Monday, February 15, 2016

UK vs US vaccinations

One Mother says:
Hepatitis B: 
USA: Hepatitis B shot at 4 weeks, 6 months and again at 10 months.   
UK: Mentioned in the the “red book” but was never mentioned to me in person by anyone. 
BCG (aka the TB vaccine):
USA: No shot, but tested in a skin-prick test. 
UK: BCG shot given in the first year. (Optional). 
** This is a controversial one. US doctors I have spoken to have advised against if you are ever planning on moving back to the USA. But UK doctors think it’s a must. 
Chicken Pox: 
USA: Given at 1 year and 5 years. 
UK: If you see a private pediatrician, you can get it here in the UK also. 
There are some parents that are very strict about the US schedule, and some (like me) that have done a combination after speaking with the doctors…… 
Chicken Pox
  • "Chicken Pox: chickenpox (varicella) vaccine is recommended routinely in Australia and the USA, but not in the UK." - Source: Oxford Vaccine Group

Vaccination Efficacy

Based on this diagram, I would conclude that before 1968 cases of disease before a vaccination was introduced that there was high risk of getting a disease and vaccinations where very effective. From 1992 to present the number of cases of disease are less or about the same as the rates of the other diseases pre-1968 after the vaccinations where introduced. I take that to means that the risk is quite low even without a vaccination today. That isn't to say that vaccinations are not as effective today, that just means that the number of people infected by vaccine-preventable diseases is smaller for some reason.
Source: UK Gov Site

Interesting Sites or articles

http://www.smartvax.com/
http://www.ovg.ox.ac.uk/
Introduction of vaccines in UK by year
The routine immunisation schedule in UK
Japan bans MMR - The government reconsidered using MMR in 1999 but decided it was safer to keep the ban and continue using individual vaccines for measles, mumps and rubella.
More vaccinations means higher risk of hospitalization or death for infants - Infants can include up to age 2 by some loose definitions, but usually means a year or less of age. So, waiting until after age 2 may be a good idea, but then again, it could be there is no study yet for that age group.
http://www.ovg.ox.ac.uk/links#spcs
http://www.ovg.ox.ac.uk/uk-schedule
http://www.ovg.ox.ac.uk/infectious-diseases

What vaccines are used in different countries


  • Countries such as Denmark, Canada, and Japan have significantly fewer recommended vaccines but yet have healthier child populations 
  • The United States requires infants to receive 26 vaccines (the most in the world) yet more than 6 U.S. infants die per every 1,000 live births. In contrast, Sweden and Japan administer 12 vaccines to infants, the least amount, and report less than 3 deaths per 1,000 live births. - See more Source: Health Impact News 

UK Vaccination Schedule

Source NHS


Diphtheria, tetanus, whooping cough, polio, Hib

5-in-1 (DTaP/IPV/Hib) - Pediacel is the most common in UK
8 weeks, 12 weeks, 16 weeks

4-in-1 pre-school booster (DTaP/IPV) - 3.3 years

3-in-1 (Td/IPV) teenage booster - REVAXIS is given in the UK
13-18 years

Denmark - protects children against: Diphtheria, Tetnus, Polio, Pertussis, Measles, mumps, rubella, Hib, Pneumococcal, HPV

Denmark - protects children against: Diptheria, Pertussis, Tetanus, Polio, Hib, Pneumococcal, HepB,  Measles, Rubella, Mumps, Japanese encephalitis, flu, Rotovirus, HPV, Chickenpox

Wednesday, February 10, 2016

Which is riskier: The 5-in-1 vaccine or the diseases it is meant to prevent

What

The 5-in-1 Pediacel vaccine protects against: diphtheriatetanuswhooping cough (pertussis)polio, and Hib (Haemophilus influenzae type b)  Ref

Descriptions below per Ref
Diphtheria is a serious, potentially fatal, disease that usually begins with a sore throat and can quickly develop to severe breathing problems. It can damage the heart and nervous system. Diphtheria spreads through close contact with an infected person.
Tetanus is a very rare and painful and potentially deadly disease that affects the muscles and can cause breathing problems. It is caused by bacteria found in soil and manure, which can get into the body through open cuts or burns.Caused by bacteria commonly found in soil and manure and enter through a wound (cuts, scrapes, burns, bites, piercings, etc) Most commonly caused by deep wounds, but can be from minor wounds as well. Treatment is tetanus immunoglobulin (contains antibodies that kill the tetanus bacteria), antibiotics and when necessary ventilator/feeding tube.
Whooping cough, known medically as pertussis, is a disease that can cause spells of severe coughing and choking, making it hard to breathe. It lasts for up to 10 weeks. It's not usually serious in older children, but it can be very serious or even fatal in babies under the age of one.
Polio is a virus that attacks the nervous system and can permanently paralyse the muscles in the arms and legs. If it affects the chest muscles, it can kill.
The Hib bacteria can cause a number of serious diseases, including epiglottitis (a severe form of croup) or meningitis.


