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Old 04-30-2015, 05:14 PM
 
Location: Georgia, USA
21,524 posts, read 26,139,087 times
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Quote:
Originally Posted by MissTerri View Post
I should have said significant instead of massive. Shingles case went up 39% in an 18 year period. I consider that to be significant.
Yes, it is significant, but it helps to understand that statistically significant may not translate into large numbers of affected people.

For example, if you have a very rare condition that is present in 1 in a million people, finding that condition in 10 in a million would be a 1000% increase, but is 10 in a million really that much more risk than 1 in a million? Would a 10 in a million chance of winning a lottery make you more likely to buy a ticket than 1 in a million?

If you look at some of the studies, the incidence numbers used vary considerably, because of difficulty in capturing all shingles cases. Some studies find a higher incidence than others. Is that a real difference in incidence or just a function of some databases being more complete than others? Is the increase in shingles incidence perhaps at least partially due to data mining of health information becoming more efficient over the last twenty years?

At any rate, it does not appear that immunizing kids against chickenpox is making seniors have shingles. Even if it did, that is no reason to not vaccinate a child against the disease.

 
Old 04-30-2015, 05:20 PM
 
8,545 posts, read 5,269,960 times
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Quote:
Originally Posted by MissTerri View Post
Does the CDC have any data showing the numbers of children with shingles past and present?
I can't seem to find any and they say that they don't track shingles so where they are getting their info is unclear.
 
Old 04-30-2015, 06:12 PM
 
Location: Georgia, USA
21,524 posts, read 26,139,087 times
Reputation: 26519
Quote:
Originally Posted by MissTerri View Post
Does the CDC have any data showing the numbers of children with shingles past and present?
Raw numbers are not usually reported. Rates are used.

The studies on the effect of the vaccine on shingles use comparisons of vaccinated and unvaccinated children. They may also look at a group of kids with shingles and see how many were vaccinated and how many were not.

Ideally, the studies start with vaccinated and unvaccinated kids, observe prospectively for cases of shingles, and test to see whether the shingles is due to the wild virus or the vaccine virus. Like here:

http://www.ncbi.nlm.nih.gov/pubmed/23922376

Last edited by suzy_q2010; 04-30-2015 at 06:26 PM..
 
Old 04-30-2015, 06:13 PM
 
8,545 posts, read 5,269,960 times
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Quote:
Originally Posted by suzy_q2010 View Post
Raw numbers are not usually reported. Rates are used.

The studies on the effect of the vaccine on shingles use comparisons of vaccinated and unvaccinated children.
So they won't provide a source for their claim that shingles is down in children? Are we just supposed to take their word for it?
 
Old 04-30-2015, 06:24 PM
 
8,313 posts, read 8,591,539 times
Reputation: 25959
Quote:
Originally Posted by MissTerri View Post
So they won't provide a source for their claim that shingles is down in children? Are we just supposed to take their word for it?
You don't have to take their word for it.

Here's a study with numbers showing a 79% decrease in HZ among vaccinated children when compared to those who are unvaccinated. This is from the Journal of Infectious Disease from 2013.

Incidence and clinical characteristics of herpes zoster among children in the varicella vaccine era, 2005-2009. - PubMed - NCBI

I do wonder though if the next argument will be that the study was "made up" because the results don't fit certain agendas.
 
Old 04-30-2015, 06:55 PM
 
8,545 posts, read 5,269,960 times
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Quote:
Originally Posted by markg91359 View Post
You don't have to take their word for it.

Here's a study with numbers showing a 79% decrease in HZ among vaccinated children when compared to those who are unvaccinated. This is from the Journal of Infectious Disease from 2013.

Incidence and clinical characteristics of herpes zoster among children in the varicella vaccine era, 2005-2009. - PubMed - NCBI

I do wonder though if the next argument will be that the study was "made up" because the results don't fit certain agendas.
We already looked at this study, Mark and it's not related to my question at all. My question was about the CDC's claim that the shingles rate is declining in children. I'd like to see the numbers showing the rate of shingles in children over time.
 
Old 04-30-2015, 07:00 PM
 
8,313 posts, read 8,591,539 times
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Quote:
Originally Posted by MissTerri View Post
We already looked at this study, Mark and it's not related to my question at all. My question was about the CDC's claim that the shingles rate is declining in children. I'd like to see the numbers showing the rate of shingles in children over time.
Dang, Suzy beat me to it!

Honestly, I think most of us are on to your game. No matter what proof is presented, insist that it isn't enough. Demand endless studies and contend no vaccine should be approved without decades of research. Never concede anything is proven while at the same time never offering proof of your own for any of your contentions.

Its a one-sided debate.
 
Old 04-30-2015, 07:11 PM
 
8,545 posts, read 5,269,960 times
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Quote:
Originally Posted by markg91359 View Post
Dang, Suzy beat me to it!
You both didn't understand the question because you're both so hell bent on defending the vaccine at all costs that you aren't even listening. My question had nothing to do with the vaccine, it had to do with how do they know that shingles is declining in children? If they know that shingles is declining in children then surely they have a source for that claim,? Basic numbers over the years. My question has nothing to do with any vaccine. If you and Suzy weren't so busy trying to defend the vaccine industry at all costs maybe you would notice that.

Quote:
Honestly, I think most of us are on to your game. No matter what proof is presented, insist that it isn't enough. Demand endless studies and contend no vaccine should be approved without decades of research. Never concede anything is proven while never thinking for a minute you have to prove anything on your own.
Honestly, I could not possibly care less what you think about me. You haven't shown me that you are very knowledgeable about this topic. Your attempts to grandstand fall flat.

