How To Argue With Under-informed “Science” Magazines and Their Well-Intentioned Writers: A Guide

“What are we supposed to do? We’ve already funded our own research center!”- Lucky Strike Tobacco executive in “Smoke Gets In Your Eyes”, Mad Men, Episode 1, Season 1

Popular Science is an interesting name for a magazine. My understanding has always been that popularity and science don’t necessarily always go hand-in-hand. After all, some of the greatest scientific discoveries and theories have been the most unpopular (like Ignaz Semmelweiss’ research on hand washing, the heliocentric model of the solar system and the theory of evolution). So perhaps you can understand why I raise an eyebrow at a magazine that touts itself as being both scientific and popular. Indeed, it forces a choice on said publication as to where their loyalties lie. Is this publication more interested in being popular or being scientific?

The 2013 article from Popular Science seems to be much more grounded in the “popular” part of its name than the “science”. Written by Francie Diep and titled “How to Argue With The Anti-Vaccine Crazies: A Guide”, this smug little article claims to be a fact-based guide preparing people to refute common anti-vaccine questions and claims. Unfortunately, it looks at popular arguments rather than examining larger issues backed up by credible research. Quotes from the article will appear in italics. You can read the full text (which is far shorter than my analysis here) at the link above. For those of you who remember the infamous Kristen Bell post, this is another one to strap in for as I have gone to great pains to be very thorough in my research and explanation. And as always, I see new connections every time I do one of these grand dissections. I think that is what I love most about writing this blog. So here we go…

CLAIM: Historically, recommended vaccines have been shown to harm children. Why would today’s recommendations be any different?

Yes, some older vaccines had severer side effects than current ones do. I’ll look at two examples, polio and pertussis, which is commonly known as whooping cough.

No one has gotten polio from the newer polio vaccine. Before 2000, pediatricians in the U.S. routinely gave kids a polio vaccine that contained live, attenuated polio virus. Now, American kids get a vaccine with an “inactivated,” or killed, virus. Very rarely, the live virus in the older vaccine could actually revert to its natural state and cause paralysis, a tragic consequence.

Some people in the world still deal with this risk. Live, attenuated polio vaccines are used in some regions where polio is endemic because those who get the live, attenuated vaccine are able to pass on their immunity to others around them, which helps spread immunity more quickly. People are also able to take the live, attenuated vaccine by mouth, instead of in a shot, so it’s quicker and easier to get to people in regions where there are few doctors and nurses. Different countries must judge the risks and benefits of the oral polio vaccine differently; even the U.S. had once judged the live, attenuated vaccine worth the risk, when there was nothing better available.

No one has gotten polio from the newer polio vaccine.

Before the 1990s, kids in the U.S. got a pertussis vaccine with severe potential side effects ranging from fever to fainting fits. Some parents sued vaccine manufacturers, claiming that the shot caused brain damage. Scientists have since determined that the parents’ claim is unproven. U.S. doctors now use a new pertussis vaccine with milder side effects.

Of course, it’s up to everyone to decide individually whether the risks of a medicine outweigh its benefits. Consider the numbers around vaccines, though. Often, something like 1 in 1,000 kids experience moderate side effects such as prolonged crying. For more severe side effects, such as seizures or that rotavirus-caused bowel blockage, the odds go down to one in tens of thousands.

Among children who contract measles, one in 1,000 get encephalitis, an acute brain infection, and one or two in 1,000 die. In 2011, among the 18,000 Americans who got whooping cough that year, more than 1 in 2,000 died, all of them babies.

Alright, let’s get started with polio. I think we can safely assume that Diep is referring to the issue of the live virus oral poliovirus vaccine (OPV) versus inactivated poliovirus vaccine (IPV), though this article fails to actually use such precise terminology. The OPV was indeed discontinued in the US in 2000 because of vaccine acquired paralytic polio (VAPP). Diet’s assertion is  “No one has gotten polio from the newer polio vaccine.” This is an oversimplification of a much more complex issue. (First of all, the OPV and IPV were developed in a very close time frame, pretty much simultaneously, so to say that the IPV is “newer” is inaccurate.)  Provocative poliomyelitis is a medically documented condition in which polio is brought on by a surgery, intramuscular injection or other medical procedure. It was well documented to be associated with the DTP vaccination, but any type of intramuscular injection can induce provocative polio. Because of this, some countries like India actually advocate for the usage of the OPV because they feel it is safer than the risks of the provocative polio from the IPV.

Provocative polio has been well-documented to follow intramuscular injection, for further information I recommend taking a look at the 1949 J.K. Martin study titled Local Paralysis in Children After Injections,  the 1998 study by Drs. Matthias Gromeier and  Eckard Wimmer which found that injury to tissue to during certain types of injections allowed the polio virus easy access to nerve channels, thereby increasing the likelihood of paralysis and the more recent HV Wyatt study from 2003 which found that three-quarters of children with paralytic polio receive injections just before the onset of paralysis. And really, if we are going to get technical, the Salk vaccine has been documented to cause polio as in the case of the 1955 Cutter Incident. Though the general public has received a highly simplified (and not entirely accurate) account where an entirely selfless Jonas Salk eradicated polio, the controversy about which is more effective and safe, the Salk IPV or Sabin OPV has continued to be debated amongst scientists.

Live, attenuated polio vaccines are used in some regions where polio is endemic because those who get the live, attenuated vaccine are able to pass on their immunity to others around them, which helps spread immunity more quickly. Ah, the fanciful thinking of vaccine proponents attributing all sorts of powers to vaccines that don’t actually exist. It seems Ms. Diep needs a refresher in how vaccines are supposed to work. Vaccines don’t contain “immunity” and they don’t allow people to “pass immunity” to one another- that would defeat the point of mass vaccination and herd immunity which she claims to believe in later in her article. Vaccines contain live or weakened viruses or bacteria that when introduced to the body are supposed to “train” the immune system to recognize and reject the pathogens, supposedly allowing the vaccine recipient to gain immunity without actually suffering the illness. However, while you can’t “pass immunity” through the OPV, the OPV can give an immunodeficient recipient the poliovirus which they may excrete for several years, passing it to others. This is a significant issue with the worldwide eradication of polio, especially in countries with a a high number of HIV infected individuals.

You can still develop paralysis from enteroviruses other than polio. Since polio is said to be eliminated from the United States, these types of enteroviruses are called non-polio enteroviruses. The CDC states that these viruses (often manifesting as cold-like illnesses in the summer and fall) often produce no symptoms or mild symptoms, but can cause serious infection and paralysis.  Curiously enough, despite the fact that so-called non-polio enteroviruses can potentially cause the same serious effects as polio, there is no vaccine for them and in fact the CDC recommends hand washing and good hygiene to prevent transmission. The United States has started seeing an increase in children with paralysis from enteroviruses as well.

Moving on to DTP vs DTaP… (Again, Diep has not specified which vaccines she is referring to, but judging by the context, it is reasonable to infer that she is referring to the whole-cell live virus diphtheria-tetanus-pertussis shot (DTP) and the inactivated virus diphtheria-tetanus-acellular pertussis shot (DTaP).) “Some parents sued vaccine manufacturers, claiming that the shot caused brain damage. Scientists have since determined that the parents’ claim is unproven. U.S. doctors now use a new pertussis vaccine with milder side effects.” 

It sounds like what Diep is referring to hear is the 1980’s controversy over SIDS and DTP, though her account glosses over some pertinent facts. During the 1970’s and 1980’s there were many complaints of death and injury regarding the DTP shot as well as the influenza vaccine and OPV. In 1980, the Office of Technology Assessment was asked by the House Interstate and Foreign Commerce Committee to put together a memorandum on the possibility of a federally funded vaccine injury compensation program. This is a very interesting read and highly informative. The full memorandum can be found here.

From the OTA:

“As there is no one ‘at fault’ for these reactions, the injured vaccinee would not be able to successfully sue the manufacturer, doctor, or other defendant in a lawsuit based on negligence; e.g., faulty manufacturing of the vaccine such that it was contaminated, or faulty vaccination such that a nerve was damaged by the injection. However, the courts have developed a legal basis for a potentially successful lawsuit in the doctrines of ‘informed consent’ and (1) the ‘duty to warn.’ l)a person about to be vaccinated should be given a clear explanation of the benefits of vaccination and of the potential side-effects that might occur; and (2) someone in the chain from manufacturer to purchaser (such as a state or federal health agency) to the person who administers the vaccine bears the responsibility to give that explanation.

