I come across stories about what the press likes to call “vaccine-preventable diseases” rather frequently. There are often warnings about the clusters of illness caused by people who choose not to vaccinate. They point to mini-epidemics of whooping cough, measles and mumps, and lament how all this wreaks havoc even for those who have been vaccinated (since vaccines are not 100% effective). There’s always an outbreak here or there, and if you search the archives of any major newspaper you will get quite a few hits.

But I can’t remember the last time I saw the press covering a severe vaccine reaction, or death. I suspect it has something to do with my observation that when there is a temporal relationship between a vaccine and an illness or death, we are reminded that temporal relationships are not the same thing as causality, and that it is a coincidence that a problem occurred shortly after vaccination. But in the amazingly rare instances that a child dies of a vaccine-preventable illness, like measles, the temporal relationship takes priority, and we are told that the child died of measles, even if the child was taking azathioprine or other immune-suppressive drugs to shut down their immune system due to other ailments or organ transplant.

Whatever the reason, today I can stop complaining about the lack of coverage for vaccine reactions, because I came across a story this morning about a healthy three month old infant who received an MMR vaccine, developed a fever, and seemed generally unsettled, who then died the following day. Of natural causes.

Consultant forensic pathologist, Dr Charles Wilson, told the hearing that he believed the baby had died of pneumonia.

He said: “Kenzie had the early stages of a lung infection, the kind you tend to see with bacteria. It was the earliest stage of pneumonia. It was an entirely natural, tragic and unforeseeable cause of death.”

I’m glad the pathologist mentioned that the pneumonia was the type you tend to see with bacteria. That would (phew!) completely rule out any involvement of the vaccine then, since it is comprised of three live-attenuated viruses. I’m a little surprised though, that he thought the pneumonia was the type that one tends to see with bacteria. Didn’t he check the infected lung tissue? I’m surprised he doesn’t know what pathogen was in the lungs.

I’m going to confess now that I find this a bit odd. Do children who seem fine and healthy often die in the very beginning stages of pneumonia, before anyone knows they are ill? Maybe this is truly so common that there is no need to raise an eyebrow, or to send some lung tissue to histopath.

In order to take this article, and the pathologist, at face value we have to believe: 1) the child was absolutely fine at the healthcare visit where he had received the MMR, and that there was no sign of pneumonia that a clinician should have noticed, even if the child was going to die of it about 30 hours later, 2) the administration of the MMR was strictly coincident in time with the unrelated fatal illness, 3) healthy children die rapidly in the early stages of infections, even when it is sufficiently early that there are no symptoms of any concern, and 4) that #3 happens often enough that no one bothers to send infected tissue for histopathological assessment. Apparently the coroner agrees this is reasonable:

Coroner Jennifer Leeming recorded a verdict of death by natural causes.

For myself, I remain slightly skeptical.

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