NVIC, Hepatitis B and accuracy

When you go to the NVIC “about” page, this is what you see:

NVIC-about-page

 

I want to draw your attention to the “Our Mission” section:

Our Mission

The National Vaccine Information Center (NVIC) is dedicated to the prevention of vaccine injuries and deaths through public education and to defending the informed consent ethic in medicine.

 

As an independent clearinghouse for information on diseases and vaccines, NVIC does not advocate for or against the use of vaccines. We support the availability of all preventive health care options, including vaccines, and the right of consumers to make educated, voluntary health care choices.

Note the balance in the paragraphs above. Note that there is absolutely no mention of the “prevention of injuries and deaths from infectious disease.” Keep these words in mind as through the following discussion.

Under the Vaccines tab , one finds a list of “Diseases & Vaccines”:
Vaccines and diseases nvic
We wish to highlight one phrase from the above:

Below are links to specific disease and vaccine information. Each topic contains information from peer reviewed science, resources and federal agencies to assist consumers in making an educated vaccination decision.

Let us examine accuracy of the information NVIC provides. This time, we will look at the information about Hepatitis B and the vaccine that prevents it.
Summary of NVIC’s Hepatitis B Article
The article  describes Hepatitis B as “a viral infection that infects the liver and requires direct contact with infected blood or other body fluids for transmission.” It claims that most infections do not persist, though it acknowledges that those that do can lead to liver disease, liver cancer and death and that it has a high death toll world wide. But it also claims that hepatitis B is not common among children in the United States and was not common before the vaccination campaigns. It says that Hepatitis B “is not highly contagious in the same way that common childhood diseases like pertussis and chicken pox are contagious,” and highlights sexual activity, blood transfusions and drug abuse as the primary modes of transmission, though it does mention infection of a newborn via an infected mother.

 

NVIC-Hep-B-page

 

NVIC’s article argues that “the primary reason that the CDC recommended hepatitis B vaccination for all newborns in the United States in 1991 is because public health officials and doctors could not persuade adults in high risk groups (primarily IV drug abusers and persons with multiple sexual partners) to get the vaccine.”

 

The article describes the vaccine creation as “genetic engineering of DNA.” In terms of risks of the vaccine the article claims that “As of March 2012, there was a total of 66,654 hepatitis B vaccine-related  adverse events reported to the federal Vaccine Adverse Events Reporting System (VAERS), including reports of headache, irritability, extreme fatigue, brain inflammation, convulsions, rheumatoid arthritis, optic neuritis, multiple sclerosis, lupus, Guillain Barre Syndrome (GBS) and neuropathy. There have been more than 1500 hepatitis B vaccine-related deaths reported, including deaths classified as sudden infant death syndrome (SIDS).”

 

The second part of the page includes an article by NVIC co-founder Barbara Loe Fisher, but this post focuses on the description of the disease and the vaccine.

 

What is the Article Claiming?

The article is suggesting that children are not at high risk of the disease unless the mother is infected (and even then, there is little discussion of the meaning of the risk). It suggests that the vaccine was adopted because authorities were unable to vaccinate the adults at risk, not to protect children. It at least implies that, in the United States, most people overcome the disease quickly.

 

It also suggests that the vaccine is highly dangerous, with a high risk of very serious adverse events.

 

Are the Claims Accurate?

Hepatitis B and Children:

One can argue about what is common, but before the vaccine thousands of children were infected with hepatitis B each year. One source says that “Before 1982, an estimated 200,000–300,000 persons in the United States were infected annually with HBV, including approximately 20,000 children.”  In a detailed article examining multiple sources of data, researchers demonstrated that before the vaccine about 16,000 children got the disease each year. Contrary to NVIC’s claims, only about half got it through an infected mother; the other half got it from other sources (id).

