Google University equals research for anti-vaccine pseudoscience

Google University

I’m sure everyone has run into the type – a science denier who thinks their two hours at Google University makes them as knowledgeable as a real physician or scientist. This arrogance manifests itself in ridiculous discussions with anti-vaccine religious nutjobs who claim to have “done the research,” and who believe their pseudoscientific research is more valuable than real scientific research.

This Google University education from vaccine deniers, really all science deniers, can be frustrating. I frequent a couple of large Facebook groups that try to help on-the-fence anti-vaxxers understand what constitutes evidence and what doesn’t with respect to vaccines. Recently, one of the anti-vaccine true believers kept saying she knew more than a nurse with a public health master’s degree. The arrogant anti-vaxxer kept claiming that she “did her research.”

Hang on. The old dinosaur needs to slam his head on the desk.

Because of this absurd overvaluing of their Google University research, I want to review a handful of points that every science denier seems to use that makes us laugh. All but one applies to any type of science denial, but we’re sticking with vaccines. Because we can. Continue reading “Google University equals research for anti-vaccine pseudoscience”

Scientific consensus – collective opinion on vaccines and other science

scientific consensus

In the hierarchy of scientific principles, the scientific consensus – that is, the collective opinion and judgment of scientific experts in a particular field – is an important method to separate real scientific ideas and conclusions from pseudoscience, cargo cult science, and other beliefs.

I often discuss scientific theories which “are large bodies of work that are a culmination or a composite of the products of many contributors over time and are substantiated by vast bodies of converging evidence. They unify and synchronize the scientific community’s view and approach to a particular scientific field.”

A scientific theory is not a wild and arbitrary guess, but it is built upon a foundation of scientific knowledge that itself is based on evidence accumulated from data that resulted from scientific experimentation. A scientific theory is considered to be the highest scientific principle, something that is missed by many science deniers. In addition, a scientific consensus is formed by a similar method – the accumulation of evidence.

I have written frequently about the scientific consensus because it is one of the most powerful pieces of evidence in a discussion about critical scientific issues of our day – evolution, climate change, vaccines, GMOs, and many areas of biomedical knowledge.

This tome has one goal – to clarify our understanding of the scientific consensus, and how we arrive at it. Through this information, maybe we all can see the power of it in determining what is real science and what are policy and cultural debates.

Continue reading “Scientific consensus – collective opinion on vaccines and other science”

Italian vaccine policy – bans unvaccinated kids from school

Italian vaccine policy

The Italian vaccine policy has been perplexing over the past few years. Although Italy is not the center of the vaccine universe, there have been some amusing and troubling decisions out of Italy that have caused me to write about it on a number of occasions.

Implementing smart public health policy, Italy has decided that if a child under the age of 6 has not been vaccinated, they will not be able to attend kindergartens or elementary school. And if the child is between ages 7-16, the parents will face a fine. This happened despite the promises of the new Italian government elected in 2018 which seemed to delay the previous government’s law that mandated vaccines

However, the recent measles epidemic hitting Europe, mostly caused by vaccine refusal, and relatively low vaccination rates in the country, probably convinced the government that it needed to protect its citizens.

Let’s take a short look at the Italian vaccine policy over the years, and see how we got here. Continue reading “Italian vaccine policy – bans unvaccinated kids from school”

Another SB277 lawsuit rejected – anti-vaccine Voice for Choice loses

SB277 lawsuit rejected

On 20 November 2018, the California court of appeal for the third appellate district, in a strong decision, rejected a challenge by the anti-vaccine organization A Voice for Choice and three individual plaintiffs to SB277, California’s law removing the personal belief exemption to school immunization mandates. The decision included scathing criticisms of the arguments and a powerful endorsement of school vaccines mandates. This article will examine yet another SB277 lawsuit rejected by courts.

Background

The first iteration of the lawsuit in question here was first discussed in November 2016, and it was then filed with a federal district court. After the initial rejection of that lawsuit, it was refiled with a state court, and after that was rejected, the plaintiffs appealed. 

The court opened by stating that “Plaintiffs’ arguments are strong on hyperbole and scant on authority.” Its decision drew extensively on the California Court of Appeal, Second Appellate District’s decision in Brown v. Smith, and on the federal district’s court decision in Whitlow v. California (discussed here). 

The Court opened with the California Supreme Court decision in Abeel v. Clark (1890) 84 Cal. 226, in which the Court upheld a school immunization requirement, and the extensive jurisprudence, state and federal, that upheld vaccines mandates since. It reminded us that for over a century, courts upheld school mandates in the face of challenges, and cited Brown v. Smith to explain that “[t]his is another such case, with a variation on the theme but with the same result.” 

