Immunizations..

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mjl1717

mjl1717

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Immunizations is ONE of the areas where we are affective. (compared to heart disease and cancer)..There seems to be many variables and this area constantly changes..

Can you guys add any info you can? (no matter how trivia or common) Id like to beat this important area into the ground ..
Ill start:

1)MMR has at times been associated with SSPE(sub acute sclerosing encephalitis) MMR is given two times..

2) Meningitis vaccine has rarely been associated with Guilllian Barre syndrome...

3)Trivia-(lower priority I think) some parents were associating vaccines with Autism..😕
 
What's your goal here? Random facts? How vaccines have helped the world population? How they have harmed the population in certain instances?

MMR still has a shady reputation in the UK and it shows in the number of people there who get those three infections and it is serious. Live vaccines should not be given to those that are immunocompromised, but to show how important the MMR vaccine is, physicians will give it to HIV patients who haven't had it yet despite the risks. There was been mumps outbreaks in 2006 in US college-aged adults who seemed to only receive one dose of the MMR as a child. The MMR is now given as two doses.

Many young adults get pertussis because immunity from the vaccine only last about 15 years. Since the TDaP vaccine was developed physicians should make sure to give it to their adult patients every 10 years. The tetanus toxoid portion is important if there is a serious puncture wound and the patient hasn't had the vaccine in 5 years. The Diptheria toxoid portion seems to prevent colonization of C. diptheriae.

As for your autism link, it is mainly parents who don't like the influenza vaccine because of the thimerosol mercury content. Though it is very small, and there has been no scientific evidence that there is a link with autism. Parents also don't like the influenza vaccine because they think it gives them the flu when "the flu" means different things to different people. Many people associate norovirus "stomach flu" with the influenza virus and any kind of upper respiratory tract infection with the flu.

The US has enough smallpox vaccine stockpile to vaccinate the population within a few days in case of a terrorist attack. Smallpox is one of the few infectious agents that has been fully eradicated from the human population.

Polio is nearing eradicated status except for a few areas where it is endemic.

There is a new rotavirus vaccine for young children since the old one was linked to intussusception. It is only needed in infants, as most people have lasting immunity due to childhood exposure.
 
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TMP-SMX said:
What's your goal here? Random facts? How vaccines have helped the world population? How they have harmed the population in certain instances?

MMR still has a shady reputation in the UK and it shows in the number of people there who get those three infections and it is serious. Live vaccines should not be given to those that are immunocompromised, but to show how important the MMR vaccine is, physicians will give it to HIV patients who haven't had it yet despite the risks. There was been measles outbreaks in 2001 in US college-aged adults who seemed to only receive one dose of the MMR as a child. The MMR is now given as two doses.

Many young adults get pertussis because immunity from the vaccine only last about 15 years. Since the TDaP vaccine was developed physicians should make sure to give it to their adult patients every 10 years. The tetanus toxoid portion is important if there is a serious puncture wound and the patient hasn't had the vaccine in 5 years. The Diptheria toxoid portion seems to prevent colonization of C. diptheriae.

As for your autism link, it is mainly parents who don't like the influenza vaccine because of the thimerosol mercury content. Though it is very small, and there has been no scientific evidence that there is a link with autism. Parents also don't like the influenza vaccine because they think it gives them the flu when "the flu" means different things to different people. Many people associate norovirus "stomach flu" with the influenza virus and any kind of upper respiratory tract infection with the flu.

The US has enough smallpox vaccine stockpile to vaccinate the population within a few days in case of a terrorist attack. Smallpox is one of the few infectious agents that has been fully eradicated from the human population.

Polio is nearing eradicated status except for a few areas where it is endemic.

There is a new rotavirus vaccine for young children since the old one was linked to intussusception. It is only needed in infants, as most people have lasting immunity due to childhood exposure.
Click to expand...

