I regularly write about Gardasil safety and effectiveness, because I consider the HPV vaccine one of top 100 greatest medical inventions over the past century or so. We have so few ways to prevent cancer, despite the nonsense pushed by pseudoscientists like the brainless Food Babe. And one of the best ways to prevent cancer is getting the HPV vaccine to prevent HPV related cancers.
I originally wrote this article around 5 years ago, but it needed updating on several issues since things have changed on this website. But why do I care about maintaining a 5-year-old article about Gardasil safety? Because this is one of the seminal articles about Gardasil safety, one that is important to anyone’s understanding of the subject.
Let’s get into it. Continue reading “Gardasil safety supported by a large study of 200 thousand young women”
The HPV cancer-preventing vaccine, especially Gardasil (or Silgard, depending on market), has been targeted by the anti-vaccine religion more than just about any other vaccine being used these days. So many people tell me that they give their children all the vaccines, but refuse to give them the HPV vaccine based on rumor and innuendo on the internet. This article provides all the posts I’ve written about Gardasil safety and efficacy.
As many of regular readers know, I focus on just a few topics in medicine, with my two favorites being vaccines and cancer – of course, the Gardasil cancer-preventing vaccine combines my two favorite topics. Here’s one thing that has become clear to me – there are no magical cancer prevention schemes. You are not going to prevent any of the 200 different cancers by drinking a banana-kale-quinoa smoothie every day. The best ways to prevent cancer are to quit smoking, stay out of the sun, keep active and thin, get your cancer-preventing vaccines, and following just a few more recommendations.
The benefits of the vaccine are often overlooked as a result of two possible factors – first, there’s a disconnect between personal activities today and cancer that could be diagnosed 20-30 years from now; and second, people think that there are significant dangers from the vaccine which are promulgated by the anti-vaccine religion.
It’s frustrating and difficult to explain Gardasil safety and efficacy as a result of the myths about safety and long-term efficacy of the vaccine. That’s why I have written nearly 200 articles about Gardasil safety and efficacy, along with debunking some ridiculous myths about the cancer-preventing vaccine. This article serves to be a quick source with links to most of those 200 articles.
And if you read nothing else in this review of Gardasil, read the section entitled “Gardasil safety and effectiveness – a quick primer” – that will link you to two quick to read articles that summarize the best evidence in support of the vaccine’s safety and effectiveness.
Continue reading “Gardasil facts – debunking myths about HPV vaccine safety and efficacy”
How many times have you heard tiresome tropes about the HPV vaccine causing this or that? No matter how many times we debunk the nonsense, it persists. One of the critical points I try to make is that before an anti-vaccine claim can be made, there has to be a biological plausibility. That is, can we establish a reasonable and plausible biological mechanism, without resorting to special pleading and pseudoscience, that can lead one from one action, say receiving a vaccine, to some result, real or imagined.
Biological plausibility is a requirement to establish that correlation means causation. It is almost an essential requirement for one to claim a causal association. But biological plausibility must be consistent with our existing knowledge of biology, chemistry, physics, and medicine. How many times has an anti-vaccine zealot tried to convince us that “mercury in vaccines causes autism” but ignores the basic scientific tenets of numerous fields of biomedicine like biochemistry, cell biology, toxicology, immunology, neurology – well, just about every field?
Or someone who claims that acupuncture treats a bunch of diseases, yet we cannot find any reasonable biological plausibility between sticking a needle in the arm to treating some medical condition like pain. They tend to ignore that by using their own personal anecdote as “proof.”
That’s why science is much harder than what is said by the pseudoscience pushers. Establishing plausibility requires a strong knowledge of science to make the case. It’s much more than simply stating that plausibility does exist, you have to use actual real science, published in real scientific journals, to make the case.
So let’s talk a little bit about causality. And a large dose of biological plausibility. Continue reading “Biological plausibility – a keystone of medical and vaccine research”
We all know about anti-vaccine education. They are ignorant about science. They’re unknowledgeable about clinical trials. They’re uneducated about the vaccine court. And they rely upon package inserts, written by Big Pharma of course, as their proof of whatever.
