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Rapid Responses: Rapid Responses published:
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Chiropractic and measles
- Edzard Ernst (5 December 2008)
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Measles outbreaks and epidemics occur in the vaccinated, not because chiropractors and homeopaths allegedly advising parents not to vaccinate their childen
- Viera Dr Scheibner PhD (6 December 2008)
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Measles vaccine, measles outbreaks and side effects of the vaccine.
- Peter J Flegg (18 December 2008)
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Edzard Ernst, Director of Complementary Medicine Peninsual Medical School, Universities of Exeter & Plymouth
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According to recent reports 1, the UK is heading towards a “large epidemic”: 78 cases were registered in 2005, 740 in 2006, 990 in 2007 and 1049 in the first 10 months of this year. Mass vaccination is currently underway in Cheshire 2, and GPs are urged to offer “catch-up” immunisations to reduce the risk 1 . This situation is not helped by some chiropractors advising against immunisations 3. One of the founding fathers of chiropractic wrote “the idea of poisoning healthy people with vaccine virus…is irrational…” and likened immunisation to “being inoculated with rotten pus, which, if it takes, is warranted to give [children] a disease” 4. This was ~100 years ago, and one might have hoped that chiropractors’ attitudes have now changed. On 3 December 2008, I googled “chiropractic/measles” and received 82400 hits. I analysed the first 12 websites from chiropractors or their organisations. One was pro-immunisation and one seemed neutral. The rest promoted anti-vaccination attitudes claiming that measles vaccinations were harmful (n=4) or useless (n=4) or that the germ theory was doubtful (n=1). Four sites recommended “natural” therapies, including chiropractic, instead of immunisation. If we want to avert the epidemic, we should also try to convince anti -vaccinationists like chiropractors or homeopaths 3. E. Ernst Reference List (1) Kmietowicz A. Doctors fear epidemic as measles cases in England and Wales reach highest point for 13 years. BMJ 2008; 337:1312-1313. (2) Carvel J. Warning of measles epidemic risk as cases rise sharply. The Guardian 2008; 29 November:15. (3) Schmidt K, Ernst E. Aspects of MMR. BMJ 2002; 325:597. (4) Palmer BJ. The Science or Chiropractic: Its Principles & Adjustments. Davenport, Iowa: The Palmer School of Chiropractic. 1906. Competing interests: None declared More details of the search [added by BMJ on 22.12.08] The search term was "chiropractic measles" in a Google search. The 12 websites are listed below. 1) chiropractic anti-vaccine - why do they wage all out war on public health - http://www.healthwatcher.net/chirowatch.com/Chiro-anti-vax/index.html 2) chiropractic west palm beach, florida – http://cw11.empowereddoctor.com/doctor_story.php?storyid=103&id=2096 3) chiropractors on vaccination http://www.whale.to/m/chiropractors9.html 4) landi chiropractic office http://www.landichiropractic.com/ 5) the great measles misunderstanding http://www.planetc1.com/cgi-bin/n/v.cgi?c=1&id=1205211519 6) issues in chiropractic pediatrics: vaccination http://www.chiro.org/LINKS/ABSTRACTS/Issues_in_Chiropractic_Pediatrics.shtml 7) welcome to chiropractic health clinic http://www.chiropractichealthclinic.com/expect.html 8) ICPA-childhood diseases http://www.icpa4kids.org/research/chiropractic/diseases.htm 9) cornerstone family chiropractic, the story of masha and dasha http://www.cornerstonefamilychiropractic.com/Research/MashaandDasha.aspx 10) FTC questions chiropractor's claims http://www.chiroweb.com/mpacms/dc/article.php?id=37450 11) boosting your immunity with chiropractic http://www.campchiropractic.com/boosting_your_immunity.htm 12) chiropractic and infectious disease - an historical perspective by dr christopher kent http://www.worldchiropracticalliance.org/tcj/2003/apr/apr2003kent.htm ref1 was pro immunisation
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Viera Dr Scheibner PhD, Scientist/Author Retired Blackheath NSW Australia
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Dear Editor, Ever since the introduction and mass use of any measles vaccine (whether containing 'live' of 'dead' virus), reports of outbreaks and epidemics of measles in the vaccinated started filling pages in orthodox medical research papers. Measles vaccine virus is inactivated by subjecting it to formaldehyde treatment, which is subject to asymptotic factor, meaning within about 40 hours, most viruses are inactivated, but afterwards there is a viable residue of live viruses indefinitely. This phenomenon was described in inactivation of polio viruses (Gerber et al. 1961), but it is valid for all viruses and even for bacteria and toxins (Samore and Siber 1992). Moreover, even the inactivated viruses revert back to the original virulence when introduced into the recipients of the vaccine (Fenner 1962). That is the real reason why outbreaks of viral (and bacterial, or toxin mediated) diseases followed vaccination drives. Measles is no exception. The net result of the introduction and mass use of measles vaccines is: 1) Outbreaks of measles at the time when due to the natural dynamics there would have been no outbreaks. The example of the Amish is instructive in that they claim religious exemption, and yet, they