Vax Sin Nation
There's a lot of good and bad in our world today, always has been. The quest for power or money or "more" seems to be a trait of our humanity; but for many the opposite is true as the search for contentment and being comfortable is near or has been reached. Friends, family, home, quiet...all have arrived around this time of year and the protective bubble hardens. Part of this comes from discovering certain areas of trust in life: police will keep the order, mechanics will fix our cars, and dentists will repair our teeth. This doesn't always happen of course, but for the most part this trust of society and our inner circle adds to our stability and our balance. So when someone in these professions goes rogue or something goes wrong and we find that we've been taken advantage of, our view of the entire profession can change. Doctors are people we generally see when we're sick or are wanting preventative care...getting a physical checkup, or antibiotics, or a vaccine for the flu or shingles; and we trust them so much that we'll bring in our babies (and animals in the case of veterinarians), those who cannot speak for themselves. Trust us we tell our babies, and in return we hear the same from the doctors and surgeons...trust us. But for many diseases, there is no such compassion. As with most bacteria and viruses, Ebola, West Nile and other diseases are opportunistic and spread however and whenever they can, including something from the past...measles.
Said a piece in The New Yorker about an outbreak there: Measles, often called the most contagious disease on earth, is an airborne virus. If a person with measles walks into a room, the pathogens can linger there for two hours after the person has gone...Almost everyone who contracts measles exhibits symptoms; this is not the case with, say, polio, a disease in which three out of four people don’t show any symptoms at all. “The measles vaccine really works, and the virus finds those who are unprotected, either because they haven’t been vaccinated or because they don’t have immunity from a prior measles infection,” Bruce Gellin, the president of global immunization at the Sabin Vaccine Institute, in Washington, D.C., told me. “So you can see it spreading. You can see where you’re vulnerable, on a mass scale.” It’s a little like sticking a punctured tire in a barrel of water. Measles finds the leak. One might think, no big deal, a rationale of individual decision making; but here's what sites such as the Center for Disease Control and WebMD are adding: Measles is a contagious disease spread by a virus. It’s so contagious that when someone has measles, 90% of the people around them who aren’t immune will also catch it. And it’s so serious that one in four people who get measles will need to be hospitalized...There is no treatment, and it can cause serious health complications, especially in small children. Currently, five patients in New York City have been admitted to the intensive care unit. In general, one out of every 10 children with measles get an ear infection, which can lead to permanent hearing loss. And one or two out of every 1,000 will die.
Much of this preventable disease was eliminated in the U.S.* nearly 20 years ago with the onset of vaccinations (you may remember such vaccines given for smallpox and polio as well); but it was around this time when a British doctor, Andrew Wakefield, released and published a study with allegedly falsified data that showed a link between vaccines and autism (he was later stripped of his medical license after an investigation). The study (retracted not long after publication) caused fears in many, including such television personalities as Oprah Winfrey and Jenny McCarthy, and began an anti-vaccine movement leading to such sites as Learn the Risk and Anti-Vaxxers. Before long, non-vaccinated children began arriving in schools and playgrounds (some parents felt that rather than subject their children to a vaccine, "exposure" to a disease such as measles would prove a better form of their child developing a "natural" resistance). But for the mothers whose children are being unwillingly exposed to the disease, the concern becomes one of who's right. An article in WIRED displayed this frustration from a mother named Zahava: She heard a rumor that a child in her son’s preschool class had measles. Zahava called the mother, explaining that if her son contracted the virus it could lead to pneumonia, brain swelling, and even death. She needed to know if the woman’s child had the disease before she sent him back to school. “I told her I needed to protect my child,” Zahava says. “And she said, ‘So maybe give him some vitamins to boost his immune system.’ I told her that wasn’t going to help at this point…She went on about how vaccines cause cancer and autism and everything in between. I’m like, ‘This is totally not where I wanted the conversation to go. Can we start again? Does your child have measles or not?’ ”
Another piece in WIRED described that mother's concern from a medical standpoint: Among airborne respiratory pathogens, measles is an elite virus—the most contagious disease in the world. If you give this virus a lung, it’ll take a town. A cough from an infected person on a subway car would spread the disease to 90 out of 100 unprotected people. The virus stays alive, airborne outside the body of its human host, for up to two hours...It’s really two things,” says Roberto Cattaneo, a molecular biologist at the Mayo Clinic who has been studying the measles virus for more than three decades. The first has to do with the kind of cells the virus infects first: alveolar macrophages. These immune cells patrol your airways, hoovering up and degrading bits of dust, pollen, and any other foreign objects that you breathe in. They also have a surface receptor the exact shape of a measles protein. “They’re supposed to be on a mission to destroy viruses, and instead they act as a shuttle, delivering measles straight to the closest lymph nodes.” Once they’re in the lymph nodes, a sort of bustling immune system transit hub, the virus hops to its intended target—a subset of cells responsible for making antibodies to remember past pathogens. They form your immune system’s memory palace, the home base of future resistance. Measles hijacks those cells’ machinery and begins replicating and spreading at a breakneck pace. By Cattaneo’s estimates, one week after inhaling the virus, more than 50 percent of those cells have been infected. “It’s not subtle,” he says. “At that point you’re walking around with less than half of your immune system.” During this stage of the disease, while your body’s security forces are badly depleted, you become more vulnerable to other bacterial and viral infections.
