Samoa vaccine story – tragedy abused by anti-vaccine websites

Samoa vaccine story

On Friday, July 6, a tragedy occurred in Samoa, a small country located in the Pacific Islands. Two children brought in for routine MMR vaccination died within minutes of receiving the vaccine (one report said hours and the first expert quoted below was responding to that, but the rest consistently said minutes – another question for investigation). The government reacted to the Samoa vaccine story immediately, opening an inquest into what may have killed the children. 

These are the known facts about the Samoa vaccine story. First, my deepest condolences to the families – it is beyond tragic. This tragedy should be investigated, and when the facts are known, they should be shared, steps should be taken to prevent recurrence, and consequences imposed where appropriate (the fact that a second vaccine was administered after the first death is especially troubling).

Unsurprisingly, this has been picked up by anti-vaccine pages and activists as evidence that vaccines kill and that there is a conspiracy of silence to hide that. Both of those storylines are wrong. I want to take a look the facts behind this Samoa vaccine story. Continue reading “Samoa vaccine story – tragedy abused by anti-vaccine websites”

Flu vaccine mandate for day care reinstated by New York court

flu vaccine mandate

On Thursday, June 28, 2018, New York State’s highest court, the Court of Appeals, unanimously reinstated New York City’s flu vaccine mandate for certain daycares, which was previously struck down by two lower courts on different grounds. The decision, Garcia v. New York City Department of Health and Mental Hygiene, is mostly about a specific legal issue – the line between when agencies act independently, and when they need legislative direction and direct authority to act.

At its core, it is a question about the limits of bureaucratic power. However, the decision also makes it clear that the New York City Board of Health has extensive power to establish a flu vaccine mandate (and for other vaccines) and to act to prevent infectious diseases. In that sense, it’s good news, upholding the ability of the Board to protect public health.  Continue reading “Flu vaccine mandate for day care reinstated by New York court”

Dr Bob Sears medical license on probation resulting from his anti-vaccine views

Dr Bob Sears

On 27 June 2018, Dr Robert (Bob) Sears, an anti-vaccine pediatrician, agreed to a stipulation with the California Medical Board that put his license to practice on probation and subjected him to a set of non-trivial conditions. The revocation of the medical license of Dr Bob Sears was stayed by the Medical Board – it will not become operative unless he violates the conditions – but given the specific allegations in the complaint and the fact that this was his first disciplinary action, an immediate full revocation was not likely. The sanction is non-trivial, and a clear warning against future misconduct.  Continue reading “Dr Bob Sears medical license on probation resulting from his anti-vaccine views”

SB277 appeal rejected by court – California’s vaccine mandate stands

sb277 appeal

On 27 June 2018, the remaining plaintiffs in the problematic lawsuit Brown v. Karen Smith (formerly Buck v. Smith) posted a tentative ruling rejecting their SB277 appeal against the dismissal of their case. The decision is a very strong endorsement of SB277 and immunization mandates generally, and if it is adopted as the Court of Appeal’s final ruling – as it likely will be – it will become a strong barrier to future suits against SB277 unless and until the California Supreme Court deviates from it. Continue reading “SB277 appeal rejected by court – California’s vaccine mandate stands”

“Bad Advice” by Paul Offit – a book review by Dorit Rubinstein Reiss

Bad Advice

A new book, “Bad Advice: Or Why Celebrities, Politicians, and Activists Aren’t Your Best Source of Health Informationby Dr. Paul Offit, is different from his previous writings in two ways – much of it is autobiographical, with a lot of personal anecdotes, and it is about science communication rather than the actual science.

“Bad Advice” opens with a story of a 1997 TV interview Dr. Offit has, and how he bungled – by his account – a question about which vaccines children get, how many, and when. The story sets the tone for the book – it’s funny, it’s candid about what Dr. Offit did, in his view, wrong, and it offers sound advice for other science communicators.

To a large extent, this book was written for those engaged in science communication, and it is full of tips that can help every current or would-be science communicator.

What gives the book its charms are the anecdotes and the humor sprinkled throughout it, and its accessible and conversational tone, but I don’t think I can mirror that here without spoiling the effect – I think these are best enjoyed in context. So this review describes the content but does not capture what makes “Bad Advice” so much fun.

