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What Is Wrong With This Picture?

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by Sandy Gottstein

Measles is deadly in Africa and other developing nations, where overall health is extremely poor, unlike what has traditionally been the case  in the U.S. and other developed nations, where living conditions are considerably better. Rather than calling for an improvement in living conditions in order to improve overall health, or emphasizing the prescribing of vitamin A, known to significantly improve measles survival rates,W.H.O. (The World Health Organization) decided to use a high-titer vaccination strategy.  The rationale was based on a Catch 22 in the whole early infancy approach to "measles control".   Mothers who have experienced natural measles pass measles antibodies transplacentally to their infants (also called "maternally acquired passive immunity"), protecting them for the first 6 or so months of their lives, when measles can be quite serious. (Mothers who were vaccinated against measles also do so, but the protection does not last as long.)  Those very maternal antibodies, however, interfere with the effectiveness of measles vaccines.  So to make the strategy work they developed what was called a "high-titer" measles vaccine, in order to overcome those maternal antibodies, but which ended up eventually being withdrawn because of the high death rate, particularly among girls, for up to 4 years post vaccination.  (For some opposing views, click here.)

Might it not have been better to work with, rather than against, those powerfully effective maternal antibodies, better respecting their role in protecting infants?

While granting that such things are complex, and applauding the call for better understanding of measles vaccine and standardization of study procedures noted in one article,  it's hard not to wonder why measles vaccine was and continues to be universally recommended, even though achievement of such understanding and implementation of such standards has not been accomplished.

Why hasn't the knowledge of such important sex differences in this fatally flawed vaccination program led to a change in  the current "one-size-fits-all" approach to vaccination policy?  

What does all this say about how long it might take for serious adverse vaccine reactions to become apparent?  And since they can clearly take years to show up, how many serious adverse vaccine reactions are going unrecognized?

Sandy Gottstein

2-1-2002