Vaccine of the day: Flu

It's this time of a year again. The flu season just started and so did the endless (free) flu shot advertizements. I don't watch TV (except for HGTV and only when in a hotel, like now, as we don't have HGTV at home), so I don't notice the scare commercials so much these days. I have also never have and never will get a flu shot. Nor will I allow P to get one before he is 21 and can decide for himself. But either way, I decided to do a bit of research on how really dangerous is the flu. Please note that my only source of information is CDC website, so it's all legit (well, as legit as it gets, anyway).

Estimates of Deaths Associated with Seasonal Influenza --- United States, 1976--2007 (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5933a1.htm):

"A previous study (2) presented an average annual estimate of 25,420 influenza-associated respiratory and circulatory deaths during a 23-season period; this study estimated an average of 23,607 annual influenza-associated deaths using the same model but over a 31-year period. The findings in this report are similar to those of previous CDC studies (2,3) and other cross-decade studies that used similar models (4,7).

(...)

Variations in influenza-associated mortality by age group also should be noted. As reported in this and other studies (2,3), approximately 90% of influenza-associated deaths occur among adults aged ≥65 years. An estimated annual average of 124 persons aged <19 years and 2,385 aged 19--64 years die from influenza-associated respiratory or circulatory causes. (...)"

If I am reading it correctly, an estimated average of 124 persons aged 0-19 died of influenza annually between 1976 and 2007. Per Census data (http://www.census.gov/prod/cen2010/briefs/c2010br-03.pdf), there were 74,181,467 persons under 18 in 2010 (we are not even including those who were 18 and 19 in 2010, which would make the chances even smaller). 124 accounts then for... 0.000167% (rounded here), which is 0.00000167. Just to compare, the chances of getting stuck by lightning are 0.00000143. This number includes those with compromised immune system, so the chances for a young healthy person are most likely significantly smaller than even that tiny number.

Let's look at the rest of the population. Again, if I am reading it correctly, an estimated 2,509 persons 65 and younger died annually of influenza during the same time period. The same Census report estimates 308,745,538 total population for 2010 including 40,267,505 over the age of 65, which leaves 268,478,033 younger than 65 (again, this number doesn't include people who actually were 65 in 2010). This means that an average person younger than 65 has 0.000935% or 0.00000935 (rounded) chance of dying from the flu.

Just as a comparison, here is a link to Leading Causes of Death (http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm) which lists the following 10 top causes and the numbers:


Heart disease: 596,577
Cancer: 576,691
Chronic lower respiratory diseases: 142,943
Stroke (cerebrovascular diseases): 128,932
Accidents (unintentional injuries): 126,438
Alzheimer's disease: 84,974
Diabetes: 73,831
Influenza and Pneumonia: 53,826*
Nephritis, nephrotic syndrome, and nephrosis: 45,591
Intentional self-harm (suicide): 39,518

* includes both Influenza AND Pneumonia

With approximated 25,000 deaths per year (90% of which in population 65 and older), influenza is far from being a real threat.

Now, even if you do get the vaccine, the antibodies, which are supposed to prevent you from getting the flu, do not develop in the body until about two weeks after vaccination (http://www.cdc.gov/flu/protect/keyfacts.htm). However, even if it worked, the vaccine is designed to work against only 63% of all flu viruses (http://www.cdc.gov/flu/news/nasal-spray-effectiveness.htm):

"Of the subtyped viruses reported to CDC from the week ending October 5 through the week ending October 25, 2014, 387 (31%) have
been H3N2 viruses, 387 (31%) have been influenza B viruses and 16 (1%) have been H1N1 viruses. Another 466 influenza A viruses were not subtyped."

The flu vaccine works only against the H3N2, H1N1, and influenza B, therefore it does not work against 37% of other influenza viruses.

Now, I showed above that there is a really, really, really small chance of dying of the flu. But the flu isn't fun anyway, I get that. I would rather not get the flu, and not feel like cra* for a week. Unfortunately (to those who think getting the shot will prevent that) there are some side effects you are likely to get after getting the flu shot (http://www.cdc.gov/flu/protect/keyfacts.htm). Ant they are:

• runny nose, nasal congestion or cough
• fever
• headache and muscle aches
• wheezing
• abdominal pain or occasional vomiting or diarrhea
• sore throat
• cough, chills, tiredness/weakness

Well, if I feel like this, I really don't care if you call if a flu or flu vaccine side effect.