For full disclosure, I highly admire Dr. Offit, have sought his advice and help on many issues in my writing on and advocacy related to vaccines, and consider him a personal friend. I have also read a draft of the book and provided comments. 

Why Science Communication?

The first three chapters of “Bad Advice” provide important background by explaining why science communication is needed, and some of the obstacles to it. 

The first two chapters of the book set out what science is and what scientists do, and why their training and background make it difficult for them to be effective science communicators. Among the things covered – again, with a lot of humor, humility, and personal anecdotes – are that much of the scientific work is done alone, and much of what it requires makes people less, rather than more, suited to work with people. 

Dr. Offit discusses the fact that the scientific method trains scientists away from using absolute statements, but qualified statements can backfire when communicating about science; the challenge of reducing complex, nuanced reality into sound bites that work in a digital age; and more.

The next chapter analyzes why we need science communication, why people – however smart – may fall for misinformation. It looks at several natural, human features that make us easily wrong on scientific issues. “Bad Advice” also examines our difficulty identifying and assessing risks, the pull of celebrities as authority figures, even though they may not have the background to provide good information, and may, in fact, promote bad information (for example, Robert F. Kennedy Jr.  – revisited later in the book – constantly provides bad information about vaccines  ). The chapter also talks about other limits on the ability of humans to think rationally and the ways we acquire knowledge.

After thus setting the stage for why it’s important to engage in science communication and some of the challenges, Dr. Offit is ready for the next stage.

Good advice vs bad advice

Chapters 4 through 7 offer direct advice on communications through personal anecdotes of things that worked and things that didn’t in Dr. Offit’s over 20 years of doing it.

In chapter 4, Dr. Offit offers “some painful, hard-earned, and occasionally humorous lessons gleaned from personal experience” on communicating with the public. These range from the deeply practical (“be comfortable”) to the content based (“be sympathetic,” in the context of an eleven-year-old diagnosed with AIDS at the time when HIV was a death sentence, and “Don’t panic.

The facts are your safety net.”). But they’re invariably written as amusing anecdotes leading to a useful punchline. In one of the stories, Dr. Offit describes how he arrived at the famous “10,000 vaccines” quote that anti-vaccine activists like to misuse. The punchline? “You are going to say things that, although scientifically accurate, you will regret. It’s unavoidable.”

Chapter five addresses whether it’s appropriate for scientists to debate science deniers, using several examples. Dr. Offit’s recommendation is to avoid it, but he does provide three successful examples of such debates. His conclusion is that he, personally, is too angry and passionate on vaccine issues to successfully participate – because he annually sees children die from preventable diseases, “invariably, .. because parents have chosen not to vaccinate their children. And the reason they had made that choice was that they had read or heard bad information..”

Bad Advice ends with a recommendation that “debating the undebatable is worthwhile,” if, and only if, scientists can see the discussion as a teachable moment, and not focus on the people they are debating or the others in the room.

I’m not sure I agree, at least in terms of a televised debate. I think Dr. David Gorski said it well when he wrote:

…debating cranks doesn’t sway anyone, sharing the stage with a real scientist does unduly elevate the crank in the eyes of the public. Besides, whatever the seeming outcome of the debate, you can count on the crank to declare victory and his believers to agree. In any event, science isn’t decided by the metrics used to judge who “wins” a public debate, which rely more on rhetoric and cleverness rather than science to decide the outcome. Finally, such debates are not without risks. Although Julian Whitaker, for example, was terrible at it, other cranks are adept at the Gish Gallop, and an unprepared skeptic or scientist can be made to appear clueless in front of a crowd that is almost always packed with supporters of the crank, not the skeptic.

I think I agree with Dr. Offit’s initial position that agreeing to a debate is a bad idea.

Chapter six looks at the role of comedians in combating misinformation about science, focusing on vaccines – covering the Penn and Teller episode, Jimmy Kimmel, the Daily Show and the Colbert Report. And I’m really going to let you read that by yourselves. It’s fun.

