the vaccine war



Sigall Bell, M.D.
April 24, 2010 18:20
Sigall Bell M.D.An assistant professor of medicine at Harvard Medical School and a member of the Division of Infectious Diseases, Beth Israel Deaconess Medical Center. She is the director of the BIDMC travel medicine clinic and the mother of two young children.

Thanks for the contributions, here are a few responses:
TJ Kline questions the efficacy of vaccines since many of the persons affected by the current mumps outbreak in New York and New Jersey were already vaccinated. That's true, TJ, and an unfortunate reality in vaccine medicine: despite ongoing efforts, vaccines aren't 100% effective. This is particularly true for mumps vaccine, which has a more variable efficacy rate in the literature. Compare that to recent measles outbreaks where 91% of the people who got measles were not vaccinated or had unknown vaccination status, and only 5% of those who got sick received the recommended 2 doses.

Even though vaccine effectiveness is not 100%, vaccination is still worthwhile. Why? Even in those who get the disease, prior vaccination can decrease the severity or duration of the illness.

Barca Strnadova states that herd immunity has no scientific basis - the Loeb article suggests otherwise. Several people also commented about how vaccinated kids should be fine if there were an outbreak, so why all the hubbub? That brings us back to the mumps situation above,... vaccinated kids are not always fine, unfortunately. Tanya Sherman wonders can't we do more bloodwork to figure out who is immune? Absolutely! Good call, Tanya. In the travel clinic where I work, we do this all the time. For people who aren't sure if they got 2 doses of MMR, or were born before 1957 and can't recall if they had the diseases, we routinely check blood titers. Speaking of MMR, I loved the boogeyman reference, Smibbo.

A few of you asked about vaccine spacing. Stay tuned, I'll write about that next...

posted april 27, 2010

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