It seems UK and US rubella vaccination policy might be invalid, based on incorrect data and assumptions. 

The following is a reply to Professor Cooper's letter:- Re: False Government Rubella Scare Stories - Only 20,000 Percent Overstated 3 June 2005

http://bmj.bmjjournals.com/cgi/eletters/330/7500/1132#108947

False Government Rubella Scare Stories - Reply to Professor Louis Z Cooper 6 June 2005
Clifford G. Miller,
Lawyer, graduate physicist, former university examining lecturer in law
BR3 3LA

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Re: False Government Rubella Scare Stories - Reply to Professor Louis Z Cooper
 

 

Dear Sir,

FALSE GOVERNMENT RUBELLA SCARE STORIES

I am grateful to Louis Z Cooper, Professor Emeritus of Pediatrics, Columbia University, New York for his personal account of 1964, albeit anecdotal. [1] Regrettably it shows official 'estimated' figures are less well grounded in fact than prudence might dictate - illustrating my point. The Orenstein 'estimated' 20,000 congenital rubella syndrome ('CRS') figure [2] is suddenly an 'estimated' 40,000 - doubled at a stroke. In contrast, the figures I cited [3] were documented official figures from real reported cases. I cite more here to assist waverers.

A brief literature survey shows varying figures cited with abandon: 12 million, 12.5 million, and from 10,000 to 30,000 miscarriages, stillbirths and CRS. Even if right, and they are not, just as hard cases make bad law, worldwide policy should not be based on uncommon once-in-25-to-50 year epidemics and never on inaccurate wildly varying data.

Further, and obviously an oversight, Professor Cooper's interests were not disclosed. His involvement since 1964 in all aspects of rubella vaccination, including research, commercial, official and political assists in putting his perspective in context. [4]

Reported US rubella cases prior to vaccination were less than 50,000 per annum. [3], [5] Average US CRS incidence was less than 50 per annum. [3] One study averaged 80 Japanese CRS cases per annum between 1965 - 1985 [6]. Another notes 39 Japanese CRS babies in 2,000,000 cases in 1975-1977 when notification was operating. [7]

Contrast the US CDC's official autism spectrum disorders ('ASD') incidence of 24,000 ASD children per annum, with a 500,000 prevalence aged 0 to 21. [8]

We cannot justify mass vaccination on this basis, particularly where the vaccines are not properly tested or subject to short and long term safety monitoring. No one knows the full extent of all problems vaccines cause because no one is looking or counting - less than 50 CRS cases per annum against 24,000 autism spectrum disorder? All when disease incidence has been falling dramatically irrespective of vaccination.

It seems rubella overestimation might be misdiagnosis. According to Kibrick:
 
"... illness with features resembling those of rubella may sometimes be due to other causes. Thus, rubella-like illness may be incorrectly diagnosed as rubella ....." [9]

A paper from one of Professor Cooper's own New York Rubella Project colleagues, John Sever, states:-
Evidence that erroneous diagnoses are common in this disease is provided by results of a study on 464 pregnant women wherein attempts were made to correlate the patient’s history of rubella with presence or absence of antibody. No correlation was observed. This suggests that “the occurrence of rubella as reported by patients cannot be taken as a reliable index of previous exposure” . [10]
As for birth defects, with a low average incidence of CRS, rubella cannot be the culprit (and the following is 2005 published - when indigenous US rubella is claimed eradicated):-
"Birth defects affect about one in every 33 babies born in the United States each year. They are the leading cause of infant deaths, accounting for more than 20% of all infant deaths. Babies born with birth defects have a greater chance of illness and long term disability than babies without birth defects." [11]
Compounding these inaccuracies, 1964 house to house survey data collection methods were questionable, with limited sample sizes (0.00022 fraction of the US population).

As for the varying figures for miscarriage (10,000 to 12,000), two fifths of pregnancies miscarry. 4,000,000 live US births means 1.6 million annual miscarriages in the US, so where the assorted 10,000 to 12,000 figures comes from is anyone's guess (and it seems that is precisely what they are).


