NEJM Reports What happens When Too Few Get Vaccinated
Interesting article in the current issue of The New England Journal of Medicine, full text available online:
http://content.nejm.org/cgi/content/full/355/5/447?query=TOC
This article about a case series investigation makes some very succinct points and clearly demonstrates the reality of illness that directly results from not being vaccinated.
I found myself hoping this review would also clearly show the risks of how much more likely you are to get measles when you are not immunized/vaccinated.
The opening statement suggests that 50 out of 500 people at a church function were not vaccinated, but both of these numbers were derived based on interviews with church clergy. The authors go on to say, "The church estimated that 35 of its members declined vaccination... Of these, 31 (89 percent) became infected." It seems that any conclusions about rates of infection among vaccinated versus unvaccinated
parishioners is mostly speculative at best, because the vaccination rates and number of exposed individuals are based merely on clergy estimations.
The "89 percent" infection rate above doesn't jive with the more real "57 percent" listed later in the article:
"Of 69 persons in the 11 affected households, 56 (81 percent) lacked evidence of immunity according to the ACIP standards. Of these, 32 (57 percent) acquired measles"
But, I worry about this number, too. Immunization proved per ACIP standard doesn't mean you have, or have not been effectively immunized in every case.
The article might show a case in point about the problems with having a documented immunization record.
"The other patient with vaccine failure was a 34-year-old hospital phlebotomist who was hospitalized for severe measles.... She had received one dose of measles vaccine at 12 months of age but did not have documentation of a second dose and had not been tested for serologic evidence of immunity on employment. The ACIP recommends either proof of measles vaccination with two doses or evidence of immunity for health care
workers."
Anyone have any idea how easy it might be to forge a an employer required vaccination record?
Suffice to say that because I am vaccinated, I could have attended the church function without fear, because 16 out of the 18 people who got measles there were not vaccinated. And, a good number of (all) ACIP-proved vaccinated persons in affected homes did not get sick. But, there was also a good number of
un-vaccinated people who did not get sick. Thus, "natural immunity remedies really work."
It would be nice to know how many people interacted with "Measles Mary," and whether they were actually vaccinated, immune, or not vaccinated, so we could have a rate-of-infection argument. Maybe, given all the variables, even if I had these numbers they could not be definitive. But, they would be better than basing them on guesses by clergy.
Nawledge
http://content.nejm.org/cgi/content/full/355/5/447?query=TOC
This article about a case series investigation makes some very succinct points and clearly demonstrates the reality of illness that directly results from not being vaccinated.
I found myself hoping this review would also clearly show the risks of how much more likely you are to get measles when you are not immunized/vaccinated.
The opening statement suggests that 50 out of 500 people at a church function were not vaccinated, but both of these numbers were derived based on interviews with church clergy. The authors go on to say, "The church estimated that 35 of its members declined vaccination... Of these, 31 (89 percent) became infected." It seems that any conclusions about rates of infection among vaccinated versus unvaccinated
parishioners is mostly speculative at best, because the vaccination rates and number of exposed individuals are based merely on clergy estimations.
The "89 percent" infection rate above doesn't jive with the more real "57 percent" listed later in the article:
"Of 69 persons in the 11 affected households, 56 (81 percent) lacked evidence of immunity according to the ACIP standards. Of these, 32 (57 percent) acquired measles"
But, I worry about this number, too. Immunization proved per ACIP standard doesn't mean you have, or have not been effectively immunized in every case.
The article might show a case in point about the problems with having a documented immunization record.
"The other patient with vaccine failure was a 34-year-old hospital phlebotomist who was hospitalized for severe measles.... She had received one dose of measles vaccine at 12 months of age but did not have documentation of a second dose and had not been tested for serologic evidence of immunity on employment. The ACIP recommends either proof of measles vaccination with two doses or evidence of immunity for health care
workers."
Anyone have any idea how easy it might be to forge a an employer required vaccination record?
Suffice to say that because I am vaccinated, I could have attended the church function without fear, because 16 out of the 18 people who got measles there were not vaccinated. And, a good number of (all) ACIP-proved vaccinated persons in affected homes did not get sick. But, there was also a good number of
un-vaccinated people who did not get sick. Thus, "natural immunity remedies really work."
It would be nice to know how many people interacted with "Measles Mary," and whether they were actually vaccinated, immune, or not vaccinated, so we could have a rate-of-infection argument. Maybe, given all the variables, even if I had these numbers they could not be definitive. But, they would be better than basing them on guesses by clergy.
Nawledge
posted by nawledge at
8:21 PM
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