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Congressional hearing on Vaccination

11 Feb

schuchatIn the wake of several months of nation wide fear of ebola,  a new outbreak strikes home. One can only wonder whether the timing of these events will have a lasting effect on the country.

as a side note, it’s interesting to hear Dr Schuchat, the Director of the National Center for Immunization and Respiratory Diseases at the CDC, bring up the number of annual deaths attributed to influenza in the US as between 5-30,000. Because of the way deaths are reported, it is actually tricky to get a very accurate number for this, but a CDC study attempting to do so sets the range as falling between two recent extremes of  “3,349 in 1986–87 to 48,614 in 2003–04.”  For perspective, the 2014 / 15 outbreak of ebola in Africa has claimed just over 9,000 lives.

Despite the high annual mortality of flu, only about 40% of American adults get vaccinated each year.

Screen Shot 2015-02-11 at 1.10.13 PM

Measles has a track record of much higher mortality rates than flu, and is much more contagious. The WHO warns, “[t]he highly contagious virus is spread by coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions.

The virus remains active and contagious in the air or on infected surfaces for up to 2 hours.”

In 2004, Perry and Halsey summarized what we, as a population have forgotten, “Before the introduction of measles vaccines, measles virus infected 95%–98% of children by age 18 years, and measles was considered an inevitable rite of passage.”

Measles is associated with a number of complications, including pneumonia (either directly as a result of measles or from another agent) which is associated with the majority of deaths attributed to the disease. Over the years, as medical interventions have improved, the number of measles-associated fatalities has dropped from “One hundred years ago in Scotland, the measles case-fatality rate was 30–40 deaths per 1000 cases. In the United States, mortality from measles decreased from 25 per 1000 reported cases in 1912 to 1 per 1000 reported cases in 1962.”(see figure below) Nevertheless, it remains a dangerous disease capable of causing a number of complications and death. (all those deaths from flu mentioned above, flu kills only about 1.4 to 16.7 deaths per 100,000 persons.)

Screen Shot 2015-02-11 at 1.30.17 PM

Perry and Halsey conclude:

Measles vaccination is one of the most cost-effective health interventions ever developed. Without the vaccine, 5 million children would die each year from measles-assuming an estimated case-fatality rate of 2%–3%. Without measles vaccination, the costs of caring for those with measles in the United States would be ~$2.2 billion annually, and the indirect costs would be an additional $1.6 billion. Each dollar spent on measles vaccine saves $12–$ 17 in direct and indirect costs.

With this in mind, here is the full video broadcast of CSPAN’s coverage of the the hearing on childhood vaccination:

http://www.c-span.org/video/?324253-1/hearing-childhood-vaccination

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Posted by on February 11, 2015 in Uncategorized

 

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