Even on the basis of Professor Cooper's own paper there could be no more than 4,000 US CRS cases. This assumes his 'Rubella Project' was limited to the cited area of 20 million [12] (and the population of New York State in 1963 was less than 17.5 million [13]). Professor Cooper also cites anecdotally 400 women reported to the New York City Department of Health during 1964-5; 300 having terminations. As 92% of rubella cases deliver normal healthy children, adjusting for normal miscarriages, had these run full term they provide a potential figure of CRS births for this cohort of 24. [14]
 

email Clifford Miller: bmj050604{insert an 'at' sign here}cliffordmiller.com
_________________________________________________________________

[1] Re: False Government Rubella Scare Stories - Only 20,000 Percent Overstated 3 June 2005


[2] Orenstein WA, Bart KJ, Hinman AR, Preblud SR, Greaves WL, Doster SW, Stetler HC, Sirotkin B. The opportunity and obligation to eliminate rubella from the United States. JAMA. 1984 Apr 20;251(15):1988-94.

[3] False Government Rubella Scare Stories - Only 20,000 Percent Overstated 1 June 2005

[4] New Study Shows No Link Between MMR Vaccine and Autism NNii Press Release November 07, 2002
Board of Trustees of The Albert B. Sabin Vaccine Institute

[5] In the early 1960s, there were 40,000 and 45,000 cases of rubella per year (Horstmann, 1986; Parkman, Meyer, & Hilleman, 1997, 2000; Cooper, 1966)

[6] Rubella and Congenital Rubella Syndrome in Japan: Epidemiological Problems Jpn.J.Infect.Dis.,56,81-87,2003

[7] Epidemiology of rubella and congenital rubella infection in Japan. Kono R, Hirayama M, Sugishita C, Miyamura K. Rev Infect Dis. 1985 Mar-Apr;7 Suppl 1:S56-63.

[8] About Autism Autism Information Center, National Center on Birth Defects and Developmental Disabilities - accessed 4 June 2005

[9] 'Rubella And Rubelliform Rash' BACTERIOLOGICAL REVIEWS p. 452-457 December, 1964

[10] 26. SEVER, J. L., G. 811. SCHIFF, AND R. J. HUEBNER. 1964. Frequency of rubella antibody among pregnant women and other human and animal populations. Obstet. Gynecol. 23:153-159.

[11] Birth Defects US Centers for Disease Control and Prevention - accessed 4th June 2005

[12] THE BURDEN OF CONGENITAL RUBELLA SYNDROME Vaccines. Preventing Disease and Protecting Health, 1 January 2003, vol. 1, no. 1, pp. 53-60(8)

[13] COMPONENTS OF POPULATION CHANGE

[14] DANISH MEDICAL BULLETIN MARCH 1987 - WAVES Vol. 11 No. 4 p. 21
 

Competing interests: None declared

http://bmj.bmjjournals.com/cgi/eletters/330/7500/1132#108656

Re: False Government Rubella Scare Stories - Only 20,000 Percent Overstated 3 June 2005
Louis Z Cooper,
Professor Emeritus of Pediatrics, Columbia University
80 Central Park West, New York, NY 10023, USA

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Re: Re: False Government Rubella Scare Stories - Only 20,000 Percent Overstated
 

 

I do not know where Clifford Miller looked since he missed a wealth of literature about the 1964-65 rubella epidemic. His conclusion is totally incorrect. I write from painful, personal experience.

With my team at the Rubella Project, then at the New York University Medical Center-Bellevue Hospital I took care of and published on more than 400 children with congentital rubella syndrome. We had some contact with double that number. These are not statistics, but real children and their families seen by one single program. To make matters even more disturbing, approximately 75% of the pregnant women reported to the New York City Department of Health as having rubella did not come to term because of therapeutic or spontaneous abortion.

As to the overall impact of rubella during that single peak period, in the United States, reasonable extrapolations support the estimate that approximately 1% of pregnancies were adversely affected. With 4 million births, that represents approximately 40,000 unfortunate outcomes.

Because of almost universal administration of rubella vaccine to children, mostly as MMR, on March 21, 2005 at the CDC National Immunization Conference, Dr. Julie Gerberding, the CDC Director was pleased to announce the elimination of endigenous rubella and congenital rubella syndrome in the United States.

I hope this personal experience helps to set the record straight.

Competing interests: None declared