A Conversation for The MMR Vaccine

Peer Review: A43195214 - Update - *The MMR Vaccine*

Post 1

AlexAshman

Entry: Update - *The MMR Vaccine* - A43195214
Author: Alex Tufty Ashman [!] - U566116


This really needed a re-write. As always, no double glazing salesmen, please.

Alex smiley - smiley


A43195214 - Update - *The MMR Vaccine*

Post 2

Jhawkesby

What do you mean no double glazing salesman.


A43195214 - Update - *The MMR Vaccine*

Post 3

Galaxy Babe - eclectic editor

Hello Alex smiley - smiley

<>
entry = Entry

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<>
fifteen = 15

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sixteen = 16

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<>
smiley - erm
I'd suggest:
In the year before MMR vaccination was introduced, the mumps virus produced around a thousand hospitalisations, and five of those patients died.

smiley - tea

<>
forty = 40

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fifteen = 15
fifty = 50

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fourteen = 14
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<> you need a &nbsp; after the close tag

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<> = link to A19645220

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twelve = 12

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<> = link to A19773624

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<>
There's a missing element in that sentence.

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<>
=
and there *may* be an increased risk of the child missing one or more of the vaccinations.

Good update, thanks Alexsmiley - ok

GB
smiley - galaxy


A43195214 - Update - *The MMR Vaccine*

Post 4

h5ringer

Yes, important update this one - well done Alex smiley - ok

immunosupressant >> immunosuppressant

Also, would it be worth pointing out in the herd immunity discussion, that a virus can only survive if it can find new hosts to infect. If the average number of new people infected by each infected person is less than 1, the disease will die out naturally.


A43195214 - Update - *The MMR Vaccine*

Post 5

BigAl Patron Saint of Left Handers Keeper of the Glowing Pickle and Monobrows

smiley - book


A43195214 - Update - *The MMR Vaccine*

Post 6

AlexAshman


"No double glazing salesmen" = no long, arduous rants about a certain point of view, such as those you might encounter when you have a double glazing salesman with his foot in your door. smiley - smiley

GB, I've made all those changes (smiley - cheers) except for the first one ("However, use lower case when talking about entries in general." - <./>EditedGuide-Style</.&gtsmiley - winkeye and the last one ("there would be an increased risk of the child missing one or more of the vaccinations" - the word 'risk' already implies a 'may or may not', and besides it's a recognised fact)

I've added a footnote about viruses dying out smiley - cheers


A43195214 - Update - *The MMR Vaccine*

Post 7

AlexAshman


I've added a section on Clinical Reasons Not to Vaccinate


A43195214 - Update - *The MMR Vaccine*

Post 8

Danny B

Hi Alex - nice job smiley - smiley

This statement leapt out at me a bit:

"Scientifically sound studies consist of thousands of subjects"

That is certainly true for *epidemiological* studies, but not for all scientific studies! A well-designed clinical trial in patients with a very rare disease might be scientifically sound with only 40 or 50 patients. I'd suggest clarifying that a little.

And a minor point: I was always taught (as a medical writer by trade) not to use the word 'subjects', but use patients, individuals, participants or something similar. It just reminds the reader that these are human beings we're talking about, not animals or inanimate objects!

smiley - ok


A43195214 - Update - *The MMR Vaccine*

Post 9

AlexAshman


Sorted smiley - oksmiley - cheers


A43195214 - Update - *The MMR Vaccine*

Post 10

BigAl Patron Saint of Left Handers Keeper of the Glowing Pickle and Monobrows

Nice, well-balanced Entry, Alexsmiley - smiley (I'd had it in mind to do this Updater myself at some point)

A couple of things:

smiley - biro I think it would be worth emphasising that 'Like ALL vaccines, the MMR vaccine can cause side-effects... (i.e. the soreness, redness, swelling etc. at the site of injection. These are caused by an immune response against vaccine components e.g. ovalbumen in virus vaccines that have been produced in eggs..

smiley - biro Mention that thimerosal contains mercury, and I'm sure there's a LINK you could make here.

