What is Intussusception

An Introduction

Intussusception is a clinical condition where a part of the intestine folds into the adjacent segment of the intestine. Any alteration of normal peristaltic movement of the intestine creates the invagination in the segment of the small intestine (mainly ileum folds into cecum). The blood supply of the involved bowel segment is cut off and this may give rise to symptoms like abdominal pain, vomiting, and bloody stool (red currant jelly stool). It is seen commonly in children of age between 6 to 18 months of age. The condition requires urgent treatment and occasionally needs surgery.

What causes Intussusception?

The exact cause of Intussusception in children is not known in about 90% of the cases. [1] Works of the literature suggest various factors that could cause Intussusception in children and these are grouped as:

1. Intestinal infections.

2. Altered anatomy of the intestine.

3. Altered bowel movement.

4. Intestinal pathologies like Appendicitis, polyps, Meckel’s diverticulum, cystic fibrosis, hyperplasia of Peyer’s patches.

How common is Intussusception?

Intussusception is the disease of infants and young children and affects about 2000 children per year in the United States. It is the most common cause of abdominal emergency amongst young children and is the second most common cause of intestinal obstruction. [2]The condition peaks starting from 4months to 9 months of age and gradually decreases after 18months of age. Boys are more frequently affected than girls. [1]

Adults are also affected with Intussusception and the condition is more serious because it can be associated with neoplasm (cancer). Intussusception counts for 1% of bowel obstruction in adults. [1]

What are the risk factors?

Childrens when affected with disease conditions like bowel infections, polyps of the intestine, and cystic fibrosis have a higher risk of developing Intussusception. However, adults have separate known risk factors and they are endometriosis, intestinal tumors, and adhesions of the bowel wall.

What are the symptoms of Intussusception?

A child suffering from Intussusception initially develops intermittent abdominal pain. A child may also vomit and the vomitus may have a greenish stain of bile. Later on, as the disease advances, the child may develop rectal bleeding and the stool is typically “red currant jelly” in appearance. The pain may increase in intensity and the child cries excessively, and may even draw the knees up to their chest. The child may dehydrate and may become lethargic when the disease is severe.

The doctor (pediatrician) when examines the child feels a “sausage-shaped” mass in the abdomen. Digital rectal examination when performed by the doctor may feel for the fold (intussusceptum).

What tests should be performed to diagnose intussusception?

Ultrasound examination is the test of choice to diagnose the condition. “Target sign” or “Doughnut sign” is seen by the radiologist which confirms that the child is suffering from intussusception. However, when the Ultrasound cannot confirm the diagnosis CT scan of the abdomen has to be performed. Getting a CT scan in young children needs anesthesia and carries some risk. An “Air enema test” also can confirm the diagnosis and simultaneously can treat the condition as well.

How is this condition treated?

Intussusception requires rapid treatment as the small intestinal segment is cut off from its blood supply and further delay can put the segment of the intestine at the risk of necrosis. Necrosis can lead to the spreading of the infection and may even put the child at risk of sepsis and multiorgan failure. Early treatment carries a good prognosis and decreases the likelihood of the need for surgery.

Barium enema, water-soluble enema, or air-contrast enema can confirm as well as successfully treat the condition in almost 80% of the cases. [1] Enema, however, cannot reduce the folded intestinal wall in the rest 20% of the cases, and these subsets of patients need surgery. The surgeon manually reduces the part by squeezing the intestine either by open or laparoscopic method. If this is still not successful then the involved segment of the intestine is surgically cut off and removed.

Intussusception in adults has different treatment modalities. Adults usually have an organic lesion (neoplasm) which should be addressed. Treatment with air contrast enema is not preferred in adult intussusception.

What are other clinical diseases which mimic intussuception?

Numerous diseases can present with clinical features similar to intussusception. Appendicitis, abdominal hernia, colic, volvulus of intestine, testicular torsion, and blunt abdominal trauma have listed as important ones.

References:

1. Jain S, Haydel MJ. Child intussusception.

2. Marsicovetere P, Ivatury SJ, White B, Holubar SD. Approaches and Treatment of Intussusception, Volvulus, Rectal Prolapse, and Functional Disorders of the Colon, Rectum, and Anus: Intestinal Intussusception: Etiology, Diagnosis, and Treatment. Clinics in Colon and Rectal Surgery. 2017 Feb;30(1):30.

If you or anyone you know has been injured by a covered vaccine, contact Gold Law Firm, LLC. at info@goldlawfirm.net or text/tel at 781-239-1000. Vaccine Injury Law is all we do.

Rotavirus Vaccine

About Rotavirus

Rotavirus, discovered in 1973 A.D. is the leading cause of severe dehydrating diarrhea in children < 5 years of age, globally. It is responsible for 3.4% of all under 5 deaths, 37% of total diarrheal deaths, and 40% of total diarrhea-related hospitalizations. [1]

Rotavirus is a double-stranded RNA virus of the family Reoviridae. It is wheel-shaped under an electron microscope, hence its name. There are 9 species A-I of which Rotavirus type A is the most common.

