Facts about meningococcal disease

The Melbourne Vaccine Education Centre has an excellent page on meningococcal disease and vaccines which includes comprehensive resources and the video below from the Australian Academy of Science.

Meningococcal disease is a bacterial infection which can kill in hours. It is caused by the bacteria Neisseria meningitidis. Risk groups include children under 5, teens and young adults aged between 15 – 24, smokers, those with a suppressed immune system and anyone living in crowded accommodation. Of the 13 known sub-types of meningococcal bacteria, five are vaccine preventable.

These are B and A, C, W, Y.

Over 2018 the main serotypes causing disease in Australia were B, W and Y. Variations in serotype infection were specific to Australian states. On the information page the Melbourne Vaccine Education Centre (MVEC) notes;

People with meningococcal disease can become extremely unwell very quickly. Invasive meningococcal disease (IMD) can cause meningitis (inflammation of the membrane covering the brain and spinal cord), septicaemia (infection in the blood) as well as other infections like pneumonia (lung infection), arthritis (inflammation of the joints) and conjunctivitis (eye infection). Mortality (death) can be as high as 5-10% and permanent lifelong complications can occur in 10-20% of those who survive. Disease is transmitted via respiratory droplets (sneezing and coughing etc).

Prevention is via vaccination. Three quadrivalent vaccines are available for the A, C, W and Y meningococcal serogroups. One, Nimenrix® is freely available from 12 months of age as part of the National Immunisation Program.

In September last year it was announced that the federal government will fund the addition of meningococcal A, C, W and Y vaccine for 14 to 19 year olds. From April 2019 teens aged 14 to 16 years will have free access via school based programs as part of the National Immunisation Program. Teenagers aged 15 to 19 years who do not receive the vaccine at school can be vaccinated for free via “an ongoing GP based catch up program”.

The details of access to the vaccines are clearly explained on the MVEC information page. Private scripts are available and required to purchase the meningococcal A, C, W, Y vaccine for those who don’t meet NIP criteria.

Meningococcal B vaccines are available although not yet part of the National Immunisation Program. Bexsero® is suited for use from 6 weeks of age. Trumenba® is suited for use from 10 years onward.

There is additional information in this post from September last year. Access the Department of Health immunisation information here.

Facts About Meningococcal DiseaseAustralian Academy of Science

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Anti-vaccination campaigners: Misleading and Unsafe

When it comes to public advocacy this year, one of the most effective announcements came in December.

The NSW Health Care Complaints Commission issued a public warning under s94A of the Health Care Complaints Act 1993 with regard to the “misleading and unsafe practices by anti-vaccination campaigners”.

The HCCC had received numerous complaints about individuals and associations and is concerned about the risk they pose to public health and safety.

The anti-vaccination lobby pushes messages which;

have the potential to engender fear and alarm in the community, often targeting vulnerable members of the community through misinformation which may have a detrimental effect on the health care decisions of individuals.

 

PUBLIC WARNING UNDER S94A OF THE HEALTH CARE COMPLAINTS ACT 1993:  MISLEADING AND UNSAFE PRACTICES BY ANTI-VACCINATION CAMPAIGNERS

The NSW Health Care Complaints Commission (“the Commission”) has received multiple complaints regarding misleading and unsafe practices by anti-vaccination (“anti-vax”) campaigners and the potential risks that such persons and associations pose to the public health and safety.

Immunisation is a simple, safe and effective way of protecting people against harmful diseases before they come into contact with them. Immunisation protects individuals and the community by reducing the spread of preventable diseases.

Complaints have been received in relation to individuals (including registered and unregistered health practitioners as well as academics) and organisations engaged in the widespread promotion of dangerous anti-vax messages.

Why is this warning being issued?
Misleading and inaccurate information communicated by anti-vax campaigners has the potential to engender fear and alarm in the community and result in fewer people being vaccinated. This information commonly quotes scientific research and studies in support of anti-vax claims, but is often selective, including exaggerating the risks and minimising or discrediting the benefits of vaccines. The research presented does not align with the true evidence-base on which independent and government bodies worldwide make vaccination recommendations.

