Applying the Scientific Method to Vaccination

Joy: “All these facts and opinions look the same. I can’t tell them apart. “

Bing Bong: “Happens to me all the time. Don’t worry about it”.- Pixar’s Inside Out

Ah, the scientific method. People love to bring up the scientific method when talking about vaccination. Most will tell you that the scientific method supports vaccination. Actually it doesn’t.

What is the scientific method? Some people seem to struggle with what exactly it is, so here’s the definition: “...the process by which scientists, collectively and over time, endeavor to construct an accurate (that is, reliable, consistent and non-arbitrary) representation of the world.” So we’re talking about a method for testing hypotheses to see if our ideas translate to what actually goes on in the natural world. It’s based on observation, not popularity.

The Scientific Method has four steps:

“1. Observation and description of a phenomenon or group of phenomena.

2. Formulation of an hypothesis to explain the phenomena. In physics, the hypothesis often takes the form of a causal mechanism or a mathematical relation.

3. Use of the hypothesis to predict the existence of other phenomena, or to predict quantitatively the results of new observations.

4. Performance of experimental tests of the predictions by several independent experimenters and properly performed experiments.

If the experiments bear out the hypothesis it may come to be regarded as a theory or law of nature.”

So let’s apply the Scientific Method to the idea that vaccines stop the spread of illnesses.

1. Observation and description of a phenomenon or group of phenomena.

People are not severely disabled or dying in large numbers from infectious diseases. The spread of these diseases appears to be uncommon amongst vaccinated populations.

2. Formulation of an hypothesis to explain the phenomena. In physics, the hypothesis often takes the form of a causal mechanism or a mathematical relation.

The hypothesis is that vaccines create immunity in the vaccinated individual by getting the immune system to recognize and then fight off infectious agents without the individual actually developing the disease. If enough individuals are vaccinated, the disease will be eliminated or eradicated in a particular area or even across the whole world.

3. Use of the hypothesis to predict the existence of other phenomena, or to predict quantitatively the results of new observations.

So based on our hypothesis we think that vaccines could be formulated for all kinds of diseases and that they could lead to a disease free world. We would expect that vaccines would eliminate most incidences of disease (maybe 80-99% if we’re going to put a number on it).

4. Performance of experimental tests of the predictions by several independent experimenters and properly performed experiments.

…And here is where we start running into problems. Studies on large populations of vaccinated and unvaccinated populations have not been carried out. We have many studies for the approval of individual vaccines, but  we do not have tests run by several independent experimenters. Even the approval tests of vaccines do not fulfill this requirement because they are tests on specific vaccines for release onto the market and they are carried out by the pharmaceutical companies who have developed them- not independent experimenters who have no stake in the outcome.

In fact, media darling Dr. Paul Offit said in his interview to PBS that such experiments comparing the health of large numbers of vaccinated and unvaccinated individuals would be impossible because people who choose not to vaccinate are so mentally incompetent that the results can’t be accurately assessed. But if we can’t run such experiments, then we’re not dealing with a scientific fact, law or even hypothesis, we’re dealing with a  matter of belief or opinion. And the government certainly has no constitutional right to force opinions, beliefs and preferences on us.

Other problems with applying the scientific method to vaccination is that arguments in favor of vaccination have been subject to a number of biases related to the scientific method. They overlook information that does not support the use of vaccination (such as lack of efficacy and modified illnesses in vaccinated individuals that are still communicable, but lack classic symptoms.) They also overlook information pointing to other improvements in health that could explain a decrease in morbidity and mortality such as nutrition and sanitation. Another common one is the idea that vaccination is so safe and so essential and so established that we don’t need to run tests and experiments comparing the health of individuals or disease occurrence in populations- especially accounting for non-classical symptoms. And everyone I have met who supports the use of vaccination seems to be falling error to the most fundamental mistake of the scientific method: assuming that the hypothesis is an explanation for the phenomenon observed.

Also problematic with the concept of disease eradication is the concept of reproducibility.

“Independent confirmation of a scientific hypothesis through reproduction by an independent researcher/lab is at the core of the scientific method.” So when we start talking about eradicating measles, polio, etc. just like we eradicated smallpox, we’re not dealing with a fact. There is no fact or law that a disease can be completely eradicated from the planet, because the declaration of eradication has only happened once. (And there are significant problems with it that are rarely discussed.) Assuming that all of the ideas eradication is based on hold true, it’s only been done once and has not yet been reproduced by anyone. Yet a great deal of public health policy is based on the hypothesis of eradication and simply assumes that it is true.

Vaccination may be popular, yes, but its current use in not based on systematic observations and experimentation.

 

 

The Anti-Vax Crackpot Article From the New York Times: A Rotavirus Story Full of Crap

“The implementation of rotavirus immunization programs will require scientists and health officials to work effectively with the media to ensure that the public is informed about both the risks and benefits of the new rotavirus vaccines, particularly since the media may be the public’s principal source of such information”- Clinical Microbiology Review“Rotavirus Vaccines: An Overview”

The “I Was An Anti-Vax Crackpot” article from the New York Times. This little beauty has been making its way around the internet. But after reading it, I have my suspicions about its veracity. Here’s why:

The reasons this woman supposedly gives for not vaccinating are not typical of most non-vaccinating parents. This is the biggest red flag with this article, and I’m basing that on having interviewed literally hundreds of non-vaccinating parents over the past few years. I have yet to hear anyone say that they would rather someone else’s child suffer harm to save their own, relying on herd immunity for protection. Not once. (This is because we know that herd immunity is like Santa Claus- a nice story that doesn’t actually exist. Failure rates for many vaccines are such that there is no way to establish 80-99% immunity in a population and diseases like measles and pertussis in vaccinated individuals often don’t present with classical symptoms even though infected vaccine recipients can still pass these diseases to others. For examples from medical and public health literature, see here.)

Off the top of my head, the reason I have heard the most frequently is bad reactions after vaccination. Other reasons that I have heard frequently are that the parents had encountered research that showed that vaccines were not very effective at preventing diseases (negating the whole herd immunity sacred cow- no pun intended), their children were frequently sick despite receiving full and timely vaccines, they were second or third generation non-vaccinating families, or they were concerned about the MTHFR gene and the possibility of vaccine reactions. The explanation this woman alleges is more in line with the media perpetuated myth about why people choose not to vaccinate than the reality. Of course, most pro-vaccinating individuals don’t really know or attempt to understand why others refuse vaccines- personally I think it’s because they are afraid that our reasons have some validity.

Oh and BTW, many non-vaccinating parents are actually extremely fearful of your courageous little vaccinated angels spreading live viruses to their children through vaccine shedding. It’s one of the most common fears I hear about from non-vaccinating parents about vaccinated children.  Table 5 from Edelman’s section on adjuvants in Vaccine Adjuvants: Preparation Methods and Research Protocols states that the spread of a live vectored vaccine to the environment is a “real or theoretical risk” with vaccines. (He doesn’t specify which.) For my part, my children went to a birthday party where they were around several fully vaccinated children (it’s very likely they were the only unvaccinated children present) and then came down with chickenpox about week later. (Where’s my Law and Order episode about vaccinated children getting my unvaccinated children sick with a deadly disease?)

This is a very convenient advertisement for Paul Offit and his rotavirus vaccine. It is extremely interesting that this woman claims that rotavirus changed her mind about not vaccinating and that she also claims that reading Paul Offit’s books helped her to “wake up”. Paul Offit is one of the inventors of the Rotateq vaccine- a vaccine that is relatively new for a disease that no one thought too much about in developed countries fifteen to twenty years ago. It is extremely necessary for Mr. Offit to keep reaping the financial rewards of his vaccine that people not question its usage. For its continued widespread use, people need to believe that rotavirus is a serious illness in developed countries for otherwise healthy children. This little New York Times piece is certainly trying to present that view.

For a sampling of Dr. Offit’s tactics, take a look at this interview PBS did with him for the ever so diplomatically named documentary, “The War on Vaccines”. You will actually read him calling not vaccinating for measles as playing Russian roulette. We’re talking about a disease with a fraction of the morbidity and mortality of cancer in the United States. For comparison, recall that the CDC states that  “In the United States, measles caused 450 reported deaths and 4,000 cases of encephalitis annually before measles vaccine became available in the mid-1960s.” Here are the estimates of numbers for cancer in the United States for 2016 from the American Cancer Society: “About 1,685,210 new cancer cases are expected to be diagnosed in 2016 and… about 595,690 Americans are expected to die of cancer in 2016, which translates to about 1,630 people per day.” Another example of his biases include his claim that a study comparing parents who vaccinate and don’t vaccinate would be fundamentally flawed because parents who vaccinate and those don’t are so fundamentally different. Parent who don’t vaccinate, he claims would be less likely to think their child has a problem because they think that not vaccinating will prevent developmental problems and other health problems. He does not think that parents who vaccinate could be subject to the same bias in reverse.

Another assertion from his interview that I have not been able to find corroborating evidence for is the Delaware pertussis outbreak. He says that in 2006 there was an outbreak of pertussis in Delaware that was reported in the CDC’s Morbidity and Mortality Weekly Report and that most of the incidents of pertussis were in school age children ages 5-9. I have not been able to find a MMWR bulletin that meets this particular description. However, I did find one that detailed a pertussis outbreak in Kent County, Delaware in an Amish community during September 2004 through February 2005. This was published on August 4, 2006. This report details that most of the cases were preschool age children. (And in fact the charts published with this report showed that the breakdown by age group of pertussis cases in the Amish community differs substantially from the United States as a whole. The majority of the pertussis cases in the United States actually occur in adults with children ages 11-14 second.)

If this is the outbreak of pertussis he was referring to, there is something very ironic about it and that is that pertussis was still present in vaccinating households. Of the 123 patients ages 6 months to 5 years in the interviewed Amish households, almost one in four (24%) had records of receiving three or more doses of DTP or DTaP. (And another 5% had records of receiving 1 or 2 doses of DTP or DTaP.) The rate of vaccination for the interviewed households where clinical pertussis had been discovered was 45% not vaccinating any children, 42% vaccinating at least some children and 14% declined to give information about vaccination status. So out of the 40 households with at least one clinical pertussis case reporting at least some level of vaccination, 35 cases of pertussis were present. And out of 43 households with at least one pertussis case reporting no vaccination, 88 cases were present. But then of course, this may not account for vaccinated cases that do not meet the clinical definition see this news story, this dispatch from the CDC and this study.

But let’s take her story at face value, that there are no other competing interests and she is genuinely telling the truth. There are still several problems with using this tear-jerker as a rationale for the necessity of vaccination:

Rotavirus is deadly- if you live in a third world country. Malnutrition, poor healthcare and bad living conditions all contribute to rotavirus’ death toll in less developed countries. However, even the Clinical Microbiology Review in their overview of rotavirus and its vaccines state that rotavirus is generally not deadly in developed countries and that the goal of the vaccine isn’t necessarily to prevent death, but rather decrease hospitalizations for rotavirus. So unless she has been starving her children and permitting them to live in squalor or they are otherwise immunocompromised, rotavirus is not actually deadly for her children. (And she grew up just fine without the vaccine herself.)

