Delaying Vaccination Cuts Asthma Risk

Image:

Background

Early childhood immunizations have been viewed as promoters of asthma development by stimulating a TH2-type immune response or decreasing microbial pressure, which shifts the balance between TH1 and TH2 immunity.
Objective

Differing time schedules for childhood immunizations may explain the discrepant findings of an association with asthma reported in observational studies. This research was undertaken to determine whether timing of diphtheria, pertussis, tetanus (DPT) immunization has an effect on the development of childhood asthma by age 7 years.
Methods

This was a retrospective longitudinal study of a cohort of children born in Manitoba in 1995. The complete immunization and health care records of cohort children from birth until age 7 years were available for analysis. The adjusted odds ratio for asthma at age 7 years according to timing of DPT immunization was computed from multivariable logistic regression.
Results

Among 11, 531 children who received at least 4 doses of DPT, the risk of asthma was reduced to ½ in children whose first dose of DPT was delayed by more than 2 months. The likelihood of asthma in children with delays in all 3 doses was 0.39 (95% CI, 0.18-0.86).
Conclusion

We found a negative association between delay in administration of the first dose of whole-cell DPT immunization in childhood and the development of asthma; the association was greater with delays in all of the first 3 doses. The mechanism for this phenomenon requires further research.
Key words: DPT combination vaccine, childhood asthma, retrospective birth cohort, administrative health data
Abbreviations used: DaPT, Diphtheria, acellular pertussis, tetanus, DPT, Diphtheria, pertussis, tetanus, ICD-9, International Classification of Diseases, Ninth Revision, MIMS, Manitoba Immunization Monitoring System, MHSIP, Manitoba Health Services Insurance Program, OR, Odds ratio.

Source: Delay in diphtheria, pertussis, tetanus vaccination is associated with a reduced risk of childhood asthma, The Journal of Allergy and Clinical Immunology, Volume 121, Issue 3, Pages 626-631 (March 2008).

Put in plain English!

Researchers gave 11,531 babies four doses of the DPT vaccine.

5,000 of these babies started their jabs at 2 months old and 13.8% of them developed asthma.

In the babies who were 4 months old or older at the time of their first vaccination, there were only 5.9% who developed asthma.

The study also found a decreased incidence of asthma if the subsequent doses were delayed, but the strongest evidence for this was with the first dose.

The journal revealed that a staggering 12% of children go on to develop asthma after vaccination.

In spite of this evidence, they do not intend to change the vaccination schedule.

Parents of Unvaccinated Children Report Less Asthma

WOW! A study which looks at the health of the unvaccinated - this is 2nd study I have read on the subject. Doctors don't normally study the unvaccinated

Background

In the last 3 decades, there has been an unexplained increase in the prevalence of asthma and hay fever.
Objective

We sought to determine whether there is an association between childhood vaccination and atopic diseases, and we assessed the self-reported prevalence of atopic diseases in a population that included a large number of families not vaccinating their children.
Methods

Surveys were mailed to 2964 member households of the National Vaccine Information Center, which represents people concerned about vaccine safety, to ascertain vaccination and atopic disease status.
Results

The data included 515 never vaccinated, 423 partially vaccinated, and 239 completely vaccinated children. In multiple regression analyses there were significant (P < .0005) and dose-dependent negative relationships between vaccination refusal and self-reported asthma or hay fever only in children with no family history of the condition and, for asthma, in children with no exposure to antibiotics during infancy. Vaccination refusal was also significantly (P < .005) and negatively associated with self-reported eczema and current wheeze. A sensitivity analysis indicated that substantial biases would be required to overturn the observed associations.
Conclusion

Parents who refuse vaccinations reported less asthma and allergies in their unvaccinated children. Although this relationship was independent of measured confounders, it could be due to differences in other unmeasured lifestyle factors or systematic bias. Further research is needed to verify these results and investigate which exposures are driving the associations between vaccination refusal and allergic disease. The known benefits of vaccination currently outweigh the unproved risk of allergic disease.