The Atlantic asked the question of whether anti-vaxxers (as the movement has come to be known) are the new conscientious objectors, firm in their belief that they have a right to not vaccinate even if the states and courts order them to do so (some states are now imposing rather hefty fines, even to the point of confiscating their property if they fail to pay). The piece, adapted from a longer essay, concluded with this: Our bodies are not entirely independent, vulnerable as they are to infection from others, and neither are our minds. Conscience is not an isolated space, cut off from the rest of the world. It is what reminds us of our own fallibility, and what makes us accountable to others. As measles spreads across the world, even in places where it is no longer endemic, the meaning of conscience suggests that none of us is exempt from our obligations to others. The Supreme Court seemed to agree as far back as 1902 when it ruled in favor of mandatory smallpox vaccinations after an outbreak in Massachusetts, writing: There are manifold restraints to which each person is necessarily subject for the common good. Many people polled in the U.S. agree, as many as 82% according to a Pew Research Center study. Even Facebook and Instagram have protection as they decide to stop and shut down vaccine misinformation, even though such comments continue to appear on their pages; said TIME, the result has led some people to stop vaccinating their pets, a view especially prevalent in the UK where some believe that such vaccines will cause their dogs to get autism (also debunked).
So back to the question of who's right? While vaccines have proven quite effective in many areas, especially in the prevention of shingles, there are more and more reports of contaminants in generic drugs. Said Bloomberg Businessweek: 90% of the pharmaceuticals sold in the U.S. are generics. 80% of the active ingredients are produced overseas, where FDA inspections are declining...An FDA inspector reported that technicians at the flagship facility of Mylan NV in India disregarded about 75% of failing quality checks, for no good scientific reason, over six months in 2016. The inspector suggested that staff were retesting failing drugs until they passed. Because the FDA routinely keeps crucial information in these audits secret, it’s unclear which drugs were involved. Mylan recalled its valsartan last November. The company makes its own active ingredient for the drug in India and also sold it to such companies as Teva Pharmaceutical Industries Ltd. Teva recalled its valsartan. The article goes on to mention the key changes involved in the residue left by a solvent used in a Chinese manufacturer of such generics. So there's that, the alteration or introduction of contaminants or carcinogens into the drug supply line. But in another disturbing trend of sorts, there are outright fraudulent medicines as reported in Mosaic. Suresh Safi, a private investigator of such fraudulent medicine manufacturing, said that India's "official" study of just 3+% of drugs being affected didn't show the reality of the problem: For one thing, he has reservations about the studies’ sampling methods. He also says that averages are misleading because some kinds of medicines --painkillers, antibiotics, drugs for heart disease and cancer-- are falsified more than others. According to him, the more commonly prescribed they are, the more often they are falsified. Sati points at one of the boxes in front of him, a ten-strip cardboard container of Zifi 200 – a trade name for the antibiotic cefixime, used for throat infections, urinary tract infections and gonorrhoea. “Now the monsoons are beginning, and people are going to start falling ill. This sells the most. Every doctor is going to prescribe Zifi 200,” he says. That makes it a popular target for the fakers. Extrapolating from what his sources report, he estimates that 40 per cent of the Zifi 200 on the market is fake.** Added the author of the piece: When I interviewed Sati, he kept pulling out samples of fake medicines from a large bag he carried until there was no room left on the table between us. It was surprising --and alarming-- just how convincing the packaging was. Fakes are of course only one of many ways we arrive at poor quality medicines. Taking all the others ways into account, learning that distribution chains are intricate almost beyond comprehension, and that regulation can be patchy across all this complexity has been quite sobering.