This is likely to have a detrimental effect on the health care decisions of individuals and may lead them to make decisions not to vaccinate which pose an avoidable risk to their own health and to the safety of the wider community.

It is unfortunate that anti-vax campaigners are also known to target particularly vulnerable members of the community, including impressionable young parents who are concerned about making the right health decisions for their infants.

The spread of misleading and false information by anti-vax campaigners presents an ongoing challenge for government agencies, particularly due to the rise in use of social media and the proliferation of information concerning vaccinations available via the internet.

Given the continuing efforts of anti-vax campaigners to mislead and misinform members of the public, the Commission considers it necessary to warn all health consumers of the danger of relying on information that is not from a reliable and trusted source. This can include websites that appear to be “professional” and groups that are well-organised in their approach. Some persons and associations will go as far as to distance themselves from “anti-vax” campaigners, while essentially promoting the same message.

What should consumers do to protect themselves?
The Commission strongly urges consumers to exercise caution in relying on information concerning the safety and efficacy of vaccinations which is promoted via social media and websites that are not government affiliated or endorsed. Further, consumers should be cautious of persons or groups spreading anti-vax messages via other means, including face-to-face information sessions and other public events.

In all cases the following factors should be considered by consumers when presented with any information or advice concerning the safety and efficacy of vaccines and immunisation programs in Australia.To ensure that you are receiving reliable information concerning the safety and efficacy of vaccinations and to assist you in making an informed decision concerning the benefits and risks of particular vaccines, it is recommended that you consult a registered medical practitioner (e.g. your family GP or paediatrician).

Health consumers should be particularly wary of persons claiming to be “experts” or to have conducted “research” into the safety and efficacy of vaccines or immunisation programs in circumstances where they do not hold relevant medical qualifications and are not a registered health practitioner.
Consumers should be wary of persons holding themselves out to hold qualifications that cannot be verified. If you wish to ensure that the person providing advice is a registered health practitioner you should check on the National Register of health practitioners – https://www.ahpra.gov.au/Registration/Registers-of-Practitioners.aspx

Health professionals play a role in health education and administration of vaccines, however it is not appropriate for health professionals to promote anti-vax messages via their personal social media pages or other online forums.  Consumers should avoid placing any reliance on “comments” made via social media that are not from a reliable and trusted source.

When researching online, it is recommended that you visit trusted government websites including the NSW Health and Commonwealth Department of Health websites and also the National Centre for Immunisation Surveillance and Research (NCIRS) website, which provide reliable information concerning immunisation and Immunisation Programs:

https://www.health.nsw.gov.au/immunisation/Pages/default.aspx

https://beta.health.gov.au/health-topics/immunisation

http://www.ncirs.edu.au/

 

The Health Care Complaints Commission (“the Commission”) has issued a public warning under s94A of the Health Care Complaints Act 1993 regarding Misleading and Unsafe Practices by Anti-Vaccination Campaigners.

The Commission is concerned about a number of complaints it continues to receive regarding misleading and unsafe practices by anti-vaccination (“anti-vax”) campaigners and the potential risks that such persons and associations pose to the public health and safety.

Anti-vax messages have the potential to engender fear and alarm in the community, often targeting vulnerable members of the community through misinformation which may have a detrimental effect on the health care decisions of individuals. Anti-vax campaigners will often selectively quote scientific research and studies in support of anti-vax claims, including exaggerating the risks and minimising or discrediting the benefits of vaccines. The research presented does not align with the evidence-base on which independent and government bodies worldwide make recommendations.

Given the continuing efforts of anti-vax campaigners to mislead and misinform members of the public, the Commission considers it necessary to warn all health consumers of the danger of relying
on information that is not from a reliable and trusted source. This can include websites that appear to be “professional” and groups that are well-organised in their approach that often use popular mechanisms like social media to promote their messages.

What should consumers do to protect themselves?

