The dopes, I mean tropes, of the vaccine, evolution and climate change denialists

This morning, I was reading a posting by Orac, the nom de guerre (or nom de blog, according to him) of a rather snarky, humorous, and brilliant (yeah, I think he’s brilliant) surgeon hiding somewhere in the midwest.  In his article, The Tactics and Tropes of the Antivaccine Movement, he amusingly and pointedly exposes the pathetic myths of the anti-vaccine movement.  Seriously, it’s not that hard dismissing the unsupported claims of the vaccine denialists, but the postings from the evidence-based crowd are necessary to make sure those people who make decisions through the University of Google Medical School have some accurate information.  At least that’s the theory.

So what is a trope?  If you’re talking about a religious service, it’s a musical embellishment, which sounds about right.  But in writing, a trope is a word or words that are used in a sense that is different from their literal meaning.  Hyperbole, used frequently by the vaccine denialism gang, is an example.

Orac listed several tactics, then the tropes, of the anti-vaccine movement, but it’s clear that they are used by the Big 3 of pseudoscience, Climate Change Denialists, Evolution Denialists (creationist) and Vaccine Denialists.  There are others, of course, like the HIV/AIDS denialists (claiming that HIV does not cause AIDS), and Physics Denialists (homeopathy).  First their tactics (liberally paraphrasing and embellishing on what Orac wrote):

  1. Skewing the science. This involves cherry picking studies, quote-mining, and attacking science that doesn’t support their denialist point-of-view, while trumpeting any report or study that supports them. The Big 3 of Denialism even attempt to rename their pseudoscience into “science”, with creation science and the “theory” of Intelligent design by way of illustration.  Case in point, Generation Rescue, Playmate of the Year Jenny McCarthy’s vaccine denialism website, contains a list of ingredients in vaccines and the side effects.  No citations.  No list of the concentration of ingredients.  No description of the actual risk of said side effects.  In other words, it looks like science.  But it doesn’t even meet the standards of a high school science paper or Wikipedia.
  2. Shifting hypotheses. Using a football metaphor, Orac calls it, “moving the goalposts.”  The denialist crowd changes either their requirements for evidence or just dismiss whatever evidence that doesn’t support their point-of-view.  One of the best examples (of so many good ones) is the old macro vs. micro-evolution canard used by creationists.  For scientists, macroevolution (change in a large population of organisms over geologic time periods) and microevolution (change at a species level over a relatively short period of time, usually one that is observable) are both driven by the same mechanisms, that is genetic drift and natural selection.  Creationists will regularly state that they “believe” in microevolution but not macroevolution.  Science answers questions, and it thrives on answering new ones.  But artificial questions that are just invented to shift the emphasis is a waste of time.
  3. Censorship. This is an extreme characteristic of all anti-science movements. For example, the Age of Autism does not allow dissenting comments in any of their discussions about vaccines.  Answers in Genesis, the evolution denialist website, only “answers” questions that are moderated.  Real science loves these discussions.  If some vaccine denier came to this website, I’d engage them in debate (except it’s hard to debate someone who doesn’t use real evidence).
  4. Attacking the opposition. Dr. Paul Offit, a respected pediatrician, is regularly attacked by the anti-vaccine gangsters (sorry, I fell into hyperbole, please pardon the mess), because of his writings on the subject of the safety of vaccines.  His 2011 book, Deadly Choices:  How the Anti-Vaccine Movement Threatens Us All, probably angered those gangsters (oops, once again) as much as anything.  Orac himself apparently had an email campaign written about his evil ways passed along to his university (I guess his nom de blog isn’t that secret).  I once spent a substantial amount of time editing Wikipedia anonymously, focusing on vaccines, evolution, and alternative medicine articles.  I was very careful with my identity, but someone found my address in California and began spamming my email and regular mail.  They contacted my employer, but since it was my company, I wasn’t too concerned.

