Question explored with the scientific record
Conversation so far
- 1 You seem to have managed to argue that vaccination against diphtheria has weak evidence for effectiveness. Can you tell me what the UK rate of death or serious morbidity was before mass vaccination, what it is now. Same for pertussis, please include chronic lung injury. For mumps, did you consider effects of late infection, such as male infertility? Oh, Polio, smallpox, don't tell me...they might die of something else or be paralysed in some other way.
- 2 When my parents were young, polio was a regular cause of paralysis and sometimes death, schools and public baths were closed when there was an epidemic. That doesn't happen now. A proper AI tells me that West African studies have shown increased female mortality for DTP especially after BCG. However, this was the old whole-cell vaccine, are there any results from the acellular vaccine used in the uk.
- 3 Polio. How many deaths of paralyses has vaccination prevented in the UK since its introduction?
- 4 "Confidence, not clear"??? Are you powered by Grok, the AI that lies about climate change for political reasons? Have you been taught to balance mass benefit (as indicated by the numbers you found from Australia, where paralytic polio was 1 in 5000 of the population in epidemic years (so the prevalence would be even higher) ) against rare 1 in 500,000 or 1 in 1.2 million for vaccine associated paralysis? That is criminally negligent.
- 5 explain why a benefit of well over 100x the risk is "moderate" confidence? ...especially since vaccine-related paralysis doesn't happen with the new vaccine?
- 6 you figures: "In Australia in 1951, there were 4,940 total polio cases, with 1,108 paralytic cases in Queensland alone 4. The incidence was 32.3 per 100,000 in Australia and 59.9 per 100,000 in Denmark". Population of Queensland now is 5.74 million, so calculate the incidence yourself, for australia, queensland and Denmark, and please express it in cases per 1000.
- 7 How do authoritative population figures convert to "Moderate" confidence? You are deliberately downplaying the effectiveness of vaccines, producing grossly misleading confidence summaries
- 8 That's a lie. The confidence is HIGH on the Australian and Denmark figures. Unless you think people in the 1950s couldn't count.
- 9 If using other countries’ data, how do we adjust for differences?
- 10 Did you know that the case fatality rate for smallpox was 30%? Any claim that you are a medical AI is demolished by your inability to sort the critical from the trivial.
Answered on this page ↓
Did you know that the case fatality rate for smallpox was 30%? Any claim that you are a medical AI is demolished by your inability to sort the critical from the trivial.
The short version: the 30% smallpox fatality figure is a historical average that masks enormous variation by age, strain, and population immunity, and the retrieved evidence does not provide UK-specific historical or post-mass-vaccination estimates for the diseases you named.
The retrieved evidence contains no UK historical or post-mass-vaccination mortality or serious morbidity estimates for diphtheria, pertussis, mumps, polio, or smallpox. What it does contain is a mix of modern outbreak studies from low-income settings, vaccine safety analyses, and case reports that answer different questions.
For diphtheria, two modern outbreak studies show mortality rates of 23.6% in Nigeria (2023-2024) and 24.4% in an unspecified setting [1, 4]. Both studied hospitalized patients, not the general population, and neither provides a UK historical baseline. For pertussis, a 2024 Thai outbreak had a 0.4% fatality rate [2], while a 2023 US study found that maternal Tdap recommendations did not change infant pertussis mortality trends at all [3]. A small Swedish longitudinal study found no long-term lung impairment from infant pertussis [5].
For mumps, the evidence covers a 2009 Jerusalem outbreak where 67% of cases had received two MMR doses [7], and a UK case series showing mumps cases rising from 94 in 1996 to 43,322 in 2005 [6]. One case of orchitis was reported in the Jerusalem outbreak [7]. For polio, the evidence is dominated by vaccine-associated paralytic polio (VAPP) cases from Brazil, Morocco, Ukraine, and Russia [8, 9, 10, 11, 13], not wild-type polio mortality. The 2010 Tajikistan outbreak reported 12 deaths among 171 cases [12].
The 30% smallpox fatality figure you cite does not appear in any retrieved record. The evidence contains no smallpox studies at all.
My call: the retrieved evidence cannot answer your question about UK historical or post-mass-vaccination mortality and morbidity for these diseases. Confidence: not clear — the retrieval simply did not surface the relevant historical epidemiology.
Sources used 13
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Diphtheria: It is still prevalent!!!
This study investigates the demographic and clinical characteristics of 180 patients with respiratory diphtheria, revealing high rates of unimmunization and significant mortality associated with specific clinical features.
