Immunisation: Why we do it and how ‘herd immunity’ works

Denial of community immunity or herd immunity is a common feature of antivaccinationists.

In fact groups that spread harmful disinformation, such as the Australian based Australian Vaccination-risks Network (AVN), have for years been refining the denial of this evidence based fact. Notably they misrepresent what herd immunity is, primarily by referencing an aspect of herd immunity or an expected result of herd immunity.

The Australian Government Department of Health offer this definition;

If enough people in a community are immunised against an infectious disease, there is less of the disease in the community, which makes it harder for the disease to spread.

Immunisation protects both people who are vaccinated and also helps the entire community. It helps protect those who are too young to be vaccinated and those who can’t be vaccinated for medical reasons. This is known as community (herd) immunity.

Claiming that the “laws” of No Jab No Pay and No Jab No Play “are based on herd immunity”, Meryl Dorey of the AVN contends;

The theory claims that the unvaccinated are more likely to contract and transmit diseases than their vaccinated peers.

Travel to a largely unvaccinated country, get shots and you’re apparently in a protected bubble. Back home and they’d have us believe we need a 95 per cent plus vaccination rate to be protected and that a lone unvaccinated individual can be responsible for an epidemic.

Indeed rather than “claim” that unvaccinated community members will contract and transmit disease, herd immunity provides greater protection for the unvaccinated. Nonetheless herd immunity cannot protect any particular unvaccinated individual and is very important with respect to protection from measles infection.

This is why individuals who cannot be vaccinated for specific reasons or those with weakened immune systems will be better protected in a community that has a vaccination level of 95% or above. In certain communities where vaccination levels are low, herd immunity and the cluster of immune individuals doesn’t exist. In this instance measles can easily spread from an infected individual to unvaccinated individuals.

If not for herd immunity providing protection to those who refuse vaccination and deny their children the protection of vaccine induced immunity, many of the false beliefs held by antivaccinationists could not persist. The success of so-called natural remedies, homeoprophylaxis and so on persist simply due to the protection of herd immunity.

  • The video below was produced by the BBC and provides an accurate summary of vaccination and herd immunity.

Immunisation: Why we do it and how ‘herd immunity’ works – © BBC News

Discredited anti-vaccine conspiracy theorist Judy Wilyman has even used denial of herd immunity in her ongoing attacks on Australia’s successful vaccination policy. Wilyman wrongly contends that only public health reforms such as sanitation led to the control of vaccine preventable diseases.

Vaccines did not create herd immunity to control infectious diseases, is an open letter on her website. The monumental flaw in her fallacious claim begins with her use of only mortality, and no morbidity data.

Also, Wilyman refers to changes in public health occurring before 1950. This ignores more modern vaccines such as that for Haemophilus influenzae type b (Hib) used in Australia from 1993 and later in Kenya from 1999.

Only vaccination can explain the control of Hib and the emerging success of the HPV vaccine.

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Black Salve – The Pro-Necrotic Agent

Last April Questions for Pseudoscience published an informative video on the very nasty, dangerous, bogus skin cancer “treatment” known generally as Black Salve.

Main points might be summed up as;

  • It isn’t anti-tumour cream.
  • It is anti-skin cream.
  • It kills tissue via the caustic salt zinc chloride (listed by the FDA as a fake skin cancer treatment) and sanguinarine (a toxic alkaloid).
  • The combination of zinc chloride and sanguinarine is “incredibly lethal to living tissue”.
  • Apart from burning skin due to its caustic nature zinc chloride adversely effects other body organs and systems (eyes, G.I. tract, lungs).
  • Sanguinarine blocks sodium potassium pumps located in the cell membrane, killing cells.
  • The ridiculous myth peddled by proponents of Black Salve is that cell death can be controlled by removing the salve at just the right time so that only cancer cells are effected.
  • However once begun the process continues leading to widespread necrosis. As cells die, enzymes are released leading to the breakdown of neighbouring cell membranes.
  • A domino effect follows leading to widespread cell death.
  • Thus Black Salve is really a Pro-Necrotic Agent and will kill any tissue it comes into contact with.

In March 2012 we visited the issue of AVN selling the One Answer To Cancer DVD – a blatantly bogus promotion of Black Salve. The post included the banning of this dangerous product by Australia’s TGA, (Therapeutic Goods Administration).

The TGA at that time issued a warning on Black Salve, which was covered by the ABC’s The World Today.

  • Listen to the audio in the player below;

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Fake news and the spreading of measles

“Fake news” isn’t my favourite term for the disinformation spread by antivaccinationists. However it conveys a meaning that is usefully accurate when it comes to labelling deception spread with the aim of misrepresenting the facts about vaccines.

The narrator in the US video below asks the question, “Is fake news making people sick?”. He notes that the country has broken a 25 year old record for measles cases this year. At the time of making the video there were over 700 cases across 22 states since the beginning of 2019. In states where population density is high we can expect to see the impact of vaccine induced immunity and herd immunity (or the lack thereof) in their unmistakably predictable manner.

New York city has had over 400 cases since October 2018. Some – not all – members of the orthodox Hasidic Jewish community have been avoiding vaccines. The narrator tells us this is due to “rampant misinformation around vaccines”, even though the orthodox community “overwhelmingly” believes in vaccines. One woman seems to doubt vaccine safety and efficacy. She argues that “some people question why would I subject my three year old to toxins when it’s not going to protect him or her”.

There is an increase in insular socialising habits in close orthodox communities. This ensures the successful spread of misinformation by The Vaccine Safety Handbook. Packed with the most well constructed vaccine myths, it targets these communities with well debunked anti-vaccine conspiracies, codswallop and even commentary from rabbis, specific to Jewish religious law.

WhatsApp groups have been set up to push anti-vaccine disinformation further, with some orthodox members reporting that their only source of news is via WhatsApp.

If this reminds you of the Somali community in Minnesota in 2017 and 2011, you’re not alone. 80% of reported measles cases in 2017 were of Somali children whose parents had been convinced of the risk between autism and MMR. It was the largest measles outbreak for 30 years.

What’s this got to do with orthodox Jews in New York? Well I mentioned the insular nature of close communities. In an article headed Minnesota’s measles outbreak is what happens when anti-vaxxers target immigrants, it is noted some of these Somali Americans had concerns about higher than average rates of autism amongst their children. This entire episode is indicative of the impact that calculated disinformation can have. Particularly when provided in an area of uncertainty and despite the effort and funding from health experts and government authorities.

In 2008 Somali parents stressed that there appeared to be more 3-4 year old Minnesota Somali children enrolled in the public preschool special education program for Autism Spectrum Disorder, compared to the overall percentage of Somali children enrolled in public schools [page 4].

Also a couple of years before this time MMR vaccine coverage had started to decrease in Minnesota-born Somali children from 2006 at which time rates had been above 90% [Figure 2].

Cultural differences meant that the most genuine efforts to assist the Somali-American community with this issue proved difficult. There is no word in Somali for “autism”. Indeed there is no grey area as one Somali parent put it. Mental health is seen as either “crazy” or “sane”, and this leads to the fear that a child may be called an unhelpful name within the community. A name used behind the parents’ back [page 4].

The Minnesota Department of Health (MDH) worked to re-examine enrollment data for pre-school aged children in the special education program. The results were published in a report which tended to focus on participation rates only. The report [pp 4-5];

…did not attempt to measure the true occurrence of ASD in all children, and it did not attempt to identify possible causes or risk factors for ASD. Instead, the focus was on developing a better understanding of reported differences in program participation rates among preschool-aged children enrolled in this MPS program.

The three main findings in the report confirmed parent’s observations and also raised questions as to better outreach services to Somali children vs genuinely higher levels of ASD, compared to non-Somali children accessing ASD services outside of the MPS. The proportion of Asian and Native American children participating in ASD programs was significantly lower. The cause for this remained elusive. Participation rate differences between Somali pre-school children and pre-school children from other ethnic backgrounds decreased “substantially” over the three years studied. The basis for this final point remained unclear.

Following the 2009 MDH report advocates for the Somali community called for further research. The CDC, NIH and Autism Speaks provided technical assistance and funding to the University of Minnesota. The aim was to focus on ASD in Minnesota and within Somali vs non-Somali communities. The MDH and the University of Minnesota’s Institute on Community Integration added in-kind staff and funding.

Still, we need to remember that it was 2008 when Somali parents first raised their concerns about ASD with the Minnesota Department of Health.

Enter disgraced fraud, data falsifier and ex-gastroenterologist, Andrew Wakefield, who was struck off the U.K.’s General Medical Council 21 years ago and the many-faced Organic Consumers Association. Wakefield targetted and set about convincing Minnesota’s Somali Community that MMR could not be trusted as health authorities claimed. It caused autism he lied. The rumour spread through the community. During the 2017 measles outbreak Wakefield insisted he didn’t feel responsible at all.

In short Wakefield and fellow antivaccinationists spread his anti-vaccine lies with the result that MMR vaccination fell in the Somali community for a number of years. Immigration status can be a risk factor with respect to immunisation status and this fact played very well into the hands of antivaccinationists.

Nonetheless, no vaccines cause autism.