There has been considerable difficulty in determining what constitutes an adequate warning and whether or not a truly informed decision had been made to be vaccinated (the ultimate test of whether the condition had been satisfied takes place by hindsight in a lawsuit, when the injury has already occurred and the answer is crucial to the success or failure of the lawsuit). Furthermore, ‘informed consent’ and the ‘duty to warn’ imply that the potential vaccinee can refuse the vaccination, but almost all states require that children receive certain vaccinations as a condition of attending school.”

So there are legal grounds for suits that can apply to vaccines because people may not be fully informed of the actual benefits and risks associated with vaccines and because in many cases people are legally required to receive vaccines- and more states are limiting options to refuse for things like school or employment. Along with these legal grounds for suit, people can and have successfully sued in court for vaccine injury.

From the OTA:

The report noted that in three major cases in the past 11 years, plaintiffs have won large judgments against vaccine manufacturers for injuries caused by non-defective and properly administered vaccines. The resulting uncertainty for manufacturers has affected their willingness to produce and supply vaccines.” Note that the vaccines didn’t necessarily have to be defective or improperly administered to cause a serious injury- which implies that some aspect of vaccines or the process of vaccination is inherently risky. However, the belief that vaccines were an essential part of maintaining public health overrules any questions about whether we should be implementing mass vaccination programs.

In the late 1980’s, the US government instituted the Vaccine Injury Compensation Program administered through the Health Resources and Services Administration, a federal public health agency. In the HRSA’s own words, the purpose of the VICP is as follows:

“The National Childhood Vaccine Injury Act of 1986 (PDF), as amended, created the National Vaccine Injury Compensation Program (VICP), a no-fault alternative to the traditional tort system. It provides compensation to people found to be injured by certain vaccines. Even in cases in which such a finding is not made, petitioners may receive compensation through a settlement.

The VICP was established after lawsuits against vaccine manufacturers and healthcare providers threatened to cause vaccine shortages and reduce vaccination rates. The Program began accepting petitions (also called claims) in 1988.”

Now back to DTP specifically. As of 1988, 3,982 petitions have been filed about the DTP vaccine. 3,286 petitions were for injury and 696 were for deaths. 1,273 were compensated and 2,706 were dismissed. Compensation does not mean an admission of guilt that the vaccine caused the injury, often it can mean simply that a negotiated settlement was reached, often with a desire to avoid the cost and expense of litigating a case. The government just pays people to make the problem of vaccine lawsuits go away and is doing it now more than ever. DTP still holds the VICP record for most claims filed, though influenza vaccines are catching up and slightly more compensations have been made for influenza vaccines than DTP at this point.

On to the issue that scientists have now proven parents’ claims of death and injury to be unproven. In the late 1980’s several studies started coming out in response to claims that DTP caused SIDS. Dr. James Cherry of UCLA was at the forefront of the movement to discredit a relationship between the two and has since participated in many other studies and works advocating the further need for use and continued to development of the pertussis vaccine. There is one possible problem with Dr. Cherry though. He has a substantial conflict of interest because he has served as a consultant for GlaxoKlineSmith Biologicals and Sanofi Pasteur for pertussis vaccines. Another article he worked on contains this financial disclosure: “Dr. Cherry has given talks in programs supported directly and through program grants by Sanofipasteur and GlaxoSmithKline. Dr Cherry has consulted about pertussis vaccines with Sanofipasteur and GlaxoSmithKline.” Interestingly enough, Andrew Wakefield has been roundly condemned for conflicts of interest, though that argument has not been seen as a legitimate reason for questioning the research of scientists like Dr. Cherry. As for the infants who die from pertussis, the numbers are not in dispute, but the ability of the pertussis vaccine to actually prevent the spread of the disease is highly debatable and will be addressed later on herein.

On to measles. Measles has become kind of a “boogeyman” that lurks in the closet. The reality is that before the measles vaccine was introduced, people were probably less afraid of it than they are now and that we have far more deadly threats than measles in the 21st century that don’t get nearly as much media attention. The 1953 report from the office of Vital Statistics shows that measles deaths were approximately 13 per 100,000 in 1918 for an estimated population of 103, 208,000. But by by 1950, measles deaths had fallen far below 1 in 100,000. This report states that while infectious diseases like diphtheria, measles and whooping cough were responsible for 242.6 per 100,000 deaths in children under 15 in the early twentieth century, by 1950 these diseases combined accounted for only 5 deaths per 100,000 for children under 15. Take note that the measles vaccine was not introduced until 1963. (MMR became available in 1971  and the DTP vaccine started mass usage in 1948.) Ironically enough, this report is glowing with optimism about the state of health in America, while we perceive this to be a time of rampant disease and death.

The CDC’s official statement on measles reads: “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.” So by the CDC’s standard, 450 deaths and 4,000 cases of an illness is a serious public health impact. How does this compare with other causes of death today? According to the American Cancer Society, an estimated 15,780 children will be diagnosed with cancer this year and 1,960 children will die from cancer. Most of these childhood cancer cases will be leukemia, brain and nervous system cancers, and lymphoma. Much has been said about the great burden and cost that fighting measles would entail if the disease was to become endemic, but cancer is already far more common and far more costly to treat. Here’s another example. According to the CDC, in 2013 2 million people developed antibiotic resistant bacterial infections and 23,000 died as a result of an antibiotic resistant bacterial infection.   That’s far in excess of the numbers the CDC cites for measles death before the vaccine was introduced!

While we praise the lower rates of measles cases today (which can be disputed as well, we’ll get to that in a minute), the actual death rate from measles has actually increased since the mid-twentieth century. In 1912, the case fatality rate for measles in the United States was 25 per 1,000 and 30-40 per 1,000 in Scotland at the beginning of the 20th century. Those numbers declined to approximately 1 per 1,000 in the United States and the United Kingdom by the mid 20th century. Today the mortality rate for measles in approximately 3 per 1,000. The authors state: “This increase is most likely due to more complete reporting of measles as a cause of death, HIV infections, and a higher proportion of cases among preschool-aged children and adults.”

Better reporting could be debatable (again we’ll get to non-classical measles in a minute), though the emergence of HIV certainly added a new variable to the measles equation that had not been seen before. The other interesting thing is the higher proportion of cases among children under 5 and adults. If you check out Table 2 of this study, it will show you the rates of complications for measles cases between 1987 and 2000 by age group. As you can see, school age children (the group most likely to get measles before routine measles vaccination) are actually the least likely to suffer complications. However, children under 5 and adults have a greater risk for complications, with adults over 30 having the greatest risk for severe complications like encephalitis and death. In our haste to prevent the spread of measles in our schools, we have overlooked the fact that school age children as a group have the fewest complications for measles and if they do contract the virus they gain lifelong immunity. Instead, when the measles vaccination does grant temporary immunity to children, it can leave them open to measles as adults when they are more prone to serious complications.

CLAIM: It is dangerous for little babies to get so many vaccines at one time. The immune system can get overwhelmed.

Babies really do get a lot of vaccines at once. Their first round alone includes six shots. And the list of recommended childhood vaccines has grown in recent decades, as researchers have developed more and more immunizations.

States with lenient policies about immunization exemptions had 90 percent more whooping cough cases than stricter states.However, numerous studieshave found no link between getting the recommended schedule of vaccines and getting other diseases later in childhood. There’s no credible scientific evidence that vaccines are able to “overload” babies’ immune systems. Though immature, babies’ systems are prepared to handle vaccines. They already handle numerous viruses and bacteria all around them in everyday life.

The U.S. Centers for Disease Control and Prevention recommend vaccines at very young ages because that’s when kids are the most vulnerable, as some of the natural immunization they got from breastfeeding fades.

“States with lenient policies about immunization exemptions had 90 percent more whooping cough cases than stricter states.” Now this is an interesting claim since the pertussis vaccine has had a number of problems with efficacy.

However, numerous studieshave found no link between getting the recommended schedule of vaccines and getting other diseases later in childhood. There’s no credible scientific evidence that vaccines are able to “overload” babies’ immune systems.