My goal here is basically random facts about vaccines...Because what is written in the book and what happens in the real world often is 2 different things...Also the immuniztion schedule is always changing...
This is a hi yield topic that will come up again and again in most medical exams And an area where we are often affective...
Im aware of how vaccines have helped the world population...But I know that some harm has been done also..
Im just trying to cover all bases. Thank very Much for you input...🙂
 
mjl1717 said:
My goal here is basically random facts about vaccines...Because what is written in the book and what happens in the real world often is 2 different things...Also the immuniztion schedule is always changing...
This is a hi yield topic that will come up again and again in most medical exams And an area where we are often affective...
Im aware of how vaccines have helped the world population...But I know that some harm has been done also..
Im just trying to cover all bases. Thank very Much for you input...🙂
Click to expand...

Tetanus hurts like a bitch.


Oh and I believe that the Flu vaccine is associated with GBS.
 
mjl1717 said:
3)Trivia-(lower priority I think) some parents were associating vaccines with Autism..😕
Click to expand...

Notwithstanding articles in the popular media (Time and Newsweek), the scientific community takes the position that there is simply no link. Lots of studies have been done and to date there is no good evidence. The confusion here stems from the fact that autism is recognized at around the same years that many shots are given. So it's really a "true-true- but unrelated" issue. There is no link, other than the timing. If we gave the shots at different times, there would have been another culprit.
 
mjl1717 said:
My goal here is basically random facts about vaccines...Because what is written in the book and what happens in the real world often is 2 different things...Also the immuniztion schedule is always changing...
This is a hi yield topic that will come up again and again in most medical exams And an area where we are often affective...
Im aware of how vaccines have helped the world population...But I know that some harm has been done also..
Im just trying to cover all bases. Thank very Much for you input...🙂
Click to expand...

Sorry to tell you this but immunization random facts are pretty low yield on medical exams.
 
in other news carrying a lighter in your pocket has been statistically linked to lung cancer

more at 11
 
Law2Doc said:
Notwithstanding articles in the popular media (Time and Newsweek), the scientific community takes the position that there is simply no link. Lots of studies have been done and to date there is no good evidence. The confusion here stems from the fact that autism is recognized at around the same years that many shots are given. So it's really a "true-true- but unrelated" issue. There is no link, other than the timing. If we gave the shots at different times, there would have been another culprit.
Click to expand...

To my knowledge, the only scientific paper that has linked MMR to autism is

Wakefield AJ et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 1998 Feb 28;351(9103):637-41 PMID: 9500320

(Partial retraction in: Murch SH, Anthony A, Casson DH, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Valentine A, Davies SE, Walker-Smith JA. Lancet. 2004 Mar 6;363(9411):750)

It has since then been largely discredited because of:

1) Being pretty bad evidence to begin with: anecdotal evidence (a case series of 12) is the lowest form of evidence.
2) An undisclosed conflict if interest (I don't remember the exact details, but I believe the Wakefield study was funded by a group of parents who were in the process of litigation with the vaccine manufacturer, a fact that he failed to mention to Lancet)
3) A retraction by Lancet, as well as many (or was it all?) of the co authors withdrawing their names from the paper and the conclusion that MMR causes autism.

The consensus in the medical community (at least that part of it that practices evidence based medicine) is that there is NO EVIDENCE of the link between MMR vaccination and autistic disorders.
 
If William osler came back from the dead Id tell him that immunization along with Pennicillin (actually PCN may have save him) are probably 2 of the greatest creations that we have had in 100 years...

Some other points:

1) Although not really used in this country intra vesicular BCG is used to treat high risk Bladder CA!

2)Unfortunately post vaccination has been associated with acute Menningitis...

3)Swollen nodes in the neck are not uncommon after a series of vaccines..

4)As mentioned DPT is currently called T DAP..

5) Injected myself with a Flu vaccine while working at a shelter( it didnt bother me)

6) Geez!!-For the militaries sake Im happy they get those foreign vaccines (eg. Yellow Fever)
 
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gro2001 said:
3) A retraction by Lancet, as well as many (or was it all?) of the co authors withdrawing their names from the paper and the conclusion that MMR causes autism.
Click to expand...

If I recall correctly, it was all except one or two.
 
DTP isn't used anymore because the pertussis killed vaccine had some issues with it (supposedly). It is now acellular hence DTaP for children and TDaP for adults.
 
Tired said:
If I recall correctly, it was all except one or two.
Click to expand...

