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appened in Taiwan is that 65 per cent of vaccinees Eighty-seven per cent of case patients in Oman developed paralysis within 28 days of the first vaccine received at least one dose of OPV, and 50 per cen dose, thus confirming observations of others that the received at least three doses. The authors wrote: majority of vaccine-caused paralysis occurs after the "Accumulation of enough children to sustain the irst dose of any vaccine, the polio vaccine being no —_ outbreak seems to have been due to previous success of exception. The case fatality rate was nine per cent. the immunisation program in reducing spread o However, this rate was calculated as per total endemic strains, suboptimum efficacy of OPV, and delay population, even though the definition of polio is | in completing the primary immunisation series until 7 "infantile paralysis". It should have been calculated on months of age. Additionally, the estimated attack rate he numbers of children in the relevant age groups. of infection among children aged 9-23 months exceeded Moreover, because before this 1982 outbreak there 25% in some regions, suggesting that a substantia ad been no outbreaks of polio in Taiwan for seven proportion of fully vaccinated children had been years, it is not likely that all those who developed __ involved in the chain of transmission.” paralysis within 28 days of the first vaccine dose were Their statement that "3 doses of OPV reduced the risk already incubating the disease. In addition, less than of paralysis by 91%" is facetious: if most cases occur seven per cent of the surveyed after the first dose, there will be fewer population had not received any OPV. vaccinees left to develop paralysis Equally flawed is the conclusion of after the second dose and even fewer he authors that failure to vaccinate, after the third. rather than vaccine fai ure, ras ‘ne No correlation? While alleging that "|wlidespread most important risk factor for the polio use of oral poliovirus vaccine (OPV) epidemic in Taiwan. In fact, there was has led to the virtual elimination of What sends shivers down my spine a perfect paralytic poliomyelitis in is the ease with which the pro- | . industrialised countries, in addition to vaccinators got away with an obviously correlation substantial reduction in the incidence caused outbreak of paralysis, at tne | SHOWing that the yo: “the authors also stated: same, | praise both the authors and vaccines caused "However, the efficacy of OPV in ie tame orpubishing may) the outbreak, the | ing humeral munity agains to see through the smokescreen highest incidence countries has been lower than and mirrors. John (1985) wrote: Q expected. Recent outbreaks in "The proposed explanation— of paralysis The Gambia, Brazil, and Taiwan ave also raised concern that primary reliance on routine immunisation may be inadequate ‘© achieve the goal of eradicating wild poliovirus infection globally by the year 2000." The authors also wrote: "vaccination coverage with 3 doses of OPV at the time of the namely, pockets of low vaccination coverage sustaining poliovirus transmission and seeding an outbreak (5.8 cases per 100,000—was unconvincing. Cases did not cluster in pockets and, since the mean coverage rate was very high, pockets of low coverage could have been occurring with the highest compliance. infrequent...Taipei and Kao- outbreak was 87% for children Hsiung cities had high incidence despite better aged 12 months. Based on the number of reported vaccination efforts.” cases, the overall attack rate of paralytic disease in children 9-23 months was 57/100 000. There was no Outbreak in Oman correlation between vaccination coverage and attack Virtually the same thing as described in Taiwan rates by region; the region with [the] then highest attack happened in Oman. Sutter et al. (1991) and Sutter et al. rate (Batinah, 117/100 000) had one of the highest (1992) described an outbreak of paralytic poliomyelitis | coverage rates (88%), whereas the region with the type I (118 cases) between January 1988 and March __ lowest coverage (Capital, 71%) had a low attack rate.” 1989. They wrote: "Incidence of poliomyelitis was No correlation? In fact, there was a perfect correlation highest in children younger than 2 years (87/100 000) showing that the vaccines caused the outbreak, the despite an immunisation programme that recently had highest incidence of paralysis occurring with the highest raised coverage with 3 doses of oral poliovirus vaccine — compliance. LAM aan 1D wanthas Ald abildenn fea £70/ #4 O70/ a perfect correlation the outbreak, the highest incidence of paralysis occurring with the highest compliance. also Outbreak in Oman Virtually the same thing as described in Taiwan happened in Oman. Sutter et al. (1991) and Sutter et al. (1992) described an outbreak of paralytic poliomyelitis type I (118 cases) between January 1988 and March 1989. They wrote: "Incidence of poliomyelitis was highest in children younger than 2 years (87/100 000) despite an immunisation programme that recently had raised coverage with 3 doses of oral poliovirus vaccine (OPV) among 12-months-old children from 67% to 87%." Despite? NEXUS ¢ 41 No correlation? In fact, there was showing that the vaccines caused Continued on page 82 AUGUST — SEPTEMBER 2009 www.nexusmagazine.com