Rachael Ross gets Vaxxed – that’s never good for a real doctor

Recently,  Dr. Rachael Ross, who gained fame when she was on the medical talk show, The Doctors has written a letter that suggests she now subscribes to a large number of anti-vaccine tropes. While there really isn’t anything new in the letter – the claims in it are far from original, and have been repeatedly shown untrue – as a doctor, her words carry weight. So Rachael Ross gets Vaxxed – it’s worth responding to her.

I don’t know what drove Dr. Ross to promote anti-vaccine misinformation. It may have been misplaced trust, believing in Del Bigtree, Vaxxed producer, who has been promoting quite a bit of misinformation recently, some of it incredibly harmful. She may have already been susceptible. Maybe all of the above. It doesn’t matter.

She chose to speak up, and whatever her intent, the result is that she provided ammunition to anti-vaccine activists and anti-vaccine parents that can be used to sway others away from protecting children from disease. Dr. Ross includes in her letter the mantra of “do no harm.” But a letter promoting this kind of misinformation – by a doctor, with the authority the profession confers – is very likely to do harm. It’s unfair to the children denied vaccines because of it. 

Rachael Ross gets Vaxxed – a letter

Dr. Ross’ letter (repeated at the Vaxxed website) starts with a vaccine injury story in which a mom of triplets claimed her six months old triplets “checked out” after her shots. That it was “as if someone replaced her children with new ones.  They unlearned all they knew…regressed and screamed for days. “

Dr. Ross uncritically accepts this story as fact, problematic as it. She asks no questions. And, she does not ask what did these six years old babies unlearn, and in what way did they regress. Dr. Ross did not examine the plausibility of all three having a dramatic reaction of that kind at the same time. Finally, she did not ask what, if any, was the long lasting harm, and is it something vaccines cause?

Now, I can understand not wanting to subject a stranger telling a hard story to critical questions. But if you do not, using the story, not thoroughly examined, in a letter that is pretty much designed to lead people to doubt vaccines is problematic.

Dr. Ross repeats the concerns about the growth of the schedule. Yes, we protect against more diseases today than we could in the 1960s or 1980s. As a doctor, Dr. Ross should see the ability to prevent more diseases as a good thing – but she is not using it that way. She suggests a connection between the increase in the schedule and increase in chronic illness.

She writes:

We had fewer learning disabilities, less asthma, less autism, and less diabetes.  Autism in particular was 1 in 500 in the late seventies and it has now skyrocketed to 1 in 50.  Why so many?  Why so soon?

What science says

However, scientists have responded to the claim in several ways. A little research that would have taught Dr. Ross that:

  1. While the number of vaccines on the schedule increased, thanks to better technology, they now put less of a burden on the immune system: there are fewer antigens in the current schedule than there were in the 1980s.
  2. The challenge either schedule presents to the immune system is far, far below what it can handle – and far less than an infant has to deal with simply by living in the world, a world full of germs.
  3. If you compare our current vaccines to the 1970s, today’s vaccines have substantially less side effects than two of the vaccines routinely given then – the smallpox vaccine had more serious side effects than any of our current vaccines, and DTP had more moderate and scary side effects than any we use. In other words, while we can protect against more diseases today, we can do so with less risks than in the 1970s.
  4. The links between autism, vaccines and asthma or allergies, and so forth  has been investigated (the evidence is here, here, here, and here). Vaccines don’t cause any of these things.

 

Rachael Ross gets Vaxxed – more

The next claim Dr. Ross raises is the fact that the National Vaccine injury Compensation Program paid over 3 billion dollars over its almost 30 years of existence. Dr. Ross points on this, again, suffer from several errors.

  1. While 3 billions is a high amount, putting it in perspective is important: one debilitating injury costs millions. If you look at the actual compensations the program provided, they are less than one per million doses of vaccines – and most of those are through settlements, where causation doesn’t need to be shown. Over a thousand are from the DTP vaccine, no longer given – and based on claims that were believed in the 1980s, but that later studies showed were not caused by the vaccine. In fact, the small number of NVICP compensations reinforces what science shows: vaccine injuries are very, very rare.
  2. Dr. Ross says that “there are tens of thousands of families on a list that have never received compensation because they couldn’t 100% prove that the vaccine created an injury.” Dr. Ross seems to misunderstand the standard of causation required in NVICP. It’s not 100%. If you have a Table Injury, causation is presumed. If you have an off-table injury, you have to provide expert opinion and make a case that it’s more than 50% likely your harm was from the vaccine. It’s a low burden. If there’s a settlement, you don’t have to prove anything. In other words, when a family cannot meet the NVICP standards for causation, chances are that it’s because the evidence doesn’t support the claim that the vaccine caused it.
  3. I would add that Dr. Ross references to – I presume – children with autism are troubling, and reflect the negative attitude of many anti-vaccine activists. Language like “their babies’ lights dimmed” “someone replaced her children with new ones” is unaccepting and hostile to these children. That is part of why autistics find the kind of claims Dr. Ross now promotes hurtful

 

The CDC whistleblower – again

Then Dr. Ross repeats her belief in the CDC whistleblower manufactroversy, also promoted in the misleading anti-vaccine film Vaxxed.

As pointed out by scientists, there’s no evidence that the 2004 study by the CDC attacked by her actually ever showed a real increase in autism in any group – including African American males. Analysis with proper controls did not show it. The recordings with Dr. Thompson don’t support the claims – and the Thompson documents even less so.

I would add that even if all the claims in Vaxxed were true – and they are not  – it wouldn’t change the facts and wouldn’t justify Dr. Rachael promoting a false link between MMR and autism. The 2004 study that anti-vaccine activists attack is simply one in many studies that asked if there is a link between MMR and autism. It is a relatively small scale study. Other studies had tens of thousands of children – for example, a recent sibling study or hundreds of thousands of children – and found no link. In the face of that, claiming a link is highly irresponsible.

Dr. Ross then asks why won’t Congress subpoena Dr. Thompson? Well, maybe because Congress realizes that there are numerous studies showing there is no link between MMR and autism and is not inclined to spend more time on anti-vaccine conspiracy theories.

 

Final remarks

Dr. Ross’ letter combines anti-vaccine tropes with an emotional appeal to other parents to see Vaxxed, and by implication, to suspect vaccines. She implies she has hesitation about protecting her precious  newborn from disease because of the claims in Vaxxed – another harm Andrew Wakefield, director of Vaxxed, and his collaborators appear to have caused.

It would be a shame if her letter influenced other parents in similar ways. It’s unfair to them, and unfair to their children.

 
 

 

Dorit Rubinstein Reiss
This article is by Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), is a frequent contributor to this and many other blogs, providing in-depth, and intellectually stimulating, articles about vaccines, medical issues, social policy and the law. 

Professor Reiss writes extensively in law journals about the social and legal policies of vaccination. Additionally, Reiss is also 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.