The Commission strongly urges consumers to:

  • Exercise caution when relying on vaccination efficacy information which is promoted via social media and websites that are not government affiliated or endorsed;
  • Be cautious of persons or groups spreading anti-vax messages via other means, including face-to-face information sessions and other public events;
  • Be wary of persons claiming to be “experts” or to have conducted “research” into the safety and efficacy of vaccination programs;
  • Be wary of persons holding themselves out to hold qualifications that cannot be verified. If you wish to ensure that the person providing advice is a registered health practitioner you should check on the National Register of health practitioners – https://www.ahpra.gov.au/Registration/Registers-of-Practitioners.aspx;
  • Consult a registered medical practitioner concerning the benefits and risks of vaccines;
  • Visit trusted government websites when researching online, including the NSW Health and Commonwealth Department of Health websites and the National Centre for Immunisation Surveillance and Research (NCIRS) website.

 

Further Information

For further information, contact the Executive Officer of the Health Care Complaints Commission, on 9219 7444 or send an email to media@hccc.nsw.gov.au.

 

Vatican position on vaccines derived from the descendent cells of fetal material

Despite very clear facts on the issue of fetal material used in the production of some vaccines, there is ample misinformation in circulation.

The anti-vaccine lobby aim to benefit from any confusion that can be created by misrepresenting the fact that human diploid cells derived from fetal cells are used in the production of some vaccines. During production the vaccines themselves are purified so that no cells remain in the final product.

In January 2014 I published Vaccines contain no aborted fetal cells and the piece is still relevant today. It’s important to remember that the diploid cellular material used to grow viral material in vaccine production are descendent cells.

Descendent cells are the medium in which these vaccines are prepared. The cell lines under consideration were begun using cells taken from one or more fetuses aborted almost 40 years ago. Since that time the cell lines have grown independently. It is important to note that descendent cells are not the cells of the aborted child. They never, themselves, formed a part of the victim’s body.

Source – National Catholic Bioetics Center

I see. One must be sure to observe “that descendent cells are not the cells of the aborted child. They never, themselves, formed a part of the victim’s body.”

A very clear source of information specific to the morality of this issue is the Vatican Statement on Vaccines Derived From Aborted Human Fetuses.

The article includes;

The matter in question regards the lawfulness of production, distribution and use of certain vaccines whose production is connected with acts of procured abortion. It concerns vaccines containing live viruses which have been prepared from human cell lines of foetal origin, using tissues from aborted human foetuses as a source of such cells. The best known, and perhaps the most important due to its vast distribution and its use on an almost universal level, is the vaccine against Rubella (German measles).

[…]

To summarize, it must be confirmed that:

  • there is a grave responsibility to use alternative vaccines and to make a conscientious objection with regard to those which have moral problems;
  • as regards the vaccines without an alternative, the need to contest so that others may be prepared must be reaffirmed, as should be the lawfulness of using the former in the meantime insomuch as is necessary in order to avoid a serious risk not only for one’s own children but also, and perhaps more specifically, for the health conditions of the population as a whole – especially for pregnant women;
  • the lawfulness of the use of these vaccines should not be misinterpreted as a declaration of the lawfulness of their production, marketing and use, but is to be understood as being a passive material cooperation and, in its mildest and remotest sense, also active, morally justified as an extrema ratio due to the necessity to provide for the good of one’s children and of the people who come in contact with the children (pregnant women);
  • such cooperation occurs in a context of moral coercion of the conscience of parents, who are forced to choose to act against their conscience or otherwise, to put the health of their children and of the population as a whole at risk. This is an unjust alternative choice, which must be eliminated as soon as possible.

 

  • Further reading;

Do vaccines contain aborted fetal tissue?

The Catholic Church and vaccines – Vaxopedia

The Australian Immunisation Handbook

Australian government to provide meningococcal vaccine to teens

Recently the Australian government announced that from April 2019 the meningococcal vaccine Nimenrix will be available free to teenagers aged 14-19. This will prove to be a significant public health measure against Invasive Meningococcal Disease (IMD).

