https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-018-3321-4

Manifestation of anaplasmosis as cerebral infarction: a case report

  • Seok Won Kim†, Choon-Mee Kim†, Dong-Min Kim and Na Ra Yun
†Contributed equally
BMC Infectious Diseases201818:409

https://doi.org/10.1186/s12879-018-3321-4

Abstract

Background

Human granulocytic anaplasmosis is a tick-borne zoonotic disease caused by Anaplasma phagocytophilum, an obligate intracellular granulocytotropic bacterium.

Case presentation

A 70-year-old female patient was admitted with the clinical signs of fever and an altered state of consciousness 1 week after experiencing a tick bite while planting lawn grass. Magnetic resonance imaging, performed at the time of admission, indicated cerebral infarction in the left basal ganglia, whereas increasing immunofluorescence assay antibody titers for A. phagocytophilum were also documented. A. phagocytophilum was identified using groEL and ankA targeted polymerase chain reaction and sequencing. Because of severe thrombocytopenia, only doxycycline was administered, without any antiplatelet agents. Subsequently, the symptoms improved without any focal neurologic sequela.

Conclusion

This is the first reported case of cerebral infarction occurrence in an anaplasmosis patient.

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**Comment**

I could literally hug these researchers who didn’t make the mistake of pronouncing this to be a “rare occurrence.”  They wisely stated it is the first reported case. 

Big difference.

Please notice the altered state of consciousness.  This stuff is surreal and unless you’ve had it, nearly unbelievable.  The basal ganglia is often affected with Lyme/MSIDS and certainly has been a marquee symptom for me personally.  Thankful this woman got prompt treatment.  Let’s pray the doxy was enough but she should be followed up on.  

Most practitioners don’t treat this seriously enough.  It can kill you.

It is a head scratcher; however, that even with severe thrombocytopenia (low platelets) and a cerebral infarction in the brain, it appears she obtained just 12 days of doxycycline.  This is a great example of an issue for further research as to treatment type and duration.  Just because “the patient exhibited an improvement in symptoms after doxycycline treatment and was discharged on the 12th day with no specific sequela,” does not mean she’s out of the woods.

 

 

 

https://livingwithlyme.us/episode-36-oral-surgical-procedures-and-chronic-illness/

Episode 36: Oral Surgical Procedures and Chronic Illness

https://html5-player.libsyn.com/embed/episode/id/7005255/height/90/theme/custom/autoplay/no/autonext/no/thumbnail/yes/preload/no/no_addthis/no/direction/backward/render-playlist/no/custom-color/87A93A/

Cindy Kennedy, FNP, talks with Dr. Christopher Hussar, a dentist who sees a link between oral surgical procedures and chronic illness like Lyme disease.

Hussar is a holistic dentist who has over 25 years of experience. He received his D.D.S. degree from the University of Detroit Dental College in 1978 and his D.O. degree from Michigan State University College of Osteopathic Medicine in 1986.In 2004, Hussar began a study involving thermal imaging technology. The medical applications of thermographic imaging studies were developed by Hussar, who is an expert in the fields of necrotic dental bone surgery and Lyme disease. He was directly involved in a study that looked at developing an affordable, non-radiological clinical imaging device.

Hussar has worked in several aspects of medicine, in particular chronic pain. He specializes in work involving extensive oral surgery to remove cavitations from patients with Lyme disease.

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**Comment**

So thankful this podcast is available.  I’ve long desired to do a piece on dentistry and tick borne illness but can barely keep up with all the information that’s coming out.  The great news is that doctor Mercola has already done the footwork on this and you can read all about it here:  articles.mercola.com/sites/articles/archive/2018/08/18/mercury-toxicity-amalgam-fillings.aspx?

Within this link you can watch “Mercury Undercover,” and learn about silver fillings in amalgams.  There is no known safe level of mercury exposure.

Excerpt from article here:

Indisputable evidence exists that dental amalgams readily release mercury in the form of vapor when you eat, drink hot liquids, brush your teeth or otherwise stimulate your teeth.

As noted in a 2010 scientific review2 on mercury exposure and children’s health, there is no known safe level of exposure for mercury. Ideally, exposure should be zero, so any dentist insisting that mercury exposure from amalgam is “minimal” or “inconsequential” is really not acting in an ethical manner.

