This article was written by Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law in San Francisco, CA. She has written a valuable review of the recently published article, “Power and Persuasion in the Vaccine Debates: An Analysis of Political Efforts and Outcomes in the United States, 1998-2012”.
Dr. Reiss writes extensively in law journals about the social and legal policies of vaccination. She 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.
The article reviewed here examines how the success of the anti-vaccine movement in achieving its legislative goals changed over time. The authors use the term “vaccine critiques”, and I will follow their terminology, though I think the anti-vaccine label fits many of the actors they describe. The peer reviewed article does two extremely valuable things: describes patterns, and suggests a causal explanation. While the authors are, justifiably, confident in their descriptive analysis, they appropriately warn us that their conclusions about causation are tentative. Their points are, however, very plausible.
This post proceeds in three parts: describing the patterns the authors found, describing their causal conclusions, and asking for a wish-list of further research (an easy enough and somewhat unfair things to do when you don’t have to actually do it).
Note: the authors have expressed their willingness to provide the full paper to individuals, upon request. I recommend it. The paper also states that the database will be made available on request.
(more…) «Success and Failure of Anti-Vaccine…»
Suddenly, there has been a lot of noise about the price of vaccines. Well, there’s always been over-exaggerations and outright misinformation about vaccine prices and profits from the antivaccination gang, and they must be embarrassed by the quality of their arguments. OK, I doubt that. But there is noise out there.
But when the criticism comes from the “pro-vaccine” world, I needed to stand up and see what was being said. In my world of vaccines, I believe that anyone, especially children, who needs vaccines should get them for free. This is true in the USA (which leads the world in this one facet of healthcare), thus, any argument about vaccines costing too much falls rather flat to me. I hate dropping anecdotal data on my readers, but the fact is my health insurance plan, by no means some corporate executive level concierge plan, pays for all vaccines. In fact, I asked for one vaccination out of indication (meaning I was about 10 years too young to receive it), and the insurance company paid for it immediately and without question.
In the USA, the Affordable Care Act (best known as Obamacare) mandates vaccinations for adults and children with no out-of-pocket costs. Medicaid pays for vaccines. Medicare pays for vaccines, though the rules for payment are unnecessarily bureaucratic and confusing, unless the member is in Medicare Advantage. Maybe not as of today, but certainly soon, the cost of vaccines shouldn’t matter to the average rich or poor or middle-class American. And considering the number of lives saved by vaccines, this is an incredible and modern aspect of the USA health care system.
(more…) «Prices of vaccines–an uncomfortable discussion»
Update 1. Added more criticism of this paper (since the data is not new) from Emily Willingham.
One of ongoing criticisms of science deniers (and more specifically, of vaccine deniers) is that they make claims without the support of peer reviewed published articles. What the antivaccination movement doesn’t understand (really, it’s about all anti-science groups, but this is about vaccines) is that “peer review” is not by itself some magical bit of information. It’s really the result of the quality of journal, the reputation of the authors, the methods that were used to gather the data, the quality of statistical analysis of the data, and whether the conclusion is supported by the evidence or data.
So it’s not magic, it’s discernible and objective quality.
Moreover, it’s important to know if this research is repeated and used to build stronger hypotheses in subsequent research. A scientific paper, standing by itself, may or may not have any usefulness going forward. I’m sure you’ve read how marijuana cures cancer, but the data supporting that is based on one-off, unrepeated animal studies. This happens all the time. The mainstream news will claim XYZ prevents ABC cancer. Within 12 months, no one talks about it anymore, because the research is never repeated.
That’s why, on the hierarchy of scientific research, systematic- or meta-reviews rank at the very top, because they roll-up data from all of the other studies, giving more credence to studies that are repeated over and over again. And the better the journal in which they’re published, the better the systematic review. Primary research exhibited at a medical conference, unpublished, and then loudly advertised by a press release ranks near the bottom (but still higher than anything at Natural News).
