Saturday, February 19, 2011

Whooping vaccine hysteria

A WSJ op-ed by Paul Howard and James R. Copland says:
Vaccines, which save millions of lives every year, are one of the most successful public-health interventions in the history of modern medicine. Among the diseases that they prevent is the whooping cough. Why, then, is that sickness making a scary comeback in California, which is currently weathering its largest whooping-cough epidemic since 1947, with over 7,800 cases and 10 deaths in 2010? Mainly because more and more parents, worried about the vaccine's supposed side effects, are choosing to delay vaccinating their children -— or not to do it at all.
No that is not why California has a pertussis (whooping cough) outbreak. Pertussis is primarily spread by teenagers who were vaccinated as infants, but had the vaccination wear off. Even the NY Times reported:
The rise in pertussis doesn’t seem to be related to parents’ refusing to have their children vaccinated for fear of potential side effects. In California, pertussis rates are about the same in counties with high childhood vaccination rates and low ones. And the C.D.C. reports that pertussis immunization rates have been stable or increasing since 1992.
Five babies have died, but they were too young to be vaccinated, and would not have been saved by stricter vaccine requirements. California's reaction, appropriately, has been to target older kids and adults. See Calif. urgers pertussis vaccination for pregnant women and New Calif. law requires vaccine for grades 7-12.

The op-ed continues:
Today's anti-vaccine hysteria can be traced in part to a 1974 British study that appeared to link the whooping-cough vaccine to rare brain injuries. The study was later debunked, but vaccination rates plummeted for a time in the United Kingdom, Japan, and Sweden.
No, that is not true. As you can read here, The DTP vaccine rate dropped in Sweden because a defective vaccine was ineffective, and in Japan because of adverse reactions. That's right, the parents who had a choice about the vaccines seemed to have a better understanding of the situation than the public health authorities. The rates went back up in Sweden when they got a more effective vaccine, and in Japan when they got the safer DTaP vaccine.

Because of greater medical freedoms, Japan and other countries got the safer DTaP (acellular pertussis) vaccine 20 years before the USA. The US CDC did not want to introduce the DTaP in the USA because the mandatory DTP vaccine had been accepted with about 98% compliance, and the feds did not want to admit that we were using an inferior vaccine.
In October, the Supreme Court heard arguments in Bruesewitz v. Wyeth, a case involving the seizures and mental retardation suffered by an infant vaccinated for whooping cough in 1992. The plaintiffs' lawyers in Bruesewitz argue that cases involving defects in drug design shouldn't be decided by the VICP -— and that Wyeth is at fault because it didn't use a supposedly safer vaccine design developed by Eli Lilly in the 1960s. (The Lilly design, by the way, was never certified by the FDA as safer.)
I am not sure about VICP jurisdiction, but there is no question about DTaP being safer than DTP. That is what Japan and Europe decided in the 1980s, and what the CDC decided in about 2000. The DTP is off the market.

The op-ed authors work for the Manhattan Institute for Policy Research, a "conservative, market-oriented think tank". What they are really saying here is that drug companies should not be liable for what they lobby to become a govt mandate, and they pretend that a California pertussis outbreak proves that the mandates are necessary. The pertussis scare story is just a big smokescreen to cover up some flawed govt mandates. A truly conservative market-oriented solution would be to drop the mandates, let people use the safer vaccines, and encourage vaccine usage among those who are actually spreading the disease.

Update: The US Supreme Court just ruled 6-2 in favor of the vaccine manufacturers.
In a final footnote, Justice Sotomayor wrote that a concern about an asserted link “between certain vaccines and autism spectrum disorders” appeared to “underlie the majority and concurring opinions in this case.”
That is weird. All of the experts say that the alleged link has been disproved.

Much of the oral argument was concern with the policy question of who should be determining which vaccines are safe and effective. Some of the justices did not want state juries second-guessing CDC determinations. But nobody was able to say just what the CDC determines when it makes a recommendation.

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