The price exacted by the anti-vaccine movement

As 2009 ended and 2010 began, I made a vow to myself to try to diversify the topics covered on this blog. Part of that vow was to try to avoid writing about vaccines and the anti-vaccine movement for more than a couple of days in a row. Unfortunately, even in the middle its very first full week, 2010 has already conspired to make a mockery of any "plans" I thought I might have for the blog, with a flurry of vaccine-related news items relevant to the pseudoscience that is the anti-vaccine movement coming fast and furious. Oh, well. I might as well just go with the flow and do what I do best--at least for now.

When I wrote the other day about the libel suit brought by the grand dame of the anti-vaccine movement, Barbara Loe Fisher, against the man whom they view as the Dark Lord of Vaccination or even Satan himself, Dr. Paul Offit, I mentioned that lawsuits against prominent defenders of vaccines could be a strategy to intimidate them into silence. Including the reporter who quoted Dr. Offit (Amy Wallace) and the publisher of the magazine in which the article appeared (Condé Nast, publisher of WIRED) also struck me as a rather transparent attempt to discourage reporters and publishers from writing about the anti-vaccine movement.

The reason I made this latter conclusion is that 2009 was in general a great year for the media's waking up and examining the anti-vaccine movement in a much less positive light. Whether it was Amy Wallace's article that provoked Barbara Loe Fisher's lawsuit, Brian Deer's expose of Andrew Wakefield's scientific fraud, or Trine Tsouderos' expose of Mark and David Geier, Dr. Mayer Eisenstein, and the autism/a> biomed movement, 2009 marked the year that the mainstream press started to realize that the harm the anti-vaccine movement is doing to public health is actually the story, not scorned parents bucking the system in a Lorenzo's Oil frenzy of crushing existing paradigms no matter what science and medicine think about the issue of whether vaccines cause autism. This is a very good thing indeed.

And the anti-vaccine movement does not like it at all.

Another excellent example of such journalism appeared in, of all places, USA Today, yesterday, starting this way:

Brendalee Flint did everything she could to keep her baby safe. She nourished her with breast milk; she gave her all the routine vaccines. But Flint never realized how much her daughter's health would depend on the actions of her friends, neighbors and even strangers.

By 15 months old, Flint's daughter, Julieanna Metcalf, was walking, exploring and even saying her first few words. Then one day in the bath, while fighting what seemed like an ordinary stomach bug, Julieanna became so weak and floppy that she couldn't hold up her head.

"She couldn't say 'Help me,' but her eyes were begging me to do something," says Flint, 35.

It turns out that Julieanna had severe Haemophilus influenzae type b meningitis. She was one of the victims of the recent Hib outbreak in Minnesota, which was linked to pockets of unvaccinated children. She still has serious sequalae from her bout of meningitis that will likely be with her for the rest of her life. Because Julieanna has a rare immune deficiency, vaccines don't work in her; she depends on herd immunity:

That worries moms such as Flint, who learned that her daughter has a rare immune deficiency only after she contracted Hib. Because Julieanna doesn't respond to vaccines, she depends on other parents to keep germs out of circulation by vaccinating their kids, a phenomenon called "herd immunity."

Then there was this mother, whose daughter died of invasive pneumococcal disease:

The most shocking part of this video is that the dead girl's doctor didn't believe much in vaccinations and in fact encouraged her parents not to vaccinate. My recommendation: Sue the doctor for malpractice. Given that I'm one of the "tribe" and have just as intense a loathing for malpractice attorneys and malpractice suits as any other physician, you can be sure that if I say that about another doctor I really mean it and really consider the offense to be egregious. Any pediatrician who discourages recommended vaccines is very likely committing malpractice. In this case, a girl died as a result; so there is demonstrable injury as a result of this physician's negligence. Sue his ass. Maybe if more parents started doing this when their children suffer or die from vaccine-preventable illness because their doctors discouraged vaccination fewer doctors would be so cavalier about such advice not to vaccinate.

Worse, the rationale for not vaccinating can border on seriously burning stupid:

Parents such as Rebecca Estepp of San Diego decided not to vaccinate her younger son after his older brother was diagnosed with autism. When measles broke out in Southern California in 2008, "I had to decide, 'Would I rather have him get the measles or risk having him get autism like his brother did?' " says Estepp, national policy manager for Talk About Curing Autism. "My husband and I decided we'd rather he get measles."

Because of fear of a vaccine that is, by any measure, incredibly safe, Estepp decided that she'd put her her son at extreme risk of contracting measles, which, contrary to the misconception, is not a benign disease. Worse, she did it because she believed in a myth, a lie promulgated by the anti-vaccine movement, namely that the MMR vaccine causes autism. It is not a choice of "measles versus autism." It is a choice of preventing measles at a very low risk versus the risk of getting the measles and its potential complications.

The USA Today article then goes on to describe how pockets of low vaccine uptake are placing us at risk for outbreaks of vaccine-preventable diseases. Certainly, they are, and, unlike in the past, when areas of low vaccination rates tended to be associated more with poverty and poor access to health care, these days pockets of low vaccine uptake tend to be more associated with upper middle classed "worried" parents who have never seen the ravages that vaccine-preventable infectious disease can cause. Protected by herd immunity, they see only risks and no benefits from vaccines, and these risks are exaggerated by the anti-vaccine movement to the level where even rational parents might take pause. But what if herd immunity fails?

The USA Today article is, I hope, a continuation of the trend begun in the mainstream media in 2009, namely telling it like it is when it comes to the anti-vaccine movement and pointing out how (1) it is not based on any science and (2) its adherents are frightening parents into not vaccinating, a decision that can result in death.

I can only hope that, in April (which is Autism Awareness Month, a month I've come to dread every year now) dim and dimmer Jenny McCarthy and Jim Carrey start showing up on Larry King Live to hawk the latest propaganda angle of pseudostudy from Generation Rescue, when vaccine "skeptics" such as Dr. Jay Gordon or Dr. Bob Sears start repeating the brainless "too many too soon" mantra, when J.B. Handley slimes his way onto various TV shows to trumpet his usual nonsense, there will be real skeptical journalists there instead of lapdogs to challenge them on the facts.

Your children's health is at stake.

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When I read that USA Today article, the Estepp's made me grind my teeth. There's so much wrong with what they believe, and so much more wrong with what they're doing.

Orac, you may have exceptionally rough going avoiding the vaccine nonsense. Just this morning AoA had to run Barbara Loe Fisher's latest nonsense, "2010 Needs A Fearless Conversation About Vaccination."

kwombles @2
2010 does need "A Fearless Conversation About Vaccination" - It needs a conversation about vaccination without the irrational fear of vaccination causing autism.

By Militant Agnostic (not verified) on 07 Jan 2010 #permalink

Thanks for mentioning this article. I've added a bit to antiantivax about the anti-vax question "Why worry if I don't vaccinate my kids?" This article is linked as an example of why it's important.

Sue his ass. Maybe if more parents started doing this when their children suffer or die from vaccine-preventable illness because their doctors discouraged vaccination fewer doctors would be so cavalier about such advice not to vaccinate.

As an objective onlooker to this debate, can you please explain to me why a person that suffers from infectious disease is more important than one that suffers from vaccine injury? Doctors that suggest vaccinating a gestationally immature baby should also be sued, but you see, this can't happen. There is no consistency among those defending the universal application of the current recommended schedule.

People advocating for a safer schedule for their very young child (who very well may be predisposed to injury) are ones who have been previously harmed. When they read stuff like that, they cannot understand why you value the life of a child that suffered from infectious disease more than you value the life on a child that participated and tried to protect that child. If you continue to discount that they contributed to herd immunity, and suffered a price for it while making those that suffer from disease more important, you will continue to have vaccine refusal.

Because of fear of a vaccine that is, by any measure, incredibly safe

A passive reporting system hardly demonstrates safety. Vaccine trials performed on healthy people, do not demonstrate safety or the real world. These are the legitimate arguments being made.

Orac,

Dr Bob's "The Autism Book - What Every Parent Needs to Know About Early Detection, Treatment, Recovery, and Prevention" is scheduled to come out April 2, 2010, that should keep everyone busy for the month.

@anon

If a doctor uses a vaccine off-label (i.e., contrary to what is included in the insert/labeling), particularly in an instance where the labeling clearly says it should not be used, and harm results, then the doctor should be sued. The doctor should have known, with a reasonable degree of certainty, of the increased risk of injury. And example of this would be administering a flu vaccine to a child when the doctor knows that the child has severe egg allergies.

If the doctor uses a vaccine on-label, and harm results, the doctor should not be sued, as the doctor could not have known, with a reasonable degree of certainty, that the child would suffer a rare injury.

If a doctor encourages patients to refuse vaccines, the doctor is knowingly advocating a behavior which puts the patient (and those around them) at risk and is operating outside the standard of care. In a legal sense, any reasonable person with the doctor's knowledge and experience should have known better, and is therefore being negligent.

A passive reporting system hardly demonstrates safety.

That's why we have clinical trials to establish safety and efficacy before the product is marketed, and post-marketing surveillance studies and programs after it is marketed.

Vaccine trials performed on healthy people, do not demonstrate safety or the real world.

Which is why Phase III clinical trials are typically large, randomized, controlled trials to ensure as much as possible that the populations in the treatment and control arms are representative of the real world, as much as is possible, rather than only conducting trials in "healthy" people. This is also why we have a rather robust vaccine surveillance program to monitor new vaccines that have either just reached the market or have only been around for a couple years.

@ anon

Premature babies are in particular need of vaccinations (especially against all bugs that go to the lungs), since they will have little or no maternal immunity.

anon said:

can you please explain to me why a person that suffers from infectious disease is more important than one that suffers from vaccine injury?

I will leave it to others to tackle the rest of your argument, but I just want to address this one question, which is a strawman through-and-through. Nobody is arguing that one patient is more important than the other -- the argument is about whether the doctor's recommendation was sufficiently irrational that it put the patient at unnecessary risk.

To take it out of the medical realm... if person A tells their children, "Always wear your seatbelt," and person B tells their children, "Seatbelts are for squares!", then I would argue that person B is an asshole. This does not imply that the incredibly rare victim who gets trapped in a burning vehicle as a result of a stuck seatbelt is "less important" than any one of the thousands of people whose lives are saved each year by seatbelts. Both potential victims are just as important -- it's just that one piece of advice is far more likely to save your life, while the other piece of advice is far more likely to end your life.

If you want to make an argument that vaccinating is a poor cost-benefit tradeoff, I'll let others tear that one apart. But please, the appeal-to-emotion strawman I quoted above -- that's just embarrassing.

anon@5

"Vaccine Injuries" aren't contagious. People who suffer adverse reactions to vaccines are not a danger to other people, as opposed to untreated disease carriers.

By Dave Robinson (not verified) on 07 Jan 2010 #permalink

As an objective onlooker to this debate, can you please explain to me why a person that suffers from infectious disease is more important than one that suffers from vaccine injury?

Amazing how anti-vaxxers are able to lie with every breath.

This isn't about importance, this is about risk versus benefit. Nutbars like you think that a one-in-a-million risk, alongside an infinite number of imaginary risks born from the greedy imaginations of lawyers to your children are more important than the deaths of hundreds of others.

You think your tinfoil hat paranoia is more important than the lives of many, many others. You would have us shoulder a very real risk so that you can be safe from imaginary and absurdly unlikely ones.

Chance of encephalitis from a measles shot: 1 in 1,000,000.
Chance of death from getting the measles: 1 in 2,000.

You think that we should stare death in the face so that your paranoid mind can sleep a few nights before inventing more imaginary risks. You think that you are superior to us mere mortals.

Why Todd, if I didn't know any better, I'd think you were kinda being reasonable about some of our concerns. "If a doctor uses a vaccines off-label... and harm results, then he should be sued. Bravo!

Orac you're a little late to the fear-mongering party. USA Today and Left Brain/Right Brain had this propaganda yesterday. PKIDS must not realize what a useful tool you are and can be. Anyway I'll repost what I said yesterday since lb/rb has no readership.

Tragic story. Itâs sad to see the medical establishment using it to push more vaccine. Anyway it looks like the âyoungerâ doctor is off the hook since:

it is recommended that Prevnar not be routinely given to children over five years old. The risk of invasive infection with the pneumococcus bacteria is much less in children over age five.

I wonder what made this child so vulnerable to such a rare occurrence? And should I have my child vaccinated if he or she doesnât share those vulnerabilities? Unfortunately these videos, full of fear and forebodence, are always short on detail.

PS

You really need to show the one on the killer chikenpox

By Sid Offit (not verified) on 07 Jan 2010 #permalink

@jen

I'm not expressing any view I have not expressed before, first of all. Second, a doctor being negligent does not impact whether or not a vaccine is safe when used as directed.

No need for sarcasm.

@Anon

Just how would you define "objective observer"? I can't wait for Orac's response.

By Janet Camp (not verified) on 07 Jan 2010 #permalink

@ James Sweet; @ Bronze Dog: I agree; however,people are notoriously bad at understanding risk and probability,a fact which has contributed endless material for psychological studies and guaranteed profit for the casino/lottery industry.When anti-vax drama queens constantly dispense their *bon mots*,worried parents re-evaluate their (probably) already over-estimated risk from vaccines while the facts and figures remain unchanged- which might provide a hint how to instruct parents about risk of vaccines vs. illness.

By Denice Walter (not verified) on 07 Jan 2010 #permalink

The Chicago Tribune articles were absolutely terrific, but Patricia Callahan also deserves a mention, along with the aforementioned Trine Tsouderos, as they generally shared the byline for each article.

By Richard Mathews (not verified) on 07 Jan 2010 #permalink

As an objective onlooker

Q. How can you tell when an anti-vaxer is lying?

A. Their lips move.

Boom-Tish! Thanks folks, I'll be here all week...

These are the legitimate arguments being made.

Seriously, if the anti-vax movement was genuinely interested in making legitimate arguments, it would start by nixing the vast amount of blatantly illegitimate ones it peddles every day. Getting its own house in order before attacking others' would go a considerable way to dragging its credibility out of the giant hole it's dug itself into.

Alas, the anti-vax movement seems far less interested in having the correct answers than having the only answers. Says volumes about what's really driving them.

"Chance of encephalitis from a measles shot: 1 in 1,000,000.
Chance of death from getting the measles: 1 in 2,000."

Cases of measles in the US in 2008: 140. Deaths from measles, statistically: 0.07.

Children born in the US in 2007: 4,315,000. Assuming a 95% vaccination rate, and a one in a million chance of encephalitis (the actual rate is far higher, but Big Pharma hushes it up): four children crippled.

4/0.07 = the MMR vaccine is 57.1 times more likely to cripple or kill a child than measles are.

And we inject these destructive toxins into the bodies of innocent children?!??

/statistics ftw

By mad the swine (not verified) on 07 Jan 2010 #permalink

Over age 5 they can get pneumovax instead of prevnar, right? My kids got their pneumovax this year, but they're jr. high students. I don't know what the recommendations are for kids in between 5 and 12.

My kids also got their H1N1 shots, and their newly requred DTaP boosters, etc. I got an MMR, DTap, and pneumovax because I went back to school.

We all seem to be in fine health so far...no need for a multi-Generation(al) Rescue here.

By military wife (not verified) on 07 Jan 2010 #permalink

Nice how the wolves descend when opposition rears its head. If nothing else, it is entertaining.

Todd @7:If the doctor uses a vaccine on-label, and harm results, the doctor should not be sued, as the doctor could not have known, with a reasonable degree of certainty, that the child would suffer a rare injury.

Do on-label directives address predisposition? Or is there denial that predisposition is a factor?

This is also why we have a rather robust vaccine surveillance program to monitor new vaccines that have either just reached the market or have only been around for a couple years.

I don't know how you can say that with a straight face.

Catherina @8:Premature babies are in particular need of vaccinations (especially against all bugs that go to the lungs), since they will have little or no maternal immunity.

Are there sufficient data that suggests it's safe? Immune challenges in animals of this age are not all that favorable.

James Sweet @10: I just want to address this one question, which is a strawman through-and-through. Nobody is arguing that one patient is more important than the other -

I'll concede the strawman, for debating purposes. I didn't say it to debate it. I said it, because the tone of the statement is highly suggestive that the doctor was negligent for not recommending vaccines - and when those that do result in harmed children, the outpour of sympathy is... well, you'll never see it here.

appeal-to-emotion strawman I quoted above -- that's just embarrassing.