I hear ya.. Thats what Im saying.. There is a lot of s#@t (I dont use this word often) with these vaccines... [I just want to beat it into the ground]

1) If influenza vaccine and Tetanus is given to a pregnant women.. It would be given in the 2nd and 3rd trimester not the 1st..

2)Here in the Western hemispher we give an inactivated polio vaccine not the OPV! (we use to give the OPV..

3)Hep B vaccine and HBIG given post exposure, but only if the person doesnt have enough antibodies..
 
8 live viruses..MMR or SMALL Blistering Yellow Vesicles...

1)Measles> will shed in stool for 8 wks, need to tell women not to get pregnant for 2 months after recieving vaccine

2)Mumps
3)Rubella

4)OPV -will shed for 2 weeks
5)Rota virus

6)Smallpox
7)BCG

8)Yellow fever
9)Varicella

:idea:

Never ever give in an immunocompromised state or a pregnant female..
But a pregnant female can have a TB test...
 
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Let's not forget the rabies vaccine, talk about cost benefit ratio! ( i had a run in with a bat this year....)
 
mjl1717 said:
Immunizations is ONE of the areas where we are affective. (compared to heart disease and cancer)..There seems to be many variables and this area constantly changes..

Can you guys add any info you can? (no matter how trivia or common) Id like to beat this important area into the ground ..
Ill start:

1)MMR has at times been associated with SSPE(sub acute sclerosing encephalitis) MMR is given two times..

2) Meningitis vaccine has rarely been associated with Guilllian Barre syndrome...

3)Trivia-(lower priority I think) some parents were associating vaccines with Autism..😕
Click to expand...

Hep B vaccination is associated with demyelinating peripheral neuropathies that can be quite devastating. This is one of the more solid links out there.

And Gardasil is just plain stupid with regard to cervical cancer prevention. Probably effective from a genital warts perspective. It doesn't make sense from an epidemiological point of view. A 30% hole in coverage is HUGE and will only get bigger as the non-covered strains will increase in frequency now that the 2 biggies are inhibited. All we're doing is giving a competitive advantage to the other cancer-causing strains.

Oh and VACS and VAERS, by the CDCs own admission only pick up 1-10% of adverse events. Yet when we report rates of adverse events we use uncorrected figures. An order of magnitude or two can really affect the cost-benefit analysis, especially with regard to lifestyle-preventable illness.
 
mjl1717 said:
Do you guys take the flu vaccine?.. I took it once and that was it.. From what I see many docs do not take it..😕
Click to expand...

Many hospitals require physicians to have the flu vaccine. We are required as first and second year medical students to get it also. It's not about you. It's about you spreading the flu to patients.

geogil said:
Let's not forget the rabies vaccine, talk about cost benefit ratio! ( i had a run in with a bat this year....)
Click to expand...

Yeah if you don't get the human diploid cell vaccine plus rabies immunoglobulin you will die. The good thing about rabies is that it takes so long to travel up the peripheral nerves before you start getting hydrophobic and foaming at the mouth.

masterofmonkeys said:
Hep B vaccination is associated with demyelinating peripheral neuropathies that can be quite devastating. This is one of the more solid links out there.

Maybe, but this is only in the very small susceptible population where the only link between the two are temporal. All I have seen are a very small number of case studies on the subject. All babies are vaccinated and that is the way it should be. When adults come in without vaccination you can talk to them about it if they want it. Unless they are high risk it isn't really needed. Hep B is a devastating disease and C is worse. I hope a vaccine is on the horizon.

And Gardasil is just plain stupid with regard to cervical cancer prevention. Probably effective from a genital warts perspective. It doesn't make sense from an epidemiological point of view. A 30% hole in coverage is HUGE and will only get bigger as the non-covered strains will increase in frequency now that the 2 biggies are inhibited. All we're doing is giving a competitive advantage to the other cancer-causing strains.

Oh and VACS and VAERS, by the CDCs own admission only pick up 1-10% of adverse events. Yet when we report rates of adverse events we use uncorrected figures. An order of magnitude or two can really affect the cost-benefit analysis, especially with regard to lifestyle-preventable illness.
Click to expand...

