Author Topic: Tetanus shot  (Read 19430 times)

juandoe

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Re: Tetanus shot
« Reply #45 on: August 20, 2014, 09:15:04 PM »
Here is what Mercola puts on the website:
It should also be noted that the recently reported pertussis (whooping cough)9 and mumps outbreaks10 have occurred predominantly among the vaccinated –and measles "outbreaks"11 have also involved vaccinated persons —invalidating claims that vaccinated people cannot get sick from or transmit infectious diseases.

Here is what the actual references state:
In a large case-control study, children with pertussis were significantly less likely to have had all five doses of the DTaP (diphtheria, tetanus, and acellular pertussis) vaccine than were controls, according to Lara Misegades, PhD, of the CDC, and colleagues.

The low attack rate (2%–8%) in the roommate study suggests that, overall, 2 MMR vaccine doses protected most exposed students from developing clinical mumps. Reported attack rates among unvaccinated household members without a history of mumps have ranged from 31% to 48% in observational studies [15–17]. The low attack rate (measured among roommates who had received 2 doses of MMR vaccine and were exposed to case students, virtually all of whom had also received 2 doses of MMR vaccine) likely occurred because of adequate immunity in roommates.

Both studies are addressing waning efficacy over time for dtp and measles vaccines, however, both are still effective.

Either Mercola is pushing some agenda or he does not understand the literature. 

The small baboon study is interesting (I did not pull the actual article but will accept the Science synopsis) in that it posits that an infected individual could spread the disease because 1. they have fewer symptoms and 2.  take longer to clear the infection relative to those vaccinated with whole cell vaccine.  It should be noted that the vaccine is still effective in decreasing the severity and length of infection. 

Mercola is full of bluster but I find little substance. 

PonoBill

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Re: Tetanus shot
« Reply #46 on: August 20, 2014, 10:03:06 PM »
He's selling nonsense products for high prices getting traffic by appealing to people who have strong antivaccine and/or alternative medicine beliefs. No mystery, just a sleazeball.
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Blue crab

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Re: Tetanus shot
« Reply #47 on: August 21, 2014, 01:00:49 AM »
Nobody involved in this forum discussion need be demonized as presumably those in the anti-vaccine crowd are at least well intentioned. However, many of points being espoused by the anti-vaccine crowd need to be discredited.

Vaccine science is a complex field that requires years of multi-disciplinary training to gain competence.  Let's take a parallel field such as engineering. Would it be acceptable to have a high level debate (on a paddle board blog!) amongst non-engineers, about the best way to earthquake proof a bridge or design an airplane? These are issues that impact public safety and no sane untrained  person would feel strongly about the technical components for these sorts of projects.

The exact same concepts apply for vaccine studies.  To have a valid opinion on a scientific issue, you can't just quote 2 studies that you have never actually read on some quack's website and call it a day. To even begin to debate the quality of this type of scientific research, at minimum you need to 1) know how to conduct a thorough PubMed search, 2) be able to identify the pros and cons of different clinical study designs, 3) take multiple relevant courses in biostatistics and epidemiology, 4) understand immunology, 5) have a deep understanding of clinical context in which a vaccine may be implemented and 6) have a wealth of knowledge regarding the pathogen of interest.  When I hear well accepted concepts such as herd immunity being rejected as pseudoscience, it is pretty clear that we are not dealing with a well informed group of nay-sayers here.

With this standard in mind, Dr. Mercola deserves the harshest of criticism as he is capitalizing on people's naiveté and anxiety to make a quick buck.  Most of the studies he cites are in non-peer reviewed "throw away" journals. As juandoe notes, the few real studies he references are thoroughly misrepresented. Dr. Mercola combines profiteering & extreme intellectual laziness into a single crappy website that lacks any credibility. 

I understand how this phenomenon happens. Human health is more personal than building a bridge and bad things happen to people unexpectedly. Patients and family members want answers when unanticipated diseases like autism occur, even when there are no available simple causative answers.  While I sympathize with those in this situation, it is scientific studies which ultimately rule in or rule out vaccines as a cause of human harm.  For these sorts of studies to be done correctly, the expertise of those involved really, really matters.