Now there were a couple of interesting things here. The study about how there are no cognitive delays in fully vaccinated versus children who do not meet the definition of fully vaccinated has a couple of questionable things about it. First of all is the financial disclosure : “Drs Smith and Woods are or have been unfunded subinvestigators for cross-coverage purposes on vaccine clinical trials for which their colleagues receive funding from Wyeth, Sanofi Pasteur, GSK, MedImmune, and Novartis; and Dr Woods has received honoraria for speaking engagements from Merck, Sanofi Pasteur, Pfizer, and MedImmune and has received research funding from Wyeth and Sanofi Pasteur.” So again, it’s something to consider. If we’re uncomfortable accepting research about autism and vaccination from someone who has financial conflicts of interest, in the nature of scientific inquiry, we should be willing to apply a similar standard to research that supports vaccination.

Another potential problem with this study is what is referred to as “confounding” in statistics. If you read the full text of the study, it states: “Children with later vaccine receipt had lower family household incomes in both analyses, although all groups averaged well above the poverty level. They also had lower percentages of mothers with college degrees. Finally, there were greater proportions of male children and single-parent households in the less timely groups. These differences did not reach statistical significance in the primary analyses of timely versus untimely receipt but did in the secondary analyses of most timely versus least timely receipt.” (Quick note: the term “statistical significance” means that after doing a set of calculations you can determine whether or not a particular result is due to chance or “fluke”. If something is determined to be “statistically significant”, it means that the result is not due to chance. If a result does not reach statistical significance, it means that the result could be due to chance. This is a simplified version of the definition that doesn’t get into things like p values and the value of alpha, but for the purposes of understanding a study, it’s sufficient.)

So when the researchers in this study say their results did not reach statistical significance the first time, it means that the results did not indicate a strong correlation between vaccination status and cognitive function in their first analysis. But they ran a second analysis and say their results did show a strong correlation. (Which would certainly be fortunate for their interests in performing this study and getting the desired outcome.) If you take a look at Table 2, you can see that the sample sizes (value denoted as n) are different on the primary vs. secondary analysis. In the secondary analysis, the researchers compared only children classified as “most timely” and those classified as “least timely”. In certain parts of the study, the authors state that they did control for factors such as maternal education and IQ, computer experience, etc. , the multivariable analysis, but when comparing the most and least timely, there could be problems with confounding since the researchers acknowledge that there were more children in the least timely category who came from single parent homes with mothers who had lower education levels and lower incomes while more children in the most timely category had higher incomes and two parent homes with better educated parents, so if they really did just compare the most and least timely, socioeconomic factors could be responsible for the outcome in the secondary analysis. Thus, the term confounding.

Furthermore, since this study was published new vaccines and doses have been added to the American vaccine schedule so the results are less relevant with the current schedule. I wouldn’t take this study as conclusive proof that vaccination will affect your child’s cognitive abilities one way or the other. There may have been some “massaging” of the data that in my mind makes it less reliable as a source. Now that I’ve flogged that one to death, let’s take on just one more of the safety studies cited in this article…

The 2001 study by Destefano, Mullooly, Okoro, et. al. in Pediatrics concerns the timing of vaccine as a possible risk factor for developing type 1 diabetes mellitus (formerly known as juvenile diabetes). The article links off to an abstract of this study, but with a little digging, you can find the full text. The authors claim to be looking at the hepatitis B and Haemophilus influenzae B vaccines specifically, though the study gives results for several other vaccines including whole cell and acellular pertussis vaccines, MMR and varicella. There are a couple of interesting things going on with this study. One has to do with cases and controls. This is a case-control study, meaning that the study compares people with the disease or outcome (cases) with those who do not have the disease or outcome (controls or referent). This study is a little hazy about what they actually qualify as a control. In the case of Hepatitis B vaccination, those who had never been vaccinated for Hepatitis B were used as the referent. (We can assume that all the children had received at least some vaccines as the study later states that all the cases and controls had received the MMR vaccine.) The referent switches on the data for Hib vaccination to children who had received 3 doses by 8 months plus 1 dose at 12–18 months. Referents are not specified for either of the pertussis vaccines, MMR or varicella. (It seems it would be difficult to come up with a referent for MMR since all the children in this study had received the shot.) A big weakness that I see in this study is that half of the cases were born between 1988 and 1990, meaning that they were on a vaccine schedule with fewer vaccines than the children in the study who were born between 1991-1997.

CLAIM: Vaccines have dangerous ingredients in them.

One of McCarthy’s–and other vaccine opponents’–most popular claims is that thimerosal, a mercury-based preservative once common in vaccines, causes autism. There’s so much evidence showing thimerosal doesn’t cause autism.

Nevertheless, thimerosal no longer appears in any vaccines except influenza because an infant receiving the recommended schedule of old vaccines would get a higher-than-recommended dose of mercury, which is toxic in high levels.

The Children’s Hospital of Philadelphia has more information on the ingredients in vaccines. They are not dangerous.

Thimerosal may be dubious. Personally, I think it’s possible that the symptoms described by many parents like Jenny McCarthy might be due to encephalitis- which is a legitimately acknowledged side effect of live virus vaccines. The Merck Manual Home Edition states that autoimmune encephalitis can be caused when “A virus or vaccine triggers a reaction that makes the immune system attack brain tissue (an autoimmune reaction).”  (I consider the Merck Manual to be a reliable source of information, do you?) If you would like a second opinion, the Mayo Clinic’s website states: “Secondary encephalitis often occurs two to three weeks after the initial infection. Rarely, secondary encephalitis occurs as a complication of a live virus vaccination.”

Now getting into the actual link cited here, the page was written by Dr. Paul Offit. He is one of the developers of the Rotateq vaccine and has gotten a great deal of media attention lately from news articles applauding his hard line stance against parents who want to selective/delay vaccinate or not vaccinate at all and from his involvement with the PBS documentary “The War on Vaccines”. Despite his claims that alternative medicine and figures like Dr. Sears take advantage of parents’ feelings and media attention, Dr. Offit receives the same kind of attention and it has made him (and the Rotateq vaccine) more and more prominent. Frankly, I don’t find him a credible authority on vaccines because of the following:

  • A tendency to overdramatize- 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.” (And by the way, heart disease causes even more deaths in the United States annually than cancer does.) And here is Dr. Offit trying to convince us that measles will be a serious health impact?! But remember it’s extremely important for his Rotateq vaccine and his position as vaccine developer and expert that parents and pediatricians not question the current vaccine schedule and believe that death and destruction will  follow from not vaccinating. If parents start questioning which vaccines are necessary, rotavirus will probably be one of the first on the chopping block because it’s extremely rare for a child in a developed country to actually die from the disease and all of us grew up just fine without it. And if we start questioning that, then we start asking about why we need to vaccinate for chickenpox (which was a mild illness when we were growing up and not a cause for concern), and then we’ll start questioning measles and mumps (which were considered mild illnesses when our parents were growing up and not a cause for concern). Pretty soon, the entire vaccine industry would be losing a lot of money. So yes, characterizing measles as “Russian roulette” is not an accurate representation and instead sells parents and healthcare providers an inaccurate picture of risks that favors Dr. Offit’s interests.

    Bigotry- If you’re on the right side of the debate (the side that believes vaccines are the answer and the more the better), you are rational and well-informed and without any competing interests. If you don’t vaccinate or selective/delay vaccinate or support such decisions, you are selfish, ignorant and have ulterior motives, based on attention or profit. He claims it doesn’t matter that he has a profit interest in vaccines, because his vaccine works. Dr. Offit claims in his interview 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 prejudice in reverse. PBS should be ashamed to be disseminating such bigotry, but they don’t seem to be able to pull their heads out and see this sort of “snow job” for the prejudice it is, they’re simply too set in the mindset that we must vaccinate or die to see anything else. But remember folks, when people were protesting on the steps of Little Rock High School about integration, they weren’t doing it because they considered themselves ignorant, prejudiced, bigoted, uninformed or hateful. They were doing it because they believed integration to be a genuine threat to their children’s health and safety and could point to research showing that people from other ethnicities were inferior to back up their stance. That’s the great thing about bigotry. It’s easy to see it in other decades and places, but not in our time and place.

    Can he even get his facts straight? I was not impressed with his scare story of a pertussis outbreak in Delaware and I’m a little suspicious of whether he is even presenting accurate facts on this incident. 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. 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, as noted above.

