Hard News by Russell Brown

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Hard News: Sunday newspaper prints informative and well-researched story

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  • James Green,

    Ross -- Can you clarify how the epidemic is both waning and the death rate has skyrocketed? (preferably with some numbers).
    I'd also be intrigued if you could explain the mechanism whereby a boffin would make a tidy sum.

    Dunedin • Since Nov 2006 • 667 posts Report Reply

  • ross f,

    > They didn't record the socio-economic status of those who did get the disease but I remember wondering whether the root cause wasn't inadequate and crowded housing, and wondering whether that just wasn't too much of an admission for a Labour government to make. In other words, we don't have a meningitis epidemic, we have a housing crisis, with meningitis as its symptom.

    That's basically correct. The MOH did some research a few years before the vaccine was rolled out and came to the same conclusions. Smoking was also a factor. But mysteriously this research was not mentioned at the time of roll out.

    The MOH also exaggerated the risks and claimed than many chilkdren would lose limbs, etc. if they weren't vaxed. Apparently you've got a better chance of winning Lotto than losing a limb. In fact, the MOH showed an Aussie kid with a missing limb when it did a promo for the vaccine because there were so few NZ kids avaliable.

    wairarapa • Since Mar 2007 • 45 posts Report Reply

  • James Green,

    half of the population could've been given the vaccine and the other not. So we'd have seen whether it worked or not.

    Of course they could have done that. However, if it is accepted that there is little risk to the vaccine, and that the relative cost is low enough, then it's not ethically acceptable to do that. You might want to re-read the links I provided to Bradford Hill's stuff (assuming that you've already read them).

    Dunedin • Since Nov 2006 • 667 posts Report Reply

  • ross f,

    James,

    The epidemic was waning BEFORE the vaccine was rolled out. The death rate and the incidence had dropped dramatically. A quick search of the internet will give you the exact figures, but such was the fall in numbers that the expected reduction in deaths from the vaccine was simply impossible. The vaccine was given approval by Cabinet in the expectation that it would save dozens of kids' lives, but this was physically impossible given the small numbers dying from the disease at the time of roll out.

    And since roll out...
    http://www.scoop.co.nz/stories/GE0611/S00058.htm

    wairarapa • Since Mar 2007 • 45 posts Report Reply

  • ross f,

    > However, if it is accepted that there is little risk to the vaccine, and that the relative cost is low enough, then it's not ethically acceptable to do that.

    What are you talking about the cost being relatively low? This has been the most expensive health initiative ever! As for risk, we don't know what the risk is, notwithstanding that Norway is currently conducting an inquiry into some serious adverse effects from an almost identical vaccine.

    wairarapa • Since Mar 2007 • 45 posts Report Reply

  • James Green,

    Ross -- that graph in the Scoop article looks impressive, except for one slight ommission. There's no variance indicator. The 150% claimed, is a relative rather than an absolute increase. Those fatality rates are calculated monthly (so fewer than 100 cases), meaning that the margin of error is rather large, like in excess of 5%. In other words, the apparent pattern is most likely noise.
    Also, and equally importantly, if the number of cases is waning (and especially if the number of cases are diminishing because of the vaccine), then because the number of cases is a key part of the fatality calculation, you can't compare them like that. An example confound would be that if people with weakened immune systems are not helped by the vaccine, and are over-represented in the number dying, then as those with normal immune systems stop dying, the fatality rate will appear to increase, but only because you're not comparing apples with apples.
    Thus, that graph appears completely rotten on 2 key points -- the apparent presence of a serious confound, and no evidence of a significant difference.

    As to the cost being relatively low. It's presumably relatively low (cost of vaccine divided by cost of prevented cases), despite being absolutely expensive.

    Dunedin • Since Nov 2006 • 667 posts Report Reply

  • James Green,

    I downloaded the reports from the Ministry of Health, and it was very apparent from the breakdown of area, age, and ethnicity that basically a middle-class Pakeha child at primary school had a very low chance of contracting the disease, at least an order of magnitude less than the equivalent Polynesian child. (If I can dig up the numbers I ran, I'll post them).

    The 2004 data does tend to suggest that. However, in 2001 where there were many more cases, Otago and Canterbury were particularly peaky, which somewhat goes against that interpretation.

    Dunedin • Since Nov 2006 • 667 posts Report Reply

  • Riddley Walker,

    anything else you want to blame on the Lesbian Communist Cabal Conspiracy ross? hair loss perhaps? lack of live people who will talk to you? can't get it up like you used to? how about those muslims? i bet the LCCC is behind that too...

