Showing posts with label Varicella. Show all posts
Showing posts with label Varicella. Show all posts

Monday, January 14, 2013

The Profit of Vaccinations

The New York Times recently published an article about the flu season which shows that the levels of deaths have officially crossed over into "epidemic" territory.  The full article can be found here:  Flu Season Deaths Reach Epidemic Level but May Be at Peak, C.D.C. Says

This is a well balanced article speaking about the impact of the flu as well as explaining that the flu vaccine isn't nearly as effective as some other vaccines like those for the norovirus (aka: the "stomach flu" or gastroenteritis) or pertussis (aka: whooping cough).  Part of this is obviously due to how quickly flu viruses mutate, but another aspect that could be partly responsible is the simple fact that on any given year only around a third of the population bothers to actually get a vaccine.  This means there is a much greater chance that the virus can spread among those who have no protection from the vaccine, as well as among those who the vaccine wasn't effective.

Clearly there are failures in the system and improvements must be made.  Not only do we need better vaccines, but we need to do a better job informing the public as to the benefits.  The good news is we appear to be making progress on both of these fronts, and the percentage of those who receive flu vaccines is on the rise each year.  There are also new vaccines in development that hope to address some of the problems with the current targeted vaccines although progress is slow, and funding is difficult to obtain.

This latter point is one which I wanted to speak about, because all too often we hear antivaxxers complain that vaccines are merely a profit mechanism for pharmaceutical companies and that there is no true benefit.  As the article explains it could take as much as $1 Billion to actually bring a vaccine to market, which at first glance seems like an insurmountable figure.  If a new vaccine was to be developed which either prevented the flu or even merely significantly reduced the chances of contracting a flu virus and if the usage of that vaccine was on par with vaccines for MMR or Hib, chances are we would see a vaccine acceptance rate somewhere above 90%.

So let's be conservative and use a vaccination rate of only 80% for the "one-time" flu vaccine.  We know not everyone would bother to be vaccinated the first year, but after a few years when people realized they no longer need an annual flu vaccine, they would probably be more willing to get the single vaccine, and since many other vaccines have rates well above 90%, I don't think 80% is that unbelievable.

So if we focus on the United States alone, we know there are around 312,000,000 (312M) people who could potentially be vaccinated.  80% of this is around 250,000,000 people who would likely receive a flu vaccine.  So let's assume the cost of this vaccine is $35.  The current wholesale costs of single year flu vaccines is closer to $10, but a one-time vaccine is likely to be incrementally higher due to the complexity.  For example an adult vaccine for MMR costs around $35 while the vaccine for varicella is over $60.  A childhood vaccine for Hib may be only $12 while rotavirus can be over $70, so it isn't hard to a flu vaccine could cost at least $35 wholesale - at least for the first few years after release.

Ok, so now we have 250,000,000 potential customers each of which will spend $35 for a grand total of $8,750,000,000 ($8.75B).  Even if we assume only a 50% vaccination rate (156M) and an even lower cost of $25 per vaccine, the total is still $3,900,000,000 ($3.9B).

Of course the $1B it takes to bring a vaccine to market does not include the costs to produce, distribute, and market the vaccine, so it isn't as if there will be billions in profit the first year, but the flip side of this equation is that we are only factoring in the population of the US.  Chances are once the vaccine was available it could be submitted for approval in numerous other nations with the potential to sell hundreds of millions of doses to those nations.

The moral of this story is, there would be a lot of money to be made from a one-time flu vaccine, yet to date we haven't seen anything available.  Since antivaxxers seem to feel vaccine manufacturers are only interested in profits, how can they explain that not a single manufacturer has unleashed such a vaccine on the public?  It shouldn't matter if the vaccine is effective or not, because as any good antivaxxer will tell you vaccines don't actually work (and yes I'm being sarcastic).  Antivaxxers are even willing to claim publicly that the polio vaccine and the smallpox vaccine did nothing to prevent those diseases (suggesting the diseases just magically disappeared on their own apparently), and they feel that vaccines are generally ineffective.

These same antivaxxers will tell you that the MMR vaccine does far more harm that good and that there is no evidence that viruses like the Measles have been controlled by the vaccine in any way.  They will also claim that the HPV vaccines don't work at all and that it is merely a method for the manufacturers to collect millions upon millions from insurance companies and the unsuspecting public.