The Rotavirus vaccine actually causes slightly greater rates of gastrointestinal upsets like nausea vomiting and diarrhea. It’s considered successful because there are fewer hospitalizations for rotavirus, not because it actually prevents the disease. I’m not joking. Again this comes the Clinical Microbiology Review in their overview of rotavirus and its vaccines. Direct quote: “Pooled data from the large phase III and two smaller phase III trials showed that in the week following the first dose of RotaTeq, the incidence of fever and irritability did not differ between vaccine and placebo recipients. Diarrhea and vomiting occurred more frequently among vaccine recipients than among placebo recipients (10.4% versus 9.1% and 6.7% versus 5.4%, respectively).” And rotavirus is only deadly to children in developed countries in the loosest sense: “Rotavirus gastroenteritis results in only 20 to 70 childhood deaths per year in the United States.” The CDC places the number of deaths of children in the US under the age of five to be 1 in 200,000 before the advent of mass rotavirus vaccination. (They don’t specify how many are immunocompromised out of this number). For a point of comparison, consider that the Vaccine Injury Compensation program has awarded 556 payouts for 2016 so far.  So far more people are receiving vaccine injury payouts annually than are dying from rotavirus. Rotavirus accounts for about 600,000 deaths worldwide annually- slightly less than the number of deaths from heart disease in the United States annually, for a point of comparison. 

Another direct quote from Clinical Microbiology Review: “A realistic goal for a rotavirus vaccine is to duplicate the degree of protection against disease that follows natural infection. Therefore, vaccine program objectives include the prevention of moderate to severe disease but not necessarily of mild disease associated with rotavirus. An effective rotavirus vaccine will clearly decrease the number of children admitted to the hospital with dehydration or seen in emergency departments but should also decrease the burden on the practicing primary care practitioner by reducing the number of office visits or telephone calls due to rotavirus gastroenteritis.” Rotavirus vaccination is not completely about eliminating the disease and creating herd immunity, but rather decreasing hospital and doctor visits.

The quote I used at the beginning of this post goes on to say that information from the media must be factual and accurate to gain support. However, if people were told the full story of rotavirus and its vaccines- that the disease is almost never causes death to American children and that the vaccines don’t necessarily keep children from developing gastrointestinal symptoms- rotavirus vaccination might be less popular. And if people started questioning rotavirus vaccination, they might start questioning measles, mumps, rubella, varicella, hepatitis B, pertussis, and tetanus for 2 month old babies.

Pieces like this are probably not written to convert non-vaccinating individuals to vaccination- no care has been taken to actually address the concerns of non-vaccinating parents. Since this article plays to the perceptions and fears of vaccinating parents, I think it is more likely that the goal of this piece is to keep vaccinating parents vaccinating by presenting people who question vaccines as morally corrupt and ignorant.

As for me, well, the only time my kids have ever had severe diarrhea was when we all got food poisoning- and no vaccine would have helped that one!

 

 

 

Wearing the Big Sign that Says: “Lie to Me! PLEASE!”

“It didn’t come from the Government down. There was no dictum, no declaration, no censorship, to start with, no! Technology, mass exploitation, and minority pressure carried the trick, thank God. Today, thanks to them, you can stay happy all the time, you are allowed to read comics, the good old confessions, or trade journals.”– Ray Bradbury, Fahrenheit 451

“Remember the firemen are rarely necessary. The public stopped reading of its own accord. You firemen provide a circus now and then at which buildings are set off and crowds gather for the pretty blaze, but its a small sideshow indeed, and hardly necessary to keep things in line.”– Ray Bradbury, Fahrenheit 451

“Love me love me/ Say that you love me/ Fool me fool me/ Go on and fool me/ Love me love me/Pretend that you love me.”– “Lovefool”, the Cardigans

“And the big lie is always present when we get played. To be a chump (not merely the victim) is to be open to the big lie. Not merely open to it, eager to buy into it.”Seth Godin

Question: What would happen if entrepreneur/author Tim Ferriss were to interview me on one of his podcasts?

Answer: No one knows for sure, but it would probably stoke up more controversy than any of his other podcasts. (And he’s interviewed Dr. James Fadiman about micro-dosing with psychedelics for therapeutic use and chemist Patrick Arnold, known as the “father of prohormones”, controversial substances used by some athletes convicted of doping.)  He would need to consult his attorney for one helluva disclaimer. His sponsors might pull out. He could receive a lot of very bad press for a time.

A little while ago I was listening to a podcast between Tim and Ryan Holiday (author of The Obstacle Is the Way, a book I highly recommend to anyone). Over the course of the interview, Tim brought up an experience he had when he had been asked to speak at a large, prestigious university (UCLA, if I am remembering correctly). He had been asked what he perceived the greatest threat to be to America. And he responded that he felt like the greatest threat to America was the kind of over sensitivity towards offending people that causes us to avoid discussing uncomfortable subjects in an honest and open manner. (Which he pointed out to his audience is often perpetuated by idealistic young college students.) Ryan brought up the book Fahrenheit 451 by Ray Bradbury, saying that when he had read it initially as a teenager, he thought it was about a totalitarian government that wanted to keep its people from thinking and becoming educated. However, upon a second reading as an adult, he noted that it wasn’t a government mandate that led to the burning of all the books. It was the desire of the people themselves to avoid dealing with unpleasant ideas. (See the above quotes from the book.)

That vaccination may not be as effective or safe as we have thought is probably one of the most unpleasant of these unpleasant ideas.

Saying that vaccination is anything less than lifesaving- even certain vaccines on the current American schedule that are not considered important by other developed countries- is considered heretical in the United States. When Jenny McCarthy was granted a spot on “The View”, I remember people saying that because she is an advocate for vaccine choice and believes her son’s autism was caused by vaccines that she should not be hosting such a popular talk show. Her views were just too dangerous. (Comments such as these were frequently preceded with phrases such as “I’m against censorship, but…”.)

You can throw actual facts and statistics from public health records and medical journals at vaccine believers until you’re blue in the face, but unless they are open to hearing a different point of view, you will probably be met with a broken record response of the following statements: “Vaccine save lives”, “People used to die from mumps/rubella/measles”, and “Which deadly disease do you want your child to catch?”