Now, it’s clear that human nature is such that when one takes a position, say on vaccines, they kind of lock in on it, despite the evidence. And the vast majority of unbiased, non-cherry-picked evidence leads to only one simple conclusion – vaccines are relatively safe and effective. A truly open-minded person, say a scaly extinct dinosaur, examines and re-examines their position in light of all of the evidence.
But it’s not just science where the anti-vaccine crowd gets it all wrong. I’ve written before about vaccine profits – if Big Pharma were as evil and nefarious as the science deniers claim, then vaccines would slowly disappear from the market. Why? Because the industry would make boatloads more money selling everything else to hospitals and physicians to treat long-disappeared vaccine-preventable diseases.
And there’s more. I completely overlooked the major problem with huge epidemics, which don’t exist today – there are insufficient hospital beds in all developed countries (and it goes without saying, it’s worse in poorer countries) to care for the hundreds of thousands or millions of kids who get sick. Every new bed in a hospital probably sends $1 million in revenues to Big Pharma (or more broadly Big Medical, which includes devices, equipment, and other products). The windfall to Big Medical/Big Pharma would be so huge that if ending vaccination were a real thing, I’d be going long in Big Pharma stocks, and waiting for the delivery of my brand new shiny Ferrari.
Related to the ignorant anti-vaccine education on Big Pharma profits, their utter lack of understanding about personal finance and investing is almost laughable. Especially, since it’s one of their core ad hominem attacks on several pro-science writers. Let’s look at one.
Continue reading “Anti-vaccine education – ignorance about science and about finance”
I’ve written about 2017-18 influenza vaccine effectiveness several times over the past few months (see here and here) because of the claims, that have grown into facts, about the “useless flu vaccine.” I keep reading comments (even in articles I’ve written) that people aren’t getting the flu shot this year because it has only a 10% effectiveness.
That 10% number seems to be tied to an article published in late 2017 in Eurosurveillance, a journal focused on tracking infectious disease outbreaks. They derived their number from a very conservative review of data in Australia with respect to the current influenza vaccine effectiveness against the H3N2 influenza A virus. As I wrote late in 2017, that the Australian government estimated that the actual effectiveness ranged from 16-33% effective against hospitalization from the flu, so that seems to be much higher than what was stated in the Eurosurveillance article.
In addition, the 10% figure is for only the H3N2 antigen in the vaccine – it still is effective against the influenza A H1N1, and two influenza B viruses. But in the end, I said that almost all predictions about the influenza vaccine effectiveness were estimates based on rather limited data. But now we have better information after a few months of the season, and the CDC just published the data in a peer-reviewed journal. Let’s review real data instead of estimates. Continue reading “Influenza vaccine effectiveness for 2017-18 season – interim CDC report”
One of the enduring zombie myths pushed by the anti-vaccine side is that their children are healthier than vaccinated children. But are vaccinated children sicker? Not based on any real, scientific evidence. But that never stops the science denying anti-vaccine crowd.
The vaccine myth website, vaccines.news published an article recently pointed to two poorly designed studies to make the outlandish claim that vaccinated kids are sicker. One the studies, a German one, which used internet surveys (yeah, think about that) to get data, was pushed by several anti-vaccine groups, including the propaganda blog, Age of Autism, as “proof” vaccines are dangerous. But as the silver-tongued Orac concluded:
In any case, I take some comfort in the hilarious result of this survey that demonstrates that autism prevalence in the unvaccinated is similar to autism prevalence among the vaccinated, no matter how much anti-vaccine activists try to spin it otherwise. I realize that this survey is in fact so poorly designed that it really doesn’t tell us much of anything, but it is fun watching anti-vaxer brains explode trying to spin this result as supporting the vaccine/autism hypothesis.
Remember, there is no scientific evidence supporting the vaccine/autism hypothesis.
Now we have a new study that barely rises to the same abhorrent quality level of the aforementioned German study. Of course, we have to look at it.
Vaccinated children sicker – the research behind the myth
The claims that are circulating across the anti-vaccine blogosphere are based on a recent article published in the Journal of Translational Science. Before we get into the article, you might be wondering what is “translational science,” because it sounds a bit woo-based. Translational medicine or science is an interdisciplinary approach which combines resources, expertise, and techniques within basic sciences to discover enhancements in prevention, diagnosis and therapies for various diseases. It’s actually pulling medicine back to basic sciences to better understand everything going on in the body.
