The antivaccine cult’s Argument by Vaccine Package Inserts

Originally published 24 April 2013
Revised 2 October 2013
Revised 11 February 2014
Revised 6 December 2014
Revised 20 January 2015
Revised 24 January 2015
Revised 25 April 2015

One of the cherished strategies of the antivaccine cult is to quote vaccine package inserts (called a Patient Information Leaflet in EU countries and Instructions for Use in the case of medical devices) to “prove” that vaccines are dangerous. Vaccine deniers consider the package insert to be golden tablets of the Truth™. It’s ironic that these antivaccine groupies rail against Big Pharma, as if they are demon reptilians, but the package insert, written by Big Pharma, is considered gospel. Irony abounds.

Just spend more than a couple of minutes in discussion with an antivaccine cultists, and you’ll get a reference to any of the many vaccine package inserts (PI) as “proof” that it is dangerous, contains dangerous stuff, or is just plain scary.

Orac has recently proclaimed it “Argument by Package Insert”–it’s almost at the level of logical fallacy. (David Gorski has just given it the Latin name, argumentum ad package insert, so it’s officially a logical fallacy.)

Before we start, vaccine package inserts are important documents, but only if the information included therein is properly understood. It is not a document that serves as medical and scientific gospel. But it is a document that can help clinicians use vaccines (or frankly, any medication) properly.
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Your one stop shop for real science and myth-debunking about Gardasil

Updated 23 April 2015.

Recently, I read a new article published in Pediatrics that described how educating either teenagers or their parents about HPV vaccinations had little effect on the overall vaccination rate for the vaccine. Essentially, the researchers found that it was a 50:50 probability that any teen would get the vaccine, regardless of their knowledge of HPV and the vaccine itself.

So I thought about why that Pediatrics study found that education about HPV and Gardasil didn’t move the needle on vaccination uptake. It’s possible that the benefits of the vaccine is overwhelmed by two factors–first, that there’s a disconnect between personal activities today vs. a disease that may or may not show up 20-30 years from now; and second, that the invented concerns about the HPV quadrivalent vaccine, promulgated by the usual suspects in the antivaccination world, makes people think that there is a clear risk from the vaccine which is not balanced by preventing cancer decades from now. It’s frustrating.

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HPV vaccine prevents cancer and cuts medical costs

Genital and oral human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the USA. There are more than 40 HPV sub-types that can infect the genital areas of males and females. Additionally, some HPV types, typically subtypes 16 and 18, can also infect the mouth and throat. HPV is generally transmitted from personal contact during vaginal, anal or oral sex. (For further information, please see my review of HPV vaccines.)

HPV is believed to cause nearly 5% of all new cancers across the world, making it almost as dangerous as tobacco. According to the CDC, roughly 79 million Americans are infected with HPV–approximately 14 million Americans contract HPV every year. Most individuals don’t even know they have the infection until the onset of cancer. About 27,000 HPV-related cancers are diagnosed in the USA every year.
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Autism and MMR vaccines – still not linked

A new study was published recently that showed, once again, that there is no link between autism and MMR vaccines. Are we still wasting good research dollars on showing that there is not one single link between autism and MMR vaccines (to prevent mumps, measles and rubella)? Apparently, we are going to do this until the evidence is literally the size of a mountain.

Despite the fraudulent claims of one MrAndy Wakefield, there is simply no evidence that vaccines are related to autism. Moreover, when we have gone looking, there is evidence that that autism is totally unrelated to vaccines.

And it’s more than just me yelling this loudly. Orac says soScience Based Medicine says soEmily Willingham says so. Oh I know, these are all bloggers, which isn’t real science–except, like me, whatever they write is actually linked to real science in the form of peer-reviewed studies. And we all conclude that there is simply not one shred of evidence to support the implausible hypothesis that autism and MMR vaccines are linked.

By the way, the CDC agrees with all of us. And they’re really smart people–Ph.D.’s, MD’s, and other public health specialists, whose backgrounds are in relevant areas of medicine like immunology, virology, epidemiology, microbiology, and so many other fields of research.

So despite overwhelming tons of evidence that vaccines, especially the MMR vaccine, do not cause or are completely unrelated to autism and autism spectrum disorders, the loud noise from the antivaccine cult continues. Using false balanced “debates” to pretend that there is actually some sort of scientific discussion about this point, some news reports will often make you think that there are really two sides to this story. But there isn’t. There’s one side with real science, and the other side with, well, nothing.

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Real scientific evidence says vaccines and autism are unrelated

Updated 22 April 2015.

On 28 March 2014, the United States Centers for Disease Control and Prevention (CDC) announced that new data show that the estimated number of children identified with autism spectrum disorder (ASD), a disorder of neural development, usually appearing before the age of 3 years, characterized by impaired social interaction and verbal and non-verbal communication, and by restricted, repetitive or stereotyped behavior, continues to rise.  The picture of ASD in US communities is changing.
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Multiple vaccinations weakens the immune system – a myth

Updated 21 April 2015

If you explore the dark and myth filled back alleys of the antivaccination movement, you will find a wide variety of myths that try to convince people that vaccinating children is dangerous. I’ve covered and refuted many of the myths, although the vaccine deniers tend to rely on zombie myths that keep returning over and over again, never quite dying.

These myths range from outrageous, such as it’s a conspiracy of the government to control population (which I find odd, since the government is barely competent enough to build a post office), to scientific sounding, but ultimately pseudoscientific claims. There are a lot of great websites that debunk many of the myths, and they’re easy to find.

One of the most annoying legends of the antivaccination cult is that multiple vaccinations weakens the immune system of the poor baby’s tender physiology. About that immune system? It’s comparatively strong relative to almost every other organ system in the body.

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Index of articles by guest author–Prof. Dorit Rubinstein Reiss

Updated 21 April 2015

Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), is a frequent contributor to this and many other blogs, providing in-depth, and intellectually stimulating, articles about vaccines (generally, but sometimes moving to other areas of medicine), social policy and the law. Her articles usually unwind the complexities of legal issues with vaccinations and legal policies, such as mandatory vaccination and exemptions, with facts and citations. I know a lot of writers out there will link to one of her articles here as a sort of primary source to tear down a bogus antivaccine message.

Professor Reiss writes extensively in law journals about the social and legal policies of vaccination–she really is a well-published expert in this area of vaccine policy, and doesn’t stand on the pulpit with a veneer of Argument from Authority, but is actually an authority. Additionally, Reiss is also member of the Parent Advisory Board of Voices for Vaccines, a parent-led organization that supports and advocates for on-time vaccination and the reduction of vaccine-preventable disease.

Below is a list of articles that she has written for this blog, organized into some arbitrary and somewhat broad categories for easy reference. Of course, she has written articles about vaccines and legal issues in other locations, which I intend to link here at a later date. This article will be updated as new articles from Dorit are added here.

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Yes, herd immunity works

Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), is a frequent contributor to this and many other blogs, providing in-depth, and intellectually stimulating, articles about vaccines (generally, but sometimes moving to other areas of medicine), social policy and the law. Her articles usually unwind the complexities of legal issues with vaccinations and legal policies, such as mandatory vaccination and exemptions, with facts and citations.

Professor Reiss also writes extensively in law journals about the social and legal policies of vaccination. Additionally, Reiss is also member of the Parent Advisory Board of Voices for Vaccines, a parent-led organization that supports and advocates for on-time vaccination and the reduction of vaccine-preventable disease.

This piece is a summary of Herd Immunity and Immunization Policy: The Importance of Accuracy, soon to be published in v. 94 of Oregon Law Review.

In an article that was published in the Oregon Law Review in 2014, authors Holland and Zachary claimed that school immunization mandates are inappropriate because they reject the concept that herd immunity works.

This piece will explain  why Holland and Zachary’s analysis is simply incorrect. And let’s be clear–there is a legitimate debate about  whether school immunization mandates are appropriate, policy wise, as a response to non-vaccination.

Unlike vaccine science, the appropriate policy to handle non-immunization is not agreed upon, and the data on what is the right way to get people to vaccinate is anything but clear (though some things are clear: for example, harder to get exemptions lead to higher vaccination rates). But the debate needs to be premised on accurate facts – not on misuse of legal terms and incorrect scientific data. Holland and Zachary’s article does not provide that.
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HPV vaccine adverse events – this time, POTS

I make my goal that if you’re going to make some claim that goes against the scientific consensus, then it must be done with high quality evidence, preferably published in a high quality medical or scientific journal. It better be peer reviewed. And it better be good research.

Even if the evidence meets that standard, there is an hierarchy of published evidence from meta- or systematic-reviews at the very top, and junk science published in pseudoscience-pushing websites at the bottom. But there is a range of scientific scholarship, and sometimes, even if an article is published in a top quality journal, the results may be misinterpreted, or even be poorly analyzed.

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Antivaccine cult resorts to ad hominem attacks

I get a lot of email about this blog. Most of it is nice, many asking questions or recommending future topics. I do enjoy the recommendations, because it sometimes leads to some interesting areas of research.

Occasionally, I get critical emails, some civil, and some not quite as civil. And I got one of those emails, with interesting and not very creative ad hominem attacks – really could some of you do better than this?

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