Nashville, Tenn, London, United Kingdom, and Chicago, Ill
Key words: Immunization, asthma, allergic rhinitis, eczema, prevalence, cross-sectional survey
Abbreviations used: DTP, Diphtheria, tetanus, and pertussis, HiB, Haemophilus influenzae B, MMR, Measles, mumps, and rubella, NVIC, National Vaccine Information Center, RR, Rate ratio.

Source: The Journal of Allergy and Clinical Immunology, Volume 115, Issue 4, Pages 737-744 (April 2005).

VAN UK'S Comment: I have no doubt that lack of antibiotics and antipyretics would also decrease asthma and is a factor in addition to non-vaccination, however, other studies have linked vaccination with asthma, so this shouldn't be ignored.

As a mother of unvaccinated children I can say that if my child was having difficulty breathing, I most certainly would get him seen by a doctor, as would other mothers, so I don't think the low asthma rate is due to not reporting to the GP

Vaccines Cause Auto-Immune Disease

Infectious agents contribute to the environmental factors involved in the development of autoimmune diseases possibly through molecular mimicry mechanisms. Hence, it is feasible that vaccinations may also contribute to the mosaic of autoimmunity.

Vaccines are a prototypic source for natural immune stimulation, but may be involved in pathogenic disease in the setting of aberrant immune system function. Possibly, the burden on the immune system resulting from simultaneous multiple vaccines and even the different types of vaccines may also be an overwhelming challenge in the autoimmune prone individual (Shoenfeld et al., 2008). In this review, we discuss the evidence for the development of autoimmune diseases following infections.

In studies of more than 10 patients, the reported manifestations following hepatitis B vaccination were arthritis, thrombocytopenia, demyelinating encephalitis, and demyelinating neuropathy. A case-control study of 265 newly diagnosed lupus patients did not show that HBV vaccine was a risk factor for developing SLE [odds ratio (OR)-1.4] (Schattner, 2005). In a current study, 10 lupus patients were diagnosed within several days and up to one year following hepatitis B vaccination (Agmon-Levin et al., 2009). Previously, 11 cases were reported in the literature regarding the onset or exacerbation of SLE post hepatitis B vaccination (Schattner, 2005).

In concordance, a latency period of less than one week and up to 2 years between vaccination and SLE onset was reported. The classical period between vaccination and autoimmunity was considered to be several weeks, similarly to the time frame suggested in the past for post-infectious autoimmunity phenomena. Interestingly, in this case series, 70% of patients continued their immunization protocol although adverse events were documented. Similarly, in previously reported cases, the affected subjects continued to be vaccinated and aggravation of their condition by additional doses had been documented (Agmon-Levin et al., 2009). Overall, SLE patients presented post hepatitis B vaccination with mild to moderate disease and without life threatening organ involvement.

Multiple sclerosis

Neurological manifestations are common following vaccinations (Huynh et al., 2008). In a case-control epidemiological study for serious adverse events reported in the hepatitis B vaccination exposed group compared to those that received tetanus vaccine, MS was prominent with an odds ratio of 5.2 (P<0.0003). Optic neuritis was also very commonly encountered (OR-14, p< 0.0002) (Geier et al., 2005).

Guillain-Barré syndrome

In GBS, activated macrophages invade intact myelin sheaths resulting in myelin damage and demyelination (Vucic et al., 2009).