had not reported a single case of measles for 18 years, between 1970 and the end of 1987 (Sutter et al. 1991). This was also the time when the well- vaccinated non-Amish communities experienced regular 2-3 year measles epidemics; obviously, the vaccine kept measles alive and kicking. Rauh and Schmidt (1965) described a 1963 epidemic of measles in Cincinnati and wrote "It is obvious that three injections of killed vaccine had not protected a large percentage of childen against measles when exposed within a period of two-and-a-half years after immunization". Measles outbreaks in 100% vaccinated populations have continued anabated. Robertson et al. (1992) wrote that in 1985 and 1986, 152 measles outbreaks in the US school-age childrden occurred among persons who had previously received measles vaccine. "Every 2-3 years, there is an upsurge of measles irrespective of vaccination compliance." Linnemann et al. (1973) demonstrated that measles vaccines were not provoking a proper immunological response in vaccinated children. 2) A new phenomenon occurred: vaccinated children developed atypical an especially vicious form of measles, with 12-15% mortality, due to altered host immune response due to deleterious effect of the vaccine (Fulginiti et al. 1967). 3) With passing years, younger and younger children contracted measles indicating poor or no transplacentally-tranmsmitted immunity (TTI). These wre the babies born to mothers who were vaccinated as children (Lennon and Black 1986). 4) Besides their ineffectiveness to prevent measles, the vacines caused a host of serious reactions (Scott and Bonnano (1967); Landrigan and Witte (1973)). Indeed, they resulted in the appearance and/or increase in degenerative diseases of bone and cartilage, sebceious skin diseases, immunoreactive diseases and cancers (Ronne 1985). Indeed, well managed (not suppressing fever and not administering any drugs), measles, and other infectious disease of childhood, are beneficial by priming and maturing the immune system and representing developmental milestone. It is the inherent problems with measle vaccines that result in outbreaks and epidemics of measles. Why not let Nature do its own thing; it does it so much better than homo sapiens (or is it homo stupidissimus?) References Gerber P, Hottle GA and Grubbs RE. 1961. Inactivation of vacuolating virus (SV40) by formaldehude. Proc Soc Exp Biol & Med; 108: 205-209. Samore MH, and Siber GR. 1992. Effect of pertussis toxin on susceptibility of infant rats to Haemophilus influenzae Type b. J Infect Dis; 165: 945-948. Fenner F. 1962. The reactivation of animal viruses. BMJ; July 21: 135-142. Sutter RW, Markowitz LE, Bennetch JM, Morris W, Zeil ER, and Preblud WSR. 1991. Measles among the Amish: a comparative study of measles severity in primary and secondary cases in households. J Infect Dis; 163: 12-16. Rauh LW, and Schmidt R. 1965. Measles immunization with killed virus vaccine. Am J Dis Child; 109: 232-237. Robertson SE, Markowitz LE, Dini EF, and Orenstein WA. 1992. A million dollar measles outbreak: epidemiology, risk factors, and selective revaccination strategy. Publ Health Reports; 197 (1): 24-31. Linnemann CC, Hegg ME, Rotte TC et al. 1973. Measles MGE response during re-infection of previously vaccinated children. J Pediatrics; 82: 798-801. Fulginiti VA, Eller JJ, Downie AW, and Kempe CH. 1967. Altered reactivity to measles virus. Atypical measles in children previously inoculated with killed-virus vaccines. JAMA; 202 (12): 1075-1080. Lennon JL, and Black EI. 1986. Maternally derived measles immunity in era of vaccine-protected mothers. J Pediatrics; 108 (1): 671-676. Scott TF, and Bonnano DE. 1967. Reactions to live-measles-virus vaccine in children previously inoculated with killed-virus vaccine. NEJM; 277 (5): 250-251. Landrigan PJ, and Witte JJ. 1973. Neurologic disorders following live measles-virus vaccine. JAMA; 223 (13): 1459-1462. Ronne T. 1985. Measles virus infection without rash in childhood is related to diseases in adult life. Lancet; Jan 5: 1-5. Competing interests: None declared |
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Peter J Flegg, Consultant Physician Blackpool, FY3 8NR
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Viera Scheibner plainly doesn’t like vaccines. She has produced a list of horrors which are “The net result of the introduction of measles vaccines”. This list is nothing less than her personal opinion dressed up with some references to scientific papers that have been both misrepresented and misinterpreted so as to provide a semblance of (non- existent) evidence for her claims. Firstly, Dr Scheibner says one of the consequences of the use of measles vaccines is “outbreaks of measles at the time when due to the natural dynamics there would have been no outbreaks”. Dr Scheibner states that it is measles vaccination that is the cause of outbreaks and epidemics. In the prevaccination era, outbreaks of measles typically occurred in 2-year cycles (because in the year following an outbreak there was good protective herd immunity, and one had to wait until the pool of susceptible infants grew sufficiently large over the next year to reach the point where a new outbreak among them would happen). Of course, now that vaccination is so effective at preventing measles, we do not see these biannual cycles, and instead become susceptible to outbreaks far less frequently. When they do occur, they do so primarily in the unvaccinated population, and not in those who have