The mode of transmission is via fecal-oral route (person-to-person or via fomites). During the first episode of infection, viruses are shed for several days in a very high concentration (>1012 particles/gram) in stool and vomitus. The incubation period is 1-3 days where vomiting and diarrhea occur. This either resolves in 3-7 days or leads to electrolyte imbalance and shock and ultimately death. Protective immunity develops after natural infection and is strongest against moderate-to-severe disease.

Prevention

A realistic goal for a rotavirus vaccine is to duplicate the degree of protection against disease that follows natural infection.

Goals for a Rotavirus vaccine:

  • To duplicate the degree of protection that follows natural infection
    • To prevent moderate-to-severe disease but not a mild disease from rotavirus
    • To reduce the disease burden
    • To provide vaccines in developing countries where rotavirus mortality is high.

Attenuation of rotaviruses by oral vaccines may be achieved in several ways: [1]

  • First-generation vaccines (Jennerian approach):

These early rotavirus vaccines were single-animal strains that were naturally attenuated in that they did not cause clinical disease in humans but conferred protection against subsequent infection with human rotavirus strains. They are available in trade names RI T 4237, RRV-MMU, WC3 (non-reassortant), and LLR, out of which LLR, is the licensed vaccine and the rest are discontinued today.

  • Second-generation vaccines (modified Jennerian approach):
  • Animal-human reassortant:

These reassortants contain an animal strain that incorporates additional genes from human strains by capitalizing on the viruses’ ability to reassert in vitro. They are available as Wa X UK, RRV-TV (Rotashield), and Reassortant WC3 (Rotataq). Out of these, Wa X UK is in active Phase I trial, Rotashield is withdrawn and Rotataq is the licensed vaccine.

  • Human attenuated strains:

These are vaccines developed through attenuation of human rotavirus strains. They are available as M37, Rotatrix, and 116E of which, M37 is discontinued, Rotatrix is the licensed vaccine and 116E is in active phase I trial.

Two safe and effective vaccines are now licensed in 100 countries but used in 17 countries; Rotarix (RV1) and RotaTeq (RV5). In April 2009, WHO provided a recommendation for the global introduction of these vaccines in national immunization programs of developing countries worldwide. [2]

RotaTeq vaccine

It is manufactured by Merck and was licensed by the FDA in 2006. It is a pentavalent human-bovine reassortant live-attenuated, oral vaccine. This vaccine contains five live reassortant rotaviruses. It is administered in three oral doses at 1- to 2-month intervals beginning at 6 to 12 weeks of age. [3]

In a large clinical trial conducted primarily in the US and Finland, RotaTeq showed an efficacy of 98% against severe rotavirus gastroenteritis. Protection was good (88-100%) against all G1-4 and G9 serotypes. In the US, the field effectiveness of the vaccine was similar to that observed in the clinical trial. [4]

Rotarix vaccine

Rotarix vaccine is manufactured by GlaxoSmithKline and was licensed by the FDA in 2008. A live-attenuated human rotavirus vaccine was originally developed in Cincinnati, OH by tissue culture of a wild-type human rotavirus isolate. It is a monovalent vaccine and is administered at 2 and 4 months of age.

In a clinical trial conducted in 11 Latin American countries and Finland, the results demonstrated a protection rate of 85% against severe rotaviral gastroenteritis and 100% protection against the most severe dehydrating rotaviral gastroenteritis episodes. [1]

Vaccines in development

An Indian-made rotavirus vaccine, Rotavac, is in development, and its phase III trials.

Other vaccines are undergoing clinical trials like- human neonatal P[6]G3 strain, RV3, developed by Ruth Bishop and colleagues in Australia, a neonatal strain vaccine (G9P11) being developed by Bharat Biotech in India. These novel approaches are being pursued using animal models.

If you or anyone you know has been injured by a covered vaccine, contact Gold Law Firm, LLC. at info@goldlawfirm.net or text/tel at 781-239-1000. Vaccine Injury Law is all we do.

References

  1. Dennehy P. Rotavirus Vaccines: an Overview. Clinical Microbiology Reviews. 2008;21(1):198-208.
  2. Burnett E, Yen C, Tate J, Parashar U. Rotavirus vaccines: current global impact and future perspectives. Future Virology. 2016;11(10):699-708.
  3. [Internet]. Who.int. 2021 [cited 22 March 2021]. Available from: https://www.who.int/immunization_standards/vaccine_quality/RotaTeq_Product_Insert.pdf
  4. Jiang V, Jiang B, Tate J, Parashar U, Patel M. Performance of rotavirus vaccines in developed and developing countries. Human Vaccines. 2010;6(7):532-542.

What is Transverse Myelitis?

