Paul Offit, Rotavirus, and a counterpoint to AoA

First a reminder:

Call it a two-fer kind of day. I'm just that disgusted with Blaxill's "The benefits of preventing rotavirus infection have been harder to sell to both parents and pediatricians. Death from meningitis is one thing, a little baby diarrhea is another, especially in an advanced country like the US. "The benefits of preventing rotavirus infection have been harder to sell to both parents and pediatricians. Death from meningitis is one thing, a little baby diarrhea is another, especially in an advanced country like the US."

Alright, rotavirus. What is it and is Blaxill right? According to Dr. Lipson at Science-Based Medicine, "Rotavirus is the world’s most common cause of severe childhood diarrhea.  In the U.S. alone, rotavirus disease leads to around 70,000 hospitalizations, 3/4 million ER visits, and nearly half-a-million doctor office visits yearly.  But it rarely causes death." 

The CDC says that before the vaccine, 20 to 60 children in the US died each year: "Rotavirus was also the leading cause of severe diarrhea in U.S. infants and young children before rotavirus vaccine was introduced for U.S. infants in 2006. Prior to that, almost all children in the United States were infected with rotavirus before their 5th birthday. Each year in the United States in the pre-vaccine period, rotavirus was responsible for more than 400,000 doctor visits; more than 200,000 emergency room visits; 55,000 to 70,000 hospitalizations; and 20 to 60 deaths in children younger than 5 years of age."

You tell me, is Blaxill right? I don't think so. Everything I've read on rotavirus  leads me to further outrage that 20-60 deaths in the US, a ballpark figure of 60,000 babies being hospitalized a year, is nothing more than "a little baby diarrhea." You have to be a cold-blooded SOB to trivialize diarrhea severe enough to warrant 200K visits to an emergency room. 

I mean, Blaxill is so sure of his ability to ascertain facts, I'm going to assume (even if he can't count), that he can read and take the time to look up the facts on rotavirus before he attempts to eviscerate Paul Offit for having spent over two decades of his life working on a vaccine to prevent children from suffering and dying. I mean, the fact that "Rotavirus is the leading cause of severe diarrhea in infants and young children worldwide. Globally, it causes more than a half a million deaths each year in children younger than 5 years of age" (CDC) can't possibly be lost on Blaxill, right? 500,000 children a year worldwide die from a vaccine preventable disease and he's not outraged that more isn't being done to save a half million kids? No, he'd rather try to figure out how much Offit makes from the vaccine the man spent 25 years of his life creating. He'd rather spend hours creating charts and clever names and try to create fear in parents' minds by trying to link intussusception to Offit's vaccine. If that isn't unjustified fearmongering, what is?

Intussesception was linked not to Offit's vaccine, but to Rotashield. The CDC writes: "Intussusception from all other causes is most common among infants in the first year of life; 1 child in 2,000 children to 1 child in 3,000 children is affected before one year of age. Based on the results of the investigations, CDC estimated that one or two additional cases of intussusception would be caused among each 10,000 infants vaccinated with RotaShield® vaccine. In other words, the CDC found a needle in a haystack, but those who are agitating against vaccines ignore the very real fact that epidemiological studies detected these 1-2 extra cases in 10,000 and yet decry studies that show no increased prevalence of autism with thimerosal or MMR. So, in the one case, the needle is way over-estimated and overplayed to skewer Offit, but when studies find no such needle, they're bad studies bought and paid for. 

Also fascinating is the ability of said individuals to both use VAERS when it suits their needs and badmouth it when it doesn't, as Blaxill uses VAERS entries to bolster his case that intussesception is linked to the rotavirus vaccine. Blaxill writes "Intussusception is a dangerous and occasionally fatal complication of vaccination but it is not the only deadly adverse event associated with Rotateq."

What Blaxill uses to support this is unsubstantiated VAERS reports. When one looks into intussesception in general, what one finds is that "Intussusception is the predominate cause of intestinal obstruction in persons aged 3 months to 6 years. The estimated incidence is 1-4 per 1000 live births." In addition, "Most patients recover if treated within 24 hours. Mortality with treatment is 1-3%. If left untreated, this condition is uniformly fatal in 2-5 days. Recurrence is observed in 3-11% of cases. Most recurrences involve intussusceptions that were reduced with contrast enema." Indeed, when one looks into the cases of intussusception and Rotashield, there were "15 infants with intussusception reported to VAERS," all of whom recovered. NONE died as a result.