(more…) «The antivaccination cult’s idea of…»
If you know none of the details of the antivaccination lunacy, then your education should start with the perpetrator of one of the greatest scientific frauds, Mr. Andy Wakefield. Mr. Wakefield published a paper, subsequently withdrawn by the highly respected medical journal, Lancet, that blamed the MMR vaccine (vaccination for measles, mumps and rubella) for causing autism spectrum disorder (ASD).
From that one fraudulent article, some of the most dangerous outbreaks of vaccine preventable diseases can be laid at the feet of Wakefield, as parents started to refuse to vaccinate their children against these diseases. And of course, billions of dollars, money that could have been spent on actually treating and assisting children with ASD, was spent to investigate this claim, with over 100 peer-reviewed papers completely dismissing and debunking any link between any vaccine and any type of autism. Let me make this absolutely clear–vaccines do not cause autism even when we looked hard for a link.
But one more article, one more peer-reviewed paper has just been published that should slam the door shut on the vaccine-autism myth. But I am not naïve, I know that the antivaccination cultists will invent some logical fallacy to continue to lie about the tie between vaccines and autism. The research, published in the journal Vaccine, is a meta-analysis of five cohort studies involving 1,256,407 children, and five case-control studies involving 9920 children. As I’ve written before, meta-analyses form the basis, the deep foundation, of the scientific consensus, and they are the highest quality scientific evidence available. This study is like a gigantic clinical trial because it rolls up the highest quality data from those millions of subjects to develop solid conclusions.
So what did the authors find?
- There was no relationship between vaccination and autism (OR: 0.99; 95% CI: 0.92 to 1.06). This means that the odds that a person has autism and being vaccinated is equivalent to the odds that a person has autism and not being vaccinated.
- There was no relationship between vaccination and ASD (OR: 0.91; 95% CI: 0.68 to 1.20).
- Similarly the case-control data found no evidence for increased risk of developing autism or ASD following MMR, Hg, or thimerosal exposure when grouped by condition (OR: 0.90, 95% CI: 0.83 to 0.98; p=0.02) or grouped by exposure type (OR: 0.85, 95% CI: 0.76 to 0.95; p=0.01).
So what did the authors conclude? “Findings of this meta-analysis suggest that vaccinations are not associated with the development of autism or autism spectrum disorder. Furthermore, the components of the vaccines (thimerosal or mercury) or multiple vaccines (MMR) are not associated with the development of autism or autism spectrum disorder.”
This was a powerful, large, and well analyzed meta-review. It takes all of the evidence and data that had been developed previously, and rolled it up into one huge cohort and clinical trial. And once again, we find that vaccines don’t cause autism.
Given this information, maybe Age of Exploiting Autism will shut down. Anything they say now about vaccines and autism is simply denial or worse yet, a horrific lie, which will lead to the deaths of children.
- Retraction–Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 2010 Feb 6;375(9713):445. doi: 10.1016/S0140-6736(10)60175-4. PubMed PMID: 20137807.
- Taylor LE, Swerdfeger AL, Eslick GD. Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies. Vaccine. 2014 May 6. pii: S0264-410X(14)00636-7. doi: 10.1016/j.vaccine.2014.04.085. [Epub ahead of print] PubMed PMID: 24814559.
When dealing with those pushing pseudoscience, like the antivaccination cult, the most frustrating thing is that they tend to ignore and deny the most basic tenets of science. If denying the fact of gravity would further their goals of “proving” vaccines are neither effective nor safe, they would do so. For all I know, they have.
Water is two parts hydrogen and one part oxygen. What if someone says, “Well, that’s not how I choose to think about water.”? All we can do is appeal to scientific values. And if he doesn’t share those values, the conversation is over. If someone doesn’t value evidence, what evidence are you going to provide to prove they should value it? If someone doesn’t value logic, what logical argument could you provide to show the importance of logic?