Emotion? That's rich. The only emotion here is calling people assholes (yeah you Pablo) for having concerns over ANOTHER one of their children being harmed by doing what's best for the public.

Dave Robison @11:"Vaccine Injuries" aren't contagious. People who suffer adverse reactions to vaccines are not a danger to other people, as opposed to untreated disease carriers.

As if vaccination status is the singular action that determines the overall capability to spread disease? C'mon, really? If we are going to measure immunity by when we stop showing symptoms, how the hell do you know who is or isn't spreading disease? The one showing symptoms will always get the prize.

Bronze Dog @12:Amazing how anti-vaxxers are able to lie with every breath.

Ad hominem. Or is it defamation per se?

Nutbars like you think that a one-in-a-million risk,

Accurately reported in VAERS.

You think your tinfoil hat paranoia is more important than the lives of many, many others. You would have us shoulder a very real risk so that you can be safe from imaginary and absurdly unlikely ones.

Well the conspiracy card is pretty original. You're not shouldering anything for me. Demonstrate that your vaccination status is keeping me safe, because we all know it's the singular mechanism that determines whether or not you'll respond accordingly if challenged. Right? Sell that to someone else, I'm not buying.

Chance of encephalitis from a measles shot: 1 in 1,000,000.
Chance of death from getting the measles: 1 in 2,000.

OOOOhhh... Scary stuff. Based on what? Not like scaring the shit out of the public with the world wide pig flu pandemic, declared "National Emergency" isn't going to send every yahoo to the doctor to get diagnosed for it thereby increasing morbidity. Plus, it's pretty easy not find signs of injury if you'll only look at them in Vaccine Court.

You think that we should stare death in the face so that your paranoid mind can sleep a few nights before inventing more imaginary risks. You think that you are superior to us mere mortals.

Holy sensationalism. If you're staring death in the face from measles, it's very likely that you've got some co-morbidities that aren't cooperating in your response. Or you've got someone shoving tylenol down your throat. Measles virus doesn't seem to do very well in high temperatures or in the environment in general, so it makes perfect sense to keep that fever in check.

No Dog, I'm not superior. I just think that the promotion of discrimination has no place in a civilized society. I guess that's because we've yet to create one.

If you can look aside your "anti-vax" rhetoric long enough to realize that the people that are now asking if there is a safer way to vaccinate are people that HAVE VACCINATED, you might be on to something. I know it's not as entertaining as talking smack about the illuminati or the NWO, and it sure helps to character assassinate when you bring that nonsense up... can't always be fun and games.

@ mts

Germany 2006: 1700 cases of measles, 2 children dead, one girl looses her speech after encephalitis - 2009 one more girl who got measles in that outbreak comes down with SSPE - so all it needs is about 2000 cases of measles in the US to break even with your calculated risk of universal MMR vaccination. Anti-vaccine liars are pretending that the low rate of measles infections is some kind of "natural order", where in fact it is the consequence of 2xMMR for nearly every child. If vaccination rates drop just a little bit, we are so going to see deaths and disability return.

Janet Camp @17:Just how would you define "objective observer"? I can't wait for Orac's response.

An objective observer is someone that doesn't have anything to gain from being on either side of the issue. One that reads information posted by the skeptical community, then goes to verify that they've reported unbiasedly. I read here quite a bit, post less than I read. Sometimes I get irritated enough to speak my mind. Today is one of those days.

Orac will tell you that I'm certainly anti-vaccine and I'm couching my views in emotional sentiment without providing evidence for an alternative. If you don't know that, you've not been reading here long enough.

You can get Prevnar if you're over five. I believe it is approved up to nine. It just isn't recommended because the risk is much lower in the over five group. It hard to keep up with the convoluted and ever changing sched.

As to Pneumovax:

Pneumovax® and Pnu-Immune® are 23-valent polysaccharide vaccines (PPV23) (recently renamed PPSV) that are currently recommended for use in all adults who are older than 65 years of age and for persons who are 2 years and older and at high risk for disease (e.g., sickle cell disease, HIV infection, or other immunocompromising conditions.)

Here's a good link that covers them all
http://www.cdc.gov/vaccines/vpd-vac/pneumo/default.htm

By Sid Offit (not verified) on 07 Jan 2010 #permalink

mad the swine, that is the most idiotic use of illogical math I have ever seen. The only reason the risk of getting measles is so low is due to high vaccine coverage. If we had it your way and stopped using the MMR, measles and mumps will return. Which has happened in the UK, Switzerland, Japan and elsewhere.

You also neglect to factor that several of those who got measles in 2008 were hospitalized.

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mad the swine, your numbers only hold if the measles infection rate doesn't increase without vaccination... I believe that Phil Plait knocked that assumption on its head pretty vigorously.

Before MMR came out, measles rates in the US averaged ~400,000/yr; that changes your estimation significantly, in that you're looking at 200 dead kids every year in comparison with only 4... even granting your "one in a million" number, which I'm not certain I should.

By my reckoning, that makes MMR 50 times safer than going without.

-- Steve

@anon:

"As an objective onlooker to this debate,"

More often than not, when someone says they donât have an opinion on something, it usually means they really do, but deny it so they can maintain the appearance of impartial objectivity.

When someone prefaces a comment by stating what they are not, or what they donât believe, or what theyâre not sure of, it tends to be followed by a statement that shows they do have an underlying true belief and their preface was dishonest BS.

To the two proceeding statements, I guess I must now add the following: When someone prefaces a comment with a claim to be an impartial or objective onlooker, please see above.

Of course, anaon's next comment @21 pretty much proved my point, rendering this comment dunsel.

Steve@26:Before MMR came out, measles rates in the US averaged ~400,000/yr;

The Pink Book, Chapter 11, page 162:

Before 1963, approximately 500,000 cases and 500 deaths were reported annually, with epidemic cycles every 2â3 years. However, the actual number of cases was estimated at 3â4 million annually.

3-4 million changes your estimation significiantly.

Before the measles vaccine CDC estimates 3-4 million cases yearly. If deaths were 500 that gives us one death per 8,000 cases. Since there are risk factors for measles complications, a healthy child living in good conditions would be at little risk. In addition since mortality was falling for many years prior to vaccination why should we assume that the figure of 500 would have remained stagnant?

By Sid Offit (not verified) on 07 Jan 2010 #permalink

@anon

Do on-label directives address predisposition? Or is there denial that predisposition is a factor?

What kind of predisposition? You need to be specific. For example, someone with egg allergies is predisposed to injury from a vaccine that uses eggs in production. This is why, for example, flu vaccine inserts have warnings about egg allergies.

If you simply say "a predisposition to vaccine injury", that's too vague. Further, even have a predisposition (of whatever kind) must be weighed against the risks of injury from the disease, as well. For example, if someone has a known disorder that would lead them to greater risk of injury from, say, the measles vaccine, the doctor must also consider if there is equal or greater risk of similar injury from measles. If the disease is likely to pose greater potential risk than the vaccine, and doctor opts to give the vaccine, then by a reasonable person standard, the doctor is not being negligent.

The key thing, though, is whether or not the predisposition, whatever it may be, is known to be a risk with the vaccine and whether or not it is known that the child has that predisposition. If it is not known to exist, and the doctor gives it to a child who happens to have that predisposition, there is no way that the doctor could have reasonably known that the child was going to be harmed, thus, no case to file suit. Likewise, if there is a known predisposition, but the doctor does not know that the child has that predisposition (e.g., no diagnostic tests available, negative test results, etc.), gives the vaccine and the child is injured, there is no way the doctor could have reasonably known, and again, no case for suit.

Make sense?

Epidemiology & Prevention of Vaccine-Preventable Diseases - 3rd ed. / 1996 / P92 /

By Sid Offit (not verified) on 07 Jan 2010 #permalink

Karl, that's a fair point. The fact is, I don't have a stake in vaccinating children that's why I consider myself objective. The fact that I read here, but don't always agree confirms my own point (at least in mind).

But I never claimed I didn't have an opinion, only I didn't have anything to gain or lose by being on either side.

Orac's followers will be here shortly to rake me, so I best be going now.

So anon and Stone Deaf Sid, you guys would be good with the return of measles at the pre-vaccine levels of millions per year, and don't mind that one out of eight thousand get to die. Lovely.

Of course, I bet none of the over 120 people who died about twenty years ago in the USA are missed. Who cares? They were just other people's children, sisters, brothers and even parents (some were adults). Not that you should care.

Still, your little games with the numbers in no way shows that the MMR vaccine has more risk than measles, mumps or rubella.

anon@28: Indeed... raising the infection rate by a factor of 8 would, given "mad the swine"'s calcuation, make MMR 400x safer than non-vaccination instead of a mere 50x.

Which takes the safety difference in the vax vs. no-vax decision to the level of "letting your kid ride inside the car vs. making your kid ride on the roof rack".

-- Steve

@anon

I didn't have anything to gain or lose by being on either side.

So, you either do not have children/young nieces or nephews, good friends with young family members, family members or good friends with weakened immune systems (due to medical conditions/transplant recipient, or in some other way compromised), elderly family members, good friends with elderly family members or anyone else that would be adversely affected by vaccine-preventable diseases, or you do but just don't care whether they suffer injury from the diseases. Fair enough. Thanks for letting us know.

To add a bit more evidence against the anti-vaxers, here is an analysis of the rubella outbreak that happened in the Netherlands and spread to Canada in 2004-2005:

http://www.pediatricsupersite.com/view.aspx?rid=43990

* Two intrauterine deaths at 16 and 23 weeks gestation following initial infection at weeks four and five.
* Eleven infants had defects associated with congenital rubella (85% risk rate; 95% CI, 55%-98%), with all experiencing deafness and no reported cases of cataracts or vision loss.
* Disability and/or delayed development in six of the 11 infants with defects reported at follow-up.
* Interventions included cardiac operations in three children and cochlear implants in two children.
* Lab-confirmed maternal rubellavirus infection was evident in the first trimester for the 11 children with defects.

Which takes the safety difference in the vax vs. no-vax decision to the level of "letting your kid ride inside the car vs. making your kid ride on the roof rack".

With or without seatbelts?

Do the seatbelts have needles sticking out of them?

By Sid Offit (not verified) on 07 Jan 2010 #permalink

@anon,

Objective: not influenced by personal feelings, interpretations, or prejudice; based on facts; unbiased: an objective opinion.

"The fact is, I don't have a stake in vaccinating children that's why I consider myself objective."

Non sequitor. I don't see anything in the definition about not having a stake in something.

"The fact that I read here, but don't always agree confirms my own point (at least in mind)."

Non sequitor. Objectivity doesn't depend on how often you do or do not agree with others.

"Orac's followers will be here shortly to rake me, so I best be going now."

Hey, you've indicated that you've been reading this blog for a while, so if you don't like heat, don't go in the kitchen in the first place.

I'm a little reminded of one of my favorite forum comments of all time:

âAnd the moral we learn from that last comment, Boys and Girls, is that if you canât win an argument on its merits, take a shit on the desk and leave.â

-Someone named Jody in a thread on skeptico

@anon,

Objective: not influenced by personal feelings, interpretations, or prejudice; based on facts; unbiased: an objective opinion.

"The fact is, I don't have a stake in vaccinating children that's why I consider myself objective."

Non sequitor. I don't see anything in the definition about not having a stake in something.

"The fact that I read here, but don't always agree confirms my own point (at least in mind)."

Non sequitor. Objectivity doesn't depend on how often you do or do not agree with others.

"Orac's followers will be here shortly to rake me, so I best be going now."

Hey, you've indicated that you've been reading this blog for a while, so if you don't like heat, don't go in the kitchen in the first place.

I'm a little reminded of one of my favorite forum comments of all time:

âAnd the moral we learn from that last comment, Boys and Girls, is that if you canât win an argument on its merits, take a shit on the desk and leave.â

-Someone named Jody in a thread on skeptico

To erase another anti-vax lie that seems to persist around the internet, vaccine are tested on "unhealthy" children, including premature and HIV positive infants. Here are some examples:

http://linkinghub.elsevier.com/retrieve/pii/S0022347604002823

http://www.journals.uchicago.edu/doi/abs/10.1086/324666

Those are just the top two of a very long list found by a simply google scholaring "DTaP premature"

Here are the top two when googling DTaP HIV:

http://linkinghub.elsevier.com/retrieve/pii/S0091674905013126

http://pediatrics.aappublications.org/cgi/content/abstract/peds.2007-07…

"the incredibly rare victim who gets trapped in a burning vehicle as a result of a stuck seatbelt"

As far as I know, there is no evidence that this has EVER happened. I have read comments on this from "urban legends" scholars. A relevant datum is that less than 1 in 200 accidents involve a fire. My own take is that, when a fire does occur, there is likely to be no conclusive evidence of the victim's situation after the fact!

By David N. Brown (not verified) on 07 Jan 2010 #permalink

Lost in the discussion about deaths due to MMR vs. measles is the cost. So maybe the mortality rate of measles was dropping, but what was the outcome for those that were hospitalized and survived? Perhaps more survived, but did more survive with permanent injury or disability? What was the cost of care both in the hospital and afterward for those who suffered permanent injury?

Also, no one has extrapolated the number of cases to today's population. According to the Census Bureau the population today is about 1.6x that of 1963. Even if the mortality rate drops (probably would given improvements in medical care) the increased number of cases would likely still lead to hundreds of deaths per year.

What would the cost of care be for 5-6 million cases of the measles each year? Could our health care system really survive that kind of onslaught? What about the lost time at work for the sick or the parents caring for their kids? Travel restrictions? Quarantines? The world now is different than it was before measles vaccine. Outbreaks would be swift and global.

There is not an infinite pot of money to provide medical care to all those who would seek it during an outbreak or to provide life-long care for those injured or disabled. Vaccines appear to provide the most benefit for the least cost. Perhaps they can be made safer, but not vaccinating will kill more people and cost more money and lead to greater disruption of society.

By The Gregarious… (not verified) on 07 Jan 2010 #permalink

mad the swine:
"4/0.07 = the MMR vaccine is 57.1 times more likely to cripple or kill a child than measles are."

Others have pointed out the fallacy with this argument in the event that vaccination rates drop. But, from a purely selfish point of view, does this argument hold water? i.e. if an individual parent assumes vaccination rates remain high, are they better off to risk measles over the risk of vaccines today?

The answer is "no." It turns out mad the swine completely butchered the statistical argument. Foremost, taking the ratio of cases of measles deaths versus vaccination-induced encephalitis fails to account for the disparity in the size of the at-risk population. The correct statistic would be to compare the relative risk of adverse outcomes in unvaccinated children versus vaccinated children. Secondly, comparing measles deaths to vaccine-induced encephalitis is an apples-to-oranges comparison. Measles comes with other serious complications, such as, oh yeah, measles encephalitis. It would be best to compare severe adverse outcomes in both populations.

So what is the rate of adverse outcomes in unvaccinated children today? Let's take mad the swine's estimate of 5% of 4,315,000 unvaccinated (i.e. 215,750). Then, using data from 2008 (On Wikipedia, I found 131 cases leading to 15 hospitalizations. Of the 131, 122 were not vaccinated yielding ~14 hospitalizations in unvaccinated children). So the risk of landing in the hospital due to complications from measles in an unvaccinated child is 14/215,750 or ~1 in 15,000. This is a heck of a lot higher than 1 in 1,000,000 risk faced with vaccination.

So, if you don't vaccinate, you are not just selfish, you are also stupid.

(Final note: I'm sure my numbers are flawed to some extent, but I wanted to come at this from the numbers and argument offered by mad the swine. Perhaps someoone knows the true risk numbers in these populations?)

Sid:

Since there are risk factors for measles complications, a healthy child living in good conditions would be at little risk.

The presence of risk factors doesn't mean that none apply to "a healthy child in good conditions", nor does it mean that if you have no risk factors, you will not die. (Tell that to a person with lung cancer who has never smoked and never been exposed to second-hand smoke. Just because you don't have special risk factors doesn't mean you're safe.)

In addition since mortality was falling for many years prior to vaccination why should we assume that the figure of 500 would have remained stagnant?