Chapter seven looks at the ways the cinema helps or harms science communication. It opens by comparing two films about outbreaks – “Contagion,” that got the science right, and “Outbreak,” that did not. To give a flavor, when talking about “Outbreak,” Dr. Offit describes how a monkey carrying the harmful virus was caught, and the movie scientists had to “determine which antibodies are neutralizing the mutant virus, synthesize those antibodies, and make several liters of life-saving antisera. Assuming everything goes well, Hoffman’s task should take about a year. Cuba Gooding Jr. does it in a little less than a minute. (Now I understand why people are angry that we still don’t have an AIDS vaccine.).”

Nonetheless, Dr. Offit sees an important role for movies in science communications, and urge scientists to work with filmmakers to get it right.

Science communication in action – confronting the anti-vaccine movement:

The last part of the book uses the anti-vaccine movement as a story of the pitfalls and successes of science communication.

Chapter 8 of “Bad Advice” looks at how charismatic figures can promote anti-science misinformation. Although it covers several examples, the heart of the chapter is the case of Andrew Wakefield, the British doctor who promoted misinformation about MMR. Dr. Offit tells the dramatic story of Wakefield’s rise, the scientific literature that showed him wrong, and the discovery of his misdeeds, that led to his fall. He describes Wakefield’s situation today – thoroughly discredited, on par with other conspiracy theorists – through his participation in the infamous Conspirasea Cruise.  The end of the chapter examines different explanations for why Wakefield sticks to his original claims, years after they’ve been thoroughly disproven. I’ll let you find out yourselves. It’s not exactly flattering to Wakefield, though. 

Chapter 9 looks at the role of politicians in promoting anti-science misinformation, focusing on Dan Burton’s hearings that tried to make a case that vaccines cause autism (YouTube snippets of the hearings, out of context, are still used by anti-vaccine activists. Dr. Offit will give you a more comprehensive view). Dr. Offit also tells of his own experience in the hearing, and what he sees as errors committed because of his naiveté and inexperience. It’s half sad and half comical to read through both his preparation for the hearing, and the actual experience of Mr. Burton, who came into the hearing with a set conclusion and a set role he wanted Dr. Offit to play, trying to delegitimize him. 

Chapter 10 warns science communicators to expect a campaign of personal delegitimization and attacks, drawing on Dr. Offit’s own extensive experiences with anti-vaccine efforts to attack him. It goes from hateful emails, through lawsuits, to death threats. It’s painful but incredibly important for people who go into these areas to be prepared for the ugly reaction from misguided but passionate people on the other side, in all its extreme forms. 

Chapter 11 goes more deeply into Dr. Offit’s own reasons for entering the fray. It is very autobiographical (some of the events in it were described in some of Dr. Offit’s other books, but many will be new to readers), telling his career story – again, with lots of humor, more than a few lumps. This is to explain what motivates him to speak up, and to some degree, to counter the claims accusing him of having a conflict of interests because of his involvement in the creation of the rotavirus vaccine. It’s a powerful chapter.

Chapter 12 ends on an optimistic note, pointing out things that have improved in the war for science – the rise of science bloggers, the better attitude of the media. And in the epilogue, Dr. Offit ends with the March of Science, as an embodiment of the willingness of science supporters to fight back.

Takeaway

In this very autobiographical, often humorous, extremely candid and full of good advice book, Dr. Offit does a service to science communicators by telling them what worked, what didn’t, and some thoughts on what comes next. You may not always agree with his advice, but you are very likely to agree with large parts of it, think about much of it, and enjoy the way it’s delivered. It’s a very fast read, and worth reading and probably rereading. And rereading.





There are three ways you can help support this blog. First, you can use Patreon by clicking on the link below. It allows you to set up a monthly donation, which will go a long way to supporting the Skeptical Raptor
Become a Patron!


You can also support this website by using PayPal, which also allows you to set up monthly donations.



Finally, you can also purchase anything on Amazon, and a small portion of each purchase goes to this website. Just click below, and shop for everything.




National Vaccine Injury Compensation Program facts

national vaccine injury compensation program

In this post I explain how one goes about proving a case in the  National Vaccine Injury Compensation Program (NVICP), and how that differs from proving a case in the civil courts, focusing on what it means to have a no-fault program and proving causation. I will use a case that started with the tragic death of a young child after a vaccine to illustrate the complexity and operation of the program, and also to address the idea of federal preemption, and how it limits the ability of those claiming vaccine injuries to use state courts for their claims.