The biggest problem with our culture of vaccines, biased media coverage and even public health measures and legislation promoting vaccination lies in the fact that the vast majority of Americans want so badly to believe that vaccines are 99.999999% safe and effective- despite all evidence to the contrary. The only thing that gives these public health agencies, the medical establishment, the government, pharmaceutical companies, schools, and your friends and family any power is the widespread desire for vaccination to be the cure-all for diseases of all kinds. Essentially, most people are walking around wearing a big sign that says “Lie to Me! PLEASE!”

And there are plenty of people who will tell them what they want to hear. Some have financial motivations, but most, in my opinion are motivated by fear. Fear that maybe vaccination is actually more harmful than they have been told. Fear that it isn’t very effective and that their child could contract what they view as a deathly illness. I think the greatest fear is that the people we trust most with our health- doctors, public health agencies and and pharmaceutical companies- are either ignorant or dishonest. It means losing our heroes as we find out that some vaccine pioneers like Jonas Salk and Louis Pasteur were not as selfless as we thought, but rather people who had interests and egos like the average person or business. When I was first questioning vaccines, this was the thing I was most afraid of.  It’s painful to find out that the people you looked up to were not as altruistic as you thought. It’s kind of like finding out Santa Claus doesn’t exist.

We can talk about legislation to protect our rights against mandatory vaccination. We can blame “Big Pharma”. But really it’s all of us wearing the big sign that says “Lie to Me! PLEASE!” that are to blame. These entities would have no power if the public actually wanted the truth. Their power comes because people desperately want a lie. The change will never come from the top down. It will come from the bottom up as more people take off that big sign.

A Case Study In How Something With Little Substantial Research Can Be Adopted As Fact

“It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.”- Mark Twain

“No one can see a bubble. That’s what makes it a bubble.”– The Big Short

“I cannot give any scientist of any age any better advice than this: The intensity of the conviction that a hypothesis is true has no bearing on whether it is true or not.”- Peter Medawar

If the US government and other prominent health organizations endorse a particular measure, we assume it must be scientifically based and appropriately researched. After all, they can point to research and if that research wasn’t substantial then they wouldn’t endorse it, now would they? Unfortunately, that’s not how the public health world works sometimes.

Now while we’d love to live in a world where all public health recommendations are made solely on the basis of accurate research with the health of the population in mind, and where we could see unicorns at the local zoo, both are impossibilities. The fact is that research is conducted and analyzed by human beings who have their own agendas, desires, egos, and biases, all of which sometimes carry over into the research and into subsequent recommendations based on that research. Sometimes, this means that an idea that isn’t fully substantiated makes its way into health policy. So how does this type of thing happen? Well let’s take a look at our case study: the American Heart Association’s low fat diet.

Earlier in the 20th century, the average American diet consisted of very high fat foods with a great deal of animal protein and/or sugar and very little fruits and vegetables. In some areas- especially the South- food was the accepted indulgence of choice since alcohol was considered a sin. In the 1940’s and 1950’s, research began to show that high levels of cholesterol were correlated with heart disease and some researchers began proposing that overweight Americans should decrease their fat intake. In 1977, the McGovern report instructed that Americans in general should eat more whole grains, less meat, more fruits and vegetables and substitute nonfat dairy products for whole fat ones. From Anne LaBerge’s overview of the history of the low-fat diet:

“A turning point in obesity/heart disease studies came in 1983 with the publication of an article based on the Framingham studies, which cited obesity as an independent risk factor for heart disease.21 This finding lent further support to the low-fat approach because scientists believed that the low-fat diet might not only prevent coronary heart disease, but also could promote weight loss, thereby reducing the incidence of obesity. By 1984, the scientific consensus was that the low-fat diet was appropriate not only for high-risk patients, but also as a preventive measure for everyone except babies.22 Low fat carried the day, in spite of continued serious skepticism.23 The diet-heart hypothesis remained a hypothesis, but, as if already proven, it became enshrined in federal public health policy and was promoted by health-care practitioners and the popular health media. By 1988, the Surgeon General’s report emphasized the health dangers of dietary fat, and in 2000, the federal government’s “Report on Nutrition and Health” labeled fat the unhealthiest part of the American diet. From 1984 through the 1990s, dietary fat was increasingly blamed not only for coronary heart disease but also for overweight and obesity.”24

So here we have a hypothesis and some research on a high-risk population. And for people who were eating primarily meat, dairy and sugar, a diet that focused on whole grains and produce might actually bring about some positive changes. However, instead of doing further research to understand if this is actually a correct thing for every single man, woman and child, health authorities latched on to it and ran with it as if it was fact, promoting it for all. Doctors who were skeptical of the idea that the low fat diet was correct for every person accept infants were roundly criticized.

Harvard Medical School sums up the low fat diet this way: “Once the main strategy for losing weight, low-fat diets were shoved aside by the low-carb frenzy. But healthy fats can actually promote weight loss, and some fats are good for the heart; eliminating them from the diet can cause problems. Since fat contains nine calories per gram while carbohydrates contain four, you could theoretically eat more without taking in more calories by cutting back on fatty foods and eating more that are full of carbohydrates, especially water-rich fruits and vegetables. Still, such a diet tends to be less filling and flavorful than other diets, which lessens its long-term appeal. And if the carbs you eat in place of fat are highly processed and rapidly digested, you may be sabotaging your weight-loss plan.” Again, serious problems with the low fat diet as a long-term, blanket strategy for weight loss and health.

Despite emerging research on the importance of moderate consumption of healthy fats, we can still see the vestiges of the low-fat diet “gospel” in government supported food programs. Children at schools drink low fat or non fat milk. Women and children on WIC can only use their WIC vouchers to purchase whole dairy products under special permission- such as if the woman or child is severely underweight.

