Gun control regulations and firearms mortality

Gun control regulations and public health.

Firearms mortality, either murder, accidental or suicide, has always been a public health issue in the USA. There have been several good epidemiological studies that have examined whether gun control regulations and firearms mortality risk are related – and the results are surprisingly vigorous.

From recent epidemiological research, there is some convincing evidence that establishes a correlation between state-level gun control regulations and firearms mortality rates. However, the link is not as black and white as one might wish – the relationship between firearms regulations and mortality depends on the quality of the law.

The nation’s leading public health organization, the Centers for Disease Control and Prevention (CDC), is essentially prevented from analyzing and publishing any epidemiological research that would help us understand what, if any, links there are between gun control and firearms mortality. The Republican dominated congress have done everything they can to prevent the CDC from using any funds to study the issue.

Furthermore, because the CDC cannot (or will not) fund research into gun control, it has lead to a chilling effect on gun control research in academia. According to the Washington Post, “young academics were warned that joining the field was a good way to kill their careers. And the odd gun study that got published went through linguistic gymnastics to hide any connection to firearms.”

But maybe because this public health menace can no longer be ignored, a smattering of well done epidemiological research is being published in very high quality medical journals. Let’s look at one.

Continue reading “Gun control regulations and firearms mortality”

Tetyana Obukhanych – another anti-vaccine appeal to false authority

There are so many annoying issues about the antivaccination cult, that most of us can’t even keep up with it. If only they would provide evidence published in high quality, peer reviewed journals (yes, a high standard, but if we’re talking about public health, a high standard is required), the fake debate would move into a real scientific discussion. One of their favorite feints against real evidence is to push people, like Tetyana Obukhanych, who appear to have great credentials, but once you dig below the surface, not much is there.

One of the most irritating problems I have with the antivaccination movement  is their over-reliance on false authorities, where they trumpet the publications or commentary from someone who appears to have all of the credentials to be a part of the discussion on vaccines, but really doesn’t. Here’s the thing – it simply does not matter who the authority is or isn’t, all that matters is the evidence.

For example, Christopher Shaw and Lucija Tomljenovic, two researchers in the Department of Ophthalmology at the University of British Columbia, have, for all intents and purposes, sterling credentials in medicine and science. However, they publish nonsense research (usually filled with the weakest of epidemiology trying to show population level correlation between vaccines and adverse events) in low ranked scientific journals.

Now the anti-vaccine world has a new hero – Tetyana Obukhanych. Continue reading “Tetyana Obukhanych – another anti-vaccine appeal to false authority”

Properly evaluating vaccine mortality – let’s not abuse VAERS

vaccine mortality

The public’s concern about adverse events, especially death, immediately or soon after vaccinations is very disruptive to vaccine uptake, leading to increased morbidity and mortality of vaccine-preventable diseases. For example, a 2009 Japanese study that showed 107 deaths following H1N1 influenza A vaccination, assumed a causality between the vaccine and the deaths without any evaluation of background rates of of deaths, which would help indicate whether there was any significance to the death rate or even if its related to the vaccination. Vaccine mortality is one of the most abused terms in discussions about vaccines.

It has been demonstrated that passively reported data, that is, data that isn’t actively investigated by trained researchers, cannot be used to assess causality. In an active investigation, it was found that only 2 of the 107 deaths had an autopsy performed, and most of the others had other underlying diseases and conditions that were causally related to the mortality events. Furthermore, 15 million people were vaccinated with the H1N1 seasonal vaccine, and it would be expected that there would be >8000 deaths during the 20 days after vaccination using a crude mortality rate in Japan. Though it would still be a misuse of statistics,  there really is more evidence that the H1N1 vaccination lowered the background death rate from 8000 to 107 post vaccination. Continue reading “Properly evaluating vaccine mortality – let’s not abuse VAERS”

Zombie research – epidemiology, prevention and treatment

zombie research

Zombie research on the potential of a massive zombie outbreaks has become an important focus of science and medicine recently.

Zombies are known as biters, cold bodies, creepers, dead ones, floaters, geeks, lamebrains, lurkers, monsters, roamers, rotters, skin eaters, and walkers, according to the historical TV show The Walking Dead. Other historical documents have called them Zeds, Zs, Zekes, and ghouls.