Whatever you say Mr. Lifestyle preventable. Perhaps when you go into peds just tell your teenage patients that they shouldn't ever have sex because you won't offer them a vaccine. Soon young male adolescents are going to start getting the vaccine so Merck can start getting more money. The 4 HPV strains covered cause 70% of the cervical cancers and 90% of warts respectively. How can you argue with that? Perhaps other strains may increase in prevalence but this is in its infancy. The problem of course is that women still need regular pap smears due to the strains that are not covered. So hopefully in the future there is a vaccine with more cancer-causing strains.
 
Thank you for the info, some of which I didnt invision.. Dont be at odds too much...Because one of the greatest things that we do (as far as Im concerned ) is share information, facts and come up with new ideas..

And true, one of the profound things about the HPV vaccine is that it is in the earliest stages of development!

I will actually admit that this "vaccine thing" to me at times seems overwhelming, mostly becuase it is so relavent, people asking about side effects and reactions, parents and kids with skeptical eyes, as well as covering the spectrum of the most common-fever to most lethal acute encephalitis, [the attitude of "get the epinephrine ready"!] plus the obscure entities! Thank you guys!.. 👍
 
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TMP-SMX said:
Whatever you say Mr. Lifestyle preventable. Perhaps when you go into peds just tell your teenage patients that they shouldn't ever have sex because you won't offer them a vaccine. Soon young male adolescents are going to start getting the vaccine so Merck can start getting more money. The 4 HPV strains covered cause 70% of the cervical cancers and 90% of warts respectively. How can you argue with that? Perhaps other strains may increase in prevalence but this is in its infancy. The problem of course is that women still need regular pap smears due to the strains that are not covered. So hopefully in the future there is a vaccine with more cancer-causing strains.
Click to expand...


I actually stated that as warts prevention goes, the HPV vaccine is fine. But as of right now, as cancer prevention, every time we use it, the efficacy goes down. Every minute of every day it is falling from 70% to lower. And the more people who get it, the further it will fall. It is basic epidemiology/evolutionary biology/microbiology.

If they wanted the vaccine to be effective in cancer prevention it should have been LAUNCHED with more strains covered. All we've done is complicate the picture for the future.

I am not anti-vaccine. And in fact I really don't have a problem with vaccines other than gardasil and hep b. And even there it's a relative problem rather than an absolute one. If you look at the hep b studies they decided that the risk of neurologic damage to anyone who received the vaccine was worth it given that it would still be of benefit in the 'high risk' groups. So we were exposing EVERYONE to the risk of vaccine to benefit only a small portion of the population. I have a problem with that kind of logic.

With gardasil, it's a different sort of thing. Everyone has sex. I somehow got through college and med school without tripping and falling penis-first into a vagina, but I recognize that most people don't. I think it's fine as wart protection goes. But it doesn't make epidemiological sense to release a vaccine with 70% coverage of cancer-causing strains, at any level.

And I continue to have a problem with how weak the VACS and VAERS system are and given that the organizations that publish these figures acknowledge these figures, continue to ignore them.

And for some fun, go read up on what they used as a placebo in the gardasil safety studies. And if you are REALLY interested compare the effects of the placebo they used to something more innocuous like normal saline.

You probably think I'm some sort of bible thumping conservative. I'm probably more socially liberal than you are. I just have a problem with some of the logic we use in 'public health'.
 
TMP-SMX said:
Yes it is eradicated from the human population, however it is stored in labs here and abroad. It could potentially be used for bioterror.
Click to expand...
I think that the only stocks of smallpox are in the CDC in the US and at one lab in Russia. The story of its eradication is just awesome. We completely annihilated it.
 
mjl1717 said:
I heard its not unusual to have a high fever for a few days after the rabies vaccine..
Click to expand...

My father-in-law runs a public health lab and had to get a rabies vaccine. He had a fever ~102-103 for two or three days, called his doc who told him that can happen w/ the rabies vaccine. He finally went to the ER and turned out he had pneumonia. Just for fun I looked the vaccine up and it said low grade fever can be associated with the vaccine.
 
nogolfinsnow said:
My father-in-law runs a public health lab and had to get a rabies vaccine. He had a fever ~102-103 for two or three days, called his doc who told him that can happen w/ the rabies vaccine. He finally went to the ER and turned out he had pneumonia. Just for fun I looked the vaccine up and it said low grade fever can be associated with the vaccine.
Click to expand...