And this isn’t the first time an idea has quickly morphed from hypothesis to full blown public health campaign. Take Shaken Baby Syndrome– a diagnosis founded largely on research performed on adult baboons and confessions from people under severe emotional duress. Shaking a baby is still abusive and can seriously injure a baby, but the actual diagnosis of Shaken Baby Syndrome as the only cause of subdural hematoma in an infant has come into question in court cases and rightly so. Interestingly enough, we have a great deal of material on not shaking babies, but very little about other abusive behavior towards infant and children. Shaking is specifically singled out in these campaigns.

Or if we really want a throwback, how about the idea that circumcision of male infants should be routine because it would prevent masturbation and a proposed host of accompanying ills? Robert Darby’s paper on the subject notes the “insularity” of the American medical profession in clinging to a belief in “congenital phimosis” long after it had been debunked in Europe. Indeed, despite a mountain of evidence to the contrary, medical texts continued to promote circumcision as a preventative for masturbation into the 1970’s. Whatever your thoughts on circumcision, the point is that the reasons for its widespread promotion during the twentieth century were not scientifically grounded (but rather derived largely from social and cultural ideas) and were presented as fact long after scientific evidence had proved otherwise.

The list can go on and on of “sacred cows” that are founded largely on a belief that something is to true to be untrue or that we simply don’t want to believe it to be true. The mortgage market could never fall apart, it’s simply too safe. The NFL has a history of presenting flawed research as its proof that football players can not develop serious brain injuries from repeated head trauma. Enron was simply too safe and conservative an investment to fail. Madoff was too trustworthy to screw over the investment world.

Sure, you can go around waving research and credentials in people’s faces saying that it’s proof of what you want to hear. But that doesn’t mean the research was carried out in a systematic and unbiased manner or that its results are being correctly interpreted. Just think about next time someone tells you that the research on the safety and efficacy of vaccines is undeniable.

Information for Parents About Vaccines- A Study of the Dissemination of Ignorance

“I do not approve of anything that tampers with natural ignorance. Ignorance is like a very delicate exotic fruit. Touch it and the bloom is gone.”– Lady Bracknell, The Importance of Being Earnest, by Oscar Wilde

“I trust doctors, not know-it-alls.”- Kristen Bell

“Just because a baby dropped out of you doesn’t mean a PhD did.”- Pro-vaccination Facebook meme

Trusting doctors and scientists is the smart thing to do isn’t it? After all, they have had years, even decades of schooling and the information they learn in medical schools and PhD programs is absolutely proven- otherwise it wouldn’t be a part of the curriculum.

But what if it’s not?

What if the curriculum taught in universities and medical schools about medicine and disease prevention is influenced by politics, economics, and cultural biases?

Oh, that is a very scary place, isn’t it?

It means that the information we get from health officials and doctors may not be completely accurate. (Gasp! We might gain greater scientific knowledge in the future and find out some of our current medical practices are based on faulty assumptions- like bleeding patients and prenatal x-rays were. You mean we don’t everything right now?!)  It means that profit motive could play a role in how medical treatment and procedures are administered and represented to us. It’s so scary that we would rather turn a blind eye and not examine that possibility and continue living in ignorance. And that brings us to agnotology- the study of willful acts to spread confusion or deceit.

Agnotology is a relatively new field of academic study and has yielded a great deal of interesting information about how businesses and even governments have used the deliberate spread of misinformation to keep people from understanding the truth about something. Quoting a LA Times article (where columnist Michael Hiltzik displays his own ignorance by claiming that people who oppose vaccination base their entire position on one discredited study): “The tobacco industry was a pioneer at this. Its goal was to erode public acceptance of the scientifically proven links between smoking and disease: In the words of an internal 1969 memo legal opponents extracted from Brown & Williamson’s files, “Doubt is our product.” Big Tobacco’s method should not be to debunk the evidence, the memo’s author wrote, but to establish a “controversy.” From a BBC article on the tobacco company’s efforts to create confusion: “[Science historian Dr. Robert Proctor of Stanford University] had found that the cigarette industry did not want consumers to know the harms of its product, and it spent billions obscuring the facts of the health effects of smoking.” Remember, folks, there was a time when smoking was considered very safe- even by doctors- and a big part of that was deliberate efforts of the tobacco companies to discredit research that showed their products caused cancer.

How about another example of agnotology and medical science? From the late 1800’s to about the middle of the twentieth century so-called “racial hygiene” was considered a public health necessity. It did not originate from the Nazi’s in World War II, it was already being preached and practiced as the best way to maintain a healthy populace in both Europe and America. In fact, America was among the first countries to institute sterilization laws for those considered unfit to reproduce. That was in 1907. It would be a decade more before Germany began instituting such laws. Racial hygiene was taught as a fact in medical and nursing schools in Germany and other countries. It was held up by research from MD’s and PhD’s claiming that people of other races were intellectually inferior. Sterilization laws soon gave way to “mercy killings” of the mentally ill or disabled and soon to mass genocide of Jews, gypsies, homosexuals and other groups deemed to be a burden on public health. (I highly recommend reading all of the aforementioned link. It’s a summary of Dr. Proctor’s very comprehensive look at the how the Nazis influenced the medical system of Germany.)

So for all of you who loudly proclaim that you trust your doctors and do what they tell you because doctors and PhD’s know best, how about this? What would you do if your doctor told you it was a public health necessity to execute your neighbor because of her ethnicity? Or how about a special needs child? What about someone who was disabled or suffered depression? Would you be the type of person who steps back and says, “Now wait a minute. These people may not be like an artificial ‘ideal’, but their lives have value- many of them can have a very positive impact on our society if we let them. Even if the experts are saying one thing, they could be wrong.” Or would you be turning in your neighbor or handing your disabled family members over for a mercy killing because it is the “scientific” thing to do? If you have ever said that you vaccinate yourself and your child because you trust doctors and scientists, think very carefully about your answer. (Kristen Bell, care to field this one?)