We shouldn't. Truthfully, there is no way to know what the rate would be with modern medical care apart from letting everybody's vaccinations lapse and seeing what happens. The price of this strategy has already been demonstrated in regions where lots of people skipped vaccination (or at least skipped MMR) -- we can expect to see deaths increase. The only real questions are "how much" and "what about non-fatal negative consequences of measles"? You can wind up hospitalized from measles without actually dying, and modern medicine has some great techniques to assure that. You might wind up severely brain damaged due to measles encephalitis, but you wouldn't be a death statistic. I don't know about you, but I would consider that a significant factor to consider as well.

I'm quite certain that we would not see as many deaths as happened pre-vaccine, because medical science has improved remarkably. But that is not to say all cases would be minor, nor is it to say that the costs* would be less than the costs of vaccination.

*I'm not talking money here. I'm talking pain and suffering.

By Calli Arcale (not verified) on 07 Jan 2010 #permalink

@The Gregarious Misanthrope

Good points. Along with the increase in number of individuals hospitalized, that means fewer beds available for other patients with diseases or injuries that cannot be prevented by vaccines. Over at antiantivax, I've linked to a study on the 2006 measles outbreak in Germany. That study includes a table showing the costs of treating the disease-caused injuries. It does not include the costs to the business who lost workers for periods of time, the non-monetary costs to families who had to miss work or have to live with the consequences of the disease, etc.

FYI, mad the swine has a history of poe-ing over at Ed Brayton's Dispatches blog. At least in regards to culture war issues, he/she is actually a pretty reasonable person who pretends to be insane.

I've never heard mts comment on vaccines before, though, so I have no idea if this is also a poe. If those numbers are accurate, they are intriguing, though... it suggests those who chose to get a free ride based on herd immunity really are getting the incremental benefit they expect (though at the cost of everybody else's child's well-being...)

"the incredibly rare victim who gets trapped in a burning vehicle as a result of a stuck seatbelt"

As far as I know, there is no evidence that this has EVER happened. I have read comments on this from "urban legends" scholars.

I feared this might be true, but I've been ignoring that reality because it would take away my favorite analogy for why it's silly to place an overemphasis on minuscule risks in the face of obvious large benefits. :(

I suppose airbags? But the problem is there that they are a bit controversial... pretty much just complete crackpots are anti-seatbelt these days. Can I just pretend that seatbelts result in a small number of deaths, so that I can make my point about how that pales in comparison to the large number of lives they save? Pretty please???

Sid Offit says:

Do the seatbelts have needles sticking out of them?

Bravo, Sid, you have finally revealed the core of the anti-vax movement: Irrational fear and appeals to emotion.

Numbers? Data? Reality? Fuck dat shit, dem needles is SCARY!

Reading this makes me want my entire family to get the MMR again. And I just got a booster last year!

Some good news, for a change-- I was thrilled to see a very high uptake of H1N1 vaccine at my child's elementary school. Perhaps non-coincidentally, he goes to a public school in a poorer neighborhood with a high population of Somali immigrants. And guess what-- they appreciate vaccination!!! Perhaps they or their close relatives have seen firsthand the ravages of vaccine-preventable diseases and know said diseases are nothing to be toyed with.

By Perky Skeptic (not verified) on 07 Jan 2010 #permalink

Also, no one has extrapolated the number of cases to today's population. According to the Census Bureau the population today is about 1.6x that of 1963. Even if the mortality rate drops (probably would given improvements in medical care) the increased number of cases would likely still lead to hundreds of deaths per year.

------------------------

Deaths were falling throughout the 1st half of the 20th century as population was expanding

By Sid Offit (not verified) on 07 Jan 2010 #permalink

Brian Deer's expose of Andrew Wakefield's scientific fraud,

Wasn't there something supposed to move forward on his professional misconduct case on December 19th? I might be thinking of something else.

Also, if 1 in 1,000,000 children get encephalitis from the MMR shot, is that the same as 1 in 1,000,000 children "crippled"?

@Calli

The price of this strategy has already been demonstrated in regions where lots of people skipped vaccination (or at least skipped MMR) -- we can expect to see deaths increase.
----------------
England? 2 or 3 deaths during the 14 year panic created by the abominable Dr. Wakefield?

By Sid Offit (not verified) on 07 Jan 2010 #permalink

I believe Wakefield's work can also be seen in the drop in MMR uptake throughout Europe, which means many more attributable deaths and disabilities. And let's not forget the MMR isn't only about measles (see the rubella outbreak link I gave).

Here's a thought that will probably get lost in the thread:

Vaccines are, I understand, less effective for older persons, especially the elderly. Has anyone thought about whether the rates of vaccination required for heard immunity against various diseases are going to increase as the baby boomer generation ages?

If so, this would seem especially problematic since at the same time the large baby boomer population is getting older, vaccination rates are actually declining instead of rising.

Sid,What do you think about vaccination of adult people. For example if you are going to travel to Africa, will you get vaccinated against malaria? Or will you get vaccinated against tetanus? Do you think the vaccines are unsafe to the adults or only that they unsafe to the children?
I'm just curious about that.

anon,

First, I'm ashamed to almost share a handle with you.

Second, you are not an objective observer. If you were, you would concede that there are numerous studies done that illustrate the safety and effiacy of vaccines.

You've clearly taken time to cherry-pick research that supports your view, so unless you're dense or google-deficient, you know about these studies. And I already know what you're going to say, and no, I am not going to point you in the direction of these studies, because I'm pretty sure you know where they are.

And finally - and critically, I might add - way to go with the "if you get measles and die it's your own fault" gambit. Nothing screams non-objective anti-vaxer by pulling out one of the old canards, mainly that if you get sick, it's your own fault.

@Karl

Interesting thought. Generally, children have been (I think) the main vectors for expansion of vaccine-preventable diseases, but with a growing older population whose "natural" or vaccine gained immunity has waned, the elderly population may become a significant potential pool for diseases to spread.

If it's any consolation, my medical school's lecture on vaccination today placed a strong emphasis on how vaccine scares damage national vaccination programs.

History shows the effect lasts about 20 years - a whole generation of parents can be scared off vaccines by the media spouting nonsense.

At least doctors are being educated about these things.

I think adults can decide for themselves based on a risk/ reward basis. If someone wants a flu shot they should get it.
If I had to go somewhere where malaria was present I'd seriously look at the disease's risks. As to tetanus the risks are wildly exaggerated (about 50% of the population is vulnerable yet there occur only about 50 cases per year) As we as a society moved off the farm the dangers of tetanus have fallen dramatically. As to the safety of vaccines I'd theoretically be more concerned with those whose immune systems are still developing. Although I, at this point, don't subscribe to the idea that vaccines - at least regarding known and excepted adverse events are all that dangerous. I'm concerned with the unknown. And I don't view vaccine preventable diseases threatening enough to embark upon a never-ending journey of vaccination

By Sid Offit (not verified) on 07 Jan 2010 #permalink

I think adults can decide for themselves based on a risk/ reward basis. If someone wants a flu shot they should get it.
If I had to go somewhere where malaria was present I'd seriously look at the disease's risks and possibly vaccinate.

As to tetanus the risks are wildly exaggerated (about 50% of the population is vulnerable yet there occur only about 50 cases per year) As we as a society moved off the farm the dangers of tetanus have fallen dramatically.

In regards to the safety of vaccines, I'd theoretically be more concerned with those whose immune systems are still developing. Although I, at this point, don't subscribe to the idea that vaccines - at least regarding known and excepted adverse events are as dangerous as some contend. Unknown risks are however a concern.

Basically I don't view vaccine preventable diseases, those affecting children and adults, threatening enough, in the absence of specific risk factors, to embark upon a never-ending journey of vaccination

But if I thought the mumps etc... were dangerous I'd vaccinate and except the inherent risks that accompany any drug/medical intervention

By Sid Offit (not verified) on 07 Jan 2010 #permalink

Dan Weber @51
The GMC has pushed the 19 December decision on Wakefield off to the end of January 2010. Carmel Wakefield, the asshole's wife, has a plea for support posted on AoA. She rather disingenuously decries the money spent going after her husband when it could have been better spent elsewhere. Damned right it could have been better spent. If her husband hadn't been such a money grubbing ass, it might have been.

Yes, the lawsuit also strikes me as an attempt to discourage reporters and publishers from writing about the anti-vaccine movement. It's a SLAPP case, but as you already pointed out, there's no anti-SLAPP law in this jurisdiction.

Sid @ 29,

Before the measles vaccine CDC estimates 3-4 million cases yearly. If deaths were 500 that gives us one death per 8,000 cases.

You are making the dangerous assumption that measles deaths were accurately reported, they weren't
http://www.ncbi.nlm.nih.gov/pubmed/16235165
http://www.ncbi.nlm.nih.gov/sites/entrez/15106092

Since there are risk factors for measles complications, a healthy child living in good conditions would be at little risk.

Another wrong assumption. Previously healthy children did and still do die of measles complications, in fact, the majority of deaths were in children and adults with no underlying conditions (see links).

In addition since mortality was falling for many years prior to vaccination why should we assume that the figure of 500 would have remained stagnant?

The case fatality rate reached a plateau in the ~8 years prior to vaccine introduction, it was only then that mortality declined. The case-fatality rate was just as high during the 1989-1991 U.S. outbreak as it was pre-vaccine.

And I don't view vaccine preventable diseases threatening enough to embark upon a never-ending journey of vaccination

Then what, pray tell, WOULD be so threatening? Just what probability of death or severe disability would convince you?

Scott @63
I suspect Sid's threshold is near 100% except for someone he cares about. The rest of humankind can go suck an egg as far as he is concerned.

Sid has attempted to minimize the impact of catching vaccine preventable disease for as long as I've seen his posts here. I wish him personally all the whoops he can handle and all the shingles he can stand.

Personally I think it's 101%, since no evidence would ever cause him to actually THINK about it. Still, hope springs eternal.

Can I just pretend that seatbelts result in a small number of deaths, so that I can make my point about how that pales in comparison to the large number of lives they save? Pretty please???

Seatbelts can cause fatal injuries in a small percentage of MVAs from rupture of internal organs beneath the belt. This of course is much smaller in number than the number of deaths prevented by seat belt use.
BTW, the scenario of escaping death or injury by being "thrown clear" of a MVA is a myth. A lot of MVA deaths occur when an occupant is ejected partly or completely from a car, which rolls over and crushes him or her - a good reason to wear a seatbelt.
I now expect that Stoney Sid will give up the use of seatbelts to save his spleen from rupture.

By T. Bruce McNeely (not verified) on 07 Jan 2010 #permalink

BTW, the scenario of escaping death or injury by being "thrown clear" of a MVA is a myth. A lot of MVA deaths occur when an occupant is ejected partly or completely from a car, which rolls over and crushes him or her - a good reason to wear a seatbelt.

Is there still any prevalent belief that being thrown clear is a means of "escaping" injury? I would think that has been long abandoned.

I mean, when you realize that the first step in "being thrown" from the accident involves going headfirst through the windshield, you start to think that maybe that isn't the best course of action. Put that together with watching NASCAR drivers walk away from a 15-rollover crash and the idea that staying secure in your seat is a good idea starts to make sense.

#60
Thank you for the answer.
(blockquote)And I don't view vaccine preventable diseases threatening enough to embark upon a never-ending journey of vaccination (/blockquote).
But, why not?. Do you prefer to suffer preventable diseases rather than take the vaccines when you are an adult, and therefore you are not going to become autistic? Do you fear allergic reactions? Do you prefer to have the real disease than to prevent it with vaccinations?

Tetanus correction. It's not 50% of the population that's vulnerable, it's 50% of those over 50. Still tens of millions of people though.

By Sid Offit (not verified) on 07 Jan 2010 #permalink

I was pleased to see a well-written and rational article about vaccination appear in USA Today (a newspaper which has occasionally enabled quackery through its articles and by running prominent ads for unproven and useless health products).

The compromise of herd immunity and risks to vulnerable children posed by antivax fanaticism are welcome topics, as was the table accompanying the story, which detailed the tremendous drop in once-prevalent infectious diseases since the advent of vaccines.

The tide has been turning against antivaxers recently, which is why I think we can expect increasingly vicious personal attacks against the medical/scientific community in addition to the targeting of spokesmen for the value of immunization (like Dr. Paul Offit).

By Dangerous Bacon (not verified) on 07 Jan 2010 #permalink

Sid: regarding tetanus, the problem is that you have zero protection from herd immunity. With MMR, you can skate by on other people's protection, but as the tetanus organism doesn't need humans to live and only accidentally causes us harm, vaccination of others won't do a thing to save you.

I suppose you could decide you'd rather count on getting tetanus prophylaxis should you ever get a deep wound, or anti-tetanus if you ever show symptoms. I hope you don't do a lot of wilderness camping, where such prophylaxis would be difficult to get in time. This is a valid strategy, but personally, I'd prefer something a little more proactive.

Pablo:
Weird things happen. Sometimes people do escape injury by being thrown clear of a car. This is very rare, and would be essentially a freak event -- you couldn't count on it happening. More often, people who are unrestrained suffer far greater injuries, and those who are actually ejected suffer the worst because they are unprotected by the car itself.

One interesting (but freakish) example occurred here in Minnesota last winter. A guy skidded out on a patch of black ice on I-35E and rolled the car. He was seatbelted in, and was killed. But his infant daughter, who was properly restrained in a child seat, was ejected and survived. It is not known why the child seat's base unit failed to restrain the child seat, but the seat itself essentially acted like an ejection seat, protecting the child. The poor kid is growing up without a daddy, but nobody could've predicted that it could have ended like that, and it's sheer luck. As far as anyone could tell, the base unit to which the infant seat was supposed to be latched was working properly. State patrol speculated that maybe it was only partially engaged. In any case, the girl only survived that because she was ejected *inside* an infant seat, which is specifically designed for crash protection, and was properly restrained in that seat.

Meanwhile, I've heard several stories since then of accidents where those in seatbelts survived with minor injuries and those without were ejected and killed. The balance isn't even close -- it's waaaaaay safer to wear your sealtbelt than to count on a freak accident.

By Calli Arcale (not verified) on 07 Jan 2010 #permalink

Seatbelts can cause fatal injuries in a small percentage of MVAs from rupture of internal organs beneath the belt.

I knew someone who sustain some pretty extensive intestinal damage from just such an accident (not fatal, "just" required a bunch of surgeries)... but I assumed if the vehicle decelerated fast enough for that to happen (in this case by hitting a tree), it's not likely she would have survived without the seatbelt either?

Anyway, if it restores my example to legitimacy, I'll take it!

I am an "autism mom" and I am very annoyed with other autism moms demonizing Dr. Offit. I don't think our kids are mercury poisoned. I think I am a sensible person and I like to see both sides of every story.
That being said, I would like some understanding that after receiving a vaccination, my daughter developed a very high fever and had a seizure. My daughter was diagnosed with autism at age 2. After some immune panels and viral titers were done on our daughter, we discovered that she has a very dysfunctional immune system. Once we started treating her immune system, she started getting better. I really do believe that autism is an auto-immune disease that affects our children's brains at a critical developmental period in their lives, therefore they suffer developmental delays. Once you start getting their brains healthier, they start picking up where they left off developmentally.

I feel very alone because I am left out and alienated from other "mother warriors" as they like to call themselves because I don't join them in their AMA and vaccine-bashing. But I do think that some more studies in vaccines and their effects on the immune system and the brain need to be done.

Jennifer, you won't get any support here. Sadly, such a moderate view on vaccinations makes you "anti-vax" in the pea-brains of Orac and his ilk. Anyone who questions vaccine safety in any way, to them, means that they are "anti-vax."

Gotta love those "scientific" minds.

It's not a matter of preference. I prefer not to get sick -and I don't really get sick very often (knock on wood). I also prefer to avoid needles and medications if not needed. Let's take the flu and tetanus vaccines: two given to adults. I can't think of the last time I had the flu so I'm not motivated to get the shot, especially when the shot itself could make me feel sick. And as I said the risk of tetanus is exceedingly remote. Here's the link to the possible reactions I'd have to which I'd have to subject myself in order to get protection which I my mind has little value

http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-tdap.pdf

As for myself, it's not autism, but the prolonged crying I'm worried about.

By Sid Offit (not verified) on 07 Jan 2010 #permalink

"Sadly, such a moderate view on vaccinations makes you "anti-vax" in the pea-brains of Orac and his ilk. Anyone who questions vaccine safety in any way, to them, means that they are "anti-vax.""