If the antivaccination movement didn’t lead to epidemics of long-gone diseases, which can harm and kill children, the conversation would be over. I would just put the vaccine deniers in the same group as evolution deniers (creationists) or gravity deniers (there has to be some, somewhere). I would mock their pseudoscience, and move on. Of course, their denialism does lead to deaths of children, so we have to do what is right, and stop their lies, misinformation and ignorance in every forum we can.
We have to appeal to scientific values, and despite the fact that antivaccination pushers don’t share those values, we must continue to try. I have gotten enough emails and comments from people that they have started to vaccinate because of what I have written, so maybe some child’s life is better because all of us who support vaccines are heard.
The lunatic Mike Adams, self-styled Health Ranger, pusher of pseudoscience, and publisher of the ignorant self-congratulatory, pseudoscientific website, Natural News, has issued an insane “challenge” to Neil DeGrasse Tyson, eminent astrophysicist, real scientist, and inheritor of Carl Sagan’s common-man touch about the wonders of science.
What is this challenge? Well, Adams claims that since Tyson, who stated, in the new series Cosmos, that “follow the evidence wherever it leads, and question everything,” then because Adams only follows the evidence in his “cutting-edge science” publication, Natural News, then Tyson ought to accept all of the evidence uncovered about vaccines.
OK, before you read the next sentence, please put down your coffee or other liquid refreshment, take a deep breath, exhale. Then Adams demanded that “Neil DeGrasse Tyson, will you publicly denounce the use of mercury in medicine and join the growing call for mercury-free medicine?”
What mercury used in medicine? Oh yeah, that old thiomersal in vaccines trope. The thiomersal which is an organo-mercury molecule that is quickly cleared from the body by the incredibly efficient kidneys. Or the thiomersal that was removed from vaccines despite no evidence that it did anything to anyone getting an immunization.
Even though Tyson is an astrophysicist, he really does follow the evidence. And believe it or not, Neil DeGrasse Tyson has said something about vaccines. He accepts that they work.
Getting over the laughable claim that Mike Adams thinks he follows any evidence, unless by evidence we mean pseudoscience that supports his ignorant beliefs about medicine, his challenge to Tyson is just plain ridiculous. Tyson, like any good scientists, accepts vaccines as safe and effective.
Those lies from individuals who push pseudoscience can be likened to zombies. The lies seems to arise out of unscientific, ignorant, and brainless nonsense. The lies keep arising even after scientific skeptics bury them. Of course, the lies are so loud, it really sounds like the groans of the living dead. Oh, and we can’t forget that the goal of these lies is to eat the brains of the innocent people who are trying to understand the real facts about vaccines. Of all of the pseudoscience zombies out there, the vaccine deniers are the worst, because people die from the zombies, much like what happens from vaccine preventable diseases.
There is a particularly annoying and obnoxious vaccine-denying zombie liar who goes by the handle of The PatriotNurse. Now, as you would expect from her name, she is a nurse, but she runs with the anti-government, conspiracy theory loving, pro-gun (and I don’t mean just owning one gun, but having a full armory because of the government and conspiracies) crowd. And she is antivaccination, as you may have guessed. She posted a crazy video on YouTube, which lists out all of the canards and lies of the antivaccine zombies.
Amusingly, she has disabled comments to this video by stating, “The comments are OFF for many reasons. Foremost is that I refuse to be abused for a contrarian viewpoint that goes against mainstream “Sickcare.” One of the fun things about YouTube is the comments section, where you can cheer for a good music video, or attack someone who posts dumb stuff. But The PatriotNurse refuses to allow her zombie ideas to be shown in the bright light of the day. After watching some of her other videos, I cannot believe someone actually gave her a degree in nursing.
In her vaccine denying, anti-science video, The PatriotNurse uses the standard repertoire of unsupported claims, myths and fairytales that most antivaccinationists use to make their ignorant cases. So, in order of the stupidity of her zombified argument, let me try to chop of its head, and hope the argument doesn’t come back again. Maybe I’m naive about that.