Lastly, if you actually do get the flu, you can still be treated! Per CDC (http://www.cdc.gov/flu/antivirals/whatyoushould.htm): "There are prescription medications called "antiviral drugs" that can be used to treat influenza illness." Don't get me wrong, I do NOT recommend taking them (what I would do if I got a flu is a story for another post), but there clearly are alternatives or options for someone who does get the flu.

So, no flu vaccine for us. But, as always, you need to decide for yourself.

Vaccine of the day: Measles

A while ago, over a year, actually, I promised myself to do research about one vaccine (or disease) a month. This went nowhere as I would always find some great articles about other vaccines/diseases and get sidetracked. But today I found a lot of great articles from US National Library of Medicine National Institutes of Health that are related to Measles and vaccines against it. Here is the list, not in any particular order:

1. Measles incidence, vaccine efficacy, and mortality in two urban African areas with high vaccination coverage. (“Even though 95% of the children had measles antibodies after vaccination, vaccine efficacy was not more than 68%.”) - http://www.ncbi.nlm.nih.gov/pubmed/2230232

2. Measles-specific neutralizing antibodies in rural Mozambique: seroprevalence and presence in breast milk. (“A notable proportion of the population in Manhiça, Mozambique apparently remains susceptible to clinical measles despite recent mass vaccination campaigns.”) - http://www.ncbi.nlm.nih.gov/pubmed/18981523

3. An evaluation of measles serodiagnosis during an outbreak in a vaccinated community. (“A history of prior vaccination is not always associated with immunity nor with the presence of specific antibodies.”) - http://www.ncbi.nlm.nih.gov/pubmed/3168353

4. Herd immunity. Measles outbreak in a fully immunized secondary-school population. (“We conclude that outbreaks of measles can occur in secondary schools, even when more than 99 percent of the students have been vaccinated and more than 95 percent are immune.”) - http://www.ncbi.nlm.nih.gov/pubmed/3821823

5. A persistent outbreak of measles despite appropriate prevention and control measures. (“This outbreak suggests that measles transmission may persist in some settings despite appropriate implementation of the current measles elimination strategy.”) http://www.ncbi.nlm.nih.gov/pubmed/3618578

6. Major measles epidemic in the region of Quebec despite a 99% vaccine coverage. (“Vaccination coverage for the total population was 99.0%. Incomplete vaccination coverage is not a valid explanation for the Quebec City measles outbreak.”) http://www.ncbi.nlm.nih.gov/pubmed/1884314

7. How threatening is measles in a civilized country. Clinical and epidemiological findings during a measles outbreak occurring in a population with a high vaccination coverage. (“One or more complications were reported for 68 cases and in 8.9% of the studied cases hospitalization was required.”) - http://www.ncbi.nlm.nih.gov/pubmed/8668833

8. The 1992 measles epidemic in Cape Town--a changing epidemiological pattern. (“The possible reasons for this [outbreak] include both primary and secondary vaccine failure.”) - http://www.ncbi.nlm.nih.gov/pubmed/7740350

and the last but not least:

9. Lack of correlation between the number of measles cases (goes up and down) vs. vaccination efforts (increased with time). However, there seems to be another trend: With more children being vaccinated over the years, more of the little ones become sick with Measles (median age fell from almost 7 years to 14 months and to 11 months. Note, first Measles vaccine is given in China at 9 months). Monitoring progress towards the elimination of measles in China: an analysis of measles surveillance data ("The number of provinces that reported an annual incidence of less than one case per million population increased from one in 2009 to 15 in 2012 but fell back to one in 2013. Median case age decreased from 83 months in 2005 to 14 months in 2012 and 11 months in January to October 2013. Between 2008 and 2012, the incidence of measles in all age groups, including those not targeted for vaccination, decreased by at least 93.6%.") - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4007128/

Enjoy.

Parker turns 3

I can't believe Parker is already 3! I don't have much time to write now so this will be quick. Just wanted to note that he dropped his naps almost entirely (takes a nap 1-2/week). Wakes up around 7 am and goes to sleep at 6 if you let him. :) Unfortunately, due to our work schedule we can't put him to sleep until closer to 7 or 8 (we don't come home until 6:30-6:45). In this case he is exhausted and his sleep is not very restful as he wakes up multiple times. Those days he is likely to fall asleep at 6 pm. Last Monday I teleworked from a coffee shop and Aga and Parker came to see me on the way from school. We had lunch together and they decided to stay as there was a playroom attached where Parker played. Parker and I walked home and he ended up falling asleep in my arms at 5:45. Marc and I tried to wake him up for an hour after which we changed him into his PJs and let him sleep,. He didn't wake up until 6:45 am.