Transverse Myelitis

An introduction

Transverse myelitis is a rare disease condition of the nerves, mainly the spinal cord. The spinal cord and its coverings are inflamed at the level of the cervical or thoracic vertebra. There is sharp, shooting type of pain, abnormal sensation, and weakness or even the paralysis of the body part (mainly both the lower limbs) below the level of the involvement. Although the limbs are equally weak on both sides of the body, the weakness may be partial or unequal sometimes. However, the disease condition commonly affects the bowel and bladder function in almost all the patients and adds up the morbidity.

How does a person develop transverse myelitis?

Transverse myelitis is not a disease that we get by birth. It is an acquired disease condition but most often the cause of the disease is not known. [1] Viral infections caused by enteroviruses, herpes viruses, HIV, West Nile virus, etc. are linked with the development of inflammation of nerve sheath leading to Transverse Myelitis. Apart from infections, other disease conditions like rheumatoid arthritis (RA), ankylosing spondylitis, antiphospholipid syndrome, sarcoidosis, scleroderma, and systemic lupus erythematosus (SLE) has also been found to cause transverse myelitis. [1]

Who are at the risk of getting this disease?

Transverse myelitis is a rare disease in itself and has been found to affect 1 to 8 people per million people in a year. [1] The disease can affect both men and women equally. Although the disease can affect patients of all age groups, the incidence is more amongst the people between 10 and 19 years of age and also amongst the people between ages 30 and 39. [1]

Patients with other disease conditions like SLE, RA, HIV, etc. are even at more risk of developing this condition.

How do I know whether someone has developed Transverse Myelitis?

As the white matter of the spinal cord gets involved the patient starts developing symptoms like pain, tingling, and burning sensation of the body part below the level of involvement. More often the whole segment of the spinal cord is involved and when this happens there is the weakness of the limbs. The weakness may be complete or incomplete and may affect all four limbs when the disease is severe. The symptoms arise suddenly and the limbs are floppy (flaccid) initially which later on becomes stiff (spastic).

Autonomic nervous system involvement may give rise to problems like urinary and/or fecal incontinence. There might be other symptoms like difficulty voiding urine, constipation, and even sexual difficulties.

In severe cases, there is difficulty breathing when the spinal cord is affected in the level of the neck (C5 nerve root involvement). Respiratory failure can be devastating and can lead to death, unfortunately.

How does a doctor diagnose Transverse Myelitis?

Doctors initially take a detailed history and perform a relevant clinical examination and then ask for investigations. The most useful investigation modality is magnetic resonance imaging (MRI) of the brain and spinal cord. Sometimes, lumbar puncture (LP) is done by the doctors to examine the cerebrospinal fluid. Apart from these tests, blood is withdrawn to test for HIV, thyroid disorders, autoantibodies like rheumatoid factor (RA factor), serum antinuclear antibodies (ANA), Ro/SSA, and La/SSB autoantibodies, etc.

What are the treatment options?

The treatment of transverse myelitis should begin as soon as possible. Hospitalization of the patient is needed for newly diagnosed cases to monitor vital signs, to carry out investigations, or when symptoms are severe. Intravenous glucocorticoids in high doses are the preferred treatment modality. Medicines like methylprednisolone or Dexamethasone are used for 3 to 5days and are continued as per the progression of the disease. There are very few contraindications of steroid use and that’s why steroid treatment is started even before the test results are available. Steroids are believed to decrease the ongoing inflammation and reduce swelling of nerve sheath around the spinal cord. [2]

Intravenous immunoglobulin (IVIG) therapy and Plasma exchange therapy has gained popularity these days and this treatment modality may be effective when there is no appropriate response to the steroid therapy. [3]

Other medicines under study are cyclophosphamide, mycophenolate, and rituximab. These medicines are believed to have an immunomodulatory effect and can decrease the severity of the disease. [1]

Physiotherapy and rehabilitation programs also have an important role to prevent the development of contractures and deformity of the joints.

What are the chances of recovery once the patient develops this condition?

According to the researchers, almost one-third (33%) of the patients recover completely with minimal or almost none of the residual paralysis. The recovery starts within 1-3months of disease onset and progress speeds up with exercise and rehabilitation therapy. The complete recovery may take 2years in total.

 Another one-third patient population (33%) recover incompletely and have some degree of paralysis. These subsets of patients have a moderate degree of disability while carrying out daily activities. The remaining one-third of the patient population (33%) don’t recover at all and develop a permanent disability. [4]

The outcome is poor when the patient has severe symptoms including spinal shock during the initial visit, or has presented late, or has developed extensive lesions and syringomyelia when seen on MRI. [5]

How can the condition get complicated?

There are several complications of transverse myelitis and many of them are preventable. Complications like Urinary tract infections, pressure sores, spasticity, chronic pain, depression, and sexual dysfunction are common. Appropriate care and rehabilitation measures with frequent position change, urinary catheter exchange, appropriate antibiotics, and antispasmodic agents can prevent most of these and may improve outcomes.

