There was an 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. Some of the reasons why the HPV vaccine uptake is so low is a result of several myths about Gardasil safety and efficacy.
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. Continue reading “Gardasil safety and efficacy – debunking the HPV vaccine myths”
Over the past decade, Lyme disease has spread from its traditional confines of the northeast USA to throughout the country. Even though dogs have access to a Lyme disease vaccine, there have not been any available for humans for 18 years. But that’s about to change.
Vaccine manufacturers do not value dogs more than humans for this vaccine. In reality, the blame for why there isn’t a Lyme disease vaccine for children can be placed right where some of you expect it to be – loud-mouthed anti-vaxxers without any scientific evidence supporting their hatred of the vaccine.
Of course, this happened in the mid-1990s, and the internet was in its infancy. But there were people pushing the same narrative that we hear about the cancer preventing HPV vaccine – that the Lyme vaccine was actually worse than the disease itself. They made these claims based on bad or no evidence.
But a new lyme disease vaccine might be on its way fairly soon. This is good news.
Continue reading “Lyme disease vaccine on the way – if only the anti-vaxxers stay away”
More and more people are being misdiagnosed with “chronic Lyme disease,” a medically unrecognized condition that encompasses (pdf) “a broad array of illnesses or symptom complexes for which there is no reproducible or convincing scientific evidence of any relationship to B. burgdorferi infection.” A whole industry of chronic Lyme disease treatments have arisen over the past few years to treat this pseudomedical condition.
There is no evidence that the symptoms of “chronic Lyme disease” are caused by a persistent and hidden B. burgdorferi infection. According to the eloquent Orac, it is simply a “fake disease.”
On the other hand, post-treatment Lyme disease syndrome (PTLDS) describes a set of persistent symptoms that arise after successful treatment of the Lyme disease. The symptoms of “chronic Lyme” are generic and non-specific “symptoms of life.”
Chronic Lyme disease treatments include mostly alternative medicine therapies, especially controversial and harmful long-term antibiotic therapy, particularly intravenous antibiotics. The CDC specifically disputes the effectiveness of long-term use of antibiotics to treat Lyme disease.
A new report from the CDC examined chronic Lyme disease treatments, and found that they are expensive, that they don’t work, and that they can be dangerous. Let’s take a look at that study. Continue reading “Chronic Lyme disease treatments – unproven and dangerous”
Apparently, the “polio vaccine causes cancer” zombie meme has been reanimated by the antivaccination cult. Lacking evidence for their beliefs, retreading old debunked memes is their standard operating procedure.
The interesting thing about social media (Facebook, Twitter, blogs, Google, reddit) is that it’s fairly easy to push pseudoscientific beliefs. The first problem is that many people read the headlines, and never the underlying discussion. If it can be said in 140 characters, or a misleading infographic, many individuals will share that across the internet as a “fact”. So, if you see an claim that “Polio vaccines infected 98 million Americans with a cancer virus,” many people will immediately see that an accept it without much criticism.
Of course, this leads to a second problem. To refute this claim takes a lot more than 140 characters. The refutation is often complex, nuanced and highly scientific, and may take 2000 words or more to blast the claim into orbit. It’s highly emotional to claim a vaccine can cause cancer. On the other hand, to say it is not isn’t emotional–it’s coldly logical. And takes a lot of words.
And the third problem is that is that social media fallacies have multiple lives, so when someone reads one of these memes a year from now, they think “yeah, this is great information”, and pass it along as if it’s the Truth. Killing zombie memes are just as difficult as killing zombies in real life, or at least, on a TV show. Debunking these zombie memes is a full-time job. And, once it’s been debunked, we move back to the first problem again, again, and again.
Continue reading “Polio vaccine causes cancer – just a myth”
Here we go again, another anti-vaccine trope based on one paper without adequate scientific criticism of said paper. What is this trope? Mumps and measles infections prevent heart disease and stroke. Let me jump right to the conclusion – wrong.