The mercury vapors released from the amalgam in your teeth readily pass through your cell membranes, across your blood-brain barrier, and into your central nervous system. Effects can be psychological, neurological, and/or immunological.

I remember trying to discuss this issue with my regular dentist who looked at me as if I was from Mars.  Finally, tired of the wall of denial I found a biological dentist who interestingly had to retire recently.  Why?  He had mercury toxicity from all the years of removing mercury amalgams!  True story!

Resources to Help You Find a Biological Dentist

The following organizations can help you to find a mercury-free, biological dentist:

Let’s Help Consumers for Dental Choice Get the Funding They Deserve

Consumers for Dental Choice and its leader Charlie Brown continue their full-court-press campaign to bring mercury-free dentistry to the U.S. and worldwide. If you wish to stay informed, I encourage you to follow them on Facebook; if you wish to stay informed by receiving their announcements, you can sign up by CLICKING HERE.

https://undark.org/2018/09/06/lyme-research-funding/

As the Threat of Lyme Disease Rises, Why Hasn’t Research Funding Followed Suit?

The tick-borne illness now costs Americans up to $1.3 billion a year in medical expenses. It’s time for politicians to mount a response.

 

“The best thing about Lyme disease is you usually don’t die,” Franklin says. “The worst thing about it is that you don’t die.”

Franklin is not alone. According to the U.S. Centers for Disease Control and Prevention (CDC), annual cases of Lyme disease and other tick-borne illnesses in the U.S. have skyrocketed to more than 300,000 — up from just 50,000 three decades ago. And those totals are thought to underestimate the true tally of patients who suffer from chronic tick-borne illnesses. A Johns Hopkins study estimates that Americans now spend up to $1.3 billion a year battling Lyme disease alone. Yet, the research that could help us better understand, treat, and prevent the disease remains woefully underfunded. That needs to change.

The recent explosion in Lyme disease cases stems from a perfect storm of climate and environmental change: Global warming has made northern latitudes more hospitable to the tiny blacklegged ticks that transmit the disease, and rapid deforestation and development have left large populations exposed to the wooded areas that harbor the ticks. The CDC reports that the number of tickborne illnesses in the U.S. has doubled from 2004 to 2016, and a new study finds that Lyme disease, once primarily a scourge of the northeast, has now spread to all 50 states. Economist Marcus Davidsson predicts that as many as one million Americans will be infected in 2018. And experts say it will only get worse.  (Please see my comment after article)

The growing medical crisis has exacted not only a physical but a financial toll as well. Policy experts say that, after accounting for lost productivity and hard-to-detect chronic conditions, the real costs of Lyme disease could be many times more than the $1.3 billion estimated in the Johns Hopkins study.

Laurie Johnson, executive director of the Climate Cost Project, and co-founder Sieren Ernst are working to home in on the true societal costs of Lyme disease. The team has been collecting surveys from Lyme disease patients to create a database of the patients’ medical expenses. So far, the results are astounding. Half of the respondents reported more than $30,000 in out-of-pocket expenditures on Lyme disease treatments, with some reporting more than $200,000.

“We believe the data is just the tip of the iceberg,” Ernst says.

What’s more, the rising threat of tick-borne disease has led Americans to take fewer trips outdoors — up to a billion fewer trips annually in the northeastern U.S. alone, according to a Yale study published last year. The authors of that study estimate that the economic burden associated with the lost trips could amount to as much as $5 billion annually.

As the societal costs of Lyme disease soar, funding for Lyme disease research remains in a rut. An unpublished draft report by the U.S. Department of Health and Human Services Tick-Borne Disease Working Group finds that, while the National Institutes of Health and the CDC spend $53,571 and $14,054 respectively for each new case of HIV/AIDS, they spend just $90 and $35 per new case of Lyme disease.

“Federal funding for tick-borne disease today is orders of magnitude lower, compared to other health threats, and it has failed to increase as the problem has grown,” the report states.

Dr. John Aucott, chair of the working group and director of the Johns Hopkins Lyme Disease Research Center, says the federal research community is not doing enough to find an accurate test and a cure for Lyme disease. He adds that the problem is compounded by controversies surrounding the symptoms of chronic Lyme disease, which makes it difficult for patients to get proper medical care.

