Vaccination Deaths in Mexico and Syria

Vaccine Basics

Syrian Kurdish refugees getting vaccinated at a camp in Turkey.
To prevent the return of vaccine-preventable diseases, Syrian Kurdish refugees are getting caught up on their vaccines. Photo by Stringer/Getty Images

Vaccines work to save lives each and every day. Tragically, errors sometimes occur in vaccination programs that lead to deaths, including when workers:

  • use a reconstituted vaccine after six hours - live vaccines can quickly become contaminated if they are kept and used for too long a time
  • mixup diluents - in addition to using the wrong diluent, vaccination tragedies can occur when a dangerous medication is used instead of a vaccine’s standard diluent
  • improperly handle vaccines - breaking the cold chain

Fortunately, these types of incidents are extremely rare, especially with all that is done to avoid vaccine errors.

Vaccination Deaths in Mexico

On May 8, 2015, two infants died in Comunidad La Pimienta, Simojovel, Chiapas in southern Mexico.

The two deaths occurred after they had been given National Immunization Program vaccines earlier in the day at a small community clinic in the area.

About 52 children were vaccinated that day and 29 got sick, requiring transfer, reportedly by special vans that the parents had to pay for themselves. Initially transferred to Bochil, they were then transferred again, to Tuxtla Gutiérrez, the capital of Chiapas.

At least 29 of the children required hospitalization, including six of whom were in “severe” condition.

The latest Mexican Social Security Institute (IMSS) report is that most of these children were released from the hospital over the first few days, and as of May 22, only 2 remained hospitalized, and they are both in stable condition.

Many people are speculating about what happened to these children in Mexico. We may never have the full story, as the parents of the children who died refused an autopsy, but we do know that it likely wasn’t a vaccine reaction.

The children were reportedly given a BCG vaccine, the rotavirus vaccine, and/or a hepatitis B vaccine that day.

However, the only vaccine that all of the sick children received in common was the hepatitis B vaccine.

So what happened to these kids in Mexico?

The recent vaccination deaths in Syria were caused by a mixup between the measles/rubella vaccine diluent and atracurium, a paralyzing agent. Could that kind of mixup have happened again?

Since the hepatitis B vaccine doesn’t require a diluent (a liquid that is mixed with a freeze-dried vaccine powder or wafer), that should leave out the possibility of this type of mix-up. Vaccines that do require a diluent include those that protect against tuberculosis, Hib, rabies, measles, mumps, rubella, chicken pox, meningococcal disease, rotavirus, yellow fever, and shingles.

There are also reports that they have found bacterial contamination of the vaccines. It is known that 130,000 doses from the same batch of vaccines have been given in the area, so it is not thought to be a manufacturing problem or widespread issue.

It is known that vaccine vials can be contaminated with Staphylococcus bacteria if they are mishandled.

Although Staphylococcus aureus bacteria can directly cause infections, they can also release a toxin that can cause toxic shock syndrome (TSS). Considering how quickly these children got sick, it is possible that the vaccines became contaminated with Staphylococcus toxins. There have been reports of TSS following vaccination in the past, usually with vaccines that don’t use preservatives, though, like the measles vaccine.

The latest update by the IMSS reported that they had identified Staphylococcus hominis bacteria in cultures and that this was the cause of the contamination and sickness in these children.

Could the removal of thimerosal from the hepatitis B vaccine have caused this tragedy?

Well, since so many kids were affected, it is likely that multi-dose vials were used and that would mean that they still contained thimerosal. The reason that we were able to remove thimerosal from vaccines in the United States and some other countries is simply because we switched to single dose vaccines which don’t require a preservative.

Could this type of single dose vaccine have been used in Mexico? It would be much less likely for a single dose vaccine dose to become contaminated and especially for multiple, single dose vaccines to become contaminated at the same time.

Vaccines with thimerosal are still used in many parts of the world as the Global Advisory Committee on Vaccine Safety considers that “that available evidence strongly supports the safety of the use of thiomersal as a preservative for inactivated vaccines.” That’s good because single dose vials are often much more expensive. For example, a WHO report stated that single dose hepatitis B vaccines cost twice as much as each dose from a 10 dose vial.

