US

Physicians

Vaccination practices among physicians and their children. 2012, Martin, OJPed.

21% of pediatric specialists and 10% of total pediatricians will refuse at least one vaccination for their child.
19% of specialist pediatricians and 5% of general pediatricians will delay MMR vaccination until 1.5 years of age.
18% of specialist pediatricians will not vaccinate their child against rotavirus, 6% will not vaccinate against hepatitis A. (USA)

Physicians

Physicians who do and do not recommend children get all vaccinations. 2008, Gust, J Health Commun

11% of the physicians did not recommend their patients to vaccinate their children with all the scheduled vaccines.
Therapists did not provide recommendations to vaccinate twice as often as pediatricians (therapists' vaccines-related earnings are lower).
Physicians trust medical journals more than the CDC and the FDA. They trust the pharmaceutical companies less than the Internet. (USA)

Physicians

Influenza vaccination attitudes and practices among US registered nurses. 2009, Clark, Am J Infect Control

41% of nurses are not vaccinated against the flu. They were afraid of the adverse effects, they believed that the risk of the infection was low, and in general, they did not consider this vaccine to be effective. (USA)

Physicians

Skepticism towards Emerging Infectious Diseases and Influenza Vaccination Intentions in Nurses. 2017, Maridor, J Health Commun

Swiss nurses are skeptical of infectious diseases and the vaccine against influenza.
Outbreaks of diseases are always less dangerous than being announced by public health authorities and the media, reducing public confidence in the reliability of expert sources of information. Conflict of interest between public organizations and private corporations also reduces public confidence.

Physicians

Are Recent Medical Graduates More Skeptical of Vaccines? 2013, Mergler, Vaccines (Basel)

Recent graduates of medical faculties have lower belief in vaccine efficacy and safety. More recently graduated health care providers also oppose compulsory vaccination and believe vaccines do more harm than good.

Vitamin K

Vitamin K prophylaxis for premature infants: 1 mg versus 0.5 mg. 2003, Costakos, Am J Perinatol

In premature infants, vitamin K levels on the second day after injection (0.5–1 mg) were 1900–2600 times higher than normal levels in adults, and on the tenth day, they were 550–600 times higher. The vitamin level in the group that received 0.5 mg did not differ from the group that received 1 mg.

Vitamin K

Are There Long-Term Consequences of Pain in Newborn or Very Young Infants? 2004, Page, J Perinat Educ

For years, health-care practitioners in the United States have cared for infants without viewing pain as one of the significant risks or disadvantages in making treatment decisions. Superficial observations conceded that pain medications had some risks along with their advantages, and that infants seemed to forget pain anyway. If the patient never returns to complain about the pain later, how could it be very important?
However, studies conducted in the 90s revealed that pain experienced in infancy has long-term consequences. For example, babies who were circumcised without lidocaine ointment suffered from pain during the vaccination more than circumcised with lidocaine, which in turn suffered more than uncircumcised.
Compared to undisturbed pups, rat pups who had been separated from their mother exhibited suppression of immune system and significantly greater susceptibility to the metastasis of injected tumor cells.
Endotoxin injection on as few as two occasions in the first week of life has been shown to exacerbate responses to stress much later in the mature animal. Neonatal endotoxin injection in rats has also been shown to result in delayed wound healing in the mature animal, which reflects the animals' inability to mount an inflammatory response.
Neonatal rats that underwent needle prick (painful) on a paw exhibited increased pain sensitivity in preadolescence, greater anxiety, a significant alcohol preference and social hypervigilance manifesting as prolonged chemosensory memory of a novel juvenile rat.
In prematurely born babies (which are subject to many more painful medical procedures than those born at term), pain sensitivity was reduced.
Multiple birth trauma increased the relative risk for adult violent suicide 5-fold in men versus 4% in women. However, the provision of opioids to the mother at the time of delivery lowered the suicide risk by 31% in both sexes.
The authors conclude that although an individual may not preserve a conscious memory of an early painful event, it is recorded elsewhere in the body, as evidenced by the previously presented long-term outcomes. Multiple procedures in the preterm and low- to extremely low-birth-weight infant, as well as “routine” newborn medical procedures (from heel sticks to circumcision), may alter infant development. The implication is that infant pain should be avoided when possible and, when necessary, assessed and treated at least as diligently as adult pain. Parents, as well as caregivers, need to recognize that pain must be added to the list of risks when deciding whether to provide a treatment or consent to a procedure in an infant. This consideration has not been a part of the traditional decision-making model for most practitioners.

Vitamin K

Reasons for refusal of newborn vitamin K prophylaxis: implications for management and education. 2016, Hamrick, Hosp Pediatr

Among the parents who refused vitamin K injection, most were white (78%), over 30 years old (57%), and college graduates (65%). Most refused hepatitis B vaccine (90%) and erythromycin eye ointment (77%). The most common source of information was the Internet. Concerns included synthetic or toxic ingredients, excessive dose, and side effects. Eighty-three percent of parents reported awareness of risks associated with vitamin K refusal, but most did not understand the potential danger of bleeding, especially the likelihood of intracranial hemorrhage and death.
In the hospital where oral administration of vitamin K was available, the percentage of refusals from the injection was much higher.
The authors conclude that the information on the Internet on which the parents' decisions are based is often unconfirmed by peer-reviewed scientific sources, and encourages natural childbirth without medical intervention. The most important issue, per the authors, is that the specific problems that are highlighted on Internet sites are not addressed by doctors in their conversations with mothers.

Meningococcal

Changes in Neisseria meningitidis disease epidemiology in the United States, 1998-2007: implications for the prevention of meningococcal disease. 2010, Cohn, Clin Infect Dis

Between 1998 and 2007, the incidence of meningococcal infection decreased by 64%. On average, the incidence was 1 in 20 thousand during these years, and by 2007, it decreased to 1 in 300 thousand.
The highest incidence was among infants under 1 year of age (5 in 100 thousand). 50% of the cases in them were caused by serogroup B, and two thirds of the cases that happened in infants under 6 months old.
Black people get infected 44% more often than white people.
The mortality rate of meningococcal infection was 11%, and increased with age. The mortality rate among the elderly was 24%, and 3-6% among infants.
The most cases were observed in January and February, and the least in August.
The authors conclude that before the introduction of vaccination, the incidence of meningococcal infection in the USA was at a historical minimum, and that after the introduction of vaccination, there was no significant decrease in the incidence among teenagers, who were vaccinated, because only 32% have been vaccinated.
(The tune that runs through almost all studies: If there was no significant decrease in incidence after the introduction of a vaccine - that is because the coverage was insufficient, but if there was a decrease – that is, obviously, due to vaccination, even if only 2% had been vaccinated).

Meningococcal

Tobacco smoke as a risk factor for meningococcal disease. 1997, Fischer, Pediatr Infect Dis J

The risk of meningococcal infection in a child under 18 years of age, increases by 3.8 times if their mother smokes.
Smoking increases the risk of meningococcal infection in adults by 2.4 times, passive smoking by 2.5 times, and chronic disease by 10.8 times.

Meningococcal

Increased Risk for Meningococcal Disease Among Men Who Have Sex With Men in the United States, 2012-2015. 2017, Folaranmi, Clin Infect Dis

The risk of meningococcal infection in homosexuals in 4 times higher, than in heterosexual people. HIV positive homosexuals suffer from meningococcal disease 10 times more often, than HIV negative ones. 45% of meningococcus patients reported multiple partners and participation in anonymous sex.
Among homosexuals, 32% smoke (as compared to 18% among adults in the USA), and 48% are drug users (as compared to an average of 10%).
In New York and Southern California, the risk of meningococcal infection among homosexuals was 50 times higher, than in general; in Germany, it was 13 times higher; and in Paris – 10 times higher.
24% of homosexuals are carriers of meningococcus, as compared to 6% of heterosexual women. Among homosexuals, who have had oral-anal contact recently, 43% were carriers.
Meningococcus was also found in the anal canal in 4.5% of homosexuals.
A new strain of meningococcus that can be transmitted sexually was discovered in 2016.
CDC reports that in 2016, 57% of men over 16 years of age infected with meningococcus, reported homosexual relations. More: [1] [2] [3].

Meningococcal

Prolonged university outbreak of meningococcal disease associated with a serogroup B strain, rarely seen in the United States. 2013, Mandal, Clin Infect Dis

Meningococcus outbreak in a university in Ohio (13 cases). Attending bars was associated with an 8 times increase in the risk of infection, and kissing more than one partner with a 13.6 times increase.
Crowding (more than 2.5 people per bedroom), low level of education in mothers, low income level, alcohol abuse and chronic illness have been risk factors of meningococcal infection in Chile.
Low level of education in parents is associated with a two fold increase in the risk of meningococcus colonization in Brazil, which probably reflects the socioeconomic conditions.
Crowding and previous acute respiratory infections are associated with a 3 fold increase in infection in children, and father’s smoking is associated with a 4.5 fold increase, in Greece. More: [1] [2]

Meningococcal

Updated Recommendations for the Use of Meningococcal Conjugate Vaccines - Advisory Committee on Immunization Practices (ACIP), 2010. 2011, CDC, JAMA

Clinical effectiveness of Menactra a year after vaccination is 91%, and in 2-5 years, it decreases to 58% (CI: -72 - 89).

