Diane Harper supports HPV vaccine – and she published it

diane harper

A few years ago, Dr. Diane Harper was the darling of the anti-vaccine world, for two reasons. First, she was one of the researchers who performed clinical trials for Gardasil. And second, she appeared to be against HPV vaccines, specifically Gardasil.

But the story was much more nuanced.  I argued that her publication record presented a much different picture – she actually supported the vaccine. But typical of the zombie memes and tropes of the anti-vaccine world, every few months it’s breathless reported that Dr. Harper is opposed to Gardasil.

Recently, she published another article about HPV vaccines, and if there’s any doubt that she is in favor of HPV vaccines, that is gone. But that probably won’t stop the anti-vaccine crowd.

Continue reading “Diane Harper supports HPV vaccine – and she published it”

Dorit Rubinstein Reiss – an index of contributions to this website

Dorit Rubinstein Reiss

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 Dorit Rubinstein Reiss has written for this blog, organized into some arbitrary and somewhat broad categories for easy reference. This article will be updated as new articles from Professor Reiss are added here.

Continue reading “Dorit Rubinstein Reiss – an index of contributions to this website”

Coffee health benefits – what does the science say?

coffee health benefits

I am an degenerate coffee addict. This has been so since I took my initial drink during my first chemistry finals as a college freshman. My coffee consumption hasn’t decreased much since then. I drink coffee because of its taste and the caffeine. Potential coffee health benefits are, personally, way down the list of reasons for drinking it. And frankly, I’m always skeptical of claimed health benefits for any food, unless there’s some really strong scientific evidence, which is generally lacking.

But recently, news outlets have been touting a couple of robust studies that seem to indicate that there are significant coffee health benefits. For those who know me, I rarely accept popular news sites analysis of scientific research. I think my loyal readers expect me to look at the science and see if there is any validity to the claims made by the press.

Claims about coffee health benefits and claims goes back centuries. It cured alcoholism. Coffee made you work longer. It was good for your heart. Drinking it was bad for your heart. It increases risks of some cancers. Wait, it decreases risks of some cancers. In other words, we really didn’t have vigorous evidence supporting anything definitive with respect to the drink’s health benefits or detriments.

It’s time to look at these two new studies and see what they tell us about drinking coffee.

Coffee health benefits – the first study

The first study we’re going to examine, from Gunter et al., published in the Annals of Internal Medicine. At a meta level, this epidemiological study was run by respected scientists, with the results published in a very high impact factor (17.2020) journal. Moreover, the study included around 520,000 participants in 10 European countries, which makes it one of the largest studies to date on coffee health benefits.

Compared to some of the horrifically bad studies that we have seen making outrageous claims about this or that food, drink or diet, this study is impressive. This is the kind of study that is equivalent to some of the best vaccine epidemiological research out there.

But what does the results say? To be blunt, they found that drinking more coffee would significant lower a person’s risk to all mortality.

The hazard ratio (HR), which compares the risk of dying between the coffee-drinking and non-coffee groups, was 0.88. In other words, there was a 12% reduction in all death causes in men who were in the upper quartile of coffee consumption. The HR for women in the upper quartile of consumption was 0.93, or a 7% reduction.

Frankly, a 12% or 7% difference in mortality is interesting and intriguing, but from a perspective of evidence-based medicine, it’s difficult to say this is clinically meaningful. However, if there are no known risks to coffee, which would have been uncovered by this study, the importance of those decreases in mortality become more substantial.

There were more significant results for certain diseases. The HR for coffee consumption and digestive disease mortality for men was 0.41 (a 59% reduction), and for women was 0.60 (a 40% reduction). Interestingly, for women, the HR for coffee drinking and circulatory disease mortality was 0.78 and cerebrovascular disease mortally was 0.70. However, the HR for coffee drinking and ovarian cancer mortality was 1.31, or a 31% increase.