So how would a multi-dose vaccine vial with thimerosal get contaminated with a bacteria? Isn’t that what the preservative is supposed to prevent? Unfortunately, it is known that “preservatives in multi-dose vaccine vials do not prevent short-term bacterial contamination” and that “the literature contains several reports of bacterial contamination of vaccines despite the presence of a preservative, emphasizing the need for meticulous attention to technique in withdrawing vaccines from multi-dose vials.”

The use of sterile technique and proper handling of the vaccines almost always prevents that type of contamination, but not when opened vials are saved and reused, as reportedly happened at this clinic that has been described as being “abandoned” - a shed made of concrete blocks and a tin roof with dusty shelves. This is also an area that reportedly has high rates of unvaccinated children, above average infant mortality rates, and little access to health care.

Like other incidents related to vaccines, many of the initial reports were wrong, including that:

  • all vaccinations had been halted in Mexico - they weren’t. Vaccinations from the same lots were stopped locally, but were quickly resumed.
  • the media wasn’t giving any attention to the story - they were, including stories in The New York Times and The Guardian
  • these infants should not have been getting a hepatitis B vaccine in the first place, as it is only needed if a mother tests positive for hepatitis B - although this is in general just an anti-vaccine myth, most of these mothers likely have no idea about their hepatitis B status, as the infants in this area are mostly delivered at home, with the aid of midwives, and likely had little in the way of modern pre-natal testing

And of course, this tragedy was not caused by some insane conspiracy of vaccine-induced depopulation to “directly kill vaccine recipients by intentionally lacing vaccines with euthanasia chemicals that cause death,” as was actually ‘reported’ by the Health Ranger at Natural News.

But we are still left speculating on what did really happen.

Could this all have been triggered by one previously used, contaminated, a multi-dose vial of hepatitis B vaccine? Considering that that only 8 children were seriously affected, including the two who died, then it certainly becomes possible. The rest of the children were quickly released and may have been children of worried parents. They were seeing the other recently vaccinated children get so sick so quickly and were likely concerned that their children would get sick too.

Hopefully, we get a definitive answer soon, though, mostly to help prevent this type of tragedy from happening again.

Vaccination Deaths in Syria

On September 16, 2014, 75 children got sick and 15 died very shortly after getting vaccinated in rebel-controlled areas of Syria. Although most initial reports blamed the vaccines themselves, we now know that the tragedy was caused by human error. The measles/rubella vaccine that the kids were given was mixed with atracurium, a paralyzing agent was used to mix the vaccines instead of the standard diluent that should have been used. Apparently, the two bottles look very similar and the atracurium bottles were added to the vaccination packs by mistake.

Preventing Vaccination Deaths and Disasters

Unfortunately, there have been other vaccination disasters in the past, including:

  • the Lubeck Disaster - 75 children died and others got tuberculosis in 1929 Germany after there was a mix-up between the BCG vaccine and the strain of Mycobacterium tuberculosis that causes tuberculosis. The BCG vaccine was supposed to be made with a weakened strain of Mycobacterium bovis bacteria instead.
  • the Bundaberg incident - 12 children died in Australia in 1928 after being given contaminated diphtheria vaccine from a multidose vial without preservative
  • hepatitis-contaminated yellow fever vaccines - some lots of yellow fever vaccines used in the military in 1942 were unintentionally contaminated with the hepatitis B virus
  • the Cutter incident - in 1955, at least 56 people developed polio and 5 children died after being vaccinated with inactivated polio vaccine that was poorly manufactured by Cutter Laboratories and still contained live polio virus

As rare as they are, though, especially considering how many vaccines are given each and every day throughout the world, these incidents should never happen. That doesn’t keep people from creating new myths around them, though, including that idea that hot lots of vaccines cause many side effects or that vaccination deaths are a common occurrence.

Like vaccine injuries, vaccination deaths are rare. Tragically, what is still common are deaths from vaccine-preventable diseases.

Sources:

FDA. Thimerosal in Vaccines. Accessed May 2015.

Offit, Paul A. The Cutter Incident: How America's First Polio Vaccine Led to the Growing Vaccine Crisis, Yale University Press, 2005

Stetler HC. Outbreaks of group A streptococcal abscesses following diphtheria-tetanus toxoid-pertussis vaccination. Pediatrics. 1985 Feb;75(2):299-303.

WHO. Trends in use of multi-dose vaccine vials in UNICEF procuring countries. 4 April 2012.

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