Pharmaguy's Insights Into Drug Industry News
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Pharmaguy's Insights Into Drug Industry News
Pharmaguy curates and provides insights into selected drug industry news and issues.
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Intelligent, High Income People Refuse Vaccinations

Intelligent, High Income People Refuse Vaccinations | Pharmaguy's Insights Into Drug Industry News |

The people most likely to refuse to have their children vaccinated tend to be white, well-educated and affluent, researchers report.

A study published in the January issue of the American Journal of Public Health used California state government data on “personal belief exemptions,” or opting out of vaccinations for nonmedical reasons. From 2007 to 2013, the rate of vaccine refusal for personal belief doubled, to 3.06 percent.

The researchers reviewed data among all kindergarten children in the state during that time. More than 17,000 children, attending 6,911 schools, were exempted.

Exemption percentages were generally higher in regions with higher income, higher levels of education, and predominantly white populations. In private schools, 5.43 percent of children were exempt, compared with 2.88 percent in public schools.

In some suburban areas, rates of exemption were near 50 percent, and more than a quarter of California’s schools have measles immunization rates below the 92 to 94 percent required for herd immunity, the level of vaccination necessary to protect people who are not immune.

The lead author, Y. Tony Yang, an associate professor at George Mason University, said that broader vaccination coverage is critical for public health. The findings “emphasize the importance of a targeted approach, focusing on selected communities,” he said. “And we have to think about communicating with these people effectively without attacking them or making them feel defensive.”

Pharma Guys insight:

Meanwhile, while there is so much handwringing over how to handle the "anti vaxxers," data shows that the measles vaccine at least is as effective as ever in preventing measles overall. See the date here: 

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Merck - the Josef Mengele of Vaccinators?

Merck - the Josef Mengele of Vaccinators? | Pharmaguy's Insights Into Drug Industry News |

As cases spike and despite the weight of scientific opinion opponents of vaccination are undeterred in what they see as a battle between good and evil.

Eileen Dannemann is at war. “It’s a war between good and evil. It’s a primordial, cosmic war,” she says. At one point in our interview she compared Merck, the pharmaceutical company that makes the MMR vaccine, with Josef Mengele, the infamous Nazi doctor at Auschwitz.

Her website, which is called the “Vaccine Liberation Army”, is one of a network of blogs and forums espousing, largely, the same message: that vaccines are bad for you, and that they are part of a nefarious, nebulous scheme by “Big Pharma” and, in some cases, the government.

In a way, it is a war – one of opinion, being waged on blogs, on parenting forums, in the media and, lately, by politicians.

An outbreak of measles – one of the most virulent diseases known to man, but one which the CDC declared eliminated (defined as the absence of continuous disease transmission for greater than 12 months) in the United States in 2000 – in the US this year has brought the issue to the forefront of public awareness.

Last year saw a drastic spike in measles cases compared to the years since 2000, with 644 cases reported in the US, and 2015 is on track to exceed that easily, with 102 reported in 14 states in January alone. Two other diseases that had been all but eradicated from the US after mass vaccination for them began – whooping cough, also known as pertussis, and the mumps – are making comebacks of their own.

Pharma Guys insight:

You're not going to win the argument by just saying these people are crazy. You have to use numbers. For example, this article cites an anti-vaccinator claim: “Zero measles deaths in 10 years, but over 100 measles vaccine deaths reported.” I have not seen any data disputing that statistic, which applies only to the U.S.

To win their argument, however, Pro-vaccinators deceptively cite global numbers indicating that hundreds, even thousands of people -- mostly children in poor countries -- die each year from measles (not actually measles itself but other complications caused by measles). This statistic has little relevance for the U.S. where conditions are much better and where measles doesn't lead to more serious conditions that actually do the killing.

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Measles cases are spreading, despite high vaccination rates. What’s going on?

Measles cases are spreading, despite high vaccination rates. What’s going on? | Pharmaguy's Insights Into Drug Industry News |

It’s now official: Measles cases in the United States are at their highest levelsince 2000, when the disease was declared eliminated — meaning that regular, year-round transmission had been interrupted. Five hundred fourteen cases have been reported this year — more than double the previous high, in 2011 — and the number is expected to continue to climb.

