“The state With the Highest Vaccination Rate Has the Highest Infant Mortality Rate”

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It’s rare to run across facts from an anti-vaccine proponent, so it shocked me when I found out this one was true:

maryjo-blurAccording to a 2010 CDC report on infant mortality, Mississippi led the USA with 9.62 infant deaths per 1,000 live births (1). Gleefully, anti-vaxxers point out multiple references showing Mississippi also leads the nation in vaccinating children, with rates at or better than 99.9% overall. For example see references (2) and (3).

As a scientist, I’m forced to concede facts, and here we have one:  the state with the best vaccination record is also losing children at the highest rate.

So what’s the problem here? Are vaccinations failing to protect the children of Mississippi as the anti-vaccination forum post claimed? Or, worse yet, are vaccinations somehow harming the children?

Well, as is often the case, just because someone is throwing a fact out at you, it doesn’t mean they’re being honest. I’ve always found this to be true of the anti-vaccination crowd, so I did a bit of research. My suspicions were confirmed, and what’s really happening in Mississippi is obvious.

Comparing Apples to Oranges
The problem is that Mississippi children are dying at birth, before they ever have a shot at vaccination (no pun intended). Or, they’re dying from causes that couldn’t be helped by a vaccine. For example, how do you vaccinate a child in the womb against a parent who smokes (smoking causes pre-mature birth, which leads to higher infant mortality)?

According to a 2013 Mississippi Infant Mortality Report (4), pre-term birth complications are the leading causes of infant death. Birth defects account for 19.1% of deaths, low birth weight/prematurity 15.2%, Sudden Infant Death Syndrome (SIDS) 10.6%… accidents, maternal complications, respiratory distress, and infections present at birth are all in the top 10 – none possibly preventable (or caused by) vaccines.

Let’s say this again because it’s the point anti-vaxxers intentionally choose to ignore: Mississippi infants are dying before they ever live long enough to get vaccinated.

Another major contributor to infant mortality in Mississippi is socioeconomic conditions. According to the same report (4), poor and un-insured women, teens, and African-American women are more likely to lose babies due to pre-term births.  For example, there are 14.1 pre-term births for white Mississippian women vs. 20.6 for blacks per 1,000 live births.  As pointed out two paragraphs earlier, pre-term birth complications are the leading cause of infant death in this state.

Why am I harping on about social and economic conditions in a discussion of infant mortality rates in Mississippi?  Well, we know they’re a contributor to higher infant mortality. Guess which is the poorest state in the USA? Yes, it’s Mississippi (5).   How do you vaccinate a child against a mother’s lack of access to proper pre-natal care?

The socioeconomic study is reinforced by a CDC study (6) that shows infant mortality rates nationwide for black women are more than twice those for white women. Why would this matter for infant mortality in Mississippi? According to the 2010 U.S. Census, Mississippi has the highest percentage of African-Americans in the United States (7).

Last but not least, exposure to cigarette smoke is known to have an effect on low birthweight, which in turn increases the risk of infant mortality (4). A 2013 Gallup poll places Mississippi third in the nation when it comes to addiction to cigarette smoking, behind only Kentucky and West Virginia (8). No wonder so many children are dying. How do you vaccinate a child against a parent who smokes?

So now we know why so many children are dying in Mississippi, and anti-vaccine nutters are comparing apples to oranges when quoting infant mortality and vaccination rates for the state.

But let’s not stop there – let’s compare vaccinated Mississippi children against unvaccinated children in other states.

Comparing Apples to Apples
Before poorly informed anti-vaccination campaigners started making their rounds, measles was a disease that was considered beaten. Now, thanks to unvaccinated children, it’s on the comeback, and people are dying (12).

