Wednesday, January 28, 2015

Can the Vaccine Wars Get Any Weirder? Father of (Unvaccinated) Boy With Leukemia Asks California School Officials to Bar Unvaccinated Students/ NY Times

The son has been treated for leukemia and is still immune-compromised, has not received the live measles vaccine, as it might be dangerous for him.

So the dad wants his child protected by forcing everyone else in the school to be vaccinated, to create a safe cocoon (at least while in school) for his child. Dad acknowledges his child will still be at risk everywhere else.

Except--there is another little boy in the same class who also has a medical condition that precludes vaccination.  Where does that leave dad?

Maybe someone should tell the dad that when kids get live virus vaccinations they sometimes excrete the live virus and pass it on to their schoolmates, "vaccinating" them inadvertently. For a virus like polio, there is often increased virulence when spread this way. This is what caused all US polio infections for years. That is why live polio vaccine is no longer used in the US. But live measles, mumps, rubella, flu, chickenpox, rotavirus and some other vaccines are still used, and a crash vaccine program at the school might expose his child to live vaccine viruses.

Maybe someone should tell dad that no one has died from measles in the US for at least ten years.

The county health officer brought sanity to the issue.  He pointed out that there has not been a single case of measles in Marin county, so in fact, there is no issue. From the NYTimes. And below is an abstract of an expert group opinion paper on this subject.

 2014 Apr;133(4):961-6. doi: 10.1016/j.jaci.2013.11.043. Epub 2014 Feb 28.

Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts.


The present uncertainty of which live viral or bacterial vaccines can be given to immunodeficient patients and the growing neglect of societal adherence to routine immunizations has prompted the Medical Advisory Committee of the Immune Deficiency Foundation to issue recommendations based on published literature and the collective experience of the committee members. These recommendations address the concern for immunodeficient patients acquiring infections from healthy subjects who have not been immunized or who are shedding live vaccine-derived viral or bacterial organisms. Such transmission of infectious agents can occur within the hospital, clinic, or home or at any public gathering. Collectively, we define this type of transmission as close-contact spread of infectious disease that is particularly relevant in patients with impaired immunity who might have an infection when exposed to subjects carrying vaccine-preventable infectious diseases or who have recently received a live vaccine. Immunodeficient patients who have received therapeutic hematopoietic stem transplantation are also at risk during the time when immune reconstitution is incomplete or while they are receiving immunosuppressive agents to prevent or treat graft-versus-host disease. This review recommends the general education of what is known about vaccine-preventable or vaccine-derived diseases being spread to immunodeficient patients at risk for close-contact spread of infection and describes the relative risks for a child with severe immunodeficiency. The review also recommends a balance between the need to protect vulnerable subjects and their social needs to integrate into society, attend school, and benefit from peer education.

No comments: