By the Vaccination Media Watch team
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Matthew Killoran’s article on polio in the Courier Mail made the following assertions that we feel need an explanation:
Injectable Polio Vaccine (IPV) is administered to children and adults in Australia as part of the vaccination schedule.
WHO Vaccine Information Statement on Polio vaccine states “No reports of anaphylaxis, thrombocytopenia or transverse myelitis after IPV have been published” [1]. IPV Polio vaccine is given within a combined vaccine, either hexavalent (Infanrix hexa 6-in1 vaccine) or quadrivalent (Infanrix IPV or Quadracel 4-in-1 vaccines). The combination of diseases vaccinated for simultaneously makes it hard for researchers to know whether polio vaccine virus antigens or excipients are the cause of adverse events. An Australian Therapeutic Goods Association report (TGA DAEN) report that can be downloaded from the DAEN database quotes that IPV-containing vaccine in Australia has been responsible (from 2017-2019) for:
The total number of case reports for IPV polio vaccine adverse events is listed as 2,291. We know that only around 5-10% of vaccine adverse events are actually reported [3] [4]. That equates to a probable 41,238 adverse events from polio vaccine in Australia from 1st January 2017 to 1 May 2019 and is more than “one-in-1 million”.
In the days before laboratory confirmed testing for polio virus, a number of paralytic conditions similar to polio would have been diagnosed as polio. Some modern names for these paralytic diseases include Provocation Polio, Acute Flaccid Paralysis (AFP), Acute Flaccid Myelitis (AFM), Vaccine Associated Paralytic Polio (VAPP), Transverse Myelitis and Guillan-Barre Syndrome [5].
All of these diseases are now individually classified and reported on in medical literature and can manifest after/as a result of polio vaccination or independently of polio vaccination.
As part of the global initiative to eradicate polio, AFP and polio cases are reported to the CDC and the WHO by every country and are tabled by region e.g. Australia is part of the Western Pacific Region. This table from the CDC reports cases of AFP and polio in 2017 and 2018.
In 2018, out of 1.7 billion people in the Western Pacific Region there were 13,638 cases of AFP (a rate of 8 per million), of which 0 were wild-type polio and 374 cases were varying forms of vaccine-strain polio (0.22 cases per million) [6].
Out of the above 374 cases, 26 cases were the vaccine strain of polio virus (cVDPV) which classified as an epidemic and all of those cases were in Papua New Guinea. Out of 8,500,000 people in PNG there were 26 cases of vaccine-strain polio (a population rate of 3 per million) [7], zero cases of wild type polio and 284 cases of AFP (33.4 cases per million).
Australia’s annual reported case rate of AFP is around 8 cases per million in children under 15 years of age [8] . As can be noted by both the table below from the WHO [21] and the table above from the CDC, AFP is a far more prevalent disease condition of paralysis.
According to the WHO, “The polio virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle (for example, contaminated water or food) and multiplies in the intestine.” [9]
In 2019 the majority of polio outbreaks around the world involved circulating vaccine-derived polio virus (cVDPV), which come from the oral polio vaccine [10].
The OPV virus can mutate inside the gut of a vaccine recipient and is then able to enter nerve cells to cause paralysis and infect others and then circulate in communities [11].
Outbreaks of paralysis arising from infection with circulating vaccine derived virulent polio virus pose a continuing problem around the world.
The cVDPV strain circulates in the absence of wild-type polio. It is transmitted in unsanitary conditions between immune-compromised and malnourished people. Another quote from WHO: “persistent vaccine-virus excretion in immunodeficient individuals are problems yet to be solved.” [12]
CDC and WHO reports about cVDPV are careful to state this type of polio has arisen from “under-immunised populations”, which often means affected people have received 2 or more polio vaccinations but implying this dosage isn’t enough. [13]
The index (first) case of cVDVP in Papua New Guinea has been found to be a 6 year old boy, who had previously received 2 doses of oral polio vaccine. [14]
Given the faecal-oral route of transmission for cVDPV this is unlikely to “spread like wildfire” in Australia. WHO: “It takes a long time for a cVDPV to occur. Generally, the strain will have been allowed to circulate in an un- or under-immunized population for a period of at least 12 months.” [15] Our opinion of the WHO using the term “under-immunized” is that this is being used to cover up for the ineffectiveness of the vaccine. The 6 year old boy from PNG had already received 2 doses of OPV, which clearly failed to protect him, therefore he was “under-immunized”.
The cVDPV strain is already detected in the sewerage system in Australia. In 2017 it was discovered in Melbourne.[16] A quote from The Age newspaper article reporting this states: “Dr Sutton said there was an extremely low risk that anyone in Victoria would have become infected as a result of the virus detected in sewerage. Firstly, polio virus usually doesn’t cause illness even when infection occurs. Secondly, this polio virus was found at concentrations that do not cause infection. Finally, Australia has very high immunisation coverage and excellent sanitation infrastructure that prevents people being exposed to sewage”.
What Dr Sutton should also have added is that the people of Melbourne would not be in danger of catching polio unless they came into contact with the sewage of an infected person. As our sewage is piped we can sit tight and breathe a sigh of relief.
Oxford Vaccine Group reports an effective herd immunity level for polio requires an 80-85% vaccination rate. “A disease like polio is less contagious, and 80-85% of the population would need to be vaccinated for herd immunity to work ” [17].
According to an article on The Conversation, the American Journal of Epidemiology quotes a wider percentage range of 50-93% vaccination rate in relation to achieving herd immunity to polio [18] .
Scientific opinion on the concept of herd immunity is based on varying statistical calculations that depend on many assumptions about the way that a society operates. Statistics used to calculate herd immunity to polio in the developing world cannot be used to accurately predict a polio outbreak in a country such as Australia. The journalist in this article quoting “A vaccination rate of 95 per cent is needed for “herd immunity” against diseases” is simply misinformed on the subject of polio.
Dr Perry lastly states that should a polio outbreak occur in Australia “those people in the area who have vaccinated their children are in trouble too.” IPV creates antibody immunity to poliovirus but does not create sustained or adequate mucosal immunity, which would be necessary to mount a defense to a poliovirus acquired through the faecal-oral route [19].
Should a credible polio outbreak occur in Australia the appropriate public health response would be to re-vaccinate the affected population and/or family and local contacts with “2-3 rounds of oral polio vaccine” [20] (OPV), as currently occurs in developing countries. This fact is true and we highlight it because it shows up how ineffective the IPV vaccine would be in an outbreak. In addition, no polio vaccine protects against the very real threat of AFP, whose incidence numbers far outweigh the dangers of contracting polio virus.
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