This leads to my second point. Several anti-vaccine champions in this thread have voiced a deep and pervasive mistrust of the intentions of all scientific experts involved in medical research, and promoted the idea that all medical studies suffer from bias and greed.  This is actually sort of insulting.  I have been in medicine and science for a long time. Certainly I have crossed paths with persons whose ethics I questioned. There are no shortage of big egos in science and one worries about bias for sure.  However, the majority of medical scientists are ultimately decent and careful people who would not dream of placing patients in harms way to make an extra buck, or of being "bought" & "sold". To imply that those who chose science as a career are somehow prone to morally deficiency is a rather damning accusation. To add a bit of soft data to the argument, academicians who are more apt to do this sort of research, typically have considerably lower salaries than their peers in private practice.

It is equally important to recognize that the regulatory environment surrounding clinical science is extremely stringent on many levels.  All clinical trials are supervised by data safety monitoring boards. This system is not easily corrupted as this board, usually consists of >5 scientists who are not related to the study and often do not know each other. A DSMB is legally responsible for stopping a study in which the drug / vaccine appears harmful or not effective. My personal experience is that people take this role extremely seriously. 

Once data is processed, all scientific studies are submitted to journals & undergo independent peer review by multiple reviewers.  Any financial relationships with pharma must be disclosed by researchers in all published studies and public scientific talks.  These disclosures definitely influence how other scientists perceive the work.

Most clinicians I know have a healthy mistrust of drug companies. Pharma's bottom line is not always consistent with human health and certainly there are subtle efforts to have clinicians provide drugs for non FDA approved indications. For these reasons, I will never talk to a drug rep, even casually. Yet, recognizing these facts is completely different from rejecting the entire biomedical enterprise, and in particular, vaccines, which provide such a tangible overall benefit to human well being











bts

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Re: Tetanus shot
« Reply #48 on: August 21, 2014, 02:11:53 AM »
Watched a bit on Colbert the other night.  He was talking about how the media skews these discussions.  You have a "pro" guy talking at the same time as a "con" guy, and whoever talks the loudest wins.  What you really need is a representative number of pros vs cons in the same room.  Put a bunch of epidemiologists, public health people, and pediatricians in a room at the same time and let them all talk at once.  I'm not sure how many people you would need to stuff into that room to find single knowledgeable person who thinks vaccines are a bad idea.  It would be a really big number, and the anti-vaccine guy probably would not be against vaccination, he would probably be arguing an individual in a vaccinated population is protected by the good behavior of the rest of the population.

Small pox. Polio.  Dropping death rate of childhood diseases.  Vaccines work. Vaccines, clean water, and adequate food.  Pretty much your public health trifecta. Everything else is window dressing.

Just for perspective, 200 million people will get malaria next year.  Somewhere between 500,000 and 750,000 will die.  Some work yet to do.






Ichabod Spoonbill

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Re: Tetanus shot
« Reply #49 on: August 21, 2014, 05:27:19 AM »
Thanks juandoe, Blue Crab and bts, I think you put it well. I don't have the expertise to judge the literature well, nor the time to do an in-depth analysis of it. As I said, I'm an English teacher, and I think scientific peer review is a process that works pretty well. It's not perfect (It should have caught that damnable Wakefield study before it was published), but it's the best system we have.

I also am sympathetic to criticisms of the medical industry. I get how so much of it is big business, especially drug companies. Our whole system is a mess. I do think, however, that vaccines are one of our great success stories.
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juandoe

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Re: Tetanus shot
« Reply #50 on: August 21, 2014, 05:40:57 AM »
http://en.wikipedia.org/wiki/Joseph_Mercola

Interesting Mercola reading.  Surely money has nothing to do with his evangelism. 