Setting the ground, it explained the act, and its purpose “to provide “[a] means for the eventual achievement of total immunization of appropriate age groups against [certain] diseases.” (§ 120325, subd. (a).)” It explained the need for the act – the measles outbreak centered on Disneyland and the warning it provided that vaccine rates are too low, and exemption rates increasing too fast, and in some areas are dangerously high.

It set out the standard of review for a demurrer. A demurrer is a claim that the complaint does not raise a cause of legal action – in some jurisdictions, it would be titled a motion to dismiss. Because sustaining – accepting – a demurrer means a case is kicked out without going through fact-finding, without plaintiffs having their full day in court, the standard is pretty high, and appellate review is aggressive: 

We review the complaint de novo to determine whether it alleges facts sufficient to state a cause of action. For purposes of review, we accept as true all material facts alleged in the complaint, but not contentions, deductions or conclusions of fact or law. We also consider matters that may be judicially noticed.” (Brown v. Smith, supra, 24 Cal.App.5th at p. 1141.) We may affirm a trial court judgment on any basis presented by the record whether or not relied upon by the trial court. 

De novo means the appellate court is not bound by the finding and conclusions of the court below but reevaluates the claims from scratch. As the court explained, it is assuming factual claims are true, though if there’s judicial notice of well known, external facts, it can reject clearly implausible claims.

Note that a demurrer is usually sustained with a “leave to amend” because the court thinks it is possible for the plaintiff to state facts sufficient to constitute a cause of action. In this case, the demurrer was sustained without leave to amend because the court believes that the plaintiffs’ claim is so weak that no amending of the complaint will solve the fundamental problems.

SB277 lawsuit rejected – substantive due process

A substantive due process claim argues that the government overstepped in interfering with individual rights, beyond a legal standard. 

Here, there are three parts to this argument, as addressed by the Court – plaintiffs claim that SB277 violates their right to bodily autonomy, conditions their right to attend school on giving up bodily autonomy, and interferes with their parental rights. The court rejected the argument both because plaintiffs did not provide any legal authority supporting it (they couldn’t – there are none) and because they did not succeed in convincing the court that the law violates either of the possible legal standards. A substantive due process claim that affects a fundamental right (like bodily autonomy) would be held to the high standard of strict scrutiny. Under it, a law is “upheld only if it is narrowly tailored to promote a compelling governmental interest.” In other claims, a much lower bar – rational-basis review – applies. The court found SB277 would meet either standard. The court said that:

“It is well established that laws mandating vaccination of school-aged children promote a compelling governmental interest of ensuring health and safety by preventing the spread of contagious diseases.”

It cited multiple cases upholding vaccine mandates and criticized the plaintiffs for not addressing them and responding to them. I’m not sure that’s completely fair – the plaintiffs did try to address at least one of the cases the court pointed to, Zucht v. King and the decision later responded to that. But the court is completely right that plaintiffs did not succeed in providing a convincing reason to reject that abundant jurisprudence. 

Addressing bodily autonomy, the court rejected plaintiffs’ effort to argue that the vaccine cases are before cases upholding bodily autonomy, and therefore invalid. The court said: “We are aware of no case holding mandatory vaccination statutes violate a person’s right to bodily autonomy.”

I agree with the court’s conclusion, but I would support it differently. First, at least one famous bodily autonomy case – Schloendorff v. Society of New York Hospital  dates to 1914, while Zucht is a 1922 case, so the timing does not fit the plaintiffs’ claim. But more importantly, while I think the bodily autonomy cases would be important if a state were to impose an adult mandate, that’s not the issue here. These are children who are required to be vaccinated – and bodily autonomy does not work quite the same way. The children are not capable of making autonomous decisions, and the issue is not their autonomous choice not to be protected from diphtheria, measles, hib, etc. – it’s their parents’ choice not to protect them.

There are other arguments against the cases, but I want to keep this short, so I will not go into detail about them. 

The more tricky prong of the strict scrutiny standard for this purpose is that a law limiting rights has to be narrowly tailored. Here, plaintiffs – as they should have – argued that there are other, less aggressive means to prevent outbreaks. And the court – correctly, in my view – rejected it, drawing on Brown v. Smith and Whitlow again. The court pointed out that the state’s objective – total immunization of the relevant age groups – is ambitious, and lesser means won’t achieve it. It then quoted language from Brown strongly endorsing mandates (pdf):

“This argument fails, of course, as compulsory immunization has long been recognized as the gold standard for preventing the spread of contagious diseases. As is noted in the legislative history, studies have found that ‘when belief exemptions to vaccination guidelines are permitted, vaccination rates decrease,’ and community immunity wanes if large numbers of children do not receive required vaccinations.”