 

What the article is downplaying is the fact that Hepatitis B is a very hardy virus that’s much more contagious than HIV, perhaps a hundred times more contagious. The virus can survive a week in microscopic drops of blood. In adults, infection with Hepatitis B is often asymptomatic; a child or infant may be living with someone who is unaware that he or she is infected with Hepatitis B. The child then may be exposed to its harms through microscopic drops of bodily fluids that get onto household items. A child may also be exposed to Hepatitis B from microscopic drops of blood on the playground or in other places.

 

The risk of being infected is higher than NVIC is suggesting. NVIC is also incorrect about the course of infection for children. While NVIC is right that most adults do not develop chronic hepatitis B, that’s not true for children. When an infant contracts hepatitis B, there is a 90% chance that the infant will go on to develop the chronic version. Children under five have 30-50% of getting the chronic version (see: http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/hepb.pdf). High rates of individuals with chronic Hepatitis B infection will go on to develop liver disease or liver cancer.

 

In short, NVIC’s article substantially underestimates the risk of the disease to infants and children, and the importance of protecting them against it.

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The Hepatitis B Vaccine and its Risks:

 

If NVIC is inaccurate about the risk of Hepatitis B infection, are the claims about the risk of the vaccine any more accurate? The image below is NVIC’s risk statement about the Hepititis B vaccine:
HepB-VAERS

 

Note that NVIC makes the claim for the dangers of the vaccine by using reports to the Vaccine Adverse Event Reporting System (VAERS). It uses VAERS in two ways: enumerating the number of reports relative to the vaccine; and listing the range of physical ailments the reportees attribute to the having received the vaccine.

 

Both of these usages are, at best, problematic; at worst, they are clear intentional fear-mongering.

 

Here is why: the Vaccine Adverse Reports System is a passive reporting system: anyone can report anything, and while there is no doubt some level of underreporting to it, the evidence is that many of the reports in it are for things not actually caused by the vaccine (see here and here).

 

 

We repeat: anyone can report anything to VAERS, and without verification, all the report shows is that someone filed a report (and see here).

The NVIC article has this sentence:

There have been more than 1500 hepatitis B vaccine-related deaths reported, including deaths classified as sudden infant death syndrome (SIDS).

 

This reference to SIDS as an adverse event following Hepatitis B vaccination bears close examination. SIDS rates peak at the age of 2-6 months, ages in which certain vaccines, including Hepatitis B, are given. It’s hardly surprising, with millions of children vaccinated, that some cases of SIDS would occur right after the vaccine. In fact, an Australian study showed that it’s bound to happen by coincidence alone every year. It’s natural for parents in that situation to think receipt of the vaccine caused their child’s death, but that’s not what the evidence shows. Studies that examined rates of SIDS in children found, in fact, that vaccinated infants have a lower rate of SIDS. That doesn’t mean vaccines reduce the chances of SIDS; there may be other factors, and the causal mechanism is unclear. But the finding is powerful evidence against the claim that vaccines cause SIDS.

 

 

NVIC does not explicitly say that the reports show the vaccine caused all these scary things, such as SIDS, or that the vaccine caused over 66,000 injuries, but by listing the reports without warning readers of the limitations of the system it is clearly implying that. At the very least NVIC has to know that many readers will assume that. Presenting the information in such a way is highly misleading.

 

In contrast, the Centers for Disease Control and Prevention (CDC) describes the Hepatitis B vaccine’s adverse reactions as including local reaction, fatigue, headache, and mild fever. Very rarely there can be an allergic reaction to the vaccine. The Vaccine Education Center of the Children’s Hospital of Philadelphia lists similar problems – most commonly local reactions or low fever, very rarely a severe allergic reaction – putting the rate of a severe allergic reaction at one per 600,000.

 

 

In short, NVIC’s discussion of Hepatitis B underestimates the dangers of the disease, misrepresents the risk it poses to children in the United States, and overstates and misrepresents the risks of the vaccine. It is not a good source of information about this vaccine and this disease.

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