Meningococcal

High Risk for Invasive Meningococcal Disease Among Patients Receiving Eculizumab (Soliris) Despite Receipt of Meningococcal Vaccine. 2017, McNamara, Am J Transplant

Eculizumab is a medicine for very rare diseases, which suppresses the complement system (one of the components of innate immune system). This medicine is associated with a 1,000-2,000 increase in the risk of meningococcal infection.
16 people using this medicine got meningococcemia, 14 of them have been vaccinated.

Meningococcal

Meningococcal Carriage Evaluation in Response to a Serogroup B Meningococcal Disease Outbreak and Mass Vaccination Campaign at a College-Rhode Island, 2015-2016. 2017, Soeters, Clin Infect Dis

Serogroup B meningococcal infection outbreak occurred in a college in Rhode Island in early 2015 (two cases). Both recovered. As a result of the outbreak, 5 three-dose vaccination campaigns were conducted for students and teachers on campus, as well as for their intimate partners. A total of about 4,000 people had been vaccinated with the newly licensed Trumenba vaccine. Since it was unknown, how this vaccine affected colonization, the authors used this vaccination campaign determine it.
20%-24% were carriers of meningococcus, and 4% were carriers of serogroup B. The risk of colonization was 30% higher in smokers, and among those who attend bars and clubs at least once a week, the risk of colonization was 80% higher. The authors concluded that vaccination does not affect colonization of meningococcus and herd immunity, and therefore, high vaccination coverage is necessary.

Meningococcal

Meningococcal carriage among a university student population - United States, 2015. 2018, Breakwell, Vaccine

A study of meningococcal colonization in another university in Rhode Island.
Vaccination did not affect colonization. Smoking was associated with a 1.5 times increase in the risk of colonization, and attending bars at least once a week – with a 2 times increase.

Meningococcal

Meningococcal Carriage Following The Vaccination Campaign With MenB-4C and MenB-FHbp in Response to a University Serogroup B Meningococcal Disease Outbreak-Oregon, 2015-2016. 2017, McNamara, J Infect Dis

A vaccination campaign was conducted, as a result of an outbreak in a university in Oregon. 11%-17% were carriers of meningococcus, of them 1.2%-2.4% were carriers of serogroup B. Vaccination with 1-2 doses of Bexsero and 1-3 doses of Trumenba, did not affect the meningococcal colonization in general, and colonization of the serogroup B in particular.

Meningococcal

Guillain-Barré syndrome among the recipients of Menactra meningococcal conjugate vaccine - United States, June-July 2005. 2005, CDC, MMWR Morb Mortal Wkly Rep

Menactra was licensed in January of 2005, and was recommended for 11-12 year olds, as well as for university freshmen. 5 cases of the Guillain-Barré syndrome were registered with VAERS among vaccinated freshmen between June 10th and July 25th of 2005. In one case, the vaccinated girl already had Guillain-Barré syndrome twice before, at the ages of 2 and 5 years; both times within 2 weeks of vaccination.
CDC concludes that it might be a coincidence, and recommends continuing vaccination. The manufacturer added to the insert that Guillain-Barré syndrome might be related to vaccination.

Meningococcal

Safety of Quadrivalent Meningococcal Conjugate Vaccine in 11- to 21-Year-Olds. 2017, Tseng, Pediatrics

The risk of Bell's palsy (facial paralysis) within 12 weeks of vaccination was 5 times higher for those who received the meningococcal vaccine (Menactra/Menveo) together with other vaccines, as compared to the control group. However, patients vaccinated with the same vaccines over 12 weeks before, were used as a control group.
The risk of Hashimoto’s disease was 5.5 times higher among those vaccinated, the risk of iridocyclitis was 3.1 times higher, and the risk of epileptic seizure was 2.9 times higher. All these cases were later reviewed, some of them were excluded, and the authors concluded that there was no statistically significant relationship between the vaccine and these diseases.

Meningococcal

Introducing MEDWatch. A new approach to reporting medication and device adverse effects and product problems. 1993, Kessler, JAMA

From 3% to 11% of hospitalizations can be the result of side effects of drugs. Only 1% of serious side effects are reported to the FDA.
This leads to problems with drugs not being detected on time. , that silicone implants exist on the market for 30 years, only recently it turned out that they are associated with autoimmune diseases.

Tuberculosis

The Association between Active and Passive Smoking and Latent Tuberculosis Infection in Adults and Children in the United States: Results from NHANES. 2014, Lindsay, PLoS One

Active and passive smoking is associated with a doubling of the risk of tuberculosis. In past and present smokers, the risk of infection with the tuberculosis bacterium, the risk of developing tuberculosis, the risk of complications, and the risk of death from tuberculosis are increased.
The risk of recurrent tuberculosis was 2 times higher in those who smoked more than 10 cigarettes a day than non-smokers. In addition: [1] [2] [3] [4]

Tuberculosis

Nutritional risk factors for tuberculosis among adults in the United States, 1971-1992. 2012, Cegielski, Am J Epidemiol

In people with reduced weight, the risk of tuberculosis was 12 times higher than in people with normal weight. In overweight people, the risk of tuberculosis was 3 times lower, and in obese people 5 times lower.
In the 1950s, it was found that people with vitamins A and C deficiency contracted tuberculosis more often, and the addition of vitamins and minerals reduced the incidence in the patients' families. Since then, no adequate research has been carried out on the effect of nutrients on tuberculosis risk.

Tuberculosis

Long-term results of BCG vaccination in the southern United States. 1966, Comstock, Am Rev Respir Dis

A controlled trial of BCG vaccination was conducted in 1950 in the USA.
Throughout 14 years of observation, vaccination accounted for a reduction in tuberculosis of only 14%. Moreover, BCG vaccination had negative efficacy among the African-American population. It was concluded that the BCG efficacy was too low (and least effective among groups most in need of protection), and the protection was too short-term to justify the use of BCG in the US. Thus BCG has never been introduced into the US vaccination calendar.

Hepatitis A

Type A viral hepatitis: epidemiology, diagnosis, and prevention. 1997, Lemon, Clin Chem

70-80 people die each year from hepatitis A in the USA, and those are almost exclusively people over 50 years old. Severe cases of hepatitis A are more likely to occur in people with alcoholic liver disease or chronic hepatitis.
Some of the vaccinated people developed Guillain-Barre syndrome, but it is unclear whether this is due to vaccination.

Hepatitis A

Before the licensing of the vaccine, the incidence of hepatitis A in USA was approximately 1 in 10,000, and mortality rate was 1 in 3 million. In 1999, vaccination was introduced in 11 states, where the incidence was higher than 1 in 5,000.
In 2006, the vaccine was added to the national immunization schedule. Hepatitis A incidence at that moment was 1 in 100,000, and mortality rate was 1 in 10 million; and almost all lethal cases were in people over 50 years of age with comorbidities.

Hepatitis A

Hepatitis A outbreak in the USA. 2018, Nelson, Lancet Infect Dis

In 2001, the advisory committee of San Diego (California) emphasized the need to increase the number of public toilets in the city center.
In 2010, a plan to finance these toilets was developed.
In 2016, two toilets were installed. One of them was later closed due to operating costs and concerns about crime, and only one toilet remained open in 2017. Altogether, there were 8 public toilets in San Diego, but only three of them were available 24 hours a day.
In San Francisco, where the number of homeless people is comparable to San Diego, there are 25 public toilets and they are all open 24 hours a day.
In 2017, a hepatitis A outbreak began in the USA, affecting mainly homeless people of San Diego, where more than 500 people got sick and 20 people died. Thus, 16 portable toilets were opened.
Due to the fear of hepatitis A, the authorities arrest those who distribute food to homeless people in San Diego suburbs.

Rotavirus

Diarrheal deaths in American children. Are they preventable? 1988, Ho, JAMA

Development of rotavirus vaccine began in the 90s, so the CDC began to wonder, who many kids die from it. They conducted the following studies on this question:

Death from diarrhea (for any reason) makes up 2% of all post-neonatal mortality rates. In 1983, an average of 500 children died of diarrhea in USA in a year, 50% of them died in hospitals. Diarrheal death rate decreases drastically with age – it is twice as high for infants at the age of 1-3 months, as at the age of 4-6 moths, and 10 times higher than for 12-months-olds.
Risk of diarrheal death is 4 times higher for black people (and in some states 10 times higher) than for white people; 5 times higher for infants whose mothers are younger than 17 years old; twice as high for those, whose parents are unmarried; 3 times higher for those, whose parents have not graduated from high school.
Diarrheal mortality rate is higher in winter than in summer, and it is believed that the rotavirus is responsible for that. It is estimated that 70-80 children die each year from rotavirus.

Rotavirus

Trends of diarrheal disease - associated mortality in US children, 1968 through 1991. 1995, Kilgore, JAMA

Diarrheal death rate in the USA decreased by 75% (79% among infants) and stabilized between 1968 and 1985. 300 people (240 of them children) died of diarrhea each year between 1985 and 1991. Mortality rate among children was 1:17,000. From 1985, half of the children died at the age under 1.5 months (that is, before the vaccination age).
Here’s a graph of diarrheal mortality rate from 1968 to 1991.
Every winter it is possible to observe death peaks that disappear in the mid-1980s, and only small peaks remain in the group of 4-23 month old children. As rotavirus is affected almost and exclusively in the winter, the authors believe that those peaks are deaths from rotavirus.
The authors conclude that a vaccine against rotavirus will have a measurable but small impact on mortality from diarrhea.