We have to trust somebody, if not the government then at very least the doctor and the pharmaceutical companies making the medicines; and we hope that their drugs do what they say that they do. But do they? The testing and the regulatory inspections are trustworthy, aren't they? One could begin to wonder. Jump back to the Sackler family and their privately held company (thus no financial disclosures) of Purdue Pharma, best known for its creation of the addictive opioid, Oxycontin. Now that lawsuits are coming in, many from states, its been revealed that the family had secretly sent $10 billion of their fortune to offshore accounts, this before declaring bankruptcy (earlier settlements were moving into a combined $1 billion per year judgement among the major pharmaceutical companies which manufactured the opioids). And then there's the flu vaccine (commonly called the flu "shot" instead of "vaccine" here in the U.S.), a gamble of sorts as the World Health Organization tries to anticipates which mutated flu virus will arrive in six months and sends that information to the pharmaceutical companies. As reported in The Week: Given the six-month time lag, it's all but impossible to swiftly order up vast new batches of vaccine in case an unexpected strain emerges, which is what happened in the 2009-10 flu season with the H1N1 virus, better known as swine flu. The virus infected an estimated 61 million people in the U.S., killing 12,000.
Here in the U.S., the courts have already begun to rule in favor of states on mandatory vaccination for certain diseases if your child will be attending a public school, the ruling being that you can opt out and home school your child (even though he or she could still transmit the virus at a park or a shopping center) but choosing not to vaccinate due to religious or conscientious beliefs will no longer hold up (in some cases you can be fined $1000 as well). Doctors are supposed to ensure that your child receives the vaccinations and in turn, that you are receiving the actual vaccine and not a knockoff. If you're scratching your head at all of this government oversight, you need only think of future travel, especially to parts of Africa where proof of vaccination is needed or you are denied entry. But consider the viewpoint of a parent with her baby or young child, now boarding a plane or a train and realizing that for the next few hours or longer her child may be exposed to a possibly fatal disease because another parent onboard didn't feel the need to vaccinate her child. But reverse the roles and imagine that of the other mother discovering that the pills she took for years were fakes and has grown suspicious of the substance they want to inject into her child's arm; what if it is fake or contaminated as well? And how can you get back a child's life or vision or hearing? Is it even worth taking a chance? Both mothers viewpoints can be firm and in many ways justified. Vaccines do have a strong record in eliminating such diseases as polio and meningitis; but now unscrupulous black market profiteers are seeing the dollars to be made with world craving quick fixes...a pill for this or a pill for that. Blood pressure, cholesterol, cancer...perhaps even a vaccine. At what point does a mother or father give in for the common good, the possible sacrifice of a few for the betterment of many?
One final thought came from The New Yorker: Vaccination is a basic political issue, because it is the subject of community agreement. When a high-enough percentage of community members are immunized, a disease can be effectively vanquished. In epidemiological terms, this is known as “herd immunity,” which cannot be maintained below a certain threshold. When enough people reject the community agreement, they endanger the rest. Willfully unvaccinated adults and children can spread diseases to those who cannot be vaccinated or haven’t been vaccinated, such as infants and people with a compromised immune system; these vulnerable populations would probably be safe in conditions of herd immunity. Vaccination and the refusal to vaccinate are political acts: individual decisions that affect others and the very ability of people to inhabit common spaces. Unfortunately for many, there's a new kid in town and it may just prove to be a new sort of drug cartel, one with the law on its side.