That is simply not true. Questioning the safety of vaccines is perfectly healthy, normal and, in fact, questioning the safety of anything is a very good state of mind. Continuing to question this after a ludicrous amount of evidence shows something (in this case vaccines) is percectly safe, is wrong-headed. Dismissing all research that has shown vaccines are safe as being payed my Big Pharma and therefore not being legit, is not my idea of having a healthy state of mind. After so much evidence has shown it is safe, and after even more evidence has shown it is far more dangerous to not vaccine (this evidence is provided in the form of DEAD CHILDREN), opting to not vaccinate yourself and your children (if you have children) is more than just wrong-headed. It's dangerous.

And now, ladies, fish and gentlemen, for my more cynical-sarcastic, Orac-like side.

"But I do think that some more studies in vaccines and their effects on the immune system and the brain need to be done."

Exactly. We need more studies! We don't need to look at the current evidence at all and conclude that 'more research' would be a waste of money, effort and time. We just need more studies that aren't FUNDED by Big Pharma! And, let's not forget: if the studies show vaccines are safe, it is PROOF that it has been funded by Big Pharma and is therefore absolutely not legit. Because of that, we need more studies! We need to research and research until we have diverted funds from all other useless sciences like cancer research and use that to fund Big Pharma-free research on vaccines. And if it doesn't show vaccines are, in fact, causing autism and essentially makes children lose their shit: the research wasn't good enough! In other words: let's research and research until reality conforms with our view (i.e. never).

...

Stop trying to destroy humanity.

Todd: So, you either do not have children/young nieces or nephews, good friends with young family members, family members or good friends with weakened immune systems (due to medical conditions/transplant recipient, or in some other way compromised), elderly family members, good friends with elderly family members or anyone else that would be adversely affected by vaccine-preventable diseases, or you do but just don't care whether they suffer injury from the diseases.

I don't usually make a practice of telling people how to live their lives. I don't expect other people to keep me free from disease, and in turn I hope that they don't ask that I do the same. I will behave responsibly, and stay out of the herd when I am sick and take every precaution possible. Being exposed to disease is a choice I make by living in a society of diverse people in diverse areas. Vaccination status alone will not tell me whether or not people will be adversely affected by vaccine-available diseases. I think the difference, is that I care equally about those that suffer from disease, and vaccine injury alike. The first step in this equilibrium is recognizing that vaccine injury, does in fact, exist.

As to the previous comment asking for specifics on predisposition - consider this example:

I take my infant child to the pediatrician for routine vaccinations at 2 months. The child presents with slight fever, coughing up small amounts of phlegm. My medical history predisposes me to brain cancer, multiple sclerosis, heart disease, 'autism' and alzheimer's. Can you tell me #1) if the routine vaccines called for at this age and my child's symptoms make the vaccines advisable at this time and #2) whether my medical history predisposes my child to an adverse event due to our collective genes and if the answer to 1 is yes, is there data to support this? And if the answer to 2 is no, how do you justify this? Using the current studies as they relate to vaccines and autism will not apply, since the two round shots don't include the MMR - and thimerosal would likely be a passive issue since it's probably only present in trace amounts from manufacture. (The accurate way to address thimerosal by the way... instead of saying it was phased out in ______ and they no longer use it)

Karl @43:âAnd the moral we learn from that last comment, Boys and Girls, is that if you canât win an argument on its merits, take a shit on the desk and leave.â

Guilty as charged. I'm in a better mood now.

a-non @61:you are not an objective observer. If you were, you would concede that there are numerous studies done that illustrate the safety and effiacy of vaccines.

I will concede that there are numerous studies showing seroconversion in healthy vaccine recipients. I will concede that the measles vaccine works very well at reducing symptoms and transmission of measles virus. I'm far more objective than you think.

way to go with the "if you get measles and die it's your own fault" gambit. Nothing screams non-objective anti-vaxer by pulling out one of the old canards, mainly that if you get sick, it's your own fault.

Didn't say that. By and large, in immune competent people, measles is a self limiting disease and prior to mass vaccination programs it was not feared among the majority to be a deadly illness. Certainly it can cause problems in a subset of people, this is tragic. The vaccine does the same thing to a different subset of people, and being objective, is having the ability to realize and admit that.

Jennifer @81:I do think that some more studies in vaccines and their effects on the immune system and the brain need to be done.

Me too.

Harman Smith @82:We need more studies! We don't need to look at the current evidence at all and conclude that 'more research' would be a waste of money, effort and time. We just need more studies that aren't FUNDED by Big Pharma!

Please tell me what happens to a dendrite when it comes into contact with tetanus or diphtheria toxoids? Pharma funded will be fine. Thanks in advance.

#52 said it was an urban myth that seatbelts caused a death by being stuck and holding someone in a burning vehicle. Sticking may not be the failure mode. About 35 years ago there was an accident at the Mobil refinery in Torrance California in which an employee perished because of the seat belt. A brave soul managed to open the door but heat beat him back before he could release the buckle. As a result the man burned to death.
My cousin drove wrecker truck near the Snake River in Idaho. Of the vehicles that went in the canal there were zero survivors that wore belts. So he refused to wear his belt. I wear mine. I think the odds are with me.

@Harman Smith - your attack on Jennifer was uncalled for. Clearly, she is not in the rabid anti-vax camp, or at least wasn't. That she hasn't jumped on the anti-vax bandwagon despite what she has experienced (whether vaccine-related or not) is commendable. Prefacing your commentary with "cynical-sarcastic" does not excuse it. How about simply stating that the answers are in and pointing Jennifer to the studies? Perhaps that would give her a little more armor amongst the "warrior moms" (lame name, by the way, smells a bit of Munchausen by proxy).

Are you working with amused or something? He/she predicted that reaction.

By The Gregarious… (not verified) on 07 Jan 2010 #permalink

@Jennifer: Welcome. No, you won't be scorned for questioning vaccine safety unless you espouse one of the antivax canards that have been refuted multiple times. Orac, and all of the logical people here, DO recognize that some people have bad reactions to vaccines. Vaccines, like life, are not 100% guaranteed to be safe. However, the argument is that vaccines DON'T cause autism.

Your comment, that your daughter had a fever and seizure after a vaccine, and was later diagnosed with autism and an immune system problem.

If you are blaming the autism on the vaccine, you will get smacked down here. If you are saying that they occurred at same time - most kids are diagnosed around age 2 with autism, about the same time they have completed their first childhood vaccine series - then yes, that will be accepted.

If you are saying that the vaccine caused a fever and seizure, which then worsened the immune dysfunction which led to an increase in autistic behaviors, then that could also possibly be accepted. But not a statement that the autism was caused by the vaccine.

Vaccines have not been shown to worsen immune disorders. Generally, people with immune disorders do not create sufficient antibodies to disease, whether acquired naturally or through immunization. Those children depend on herd immunity to prevent illness.

Can an immune dysfunction lead to autism? No one knows the answer to that. So far, the majority of studies seem to show autism is related to genetics and/or intrauterine issues. Can treating an underlying health issue improve an autistic child's ability to function and learn? Sure. We all agree to that. Treat any person's health issues and they are better able to function and learn, whether they are autistic, mentally retarded, neurotypical with health issues, or elderly. We need to feel well in order to function, and no one here denies that.

I hope you hang around to read and learn. An open mind is welcome here (as long as it's not so open your brains fall out...as the saying goes).

Jennifer said: "I would like some understanding that after receiving a vaccination, my daughter developed a very high fever and had a seizure. My daughter was diagnosed with autism at age 2. After some immune panels and viral titers were done on our daughter, we discovered that she has a very dysfunctional immune system. Once we started treating her immune system, she started getting better."

Leaving aside for the moment just what criteria were used to diagnose the child's "very dysfunctional immune system" and what treatment supposedly improved it - did Jennifer notice what happened to the child with the immune deficiency described in the USA Today story? She developed Hib meningitis, in an outbreak spread by unvaccinated children.

What's really scary for people with immune dysfunction (children or adults) is the prospect of severe injury or death from an infectious disease, not the vaccines that prevent them.

By Dangerous Bacon (not verified) on 07 Jan 2010 #permalink

Jennifer@79: It sounds like you have had a tough road. I am sorry to hear that. There are a couple of things worth considering as you seek out resources. First, the autism spectrum is broad as I am sure you know. I would expect that the causes of autism are also many. Second, as the seatbelt example illustrates people often use possibility to make decisions when using probability would be more useful. It seems that understanding the causes of autism is an area that would benefit from significant research resources. It also seems that one significant barrier to research in the causes of autism is very vocal groups demanding that resources be devoted to improbable causes.

Well at least the so called "anti-vaccine" movement is not paralyzed, brain damaged or dead due to vaccines!

How many girls has Gardasil killed?

How many people died from the hyped up swine flu vaccine?

How many are disabled after taking your silly vaccines?

We are not anti-accine. We just want medicien that won;t kill us faster than the disease they pretend to protect us against. Is that too much to ask?

By Dr. Smart (not verified) on 07 Jan 2010 #permalink

Oh look, the antivax trolls.
Quick, snap some photos as we roll by, and remember, don't offer them food, it'll make them unmanageable.

Oh look, the vaccinated mercury slupers with permanent vaccine induced brain damage.

Quick cover your head before they reach up your butt grab your uvula and pull out your brains for themselves.

By Dr. Smart (not verified) on 07 Jan 2010 #permalink

@90 Dr. Smart,

I have not done an examination of the literature, but my recollection of news stories was that at least 3 people within 20 miles of my house died from complications of H1N1 flu over the last 8 months; I don't recall a single news story about deaths or serious complications that could be directly attributed to the vaccine. I am unaware of any deaths attributable to Gardasil, but freely admit to being totally ignorant on the subject.

If you have statistics comparing the death/injury rate of these vaccines compared to the actual diseases they prevent, I for one would be delighted to see them. Thanks in advance.

If you have other dat

By Mephistopheles… (not verified) on 07 Jan 2010 #permalink

He is not going to answer you, Mephistopheles. He is a drive-by troll that seems to have wandered over here because PalMD now deletes his comments at the WhiteCoatUnderground blog.

Dr. Smart might not be back, but does anyone know the answer to these questions:

How many girls has Gardasil killed?

How many people died from the swine flu vaccine?

As far as I know the answer to both is 0 but if I am wrong I would like to know.

www.naturalnews.com and preventdisease.com

H1N1 was not a pandemic as was reported. Europe is investigating the UN for calling it a global pandemic. Yes alot of people got sick, but most got over it. The media failed to report (as they usually do) that most of the people who died from the swine flu already had health issues before they even contracted the flu. Remember the Washington Redskins cheerlead who was paralyzed afte her vaccination? Go ahead and start looking it up. Of course the corrupt FDA and WHO won't accurately report these things. They have deals to push, money to make, and power to gain.

Go ahead and vaccinate yorself, but count me out. I'll take my chances with the disease. If push comes to shove, I know where some available prescription medication can be obtained fairly quickly and it won't be tamiflu either.

Yes PalMD deletes my comments. If I could only delete his in return. Maybe he don't like competition when i start posting alternative treatments. Oh well. Some just can't handle competition.

By Dr. Smart (not verified) on 07 Jan 2010 #permalink

Thanks Chris: I am going to read the JAMA paper tonight. I thought that this comment from the highlights on the CDC page [http://www.cdc.gov/vaccinesafety/Vaccines/HPV/jama.html] was useful

"In cases where there was an autopsy, death certificate, or medical records, the cause of death could be explained by factors other than the vaccine. Some causes of death determined to date include diabetes, viral illness, illicit drug use, and heart failure."

@BKsea (#48) dr. sears makes the same error as mad the swine in his vaccine book. infuriating, and trying to explain the error to the anti-vax moms in my old neighborhood was like banging my head against the wall...

Scopie's Law also applies to NaturalNews. Also, Desiree Jennings has been discussed on this blog.

Chris - thanks for the response and the info.

Dr. Smart - If my understanding of "pandemic" is correct (an infectious disease that spreads through populations on a very large scale - across multiple continents, say - over a well defined period of time. Since people contracted H1N1 influenza in the Americas, Asia, and EMEA over a relatively short period, I'd have to disagree when you say it wasn't a pandemic. On the other hand, it apparently wasn't nearly as deadly as initial reports suggested.

By Mephistopheles… (not verified) on 07 Jan 2010 #permalink

Yes, the H1N1 flu was not as bad as predicted, though it did tend to kill the young.

James Sweet
"it's not likely she would have survived without the seatbelt either"
That is more or less the point I wished to make as a generalization. It's pretty elementary that if you can't rule out a victim being unconscious, pinned, paralyzed or already fatally injured, then the role of the belt either way remains uncertain. (Plus, there's the dilemma of how much evidence can be destroyed by the fire or putting out the fire.)
Another point of interest is that there are serious critics of seatbelts out there. I have reviewed a website of this kind, and found no mention of the "doomed by seatbelt" story.

By David N. Brown (not verified) on 07 Jan 2010 #permalink

Dr. Smart sez: "Go ahead and vaccinate yorself, but count me out. I'll take my chances with the disease. If push comes to shove, I know where some available prescription medication can be obtained fairly quickly and it won't be tamiflu either."

Well, don't keep us in suspense. What is this terrific flu-fighting medication you have access to? Vicodin? Colloidal silver? Lithium?

"The media failed to report (as they usually do) that most of the people who died from the swine flu already had health issues before they even contracted the flu."

What's your source for this claim? Even if it was true (in contrast to typical seasonal flu, H1N1 has disproportionately affected younger, previously healthy people), wouldn't it make sense for people with "health issues" to protect themselves through vaccination?

Remind me again, what sort of doctor are you? Please tell me you're not an M.D. - it gets dispiriting having to wear a bag over my head in shame over what my profession occasionally produces.

By Dangerous Bacon (not verified) on 07 Jan 2010 #permalink

Dangerous Bacon:

Remind me again, what sort of doctor are you?

Mail order.

Dangerous Dead Pig:

I am a doctor of homo-pathic medicine. I suspect that you have homopathic tendencies eh?

I prescribe the following procedure for your immediate benefit:

Stick your arm up your butt, grab you uvula and pull real hard. Be sure to fart out your ears three times daily. Take a whole bottle of viagra with a whole bottle of castor oil and call me in the morning.

By Dr. Smart (not verified) on 07 Jan 2010 #permalink

Well, if not mail order, his degree was definitely awarded by the voices in his head!

I prescribe this procedure to Dr. Cumfart for the immediate benefit of humanity.

By Tyler DiPietro (not verified) on 07 Jan 2010 #permalink

(Tyler, not funny)

H1N1 was not a pandemic as was reported. Europe is investigating the UN for calling it a global pandemic.

Bullshit! H1N1 was a pandemic (which only comes in "global" btw) and "Europe" is not "investigating the UN". One weird science journalist has gone off the bend and has filed a frivolous law suit.

#97 "The media failed to report (as they usually do) that most of the people who died from the swine flu already had health issues before they even contracted the flu"

In Spain the Media emphasized the fact that the people who died from the swine flu had previous health issues, in order to mitigate the public fear of the pandemic.

84

Harman Smith @82:We need more studies! We don't need to look at the current evidence at all and conclude that 'more research' would be a waste of money, effort and time. We just need more studies that aren't FUNDED by Big Pharma!
-----------------------------------------------------------
Please tell me what happens to a dendrite when it comes into contact with tetanus or diphtheria toxoids? Pharma funded will be fine. Thanks in advance.
-----------------------------------------------------------
Hello to all you scientific minds out there in cyberspace.
Wow. So here we are.
What bothers me is that anon made a brilliant comment that none of you dared to question or attempt to answer for that matter.
What happens to a dendrite when it comes into contact with some of those sweet-ass toxins???
Anyone? Anyone? Bueller?
You can't answer it.
And neither can anyone else right now.
Why aren't these studies being done?
Let me help you geniuses:
A dendrite is like a tree, in fact, the word dendrite is derived from the Greek word tree (dendron).
Like everything in that big mass of shit in our skulls---dendrites are very important. Some would venture as far to say that they are extremely important.
They act as conductors of electrochemical stimulation.
They are easily SET OFF. They can overreact.
Dendrites are just facilitators...they don't understand that the colorful shit in vaccines like aluminum phosphates or 2-Phenoxyethanol which has the ability to inhibit phagocyte activity, meaning it's fucking toxic to ALL cells...dendrites just don't get it. They mean well.
No, really, they do.
They're just doing as they're told. As soon as that needle enters the arm----they're just bursting with action potential. It's quite frightening actually.
Don't get me wrong peeps. Communicable diseases are scary.
They kill. They suck.
But so do vaccines. And please don't give me this line of crap about vaccines saving all of us from diseases.
The death rate for measles declined nearly 98 percent during the first 60 years of the 20th century.
For the love of Darwin!
The mortality rate in the United States was 133 per 1 million people in 1900. In 1962 Measles caused less than 95 deaths for the entire population of the USA before there was a vaccine developed ('63).
The same exact thing happened with diphtheria and pertussis.
So how did vaccines save us again?
And you're all sure (doctors, arm-chair doctors) that vaccines have nothing to do with the number of neurological disorders that seem to be raining from the sky on our heads like chunks of burning volcanic hell?!?
Really?
Look in the mirror and say that they are unrelated.
The phenol in 2-PE is capable of disabling the immune system's primary response mechanism. Wait, what?
But it's okay guys...it's in our vaccines. There's no irony here. Move along.
I could sit up all night and run circles around these feeble attempts by you so-called "sciencebloggers" to string together anything substantial that would make me have a change of heart, er, mind. But I can't.
I have a full time job and a full load of college classes to tackle.
Oh and please don't worry about trace amounts of mercury. That's the least of your worries.
Howsabout: Glutaraldehyde?
There are so many nasty, nasty things in our vaccines and
the way they interact inside us like a deathsymphony of confusion is just baffling.
Oh Glutaraldehyde, I love you.
You've been proven to change my DNA. You're so powerful.
Who needs an immune system when you've got dem vaccines, right people?
Wait, uh, what? No, the vaccines aren't damaging us. That's just silly. Why would they do that?
There's no conflict with regards to the ingredients and how they dance around inside my body.
Who needs Darwin when you have humans playing God?
Survival of the shittiest.
Good luck to you all.
Eat those chemicals up.

By DNACopernicus (not verified) on 07 Jan 2010 #permalink

What happens to a dendrite when it comes into contact with some of those sweet-ass toxins???

Specify the "toxins" AND the concentrations. Both are very relevant. In fact, tell us what concentrations of these "toxins" appear in the bloodstream after a standard vaccination. If you can't do that, your question is meaningless twaddle.

Actually, your question is just meaningless twaddle.

I could sit up all night and run circles around these feeble attempts by you so-called "sciencebloggers" to string together anything substantial that would make me have a change of heart, er, mind. But I can't.

That sounds like a challenge. This could be fun. Go for it if you will.

Nah. I couldn't even get through DNACopernicus' screed without closing my eyes and wondering who let the nut at the computer. Dendrites? Toxins? I don't know about DNAC, but MY dendrites don't curl up and scream when exposed to the small amount of fluid in a vaccine. My dendrites respond to the electrochemical stimulents released by my body.

DNAC: I'm so glad you have a full time job and college classes. Try taking physiology along with anatomy, so you learn the functions of the cells as well as the big, scary names. Take a pharmacology class after all your organic chem classes so you understand that some of the most common things in the world have big, scary science-y names. Go have some dihydrogen monoxide mixed with tannic acids and other scary things and take a nap.

anon writes:

in immune competent people, measles is a self limiting disease

A "self limiting" disease? Viruses (and bacteria) know when to stop?

Or do you mean "self limiting" in the sense of the Black Plague in medieval Europe, where the disease limited itself by running out of live victims?

Darn. I returned hoping to find out the name of that precription drug that works so much better than Tamiflu (in case the influenza isn't self-limiting enough), and instead get unintelligible rantings. I hope it isn't H1N1-induced delirium.

Odd how the antivaxers get worked up about theoretical "toxins" not demonstrated to be in vaccines, but have no concerns about the known, high levels of actual toxins produced by infectious agents. It's like the guy on another forum recently who triumphantly announced that he was curing his migraines by getting all his amalgam fillings yanked out and replaced by resin composite fillings. My revelation that resin fillings contain a long list of chemicals (some of which are known to produce immunosuppression and cytoxicity in cell culture studies) was ignored. Apparently, only the minute amount of mercury in amalgam fillings was of concern, and anything else he was exposed to in similarly minute amounts was alright, as long as it wasn't the dread mercury.

Not only do these people (and the antivax cranks) not know what "toxins" actually are, they have a peculiar way of compartmentalizing so that only certain "toxins" must be feared. For antivaxers, disease toxins are A-OK. Even when they kill or maim, they're organic and natural.

And self-limiting. Even when the limit is on the self's survival.

By Dangerous Bacon (not verified) on 08 Jan 2010 #permalink

It's interesting that the anti-vax crowd only seems to worry about deaths from disease, but any side affects from vaccines are too many. As many posters here have mentioned, diseases such as measles, mumps, rubella, and polio have "side effects" other than death as well.

Bacon - did you list sodium chloride as one of the components? We know anti-vaxxers are all on a rampage about that these days.

Back to Orac's post. I'm trying to understand how the patient who got sick after the doctor recommended against vaccination would NOT win a malpractice suit? How could anti-vaccination be defended as part of normal standard of care? I mean, if Orac chose to not prescribe an antibiotic after surgery because he "didn't believe in antibiotics", and the patient developed an infection, he'd be sued to high-heaven, and rightfully so. How is this different?

Vaccination is recommended as standard care by every medical organization. Bucking that recommendation is allowed, but jesus moses, if going against standard care goes wrong, how can one not expect repurcussions?

I know doctors complain about malpractice lawsuits because people make mistakes, but this wasn't even a mistake! This was a deliberate act in opposition to a normal standard of care. How can that NOT be malpractice?

@anon

I take my infant child to the pediatrician for routine vaccinations at 2 months. The child presents with slight fever, coughing up small amounts of phlegm. My medical history predisposes me to brain cancer, multiple sclerosis, heart disease, 'autism' and alzheimer's. Can you tell me #1) if the routine vaccines called for at this age and my child's symptoms make the vaccines advisable at this time and #2) whether my medical history predisposes my child to an adverse event due to our collective genes

First off, if the child comes into the office with a fever and coughing up phlegm, they should not receive any of the 2-mo. vaccines. For example, the RecombivaxTM HepB vaccine insert contains this warning:

Any serious active infection including febrile illness is reason for delaying use of the vaccine except when in the opinion of the physician, withholding the vaccine entails a greater risk.

Tripedia (DTaP vaccine) has this warning, regarding coagulation disorders (which, on my casual understanding, may be something to consider, if there's a history of heart disease):

Because of the risk of hemorrhage, Tripedia vaccine should not be given to infants or children with any coagulation disorder, including thrombocytopenia, that would contraindicate intramuscular injection, or to those on anticoagulant therapy, unless the potential benefit clearly outweighs the risk of administration. If the decision is made to administer Tripedia vaccine in such infants or children, it should be given with caution, with steps taken to avoid the risk of bleeding and hematoma formation following injection.

I don't have the time, atm, to see if there is anything listed about MS in any of the inserts, nor do I know enough about the disease to understand what, if any, genetic heritability there may be. As to alzheimer's, while there is likely a genetic component, the aetiology of this disease is not well-enough understood to determine whether or not a risk of alzheimer's exists from the vaccine. Which leaves autism. Currently, there is no evidence to suggest any greater risk of injury in autistic populations vs. neurotypical populations, or even in families with autism in its history vs. those without.

All that being said, and with the caveat that I am not a physician and that nothing I say should be taken as medical advice, I would say that, based solely on the fact that the child is presenting with clear signs of an infection, the vaccines should not be administered. If the child presented without signs of a current or recent (w/i the last 48 hours, say) infection (i.e., "healthy"), it would seem to me that your medical history would possibly indicate caution, but not necessarily rule the vaccines out completely.

I am wondering if anon actually has any kids or not, and has ever been through the child vaccination process? When we go in for vaccines for the offspring, we always have to fill out a questionaire about his current health. If he were running a fever, the doctor would recommend delaying the vaccination until he was healthy again. If he was showing signs of sickness, it would probably depend on how long it has been going on. If it were just the remnants of a lingering viral cough, their probably wouldn't be too much concern. If he was in the height of a cold, they'd probably delay.

I don't doubt there are times when unhealthy kids get vaccines, but I propose that this is mainly the result of _parents_ lying about the health status (because they don't want to go through the hassle of having to reschedule) as opposed to doctors not paying attention.

Todd W,

Thanks for responding. You snipped this from the VIS for Hep B:

except when in the opinion of the physician, withholding the vaccine entails a greater risk.

This would infer that the decision whether or not to vaccinate the child under the circumstance I described, lay in the hands of the physician. You and I agree that doing so is ill-advised. CDC doesn't seem to agree with us though.

Screening is something I take an interest in, after having read literally hundreds of posts from regular parents saying that their child either wasn't screened, or were sick and they were administered vaccines anyway. A bit of digging into the CDC's website turned up this presentation on screening for contra-indications:

ANNOUNCER:
Is the child sick today?
WEXLER:
The first question addresses whether the child has a moderate or severe acute illness, which is a precaution to vaccination. If the child has been examined, this question may not be necessary, or already may have been answered. There's no evidence that acute illness reduces vaccine efficacy or increases vaccine adverse events. But with moderate or severe acute illness, vaccines should be delayed until the illness has improved. This avoids confusing a symptom of the illness - such as fever - with a vaccine adverse event, or vice versa. Mild illnesses, such as otitis media or an upper respiratory infection, are NOT contraindications to vaccination.

Their standard page for contraindication realities and myths would seem to concur.

If a parent considers their child ill, because they spend all day, every day with the child (even based on a few symptoms ie: overall temperament, fever etc..), but the physician upon examination disagrees since there's "no evidence" (we have a tendency to interpret the absence of evidence to be evidence of absence), shouldn't the parent be able to interject and delay this vaccination? Shouldn't we be erring on the side of caution? Why do we consider the person that spends the most time with a child, one that cannot relay an accurate description to a clinician providing them medical treatment? Do clinicians just disregard what caregivers tell them because of they suffer from "confirmation bias"? If yes, could it possibly be that this is not the best approach to patient care?

Currently, there is no evidence to suggest any greater risk of injury in autistic populations vs. neurotypical populations, or even in families with autism in its history vs. those without.

Since we are again relying upon the absence of data, and ignoring anecdotes, is there enough evidence (animal models, etc...) to justify allowing a parent to delay until the child is say... 18 - 24 mos?

If the answer is no, because it leaves them vulnerable to "vaccine-preventable" diseases, is there a conclusive study that equates antibody levels to disease resistance? I've heard some in the pro-vaccine camp claim that high antibody levels are not equivalent to "proper vaccination" and therefore testing titres is no substitute. If this is true, then low levels are also no indication that any particular organism can resist any one disease. Critically thinking people are looking for consistency, and they're not finding it.

Jud @115:A "self limiting" disease? Viruses (and bacteria) know when to stop?...Or do you mean "self limiting" in the sense of the Black Plague in medieval Europe, where the disease limited itself by running out of live victims?

A virus that burns up its host is not a successful virus. Medieval Europe is not 21st Century USA. A self limiting disease creates damage in its host based upon the host's response and other co-morbidities or underlying factors (in some cases, intervention) to the offending pathogen. If a child is running a fairly high fever (in many cases humans will self-regulate, save for poisoning, or heat) in response to exposure to a disease causing agent, does containing it with an antipyretic become consideration for the child's failure respond adequately to the threat? If no, then why? How many cases of secondary infection, or immune response failure in general, involve the practice of fever-containment?

Dangerous Bacon @116:And self-limiting. Even when the limit is on the self's survival.

That may be the case in a small population of people, and it is probably very difficult for their caregivers to take the necessary precautions to protect them from harm. The decisions they face are very difficult ones, I've read them. If I had a child that was compromised, I would certainly not look to my next door neighbor to take those precautions for me. I would also not have a false sense of security over interaction with only vaccinated people. To do so, would be to discount the numerous vaccine failures that history has illustrated.

We have chosen to vaccinate the masses (save for developing nations that have benefited greatly from vaccine programs) to protect that population, and the damage that has occurred along the way appears to be irrelevant. If the consensus weren't so lopsided on who's life is more important, or their constant cries of poorly demonstrated safety ignored (like the day old newborn), you wouldn't have an anti-vaccine movement in the first place. Contrary to what some here believe, the antivaccine movement didn't start with Barbara Loe Fisher or the likes of JB Handley, for whom everyone here has a special place in their heart. People have been opposing vaccines since they were created. Most of those doing so, have been exposed to someone that's been injured or killed by their use.

"People have been opposing vaccines since they were created. Most of those doing so, have been exposed to someone that's been injured or killed by their use."

In reality, if you read up on the history of immunization you'll find that a high percentage of antivax sentiment has been due to resentment of "government telling us what to do", fear of needles, "naturalistic" opposition to "foreign substances injected into our bodies" (as though disease organisms are not foreign substances), with a small percentage knowing someone purportedly injured by a vaccine.

With modern vaccine safety the latter has dropped to a tiny number - but the other sentiments still prevail among antivaxers. The big difference between now and the early days of vaccines is that people have forgotten or never learned about the toll exacted by infectious diseases, so they're more easily recruited by fearmongers.

"A virus that burns up its host is not a successful virus."

On the contrary, such viruses have been highly successful. Smallpox did quite well until inoculation, and then vaccination ultimately eradicated it, the objections and expostulations of antivaxers not withstanding.

By Dangerous Bacon (not verified) on 08 Jan 2010 #permalink

When I went to school I was taught that infants have such an immature immune function that they relied on the antigens and antibodies in mothers milk. Since that is accepted as true then why do we innoculate newborns if they cannot form an immune response?

When I went to school I was taught that infants have such an immature immune function that they relied on the antigens and antibodies in mothers milk. Since that is accepted as true then why do we innoculate newborns if they cannot form an immune response?

Because that is not what "immature immune function" means. Recall that the way the immune system works is that it is exposed to antigens and then develops defenses based on those antigens it sees. Over time, these defenses build up in number in response to the cumulation of antigens it faces. The reason an infant's immune system is immature is because it has not had time to be exposed to many bugs, and so it relies on the fact that the mother has.

The purpose of immunization is to direct the body to build immunity against specific antigens, instead of relying on the child to encounter it in their natural environment.

@97 Dr Smart

"Europe is investigating the UN for calling it a global pandemic."

Will Asia and South America follow suit?

Who's the president/prime minister of Europe these days, anyway?

@anon #23
@Sid #32

If you're staring death in the face from measles, it's very likely that you've got some co-morbidities that aren't cooperating in your response.

a healthy child living in good conditions would be at little risk

So, let me get this straight, if a child dies of a vaccine preventable illness, it is definitely that child's fault for not being strong enough to get through it.

You both sound cold and heartless! I doubt either of you have children, or if you do, they must be better than those children who aren't in "good conditions".

I, for one, am not comfortable with your "Brave new World" in which children who are "weak" deserve to be weeded out.

@anon

If a parent considers their child ill, because they spend all day, every day with the child (even based on a few symptoms ie: overall temperament, fever etc..), but the physician upon examination disagrees since there's "no evidence" (we have a tendency to interpret the absence of evidence to be evidence of absence), shouldn't the parent be able to interject and delay this vaccination? Shouldn't we be erring on the side of caution? Why do we consider the person that spends the most time with a child, one that cannot relay an accurate description to a clinician providing them medical treatment? Do clinicians just disregard what caregivers tell them because of they suffer from "confirmation bias"? If yes, could it possibly be that this is not the best approach to patient care?

Short answer: parents, as the primary caregiver and one with the power to decide medical care, have the right to refuse or delay vaccination. Clinicians must follow the parents' wishes (unless of course the parents' decision puts the child in direct and immediate harm).

Longer answer: Clinicians should listen to and respect a parent's decision and description of the child's condition. The clinician should take the information provided and add to it their background, training and expertise to counsel the parent about their decision. In some cases, the clinical and scientific experience may contradict the parent's experience. At that point, the clinician should describe, in a manner that is easy to understand, where the contradiction lies and what is the recommended course of action, based on the science. It is still up to the parent whether or not to delay or refuse vaccination. Hopefully, they will apply reason to their decision, rather than fear or a skewed perception of the risks involved.

Since we are again relying upon the absence of data, and ignoring anecdotes, is there enough evidence (animal models, etc...) to justify allowing a parent to delay until the child is say... 18 - 24 mos?