Nimenrix is a quadrivalent vaccine protecting against 4 of the 13 serogroups of the bacterium Neisseria meningitidis. The four serogroups are A, C, W and Y. The vaccine Bexsero protects against serogroup B and is presently the subject of a South Australian study. The manufacturers of the vaccine, GlaxoSmithKline have confirmed they will seek to have Bexsero listed on the National Immunisation Program once they have the study results. The ACWY vaccine has been freely available to 12 month olds since July 1st, 2018. Of these five primary strains of meningococcal disease, B and W serogroups are the most common.

The incidence of meningococcal disease and the serogroup responsible fluctuates over time. According to the National Centre for Immunisation Research and Surveillance (NCIRS), serogroup B (MenB) was the most common cause of IMD from 2006 to 2015. Over this period MenB accounted for 63% to 88% of annual notified cases where a serogroup was identified. An NCIRS fact sheet notes that since 2013 serogroup W (MenW) has increasingly caused IMD.

In that year 17.4% or 17 cases with an identified serogroup were responsible for the disease. By 2017 MenW was identified as responsible for 38.1% or 139 cases. It is also clinically interesting that the NCIRS have reported, “many of the MenW cases have been due to a single clone of meningococcus, the ST-11 strain type”. This suggests sustained person to person transmission. MenW appears to have a higher fatality rate (9.3%) than MenB (5%).

With serogroup Y there has been a “smaller but notable” increase. In 2014 there were 7.4% or 12 cases of those with an identified serogroup, increasing to 20.5% or 75 cases in 2017. IMD due to serogroup Y is more common in older Australians. 61% of the 75 notified cases in 2017 were in adults ≥ 45 years or older. The decrease in cases due to serogroup C (MenC) is an indication of the efficacy of immunisation programmes.

The MenC conjugate vaccination programme began in 2003. The number of MenC cases with an identified serogroup was 225 in 2002, falling to 14 (3.8%) in 2017. The NCIRS observe that, “serogroup A disease remains rare in Australia”. Nonetheless overall meningococcal disease and death from different serogroups has increased in recent years.

Reporting recently on the government intention to soon provide the quadrivalent Nimenrix vaccine to teens, both SBS and Fairfax published the following figures on IMD for 2015 – 2017.

  • 2015: 182 cases, 12 fatalities
  • 2016: 252 cases, 11 fatalities
  • 2017: 382 cases, 28 fatalities

The Fairfax article was published at 12.00am on September 25th and noted that there had been ten fatalities from meningococcal “so far this year”. A little over 44 hours later at 8.07pm on September 26th the Moree Champion reported;

Laboratory tests have confirmed meningococcal disease as the cause of death in a 25 year old woman in the New England region. The young woman collapsed at home on Saturday, September 22 and was taken to hospital by ambulance, but was unable to be revived.

Meningococcal disease can kill within 24 hours if not treated in time. The audio below is from Meningococcal Australia and addresses important points regarding infection, symptoms, prevention and treatment.

The Meningococcal Australia website notes;

10% of those infected will die, and around 20% will have permanent disabilities — ranging from learning difficulties, sight and hearing problems, to liver and kidney failure, loss of fingers, toes and limbs and scarring caused by skin grafts.

It is important to access reputable information with respect to diseases such as Invasive Meningococcal Disease. IMD from the five primary serogroups A, C, W, Y and B can be prevented by vaccination. This makes it a target for misinformation from the anti-vaccination lobby. In Australia the most vocal group is the Australian Vaccination-risks Network, or AVN.

Meningococcal bacteria can live harmlessly in the throat and nose in 20% of people and IMD is one of the less common bacterial diseases. Antivaccinationists use this information to wrongly assert there is no need to be vaccinated. Yet the reality is that in cases of meningococcal disease the bacteria enter the bloodstream and multiply rapidly, causing septicaemia and damage to blood vessel walls. This leads to bleeding into skin tissue producing the dark purple rash associated with meningococcal disease.

Bacterial meningitis caused by meningococcal disease is the most dangerous type of meningitis. Meningitis is a serious inflammation of the meninges – the lining of the spinal cord and brain. Thus the argument that humans “naturally” carry meningococcal bacteria and should avoid vaccination is based on deceptive reasoning and is dangerously misleading.