Although I’ve seen this story before, like most zombie tropes in the anti-vaccine world, this one has come back from the dead. In the pseudoscientific website, Health Impact News, the author writes:
By my calculations, natural infection with the measles and mumps will prevent millions of heart attacks and strokes. Why is this information not all over the TV and internet? I will tell you why. Because mainstream media is in bed with Big Pharma who pay their bills. The politicians are slaves to their corporate masters. Our children should be exposed to every virus and bacteria for which a vaccine exists.
The author’s shrill claim is based on a 2015 article published in the lower impact factor journal, Atherosclerosis. The authors concluded that “measles and mumps, especially in case of both infections, were associated with lower risks of mortality from atherosclerotic CVD (cardiovascular disease).”
Now, it’s time to turn a critical and skeptical eye towards that article.
Mumps and measles infections prevent heart disease – the paper
The study evaluated lifestyle questionnaires from 43,689 men and 60,147 women who were aged 40-79 years at the baseline period of 1988-1990. Individuals of that age probably were not vaccinated against measles or mumps, since that vaccine wasn’t available for children until the late 1960s, when the individuals in the study would have been 20-50 years old. The questionnaire included history of measles and mumps, and were followed until 2009.
The authors then determined hazard ratios (HR, see Note 1) for mortality from cardiovascular disease (CVD) between groups with history of measles and/or mumps infection versus those who did not have those infections. Here are some of the results of the analysis:
- Men with history of measles had an HR for all CVD deaths of 0.92.
- Men with history of both measles and mumps had an HR for CVD deaths of 0.80.
- Women with both infections had an HR for all CVD deaths of 0.85.
The researchers also looked at comparisons between infected and non-infected groups for various types of CVD, but these data probably are the most important.
The study also attempted to show that there was no difference in infected and non-infected groups for a series of confounding variables. They include:
- Body mass index
- Previous history of CVD
- Exercise level
- Stress level
Taken at face value, the research does seem to support the contention that we shouldn’t get the MMR vaccine to protect ourselves against measles and mumps, because catching those diseases may protect us against cardiovascular disease when we get older. But really, does it really gives us evidence to quit vaccinating? Let’s take look.
- This is a one-off primary study that has not been confirmed by any other researchers. This places it at the lower end of the hierarchy of scientific research.
- The authors did not propose a biologically plausible explanation. If one is to propose a correlation between two events, especially when the temporal difference is over 50-70 years, one must also propose a plausible reason why you might assume there is correlation. Is there a plausible reason for anyone to believe that a mumps or measles infection will protect someone from cardiovascular disease? I have a scientific bias towards plausibility, otherwise we can propose inane scientific hypotheses that waste the time of everyone involved.
- There is simply little evidence that measles or mumps is correlated with CVD – a review of PubMed for any articles that might establish a relationship between mumps and/or measles with CVD provided me with two articles. The first is the one we are discussing herein. The second, also published in Atherosclerosis, seems to indicate that mumps and measles is related to higher rates of CVD. This is why cherry picking is bad – you seek out articles that support your pre-conceived conclusion rather than let all of the evidence lead you to a conclusion.
- The use of questionnaires for epidemiological studies is frowned upon by many researchers. The reasons for this are many, but they include a reliance upon the memory of the participant for events that may be 50 or 60 years in the past. For a highly infectious disease like measles, it’s hard to believe that 50% of the participants in this survey caught neither mumps or measles as a child. It’s more likely that they actually had caught the disease but forgotten about it. A properly designed study would have measured measles and mumps antibodies then determined the HR. Or used actual medical records (like a lot of vaccine studies use for case control studies of vaccine effectiveness and safety).
- The hazard ratios were tiny. Yes, it appears that mumps and measles infections prevent heart disease – the data seem to show a 8-20% reduction in CVD risk. But is that clinically significant? If being vaccinated against measles and mumps showed a 200-300% increase in the risk of CVD, I would be impressed and troubled by the results. But such a tiny reduction in the risk could be explained by anything. A missing confounder. Other infectious diseases. Nutritional levels. In fact, I can go on and on. Furthermore, is an 8% reduction in risk of CVD, if it is valid, worth the risk of death or disabling conditions from contracting measles or mumps? Although the question is rhetorical, it’s actually necessary to come to a conclusion based on the results provided.
