In two years, India went from the country with the most cases of polio to one with zero cases. They didn’t do this with magic water or pseudoscience, but good old fashioned vaccines.
Right after I pushed the “publish” button, I saw a second news article about Missouri. Apparently, there’s nothing really important going on in Missouri, so they decided to write two bills to add religious teaching in schools of Missouri.
This is sad, because Missouri is one of the top states in the USA for science education.
Not that anyone needs reminding, but just in case, Intelligent design is not scientific, it is not a scientific theory, and it is religion. In Kitzmiller v Dover Area School District, the US District Court held that:
Teaching intelligent design in public school biology classes violates the Establishment Clause of the First Amendment to the Constitution of the United States (and Article I, Section 3 of the Pennsylvania State Constitution) because intelligent design is not science and “cannot uncouple itself from its creationist, and thus religious, antecedents.
It cost the Dover Area School District over $1 million to defend this lawsuit, money that probably could have been spent on textbooks, teachers, and new computers. I believe in the aftermath, all school board members who supported the teaching of Intelligent design were ousted by voters. That’s how democracy I suppose.
The bill states:
If scientific theory concerning biological origin is taught in a course of study, biological evolution and biological intelligent design shall be taught. Other scientific theory or theories of origin may be taught.
Just a tiny point, and I can’t expect much out of Missouri’s legislators, but the theory of evolution does not discuss the origin of life. The theory of abiogenesis does, and that’s more chemistry and physics than biologists. Biological evolution, or modern evolutionary synthesis, is based on a mountain of evidence. The theory isn’t used in the sense of a random guess, but a scientific one with a foundation in scientific method and piles of evidence. It is falsifiable (but has not been falsified) and has itself evolved into a power predictor of how populations of organisms change over time.
Intelligent design is not falsifiable (in that it requires an all powerful creator) and is not scientific. It is based on no evidence, just ideology and rhetoric. It fails as science once the bright light of criticism is shone on it.
Well, I don’t know how Missouri’s legislature is organized, but I hope they’re intelligent enough not to do this. But if they do, expect several lawsuits. And they’ll lose them all.
I use Twitter not only to tweet about my favorite sports teams, but to see what’s being said in science, medicine, politics, and anything interesting. I actually have a list (you can read by list if you want) that I call “Pseudoscience” that are tweets from the biggest anti-science medical people around. Today, I received the following tweet:
— Kilikina (@XtyMiller) January 13, 2012
So that lead me to a post at “Natural News” (OK, I’ll admit that my skeptical radar fired up) entitled, “Medical journal openly questions science, ethics of HPV vaccinations.” As an aside, Natural News’ url for the article is “vaccinations_quack_science_medical_journals.html”; not very subtle are they?
First a little background is necessary before starting this story. Gardasil (Merck’s brand name) is a vaccine against human papillomavirus (HPV), a sexually transmitted virus. In early stages, HPV only results in mild symptoms like warts in the genital and anal areas, but in some cases can lead to cervical cancers. The vaccine not only prevents the transmission of the disease but seems to reduce the long-term risks of cancer.
But, I digress. Imagine my reaction to the article. “Oh no, HPV vaccinations are unethical!!!!!” Call the police. I’ve been all wrong about vaccines. Oh wait, let me look up the original article, because even very unbiased news sources like the Wall Street Journal and New York Times sometimes get medicine wrong. Let me run over to the article before I post my mea culpa about vaccines.
The article, Human papillomavirus (HPV) vaccine policy and evidence-based medicine: Are they at odds?, published in the Annals of Medicine in December 2011. The authors, Tomljenovic and Shaw are associated with the University of British Columbia, Department of Ophthalmology. I don’t want to degenerate into some sort strawman fallacy, but I question why two individuals in a medical specialty, ostensibly involved with the eyes, are so obsessed with vaccines. Furthermore, they have a long history of anti-vaccination papers, most published in low impact journals. For example, they recently published an article correlating aluminum with autism, though the correlation is specious and providing no causality. One of the worst mistakes of research is conflating causality and correlation.