Let’s take a look at vaccine information now. For those of you out there who are vaccine proponents and claim to believe in facts, logic and research, you should have absolutely no problem with comparisons of vaccine information distributed to parents with epidemiological research on the diseases and medical facts about the vaccines.

Let’s start with Hepatitis B.

The CDC’s information page for parents on Hepatitis B claims that “of the more than 1 million people in the United States living with lifelong Hepatitis B, most got the virus as a child” and that “When infants and young children are infected with Hepatitis B, they have 90% chance of developing a life-long, chronic infection”. The CDC says that Hepatitis B can be passed through more every day means such as chewing food to give to a baby, sharing toothbrushes and gum and touching open cuts or sores. Statements like these may give the impression that Hepatitis B is a disease that frequently affects children and that transmission outside of sexual contact, needle sharing and maternal transmission are also frequent phenomena.

However, reports of epidemiology presented at the National Institutes of Health Workshop on the Management of Hepatitis B show a different breakdown. Their statistics show that 45% of all new HBV infections in the United States are sexually transmitted, with injection drug use causing another 21% of cases and the remainder (33%) being cases of mother-to-child transmission occurring at birth or in the first few years of life. (pg. 20) Overall, the CDC statistics show that rate of HBV infection is very low in the United States and Canada, averaging 0.1 to 0.5% for current or chronic infection, however the rate of infection is much higher among native populations and Asian emigres. About 5% of Americans have been infected with the hepatitis B, but 90-95% of the time these cases are cleared by the immune system on its own, especially in adults. (See page 19 under the heading “Canada and the United States”.) Child-to-child transmission of hepatitis B (mostly through contact with open sores) has been well documented in developing countries. In the United States and other developed countries child-to-child transmission incidents have been extraordinarily rare, even in daycare and school. Urine and feces are not vehicles for transmission unless blood is present and oral transmission of hepatitis B is almost non-existent. (pg. 48 under heading “Risk of Hepatitis B Infection in Daycare Centers”.)

So notice that while CDC’s information for parents has some truth in it (that HBV can be spread through sharing personal care items and that children have a greater chance of developing a lifelong HBV infection than adults). However, there are a couple of big, glaring factual omissions here. One is that the overall rate of HBV infection in the United States is very low. This is not a common disease, so the chances of an individual in a low-risk population contracting are extremely low. The other omission is that almost all children who are infected with HBV contract the virus through mother-to-child transmission either at birth or in the first few years of life, so unless the mother is infected at birth or during the child’s first few years of life, the chances of a child contracting HBV are extremely low. The other thing they fail to mention is that incidences of child-to-child transmission of HBV are extraordinarily rare in the United States and other developed countries. This vaccination is becoming required by more and more states for entrance into kindergarten, but ironically enough parents and doctors can vaccinate all the kindergarteners they want, but the small number of children who are most at-risk for HBV infection will probably contract the infection at birth or before they enter kindergarten from their mothers. In other words, vaccinating kindergarteners for HBV is one of those feel-good measures that doesn’t actually accomplish much. The CDC’s information for parents on HBV is deliberately misleading.

Moving on, let’s take a look at pertussis next. The CDC says this about pertussis prevention:

“Pertussis (whooping cough) can lead to serious illness, needing treatment in the hospital, and death — especially in babies who are too young to be well-protected by vaccines. You can help protect your baby from pertussis by:

  • Getting a pertussis vaccine (Tdap) if you are pregnant
  • Encouraging those around your baby be up-to-date with pertussis vaccination
  • Making sure your baby gets his pertussis vaccines on time”

But here is what they are not telling you about pertussis and pertussis vaccination:

I could go on and on with other diseases, but you get the idea. So let’s review here: the information that is distributed to parents from agencies like the Centers for Disease Control leaves out several very important facts and twist others to present an unrealistic picture of the risk for diseases and the benefits of vaccines. The doctors, scientists and public health professionals at the CDC are considered very educated about the spread of disease, so unless the people employed there are in reality extremely ignorant about diseases and their spread (and therefore unqualified for their positions), we can only assume that they are deliberately keeping parents from this information. Sounds like a subject worthy of agnotology.

A Grab Bag of Thoughts…

Common Ground

Often, vaccine choice and vaccine resistance proponents focus on devastating vaccine reactions when they try to support their stance. While it’s true that vaccines have numerous unpleasant (even deadly) and vastly underreported side effects, I would like to propose a change of tactics.

We need to focus on the lack of efficacy with vaccines. And there is plenty of evidence from documented medical sources on how vaccines have not been able to stop breakouts of diseases. (Read my other posts.) The medical community has most people thinking that vaccine reactions are so incredibly rare as to be non-existent.

This idea is so ingrained that it will be very difficult to remove from most people’s minds. I’ve seen parents whose children have screamed for hours the night after a DTaP vaccine or whose children have had febrile seizures following a vaccine take their children right back for more shots. The biggest defense vaccine proponents have is that vaccine “save lives”, i.e. are very effective at preventing disease. If the vaccine theory were a strong fortress, trying to convince people based on dangerous reactions would be like trying a full frontal assault. You’re trying to hammer away at the most strongly guarded part of the fortress in plain view of everyone.

If we want to build bridges with people in the pro-vaccine camp and help them understand us, we need to go around to the back of the fortress and focus on the issue of efficacy. Because here’s the great thing: both vaccine proponents and vaccine resistors want better health for themselves, their children and the public.  When you help them see that vaccines are not nearly as effective as they have been led to believe, some people start to consider our point of view. I know that for me, the nail in the coffin of leaving vaccines behind came when I found sound research demonstrating high rates of failure. So next time you want to help someone understand the dangers of vaccination, focus on efficacy and leave reactions off the table for the time being.