References:

1. Simone CG, Emmady PD. Transverse Myelitis. StatPearls [Internet]. 2020 Jun 9.

2. Scott TF, Frohman EM, De Seze J, Gronseth GS, Weinshenker BG. Evidence-based guideline: clinical evaluation and treatment of transverse myelitis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2011 Dec 13;77(24):2128-34.

3. Cortese I, Chaudhry V, So YT, Cantor F, Cornblath DR, Rae-Grant A. Evidence-based guideline update: plasmapheresis in neurologic disorders: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2011 Jan 18;76(3):294-300.

4. Krishnan C, Kaplin AI, Pardo CA, Kerr DA, Keswani SC. Demyelinating disorders: update on transverse myelitis. Current neurology and neuroscience reports. 2006 May 1;6(3):236-43.

5. Lim PA. Transverse myelitis. Essentials of Physical Medicine and Rehabilitation. 2020:952.

Guillain-Barre syndrome GBS

GUILLAIN-BARRE SYNDROME

What is Guillain-Barre Syndrome (GBS)?

Guillain-Barre Syndrome is a rare condition where the body’s immune system attacks the nerve tissue. It is an acute, progressive, autoimmune, inflammatory demyelination of peripheral sensory and motor nerves and nerve roots. GBS is the most common cause of acute non-trauma-related paralysis in the world. It is also the most common cause of acute motor paralysis in children.

What is its prevalence?

The annual incidence in the United States is 1.65 to 1.79 per 100,000 persons.1 Males are one and a half times more likely to be affected than females. No evidence exists for any racial predilection.

What are the triggering factors?

The exact cause is unknown. Two-thirds of patients report symptoms of viral or bacterial infections like Campylobacter jejuni, cytomegalovirus, Epstein-Barr virus, Mycoplasma pneumonia in the preceding 6 weeks. Vaccination against the flu, Rabies, meningitis is also the documented precipitating factors. It can also be seen in patients with lymphoma, HIV, SLE.

What are its subtypes?

There are 3 subtypes of Guillain-Barre syndrome:

  • Acute inflammatory demyelinating polyradiculoneuropathy (AIDP): It is the most common form in the U.S. the most common sign of AIDP is muscle weakness that starts in the lower part of the body and spreads upwards.
  • Miller Fisher syndrome (MFS) in which the paralysis starts in the eyes. It is also associated with an unsteady gait. It occurs in about 5 percent of people with GBS in the U.S. but is more common in Asia.
  • Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN) which is less common in the U.S.

When to see a doctor?

The symptoms of Guillain-Barre syndrome are pain, progressive muscle weakness in the legs spreading to the upper body, tingling sensations, blood pressure instability, paresthesia (abnormal sensations in the skin), and muscle pain. There are also symptoms of muscle spasms, difficulty in eye movement, facial movement, speaking, chewing, or swallowing.

Weakness and tingling sensation in the fingers, toes, ankles, or wrists are usually the first symptoms. These sensations can quickly spread, eventually paralyzing the whole body. There is no history of fever at the onset of weakness.

What does a doctor see on physical examination?

Ascending motor weakness is noted along with areflexia is the classic form. Areflexia is a hallmark of GBS. Some of the proximal reflexes may still be elicited during the early phase of the disease. Documentation of the reflexes in serial examinations is of clinical value. Occasionally there may be autonomic instability (26%), ataxia (23%), dysesthesias (20%), cranial nerve findings (35-50%) predominantly facial nerve palsy are noted. Later, respiratory muscles and upper extremities show involvement.

Autonomic neuropathy manifests as orthostatic hypotension or hypertension, pupillary dysfunction, sweating abnormalities, and sinus tachycardia.

How does the doctor confirm the diagnosis?

After taking the history of symptoms and physical examination, certain tests can be done to confirm the diagnosis. These tests are:

  • Nerve conduction studies – electrodes are taped to the skin above the nerves under study. It shows a slowing or possible blockage of conduction
  • Spinal tap – a small amount of fluid is withdrawn from the spinal canal in the lower back. It shows increased protein levels but a normal white blood cell count.
  • Electromyography – thin needle electrodes are inserted into the muscles which the doctor wants to study. The electrodes measure nerve activity in the muscles.
  • Electrocardiogram, and
  • Pulmonary function test.

What are the treatment options available?

Following treatment options can speed up recovery and reduce the severity of illness:

  • Plasmapheresis – This treatment includes the exchanging of the plasma of the patient with the recovered patient or with that of normal people. This method improves short-term and long-term outcomes in the patients, as per various studies.
  • High dose intravenous Immunoglobulin therapy.
  • Mechanical ventilation may be required in severe cases until the respiratory muscle function returns to normal.
  • Pain control with non-steroidal anti-inflammatory drugs, carbamazepine, or gabapentin.
  • Supportive care – monitoring for respiratory and autonomic complications, prevention of venous thrombosis, skin breakdown, and deconditioning.