Moving on to the article, their abstract states:
All drugs are associated with some risks of adverse reactions. Because vaccines represent a special category of drugs, generally given to healthy individuals, uncertain benefits mean that only a small level of risk for adverse reactions is acceptable. Furthermore, medical ethics demand that vaccination should be carried out with the participant’s full and informed consent. This necessitates an objective disclosure of the known or foreseeable vaccination benefits and risks. The way in which HPV vaccines are often promoted to women indicates that such disclosure is not always given from the basis of the best available knowledge. For example, while the world’s leading medical authorities state that HPV vaccines are an important cervical cancer prevention tool, clinical trials show no evidence that HPV vaccination can protect against cervical cancer. Similarly, contrary to claims that cervical cancer is the second most common cancer in women worldwide, existing data show that this only applies to developing countries. In the Western world cervical cancer is a rare disease with mortality rates that are several times lower than the rate of reported serious adverse reactions (including deaths) from HPV vaccination. Future vaccination policies should adhere more rigorously to evidence-based medicine and ethical guidelines for informed consent.
I won’t go through each point, but a couple are important to refute:
- Uncertain benefits. The Centers for Disease Control disagrees.
- Clinical trials show no evidence that HPV vaccination can protect against cervical cancer. This is partially true, since HPV-related cancers can take from 15-25 years to arise. Epidemiological data takes time. However, we know that HPV is the cause for several types of cervical and other cancers, so preventing HPV is a logical choice to make, given the prevalence of the virus.
- Vaccination polices should adhere more rigorously to evidence-based medicine. It does already. Pretty strongly. Anti-vaccination, as best as I can tell, is based on fraudulent journal articles (see anything by Andrew Wakefield).
HPV vaccine is safe and efficacious. If you need more information on the HPV vaccine safety, the good researchers at Science Based Medicine did a great article called, The HPV Vaccine (Gardasil) Safety Revisited.
Let me make this clear. Every single medical procedure, pharmaceutical, and device has some risk associated with it. Can you get an infection at the injection site? Yes! Can you be allergic to the injection? Yes! Can it cause paralysis? No. Can it cause a broken leg? No, though if you did a random study, you’d find a large percentage of young girls who broke their legs within six months of being vaccinated, so obviously correlation is equivalent to causation. Or it doesn’t.
If Tomljenovic and Shaw could prove either no benefit with some measurable risk, or little benefit with large risk, then there is an ethical issue with the HPV vaccine. But actually, there is a high level of benefit with almost no risk, or risk that actually is imaginary rather than shown in evidence based medicine. You see, just because you use “evidence-based” in your article title, it doesn’t mean you actually follow it.
HPV vaccine should be recommended for all young men and women (yes, I said men too), reducing the future risk of cancer and it’s burden to the family, individual and health-care system.
No, it doesn’t have to do with covered bridges, old growth forests, or a vintage Harley-Davidson motorcycle.
Hostess, makers of Twinkies (immortalized in the since debunked urban myth that they have an indefinite shelf life), Ding Dongs and other comfort foods, is part of the culture of America. You drive into any convenience store, and there are shelves of the stuff. I admit to not either liking or having a Twinkie in years (quite possibly since college), but I know exactly how they taste.
And Eastman Kodak, once the power of Rochester, NY, and whose ubiquitous yellow and red film was everywhere. Now, we think of film as being quaint (though in Hollywood, Kodak still makes a significant percentage of film stock, since many top filmmakers still prefer film to digital). I learned how to develop Ektachrome and Kodachrome slides, taking almost all my photos on slides up until the early 2000’s. In fact, I was cleaning out some old boxes, and I found several rolls of exposed Kodachrome, which I could have developed, but the cost was too high, and given the 10 year old age, I wasn’t sure that I’d get good quality.
