in thinking Measles can't be more dangerous now than it was 15 years ago ?

[Onajourney]

Hi

Wondering if there are any GP's out there that can tell me this ?

My eldest child is 15 and I still have his baby books and they say Measles is a mild disease and just to keep their temperature down etc, they liken it to chickenpox. I remember not being worried about it at all when he and his 11 year old brother were small.

Fast forward 14 years and we have a 1 year old who is at "huge risk from this killer disease" according our GP, but I can't understand how it can have changed so much.

Can anyone tell me, is Measles worse now than it was 15 years ago and if so why ?

Thanks

Sassy, did you read what I and specifically Beachcomber wrote about George Fisher's death? Have you ignored it on purpose? Have you any response to that apart from "okay"?

I feel desperately sorry for Anna Duncan's parents. I believe there was no history of mental illness in the mother before her daughter's death. Police looked at Anna's death again, but found nothing suspicious and ruled out theories that her mother suffered Munchausen's syndrome by proxy.

So, do you have anything to say about George Fisher's death apart from "okay"? Totally unconcerned by it? Or just reading to try to "prove" it had nothing to do with MMR?

George Fisher should never have been given the MMR with his history of fits. Febrile convulsions used to be a contraindication to the triple vaccine but somebody noticed that that would rule out too many children so they changed the rules.

George died 10 days after his MMR which is known to be the peak time for a convulsion type reaction. He had measles virus in his lungs and blood and evidence from his spleen showed he was fighting a viral infection - this is not supposed to happen with a vaccine. He had a raised temperature and fitted and died in his sleep.

To declare his death to have been of unknown natural causes when he was clearly having a vaccine reaction is irresponsible and cruel.

Hey gotta protect that vaccine programme though, gotta protect the greater good. Children like George are just collateral damage - they are a minor inconvenience.

" Febrile convulsions used to be a contraindication to the triple vaccine but somebody noticed that that would rule out too many children so they changed the rules."

That is nonsense. It was a contradiction to the single measles many years ago, because I didn't have it because my sister had febrile convulsions. DS had his mmr at 13 months and had his first febrile convulsion at 15 months. Now at 14 he has just been diagnosed with GEFS+. I spoke to the gp at 5 for his booster and she pointed out that the risk of febrile convulsion is far greater from the normal disease than from the vaccination.

I feel uneasy with the speed at which the medical profession will attribute reactions and side effects to diseases yet will not accept the same for vaccinations.

How can enchephalitis be widely accepted as a (rare) complication of chicken pox, yet febrile convulsions will not be accepted as a side effect of a vaccine, merely a coincidence?

My children see an elderly paediatrician - he does not want to give either of my DDs MMR because DD1 has febrile convulsions (and a history of reacting badly to vaccines).

He told me that when Urabe MMR first came out it was not recommended for children with a history of convulsions. The Urabe vaccine has since been withdrawn as it was unsafe (caused mumps meningitis). When the MMRII replaced the Urabe MMR doctos were told to be 'cautious' in vaccinating children with a history of convulsions.

www.merck.com/product/usa/pi_circulars/m/mmr_ii/mmr_ii_pi.pdf

"Due caution should be employed in administration of M-M-R II to persons with a history of cerebral
injury, individual or family histories of convulsions, or any other condition in which stress due to fever
should be avoided. The physician should be alert to the temperature elevation which may occur following
vaccination (see ADVERSE REACTIONS)."

I wonder how many parents are asked before vaccinating with MMR about family history of febrile convulsions and told to carefully monitor their child?

The Fisher family have clearly stated that they were not warned about this.

Febrile convulsions are listed in the adverse events (in the Merck link above).

Encephalopathy is listed as being 'temporal associated' but never been shown to have been caused by the vaccine. (This is an odd statement because the Vaccine Court in the US has compensated children for encephalopathy following MMR vaccination).

PFT, febrile convulsions are accepted as a risk of vaccination, the rate is about 1 in a 1000, nobody is denying that, however the risk of the original illness is likely to be higher. My DS had never had a febrile convulsion before his MMR, but went on to have over 20 and had one last year at 13. He has never had a febrile convulsion as a reaction to a vaccine, yet the first sign of flu is a febrile convulsion. My family has a genetic defect which means that for generations children have far more febrile convulsions than normal and have them until at least until puberty and beyond, yet no one has ever had a febrile convulsion as a reaction to a vaccine.

