Vaccination rates vs SIDS during Covid-19 lockdown?

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Have any of you seen or heard about this article published by Robert F Kennedy Jr’s anti-vax organization, Children’s Health Defense?

At the very end of presenting a bunch of academic graphs and charts about death rates during the pandemic, it makes the claim:

But the pandemic experience has brought on a surprising effect on this expected death rate among children. Starting in early March, expected deaths began a sharp decline, from an expected level of around 700 deaths per week to well under 500 by mid‐April and throughout May. [1]

As untimely deaths spiked among the elderly in Manhattan nursing homes and in similar settings all over the country, something mysterious was saving the lives of children. As springtime in America came along with massive disruptions in family life amid near universal lockdowns, roughly 30% fewer children died.

Was this a protective effect of school closures? Were teenagers getting themselves into risky situations at a lower rate? No. There was very little effect among school age children or adolescents. [3]

Virtually the entire change came from infants. Somehow, the changing pattern of American life during the lockdowns has been saving the lives of hundreds of infants, over 200 per week.

and later in the article…(some sentences bolded by me for emphasis)

Causation ?

When infants die, the cause is frequently some form of congenital condition or birth defect. Sadly, accidents and homicides are frequent causes as well. There are however, frequent cases in which previously healthy infants die unexpectedly. These deaths are usually classified as “Sudden Infant Death Syndrome” or SIDS. According to the CDC, SIDS deaths are one of the two largest causes of death among infants aged 1 month to 1 year. [7]

We have no specific data on the trend in SIDS deaths during the pandemic. We have, however, heard anecdotal reports from emergency room (ER) doctors suggesting some have observed a decline in SIDS. One group of doctors who might see 3 cases of SIDS in a typical week has seen zero cases since the pandemic and associated lockdowns began.

What has changed during this period that might have such an effect? Are infant deaths not being recorded? Are parents taking better care of their families while working remotely and their children are not going to school? There are many possible hypotheses about the infant death decline.

One very clear change that has received publicity is that public health officials are bemoaning the sharp decline in infant vaccinations as parents are not taking their infants into pediatric offices for their regular well‐baby checks. In the May 15 issue of the CDC Morbidity and Mortality Weekly Report (MMWR), a group of authors from the CDC and Kaiser Permanente reported a sharp decline in provider orders for vaccines as well as a decline in pediatric vaccine doses administered. [8] These declines began in early march, around the time infant deaths began declining.

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This effect may not be confined to the U.S. The World Health Organization issued a press release on May 22 noting that, “Since March 2020, routine childhood immunization services have been disrupted on a global scale that may be unprecedented since the inception of expanded programs on immunization (EPI) in the 1970s.” [9] Are fewer children dying because their parents are skipping their routine childhood vaccines? If lives are being saved during the pandemic, this is a question that urgently needs answering.

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Covid19 is unique among recent pandemics in that the mortality toll is measurable, real and convincing. It is also nearly certain to be transitory, but that won’t stop the propaganda juggernaut from rolling forward. However, as the saying goes, “the best laid plans of mice and men often go awry.” What no one would have predicted in advance of Covid19 is that the extreme lockdown response has produced a natural experiment that actually calls into question the very actions—widespread, mandated vaccines for all‐‐that the infectious disease and public health community have been pushing for years. We should mourn the deaths of the elderly Manhattan nursing home residents but also take heed of the hundreds of avoided infant deaths. Only with that kind of balance will we draw the proper lessons from the pandemic and the lockdowns that have followed in its wake.

A Facebook friend of mine sent me this article as evidence against childhood vaccination. Would any of you have advice about how to respond? I was thinking that “correlation is not causation” and that there could be alternative explanations: such as reduced infant deaths and SIDS due to children being exposed to less infections in daycare facilities, playgroups, churches, stores, etc. There would also be reduced deaths due to lack of travel and car accidents, as well. I was also thinking that although the numbers sound big, the absolute change in magnitude of change displayed on the graphs is really not that big, so is it a meaningful difference? And is the difference statistically significant? Would you have other thoughts?