It’s important to remember, and realise, how much damage antivaccinationists can do to public health. Yes, “fake news” is making people sick. Cities with high density and insular communities that are convinced to skip vaccination will constantly face the possibility of outbreaks. The anti-vaccine lobby and their minions will continue to spread misinformation and where possible it must be refuted.

I read a comment recently dismissing the need for any vaccine and contending that only three people had died since 2000. Forgetting that this US citizen is ignoring the rest of the world, it is just such complacency that helps drive the luxurious nonsense that vaccines are more harmful than the diseases they prevent.

Because after all, in the developed world vaccines are a victim of their own success.

 

 

Measles outbreaks are due to low vaccination rates and antivaccinationists

The video below is from the USA. The reasons it lists for the increase in measles cases there however, apply directly to Australia.

First however I want to draw attention to the screenshot from the video. Note the high number of fatalities. In the USA measles killed around 500 children per year during the 1950’s. Also pay attention to the drop in measles cases after the 1963 introduction of the measles vaccine.

In Australia a live attenuated measles vaccine was first licenced in 1968. Since then according to the Department of Health, “the burden of measles has substantially fallen in Australia”.

Measles cases USA – Source: CDC

You may be thinking, “But… I’ve seen graphs showing a huge decline in vaccine preventable diseases before vaccines were even introduced”. Yes, yes you have… kind of. What the anti-vaccine lobbyists did to create those misleading graphs is to firstly plot mortality rate (fatalities), and not morbidity (cases). Their argument is that diet, personal and public sanitation alone controlled vaccine-preventable disease and that vaccination had no effect.

Health professionals agree that sanitation and nutrition is vital to health. Cleaner cities, homes, personal hygeine and a varied diet play a large role in keeping us healthy, aiding in recovery and in fighting off the effects of disease. Including mortality caused by disease. But the incidence, or morbidity of disease is not reduced anywhere near as dramatically. So to discredit vaccines antivaccinationists would plot mortality and not morbidity of disease.

More so, they crammed many years horizontally and a comparatively small number of fatalities vertically. This had the effect of squeezing data in so tightly that individual bars vanished and were replaced with a single contoured shape that seemed to hit zero well before vaccines were introduced. With an accompanying narrative or explanatory text the listener or reader was easily fooled into “seeing” diseases dwindle away long before vaccines were introduced.

And the best trick was to emphasize, in the true Viera Scheibner and Judy Wilyman fashion, that it’s all government data to begin with. So it must be true. But it never was. It was and is a lie. A dangerous lie that hides the truth of how dangerous vaccine-preventable diseases are and how permanent are the injuries and disabilities for many of those who contract them.

The rumour that Donald Trump would be supporting the anti-vaccine lobby and financing vaccine conspiracy theorist, Robert F. Kennedy, is all but dust. Just three days ago when asked about the measles outbreak he replied, “They have to get the shot. The vaccinations are so important. This is really going around now, they have to get their shot”.

The Australian Department of Health has a page dedicated to the current measles outbreak, Measles Outbreak 2019. It was updated two weeks ago and includes;

Anyone who is not fully vaccinated against measles is at risk of becoming infected when traveling overseas. You may also risk exposing others to this highly infectious, serious illness either while travelling, or when you return to Australia.

Measles is a very contagious viral illness that causes a skin rash and fever in some cases. Measles can cause serious, sometimes fatal, complications including pneumonia and encephalitis (swelling of the brain). Measles spreads when an infected person coughs or sneezes and another person breathes in the droplets from the air, or touches the droplets and then touches their nose or mouth.

Measles remains a common disease in many parts of the world, including areas of Europe, Asia, the Pacific, and Africa, with outbreaks often occurring.

In Australia, the majority of measles cases are due to unvaccinated individuals becoming infected while travelling to countries in which measles is either common or there are outbreaks occurring. As measles is highly contagious, these people can then spread the disease to others, causing outbreaks, often before they are aware that they have the virus.

Why Measles Is Back In The US

Don’t be fooled by claims that antivaccinationists are not to blame. That we must accept socioeconomic and language hurdles are placing a considerable downward pressure on vaccination numbers. The increased use of social media has been a boon to antivaccinationists. From spreading misinformation, to organising events to raising money and making their entire gig easier we must accept they continue to ruin lives and public health strategy.

No doubt there are socioeconomic problems that play a role. But not the role. That argument is partial evidence denial at best. In fact social media should be used more skillfully to address problems faced by members of our community who are struggling to meet vaccination schedule requirements due to genuine hurdles.

Social scientists interested in vaccination and/or resistance to vaccination may have much to offer in addressing socioeconomic hurdles to vaccination via social media.

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