Vaccination, Coincidence, and SIDS

June 4, 2010 at 5:56 pm (Anti-Vaccination) (, , , , , , ,, )
A hypothetical situation: A child dies suddenly. There is no obvious cause of death. They had, though, been vaccinated that very day. What conclusion do people reach for?
I would argue that a single unexplained death – no matter how tragic and no matter how ‘available’ – can tell us very little indeed about vaccination.
Sudden infant death syndrome (SIDS) and sudden unexplained death (SUD) are not so common as to be described as an “everyday occurence”, but are not so very rare either. Vaccination, on the other hand, is extremely common indeed. There are a number of vaccinations given to children, and some of these are given repeatedly – for example that for diphtheria tetanus and pertussis (DTP/DTaP). These vaccines are given to the vast majority of children in most countries fortunate enough to have a decent healthcare system.

It seems likely that some SIDS deaths will occur on the same day as vaccination purely by chance.
Researchers looked at vaccination and SIDS in Australia. They concluded that while SIDS coinciding with vaccination would be infrequent, it would likely happen at least once in any given year in Australia purely by chance alone.
The probability of recent vaccination and SIDS coinciding varied by age and day of the week of death. The overall estimated probability of vaccination within the last 24 hours for a child who has died of SIDS in Australia is estimated as 1.3%. In the last 48 hours, it is 2.6%. With the average number of SIDS deaths for the period 1997-2001 equal to 130 cases per year, we estimated that a case of SIDS will occur when vaccination was given in the last 24 hours in 1.7 cases per year and within 48 hours in 3.5 cases. [Link]
This means that of 130 cases of SIDS per year, one or two cases will likely coincide with a vaccination given that very day. This is purely due to chance and means nothing in terms of vaccine safety – the vaccination and the death are unrelated. It is also worth pointing out that the other 128 cases of SIDS will not coincide with vaccination. It seems that we must look elsewhere for the cause of SIDS.
Here, we have a case-control study looking at SIDS and SUD:
We identified 114 cases of SUD aged between 30 and 90 days and 341 live controls matched for age and sex and born in the same maternity unit as the case. DTPP±Hib immunization did not increase the risk of SUD (OR 1.08) (95% CI 0.49, 2.36) in children under 3 months of age when adjusted for sleeping position, illness in the week before death, maternal tobacco consumption, birth weight, type of mattress, breastfeeding and sex. However, low birth-weight (6.53 [2.29, 18.9]), multiple birth (5.1 [1.76, 15.13]), no breastfeeding (1.77 [1.1, 2.85]), prone sleeping position (9.8 [5, 8, 18, 9]), soft mattress (3.26 [1.69, 6.29]), recent illness (3.44 [1.84, 6.41]) and parental smoking (1.74 [1.2, 2.96]) were confirmed as risk factors in early SIDS. [Link], [PDF].
No increase in risk of SIDS is seen for DTPP±Hib immunisation. The researchers do, though, find other risk factors for early SIDS.
It’s perhaps worth noting that in the discussion section of the second paper, the authors write: “Moreover, recent epidemiological evidence indicates that infants immunized against DTP are perhaps at decreased risk of SIDS (25, 26).” Here are references 25 and 26:
25. Mitchell EA, Stewart AW, Clements M. Immunisation and the sudden infant death syndrome. New Zealand Cot Death Study Group. Arch Dis Child. 1995;73:498–501. [PMC free article] [PubMed] [Link]
26. Essery SD, Raza MW, Zorgani A, et al. The protective effect of immunisation against diphtheria, pertussis and tetanus (DPT) in relation to sudden infant death syndrome. FEMS Immunol Med Microbiol. 1999;25:183–192. [PubMed] [Link]
The case of Chris Blum is introduced into this discussion in the BMJ: link. The citation provided in this rapid response is to this article in the Guardian.
The date of the Guardian article is given as 29 January 2007. The Australian research on SIDS, coincidence and vaccination is from 2005. The case-control study I link to is from 2001, and the two references cited to support the statement that “epidemiological evidence indicates that infants immunized against DTP are perhaps at decreased risk of SIDS” come from 1995 and 1999.
All the research I have alluded to in this blogpost was available in 2007 when the Guardian article seems to have been written. None of it was referred to. Instead, the journalist wrote this:
The pathologist told the parents that their son had died of cot death. They didn’t believe it, and they still don’t. Hours before his death, Christopher had been given a triple vaccination.
I don’t think it’s helpful to publish an article implying a link between vaccination and cot death, SIDS, or SUD – particularly when the article in question fails to even mention the chances that vaccination will coincide with a case of SIDS and fails to refer even tangentially to the epidemiological evidence relating to vaccination and risk of SIDS.
More
Vaccines are often linked to diseases  or symptoms. However, when researchers investigate these apparent links they very often turn out to be spurious:
During recent years a scala of diseases or symptoms have been associated with vaccination (presumed side effects). Careful and extensive investigations have shown that such hypotheses could not be supported. Examples are allergic diseases as asthma, diabetes mellitus, multiple sclerosis (after hepatitis B vaccination), autism and inflammatory bowel disease (after MMR vaccination) and sudden infant death syndrome. [Link]
SIDS and DTP-IVP vaccination:
The only specific risk factor for SIDS is age (2-4 months), though birthweight, prematurity and the younger age of the mother increase the probability of dying in the same manner as for accidental causes and all other postneonatal deaths. [...] No significant differences were found in the DTP IPV immunization rates between SIDS and other causes of death or between SIDS and living controls. [Link]
In March 1986 five sudden infant deaths were reported, following the diphtheria-tetanus toxoids-pertussis and inactivated poliomyelitis virus (DTP-IPV) immunization of the infants concerned. An epidemiological study was carried out in order to investigate the possibility of a relationship between this immunization and sudden infant death syndrome (SIDS). A detailed examination of the five cases had been carried out by a doctor. An exhaustive survey of all postneonatal deaths occurring between January and March 1986 was conducted and also a matched case-control survey. No significant differences were found in the immunization rates between SIDS and other causes of death, nor between SIDS and living controls. These results are compared with the results from previously published studies on the topic. [Link]
 