Anyways, these two brand names are part of the cultural memory of the United States. But they are disappearing, for Hostess, because we should be eating less processed, high sugar foods, and Kodak, because they stumbled in the transition from analog to digital (though they hold many of the key patents in digital photography and filmmaking).
I guess Whole Foods and Apple are their replacements these days, but they’ll be replaced by something new and better when the next generation replaces us.
Polling pastors on evolution–National Center for Science Education
There are a few interesting points regarding this poll:
- The poll was commissioned by LifeWay Christian Resources of the Southern Baptist Convention, a rather conservative Christian denomination. I’m concerned about the inherent bias.
- Protestants in various parts of the country have different beliefs about science and evolution. This poll may be biased towards Southern US churches, where more literal beliefs in biblical myth is more prevalent.
- Of course, this polling does not include anyone outside of the US.
- The first question was “I believe god used evolution created people”. About 24% agreed with that, over 72% disagreed. Of course, that’s a loaded question, because a pastor might accept evolution and not think a god was involved, but it’s hard to tell without the real data.
- Interestingly, only 46% thought the earth was 6000 years old, whereas 43% disagreed (although, not sure if they thought it was 4.5 billion or something else).
- One minor, but very annoying point. One does not believe in evolution, since belief implies acceptance with or in spite of evidence. Evolution is a theory (and in science, a theory is essentially a fact) based on mountains of evidence. It does not require evidence, it requires acceptance of the evidence, or rejection of the evidence based on denialism, ignorance, or belief in an alternative explanation–or all three.
There are churches that accept evolution as is. Jews, Catholics, and most mainstream Protestants (such as Anglicans) were, of course, excluded from this poll, and would have skewed it toward “pastors” supporting evolution. Of course, anti-evolution (or evolution denialism) is so prevalent these days, we probably shouldn’t be surprised by this poll.
By the way, if you aren’t, follow the National Center for Science Education. They keep everyone updated on important issues in science education in the USA.
- Immunization prevents an estimated 2.5 million deaths every year. Immunization prevents deaths every year in all age groups from diphtheria, tetanus, pertussis (whooping cough), and measles. It is one of the most successful and cost-effective public health interventions.
- More children than ever are being reached with immunization. In 2010, an estimated 109 million children under the age of one were vaccinated with three doses of diphtheria-tetanus-pertussis (DTP3) vaccine. These children are protected against infectious diseases that can have serious consequences like illness, disability or death.
- An estimated 19.3 million children under the age of one did not receive DTP3 vaccine. Seventy percent of these children live in ten countries, and more than half of them live in WHO’s Africa and South-East Asia regions.
- Over 1 million infants and young children die every year from pneumococcal disease and rotavirus diarrhea. A large number of these deaths can be prevented through vaccination.
- Public-private partnerships facilitate the development and introduction of vaccines. For example, a new vaccine which prevents the primary cause of epidemic meningitis in sub-Saharan Africa, meningococcal A, MenAfriVac, was introduced in Burkina Faso, Mali and Niger last year. At the end of 2011. Cameroon, Chad and Nigeria are vaccinating more than 22 million individuals with the vaccine which has the potential to eliminate the leading cause of meningitis epidemics in Africa.
- The supply of influenza vaccines has been significantly expanded. The expansion has been possible as a result of WHO supporting the efforts of vaccine manufacturers to produce and license influenza vaccines in 11 developing countries.
- Global measles mortality has declined by 78%. Global measles mortality has been reduced from an estimated 733 000 deaths in 2000 to 164 000 deaths in 2008, thanks to intensified vaccination campaigns.
- Polio incidence has been reduced by 99%. Since 1988, polio incidence has fallen by 99%, from more than 350 000 cases to 1410 cases in 2010. Only four countries remain endemic – Afghanistan, India, Nigeria and Pakistan – down from more than 125 countries in 1988.
- Annual deaths from neonatal tetanus have fallen. Neonatal tetanus deaths have declined to an estimated 59 000, down from 790 000 deaths in 1988.