In late August came a ray of hope from Capitol Hill. Senate Minority Leader Charles Schumer announced that, after five years of stagnant funding, the Senate had authorized a 12 percent increase for the CDC’s research on Lyme disease and other tick-borne illnesses for the 2019 fiscal year. The measure would raise allocations from $10.7 million to $12 million.

Still, patients like Sherrill Franklin say that’s sorely inadequate, and that the measure would do little to address chronic conditions that afflict millions like her. As the planet warms and populations grow, tick-borne illnesses are skyrocketing. It’s time for politicians to mount a serious response to the rising threat.

William “Rocky” Kistner is a multimedia journalist who writes about environmental issues and climate change. He publishes stories at www.TheRockyFiles.com and lives near Washington, D.C.

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**Comment**

Once again, according to independent tick researcher John Scott, the climate has absolutely nothing to do with the spread of ticks and therefore Lyme/MSIDS:  https://madisonarealymesupportgroup.com/2018/08/13/study-shows-lyme-not-propelled-by-climate-change/ A recent study shows that warm winters are lethal to I. scapularis (black-legged) ticks. In fact, overwinter survival dropped to 33% when the snow melted. This has been substantiated by other researchers as well. Scott & Scott, 2018, ticks and climate change, JVSM

This is an important distinction for a number of reasons:

  1. Earmarking tick/MSIDS research with the moniker “climate change” will divert precious money to the wrong subject matter when issues like accurate testing, education on how to clinically diagnose, settling the matter of pathogen persistence once and for all, and the need for research studying the cumulative effects of ALL of the pathogens involved on the human body would get a great start in helping patients.  But, there are hundreds of other topics as well.  
  2. Scott goes as far as to state the climate change issue is a “red herring” to divert attention away from the fact nothing has been done to help patients in over 40 years and is actually part of a “nefarious plot.”  https://madisonarealymesupportgroup.com/2017/08/14/canadian-tick-expert-climate-change-is-not-behind-lyme-disease/
  3. Scott, infected himself, has determined black legged ticks require 14 hours to molt to the next stage, something he dubs “photo period.”  Light has much more of an impact on ticks than climate as ticks are marvelous ecoadaptors and will seek out leaf litter and snow when conditions become harsh.
  4. Scott offers that yearly bidirectional, songbird migration in spring and fall is behind tick expansion and that the climate change model actually reflects migratory flight not warmer futuristic temperatures.
  5. Research on migratory birds and their impacts on tick expansion would be a far better topic to spend money on than more climate data.
  6. We need to know if other insects can transmit this.  To date, researchers smugly point to a 30 year old study and say it can’t, yet patients all over the world have far different experiences:  https://madisonarealymesupportgroup.com/2018/03/01/strides-in-lyme-research-links-to-mosquitos-as-carriers/.  The potential for ALL blood sucking insects to transmit all or some of the pathogens commonly blamed on ticks is very real.  And just because it can’t be seen doesn’t mean it isn’t there.  These are notoriously stealthy pathogens who thrive on hiding and avoiding detection.
  7. We all know that MS, Lupus, Fibro, ALS, dementia, and Alzheimer’s can be undiagnosed Lyme as well as the fact that according to a prominent Wisconsin Lyme doctor, 80% of his PANS/PANDAS patients have Lyme/MSIDS as well.  Research on these topics would again, be far more helpful than the same – o- same-o climate data that’s been collected for years.
  8. Since many couples are infected and they’ve actually found borrelia in semen and vaginal secretions, we need to know if this is a STD:  https://madisonarealymesupportgroup.com/2017/02/24/pcos-lyme-my-story/  We also need the medical community to admit it’s congenital and spread via breast milk https://madisonarealymesupportgroup.com/2018/06/19/33-years-of-documentation-of-maternal-child-transmission-of-lyme-disease-and-congenital-lyme-borreliosis-a-review/ and https://madisonarealymesupportgroup.com/2018/05/24/new-berlin-mom-given-life-altering-lyme-disease-diagnoses-after-pregnancy/  These are practical day to day issues that require answers.  Knowledge is power and we need it!  I literally could go on and on to infinity here but these 7 issues are screaming for research.  Nobody is touching this with a 10 foot pole yet life marches on with the very real probability we are transmitting this is far more ways than the dastardly black legged tick.  We need to know.
We needed to know these answers 40 years ago.

https://health.usnews.com/health-care/patient-advice/articles/2018-09-05/pain-at-the-prescription-counter-how-to-reduce-what-you-pay-for-drugs?

Pain at the Prescription Counter: How to Reduce What You Pay for Drugs

Even generic medications are often shockingly pricey. Here’s what you can do to bring your drug costs down.
By Elizabeth Gardner, Contributor Sept. 5, 2018
U.S. News & World Report

Pharmacist talking to customer

One strategy to reduce prescription costs is to check local pharmacies for the best prices.(Getty Images)

Have you seen the cost of a prescription jump from $3 to $30 when your doctor changed your dosage? Were you ambushed by a $500 copay for a tube of steroidal skin cream? Are you carrying a $300 EpiPen – essential for emergency treatment of deadly allergic reactions – that used to cost $50? Have you discovered that your atorvastatin (generic Lipitor) costs less if you put away your insurance card and pay cash?

Welcome to the drug price maze! More and more, certain peculiarities of the pharmaceutical market are clashing with insurance arrangements that require patients to pay a bigger share for their prescriptions, leading to confusion and sticker shock.

“When your insurer paid most of the cost and copays were minimal, no one complained as the prices skyrocketed,” says physician Elisabeth Rosenthal, editor in chief of Kaiser Health News and author of “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back.”

Now, she explains, “copays and deductibles are going up, and we’re all feeling those prices in a way that has made everyone sit up and go, ‘Whoa!’ ” There are ways for consumers to reduce what they pay for many drugs, but they must learn how to ask questions and where to look for answers.

Drug pricing has been relatively straightforward until recently, at least for consumers. Branded drugs, patented by their creators, cost a lot, but insurance picked up most of the bill. When the patents expired, manufacturers of generic drugs offered much cheaper versions, and typical copays dropped to just a few dollars. Pharmaceutical companies had an incentive to keep discovering new drugs, and the price burden for underwriting those discoveries was temporary and led to a steady flow of new, inexpensive generics.

 

It’s still a straight path most of the time. Generic drugs accounted for 90 percent of the more than 5.8 billion U.S. prescriptions written in 2017, according to research firm IQVIA, and more than 97 percent of all prescriptions (both branded and generic) cost patients less than $50 out of pocket. Almost a third of prescriptions written in 2017 were free to the patient, because of regulations or insurance arrangements. (For example, the Affordable Care Act mandates no patient payment for all FDA-approved contraceptives and preventive medications, like cholesterol-lowering drugs and vaccines, and insurance plans may stop charging copays once patients have reached their deductible limit for the year.)

“The vast majority of drugs are inexpensive and are one of the best values in the health care system,” says Brigham and Women’s Hospital’s Aaron Kesselheim, associate professor of medicine at Harvard Medical School, who studies drug pricing.

But he notes that several factors distort the market for pharmaceuticals in general and generics in particular, and they can deliver extreme price blows to people whose prescriptions are in that expensive 3 percent, or to those whose insurance coverage, or lack of it, makes them responsible for a significant chunk of their medication costs. Those factors include:

No standard pricing. Retail pricing for prescription drugs is a black box, says Doug Hirsch, a former Facebook executive who co-founded GoodRx, a drug price comparison app and website, in 2011. He realized there was a need for such a service when he discovered that the cash cost for a month’s supply of the ADHD medication Vyvanse, which wasn’t covered by his insurance, could vary by as much as $150 depending on which pharmacy he went to.

“I assumed the guy with the white coat had a master price list, but there isn’t one,” he says.

Most insurers rely on pharmacy benefit managers, or PBMs, to negotiate with drug companies, and those deals vary. If a pharmacist tells you that a drug isn’t “on your formulary,” Hirsch says, it means your insurer’s PBM hasn’t negotiated any savings on it and may not cover it. Sometimes you can make out by skipping your insurer entirely, using discounts available on price comparison websites or “doorbuster” specials offered by some pharmacies. Take the cholesterol drug atorvastatin, for example. In early June 2018, GoodRx showed that the cash price for a month’s supply was $150 at Walgreens but a mere $17 at Costco ($7.84 with a GoodRx coupon). If you check your coverage, you may find that your copay at Walgreens is more than the cash price at Costco.

No competition. A three-month supply of 40-milligram capsules of the popular antidepressant fluoxetine (generic Prozac) costs as little as $10 at Walmart, according to GoodRx, and will rarely trigger more than the minimum copay at most pharmacies. But if your doctor ups your dosage to 60 mg, the cash price can hit $900 at many pharmacies, according to GoodRx, though a store coupon can knock it down by more than one-quarter. Your insurance copay is likely to rise accordingly.

That’s most likely because that particular dosage is available from only one or a small number of sources, Kesselheim says.

“If there are eight manufacturers making a 40-mg version of a certain drug, but only one making a 60-mg version, then that manufacturer can charge whatever it wants.”

It takes four or more manufacturers of the same product for prices to go down significantly, according to his research. Patients can sometimes avoid the high-priced version by asking their doctors to prescribe a drug in its cheapest form (in the example above, by asking their doctor to prescribe a combination of 40-mg and 20-mg capsules), but that strategy requires knowledge.

“Most physicians don’t know anything about costs, or talk about them with their patients,” Kesselheim says.

No price regulation. As a generic drug’s price approaches rock bottom, manufacturers may lose interest and leave the field. The last one standing can jack up the price, and patients who need the drug have to pay. That’s how the anti-parasite drug Daraprim went from $1 per pill several years ago to $750 in 2016. Martin Shkreli, who engineered that headline-grabbing increase while at the helm of Turing Pharmaceuticals, recently went to prison, though for securities fraud rather than price-gouging (still widely legal at this writing). But Daraprim still costs about $750 per pill (as of June 2018), leaving patients with life-threatening toxoplasmosis or other parasitic infections to either pay up or resort to less effective medications. This incident and others have prompted a flurry of state-level legislative activities – 357 bills in 47 states in the first five months of 2018 alone – directed at pricing and payment, according to the National Conference of State Legislatures.

No generics. Even if a product goes off patent, generic drug manufacturers may ignore it if it’s hard to duplicate the branded version. Creams, ointments and inhaled medications are especially likely to be available only as branded products, Rosenthal says. In March of 2018, Kaiser Health News’s “Bill of the Month” – a column that deciphers medical bills submitted by readers – featured a $1,500-per-month treatment for toenail fungus that drained the patient’s health savings account without her knowledge when she relied on her insurer’s mail-order pharmacy.

“The dermatologist’s office never told her it was expensive,” Rosenthal says. “But it’s the first thing you should ask.”

EpiPen supplier Mylan raised its price from about $100 to over $600 for a two-pack between 2007 and 2016. After public outcry and protests from lawmakers, the company started offering coupons and making a generic EpiPen.

You may be able to get your drug costs down with a few simple strategies. Jennifer Spare, of Hanover Park, Illinois, usually saves between $25 and $40 per prescription just by checking local pharmacies for the best prices. She usually skips large chains in favor of a small family-owned pharmacy.

“They have the best pricing around, and they’ll mail your prescription to you at no charge,” she says.

Spare has also saved as much as $60 just by asking the pharmacy for a discount. Comparison shopping is a little more complicated with electronic prescribing, where the doctor automatically sends the prescription to the patient’s pharmacy of choice. Many states now require e-prescriptions for some or all medications. You might find it a pain to compare costs every time and request that the pharmacy in your electronic medical record be changed once you find the best price, but it should take your doctor under a minute to make the switch, says Los Angeles internist Sharon Orrange, a clinical associate professor of medicine at the University of Southern California’s Keck School of Medicine. She often uses the GoodRx phone app to check local prices with patients before she writes a prescription.

Some patients look abroad to find deals. Consumers can sort through the many foreign sources of medication to find ones that are reputable at PharmacyChecker.com. The site verifies the credentials, contact information, product quality and pricing for foreign pharmacies, says Gabriel Levitt, president and co-founder.

“It is technically against the law to import a medication, but as far as we know the government has never prosecuted anyone as long as it’s for themselves or a family member.”