    AKL • Since Feb 2007 • 890 posts Report Reply

  • Riddley Walker,

    oh yes, what about flouride in drinking water ross - that's probably how they're getting to you. or are you on tank water out there in the country? it could be through radio waves - have you considered lining your bedroom walls with tinfoil?

    AKL • Since Feb 2007 • 890 posts Report Reply

  • Stephen Judd,

    <i>Otago and Canterbury were particularly peaky</i>

    My initial scrabble to defend my hypothesis would be to ask how many Otago cases were students...

    Wellington • Since Nov 2006 • 2906 posts Report Reply

  • James Green,

    Ross. Here's a fatality rate graph from MOH. As you'll see, it's bucked around a bit. The apparent spike in 2005 includes 30% of deaths caused by C-strain meningitis. And the provisional data from 2006 looks like back to 4.2%, the long term average (and still within the +/-2% band for annual fatality rates).

    Stephen -- IIRC, there was an outbreak around a high school ball in Owaka or Balclutha, plus perhaps some scarfies. It's certainly not the only time a school ball has been involved (one in the wraps methinks?). Anyway, the median age for a Pakeha case is 16 I think I saw somewhere, compared with sub-5 for other ethnicities. So potentially quite distinct transmission lines.

    Dunedin • Since Nov 2006 • 667 posts Report Reply

  • ross f,

    > The 150% claimed, is a relative rather than an absolute increase.

    You're wrong. It is an absolute AND relative increase. As the writers make clear, there are 13 unexplained deaths. Although the number of cases has fallen, the number of deaths has increased, causing the large increase in the death rate. This has got nothing to do with margins of error. Whichever way you try to spin it, there has been a 150% increase in the rate of deaths and there has been an increase in the total number of actual deaths.

    You've since referred to the C-strain. You may not be aware but when the MOH argued for the introduction of the MeNZB vaccine, it included figures from ALL strains of the disease. Surely it is bad science (and bad policy) to argue for vaccine, claiming we have an epidemic, on the basis of ALL strains. But since that was the methodology used, it seems entirely appropriate to measure the success of the vaccine using the same methodology.

    wairarapa • Since Mar 2007 • 45 posts Report Reply

  • ross f,

    In December 2006, the Ministry of Health claimed, "Overall, we used to have 213 epidemic strain cases a year in under-20s, now we see around a quarter of that. We used to have seven deaths a year. So far this year there have been two."

    The fact is that the decline in the epidemic in under-20s (and other sub-groups) occurred well before the vaccine's rollout and has continued since.

    The epidemic strain killed 2 only under-20s in 2003, the year before rollout began. There has apparently never been a year when there were seven deaths due to the epidemic strain of the disease in under-20s.

    Figures for 2006 show that incidence of the disease continues to be at epidemic levels, depsite the stated goal of the MOH to wipe it out.

    It's a real concern that the ministry has resorted to deliebrately falsifying information in order to justify the most expensive health initiative ever.

    wairarapa • Since Mar 2007 • 45 posts Report Reply

  • ross f,

    The debate about MeNZB is brought into sharp focus by Pharmac's decision not to fund the Herception drug. Ironically, the same reasons that Pharmac has used to deny women access to this drug are the same reasons that should have seen MeNZB axed. In fact, there may well be a stronger case for Herceptin than there was for MeNZB. The number of women who die from breast cancer far exceed the number of people who die from meningococcal disease.

    wairarapa • Since Mar 2007 • 45 posts Report Reply

  • Jason Lea,

    What do they mean by '13 unexplained deaths'? Does it mean they were caused by meningococcal disease?

    Christchurch • Since Nov 2006 • 30 posts Report Reply

  • Russell Brown,

    What do they mean by '13 unexplained deaths'? Does it mean they were caused by meningococcal disease?

    Basically, it just sounds scarier when they put it that way.

    Auckland • Since Nov 2006 • 17938 posts Report Reply

  • James Green,

    "the number of deaths has increased"

    Incorrect. The number of deaths for 04 and 06 are lower than every year since '96; and 05 is lower than all pre-vaccination years except 03.

    "Figures for 2006 show that incidence of the disease continues to be at epidemic levels, depsite the stated goal of the MOH to wipe it out."

    The incidence in 2003 (pre) was 14.5/100,000. In 2005, it was 6.4. The number of cases in 06 was lower than 05, and continues to trend down. That looks a lot like it's being wiped out.

