The repackaging of post-vaccination measles

Following introduction of the measles vaccine, there have been several outbreaks of diseases "clinically similar" to measles, raising questions about the efficacy of the measles vaccine

Table of Contents

Summary

Supplement 1 - Kawasaki Disease (KD) and Measles

Supplement 2 - Rocky Mountain Spotted Fever (RMSF) and Measles

Supplement 3 - Hand-foot-and-mouth-disease (HFMD) and Measles

Supplement 4 - Atypical Measles

Recommendation

References

Summary

While measles death rate in US had declined by 98% and survival rate was estimated at 99.98% in UK, before the introduction of the measles vaccine, proponents of the measles vaccine often argue that the measles vaccine was effective in bringing down the incidence of measles, quoting CDC’s data. [1, 2, 3]

However, a closer scrutiny of publicly available data about the prevalence of exanthematous diseases, clinically similar to measles, before and after the introduction of measles vaccine (and indeed other vaccines in some cases), leaves the above claim of a declining incidence post measles vaccine introduction on a very shaky ground.

In another writeup, I have argued how true vaccine efficacy is grossly overstated often by redefinition of the so called ‘vaccine preventable disease’, and introduction of new terminologies or ‘discovery’ of new diseases attributed to a ‘novel pathogen’. This is true of virtually every single so-called ‘vaccine preventable disease’ such as polio, smallpox, Japanese Encephalitis etc. [4]

It is important to understand that many of the so called vaccine preventable diseases used to be diagnosed clinically prior to the introduction of vaccines, but following the introduction of vaccines, gradually, laboratory diagnosis took over and clinically compatible diseases were diagnosed as something else, and for the most part, attributed to other viruses or designated as having an unknown etiological agent.[5, 6, 7]

In this writeup, we drill down further on measles, and specifically talk about the below 4 conditions, which, when looked at in totality, raise severe doubts about any efficacy whatsoever of the measles vaccine. These include

1. Atypical Measles: This terminology was attributed to recipients who had previously received the measles vaccine, both killed virus vaccine and live virus vaccine. It led to the eventual discontinuation of the killed measles virus vaccine.

2. Rocky Mountain Spotted Fever (RMSF): This is another disease clinically similar to measles. It had declined significantly before the introduction of the measles vaccine. However, after the introduction of the measles vaccine, its incidence increased significantly, raising questions of whether vaccinated individuals with measles were being misdiagnosed as RMSF.

3. Kawasaki Disease (KD): Kawasaki disease was a new disease that was discovered after the trial and introduction of the measles vaccine in Japan, and its incidence increased significantly after the measles vaccine was made mandatory in Japan. Its incidence is not tracked in North America, but studies have indicated an increasing incidence as well as the possibility of measles being misdiagnosed as KD.

4. Hand-foot-and-mouth disease (HFMD): HFMD is another disease that’s clinically similar to measles. While its incidence had not been actively tracked historically, recent data indicates an increased incidence, particularly in children under the age of 5, raising questions of the impact of vaccines or immunization schedule.

There are other diseases that are clinically similar to measles, however their incidence data is hard to come by. Hence this writeup focuses on the above 4, to demonstrate the illusion of reduced incidence of measles post introduction of the measles vaccine.

Eventually, if true efficacy of the measles vaccine is to be deduced, and it’s epidemiological impact be studied, then any surveillance system should track 2 things : (1) the incidence of all acute exanthematous diseases clinically similar to measles, before and after introduction of the measles vaccine, and (2) the prevalence of acute exanthematous diseases in vaccinated versus unvaccinated cohorts.

Supplement 1: Kawasaki Disease (KD) and Measles

“Kawasaki Disease: A Measles cover up?”

“ The continuing endemicity of measles in countries where Kawasaki disease is not seen and the increasing recognition of Kawasaki disease as the measles rate has declined suggest that measles has masked Kawasaki disease until very recently in developed countries and continues to obscure the diagnosis in many other parts of the world." [8]

Kawasaki disease was discovered in Japan around the same time the measles vaccines were trialled & introduced & incidence increased significantly once the vaccine was made mandatory. [9, 10, 11]

“Difficult to differentiate Kawasaki disease from measles on clinical grounds alone.” [12]

“Measles mimics Kawasaki Disease. Measles and Kawasaki Disease may be associated.” [13]

“Cases of measles have been misdiagnosed as Kawasaki Disease.” [14]

Incidence of Kawasaki disease sharply increased in South Korea after measles vaccines were made mandatory in 1985 [15, 16]

Kawasaki incidence in Ontario from 1995 to 2017 showed a steady increase. [17]

“This case highlights the potential role of measles virus in triggering Kawasaki disease” [18]

“The differential diagnosis of atypical measles includes Kawasaki disease” [19]

Case report of a 14 year old.
Diagnosis: Measles related Kawasaki syndrome or atypical measles mimicking Kawasaki syndrome [20]

US: Kawasaki disease hospitalizations almost doubled from 1988 to 1997 (representative data from 900 hospitals in 22 states) [21]

India: “Kawasaki disease was rarely reported till the mid 90s” i.e it started getting more frequently reported only after the introduction of the measles vaccine (licensed in 1985, added to immunization schedule in 1990) [22, 23]

“Some cases of Mucocutaneous Lymph Node Syndrome (i.e. Kawasaki Disease) may be misdiagnosed as Rocky Mountain Spotted Fever (RMSF)”. [24]