- Immunization provides an opportunity to deliver other life-saving measures. Immunization not only protects children from vaccine-preventable diseases. It also serves as an opportunity to deliver other life-saving measures, such as vitamin A supplements to prevent malnutrition, insecticide-treated nets for protection against malaria and deworming medicine for intestinal worms. In addition, the benefits of immunization are increasingly being extended across the life course to include adolescents and adults, providing protection against life-threatening diseases such as influenza, meningitis, and cancers that occur in adulthood.
Has there been a more successful human medical effort in the history of man? No.
Along with HIV and malaria, tuberculosis (TB) is one of the most dangerous diseases in the world. According to the World Health Organization, there were 8.8 million new worldwide cases of TB, along with 1.4 million deaths in 2010. TB is difficult to treat, usually taking over six months with antibiotics that sometimes have difficult side effects.
Also, because of low patient compliance, misdiagnosis, and other issues, multi-drug resistant (MDR) and extensively drug-resistant (XDR) versions of TB can arise in a population. MDR is resistant to the first-choice drugs, requiring treatment with a larger cocktail of one or more of the nine different “second-line” antibiotics, which are less effective, have more adverse effects, and can take much longer to effect a cure, up to 2 years or more. XDR TB is resistant to the three first-line drugs and several of the nine antibiotics usually considered as second line choices.
As the article states:
The vast majority of these unfortunate patients seek care from private physicians in a desperate attempt to find a cure for their tuberculosis. This sector of private-sector physicians in India is among the largest in the world and these physicians are unregulated both in terms of prescribing practice and qualifications. A study that we conducted in Mumbai showed that only 5 of 106 private practitioners practicing in a crowded area called Dharavi could prescribe a correct prescription for a hypothetical patient with MDR tuberculosis. The majority of prescriptions were inappropriate and would only have served to further amplify resistance, converting MDR tuberculosis to XDR tuberculosis and TDR tuberculosis.
The spread of this disease could be quicker than some other infectious disease (like HIV), because of how easily it’s spread (one patient can infect up to 15 others before diagnosis and treatment), and, of course, the lack of viable antibiotics for XDR TB.
Right now, the infection seems to be in a small subgroup of TB patients in India (and Iran) in a border region that has poor medical care. However, given the lack of effective antibiotics means that we’re all in this together.
The interesting fact about the title of the article–the authors seem to have invented a new subset of TB, Totally Drug Resistant.
The good thing about being a skeptical, and applying the scientific method to everything is that you learn to think critically, to analyze data, and to demand data. I had a sneaking suspicion that airline security was more of a PR scheme than anything else. In medicine, every procedure, medication, and device has some marginal increase in harm to the patient, but that should be far exceeded by the benefit. In the case of the TSA, the harm (cost, inconvenience, delays, risk of radiation from scanners, and anything else you can imagine) seems to far outweigh any marginal benefit.
The fact is I can think of dozens of ways to disrupt and terrorize Americans with a small bomb or gun (both so easily obtained in today’s USA)–I won’t list them here, just in case the terrorists or so damn lazy that they google the internet for ideas. Get 21 deluded religious fanatics together, a few weapons, and an inviting target, and we will forget about the airports. What are we going to do next? Put up scanners at supermarkets, malls, gas stations, movie theaters, and golf courses?
TSA receives $8.1 billion in funding every year, and I have to imagine that amount could be better spent on other types of security measures that get at the issue at the core. Again, using medicine as analogy, try not to treat the symptoms, but the causes.
By the way, there are websites that provide you with detailed instructions on how to generate fake boarding passes. They’re meant for family members to go to the gate to meet other family members. Some are there to show the vulnerability of the TSA system. So, even non-terrorists know how to get around the rules.
TSA doesn’t pass even the smallest bit of scrutiny or critical analysis. Wish it would be gone, but there’s not much we can do to make that happen.
Her words are enough.