had full measles vaccination, so they are quite limited in terms of the numbers affected. Of course, if no one vaccinated, we would see a return to the days when every single child got measles in the first few years of life, like it or not. Measles would be hyperendemic. Dr Scheibner says that “Measles outbreaks in 100% vaccinated populations have continued anabated[sic].” In fact the reference she gives to support this claim says nothing of the sort. Robertson et al published the experience of the Arkansas outbreak of 1986 (1). This was at a time when measles vaccine was still given as a single dose following the first birthday. Between 8-10% of the children at the affected schools had not been vaccinated. Study of the records for one school revealed the following: Measles attack rate for unvaccinated children was 60%, confirming the high likelihood of catching measles if you were unprotected. The relative risk of catching measles was 20.2 for an unvaccinated child compared to a child who had one dose of vaccine over the age of 15 months (for whom the attack rate was 3%). Since measles vaccine is not 100% protective and there is a risk of primary vaccine failure, a small percentage of exposed but vaccinated children developed measles, particularly if they are younger than 12 months. This finding prompted vaccination policy to recommend a second booster dose of measles vaccine, something that has proved to be very successful. This paper does not suggest that outbreaks occur in "100% vaccinated" populations as she claims. Secondly, Dr Scheibner refers to the phenomenon of atypical measles. This is something that can occur in those who have had killed measles vaccine (something that has not been used for decades) and who are subsequently infected with wild measles virus. This phenomenon is of historical importance, and is of no relevance to current vaccinology. (It was also actually an argument for vaccinating those who have had killed virus vaccine with the “newer” live vaccine, in order to guarantee protection against natural measles.) Thirdly, Dr Scheibner points to the phenomenon of lower maternal measles immunity among mothers vaccinated rather than having natural measles, which she presumably feels is a problem. The estimated age of loss of maternal protection in the infants of vaccinated mothers is 8.5 months rather than 11.5 months in infants of mothers who have had natural measles. It is true that infants of vaccinated mothers would become susceptible to measles from the age of 9 months (and would only be due to get vaccinated at 12 months), but herd immunity should normally be sufficient to protect this group during these 3 months of higher susceptibility. Of more relevance is the decision as to when to give children their first vaccine dose – this has traditionally been 12 months, but as the majority of mothers having children will be vaccinated, there is a valid argument for bringing this forward to 9 months. This issue, while perplexing for vaccination policy makers, is hardly an example of the evils of measles vaccine. Fourthly, Dr Scheibner says measles vaccine is “ineffective” at preventing measles (it is not). She also says it has caused “a host of serious reactions”. Her references to these “serious reactions” consist of one paper pointing to reactions from live virus vaccine following initial killed vaccine administration (these reactions were local skin reactions, and are of historical interest only); one paper pointing out that vaccine recipients are still susceptible to neurological effects of vaccine strain measles virus (such as encephalitis);- this they are, but at a much lower rate than occurs with natural measles; and finally a paper suggesting a hypothesis (not subsequently confirmed) that someone who acquires measles naturally and is also given normal immunoglobulin at the time might have persistence of measles antibodies and develop long term health problems. This scenario is, like the others Dr Scheibner mentions, is largely of minimal historical interest and it has nothing to do with the modern use of measles vaccines. If these examples are the best Dr Scheibner can come up with to illustrate measles vaccines “serious reactions”, I am decidedly underwhelmed. That is not to say that measles vaccine cannot cause reactions; it undoubtedly can. But it is mistaken of Dr Scheibner to use outdated examples of rare, theoretical or non-existent reactions and combine these with incorrectly interpreted references in order to support her advice that we should cease to vaccinate against measles and “let Nature do its thing”. Experience has taught us that even in countries with good health care infrastructure, natural measles infection will hospitalise 20% of its sufferers, one in 200 will have a convulsion, one in 1000 will get brain damage through encephalitis, and it will kill one in every 5000. Dr Scheibner may feel having measles is harmless, but that sentiment would only apply to those who are fortunate to survive its consequences. I have discussed the risk/benefits of vaccination against measles in several other BMJ rapid responses; perhaps Dr Scheibner can read these. It is clearly much, much more dangerous to have measles than it is to have the vaccine. (1). Robertson SE et al. A million dollar measles outbreak: epidemiology, risk factors and selective revaccination strategy. Public Health Reports 1992; 197(1): 24- 31 Competing interests: None declared |
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