SUPJorge

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Re: Tetanus shot
« Reply #51 on: August 21, 2014, 07:32:55 AM »
Thanks Juandoe, Blue Crab, bts and PB for treating a serious subject seriously and taking the time too put it down in writing.
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Blue crab

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Re: Tetanus shot
« Reply #52 on: August 21, 2014, 08:18:58 AM »
Here is fair and balanced: scientific misconduct is an increasing problem (though restricted to a vast minority of scientists). This is a great article highlighting the forces at work:

http://www.nytimes.com/2012/04/17/science/rise-in-scientific-journal-retractions-prompts-calls-for-reform.html?pagewanted=all&_r=0

In short, the scientific environment is reeling at present due to extreme competition for very limited funding, and falsification of data is an unfortunate consequence. It is depressing.

When processing this article, it is important to note that the retractions being highlighted are from single labs where "small science" is being performed.  These labs operate much like small businesses and are inherently high risk ventures.  In this setting, data falsification is much easier to pull off.  Often, it is when another lab cannot reproduce results, that skepticism starts to grow.

In contrast, it remains exceedingly difficult, if not impossible to alter or misrepresent data in large multi-center clinical trials. These types of studies are regulated by multiple agencies at frequent time intervals.

So is science hurting? Yes it is. But much more so at the ground level where creative, high risk ideas should germinate, than at the "big science" implementation level.

 

Subber

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Re: Tetanus shot
« Reply #53 on: August 21, 2014, 08:32:35 AM »
Here is fair and balanced: scientific misconduct is an increasing problem (though restricted to a vast minority of scientists). This is a great article highlighting the forces at work:

http://www.nytimes.com/2012/04/17/science/rise-in-scientific-journal-retractions-prompts-calls-for-reform.html?pagewanted=all&_r=0

In short, the scientific environment is reeling at present due to extreme competition for very limited funding, and falsification of data is an unfortunate consequence. It is depressing.

When processing this article, it is important to note that the retractions being highlighted are from single labs where "small science" is being performed.  These labs operate much like small businesses and are inherently high risk ventures.  In this setting, data falsification is much easier to pull off.  Often, it is when another lab cannot reproduce results, that skepticism starts to grow.

In contrast, it remains exceedingly difficult, if not impossible to alter or misrepresent data in large multi-center clinical trials. These types of studies are regulated by multiple agencies at frequent time intervals.

So is science hurting? Yes it is. But much more so at the ground level where creative, high risk ideas should germinate, than at the "big science" implementation level.

Thank you for bringing more & more honest skepticism into this discussion.

As for "big science" and restriction of scientific misconduct to a vast minority of scientists, I do believe Vioxx and Celebrex and the statins, etc. were from some of the biggest drug companies.


Most clinicians I know have a healthy mistrust of drug companies. Pharma's bottom line is not always consistent with human health and certainly there are subtle efforts to have clinicians provide drugs for non FDA approved indications. For these reasons, I will never talk to a drug rep, even casually. Yet, recognizing these facts is completely different from rejecting the entire biomedical enterprise, and in particular, vaccines, which provide such a tangible overall benefit to human well being

There's probably a reason for that.  Similarly, someone mentioned nurses not taking vaccinations - must be a reason.

(I don't think anyone here rejects "the entire biomedical enterprise.")

Again, I appreciate your more fair discussion, Thank you.
« Last Edit: August 21, 2014, 08:47:11 AM by Subber »
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Blue crab

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Re: Tetanus shot
« Reply #54 on: August 21, 2014, 09:08:25 AM »
Subber: While I appreciate your conciliatory tone, you can't simply cherry pick the pieces of information that suit your preconceived notion of truth, which in this case happens to be fairly off base.  Some nurses refuse vaccines for a simple reason: they have a false understanding or no understanding whatsoever of the science underlying these policies. Same for certain MDs.

At the core of science is skepticism, the key point being that it is informed skepticism.

Subber

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Re: Tetanus shot
« Reply #55 on: August 21, 2014, 10:17:14 AM »
Subber: While I appreciate your conciliatory tone, you can't simply cherry pick the pieces of information that suit your preconceived notion of truth, which in this case happens to be fairly off base.  Some nurses refuse vaccines for a simple reason: they have a false understanding or no understanding whatsoever of the science underlying these policies. Same for certain MDs.

At the core of science is skepticism, the key point being that it is informed skepticism.