The WHO and CDC site safety information claiming a lack of link with SIDS and vaccination. But I imagine that people who are skeptical about vaccines would not trust information from those sites.

@AndyWalsh @glipsnort and @swamidass wondering if you might have any helpful interpretations of the data or advice about how to respond to this article. Do my thoughts on the topic seem reasonable to state?
Thanks!

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I don’t have time to look into this in any depth, but I immediately see multiple problems just in the bit I looked at. The claim is that more than 200 fewer infants are dying per week, and that the reduction is only in infants. Looking at figure 15, though, the actual reduction is more like 125 per week. If you look at the two older categories, you’ll see that proportionally their rates actually fall at least as much as that of infants – it’s just not as obvious since they’re lower to start with. So the core claim here is wrong on the face of it. Note also that there are only about 27 deaths from SIDS per week in the US, or about 52 per week if you include all cases of sudden unexplained deaths. So the observed drop cannot possibly be caused mostly by a decline in SIDS.

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There are other major problems with the reasoning here, and some very suspicious reporting of data.

  • There are many things that changed with lock down. Any one of the factors that increased or decreased could contribute to reduced infant deaths. There is not good evidence to fixate on vaccines, while ignoring every other factor.

  • There are quite a lot of assertions without evidence that seem pretty implausible. E.g. @glipsnort points out correctly that the reduction cannot be SIDS alone.

As whole, this article seems to be conjecture about what could be happening, playing loose with the actual evidence.

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It’s also worth pointing out that SIDS is always less than 12 months, and vaccinations levels for less than 24 months quickly rebounded. The data is truncated (suspicious), but I expect most kids have caught up on their vaccinations by now.

So, among kids at risk of SIDS, it isn’t even clear if vaccination rates are appreciably lower.

We don’t know for sure if the SIDS rate is lower to be clear, because they only present anecdotal evidence that could be explained other ways.

If SIDs rate is lower, my first hypothesis would be about increased parental supervision during lockdown. We know for a fact that sleeping patterns impact SIDS (eg belly vs back sleeping). Closer monitoring of an infant, more likely from parents than sitters or daycare, may reduce SIDS rates.

That’s speculative, because we don’t even know of SIDS rates are decreased. Nonetheless, it is an example of a far more likely mechanism than vaccines. All hypothesis like this would need to be considered alongside vaccines, and it is notable that this is not what the article does.

I could go on but this is obviously not a trustworthy analysis. No scientists should endorse it because it’s conjecture in this case is also damaging to public health.

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Due to the public health implications, @moderators will watch this thread closely to prevent any misguided defenses of this paper. I have mixed feelings about even allowing it in the forum at all, because I don’t want to direct anyone to this misinformation. At the same time, focused rebuttal is important to have available to the public.

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@Michelle, I think the points you raise are valid, and I agree with the assessments of @glipsnort and @swamidass.

As a further point of discussion, it has been reported (preprint study here, separate preprint accepted for publication here, NY Times reporting here) that the lockdown has resulted in a reduction in premature births. While those data are not from the US and the peer review of the methods and data are not complete, a reduction in premature births could result in a reduction of infant mortality.

As for advice on responding to the article, I’d just add a reminder about the usual challenges of communications on these topics. The person sharing it or asking it about it may not actually be looking for a scientific rebuttal and may not be ready to hear or accept one. Asking questions to understand their interest and whatever pre-existing investment in the topic they might have may be necessary first.

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I checked out A Children’s Health Defense site a few months back. The first fact on their page was a claim that 150 children died because of a vaccine study funded by Bill Gates. When looked up the citation I found this to be a complete misrepresentation; 150 children did die, but they were roughly equally distributed between the control and vaccine arms of the study, with no statistical difference.

I don’t know what beef Robert F Kennedy Jr. has with Bill Gates, but he is willing to tell blatant lies about it.

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That would certainly explain much of the reduction in SIDS, if it is real.

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These are all very helpful and thoughtful responses. Thanks, everyone! I had looked for other rebuttals online, but found none, so I think it is very useful to have an analysis like this available. It’s also helpful example to show how data can be misrepresented and misconstrued to tell a false narrative.

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