I think it would be interesting to examine the rates of febrile convulsions and seizures in vaccinated and unvaccinated populations.

Sympathy bruffin for your DS - they are scary and horrible things. DD had one last week and the doctor wants us to do a scan because she is getting a little old for having them. He doesn't rule out that she may be more prone to them since her vaccine reaction which was when she had her first one.

I would also point out that even though febrile convulsions are very scary to watch when they happen they are very rarely leave any lasting damage.

This is true although it is important to monitor a child who has a convulsion following vaccination as the convulsion can be a sign that a more serious event is to follow. (This was the case with my daughter for example).

So what people want is vaccines with no side effects? Or no serious side effects?

All drugs have side effects. I am not sure that is possible.

If vaccines without side effects cannot be manufactured, what then?

Not that a vaccine is a drug, you get my drift though.

Straw man argument again. Wishing for safety studies to be more rigourous [the govt's own Cochrane report into MMR atually concluded safety studies inadequate despite the soundbites released to the press which avoided that bit] and for vaccines to be made safer, and for singles to be available on the NHS rather than treating us all like cretins who are not capable of turning up for three jabs is not the same as wanting vaccines with NO side effects.

It's not an argument, it's a question.

And this is not just about the MMR. People are desperately trying to turn the discussion into one about the MMR, but it was a more general conversation about measles (the disease) and about whether we need to vaccinate for it and various other diseases.

Vaccines are always going to have side effects. All of the vaccines we use, including the very established ones, have side effects.

So what people are saying is that their current risk assessment is that the side effects do not outweigh the risk of the disease, I think? And different people have different vaccines for which they feel personally that the benefit does not outweigh the risk for their children?

It is interesting to try and understand why people don't vaccinate, or don't want to, or dont follow the guidelines.

What about diptheria? What is it, for you, that makes that one a disease it's better to rick catching, than to vaccinate for? What are your criteria IYSWIM, for choosing which ones to have?

If everyone picks and chooses, in a menu-stye offering, and has only the ones that they feel for whatever reason are the right ones to have, then the whole vaccination program will be more or less pointless, I think? The take-ups will sink to a point where the illnesses get back into the population and then the people who are vulnerable will be badly affected, as they used to be before we had all of these jabs.

Different for tetanus, obviously.

Well I argue for one thing and then you say, 'oh no, we're not arguing about that, we're arguing about this' so it is rather hard to argue any point at all.

And posing a question as if others are asking it is indeed a straw man argument.

Actually, IPV is an interesting one. IPV confers only individual protection - if a child travels to an area where polio is endemic, that child can still bring polio back to the UK and excrete it and be contagious for unvaccinated children. With OPV that was not possible, as it prevented the virus replicating in the gut. So, if a large proportion of children are not vaccinated against polio, it will be interesting to see if, in these days of international travel, if polio returns. Certainly I think polio vaccination is now more crucial than ever.

ImSoNotTelling - It is a trade-off. Rational decision maker will weigh the perceived risks and benefits of both vaccine & disease and take the route they judge to be safest for their particular circumstances.

I'm not arguing about anything, I have been quite careful not to do so. I don't want to have to have a big argument.

I am asking lots of questions of people, but people who I am not asking seem to keep answering (like with the questions i was asking bubbley).

I ask a question, and get told that it is an invalid argument.

I am trying to get to the bottom of what people want, not just you, but others on the thread. Why they feel the way they do.

I think the answer is fear, and I think that when that transmits into the population (stoked up by the press) and people start eschewing vaccinations, what then for the programme? Are there some vaccines that people universally say are a good idea, a core set if you like. That we could continue with and be confident that take-up would not be eroded. Or is it all up in the air?

Certainly with the current uptakes for some vaccines, and teh outbreaks that have been happening, there will come a point where something needs to be done. Whether that will be an offering of a "menu style" innoculation programme, or simply the removal of certain innoculations from the programme entirely, who can say. Certainly with take-ups as low as they are, it might not be cost effective to offer certain vaccines in a menu form.

I worry about the future, and about public health, that is where my interest in this lies. I worry that with take-ups being so low we are going to start seeing more outbreaks, and serious illness, and death. It plays on my mind.