8 month old infant suspected of having measles was diagnosed with Kawasaki disease. [25]

South Africa: A child initially diagnosed as measles was re-diagnosed as Kawasaki disease . [26]

Supplement 2: Rocky Mountain Spotted Fever (RMSF) and Measles

“Several patients diagnosed having RMSF were subsequently proven to have measles. These patients had received killed measles vaccine in the past”. [27]

Prior to the introduction of the measles vaccine, RMSF (the most common form of rickettsioses or spotted fever in US) had declined by 74% since 1939. However, after the introduction of the measles vaccine, RMSF incidence increased over fourfold over the next 17 years. [28, 29, 30, 31, 32, 33, 34]

As RMSF incidence increased over fourfold 17 years after the introduction of the measles , despite voluntary reporting, CDC redefined its diagnosis using stricter criteria likely understating incidence post-1980 by ~50%. Plotted below is the RMSF incidence with and without change in CDC’s definition. The 1980 change in diagnostic criteria coincided with introduction of requiring measles vaccination for school enrolment in 50 states. [28, 29, 30, 31, 32, 33, 34]

Plotted below are RMSF deaths vs. measles deaths since the introduction of the measles vaccine. There was hardly any change in the combined fatality rate of these 2 diseases after the introduction of the vaccine. [29, 35]

Italy - Spotted fever incidence (rickettsioses) increased significantly after measles vaccine was made available in 1976. [36, 37]

“Vaccinees developed atypical measles, which resembles Rocky Mountain spotted fever”. [38]

A patient diagnosed as RMSF was rediagnosed as atypical measles after confirming history of killed measles vaccination. [39]

“The rash may suggest Rocky Mountain Spotted Fever but lead to diagnosis of atypical measles following serologic examination”. [40]

"Rocky Mountain spotted fever is sometimes confused with typhoid, measles, scarlet fever, smallpox, postmeasles encephalitis, purpura haemorrhagica, epidemic cerebrospinal meningitis, secondary syphilis, Colorado tick fever and endemic typhus." …”The diseases most commonly causing confusion are typhoid, severe measles, smallpox, epidemic meningitis , ....typhus fever” [41, 42]

“After the eruption has evolved, Rocky Mountain spotted fever may have to be distinguished from such diseases as meningococcemia, typhoid, endemic typhus, measles, and dermatitis medicamentosa.” [43]

“Measles can be confused with RMSF due to rash and respiratory symptoms” [44]

“Atypical measles rash mimicking Rocky Mountain Spotted Fever” [45]

Supplement 3: Hand-foot-mouth- disease (HFMD) and Measles

“Hand-foot-and-mouth disease has similar manifestations to measles and is easy to misdiagnose” [46]

“HFMD should be differentiated from other exanthemata seen in childhood….including atypical measles”. [47]

“Measles may be mistaken for HFMD in an outbreak setting” [48]

Case Report: Hand-foot-and-mouth disease resembling measles. [49]

“Measles is sometimes misdiagnosed as hand-foot-and-mouth disease” [50]

“The foot-and-mouth-disease virus may also be a contaminant of vaccine employed for jennerian (i.e. smallpox) vaccination.” [51]

HFMD in Thailand occurs predominantly in children 1-2 years of age. 89% of the cases are in children 5 years and under. This brings into question the impact of the vaccination schedule on HFMD as the incidence has increased significantly as more vaccines/doses kept getting added to the immunization schedule. [52, 53, 54]

In China, HFMD incidence increased significantly following the introduction of JE vaccine in 2007. In 2014, HFMD cases were up fivefold compared to 2008, resulting in the introduction of the HFMD vaccine in December, 2015. [55, 56]

Japan experienced it’s first outbreak of HFMD just 3 years after the introduction of the measles vaccine in 1969. Just 2 years after the vaccine was made compulsory, Japan experienced its largest outbreak of HFMD until then, with over 36,000 reported cases (actual incidence was likely 10 times higher per the report). In short, following the introduction of the measles vaccine, Japan experienced several outbreaks of “measles like illnesses”, namely Kawasaki disease and Hand-foot-and-mouth disease. [57, 58]

Supplement 4: Atypical Measles

“Atypical measles can be mistaken for several other diseases such as Rocky Mountain Spotted Fever, Kawasaki disease etc.” [59]

Atypical measles is measles in those who were previously vaccinated for measles - either killed virus vaccine, or live virus vaccine, or multiple doses involving both these types of vaccines. [60, 61]

5 out of 10 children with atypical measles were diagnosed as some other disease. [62]

This study highlighted that atypical measles was correctly diagnosed in only 17 out of 56 cases, another example pointing to an artificially reduced incidence of measles due to misdiagnosis, after the introduction of the measles vaccine. [63]

“Atypical measles may be misdiagnosed as varicella, Rocky Mountain spotted fever, toxic shock syndrome, or drug eruption.” [64]

Recommendation

Given the different types of exanthematous diseases that measles may be confounded with, the high likelihood of misdiagnosis in a vaccinated person, the correct scientific approach would be to track prevalence of all exanthematous diseases before and after vaccination, measuring the overall burden of all exanthematous diseases on the target population. Additionally, the prevalence of these acute exanthematous diseases should be recorded and compared between vaccinated and unvaccinated cohorts. This will uncover any misleading ‘vaccine efficacy’ driven by widespread misdiagnosis. [65]

References

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