Jayrod said:
I'll agree that I oversimplified things, but so have you. No doubt the success of vaccines has played a large part in their increased use and I'm not completely anti-vaccine, but to ignore the money aspect is both naive and assanine. Merck vaccine sales is 20% of their revenue for the first 3 qtrs of 2009 and GlaxoSmithKlein made 12% of their profit from vaccine sales in the same period from what I can tell from their financial statements.
We are talking billions of dollars here. Maybe there are higher margin drugs, but vaccines are a high margin. I may not know as much about medicine, but business I know and when you have the CDC suggesting your product to every single baby born in the world, it makes it easy to turn a profit.
I’m not ignoring the money aspect at all. I have no idea how much money the pharmaceutical companies make on vaccines. Generally speaking, pharmaceutical profit amounts in relation to the rising cost of health care is an issue for me, but one that’s very difficult to get my head around. And I’m not so naïve to dismiss the possibility that shady things happen in business. However, as it pertains to my daily practice, the business side of vaccination has absolutely no bearing on my decision to recommend vaccination. I do it because I believe it to be in the best interests of the child.Specifically, I see no reason to doubt the multiple studies from multiple countries over multiple years in many cases that vaccines are effective and well within the risk-benefit curve for the vast majority of children. And, if you’ll forgive my using anecdotal evidence to support my claims, I’ve seen the number of cases and complications of the infectious diseases these vaccines seek to prevent drop significantly. I have not seen credible evidence that many of the high-profile adverse events (particularly SIDS and autism) have been caused by vaccination.
Jayrod said:
You are totally ignoring my point. I'm talking about the increased risk of side effects. I know there are net benefits on society as a whole for vaccines. But some of this stuff isn't even 10 years old yet. The earliest test subjects aren't even teenagers.
Take the Rotavirus vaccine for example. It was put on the
CDC list of recommended vaccines for infants age 0-6 years in 2009. According to the WHO, it is a vaccine against a diarrhea causing virus that killed about 575,000 children in 2004
worldwide, primarily in "developing countries".
link
In 1998 a version of the vaccine was licensed in the US and used. Unfortunately, it caused problems in 1/12,000 cases which caused it to get yanked a year later. In 2006, two new versions came out and are licensed which are the ones suggested in the 2009 CDC schedule.
Basically, you have a 3 year old vaccine for diarrhea being given to every kid in the US whose parents don't say no to their pediatrician (who can have a habit of lecturing you when you do this). There is no life threatening issue with diarrhea in most of the US as we are a developed nation and death by dehydration is the only real threat from rotavirus, yet the CDC suggests every kid in the US to get the vaccine.
So basically the question I'm posing is this. Why do my wife and I (who have insurance and recognize the signs of dehydration by diarrhea) want to risk any potential side effects of a three year old drug on our newborn baby girl? The risks of serious problems with Rotavirus are essentially null for our daughter, but the risks of the vaccine are quite unknown since the vaccine isn't even 10 years old yet. If there is even the slightest chance of complications with the vaccine, I'm not going to let someone give it to my child, no matter what the CDC says. Because the CDC has kids in 3rd world countries and impoverished Americans in mind who don't have access to decent care...not my daughter.
Learning of the risk of intussusception after the first Rotavirus vaccination (Rotashield) was already approved for use was unfortunate. It warrants mentioning, however, that the relationship was discovered
by the CDC through its adverse event reporting system and the pharmaceutical company who developed the vaccine
voluntarily pulled it from the market, which I would argue directly contradicts your concerns that the CDC and pharmaceutical companies potentially minimize or sweep adverse effects under the rug to protect profits. Smaller studies leading up to vaccination approval may not catch every concerning side effect due to sample sizes. Multiple surveillance studies are done with every vaccine (new and old) to look for causal relationships with potential side effects to assure safety profiles. Those surveillance studies also examine whether and how effective those vaccines are.It’s unfortunate that parents see what should be a give and take discussion with their doctors about vaccination concerns as lecturing. As I’ve said in other threads, if you don’t have a strong relationship with your pediatrician/family doctor, find another one. I’m not a fan of doctor shopping, but a trusting relationship built on strong communication is a must. It sounds like you’ve done that already.
Had you come to me with appropriate concerns over the second generation of rotavirus vaccinations, specifically that you were concerned that we could see another post-approval study showing a concerning side effect and would prefer not to give your child the vaccine until its safety in large numbers was decided to your satisfaction, I’d likely be fine with that after some discussion. In fact, we did something very similar with my now three year old when the second generation Rotavirus vaccination was licensed.
Parents who come to me refusing vaccines due to autism or thimerosal or squalene or because they believe getting chicken pox naturally to be a better idea than vaccinating are going to get a little more forceful push back from me. That’s my job – use my training to critically examine the evidence and make recommendations in the best interests of the health of the child. I think the vast majority of my colleagues are doing the same. Parents should be doing absolutely the same. You’re in the minority here, Jayrod. You’re looking at the evidence and questioning it appropriately here, though I’d argue that the “vaccines are a racket” argument is misguided. Of the long discussions I have about vaccines with families, the vast majority have little idea of the depth of the evidence in favor of vaccinations and the risk of the infectious diseases they prevent. They’ve heard something from a friend or read something on a mommy board on the internet and did no research on their own.
This goes for any number of controversial topics in child’s health – breastfeeding, ADHD, and on and on. It's not limited to the vaccination debate.
With respect to the newer Rotateq vaccination, I think ten years of a strong safety profile is asking a lot. If I'm remembering correctly, the relationship between RotaShield and intussusception was noted within 18 months and took another 6-12 months to be confirmed. The increased risk of fever and febrile seizures associated with MMRV took less time than that. We eventually vaccinated my younger son with RotaTeq a few months after the vaccination had been in circulation, when we were comfortable that his risk of getting rotavirus was higher than the risk of any complications.
You’re correct that your daughter isn’t at any real risk of dying from a rotaviral infection. She is, however, at fairly significant risk of significant dehydration and hospitalization if she gets a rotaviral infection. Before vaccination, 50,000-70,000 children were hospitalized with dehydration every year. Thousands more required treatment in the ER. There are complications associated with that. Rarely, especially in the youngest children, dehydration can rapidly progress to shock. That can affect long-term kidney function or other critical functions. IV fluids aren’t the most invasive treatment in the world, but exposure to hospital acquired infection and other issues are a possibility. Those are the things you’ll want to consider against the small (and likely much smaller) risk of a complication like intussusception.
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To bring this full circle, compare and contrast our arguments with the
comments of Jenny McCarthy. Take a look at her website and the comments of those who back her website. Examine them closely for inconsistencies. Make your own decision.
I do believe sadly it's going to take some diseases coming back to realize that we need to change and develop vaccines that are safe. If the vaccine companies are not listening to us, it's their f___ing fault that the diseases are coming back. They're making a product that's s___. If you give us a safe vaccine, we'll use it. It shouldn't be polio versus autism.
And please understand comments like these for what they are -- utterly ridiculous and unnecessarily inflammatory and dangerous.