    The number of women who die from breast cancer far exceed the number of people who die from meningococcal disease."

    While this is true, it couldn't be less relevant. Herceptin only treats some types of breast cancer, and only helps a small portion of those (approx. 19). Inconveninently, 18 people died from MeB in 2001.

    You're wrong. It is an absolute AND relative increase.

    Uh, no. You're wrong. The increase they refer to is from 2.4% (2003) to 6.1%. The relative increase is 6.1/2.4=2.54 (254% of original, or a 154% increase). The absolute increase is 6.1-2.4, which is 3.7%.

    Dunedin • Since Nov 2006 • 667 posts Report Reply

  • Riddley Walker,

    those fancy book-learnin numbers are a bitch eh ross when you're using them against people who can like, count and read and stuff.

    AKL • Since Feb 2007 • 890 posts Report Reply

  • Russell Brown,

    those fancy book-learnin numbers are a bitch eh ross when you're using them against people who can like, count and read and stuff.

    Ross's facts come from the Ron Law/Barb Sumner lobby. Their use of the "unexplained deaths" phrase was scurrilous, but obviously, "other causes" doesn't sound scary enough.

    I think there are legitimate questions about the way the MeNZB rollout was handled, but these aren't those.

    Auckland • Since Nov 2006 • 17938 posts Report Reply

  • James Green,

    I think there are legitimate questions about the way the MeNZB rollout was handled, but these aren't those.

    There is definitely some interesting stuff in there, but packaging it in an explicable fashion for public consumption would be pretty difficult. There's an enormous number of different considerations in there.

    I'm pretty much ready to give up on this. However, I've prepared a graph of my own to compare with the Ron Law/Barb Sumner one. As you can see here, if you're anti-MeNZb, you'd do well to concentrate on the fatality rate. The number of cases and the number of deaths have both declined a great deal, but if you combine them mathematically, and ignore the concerns I raised about both it's reliability and validity, it's the only way you can spin the figures to look bad.

    Dunedin • Since Nov 2006 • 667 posts Report Reply

  • Stephen Judd,

    That's a pretty compelling graph, James. Kudos for putting that together.

    Wellington • Since Nov 2006 • 2906 posts Report Reply

  • Riddley Walker,

    so they aren't even real numbers ross, that's even worse than just ignorant mininterpretation and misrepresentation. you should have a chat to coddington, she'd likely be really interested - may even contract you as a statistician.

    AKL • Since Feb 2007 • 890 posts Report Reply

  • Russell Brown,

    There is definitely some interesting stuff in there, but packaging it in an explicable fashion for public consumption would be pretty difficult. There's an enormous number of different considerations in there.

    I think the MoH played down the possibility of adverse reactions more than was wise. Our older boy was knocked sideways by every shot - the sickest he's been in his life.

    It made more sense once I found the MedSafe data sheet online. I blogged about it (and consequently and somewhat reluctantly wound up talking to Linda Clark on the radio):

    http://publicaddress.net/default,2201.sm
    http://publicaddress.net/default,2204.sm

    I thought it had been worthwhile after I got this from a regular reader:

    I agree with what I think is your main point - that the information we were given as parents was poor and left us unprepared for what happened following the vaccination.

    We took our 3 1/2 month old son in for the first vaccination last week. I asked "what are the likely side-effects" and was told that on that day there was likely to be a bit of a temperature and maybe some grizzliness, but that's all.

    Until I read the Medsafe sheet you linked to, we didn't link the vaccination to the subsequent inability to sleep for longer than 90 minutes (after having started sleeping 9 hours), and the severe irritability. This all lasted about five days and we had all manner of things checked out - ears, flu, etc. But if we had known the side effects, we would have been less concerned. We would still have had him vaccinated, but we would have had a better week as we would have understood what was happening.

    Oh, and Riddley, much as I enjoy your contributions, your taunting of ross is in danger of breaching the spirit in which these forums are supposed to run. Best addressed in a kinder fashion, I think.

    Auckland • Since Nov 2006 • 17938 posts Report Reply

  • Emma Hart,

    I think the MoH played down the possibility of adverse reactions more than was wise.

    This is exactly what pissed me off. Had I had the information that came out through PA in the first place, I would still have had my kids immunised, but I would have done it at our dr's and had them home the rest of the day, rather than having them done at school. Simple.

    Christchurch • Since Nov 2006 • 4285 posts Report Reply

  • Riddley Walker,

    fair enough

    AKL • Since Feb 2007 • 890 posts Report Reply

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