smiley - biroI don't think you emphasise sufficiently the dangers of measles virus infection.smiley - 2centsIn the developing world, mortality from measles in malnourished infants is one of the leading causes of death. If I recall, measles virus is THE leading cause of blindness in such children. Thus children lose appetite and this particularly affects vitamin A intake (LINK) leading to blindness. If I recall, 100,000 cases of blindness per year in the world are attributable to infection by measles (However, I've mislaid my textbook of medical virology since tidying my officesmiley - grr.

smiley - biroMeasles virus is also associated with various diseases of unknown aetiology. Many of these are 'autoimmune'. Conditions which have been linked with measles virus infection include MS, Crohn's Disease, Kawasaki and Paget's Diseases (When I was working at &*$£% colleagues in my department were collaborating with Wakefield's group using labelled antibody techniques to see if they could detect measles virus antigens in bowel tissue from patients with Crohn's. I left before this work was completed so I don't know the outcomes.)

I may come back to this next week. I have to smiley - run off to attend a wedding this weekend.

A


A43195214 - Update - *The MMR Vaccine*

Post 11

BigAl Patron Saint of Left Handers Keeper of the Glowing Pickle and Monobrows

Ref encephalitis, there are three forms of virus encephalitis.

The figures I have to hand (1993) are:

*Acute postinfectious measlres enceph. (1 in 1000 cases)
* Measles inclusion body enceph.. Usually occurs in immune-suppressed individuals.
*SSPE. 1 in 25000. i.e. Rare but fatal.

A


A43195214 - Update - *The MMR Vaccine*

Post 12

AlexAshman


smiley - cheers I've included most of that, except for the encephalitis figures (they change all the time and don't mean all that much to the lay person).


A43195214 - Update - *The MMR Vaccine*

Post 13

Giford

Fantastic Entry!

My only query is over the last sentence - given what you've said about herd immunity earlier.

Gif smiley - geek


A43195214 - Update - *The MMR Vaccine*

Post 14

AlexAshman


Sorted smiley - ok


A43195214 - Update - *The MMR Vaccine*

Post 15

BigAl Patron Saint of Left Handers Keeper of the Glowing Pickle and Monobrows

smiley - biro 'thimersal, a mercury-containing vaccine component...' > thimerOsal, a merccury-containing vaccine PRESERVATIVE...'

smiley - biroI still don't think you emphasise enough the dangers of natural measles infection. Thus in the 3rd World it is a massive killer - for reasons as yet unknown. This is what an article from NIMR Mill Hill says (I'll put the link in the following post):

'If there were no vaccination every child in the country would get infected with measles giving an average of about six hundred thousand cases per year. It is estimated that between fifty and one hundred would die as a result either of infection of the brain, (encephalitis) or from pneumonia. Up to ten years later a few more would die of the effects of measles virus lingering in the brain rather than being cleared from the body by the immune system as in most cases. Delayed death is due to the invariably fatal disease called sub acute sclerosing pan encephalitis, or SSPE for short. In developing countries, in contrast, measles is a massive killer, for reasons that are still not entirely clear'.


A43195214 - Update - *The MMR Vaccine*

Post 16

BigAl Patron Saint of Left Handers Keeper of the Glowing Pickle and Monobrows

http://www.nimr.mrc.ac.uk/millhillessays/1998/mmrcrohns.htm


A43195214 - Update - *The MMR Vaccine*

Post 17

AlexAshman


Ok, sorted smiley - ok


A43195214 - Update - *The MMR Vaccine*

Post 18

BigAl Patron Saint of Left Handers Keeper of the Glowing Pickle and Monobrows

Yep, that's smiley - ok

... but thiomerosal >thimerosal (unless your way is an accepted alternative. I only know the latter)

A


A43195214 - Update - *The MMR Vaccine*

Post 19

AlexAshman


Ah. There are two ways of spelling it, hence my confusion...

>>>thiomersal (aka thimerosal)<<< smiley - ok


A43195214 - Update - *The MMR Vaccine*

Post 20

AlexAshman


Any more comments for this one? smiley - smiley


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