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Population Council Vaccine Study
Rebuttal or Whitewash?
A look at Vaccination in Ghana,
an unsubstantiated and unscientific claim that vaccines save lives
Associations: Temporal and CausalThe wearing of bowler hats is associated with better health.
The use of cow manure on gardens is associated with healthier vegetables.
The use of vaccines (injectable waste material) has been associated with lower mortality. The use of vaccines has also been associated with higher mortality and multiple modern as well as ancient diseases.
Which of these associations are simply temporal, that is events occurring at the same time but without a causal connection and which associations are casually related?
The wearing of bowler hats is not a cause of better health. However, in England, bowler hats were popular in higher society where the advantages of better socio-economic conditions prevailed, such as less strenuous jobs (mine owners not mine workers) and better year around diet that led to better health. Thus the association of bowler hats to health is a correct temporal association but not a causal association.
The use of manure (animal waste) on gardens nourishes the soil and thus the use of manure actually causes healthier vegetables. This is a casual association.
The use of vaccines (injectable waste material) has occurred along side vast improvements in sanitation and nutrition as well as hygiene, better ventilated housing and many other environmental changes. Separating the individual effects of each lifestyle change can be quite challenging, however it is well documented that sanitation and nutrition are the major factors in lowering childhood mortality and controlling infectious diseases.
Our central question is:
Are vaccines associated with lower mortality only as a temporal association, such as the wearing of bowler hats is temporally associated with better health, or is there an actual causal relationship, similar to putting manure on gardens?
This question can be answered with scientific trials, but vaccine proponents are highly reluctant to engage in such tests. Much information to answer this question can be gained from reading a true history of vaccines, as well as comparing the health of vaccinated to non-vaccinated individuals. However, that study is outside the scope of this web page. Please see our Home Page
To understand why we can say that a published pro-vaccine rebuttal to vaccine harm did not follow standard scientific procedures, let us start with an analogy.
Associating Poisons with Declines in Mortality
Once upon a time an experimenter entered an area where a large number of children died before their fifth birthday.
The experimenter determined that the mortality rate could be cut in half if most of the children drank a mixture of several
raw vegetables made into juice and combined with small amounts of several poisons. The growers of each vegetable claimed
that their vegetable was the most important one in preventing children's deaths. The manufacturers of each poison associated
their poison with the 50% decline in mortality and claimed their poison was essential to the survival of children everywhere.
In our analogy above,
the more juice given - The more lives were saved.
Is it also true,
that the more "poison" given, the more lives were saved? ? ?
Could the poison be left out of the "juice" and save even more lives?
That question will be examined below.
The WHO sponsored Population Council study,
What the WHO study CLAIMED (Summary)
How vaccination takes credit for the benefits of sanitation and nutrition.
Figure 1, above, summarizes the claims made by the WHO study authors. Five levels of intervention are shown with the resulting number of deaths per 1000 live births in each group. The column B (red) line shows approximately 246 deaths per 1000 with little or no interventions.
Lines labeled for columns C (Magenta) through F (Violet) show a lower number of deaths associated with higher numbers of interventions (lifestyle changes) including more vaccinations.
Using an estimate for the number of deaths in the first 3 months of life, plus the published data for the 4 to 59 month ages, gives the following total number of deaths per 1000 live births for children under 5 years (U5MR) claimed for each level of intervention:
Based on data published in the reference study:
Estimated U5MRs for children with 5 levels of intervention:
"Unvaccinated" = 246 % Partial series of BCG/polio/DPT = 147 * % Full series of BCG/polio/DPT = 105 * % # Partial series of BCG/polio/DPT and measles = 105 * % # All vaccinations = 95 * % # * Totals do not include an estimate for vaccine caused deaths. % Totals do not include an estimate for deaths in the vaccinated classified as unvaccinated. # No correction for self-selective healthy bias was made.
What is wrong with the above figures?
"No or little Juice" = 246 lives lost per 1000 born:
"Some Juice" = 147 lives lost per 1000 born:
"More Juice" = 105 lives lost per 1000 born:
"Abundant Juice" = 95 lives lost per 1000 born:
Bias 1: Failure to consider all interventionsUnfortunately, the WHO Population Council study listed only vaccination interventions into the lifestyle of families in the KND! Not listing the additional interventions that accompanied the vaccinations makes it impossible to determine what level of benefit, if any, should be credited to various vaccinations in this study. As an example, children who received the measles vaccine at 9 months of age almost certainly received a vitamin A capsule and most of the other available interventions. In the setting under consideration, vaccinations are almost always accompanied by other health interventions. See the long list below of interventions available in the study area.