In the news recently, the three states with the highest number of measles outbreaks were Ohio [138], California [60], and New York City [26] (9). How do OH, CA, and NY compare to well-vaccinated Mississippi when it comes to MMR (Measles-Mumps-Rubella) vaccinations?   If you’re anti-vaccine lady whose quote opened this article, you’re not going to like the answer:  Ohio, California, and New York lag Mississippi by 3 to 7 percent in vaccination levels (9).  And that lady needs to sit down now and hold on to her seat:

How many measles cases have been reported in highly vaccinated Mississippi?  In the last decade, there has been one confirmed case of measles in the Magnolia State.

To drive the point home, most of the 288 measles cases reported in the USA this year have been in unvaccinated persons or those with unknown vaccination status (9).  So Mississippi is clearly doing a great job, once the child lives long enough to get vaccinated.

If the anti-vaccine lady is still seated, she should stay there, because it gets worse.

Measles isn’t the only example for which we have hard evidence.  In 2012, the largest Chickenpox outbreak in the USA hit Vigo County in Indiana (11). 84 cases were reported in a county that usually sees less than 10 per year. Chickenpox can cause serious problems for older children and adults and is extremely contagious.

In 2012, the state of Indiana reported 469 cases of Chickenpox. Mississippi reported only 11 (13). Not surprisingly, Indiana ranks very poorly compared to Mississippi – approximately 7% less of the Indiana population is vaccinated against Chickenpox (3).  Again, when you look at the facts, Mississippi’s vaccination programs are working, while states with poor vaccination records are suffering the consequences.

Conclusion
When reading anti-vaccination posts in online forums and on Facebook, it’s best to keep an old saying in mind:

 “Figures don’t lie, but liars figure”

The quote has been attributed to various sources including Mark Twain, but regardless of who said it, the truth behind the Mississippi vaccination/infant mortality myth is nothing more than a phenomenon with a fancy name of false or illusory correlation: you simply take two numbers that have nothing to do with each other, and convince your audience that there’s a relationship between them.

I’ll close by a fun example of false correlation that everyone can understand, courtesy of the Spurious Correlation Generator at http://www.tylervigen.com: Did you know that taking anti-diabetic drugs is directly linked to your chances of drowning in a fishing boat accident?

Hey, anti-vaccine believers, the numbers don’t lie!

correlation

References
(1)  CDC Infant Deaths Per 1,000 Live Births, By State: 2010
http://www.cdc.gov/nchs/pressroom/states/INFANT_MORTALITY_RATES_STATE_2010.pdf

(2)  Advisory Board Company Daily Briefing – States With the Best – and Worst – Vaccine Coverage (August 2013)
http://www.advisory.com/daily-briefing/2013/08/08/the-states-with-the-best-and-worst-vaccine-coverage

(3)  CDC MMWR Vaccination Coverage Among Children in Kindergarten –USA, 2012-13 School Year
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6230a3.htm?s_cid=mm6230a3_e#Tab1

 (4)  Mississippi Department of Health and Vital Statistics
http://msdh.ms.gov/msdhsite/_static/resources/5629.pdf

(5) State & County Quick Facts, United States Census Bureau
http://quickfacts.census.gov/qfd/download_data.html

(6)  Recent Declines in Infant Mortality in the United States, NCHS Data Brief, April 2013 http://www.cdc.gov/nchs/data/databriefs/db120.pdf

(7)  Historical Census Statistics on Population Totals By Race, U.S. Census Bureau http://www.census.gov/population/www/documentation/twps0056/twps0056.html

(8)  Gallup Well-Being: In U.S., Smoking Rate Loest in Utah, Highest in Kentucky http://www.gallup.com/poll/167771/smoking-rate-lowest-utah-highest-kentucky.aspx

(9)  CDC Morbidity and Mortality Weekly Report
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a4.htm

(10)  Mississippi Morbidity Report, Vol 24, No. 12. Dec 2008
http://msdh.ms.gov/msdhsite/_static/resources/3095.pdf