Rotavirus

The epidemiology of rotavirus diarrhea in the United States: surveillance and estimates of disease burden. 1996, Glass, J Infect Dis

It is estimated that 873 thousand people die from rotavirus each year around the world. However, there was no information on mortality rate of rotavirus in developed countries, and so in 1985 IOM concluded that this vaccine is not a priority for the USA. However, they used one prospective study as a basis, even though other studies determined that one third of children hospitalized with diarrhea had rotavirus infection.
Since not a single child in the USA died with a rotavirus diarrhea diagnosis, many pediatricians believed that rotavirus is never severe or lethal. However, mortality data analysis (in the previous studies) provided convincing, albeit circumstantial proof, that rotavirus can be lethal.
On the basis of two previous studies, the authors estimate that 55,000 children are hospitalized due to rotavirus each year, and 20 children die, i.e. 1 in every 200,000. They believe that these children also had some other disease, or they were premature, for example.
The authors conclude that less than 40 children each year die of rotavirus, although they never explain how they came up with the number ‘40’, since they only counted 20 in the body of article.
CDC claims that 20-60 children die of rotavirus each year, but they do not explain where they got ‘60’ from, since their own studies only got 20.

Rotavirus

Cost-effectiveness and potential impact of rotavirus vaccination in the United States. 2007, Widdowson, Pediatrics

Rotavirus vaccination in the USA will prevent 63% of all rotavirus cases, and 79% of all serious cases, thus preventing 13 deaths and 44,000 hospitalizations per year.
If the price of the vaccine dose is more than $12, vaccination will not be economically feasible, and at the price over $42, it will not be justifiable from the societal point of view either. Today, RotaTeq costs $69-$83 per dose, and Rotarix is $91-$110 per dose.

Rotavirus

Rotavirus vaccine and intussusception: how much risk will parents in the United States take to obtain vaccine benefits? 2001, Sansom, Am J Epidemiol

Despite the obvious benefits of vaccination, no vaccine is completely safe. Post-clinical studies have shown that recently licensed rotavirus vaccine increases the risk of intussusception. However, it is unknown what risk would be acceptable to the parents, and how much they would be willing to pay for this vaccine.
To reach the 50% vaccination coverage, the parents are ready to allow 2,897 cases of intussusception per year, which would cause 579 surgeries and 17 additional lethal cases. And to achieve 90% coverage, the parents are ready to allow no more than 1,794 cases of intussusception per year, including 359 surgeries and 11 deaths due to vaccine.
Without rotavirus vaccine 20 children die.
The lower the parents’ income, the higher the risk they are willing to accept.
The parents are willing to pay $110 for three doses of risk-free vaccine, but only $36 for three doses or risky vaccine.
Other studies already determined that parents prefer death from disease, rather than from vaccine, and this study confirms this fact.

Rotavirus

An infant with a gastroenteritis caused by a secondary infection with a Rotarix-derived strain. 2017, Sakon, Eur J Pediatr

Two-months-old girl was vaccinated with Rotarix in Japan, and in 10 days her two-years-old sister was hospitalized with severe gastroenteritis. It turned out that her sister infected her with a mutated vaccine strain of the virus.
A similar case with a RotaTeq vaccine in the USA is reported here. Vaccinated infant infected his brother 10 days post-vaccination with a rotavirus strain that was reassortant of two vaccine strains.

Anti-vaxxers

Children Who Have Received No Vaccines: Who Are They and Where Do They Live? 2004, Smith, Pediatrics

Unvaccinated children are mostly white. Their mothers are over 30, married, have an academic degree, and their families earn more than $75,000 a year. (USA)

Anti-vaxxers

Effects of Maternal and Provider Characteristics on the Up-to-Date Immunization Status of Children Aged 19 to 35 Months. 2007, Kim, Am J Public Health

Children of less educated mothers and children in families with low income-to-poverty ratios were more likely to have completed the vaccination series.
More African and Latin Americans are vaccinating their children, and the poorer they are, the more they vaccinate. (USA)

Anti-vaxxers

Deciding to opt out of childhood vaccination mandates. 2008, Gullion, Public Health Nurs

Parents who do not vaccinate their children, value scientific knowledge, know where to look for, and how to analyze information about vaccinations, and at the same time expressed high levels of distrust of the medical community. (USA)

Anti-vaxxers

Sociodemographic Predictors of Vaccination Exemptions on the Basis of Personal Belief in California. 2016, Yang, Am J Public Health

In California, the percentage of students with non-medical vaccination exemptions increased 4-fold between 2001 and 2014 (from 0.77% to 3.15%). Higher income, white population, and private school type significantly predicted greater increases in exemptions.
In other states the same phenomenon is observed - the percentage of private school students who opt for exemptions is much higher than in of public school students.

Anti-vaxxers

Acceptance of human papillomavirus vaccination among Californian parents of daughters: a representative statewide analysis. 2007, Constantine, J Adolesc Health

Parents with higher education and conservatives rarely allowed their daughters to get vaccinated against HPV. Higher percentage of parents who did not complete high school, Catholics and liberals, allowed their daughters to have this vaccination. (California, United States)

Anti-vaxxers

Maternal characteristics and hospital policies for risk factors for nonreceipt of hepatitis B vaccine in the newborn nursery. 2012, O'Leary, Pediatr Infect Dis J

More educated mothers and mothers with higher incomes often refuse to vaccinate their newborn child against hepatitis B. (Colorado, USA)

Chickenpox

Live attenuated varicella vaccine: evidence that the virus is attenuated and the importance of skin lesions in transmission of varicella-zoster virus. National Institute of Allergy and Infectious Diseases Varicella Vaccine Collaborative Study Group. 1990, Tsolia, J Pediatr

Vaccine strain of the virus is produced by sequential passages through animal cell cultures, which attenuates the virus. But how can one be sure that this procedure truly attenuates the virus?
The hypothesis that chickenpox and shingles are caused by the same virus was proposed in 1909. To test it, researchers extracted fluid from the blisters of shingles patients, and injected it to children who have not been exposed to varicella, in 1925 and 1932. 50% of the children got infected with chickenpox, but the rash was less severe than usual. That is, if an airborne virus is administered by injection, it causes an atypical disease. Therefore, it is impossible to conclude that the vaccine strain of the virus is attenuated, only on the basis of it having caused mild symptoms. It is also possible, that the injected dose of the virus was not enough to cause the usual symptoms.
In this study, the authors vaccinated children with leukemia and examined how often they infected their healthy siblings. It turned out that only 17% of the siblings got infected. Since the wild strain of the virus infects 80%-90%, the authors concluded that the vaccine strain indeed is attenuated.

Chickenpox

Outbreak of varicella at a day-care center despite vaccination. 2002, Galil, N Engl J Med

Varicella outbreak in daycare, where 66% of children had been vaccinated.
Vaccine efficacy was 44%. After three years the effectiveness decreased by 2.6 times. Vaccinated children had less rash than those unvaccinated.
The outbreak began with a vaccinated boy, who infected half of his class, who had no previous varicella exposure. The boy himself got infected by his 11 years old sister, who was suffering from shingles.
Vaccine efficacy was much lower than was determined during clinical trials. That is, most probably, due to the fact that in clinical trials, children who did not develop antibodies got repeat vaccination or were excluded from the efficacy analysis, or were analyzed separately, which is what led to an overestimated effectiveness rate.
Here is a meta-analysis of 14 studies of chickenpox outbreaks. The effectiveness of one dose was 72.5%.

Chickenpox

Chickenpox outbreak in a highly vaccinated school population. 2004, Tugwell, Pediatrics

Varicella outbreak in a school, where 97% of children had been vaccinated (with one dose). Vaccine effectiveness was 72% (CI:3-87). Children vaccinated over 5 years prior to the outbreak got infected 6.7 times more often than those vaccinated less than 5 years ago. More: [1], [2], [3].

Chickenpox

An outbreak of varicella in elementary school children with two-dose varicella vaccine recipients - Arkansas, 2006. 2009, Gould, Pediatr Infect Dis J

Varicella outbreak in a school, where 97% of children had been vaccinated (39% of them with two doses). The effectiveness of one dose and two doses was almost the same.

Chickenpox

Measles, mumps, rubella, and varicella combination vaccine: safety and immunogenicity alone and in combination with other vaccines given to children. Measles, Mumps, Rubella, Varicella Vaccine Study Group. 1997, White, Clin Infect Dis

After the MMRV vaccine, much less varicella antibodies are produced than after a separate vaccine, but more measles antibodies, as compared to MMR. [1].

Chickenpox

Herpes zoster ophthalmicus: declining age at presentation. 2016, Davies, Br J Ophthalmol

Herpes zoster ophthalmicus (HZO) accounts for 15% of all herpes zoster cases.
The number of HZO cases in Boston increased by 2.7 times between 2007 and 2013. The average age of patients decreased from 61.2 to 55.8 years, while the number of patients at the clinic during the same years has not changed.
The same was found in another study in Oklahoma, where the average age of HZO patients decreased by 8 years, from 65.5 to 58.9 years. Smokers got sick 11.5 years earlier than non-smokers.

Chickenpox

The incidence of varicella and herpes zoster in Massachusetts as measured by the Behavioral Risk Factor Surveillance System (BRFSS) during a period of increasing varicella vaccine coverage, 1998-2003. 2005, Yih, BMC Public Health

The incidence of varicella in Massachusetts decreased by 79% between 1998 and 2003, but the incidence of herpes zoster increased by 90%, and 161% in the 25-44 years age group.
The incidence of herpes zoster in Minnesota increased by 28% between 1996 and 2001.
The incidence of herpes zoster among children under 10 years of age in California decreased by 55%, but increased by 63% among teenagers of 10-19 years of age.

Chickenpox

Herpes zoster-related hospitalizations and expenditures before and after the introduction of the varicella vaccine in the United States. 2008, Patel, Infect Control Hosp Epidemiol

The incidence of varicella fell 4-fold, and hospital costs associated with it decreased by $100 million per annum. However, hospital costs associated with herpes zoster increased by $700 million per annum by 2004.

Chickenpox

Herpes zoster at the vaccination site in immunized healthy children. 2018, Song, Pediatr Dermatol

Some children develop shingles at the vaccination site several years after vaccination.

Chickenpox

Postlicensure safety surveillance for varicella vaccine. 2000, Wise, JAMA

It is usually argued that vaccines are completely safe and that serious side effects occur in one in a million vaccinated individuals. How is such statistics obtained? Here is an example for chickenpox.
The authors (from FDA and CDC) analyze VAERS from 1995 to 1998. 14 deaths were recorded in this period. To calculate the probability of death after vaccination, they use the number of vaccines sold for this period (9.7 million), and conclude that the probability of death is 1 in one million (they round it up a little, as in fact it come up to 1 in 700,000).
It does not take into account that:
1) Only 1%-10% of all side effects get registered with VAERS.
2) The number of vaccine doses sold does not equal to the number of doses administered. Moreover, 9.7 millions doses sold is not an exact figure, but a CDC estimate.
A total of 6,574 adverse events have been registered with VAERS, 4% of which were serious. However, among children under 4 years of age there were 6.3% serious adverse events, among children under 3 years of age – 9.2%, and among children under one year of age, who got vaccinated by mistake – 14%.
A total of 271 serious adverse event have been registered, that is, 1 in every 36,000. These figures should be multiplied by 10-100 (that is, the real number is between 1:3600 and 1:360), and considering that the quantity of administered doses was lower than the quantity of sold doses, which is quite possibly overestimated, they should be multiplied by an additional factor.

Haemophilus influenzae

Changing incidence of Hemophilus influenzae meningitis. 1972, Smith, Pediatrics

Hib incidence in the USA has increased five fold between the 1940s and the 1960s.

Haemophilus influenzae

Day care attendance and other risks factors for invasive Haemophilus influenzae type b disease. 1993, Arnold, Am J Epidemiol

Passive smoking is associated with a 40% increase in the risk of Hib. Daycare – with 3-fold increase in the risk. Breastfeeding decreases the risk by 50%. African Americans got infected 4 times more often.

Haemophilus influenzae

A case-control assessment of risk factors for Haemophilus influenzae type b meningitis. 1993, Sherry, Eur J Pub Health

Breastfeeding for more than a month is associated with a 62% decrease in the risk of Hib meningitis. Breastfeeding for more than 9 months – with 88% decrease in the risk. Daycare – with 2.6-4.7 times increase in the risk.

Haemophilus influenzae

Risk factors for invasive Haemophilus influenzae type b in Los Angeles County children 18-60 months of age. 1992, Vadheim, Am J Epidemiol

Analysis of all the Hib cases in Los Angeles in 1988-9 (8.7 million population, 750 thousand of them – children under the age of 5 years). 88 cases were registered among children during the year. Mortality rate was 4.5%.
The risk of Hib in children living in homes with more than two smokers was 6 times higher.
Six or more people living in one hearth is associated with a 3.7-fold increase in the risk of Hib. African Americans get infected 3.5 times more often. Chronic illness and low income also increase the risk.
Vaccination and breastfeeding decrease the risk of Hib (for white people). Vaccination with polysaccharide vaccine increases the risk of Hib.
Another study found that a smoking parent increases the risk of Hib by 2.4 times.

Haemophilus influenzae

Before the introduction of vaccination, Alaskan Inuits got infected with Hib 10 times more often than the rest of the USA population.
Australian native people, Native American, Inuits and Africans in Gambia and Somalia got infected 3-4 times more often than Americans, and 10 times more often than Europeans.

Haemophilus influenzae

Lack of efficacy of Haemophilus b polysaccharide vaccine in Minnesota. 1988, Osterholm, JAMA

Polysaccharide Hib vaccine was licensed in the USA in 1985. A clinical trial in Finland found that the vaccine is ineffective in children under the age of 2 years, and is 80% effective for ages 2-3 years. Before the licensing, the only study in the USA of 16,000 children did not find the vaccine effective. The vaccine was thus licensed on the basis of the Finnish study, only for children over 2 years of age (even though most cases occurred in children under 1 year of age). Once the vaccine got licensed, conducting a randomized study turned out to be impossible. However, since Hib is a rare disease, conducting this kind of study is difficult anyway, as it requires many participants.
An observational study in Minnesota found that the effectiveness of this vaccine is negative, and it increases the risk of disease by 58%.
Other studies have found that the vaccine increases the risk of disease in the first week after vaccination. Subsequently, the IOM also determined that polysaccharide Hib vaccine increases the risk of infection.

Haemophilus influenzae

Haemophilus influenzae Serotype a Invasive Disease, Alaska, USA, 1983-2011. 2013, Bruce, Emerg Infect Dis

Before the introduction of vaccination, Hib incidence in Alaska was the highest in the world. It decreased sharply due to vaccination, but H. influenzae incidence of other serotypes increased, mostly of serotype A and noncapsulated strains.

Haemophilus influenzae

Increasing incidence of invasive Haemophilus influenzae disease in adults, Utah, USA. 2011, Rubach, Emerg Infect Dis

Vaccination decreased the number of Hib cases in Utah children by 99%, but the incidence of H. influenzae infection among adults increased by 11.5 times between 1998 and 2008. Most cases were of serotype F and noncapsulated strains. Mortality rate was 22%.

Haemophilus influenzae

The changing epidemiology of invasive Haemophilus influenzae disease, especially in persons> or = 65 years old. 2007, Dworkin, Clin Infect Dis

The number of Hib cases in Illinois increased by 2.5 times (3.5 times among the elderly) between 1996 and 2004.
The number of cases of infection with noncapsulated Hib strain increased by 657%. In 1996, noncapsulated Hib strain was responsible for 17% of disease cases, whereas in 2004, it was responsible for 71% of the cases already. Mortality rate was 13% (21% among elderly).
Mortality rate for serotype F among the elderly was 11%, and 39% for serotype E.

Haemophilus influenzae

Hypothesis: conjugate vaccines may predispose children to autism spectrum disorders. 2011, Richmand, Med Hypotheses

For a long time I doubted about the vaccinations from Hib and pneumococcus, because these diseases can really be dangerous.The fact that I personally put the final cross on these vaccinations was the following article published in a rather marginal journal specializing in hypotheses It seems that even for this marginal magazine, the article was too marginal, and accompanied by an editorial article in which they write that, despite , that the theme of the connection between vaccines and autism is already worn to holes and a denial bent, and that although the author of the article is not a scientist at all, his hypothesis is, nevertheless, quite plausible, and it should be checked.

I highly recommend reading this article in full.
Editorial article is also worth reading.
Conjugated vaccines radically change immunological response to carbohydrate antigens In the absence of a conjugated vaccine, carbohydrate antigens usually do not induce an immune response of T cells, but induce a weaker response (T-cell independent). This is due to the fact that B2 cells do not synthesize antibodies without the signal of T-helper cells. In order for this to happen, the B2-cell, and its related T-helper cell, should recognize the same, or similar epitope. But since T cells recognize only protein epitopes, T helper cells are usually able to activate B2 cells in response to protein antigens. In response to bacterial capsular polysaccharides, the immune system forms a response through cells B1 and MZB (Marginal zone B). B1 cells do not begin to react to bacterial carbohydrate antigens until 18-24 months, and their response does not fully mature until about 5 years of age. Therefore, infants and young children are unable to respond effectively to capsular bacteria. Conjugated vaccines use the fact that B2 cells and their related T helper cells do not have to respond to an identical epitope, but rather recognize closely related epitopes. Although the mechanisms by which conjugate vaccines work are not fully understood, it is believed that antigen-presenting cells, treat the combined protein carrier and carbohydrate hapten, which leads to recognition of the protein carrier by T-helper cells, and recognition of carbohydrate antigens by B2 cells. That is, conjugated vaccines change the immunological response to carbohydrate antigens in infants and young children, from a hypo-sensitive to a full T cell response.
Because antibodies against carbohydrate antigens are often autoreactive with their own carbohydrates, the differentiation of B cells to B2 cells can lead to an autoimmune reaction. Therefore, B cells against carbohydrate antigens are carefully regulated by the immune system. Antibodies to native carbohydrates are associated with several autoimmune diseases, such as systemic lupus erythematosus, myocarditis and rheumatic heart disease, Sydenham's chorea, and children's autoimmune neuropsychiatric disorders associated with Streptococcal infections (PANDAS).
Unlike antibodies produced by B2 cells, antibodies produced by B1 and MZB cells are short-lived and low-affinity, and conducted to an autoimmune reaction with
Autism has an increased level of antibodies to nervous structures and an increased level of proinflammatory cytokines in the brain, which indicates that autoimmune and neuroinflammatory processes can play a role in some cases of autism.
Because myelinization (the formation of an insulating nerve fibers) is most intense during the first 9 months of life, and continues in early childhood, neuronal development in infants and young children can be particularly vulnerable to self-reactive antibodies, including those that react with glycoproteins in myelin sheaths.