Historically, improvements (interventions) in the areas of sanitation, nutrition and hygiene have been the GREAT immunizers. In the USA. 90% of decline in infectious disease mortality occurred before the introduction in specific vaccines. In certain areas, like Panama, insect control for malaria was also helpful in reducing mortality. In the study area, there were improvements made in all four of these immunizing activities, sanitation, nutrition, hygiene and insect control. Typically, lacks of sanitation, nutrition and hygiene have been associated with poverty. However, no significant economic improvements occurred during the study period. In addition, health promoting lifestyle improvements were not uniformly applied throughout the KND as portions of this district are inaccessible during part of the year.
The large number of non-vaccine interventions that have a high level of efficiency in producing better health and under age five survival rates make it certain that vaccination can NOT be credited with a large part, if any, of the total improvement in mortality in the subject study. Vitamin A capsules alone were credited with a minimum of 20% of the decline in mortality. See the Expanded Background Information.
Yet, going completely against vaccines' proven ineffectiveness, the authors made the absurd claim that "The independent reduction in mortality associated with measles vaccination is 50 percent." This inflated claim is made even while admitting that "a mere 3–4 percent of child deaths can be attributed to measles (Binka et al. 1995)"... Keep in mind that the purpose of the study's unscientific methodology was supposedly to rebut data showing increased deaths in a population of children living in socio-economic conditions similar to the KND area and who had experienced higher mortality in response to the DPT vaccine.
This list of lifestyle changes can be expanded as follows:
Note: The number of Insecticide Treated Nets was low and stable during the study period. Many other educational and medical based interventions increased in the study period due to the posting of community nurses. Of interest is the fact that Measles vaccination coverage declined during this period of improving mortality.
If most of the interventions in the long list above contribute to a decline in child mortality, then one or more of the interventions could actually be harmful and still the total effect of all interventions would be to lower childhood mortality.
Wrong label for minimal or NO Interventions
Second Bias:Figure 2 at the right is a subset of Figure 1 and shows mortality rates for only the first four months of life for children in the KND during the study period. Note the starting points of the red and blue lines at the lower left side of the chart. The samples of children labeled "vaccinated" had an estimated neonatal mortality (deaths in first 28 days following birth) of 20-23 per thousand and the "non vaccinated" labeled sample had an estimated neonatal mortality of twice the "vaccinated" although both groups were UNVACCINATED in the first month of life. [Our estimates based on published declines.] Why do two groups of unvaccinated children have such a wide disparity in neonatal (first month) survival?
A grossly inflated baseline is used for Unvaccinated Children
A true comparison between vaccinated and unvaccinated children must compare children whose only difference in lifestyle interventions is vaccinations. One can not legitimately compare children who receive a dozen or more interventions including a few vaccinations with children receiving no interventions and claim that the difference in mortality between the two groups is due to vaccination.
The group of children who benefit from non vaccine interventions, affecting both the child and mother, have about half the rate of deaths in the neonatal period as those children who have little or no interventions.
Thus if the children favored with early life non-vaccine interventions continue to receive no vaccinations, and continue to benefit from non-vaccine interventions, then their under five mortality rate (U5MR) should continue to be about half the mortality of those children with no interventions. Half of 246/1000 is 123/1000. This "estimated true baseline" of 123/1000 U5MR for unvaccinated children is less than the 147/1000 estimated deaths listed for the children (Column C) who received a partial series of BCG, Polio and DPT.
Bias 3: Unpublished Vaccine Contribution to Death RateDeath rates in the 1 to 4 month age were not published in the reference study; therefore, our chart shows estimates for all 5 intervention levels in this age group but our estimates do not include deaths caused by vaccinations. In a society with few socio-economic advantages, vaccine caused mortality can be very high as mentioned above for reference three.(3) Most of the vaccines other than measles vaccine were given in the first six months of life with nearly half of these vaccinations given in the 1-3 months age range in which the mortality rates were not published. The Measles vaccine was usually given near 9 months of age. We expect that publishing the mortality figures for the 1 to 3 month age bracket would increase the number of deaths in the U5MR for all four of the vaccinated groups, labeled as columns C through F.