And now the tropes (mostly from the vaccine denialist mob):

  1. “I’m not antivaccine; I’m pro-safe vaccines.” Of course, there’s no evidence that vaccines are unsafe, but this sounds good.  A similar one is the evolution denialist “I believe in microevolution, but not in macroevolution.”  Or the climate change version, “sure, the temperature is rising, I just don’t believe humans are involved.”
  2. Vaccines are toxic. Thoroughly debunked and debunked.
  3. A demand for absolute safety.  As anyone who’s in medicine states, every medical procedure, technique, injection, device, pharmaceutical, or whatever else has some risk.  When the benefits outweigh the risk, then the choice is clear.  When the benefits outweigh an invented risk, then it’s extremely clear.
  4. A demand for absolute “proof” that vaccines are safe.  I hate these arguments.  Science doesn’t work in absolute proofs, it works to provide evidence that supports a hypothesis.  Science is open-minded, so it demands the best possible evidence, but leaves the possibility that an alternative hypothesis may supplant the original one.
  5. “Vaccines didn’t save us.”  Pure delusion.
  6. Vaccines are “unnatural.”  This trope is used by the alternative medicine world every day, because, they state, without any evidence, “natural” is better than real science.  In fact, there’s nothing more natural than inducing an immune response, since it happens billions of times.  Debunked.
  7. Choosing between “vaccine injury” and disease. What injury?  Last I checked, the real evidence doesn’t support vaccine injury.  So, there is no choice, since the real disease is worst.

What is troublesome about these tropes is that they are simple to state.  “Vaccines are toxic” is a three word statement that is scary, even if not supported by evidence.  To discredit it, one needs to discuss each of the ingredients, providing real evidence, and then try to tie it all together.  That’s way beyond three words.  I once heard Paul Offit on NPR, and his answers were intelligent and correct, but they are so nuanced and complex, the listeners defaulted to the “vaccines are toxic” meme.

I believe that patients should be informed about their health and their healthcare choices.  But searching the internet for this information has always troubled me.  If you google “vaccines and autism”, you get over 7 million hits (with number 2 being the Jenny McCarthy Body Count, so that’s comforting).  But what is the quality of these hits?  Is Wikipedia a good choice?  Well, I’ll answer that question because I know a couple of physicians and medical researchers watch over it carefully.  In todays world of the interwebs, readers tend to accept every website as being “the truth”.  I know people who actually count the number of websites that support a particular point of view!

Where are the critical thinking skills?  I bet the various science deniers will state that they are thinking critically, but mostly what I see is trying to support a viewpoint by manipulating the information, instead of being openminded.  It is difficult to engage in this discussion with such individuals.

Vaccines–once more with emphasis

As I’ve discussed previously, I find the anti-vaccine movement, linking cases of autism to pediatric vaccinations, to be based on pseudoscientific principles.  There are several individuals that have pushed this quackery, but one of the more visible is Jenny McCarthy, ex-Playboy Playmate of the Year (no, I’m not going to link to it), bad actress, and failed game-show host.  I am flabbergasted, befuddled, and generally gobsmacked that anyone would listen to this woman, a scientific illiterate, about anything outside of how to model and possibly how to choose a career in bad movies.  That parents are making decisions about vaccinating their children based on her bogus beliefs is beyond my simple understanding of the world.  I guess if you get an endorsement from Oprah Winfrey, you have power!

However, there are always consequences to every action, and there are many by delaying or refusing vaccinations.  The Jenny McCarthy Body Count is a website that lists every vaccine-preventable case and death that has occurred since Jenny made public her belief that vaccines caused autism in her son (which many believe is a misdiagnosis) in June 2007.  Since then, there have been 142, oops, I mean 866 preventable deaths (as of today).  (As an aside, I had taken a screenshot of the Body Count three years ago to make a presentation, and the number was 142.  It is horrifying that the number has increased 7X since then.) As the website says, she’s not responsible for everyone one of these cases or deaths.  But if she convinces just one person to not adhere to a vaccine schedule for their children, then it’s one too many.