*According to the CDC, measles is still prevalent in other parts of the world. One report said: In 1912, measles became a nationally notifiable disease in the United States, requiring U.S. healthcare providers and laboratories to report all diagnosed cases. In the first decade of reporting, an average of 6,000 measles-related deaths were reported each year. In the decade before 1963 when a vaccine became available, nearly all children got measles by the time they were 15 years of age. It is estimated 3 to 4 million people in the United States were infected each year. Also each year, among reported cases, an estimated 400 to 500 people died, 48,000 were hospitalized, and 1,000 suffered encephalitis (swelling of the brain) from measles. The National Vaccine Information Center recently reported this: Measles has re-emerged globally and as of mid-April of 2019, WHO reported 112,000 cases impacting 170 countries, which WHO officials said reflected about 10 percent of all cases.
**If you suspect that you may have contaminated or fake medicines, Mosaic also provides a few links where you can turn to for more information and to report such.
Said a piece in The New Yorker about an outbreak there: Measles, often called the most contagious disease on earth, is an airborne virus. If a person with measles walks into a room, the pathogens can linger there for two hours after the person has gone...Almost everyone who contracts measles exhibits symptoms; this is not the case with, say, polio, a disease in which three out of four people don’t show any symptoms at all. “The measles vaccine really works, and the virus finds those who are unprotected, either because they haven’t been vaccinated or because they don’t have immunity from a prior measles infection,” Bruce Gellin, the president of global immunization at the Sabin Vaccine Institute, in Washington, D.C., told me. “So you can see it spreading. You can see where you’re vulnerable, on a mass scale.” It’s a little like sticking a punctured tire in a barrel of water. Measles finds the leak. One might think, no big deal, a rationale of individual decision making; but here's what sites such as the Center for Disease Control and WebMD are adding: Measles is a contagious disease spread by a virus. It’s so contagious that when someone has measles, 90% of the people around them who aren’t immune will also catch it. And it’s so serious that one in four people who get measles will need to be hospitalized...There is no treatment, and it can cause serious health complications, especially in small children. Currently, five patients in New York City have been admitted to the intensive care unit. In general, one out of every 10 children with measles get an ear infection, which can lead to permanent hearing loss. And one or two out of every 1,000 will die.
Much of this preventable disease was eliminated in the U.S.* nearly 20 years ago with the onset of vaccinations (you may remember such vaccines given for smallpox and polio as well); but it was around this time when a British doctor, Andrew Wakefield, released and published a study with allegedly falsified data that showed a link between vaccines and autism (he was later stripped of his medical license after an investigation). The study (retracted not long after publication) caused fears in many, including such television personalities as Oprah Winfrey and Jenny McCarthy, and began an anti-vaccine movement leading to such sites as Learn the Risk and Anti-Vaxxers. Before long, non-vaccinated children began arriving in schools and playgrounds (some parents felt that rather than subject their children to a vaccine, "exposure" to a disease such as measles would prove a better form of their child developing a "natural" resistance). But for the mothers whose children are being unwillingly exposed to the disease, the concern becomes one of who's right. An article in WIRED displayed this frustration from a mother named Zahava: She heard a rumor that a child in her son’s preschool class had measles. Zahava called the mother, explaining that if her son contracted the virus it could lead to pneumonia, brain swelling, and even death. She needed to know if the woman’s child had the disease before she sent him back to school. “I told her I needed to protect my child,” Zahava says. “And she said, ‘So maybe give him some vitamins to boost his immune system.’ I told her that wasn’t going to help at this point…She went on about how vaccines cause cancer and autism and everything in between. I’m like, ‘This is totally not where I wanted the conversation to go. Can we start again? Does your child have measles or not?’ ”
Another piece in WIRED described that mother's concern from a medical standpoint: Among airborne respiratory pathogens, measles is an elite virus—the most contagious disease in the world. If you give this virus a lung, it’ll take a town. A cough from an infected person on a subway car would spread the disease to 90 out of 100 unprotected people. The virus stays alive, airborne outside the body of its human host, for up to two hours...It’s really two things,” says Roberto Cattaneo, a molecular biologist at the Mayo Clinic who has been studying the measles virus for more than three decades. The first has to do with the kind of cells the virus infects first: alveolar macrophages. These immune cells patrol your airways, hoovering up and degrading bits of dust, pollen, and any other foreign objects that you breathe in. They also have a surface receptor the exact shape of a measles protein. “They’re supposed to be on a mission to destroy viruses, and instead they act as a shuttle, delivering measles straight to the closest lymph nodes.” Once they’re in the lymph nodes, a sort of bustling immune system transit hub, the virus hops to its intended target—a subset of cells responsible for making antibodies to remember past pathogens. They form your immune system’s memory palace, the home base of future resistance. Measles hijacks those cells’ machinery and begins replicating and spreading at a breakneck pace. By Cattaneo’s estimates, one week after inhaling the virus, more than 50 percent of those cells have been infected. “It’s not subtle,” he says. “At that point you’re walking around with less than half of your immune system.” During this stage of the disease, while your body’s security forces are badly depleted, you become more vulnerable to other bacterial and viral infections.