(more…) «The Zombie Apocalypse of antivaccine…»
Pseudoscience pushing individuals can be likened to zombies. They have no brains, and their only goal in life is to eat the brains of those who don’t adhere to their position. The anti-vaccine crowd are my favorite zombies, because the metaphor can be further extended because the victims of these zombies can die (the logical result of non-vaccination).
Yesterday, I ran across this YouTube video by someone called the PatriotNurse. As an aside, WordPress (the blogging software I use) allows for embedding of YouTube videos, which is perfectly within my programming capabilities. But for some unknown, and admittedly perplexing reason, PatriotNurse disabled the embedding feature. Lacking evidence, I won’t speculate as to why. She also has disabled comments to her video by stating, “The comments are OFF for many reasons. Foremost is that I refuse to be abused for a contrarian viewpoint that goes against mainstream “Sickcare.” In other words, she refuses to allow her zombie ideas to be shown in the bright light of the day. Also, if you look at her other videos, well, let’s just say I’m concerned about who trained her as a nurse and who would currently employ her, but that’s not the point here.
Basically she uses the standard repertoire of unsupported claims, canards and fairytales that most vaccine denialists use to make their case. Every once in a while we should list out all their claims, debunk them, and refer to them in the future. The anti-evolution crowd, which probably relies upon 100 times more myths than the anti-vaccine group, has spawned a few websites that list out creationist claims, then thoroughly debunks them. At this time, the anti-vax websites focus on just a few claims, all of which are easily dismissed.
In order of weakness of the argument, here we go!
- After my friend’s neighbor’s cousin’s sister-in-law’s daughter was vaccinated, she got….This argument is a typical example of the logical fallacy called post hoc ergo propter hoc or post-hoc fallacy, a Latin phrase which literally means, “after this therefore because of this.” In other words, just because one event follows another event, one cannot conclude the first event caused the second event. Or even that they are even peripherally related. One of the worst mistakes in science is conflating correlation (this event happens when another event happens) with causation (that one event actually causes the second event). Let’s put it this way. I’m sure a certain percentage of children who are vaccinated break there arms in a fall, get a cold, or draw on the wall with a pen. I’m sure some of us recall such an event. But are they related to the vaccination? Well, I’m sure someone would make a case that the child going to the pediatrician’s office to get a vaccine picks up a cold from another kid, but that’s a perfect example of pure coincidence. In other words, without providing a logical mechanism for the correlation, then causation is far from proven.
- Everyone I know who gets a vaccination gets sick, paralyzed, or (put almost anything here). Similar to the post-hoc fallacy, it depends on a confirmation bias, that is, individuals look for evidence that supports their own beliefs or assumptions, ignoring all else. Of course, the vast majority of children or adults that get vaccinated do not have any serious side effects (nota bene: I chose one of literally thousands of articles that dismiss any serious side effects from vaccines). Essentially, this claim barely rises above personal anecdote.
- Vaccines cause autism. I’m not even sure this claim should be discussed because it’s been so thoroughly and scientifically quashed, it is almost sad that it’s still used as an excuse to not vaccinate. But since this is supposed to be a thorough list, I’ll go through the debunking again. Andrew Wakefield, who first invented the claim in a article in the British medical journal, The Lancet. Eventually, several co-authors removed their names from the paper in 2004, and finally the article was fully retracted by the journal in 2010. Finally, Wakefield was found to be a fraud. Still, the anti-vax conspiracists believe that vaccines cause autism, despite substantial evidence in peer reviewed journals (pdf file). Since all the evidence dismisses the claim, but it’s still trotted out by anti-vaxers, one can only reply with the evidence.