* * *

I find it incredibly ironic when I see people and media declaring that people who refuse vaccination “hate science”. Yes, of course the reason I am against vaccination must be because I hate science. That’s why I spend my free time reading science magazines, immunology and epidemiology journals, medical textbooks, public health statistics and reputable newspaper reports. (End sarcasm.)

***

When I was in college I went to my campus’ international cinema frequently. One time I saw a movie from China about a family dealing with life after the Communist Revolution. (For the life of me I can not remember the name of it and haven’t been able to find it out online.) Near the end of the movie, their daughter is grown, married and pregnant with her first baby. She goes to a hospital to have her baby and it is staffed by teenage girls. When the Grandmother-to-be asks the girls if they have experience delivering babies, the girls assure her they know what they are doing.

(During China’s Cultural Revolution, educated professionals were frequently attacked and harassed or even tortured and killed in the name of preserving the revolutionary spirit that had led to Mao Zedong’s takeover of China 20 years previously. The idea behind this ideology, of course, was that a loyal young follower of Chairman Mao was far more trustworthy than educated people and intellectuals.)

As the grandparents wait together for the baby’s birth, they hear the young girls screaming. The mother is losing consciousness and they don’t know what to do. (I believe she is depicted as having a postpartum hemorrhage; a complication that is very common, but very treatable with an experienced doctor or midwife.) The mother dies and the grandparents and father are left to raise the baby boy without her.

If you’ve read my post on education and vaccines, you probably know that I’m going to draw an uncomfortable parallel between Communist China and American public health here. Because just like Communist China championed ignorance as a virtue, our public health system in America is doing the same. The educated parents, doctors and celebrities are the ones who read a little information from the CDC and parrot back comfortable slogans about how vaccines save lives. People like me who spend their days reading material on public health, immunology and epidemiology are dangerous.

The result is that we are the sickest nation in the developed world while spending the most on healthcare. Obviously what we’re doing isn’t working so we need to ask more questions and be more open to different points of view. Not less.

“Shaken Baby Syndrome” and Vaccine Injuries

Shaken Baby Syndrome was once unchallenged in the medical community. But lately it has been under greater scrutiny- especially with more parents and caretakers being tried for murder with an SBS diagnosis though they maintain their innocence. The scrutiny has brought to light some uncomfortable truths for SBS proponents.

For example, the research behind SBS is not based on documented and witnessed accounts of shaking deaths of real human infants, but rather on brutal and inhumane research conducted on adult baboons. The researcher who carried out these experiments found that if rammed with excessive force, the baboons developed a subdural hematoma- the part of a “triad” of symptoms (subdural and retinal hemorrhage and brain swelling) which form the linchpin in many SBS convictions. Most SBS experts frequently testify that the excessive shaking is  the only way that this triad could be found in a human infant. The next step in the “research” of Shaken Baby Syndrome was to assume that if such excessive force caused baboons to develop a subdural hematoma, then shaking would be enough to cause a subrudal hematoma in a human baby.

Of course, this is actually not the case at all since certain vitamin deficiencies and encephalopathy are known to cause the triad of SBS symptoms. And more and more fequently experts who believe Shaken Baby Syndrome to be a diagnosis built on a sandy foundation are testifying as much in court casses and talking about the problems with the SBS diagnosis. Other research has called SBS into question. An experiment with dummies that mimicked the size and weight of human infants with sensors attached throughout showed that shaking would not cause the type of acceleration which would produce a subdural hematoma in a human infant. Other inconsistiencies with SBS are that experts admit that bruises on the baby’s arms and torso that would normally be expected to be seen in a baby subjected to excessive force are mostly absent from SBS cases.

Frequently people accused of shaking a baby to death or brain damage have no history of violent behavior. In one cae highlight in the New York Times, the daycare worker convicted of shaking a two month old baby had cared for her own children and several others including an autistic boy and a girl with one arm without any history of violent behavior. The other daycare workers described her as a very patient and gentle person. Many cases of SBS ask us to assume that people without any history of abusive, violent or maltreatment behavior and have frequently raised their own children without any abuse suddenly shake a baby to death or brain damage out of the blue. This doesn’t mean that other injuries would not result from a shaking incident, but simply that a subdural hematoma is not necessarily the smoking gun for SBS that experts have portrayed to parents, the media and judges and juries.

SBS proponents frequently point out that the diagnosis still holds up because they have confessions from parents and caretakers as their evidence for SBS. However, these confessions frequently come from parents and caretakers  who have admitted to gently shaking a baby they have just found lying unconscious in a crib to rouse the child. Others have been told point blank by law enforcement and medical experts that the police and doctors know the accused is guilty and that he or she will no chance at acquittal in a trial since doctors and scientists will testify that there is no other way the baby could have died than at the hands of the accused. Sometimes these people are offrerd a plea bargain anfd told it is the only way they will escape a lifetime in prison. So with SBS what we have is a diagnosis built upon speculative research and bolstered by confessions of people under duress. It doesn’t take a Ph D to see that we’re looking at a fragile theory here.

So where do vaccines come into play with SBS? You’re probably thinking i’m going to tell you that vaccines cause the desth and brain damage of babies said to suffer from SBS. Ah, the ravings of a paranoid, ignorant mother who hates science. How easy it would be to dismiss this idea if it were me who came up with it. But I can’t take credit for that theory. Experts who have researched SBS and testify for defendants in SBS cases state that vaccine reactions can cause the subdural hematoma and other features associated with SBS. You could accuse them of simply saying things for financial gain, but they frequently testify at trials for reduced fees or waive their fees entirely for families with financial need.  And this isn’t coming from whale.to, it’s coming from Discover Magazine, a respected science magazine that is very pro-vaccine. (A while ago they ran an article about why people still question vaccines despite the “proven” safety and efficacy.)