For example, they may discover a mutated gene that produces a dysfunctional protein that has a profound effect on the body. They then target that gene and its protein production to treat the disease, rather than target the symptoms that are caused by the bad protein. Translational medicine is an exciting field of biomedical research, on which has shown much promise. However, some “translational medicine” has moved into the world of woo.
Here’s what the Journal of Translational Science (JTS) says its goals are:
JTS is a novel journal that will focus upon the translation of cellular, molecular, and genetic pathways into clinical strategies for multiple medical disciplines that can impact a broad spectrum of disorders that involve stem cells, degenerative diseases, aging, immune function, tumorigenesis, epigenetics, musculoskeletal function, cognition, behavior, neuronal, cardiac, pulmonary, gastrointestinal, and vascular targets, and metabolic function overseeing all aspects of translational research and medicine. JTS will provide a platform in today’s scientific and medical literature to serve as an international forum for the healthcare and scientific communities worldwide to translate novel “bench to bedside” science into clinical therapies as well as report upon prognostics, novel therapeutic strategies, and biomarker development.
That’s all well and good, but the study from JTS that we’re discussing in this post doesn’t fit in any of those. And a review of much of the research they publish is laughably woo-based. In the same issue of JTS as the article we’re discussing, they had published an article examining traditional Chinese medicine, which is neither traditional nor medicine.
So, let’s take a closer look at the “vaccinated children sicker” paper.
A 10,000-meter meta-critique of the paper.
There’s a lot to dislike about this paper and journal. But I think it’s important to take a meta-approach to this paper to make sure you have a good grasp of the quality of what we’re critiquing.
- The Journal of Translational Science is not indexed in PubMed. It’s been over two years since the journal was first published, and it is rare for a journal to not be indexed there. Without PubMed, it is extraordinarily difficult to cites one of the articles published in JTS. Of course, there’s no reason given for its exclusion from PubMed, but we can speculate that possibly the science is bad.
- JTS lacks an impact factor. The impact factor gives us a relative understanding of the quality of a journal – generally, the impact factor tells us approximately how many times an average article published in a journal is cited per year. A journal like Nature has an impact factor of 36, which means the average article is cited 36 times a year. Why is this important? We know that more pivotal and valuable research is cited many times and often repeated by other scientists, especially in new publications. This is how science develops solid evidence, by examining and repeating the findings of others.
- The publisher of JTS, OAT, is a predatory publisher according to the definitive Beall’s List of predatory publishers. A predatory publisher is “exploitative open-access publishing business model that involves charging publication fees to authors without providing the editorial and publishing services associated with legitimate journals.”
- Low impact factor, predatory journals are generally dismissed by scientific researchers because the peer-review is weak. These journals are often abused by researchers whose data has been rejected by one or more of the respected journals, so they settle for these low-quality versions. In the academic community, publications such as these often cannot be used as evidence of qualification for tenure.
None of these issues alone should lead one to dismiss the data outright. However, if one had real data that leads to a conclusion that “vaccinated kids sicker – watch out,” it would have been accepted by any of the journals that have focused on vaccines. But if the research was not well-designed, and well-analyzed, then the better journals would move away, and quickly, from adding it to their publication.
Critique of the “vaccinated children sicker” paper
The authors, Anthony R Mawson et al., hypothesized that there was an association between vaccines and neurodevelopmental disorders (NDD) of 6- to 12-year old biological children. The study was of homeschooled children in Florida, Louisiana, Mississippi, and Oregon. The mothers were asked to complete an anonymous online questionnaire on their children with respect to pregnancy-related factors, birth history, vaccinations, physician-diagnosed illnesses, medications used, and health services utilized. The NDD was defined as having one or more of these diagnoses – learning disability, attention deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD).
The study found the following conditions were more prevalent in vaccination children:
- Allergic rhinitis (odds ratio = 30.1). We’re going to take a look at odds ratio down below.
- Other allergies (OR= 3.9)
- Eczema/atopic dermatitis (OR=2.9)
- Learning disability (OR=5.2)
- ADHD (OR=4.2)
- ASD (OR=4.2)
- Any chronic illness (OR=2.4)
Well, all that sounds like vaccines are worse for our children. Except it really doesn’t.