Bias 4: Vaccinated Dead Classified as UnvaccinatedAnother major bias is due to the methodology of data collection; some children classified as not vaccinated were in fact vaccinated. Children who are vaccinated and then die are sometimes recorded as unvaccinated because the parents throw away the vaccination card that is used by the data collection team to confirm vaccination status.
It would require only 18 total unpublished (Bias 3) and falsely labeled deaths (Bias 4) per 1000 life births in the 1-3 month age period to bring the U5MR of columns D and E to equal the estimated "true baseline" of the unvaccinated children.
(Columns D or E | 105 + 18 = 123)
Bias 5: Healthy Self Selective BiasFor the vaccine group that received all vaccines, there is another bias in addition to the ones already listed above and that is a self selective bias. Only 45 percent of the children received a measles vaccine compared to 75 percent for other vaccines. The measles vaccine was usually given at nine months of age, several months after the other vaccines were received and only to those whose parents voluntarily initiated a visit to a health clinic. Likely, parents who saw their children experience a severe reaction to earlier vaccines would be more likely to refuse measles vaccination for their child. Thus the group who received the measles vaccine would have been a self-selected healthier group than the children who experienced severe reactions to vaccines. For this relatively healthy group to have a minimum of 10 fewer deaths per 1000 children than the rest of their age group is likely.
The "suggested" minimum of 10/1000 self selected health bias (Bias 5),
plus the lost card (Bias 4)
and unpublished deaths (Bias 3)
would bring Group F's U5MR equal to the estimated unvaccinated base line of 123 deaths per 1000 live births.
(Column F = 95 +10 + 18 = 123)
Conclusions:Vaccinations, usually labeled "immunizations", were routinely given at the same time as other lifestyle interventions.
The association of vaccines with lower mortality is purely a temporal association.
NO evidence was given for any vaccine to support the idea that vaccination saved lives in the KND area.
The study authors admit that the effects of the DTP vaccine in question was not seperated from the effects of the other vaccines given in the study.
The published mortality rates are consistent with all vaccinations TAKING LIVES while the other lifestyle interventions saved more lives than were taken by vaccination.
The published data very carefully tells us NOTHING ABOUT VACCINE CONTRIBUTION TO MORTALITY as well as the contributions to saving lives of other lifestyle interventions.
The published baseline for unvaccinated children is very misleading in that multiple interventions were ignored. The true baseline for unvaccinated children who received the benefit of multiple changes in lifestyle would have been much lower than the published baseline.
Thus the methodology of the study is not merely flawed but is also fraudulent.
Under the socio-economic conditions of the Kassena-Nankana District:
The published mortality rates for variations in vaccination could be re-phased thusly:
Given what is known about the history of vaccinations, it is expected that the vaccines contributed nothing to the decline in childhood mortality. See Below. The decline in mortality occurred because of the various changes in lifestyle (interventions) and in spite of the harmful effects of vaccinations.
Expanded Background InformationThe following notes and references may help one understand the rather condensed information given above.
Trend and causes of neonatal mortality in the Kassena-Nankana district of northern Ghana, 1995-2002.
"Overall, the neonatal mortality rate declined at an average of 2.5 per 1000 live births per year: Down by nearly 50% from 40.9 (95%C.I. 34.1-46.8) in 1995 to 20.5 (95%C.I.17.3-22.7) in 2002.
CONCLUSION: The various health interventions undertaken in this district have had the collateral effect of causing decline in neonatal mortality. Neonatal mortality could be further reduced by preventing and treating neonatal infections, having skilled attendance at delivery and the elimination of infanticide." (4)
Vitamin A supplements are credited with 20 to 25 percent of all cause decline in mortality.(4)
Vitamin A supplements may be responsible for a larger percentage, even most, of the all cause reduction in mortality. (5)
Improved diets clearly lower mortality and even an increase in households with non-dirt floors may be beneficial.
The Community Health and Family Planning Project from 1995 to 2004 includes the period of the study above.