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20 Comments

  1. Cybertiger said,

    June 4, 2010 at 7:51 pm
    Goodness, you are a sucker for punishment, Mr. Cole!

  2. Cybertiger said,

    June 4, 2010 at 8:20 pm
    Remember Meadow’s Law?
    “One cot death is a tragedy, two cot deaths is suspicious and until the contrary is proved, three cot deaths is murder”.
    Professor Sir Roy Meadow is still alive. Remember Sally Clark? She’s dead.
    Sally Clark’s first baby Christopher died a cot death. After the death of Harry, her second baby, she was tried and convicted of the murder of both infants and sent to prison. Harry had been vaccinated on the day he died in January 1998. He was eight weeks old. Sally Clark spent three years in jail for a crime she didn’t do, for a crime that hadn’t happened. If the children had not been murdered by their mother, then why had they died?
    We know Sir Roy was an asshole and always was. A high Court Judge said he acted in good faith … but then assholes always do. Come on, Mr Cole, why did Sally’s kids die?

  3. Bob O'H said,

    June 4, 2010 at 8:20 pm
    The case-control study doesn’t have a lot of statistical power – there could still be a large effect (e.g. a doubling of the risk of SUD) and these results would still not be that unreasonable. There are a lot of risk factors with large effects, so a “SUD is caused by vaccines” argument isn’t supported. But this evidence, on its own, wouldn’t rule out a smaller effect.

  4. Cybertiger said,

    June 4, 2010 at 8:22 pm
    PS. I can’t wait for drippy draust to drop by … and tell us that the asshole was right.

  5. Cybertiger said,

    June 4, 2010 at 8:26 pm
    PPS. Instead we’ve got some right old crap from Scarlett …. prat!

  6. jdc325 said,

    June 4, 2010 at 10:23 pm
    Sally Clark’s first baby Christopher died a cot death. After the death of Harry, her second baby, she was tried and convicted of the murder of both infants and sent to prison. Harry had been vaccinated on the day he died in January 1998. He was eight weeks old. Sally Clark spent three years in jail for a crime she didn’t do, for a crime that hadn’t happened. If the children had not been murdered by their mother, then why had they died?
    If you’re trying to suggest that the vaccination coinciding with the death of Harry is meaningful, I suggest that you read the blogpost that you are commenting on.
    If you are asking me to speculate on why Christopher and Harry died, I’m afraid I’m going to have to disappoint you. It’s perhaps worth mentioning, though, that there was some evidence to suggest that the death could have been due to natural causes: link. The medical experts differed in their interpretations of the evidence, but it was sufficient to see the verdict quashed by the Court of Appeal.