The measles vaccine is among the most effective, and the vast majority of Americans have either had the measles (and are therefore immune to a second case) or have been vaccinated against it. So why are so many people being infected?

One big reason is vaccine refusals: The overwhelming majority of current infections occur in unvaccinated people, most of whom declined the injections for religious, philosophical or personal reasons, according to the Centers for Disease Control and Prevention.

Pharma Guys insight:

Some important points:

(1) The overwhelming majority of current infections occur in unvaccinated people.

(2) Vaccinated people can get the measles --  vaccines fail about 5 percent of the time.

(3) Therefore, if you are vaccinated and exposed to someone with measles who WAS or was NOT vaccinated, your chances of contracting measles are very low considering that 95% of the time YOUR vaccine will protect you no matter what the dopey parent down the block does or does not do viz-a-viz vaccination.

It is incorrect to say, therefore, that unvaccinated people put us ALL at risk as this doctor says in a NYT blog piece here.

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Measles Vaccination: Should It Be Opt-Out Rather Than Opt-In?

Measles Vaccination: Should It Be Opt-Out Rather Than Opt-In? | Pharmaguy's Insights Into Drug Industry News |

Protecting individual choice and promoting public health are seemingly at odds. However, an impasse is not inevitable. Achieving a balance between these two competing values is a dynamic process that requires dynamic policy. 

Vaccination practice may well be at a crossroads. Parents value choice and often request to follow a vaccination schedule that deviates from that recommended by the American Academy of Pediatrics and the Centers for Disease Control and Prevention. Physicians consequently must decide how far to stray from the standard of care: do they forgo a fundamental feature of health promotion and disease prevention by respecting a parent’s refusal? Do they seek a compromise by requesting continued dialogue about vaccines at future visits or encouraging some vaccines over others? Or, do they take a strong stance and advocate for the child’s and community’s health? There is little consensus on the right approach.

Data are emerging, however, that support a physician communication strategy with parents that is aligned with current vaccination policy: presentation of vaccination as the default. While more research is needed, beginning the vaccination discussion during health supervision visits with a statement regarding which vaccines the child will be getting or are due for—rather than a question soliciting parental vaccine preferences—is substantiated by evidence in the fields of behavioral economics and social psychology that suggests that choice architecture can be a powerful means to achieving a desired goal. Choice architecture leverages the propensity humans have to stick with a decision that is already made, especially among decisions perceived to be complex. Vaccination constitutes such a decision for many parents; not only is it complicated by an overwhelming amount of information, it is also fraught with emotion. It is often easier in these situations to simply accept what is recommended, especially when that recommendation is made by someone as influential and trusted as their child’s pediatrician or family practitioner. Therefore, structuring the vaccination discussion as an opt-out, not an opt-in, may be one strategy that can help optimize the tension between individual choice and public health by better accommodating physician obligations to promote the child’s and the public’s health while minimally intruding on parental autonomy.

Pharma Guys insight:

Way to go! Opting out is not a good policy for patient informed consent! 

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Pro-Life Groups Blame Merck for Measles Outbreak

Pro-Life Groups Blame Merck for Measles Outbreak | Pharmaguy's Insights Into Drug Industry News |
As the measles outbreak focuses attention on parents who object to vaccination, some pro-life groups argue one culprit contributing to the problem is actually Merck.

At issue is the MMR – or measles, mumps and rubella – combination vaccine sold by Merck. Pro-life groups say they object to the rubella component on religious grounds because it was made using cell lines derived from aborted fetuses. As a result, the groups say pro-life supporters have avoided the MMR vaccine ever since Merck ended production in 2009 of a dedicated measles vaccine.

“The current outbreak would not be as severe or widespread if parents had the ability to access separate vaccines,” says Debi Vinnedge, the director of Children of God for Life, a non-profit, pro-life organization. “Parents are being unfairly targeted as the problem when Merck is the problem. If they had the separate doses available more people would have been vaccinated.”

Pharma Guys insight:

On one hand, as one commenter said: "It really wouldn't matter what Merck did. The anti vaccine people would just come up with another excuse."

On the other hand, combining 3 vaccines in one shot is effective, but perhaps parents should have a choice.

BTW, if the current measles outbreak is due to some parents opting out of having their children take the MMR vaccine, where's the mumps and rubella outbreaks? Because these children also would not be vaccinated against those diseases. 

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