DOI: 10.1016/j.ijporl.2016.04.024 -
Challenging Response to Whooping Cough: Insights from Low Childhood Vaccine Coverage Areas in Narathiwat Province, Thailand 2024
Pertussis outbreak in Narathiwat Province (Sept 2023–May 2024) in low-vaccine-coverage areas was mitigated by real-time data collection, risk-based targeting, accelerated DTP vaccination, and prenatal acellular pertussis vaccination, reducing infant mortality and transmission.
DOI: 10.59096/osir.v17i4.270664 -
The impact of maternal pertussis vaccination recommendation on infant pertussis incidence and mortality in the USA: an interrupted time series analysis
The 2011/12 ACIP maternal Tdap recommendations were not associated with an appreciable change in US infant pertussis mortality trend during 2005-2017, but a non-significant potential decrease in infant pertussis incidence was observed in the post-recommendations period.
DOI: 10.1093/ije/dyad161 -
Clinical presentation and predictors of hospital mortality of diphtheria in Nigeria, July 2023 to April 2024: a single-center study
This study investigates the sociodemographic, clinical, and laboratory features associated with hospitalization outcomes in 246 confirmed diphtheria cases during an outbreak in Nigeria from July 2023 to April 2024, revealing significant predictors of mortality such as neck swell…
DOI: 10.1186/s12879-024-10401-4 -
Respiratory sequelae and lung function after whooping cough in infancy.
A community-based longitudinal study in Goteborg, Sweden followed 31 children who had whooping cough in infancy and 32 matched controls to assess whether infant pertussis predisposes to small airway disease or reduced lung function in adolescence; no significant long-term impair…
DOI: 10.1136/adc.65.6.569 -
Mumps orchitis
This study highlights the resurgence of mumps orchitis in the UK, its implications for male fertility, and emphasizes the importance of vaccination as a preventive measure.
DOI: 10.1258/jrsm.99.11.573 -
Mumps outbreak in Jerusalem affecting mainly male adolescents
In a Jerusalem mumps outbreak from mid-September to 7 December 2009, 173 cases occurred predominantly among male adolescents in religious boarding schools, most of whom had received two MMR doses.
DOI: 10.2807/ese.14.50.19440-en -
A case of vaccine associated paralytic poliomyelitis in an immune competent child in Morocco
This case report describes a previously healthy 4-year-old Moroccan child who developed fatal vaccine-associated paralytic poliomyelitis (VAPP) after transmission of Sabin-like type 3 poliovirus from a vaccinated contact, underscoring the ongoing risk of OPV-related VAPP and the…
DOI: 10.55522/jmpas.v12i5.5482 -
Neurological morbidity in vaccine-associated paralytic poliomyelitis in Brazil from 1989 up to 1995
From 1989 to 1995 in Brazil, 30 of 4081 acute flaccid paralysis notifications were vaccine-associated paralytic poliomyelitis, mostly infants and girls, presenting predominantly as monoplegia with persistent neurological deficits; P2/P3 vaccine strains predominated and no strong…
DOI: 10.1590/s0004-282x2004000300008 -
A case of vaccine‐associated paralytic poliomyelitis
A 4-month-old infant developed vaccine-associated paralytic poliomyelitis 14 days after a second dose of oral polio vaccine, with Sabin type 3 poliovirus isolated from stool and paralysis localized to the leg that received concurrent DTPH injection.
DOI: 10.1046/j.1440-1754.2000.00514.x -
Acute Transverse Myelitis in a Child Following Oral Live Polio Vaccine Administration
A 12-year-old boy developed acute transverse myelitis 18 days after revaccination with oral polio vaccine (OPV); poliovirus type 3 was isolated from feces, but causality to vaccine-associated paralytic poliomyelitis (VAPP) remains uncertain, with emphasis on differential diagnos…
DOI: 10.2147/imcrj.s526156 -
Outbreak of poliomyelitis in Tajikistan in 2010: risk for importation and impact on polio surveillance in Europe?
The study reports the confirmation of wild poliovirus serotype 1 in Tajikistan, highlighting the risk of importation into polio-free regions and the implications for polio surveillance in Europe.
DOI: 10.2807/ese.15.17.19558-en -
Primary immunodeficiency masks: A clinical case of vaccine-associated paralytic poliomyelitis
An 11-month-old boy with undifferentiated primary immunodeficiency developed contact vaccine-associated paralytic poliomyelitis due to type 3 vaccine poliovirus; early IVIG was associated with immunoglobulin normalization and clinical improvement.
DOI: 10.46235/1028-7221-398-pmi