Yes thank you, Im trying to only quote reliable sources..
 
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I know that the military gets Typhoid fever vaccine and I believe Japanese encephalitis times 3.. Saw this last weekend.

Once again , please add any thing that you can about vaccines...Thank you..

👍
 
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theprowler said:
i think that the only stocks of smallpox are in the cdc in the us and at one lab in russia. The story of its eradication is just awesome. We completely annihilated it.
Click to expand...

"We came, we saw, we kicked its ass!"

-Dr. Peter Venkhmen
 
Persons with IgG defiencies are not more susceptible to viral infections....However IgG deficient patients are susceptivle to poliovirses(and should not recieve live virus vaccine) and to hep A and Hep B..
This is one reason that we give inactivated polio vaccine here in the states..

Also I see that antitimor vaccines are on the horizon.

["Advanced Medicine Recall"-James D. Bergin]🙂
 
Found out that a nursing woman can take the Flu vaccine!!.. I know this because I called the C.D.C. yesterday and they confirmed this..... A person answered and they were pretty efficient answering there 1 800 232 4636 phone number..🙂
 
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vasca said:
BCG
Click to expand...

BCG is a whole different ballpark. It doesn't prevent TB infection. It may reduce mortality (supposedly) but we are able to treat it here (to those willing to take months of hepatotoxic drugs). Using BCG would remove the usefulness of the PPD skin test for Mycobacterium screening. TB has nothing to do with upscale neighborhoods. At this point in the US, it is a disease of poverty or of those in inner cities with other co-morbid conditions.

People with TB are isolated with negative pressure rooms in hospitals to try to reduce transmission. There is always a risk, but this is why we have the PPD to screen every year.

As for the flu, all it takes is someone coughing on you and then you'll be spreading it to your patients. "Stomach flu" or noroviruses, usually cause outbreaks with food but can also be transmitted by a fecal-oral route. Washing your hands is a good prevention for that. It's not about you, it's about making sure you don't infect patients. Plus, if you infect other physicians it's a bit hard trying to treat patients with no physicians.

As for Hep A, you are doing a dangerous thing. As you age, that Hep A has a higher risk of fulminant hepatitis.

As for Hep B, you should get a titer to measure your antibody levels. Hep B is dangerous. I have someone close to me that has Hep B and C with cirrhosis from a blood transfusion in the 80s with postpartum complications. Also with latent TB (from Poland). You can guess what the result is going to be after transplant and immunosuppressives. Osteoarthritis is also there but you can't do any surgeries until the liver is functioning.

This underscores the importance of Hep B vaccination and research for a Hep C vaccine.
 
TMP-SMX said:
At this point in the US, it is a disease of poverty or of those in inner cities with other co-morbid conditions.
Click to expand...

Actually, even in the inner-cities it's a pretty negligible problem. Basically it's limited to recent immigrants, the majority of whom bring it with them.

TMP-SMX said:
As for Hep A, you are doing a dangerous thing. As you age, that Hep A has a higher risk of fulminant hepatitis.
Click to expand...

And he's in Mexico . . . which makes the vaccine a no-brainer.

Honestly, the whole post makes me worry about medical education in Mexico.
 
Tired said:
Actually, even in the inner-cities it's a pretty negligible problem. Basically it's limited to recent immigrants, the majority of whom bring it with them.



And he's in Mexico . . . which makes the vaccine a no-brainer.

Honestly, the whole post makes me worry about medical education in Mexico.
Click to expand...

TB also has a higher incidence in a crowded jail situation..
From reactivation of latent T.B. especially if the person is HIV positive or immunocompromised..
 
mjl1717 said:
From what I hear, some are associating the MMR with Autism.. I find this hard to believe?? 😕
Click to expand...

Correlation does NOT equal causation.

The fact that autism is being diagnosed after MMR vaccine does not mean the vaccine caused it especially when you consider the millions of kids that recieve it every year.
 
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