Simonsen et al. in 2005 undertook investigation of the age of initial age of rotavirus vaccination and intussesception: "We found that age at vaccination strongly affects the absolute risk of intussusception. We believe that our results shed new light on the unhappy experience with RotaShield in the United States and can help to maximize the chance that any future rotavirus vaccination programs will succeed." They also note "Although statistical evidence indicates that exposure to RotaShield caused intussusception, no biological mechanism has been established." 

The CDC acted quickly in the case of Rotashield, which should act to encourage parents concerned about vaccines that when a serious side effect is suspected, the CDC works to remove that risk. Rotashield was taken off the market in 1999.

Despite Blaxill's bluster, there's no evidence that Offit writes books on vaccination in order to keep his royalties high. In fact, that Offit donates all proceeds of his new book to the Autism Science Foundation contradicts the portrait of greed that Blaxill attempts to set out. Offit's last book also saw all proceeds go to autism charities, something AoA doesn't acknowledge (other than to tweet scornfully that ASF doesn't help like TACA does). 

I contend that if one is really an autism advocate, the reality that Offit chooses to co-create a foundation to fund autism research when he is not a parent of someone on the spectrum speaks to his character. That he has devoted his life's work towards ameliorating children's needless suffering from infectious diseases is also a tremendous indicator of character. It can only be to Paul Offit's credit that those who would like to see the vaccine program crippled and dismantled hate him so.

Liz Ditz has a statement from Paul Offit on her blog, which clarifies that he receives no royalties on sales of Rotateq. 

 Offit writes "Just for the record: I no longer financially benefit from the sales of RotaTeq. My financial interests in that vaccine have been sold out by either The Wistar Institute, The Children's Hospital of Philadelphia, or me. I will, however, continue to stand up for the science of vaccines because unfounded fears about vaccines have hurt children. That is why I do what I do and why I have always done it. And I will continue to closely follow the distribution of rotavirus vaccines because these vaccines have the potential to save as many as 2,000 children a day, which is why I joined the research team at Children's Hospital." (reposted with permission from Liz)

So Blaxill got nothing right. Go figure.


farmwifetwo said...

I don't know if we got rotavirus or the Norwalk. I suspect it was the second b/c it wasn't just a little diahhrea it was out both directions for a week - and we were in emerg 2 afternoons for monitoring and 1 to see the Ped (by then it was nearly done and the child was simply hungry). Little boy was about 14mths old at the time. We also got something else the week after we started chicken pox and he simply stopped eating/drinking and about 5 days later "little baby diahhrea" - ok he was 5 at the time - was considered 'cured'.

I appreciate their's vaccines for many things, but I'm not lining up to take them all b/c we can. We caught the chicken pox, we've caught the flu (H1N1 in May before the vax was out). Never been recommended by Ped or Dr's to have a flu shot since I'm home and take them out of school.

I did pay the $70 ea for the menigitus shot - too old to get it pd for - for them. We live WAY too far away from a major medical ctr for it.

I have to admit, I don't think vaccines should be mandatory. I think you'll find most parents will have the regular one's by school age, it's giving them to their children before the first year that upsets a lot of those I have talked to. But then again, I am a firm believer in "choice". But to have "choice" people have to live with their own and they keep expecting someone else to do it for them.

KWombles said...

I think the current policy here in the US of requiring certain vaccines in order to go to school, but allowing exemptions, is the best way to go. Choice is important as is control over what goes into one's body. What I'd like is for people to make informed decisions based on accurate data.

And, yeah, we've got to live with the consequences of those decisions. The problem is that many people who screw up, make a mistake, won't: they'll self-justify their actions and never admit they made an error.

Evil Possum said...

On the intussuspection issue, I posted a question a while ago (I think it was at LBRB) whether a rotavirus infection could prevent it. Someone who self-identified as a nurse said it could happen.

Having dealt with AoA's exagerations of Offit's Rotateq income several times, what I find most myopic about their approach is that they have yet to look at what Dr. Offitt makes in SALARY.