- Speaking of vaccines, why wasn’t vaccine status asked (although the same memory issues that would plague this questionnaire would still bother me here)? Even though most of the participants probably would have missed the vaccine, some may have gotten it.
- The results also showed a 5-20% increase in risk of CVD for women who had either mumps or measles. That result alone throws into question the whole study, because the results are all over the place.
Can one use this article to claim that mumps and measles infections prevent heart disease and stroke? Not really. The best I can say, and I’m doing this with a lot of trepidation, is that this study provides us with observational data, not a confirmation or refutation of a hypothesis about mumps and measles infections. It certainly does not give us any reason whatsoever to change public health priorities in vaccinating against mumps and measles despite the anti-vaccine tropes.
- A hazard ratio describes a ratio of hazard rates between two events. In the case of this study, if the rate of cardiovascular disease mortality for the mumps infected group is 1.0 and it’s 2.0 for the non-infected group, then the hazard ratio is 0.5. That is the mumps infected group is only 50% as likely to have died of cardiovascular disease as the non-infected group.
Anti-vaccine activists tend to grab onto any story that supports their narratives about vaccines. Generally, they comb the internet for any article that either tells us that vaccines don’t work, that they’re dangerous, or that the disease prevented is innocuous. It’s a frustrating process. Recently, an article was published that seemed to indicate chickenpox prevents glioma, a rare group of cancers that arise in the brain or spine. Then, by extension, some have claimed that not being vaccinated against chickenpox helps prevent glioma.
But is this valid? What does the evidence say about chickenpox and glioma? Is it even plausible that chickenpox has some biological relationship to glioma?
As always, answers aren’t as simple as the anti-vaccine group would like them to be. It’s complicated, as most science is.
Continue reading “Chickenpox prevents glioma – not a reason to avoid the vaccine”
If you go to your veterinarian to get the Lyme disease vaccine for your dog, just make an appointment and your dog will be vaccinated against this serious disease. If you go to your pediatrician to get the Lyme disease vaccine for your children, give up now. It’s simply not available.
Is it because Lyme disease is more serious to your dog than your children? Nope. Is it because Big Pharma makes more money from dogs than humans? No. Is it because the Lyme disease vaccine is safer for a dog than in a human? Not really.
Enough with the guessing game. The blame for why there isn’t a Lyme disease vaccine for children can be placed right where some of you expect it to be – anti-vaccine activists. This was in the mid-1990s, and the internet was barely usable without Google to help us, but there were people pushing the same narrative that we hear about the cancer preventing HPV vaccine – the Lyme vaccine was worse than the disease. Let’s take time to look at this story.
Continue reading “Lyme disease vaccine – good for dogs but not for humans”
Chronic Lyme disease (CLD) is a generally unrecognized medical diagnosis that contains a broad number of disorders or symptoms that are supposedly related to a Lyme disease infection. There is no reproducible or convincing scientific evidence of any relationship between the symptoms and Lyme disease. There is no evidence that chronic Lyme disease is caused by a persistent Lyme disease infection. In fact, there’s little evidence that CLD “patients” ever had Lyme disease itself.
Despite this lack of scientific, medical and clinical evidence, a whole cottage industry has arisen to promote the myth of chronic Lyme disease along with selling expensive treatments that have shown little or no clinical efficacy. Furthermore, a whole activist movement that argues that CLD is a real disease, and they can be a vociferous and radical as your every day anti-vaccine activist. In fact, a lot of the arguments are similar between the CLD and anti-vaccine groups – over reliance on anecdotes, cherry picking scientific articles, and claims of some sort of conspiracy.
But we’re going to ignore all of that. This article will take a look at the best scientific evidence that has examined the claims about chronic Lyme disease. Because the only thing that matters is scientific evidence.
Continue reading “Chronic Lyme disease – is there any scientific evidence supporting it?”