Last edited by MissTerri; 04-30-2015 at 07:33 PM..
 
Old 04-30-2015, 08:13 PM
 
Location: Myrtle Creek, Oregon
11,069 posts, read 11,474,429 times
Reputation: 17237
Quote:
Originally Posted by suzy_q2010 View Post
I did not say the overall rate of shingles was down. I said children who have had the vaccine have a lower chance of developing shingles.

Shingles | Clinical Overview - Varicella Vaccine | Herpes Zoster | CDC

"Herpes Zoster in People Who Received Varicella Vaccine
Although uncommon among children, the rate of herpes zoster in U.S. children has been declining since the routine varicella vaccination program started. Varicella vaccine contains live attenuated VZV, which causes latent infection. The attenuated vaccine virus can reactivate and cause herpes zoster; however, children vaccinated against varicella appear to have a lower risk of herpes zoster than people who were infected with wild-type VZV. The reason for this is that vaccinated children are less likely to become infected with wild-type VZV, and the risk of reactivation of vaccine-strain VZV is lower compared with reactivation of wild-type VZV.

In a study of children with leukemia, those who got varicella vaccine had a 67% lower risk of herpes zoster compared with children who had natural infection with wild-type VZV.
Data on healthy children show a similar pattern of reduced risk of herpes zoster in those vaccinated against varicella.

The number of older adults who have gotten varicella vaccine since it was licensed in 1995 is quite small. There is very little information on the risk of herpes zoster in people who got varicella vaccine as adults.
CDC continues to study the epidemiology of herpes zoster among adults and children and to monitor the effects of the U.S. varicella and zoster vaccination programs."

This is an adult study:

Risk of Herpes Zoster in Adults Immunized with Varicella Vaccine

"We have prospectively followed a cohort of 363 individuals for up to 25 years, by means of active surveillance. We report the incidence of HZ among these vaccinees, most of whom are now middle-aged adults who normally would be considered to be at increasing risk for HZ."

They found two cases of herpes zoster, one of which was clearly due to a breakthrough wild chickenpox virus infection, confirmed with laboratory studies. The other case had a history compatible with a breakthrough infection that was not confirmed because the tests were not done.

There is indeed evidence that chickenpox vaccine reduces the risk of shingles. Will it take years to show it definitively? Yes, but waiting until that is done to decide to vaccinate against chickenpox when early results favor a protective effect would seem unwise.

Something not previously discussed is the fact that there is herd immunity for chickenpox vaccine. As vaccination rates increased in children, chickenpox infection rates decreased in unvaccinated babies and adults as well as vaccinated children.
Chickenpox in children causes sub-clinical cases of chickenpox in exposed adults. Having unvaccinated children in the household results in about a 20 year delay in the onset of shingles cases. As more adults forego having children, and more children are vaccinated, it is a really good idea to get the shingles vaccine. It is currently only recommended for senior citizens, but in the future people may find themselves at risk in their 40s.
 
Old 04-30-2015, 09:41 PM
 
Location: Georgia, USA
21,524 posts, read 26,139,087 times
Reputation: 26519
Quote:
Originally Posted by MissTerri View Post
So they won't provide a source for their claim that shingles is down in children? Are we just supposed to take their word for it?
The raw numbers are used to calculate rates. That does not mean that the raw numbers are made up. The raw numbers are not used because they do not account for differences in population. For example, there might be 100 cases of a condition in a population of 100,000 one year and 200 cases in a population of 250,000 the next year. Although 200 is greater than 100, the rate the first year was 1 case in a 1000 population and the rate the next year 0.8 cases in 1000. The second year has fewer cases when the total population is taken into consideration.

Knowing how that works is fundamental to understanding how to interpret medical studies.

Epidemiology of Pediatric Herpes Zoster After Varicella Infection: A Population-Based Study

"Of 27 517 children with medically attended varicella, 428 developed HZ. The incidence of HZ was 262.1 per 100 000 person-years. Of 25 132 vaccinated children without medically attended varicella, 106 developed HZ. The incidence of HZ was 93.3 per 100 000 person-years. ... Children with varicella infections had a significantly greater risk of HZ than vaccinated children without a history of varicella (relative risk = 2.31 at 4 years of follow-up, P < .001)."

The baseline rate (without vaccine) is 262.1 per 100,000 person-years. (A person-year is a method to standardize results in which there is a cumulative risk of an outcome over time.)

With the vaccine, the rate is 93.3 per 100,000 person years.

Over 90% of children are now receive one or more doses of chickenpox vaccine. From those figures, it is inevitable that the incidence of shingles has decreased overall in children. You do not have to have the raw number of cases to see that.

National, State, and Local Area Vaccination Coverage Among Children Aged 1935 Months United States, 2012

Take a population of 100,000 (followed for one year) in which 90% are vaccinated: 90,000. You will see 90% (90,000 divided by 100,000) x 93.3 = about 84 cases of shingles in that vaccinated group. Of the 10,000 that are not vaccinated you will see 262.1 x 10% (10,000 divided by 100,000) = about 26 cases. That is 84 + 26 = 110 cases of shingles in the entire 100,000 population, compared to 262 in 100,000 if no one is vaccinated.

That is a 58% reduction in the number of shingles cases in children, which is pretty close to the 55% previously quoted up thread.
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