Parker goes to a Montessori school 5 days a week from 8:45 to 12. He likes it a lot and really likes one of his teachers, Ms. E. Drop off was pretty hard the first few times but now, after over a week, he is happy to go and there are no tears.

P's allergy "status" has changed since last year. We have confirmed that he has dairy and chick peas allergy, however he does NOT have sesame seed allergy. Unfortunately, he has a pretty bad soy allergy.

He loves soups, pasta, and rice. He likes broccoli, cucumber, tomato and avocado in a form of guacamole. :) He also loves the "healthy" (if such exists) cereal. :)

Parker loves letters, numbers, and shapes. And he is into languages. His first language is Polish (still) and second is English, of course. Lola still speaks to him in Spanish but he is no longer as interested in Spanish as he was a couple of months ago. His new love is Russian! He taught himself Russian alphabet and asks us to tell him how to say things in Russian. He names letters in Russian (so B is Veh and P is R).

Here is the newest picture taken on our vacation at the OBX a few days before his third birthday.

Vaccine of the day: Polio

Parker hasn't been vaccinated for the most part. He got the HEP B vaccine and vit K in his first 24 hours of life.

Parker also has dairy, sesame seed, and chick peas allergy (that we know of). I may be a coincidence or it may not.

We will be faced with the decision about vaccinating very shortly, as we have decided to postpone vaccinating (if we ever decide to) until P is at least 2. The first two years are crucial for the development of a child's immune system so we didn't want to interfere with it.

Since his 2ndbirthday is approaching, I decided to do research about each vaccine/disease separately in order to see whether we vaccinate against it or not. My research will concentrate on two fronts:

1. The benefits (severity of the disease, chances of getting it, etc.)

2. The risks (what's in the vaccine, how it's made, potential side effects and long term risks, etc.)

Also, I want to rely on sources that are not against vaccines by default. I.e. as a source I may use a study cited on an anti-vaccine website, but the articles on such website will not be used as primary evidence.


POLIO

The research about Polio disease has proved to be fairly straight forward.

WHO site (http://www.who.int/mediacentre/factsheets/fs114/en/) as of July 3. 2013:

- 223 reported cases in 2012.
- In 2013, only three countries (Afghanistan, Nigeria and Pakistan) remain polio-endemic, down from more than 125 in 1988.
- One in 200 infections leads to irreversible paralysis. Among those paralysed, 5% to 10% die when their breathing muscles become immobilized."


CDC (http://www.cdc.gov/vaccines/vpd-vac/polio/in-short-both.htm):
Polio is spread by person-to-person contact and only affects humans.


There are 7 billion people living on earth, the chance that it will be you or me is 223/7,000,000,000 (my calculator couldn't display this number as it is so small). That's assuming we all have the same chance of getting it. The fact that we don't live in any of the "hot zone" countries, diminishes the chances even further.


Polio symptoms from CDC (http://www.cdc.gov/vaccines/vpd-vac/polio/in-short-both.htm)

Approximately 95% of persons infected with polio will have no symptoms. About 4-8% of infected persons have minor symptoms, such as fever, fatigue, nausea, headache, flu-like symptoms, stiffness in the neck and back, and pain in the limbs, which often resolve completely. Fewer than 1% of polio cases result in permanent paralysis of the limbs (usually the legs). Of those paralyzed, 5-10% die when the paralysis strikes the respiratory muscles. The death rate increases with increasing age.:


Polio vaccine

Ingredients from CDC (http://www.cdc.gov/vaccines/vpd-vac/polio/in-short-both.htm):

Polio (IPV – Ipol): 2-phenoxyethanol, formaldehyde, neomycin, streptomycin, polymyxin B, monkey kidney cells, Eagle MEM modified medium, calf serum protein

2-phenoxyethanol - preservative. From http://www.sciencelab.com/msds.php?msdsId=9926486:

Potential Acute Health Effects:
Extremely hazardous in case of eye contact (irritant). Very hazardous in case of skin contact (irritant), of ingestion, of inhalation. Inflammation of the eye is characterized by redness, watering, and itching. Skin inflammation is characterized by itching, scaling, reddening, or, occasionally, blistering.
Potential Chronic Health Effects:
Extremely hazardous in case of eye contact (irritant). Very hazardous in case of skin contact (irritant), of ingestion, of inhalation. CARCINOGENIC EFFECTS: Not available. MUTAGENIC EFFECTS: Not available. TERATOGENIC EFFECTS: Not available. DEVELOPMENTAL TOXICITY: Not available. The substance is toxic to kidneys, the nervous system, liver. Repeated or prolonged exposure to the substance can produce target organs damage. Repeated or prolonged inhalation of vapors may lead to chronic respiratory irritation.

formaldehyde - preservative. In 2011, the US National Toxicology Program described formaldehyde as "known to be a human carcinogen".