How about we jump in with a harsh critique of these kinds of studies:
- It uses an internet questionnaire to determine each of the data points for this study. 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 not be recalled correctly. In addition, there might be an intentional or unintentional bias of the survey participants towards relating a condition to vaccines or ignoring one in unvaccinated kids. Better done, and frankly, more expensive, epidemiological studies rely upon medical records to reduce errors in memory and bias. This is a critical point – the best studies that show no link between vaccines and autism rely upon actual medical data for each child, not on a questionnaire which may or may not be tracking accurate information.
- Homeschooled groups are unrepresentative of the school-age children at large. Many children are homeschooled because of parents dislike of vaccinations, so this forms a biased group. Now, maybe the homeschooled group mirrors a traditionally schooled group – if you want to make that case, then you need actual data published in an actual journal.
- Parents who do vaccinate may be less reluctant to visit their physician to get diagnosed with diseases, while a non-vaccinating parent may choose to ignore any health issues as minor. Thus, there may be an unintentional bias towards health care issues for vaccinated children.
- The groups (vaccinated vs. unvaccinated) are not randomized which will lead to observational and confirmation bias.
- The population for the study is quite small to tease out data on very rare conditions. A meta-review that included nearly 1.3 million children, using real medical records to establish both vaccination status and ASD status, found that there was no difference between vaccinated and unvaccinated groups with respect to the incidence of autism.
- There was a lack of analysis of potential cofounders which might bias the results. Were there other differences between he vaccinated and non-vaccinated groups that could have biased the results one way or another?
- The use of odds ratio by the researchers is curious and may have biased the results. The only reason to use OR is to inflate the difference between both groups. Real epidemiologists prefer relative risk (RR) which provides us with a much more sensitive understanding of the incidence of a condition in a vaccinated group vs. an unvaccinated group. For example, the RR for ASD from this study (if the data actually were useful, which it isn’t) is 3.1, whereas the OR is 4.2.
- The over-reliance on p-values is always a red flag to researchers. With so many p-values, the probability of false positives is fairly large. Because the population for the study was so small, it’s also worth noting that the OR had relatively large error brackets, most of which crossed near unity, that is, 1.0, indicating no difference between the groups.
- The authors seem to overlook or ignore the point that the vaccinated children had a much lower risk of diseases like chickenpox and measles, which we know bring with them significant risks of long-term health issues. Even if we accept this poorly designed study as providing us with evidence of harm from vaccines, one would have to balance it against the benefits of avoiding vaccine-preventable diseases. Of course, this study is so bad, it’s hard to accept anything useful from it.
Predictably, the authors conclude that:
First, additional research is needed to replicate the findings in studies with larger samples and stronger research designs. Second, subject to replication, potentially detrimental factors associated with the vaccination schedule should be identified and addressed and underlying mechanisms better understood.
Maybe because their paper was published in a journal that is not indexed in PubMed, they didn’t search there. If they had, they would have found find 100s of articles, with much better, unbiased studies that conclude that there is no link between vaccines and neurodevelopmental disorders. I’ll simplify for Mawson et al., I reviewed and wrote an article that included the most important real science articles that they are wrong about vaccines and neurodevelopmental disorders.
Are vaccinated children sicker? Well, if you listen to the anti-vaccine crowd, who have cherry-picked Mawson et al. to support their pre-conceived faith that vaccines and autism are linked, you’ll buy into the anti-vaccine conclusions:
This pilot study shows us that if mainstream medicine and our public health agencies are really interested in children’s health, not just vaccine profits or defending vaccine religion against blasphemy, what is needed is not the will to make everyone believe, but the courage to find out.
But real science says that the study used by this anti-vaccination believer is poorly designed, and it does not show what they claim it shows. It’s biased, poorly analyzed, and comes to conclusions that are not supported by the vast mountains of real science published in real (read, non-predatory journals). No real scientist would accept the findings of this paper, other than to laugh heartily. I don’t laugh because I know some crackpot will use it to “prove” that vaccines are dangerous when there’s no robust evidence to support that belief.