What can happen if I have GBS?2

People with Guillain-Barre Syndrome may develop complications like:

  • Pain
  • Thrombosis
  • The weakness of the respiratory muscles
  • Cardiac arrhythmias
  • Residual numbness or other sensations
  • Pressure sores
  • Bowel and bladder problems
  • Relapse: occurs in about 2-5% of cases

What is the disease course when it is left untreated?

Approximately 80% of the patients have a complete recovery. 3% of patients with GBS unfortunately may die. Neurologic problems persist in about 20% of patients, and one-half of these patients are severely disabled.1


Guillain-Barre syndrome GBS is a rare vaccine injury. Gold Law Firm, LLC. is the national vaccine injury law firm. Vaccine Law is all we do.

References

  1. AD W, G D. Guillain-Barré syndrome [Internet]. PubMed. 2021 [cited 1 March 2021]. Available from: https://pubmed.ncbi.nlm.nih.gov/23418763/#:~:text=Guillain%2DBarr%C3%A9%20syndrome%20consists%20of,to%201.79%20per%20100%2C000%20persons.
  2. Guillain-Barre syndrome – Symptoms and causes [Internet]. Mayo Clinic. 2021 [cited 1 March 2021]. Available from: https://www.mayoclinic.org/diseases-conditions/guillain-barre-syndrome/symptoms-causes/syc-20362793#:~:text=Guillain%2DBarre%20(gee%2DYAH,eventually%20paralyzing%20your%20whole%20body.

The IPV Vaccine

Polio inactivated vaccine

Polio is a disease in children that is caused by the poliovirus. Polio can cause paralysis of legs or can cause weakness of the entire body. This condition is entirely vaccine-preventable. 

Q. How does a person get this virus?

The poliovirus is a highly contagious virus and can spread through the feco-oral route. Most of the infected children (around 72%) remain asymptomatic. However, they can still shed virus and can cause disease transmission.

Q. How do I know I have developed polio?

Initially, the symptoms in a patient infected with the poliovirus are very nonspecific and similar to that of any other viral illness. Patients may develop features like sore throat, fever, vomiting, headache, joint pain, etc.

Sometimes, the virus can invade the brain and spinal cord and this event can cause paralysis of extremities or the diaphragm, causing difficulty in breathing and ultimately causing death in almost 10% of the cases.

Q. How is this condition treated?

Once the disease starts progressing there is no cure apart from symptomatic management. Therefore, prevention is the key.

Q. How do I prevent myself from developing Polio?

Since 1955, an injectable form of polio vaccine has been available in the health centers of the United States. The US government has been able to eradicate the disease itself by 1979. Owing to the success rate of the vaccine, CDC has recommended polio vaccine to be included in the list of routine vaccinations in a child.

This vaccine provides the body with the inactivated viral particles. The immune system recognizes these viral particles and starts forming antibodies to neutralize the viral particles so that whenever a fully functional virus enters the human body it is already prepared to fight off the virus and prevent the disease.

Q. When do the doctors inject the vaccine into my child?

Advisory Committee on Immunization Practices (ACIP) has recommended 0.5mL volume, 4doses to be given starting at 2months, 4months, 6-18months, and finally at 4years of age. There should be a gap of at least 6months between the 3rd and 4th dose. The vaccine is an inactivated polio vaccine (IPV) and can protect against all known strains (types 1, 2, and 3). 

If the child has to travel to the endemic region before completion of the vaccine series then CDC recommends that the child should take an accelerated schedule and the subsequent doses of the vaccine can be taken in the endemic regions itself or upon returning to the country.

Q. How should I protect myself as I am an adult?

Adults usually do not require vaccination like children because of the vaccination done during childhood. However, adults need vaccination if they have to travel to the endemic country or have to handle the suspected specimens in the laboratories, or if the adult is a healthcare worker actively involved in the treatment of a polio patient. 

Unlike the vaccination schedule in children, there are no routine recommendations available for adults. Adults have to consider accelerated vaccine series if they wish to travel to endemic regions. The first should be considered as soon as possible, and the second dose 1-2months later and the last dose 6-12months after the second dose.

Q. How effective is the vaccine?

The vaccine is highly effective and the oral polio vaccine (OPV) and inactivated polio vaccine (IPV) is equally effective. Two doses of IPV can provide 90% immunity to all three types of poliovirus and three doses can provide up to 99% of immunity.

Q, Are there any serious side effects?

Minor reactions to the vaccine may commonly occur. Pain, swelling, and redness may occur at the injection site. The serious side effects are rare, allergic reactions may occur in one case in 1million dose administration. That’s why the vaccine should not be given if the child has an allergy to the 1st dose or if the child has an allergy to medicines like neomycin or streptomycin. 

Oral polio vaccine should not be provided to immunocompromised individuals. Unlike the oral vaccine which contains live attenuated viral particles, the IPV does not carry the risk of paralysis post-administration. 

The oral polio vaccine has been discontinued in the United States since 2000 AD. 