The first conjugate vaccine (from Hib) appeared in the US in 1988, and was later licensed in most other developed countries, including Denmark in 1993, and Izr ail, where it was licensed in 1992, and introduced into the national vaccination calendar in 1994.
The incidence of autism began to rise dramatically in the US since births in the middle of 1987. In Denmark and Israel, the jump in autism began about 5 years later.
In 1990, the vaccine was licensed to infants from the age of two months, which may explain the further increase in autism.Another explanation for the increase in autism in the mid-90s could be a change in the protein carrier used in the vaccine, which made her more immune gene. If the Hib vaccine is an autism trigger, then an increase in its immunogenicity and a change in the binding site may increase the likelihood of autism.
The licensing of the pneumococcal vaccine in 2000 may partially explain the further increase in autism. Children born in 1995 were the first to be vaccinated against pneumococcus, and this is consistent with CDC data, according to which the level of autism in 1992-1994 did not change, and in 1998 autism was already 57% higher than in 1994, m.
In Denmark, the Hib vaccine was licensed in 1993, but immediately followed by an aggressive vaccination campaign for children, starting in 1988, which coincides with the growth of autism among those born in 1988 and later. > In Israel, the number of children receiving disability benefits due to autism did not change from 1972 to 1995. But from 1996 to 1998, their number increased 5-fold, which is explained by this hypothesis. In 2004, 11% of the beneficiaries were born in 1985-89 (before vaccine licensing), 21.1% were born in 1990-94 (the beginning of vaccination), and 37% were born in 1995-99 (immediately after the vaccination was introduced National calendar). The immune system in response to the carbohydrate membrane of capsular bacteria produces antibodies through B1 and MZB cells in adults, and in children older than 5 years. But children under 5 years of age react poorly to carbohydrate antigens. Conjugated vaccines consist of a protein carrier attached to a carbohydrate antigen, and are able to circumvent this restriction of the immune system to carbohydrate antigens in children. Due to the protein carrier, these vaccines can induce the production of antibodies by B2 cells.
The development of antibodies to carbohydrate antigens via B2 cells is a significant departure from the natural paradigm in which B1 and MZB cells usually produce short-lived antibodies against carbohydrate antigens, and B2 cells produce more long-living against protein antigens. In addition to the fact that the immune system of children under 5 years of age reacts poorly to capsular bacteria, the maternal IgM and IgG2 antibodies do not pass well the placenta, from which it follows that the embryos are probably also not protected from capsular bacteria. From the point of view of evolution, this is quite unexpected. It is possible that this evolutionary flaw is accompanied by a compensatory evolutionary advantage. One possible explanation is that antibodies to carbohydrate antigens can be cross-reactive with neuronal glycoproteins, and a fine balance has been achieved, by evolution, between evolutionary protection against capsular bacteria and the need for development of the nervous system. This is consistent with the fact that myelination begins with infancy, and lasts until early childhood, which coincides with the period during which the immune system is hypo-sensitive to carbohydrate antigens. Moreover, the period during which the immune system is least sensitive to carbohydrate antigens corresponds to the period of the most intense myelination. It is possible that antibodies to carbohydrates not only interfere with the development of the nervous system in infants and young children, but their negative effects are strengthened by a stable a response of the immune system induced by conjugated vaccines, which significantly disturbs the balance achieved by evolution.

Influenza

Assessment of temporally-related acute respiratory illness, the following influenza vaccination. 2018, Rikin, Vaccine

Many people believe that influenza vaccination can cause flu, the authors conducted this study to prove that it is not so.They found that: 1) The incidence of influenza among vaccinated and unvaccinated did not differ. 2) The incidence of other respiratory diseases among vaccinated children was 71% higher than that of unvaccinated children.

Influenza

Pandemic preparedness for swine flu in the United States. 2009, Edlich, J Environ Pathol Toxicol Oncol

Some health-care workers may be hesitant to take a vaccine because it contains a mercury preservative-thimerosal - which can be harmful to their health. These health-care workers and patients should be tested and treated for vitamin D deficiency to prevent exacerbation of a respiratory infection.
Optimal vitamin D level is 50-75 ng/mL, and an optimal dose for grown-ups is 4000-5000 IU daily.

Mumps

Mumps meningoencephalitis 1957, Bruyn, Calif Med

Here is the report of 119 cases of meningoencephalitis caused by mumps in San Francisco in 12 years (1943-1955). Most cases are mild, with no complications, no neurological consequences, last less than 5 days, and rarely require hospitalization. Death due to mumps meningoencephalitis is a very rare phenomenon, and in the entire medical literature only 3 such cases have been described (including one out of these 119).

Mumps

Mumps in the workplace. Further evidence of the changing epidemiology of a childhood vaccine-preventable disease. 1988, Kaplan, JAMA

20 years after the invention of the vaccine and 10 years after it became widely used, the first mumps outbreak (118 cases) occurred in the workplace (Chicago Futures Exchange). Total costs associated with the outbreak amounted to $120,738, whereas the vaccine costs only $4.47.
The authors report that historically, vaccine prevention of mumps did not get as much attention as the other diseases, because it is a mild one. However, $1,500 per case of mumps is too expensive, when the vaccine only costs $4.47 in public and $8.80 in private sectors. Research shows that every dollar invested in the mumps vaccine, saves $7-$14.
In addition, mumps in adults often leads to complications. 10-38% of post-pubertal men get orchitis. Also, mumps patients often develop meningitis (0.6% of cases among those aged 20 years or more). Getting mumps during the first trimester of pregnancy increases the risk of miscarriage.
In pre-vaccination times, mumps outbreaks were observed mainly in prisons, orphanages and army barracks.

Diphtheria

Diphtheria in North America. 1984, Dixon, J Hyg (Lond)

  • Diphtheria was always considered a childhood disease, but in mid 20th century adults also began to get sick with it. In 1960, 21% of the disease cases were in adults (over 15 years of age). In 1964, there were already 36% of adults, and it 1970s – 48%. The mortality ratio has also changed. In the 1960s, 70% of those who died of diphtheria in Canada were children, in in the 1970s, 73% of those who died were adults.
  • In the 1960s, the Indians suffered from diphtheria 20 times more often than white people, and 3 times more often black people. The reason is considered to be in the lack of proper hygiene due to the Indians’ poverty.
  • In the late 1960s, there were diphtheria outbreaks in Austin (88 cases) and San Antonio (196 cases). Diphtheria was mainly observed in the city districts with a low socioeconomic status.
  • One of the forms of diphtheria is cutaneous (skin) diphtheria. It is commonly found in homeless people, and is much less dangerous.
    Cutaneous diphtheria is associated mostly with the poorer population, living in crowded conditions with low hygienic standards. By 1975, 67% of diphtheria cases were of the cutaneous type, and it was mostly Indians who got sick.
    In an overwhelming majority of cases the cutaneous diphtheria infection is also accompanied by staphylococcus and streptococcus. It seems that a skin infection of streptococcus and staphylococcus predisposes to secondary infection with diphtheria, and the low level of hygiene is a main contributing factor.
  • In the 1970s, there was a diphtheria outbreak in Seattle. Of the 558 cases, 334 were from Skid Road (i.e. homeless). 3 people died. 74% suffered from cutaneous diphtheria. 70% were heavy alcoholics.
  • In 1971, there was a diphtheria outbreak in Vancouver (44 cases). Most of the cases were poor alcoholics.
  • In 1973, there was an outbreak among the Indian children. 4 children with cutaneous diphtheria were the source.
  • Cutaneous diphtheria was recognized as an infection reservoir in 1969 in Louisiana and Alabama. The bacterium was isolated in 30% of healthy people. Vaccinated and unvaccinated people were equally infected.
  • Since the 1980s, diphtheria is almost never found in North America.

Diphtheria

Tetanus and diphtheria immunity in urban Minnesota adults. 1979, Crossley, JAMA

84% of men and 89% of women in Minnesota had diphtheria antibodies level below 0.01 IU/ml.

Diphtheria

Serologic Immunity to Diphtheria and Tetanus in the United States. 2002, McQuillan, Ann Intern Med

40% of Americans do not have sufficient immunity to diphtheria (below 0.1 IU/ml).

Diphtheria

An Outbreak of Diphtheria in Baltimore in 1944. 1945, Eller, Am J Epidemiol

Diphtheria outbreak in Baltimore. 103 cases were recorded in 1943. 29% of the patients have been vaccinated, and another 14% claimed that they have also been vaccinated, but had no documented proof.
Consequently, they started to vaccinate more in Baltimore. In the first half of 1944, 142 cases were already recorded. 63% of them have been vaccinated.