The Atlantic asked the question of whether anti-vaxxers (as the movement has come to be known) are the new conscientious objectors, firm in their belief that they have a right to not vaccinate even if the states and courts order them to do so (some states are now imposing rather hefty fines, even to the point of confiscating their property if they fail to pay). The piece, adapted from a longer essay, concluded with this: Our bodies are not entirely independent, vulnerable as they are to infection from others, and neither are our minds. Conscience is not an isolated space, cut off from the rest of the world. It is what reminds us of our own fallibility, and what makes us accountable to others. As measles spreads across the world, even in places where it is no longer endemic, the meaning of conscience suggests that none of us is exempt from our obligations to others. The Supreme Court seemed to agree as far back as 1902 when it ruled in favor of mandatory smallpox vaccinations after an outbreak in Massachusetts, writing: There are manifold restraints to which each person is necessarily subject for the common good. Many people polled in the U.S. agree, as many as 82% according to a Pew Research Center study. Even Facebook and Instagram have protection as they decide to stop and shut down vaccine misinformation, even though such comments continue to appear on their pages; said TIME, the result has led some people to stop vaccinating their pets, a view especially prevalent in the UK where some believe that such vaccines will cause their dogs to get autism (also debunked).
So back to the question of who's right? While vaccines have proven quite effective in many areas, especially in the prevention of shingles, there are more and more reports of contaminants in generic drugs. Said Bloomberg Businessweek: 90% of the pharmaceuticals sold in the U.S. are generics. 80% of the active ingredients are produced overseas, where FDA inspections are declining...An FDA inspector reported that technicians at the flagship facility of Mylan NV in India disregarded about 75% of failing quality checks, for no good scientific reason, over six months in 2016. The inspector suggested that staff were retesting failing drugs until they passed. Because the FDA routinely keeps crucial information in these audits secret, it’s unclear which drugs were involved. Mylan recalled its valsartan last November. The company makes its own active ingredient for the drug in India and also sold it to such companies as Teva Pharmaceutical Industries Ltd. Teva recalled its valsartan. The article goes on to mention the key changes involved in the residue left by a solvent used in a Chinese manufacturer of such generics. So there's that, the alteration or introduction of contaminants or carcinogens into the drug supply line. But in another disturbing trend of sorts, there are outright fraudulent medicines as reported in Mosaic. Suresh Safi, a private investigator of such fraudulent medicine manufacturing, said that India's "official" study of just 3+% of drugs being affected didn't show the reality of the problem: For one thing, he has reservations about the studies’ sampling methods. He also says that averages are misleading because some kinds of medicines --painkillers, antibiotics, drugs for heart disease and cancer-- are falsified more than others. According to him, the more commonly prescribed they are, the more often they are falsified. Sati points at one of the boxes in front of him, a ten-strip cardboard container of Zifi 200 – a trade name for the antibiotic cefixime, used for throat infections, urinary tract infections and gonorrhoea. “Now the monsoons are beginning, and people are going to start falling ill. This sells the most. Every doctor is going to prescribe Zifi 200,” he says. That makes it a popular target for the fakers. Extrapolating from what his sources report, he estimates that 40 per cent of the Zifi 200 on the market is fake.** Added the author of the piece: When I interviewed Sati, he kept pulling out samples of fake medicines from a large bag he carried until there was no room left on the table between us. It was surprising --and alarming-- just how convincing the packaging was. Fakes are of course only one of many ways we arrive at poor quality medicines. Taking all the others ways into account, learning that distribution chains are intricate almost beyond comprehension, and that regulation can be patchy across all this complexity has been quite sobering.