References:

  1. O’Grady M, Bruner PJ. Polio Vaccine. StatPearls [Internet]. 2019 Oct 14.
  2. Polio Vaccination | What You Need to Know | CDC [Internet]. Cdc.gov. 2021 [cited 14 February 2021]. Available from: https://www.cdc.gov/vaccines/vpd/polio/public/index.html

SIRVA is about to do a disappearing act…not in reality, just in the Courts.

Shoulder Injuries as a result of Vaccine Administration (SIRVA) make up more than sixty percent (60%) of all reported vaccine injuries under the Vaccine Injury Compensation Program.

SIRVA can cause a myriad of injuries and symptoms, anything from a rotator cuff tear to shoulder inflammation. Some of these injuries cause a patient to use their arm/shoulder less….this can result in adhesive capsulitis (frozen shoulder) requiring physical therapy and/or surgery.

So why am I writing about SIRVA right now….? Because it will disappear from the vaccine injury program on February 22, 2021. Read more of the proposed changes in the Federal Register here.

The U.S. Department of Health and Human Services’ rationale is that the Vaccine Injury program is just that, meant to compensate people who have been injured by a vaccine, not the vaccination needle itself. They also point out that these cases are overwhelming the system in the United States Court of Federal Claims, taking away valuable resources and monies that could be used for other people injured by vaccines.

However much logic exists in the Government’s argument there are some counterpoints. Primarily…thousand of people are injured by SIRVA every year from vaccinations. These folks suffer pain, lose their jobs and have permanent disabilities. The injuries are real.

Further, where are they going to go for compensation? Forcing people to sue in other courts raises the burden on an injured person, costing them attorney’s fees and expenses. And sometimes, frankly quite often, simply because someone suffers SIRVA does not mean that someone is at fault. It’s a vaccination. A nurse or other medical provider does the best they can. While mistakes can and do happen, sometimes they are unavoidable or do not rise to the level of negligence (a violation of a duty of care).

So the conclusion? At a time when all of us are rightfully encouraged to receive our COVID vaccines, it is now becoming harder to recover vaccine compensation. Justice is not being served. We can do better. Let’s pause this change and try again….

How safe are the Covid Vaccines?

According to medical journal StatNews As of Jan. 19, there have been 15 confirmed cases of anaphylaxis after receipt of Moderna’s vaccine and 45 confirmed cases of anaphylaxis after receipt of the Pfizer vaccine, the CDC said in a statement to STAT. That works out to a rate of 2.1 cases per million doses of the Moderna vaccine and 6.2 cases per million doses of the Pfizer, according to the agency.

Anaphylaxis is a severe allergic reaction that can be life-threatening if not treated quickly.

Vaccine injuries are rare but real. There can be reactions to flu shots, Tetanus, HPV, Hepatitis A, Hepatitis B and others…

Anaphylaxis occurred quickly in the people affected, with the median time to the start of symptoms being 7.5 minutes. People who receive Covid-19 vaccines are supposed to be monitored for 15 minutes after the injection, with that period extended to 30 minutes for people with a history of severe allergies or anaphylaxis.

If you have been injured as a result of a vaccine, please contact Gold Law Firm, LLC. at info@goldlawfirm.net or via telephone 781-239-1000. Vaccine Injury Law is all we do.

Changes afoot to the Vaccine Injury Table?

On July 20, 2020. the Department of Health and Human Services proposed changes to the vaccine injury table In essence these changes, if adopted, would remove shoulder injuries incurred from vaccine administration, the actual need stick, from the vaccine injury compensation program.

The rationale is that the National Vaccine Injury Compensation Program was meant to compensate those injured from a vaccine…not a needle. It’s a controversial rule change that would deprive thousands of injured petitioner’s compensation. SIRVA is the most common vaccine injury, this includes rotator cuff injuries, tendonitis, shoulder inflammation. This can occur from a flu shot, Tdap, MMR, or even a COVID-19 vaccination.

If you have suffered from a shoulder injury as a result of a vaccination, please contact Gold Law Firm, LLC. today. Vaccine injury law is all we do. Period.

If you have been injured from a COVID-19 vaccination, please visit us here

Vaccine Injury Myths Debunked

U.S. public health officials and physicians have been combating misconceptions about vaccine safety for over twenty years. They’ve had mixed success. Despite the fact that numerous studies have found no evidence to support the notion that vaccines cause autism and other chronic illnesses, a growing number of parents are refusing to vaccinate their children.

Researchers now link falling immunization rates to recent resurgences of vaccine-preventable diseases. In 2010, California saw 9,120 cases of whooping cough, more than any year since the whooping cough vaccine was introduced in the 1940s. Ten infants too young to be vaccinated died of whooping cough during the outbreak. The CDC warns that events like these will become more frequent and harder to control if vaccination rates continue to fall.

Research, however, shows that most of our biggest fears about vaccinations are unfounded. These eight major vaccine myths that research has shown to be baseless:

Myth #1: Vaccines cause autism.

The widespread fear that vaccines increase risk of autism originated with a 1997 study published by Andrew Wakefield, a British surgeon. The article was published in The Lancet, a prestigious medical journal, suggesting that the measles, mumps, rubella (MMR) vaccine was increasing autism in British children.