Tetanus

Study of tetanus agglutinins and antitoxin in human serums. 1926, Coleman, J Infect Dis

The researchers ran blood tests of 104 California residents. Agglutinins to several strains of tetanus bacteria were found in the blood of 80% of them, but they did not have antibodies. The authors believe that tetanus bacteria were in the intestines of these people in the past, but did not survive there and thus they do not have the antitoxin.
Tetanus agglutinins have not been researched since then.

Tetanus

Human intestinal carriers of tetanus spores in California. 1926, Bauer, JSTOR

In four years from 1922 to 1925 in California, 245 cases of tetanus have been recorded. Mortality rate was 67%.
Among the 530 people in the study, the authors found bacteria in the intestines of 24%. They believe that the presence of tetanus bacteria in the intestines depends on the microflora, since they have always seen other types of bacteria along with tetanus bacteria, and did not see other bacteria, when the tetanus bacteria were absent.

Tetanus

A population-based serologic survey of immunity to tetanus in the United States. 1995, Gergen, N Engl J Med

70% of Americans had protective levels of tetanus antibodies (0.15 IU/ml). The children had protective levels higher than 80%, but much lower than the vaccination coverage (96%). Less than 5% of parents refused vaccination, meaning that refusing vaccination is not a significant factor for the absence of antibodies in the USA.
It is reported here that in tetanus vaccinated animals, TTC (non-toxic fragment of tetanus toxin) reached the brain in the same amount as in the unvaccinated animals.

Tetanus

Tetanus in the United States, 1900-1969, Analysis by cohorts. 1972, Fraser, Am J Epidemiol

As in the case with whooping cough, it is argued that the vaccine is responsible for reducing the incidence of tetanus by 92%, and the mortality rate by 99%.
This article analyzes cases of tetanus in USA since 1900 and shows a graph, according to which, the mortality rate decreased by more than 95% even before the vaccination began in the late 40s.

Whooping cough

Waning Protection after Fifth Dose of Acellular Pertussis Vaccine in Children. 2012, Klein, N Engl J Med

The risk of contracting pertussis after the fifth dose of the vaccine increases every year by 42%, and after five years the vaccine is already ineffective (assuming an initial effectiveness of 95%). Out of all the pertussis-affected children in northern California, none have been hospitalized, and none have died. More: [1].

Whooping cough

Prevalence of Antibody to Bordetella pertussis Antigens in Serum Specimens Obtained from 1793 Adolescents and Adults. 2004, Cherry, Clin Infect Dis

Among 1,800 adolescents and adults, only 20% had antibodies against the pertussis toxin one month after vaccination. Antibodies to other vaccine antigens were found in only 39-68% of the subjects.

Whooping cough

Unexpectedly limited durability of immunity following acellular pertussis vaccination in preadolescents in a North American outbreak. 2012, Witt, Clin Infect Dis

During the whooping cough epidemic of 2010, the majority of cases were children aged between 8 and 12 years old. There was no difference in the incidence between vaccinated, under-vaccinated and unvaccinated children (2 to 12 years).

Whooping cough

Possible temporal association between diphtheria-tetanus toxoid-pertussis vaccination and sudden infant death syndrome. 1983, Baraff, Pediatr Infect Dis

The DTP vaccine has been associated with sudden infant death syndrome (SIDS) in Los Angeles, and visits to the doctor have also been associated with SIDS.

Unvaccinated

Risk of Nontargeted Infectious Disease Hospitalizations Among US Children Following Inactivated and Live Vaccines, 2005-2014. 2017, Bardenheier, Clin Infect Dis

In USA, the risk of hospitalization among children whose last vaccine was a live one was twice lower than for those who received the inactivated vaccine as their last one.

Mercury

Iatrogenic exposure to mercury after hepatitis B vaccination in preterm infants. 2000, Stajich, J Pediatr

The blood concentration of mercury in premature infants increased more than 13-fold after the hepatitis B vaccine (form 0.54 to 7.36 μg/l). The concentration of mercury in full-term infants increased 56-fold (from 0.04 to 2.24 μg/l). The initial level of mercury in premature infants was 10 times higher, than in full-term infants (no statistical significance), which hints at a higher maternal level of mercury in premature infants.
Although, according to the HHS (Health & Human Services) guidelines, 5-20 μg/l is considered to be the normal level of mercury in the blood, there are discrepancies in the published literature about which levels are considered toxic and which are normal. Moreover, this data was obtained from adults who were exposed to mercury in the workplace.

Mercury

Thimerosal-containing hepatitis B vaccination and the risk for diagnosed specific delays in development in the United States: a case-control study in the vaccine safety datalink. 2014, Geier, N Am J Med Sci

Hepatitis B vaccine with thiomersal is associated with a 2-fold increase in the risk of developmental delays. For those who received 3 doses of such vaccine, the risk of developmental delays was 3 times higher, as compared to those, who received the vaccine without thiomersal. This same vaccine is also associated with a 10-fold increase in the need for special education in boys.

Mercury

The value of ecologic studies: mercury concentration in ambient air and the risk of autism. 2011, Blanchard, Rev Environ Health

The higher the state’s concentration of mercury in the air, the higher the risk of autism in it.

Mercury

Environmental mercury release, special education rates, and autism disorder: an ecological study of Texas. 2006, Palmer, Health Place

Every 1,000 pounds of mercury released into the atmosphere in the school district in Texas, increased the number of children in special education by 43%, and the number of children with ASD by 61%.
The number of children with autism was 437% higher in the cities and 255% higher in the suburbs than in the rural areas.
A different study reports that for every 1,000 pounds of industrial waste released, the number of children with autism increases by 2.6%, and if this waste comes from power plants, than the number of children with ASD increases by 3.7%.
Every 10 miles of distance from industrial sources of mercury or power plants are associated with a decrease in the number of children with ASD by 2% and 1.4% respectively. [1] [2] [3]

Mercury

A two-phase study evaluating the relationship between Thimerosal-containing vaccine administration and the risk for an autism spectrum disorder diagnosis in the United States. 2013, Geier, Transl Neurodegener

The authors analyzed VAERS database and found that the risk of ASD was 2 times higher in infants who received DTaP vaccine with thiomersal than in those who received a mercury-free vaccine. An analysis of Vaccine Safety Datalink (VSD), a different database, showed that hepatitis B vaccine with thiomersal is associated with an increase in the risk of ASD (OR=3.4).
Infant boys vaccinated against hepatitis B had a 3-times higher risk of developing autism, as compared to unvaccinated boys, or boys vaccinated at least one month after birth.

Mercury

The risk of neurodevelopmental disorders following Thimerosal-containing Hib vaccine in comparison to Thimerosal-free Hib vaccine administered from 1995 to 1999 in the United States. 2018, Geier, Int J Hyg Environ Health

The Hib vaccine with thiomersal is associated with a 2.75-fold increase in the risk of ADS, 5.4-fold increase for developmental delays, 2.4-fold increase for psychomotor disorders, and 2.7-fold increase for neurological disorders, as compared to those vaccinated with a thiomersal-free vaccine.

SIDS

Possible temporal association between diphtheria-tetanus toxoid-pertussis vaccination and sudden infant death syndrome. 1983, Baraff, Pediatr Infect Dis

DTP vaccination and doctor visits are associated with SIDS in Los Angeles. 6 out of 27 infants died within 24 hours of the vaccination, and 17 died in the first week after the vaccination.
This study was criticized because, in the reviewer's opinion, it does not take into account that the period of increased risk of dying from SIDS coincides with the period when infants are vaccinated and then falls sharply. It may therefore have been a coincidence that infants died more often on the first day and the first week after vaccination.

SIDS

Infant mortality rates regressed against number of vaccine doses routinely given: Is there a biochemical or synergistic toxicity? 2011, Miller, Hum Exp Toxicol

Before modern vaccination programs were introduced, "death in the cradle" was so rare that it was not included in infant mortality statistics. In the USA, national vaccination campaigns were launched in the 1960s. For the first time in history, most American children were required to receive several doses of vaccines, and soon after that, in 1969, a new medical term appeared – Sudden Infant Death Syndrome. By 1980, SIDS had become the main cause of postneonatal mortality.
In 1992, the American Academy of Pediatrics launched the "Back to Sleep" campaign, which encouraged parents to put their children to bed on their backs rather than on their stomachs.
Between 1992 and 2001, the incidence of SIDS decreased on average by 8.6% per year. However, the incidence of other causes of sudden unexpected infant death (SUID) has increased. For example, infant mortality from suffocation in bed has increased on average by 11.2% per year. Infant mortality from suffocation due to other causes as well as mortality in general has also increased. Similar observations were made in other studies as well.
Analysis of data from 1999 to 2001 shows that SIDS incidence continued to decline, but there was no significant change in overall postneonatal mortality. Although some studies have not found a correlation between SIDS and vaccines, there is evidence that some infants are more susceptible to SIDS after vaccination. For example, Torch found that two-thirds of the infants who died of SIDS were vaccinated with DTP. Of these, 6.5% died within 12 hours after vaccination; 13% within 24 hours; 26% within 3 days; and 37%, 61% and 70% within 1, 2 and 3 weeks respectively. Torch also found that non-vaccinated children died most often from SIDS in the fall or winter, while those vaccinated died most often at ages of 2 and 4 months – that is, when infants are first vaccinated with DTP. He concludes that the risks of vaccination may outweigh its potential benefits

SIDS

Here is the CDC data. SIDS incidence in the US have declined significantly since 1992, but when considering all unexpected deaths altogether, their incidence decreased by 30% by the mid-1990s and has remained virtually unchanged since then.
Native and African Americans die from sudden causes twice as often as whites and 5 times as often as Asians.
The mortality rate of infants from suffocation in bed has increased more than tenfold since the 1990s, although the recommendation to place children on their backs should have reduce the incidence of suffocation. The CDC, for some reason, has nothing to say about this fact.
The same happens in Australia – although the SIDS incidence is decreasing, the number of deaths from suffocation is increasing. More: [1]

SIDS

An 18-month-old child was vaccinated with MMR, even though he was sick. He died ten days later. The pathologist found that the child's death was not related to the vaccination, as his symptoms appeared too quickly after the vaccination to be related to it, and the child died of SIDS.