Zombie research has come to a scientific consensus that a true zombie must meet three criteria (for an exception, see Note 1):

  • It is a reanimated human corpse,
  • it is relentlessly aggressive, and
  • it is biologically infected and can pass that infection to healthy humans.

Recently, a researcher on the science of zombies, Tara C Smith (see Notes 2 and 3 ), an associate professor of biostatistics at Kent State University, published a review article on zombie epidemiology in BMJ, which examines the history, epidemiology, prevention, and treatment of zombie infections. I will endeavor to review some of the more important points as a service to my loyal readers.

Continue reading “Zombie research – epidemiology, prevention and treatment”

The fictional CDC coverup of vaccines and autism – movie time

fictional CDC coverup

The zombie anti-vaccine trope of the CDC coverup of vaccines and autism – tied to a so-called CDC “whistleblower” – has risen again from the dead. I thought it was time to bring back my zombie-killing snarky, sarcastic, and humorous debunking of that trope. Let’s have some fun.

I and about 20-30 other pro-science bloggers wrote articles about a strange story, pushed by all of the usual suspects in the antivaccine universe (starting with Natural News, Green Med Info, and the Age of Lying about Autism). Despite new information, press releases, claims and counter claims, nothing has changed in the facts about vaccines and autism as a result of this somewhat entertaining story that included fictional claims with real people.

What are the facts? Vaccines do not cause autism according to boatloads of evidence.

Nevertheless, this story is provocative, laughable at some level, and filled with rather disreputable characters – it gives all us bloggers, who focus on the real scientific evidence behind the safety and effectiveness of vaccines, a great subject for writing.

As I surmised when I first wrote this article over a year ago, this zombie trope has risen again!

Since much of this story has strong fictional elements, I think we should examine this story as if it were a synopsis for a screenplay behind a proposed new superhero movie. You know, The CDC vs. the Evil Cult of Antivaccination. 

Hey, I ought to copyright that, just in case someone does turn in into a movie. Because this synopsis has all of the important parts of a movie–unsavory characters, a fool, the superhero government agency dedicated to saving lives, and the geeky nerds who think science trumps lies. No cool spacecraft or benevolent aliens unfortunately. I’ll work on that.

OK, let’s get with the story. Continue reading “The fictional CDC coverup of vaccines and autism – movie time”

Evidence supports rotavirus vaccine effectiveness – vaccines save lives

The CDC recently published robust evidence that supports rotavirus vaccine effectiveness. There is nothing more powerful than epidemiological studies that show a correlation (and causality) between the drop in the incidence of a vaccine preventable disease immediately after wide introduction of a the vaccine itself in a relatively closed population.

Continue reading “Evidence supports rotavirus vaccine effectiveness – vaccines save lives”

Cancer rates are increasing in the USA–another myth debunked

One of the enduring zombie tropes of the junk science world is that cancer rates are increasing in the USA (and across the world), and that deaths from cancers are higher today than it was in the past. Depending on the one screaming this myth, this rate of cancer increase is a result of A) vaccines, B) GMO crops, C) pasteurized milk, D) non-organic foods, or E) everything.

To be certain, there are a few things that do cause cancer, like smoking, UV radiation, human papillomavirus, and obesity. There are no 100% guaranteed environmental risks that cause cancer (lots of smokers do not get lung cancer, and there are very rare cases of non smokers getting the same cancer).

But are cancer rates increasing?

Here and there, you might run across a study that mentions one thing or another may or may not increase or reduce the risk of cancer. But most of those studies are one-off primary research, usually using small groups, providing little clinical evidence that you may or may not be able to increase or decrease the risk of cancer. Wait until we can find these studies in large systematic reviews, before deciding that this or that may or may not increase or decrease the risk of cancer.

In the meantime, Joe Mercola certainly can make boatloads of money making such nonsense cancer claims. If he were the only one, we could ignore him, but a quick search of the internet produces millions (I kid you not) of websites pushing miracle cancer cures or prevention. Continue reading “Cancer rates are increasing in the USA–another myth debunked”

The zombie anti-vaccine lie–Peter Doshi and the appeal to authority

flulaval-flu-vaccine

Updated 4 November 2014 to add some ironic analysis of Doshi’s “not-an-epidemiologist” background.