In another study I found the following: Formaldehyde is weakly genotoxic and was able to induce gene mutations and chromosomal aberrations in mammalian cells. DNA-protein crosslinks are a sensitive measure of DNA modification by formaldehyde. However, the genotoxic effects were limited to those cells, which are in direct contact with formaldehyde, and no effects could be observed in distant-site tissues. In conclusion, formaldehyde is a direct acting locally effective mutagen.

neomycin, streptomycin, polymyxin B - antibiotics


monkey kidney cells - well, monkey kidney cells

Eagle MEM modified medium - one of the most widely used of all synthetic cell culture media. I haven't found any signs of it being toxic.

calf serum protein - haven't found anything of toxicity but it is derived from unborn calf fetuses in a non humanitarian way.


Meanwhile in India (from PubMed.gov http://www.ncbi.nlm.nih.gov/pubmed/22591873):
It was hoped that following polio eradication, immunisation could be stopped. However the synthesis of polio virus in 2002, made eradication impossible. It is argued that getting poor countries to expend their scarce resources on an impossible dream over the last 10 years was unethical. Furthermore, while India has been polio-free for a year, there has been a huge increase in non-polio acute flaccid paralysis (NPAFP). In 2011, there were an extra 47,500 new cases of NPAFP. Clinically indistinguishable from polio paralysis but twice as deadly, the incidence of NPAFP was directly proportional to doses of oral polio received.

[ME] The oral polio vaccine contains a live polio virus and has been linked to polio-like paralysis. Polio vaccines used in the US and Western Europe do not include the live virus, but polio vaccines used in India, and Africa do.

Read more: http://digitaljournal.com/article/323371#ixzz2YCGqHuQ8


Decision: Not vaccinating.

Parker 18 months

It's been a long time, I am slacking off. I only have a few minutes so this will be quick. I will try to add something later.

Parker is 18.5 months today; he really is a big boy now.

- No more bottles, he drinks water from a sippy cup since January and milk since February (off the bottle well before 18 months).

- Parker doesn't wake up at night any more so mommy and daddy are getting more sleep.

- He understands pretty much everything and uses signs to communicate, although no really speaking yet. He says "highchair" and "dada" and "Aga", he will try to say "trzy", but that's all for now. He does use the signs though.

- Favorite books are "Squishy Turtle and Friends", "Good night moon", as well as "What's wrong little Pookie" and (recently) Blue Hat, Green Hat by Sandra Boynton.

- Parker loves dogs

- We are still on no dairy diet and doing fairly well. It seems like we can't go to a restaurant without Parker getting a rash right after, so we kind of gave up. We cook a lot as Parker loves his food. He loves meat, bread, fruit and some veggies. His favorite are broccoli and avocado, but he also likes peas, cucumber, and Polish pickles.

- Parker loves playing pick-a-boo and hide-and-seek. He just recently learned how to screw and unscrew a bottle or jar.

About the unscrewing bottles we learned the hard way. I gave him a juice bottle to hold while I walked around the car to his side to pick him up. By the time I got there, all the juice was soaking into his clothes and the car seat!

We also went to visit our Charlotte, NC friends last weekend. Parker did well on the plane on the way there, the trip back was a bit more troublesome (we had to wait 45 minutes before the the take off due to the weather). He loved the warmth weather and loved playing in our friends yards. Too bad we moved to a condo. :)

But seriously, the condo is great and we are still loving it. Having some issues with the neighbors downstairs complaining about the noise (I think steps, ours and Parker's). But other than that - we are super happy.

Another trip is coming up in early May, we bought tickets to go to Poland! We are very excited for Parker to meet his family and for everyone to meet him. I don't want to think about the flight, just hope he will be able to sleep.

Parker has a stomach flu

Poor thing, Parker got a stomach bug. He didn't eat much dinner last night, which was suspicious to me, and the spat up a hole bunch of milk before bed. At 11 he woke up again to throw up whatever was let in his tummy. He was very thirsty and wanted water but couldn't keep down even that. He also had two episodes of diarrhea before morning. All in all, not a fun night.

