Diphtheria in Russia question

[Sakura]

I'm in the midst of a discussion with one of my former high school classmates on Facebook, and one of the points that was brought up was regarding diphtheria in Russia. I dug around a bit and tried to find information about the epidemiology of the outbreak, but most of the citations that I found tout the incredible effectiveness of the D vaccine in containing that epidemic.:eyeroll:

Does anyone have any sources that discuss who got diphtheria there, as well as any other information that might help to explain how the D vaccine was not the wonder that people think it was? Thank you!!

[Spy]

My sources are in Russian, so may not work for Facebook friends. :D

But consider this for a second. We have a notion that the vaccine was wonderfully effective in containing the epidemic. We do know that the vaccine is a toxoid, don't we? There is nothing, not a single thing in this vaccine, that was ever designed to affect carriage of the bacteria, the whole thing was done to limit toxic diphtheria cases in vaccine recipients. I am not saying this is how the vaccine works, I am saying this is how it was designed to work, i.e. how the manufacturers wanted it to work. Now imagine an outbreak situation. Suppose you want to use the vaccine to 'contain' it. There is no such thing as vaccine induced herd immunity for diphtheria - it's a toxoid! So all we can hope for is limit toxic diphtheria cases in vaccine recipients. And we do remember that the said recipients will carry and share the bacteria regardless, just hopefully not get sick themselves. Who do we need to vaccinate in this case to 'contain the epidemic'?? Everyone. :D You don't need 'sources' to understand that it was never done and couldn't be done in reality.

As to who got sick - pretty much vaccinated adults, mostly homeless alcoholics. Some children, some unvaccinated (i.e. sick), the usual. Same picture at exactly the same time was happening for tuberculosis, sypilis, heart disease, criminal deaths, suicides.... well, you get it. And, just for historical perspective, the first ever legal chance to avoid routine childhood vaccination was introduced in Russia in 1998.

[Momtezuma Tuatara]

Are you asking for articles about Russia in particular?

And :p have you ever known any article about a case/outbreak/epidemic that doesn't start out by extolling the holy grail's infallibility? :chair:

[Sakura]

Thanks so much! Spy, I had found a few of your old posts about the Diphtheria outbreak on mdc so I used some of the info on that to basically say what you said above. Thank you for the confirmation.

It is puzzling and honestly a bit disturbing to me that I had to explain this to my friend, who is a physician. For some reason, everybody just ASSumes that all vaccines contribute to "herd immunity" and they all work the same way, they just can't wrap their heads around the concept that some vaccines don't prevent transmission, or that live virus vaccines can shed and perpetuate the very diseases that they are meant to "prevent". I seem to have been summarily dismissed, though, but hopefully this info reached somebody that needed to read it, between my FB friends and hers. :p

MT, in my searching for more information, I was floored at the scientific conclusions regarding the epidemiology of the outbreak. Everyone is like "yay, hooray for the vaccine!" :rolleyes: Craziness!

[MinorityView]

It is a perfect example of vaccine blindness (sort of like snow blindness). You have societal breakdown. Rising poverty, governmental dysfunction, all sorts of social problems and conflicts. Health problems increase, which isn't surprising. One illness has a related vaccine. Out of all the rising health problems, this one illness is picked out as increasing because of a drop in vaccination. And what about, as Spy mentioned, all of the other health related disasters?

Craziness indeed!

[Momtezuma Tuatara]

Yes, there are some impressive graphs showing that TB and a whole host of other diseases in Russia went way through the roof and just about to the moon, but did they obsess about those? of course... not.

[Spy]

Interestingly enough, TB IS a 'vaccine preventable' disease in Russia. Big time. Except... the vaccine is not used in adults. Can't be, we are pretty much 100% infected. What happened to TB at the same time of early-mid-90s MT has seen, and everyone else can imagine. :eek: But they couldn't 'contain' it by boosting the adults which they did attempt with diphtheria. Therefore somehow TB (the incidence of which was what, ten-twenty times the peak incidence of diphtheria?) was modestly and conveniently omitted from this huge 'oh look what happens when you don't vaccinate enough' shockwave that followed. :giggle: