Risk Analysis Regarding Vaccines (Calculations that Refute Claim in NYT Review of "The Greater Good")
By Scott Laster
On the SmartVax website created by SafeMinds, the Weigh The Risks page includes quantitative analysis which indicates that for a child in the USA today that was not vaccinated until age 5, the risk from each vaccine-preventable disease would be far orders of magnitude lower than the risk of autism.
The disease-risk analysis was performed for this hypothetical child in a highly-vaccinated population (e.g. the USA today) and in a low-vaccinated population (e.g. if a substantial percentage of USA children were not vaccinated such that the population didn't benefit from herd immunity. You can see the results for each disease at the Weigh The Risks page or below (click photo to enlarge.)
In summary:
Disease Risk age 0 - 4 in USA if not vaccinated:
In highly-vaccinated population, the highest incremental risk from a disease:
Injury: 1 in 483,000
Death: 1 in 108,000
In low-vaccinated population, the highest incremental risk from a disease:
Injury: 1 in 3,400
Death: 1 in 16,000
The analysis quantified as high as a 1 in 13 incremental risk of vaccine-induced asthma. The data was insufficient to define an incremental risk of vaccine-induced autism. However if it is demonstrated that a substantial percentage of regressive autism is vaccine-induced (say for example 20%), then the risk of vaccine-injury would be several times higher than the risk from the diseases in a low-vaccinated population (in a highly-vaccinated population would be hundreds of times higher).
This 'Weigh The Risks' analysis was undertaken not to encourage non-vaccination, as vaccination is an important aspect of public health. Instead it was intended to determine whether the vaccine-injury risk has risen to an unacceptably high level in comparison to disease-injury risk, which would indicate that smart action is needed to make the current USA vaccination safer to obtain the most optimal overall health outcomes. We don't have definitive proof that vaccines cause autism. But given the disease-risk numbers I think it is invalid for the NYT Reviewer Jeannette Catsoulis to claim that even if vaccines caused some autism cases that it would have to be acceptable because of the disease risks. If vaccines cause even a significant minority portion of autism cases, the calculations indicate that the USA childhood population would have lower risk by not vaccinating. That doesn't mean that we need to stop vaccinating -- it means we need research to find the vaccine-injury causal mechanism(s) so that vaccines can be designed to avoid vaccine-injury and the vaccination program can be modified to reduce vaccine-injuries.
To David Burd, Perhaps I havent looked closely enough, but my initial reaction to the vaccine chart is to say that I think it is not as striking as one in which vaccines are shown sequentially from top to bottom, and I have an idea that since we are looking at risk-benefit, there could be a rather large column on the right of each vaccine, giving the possible adverse events.
When my grandson and grandaughter were given measles vaccine at age 7 and 10, they both got quite sick twice in 6 weeks. The worst was the girl, who at 5 weeks was very ill with a high fever that lasted nearly a week. By then I was panicking and wondering if we were up against something very serious. My daughter, needless to say, realized that her kids would have been better off to get the wild measles virus. And I saw very clearly what the bottom line of deciding risk vs benefit is- Take a look at the very worst adverse event possible and then ask yourself what you would say if your child got that effect from the vaccine.For example, if your child got Guillain Barre syndrome after a flu shot, you would not say "but I HAD to give it"- you would in fact say "What was I thinking ?Was I thinking?"
Posted by: Cherry Sperlin Misra | November 21, 2011 at 12:18 PM
Jeff C - thanks for excellent perspective. I always say IF people would see in its vibrant colors the CDC Immunization Schedule for ages 0 to 6, they would instantly grasp the potential and real damages now inflicted by up to 50 vaccine doses (a slight quibble from your number of 48, but I include the two flu doses at age 6 months and 7 months, and the one given the mother while she is pregnant.
Here it is! Please spread it far and wide!
http://www.cdc.gov/vaccines/recs/schedules/downloads/child/0-6yrs-schedule-pr.pdf
Posted by: david burd | November 20, 2011 at 09:53 AM
Jeff C, you are totally right. The risk of experiencing a disease is not, on its own, something to be avoided at all costs.
Our daughter sees a "family medicine" doctor, rather than a pediatrician, and he once voiced the opinion that he is more flexible than pediatricians on many choices (including vaccination) because he treats the child and the family holistically. (Rather than seeing all kids as part of the one-size-fits-all AAP philosophy, I guess.)
I sometimes wonder if the Baby Boom generation's experience of the polio scares of the 1950s is what made (and makes) the ever-expanding vaccination schedule possible. So many of them were so scared that they lost their ability to distinguish among diseases, and indeed, among the effects of diseases on different populations.
I had an interesting conversation with a Boomer recently about a survey of doctors that found that younger MDs were more likely to be skeptical about the safety and efficacy of some vaccines. I said that young MDs all got chickenpox and lived to tell about it, so they probably don't see the vaccine's benefits as outweighing the risks. The Boomer said, "But what if your kid was the one who died from the chickenpox?" Missing the point, of course. I could get hit by a bus on my way to church tomorrow. It's not very likely, though, and I'm sure the Boomer wouldn't tell me to avoid motor vehicles at all costs, because of the mere possibility of motor vehicle-inflicted death.
Posted by: Theresa O | November 19, 2011 at 07:52 PM
The problem with a vaccination schedule is the presumption of low (or zero) risk and high benefit in all cases. This is entirely at odds with how medicine should be practiced; an individual risk/benefit analysis performed and treatment adjusted accordingly. This is the procedure for prescription drugs where the therapeutic benefits are balanced against the negative side effects in the individual. This is also procedure for invasive procedures such as surgery. The individual’s health and potential complications are key factors in determining if surgery takes place. While the system does not always work as it should, all acknowledge this is how it should happen.
With vaccination, this premise is entirely absent. Although this is an invasive medical procedure, the risks are always presumed to outweigh the benefits. Consider these examples:
Mass vaccination against diseases that are harmless in children – chicken pox, mumps and flu are examples. These diseases are almost always mild in children with no lasting consequences; it is assumed the convenience of not experiencing the disease outweighs the risks.
Mass vaccination against diseases that are extremely rare in children – Hep B is an example. It is assumed the protection afforded the infinitesimal slice of children that might be vulnerable outweigh the risks. Since most children aren’t vulverable, there is an assumption of zero risk in giving them an unneeded vaccine.
Scheduled boosters regardless of antibody titer status – most children don’t require booster after booster to generate protective antibodies. The schedule is designed so even the “tough nuts” are cracked. Since most children don’t need the boosters, there is again an assumption they entail zero risk
Eradication is always a good thing – Pneumococcal conjugate 7 is an example. Since introduction, the eradicated strains are being replaced by other strains. Unfortunately, the chief among them is 19A, an antibiotic resistant strain with high morbidity. There was no consideration of intended consequences when evaluating risk.
Thanks for bringing some attention to this subject as we really need to change the mindset present. The absence of risk/benefit analysis has allowed the schedule to explode from 20 vaccine doses a generation ago to 48 doses today before a child starts kindergarten. This would have never happened if pediatricians had to convince parents it was an acceptable risk first.
Posted by: Jeff C | November 19, 2011 at 05:45 PM