Vaccinations and nursery schools

[Louise1010]

This is my first post so forgive me if I do anything wrong!

I am just beginning to look at nursery schools for my 15 month old son, and I am a bit surprised that they don't seem to care whether or not he has been vaccinated. I expected it to be a requirement.

It seems incredible to me that I have to provide evidence of my cat's jabs to the cattery but when it comes to children anything goes.

Has anyone come across a nursery school in the UK that does require it?

But I think I followed the rules.....

Ooh, don't know about that! I think you have fallen foul of Rule 1 - Don't question, just believe.

But as I said above, what is considered to be crankish can later become accepted theory. It happens in all branches of science, not just medicine.

I don't dispute your figures mathanxiety, but in the 'developing' world it should be set alongside the incidence of poverty and all that goes with it - poor nutrition, poor sanitation, lack of clean drinking water, lack of access to timely medical care etc, as indeed your link is highlighting.

So do we just vaccinate to try to eliminate the disease or do we also try to tackle those circumstances which cause the morbidity and death?

Vaccinate first imo. It is cheap and it works. Children born right now can't wait until their world is a better place.

I would beg to differ. Personally I would prefer to see clean water and sewage treatment offered as the basics, and I am quite sure both could be provided relatively quickly if the will was there.

lavolcan
you were referring to me in your little spiel on citations to back up statements. it really isn't hard to access the info I mentioned with a tiny bit of effort. I was basing my statement on my lecture notes from my epidemiology courses and didn't have the time to find the relevant articles. But since you are so interested in evidence based decision making (a definite step forward for you) here you go as a couple of examples (there are plenty more):
jama.jamanetwork.com/article.aspx?articleid=199235
www.ncbi.nlm.nih.gov/pubmed/12706669

Is that good enough for you?

As I said to tabitha, i agree that vaccines aren't the be all and end all. They're tempting for donors as they're quick and easy with immediate results, especially if a cold chain isn't required. Ensuring adequate nutrition, ensuring clean water, sanitation - all very important but require a longer term investment. It's not an either/or situation - it really needs to be the whole package. As math said though, vaccines are a quick win and particularly where you have malnourished children, a poorly functioning health system, vaccines have even more impact in terms of lives saved and disability averted.

Leonie
I don't think anyone here has said anything as offensive as 'baby girls in third world killed in the name of vaccination'. How disgusting. I work in international public health and I personally know many people who work on implementing vaccines in low income countries and they are committed individuals who have devoted their lives to improving those of others. You really do know nothing about what goes on in 'third world countries' as you called them. Pathetic.

With regards to the article (which has nothing to do with what we were talking about - you were just excited to find one which showed vaccine damage)

a) it's one of those horribly flawed epidemiological studies. You know, the ones which can't show anything. Where's your hyper criticism now? Or is that just reserved for studies whose findings don't match your pre-conceived ideas?

b) We already know about it and people are concerned about it, this isn't the first study which has shown this effect. Research is going on to figure out a better schedule. Note that vaccinated children were not compared to children who had been exposed to diptheria and pertussis as herd immunity has reduced transmission, the excess mortality is in relation to children who haven't had these diseases. Not that it's OK of course but the answer is not to stop vaccinating these children. You also ignored the bits of the paper which spoke about the non-specific beneficial effects of the other vaccines.

c) The fact that an unexpected and non specific side effect in a high mortality setting (so a lot of 'noise') in countries with extremely poor disease surveillance systems is picked up is another sign that vaccine damage, when it occurs, is picked up on.

I'm not sure why you introduced the name of Semmelweiss. Unlike people claiming vaccine damage, Semmelweiss actually had statistics and empirical evidence to prove his hypothesis, Semmelweiss's work was replicated. SAme with Galileo. That's how science works. Semmelweiss and Gallileo couldn't be further from what's going on here with the anti-vax crew and their rejection of scientific principles.

You're completely wrong about SIDS. Quite the opposite is true, unvaccinated babies are at a higher risk. You keep your opinion (based on woo and crystal ball gazing???), I'll base mine on scientific evidence.

www.ncbi.nlm.nih.gov/pubmed/16945457
(I could, of course, give the link a nasty and provocative name just like you did but I'd rather not stoop to that level)
www.ncbi.nlm.nih.gov/pubmed/11298074

And, as you can see, there's nothign unethical about studying vaccinated or unvaccinated children (why would there be? As long as one complies with ethical regulations of course!). What's unethical is to conduct a randomized control study as it's unethical to deprive a child of an effective and safe vaccine. Even though you voluntarily do deprive your children of vaccine protection, I'm sure you wouldn't be keen on them taking part in a study where they are randomized to be vaccinated or not vaccinated - do you understand now why this is a problem? Or are you too busy snorting (exactly what you're snorting I'm not sure)?

Tabitha

Can you please provide evidence that

a) the single measles vaccine is safer than the MMR (as opposed to the fact that you're increasing the local reaction site three fold now)

b) vaccine uptake will increase if offered (since no other country which has the MMR has felt the need to also offer a single so I'm not sure what research you're basing your assumption on)

c) what would be the impact if rubella immunity decreases (eg how much of an increase in disabled babies can we expect to see - you could look to Japan for some information on that one)

And if we have excess money to spend on vaccines, can I put in a vote that we actually spend the money on things that we have evidence that they work like a chicken pox vaccine? That will actually SAVE lives, reduce morbidity and, best of all, there's evidence for it :)

Yes, it would certainly be quicker and cheaper to provide all the piping and treatment plants, the miles and miles of trenches and all the taps and receptacles, not to mention recruiting and training all the technicians and engineers and surveyors, getting all the heavy digging equipment and the drivers, and all the fuel they would use is easily available at the local petrol/diesel station....