    And the things he won’t tell you about his Rotateq vaccine from the Clinical Microbiology Reviews

Rotateq: “Diarrhea and vomiting occurred more frequently among vaccine recipients than among placebo recipients. The efficacy of RotaTeq was evaluated in two phase III trials (1085). In these trials, the efficacy of RotaTeq against rotavirus gastroenteritis of any severity after completion of a three-dose regimen was 74%, and that against severe rotavirus gastroenteritis was 98%. RotaTeq also proved to be strongly efficacious in preventing rotavirus gastroenteritis of any severity caused by the predominant G1 serotype (75% efficacy) and the G2 serotype (63% efficacy). There was a trend toward efficacy for the remaining serotypes, but patient numbers were too small to show statistical significance (83% efficacy for G3, 48% efficacy for G4, and 65% efficacy for G9). The efficacy of RotaTeq in reducing the number of office visits for rotavirus gastroenteritis and in reducing the number of emergency department visits and hospitalizations for rotavirus gastroenteritis was evaluated in a large study. (85). The efficacy of RotaTeq in reducing the number of office visits for rotavirus gastroenteritis among 5,673 subjects and in reducing the number of emergency department visits and hospitalizations for rotavirus gastroenteritis among 68,038 subjects over the first 2 years of life was evaluated. RotaTeq reduced the incidence of office visits by 86%, emergency department visits by 94%, and hospitalizations for rotavirus gastroenteritis by 96%. Efficacy against all gastroenteritis hospitalizations of any etiology was 59%. The efficacy of RotaTeq in the second rotavirus season after immunization was 63% against rotavirus gastroenteritis of any severity and 88% against severe rotavirus gastroenteritis.”

In other words:

  • Children who receive the Rotateq vaccine may be sick with diarrhea and vomiting more frequently than those who do not.
  • Success rate for Rotateq is largely concerned with reducing office and emergency visits, not necessarily preventing actual rotavirus infections.
  • The Rotateq vaccine protects against particular strains of rotavirus. Its efficacy against other strains has not been determined with certainty.
  • Efficacy of Rotateq against all rotavirus infections of any severity is below 80%- nowhere near enough to establish herd immunity- a concept that Dr. Offit actively promotes.
  • The efficacy of Rotateq diminishes over time.

So, no, I’m not too confident in anything Dr. Offit has to say about vaccination.

Aside from Dr. Offit, I personally think there are some interesting issues with vaccine excipients that still are worth studying beyond thimerosal.  For example:

Adjuvants are the other chemicals frequently found in vaccines.

FAQ’s from the CDC about vaccine safety say that adjuvants are put in vaccines “to enhance the immune response of vaccinated individuals”. However, if you dig around in immunology literature, you’ll find a few more interesting details about adjuvants.

Let’s start with immunologist Charles Janeway. Janeway did a significant amount of research into what he called “the immunologist’s dirty little secret”– that the presence of foreign antigens alone are often not enough to elicit a response from the immune system. In fact, it has been well known amongst immunologists for a long time that the presence of bacteria and viruses is often not enough to induce a response from the immune system. This is why scientists routinely add substances like mineral oil, bovine serum albumin and mineral salts like aluminum hydroxide to their experiments to get a reaction from the immune system.

So while we’ve been told that vaccines work by imitating an infection which then leaves the body with T- and B-lymphoctes which tell it how to fight the infection in the future, it’s not the bacteria or viruses that are causing the immune reaction, it’s the adjuvants.

Adjuvants are responsible for many of the reactions to vaccines. Table 5 from Edelman’s section on adjuvants in Vaccine Adjuvants: Preparation Methods and Research Protocols details the “Real and Theoretical Risks of Vaccine Adjuvants” which include:

  • Local or acute chronic inflammation with formation of painful abcesses, persistent nodules or draining lymphadenopathy (enlargement of the lymph nodes typically associated with cancer or infection).
  • Flu-like illness with fever
  • Anaphylaxis (a whole body allergic reaction)
  • Chemical toxicity to tissues or organs
  • autoimmune arthritis, amyloidosis, (a condition in which abnormal protein buildup is deposited in an organ of the body) anterior uveitis (inflammation of the eye which can ultimately cause blindness).
  • Cross reactions with human tissue antigens causing glomurelonephritis (inflammation of the filters in the kidneys) or meningoencephalitis (inflammation of the brian and meninges that can result in speech and motor impairment, epilepsy and intellectual deficits; ironically, vaccination is often recommended as a way to prevent encephalitis and meningoencephalitis.)
  • Immune suppression (Aren’t vaccines supposed to enhance, the immune system, not compromise it? If they’re suppressing the immune system, then what’s the point?)
  • Carcinogenesis (See my post on cancer and vaccines.)
  • Teratogenesis (causes birth defects) or abortogenesis (causes abortion or miscarriage).
  • Spread of a live vectored vaccine to the environment.

Edelman doesn’t care to explicitly state which of these risks are “real” and which are “theoretical”.

CLAIM: It’s not like a parent’s decision not to vaccinate his child harms other kids.

Vaccinated kids generally won’t get sick from the preventable diseases that they’ve been inoculated against. However, if a non-vaccinated kid gets sick with a preventable disease, there are still several people he may infect beyond non-vaccinated classmates.

What do you consider “generally won’t get sick”? Is this what you consider “generally won’t get sick”?

Which one of these examples do you feel fits the description of “generally won’t get sick”?

He may infect babies that haven’t yet been scheduled to receive their vaccines. He may also infect the small percentage of kids for whom their immunizations don’t work, as immunizations aren’t 100 percent effective. The measles vaccine, for example, is more than 95 percent effective—very good, but not perfect.

Well, the CDC tells a very different story than respected vaccinologist Dr. Gregory Poland. To quote the article referenced: “Dr. Poland is no vaccine denier. Not only is he among the harshest and most outspoken critics of the ‘irrationality of the antivaccinationists,’ he is also one of the strongest proponents for vaccines and the good that they can do. As Professor of Medicine and founder and leader of Mayo Clinic’s Vaccine Research Group, one of the world’s largest vaccine research organizations; as editor-in-chief of the peer-reviewed scientific journal, Vaccine; as recipient of numerous awards; as chair of vaccine data monitoring committees for pharmaceutical giant Merck; as patent holder in various vaccines processes; as someone who enjoys special employee status with the Centers for Disease Control and the U.S. Department of Defense and as someone who has sat on every federal committee that has dealt with vaccines, no one can accuse him of seeing vaccines from a narrow perspective.”

Dr. Poland has stated that the MMR shot is not effective at preventing measles on a wide scale. He says that the MMR vaccine is far less effective than anticipated and that immunity from it quickly wanes. To quote again: “During the 1989-1991 U.S. outbreaks, 20 per cent to 40 per cent of those affected had received one to two doses. In a 2011 outbreak in Canada, “over 50 per cent of the 98 individuals had received two doses of measles vaccine… People’s failure to get vaccinated is deplorable, Dr. Poland often stresses. But the more fundamental problem stems from the vaccine being less effective in real life than predicted, with a too-high failure rate — between 2 per cent and 10 per cent don’t develop expected antibodies after receiving the recommended two shots. Because different people have different genetic makeups, the vaccine is simply a dud in many, failing to provide the protection they think they’ve acquired. To make matters worse, even when the vaccine takes, the protection quickly wanes, making it unrealistic to achieve the 95 per cent-plus level of immunity in the general population thought necessary to protect public health. For example, 9 per cent of children having two doses of the vaccine, as public health authorities now recommend, will have lost their immunity after just seven and a half years. As more time passes, more lose their immunity. ‘This leads to a paradoxical situation whereby measles in highly immunized societies occurs primarily among those previously immunized,’ Dr. Poland stated.”

And just like pertussis, vaccinated individuals can contract measles and not present with classical measles symptoms and may not be detected by tests for typical wild measles cases. And this isn’t coming from some “natural news” site, it’s coming from the 2009 Journal of Infectious Diseases. It contains an article about nonclassical measles in two fully vaccinated physicians which can be found here. It discusses a number of aspects of the disease eradication program and the role of vaccination. Little is really known about the full impact of modified/nonclassical measles because it is rarely given any consideration as a diagnosis and remains a little researched subject.  “To complicate matters, nonclassic cases of measles in vaccinated persons may be identified, which must be investigated. Often the symptoms are mild and resolve rapidly and, outside of the context of an outbreak or known exposure to a measles case patient, the nonclassic presentation might not raise suspicion of measles.” Also discusses the role of the lack of wild measles virus on the disease: “… the rate of nonclassic infection is likely to increase as measles control improves in a population, because boosting from exposure to wild-type measles virus will be rare. ” (In other words, the wild virus primes the immune system and if eliminated will not be present to “remind” the immune system of what it is supposed to be fighting.) Also discusses difficulties with detecting cases of nonclassical measles in vaccinated individuals because the usual IgM method used for measles diagnosis confirmation is unreliable in nonclassical cases.