I don’t judge people by their looks, intelligence, bank account or fame. I only judge people by the good things they have done to save and improve lives. It’s a simple equation. Using a similar life calculator, Dr. Paul Offit, in an article in the Daily Beast, examined the legacy of Rachel Carson, and her groundbreaking book, Silent Spring. Published in the early 1960s, Carson was the first to warn that DDT effects include accumulation in the environment, and by doing so, it could bring harm to wildlife. She also warned that its overuse could make it ineffective. And finally, she said that we should use natural means for pest control, like bacteria that killed the mosquito larvae.
If you’re unfamiliar with Paul Offit, he is an inventor of a lifesaving vaccine and provider of scientific information about vaccines – he absolutely cares about human lives, despite the nastiness thrown his way. Dr. Offit’s rotavirus vaccine, which he invented, has saved millions of lives across the world. Who amongst us can make that claim, of saving so many lives?
But Dr. Offit looked at something that is generally ignored with regards to the most important of DDT effects – it killed malaria carrying mosquitoes that kills millions of lives. Today, because of DDT, there is no malaria in the USA. But it’s more than just America, Dr. Offit looks carefully at other successes of the pesticide:
As malaria rates went down, life expectancies went up; as did crop production, land values, and relative wealth. Probably no country benefited from DDT more than Nepal, where spraying began in 1960. At the time, more than two million Nepalese, mostly children, suffered from malaria. By 1968, the number was reduced to 2,500; and life expectancy increased from 28 to 42 years.
It’s hard to imagine, but Nepal had a 99% decrease in malaria infections just because of DDT. From our cozy homes in the wealthy developed world, malaria seems like some distant disease that matters not. But it wasn’t too long ago that malaria was rampant in many areas of the developed world, like Italy, the American south, Greece, and other areas. It’s not some boring disease, it kills.
And since DDT was banned, malaria has come screaming back. According to Dr. Offit, “since the mid 1970s, when DDT was eliminated from global eradication efforts, tens of millions of people have died from malaria unnecessarily: most have been children less than five years old. While it was reasonable to have banned DDT for agricultural use, it was unreasonable to have eliminated it from public health use.”
There is a claim out there that whether we chose DDT, and killed ourselves and the environment, or choose malaria with no DDT, it was all the same. But in fact, real scientific studies have since shown us that the danger from DDT was overstated, while the danger from malaria stayed the same.
It’s the 0,1 binary scale of decision making that we see by a lot of anti-science types. DDT may save lives of by preventing malaria, but any harm to the environment is bad. Either an insecticide must be 100% safe, or it’s 100% unacceptable.
Let’s go into more detail about DDT and Rachel Carson – the story is complicated. Continue reading “DDT effects – Paul Offit tries to set the record straight”
A while ago, I reported on an outbreak of a mysterious viral disease that exhibited polio-like symptoms. At the time, around 23 children and young adults were afflicted with the disease. Some of them tested positive for enterovirus 68 (known as EV-68 or EV-D68), a member of a genus of viruses that includes over 66 different species that can infect humans. None of these children tested positive for the polio virus.
Polio is a crippling and potentially deadly infectious disease caused by the poliovirus, a human enterovirus, that spreads from person to person invading the brain and spinal cord and causing paralysis. Because polio has no cure, the polio vaccine is the best way to protect yourself and the only way to stop the disease from spreading.
The United States last experienced a polio epidemic in the 1950s, prior to the introduction of the polio vaccine 60 years ago. Today, polio has been eradicated from most of the planet, as the number of worldwide polio cases has fallen from an estimated 350,000 in 1988 to fewer than 223 in 2012—a decline of more than 99% in reported cases.
Predictably, the anti-vaccine community has decided to use this extremely rare virus to make specious claims about vaccines, pesticides, and who knows what else. Typical of these tropes, we pro-science types completely debunk it, thinking it’s dead and done. But like the metaphorical zombie, it arises again to eat the brains of anti-vaccine activists. So, here I go again.
Continue reading “Enterovirus 68 – don’t blame vaccines or pesticides”