If the answer is no, because it leaves them vulnerable to "vaccine-preventable" diseases, is there a conclusive study that equates antibody levels to disease resistance? I've heard some in the pro-vaccine camp claim that high antibody levels are not equivalent to "proper vaccination" and therefore testing titres is no substitute. If this is true, then low levels are also no indication that any particular organism can resist any one disease. Critically thinking people are looking for consistency, and they're not finding it.

To the best of my knowledge, the primary reason for the recommended schedule is based on a combination of the risk of infection and the potential complications of infection (e.g., the younger a person is infected with HepB, the more likely they will be to develop chronic hepatitis and cancer).

As to studies examining whether antibody titres are a reliable means of determining immunity, I'm not certain off the top of my head. I'd need to research it a bit. IIRC, and I might be mistaken, antibody titres are an accepted and generally reliable surrogate marker of immunity, since the only real way to definitively test immunity/efficacy would be grossly unethical (i.e., purposefully exposing the recipient to the virulent disease and seeing if they get sick). But, again, I'm not a physician or immunologist, so I might be wrong. Any immunologists in the house?

As to animal models (I'm assuming for autism?), there aren't any. Because autism is a developmental and behavioral (typically involving uniquely human social behaviors), no adequate animal models exist, yet. So we can't do tests in animals and claim equivalence or extrapolate to humans with any measure of reliability.

Dangerous Bacon @122:a high percentage of antivax sentiment has been due to resentment of "government telling us what to do", fear of needles, "naturalistic" opposition to "foreign substances injected into our bodies" (as though disease organisms are not foreign substances), with a small percentage knowing someone purportedly injured by a vaccine.

Perhaps the most vocal, but I don't think they represent the whole of those criticising the program. I think reasonable people are able to sift through conspiracy theories and those that appeal strictly to emotion. If we are being fair, Orac has done the very same appeal with this post. What other purpose would posting the video serve? I think the reliance upon emotion is on both sides of this issue, notably, fear and empathy.

On the contrary, such viruses have been highly successful. Smallpox did quite well until inoculation, and then vaccination ultimately eradicated it, the objections and expostulations of antivaxers not withstanding.

I think you and I were taking the polar opposite definition of the word successful. Viruses, to be successful, will not kill its host, and will wait for another. If they burn up their host before jumping to another, what good for them would that be? As to small pox, I have found this to be a misnomer of a topic and that some of the antivax sentiment is actually verifiably true. It probably deserves its own thread to dismantle all of the propaganda on both sides.

Additionally relating to immune compromised people, the common cold can be a threat to this subset of people - so placing uneven emphasis on diseases for which there are vaccines available confuses me. Any person that is sick needs to stay out of the herd, this is simply responsible behavior. In my mind, only those showing proper symptoms will know that they are sick. Vaccinated people demonstrably show less symptoms, and I don't think this is always good. Epidemioligically speaking, it makes it rather easy to always pin the index on an unvaccinated person.

@anon

Missed this earlier:

I will behave responsibly, and stay out of the herd when I am sick and take every precaution possible.

And when you are asymptomatic, but still contagious (e.g., the 1-2 days before symptoms appear with the flu), are you going to stay out of the herd? How soon after your symptoms disappear? What about illnesses that begin with symptoms similar to a mild cold (i.e., if you have what appears to be a minor cold, do you stay home or go to work)?

It's reassuring that you will quarantine yourself and take proper precautions while you are symptomatic. As anyone who gets sick should. Further, proper hand hygiene for everyone (vaccinated or unvaccinated) is very important, as is covering one's mouth with the elbow instead of hand when coughing/sneezing. The difference between vaccinated and unvaccinated individuals, is that vaccinated individuals are demonstrably less likely to be infected and therefore less likely to be wandering around while contagious yet asymptomatic.

Kristen @126:You both sound cold and heartless! I doubt either of you have children, or if you do, they must be better than those children who aren't in "good conditions".

I was talking directly to James Sweet, who initially responded to me with a fair amount of snark. In no way was it generically intended for the tragic population of people that have succumbed to infectious disease.

I, for one, am not comfortable with your "Brave new World" in which children who are "weak" deserve to be weeded out.

I have never suggested that it is fair for the weak to be culled. Everyone's life is valuable. I simply do not place the health of my life into society, as this is an unmeasurable burden. Why stop at vaccines?

Todd@127: since the only real way to definitively test immunity/efficacy would be grossly unethical (i.e., purposefully exposing the recipient to the virulent disease and seeing if they get sick).

Direct infection studies do exist. Mark Crislip posted one on SBM in October:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&li…

In all instances, vaccinees experienced mild, mostly afebrile upper respiratory symptoms, unlike controls who had moderate to severe symptoms, often with fever. Infecting virus was shed more often by unvaccinated controls

Everybody had symptoms. Sure the unvaccinated shed more virus, they have less circulating antibody to destroy the virus... doesn't mean those vaccinated weren't shedding virus. Who's more likely to stay home?

Regarding animal models, I've read several that indicate that time dependent, repeated immune stimulation, can result in the animal not responding appropriately later in life. Notably rats, for the most part, that's all we have. Veterinarians have attested to damage in animals through over-vaccination, whether it be vaccine-assiciated sarcomas, seizures, or whatever.

There is a fair amount of confusion surrounding autism, and its collective definition. How do we distinguish from "autistic like disorders" and autism?

Todd @129:is that vaccinated individuals are demonstrably less likely to be infected and therefore less likely to be wandering around while contagious yet asymptomatic

I've searched high and low for evidence for this claim. What I've found, is that vaccinated people are MORE likely to be asymptomatic than their counterparts. Bacterial vaccines (pertussis in particular) does not prevent transmission, and more than likely results in a carrier state. If a person is vaccinated, and has enough circulating antibody to destroy some, but not all, of the offending viral pathogen - who is more likely to stay out of the herd?

I was vaccinated as a child by the way, have had measles and chicken pox, and show low level antibody to both diseases I might add. Probably because my body doesn't see the need to use the resources to create and circulate antibodies to diseases that aren't posing a threat at the moment. Your description, if it is pertaining to me isn't exactly correct.

Orac @113Specify the "toxins" AND the concentrations. Both are very relevant. In fact, tell us what concentrations of these "toxins" appear in the bloodstream after a standard vaccination. If you can't do that, your question is meaningless twaddle...Actually, your question is just meaningless twaddle.

The cell slides I saw at the UT Medical Library don't demonstrate "twaddle" to me, guess you had to be there. Since the amount of anti-toxin added to the vaccine is fairly important, if not appropriately measured - it often results in death for the animals used in production. Obviously, using death as an end-point is not only cruel, it's a waste. I believe the definition I'm using is: the minimum lethal dose (MLD) of the diphtheria toxin as the least amount of the toxin required to kill a guinea pig weighing 250 g within 96 hours after subcutaneous inoculation.

@anon

I will behave responsibly, and stay out of the herd when I am sick and take every precaution possible. Being exposed to disease is a choice I make by living in a society of diverse people in diverse areas.

Oh, I understand now. Children with immune-disorders or weakened immune systems should just stay out of society.

They don't have to be culled as long as they keep themselves away from the irresponsible assholes who choose to make themselves vectors of deadly diseases. How dare they expect herd immunity to protect them, definitely not your responsibility to protect the weak.

My previous comment stands.

"Viruses, to be successful, will not kill its host, and will wait for another. If they burn up their host before jumping to another, what good for them would that be?"

Well, you know, that's why deadly infectious dieseases are infectious. Because if they weren't, they wouldn't exist.

Your statement is like saying: Fire will not destroy houses because if ot burns one house down, what good would that be?

"Any person that is sick needs to stay out of the herd, this is simply responsible behavior"

Yes. However, with many diseases you can infect others *before* you show heavy symptoms yourself. So this won't help much.

anon: "I think reasonable people are able to sift through conspiracy theories and those that appeal strictly to emotion. If we are being fair, Orac has done the very same appeal with this post. What other purpose would posting the video serve? I think the reliance upon emotion is on both sides of this issue, notably, fear and empathy.

Ha! The evidence-based medical community has often been at a perceived disadvantage because of its reliance on hard data such as clinical studies; meanwhile the stock in trade of antivaxers (in addition to the usual parade of rumors, half-truths and outright falsehoods) has been appeals to emotion based on cases where individuals were supposedly harmed by vaccines. Scientists and public health experts are accused of being cold and uncaring - but when they and supporters bring up cases of individuals harmed by antivax sentiment, they're accused of appealing to emotion? What a joke.

Such accusations only come about because antivaxers are upset about seeing an effective p.r. weapon turned against them.

And speaking of modeling a "caring" attitude, here's another gem from anon:

"Any person that is sick needs to stay out of the herd, this is simply responsible behavior."

Right - vulnerable children and adults should just shut themselves up in their homes, rather than expect others to behave responsibly to avoid infecting them with dangerous, vaccine-preventable diseases.

There's a lot of callousness within the antivax movement, but it's a bit unusual to see it revealed this directly.

By Dangerous Bacon (not verified) on 08 Jan 2010 #permalink

Thank you DB, you actually made my point better than I did. I can't believe I missed that (more directly insensitive) quote.

anon what are u saying here

A virus that burns up its host is not a successful virus. Medieval Europe is not 21st Century USA. A self limiting disease creates damage in its host based upon the host's response and other co-morbidities or underlying factors (in some cases, intervention) to the offending pathogen. If a child is running a fairly high fever (in many cases humans will self-regulate, save for poisoning, or heat) in response to exposure to a disease causing agent, does containing it with an antipyretic become consideration for the child's failure respond adequately to the threat? If no, then why? How many cases of secondary infection, or immune response failure in general, involve the practice of fever-containment?

that we have asprin and they didn't so they died. Do enlighten me about the middle ages and the 21st centruy i need a good laugh

gots popcorn

By historygeek (not verified) on 08 Jan 2010 #permalink

Bacon:The evidence-based medical community has often been at a perceived disadvantage because of its reliance on hard data such as clinical studies; meanwhile the stock in trade of antivaxers (in addition to the usual parade of rumors, half-truths and outright falsehoods) has been appeals to emotion based on cases where individuals were supposedly harmed by vaccines.

Really? That's little bit of a deflection of the comment you were commenting on, but I could be misinterpreting what you mean... if you are going to tell me that appeal to emotion only occurs in the anti-vaccine camp, I disagree.

Right - vulnerable children and adults should just shut themselves up in their homes, rather than expect others to behave responsibly to avoid infecting them with dangerous, vaccine-preventable diseases.

As if vaccination status exempts one from other reasonable health precautions? At least that's the message I gather. And it's all based on seroconversion (among other dangerous assumptions). Being vaccinated is not the determining factor for who will, and who will not spread disease. This is a ridiculous generalization that ignores vaccine failure, both primary and secondary, and other failed vaccination campaigns that resulted in attenuated virus reverting to full virulence. The proper term, is vaccine AVAILABLE, otherwise, failure would not exist. The provaccine camp is incapable of keeping ANYTHING in perspective. The comments I have received over the years are a full attestation to this.

There's a lot of callousness within the antivax movement, but it's a bit unusual to see it revealed this directly.

You are just not able to irrationally frighten me over diseases I've already had and are thereby equating my absence of emotion to callousness. I don't see how emotion helps one to think clearly.

I'm not "in" the anti-vax movement, I'm just able to recognize that some of the arguments made within the scientific community have big holes gaping in them. And that they, by and large, are flat out ignoring thousands of parents telling you what they have witnessed with their children. Then they wonder why people fan the flames of conspiracy.

Kristen: Oh, I understand now. Children with immune-disorders or weakened immune systems should just stay out of society.

No, you don't understand. I just don't think you are fairly assigning a duty. Once again, why stop at vaccines - and why are those that are compromised more important than those more robust? Being robust doesn't mean they'll be able to tolerate a vaccine in their first day of life.

How dare they expect herd immunity to protect them, definitely not your responsibility to protect the weak.

Inflammatory intent aside, having been vaccinated, you're dead wrong. Telling people that CONTRIBUTED to protecting the weak, and watched their child regress or die, that the price they paid was worth it doesn't go over very well, you should try it. I already have. What I've seen others "try" usually starts out with: "I'm sorry your kid died, BUT".... or "I'm sorry your kid has autism, BUT".... THAT, Dangerous Bacon, is callousness.

MartinB: Yes. However, with many diseases you can infect others *before* you show heavy symptoms yourself. So this won't help much.

And vaccinated people are somehow exempt from your observation?

I'm now adequately reminded of why this circular argument will go nowhere. People are often too proud to concede anything on behalf of their opponent. I've wasted way too much time here the last few days, as per usual - quote mining and eugenics is usually the end result.

Thanks Todd for the spirited, yet respectful, discussion.

@Kristen
definitely not your responsibility to protect the weak.
------------------

Exactly!

By Sid Offit (not verified) on 08 Jan 2010 #permalink

@anon

Direct infection studies do exist. Mark Crislip posted one on SBM in October:

I don't have access to the full study text, so I can't determine if the challenge virus was modified in any way (e.g., less virulent). I still feel such a study is unethical, which this one may very well have been. I'd need to know more details.

Everybody had symptoms. Sure the unvaccinated shed more virus, they have less circulating antibody to destroy the virus... doesn't mean those vaccinated weren't shedding virus. Who's more likely to stay home?

The ones who displayed symptoms of flu. In the stages where symptoms are mild and virus is being shed, the unvaccinated ones are more likely to infect others if they do go out, as they are shedding more pathogen.

What I've found, is that vaccinated people are MORE likely to be asymptomatic than their counterparts.

I'm assuming you mean "infected, contagious and asymptomatic"? If so, then please provide a citation.

Bacterial vaccines (pertussis in particular) does not prevent transmission, and more than likely results in a carrier state.

Citation.

Regarding animal models, I've read several that indicate that time dependent, repeated immune stimulation, can result in the animal not responding appropriately later in life. Notably rats, for the most part, that's all we have.

Stimulated how? What is "not appropriate" response? If the symptoms of autism include uniquely human behaviors, how do these studies relate, in any way at all, to vaccines and autism?

Veterinarians have attested to damage in animals through over-vaccination, whether it be vaccine-assiciated sarcomas, seizures, or whatever.

How do non-human animal vaccines compare to human vaccines? How do they differ? Do the reactions seen in non-human animals translate to humans? I'd like to see the studies that show that the reactions seen in non-human animals to non-human vaccines has been extrapolated to human reactions to human vaccines.

As I said before with the regs, you can't just use examples from the non-human medical world as criticism of the human medical world. Stop comparing apples to oranges.

@anon

I'm not "in" the anti-vax movement, I'm just able to recognize that some of the arguments made within the scientific community have big holes gaping in them. And that they, by and large, are flat out ignoring thousands of parents telling you what they have witnessed with their children. Then they wonder why people fan the flames of conspiracy.

I'm curious. Do you put the same amount of effort into pointing out the "big holes gaping" in the anti-vax arguments? If not, why not? If you are being honest, then you would.

As to "ignoring thousands of parents telling [the scientific community] what they have witnessed with their children", the scientific community has been listening. Its why there have been so many studies examining, e.g., MMR and autism, thimerosal and autism, vaccination in general and autism, and why money continues to be thrown at those studies. At what point is it acceptable for the scientific community to say "We've looked at what you're saying. We have been unable to find any evidence to support what you are saying. While we understand your pain and hardship, it is likely that you may be wrong about the cause."?

@anon

I speak from experience as a mother who has lost a child in the first day of life, and has a son who is autistic. I know what unbearable pain feels like!

I do know there are adverse effects from vaccines, almost no one here will tell you otherwise. But to be clear, vaccines save lives! I refuse to let emotion force me to blindly assign blame to vaccines without considering the myriad of evidence to the contrary.

I have the utmost respect for people who have to live with dangerous immunodeficiency; transplant recipients, very young infants, elderly persons, persons born with an immune disorder et al. These persons and those who care for them should not have to worry that the irrational fear of vaccines will put them at risk of serious disability or death.

People who are vaccinated are less likely to spread those diseases vaccines protect against. If you think this assertion is wrong, show me (reliable) evidence to the contrary.

Remember the Washington Redskins cheerlead who was paralyzed afte her vaccination? Go ahead and start looking it up.