Since the publication of that article in 2009, a 2011 outbreak of measles in New York was traced to a woman who was fully vaccinated. So while the media, the healthcare profession and this “science” magazine are implicating non-vaccinated individuals as ignorant specimens of humanity passing around horrendous diseases, we know that fully vaccinated individuals can contract non-typical forms of so-called “vaccine preventable diseases” and pass them on to others. Unfortunately, we don’t know the full public health impact of it because it isn’t being studied widely and most of the time individuals aren’t being tested for these diseases if they are up to date on their vaccines.

CLAIM: There’s nothing wrong with spacing out my child’s vaccines, if I want to.

Delaying a vaccine just means there’s that much longer a window for an unimmunized child to get sick. Limiting the number of doctor’s visits children need to get all their shots also helps more families stick to the recommended schedule and reduces the costs of vaccination.

“A longer window for an unimmunized child to get sick.” Well let’s talk about long windows for getting sick and the consequences. If you take above cited statistics on the measles, for example, the highest rates of morbidity and mortality are not in children, but adults- which is why developing the measles as a school age child and then having life long immunity could actually be more ideal from a health perspective. We actually do things backwards where we are immunizing school age children and then leaving them open to future infection as adults when the stakes are actually higher. The same actually goes for many other diseases like rubella and chicken pox (pregnancy complications) and mumps (infection to testicles in adolescent boys). A better strategy might actually be to forego vaccinating children for these diseases and vaccinate adults and teens who do not have demonstrated immunity through blood titers test.

How about the flu? What window of time applies to flu vaccination? Recently the flu mist vaccine was found to be almost completely ineffective against influenza after being the recommended choice for children for several years and after several studies from the manufacturer which pointed to it being highly effective. (The manufacturer stands by its studies even though real world observations have proven otherwise, prompting its downgrade from preferred method for children). And even when flu vaccines do work against the strains contained in them, they don’t work against other strains.

And side note: This article claims that vaccines just aren’t profitable for pharmaceutical companies to research and produce.  Let’s just take a quick look at that. Bringing up our dear friend Dr. Offit, he wrote an article in 2005 saying that vaccines aren’t profitable and predicting dire consequences from a lack of vaccine development, and in the past eleven years several new vaccines have some how made it into the regular rotation for children, adults of all ages and pregnant women. And while there are plenty of news articles out claiming otherwise, there are other voices from the medical and pharmaceutical fields saying the opposite:

“But the economics of this landscape are changing. The once low-margin vaccine market now includes blockbuster and megablockbuster products. Optimism over new candidates — including some for cancers, human immunodeficiency virus (HIV), and adult influenza — has led to expectations of healthy growth. Economists at the World Health Organization (WHO) report that the market has been growing at 10–15% annually, compared with 5–7% growth for other pharmaceutical segments, since 2000. That growth is expected to continue at 8% or better through 2018, reaching almost US$100 billion by 2025 (23). And some signs indicate that vaccine players may be narrowing their focus to a few areas (e.g., biosimilars) to reduce competition. Thus, an examination of the industry value chains reveals significant bottom-line potential.”- BioProcess International

“One of the new vaccines Gavi is tasked with introducing is the pneumonia vaccine (PCV), which aims to combat a major childhood killer in developing countries. A dramatic 37 per cent (or US$2.8 billion) of the total amount raised for Gavi last week from taxpayers and private foundations will go to pay for just this one high-priced vaccine, which today is produced by only two pharmaceutical giants: GlaxoSmithKline and Pfizer. The two companies have made more than US$19 billion in sales off of the vaccine since its launch, yet still charge developing countries unaffordable and unsustainable prices. It’s important to point out that this vaccine was initially developed for children in wealthy countries, and its research and development costs have long been recovered.” –Stephen Cornish, Executive Director of Doctors Without Borders, Huffington Post Canada

One of my personal favorites though was actress Kristen Bell’s Huffington Post article in which she claimed that vaccines weren’t profitable and used a link to an article in The Atlantic titled “Vaccines Are Profitable. So What?” to support her claim. (Bless her heart, I do believe that Ms. Bell has the best of intentions and cares very much about making the world a better place. And yes, I enjoyed Frozen just as much as the next person.)

Going further into the flu, is it really the flu that kills or other accompanying complications? Take for example NBC’s account of a previously healthy teen athlete who supposedly died from the flu within days with no prior history of health problems. There is something very subtle going on with this article if you take a good look at it. They keep focusing you over and over again on the flu and the flu vaccine, but they mention that the boy had been diagnosed with a MRSA (methicillin resisitant staphylococcus aureus) infection and that he went into organ failure. MRSA is a nasty bacterial infection that can and does cause death by infecting the bloodstream (MRSA sepsis) and organs like the lung and heart. And it often seems like the flu at first. According to the Mayo Clinic, athletes who play contact sports are at an increased risk of contracting MRSA.

So while this boy did have influenza and he did die very suddenly and his family has focused on his story for flu shot awareness, clinically speaking, there is a very good possibility that MRSA contributed substantially to his death- even though the article keeps deflecting the issue. (For another account of a previously healthy teenage boy who contracted MRSA through contact sports and then started experiencing flu-like symptoms, see this article here from the University of Maryland Medical Center. Fortunately, this boy’s condition was found to be MRSA infection in enough time to save him, though he spent 59 days in pediatric intensive care fighting organ failure.) The family’s reaction is completely understandable. They have experienced a living nightmare and are trying to find a way to put their lives together after a tragedy. But unfortunately, there is no flu shot that can protect against MRSA. And for a further investigation into how flu deaths are even being tallied, see my flu post here. So whether you choose to get the flu shot or not, you’re not looking at some sort window of protection.

How about Hepatitis B? Does the window of infection for that one really start at birth for babies whose mothers are negative for the disease? Because statitiscally speaking, the chances of a baby contracting hepatitis B from a low-risk mother are negligible. For a more in-depth explanation of Hepatitis B risks, see my post here.

 

Beyond that, however, there’s little evidence about which alternative schedules of vaccinations is best and whether alternative schedules are better or worse than the standard schedule. The standard schedule has been studied because the vast majority of U.S. kids get it, but alternative schedules are pretty new and several different alternatives exist, so they are difficult to study. The Institute of Medicine is trying to figure out whether a study of alternative schedules is feasible.

Some delayed schedules celebrities (and celebrity doctors) have endorsed leave out some vaccinations altogether, which leave kids vulnerable to those diseases.

Well it’s not like the APA’s schedule is the gold standard either, for that matter. Many other countries follow different schedules and we don’t label these countries as a whole to be “anti-vaccine”. They all have reasons with research for the type of schedule they employ. And for that matter, adding more vaccines isn’t proof positive of lower childhood mortality either.

You can take a look at vaccine schedules from other countries like  IcelandSingaporeGreat Britain and even our neighbor to the north Canada and see that they don’t give as many vaccines as we do. For example, Great Britain does not routinely give a varicella, hepatitis A or rotavirus vaccine, nor does Singapore. Iceland doesn’t routinely give out vaccines for hepatitis A or B, rotavirus, varicella or Human Papilloma Virus. In Canada, the vaccination schedules vary from province to province and in some provinces the rotavirus vaccine is not publicly funded. And guess what? Children are still very healthy in these nations. For a quick measuring stick, let’s take under 1 year infant mortality rates from the CIA fact book: the US ranks 167th for infant mortality, the UK 187th, Singapore is 221st, and Iceland ranks 223rd. (Lower is better, it means there are fewer deaths in a given year per 1,000 live births, e.g. Iceland has 2.06 deaths per 1,000 live births and the US has 5.87 deaths per 1,000 live births. This isn’t a perfect indicator since it includes deaths due to birthing practices. It gives an indicator of the overall state of health of children under 1 year. However, a great many vaccines are administered to children under 1 year because this is when they are supposed to be the most susceptible to many diseases- which is the argument against delayed vaccination schedules.)

CLAIM: Every medicine has side effects, and I want to protect my kids.

It’s always important to know about side effects before deciding to give your kid a vaccine or another medicine.

Most of the side effects of vaccines are mild compared to the illnesses they prevent. Different vaccines may cause temporary fussiness, swelling, prolonged crying and other effects. Some babies get mild vomiting and diarrhea after the DTaP and rotavirus vaccines. (We fully acknowledge that what doctors call “mild vomiting and diarrhea” is not fun to have to take care of.)

Very rarely, kids may be severely allergic to a vaccine. Allergic reactions generally occur within hours of getting a shot. The reaction may be bad enough that a kid can’t get the rest of the shots in that series, which means he or she will have to rely on other kids being vaccinated to protect him from that disease.

1 in 20,000 to 1 in 100,000 babies who get the rotavirus vaccine get a serious bowel blockage for which they have to visit the hospital. Some will need surgery.

This isn’t an exhaustive list of the potential side effects of different vaccines, though I’ve tried to cover the most severe ones. You can find out more from the Centers for Disease Control and Prevention.

Well, we’re in the home stretch here folks. Let’s talk about side effects. We’re used to hearing extravagantly large numbers for vaccine side effects 1 in 4,000,000 and the like. The thing is, these rates are typically based on two variables: the number of doses of vaccines manufactured and the number of incidents reported as vaccine reactions. Let’s talk about the first variable, the number of doses manufactured. Not every dose of vaccine that is manufactured is actually administered. Obviously a vaccine can’t cause a reaction unless it is administered, so counting doses manufactured doesn’t give an accurate picture. In 1980, the Office of Technology Assessment was asked by the House Interstate and Foreign Commerce Committee to put together a memorandum on the possibility of a vaccine injury compensation program. This is a very interesting read and highly informative. The full memorandum can be found here.

From the OTA: “Estimating the number of serious adverse vaccine reactions that occur annually in the United States cannot be accomplished with absolute certainty. There are conflicting incidence estimates for the various adverse reactions, and no one really knows how many doses of vaccine are actually administered (versus distributed) annually, particularly by private physicians. An often-used conservative rule of thumb is to estimte one-fourth wastage.” Current (last updated July 1, 2016) charts from the VICP simply use the number of doses administered between January 1, 2006 and December 31, 2014 simply use the number of doses distributed according to the CDC.

The second variable is how many incidents are actually attributed to vaccine reactions. I think it is entirely possible that there is a bias on the part of physicians. They have heard that vaccine reactions, especially disabling ones or death are so incredibly rare that it is extremely unlikely that they would ever see one. So, I think it is possible that many vaccine reactions are misdiagnosed as other conditions with similar symptoms. For example, encephalitis is a known side effect of live virus vaccines, though the symptoms of disability resulting from encephalitis can be very similar to those of autism. In another example, Guillain-Barre Syndrome could be mistaken for multiple sclerosis. The above cited article on autoimmune encephalitis says that the condition often looks very much like multiple sclerosis.

Underreporting is a possibility. An interesting letter from a New York pediatrician to the British Medical Journal brought up the possibility of underreporting with an example of Kawasaki Disease and Rotateq (which I did not plan): “During the 18-year period from 1990 through 2007 just 88 cases of Kawasaki Disease in children under 5 were reported to VAERS. During the same period about 88 million U.S. children passed through the 0-5 age group; consequently the incidence rate reported to VAERS was 0.10 KD cases per 100,000 person-years. (Pediatr Infect Dis J 28:943, 2009) From 1988 to 2006 the published KD incidence for U.S. children under 5 rose from 11.0 to 20.8 per 100,000 person-years. (Pediatrics 111:448, 2003. Pediatrics 112:495, 2003. Pediatr Infect Dis J 29:483, 2010) Even for infants 3-6 months old, when suspicion for vaccine adverse effects should be especially high, KD incidence as reported to VAERS was 0.11 while published background rates were 23.1 (2000) and 24.6 (2006); fewer than 1 in 200 KD cases were reported to VAERS. It is bewildering, therefore, to learn that FDA and CDC officials used VAERS data to dismiss a placebo-controlled trial that found a 5-fold KD risk associated with RotaTeq–RR=4.9; 95% CI 0.6, 239. (Pediatr Infect Dis J 28:943, 2009. 6/15/07.) If confirmed by a larger trial, the KD risk associated with RotaTeq would translate to an extra 4000 U.S. cases annually in young children.” So there could be misrepresentations with the calculation of vaccine adverse events.

But for an interesting experiment, let’s say that in some cases physicians encounter a vaccine adverse event and mistake it for some other similar condition. So let’s estimate that 1% of incidents of the following conditions are actually vaccine reactions. Sudden Unexpected Infant Deaths (not caused by accidental suffocation or strangulation in the bed area= 2,625 total, 1%=26). Autism spectrum disorder. (Finding an actual number of diagnoses per year- not a prevalence or percentage- is extremely difficult, so I’m left to my own devices. So we’ll take 73.6 million children ages 0-17 in 2015. Since autism case prevalence is computed based on 3-17 year olds, we’ll take half of the number of children ages 0-5 which is 23.7 million– 23.7 million/2= 11,850,000, so we’ll estimate that the number of children in the United States ages 3-17 is 73,600,000-11,850,000= 61,750,000. Autism prevalence for children ages 3-17 is placed at 2.24%, so 2.24% of 61,750,000 is 1,389,375. 1% of 1,389,375 is 13,893.75, we’ll round up to 13,894.) Multiple sclerosis (an estimated 10,000 new cases diagnosed every year in the US, 1% of 10,000 is 100) and Shaken Baby Syndrome (according to the New York State Department of Health is 1,000-3,000, so we’ll estimate 1,500 and 1% of that is 15- which may be extremely generous considering that SBS is a highly suspect diagnosis that may be attributed to vaccine adverse events very frequently.) So 26+13,894+100+15= 14,035. In 1980, the OTA placed their estimate of disabling vaccine reactions at 100-250 a year, but based on estimates such as mine above it could actually be much higher.

But for a moment let’s take all that off the table and say that the OTA’s estimate in their memorandum is completely accurate. We know that vaccines frequently have a very high failure rate and that herd immunity is more wishful thinking than actual fact. So parents have to decide whether they feel like it is worth the possibility of their child suffering a disabling condition to receive a medical procedure that can’t actually provide high level of protection for themselves or others.

Advertisements

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.

What Does It Mean When A Disease Is Declared Eliminated/Eradicated?

“This announcement might be premature in view of the unreliability of statistics in underdeveloped countries.”Noted medical historian Erwin H. Ackerknecht on the announcement of the eradication of smallpox (See page 507 of cited document.)

We’ve heard the claim before: “Vaccines have eradicated smallpox from the whole world and diseases like polio and measles from many developed nations.” But do you know what eradication or elimination of a disease really entails?

Most people think that when a disease is declared eliminated or eradicated that the virus or bacteria has become extinct in that area or the entire world- like the dodo bird or quagga. What it usually means is simply that the disease has been declared eradicated or eliminated. Allow me to explain in further detail…

The concept of disease elimination is rooted in the theory of community (herd) immunity- that a disease won’t be able to take hold in a population with high immunity- especially highly vaccinated populations. This sounds like a great idea “on paper”, but real world applications pose numerous problems. Efficacy is often far less than health organizations would like to admit. I’ve listed these well-documented cases from medical and scientific literature before, so if you would like to see them, read this post here for a good collection of cases of vaccine failure. Generally, the assumption that is made with elimination of a disease is that almost all individuals who have received the vaccine are immune to the disease and that immunity will last for very long periods of time. However, the reality of vaccine efficacy is much different.

A great example is the flu vaccine. The CDC has released a statement saying that the 2014 flu vaccine was only about 14% effective. They say it is usually more like 50-60% effective. Since herd immunity generally requires anywhere from 75-95% of a population to be immune, there is simply no way herd immunity could ever be achieved through the current influenza vaccination. Even if 100% of  eligible population were to be vaccinated, the maximum immunity would only be about 60%.

Yet another example is pertussis. A survey of nine counties in California showed that between 44 and 83 percent of individuals with pertussis had been immunized. Again, at those rates of failure even a fully vaccinated population will not result in herd immunity- especially when the threshold for community immunity for pertussis has been set at 92-95%.

And yet another example lies in measles. The Huffington Post reported on this here. Renowned vaccinologist Dr. Gregory Poland states that the MMR shot is not effective at preventing measles. He says that it is both far less effective than anticipated and that immunity from it quickly wanes. Despite all this, he also condemns in no uncertain terms those who refuse vaccination. (So you’ve told me that your solution doesn’t work, but I must still get it or I will be hurting others by not getting the ineffective solution? And yet I am dismissed as the emotional, unscientific one?) In a situation where immunity is conferred but quickly wanes, even if you had that “community-immunity-dream-come-true” where 100% of the eligible population has been vaccinated, because immunity is very brief, widespread immunity will be achieved only for short periods of time if at all.

(Penn and Teller, would you care to do a video where you explain how the above examples factor into community immunity?)

Moving on to the next issue with elimination and eradication, let’s talk about vaccines spreading disease. Yes, I can see the eye rolls now. Most dismiss this as fear mongering from people who where foil hats on their heads to prevent the government or the Illuminati or aliens from reading their minds. However, it is actually medically documented and is one of the prime reasons that we no longer vaccinate for smallpox. Page 501 of an article in the 1983 Microbiolocial Review details several cases of individuals who were vaccinated for smallpox after the disease was declared eradicated and subsequently became reservoirs for the vaccinia virus and passed it to others. Many of these cases came from military personnel who were vaccinated for smallpox and then passed the virus to other military personnel or family members such as children who then passed it to others.

And herein lies yet another problem with campaigns for eradication of a disease. The chances of any one person becoming a reservoir for pathogen is probably relatively small. But when you start having mass vaccination campaigns where many vaccines are being administered, the chances increase that someone is going to become a reservoir and start passing the disease. If there is a relatively high failure rate of the vaccine, the potential exists for several individuals to become infected even in a highly vaccinated population. This probably explains why during the smallpox eradication campaign areas that had very high levels of vaccination were still seeing cases of smallpox. (See page 491.)

But even with all these problems with eradication, smallpox was still declared eradicated. How did they do it? Well let’s take a look at the criteria for declaring smallpox eradicated. Going back to the 1983 Microbiological Review, the criteria for declaring eradication of smallpox required that no cases of smallpox had been reported within the last two years and that the country’s epidemiological surveillance system be evaluated and declared adequate by the World Health Organization (pg. 498).

Now surveillance and reporting bring up a number of interesting problems. The United States has a great surveillance system for diseases and yet not every disease is reported. (I never let the authorities know when my kids had chickenpox. There’s absolutely no incentive for me to do so since I would be met with persecution.) I know of other people who have “flown under the wire” with pertussis, chickenpox, the flu and even measles.

We have also seen that even in countries whose reporting and surveillance systems are adequate that breakdowns- or abuses can occur. Initially, rewards were offered for reporting cases of smallpox, but there came a point when a country’s health authorities didn’t want to report smallpox cases because it would interfere with gaining eradication status. Health officials in Somalia suppressed information about smallpox cases in the final months of that eradication campaign, not wanting their country to bear the stigma of being the last to harbor the virus. In a more recent occurrence, China kept information about its SARS outbreak secret.

The other problem with surveillance is that especially in vaccinated populations, diseases can frequently be asymptomatic. Modified measles is a medically documented phenomenon in which individuals who have been vaccinated for measles still contract the virus but because of the vaccine don’t display the typical the symptoms of the disease. The characteristic spots associated with measles are very frequently absent in modified measles. Most doctors aren’t very familiar with this so they won’t consider it a possibility in vaccinated individuals or test for it. A similar phenomenon called atypical measles was noted when the killed strain measles vaccine was in use. Pertussis is notorious for this. It is a medically documented fact that individuals who have been vaccinated for pertussis and contract the disease often don’t display any symptoms.

Furthermore, declaring measles eliminated is in many ways like a “self-graded” test. The WHO Regional Office for the Western Pacific (WPRO) has a set of criteria for the definition of elimination of  measles. However, their definitions have changed over the years. Originally the definition for measles elimination required zero incidence of infection within a defined geographic area. Now, measles elimination is defined as “the absence of endemic measles transmission and the lack of sustained transmission following an importation of measles virus in a large and well populated geographical area.”

Now here is where things get interesting. A report from the World Health Organization on the elimination of measles in Australia states: “Australia, like many other countries that have declared elimination, would have difficulty meeting the WPRO elimination criteria based on currently available reporting of the investigation of presumptive measles cases (Table 2, available at: http://www.who.int/bulletin/volumes/87/1/07-046375/en/index.html). However we believe multiple lines of evidence conclusively demonstrate the elimination of endemic measles transmission from Australia since 2005 at the latest.” OK, so Australia and most other countries that have declared measles eliminated haven’t actually met the WPRO’s definition of elimination, but these countries feel they have done a good job, so they can declare measles eliminated? This is the scientific basis for the elimination of measles? In fact, there is a nice little chart on the WHO’s site showing all the ways that countries that have declared elimination of measles have met and not met the WPRO’s definition for measles elimination. If you take a look at this chart, it shows that Australia has neither a low incidence of measles nor a high quality surveillance system, however, they can still declare measles eliminated within their borders.

And on top of all this are disease associated side effects with vaccination. Provocative polio is a well-documented example of this. In 1998, Drs. Matthias Gromeier and  Eckard Wimmer found that injury to tissue to during certain types of injections allowed the polio virus easy access to nerve channels, thereby increasing the likelihood of paralysis. The more recent HV Wyatt study from 2003 found that three-quarters of children with paralytic polio receive injections just before the onset of paralysis. Then there is Vaccine Acquired Paralytic Polio. According to the CDC, between 1980 and 1999 162 cases of paralytic polio were confirmed in the United States,  154 of which were VAPP.

The other major assumption with the WHO’s eradication criteria is that if no new cases are reported after two years that the disease must be gone. A similar assumption has been made with polio eradication, and yet has proved faulty.  For example, in 2004 a case of wild type 3 poliovirus in Sudan was discovered when the last case in Sudan was detected in 1999. The criterion for certification of eradication is the failure to discover wild poliovirus for at least three years in countries with certification-quality surveillance- very similar to that of smallpox eradication. Genetic sequencing of the wild virus found in 2004 showed that it may have been circulating undetected in Sudan for more than three years—a time when surveillance in Sudan was thought to be satisfactory. Barrett points out that while surveillance probably was satisfactory at the national level, it must also be of an acceptable standard within every local district. As Sudan has been a high conflict zone, it is very possible that local surveillance may not have been adequate.

And to be realistic, during the smallpox eradication effort there were a number of countries embroiled in conflicts, such as the Vietnam War, the Cambodian civi war and subsequent “Killing Fields”, and the Soviet invasion of Afghanistan. Even the practice of apartheid in South Africa, for example, could have led to inequalities in surveillance and reporting. Not to mention the number of localized areas that were poverty stricken or remote that could lead to inadequate surveillance and reporting on a local or regional level.

Furthermore, another big weakness with the system is that once eradication status was granted to a country, surveillance for smallpox was not quite as careful. In fact, in 1987 it was recommended that smallpox be removed from the National Notifiable Diseases Surveillance System. However, surveillance began again after the September 11 attacks in 2001 because of the possibility of a bioterrorism attacks.

When assessed from a realistic perspective, the WHO’s criteria for eradication is based on the assumption that all components of a country’s reporting and surveillance for diseases are working perfectly- not well or adequately- but perfectly. That’s a pretty big assumption. (It brings to mind something I heard in a podcast interview with General Stanley McChrystal where Gen. McChrystal talked about the importance of a “red team” to do an outside assessment of a plan. He said that something can sound like the most brilliant plan when it’s your own head, but when you get other people to look at it, they can bring out the weak points and pretty soon you see that you aren’t dealing with a strategy, but rather a set of miracles based on everything working perfectly.)

But even with all of these very significant challenges in disease eradication/elimination, let’s for the moment assume that a disease in particular can or has been eliminated. When we talk about eliminating/eradicating a disease, it is because we believe it has very detrimental effects and that if eliminated/eradicated, that people will no longer suffer those effects. But are we really free from the detrimental effects of a disease just because it has been declared eliminated or eradicated? Let’s take a look at the data…

Smallpox: We’ve already established that cases of smallpox have been documented to spread from vaccinated individuals. However, even if smallpox is no longer a threat to humans, there are a number of other animal pox viruses that can cause similar symptoms and even death. Monkeypox is one of the more well studied examples of this as detailed in pages 503-506 of the Microbiological Review. However, there are a variety of other possible pox viruses that could take hold in humans including cowpox, camel pox, tanapox, rat pox, gerbil pox and raccoon pox.

Polio: Because of polio, no one has to worry about their child coming home sick and being paralyzed, right? Wrong. One interesting newspaper article from India asserts that while polio has been eliminated in India, Acute Flaccid Paralysis (AFP) is on the rise.  According to the Johns Hopkins School of Medicine, AFP encompasses all cases of poliomyelitis. And guess what? AFP can get you here in the United States too. Several cases of paralysis from non-polio enteroviruses have been reported in the United States.

Measles: Sure, it is possible to get encephalitis from measles. But guess what else can cause encephalitis? According to the Mayo Clinic, encephalitis can occur as a result of vaccination with a live virus vaccine– like MMR.

I think at this point we should be asking ourselves if it is really realistic or prudent to eliminate a disease causing pathogen. We talk a lot about the importance of the ecosystem and that if a species like a plant or insect goes extinct, it could upset the entire ecological balance of an area. Yet, our scientists feel that these laws do not apply to bacteria and viruses. Instead of trying to eliminate viruses and bacteria, perhaps it would be more practical and lifesaving to focus on efforts to help people avoid them through clean water and fight them off through better nutrition and healthcare.

Getting The Facts Straight on Rubella

“Lots of people used to die from rubella!”

I have heard this statement from many very learned people- people who have earned bachelor or advanced degrees. These people sincerely consider themselves very educated about vaccination. The irony is that, frankly, they don’t know what they are talking about.

To quote Medscape: ” Rubella is generally a benign communicable exanthematous disease. It is caused by rubella virus, which is a member of the Rubivirus genus of the family Togaviridae. Nearly one half of individuals infected with this virus are asymptomatic. ” In other words, rubella is a very mild illness and in half of all cases people who have been infected won’t even display any symptoms. Going on, the article states that in children and infants the disease generally manifests with a rash and mild cold/flu symptoms when any symptoms are present. Adults and teens may develop arthritis and more advanced infections. And while cases of rubella encephalitis were not unheard of, they were rare. Risk of death from rubella is extraordinarily low especially if you or your chid are otherwise healthy and not immunocompromised in any way. (Medscape’s chart shows the number of rubella deaths at a total of 29 in 1969- the year the vaccine was introduced.)

So why the vaccination campaign for rubella (a.k.a. German measles)?

From the Merck Manual, Professional Version: Women who are in their first trimester of pregnancy who develop a rubella infection can pass the virus on to their own unborn child causing birth defects like deafness, blindness, intellectual impairments, seizures, microcephaly (excessively small head) and motor impairments. Congenital rubella syndrome (CRS) can also cause a stillbirth or miscarriage. Or it there may be no effect on the baby at all.

The mother may have some upper respiratory symptoms from the rubella infection, or she may have no symptoms at all. Pregnancies of less than 16 weeks gestation are most susceptible to CRS, though 8-10 weeks is the time when the baby is most vulnerable. (Actress Gene Tierney contracted rubella during a WWII USO tour while she was pregnant with her first child. Her daughter was born with intellectual impairments. Reportedly, her friend eccentric millionaire Howard Hughes helped with the medical expenses related to the girl’s care.)

So there is a real reason to be concerned about rubella in pregnancy. And the vaccine is credited with eliminating rubella in the United States. The CDC declared endemic transmission of rubella to have been eliminated in the United States in 2004. This assessment was based on a review of data by an international panel of experts who agreed that rubella had been eliminated.

There are, however, a few issues still left with rubella:

1) The declaration that rubella has been eliminated was based not any widespread and ongoing testing for rubella immunity, but rather on a review of data- which probably means records of doses of the vaccine that were distributed and maybe upon some data regarding actual numbers of rubella vaccines that were administered. So elimination may be more theoretical than practical in nature.

2) If a substantial portion of rubella cases are asymptomatic it would be extremely difficult to detect cases of both vaccine failure and rubella infection without massive and ongoing testing.

3) Why does the United States persist in vaccinating people who are not at risk for CRS like infants, kindergartners and men? Well the idea here was to prevent these people from transmitting the disease to pregnant women, and to achieve “elimination” of the disease. However, going to back to point number 2 above, there are significant number of asymptomatic cases which would make it extremely difficult to detect vaccine failure and therefore truly say that anyone is immune without a massive and constant testing campaign. Anyway, a far more efficient method for vaccination is simply to perform a blood titers test on adolescent girls or women planning to become pregnant and vaccinate only those who lack immunity.

 

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.

Mumps- Need I Say More?

A few weeks ago I was finishing up my post on SIDS and facing the prospect of writer’s block. I just wasn’t sure what to write after the SIDS post was finished. And then Sidney Crosby of the Pittsburgh Penguins developed the mumps after receiving an MMR booster before the Sochi Olympics. Suddenly, my writer’s block was solved!

I have actually heard people say that we vaccinate for mumps because people used to die from it. This is, of course, a display of ignorance. (The irony is that those of us who choose not to vaccinate are usually referred to as being uneducated or gullible no matter how sound our reasoning and research and those who defend vaccination are considered educated and sensible no matter how uninformed their stance is.) Obviously, Sidney Crosby and his fellow hockey players, referees and coaches who have been infected are all alive. Mumps is generally not deadly or even complicated unless you happen to be very immunocompromised. Even complications such as aseptic meningitis are usually mild with a good prognosis.

We keep hearing statistics that say that before the vaccine was introduced there were 200,000 cases of mumps every year and then the disease quickly dropped off after the advent of mumps vaccination. OK, so there were 200,000 cases. But why in and of itself is this a public health catastrophe? The answer is that it really isn’t a public health catastrophe.

Much has been said about the possibility of orchitis (infection of the testicles) in teenage boys and men, however, infection is unilateral most of the time, meaning that it only infects one testicle, allowing a man to still carry plenty of sperm to have children. In rare cases, fertility can be impaired, but sterility is extraordinarily rare. A condition called oophoritis (benign inflammation of the ovaries) occurs in about 5% of women and post-pubertal girls, though it does not affect fertility. Mumps during pregnancy can increase the risk of spontaneous abortion. But isn’t this why vaccination is so crucial, you say? We need to protect the adult population because these diseases can have more severe effects when they strike adult populations.

Actually, this is why it might be in the public’s best interest not to vaccinate for mumps.

Before vaccination was introduced en masse, mumps was a childhood disease. People would usually get it as young children (before puberty increased the chances of more complications) and then have life-long immunity. Trying to prevent children from getting the mumps actually opens them up to more complications later on and deprives them of life-long immunity that would protect them once they are adults. This is especially crucial when the vaccine lacks efficacy. Yep, this latest high profile outbreak of mumps has brought to light some rather uncomfortable truths and accusations about the MMR shot, especially when a star hockey player gets sick after receiving a booster shot.

Public health officials have now admitted that the vaccine is only about 88% effective- which sounds high until you realize that out of 100 vaccinated individuals, 10-15 will develop mumps. That’s not the very small percentage that the CDC has claimed for vaccine failure. Even more disturbing are the allegations from former Merck employees that Merck manipulated the results of its studies on the MMR vaccine efficacy to make the vaccine seem more effective than it actually is. In fact, in 2006 there were 6,500 cases of mumps reported in a highly vaccinated population and in 2009 there were 5,000 in a highly vaccinated population. Where was herd immunity when that happened?

So what does all of this really mean? It means that mumps is a very mild disease, especially when it is contracted during childhood. So before vaccination, we had 200,000 cases of mostly children experiencing an uncomfortable but mild illness and then having lifelong immunity to protect them into their teen and adult years. (And this immunity was completely free and easily available to everyone.) After vaccination, we have a solution that has a 10-15% failure rate at its best. At its worst, the MMR vaccine may very well be less effective than the medical community has represented because Merck may have deliberately manipulated data on the MMR shot. Regardless of its actual effectiveness, one thing is for sure: vaccine manufacturers make a lot more money by administering multiple doses of mumps vaccine than simply allowing people to develop natural immunity.