Community-based interventional studies have invariably been accompanied by numerous health education campaigns, including improved access to basic health services, high levels of antenatal attendance, use of impregnated bed-nets, etc.(6)
"Posting nurses to community locations reduced childhood mortality rates by over half in 3 years..." (7)
Other services which increased in the study time period were the provision of curative services for acute respiratory infections, malaria and other ailments. (8)
Not already mentioned immediately above are de-worming, Oral Rehydration Therapy, other home care for diarrhoea, exclusive breast feeding and complementary feeding. Preventative treatment of malaria during pregnancy, iron and folic acid supplementation and the use of Insecticide Treated Nets for pregnant women. Care for diarrhoeal diseases, antibiotic therapy and basic midwifery. Family health, nutrition and hygiene practices were taught.
"It was observed that while trends in other regions of comparable geographical, social and economic indicators were either increasing or remained the same that of UER [Upper East Region includes KND] had actually showed positive decline. Between the two five [year] periods (1994-1998 and 1999-2003) Under five mortality rate dropped significantly from 155 per 1000 live births to 79 per 1000 in Upper East Region while increasing in an adjacent region with similar socio-economic conditions. Similarly infant mortality dropped from 83 per 1000 live births to 33 per 1000 live births." (9)
A good background for vaccination studies in developing countries is the story of Dr. Archie Kalokerinos in Australia about 1970. In Dr Kalokerinos experience with children living with marginal nutrition, an intensive vaccination campaign doubled the mortality rate and in one area caused the death rate to go up to 500 per 1000 children, thus the title of the book, "Every Second Child".(3)
While it is understandable that many children who are malnourished will have severe reactions and even die from vaccination, children on the opposite end of the economic scale also benefit from not being vaccinated. Progress in Japan in lowering the infant death rate came nearly to a halt between 1970 and 1973. Less vaccinations in 1974 and 1975 were associated with a decline in infant deaths. From 1975 to 1980 in Japan vaccination was preformed only on children over 24 months of age and Japan's infant mortality continued to decline very rapidly. See: http://www.vaclib.org/basic/japanusa.htm
Do Vaccines save lives?
For a background information on vaccines NOT saving lives see:
Introduction to sanitation, nutrition and vaccination:
Index page of links to graphs proving vaccination did not save us:
UNIVERSAL IMMUNIZATION Medical Miracle or Masterful Mirage
By Dr. Raymond Obomsawin
Principles of Natural/Alternative Health
Why Vaccines are ineffective
Method of treatment for children
Seeking An Alternative by Ian Sinclair
See also: http://www.vaclib.org/intro/debate5.htm
The flu vaccine does NOT save lives. See: http://www.vaclib.org/basic/fluindex.htm
WHO sponsored the study in question
Some interesting Notes
An internet information source:
IDRC Books free online
INTERNATIONAL DEVELOPMENT RESEARCH CENTRE
POPULATION AND HEALTH IN DEVELOPING COUNTRIES
Population, Health, and Survival at INDEPTH Sites
Chapters and/or individual countries may be found here:
Down load this open E book:
POPULATION AND HEALTH IN DEVELOPING COUNTRIES [17 Megabytes - Large download!] http://www.idrc.ca/openebooks/948-8/
(1) Data may be found in a 2005 study published by the British Medical Journal:
DTP in low income countries: improved child survival or survival bias?
For data, see Table 1 in above BMJ article:
(2) Immunization Status and Child Survival in Rural Ghana
Full Study: http://www.popcouncil.org/pdfs/wp/147.pdf
(3) Every Second Child by Dr. Archie Kalokerions and Scientist Dr. Glen Detman. See also: whale.to/b/pauling.html and whale.to/v/kalokerinos.html and [More information]
(4), (6) Trend and causes of neonatal mortality in the Kassena–Nankana district of northern Ghana, 1995–2002 Full Text
(5) Vitamin A Working paper (John Snow, Inc.)
"It is fairly certain that the biggest change that has occurred in factors known to affect child mortality is the provision of vitamin A supplements to a large proportion of children in these regions." http://www.jsi.com/Managed/Docs/Publications/JSI_VitA_Working_Paper.pdf
(6) See (4)
(7) Rapid achievement of the child survival millennium development goal: evidence from the Navrongo experiment in Northern Ghana
(8) Accelerating reproductive and child health programme impact
(9) Ghana Accelerated Child Survival and Development approach (ACSD) [UNICF program]