Do More Vaccinated or Unvaccinated Kids Get Sick in Outbreaks?
Some anti-vaccine folks continue to claim that vaccines don’t work and that most outbreaks of vaccine-preventable diseases are actually caused by kids who have been vaccinated.
They also push the myth that more vaccinated than unvaccinated kids get sick in most outbreaks.
Vaccinated vs Unvaccinated in an Outbreak
So are outbreaks usually caused by kids who have been vaccinated?
No, of course not.
Do we sometimes see more vaccinated than unvaccinated kids in some of these outbreaks?
Yes, sometimes we do.
Vaccine Epidemiology
Wait, what?
Yes, we sometimes see more vaccinated than unvaccinated kids in an outbreak.
How can that be if vaccines work?
It is actually very easy to understand once you learn a little math and a little more epidemiology.
Basically, it is because while vaccines work, they don’t work 100% of the time, and more importantly, there are way more vaccinated kids around than unvaccinated kids.
The Mathematics of Disease Outbreaks
That means that you need to understand that more than the absolute number of vaccinated and unvaccinated people that got sick in an outbreak, you really want to know the percentages of vaccinated vs unvaccinated kids who got sick.
For example, in a school with 1,000 kids, you might be very surprised if six kids got a vaccine preventable disease, and three of them were vaccinated, leaving three unvaccinated.
Does that really mean that equal amounts of vaccinated and unvaccinated kids got sick?
I guess technically, but in the practical sense, it only would if half of the kids in the school were unvaccinated. Now unless they go to a Waldorf school, it is much more likely that over 90 to 95% of the kids were vaccinated, in which case, a much higher percentage of unvaccinated kids got sick.
Before we use a real world example, some terms to understand include:
attack rate – how many people will get sick when exposed to a disease
basic reproductive number or Ro – different for each disease, Ro basically tells you just how contagious a disease is and ranges from about 1.5 for flu, 8 for chicken pox, and 15 for measles
vaccine coverage – how many people are vaccinated
vaccine efficacy – how well a vaccine works
You also need to know some formulas:
attack rate = new cases/total in group
vaccine coverage rate = number of people who are fully vaccinated / number of people who are eligible to be vaccinated
vaccine effectiveness = (attack rate in unvaccinated group – attack rate in vaccinated group) / attack rate in unvaccinated group x 100
Unfortunately, it is often hard to use these formulas in most outbreaks.
Why?
For one thing, it is hard to get accurate information on the vaccination status of all of the people in the outbreak. In addition to those who are confirmed to be vaccinated or unvaccinated, there is often a large number who’s vaccination status is unknown. And even if you know the vaccination status of everyone in the outbreak, it can be even harder to get the vaccine coverage rate or a neighborhood or city.
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