What I can do is walk you through some symptoms and supporting research. The most likely culprit is a condition called encephalopathy- brain damage that can be caused by many things including DTaP and DTP vaccines. Autoimmune encephalitis is another possibility as well. Despite assertions from some in the medical community that encephalopathy is not caused by vaccines, the US government’s Health Resources and Services Administration recognizes it as a reaction to vaccines- specifically containing pertussis antigens such as DTap and DTP.

Encephalopathy:

  • Altered mental state (which can present as inattentiveness, poor judgement, lack of coordination)
  • Lethargy
  • dementia
  • seizures
  • tremors
  • muscle twitching
  • myalgia (muscle pain)
  • Cheyne-Stokes respiration (altered breathing patterns seen in cases of coma and brain damage)
  • coma

Autoimmune encephalitis:

  • Weakness/ numbness in parts of the body
  • slow speech, slurred speech or inability to speak
  • loss of balance
  • ataxia
  • involuntary movements
  • distorted vision
  • cognitve impairment
  • memory disturbance
  • decreased level of consciousness (can even become catatonic or comatose)
  • seizures (either obvious or showing up on an EEG scan)
  • partial or com[lete loss of appetite for prolonged periods
  • food and drink tasting inedible or producing nausea
  • excessive eating without feeling satiated
  • agitation
  • inability to sleep
  • loss of inhibition
  • rapid, pressured or invioluntary speech
  • visual or auidtory hallucinations or delirium
  • paranoid thoughts
  • severe anxiety

For a point of comparison, here are the symptoms of Shaken Baby Syndrome from the National Center For Shaken Baby Syndrome:

  • Lethargy / decreased muscle tone
  • Extreme irritability
  • Decreased appetite, poor feeding or vomiting for no apparent reason
  • Grab-type bruises on arms or chest are rare
  • No smiling or vocalization
  • Poor sucking or swallowing
  • Rigidity or posturing
  • Difficulty breathing
  • Seizures
  • Head or forehead appears larger than usual or soft-spot on head appears to be bulging
  • Inability to lift head
  • Inability of eyes to focus or track movement or unequal size of pupils

Hhhhhmmmm… Very similar. Also interesting to note is that the National Center for Shaken Baby Syndrome says that “Purple Crying” (prolonged periods of uncontrollable screaming which they reassure parents are completely normal) are most common at ages 2 months and 4 months. What a huge coincidence since those are also the ages babies receive their first doses of DTaP and prolonged periods of uncontrolled screaming are also a symptom of encephalitis in babies, at least that’s what the Mayo Clinic says.

So though I am not a Ph d or an MD, I still have a scientific mind and think it’s worthwhile to apply Ockhams Razor here. With most cases where someone is convicted on doctors’ testimonies of SBS, we are being asked to believe that injuries seen in adult baboons and assumed to happen to babies when shaken were inflicted by a person with no prior history of violence. The sole basis for this conviction is an “expert” testimony that there is simply no other explanation. We are also asked to dismiss the idea that encephalopathy, which is knwn to cause the same symptoms and can be caused by a vaccine reaction could be responsible. A vaccine reaction is logically the far more simple and likely explanation, but people continue to cling to Shaken Baby Syndrome. Why?

The stakes are incredibly high for proponents of Shaken Baby Syndrome. Yes there are financial stakes for pharmaceutical companies, that’s obvious. Vaccines are a huge profit center. They’re a product that is a marketers dream- every man, woman, child and animal is supposed to need them several times over a lifetime- even a few times a year- or certain death will supposedly follow. And new variations can be rolled out to an eager population excited to get the newest “life saving” product their doctors have told them about. If Shaken Baby Syndrome is dismissed as a legitimate diagnosis, it opens up the door for more attention on vaccine reactions, potentially provoking more caution and restraint from both doctors and parents in the administration of vaccines. A perfect product then becomes something that not everyone can r should get, and the profit center becomes more moderate… Like with most other products.

But the emotional stakes are arguably the highest and the strongest factor that keeps SBS proponents defending their shaky ground. For some parents, their identity has become wrapped up in being advocates for SBS awareness. The srticle from the New York Post describes a family who have a blog up detailing their experience with a baby who was diagnosed as having suffered injuries from SBS. They even wore t-shirts to their caregiver’s trial with pictures of their son at the hospital saying “This is what happens when you shake a baby.” Their story and vilification of their babysitter is certainly emotional and their grief and anger is real, but when you consider that the story they tell is based not any eyewitness account or confession but on the testimony of SBS proponents. The babysitter has she never shook or harmed their baby in any way but found him unconscious and tried to rouse him, their story becomes more unsettling.

Other parents have gotten involved with Shaken Baby Syndrome promotional materials such as the “Baby Elijah” video and Purple Crying materials. It’s completely understandable becauses it’s a way to give meaning to an unfathomable tragedy. If the SBS was actually the result of a vaccine reaction. Instead of being the victim, you’re the parent who unknowingly contributed to your child’s death or brain damage. Not a happy thought.

Medical experts have a similar problem. If Shaken Baby Syndrome is discredited, they are no longer heroes who put abusers in jail, but educated people who have built their career on pseudoscience and possibly jailed innocent parents and daycare workers. Also not a happy thought. Despite so many good intentions, shaken baby syndrome as left in is wake the shattered lives of many innocent parents and caregivers.

Of course there is an alternative. If you can’t beat them- join them. That’s what one of the SBS experts testifying for the prosecution in the Louise Woodward case did. (See the NYT article for full details). As the defense attorneys and their medical experts dismantled his arguments, he saw that Shaken Baby Syndrome was built on a shaky foundation. Today, he testifies for people who are accused of causing Shaken Baby Syndrome to save them from unjust convictions.  Parents whose babies were actually injured by a vaccine could become advocates for vaccine injury awareness. (This doesn’t mean they have to become “anti vax”, but just that they advocate for greater awareness and research into a legitimate and known but under informed problem.) Change is in the air for Shaken Baby Syndrome and with it vaccines as well.