Some Reading For A Snow Day - Measles, Brain Health, and Epigenetics

February 15, 2015

I recently read [some information](http://www.berkeleywellness.com/self-care/preventive-care/article/vacci…) provided by an "infectious disease specialist" at the UC Berkeley School of Public Health, who was asked, "How effective is the [measles] vaccine?"

John E. Swartzberg, M.D. answered, in part: "Very. In the decade before the measles vaccination program began in the late 1960s, an estimated 3 to 4 million people in the United States were infected each year, of whom 400 to 500 died, 48,000 were hospitalized, and another 1,000 developed chronic disability from measles encephalitis (a brain infection). By 2011, in contrast, widespread use of measles vaccine had led to a greater than 99 percent reduction in measles cases in this country. Globally, measles vaccination prevented an estimated 15.6 million deaths between 2000 and 2013 alone."

Someone on a health-related forum wondered: "Does anyone know if these statistics are true, or where to go for accurate statistics and explanations?"

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I am totally not into the "hate debate," as some have termed the current "discussion" circulating via Facebook and other media outlets concerning recent U.S. cases of measles. But I am _fascinated_ by the science, and I thought I'd take a stab at reviewing opinions such as Swartzberg's.

My Short Thoughts:

It's important to compare these sorts of numbers using "standardized" statistics, like "deaths per 100,000," rather than the potentially meaningless "total deaths." Also, the Death Rate from a given disease is not the same thing as Disease Prevalence. Context is really, really important.

My Long Thoughts:

I was blown away by "Dissolving Illusions: Disease, Vaccines, and the Forgotten History", by Suzanne Humphries, MD and Roman Bystrianyk. The authors not only analyze and review hundreds of factors and studies relating to the multi-century-long, massive public health experiment that is our vaccination program...but they also explain how to put various statistics into context.

In Swartzberg's example above, one needs to understand the relative nature of the numbers: how many people died from the flu in those years? From asthma? In auto accidents? From heart attacks? From Scarlet Fever (vaccine not currently available due to horrendous side effects)? From Tylenol overdose (this number was larger than I expected!)? How many people were hospitalized for those things?

The measles vaccine was introduced in 1963. The live vaccine came into use in 1968, but any deaths/complications during the five years previous (which are included as part of Swartzberg's example) should - and his doesn't - take into account Effects from the not-quite-dead vaccine that was later acknowledged to be Less Effective, but was nonetheless widely used during that time. Additionally, since vaccine-injury-reporting is not well-coordinated, and vaccinated-vs.-unvaccinated safety/mortality trials have never been done, it's difficult to evaluate the relative risks.

Also really necessary to examine: the statistical curve for deaths/measles incidence over the entire previous century. This is a hugely fascinating picture! Especially when you compare _incidence_ relative to _mortality_, and how the latter appears to have declined by >98% prior to _any_ vaccine's introduction. What happens when you try to eradicate a microbial illness with which we seem to have evolved for a Really Long Time - especially if that illness doesn't seem to cause many deaths in healthy populations? (The Saga of Antibiotics and Chronic Disease Prevention, anyone??) What are the risks of getting injured by measles vs. the risks of the measles vaccine? How do you qualify "effectiveness" in a vaccine? Is it "effective" if it requires boosters every five or ten years?

Also notable to question: how was the disease diagnosed pre- vs. post-vaccine? This diagnostic criteria affects "incidence" of everything (the polio chapter in Dissolving Illusions makes this quite clear), and every time a vaccine is introduced, diagnostic criteria tend to get changed/made more stringent.

Obviously, the final number in Swartzberg's statement ("global number of deaths prevented by vaccination") is impossible to prove, so he can insert his opinion easily...but the more I read about the measles vaccine, the fewer deaths I believe it has prevented _in total_. ...Just my opinion. :)

Something to ponder, though rarely discussed by docs such as Swartzberg: what is the relative risk of dying from measles or getting permanently disabled, if you are a well-nourished child, with ample dietary sources and bodily stores of vitamins A and C...vs. an undernourished child living on Whatever s/he Can Get (or the Standard American Diet)?