The authors concluded, without much wiggle room:

Coffee drinking was associated with reduced risk for death from various causes. This relationship did not vary by country.

Review of the first study

Although the results appeared to fairly solid, I think it’s important to be critical of the results. First, we have no data that shows us whether or not coffee drinkers are just a healthier subgroup of people irrespective of their coffee drinking (they did separate out smokers from this study). Maybe coffee drinkers exercise more or eat less fats than the average person – these confounding factors have not examined carefully.

Second, like I discussed before, dose makes the poison, and dose also makes the medicine. Is there a level of coffee consumption at which point the risks outweigh the benefits? That’s not clear in this paper.

The best I could tell you from the data from this particular study of coffee health benefits is that if you’re a coffee drinker, maybe there is a slight decrease in risk of mortality, so keep on drinking. But if you don’t like coffee (yeah, there are those types around), or the caffeine effects of coffee are not to your liking, I’m not sure you should worry about suddenly taking up the habit.

Coffee health benefits – the second study

This second study, from Park et al., was also published in the Annals of Internal Medicine, once again, a very high quality journal. At a meta level, it’s as high quality as the study from Gunter et al., although this study looked at coffee consumption from a slightly different perspective.

Park et al. surveyed over 185,000 African-Americans, Native Americans, Hawaiians, Japanese-Americans, Latinos and whites, a broader ethic diversity than the first study. The researchers compared coffee consumption at various levels to a control group who drank no coffee. They adjusted for confounders such as smoking, age, alcohol intake, body mass intake, exercise, education and other factors.

For those who drank about 1 cup per day (in this case, they mean the English measurement of a cup, about 250 ml, not the standard “cup” in your local Starbucks which is about 500 ml), the HR was 0.88 or 12% reduction in total mortality. For 2-3 cups per day, the HR was 0.82. With consumption ≥ 4 cups per day, the HR was the same 0.82, or 18% reduction. All of these numbers were statistically significant.

Moreover, the researchers found that coffee increases longevity across various races.

Park et al. also found that drinking decaffeinated coffee had no effect, so you have to go for the real stuff to see these health effects.

The researchers concluded:

In summary, higher coffee consumption was associated with lower risk for all-cause death and death from heart disease, cancer, respiratory disease, stroke, diabetes, and kidney disease. Inverse associations were found in African Americans, Japanese Americans, Latinos, and whites; never-smokers, former smokers, and current smokers; those with preexisting heart disease or cancer; and healthy participants. Our findings support the recent dietary guidelines from the U.S. Department of Agriculture (33), which indicate that moderate coffee consumption can be integrated into a healthy diet and lifestyle, by confirming an inverse association with mortality and suggesting that association’s generalizability to different racial/ethnic groups.

Review of the second study

What I like about this study is that it had a better analysis of major confounders, which gives me more confidence that it’s showing a real decrease in mortality rates for coffee drinkers. Moreover, they have the semblance of a dose response which shows 3-4 cups probably gives you the best reduction in death rate, but I’d like to see much higher consumption, like 10 cups. Maybe there’s a lowered benefit as you drink more, so further research will be informative.

But I have to point out again, the reduction in mortality was, at best, 18%, which may not have any clinical significance.

Coffee health benefits – the summary

These two studies show that there is a strong biological possibility that there is some relationship between lowered mortality and coffee drinking. The European study showed that coffee lowered the risk of dying from liver disease, cancers in women, digestive diseases and circulatory disease.

Moreover, both studies showed that those who drank three or more cups a day had a lower risk for all causes of death than people who did not drink coffee.

Of course, these two studies don’t mean drinking coffee is for everyone. For some people, for example, drinking coffee can lead to serious issues such as cardiac arrhythmias. And of course, excess caffeine can lead to sleep disorders and other issues.

Finally, we don’t know what compound in coffee has this protective effect against mortality. Coffee may contain over 200 different chemicals and compounds, and it might take decades of additional research to identify what chemical (or chemicals) in coffee may provide these health benefits.

I’m going to stand by my point that I previously made. These results are interesting, but they’re not overwhelming. The large numbers in both of these studies to give credibility to the quality of the statistical analyses, but still the risk reduction from drinking coffee seems less than impressive.

I think my skepticism would be reduced if I knew what may be the contributing factor – is it that coffee drinkers are just better people? Or is it some chemical in the coffee? Maybe unhealthy people don’t drink coffee because of a physician’s recommendation, which adds bias to these studies?

So at this time, drink coffee if you like it. It may provide you with some benefit. If you shouldn’t drink coffee, or don’t like it, I don’t think there is enough evidence for you to suddenly change your habits. Coffee health benefits are intriguing, but not quite overwhelming yet.

Citations

  • Gunter MJ, Murphy N, Cross AJ, Dossus L, Dartois L, Fagherazzi G, Kaaks R, Kühn T, Boeing H, Aleksandrova K, Tjønneland A, Olsen A, Overvad K, Larsen SC, Redondo Cornejo ML, Agudo A, Sánchez Pérez MJ, Altzibar JM, Navarro C, Ardanaz E, Khaw KT, Butterworth A, Bradbury KE, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Grioni S, Vineis P, Panico S, Tumino R, Bueno-de-Mesquita B, Siersema P, Leenders M, Beulens JWJ, Uiterwaal CU, Wallström P, Nilsson LM, Landberg R, Weiderpass E, Skeie G, Braaten T, Brennan P, Licaj I, Muller DC, Sinha R, Wareham N, Riboli E. Coffee Drinking and Mortality in 10 European Countries: A Multinational Cohort Study. Ann Intern Med. 2017 Jul 11. doi: 10.7326/M16-2945. [Epub ahead of print] PubMed PMID: 28693038.
  • Park SY, Freedman ND, Haiman CA, Le Marchand L, Wilkens LR, Setiawan VW. Association of Coffee Consumption With Total and Cause-Specific Mortality Among Nonwhite Populations. Ann Intern Med. 2017 Jul 11. doi: 10.7326/M16-2472. [Epub ahead of print] PubMed PMID: 28693036.

SB277 RICO lawsuit – Bad arguments and conspiracy theories updated

SB277 RICO lawsuit

In previous posts I addressed three of the lawsuits filed against SB277, all of which suffered defeats, at least for the moment: WhitlowBuck, and Torrey-Love. There was a fourth lawsuit, however, filed in July 2016 that I did not address until now – the SB277 RICO lawsuit from Travis Middleton.

This lawsuit had, in my view, the lowest chances from the start, and I was not sure how to cover it in the best manner, given its writing. But I think it’s time, since although a formal decision has not come down, a recommendation to dismiss the SB277 RICO lawsuit was filed.  Continue reading “SB277 RICO lawsuit – Bad arguments and conspiracy theories updated”

Coffee health benefits – is it supported by real science?

coffee health benefits

I am an degenerate coffee addict. This has been so since I took my initial drink during my first chemistry finals as a college freshman. My coffee consumption hasn’t decreased much since then. I drink coffee because of its taste and the caffeine. Potential coffee health benefits are, personally, way down the list of reasons for drinking it. And frankly, I’m always skeptical of claimed health benefits for any food, unless there’s some really strong scientific evidence, which is generally lacking.

But recently, news outlets have been touting a couple of robust studies that seem to indicate that there are significant coffee health benefits. For those who know me, I rarely accept popular news sites analysis of scientific research. I think my loyal readers expect me to look at the science and see if there is any validity to the claims made by the press.

Claims about coffee health benefits and claims goes back centuries. It cured alcoholism. Coffee made you work longer. It was good for your heart. Drinking it was bad for your heart. It increases risks of some cancers. Wait, it decreases risks of some cancers. In other words, we really didn’t have vigorous evidence supporting anything definitive with respect to the drink’s health benefits or detriments.

It’s time to look at these two new studies and see what they tell us about drinking coffee.

Coffee health benefits – the first study

The first study we’re going to examine, from Gunter et al., published in the Annals of Internal Medicine. At a meta level, this epidemiological study was run by respected scientists, with the results published in a very high impact factor (17.2020) journal. Moreover, the study included around 520,000 participants in 10 European countries, which makes it one of the largest studies to date on coffee health benefits.

Compared to some of the horrifically bad studies that we have seen making outrageous claims about this or that food, drink or diet, this study is impressive. This is the kind of study that is equivalent to some of the best vaccine epidemiological research out there.

But what does the results say? To be blunt, they found that drinking more coffee would significant lower a person’s risk to all mortality.

The hazard ratio (HR), which compares the risk of dying between the coffee-drinking and non-coffee groups, was 0.88. In other words, there was a 12% reduction in all death causes in men who were in the upper quartile of coffee consumption. The HR for women in the upper quartile of consumption was 0.93, or a 7% reduction.

Frankly, a 12% or 7% difference in mortality is interesting and intriguing, but from a perspective of evidence-based medicine, it’s difficult to say this is clinically meaningful. However, if there are no known risks to coffee, which would have been uncovered by this study, the importance of those decreases in mortality become more substantial.

There were more significant results for certain diseases. The HR for coffee consumption and digestive disease mortality for men was 0.41 (a 59% reduction), and for women was 0.60 (a 40% reduction). Interestingly, for women, the HR for coffee drinking and circulatory disease mortality was 0.78 and cerebrovascular disease mortally was 0.70. However, the HR for coffee drinking and ovarian cancer mortality was 1.31, or a 31% increase.

The authors concluded, without much wiggle room:

Coffee drinking was associated with reduced risk for death from various causes. This relationship did not vary by country.

Review of the first study

Although the results appeared to fairly solid, I think it’s important to be critical of the results. First, we have no data that shows us whether or not coffee drinkers are just a healthier subgroup of people irrespective of their coffee drinking (they did separate out smokers from this study). Maybe coffee drinkers exercise more or eat less fats than the average person – these confounding factors have not examined carefully.

Second, like I discussed before, dose makes the poison, and dose also makes the medicine. Is there a level of coffee consumption at which point the risks outweigh the benefits? That’s not clear in this paper.

The best I could tell you from the data from this particular study of coffee health benefits is that if you’re a coffee drinker, maybe there is a slight decrease in risk of mortality, so keep on drinking. But if you don’t like coffee (yeah, there are those types around), or the caffeine effects of coffee are not to your liking, I’m not sure you should worry about suddenly taking up the habit.

Coffee health benefits – the second study

This second study, from Park et al., was also published in the Annals of Internal Medicine, once again, a very high quality journal. At a meta level, it’s as high quality as the study from Gunter et al., although this study looked at coffee consumption from a slightly different perspective.

Park et al. surveyed over 185,000 African-Americans, Native Americans, Hawaiians, Japanese-Americans, Latinos and whites, a broader ethic diversity than the first study. The researchers compared coffee consumption at various levels to a control group who drank no coffee. They adjusted for confounders such as smoking, age, alcohol intake, body mass intake, exercise, education and other factors.

For those who drank about 1 cup per day (in this case, they mean the English measurement of a cup, about 250 ml, not the standard “cup” in your local Starbucks which is about 500 ml), the HR was 0.88 or 12% reduction in total mortality. For 2-3 cups per day, the HR was 0.82. With consumption ≥ 4 cups per day, the HR was the same 0.82, or 18% reduction. All of these numbers were statistically significant.

Moreover, the researchers found that coffee increases longevity across various races.

Park et al. also found that drinking decaffeinated coffee had no effect, so you have to go for the real stuff to see these health effects.

The researchers concluded:

In summary, higher coffee consumption was associated with lower risk for all-cause death and death from heart disease, cancer, respiratory disease, stroke, diabetes, and kidney disease. Inverse associations were found in African Americans, Japanese Americans, Latinos, and whites; never-smokers, former smokers, and current smokers; those with preexisting heart disease or cancer; and healthy participants. Our findings support the recent dietary guidelines from the U.S. Department of Agriculture (33), which indicate that moderate coffee consumption can be integrated into a healthy diet and lifestyle, by confirming an inverse association with mortality and suggesting that association’s generalizability to different racial/ethnic groups.

Review of the second study

What I like about this study is that it had a better analysis of major confounders, which gives me more confidence that it’s showing a real decrease in mortality rates for coffee drinkers. Moreover, they have the semblance of a dose response which shows 3-4 cups probably gives you the best reduction in death rate, but I’d like to see much higher consumption, like 10 cups. Maybe there’s a lowered benefit as you drink more, so further research will be informative.

But I have to point out again, the reduction in mortality was, at best, 18%, which may not have any clinical significance.

Coffee health benefits – the summary

These two studies show that there is a strong biological possibility that there is some relationship between lowered mortality and coffee drinking. The European study showed that coffee lowered the risk of dying from liver disease, cancers in women, digestive diseases and circulatory disease.

Moreover, both studies showed that those who drank three or more cups a day had a lower risk for all causes of death than people who did not drink coffee.

Of course, these two studies don’t mean drinking coffee is for everyone. For some people, for example, drinking coffee can lead to serious issues such as cardiac arrhythmias. And of course, excess caffeine can lead to sleep disorders and other issues.

Finally, we don’t know what compound in coffee has this protective effect against mortality. Coffee may contain over 200 different chemicals and compounds, and it might take decades of additional research to identify what chemical (or chemicals) in coffee may provide these health benefits.

I’m going to stand by my point that I previously made. These results are interesting, but they’re not overwhelming. The large numbers in both of these studies to give credibility to the quality of the statistical analyses, but still the risk reduction from drinking coffee seems less than impressive.

I think my skepticism would be reduced if I knew what may be the contributing factor – is it that coffee drinkers are just better people? Or is it some chemical in the coffee? Maybe unhealthy people don’t drink coffee because of a physician’s recommendation, which adds bias to these studies?

So at this time, drink coffee if you like it. It may provide you with some benefit. If you shouldn’t drink coffee, or don’t like it, I don’t think there is enough evidence for you to suddenly change your habits. Coffee health benefits are intriguing, but not quite overwhelming yet.

Citations

  • Gunter MJ, Murphy N, Cross AJ, Dossus L, Dartois L, Fagherazzi G, Kaaks R, Kühn T, Boeing H, Aleksandrova K, Tjønneland A, Olsen A, Overvad K, Larsen SC, Redondo Cornejo ML, Agudo A, Sánchez Pérez MJ, Altzibar JM, Navarro C, Ardanaz E, Khaw KT, Butterworth A, Bradbury KE, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Grioni S, Vineis P, Panico S, Tumino R, Bueno-de-Mesquita B, Siersema P, Leenders M, Beulens JWJ, Uiterwaal CU, Wallström P, Nilsson LM, Landberg R, Weiderpass E, Skeie G, Braaten T, Brennan P, Licaj I, Muller DC, Sinha R, Wareham N, Riboli E. Coffee Drinking and Mortality in 10 European Countries: A Multinational Cohort Study. Ann Intern Med. 2017 Jul 11. doi: 10.7326/M16-2945. [Epub ahead of print] PubMed PMID: 28693038.
  • Park SY, Freedman ND, Haiman CA, Le Marchand L, Wilkens LR, Setiawan VW. Association of Coffee Consumption With Total and Cause-Specific Mortality Among Nonwhite Populations. Ann Intern Med. 2017 Jul 11. doi: 10.7326/M16-2472. [Epub ahead of print] PubMed PMID: 28693036.

Religion and vaccinations – a review of the current knowledge

religion and vaccinations

A while ago, I wrote an article about a father who is suing the New York Department of Education to force a school to allow his unvaccinated son into school. The basis of his lawsuit is that vaccination is against his religious beliefs. How does this lawsuit fit into our ideas about religion and vaccinations?

The father is a Roman Catholic, and claimed that his church was opposed to vaccines. As far as I could find, the Catholic Church strongly supports vaccination, even making it a moral and ethical issue by clearly stating that “there would seem to be no proper grounds for refusing immunization against dangerous contagious diseases…”

The Catholic Church even advises for vaccinations in those vaccines manufactured using permanent cell lines that derive from aborted fetuses. In other words, not only is the Catholic Church not opposed to vaccination, it seems to indicate that it would immoral to not vaccinate.

This all lead me to wonder if there was research into the relationship between religion and vaccinations. And I found some.

Continue reading “Religion and vaccinations – a review of the current knowledge”

Multiple vaccines overwhelm immune system – another myth debunked

multiple vaccines

There are a large number of tropes and myths pushed by the anti-vaccine crowd. Like toxic chemicals in vaccines. Or vaccines cause autism. And one that keeps showing up – multiple vaccines overwhelm the immune system.

And like other articles I’ve written about anti-vaccine myths and tropes, the idea of multiple vaccines harming children is easily debunked by scientific facts. And we’re doing that right here.

Continue reading “Multiple vaccines overwhelm immune system – another myth debunked”

Immunization mandates case law – UC Hastings project

Immunization mandates case law

In the past year, I offered a course in University of California, Hastings College of Law allowing students to work on immunization-related legal research projects that can help members of the immunization community understand legal issues. I am now ready to present our first publicly available project, for anyone’s use, on immunization mandates case law.

This project, done by two UC Hastings’ students under my guidance, is a summary and overview of litigation on vaccine mandates – school mandates and influenza workplace mandates.

It includes a short memo summarizing the jurisprudence on these topics and a list of cases, federal and state (and if you come across any cases we have missed, please let me know and we will add them).

The memo can be found here. The cases are directly here (by category).

Toxic vaccine chemicals – the dose makes the poison

toxic vaccine chemicals

If you spend any amount of time on the internet researching science and pseudoscience, you’ll find alarming claims about toxic or poisonous substances in our foods, vaccines, air, water, and so much else. And then you’ll find a lot of people (myself included) who try to present science-based evidence that there are no toxic vaccine chemicals.

Generally, the pseudoscience argument proceeds along the lines of “this unpronounceable chemical is going to cause cancer.” Or there’s mercury in our vaccines that will cause autism.

But what the science deniers are pushing is based on a lack of knowledge about how toxicology, or the study of the adverse effects of chemicals on living organisms, determines what is or isn’t toxic.

Paracelsus, a 16th century Swiss German physician, alchemist, astrologer, is traditionally thought to have founded the discipline of toxicology, an important branch of medicine, physiology, and pharmacology. Paracelsus wrote one of the most important principles of toxicology:

All things are poisons, for there is nothing without poisonous qualities. It is only the dose which makes a thing poison.

In other words, if you’re speaking about substances in foods or vaccines or anything, the most important principle is that the dose makes the poison (or toxin). Everything that we consume or breathe is potentially toxic, but what is the most overriding principle must be the dose. Continue reading “Toxic vaccine chemicals – the dose makes the poison”

Anti-vaccine statistics – back to simple math again

anti-vaccine statistics

One of the age-old tropes of the anti-vaccine statistics world is that kids who have been vaccinated against the measles are more likely to get measles than those who are not vaccinated. I squashed this myth several times; unfortunately, those are old articles with broken links and such.

Now, the anti-vaccine statistics monsters persevere with their alternative facts. So, once more unto the breach, dear friends, once more. We will take down this trope. Continue reading “Anti-vaccine statistics – back to simple math again”