Vaccines are demonstrably very safe. The testing of vaccines before approval for use in Australia can take over a decade. Their ingredients are well understood and are themselves tested for safety.

The introduction of the quadrivalent meningococcal vaccine Nimenrix is a positive for Australian public health.

 

Risky Business

Recently the Australian Vaccination-skeptics Network emailed members to announce their change of name to Australian Vaccination-risks Network.

The author of the email took the opportunity to falsely attack Australian Skeptics Inc., thoroughly misrepresent the global Skeptics movement and reinforce baseless fears about the risk benefit ratio of vaccines. The email also misrepresented the circumstances via which the Australian Vaccination Network came to have the word “skeptics” inserted into it’s name. As will become clear below the word “risks” could have been chosen by this anti-vaccine group four to five years ago.

The word “risks” was suggested along with “skeptics” by the NSW Administrative Decisions Tribunal as a means by which the group could satisfy a request by the NSW Department of Fair Trading. NSW Fair Trading had written to the AVN referencing;

…an increasing number of requests to have NSW Fair Trading amend the name of the Australian Vaccination Network Inc., based on the contention that the name is misleading and deceptive, and therefore undesirable.

The full letter dated August 28th, 2012 is below.

 

There were ample histrionics from the AVN. Despite the clarity of the correspondence they claimed only the AMA had complained, “- an industry lobby group who obviously feels threatened by the idea that parents might choose not to vaccinate – costing them money”. This was “anti-competitive behaviour” on the part of NSW Department of Fair Trading. Democracy and truth were threatened. The matter was an “abuse of process”. Skeptic blogs began to report on the issue about one hour before media outlets did. Thus, Meryl Dorey conspiratorially queried;

Is there a direct line of communication between the Australian Skeptics, Stop the AVN (SAVN) and government departments?

Which brings us back to the groups’ most recent email, the very tiring attacks on skeptics and the even more tiring contention that Australian Skeptics Inc. is linked to Stop The AVN. It’s worth noting that because of confusion with the official sounding Australian Vaccination Network, the volunteer citizens group Stop The Australian Vaccination Network had prior to the time of NSW Department of Fair Trading involvement changed their name to Stop The Australian (Anti) Vaccination Network.

Now, above I mentioned attacks and misinformation on the part of the Australian Vaccination-risks Network. Let’s continue to call them the AVN. Below is a snap from their email;

It seems quite clear the connotation of the email is that NSW Fair Trading “forced” the AVN to adopt the noun skeptics as part of their name. Worse the noun skeptic is purposefully misrepresented in the context in which it is used, which leads to such ridiculous name calling as “anti-skeptics”.

Let’s examine the misrepresentation of a very basic definition of the word “skeptic” with the term as it is understood by the Skeptic movement first. Then by examining the evidence that Ms. Dorey discarded the option of “risks” to instead choose “skeptics” after losing an appeal against NSW Department of Fair Trading, we will appreciate the deceptive argument that is laid out.

The noun cited above is a very basic, indeed rather limited understanding of the term. In fact by citing this and then immediately referring to the global skeptic movement Ms. Dorey (whom I have little doubt wrote this unsigned email) confirms she is ignorant of the difference between a skeptic and the Skeptic movement. She has completely ignored the importance of evidence and scientific consensus to the Skeptic movement.

Her view of a skeptic as used to attack genuine scientific skeptics would seem to be someone who doubts reality. I have written about this childish abuse of science and philosophy in addressing her blog The Real Australian Sceptics. At that time – May 2012 – Dorey used the exact same definition of the noun “skeptic” as in the email above. The article examines why Dorey and the AVN are in fact pseudo-skeptics, despite her antagonistic habit of using that term to describe skeptics who request she prevent current, reproducible, peer reviewed evidence.

I imagine the inventive ‘those who do not question accepted opinions and attack those who do’, may well reflect the anti-SAVN work of Brian Martin who was initially contacted and misled about apparent attacks, by Ms. Dorey herself. He then published a number of extremely biased pieces, which laden with conspiracy theory, appear to repeat the same conclusion from various angles. Namely that the SAVN and skeptics have bullied and attacked Ms. Dorey. Yet there is absolutely no mention of Dorey producing convincing evidence.