A few  months ago, I wrote an article about Peter Doshi, a Ph.D. who is doing some postdoctoral work at Johns Hopkins University, one of the leading institutions of higher learning in the USA. Doshi is truly not very notable in science, except last year, he wrote an article about flu vaccines, basically employing the Nirvana Fallacy that because flu vaccines aren’t 100% effective they are worthless. Since vaccines are fundamentally a medical procedure to mitigate risk with a very low risk of adverse events, even 50% effectiveness will save thousands of lives. But we’ll get back to that.

The article he wrote is not actually based on real research, but appears to be an opinion paper–kind of like the opinion papers written by creationists who want to convince anyone who will listen that dinosaurs lived with humans. Doshi denies that most flu’s are even caused by the influenza virus. I guess the CDC’s high tech diagnostic tests for influenza are all wrong. But then again Doshi presents no evidence.

Because of the zombie myths of the antivaccination world, myths or papers that are reanimated every few months because the vaccine denier community actually lacks any fresh evidence to support their nonsense. So Doshi’s paper from 2013 is resurrected in the antivaccination press. A few days ago, an obscure pseudoscience promoting website started banging the drum about Doshi’s comments. The article, found in the Realfarmacy website, has this scary headline: “Johns Hopkins Scientist Reveals Shocking Report on Flu Vaccines.” Makes it sound like Doshi wrote another article. Which he didn’t. Continue reading “The zombie anti-vaccine lie–Peter Doshi and the appeal to authority”

The antivaccination cult’s idea of what constitutes “peer-reviewed”

autism-mercury-geier

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). Continue reading “The antivaccination cult’s idea of what constitutes “peer-reviewed””

Hey antivaccination gang–it’s really really simple math

©2014, Amazon.com
©2014, Amazon.com

Yesterday, I tried to show in the most simple mathematical terms that the risk of contracting measles, in the New York City outbreak, was 30X higher in unvaccinated children than it was for vaccinated. I knew I vastly underestimated the actual rate because I used a larger population than I should, because I lacked the more specific geographic spread of the disease. I’ll leave that to a peer-reveiwed paper that I’m sure will be published in the next few months that will accurately describe everything about the outbreak. Don’t hold your breath vaccine deniers–their conclusions will only vary from mine because they’ll present a much higher risk of contracting measles amongst non-vaccinated children.

Someone suggested that I discuss another article that analyzed a measles outbreak in Corpus Christi, TX, which compared those who were vaccinated with the MMR vaccine to those weren’t. The results are clear and relatively straightforward:

  • 1732 children were seropositive (meaning they had antibodies to measles) and over 99% of them were vaccinated. None, and not close to none, but absolutely 0 of these children contracted measles.
  • 74 children were seronegative (they lacked measles antibodies). Fourteen (14) of these children contracted measles.

So, let’s look at the math. All of the kids who had measles antibodies (presumably as a result of the MMR vaccine, since 99% were vaccinated) avoided the disease and its consequences. On the other hand, 18.9% of the children who lacked antibodies got sick.

Again, if this isn’t clear…0% contracted the disease if they had antibodies from vaccines, 18.9% contracted the disease if they didn’t have antibodies.

Now, the 74 children who were seronegative also were vaccinated (though the paper did not tell us how many vaccines were given, it takes at least 2 to confer full immunity). If there are no other issues (and again, the article didn’t report that) like some type of compromised immune systems in some of the 74 children), the vaccine was 96% effective in seroconverting and preventing measles.

This story is rather basic. The MMR vaccine is extremely effective in boosting the immune system to produce anti-measles anti-bodies. A small group seems to have not seroconverted for unknown reasons. But even though most of the population in this study were protected against measles, the disease is so pervasive, so pathogenic, even a small group of susceptible individuals can catch it. But because the vast majority, 96% were protected against the disease, this measles outbreak didn’t spread further.

But think about this. If the number isn’t 96%, but 70% because parents refuse to vaccinate. What happens is that the random chance that an infected child encounters an unvaccinated child increases dramatically, increasing the risk of a much larger outbreak. With all of the consequences of measles.

As I said before, it really is simple math. So simple that a vaccine denier could do it.

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