(11)  Largest Chickenpox Outbreak in the U.S. Hits Vigo County in Indiana  (Huffington Post 11/27/2012)
http://www.huffingtonpost.com/2012/11/27/chickenpox-outbreak-largest-vigo-county-indiana_n_2199231.html

(12)  World Health Organization “Measles”
http://www.who.int/mediacentre/factsheets/fs286/en/

(13)  CDC Morbidity and Mortality Weekly Report, Summary of Notifiable Diseases – United States 2012
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6153a1.htm?s_cid=mm6153a1_w

26 thoughts on ““The state With the Highest Vaccination Rate Has the Highest Infant Mortality Rate””

  1. Can you explain to me the mechanism by which a child is at risk of any serious complication to measles infection? Then I would like to discuss what can be done to actually lower the death rate of children in MS and across the US. You stated that children die from the measles and give stats of the number of infections yet how many of those children died? Also you lump unknown vaccine status with the un-vaccinated as if that is a real number showing that it is the un-vaccinated causing the infections or getting sick more often. A real scientific number would have those details because at this moment without the actual figures we could have 287 vaccinated and 1 non-vaccinated.Then we would also want to look at the complication rate of those vaccinated with infection and those not vaccinated. I hope you can help me out with this.

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  2. I love this article. Do you have any statistics for autism rates in Mississippi compared to other states, or other conditions/illnesses antivaxxers wrongly associate with vaccines?

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    • Thank you Megan. Your question is an interesting one and a great idea for a future article. I don’t have any authoritative references on hand. A quick Googling gave me some results showing Mississippi had among the lowest rates in the nation, but I’d like to have something a little more concrete before I put that in writing. It’s a great idea though!

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  3. Things your article seems to overlook:
    1. Hep B vaccines are given at birth, to preterm babies. Vaccines have a higher risk among preterm babies. http://www.smartvax.com/index.php?option=com_content&view=article&id=103:high-risk-subgroups-for-vaccine-injury
    2. Vaccines given to pregnant women can cause birth defects.
    3. SIDS is often actually just a lethal vaccine injury.
    4. Respiratory distress is also a lethal vaccine injury.
    5. Infections present at birth also sounds like a vaccine injury to me; that’s what vaccines are, injections of infectious material, I don’t know why that sounds “impossible” or implausible to you.

    You overlook/discount the high infant death rate, and triumph over no cases of measles. Ok, but nobody has died of measles in the entire US, either, even though there are cases of measles.

    But you are willing to accept the 9/1000 death rate, vs. the national 6/1000 death rate as acceptable, because vaccines could not possibly, but actually do, cause those kinds of deaths listed? I think you have your priorities out of order.

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    • Do you have any evidence for these claims? I could just as easily claim that birth defects, SIDS, and respiratory distress are caused by fig newtons. There, I’ve presented just as much evidence as you. No, seriously.

      As for infections… I’d love to hear, in your own words, how an infection is spread by a vaccine. The first amendment says you’re free to spread bullsh*t; let’s see how good you are at defending what you spread…

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      • Mark, thank you for actually daring to reply. Which claims do you dispute? My first claim disputes the entire thrust of your article: ” Mississippi infants are dying before they ever live long enough to get vaccinated.” vs. the truth that Hep B vaccines are given at birth, to preterm babies. http://www.cdc.gov/hepatitis/hbv/pdfs/correctedtable4.pdf Do you deny that hep b vaccines are given to premies? Because your article does, but they are, indeed, recommended by the CDC. I don’t think it’s a logical fallacy to assume that if the CDC recommends it, that vaccines are actually given in the real world. Now, given that I have proved you wrong on point one, you should eat your humble pie, and go do the research on the rest of my claims. Google works. Type in “vaccines birth defects” and if you read 10-20 articles, you will see a wealth of conflicting information on whether vaccines are proper to give to pregnant women or not. What you may find may disgust you so much, your entire worldview may well change. It’s not up to me to pour all the wealth of all the knowledge of all the world into your head. It’s up to you to go and learn what you care to learn. SIDS has long be associated with vaccine deaths. And thus, the medical establishment needed to come out with research proving that wrong, and so they did, just as the smoking industry came out with study after study that smoking does not cause lung cancer. Guess what? People lie. And doctors lie on death certificates. When “they just don’t know what causes death” they list SIDS. Or birth defects. And yet you have the audacity as a God to claim that it’s impossible for vaccines to cause a death of unknown cause? Or that it might just as well be caused by fig newtons? Your position is so absurdly laughable that I don’t need to argue with that kind of nonsense. Unreal. And industry lies. But you know what does not lie, what cuts through all the nonsense? Infant mortality vs. vaccine rates. No matter what lie doctors use on the death certificates, they cannot hide the deaths.

