Vaccine Debate

Question 1

Hib once an counted for 70% of bacterial meningitis cases in children <5yrs… Vaccination has reduced that by 97%

Conjugate vaccine for Hib introduced in 1988, vaccines for all infants in 1991

Answer 1

…

Question 2

S. Pneumoniae vaccine…

Answer 2

23 valent polysaccharide vaccine (poorly immunogenic in children <2 yrs)

Conjugate vaccine introduced in 2000

• conjugated to diphtheria protein
• T cell dependent response
• 59% decline in pneumococcal meningitis from 1998

Question 3

Lack of pertussis vaccination leads to whopping cough… outbreak due to anti vaccine movement

Answer 3

…

Question 4

Evolution of Immunization Program Chart…

Answer 4

Have high disease before vaccine

Drops with vaccination

Loss of confidence in vaccine leads to outbreak, and then there is a resumption of confidence..

Eradication occurs

Question 5

Where did the anti-vaccine movement arise?

Answer 5

DPT: Vaccine Roulette documentary

Showed series of children with brain damage following DPT vaccine

Formation of “dissatisfied parents together” - now called the National Vaccine Information Center

Question 6

Anti vaccine movement start date?

Answer 6

April 19, 1982

Question 7

Media coverage in the 1982 claimed the whole-cell pertussis vaccine caused brain damage. Flood of lawsuits say it caused… SIDS, coma, mental retardation, epilepsy, transverse myelitis, reye’s sydrome

Answer 7

….

Question 8

Over the next 10 years after 1982, science demonstrated that there is no increased risk of epilepsy or retardation due to vaccines… it was actually because of….

Answer 8

Sodium channel transport defect

Question 9

Impact of lawsuits for vaccines?

Answer 9

DTP vaccine rose to $12 from 0.19$

Vaccine markers decreased for OPV, measles, pertussis

Creation of National Vaccine Injury Compensation Program (VICP)

Question 10

National Vaccine Information Center..

Answer 10

Founded by Barbara Loe Fisher

Oldest son got learning disabilities and attention deficit disorder

Believes that vaccines have replaced infectious diseases with chronic diseases
Hib - diabetes
Pneumococcus = seizures
HBV = MS and SIDS
HPV = blood clots, strokes, chronic fatigue syndrome

Question 11

Jenny McCarthy…. anti-vaxxer

Answer 11

…

Question 12

1918 influenza pandemic is believed to have killed 50-100 million people worldwide

Answer 12

…

Question 13

Shifts in influenza?

Answer 13

Important antigenic changes resulting from periodic gene segment reassortment between human and animal viruses

Question 14

Influenza drifts

Answer 14

Less dramatic antigenic changes that allow virus to escape human immunity raised by previously circulating viruses (change the hemagluttin)

Question 15

Avian +pig influenza

Answer 15

Send end jumps to humans

Human viruses jump to pigs (this may result in doubly mixed pig- human and triply mixed pig-human-avian viruses (really bad)

^likely the mechanism of both the 1918 and 2009 H1N1 pandemic

Question 16

Novel H1N1 vaccine, 2009

Answer 16

CNN and Dr. Oz - which is worse: vaccine or the virus?

Contains harmful preservative:thimerosal
Contains harmful adjuvant: squalene
Not adequately tested

H1N1 caused 11,000 deaths (1000 children)

Question 17

Real Vaccine tragedies? (3)

Answer 17

1) yellow fever vaccine in military - Hep B in serum
2) Salk’s polio vaccine - 12,000 children due to poor inactivation of virus
3) BCG vaccine - did not use attenuated strain - 70 children died from TB

Question 18

Jacobson vs. Massachusetts (1905)

Answer 18

Outbreak of smallpox in Boston

Said get it or pay $5 fine

Jacobson refused both

Justice John Marshall Harlan said that you have to pay and that state/police could mandate immunization

For the common good

Question 19

Zucht vs. King (1922)

Answer 19

Zucht was expelled from high school for refusing smallpox vaccine

No smallpox epidemic - but unanimous decision saying that you have to get it or leave

Question 20

Prince vs. Massachusetts (1944)

Answer 20

Jehovah’s witness claims right to have young children distribute pamphlets

Ruled against them… cant do whatever you want with your children!

Question 21

There is no constitutional right to refuse vaccines, but the state may allow exemptions

Answer 21

..

Question 22

New York State Assembly in 1966

Answer 22

Considered a bill requiring polio vaccine for school - passed 150-2

Two dissenting votes because it provided a caveat for parents whose religion forbade vaccination (Christian Scientists)

Question 23

Christian Scientists

Founder: Mary Baker Eddy

Answer 23

Illness is spiritual, not physical

1875 - science and health publication

Question 24

christian science in 1875 was before germ theory was established or before visualization of viruse sin 1930s

Answer 24

..

Question 25

Joseph Margiotta, Nassau County

Answer 25

Did not like "opt out" caveat

Question 26

Daycroft school, greenwich, CT

Answer 26

Christian Science school Massive outbreak of polio in 1972

Question 27

How many states have religious exemptions?

Answer 27

47

Question 28

Maier vs. Besser, 1972

Answer 28

Cant discriminate me because I'm not a Christian Scientist

Question 29

Sherr vs. Northport Union School, 1987

Answer 29

Religion and philosophy are intrinsically blurred 20 states now have philosophical exemptions

Question 30

Disneyland 2015

Answer 30

Measles outbreak - multi-state California and Vermont now no longer allow philosophical exemptions - now only 18 states that have that exemption

Question 31

Consequences of vaccine fear....

Answer 31

Increase risk for measles, pertussis More measles, Hib deaths, and pertussis/whooping cough cases

Question 32

Pediatricians.... people are getting sued when children get sick if not vaccinated...some doctors refuse to see pts who do not vaccinate because of fear of getting sued or bc they might infect other children in their office

Answer 32

....

Question 33

Dr. Sears

Answer 33

Constructed own schedule - delays vaccines and spaces them further apart Gives the "bare minimum" in vaccines

Question 34

Hospitals mandate influenza vaccine

Answer 34

...

Question 35

Parents concerned about sending children to school or daycare centers are taking a stand ...

Answer 35

....

Question 36

Voices for Vaccines are a Pro-vaccine movement

Answer 36

...

Question 37

AAP (american academy of pediatrics) provides practice responses to some of the most common concerns about vaccines... such as....

Answer 37

It is safe to give at early age - timeline is provided to provide protection early Vaccines do not cause autism Hep B, flu, and varicella are all significant illnesses that can be prevented with immunizations Thimerosal has not shown to cause any harm, and it has been removed from almost all childhood vaccines