We're scaremongers! says the WHO

[Guest guest]

No vaccine for the scaremongers

Millions of deaths are prevented by vaccination every year, yet public

anxieties and vaccine scares that ignore rigorous science continue to

hamper immunization programmes. Jane Parry reports.

Dr Jonas E Salk, who developed the first vaccine against poliomyelitis

in 1955, gives a boy a polio vaccine shot during the mass innoculation

trial in Pittsburg, Pennsylvania, in the United States of America

(USA). Salk developed his successful vaccine around the time of the

Cutter incident, when thousands of people in the USA developed polio

after being given vaccine containing live virulent polio virus from

Cutter Laboratories.

WHO

Dr Jonas E Salk, who developed the first vaccine against poliomyelitis

in 1955, gives a boy a polio vaccine shot during the mass innoculation

trial in Pittsburg, Pennsylvania, in the United States of America

(USA). Salk developed his successful vaccine around the time of the

Cutter incident, when thousands of people in the USA developed polio

after being given vaccine containing live virulent polio virus from

Cutter Laboratories.

For most children in the developed world, immunization against a range

of infectious diseases is a form of health protection often taken for

granted. These children benefit from vaccines against more than 20

diseases, while new vaccines continue to be developed, most recently

for rotavirus and human papillomavirus.

In developing countries, however, getting routine vaccinations to the

people who need them remains a key public health challenge, with the

lack of health-care infrastructure, high costs and delays between

their introduction in developed countries and their rollout in the

developing world cited as the main barriers.

Despite these barriers, global vaccination has evolved as a result of

rigorous scientific research. According to the World Health

Organization (WHO) and the United Nations Children's Fund's (UNICEF)

2007 Immunization Summary, more than 2.5 million deaths a year are

prevented in all age groups owing to vaccination against four diseases

– diphtheria, tetanus, pertussis (DTP) and measles. Global coverage of

infants with the DTP vaccine reached 79% in 2006, up from 20% in 1980,

while the uptake of several under-used vaccines, including hepatitis

B, rubella and yellow fever, is increasing.

Smallpox has long been hailed as the ultimate vaccination success. It

was declared eradicated in 1979, the only disease affecting humans to

be eliminated deliberately. Polio has been eradicated in WHO's

American, European and Western Pacific Regions, while the number of

countries where polio is deemed a serious public health problem has

dropped from 125 in 1988, when the eradication drive was launched, to

only four – Afghanistan, India, Nigeria and Pakistan – where the

disease remains endemic.

There have been many other successes, such as the 99% reduction in the

incidence of bacterial meningitis caused by Haemophilus influenzae in

the United States of America (USA) which introduced vaccination

against the disease in 1988, according to its Centers for Disease

Control and Prevention. The Republic of Korea, with 99% vaccination

coverage for measles, declared the killer disease eradicated in 2006.

Despite these successes, vaccine anxieties continue to periodically

impede this highly effective public health measure. In certain

industrialized countries, most notably the USA, public concern has

shifted its focus from the diseases vaccination can prevent, to the

risks of the vaccines themselves. The Internet has become a

significant channel for anti-vaccination views. The popular

video-sharing web site YouTube offers a plethora of anti-vaccination

clips. The Internet has also become a forum for alternative medicine

practitioners to present their anti-vaccination ideas and promote

alternative products.

While parents in developing countries have, for example, first-hand

experience of measles and welcome vaccination against it, the uptake

by parents for the combined measles, mumps and rubella vaccine in many

developed countries has yet to recover almost 10 years after a study

linking it to autism, even though the original study has long since

been discredited and there is overwhelming scientific evidence that

refutes the link.

A similar scare linking the mercury compound vaccine, thiomersal, to

autism led to its elimination from most USA and European vaccines that

contained it, despite the lack of scientific evidence to support this

measure. Indeed, five large-scale studies failed to find a link

between thiomersal and autism, and, according to some studies, the

incidence of autism has risen after discontinuation of thiomersal use

in vaccines.

Anti-vaccination scares can have lasting, harmful effects. Pertussis

(or whooping cough) vaccination was halted in Japan in the mid-1970s

owing to public concerns over adverse neurological effects. At that

point, Japan had brought the disease under control after introducing

immunization in 1947. Pertussis is a highly contagious respiratory

disease and one of the leading causes of vaccine-preventable deaths

worldwide, causing 300 000 deaths a year, predominantly among

unvaccinated or partially vaccinated infants, who go on to suffer

vomiting, dehydration and malnutrition.

Dr Sniadack, medical officer with the Expanded Programme on

Immunization in WHO's Western Pacific Regional Office, says: " With

less than 10% coverage among infants in 1976, [there] followed a

resurgence of pertussis cases. A pertussis epidemic involving 13 000

cases and 41 deaths occurred in 1979. Pertussis incidence returned to

very low levels with the introduction of DTP vaccinations in 1981. "

France still has low rates of hepatitis B vaccination compared with

other countries in Europe as a result largely of misinformed public

opposition to the vaccine. Dr Zuber, group leader of the WHO

vaccine safety team, says: " From all the data we have, hepatitis B is

as benign as any other vaccine but it has been associated in rumours

with autism, multiple sclerosis and leukaemia. All the solid

epidemiological studies have not been able to confirm any hint of an

association. "

The Internet has become a significant channel for anti-vaccination

views. The video-sharing website YouTube offers a plethora of

anti-vaccination clips.

