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« Vaccine Injury Causes Life Changing Narcolepsy in European Children | Main | The Worms Crawl In The Autism Crawls Out »

Study Finds Infants Toddlers on "Slower" Vaccine Schedule Have Fewer Outpatient and ER Visits

Science post image A Population-Based Cohort Study of Undervaccination in 8 Managed Care Organizations Across the United States

Jason M. Glanz, PhD; Sophia R. Newcomer, MPH; Komal J. Narwaney, MD, PhD; Simon J. Hambidge, MD, PhD; Matthew F. Daley, MD; Nicole M. Wagner, MPH; David L. McClure, PhD; Stan Xu, PhD; Ali Rowhani-Rahbar, MD, PhD; Grace M. Lee, MD, MPH; Jennifer C. Nelson, PhD; James G. Donahue, DVM, PhD; Allison L. Naleway, PhD; James D. Nordin, MD, MPH; Marlene M. Lugg, DrPH; Eric S. Weintraub, MPH

JAMA Pediatr. 2013;():1-8. doi:10.1001/jamapediatrics.2013.502.

Published online January 21, 2013

ABSTRACT

Objectives  To examine patterns and trends of undervaccination in children aged 2 to 24 months and to compare health care utilization rates between undervaccinated and age-appropriately vaccinated children.

Design  Retrospective matched cohort study.

Setting  Eight managed care organizations of the Vaccine Safety Datalink.

Participants  Children born between 2004 and 2008.

Main Exposure  Immunization records were used to calculate the average number of days undervaccinated. Two matched cohorts were created: 1 with children who were undervaccinated for any reason and 1 with children who were undervaccinated because of parental choice. For both cohorts, undervaccinated children were matched to age-appropriately vaccinated children by birth date, managed care organization, and sex.

Main Outcome Measures  Rates of undervaccination, specific patterns of undervaccination, and health care utilization rates.

Results  Of 323 247 children born between 2004 and 2008, 48.7% were undervaccinated for at least 1 day before age 24 months. The prevalence of undervaccination and specific patterns of undervaccination increased over time (P < .001). In a matched cohort analysis, undervaccinated children had lower outpatient visit rates compared with children who were age-appropriately vaccinated (incidence rate ratio [IRR], 0.89; 95% CI, 0.89- 0.90). In contrast, undervaccinated children had increased inpatient admission rates compared with age-appropriately vaccinated children (IRR, 1.21; 95% CI, 1.18-1.23). In a second matched cohort analysis, children who were undervaccinated because of parental choice had lower rates of outpatient visits (IRR, 0.94; 95% CI, 0.93-0.95) and emergency department encounters (IRR, 0.91; 95% CI, 0.88-0.94) than age-appropriately vaccinated children.

Conclusions  Undervaccination appears to be an increasing trend. Undervaccinated children appear to have different health care utilization patterns compared with age-appropriately vaccinated children.

Comments

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I have a "slow" schedule for you.

1) The first "vaccine" is given at age 100.

2) The second "vaccine" is given at age 200

3) So on and so forth.

Favorable Results should be apparent by age 1 or less.

@Sue Morgan, I think you are absolutely right. It seems that the children on the first cohort, the ones undervaccinated "for any reason" and the ones receiving more inpatient care, are simply the generally sicker children whose parents have been busy with taking care of their primary health conditions and missed a few well-checks. Whereas children undervaccinated by parental choice come from the same pool as the generally healthy population and yet are even healthier than that, or possibly put less strain on the healthcare system if and when they do get sick. In any case, the insurance companies should be giving a break to the undervaccinated, not treating them as a plague in the making.

@John- thanks- the University of Chicago bioethicist nonchalantly discussing how much suffering he feels is appropriate to inflict upon children is simply morally repugnant. The terms "deranged" and "divorced from reality" come to mind. It is exactly on par with other "national security" forays into human experimentation that have occurred from time to time throughout history, and should be vociferously called out as such.

On a less disgusting and more relevant note- the JAMA article presents an actionable breech in the wall of vaccine injury denialism. The IOM white wash published last week is in conflict with the January 2013 JAMA piece. The latter seems to be subtly suggesting that it is time to begin studying groups of unvaccinated kids, and further conflicts with IOM in the estimate of the pool of available (voluntary) research subjects. As there is bound to be overlap between the organizations, I view this as a hopeful development.

Interesting to note that in the Medscape/Reuters reporting on narcolepsy and flu vaccine, the authors are oh so careful to point out that their science is peer reviewed and not the result of a "rogue scientist". As if challenging the vaccine orthodoxy suggests that a scientist is lying, or crazy. This article is another example of the vindication of Dr. Wakefield, as was the JPEDS supplement on ASD and gut disease November 2012 http://pediatrics.aappublications.org/content/130/Supplement_2/S160.extract?cited-by=yes&legid=pediatrics;130/Supplement_2/S160. By carefully justifying their work so as not to be labeled as frauds, they are demonstrating the difficulty of simply reporting accurately the truth about matters vaccine related.