When

Given on three separate occasions, when babies are two, three and four months old. Ref

Ingredients

Inactivated (not live) virus
Ref

Common Side Effects

  • Irritable afterwards
  • Minor or short-lived redness and swelling at the injection site


More than one in 10 babies who have the vaccine experience:

  • pain, redness and swelling at the injection site
  • irritability and increased crying
  • being off-colour or having a fever


Rare: Between one in 1,000 and one in 10,000 babies given the vaccine experience:

  • febrile convulsions (fits)
  • floppiness


Very Rare: Fewer than one baby in 10,000 given the vaccine experience:

  • high fever (more than 40.5°C)
  • unusual high-pitched or inconsolable crying
Extremely Rare: Fewer than 1 in 100,000


  • Severe allergic reaction (anaphylaxis)


Risk of getting diseases if not vaccinated

Diphtheria

Since 2010, there have been only 20 recorded cases of diphtheria in England (out of 53.9 million in mid-2013 Ref) and Wales (out of 3.1 million in mid-2013 Ref), and one death. Ref.

This means that there is a 20 in 53.9 million chance of getting diphtheria in England right now. This means on average from 2010 to 2015 (5 years) there were 20 recorded cases and this equals 4 cases a year.This also means that in a given year there is only 4 in 53.9 million (or 1 in 13,475,000) chance of getting diphtheria each year.. If put in the perspective of the vaccine side effects, it is 134 times LESS likely that your baby will get diphtheria than experience the extremely rare anaphylaxis. That means in 134 years the risks of getting the actual disease diphtheria will equal that of the most rare side effect of one dose of vaccine (you will actually need three though, but I won't bother with that added risk since it is so small in comparison).

About 10 percent of cases are fatal. In those cases, by the time the victims seek treatment (antitoxin) the disease had done too much damage. This means that 10% of 4 are fatal and equals .4 people in all of England statistically may die from diphtheria each year. That is in line with the stats from the Public Health England that say zero per year. Ref.

Conclusion on Diphtheria
If you don't care about herd immunity and you want to play by the number, then really there really isn't much reason to vaccinate for Diphtheria. Statistically you are far safer in the UK to not get the vaccination.




Tetanus

 In 2013, there were only 7 recorded cases of tetanus in England and Wales, and no deaths. Most (not all) cases occur in people who were never vaccinated or partially vaccinated for the condition. In the UK, 1 in 7 to 10 people who develop tetanus will die from the condition. Using 2013 as reference that means that one person would have statistically died, but didn't. Ref Given that the population of England (53.9 million in mid-2013 Ref) and Wales (3.1 million in mid-2013 Ref) is 57 million total people in Wales and England. This means that 7 out 57 million (or 1 in 8.1 million)  got the tetanus (an none died, but 1 statistically should have). The chance rarest side effect (anaphylaxis) of the vaccine itself is 1 in 100,000 for each dose. There are 5 doses of the vaccination needed. This means the total risk of the vaccination is at least 1 out of 100,000 (if we ignore addition risk of getting multiple doses). This means it is 280 times likely of suffering from the most common side effect of vaccine than getting a case of tetanus. The worst cases of the disease are worse probably though, so maybe it could be worth it given that both are extremely rare to have severe issues.

Conclusion of Tetanus
It can't be passed from person to person, so herd immunity isn't really a factor. Just looking at the the numbers, then really there really isn't much reason to vaccinate for Tetanus. Statistically you are far safer in the UK to not get the vaccination if you assume the side effects of the vaccine and the cost likely case of the disease are equally as bad. The worst cases of the disease are worse probably though, so maybe it could be worth it given that both are extremely rare to have severe issues.



Whooping cough is a cyclical disease with the number of cases thought to peak every three to four years. An outbreak of whooping cough in 2012 meant 9,711 cases were confirmed in England and Wales compared to 4,835 confirmed cases in 2013.
The overall increase in the number of cases of whooping cough is thought to be related to heightened awareness of the disease and more cases being reported. Ref


Deadly 5-in-1 Vaccine Kills At Least Eight Infants


---- Stopping analysis...
I give up trying to compare the risks. This is too big of a job and the data just isn't widely available for the risks on either side. In fact, the risk of getting a disease is greatly influenced by proximity to the outbreak. In the end I think getting vaccinated isn't a bad thing. My toddler is likely to experience some level of discomfort from the vaccines. Hopefully not too bad. If there is an outbreak the chances of getting a disease can increase significantly. This is the biggest risk that can't be quantified easily. Next there is the worry of not doing anything and she gets a disease. How do I accept that. On the other hand I have to accept that if I do vaccinate I am directly bringing some "harm" to my daughter, but hopefully very minor. There is no easy decision. I really don't know what to do. My wife doesn't think she can live with herself if our daughter gets a disease and we didn't vaccinate. I guess that is a reason to vaccinate. In the end, I'm tired of using logic to defend myself. No one I talk to has spent the time researching the issues unless they are not vaccinating. Weird. I guess the next step is to figure out what the doctor suggests as a catch up schedule, and then see how I feel about it.