Continue reading “National Vaccine Injury Compensation Program facts”

Vaccine refusal by a healthcare worker – is it a disability?

vaccine refusal

On June 5, 2018, the US Third Circuit Court of Appeals overturned a District Court’s decision to dismiss a case filed by a nurse who alleged she was terminated for refusing a Tdap vaccine for medical reasons. The focus of the decision was not the vaccine refusal per se; the focus was what are the pleading standards in a claim alleging a failure to provide a reasonable accommodation of a disability. While the specific claim of the nurse’s vaccine refusal is unconvincing in many ways, I think the Third Circuit (“the court”) was right to allow her case to proceed at least a bit further. 

For the purpose of the discussion of any motion to dismiss, the assumption is that the plaintiff’s factual allegations about her vaccine refusal choices are true.  Therefore, what I am describing as “the facts” is the nurse’s version. Fact-finding may show that not all these allegations are provable.  Continue reading “Vaccine refusal by a healthcare worker – is it a disability?”

NVICP Tarsell decision not proof of HPV vaccine-related mortality – just legal errors

NVICP Tarsell decision

On September 25, 2017, Special Master Christian Moran from the National Vaccine Injury Compensation Program (NVICP), acting under a Court of Federal Claims decision that changed the legal standard for compensation, awarded compensation to Ms. Emily Tarsell for the tragic death of her daughter, Christina Tarsell. The family had blamed the tragedy on Gardasil. the HPV vaccine. Let’s review the facts and legal issues of the NVICP Tarsell decision.

A reading of the decision shows that the Special Master himself had serious doubts that the HPV vaccine had actually caused the death (and could probably have more strongly stated his doubts); however, he felt bound by a flawed decision of the Court of Federal Claims and compensated because of that guidance. The claimant’s theory that was used to claim that the vaccine caused the young woman’s death is also extremely far-fetched. It should not have fulfilled the plausible theory requirement even under the watered-down version ordered by the Federal Claims judge. The timing (i.e., cause and effect) was likely wrong – the Special Master thought the disease symptoms started before the administration of the vaccine – but for procedural reasons, he did not dwell on that issue.

While anti-vaccine websites present the Special Master’s award as proof that the death was caused by the administration of the vaccine, that is a serious misreading of the NVICP Tarsell decision. Ms. Christina Tarsell’s death is extremely tragic. But there is no good basis to claim that the HPV vaccine caused it.

There are three legal errors in the decision of the Court of Federal Claims judge, a decision that was then legally binding on the Special Master it was returned to for reconsideration:

  1. Reversing the burden of proof in relation to the timing of the alleged harm;
  2. relaxing the standard under which a medical theory is evaluated; and
  3. applying a de novo standard instead of an arbitrary and capricious standard to the Special Master’s findings of facts (which I’ll explain).

Continue reading “NVICP Tarsell decision not proof of HPV vaccine-related mortality – just legal errors”

Merck whistleblowers – mumps vaccine lawsuit motions and updates

merck whistleblowers

In August 2010 Stephen A. Krahling and Joan A. Wlochowski (“the relators”), former Merck virologists and often called “Merck whistleblowers,” filed suit in the name of the United States – a so-called qui tam action, where the prosecution shares any fines or penalties with the two virologists  – against Merck.

They claimed that by faking effectiveness testing, Merck misled the United States government as to the effectiveness of the mumps component of its  MMRII vaccine (a vaccine which protects individuals against mumps, measles, and rubella). In 2012  a clinic and two MDs filed a class action against Merck claiming a violation of the Sherman Act – monopolistic, anti-competitive behavior resulting from the fraud – and violation of various state laws. (U.S. v. Merck and Chatom v. Merck). The suits were handled together. Continue reading “Merck whistleblowers – mumps vaccine lawsuit motions and updates”



There are three ways you can help support this blog. First, you can use Patreon by clicking on the link below. It allows you to set up a monthly donation, which will go a long way to supporting the Skeptical Raptor
Become a Patron!


You can also support this website by using PayPal, which also allows you to set up monthly donations.



Finally, you can also purchase anything on Amazon, and a small portion of each purchase goes to this website. Just click below, and shop for everything.