In a 2016 poll by the Kaiser Family Foundation, 8 percent of Americans said they had bought prescription drugs from another country. Rosenthal knows a U.S. asthma patient who buys his inhalers in Paris. With a $200 difference between the U.S. price and the French price, savings on two or three inhalers can cover his airfare.

Patients hit with big drug bills may have to choose between paying the rent or forgoing medications: a choice that can have dire ramifications. One study estimated the U.S. racks up $100 billion to $300 billion in avoidable health care costs annually from people not adhering to their regimen, and high costs accounted for 17 percent of those failures. In a 2016 survey by the Commonwealth Fund, 14 percent of insured Americans didn’t fill a prescription or skimped on their dosage because of cost. For the uninsured, it was 33 percent.

Orrange, like all doctors, wants her patients to use their medications. If you’re tempted to skimp or pass because of cost, she wants to know immediately – not three months later during a follow-up appointment. She’s happy to go to bat with insurers, especially if her patient does much better on a branded drug than on its generic cousin, or if the insurer suddenly decides not to cover a drug that the patient has been taking for a long time.

“Bring it up with me, and I’ll help you find the best price,” she says. “Both of us have a stake in you taking your medications.”

If your doctor isn’t as price-aware as Orrange (and most aren’t), speak up.

“Tell your physician about the price of your drugs,” Kesselheim says. “It’s possible there’s another equally effective drug that might be cheaper.” Rosenthal agrees. “Train your doctor,” she says. “If all their patients ask how much their prescriptions will cost, they’re going to have to know.”

9 Strategies for Saving Money on Prescription Meds

Hands of man holding pill bottle with pills on hand

Getty Images

9 Strategies for Saving Money on Prescription Meds:  https://health.usnews.com/health-care/patient-advice/slideshows/9-strategies-for-saving-money-on-prescription-meds

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**Comment**

I’ve found Costco Pharmacy to be the cheapest local pharmacy.  Also, I use a Canadian pharmacy https://www.pharmacyrxworld.com for really expensive meds like tinidazole and Albenza.  The advice to switch to a less expensive drug with similar action has helped me save at times, and I recommend looking into Goodrx as well as asking about coupons and looking online.

For Mepron (liquid gold) we applied for bridges to access, a program put on by the manufacturer:  https://www.scbn.org/  It’s a lot of paperwork but we were able to get 1 year of Mepron free for two people. To say that saved us a boatload would be an understatement.

Support groups are a great place to ask questions about drug prices as patients have done a lot of footwork and we can all help each other save by sharing this intel.

I would also suggest trying compounding pharmacies.  I learned the hard way that Cytomel (T3) has many additives while the compounded form at Women’s International Pharmacy has an extremely clean T3 with only olive oil as it’s additive.  Some patients are extremely sensitive to dyes and additives so make sure to ask about those as well.

https://www.facebook.com/ttavdocuseries/videos/1955704004492186/  Approx. 5 Min

Watch Dr. Larry Palevsky and Barbara Loe Fisher discuss the CDC schedule of vaccines… and the studies that have been done on vaccines with multiple viruses, like the MMR vaccine.  They’re talking about the blatant lack of safety studies on the combined doses of vaccines we’re giving to children right now, like the MMR, which is three vaccines in one.

Much, much more in The Truth About Vaccines starting on September 12 when you sign up right here to watch for FREE! –> http://bit.ly/PalevskyFisherTTAV

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**Comment**

I must correct Dr. Palevsky’s statement that people don’t get multiple diseases at the same time in nature.  Lyme/MSIDS patients are often infected with multiple things at once which is why we are so sick and why the CDC’s mono therapy of doxycycline rarely works.

If Lyme/MSIDS patients are an example of the combined effect of being infected with multiple pathogens and the resulting cytokine cascade and inflammation, we should all stop and reflect upon the potential damage combined vaccines can pose – even to a healthy population.

For the record, here you can see the ACIP vote “yes” for a new vaccine despite the lack of safety studies on the cumulative effects:  https://madisonarealymesupportgroup.com/2018/09/08/acip-vote-yes-for-new-vaccine-despite-no-safety-studies-on-cumulative-effect-with-other-vaccines/  It’s all right here in bright purple crayon.