It was conciliatory because you were presenting more and more of the other side of the story.
Like I said before there is a huge amount of evidence of the medical industry "cooking" studies -
you found the article on the little guys.  The lawsuits and payouts on Vioxx and Celebrex, etc.
etc. etc. finger the big guys - its a fact.  That is being informed, and yes we should be skeptical
especially given the track records, and the conflicts of interest, and huge sums of money at risk
plus their use of government to force the use of certain products.
Once you start looking at these issues, you'll probably notice more and more dirt.

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juandoe

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Re: Tetanus shot
« Reply #56 on: August 21, 2014, 10:35:30 AM »
Once again, it boils down to understanding risk.  Every treatment has its inherent risk and benefit profile.  The overwhelming evidence points to vaccination benefiting the population as a whole.  Look at smallpox vaccination.  Overall, I doubt many would argue that it was a bad idea.  It clearly caused some harm in those unfortunate individuals who suffered adverse effects. 

Since smallpox is effectively eradicated, the risk/benefit ratio has shifted so that we no longer receive the smallpox vaccine.  Would a pharmaceutical company benefit if smallpox vaccines were required?  I suspect so. 

FYI, the nurses who refused the H1N1 vaccine did so because, "the vaccine makes me sick."  Once again, they fail to understand risk.  The people we saw dying this year were perfectly healthy in the 4th and 5th decades of life.  Flu typically kills the young and old.  These nurses were interacting with H1N1 on a daily basis.  They could offer no rational explanation for refusing the vaccine.

headmount

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Re: Tetanus shot
« Reply #57 on: August 21, 2014, 11:20:44 AM »
Well it's amazing how my original post galvanized such strong opinions on this subject.  Wasn't totally oblivious the the controversies surrounding the issue but was surprised what a 'gun control' type subject this is.

The post was intended as a word to the wise to say how it didn't feel so great to paddle a few hours after a shot but ended up enlightening me about this subject.  Very cool.

SaMoSUP

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Re: Tetanus shot
« Reply #58 on: August 21, 2014, 11:52:14 AM »
Yeah thanks a lot headmount. Really it brings to light how we can take some things for granted and how much there is behind all of it. The only time I had to debate vaccination was when my dog was up for her rabies shot at 10 years old.

For me, tetanus shot yes, flu shot no. What's baffling is that most of the people at my job get the flu vacc every year and yet they all get some form of flu anyway. And I'm usually the last one to get sick if at all. I know there are different strains etc. Perhaps some of the smart folks here can enlighten us on this topic. Flu season is around the corner. I'd like to miss as little water time as possible. Should I start another thread?

http://www.standupzone.com/forum/index.php/topic,24838.0.html

« Last Edit: August 21, 2014, 11:56:38 AM by SaMoSUP »

bts

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Re: Tetanus shot
« Reply #59 on: August 21, 2014, 12:06:57 PM »
Subber: While I appreciate>>>


>>>Like I said before there is a huge amount of evidence of the medical industry "cooking" studies -
you found the article on the little guys.  The lawsuits and payouts on Vioxx and Celebrex, etc.
etc. etc. finger the big guys - its a fact.  That is being informed, and yes we should be skeptical
especially given the track records, and the conflicts of interest, and huge sums of money at risk
plus their use of government to force the use of certain products.
Once you start looking at these issues, you'll probably notice more and more dirt.

These statements have nothing to do with vaccines.  You don't trust modern medicine or medical science.  Lots of people agree with you. This opinion is common.  What is interesting to me is that most people who hold this opinion believe their physician is the exception to the rule..."medicine is bad but my Doc is good"

Is your point Docs and scientists are human and mistakes are made? That is certainly true. The first day of school our dean got up in front of the class and said "Half of what we teach you is correct and true, the other half is partially or completely false.  And we don't know which half is which"  That is the beauty of the scientific method.  It questions facts, exposes errors, and moves gradually forward to a more perfect understanding of reality.

You want to talk about Vioxx? Merck should have studied the link with cardiovascular death as soon as questions were raised.  They should not have ignored data.  They were overly cozy with the FDA.  Saying these facts are prima facia evidence that all medical science is flawed is 'throwing the baby out with the bath water'

 


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