- Vaccines contain mercury. In the past, a mercury-organic compound called thimerosal was used as a preservative in certain vaccines, especially those that were labeled for multiple doses (vaccines vials are often doses of 10). But to be perfectly clear, thimerosal is not metallic mercury floating in the vial, it is a compound that is bound up in a rather large organic molecule, meaning that the mercury itself is inaccessible to the body and will be excreted. Cans of tuna, a typical childhood meal, contains several times more mercury in the form of methyl mercury, which is easily absorbed by the gut and can be dangerous. Vaccines that contain thiomersal contain about 25µg (or mcg or micrograms) of mercury. A 125g (about 4 oz) portion of canned tuna contains about the same amount.
- Vaccines contain mercury–but injected is worse than eating it. The discussion then moves to the myth that ingesting mercury from foods is somehow better than getting it injected. Before we continue, remember the mercury in vaccines is thiomersal which is bound up by a relatively large organic molecule. This is a method used in a lot of pharmacological applications to isolate toxic metals from the body, but still derive a benefit from them. Contrast agents used in enhanced radiology exams (like CT’s) contain iodine, also fairly toxic. The organic molecule protects the patient from the toxic effects, while soon after the exam (usually within 30 minutes), the contrast agent is excreted. The same with thiomersal. Ingested mercury, in the form of methyl mercury (found in most fish), is actually absorbed faster, and methyl mercury also disperses to more organ systems because it mimics an essential amino acid, methionone. There are no physiological mechanisms that block the uptake of a small molecule like methyl mercury, so the effect might be worse than thiomersal.
- Vaccines contain mercury, oh my. Except, they don’t contain mercury, save for some flu vaccines. So, not only eating tuna sandwiches is a larger mercury source, vaccines is not a mercury source.
- Vaccines contain aluminum. So we dispensed with the mercury myth, but a new one shows up. In this case, vaccines do contain aluminum, in the form of aluminum salts. It is used as an adjuvant to increase the immune response of the vaccine, an important requirement to confer immunity to the disease. However, more aluminum comes from food sources (like breast milk) than from vaccines. “During the first 6 months of life, infants could receive about 4 milligrams of aluminum from vaccines. That’s not very much: a milligram is one-thousandth of a gram and a gram is the weight of one-fifth of a teaspoon of water. During the same period, babies will also receive about 10 milligrams of aluminum in breast milk, about 40 milligrams in infant formula, or about 120 milligrams in soy-based formula.”
- Vaccines bypass the gut which is our best immune defense system. It’s hard to disprove something that has no basis in real physiology. If this claim were true, of course, we’d never be afflicted by most pathogens, and we wouldn’t need vaccines. The adaptive immune response to immunizations requires interaction with the internal organs and blood.
- Too many vaccinations. While listening to video (I couldn’t bear to watch), PatriotNurse mentioned another old canard about too many vaccine doses given to infants and toddlers. Apparently, the anti-vaccination zombies need to run from one debunked myth to another one. Paul Offit, much hated by the anti-vaccine gang, has stated that “Vaccines do not overwhelm the immune system. Although the infant immune system is relatively naive, it is immediately capable of generating a vast array of protective responses; even conservative estimates predict the capacity to respond to thousands of vaccines simultaneously”, that “multiple vaccinations do not weaken the immune system,” and that “vaccines represent a minute fraction of what a child’s immune system routinely navigates; the average child is infected with 4–6 viruses per year.”
- It’s a Big Pharma conspiracy. This conspiracy is huge, because it includes the CDC, FDA, major medical journals, physicians, and, of course, the pharmaceutical industry. Of all the logical fallacies, the Appeal to a Grand Conspiracy is one of the most annoying. It is difficult to disprove, because the vaccine conspiracists don’t provide any real evidence for their assertion. Since extraordinary claims require extraordinary evidence, their claim lacks even bad evidence.
There might be other arguments that they use, and I’ll be finding them and debunking them. In the meantime, I’m going to create a vaccine FAQ that debunks these things.