cases erupt in well vaccinated populations? Do officials know that at some point waning immunity will start an epidemic even in a very highly vaccinated population? Think of the impact of this dynamic as the truly immune seniors die out of the population, and are replaced by vaccine “immune” people. 
What he actually said is:
Both diseases have been effectively controlled in the pediatric population that, in the prevaccine era, harbored them. However, with the shift in prevalence to adolescents and young adults, it is possible the diseases may be "time bombs." [http://goo.gl/MFNqlm]
Waning immunity is not a threat as long as you simply don't encounter the disease. That's it, right? If everyone on the world is immune for 25 years, then where is the disease going to come from? Apparently, nowhere, as most adults still don't get it even with waning immunity.

 6. Babies have become more susceptible to measles.

Yep. It's a good thing that the disease is nearly eradicated. Hey, maybe, if you do vaccinate, it will stay that way. Or do you want to encounter babies?

[An appeal to emotion can be turned around, in this case.]

7. Immunity is not always immunity: Shifting sands.  

Yes, injections are nasty. Yes, sometimes the story told is too hopeful. That doesn't take away the facts.
The facts are that vaccination has greatly reduced both incidence and mortality of a great number of diseases, has reduced child-death greatly and overall has had a very positive influence.

8. Immunity without antibodies

When a person gets an infectious disease for the first time, the body’s immune system uses its innate powers, which mostly involve cellular immunity. In the process, it prepares for the future. The next time that same infectious agent comes around; the body will use its memory of the first experience so that it can react faster. This is done with or without antibodies. 
Antibodies are also part of the immune system. They are the 'innate' defense, the first line, the default defense. Apparently, in the case of measles, a secondary line can also be sufficient.

That doesn't say anything about vaccines. On a sidenote, the information we started with tells us that these people are also a high-risk group for complications.

 9. Vitamins A and C are key to normal measles recovery. 

As was pointed out before - even by  the antivaxxers themselves - many diseases were already on the decline due to better healthcare, sanitation, nutrition and so forth. Is it a surprise that vitamins A and C are important?

What happened to all those USA statistics we had earlier? We're suddenly shifting towards South Africa, with entirely different nutrition/sanitation situations.

It goes on about this, and I'm really not going to fact-check the whole bogus. Seriously, if vitamine C would actually cure all those things, what do you think would happen?

That's right, the pharmaceutical industry would supply you with vitamine C. Vitamines are an industry - a large one. If research into Vitamin C as a cure was actually hopeful, someone would get it funded.

10. High titer measles vaccines increased death rates in poor countries.  

This section starts with a completely random assertion. It moves on towards another quote from a paper that supposedly contains the quote they use; but it is behind a paywall. I can't even find an abstract/summary for this paper.

The study authors concluded that instead of looking for antibody response they should have been looking for long term outcomes to measure real results of their experiments. 
Did they?

11. You can get measles and shed measles virus from the MMR vaccine.  

First question: How high do you think the chance is that you get the measles without the vaccine?

Moving on. The plural of  'anecdotes'  is not data. [Elise Andrew]. 

12. Is it really “measles” in the first place?

Yes, doctors are always wrong after they spent a decennium learning that stuff.
“Flu” is basically defined as a 100°F or higher fever or feeling feverish (not everyone with the flu has a fever), a cough and/or sore throat, a runny or stuffy nose, headaches and/or body aches, chills, and fatigue. So if you have that you think you have the flu. Right? Actually no. What is often poorly understood is that a person actually has a syndrome (influenza-like illness, or ILI) that can be caused by various agents. Only a proportion of this syndrome is caused by influenza A and B viruses, but differential diagnosis on clinical grounds alone is not possible. So in other words, just because you or your doctor think you have the “flu” doesn’t mean you have the influenza virus. 

We were talking about the measles.

It goes on with a lot of random bullshit. Yes, doctors know what you know.

They know that a set of symptomps don't necessarily mean that which you think it does.

However, the measles in the era before and after the vaccine was diagnosed through a set of criteria. The simple fact that the criteria weren't met - or people didn't even come to the doctor with the symptomps - is sufficient.  Especially as the data for all those other diseases is _also_ available.

Instead of making allegations, why don't you actually datamine this? Why don't you evaluate if such a increase in other diseases was found?

13. Declining disease incidence? 

We already went over this.

14. Measles is not serious in well-nourished people. 

That it is more serious in mal-nourished people does not mean that it is less serious in well-nourished people. It's still a disease, with its complications and its high risk groups.
 For every 1,000 children who get measles, one or two will die. Adults can also get measles especially if they are not vaccinated. Children under 5 years of age and adults over 20 are at higher risk for measles complications including pneumonia, and a higher risk of hospitalization and death from measles than school aged children and adolescents. [http://goo.gl/YplW2G]
I find this serious. That's the CDC  in the USA.

Conclusion

My conclusion isn't very surprising. A number of errors (lies) was found, a large number of fallacies was found, and a few sources couldn't be checked due to a paywall. Furthermore, the article is written in a very convincing way - you need a healthy amount of scepticism.

Most striking is the difference in the very first graph - their graph doesn't look like mine, and I just copy-pasted the table data and plotted it.

Also, it's not really fourteen points. The second point is interesting, but its value is greatly reduced by the random assertion in the middle. From the third point onwards, it is really weak.

For all the other sources - including the paywall one - guys, really? Look at the number of citations. We're talking low-impact papers, where I meant 'impact' as a way of showing how many people read and used it in their field of expertise (I can access the number of citations).

There's a thing called peer-review. This means several things. It means that your paper is checked before being admitted to the journal. But that's not all. Peer-review also means that your results can be reviewed and reproduced by your peers. For the paywalled papers, I could not find any evidence of the results being reproduced at all.







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