Why, no, I don't remember that at all. I do remember Desiree Jennings, a Washington Redskins "cheerleader ambassador" who claimed that after getting the flu shot, she had developed a case of the movement disorder dystonia, and claimed that doctors at Johns Hopkins/Fairfax Inova/Mayo Clinic (the story kept changing) had not only diagnosed her with that disorder but had specifically attributed it to the flu shot.

I do remember that no one was ever able to get confirmation from a single one of those doctors who allegedly diagnosed dystonia, that they had made that diagnosis or had attributed it to the flu shot. In fact, no one was ever even able to discover the name of any such doctor. Curious, that.

I do remember that people who do have dystonia, and doctors who specialize in movement disorders such as the one Jennings claimed she had, watched Jennings displaying her primary claimed symptom on news video and nearly without exception expressed the opinion that Jennings did not have dystonia. The specialists in movement disorders nearly universally expressed a belief that Jennings' "disorder" was psychogenic in origin, corresponding not to any real movement disorder but rather to a layman's ideas about what such movement disorders look like and what they do and don't affect.

I do remember that Jennings, after claiming to be the only case in all of recorded medical history of dystonia caused by a vaccination, then claimed to also be the only case in all of recorded medical history of dystonia being cured. The alleged cure was provided by Dr. Rashid "Prettybeads" Buttar, who had recently been brought up on charges before the North Carolina Medical Board for, among other things, diagnosing "mercury toxicity" in patients whose mercury levels were within normal according to Buttar's own tests. Buttar diagnosed Jennings, too, with mercury toxicity, and I believe that the treatments he prescribed were the "chelation creams" of his own devising which he also prescribed in the incidents that brought him before the Medical Board, treatments that the Medical Board described as "lack[ing] any evidentiary basis or any evidence of efficacy." Of course, they wouldn't need to have any evidentiary basis or any evidence of efficacy in order to "cure" a psychogenic disorder. Gee, perhaps that has something to do with them "curing" Jennings?

But hey, if it's some other Washington Redskins "cheerlead" you're referring to, just give us a name or something and we can "go ahead and start looking it up."

By Antaeus Feldspar (not verified) on 08 Jan 2010 #permalink

@Sid

I am usually a very mild person but I just have to say. You are the most cold-hearted, insensitive, self-centered, ignorant and bigoted asshole I have ever encountered! I hope that is just how you are when in an anonymous forum, such as the internet, but I fear it is not.

I sincerely hope you never have to experience the pain I have lived through. But if you do, someday, lose a child who is "weak" only then would you know how hateful your comment is. You are despicable!!

To everyone else, please forgive my tirade.

@Kristen

LOL. Bigoted, oh I feel so guilty. Yes I am cold-hearted - and selfish - when it comes to deciding whether or not to subject my child to a never ending regiment of vaccinations in order to satisfy the do-gooder aspritations of people like you.

By Sid Offit (not verified) on 08 Jan 2010 #permalink

I hope sid is not a christian. According to that religion, "Whatsoever you do to the least of my brothers, you do unto me."

when it comes to deciding whether or not to subject my child to a never ending regiment of vaccinations

One wonders what regimen of vaccinations Sid's looking at. Every single one I've seen is limited.

@Sid

I am so glad you can laugh about the pain you brought up from the depths of my soul because you think you are so much better than me. You can be proud of the distinction of being the only person since my son's death that minimized his loss.

Read my post @142

I am sorry I can't say any more, I just cahn't endure this

I hope sid is not a christian. According to that religion, "Whatsoever you do to the least of my brothers, you do unto me."

----------------

I didn't realize religion held such sway amongst this group. It's usually held up as an object of derision. And what exactly am I doing to the immunocompromised?
--------------------
Todd, are you familiar with something called the vaccination schedule? This one starts at birth and goes to 12-13:

http://www.mayoclinic.com/health/vaccines/HQ01629

...then to protect the herd, there would be the flu shot every year till 18. So when does it end considering childhood ends at 18.

By Sid Offit (not verified) on 08 Jan 2010 #permalink

Yes I am cold-hearted - and selfish - when it comes to deciding whether or not to subject my child to a never ending regiment of vaccinations in order to satisfy the do-gooder aspritations of people like you.

Asshole, it is the "do-gooder aspirations of people like me" who make it possible for your child to go unvaccinated and still avoid catching a lot of disease.

You aren't just a bigot, but a dickhead sleazeball who sponges off others. You are the equivalent of a vaccination welfare-queen - take, take, take that's all you do.

Todd W, The ones who displayed symptoms of flu. In the stages where symptoms are mild and virus is being shed, the unvaccinated ones are more likely to infect others if they do go out, as they are shedding more pathogen.

I agree. But if we can agree that unvaccinated people are likely exhibiting more symptoms, this likely precludes them from shedding more pathogen because they are home. Those that don't recognize their symptoms properly, more likely than their counterparts, will not stay out of the herd.

I said: Bacterial vaccines (pertussis in particular) does not prevent transmission, and more than likely results in a carrier state...You responded: Citation.

I don't know how many links can be supplied to stay out of moderation? Here's a couple:

http://www.cdc.gov/ncidod/eid/vol6no5/pdf/srugo.pdf

http://pediatrics.aappublications.org/cgi/content/full/104/6/1381

http://www.ima.org.il/imaj/ar06may-2.pdf

I could likely find more that, when viewed in totality, create pause for me. I question the ability of the host to adequately clear the pathogen as well. My opinion of course.

Stimulated how? What is "not appropriate" response? If the symptoms of autism include uniquely human behaviors, how do these studies relate, in any way at all, to vaccines and autism?

I should have been more careful. The focus I've had of late is all about timing. Couple this with diagnostic inconsistency, you just get more questions.

http://www.ncbi.nlm.nih.gov/pubmed/19089635?ordinalpos=6&itool=EntrezSy…

Obviously, exposure to infectious disease is factorial in the findings. But, exposure to 6 different diseases all at the same time, at 8 weeks of age in reality, is very small.

Fair point regarding the extrapolation of animal vaccines to human vaccines. I don't see the process as far removed as you do.

Do you put the same amount of effort into pointing out the "big holes gaping" in the anti-vax arguments? If not, why not? If you are being honest, then you would.

Absolutely. #1) Vaccines do NOT contain antifreeze. #2) your body produces formaldehyde #3) Aluminum is ubiquitous to the environment and you ingest far more than is in any single vaccine (though synergistic capabilities are not fully understood, and tissues of rabbits after injected vs ingested experiments showed the body burden to be greater). #4) Vaccines are not a form a genocide, they have benefited millions of people the world over. #5) Public health officials are operating in the best capacity they can to protect the public (it IS a conflict for an agency to be in charge of both safety and uptake though). #6) "Safer vaccines" is flawed logic. They are far safer now, than they were 40 years ago. This doesn't mean there isn't a safer WAY to vaccinate. There are more, and I've read them all. The ones don't appeal to emotion, are not sensationalized and contain legitimate scientific merit are the ones I take away from their viewpoint.

Kristen@142I speak from experience as a mother who has lost a child in the first day of life, and has a son who is autistic. I know what unbearable pain feels like!

Undoubtedly, you do. The loss of a child no matter what the circumstance, is extremely tragic. It's also very painful to experience, either personally, or through someone else. I'm very sorry that happened to you.

But to be clear, vaccines save lives!

Yes, they do. It is especially true in places where nutrition and living conditions are less than optimal.

I refuse to let emotion force me to blindly assign blame to vaccines without considering the myriad of evidence to the contrary.

Assign blame to what? Evidence to the contrary of what? Do you mean autism? I'd agree that the evidence to date doesn't suggest a link between a little bit of thimerosal compared to a lot of thimerosal and neurological outcomes. The MMR has been looked at for its relationship to GI disorders, but that's really all. But, since I'm not really accusing vaccines of anything, and I am a firm believer of not letting my emotions make my decisions, I don't see what your statement is supposed to mean to me.

I have the utmost respect for people who have to live with dangerous immunodeficiency; transplant recipients, very young infants, elderly persons, persons born with an immune disorder et al. These persons and those who care for them should not have to worry that the irrational fear of vaccines will put them at risk of serious disability or death.

Do you mean to suggest it is in the best interest of a person with a dangerous immunodeficiency to be out and about, mingling in close proximity to others, etc...? I'll respectfully disagree. I have respect for everyone, and I recognize the risks to everyone, not just those that are weaker.

People who are vaccinated are less likely to spread those diseases vaccines protect against. If you think this assertion is wrong, show me (reliable) evidence to the contrary.

People that are vaccinated definitely do show less symptoms to the diseases they've been vaccinated against. Showing less symptoms certainly doesn't not exonerate one from spreading disease. Since I'm not asserting that vaccinated are less likely to spread disease, I'll not be proving it wrong. The fact is, we are reliant upon seriopositivity as a measure of immunity. This is flawed through and through.

Where do you get this from?
I am so glad you can laugh about the pain you brought up from the depths of my soul because you think you are so much better than me. You can be proud of the distinction of being the only person since my son's death that minimized his loss

I was laughing at your reaction to my comment. Not your loss.

From this exchange expressing my belief that it isn't my responsibility to risk myself to protect others(definitely not your responsibility to protect the weak. / Exactly!) we get:

You are the most"
cold-hearted
insensitive
self-centered
ignorant
bigoted
asshole
hateful
despicable!!

Regardless, I refuse to be put on the defensive by
those who attempt to transform oneâs unwillingness to serve others into all the politically correct buzzwords such as racism, bigotry, hatred, selfishness etc..

By Sid Offit (not verified) on 08 Jan 2010 #permalink

I am curious how Julieanna Metcalf's mother was supposed to know she had a rare immune disorder that required her to rely on herd immunity. I'll love to be there when someone like anon told the mom that it was her responsibility to keep her daughter away from everyone else.

Kristen, Sid is a troll, and you may have noticed he has been called Stone Deaf Sid more than once. He has displayed his callousness before, and it is pretty clear he does not have children (I suspect he is an alternative health quack who practices his witch doctoring on other people's children).

@Pablo
"welfare-queen"

The racism you invoke when attacking me is quite distasteful. Bigots like you make me sick.

The implicit racist association lurking here is the welfare queen narrative--the black woman scamming the system and living like a queen off the white man's hard labor. Dripping in jewels, the welfare queen would drive to the welfare office in a brand new Cadillac to pick up her check and then it was off to the grocery store to use her food stamps. It's a powerful image embedded in the collective American psyche.

By Sid Offit (not verified) on 08 Jan 2010 #permalink

anon quoth:

"Viruses, to be successful, will not kill its host, and will wait for another. If they burn up their host before jumping to another, what good for them would that be?"

Oh, do please show me these viruses that are smart enough to stop and wait for another victim before they kill their hosts. Following your "logic," rapidly fatal diseases could not exist (such as H1N1, which killed some victims via respiratory failure, including young healthy people, within 24 hours of the onset of symptoms).

Medieval Europe is not 21st Century USA.

You've just made my point for me. We don't experience plagues of various diseases now in the USA, not because viruses have "learned to wait" before killing, but because medical and public health measures, including vaccines, have prevented infection in the first place.

Think about our unnatural diet compared to medieval Europe, our relative lack of exercise, our speeded-up lives - all the things anti-vaxxers have pointed out again and again as making us more susceptible to disease. Even as recently as the last century in the developed world, with excellent sanitation and all the public health measures one could wish for, measles, mumps, rubella, etc., were just what all kids got at some point, polio was a scourge.... But vaccines for these diseases came into widespread use, and suddenly they're no longer endemic. Strange how that works, ain't it?

That was embarassing. I responded to someone with a certain amount of vitriol that I now feel was unwarranted, and ironically, should have targeted someone else. Even more ironic is the fact today's Sb's subject is "Playing Nice on the 'Net".

I'm sorry. But sometimes I just get so angry about this whole situation... this shouldn't be happening. Please disregard my post earlier.

I don't know how you do it, Orac. I don't know how you can keep a cool head when the world is practically going insane.

By Harman Smith (not verified) on 08 Jan 2010 #permalink

@Orac
you coughed:

Specify the "toxins" AND the concentrations. Both are very relevant. In fact, tell us what concentrations of these "toxins" appear in the bloodstream after a standard vaccination. If you can't do that, your question is meaningless twaddle.
------------------------------------------
I really enjoy how you place the word toxins in quotations like it's my interpretation of what's contained in vaccines. I knew this "hooker" who was extremely "promiscuous".
Maybe I'll just "start" randomly placing "quotations" here and there in my rants. It appears to work for you and your ilk. How funny was that? I placed quotations around the word quotations. Pardon my having to explain humor to you Orac, however, it appears to be sorely lacking from this part of the world wide web.
I shall continue your method of slinging insults when I'm slightly challenged.
Have you heard about the Purdue Studies?
The "veterinarians" have been shooting dogs with vaccines.
In a nutshell: The vaccinated dogs in the Purdue studies developed autoantibodies to many of their own biochemicals, including fibronectin, laminin, DNA, albumin, cytochrome C, cardiolipin and collagen.
Let me help you out here:
THEY ARE attacking their own fibronectin, which is involved in tissue repair, cell multiplication and growth, and differentiation between tissues and organs in a living organism.
Dude, please, focus. The vaccinated Purdue dogs also developed autoantibodies to laminin, which is involved in many cellular activities including the adhesion, spreading, differentiation, proliferation and
movement of cells. Vaccines thus appear to be capable of removing the natural intelligence of
cells.
Read that last line again.
Vaccines thus appear to be capable of removing the natural intelligence of cells.
How about that "2-phenoxyethanol"?
Let's just do a small amount (less than what's in Pentacel® vaccine).
Oh and Orac, before you even think about spouting some crap about how we encounter much more in our environment and foods---think about the intramuscular aspect of this particular "encounter".
Show me studies that prove the toxins we encounter in our environment are worse than the "miniscule" amount via intramuscular injection.
The AAP doesn't want to green the vaccines because they can't. I have spoken to a few pediatricians and they tell me that they just don't have the technology to remove the harmful adjuvants.
Did they vaccinate their children? 2 out of the 3 I spoke with did.
I asked them if they were at all concerned after vaccinating their children. One said that she couldn't sleep...and watched her son like a hawk for fear of an adverse reaction.
The other just simply said "oh yes".
---------------------------------------------------
Okay MI Dawn...your turn.

You wrote:
Dendrites? Toxins? I don't know about DNAC, but MY dendrites don't curl up and scream when exposed to the small amount of fluid in a vaccine. My dendrites respond to the electrochemical stimulents released by my body.

DNAC: I'm so glad you have a full time job and college classes. Try taking physiology along with anatomy, so you learn the functions of the cells as well as the big, scary names. Take a pharmacology class after all your organic chem classes so you understand that some of the most common things in the world have big, scary science-y names. Go have some dihydrogen monoxide mixed with tannic acids and other scary things and take a nap.
---------------------------------------
I'll be sure to take those classes and absorb those big words...because hey, that's what will save us.
If I read and memorize books.
Nevermind, actually doing my own research or performing my own experiments to help further the progress of the human race. I'll accept what I'm told to accept.
I'm majoring in biomedical engineering...and I'm really excited to get into the field of pharmaceutical engineering so I can figure out what the hell is "really" going on. Maybe I'll find that I've been wrong about everything and I'll wake up bleary-eyed with a 7-day stubble on my face, half-drunk from Jack Daniels and my own denial...but something tells me that I wont.
We're questioning this entire process from top to bottom.
The nervous system is so amazing. We can't even come close to replicating it---so we just throw shit in there and watch what happens? Where are the REAL experiments?
Show us how the body responds.
So far...there hasn't been shit good enough out there to prove that they're safe.
Safe for who?
Come on kids, gather 'round, Uncle Fuckaround is gonna put a frog in the microwave...lets check it out!
You can't just accept so-called facts. Question everything.
That's what makes a great scientist.
Keep questioning, find new solutions, find better answers.
Having a doctor tell the patient that "well, we just don't have the technology to replace the toxins in vaccines"!!!!!!!!!! That shit just doesn't cut it.
That's not a good answer.
That's weak.
Has vaccine technology REALLY evolved over the last few decades? I'm not talking about the amount of vaccines available...I'm talking about the efficacy.
Are they truly helping us?
Are they holding diseases at bay---AND (big AND there) making certain that the side effects (both short and long term) aren't altering the DNA of human beings?
You want an EPIDEMIC?
Talk to teachers.
They'll tell you about the number of kids with autism has skyrocketed.
And please PM Dawn, don't tell me that we've done a better job in "diagnosing" the problem.
Since when 2002? 2006? 1998? 1993?
It's all genetic right? Because that makes sense.
Oh, wait, no it doesn't. There's no way in a short amount of time the cases just JUMP 1,800% from 1993 to 2008 from genetics alone.
Can your mind comprehend what an increase of ONE THOUSAND EIGHT HUNDRED PERCENT MEANS?
It means that in 1993 there were about 15,000 cases.
And now we're over 350,000.
When did we get so good at "diagnosing"?
A 60% increase in cases since 2002...does not mean better diagnosing. Give me a break.
We're facing a national public health emergency of historic proportions. Bigger than swine flu. Bigger than polio. Bigger than Biggie Smalls.
And it has nothing to do with vaccinations right?
Nothing at all? Even though over 9,000 boys were surveyed in California and Oregon and they found that vaccinated boys had a 155% greater chance of having a neurological disorder like ADHD or autism than unvaccinated boys.
All environment and genetics, huh? Wow. Really? You call yourselves a SCIENCE BLOG?
Vaccinated boys were 317% more likely to have ADHD. I guess I'll take a page from your book and chalk it up to mere coincidence. Numbskull.
I don't claim to have all the answers or even have a strong grasp of the English language---but I have a mind that never stops. It never stops searching for the truth.
I wish you all luck in your endeavors whatever they may be.
Now, I've got to run.
My 2 year old daughter is asking me to take her to the park. She's a smartie. Loves chess. "I wanna play chess daddy!"
All right sweetheart, we'll go play chess at the park.