I'd be interested to have a look at DTaP figures and also co-morbid conditions such as asthma.

Re: more inpatient admissions - Could it also mean that parents who have unvaccinated kids are more savvy and intelligent and refuse to be turned away at the hospital when they know their child needs serious help? Or wasn't there a study showing that those with higher educational degrees were more likely to vaccinate more discriminately? That could mean higher degree = higher likelihood to be employed in a job w/insurance = higher likelihood to be admitted ie hospitals could be more likely to admit insured vs uninsured patients. And uninsured patients are more likely to be medicare/medicaid and under all public health/CDC recommendations for vaccine schedules?

On a side note: 3 generation study of epigentic effects from plasticizers & fungicide & a couple others - including endocrine issues/early & late onset puberty/obesity/immune/ some reference to intestinal abnormalities including inflammation type problems. Also talks about changes to sperm & DNA methylation and what chromosomes are effected causes what types of health issues and in which generation.

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0055387

Sue & Zed,

Thanks for the responses. I guess I was assuming these companies might have incentive to look for some of the risks that are driving the chronic health epidemics and the increasing prescription drug use, etc. and assuming they could pretty easily do an inside vaxed vs. never vaxed (or less vaxed) study if they wanted to. And I'm assuming they would see some correlations that we can only suspect to exist, and since in theory they "cover" the cost of the suspected culprit in the first place...

"they take in exponentially more than they pay out..."

Assuming this is true (and yes, sick), is this driven by factors such as many not really seeing their insurance costs, i.e. employers provide the coverage, etc? It doesn't seem like any free market factors can positively weigh in with the "healthcare" we have right now, like patients being able to choose and create demand for what actually benefits (and let those that harm go under). Outside of emergency care maybe, I don't see that insurance covers much of anything of real health value, and adds more bureaucratic cost to our "care" on top of that (and there seems to be still some major uncertainty over whether you are covered when you really need coverage, i.e. autism coverage).

Jeanette, insurance companies base premiums on 'average cost of care' for certain conditions and age groups. Since they take in exponentially more than they pay out, the higher the risk in a certain group (in this case, children) is advantageous to them. They collect more up-front on the entire group, and pay-outs are routinely, tightly controlled (via denials for certain circumstances.)
Pretty sick game, but highly profitable.

@Jeanette, perhaps there were more inpatient admissions because some of the undervaxed had health issues that precluded them being vaccinated at all, which could account for more inpatient admissions for seriously ill children who should never be vaxed? Just a supposition.

I can't figure out why insurance companies haven't demanded a lighter vaccine schedule. Do they make more on drug kickbacks than they lose on paying for all the vaccine side effects, or do the top execs invest heavily in pharma stocks and are happy to fund their investments with customer premiums, etc., or have they just not connected the dots despite having the data the public is not allowed to see?

ok, but undervaccinated children had more inpatient admissions, signifying more serious illness? i have unvx'ed children ( 8 and 6 years old), by the way, so i do believe it's better. i just don't see that the study necessarily means undervx'ed children are healthier.
it could also be pointing towards different parental behaviour, i.e. not bringing in your child for every "well baby visit" and runny nose...

So what we can conclude from this is what those of us with unvax'ed kids already know:

Families with under-vaccinated and non-vaccinated children are more profitable for insurance companies (bc they spend less on healthcare) and less profitable for pharma companies.

Maybe now those annoying "time to vaccinate your baby" letters on insurance company letterhead (but sent at the urging of pharma companies) will stop.

Just leave us and our healthy kids alone! And if you really care about the health and well being of our nation, slow down the out-of-control vaccine schedule for the rest of the kids and grown-ups sakes!

"Conclusions: Undervaccination appears to be an increasing trend. Undervaccinated children appear to have different health care utilization patterns compared with age-appropriately vaccinated children."

"Different" = "healthier", although the CDC would never say so, even in light of their own study!!

Otto

No, there is nothing so disgusting that there won't be scientists prepared to work on it, or "bio-ethicists" prepared to defend it. In fact that is presumably the whole purpose of the "bio-ethicist" trade, to invent arguments to defend indefensible and psychopathic projects. Very good letter from Josh Mazer.

John

Here is another one: U of C is on board with testing anthrax vaccine on children too young to give informed consent:

http://mag.uchicago.edu/science-medicine/needle-and-threat#comment-777729538

This article is revolting. At long last, have these people no shame?

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