Here is the rational analysis of parents, through the prism of Game Theory:

We are willing to vaccinate our babies if the payoff is positive. (Payoff = benefit - price)

Benefit: Increased immunity to disease
Price: Risk (real or perceived) to baby's health.

Note that we are not talking about probabilities here (probability of negative effect to child is small, but so is probability of that child catching and then developing a complication to the disease). We are talking about the risk and the benefit.

Given that a small number of children develop serious complications that turn into permanent damage following the MMR vaccine, the issue of MMR vaccinations is in a 'Nash Equilibrium' and will stay thus until there is a serious study into which children are at risk from the MMR vaccine.

This equilibrium is not socially optimal because the little benefit a single child's immunisation would bring to the society as a whole is far outweighed in the eyes of the parent by the potential permanent danger to his health.

In other words, it is understandable that people are reluctant to gravely endanger their babies (however small the probability) for an incremental benefit to the common good.

cote the thing is that as these diseases have been out of the popuation for such a long time, when people weigh up the risk, are they weighing up the true risk, given that they have only dim memories/no living memory of the effects of these illnesses.

I have never met anyone who had diptheria, or polio, or tetanus. I have not lived at a time when these diseases were in the population. I imagine that they were very bad. Others imagine not so bad, they are prepared to take the risk. People talk about "antibiotics" and say "well if they catch it they'll just be treated" but it's not as simple as that.

I think there is also a danger that people think "well I won't have it, but most people do, so it's not in the population, so i won't catch it". But that's a very dangerous gamble to make IMO, when people don't actually know what the true upatke in their locality is.

There is also the question of people acting for society, rather than as individuals. To protect the vulnerable. That having innoculations isn't just about protecting yourself, but about protecting the people around you. But I know what the answer to that one is, having been on these threads before.

We are not just talking about MMR here, why do people keep on bringing it back to that.

Good analysis though cote.

@backtotalkaboutthis: The study you quote is: Kielinen M, Linna S-L, and Moilanen (2000). Autism in Northern Finland. European Child & Adolescent Psychiatry 9:162-167.

Having read the full paper, it looks like a very careful study documenting an apparent rise in incidence of autism in the northern part of Finland, compared with a different study performed in 1980. I quote some of the discussion below (you will have to trust me that this is the most relevant, as I cannot post more due to copyright restriction).

"The autistic cases detected between 5 and 7 years of age are most likely to reflect the true incidence rates. The recognition of childhood autism and the availability of services have improved over time, which means that the higher incidence rates obtained here merely reflect the improved sensitivity of the case finding in primary health care. The ongoing studies in the two northernmost provinces of Finland, the provinces of Oulu and Lapland, may have risen the sensitivity of recognition of autistic spectrum syndromes. The consciousness within the local health care has now led to a high detection rate of autism, with very few dropouts.
...
Swedish studies from the 1980s showed autism to be more frequent in the northern part of the country (6, 13). The Finnish study by Vinni and Timonen carried out in the 1980s (35) showed a similar phenomenon. There seems to be a remarkable number of cases of autism and autistic-like syndromes in Northern Finland. These results were congruent with the results from Sweden. Based on the present study, it is difficult to say if we have more autism in Northern Finland, because there is no comparative study available from the southern parts of Finland."

So the authors' conclusion is that the rise is real and the most likely explanation is that the skills in identification of autism cases have drastically improved since 1980; and this accounts for the rise. It does not mean that there are actually more cases developing, but that they are being uncovered when previously undiagnosed. It is a far cry from that to say vaccinations are involved, and there is no mention whatsoever of this in the paper. They have no other studies to say whether the high levels found in the north of the country are also found in the south.

The stuff on Chrohn's disease: well, my first question to you was about whether a claim scheme was launched or promoted around those times, which could account for the sudden rise in 'cases' (i.e. claimants)? Once again this does not provide credible evidence of an actual rise in Chrohn's in Finland, and when more reliable data is looked at (already published in the BMJ) then in fact no rise is seen.

All these caveats I pointed out are well-known statistical forms of bias which you and Beach and all those others who read, believe, and quote from whale.to etc, need to take on board. If you want to discuss things in scientific terms, anyway.

BTW your earlier graph about measles deaths falling needs an authoritative reference please.