We have to trust somebody, if not the government then at very least the doctor and the pharmaceutical companies making the medicines; and we hope that their drugs do what they say that they do. But do they? The testing and the regulatory inspections are trustworthy, aren't they? One could begin to wonder. Jump back to the Sackler family and their privately held company (thus no financial disclosures) of Purdue Pharma, best known for its creation of the addictive opioid, Oxycontin. Now that lawsuits are coming in, many from states, its been revealed that the family had secretly sent $10 billion of their fortune to offshore accounts, this before declaring bankruptcy (earlier settlements were moving into a combined $1 billion per year judgement among the major pharmaceutical companies which manufactured the opioids). And then there's the flu vaccine (commonly called the flu "shot" instead of "vaccine" here in the U.S.), a gamble of sorts as the World Health Organization tries to anticipates which mutated flu virus will arrive in six months and sends that information to the pharmaceutical companies. As reported in The Week: Given the six-month time lag, it's all but impossible to swiftly order up vast new batches of vaccine in case an unexpected strain emerges, which is what happened in the 2009-10 flu season with the H1N1 virus, better known as swine flu. The virus infected an estimated 61 million people in the U.S., killing 12,000.
Here in the U.S., the courts have already begun to rule in favor of states on mandatory vaccination for certain diseases if your child will be attending a public school, the ruling being that you can opt out and home school your child (even though he or she could still transmit the virus at a park or a shopping center) but choosing not to vaccinate due to religious or conscientious beliefs will no longer hold up (in some cases you can be fined $1000 as well). Doctors are supposed to ensure that your child receives the vaccinations and in turn, that you are receiving the actual vaccine and not a knockoff. If you're scratching your head at all of this government oversight, you need only think of future travel, especially to parts of Africa where proof of vaccination is needed or you are denied entry. But consider the viewpoint of a parent with her baby or young child, now boarding a plane or a train and realizing that for the next few hours or longer her child may be exposed to a possibly fatal disease because another parent onboard didn't feel the need to vaccinate her child. But reverse the roles and imagine that of the other mother discovering that the pills she took for years were fakes and has grown suspicious of the substance they want to inject into her child's arm; what if it is fake or contaminated as well? And how can you get back a child's life or vision or hearing? Is it even worth taking a chance? Both mothers viewpoints can be firm and in many ways justified. Vaccines do have a strong record in eliminating such diseases as polio and meningitis; but now unscrupulous black market profiteers are seeing the dollars to be made with world craving quick fixes...a pill for this or a pill for that. Blood pressure, cholesterol, cancer...perhaps even a vaccine. At what point does a mother or father give in for the common good, the possible sacrifice of a few for the betterment of many?
One final thought came from The New Yorker: Vaccination is a basic political issue, because it is the subject of community agreement. When a high-enough percentage of community members are immunized, a disease can be effectively vanquished. In epidemiological terms, this is known as “herd immunity,” which cannot be maintained below a certain threshold. When enough people reject the community agreement, they endanger the rest. Willfully unvaccinated adults and children can spread diseases to those who cannot be vaccinated or haven’t been vaccinated, such as infants and people with a compromised immune system; these vulnerable populations would probably be safe in conditions of herd immunity. Vaccination and the refusal to vaccinate are political acts: individual decisions that affect others and the very ability of people to inhabit common spaces. Unfortunately for many, there's a new kid in town and it may just prove to be a new sort of drug cartel, one with the law on its side.
*According to the CDC, measles is still prevalent in other parts of the world. One report said: In 1912, measles became a nationally notifiable disease in the United States, requiring U.S. healthcare providers and laboratories to report all diagnosed cases. In the first decade of reporting, an average of 6,000 measles-related deaths were reported each year. In the decade before 1963 when a vaccine became available, nearly all children got measles by the time they were 15 years of age. It is estimated 3 to 4 million people in the United States were infected each year. Also each year, among reported cases, an estimated 400 to 500 people died, 48,000 were hospitalized, and 1,000 suffered encephalitis (swelling of the brain) from measles. The National Vaccine Information Center recently reported this: Measles has re-emerged globally and as of mid-April of 2019, WHO reported 112,000 cases impacting 170 countries, which WHO officials said reflected about 10 percent of all cases.
**If you suspect that you may have contaminated or fake medicines, Mosaic also provides a few links where you can turn to for more information and to report such.
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