He woke up feeling even worse in the morning. Still couldn't keep down even water although insisted on drinking. We finally switched to a regular cup, as he at least drank slower this way. It definitely helped. In the meantime, Marc got us some coconut water so we switched to that. He was so thirsty he didn't mind the taste.

Finally dr. K called in a prescription for Zofran (some other brand name, but essentially that's what it is). We gave him the first dose (5ml) at 4:30. By 6 he ate half a banana, slice of French bread and requested for his drink to be switched to water (opened the sippy cup, showed me to the kitchen, and pointed at the fridge where we get the water for his sippy). He is such a big boy!

He had a couple more diarrhea episodes but no throwing up any more, lets keep our fingers crossed. He is asleep now. Fever about 102F and moaning in his sleep. :( I am hoping his body will fight off the virus and that the night will be better than last and the morning will bring recovery.

BTW, Parker will be 17 months tomorrow! He weighted in 10.760 kg which is roughly 23 lbs (before he got sick, it may be very different now), which puts him in the 50th percentile for weight, a place we have never been before! He is 84 cm or 33" tall - between 75th and 95th percentile, as usually.

We have become very radical and strict with his dairy free diet and it started to pay off. His skin is so much better! Skin on his legs is smooth and olive color, rather than bumpy red and sandpaper like. W hope this will also translate to a better immunity as he has been getting sick very often this winter season.

Also, Parker has a new favorite book! It is the Goodnight Moon book. I had to read it to him four times the other night! :)

Parker: 15-16 months update

Parker is 16 months and one week, which means that I missed his 15 months update. Bummer. He started the 2013 with bronchitis (we went to the doctor on Fri Dec 29) and I just forgot all about his update. He is pretty much completely recovered now. We gave him a cough sirup (honey based Chestal) to loosen up the phlegm so he can cough it out. Otherwise, he was gasping for air during his long cough episodes, especially at night. He also got LymphDrn 5-6 drops 2xday and some other homeopathic drops (need to provide the name), also 6 drops twice a day. He got much better on Thursday, Jan 10, almost two weeks later. We stopped giving him the medicine the following Sunday.

And here is the general update:

Parker still sleeps with mommy and daddy, but we now have a king size bed! What a difference! He still wakes up twice a night for milk, one about 12.30-1.30 (although yesterday it was 11.30) and once about 4.30-5.30. He drinks his milk, turns around and goes back to sleep most of the times.

Since we are talking about beds and sleeping, here is P's bedtime routine. We usually start a bath between 7.15 and 7.30. Put PJs on and have milk about 7.45. We then read a few books and after the milk is gone we brush teeth and go to bed. When P was sick with bronchitis a couple of weeks ago, he would fall asleep during the reading and we wouldn't be even able to brush teeth. Or he would drift off as soon as his head touched the pillow, before I got to turn down the lights. It's not as great now, he usually takes about 10-20 minutes to fall asleep. And sometimes even up to 40 minutes.

Parker's nap times change from time to time. He used to go around 12.30 and still does it on weekends. During the week, however, he falls asleep between 11 and 11.30 while eating and sitting in his highchair! We have a few really cute videos of him passing out.

Food. Parker loves fruit (pears, strawberries, blueberries, raspberries, bananas, mangoes, kiwis, you name it!). He even likes tomatoes! Veggies are harder; likes broccoli, avocado, and peas, but that's about it. He still loves meat and bread. He doesn't eat oatmeal anymore so we have decided to change his breakfasts to a bagel with cream cheese (slowly introducing dairy) or whole wheat waffles. He also eats (adult) cereal from time to time. As for lunch and dinner, he pretty much eats what we eat. I was so proud to be able to say that in front of my girlfriends last weekend!

Parker's favorite stuffed animal is still his Bamboo Buddy Zebra who he sleeps with. He also takes his "Spioch" which is the "Boyo" by Keptin-Jr to bed. As for day time toys, he loves playing with his new pots and pans that he got for Christmas. Still likes regular Mega Bloks and the Alex Jr. Baby Builder plastic connecting elements. He absolutely loves playing in the kitchen so we got him the Little Helper FunPod for Christmas, too.

Parker definitely like to read now, or, to be read to, I should say. He will bring a book, sit himself on my lap, and wait till I start readying. He usually gets up after a page or two to find another book and repeats the same ritual. :) But he pays attention and can sit through three or even four books while drinking his milk before bedtime.