  7. deetee said,

    June 4, 2010 at 10:44 pm
    Nice summation, jdc.
    As you say, common events (vaccination) will undoubtedly coincide with other events, purely by chance. Not only is there no causal relationship established for SIDS and DTaP vaccination, but there is no epidemiological link either.
    What on earth could Dr Mark Struthers have been thinking when he posted that inane BMJ response?

  8. Cybertiger said,

    June 5, 2010 at 1:13 pm
    Didn’t Christopher Clark have a nosebleed a few days before he died? It was on the telly. Wasn’t Professor David Southall the muffin who watched the telly and then accused Christopher’s Dad of murdering the baby while his Mum was banged up for the same thing, courtesy of Professor Sir Roy ‘muffin’ Meadow?
    All I know is that the world is full of muffins.
    PS. At the end of the day, when a risk-benefit analysis has been thoroughly boiled (HIV, anti-retrovirals, MMR, DTP etc), Dr Peter ‘muffin’ Flegg thinks it’s safer to go howling at the moon.
    Inane twat!

  9. Cybertiger said,

    June 5, 2010 at 1:32 pm
    The only difference I can see between Christopher, Patrick and Harry is that Christopher Blum’s Mum wasn’t banged up for killing him.

  10. Cybertiger said,

    June 5, 2010 at 4:38 pm
    Wakey, wakey. Are you up yet, jdc253?
    Wake up and smell the coffee, jdc532! And give that dollop, Flegg a nudge – he’s a lazy git too.

  11. Becky said,

    June 6, 2010 at 11:14 pm
    Sacked Dr Mark “Cybertiger” Struthers makes some interesting points. Unfortunately, they’re the same points he’s been banging on about for the last few years. Mainly Dr David Southall – who Dr Struthers’ mum went after on a completely different matter, and was shown to have no case. It’s all in the family.
    Now, Dr Struthers, could you fuck off a bit quicker than that please?
    Kind regards,
    Becky

  12. davidp said,

    June 7, 2010 at 3:11 am
    Well described JDC.
    Last week’s New Scientist described how most people depend on anecdote for their sense of what’s true – numbers alone leave them confused and feeling condescended to. I’m wondering what anecdote there is that helps counter Chris Blum’s parents’ experience.

  13. Cybertiger said,

    June 7, 2010 at 5:38 am
    Lord davidp of BollocksScience said,
    “… most people depend on anecdote for their sense of what’s true …”
    Oh Lord, another scientific expert in truth, coincidence and condescension. The Lord be praised!

  14. fedup said,

    June 8, 2010 at 12:38 pm
    (d) JAPAN In 1975, about 37 Crib Sudden Deaths were linked to vaccination in Japan. Doctors in one prefecture boycotted vaccinations, and refused to vaccinate. The Japanese government paid attention and stopped vaccinating children below the age of two years. When immunization was delayed until a child was 24 months of age, Sudden Infant Death cases and claims for vaccine related deaths disappeared. Japan zoomed from a high 17th place in infant mortality rate to the lowest infant mortality rate in the world when they stopped vaccinating. Japan didn’t vaccinate any children below the age of two years between 1975 and 1988, for thirteen years. But then in 1988, Japanese parents were given the choice to start vaccinating anywhere between three months and 48 months. The Ministry study group studied 2,720 SIDS cases occurring between 1980 and 1992 and they established that their very low SIDS rate quadrupled.