The Skeptical Movement page hosted at Wikipedia has far more suitable definitions under Scientific Skepticism. Note the importance of evidence as opposed to opinion and ideology.

What skeptical thinking boils down to is the means to construct, and to understand, a reasoned argument and, especially important, to recognize a fallacious or fraudulent argument. The question is not whether we like the conclusion that emerges out of a train of reasoning, but whether the conclusion follows from the premises or starting point and whether that premise is true.

— Carl Sagan in The Demon-Haunted World, 1995, p. 197

Science is […] a way of skeptically interrogating the universe with a fine understanding of human fallibility. If we are not able to ask skeptical questions, to interrogate those who tell us that something is true, to be skeptical of those in authority, then we’re up for grabs for the next charlatan, political or religious, who comes ambling along.

A skeptic is one who prefers beliefs and conclusions that are reliable and valid to ones that are comforting or convenient, and therefore rigorously and openly applies the methods of science and reason to all empirical claims, especially their own. A skeptic provisionally proportions acceptance of any claim to valid logic and a fair and thorough assessment of available evidence, and studies the pitfalls of human reason and the mechanisms of deception so as to avoid being deceived by others or themselves. Skepticism values method over any particular conclusion.

“Skepticism is a provisional approach to claims. It is the application of reason to any and all ideas—no sacred cows allowed. In other words, skepticism is a method, not a position.”

Back to the possible choice of “risks” to add to their name. Verily did the AVN appeal the NSW Department of Fair Trading request after proclaiming in the July 20th, 2012 email “The AVN Asks – What’s In A Name”;

The Australian Vaccination Network has no intention of changing its name and any group or government department that believes it has the right to try and force us to do so will find themselves strenuously opposed.

The AVN lost the appeal [ABC]. The full Administrative Decisions Tribunal finding can be found here.

I’d like to draw your attention to the Introduction of Reasons for Decision. A section of Part 3 has been emphasised;

1) The Australian Vaccination Network Inc (AVN) has been directed to change its name. The main reason the Director General of the Department of Finance and Services gave for making that direction was that the name is likely to mislead the public in relation to the nature, objects or functions of AVN. The Director General found that AVN’s message is anti-vaccination and that the name does not reflect that message. Two other reasons the Director General relied on were that the name is “undesirable” and that it suggests a connection with the Commonwealth government.

2) AVN applied to the Tribunal for a review of that decision. I have decided that the decision to direct AVN to adopt a new name is the correct and preferable decision. But my conclusion is not based on a finding that AVN’s message is exclusively anti-vaccination, that the name suggests a connection with the Commonwealth government or that the name itself is undesirable.

3) AVN’s main object is the dissemination of information and opinions that highlight the risks of vaccinations. AVN is sceptical about vaccinations. The existing name, Australian Vaccination Network Inc, suggests that the association is pro vaccination or, at least, is committed to providing comprehensive information and opinions about the pros and cons of vaccination. The name should be changed so that it is not likely to mislead the public in relation to its main object. Although I do not have to decide this issue, a name that includes the word “risk” or “sceptic” such as Vaccination Risk Awareness Association Inc or Vaccination Sceptics Network Inc would, in my opinion, be acceptable. The name could also include the word “Australia” or “Australian” without suggesting a link to government.

Still the choice made by Ms. Dorey and others was the word “skeptics”. They were not forced to use the term. Far from not wanting to be associated with the Skeptic movement it is more likely, given the online attacks by the AVN toward skeptics, that they enjoyed insisting that a true skeptic doubted everything. Their mistake of course is that members of the Skeptic movement are far more interested in seeking evidence and actively exposing charlatans, fraudsters and those who care little for discarding ideology in place of evidence.

Nonetheless there we have it. One simple email and once again members have been lied to. Unfortunately the group will continue to mislead the same members and readers about the risks of vaccines, which are very minor indeed.

  • Please speak to your GP about any safety concerns regarding immunisation
  • Department of Health – Immunisation