Vaccines are safe. Vaccines are effective. A badly designed, irresponsibly published article does not change the vast consensus of scientists that vaccines are safe and effective.
Editor’s note – this article was originally published in May 2017, but for some odd reason, there were a lot of dead links that had to be rehabilitated. Also, some copyediting was required (thanks Grammarly).
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One of my pet peeves, of which there are many, is when a fake science paper is published by a low ranked journal and trumpeted as if it is Nobel Prize-worthy research. You can read about anti-vaccine fake science published in these journals from notorious anti-vaccine “researchers” like Shaw and Tomljenovic, Exley, and Shoenfeld.
One of my pet loves is Star Trek, all versions, all the time. In fact, I occasionally have secret conversations with my fellow Big Pharma shills about Star Trek, in which vaccines are never mentioned. I am a self-confessed Star Trek Nerd, who has watched almost every episode of Star Trek ST: TOS through the current Star Trek: Discovery (see Note 1).
So when I get the opportunity, falling into my lap, to combine Star Trek and the anti-vaccine nonsense, I am happier than a pregnant tribble. And when a fake science paper about the Star Trek universe gets accepted by low ranked predatory journals, ones that are beloved by pseudoscience adherents across the world, it’s what I live for. Continue reading “Fake science about Star Trek accepted by predatory journals – anti-vaccine researchers happy”
In my 100 or more articles about the HPV vaccine, I spend as many words discussing HPV vaccine efficacy as I do about adverse events (which are extremely rare, despite the pseudoscientific claims of the anti-vaccine world). I keep reading comments and claims from the anti-vaccine religion that there is no “proof” that the HPV vaccine prevents infections and certainly no “proof” that it prevents cancer.
Well, a new article has been published that that describes how far HPV infection rates have dropped in Australia nine years after the implementation of HPV vaccination. Spoiler alert – the infection rate went way down, even though vaccine coverage is far from 100%.
Let’s take a look at this article, which provides us with more evidence in supporting the use of the HPV vaccine. HPV vaccine efficacy is corroborated by this new data. Continue reading “HPV vaccine efficacy in reducing HPV infections – Australia experience”
I’ll keep this short and sweet, something rare on this blog. During the week ending 3 February 2018, the CDC reported that there were over 4000 flu deaths in the USA (see Note 1). Yes, you read that right, the US flu death toll was over 4000, many of which might have been prevented by the flu vaccine.
According to the CDC, 10.1% of 40,414 deaths reported in the USA during that week were attributed to the flu or side effects of that flu. And the news will get worse over the next few weeks. The flu death toll is expected to grow even more because flu activity is still rising, and deaths usually follow flu activity.
Furthermore, hospitalization rates as a result of the flu are high, an indicator of potential mortality. So far this flu season, total hospitalization numbers are nearly equal to what we see for a full flu season, not half-way like we with the current flu outbreak. Continue reading “Flu death toll – 4000 Americans last week, more reasons for flu vaccine”
We have just passed the halfway point of the 2017-18 flu season, and if you are watching the news, you could get the impression that things are pretty bad. CDC reports that for this week, the cumulative hospitalization rate was 51.4 per 100,000, which is higher than the 43.5 per 100,000 reported at this same week during the 2014-2015 season. If that trend continues through the season, the number of influenza hospitalizations may exceed 710,000.
Furthermore, the CDC provided evidence of how bad this flu season actually is:
Last week, the number of people even in the clinic that had influenza-like illness was 6.6%. This week it is 7.1%. We’ve had two seasons in the last 15 years that were higher than that. The first was the 2009 H1N1 pandemic, which peaked at 7.8% and the 2003-2004 season, which was a high severity H3N2 season, which peaked at 7.6%.
Furthermore, at least 53 children, under the age of 18, have died of influenza or complications of the virus. And because reporting lags by a few weeks, the numbers are undoubtedly going to be higher. These are all families that have to deal with a tragic loss of a child from a disease that many anti-vaccine people classify as “not dangerous.”
Because there is a lot of myths and tropes out there about the 2017-18 flu season, I thought I would list out some of the reasons why it’s so bad – but it’s mostly your fault. Continue reading “Why is the 2017-18 flu season is looking bad? Plenty of things to blame”