The paper has since been completely discredited due to serious procedural errors, undisclosed financial conflicts of interest, and ethical violations. Andrew Wakefield lost his medical license and the paper was retracted from The Lancet.

Nonetheless, the hypothesis was taken seriously, and several other major studies were conducted. None of them found a link between any vaccine and the likelihood of developing autism.

Today, the true causes of autism remain a mystery, but to the discredit of the autism-vaccination link theory, several studies have now identified symptoms of autism in children well before they receive the MMR vaccine. And even more recent research provides evidence that autism develops in utero, well before a baby is born or receives vaccinations.

Myth #2: Infant immune systems can’t handle so many vaccines.

Infant immune systems are stronger than you might think. Based on the number of antibodies present in the blood, a baby would theoretically have the ability to respond to around 10,000 vaccines at one time. Even if all 14 scheduled vaccines were given at once, it would only use up slightly more than 0.1% of a baby’s immune capacity. And scientists believe this capacity is purely theoretical. The immune system could never truly be overwhelmed because the cells in the system are constantly being replenished. In reality, babies are exposed to countless bacteria and viruses every day, and immunizations are negligible in comparison.

Though there are more vaccinations than ever before, today’s vaccines are far more efficient. Small children are actually exposed to fewer immunologic components overall than children in past decades.

Myth #3: Natural immunity is better than vaccine-acquired immunity.

In some cases, natural immunity — meaning actually catching a disease and getting sick– results in a stronger immunity to the disease than a vaccination. However, the dangers of this approach far outweigh the relative benefits. If you wanted to gain immunity to measles, for example, by contracting the disease, you would face a 1 in 500 chance of death from your symptoms. In contrast, the number of people who have had severe allergic reactions from an MMR vaccine, is less than one-in-one million.

Myth #4: Vaccines contain unsafe toxins.

People have concerns over the use of formaldehyde, mercury or aluminum in vaccines. It’s true that these chemicals are toxic to the human body in certain levels, but only trace amounts of these chemicals are used in FDA approved vaccines. In fact, according to the FDA and the CDC, formaldehyde is produced at higher rates by our own metabolic systems and there is no scientific evidence that the low levels of this chemical, mercury or aluminum in vaccines can be harmful. See section III of this guide to review safety information about these chemicals and how they are used in vaccines.

Myth #5: Better hygiene and sanitation are actually responsible for decreased infections, not vaccines.

Vaccines don’t deserve all the credit for reducing or eliminating rates of infectious disease. Better sanitation, nutrition, and the development of antibiotics helped a lot too. But when these factors are isolated and rates of infectious disease are scrutinized, the role of vaccines cannot be denied.

One example is measles in the United States. When the first measles vaccine was introduced in 1963, rates of infection had been holding steady at around 400,000 cases a year. And while hygienic habits and sanitation didn’t change much over the following decade, the rate of measles infections dropped precipitously following the introduction of the vaccine, with only around 25,000 cases by 1970. Another example is Hib disease. According to CDC data, the incidence rate for this malady plummeted from 20,000 in 1990 to around 1,500 in 1993, following the introduction of the vaccine.

Myth #6: Vaccines aren’t worth the risk.

Despite parent concerns, children have been successfully vaccinated for decades. In fact, there has never been a single credible study linking vaccines to long term health conditions.

As for immediate danger from vaccines, in the form of allergic reactions or severe side effects, the incidence of death are so rare they can’t even truly be calculated. For example, only one death was reported to the CDC between 1990 and 1992 that was attributable to a vaccine. The overall incidence rate of severe allergic reaction to vaccines is usually placed around one case for every one or two million injections.

Myth #7: Vaccines can infect my child with the disease it’s trying to prevent.

Vaccines can cause mild symptoms resembling those of the disease they are protecting against. A common misconception is that these symptoms signal infection. In fact, in the small percentage (less than 1 in one million cases) where symptoms do occur, the vaccine recipients are experiencing a body’s immune response to the vaccine, not the disease itself. There is only one recorded instance in which a vaccine was shown to cause disease. This was the Oral Polio Vaccine (OPV) which is no longer used in the U.S. Since then, vaccines have been in safe use for decades and follow strict Food and Drug Administration (FDA) regulations.

Myth #8: We don’t need to vaccinate because infection rates are already so low in the United States.

Thanks to “herd immunity,” so long as a large majority of people are immunized in any population, even the unimmunized minority will be protected. With so many people resistant, an infectious disease will never get a chance to establish itself and spread. This is important because there will always be a portion of the population – infants, pregnant women, elderly, and those with weakened immune systems – that can’t receive vaccines.

But if too many people don’t vaccinate themselves or their children, they contribute to a collective danger, opening up opportunities for viruses and bacteria to establish themselves and spread.