  15. fedup said,

    June 8, 2010 at 12:40 pm

  16. jdc325 said,

    June 8, 2010 at 5:25 pm
    fedup – thanks for posting the link to the whale.to website. Here’s a link in return:http://www.ratbags.com/rsoles/comment/immunise.htm
    DTP and SIDS
    One of the more important concerns regarding immunisation, particularly with the DTP, is a possible link with Sudden Infant Death Syndrome (SIDS).36 This is a matter of great concern to parents and health care workers alike, and it is important to carefully examine the available evidence?
    The peak time for SIDS is between two and four months of age, which is also the recommended time for the first two doses of DTP. We would therefore expect many cases of SIDS to occur in close time proximity to immunisation merely by chance.
    Particularly in those cases where autopsy is unable to identify a cause of death such a close temporal relationship, and the understandable need by grieving parents to understand why this happened to their child, are easily exploited by anti-immunisation advocates.
    I will let readers of the Skeptic decide for themselves whether Dr Scheibner’s research in this area qualifies her for the title ‘expert witness’.
    Dr Scheibner notes a 1982 report of four unexplained deaths that occurred in Tennessee in the late 1970s.37 She first attempts to draw a link between these deaths and immunisation:
    All four deaths were classified as sudden infant death syndrome (SIDS), and all had received their first vaccination of diphtheria-tetanus toxoids-pertussis (DTP) vaccine and oral polio vaccine2(p59)
    She is forced, however, to concede that the author of the paper found “no evidence to support a causal relationship.”37(p421) In her discussion of this study she fails to mention that the author of the paper concluded:
    The findings of our study combined with the NIH results provide no support for reducing efforts to immunise infants with DTP.37(p421)
    Dr Scheibner then mentions the preliminary results of a study demonstrating a possible association between DTP and SIDS presented at a meeting in 1982.38 Though the final results of this study had not been published at the time of the publication of Dr Scheibner’s book (nor published since) she seems to be prepared to accept these preliminary results as sound science because they support her beliefs.
    Dr Scheibner devotes nearly a whole page to this ‘study’ and only one sentence to formally published studies that found no link between SIDS and DPT.39,40 She also manages, in her discussion of SIDS, to ignore completely the Institute of Medicine Report discussing the DPT vaccine.36 This found no link between SIDS and DTP immunisation.
    The Japanese experience
    One of Dr Scheibner’s trump cards is her claim that in Japan, following the shift in age of immunisation to two years, the SIDS rate declined. She makes much of this in her book:
    In 1975 Japan raised the minimum vaccination age to two years; this was followed by the virtual disappearance of cot death and infantile convulsions.2(pxix)
    When Japan moved the vaccination age to two years, the entity of cot death in that country disappeared 2(p43)
    The most important lesson from the Japanese experience is that when the vaccination age was moved to two years, the entity of cot death disappeared. 2(p49)
    The seeming and widely perpetuated dilemma: ‘is there or is there not a causal relationship between DPT injections and cot death’ has, quite adequately and indeed without a shadow of a doubt, been resolved by the Japanese experience with cot death. 2(p62-3)
    This claim of Dr Scheibner’s has been unquestioningly repeated in other anti-immunisation material.41-43
    Dr Scheibner’s claim rests upon her analysis of two papers, one by Noble et al44 and the other by Cherry et al.28 After reviewing both these papers it is clear that Dr Scheibner’s analysis of them is at best sloppy, and at worst blatantly dishonest.
    In Japan during the period concerned there was in place a Vaccine Compensation System, and the data presented by Noble and Cherry relate to claims made through this system.28,44 Compensation was commonly awarded for events considered possibly due to immunisation, unless there was clear evidence that this was not the case. Approximately two thirds of claims submitted were accepted.
    Noble and Cherry both report that when the minimum immunisation age was moved from three months to two years there were no claims made through the compensation system for vaccine related sudden death.28,44 They do not claim, as Dr Scheibner suggests, that there were no deaths from SIDS in Japan following the change in immunisation age.
    Claims for vaccine related sudden death stopped, not because children were no longer dying, but because their deaths no longer occurred during a period when they were also receiving immunisation. How can you claim for a vaccine-related death if no vaccine was given?
    If Dr Scheibner is really claiming that no children in Japan died from SIDS once the DTP immunisation age was changed she provides no evidence to support this claim, and I do not believe she can.
    The drop in compensation claims suggests that the purported reactions in infants were in large part unrelated developmental events expected commonly in that age group but attributed to vaccine because they were time related analysis of cases with paid claims in the Japanese national compensation system indicates many of the putative cases to be related to other medical conditions. 28(p973)
    Additionally, if immunisation is ineffective, as Dr Scheibner claims, then the change in the minimum age of DTP immunisation from three months to two years should not have been associated with any change in the incidence of the disease.
    On the other hand, if Dr Scheibner is wrong, and DTP immunisation protects children from pertussis, we would expect that a shift in minimum age to two years would result in an increase in the incidence of pertussis in children under the age of two. This is exactly what happened.
    During the period 1970-74, when DTP immunisation was begun at three months the incidence of pertussis in children aged under one was approximately four per 100,000. In 1975 the minimum immunisation age was moved to two years, and by 1984 the incidence of pertussis in children aged under one was over 20 per 100,000.44
    These figures, which demonstrate well the expected change in pertussis epidemiology following shift in immunisation age, are particularly damaging to Dr Scheibner’s case, so it comes as no surprise to see her not mention them.
    If DTP immunisation caused SIDS, as Dr Scheibner claims, we would expect to observe the SIDS rate rise as immunisation rates increase. As noted earlier, in the UK during the mid 1970s pertussis immunisation rates fell.
    Following the pertussis epidemics of 1977-79 and 1981-82 there were intensive efforts to improve immunisation rates. These efforts were successful and by 1992 pertussis immunisation rates were higher than they had ever been.45
    Over the same period SIDS deaths in the UK were falling, and by 1992 the number of deaths was lower than it had ever been.46 If DTP is an important cause of SIDS then how is this explained? Isn’t this the exact opposite of what would be expected according to Dr Scheibner?
    Finally, in reviewing the DTP/SIDS literature Dr Scheibner found a study by Baraff et al47 that described a possible link between SIDS and DTP, but she managed to miss the criticism of this paper (no account taken of the age distribution of SIDS cases) by Mortimer.48 She also failed to find the work of Bouvier-Colle et al49, and Taylor and Emory50, both of which offer no support for her belief.