SIDS

In 2011, a healthy four-month-old infant in the United States received 7 vaccines and died the next day with a diagnosis of SIDS. In July 2017, the Special Masters court decided that the vaccines played a significant role in the boy's death, and without their influence he would not have died.

Autism

Pilot comparative study on the health of vaccinated and unvaccinated 6- to 12- year old U.S. children. 2017, Mawson, JTS

Well, not exactly. In fact, one study comparing vaccinated and completely unvaccinated children was published in 2017 after all, and it found that vaccinated children develop autism 4 times more often than unvaccinated children.
This study has many flaws. It was retrospective, based on anonymous surveys, and only 660 homeschooled children participated in it. However, no other similar studies have been conducted yet.

Autism

Unanswered questions from the vaccine injury compensation program: a review of compensated cases of vaccine-induced brain injury. 2011, Holland, Pace Envtl. L. Rev

The authors analyzed 1,300 cases of compensation for post-vaccination complications that were heard in court, and found that although vaccines do not cause autism officially, and the class action lawsuit was dismissed, compensation to people with autism was paid in at least 83 cases. Most of the compensation cases are classified, so a group was created to call the people who went to the vaccine court.

Measles

Measles epidemics of variable lethality in the early 20th century. 2014, Shanks, Am J Epidemiol

During the American Civil War and World War I, measles was a significant cause of death among soldiers (0.2/100 person-years, mortality rate of 6%). On the other hand, during the World War II, measles mortality was extremely low (0.0005/100 person-years, or less than 0.1%).
The authors note that the reduction in measles mortality among military personnel reflects the situation among the civilian population. This decrease was preceded by the availability of vaccines and antibiotics, and was not associated with any specific medical intervention.

Polio

Active immunization against poliomyelitis. 1936, Brodie, Am. J. Public Health

Во время эпидемий полиомиелита в 1930-х, среди детей, у которых отсутствовали антитела, заболевал лишь один ребенок из 170-и.

Polio

Laboratory data on the Detroit poliomyelitis epidemic-1958. 1960, Brown, JAMA

During the polio epidemics in Michigan in 1958, only 25% of paralyzed patients had poliovirus in their blood. For most of them, paralysis was not caused by poliovirus. Coxsackie and echoviruses were the reason for more cases of nonparalytic poliomyelitis and aseptic meningitis, than poliovirus. 11 patients paralyzed due to poliovirus have been vaccinated with at least three doses.

Polio

A conversation with Paul Meier. Interview by Harry M Marks. 2004, Meier, Clin Trials

The Cutter Incident, 50 Years Later (Offit, 2005, N Engl J Med)
During the clinical trials of IPV, Salk published an article in which he claimed that the entire virus in the vaccine was inactivated, but did not provide data on all the vaccine batches. Paul Meier, a well-known scientist, believed that there was something wrong with the data, so the National Fund for Childhood Paralysis (NFIP) formed an advisory committee to deal with it. When one of the members did not agree with the licensing of a vaccine, he was removed from the committee, and a new, more accommodating member was appointed. The committee was reformed several times this way, until all members agreed. After the clinical trials, NFIP gave the committee two hours to review the materials, after which six companies were licensed to produce the Salk vaccine.
Two weeks after the license was issued, some children, vaccinated with Cutter Laboratories vaccine, were paralyzed. The vaccine was withdrawn, but 380,000 children had already been vaccinated with it. Subsequently, it turned out that 40,000 of them got polio, 200 were paralyzed and 10 died, because the vaccine was not sufficiently inactivated and contained active virus. Wyeth vaccine also caused paralysis and death in some cases. Other companies had difficulties with virus inactivation as well. Too little amount of formaldehyde did not kill the virus, while too much of it made the vaccine useless. Residues of various substances in the vaccine protected the viral particles from formaldehyde. Since other vaccine manufacturers threatened the newspapers to reduce the amount of advertising, it was decided to put all the blame on Cutter. Even though Cutter’s negligence was not proved, the court ordered Cutter to pay compensation. Overtime, this led to an abundance of lawsuits against vaccine manufacturers, which resulted in a law being passed in 1986, according to which it became impossible to sue vaccine manufacturers in the United States. Since then, compensation can only be received by filing a lawsuit with a special federal court, which is financed by the vaccine tax. However, one loophole remained. If the special court dismissed the claim, then it was possible to file a lawsuit against the company with a regular court. The already familiar to us Paul Offit believes that the loophole needs to be closed, since these lawsuits cost the companies millions of dollars and distract them from the manufacturing of such important products.

Polio

The Present Status of Polio Vaccines. 1960, Ratner, Illinois Medical Journal

(full text)
In 1960, polio experts in the USA held a conference reporting the following facts, which allow to conclude on whether the vaccine had an effect on the decrease in polio incidence in the mid-1950s:
1) In 1955, when Salk vaccine was licensed, the definition of polio was changed. While a 24-hour paralysis was enough for diagnosis before, since 1955, the paralysis had to last at least 60 days. Since most cases of paralysis are short-term, polio incidence decreased with no connection to the vaccine. Coxsackie viruses and aseptic meningitis, which were previously considered polio, were assigned a separate category. The definition of epidemic also changed. While 20 cases were previously required to declare an epidemic, now it was 35 cases.
2) Of the thousand people infected with poliovirus, only one gets paralysis.
3) The number of paralytic poliomyelitis cases increased significantly in 1958-59, which was blamed on the unvaccinated. This is quite strange, as one of the participants observes, since the number of unvaccinated people has decreased drastically. So, if the vaccine was responsible for the 1955-57 decrease in incidence, how come the much higher number of unvaccinated people did not prevent it from decreasing in those years?
4) Clinical trials of Salk vaccine only tested for its efficacy, since it was assumed that the vaccine was safe. It was determined that the vaccine is 72% effective against paralytic poliomyelitis, and ineffective against non-paralytic. However, after licensing of the vaccine, its composition was changed and another degree of filtration was added. No one knows how this affected the vaccine efficacy. Filtration was added in hopes of removing the residual active virus, even though the effectiveness of this procedure has not been confirmed experimentally. Each filtration is known to significantly reduce the amount of antigen. An Israeli study found that an addition of filtration reduces the amount of antigen by 10-30 times, and there initially was little antigen in the vaccine.
5) In 1954, active virus was found in 10 out of 48 tested vaccine batches. Different laboratories found active virus in different batches. Nonetheless, since Salk reported that 7,500 children had been vaccinated without side effects, the clinical trials were continued. Theoretically, inactivation of virus with formalin is a first-order chemical reaction. That is, if X hours are needed to inactivate 50% of the virus, then the next X hours will inactivate 50% of the remaining virus. However, this has not been confirmed practically. Everyone believed Salk, and no one double-checked his data, which subsequently led to the Cutter incident. Vaccines for clinical trials passed a triple safety check. After the licensing, this check was cancelled for the subsequent batches. Therefore, it is not surprising that there were outbreaks of vaccine paralysis. What is surprising is that there were not more of them.
6) A virulent strain is required to produce antibodies. On the other hand, virulent strain causes epidemics of vaccine paralysis among those, who do not have antibodies.
7) 57% of vaccinated people do not develop serotype 1 antibodies, 20% do not develop serotype 2 antibodies, and 77% do not develop serotype 3 antibodies. There is no difference between vaccinated and unvaccinated people with regard to serotypes 1 and 3.
8) In 1956, in turned out that the potency of vaccines of various manufacturers differed by 600 times. In 1957, the major vaccine manufacturers had products worth several millions of dollars, the potency of which was below the established minimum. FDA has reduced the required potency, so that the products could be sold.
9) In comparing the incidence among vaccinated and unvaccinated people, they forgot to count 100,000 unvaccinated, which led to overestimated efficacy. The decrease in the polio incidence is the result of manipulating the statistics.
10) It is very difficult to convince doctors to diagnose non-paralytic poliomyelitis in those vaccinated. In 1956-57, it turned out that most cases of non-paralytic poliomyelitis were actually the Coxsackie virus and echovirus.
11) During the 1958 epidemics in Israel, there was no difference in the incidence among those vaccinated and unvaccinated. During the epidemics in Massachusetts, paralysis was more common among those triple vaccinated than those unvaccinated.
12) Trials of inactivated vaccines against Rocky Mountain spotted fever, typhus and Japanese encephalitis, have shown that when the number of viral particles in a vaccine was less than 100 million, vaccinated guinea pigs and mice died faster than unvaccinated. The vaccine caused sensitization, so the susceptibility to the disease only increased due to vaccination. This immunological fact has been confirmed by public health service. That is, insufficient efficacy of the vaccine does more harm than good. This is probably what happened in Massachusetts, where 47% of paralysis cases were observed among those vaccinated. There were 10-30 millions of viral particles in the Salk vaccine, and that is before the additional degree of filtration was introduced.
13) Director in the FDA did not want to license the vaccine, since he could not get Salk to answer his questions, but the management reversed his decision.
14) The public is confident in the high effectiveness of the vaccine, although we know this is far from the case. The public is difficult to convince of the benefits of something, so it is better not to include it in the discussion of these issues.