Not to mention, as the Centers for Disease Control (CDC) warn, international travel is growing quickly, so even if a disease is not a threat in your country, it may be common elsewhere. If someone were to carry in a disease from abroad, an unvaccinated individual will be at far greater risk of getting sick if he or she is exposed.

Vaccines are one of the great pillars of modern medicine. Life used to be especially brutal for children before vaccines, with huge portions being felled by diseases like measles, smallpox, whooping cough, or rubella, to name just a few. Today these ailments can be completely prevented with a simple injection.

So as science continues to advance and tackle new challenges, people should not forget how many deaths and illnesses vaccines have prevented, and how they continue to protect us from potentially devastating forms of infectious disease.

In other words, get your vaccines. Keep your family safe. Ignorance kills.

Think the Flu Shot can give you the flu? Nope.

https://www.livescience.com/why-flu-shot-cant-give-you-flu.html

One of the common myths that leads people to avoid the flu shot is that they think the shot will give them the flu. But that is simply not true. The virus in the vaccine is not active, and an inactive virus cannot transmit disease. What is true is that you may feel the effects of your body mounting an immune response, but that does not mean you have the flu.

Why it Matters?

Facts matter and fear-mongering among anti-vax activists can have dangerous consequences as we have seen in the measles outbreaks over the last year. Some folks complain that they got the flu from the flu shot. They didn’t. The flu vaccine does not cause the flu. Full Stop.

Inactive virus

Influenza, or the flu, is a common but serious infectious respiratory disease that can result in hospitalization or even death. The CDC estimates that during a “good” flu season, approximately 8% of the U.S. population could get the flu. That is roughly 26 million people.

Each year the flu season is different, and the flu virus also affects people differently. One dangerous complication of the flu is pneumonia, which can result when your body is working hard to fight the flu. This is particularly dangerous in older adults, young children, and those whose immune systems aren’t working well, such as those receiving chemotherapy or transplant recipients.

Historically millions of Americans get the flu each year, hundreds of thousands are hospitalized and tens of thousands of people die from flu-related complications. During the 1918 flu pandemic, one-third of the world’s population, or about 500 million people, were infected with the flu. Since that time, vaccine science has dramatically changed the impact of infectious diseases.

The cornerstone of flu prevention is vaccination. The CDC recommends that everyone 6 months of age and older who does not have contraindications to the vaccine, receive the flu shot.

And just as the polio vaccine won’t give a child polio, the flu vaccine will not cause the flu. That’s because the flu vaccine is made with inactive strains of the flu virus, which are not capable of causing the flu.

That said, some people may feel sick after they receive the flu shot which can lead to thinking they got sick from the shot.

However, feeling under the weather after a flu shot is actually a positive. It can be a sign that your body’s immune response is working. What happens is this: When you receive the flu shot, your body recognizes the inactive flu virus as a foreign invader. This is not dangerous; it causes your immune system to develop antibodies to attack the flu virus when exposed in the future. This natural immune response may cause some people to develop a low-grade fever, headache or overall muscle aches. These side effects can be mistaken for the flu but in reality are likely the body’s normal response to vaccination.

And the good news is these natural symptoms are short-term side effects compared to the flu, which can last much longer and is more severe. It is estimated that less than 2% of people who get a flu shot will develop a fever.

Also, people often confuse being sick with a bad cold or stomach flu with having influenza. Influenza symptoms can include a fever, chills, sore throat, runny or stuffy nose, body aches, fatigue and headaches. Cold symptoms can be similar to the flu but are typically milder. The stomach flu, or gastroenteritis, can be caused by several different bacteria or viruses. Symptoms of gastroenteritis involve nausea, vomiting and diarrhea.

Pre-shot exposures and mismatches

Some people do get the flu after they have received a flu shot, but that is not from the shot. It can happen for a couple of reasons.

First, they could have been exposed to the flu before they had the shot. It can take up to two weeks after receiving the flu shot to develop full immunity. Therefore, if you do get the flu within this period, it is likely that you were exposed to the flu either prior to being vaccinated or before your full immunity developed.

Second, depending on the strain of the flu virus that you are exposed to, you could still get the flu even if you received the vaccine. Every year, the flu vaccine is created to best match the strain of the flu virus circulating. Therefore, the effectiveness of the flu vaccine depends on the similarity between the virus circulating in the community and the killed viruses used to make the vaccine.

If there is a close match between the two, then the effectiveness of the flu vaccine will be high. However, if there is not a close match, vaccine effectiveness could be reduced. Still, it is imperative to note that even when there is not a close match between the circulating virus and the virus used to make the vaccine, the vaccine will still lessen the severity of flu symptoms and also help prevent flu-related complications.

Bottom line: You cannot get influenza from getting the flu vaccine.

Gold Law Firm, LLC. is the National Vaccine Injury Law Firm. As vaccine injury attorneys we can say loudly and clearly…get vaccination. You owe to yourself, your family and your community.

Gold Law Firm, LLC. can be reached at info@goldlawfirm.net and via phone or text to 781-239-1000.