[H] Vaccinations

[Gaby Rottler]

Dear all,

perhaps not everybody here on the lists is acquainted with the works of
Peter Aaby. In 1978 he founded the Bandim Health Projekt in
Guinea-Bissau, West Africa. In Dec 2000 the result of his research -
the effects of vaccinations on mortality in children (publ. British
Medical Journal)- caused much 'excitement' in the medical public.

There are several newer articles available:
-------------------------------------------------
1: Int J Epidemiol. 2004 Apr;33(2):374-80.

The introduction of diphtheria-tetanus-pertussis vaccine and child
mortality in rural Guinea-Bissau: an observational study.

Aaby P, Jensen H, Gomes J, Fernandes M, Lisse IM.

Bandim Health Project, Apartado 861, Bissau, Guinea-Bissau; and Danish
Epidemiology Science Centre, Statens Serum Institut, Copenhagen,
Denmark.

BACKGROUND: and objective Previous studies from areas with high
mortality in West Africa have not found diphtheria-tetanus-pertussis
(DTP) vaccine to be
associated with the expected reduction in mortality, a few studies
suggesting increased mortality. We therefore examined mortality when DTP
was first
introduced in rural areas of Guinea-Bissau in 1984-1987. Setting Twenty
villages in four regions have been followed with bi-annual examinations
since 1979.
Subjects In all, 1657 children aged 2-8 months. Design Children were
weighed when attending the bi-annual examinations and they were
vaccinated whenever
vaccines were available. DTP was introduced in the beginning of 1984,
oral polio vaccine later that year. We examined mortality for children
aged 2-8 months who had received DTP and compared them with children who
had not been vaccinated because they were absent, vaccines were not
available, or they were sick. Main outcome measure Mortality over the
next 6 months from the day of examination for vaccinated and
unvaccinated children.

RESULTS: Prior to the introduction of vaccines, children who were absent
at a village examination had the same mortality as children who were
present. During 1984-1987, children receiving DTP at 2-8 months of age
had higher mortality over the next 6 months, the mortality rate ratio
(MR) being 1.92 (95% CI: 1.04, 3.52) compared with DTP-unvaccinated
children, adjusting for age, sex, season, period, BCG, and region. The
MR was 1.81 (95% CI: 0.95, 3.45) for the first dose of DTP and 4.36 (95%
CI: 1.28, 14.9) for the second and third dose. BCG was associated with
slightly lower mortality (MR = 0.63, 95% CI: 0.30, 1.33), the MR for DTP
and BCG being significantly inversed. Following subsequent visits and
further vaccinations with DTP and measles vaccine, there was no
difference in vaccination coverage and subsequent mortality between the
DTP-vaccinated group and the initially DTP-unvaccinated group (MR =
1.06, 95% CI: 0.78, 1.44).

CONCLUSIONS: In low-income countries with high mortality, DTP as the
last vaccine received may be associated with slightly increased
mortality. Since the pattern was inversed for BCG, the effect is
unlikely to be due to higher-risk children having received vaccination.
The role of DTP in high mortality areas needs to be clarified.

-------------------------------------------

2: Int J Epidemiol. 2004 Apr;33(2):367-73.

Divergent female-male mortality ratios associated with different routine
vaccinations among female-male twin pairs.

Aaby P, Jensen H, Rodrigues A, Garly ML, Benn CS, Lisse IM, Simondon F.
Bandim Health Project, Apartado 861, Bissau, Guinea-Bissau.

BACKGROUND: Observational studies have suggested that vaccinations have
non-specific effects that differ by sex. In the absence of randomized
trials,
studies of female-male twin pairs would allow us to investigate whether
an intervention had sex-specific effects on survival. We therefore
examined
mortality patterns among female-male twin pairs according to vaccination
status.

Design We identified female-male twin pairs using the population
registers from one urban district and three rural studies from
Guinea-Bissau and Senegal and examined the female-male mortality ratio
(MR) according to the last vaccine received among pairs in which a death
occurred before 18 months of age. As
background information, we examined sex- and age-specific mortality
patterns in the pre-vaccination era. Subjects In all, 626 female-male
twin pairs identified between 1978 and 2000.

RESULTS: There was no sex difference in mortality for boys and girls in
the pre-vaccination era. In the combined analysis of all studies, the
female-male MR was 0.25 (95% CI: 0.05, 0.93) for pairs having received
Bacille Calmette-Guerin (BCG) as the last vaccine, 7.33 (95% CI: 2.20,
38.3) for pairs having received diphtheria, tetanus, pertussis (DTP) as
the last vaccine, and 0.40 (95% CI: 0.04, 2.44) for pairs having
received measles vaccine as the last vaccine. The female-male MR varied
significantly for BCG compared with DTP (exact test of homogeneity, P <
0.001) and for DTP compared with measles vaccine (exact test of
homogeneity, P = 0.001).

CONCLUSION: Non-specific effects of routine vaccinations are likely to
be important and influence sex-specific mortality patterns in areas with
high mortality. The effects of vaccines need to be considered in the
planning of immunization programmes for low-income countries.
------------------------------------------

A medline-search will show many more abstracts, more info is also
available doing a simple Google-search.

This should shed some more light on the topic concerning a 'necessity'
of vaccinations, for those who want to be informed.

Best,

Gaby

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gaby Rottler
Germany
rottler@curantur.de

http://www.curantur.de
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

[Sheri Nakken]

Thanks Gaby for those. I had not seen them.

Sheri

At 10:09 AM 04/21/2004 +0200, you wrote:

[Tanya Marquette]

do you have info on how to get hold of this article? is there a web site

tanya

[Gaby Rottler]

Hi Tanya,
-------------------------------------------------
I had posted the abstract of this article, but I'm quite sure the
article is not available for free on the internet at the moment - it
would be highly unusual.

To get the article you need to be subscribed to the journal or buy a
copy of the article.
Simply go to:
http://ije.oupjournals.org/

and make a search.

Best,

Gaby

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gaby Rottler
Germany
rottler@curantur.de

http://www.curantur.de
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

[Sheri Nakken]

Yes, you do have to pay to read full text - $27.50 ;-(

URL for this abstract
http://ije.oupjournals.org/cgi/content/ ... t/33/2/374
URL for this abstract
http://ije.oupjournals.org/cgi/content/ ... t/33/2/367

--------------------------------------------------------------------
Sheri Nakken, R.N., MA, Classical Homeopath
Well Within & Earth Mysteries & Sacred Site Tours (worldwide)
Vaccination Information & Choice Network
http://www.nccn.net/~wwithin/vaccine.htm
http://www.nccn.net/~wwithin/homeo.htm
homeopathycures@tesco.net
ONLINE Introduction to Homeopathy Classes
ONLINE Introduction to Vaccine Dangers Classes
ANY INFO OBTAINED HERE NOT TO BE CONSTRUED AS MEDICAL
OR LEGAL ADVICE. THE DECISION TO VACCINATE IS YOURS AND YOURS ALONE
Voicemail US 530-740-0561 UK phone from US 011-44-1874-624-936