"Looking at the vaccination schedule as a whole, why do we still vaccinate against polio?"

Because polio still exists in some parts of the world.

"But as I said above, what is considered to be crankish can later become accepted theory. It happens in all branches of science, not just medicine."

It actually happens the other way round! They whole point about science that it changes in the light of new evidence. So what was once held to be accepted theory becomes crankish when new evidence comes to light. What makes a theory crankish is holding on to it in the face of the evidence.

Hmm think it's a bit of both really seeker. When ds1 was dxed and his paediatrician found out he was was gluten free he rolled his eyes and said 'well if you will waste your money'. That was about eleven years ago. 2 years go he had a neurologist appointment and the paediatrician there asked whether we had considered a different diet while the neurologist nodded and the both flicked through information showing us how different diets might help.

Likewise when he was first dxed it was fairly crankish to suggest autism might involve the immune system in some (prob quite a few) cases. Now it's accepted that is true. Actually when ds1 was diagnosed it was still pretty crankish to see autism as a anything other than a brain disorder fixed at birth. Now it's known that autism in broad terms can be seen as a biomedical disorder (to use a very loose term on purpose).

I think we are both saying the same thing in a slightly different way Seeker. Galileo was no doubt considered a crank, but he was years ahead of his time and couldn't get his evidence accepted.

Semmelweis has had a couple of mentions on these threads. He wasn't alone in stressing the importance of good hygiene, but he died in a mental institution and only after his death were his ideas generally accepted.

It's always difficult introducing new ideas. A more recent example is the idea that stomach ulcers could be caused by bacterial infection was regarded as fringe and crankish. According to one lecture I attended on paradigm shifts - that's WHY one of the researchers ended up infecting himself - it was the only way he could show without doubt the accepted understanding was wrong. The careful work he had done prior to that was ignored as it didn't fit the ideas of the time.

Or perhaps more accurately - it was the only way he could show that a course of antibiotics following a recorded infection with h. Pylori cured stomach ulcers.

Absolutely saintly. I know we are going off topic here. I know someone who suffered for years with ulcers and I can still remember her incredulity when she was cured in about 3 weeks by a simple course of antibiotics.

The whole point is that once enough evidence supports a particular theory, it becomes mainstream. The ulcer thing is a case in point. What makes crankery is persisting in belief regardless of the weight of evidence against.

saintly please don't assume that because I'm from the other camp that this is some cheap shot...I know your interested in evolution of virulence

H pylori is present in 50% of humans but most of them don't develop stomach ulcers. It seems to relate to whether certain virulence genes are present/turned on. It's possible that host life style leads to either within host evolution of virulence or switching on of virulence genes, in what is otherwise a commensal. There are a range of reasons to think that thumping pylori with antibiotics treats the proximate cause rather than the underlying cause, with all the negative knock on effects of wiping out your gut fauna. pylori may also protect us from things like asthma and allergies.

I'm at least 10 years out of date with the literature, so I'll let you follow it up if you want to.

Oh no, I realise that (didn't want to bother going into it on this thread because that was off topic). The point the lecturer was making - and I think it's a relevant one - was that in order to have the new fangled ideas accepted the researcher went to the extreme step of infecting himself. And that until he did that he couldn't get anyone to listen to him.

Any new idea is hard to get published. I don't think that's
controversial? I'm not sure people outside science realise how difficult it is to introduce new ideas via peer review.

This is another example. The article is a bit yee-ha - I suggest to google the research group if you want to see something sensible about the research. But this research was funded in large part because the father of the child couldn't see how else it was going to get funded. Now it's not at a stage of telling us all that much clinically useful yet, but I think it's the sort of thing that led to the change in response that I have seen from consultants when talking about diet and autism.

That research would not have been done without parent funding. We'd still be being told we were cranks.

I completely disagree that it's difficult to get new ideas past peer review. In fact all sorts of stuff gets past review, even Wakefield's discredited paper. It's difficult to get new ideas past peer review if you don't produce data to support the idea.

Quite right jotheho. If you have a controversial hypothesis which you've managed to prove, editors will often overlook criticism during peer review as they want people to talk about their journal.

Funny that the article saintly linked to actually supports vaccination. If its antibiotics which are causing autism (surely easy enough to see if theres a relationship) and vaccination reduced the chances you'll need antibiotics, it makes more sense to vaccinate!

I agree that we need to be open minded to new ideas. What isn't open minded is the scientific method - that doesn't change. To determine whether an idea is true, scientists establish hypotheses, collect data and subject that data to statistical analyses. There comes a time when it becomes clear with study after study reaching the same conclusion that certain beliefs just don't hold up: like the mmr causing autism.

Who was that woman who headed autism speaks who resigned after they refused to accept the evidence and still clung to the vaccine idea?

A friend of mine has a child diagnosed with autism and has been told that the child might grow out of it.

Told by who?

Sorry, I assume everyone is psychic .
Told by the paed.

Here's the brave lady from Autism speaks who stood up and said 'Enough is enough'

Autism Speaks resignation

But I see that her resignation clearly has an effect. Autism speaks now encourages vaccination. Kudos to them!

Autism Speaks on Vaccination