Cholera Vaccine Not As Effective As Claimed, Here’s the Real Reason Disease Went Down
Additionally, the cholera attack rate of the nonvaccinated group was overestimated.
It has long been known that clean water and sanitation lead to better health among the human population. However, vaccine nazis have for just as long attempted to deny the correlation and argue that the increase standards of public health were due to vaccines. Among unbiased researchers, however, that perception cannot help but go unchallenged.
In 2016, a number of researchers wrote to The American Society of Tropical Medicine and Hygiene to question the effectiveness of the oral cholera vaccine deployed in Haiti. To be clear, the researchers were not questioning the safety of the vaccine or vaccines in general but that the effectiveness of the vaccine had been overestimated by previous research teams.
Their argument was that the vaccine was tested alongside increased sanitation practices, possibly over-inflating the success rate of the shot. They argued that the vaccine should have been tested and evaluated by itself.
The researchers wrote:
Oral cholera vaccination (OCV) has been validated by the World Health Organization (WHO) as a valuable tool to complement water, sanitation, and hygiene (WASH) activities in cholera prevention for high-risk areas and populations.1 We read with great interest the recent study published by Sévère and others,2 which evaluated the effectiveness of a mass OCV campaign targeting approximately 70,000 inhabitants in several slums of Port-au-Prince, Haiti, between April and June 2012. The authors reported a 75% vaccine coverage and, using a cohort design, a striking 97.5% vaccine effectiveness in the 37 months postvaccination, whereas controlled clinical trials have measured OCV vaccine efficacy around 57% [95% confidence interval, 44–67%] during the first 2 years.3 Although it was expected that 56% of cholera cases would occur among vaccinated individuals according to the WHO screening method,4 the same proportion was 5% in the Sévère and others cohort.
A thorough analysis of this study shows that the authors did not evaluate the isolated effectiveness of OCV. They rather estimated its combined effectiveness together with WASH-associated measures. To assess the importance of such methodological bias, we computed provided data using a bias-indicator cohort analysis, as previously described in another OCV campaign,5 and found that their strategy exhibited a 95% effectiveness [93–97%] against noncholeric diarrheas as well. Pondering such bias would require adjusting the results on the observance of WASH prevention methods, which may have differed between nonvaccinated and vaccinated groups.
A cohort study requires that the population be carefully defined and monitored. Conversely, cholera surveillance of both groups was only passively conducted from the GHESKIO (The Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections) cholera treatment center (CTC), and many cholera cases may have been treated elsewhere. During the study period, at least seven CTCs operated in Port-au-Prince within a 5-mile radius around GHESKIO, including three major CTCs operated by Medecins Sans Frontières, and over 20,000 suspected cholera cases were reported to the Haitian Ministry of Public Health and Population.6 In addition, the OCV campaign was conducted from April to July 2012, during the main cholera peak of the study period. As the authors started to record cholera cases from April, the cholera attack rate of the nonvaccinated group was overestimated.
Therefore, Sévère and others should have rather conducted a case-control study. Field effectiveness of OCV has previously been evaluated with a test negative case-control design using participant-based analysis with censoring for cholera.7 Computing such an analysis using the study data with noncholeric diarrheas as the control group, we found an OCV effectiveness of 67% (41–82%), which is close to the 58% effectiveness (13–80%) of a concomitant OCV campaign conducted in rural Haiti using the same vaccine.8
Field reports of OCV campaigns can be interesting to evaluate the feasibility and impact of such strategies. Estimating vaccine effectiveness is also important to detect unexpected programmatic errors. However, vaccine effectiveness results are hampered by many biases that are difficult to ponder in observational studies. Consequently, effectiveness results shall neither be confounded with the experimentally measured vaccine efficacy, nor replace the proper evaluation of vaccine impact on the course of an epidemic.
So clearly sanitation has a major effect on public health as anyone who researches history or public health could have told vaccine nazis from the very beginning. If anyone is looking for a reason that “preventable” diseases are on the rise in places like the United States and Europe, it is not because of anti-vaxxers refusing shots, it is because decades of Free Trade and globalism have lowered wages and living standards to the point that developed Western countries are moving back toward third world conditions. Diseases are coming back because living standards are getting lower.
If we truly want to reduce preventable diseases, we will end Free Trade policies, create high-wage jobs, improve public sanitation and sanitation infrastructure, and increase general living standards both at home and abroad.
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Brandon Turbeville – article archive here – is an author out of Florence, South Carolina. He is the author of six books, Codex Alimentarius — The End of Health Freedom, 7 Real Conspiracies,Five Sense Solutions and Dispatches From a Dissident, volume 1 and volume 2, The Road to Damascus: The Anglo-American Assault on Syria,and The Difference it Makes: 36 Reasons Why Hillary Clinton Should Never Be President. Turbeville has published over 1,000 articles dealing on a wide variety of subjects including health, economics, government corruption, and civil liberties. Brandon Turbeville’s podcast Truth on The Tracks can be found every Monday night 9 pm EST at UCYTV. He is available for radio and TV interviews. Please contact activistpost (at) gmail.com.