You see this is one of those situations where antivaxxers want to have it both ways.  One one hand they claim vaccine manufacturers are simply in it for the money and that the vaccines themselves don't actually work.  On the other hand, they can't explain why the market hasn't delivered something like a one-time flu vaccine which would quite obviously be a gigantic windfall for the pharmaceutical companies.

So which is it antivaxxers?

It would seem to be the fact we don't have a one-time vaccine for the flu only proves that the system works.  We have clinical trials and data which shows us the effectiveness of vaccines, and if a vaccine is found to be ineffective it wouldn't be approved.  We have a system of checks and balances in place to ensure the public is protected and that vaccines are not only effective but that they are safe.  We have a system which rewards responsibility, and one which puts the safety and health of the public as the priority far head of profit.

We aren't talking about a nutritional supplement or a vitamin that can be sold by anyone trying to make a buck.  Vaccines are subjected to rigorous safety and effectiveness testing which can take years to complete and which requires verifiable proof of efficacy before that vaccine is ever approved for use.  Can we say the same thing about the various supplements and pills sold on antivaxxer websites?

Sort of makes you wonder what type of clinical trial or testing was done on something like the miracle "brain repair" pills sold by a well known anti-vaxxer.  I think we all know the answer, and it rhymes with none.

If vaccines were really all about profit and if the health of the public was an afterthought as so many antivaxxers have suggested, I have no doubt we would have a half dozen one-time flu vaccines on the market this very moment.  Yet we don't - and I've yet to see an antivaxxer who can explain this without contradicting themselves.

Sunday, July 31, 2011

More Proof That Vaccines Save Lives

Like most vaccine conspiracy theorists, Lowell Hubbs is often quick to explain that he doesn't believe vaccines actually work.  When shown evidence that the rate of polio essentially fell off of a cliff upon the release of the polio vaccine, Mr. Hubbs tries to suggest it was all a sham and merely due to improved hygiene rather than the result of a vaccination.  When shown evidence outlining the eradication of smallpox via vaccination programs, Mr. Hubbs claims it was a coincidence.  Not only does Mr. Hubbs not believe these vaccines actually work, but he also believes they cause autism even though there has not been a single peer-reviewed published study that has been able to even suggest a link between the two, nor has there been any scientific evidence to suggest it.

So along comes a new study published in Pediatrics (The Official Journal of the American Academy of Pediatrics) which discusses varicella (chickenpox) and the impact the vaccine had upon the varicella mortality rate. The result was a 88% reduction in the mortality rate for varicella since the vaccination was implemented (see page 216 of the full study).  In fact, varicella deaths actually decreased in every single age group including a whopping 97% reduction in deaths for children and adolescents under 20 years old.  Previous studies have also found significant reductions at a time the vaccination rate was on the rise, but this newer study is much more complete as it looks at a longer time frame and examines data from both the pre-vaccination period as well as 12 years after the vaccination was released.

Perhaps even more amazing was the fact these results reflect only one dosage of the vaccine.  The newer recommendations include a two dose program which could all but eliminate varicella related deaths within the vaccinated populace.  It is also important to consider the amount of people who no longer suffer from varicella (according to earlier studies an approximate reduction of 90% was witnessed in the first 10 years of vaccination), as well as the number of people who no longer need to be hospitalized as a result of varicella (previous studies found hospitalizations declined between 65% and 88% after implementation of the vaccine). 

If you factor in the amount of lost productivity due to people being ill and unable to attend work or school coupled with the healthcare costs of treatment, hospitalizations, and complications to other medical conditions it is clear the vaccine program is not only effective, but it is nothing short of amazing.

So if vaccines really don't work, are we to believe these reductions are nothing more than a series of coincidences?  Could it be that there is a varicella fairy that has simply been taking a vacation?  Is the reduction of varicella cases directly tied to the proliferation of Twitter accounts?  Not likely.  The only reasonable answer to be taken from all of this is that quite simply... vaccines work.  The science proves it, the results prove it, and study after study, research scientist after research scientist prove it time and time again.

If you're keeping score at home, here are the vital statistics:

Varicella related deaths* per year (1990-1994) prior to the vaccine being released: ~145
Varicella related deaths* in 2007 (the last year covered under this study): ~33

Number of children diagnosed with autism as a direct result of vaccination programs: 0

*Includes varicella as the underlying cause as well as varicella as a contributing cause.  Figures are taken from Table 1 on page 216 of the study.

Sure seems like vaccines are worth the risk to me... but then again I'm not a vaccine conspiracy theorist like Mr. Hubbs.