This body count, and Jenny McCarthy’s involvement, would be funny in any other context.  Children contracting diseases that can be easily prevented, with few or any side effects, is irresponsible and abusive.  An 18 month old child cannot decide whether they receive a vaccination or not, so we must rely upon well-informed parents to make certain it happens.  The anti-vaccine movement, based on junk science, causes harm.

And remember, the counter for the number of children who have been diagnosed with autism that has been linked to vaccinations remains at 0.

Time to return to your movies Jenny.

Who are you going to believe about vaccines

In one corner, we have Jenny McCarthy, former Playboy Playmate of the Year, Dr. Andrew Wakefield, and pseudoscience with an extra dose of quackery. In the other corner, we have the Centers for Disease Control, the Institute of Medicine for the National Academy of Sciences, UK’s National Health Service, and the National Vaccine Injury Compensation Program (what is commonly called the Vaccine Court). The battle is over MMR vaccine, a mixture of three live attenuated viruses administered by injection for immunization against measles, mumps and rubella (formerly known as German measles).

Let’s take a close look at the participants. First, Jenny McCarthy, whose extensive medical and science education includes….not much. In 2005, she announced that her child was diagnosed with autism, a diagnosis about which there is some doubt. McCarthy believes that vaccines caused her son’s autism, although that view is unsupported by any scientific or medical evidence. Her public appearances and statements have increased the public perception of this link, and may have led to decreased immunization rates and increased incidence of measles. McCarthy has stated that chelation therapy helped her son recover from autism. Essentially, McCarthy claims that mercury in vaccines causes autism, which has been rejected by scientific and clinical studies, and that the use of chelation somehow reversed the effects of the “mercury exposure.” In fact, the National Institute of Mental Health has concluded that autistic children will not receive any benefit to balance the risks of cognitive and emotional problems induced by the chelating agents used in this treatment. Really, she should stick to modeling and bad movies.

Dr. Andrew Wakefield is a whole different story. He, and 12 other researchers, published a paper in the British medical journal in 1998, The Lancet, which reported on 12 (yes 12) children with developmental disorders. They linked eight of these children to MMR vaccinations. The paper described several bowel symptoms and the possible link to the vaccine. He even gave a name to the syndrome, autistic enterocolitis. After publication of the paper, confidence in the MMR vaccine fell; pediatricians in the United Kingdom thought the British government was either hiding evidence of the link, or was failing to prove it.

Brian Deer, a reporter for the Sunday Times of London, wrote an article in the British Medical Journal that showed that Dr. Wakefield not only was in error, but probably altered key facts to show a link to autism, and outright fraudulent act.  In the meantime, 10 of the 12 original co-authors of the Lancet article retracted their authorship.  Then, in early 2010, the Lancet retracted the paper with this statement:

…it has become clear that several elements of the 1998 paper by Wakefield et al are incorrect, contrary to the findings of an earlier investigation. In particular, the claims in the original paper that children were “consecutively referred” and that investigations were “approved” by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record.

Of course, a recent review of studies of the links between vaccines and autism find that there is no scientific support for the link.  They concluded:

 No credible evidence of an involvement of MMR with either autism or Crohn’s disease was found.

This might be an intellectual or philosophical discussion of science, except for one major problem. Vaccination rates have dropped in the UK, to as low as 85%. In 2006, there were 449 cases of measles in the UK. Before Wakefield’s report, there were only 56 cases in the UK in 1998. In the US, there have been measles and pertussis (whooping cough) outbreaks attributed to the falling vaccination rate (falling from 98% to 92% in a few years).

What worries me is what do we do when a scientist and professional like Andrew Wakefield publishes an article that sets the medical world on its figurative head? The great thing about science is that it is not dogmatic.  Researchers moved quickly to understand the link, then to debunk it.  And it was a trained journalist, who uncovered the fraud.  But the consequences of that one article carries on today.  People still think that vaccines cause everything.  It doesn’t.  Nevertheless, when it comes to medicine and science, we shouldn’t listen to Playboy Playmates.

Go get your children vaccinated. The risk from measles far outweighs the non-risk of autism.