Vaccines reported as associated with GBS are diverse (Schonberger et al., 1979; Hemachudha et al., 1988; Khamaisi et al., 2004; CDC, 2006; Slade et al., 2009; Haber et al., 2009). The evidence of casual relationship with GBS is strongest with the swine flu (H1N1) vaccine that was used in 1976-7. An increased relative risk [relative risk (RR)-4-8] to develop GBS 6-8 weeks after the injection was encountered in the vaccinated group compared to the non vaccinated group. The risk for GBS was slightly less than 1 excess case of GBS per 100,000 vaccinated individuals, and hence the vaccine program was suspended (Schonberger et al., 1979). Further studies substantiated the association between the H1N1 vaccine and an increased relative risk (RR-7/1) for GBS 6 weeks after the vaccine (Safranek et al., 1991). The pathophysiology is unclear but may be related to vaccine induced anti-ganglioside antibodies (GM1) (Nachamkin et al., 2008).

The vaccine against Neisseria meningitides is for use among individuals aged 11-55 years old. The VAERS published a warning of a possible association between the Meningococcal Polisaccharide Diphteria Toxoid Conjugated Vaccine (MCV4) and GBS, because of 5 cases of GBS following the MCV4 vaccine, and later 12 additional cases were reported (CDC, 2005). Based on reports, statistical analysis did not show any significant increase in the rate of GBS occurring 6 weeks after the MCV4 vaccine compared to non-vaccinated population. However, it is recommended that individuals with a history of GBS should not be vaccinated with MCV4 unless they are in a high risk for meningococcal infection.

Vaccine induced myopathies

The reports on vaccine induced inflammatory myopathies are sporadic and include cases of following immunization with HBV, bacillus Calmette-Guérin, tetanus, influenza, smallpox, polio, diphtheria, or combinations with diphtheria (Orbach et al., 2009). There is no statistically significant increase in the incidence of polymyositis or dermatomyositis after any mass vaccination. Among 289 patients with inflammatory myopathies followed in the Mayo Clinic, no recent immunization was recorded (Winkelman, 1968; Winkelmann, 1982).

Macrophagic myofasciitis

Macrophagic myofasciitis is a reaction to intramuscular injections of vaccines containing aluminum hydroxide as an adjuvant and affects mainly adults. The symptoms are usually myalgia, arthralgia, asthenia and, less frequently, muscle weakness and fever, in the presence of elevated creatine kinase and erythrocyte sedimentation rates. The electromyogram has a unique pathologic pattern characterized mainly by focal infiltration of the epimysium, perimysium, and perifascicular endomysium by sheets of large, non-epithelioid macrophages, which show fine granular staining for periodic acid-Schiff (PAS) stain that appear as small, osmiophilic, spiky structures on electron microscopy, representing the aluminum hydroxide crystals (Gherardi et al., 2001). Immunizations containing aluminum may trigger Macrophagic myofasciitis in the context of an HLA-DRB1*01 genetic background (Guis et al., 2002). Frequently, patients improve with steroid therapy.

Vasculitis

Numerous case reports reported a possible association between polyarteritis nodosa (PAN) and hepatitis B vaccination. Overall, 25 cases of PAN were submitted to VAERS over an 11 year period until 2001. Among them, only 10 individuals were diagnosed as definite or possible PAN and are discussed here. The median age of patients was 45 years old and 5 patients were hospitalized. A modal peak of 2 weeks and median of 2.8 weeks post-vaccination was noted. All cases received at least 2 doses of vaccine prior to symptom onset. Hepatitis B surface antigenemia frequently follows hepatitis B vaccination and is detected many days after the 20 microgram vaccine. This could explain related immune-complex disease. Recently, there were less than 20 reports on the development of vasculitis following influenza vaccination. Small, medium, and large vessels were involved (Begier et al., 2004). All in all, this would be considered a rare event.

Rheumatoid arthritis

A total of 48 out of 898 (5.3%) of patients with early inflammatory polyarthritis reported an immunization in the 5 weeks prior to symptom onset. There were no important clinical or demographic differences between the 48 immunized patients and 185 consecutive patients who did not report prior immunization. The frequencies of HLA DRB1 *01 and *04 and the shared epitope in 33 of the immunized patients were no different in the non- immunized patients compared to healthy controls. Possibly, in a small number of susceptible individuals, immunization may act as a trigger for RA (Harrison et al., 1997).