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        • Jason, I respectfully submit that if you mined gold as effectively as quotes, you’d be a wealthy man 🙂

          “Mississippi’s vaccination rate” very clearly refers to the wide range of vaccinations recommended by the CDC, and the claim that these vaccines are linked to infant mortality isn’t even made by me–it’s made by the anti-vaccine crowd.

          The hepatitis vaccine you refer to is actually given over 3 to 4 doses. The first IS recommended at birth, but go ahead and ignore this:

          “According to a 2013 Mississippi Infant Mortality Report (4), pre-term birth complications are the leading causes of infant death. Birth defects account for 19.1% of deaths, low birth weight/prematurity 15.2%, Sudden Infant Death Syndrome (SIDS) 10.6%… accidents, maternal complications, respiratory distress, and infections present at birth are all in the top 10 – none possibly preventable (or caused by) vaccines.”

          If you want to blame deaths on vaccines, it seems like the first course of action would be to actually prove that the vaccines are causing the deaths.

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  4. still you quote third world country statistics to scare us into submission. Are you willing to publicly debate a so called anti vax doctor ?

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        • Not only have I read it–I WROTE it. What’s the point you’re trying to make? I’ve laid out a fact for you (thanks to unvaccinated children, a preventable disease is making a comeback) and your counterargument is… well, it’s…

          I’m sorry, exactly what IS your counterargument? It was something about the kids were only dying in 3rd world countries? Do they not count”over there”? Just to keep this discussion on track, the countries where they’re dying from these preventable diseases are the ones where vaccination rates are low. And the areas here in “first world” countries where the diseases are making a comeback are where the vaccination rates are low.

          Your turn.

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      • Now to my original question. Can we count on you to debate a pro choice vax doctor ? So far people like Paul Offit and others have chickened out will you show your face ?

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  6. Measles and chickenpox are not generally killers. Much preferable to your baby getting encephalitis and subsequent cognitive decline or SIDS.

    SIDS is linked to the pertussis vaccine. Veira Shreiber and the breathing monitor studies uncovered this. Japan realized this too. Subsequently, they increased the maximum age for pertussis vaccine to 2yrs of age. Infant mortality rates drastically reduced in accordance.

    If you are happy playing the dance of death and disease/disability with people’s infants, keep advocating vaccines.

    Not all of us started out as your purported “

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  7. Mothers are given the dtap vaccines while pregnant. Many pregnant mothers also get the flu vaccines. This makes your article invalid because the babies are getting vaccinated before they are born. I didn’t get any while pregnant because of the risks and testimonials from other mothers who had them while pregnant and then had terrible complications with babies.

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  8. The consensus is that a child’s immune system is not fully formed until age 3. Giving a vaccination with according to the vaccine maker can cause harm and death, why would one mess with Mother Nature. With the autism rate and the vaccination rate increasing how can one not see the correlation? The CDC says there is no correlation but we know they have lied about some of their studies. Where is the incentive for vaccine makers to improve quality? You keep saying majority where the interpretation is the minority are simply collateral damage. As a country is this acceptable? How come many countries other than the US have banded many vaccinations ingredients?

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