Polio

An Institutional Outbreak of Poliomyelitis Apparently Due to a Streptococcus in Milk. 1932, Rosenow, J. Infect. Dis

Эпидемия полиомиелита в 1930 году (927 случаев). Оказалось, что ее причиной было сырое молоко, в котором обнаружились "полиомиелитные стрептококки". Как только молоко перестали использовать, новые случаи перестали возникать.
Еще несколько эпидемий полиомиелита из-за молока: [1], [2], [3], [4].

Polio

DDT poisoning and elusive virus X; a new cause for gastro-enteritis. 1949, Biskind, Am J Dig Dis

The authors of the article published in 1949, write that a new, strange syndrome has appeared in the USA in the recent years, which is most likely caused by some kind of infection, and got called ‘virus X’. The syndrome is accompanied by acute gastroenteritis, nausea, vomiting, abdominal pain, diarrhea, runny nose, cough, sore throat, joint pain, muscle weakness, fatigue and paralysis. It turned out later that all of these symptoms were caused by DDT. Paralysis from DDT is similar to poliomyelitis. Although DDT is a lethal poison, it is considered completely safe in all doses. It is used in every house in unlimited quantities. It is sprayed on skin, on bed and clothes, on food and utensils, on agricultural crops and livestock. DDT is a cumulative poison. Many small doses are equally as lethal as one large dose. DDT cannot be removed from food, as it accumulates in fat cells and is excreted in breast milk. Large-scale intoxication of American population is inevitable.

Polio

The poison cause of poliomyelitis and obstructions to its investigation. 1952, Scobey, Arch Pediatr

A 1952 article analyzes dozens of cases and outbreaks of poliomyelitis, in which paralysis was caused by poisoning with lead, arsenic, mercury, cyanide, pesticides, carbon monoxide, etc. It is also reported that vitamin C, which effectively treats poliomyelitis, has been used to treat poisoning. The author writes that epidemics of pellagra and beriberi were observed earlier, and thus it was believed that these were infectious diseases. Since poliomyelitis was legally recognized as a contagious and infectious disease in 1911, only virologists dealt with it, and ordinary doctors could not participate in the research. It is also the reason why studies to determine whether poisoning could cause poliomyelitis are not being funded.

Polio

What was the cause of Franklin Delano Roosevelt's paralytic illness? 2003, Goldman, J Med Biogr

В 1921 году Франклину Рузвельту, который впоследствии стал президентом США, был поставлен диагноз полиомиелита. Рузвельт основал организацию March of Dimes (NFIP), которая финансировала создание полиовакцины и лечение этой болезни. Его диагноз никто не подвергал сомнению, в те времена любой паралич был полиомиелитом.
В этой статье авторы подробно анализируют исторические свидетельства симптомов Рузвельта, делают байесовский анализ каждого симптома, и заключают, что согласно трем различным методам анализа, у Рузвельта скорее всего был синдром Гийена-Барре, а не полиомиелит.

Polio

Franklin Delano Roosevelt's (FDR's) (1882-1945) 1921 neurological disease revisited; the most likely diagnosis remains Guillain-Barré syndrome. 2016, Goldman, J Med Biogr

Предыдущая статья, разумеется, подверглась резкой критике. Историки и неврологи не хотели терять полиомиелитного президента.
В этой статье авторы подробно отвечают на опубликованную критику, и заключают, что за 13 лет прошедшие со времени публикации их статьи, никакого альтернативного анализа болезни Рузвельта опубликовано не было, и что историки и врачи продолжают верить в полиомиелит Рузвельта из-за confirmation bias и appeal to authority, а также из-за того, что Гийен-Барре разрушает красивую историю полиомиелита, в которой болезнь Рузвельта логически связана с его руководящей ролью в победе над полиомиелитом.

Polio

Neonatal paralytic poliomyelitis. A case report. 1986, Bergeisen, Arch Neurol

Неонатальный полиомиелит встречался очень редко даже во время эпидемий. Во всей медицинской литературе упоминаются 58 случаев, и у большинства из них у матери был острый полиомиелит незадолго до, или во время родов.
18-дневный младенец заболел вакциннным полиомиелитом (серотип 3). У его матери не было полиомиелита, но она выкуривала по 30 сигарет в день во время беременности. В последствии обнаружилось, что ребенок бебиситтера был привит за несколько дней до родов, и у него началсь диарея.
С 1969 по 1981 в США были зарегистрированы 203 случая полиомиелита, из них 12.8% заразились от прививки, а 29.6% заразились вакцинным штаммом от привитых.
Обе вакцины (IPV и OPV) несомненно спасли бесчисленное количество жизней (ссылка отсутствует). Тем не менее много вопросов в отношении их эффективности и безопасности остались без ответа (ссылка присутствует). Поэтому мы рекомендуем продолжать использование живой вакцины в США.

Polio

The 1916 New York City Epidemic of Poliomyelitis: Where did the Virus Come From? 2011, Wyatt, Open Vaccine J

Эпидемия полиомиелита в Нью Йорке в 1916-м была довольно необычной. Она началась в мае, намного раньше обычного. У 2% зараженных 2-х и 3-х летних детей был паралич, летальность достигала 25%. Официально считается, что ее начали дети, которые приехали из Италии. Однако эпидемия началась до прибытия этих детей. В то время считалось, что полиовирус разносят мухи, а кошки являются его носителями. 72 тысячи кошек были убиты.
В трех милях от эпицентра вспышки находился институт Рокфеллера, где ученые пытались усилить вирулентность полиовируса, проводя его через спинной мозг макак. Автор считает, что к эпидемии привела случайная утечка вируса из лаборатории.

Pneumococcal

Geographical differences in invasive pneumococcal disease rates and serotype frequency in young children. 2011, Hausdorff, Lancet

In the USA, the incidence of invasive pneumococcal infection among children under 6 years old is 3-6 times higher than in Europe. It is also higher than in Australia and New Zealand.
This is most likely because in the United States they take blood for bacterial analysis from all children under 3 years old with a temperature of 39 and above, and from everyone who has elevated white blood cells (they are also given antibiotics), and in Europe a similar analysis is usually done only for hospitalized patients. Since most cases of invasive pneumococcal infection are temporary bacteremia that do not require hospitalization, they are, for the most part, not diagnosed in European countries.

Pneumococcal

Invasive pneumococcal disease in Dallas County, Texas: results from population-based surveillance in 1995. 1998, Pastor, Clin Infect Dis

People with low income suffer from pneumococcus 2 times more often than people with middle income, and 3 times more often than people with high income.

Pneumococcal

Invasive pneumococcal infection in Baltimore, Md: implications for immunization policy. 2000, Harrison, Arch Intern Med

Black people get pneumococcus 3.3 times more often than white people, and 40-49-year old Black people - 12 times more often. The median age of patients among blacks is 27 years lower than among whites.
Low-income people get sick more often. Urban dwellers are sick more often than suburban residents.
Almost 50% of infected blacks are infected with HIV. AIDS increases the risk of pneumococcal infection by 100-300 times.
The authors conclude that it is necessary to vaccinate young and poor people living in cities. Despite the fact that pneumococcus is mainly registered in blacks, it is necessary to vaccinate whites too since there are also poor people among whites. Since vaccination of exclusively risk groups was tested with hepatitis B and failed, the authors believe that universal vaccination against pneumococcus is necessary.

Pneumococcal

Clinical Characteristics of Children With Complicated Pneumonia Caused by Streptococcus pneumoniae. 2002, Tan, Pediatrics

In 1994, 22.6% of pneumococcal pneumonia in the United States was accompanied by complications. In 1999, there were already 53% of pneumonia with complications.

Pneumococcal

Rising rate of pneumococcal bacteremia at the Children's Hospital of Philadelphia. 1994, Foster, Pediatr Infect Dis J

During five years after the start of Hib vaccination, the incidence of pneumococcal bacteremia in Philadelphia doubled (from 38 to 73 cases per year). The incidence of hemophilic bacteremia has decreased from 34 to 9 cases per year, and the incidence of meningococcal bacteremia has not changed (3 cases per year).
The incidence of pneumococcal meningitis increased by 50% (from 5.2 to 7.6 cases per year). The incidence of H. influenzae meningitis has decreased from 18 to 5.6 cases per year, and the incidence of meningococcal meningitis has not changed (3 cases per year).

Pneumococcal

Routine pneumococcal vaccination of children provokes new patterns of serotypes causing invasive pneumococcal disease in adults and children. 2013, Norton, Am J Med Sci

The incidence of invasive pneumococcal infection among children decreased by 2 times between 1996 and 2010, but among adults it increased by a third. In general, the incidence increased slightly. (Huntington, West Virginia).

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