The court gave short shrift to the plaintiffs’ claim that SB277 violates privacy, because when dealing with health matters, the review is under rational-basis review, and the desire to prevent dangerous diseases trumps it (to those interested in a longer analysis, I engaged in one here).

Probably the strongest claim plaintiffs had is the claim that SB277 violates the right to education – though even that is not particularly convincing. But the Court rejected this claim easily, too, because the two previous decisions – Brown v. Smith and Whitlow – already dealt with the issue. The court found that the precedent enshrining the right to education – Serrano – did not apply, for two reasons.

First, it was not applicable on the facts:

[quoting Brown] “Serrano struck down a public school financing scheme as violating equal protection guaranties ‘because it discriminated against a fundamental interest — education — on the basis of a suspect classification — district wealth — and could not be justified by a compelling state interest under the strict scrutiny test thus applicable.’ ” (Brown v. Smith, supra, 24 Cal.App.5th at p. 1145.) Like the plaintiffs in Brown, the plaintiffs here “cite Serrano to support their claim that Senate Bill No. 277 . . . violates their constitutional right to attend school, but fail to explain its application here. There is no ‘suspect classification’ underlying Senate Bill No. 277.”

Second, and just as important, even assuming the statute was held to strict scrutiny because education is a fundamental right, the court already explained that it can pass strict scrutiny. 

Finally, in a very short statement, the court agreed with the Brown court that SB277 did not violate religious freedom. 

In short, this decision agreed with previous jurisprudence that school mandates are constitutional and valuable.

SB277 lawsuit rejected – what next?

A Voice for Choice has two choices. It can accept the loss and go home, or it can try and appeal to the California Supreme Court. Not appealing has advantages: this is an unpublished decision, and as such, does not serve as a precedent – it cannot be cited or relied on. It is, however, binding on the parties to the case. A Supreme Court decision, if one happens, could well echo the strong endorsement of mandates, based on strong evidence that they work and an extensive jurisprudence, and would change the legal situation for the worse – it would end the issue in terms of California law (since the claims in this lawsuit are mostly state claims, the California Supreme Court is the last word on them). On the other hand, not appealing gives up a chance to change the legal situation, leaves SB277 intact, and leaves in place the other appellate court decision – Brown v. Smith – supporting it. 

If A Voice for Choice appeals, the Supreme Court will get to decide whether to take the case. The California Supreme Court takes very few civil law cases, and this one is based on extensive jurisprudence rather than breaking new ground – so there is a strong chance it will not be taken up. On the other hand, the court may want to address the question of immunization mandates in current times. 

We will see. 

8 December 2018 Update

The state requested that the court’s decision be published. On December 6, 2018, the court granted the request, giving the decision precedential force.

14 March 2019 Update

The Love Plaintiff requested the Supreme Court of California to review the case. The California Supreme Court, like the majority of the highest courts in the states, generally has discretion on whether or not to hear cases. On 13 February 2019, the Supreme Court declined to review the case, making the court of appeals decision final.

Christopher Bunch – another tragedy blamed on the HPV vaccine

christopher bunch

On 14 August 2018, fourteen-year-old Christopher Bunch died from acute disseminated encephalomyletis (ADEM), leaving his loving, devoted family reeling. The family blamed his death on the HPV vaccine that Christopher received, and they were quickly surrounded and courted by anti-vaccine activists.

My heart goes out to Christopher’s family. I followed the case since he was in the hospital, hoping and praying with them for a good outcome, and I feel their heartbreak. I was also deeply impressed by their initial reaction, which was to create a positive legacy for Christopher, making him visible and famous.

I would rather not write about this, which is why this post is so long after the fact. But Christopher’s death is since being used to try and scare people away from HPV vaccines or vaccines generally, putting others at risk of cancer and death. With very little basis: the timing and the epidemiological evidence do not support a link between Christopher’s death and HPV vaccines. Christopher Bunch deserves a better legacy than that. Continue reading “Christopher Bunch – another tragedy blamed on the HPV vaccine”

Anti-vaccine liability – should they pay for the harm they cause?

Recently, Professor Dorit Rubinstein Reiss wrote an editorial in the San Francisco Chronicle about anti-vaccine liability – should parents who refuse to vaccinate their children be financially liable for the harm they cause to others? Professor Reiss lays out a compelling case as to why it should happen.

Professor Reiss, a frequent contributor to this website, is a Professor of Law at the University of California Hastings College of the Law (San Francisco, CA). She writes extensively in law journals about the social and legal policies of vaccination–she really is a well-published expert in this area of vaccine policy. Additionally, Reiss is also a 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.

She has written other articles about anti-vaccine liability – here and here. This is an issue that many of us think about when anti-vaxxers put not only their own children but also many others, at risk of dangerous diseases. 