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And of course...the reality is that we all will die someday, and some people/kids will die Before Their Time. Nothing can prevent this, even the most ardent vaccine enthusiast or traditional foods activist. It's rarely popular to debate with humility, though I occasionally try.

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Here are some interesting, amusing, sobering, and sometimes sarcastic articles concerning the measles circus...

What does "Herd Immunity" mean, exactly? Here's one take:

http://www.vaccinationcouncil.org/2012/07/05/herd-immunity-the-flawed-s…

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Why "The Hate Debate" is not the best way to air vaccination-related grievances:

http://www.livingwhole.org/the-hate-debate/

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"How on Earth did we get from 'everybody gets the measly measles' to 'Got measles? Federal agents are on their way to your house to lock you inside and threaten you with arrest if you try to leave; notifying your workplace that you are hereby forbidden to work; notifying your school that you are not allowed to set foot on campus, and contacting everyone you have spoken to in the last two weeks so they can be locked up too.'"

An epidemic has taken over the United States, a crippling infection of measles hysteria [warning - this essay is more humorously sarcastic than scholarly]: http://www.wellbeyondmedicine.com/mass-measles-hysteria-outbreak/

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...and wouldn't you know it, but the Libertarians have some articulate ideas on the topic:

http://www.wnd.com/2015/02/how-vaccine-hysteria-could-spark-totalitaria…

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"Crack Down on Those Who Don’t Vaccinate? A Legal Response":

http://vaccineimpact.com/2013/crack-down-on-those-who-dont-vaccinate-a-…

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It appears that Italy is not as dismissive of vaccine injury as the United States Government seems to be:

http://healthimpactnews.com/2015/u-s-media-blackout-italian-courts-rule…

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A discussion between Drs. Kelly Brogan and Suzanne Humpries (co-author of ["Dissolving Illusions"](http://www.westonaprice.org/book-reviews/dissolving-illusions-by-suzann…)), concerning vaccination in general, and in particular during pregnancy:

http://fearlessparent.org/radio-blog-vaccines-during-pregnancy-making-a…

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Articles in the Vancouver Sun notes that "Cochrane review of flu vaccine not as definitive as health officer suggests":

http://www.vancouversun.com/health/Cochrane+review+vaccine+definitive+h…

http://www.vancouversun.com/opinion/oped/Opinion+Scientist+fires+latest…

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Lest you think I care only about Vaccines, there are a few other interesting articles I've read recently...

Epigenetics and Retroviruses, and how gene expression can affect the Brain:

http://www.scientificamerican.com/article/ancient-viruses-gain-new-func…

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And now we have...behavioral epigenetics! Or, how our experiences can shape the expression of our genes:

http://discovermagazine.com/2013/may/13-grandmas-experiences-leave-epig…

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Really very interesting: concerning Alzheimer's, and why therapeutic treatments must be individualized, and how not to mistake causation with correlation (gluten doesn't _cause_ celiac, and carbohydrate consumption from whole foods doesn't _cause_ disease...and yet refined wheat flour, sugar, and seed oils appear to be present in large amounts in every culture which begins suffering from chronic diseases in large numbers). In addition: some ideas about treating Alzheimer's with a ketogenic diet:

http://chriskresser.com/carbs-alzheimers-separating-fact-from-fiction

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Really Good Article concerning ongoing research on one of my favorite topics: fecal transplants:

http://www.newyorker.com/magazine/2014/12/01/excrement-experiment

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The continues-to-be-interesting conversation about viruses, infections, microbes, and Causes of Depression:

http://op-talk.blogs.nytimes.com/2014/11/26/what-if-were-wrong-about-de…

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As the investigation into our microbiome evolves, it is heartening to me that functional medicine practitioners like Kresser are developing useful clinical experience concerning the treatment of serious illnesses - it's nice to counter all the zillion articles that proliferate concerning "anti-yeast diets", featuring people who are still sick after twenty years of following this or that protocol. This is an overview of "anti-candida" protocols, and some of the mistakes people make when trying to treat candida with diet:

http://chriskresser.com/top-4-mistakes-people-make-when-treating-candid…