HPV vaccine and autoimmune manifestations

The recently released vaccine for human papillomavirus (HPV) offers an opportunity to assess the development of autoimmune phenomena in a high risk population of young women. Hence, we chose to investigate and report separately on this vaccine.

Recently developed vaccines against human papillomavirus (HPV) and hepatitis B virus (HBV) contain a novel Adjuvant System, AS04, which is composed of 3-O-desacyl-4′ monophosphoryl lipid A and aluminum salts. All randomized, controlled trials of HPV-16/18, herpes simplex virus (HSV), and HBV vaccines were analyzed in an integrated analysis of individual data (N = 68,512). A separate analysis of the HPV-16/18 vaccine trials alone was also undertaken (N = 39,160). The reported rates of overall autoimmune events were around 0.5% and did not differ between the AS04 and control groups. The relative risk (AS04/control) of experiencing any autoimmune event was 0.98 (95% confidence intervals 0.80, 1.21) in the integrated analysis and 0.92 (0.70, 1.22) in the HPV-16/18 vaccine analysis. This integrated analysis of over 68,000 participants who received AS04 adjuvant vaccines or controls demonstrated a low rate of autoimmune disorders, without evidence of an increase in relative risk associated with AS04 adjuvanted vaccines (Verstraeten et al., 2008).

In the Danish Civil Registration system, among approximately half a million adolescent girls, 414 autoimmune disorders were listed. The 5 most common autoimmune diseases occurring within 6 weeks of vaccination among 100,000 girls were: type I diabetes, juvenile arthritis, Crohn’s disease, Henoch-Schonlein disease, and ulcerative colitis (Sutton et al., 2009).

A most probable causality occurred between exposure to swine flu vaccine and the development of GBS. In addition, MMF occurred following exposure to aluminum containing adjuvant. Vaccines, like infections, activate immune mediated mechanisms to induce a protective effect. Hence, a complex vaccine may theoretically be more immunogenic than a simple vaccine. Vaccines harbor added complex agents, for example, adjuvants including aluminum, which may induce autoimmune disease. Preservatives are more often found in viral vaccines compared to bacterial vaccines suggesting that the preservatives may be the inciting culprits (Israeli et al., 2009).

A comprehensive strategy is required to develop a new vaccine that will not induce autoimmune manifestations as previously proposed.

Perhaps, the assessment of autoantibody and HLA status prior to immunization will serve as a marker for individuals at risk. More research is required to identify those individuals who may develop autoimmune diseases following immunizations.

Source: http://www.discoverymedicine.com/Hedi-Orbach/2010/02/04/vaccines-and-autoimmune-diseases-of-the-adult/

Vaccines Cause Early onset Epilepsy but Ever so Caring Health Chiefs want to Vaccinate Anyway

Childhood vaccines may trigger early onset of a severe form of infant epilepsy, but researchers say the disorder is ultimately caused by defective genes and lifesaving vaccines should not be withheld from these children.

The researchers said they feared the study published in the Lancet medical journal would scare parents away from getting their children vaccinated but stressed the babies in the study would likely have developed seizures within months regardless of the vaccine.

The disorder, called Dravet syndrome, generally begins with seizures around six months of age. These children have poor language and motor skills and difficulty relating to others.

Up to 80 percent of them have mutations in the SCN1A gene.

Anne McIntosh of the University of Melbourne's Epilepsy Research Center and colleagues examined the medical records of 40 Dravet syndrome patients with the genetic mutation who had been vaccinated against whooping cough, or pertussis.

They said 30 percent of these children developed their first seizures within two days of receiving the vaccine but symptoms of their disorder were no worse than the other children who had their first seizures later on.

"In about 30 percent of people, it appears that (first seizures) came on rather quickly after the vaccination.

Source: Reuters Health, 4 May 2010.