Continue reading “Anti-vaccine liability – should they pay for the harm they cause?”

Vaccines and autism – robust, powerful science says they are unrelated

vaccines and autism

Vaccines and autism are not linked or associated according to real science, published in real scientific journals written by top scientists and physicians.

But this false claim is in the news again. Probably as a result of reports that more and more children are being diagnosed with autism spectrum disorders. So let’s take a look at the science.

On 26 April 2018, the United States Centers for Disease Control and Prevention (CDC) announced that new data showed a continued rise in the number of children diagnosed with autism spectrum disorder (ASD). ASD is considered to be a disorder of neural development, usually appearing before the age of 3 years, characterized by impaired social interaction and verbal and non-verbal communication, and by restricted, repetitive or stereotyped behavior.

Predictably, the anti-vaccine community jumped on this information (despite their hatred of the CDC) to make unfounded claims, not backed by science, that this was all the fault of vaccines. Of course.

Continue reading “Vaccines and autism – robust, powerful science says they are unrelated”

MMR vaccine and autism – once again, there is no association

mmr vaccine and autism

Despite the lies of the anti-vaccine religion, a huge recent Danish study has, once again, debunked any link between the MMR vaccine and autism. This is like the 140th peer-reviewed study that says the same thing – vaccines do not cause autism.

This study is particularly robust and conclusive, and it adds to the settled science that the MMR vaccine and autism are unrelated. And it is further evidence that the fraud perpetrated by Mr. Andrew Wakefield did nothing more than cause children to be put at risk of measles. 

But will this cause the anti-vaxxers to shut up? Of course not, because they prefer pseudoscience to real science. Continue reading “MMR vaccine and autism – once again, there is no association”

February 2019 ACIP Meeting – the process for vaccine recommendations

In February 2019, I attended a meeting of the Advisory Committee for Immunization Practices (ACIP) for the first time. This post describes my observations from the two-day ACIP meeting process.

Generally, the meeting taught me that the process the committee goes through is highly deliberative, data-intensive, and the committee pays close attention to safety and maximizing benefits. Though no process is perfect, the meeting increased my confidence in the decision-making process behind the vaccines recommendations that apply to my children.

Numerous anti-vaccine group attended added some excitement and some stress, but was, from a standpoint of vaccine policy-making, largely irrelevant. 

I am initially, a public administration scholar – I wrote my dissertation on agency accountability, taught the Federal Advisory Committee Act multiple times, and teach almost annually about agency decision making. This made me very interested in the committee’s process. I also knew in advance that there will be – as there has been in several previous meeting – numerous anti-vaccine activists, and was curious to see their interaction with the meeting in reality.

Initially, I thought I would describe in detail what was addressed in the meeting, but I think that would make this post too long. For those who are interested, here is the agenda for the February 2019 ACIP meeting (pdf).

Instead, I will offer my observations about the process. I will mention that the only things voted on in this meeting were related to Japanese encephalitis vaccine and anthrax vaccine. The committee voted to make some changes to the language of the recommendation of the Japanese encephalitis vaccine for travelers to clarify it, but not changes to the actual recommendation, changes to the timeline for adult priming series (the initial vaccine series) from a 28-day interval to an interval that can span 7-28 days, and expanding the age for recommending a booster for children and putting that recommendation on equal footing to the recommendation for an adult booster.

With respect to anthrax vaccines, the committee recommended giving a booster dose to high-risk people (like first responders) who are not currently exposed but may be at risk of exposure, if they want it.

Everything else discussed was informational – some of it as part of the process of preparing for future votes (Like whether to extend the recommendation for HPV vaccines to include those 26-45), some of it as part of ongoing monitoring (like the examination of flu vaccines’ data). Continue reading “February 2019 ACIP Meeting – the process for vaccine recommendations”

Doctors once said that “smoking is safe” – another anti-vaccine myth

smoking is safe

If you hang around discussions about vaccines, you will see the oft-repeated claim that doctors once claimed that “smoking is safe.” The anti-vaccine religion (or terrorists) use this trope as a strawman argument in an attempt to discredit physicians, scientists and the Centers for Disease Control and Prevention (CDC) who claim that vaccines are safe and effective.

Anti-vaxxers really lack much evidence to support their science-denying arguments against the settled science regarding the safety and effectiveness of vaccines. Thus, they have to rely upon misinformation, tropes, and lies to make arguments that vaccines are something. 

I would laugh at this “smoking is safe” claim, except it’s used to dissuade parents from trusting wonderful organizations like the CDC, which only has one goal, to protect lives from diseases. So, let’s debunk this anti-vaccine myth because that’s what we do around here. Continue reading “Doctors once said that “smoking is safe” – another anti-vaccine myth”