WHO

The Internet has become a significant channel for anti-vaccination

views. The video-sharing website YouTube offers a plethora of

anti-vaccination clips.

An 11-month hiatus in the immunization campaign in Kano and other

northern Nigerian states in August 2003 resulted in a resurgence of

polio, which then spread to 13 other African countries, and from the

Sudan to Saudi Arabia and Yemen, and then on to Indonesia.

Dr Bardan Jung Rana, medical officer with WHO's Expanded Programme on

Immunization in Jakarta, says: " After a 10-year interval of no polio

cases, on 21 April 2005, the National Polio Laboratory in Bandung

reported a wild poliovirus isolate. Genetic analysis of the virus

showed it to be similar to recently isolated viruses in Saudi Arabia

and Yemen. After the detection of the case, Indonesia conducted two

rounds of mop-up in the three provinces surrounding the case and

followed it up with five National Immunization Days (NIDs) and three

Synchro-NIDs. "

While most anti-vaccination scares are not supported by scientific

evidence, public concern about the safety of new vaccines is

understandable. American infectious diseases expert and vaccinologist

Dr Offit traces public distrust of vaccines to the so-called

Cutter incident during the 1950s, when thousands of people in the USA

developed vaccine-induced polio as a result of being given vaccine

containing live polio virus from Cutter Laboratories. In his 2007 book

entitled The Cutter Incident, Offit recalls that of 220 000 people

infected – including about 100 000 children – 70 000 developed muscle

weakness, 164 were severely paralysed and 10 died.

Dealing with vaccine anxieties requires a multi-pronged approach,

including engagement with governments in affected countries and

disseminating scientific evidence on vaccine safety, Zuber says. He

cites the successful response to opposition to vaccines in Nigeria.

" WHO met with the national authorities and other local leaders. They

listened to their concerns, which were based on a fear about vaccine

safety. " However, the authorities were eventually reassured and

acceptance of the vaccine was re-established following intensive dialogue.

As with disease itself, the prevention of anxieties about vaccines is

better than cure. It is the task of WHO's Global Advisory Committee on

Vaccine Safety to address the misinformation that undermines

vaccination efforts by constantly monitoring and reviewing vaccine

safety and providing accurate information on any adverse events. The

committee's 14 members, recruited for three-year terms to offer

expertise in a range of related fields, including epidemiology,

pharmacology, infectious disease and drug regulation and safety, are

also charged with providing scientific recommendations on vaccination.

The committee, along with other members of the health and development

community, have played a major role in tipping the balance in favour

of reliable information. WHO's Vaccine Safety Net lists web sites that

contain vaccine safety information and are considered credible.

Zuber says: " Immunization programmes are already extremely successful

but the potential impact is even greater. It would be technically

possible to prevent a further four million deaths each year due to

influenza, pneumococcus, rotavirus, rabies, cholera, typhoid, epidemic

meningitis and Japanese encephalitis. All of these diseases are

significant health issues but they all have safe, effective vaccines. " & #9632;

[Guest guest]

> Smallpox has long been hailed as the ultimate vaccination success.

> It was declared eradicated in 1979 .. Polio has been eradicated in

> WHO's American, European and Western Pacific Regions

>

Simple question for these simpletons then - why have we stopped

smallpox vaccination, but not polio? If polio has been truly

eliminated, then we shouldn't need the vaccine right? The argument

that is made is that " polio is just one plane-ride away " . Well,

smallpox is just " one bio-terrorist away " , right? Is polio more

contagious or more deadly than smallpox? I don't know. They don't

give us many real facts about these diseases that are so deadly and

" only a plane-ride away " , they just tell us to be scared to death -

just like with the current tomato-salmonella story.

If vaccination is based on " good science " , then why aren't we

using " good science " to figure out why SOME girls vaccinated with

Guardasil are getting epilepsy? That would benefit them, other girls

who might get vaccinated, AND maybe tell us something about the

pathogenesis of epilepsy as well.

Better question: people can and do still smallpox - from the

vaccine if they are vaccinated. Currently that is only parts of the

military. It can be treated if caught soon enough with IVIG and

other measures. So why aren't we trying to figure out if polio can

be treated? Rabies kills nerve cells in a way that might be similar

to polio (this is assuming that at least some polio is cased by an

actual wild-virus). The body can kill rabies virus, if the brain is

protected (this was shown by the Wisconsin treatment of the only

person known to ever successfully clear and survive the disease).

Can something similar be done with the polio virus? Presumably, if a

bio-terrorist were to attack, we would vaccinate against smallpox

again, at least until the infection were contained and " eradication "

were attained again. Why can't we do the same for polio?

These are the questions that the " good science of vaccines " is not

even asking.

Jim