  17. Cybertiger said,

    June 8, 2010 at 7:33 pm
    Jim D Cole gives a grateful plug to the ratbags and rsoles of the online world. I can understand that.

  18. gazue said,

    September 16, 2010 at 12:49 pm
    Re above comment. To all the pro vaccinators. The biggest hole of all in your arguments are simply: All statistical evidence b4 manipulation show that “childhood diseases” were on the decline well b4 the first mass vaccination campaigns were ever conducted anywhere on the planet. Reason in part being…radically improved hygeine, sanitation and plumbing in societies. If these so called “deadly childhood diseases” were in fact deadly, the human race would have been wiped out centuries ago. You talk as if babies immune systems are born defective. They become defective after given a huge assault on their system by an intramuscular vaccine. And why did Jonas Salk, the inventor of the oral polio vaccine testify in court that all cases of polio after the intro of his vaccine were a direct result of taking the vaccine? Why do children vaccinated with measles, contract “atypical measles”, which is a very virulent form of measles with a higher mortality rate than measles itself? Why has Autism numbers astronomically increased, coinciding with the large increase of the number of vaccines given to children over the last 10 to 15 years. Why does an Australian nurses handbook state that an adverse reaction of the MMR vaccine is SIDS?Wake up you lot and go peddle your drugs elsewhere!

  19. jdc325 said,

    September 17, 2010 at 2:22 pm
    Lots of assertions there gazue. Could you please post the evidence that supports them?

  20. DK498 said,

    October 15, 2010 at 5:39 pm
    The evidence can go either way, in my opinion.
    Nobody has done observations on vaccinated kids vs. unvaccinated…because all kids are vaccinated. Well, except the Amish community. Perhaps we should look there to see what we can see.
    Here’s my problem: vaccines contain some pretty nasty chemicals. Chemicals that I would never intentionally put into my own body, let alone my baby.
    Some of the side effects are pretty nasty and lifelong, though rare.
    No doctor will take responsibility for any adverse side effects resulting from vaccines. This is evidenced by the fact that you have to sign a waiver; and, if a waiver is given to them, they will not sign it.
    This certainly is a major dillemma. Each person will have to make their own choice. If you choose to vaccinate, be very careful and selective how you do it. If you choose not to vaccinate, do everything you can to keep your child healthy and know how to handle the diseases if they come.
    Just some of my thoughts.
    Source:  

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