By DNACopernicus (not verified) on 08 Jan 2010 #permalink

Thank You Chris and Pablo, I just don't know if I can be a part of these discussions anymore.

Sid can fool himself all he wants, I am sure I am not the only one who interpreted his comments the way I did. I can't decide if he is really that clueless about the possible effects of his words, or if he is just an insufferable asshole.

Chris: I'll love to be there when someone like anon told the mom that it was her responsibility to keep her daughter away from everyone else.

First, I make it a practice to NOT tell people how to live their lives or raise their children. Second, how many people in the USA passively carry Hib? In a small subset of people it becomes opportunistic and invasive and can be devastating. But we won't look in to the population that has a problem, the answer is to spend millions of dollars, create and implement a universal vaccination policy in the very young, and then confuse the public over typeable and nontypeable strains and "not observe" an increase in otitis media.

But vaccines for these diseases came into widespread use, and suddenly they're no longer endemic. Strange how that works, ain't it?

No, it's not strange. The problem, is that the shifts in diagnostic criteria have the ability to create and eliminate disease at the stroke of a pen. We either had 500,000 cases of measles every year prior to vaccination programs or we had 3-4 million. Certainly no wiggle room there.

Yes I am cold-hearted - and selfish - when it comes to deciding whether or not to subject my child to a never ending regiment of vaccinations in order to save him from suffering, potential permanent disability, and potential death.

Fixed that for ya.

Thanks Scott.
--------------
it was her responsibility to keep her daughter away from everyone else.

Not so much her "responsibility" but a way for her to protect her child rather than demanding someone else do it.

By Sid Offit (not verified) on 08 Jan 2010 #permalink

Sid - nice attempt to change the subject away from how much of an asshole you are for sponging off of the others without contributing at all.

Yes, you get called a lot of bad things. You know why? Because you deserve it.

You know, maybe the fact that everyone thinks poorly of you isn't actually our problem, but yours...

sid u suck all i can say is go take ur hand stantiser and suplemnts and go vist one of the those places in the world that has epdimics see how that works for u.

u want a case of antivax killing people checkout the small pox epidemic in stockholm sweden in 1871. in stockholm bunch dimwits thought vacines where bad and small poxs hadn't been seen in decades. so the launched a compan against the vacine. a large number of people fell for it. however the hinter lands of sweden contuine to vacinate guse what happens when small poxs pops up again several thousand die in stockhom while the hinterland sails on through with a few hundered sadly this will happen again cause of bright people freaking over OMG "toxins" in a shot that is nothing. u probly get more "toxins" in can of tuna fish. besides if the shots where so bad where was the hue and cry about autims and what have u in the 1960's seems like they would have noticed there was problem. if things are as scary u make them out.

By historygeek (not verified) on 08 Jan 2010 #permalink

Everyone, please ignore Sid. Replying to his drivel only muddies the thread. His posts generally lack substance and tend to be geared to offend.

Antaeus Feldspar @ 143

I just want to say that was beautiful.

A nice recap of all the relevant facts - just the right length to cover the material and still being easily digestible, clear, easy to read, relevant links for more in depth reading - and just the right amount of snark to leave a mark , but not leave someone scarred for life.

@Sid

"The racism you invoke when attacking me is quite distasteful. Bigots like you make me sick."

This is very interesting coming from someone who marginalizes the deaths of hundreds of thousands of children to vaccine-preventable diseases simply because they're African :(

@anon

Thanks for the citations. When I have more time, I will try to remember to look at them.

Regarding the TNFalpha study you linked, it's unclear to me how this relates to a) the effect of vaccines vs. the effect of disease and b) the effects of TNFalpha in humans. Again, don't have the time atm to look at the full text (if, indeed, I can access it).

As to your list of holes in anti-vax arguments, do you post those on anti-vax sites (or try to...I know they tend to be a bit averse to allowing comments like that through)?

Todd, they're not listening.

@JohnV

Marginalize? I simply point out that since diseases are so mild in America, the vaccine establishment must use 3rd world figures to try to scare those of us living in the 1st world. If a disease is serious in Africa or another third world country but very mild in America my decision to vaccinate depends on where I live.

Todd, any comment on the Purdue dog study?

By Sid Offit (not verified) on 08 Jan 2010 #permalink

Todd@167: the effects of TNFalpha in humans.

This is a problem, conceded.

As to your list of holes in anti-vax arguments, do you post those on anti-vax sites (or try to...I know they tend to be a bit averse to allowing comments like that through)?

If I am reading something that is patently false, yes, if the post doesn't make it through moderation - then I usually don't go back. In defense of both ScienceBlogs and SBM, I have never been censored.

I didn't invoke race.

Merriam Webster Defines Bigoted:

a person obstinately or intolerantly devoted to his or her own opinions and prejudices

Perhaps I used a word that has become too inflammatory. Fanatic also works.

I got the H1N1 shot mostly for the sake of herd immunity. There is a child in my family who cannot get this vaccine because she is badly allergic to eggs. So I want to reduce the chance of her being exposed.

That's the local; beyond that, I know there are others in a similar situation. A transplant recipient can tell his partner not to visit when she has a cold or the flu; he can't guarantee that nobody he sees on the street will be infected. But I can improve the odds a little bit.

And if I reduce my own chances of flu, that's not a bad thing either. I waited a bit, because I'm not in any of the risk groups, but at this point the U.S. has plenty to go around. I walked into a drugstore in midtown Manhattan at lunchtime yesterday, and the "line" consisted of the woman who was about to be inoculated, and nobody else. Convenient for me, but somewhat disconcerting.

By v.rosenzweig (not verified) on 08 Jan 2010 #permalink

Viruses, to be successful, will not kill its host, and will wait for another.

Anthropomorphizing is a classic mistake. Viruses don't have brains. They don't "wait"; they don't hold conceptions of what is "good" or "bad"; they don't calculate strategies to try and maximize the good and minimize the bad. They have no concept of "success" to aim for. They only do in a situation what their physical makeup dictates.

It is true that their behavior will show elements strongly reminiscent of directed behavior. That's because of evolution; even if any similarity between a virus' behavior and strategic, goal-directed action is pure coincidence (or, we should say, even though) it means that that virus is more likely to survive and propagate and be well-represented in the next generation.

But nothing says that that behavior will still be adaptive in the next generation. We actually see this all the time in nature; ask an ecologist about predator-prey cycles. Predators compete with each other for their prey species; the better they get, the better they are at bringing the population of the prey species down; the lower the population of the prey species gets, the less prey there is to support all those predators. Sooner or later the imbalance is so extreme that massive numbers of the predators starve to death -- which, ironically, gives the prey species a break and a chance for their numbers to build up again.

Viruses don't practice "sustainable infection." They simply infect, and if they kill their host, and if killing the host kills them in turn, they don't care. They have no brains, no emotions, no goals.

If they burn up their host before jumping to another, what good for them would that be?

Why do you think the fact of their course of action ultimately leading to their own destruction would dissuade them? More pertinently, perhaps -- how?

As to small pox, I have found this to be a misnomer of a topic and that some of the antivax sentiment is actually verifiably true.

... I keep reading this sentence over and over again thinking that maybe it'll start to make some sort of sense, but it doesn't. "I have found this to be a misnomer of a topic -" what are you trying to say?

By Antaeus Feldspar (not verified) on 08 Jan 2010 #permalink

Sid, just one remark:

The implicit racist association lurking here is the welfare queen narrative--the black woman scamming the system and living like a queen off the white man's hard labor.

The only welfare queen I'm personally acquainted with is white, and I am aware of a great many more white welfare queens. (I mean in the sense of deliberately skimming off welfare as an alternative to gainful employment rather than as a safety net for involuntary unemployment.) This is perhaps why I did not see the term "welfare queen" as being racist. It speaks volumes to me, though, that you *do* see the term as racist, as if you cannot conceive of a non-black welfare queen.

jennifer @ 79:

That being said, I would like some understanding that after receiving a vaccination, my daughter developed a very high fever and had a seizure. My daughter was diagnosed with autism at age 2. After some immune panels and viral titers were done on our daughter, we discovered that she has a very dysfunctional immune system. Once we started treating her immune system, she started getting better. I really do believe that autism is an auto-immune disease that affects our children's brains at a critical developmental period in their lives, therefore they suffer developmental delays. Once you start getting their brains healthier, they start picking up where they left off developmentally.

It's certainly possible that the seizure aggravated something in your daughter's brain, or that her immune problems did, or both. (I'm not sure what you mean by "dysfunctional immune system" -- that could mean a lot of things. So I won't make any assumptions.) While there is a strong genetic component to autism, twin studies and the like suggest that it isn't purely genetic; there is either an environmental or a developmental factor. Whether it's blind luck or whether it's something we can influence is not known. Things that affect the brain seem likely to aggravate it, though scientists don't really know if autism can actually be attributed to that. My brother is basically autistic (it's a complicated diagnosis in his case) following an anoxic brain injury at age 4 months. Yet autism spectrum disorders run in the family -- did the injury cause it, aggravate it, or what? It probably did aggravate it; if nothing else, the fact that he essentially lost the first two years of his life set him back a lot. My own daughter reminds me very strongly of him at times, and she is diagnosed PDD-NOS. She has never been severely ill or injured. *shrugs* So the anecdotal experience in my family is ambivalent.

One thing I do think is clear is that autistic children are more sensitive to challenges than other kids. They are less able to afford a delay. So if they get sick, it'll probably affect their development/behavior/scholastics/etc more than it would another kid.

By Calli Arcale (not verified) on 08 Jan 2010 #permalink

The only welfare queen I'm personally acquainted with is white, and I am aware of a great many more white welfare queens. (I mean in the sense of deliberately skimming off welfare as an alternative to gainful employment rather than as a safety net for involuntary unemployment.) This is perhaps why I did not see the term "welfare queen" as being racist. It speaks volumes to me, though, that you *do* see the term as racist, as if you cannot conceive of a non-black welfare queen.

Actually, I will admit that my "welfare queen" comment is somewhat bigoted, albeit in a different direction. When I think "welfare queen," I think "trailer trash," not black person. I'm not sure why.

@DNAC: Why the skyrocketing numbers? Well, partially due to diagnostic substitution (kids once called mentally retarded are now diagnosed as autistic), partially due to the ADA which expanded to allow IDEs for the diagnosis of autism, and also due to the expansion of the diagnosis criteria in DSM-IV onwards.

From my own experience, while growing up I can easily point to 1 boy who would now be considered "classic Kanner autism", 3 friends who would easily fall under PDD-NOS or HFA, and 1 family member, in the 1940's, who was considered "a severe problem and who actually was probably another child with classic autism.

My brother would probably fall under PDD-NOS; he was just considered "a really weird kid" in grade school.

So yeah, I don't think the numbers have greatly increased due to modern vaccine schedules; it's just that our perception of of autistic children is greater; they are more visible (remember the 'retard room' in elementary school...or didn't your school have one? I go back to the late 1960's and early 1970's for grade school), and the diagnostic criteria has broadened significantly.

MI Dawn you said:
Why the skyrocketing numbers? Well, partially due to diagnostic substitution (kids once called mentally retarded are now diagnosed as autistic), partially due to the ADA which expanded to allow IDEs for the diagnosis of autism, and also due to the expansion of the diagnosis criteria in DSM-IV onwards.
From my own experience, while growing up I can easily point to 1 boy who would now be considered "classic Kanner autism", 3 friends who would easily fall under PDD-NOS or HFA, and 1 family member, in the 1940's, who was considered "a severe problem and who actually was probably another child with classic autism.

My brother would probably fall under PDD-NOS; he was just considered "a really weird kid" in grade school.

So yeah, I don't think the numbers have greatly increased due to modern vaccine schedules; it's just that our perception of of autistic children is greater; they are more visible (remember the 'retard room' in elementary school...or didn't your school have one? I go back to the late 1960's and early 1970's for grade school), and the diagnostic criteria has broadened significantly.
--------------------------------------------------

Now, I'm not cold-hearted like some on this board and I must say that it sucks you have people that are close to you that have ND's.
But come on now.
1940's? Yeah. I can understand that. Retard room? Yeah, we had one. I graduated high school in 97.
Diagnosis improvements huh? You're sticking to that?
I don't know about you but 2002 wasn't that long ago.
Autism rates have risen 60% since then. 60 PERCENT!
Don't tell me that we were locking retards in the closet WAYYY back in 2002. Hello. HELLO.
60% rise since 2002 and it's because of better diagnosis!?
Ha. You're a real card. Good one.
Yeah, because 2002 was the DARK AGES OF AUTISM.
It was so new back then. Everything was so NEW. Who is that? Who are you? Are you a retard? Don't come near me creature!
Scientists were reading their slides by candlelight.
Sheesh.
I'm sorry but nothing you say adds up.
Back in 97 (right out of HS) I got a job as an Autism Therapy Aide. My best friends sister hired me on because she thought I would be a great at it. It was an incredible experience that helped to shape what I'm working towards to this day.
She had a company who took on private cases. Parents of autistic children understood that the public school system sucked at caring for their autistic children. The school system understood that these weren't retards but they were grouping them in with them in tight classrooms with only one or two instructors. In 1997 people knew the difference between kids with down syndrome, kids that are retarded and kids with autism.
They are 3 COMPLETELY DIFFERENT THINGS. Even a kid on a playground can tell the difference. Oranges, grapefruits and tangerines.
I get it. The spectrum is vast.
But come on.
I was there 13 years ago and parents of autistic kids wanted what the parents want now: ANSWERS.
There's a lot of finger pointing.
There's a lot of blaming.
Where are the answers?
When exactly do you believe this technology shift occurred where all of a sudden practitioners became so advanced at differentiating between conditions? 1997? 2002? Last week?
Let me know.
Because I was there and I was a teenager and EVEN I could tell the difference.
There are no excuses to be made.
2002 wasn't that long ago.
And who is to say that the standards of diagnosing wont improve tomorrow?
Dawn, there is still a retard room...and there's also an autism room.

By DNACopernicus (not verified) on 08 Jan 2010 #permalink

Antaeus Feldspar@172: Viruses don't have brains.

I'm sorry if I implied they did anything more than get inside of a cell, use it for replication purposes and move on to the next cell, my apologies for the oversimplification or misclassification.

Why do you think the fact of their course of action ultimately leading to their own destruction would dissuade them? More pertinently, perhaps -- how?

I'm not sure that I did? A virus that has the ability to affect *more* hosts, by NOT killing them, is the more successful virus, in my opinion. I don't pretend they exist for any useful purpose, and I understand the reasoning behind trying to make people immune to their effects. As long as the process of making one immune is demonstrably less damaging, it should be favored. Many continue to make the assertion that the vaccines carry less deleterious effects than the diseases for which they've been designed to protect, this may be true. I'd be more apt to agree with that statement if there were a mandatory reporting system that includes a follow-up visit after administration of vaccines (and all of their possible combinations) that also includes swabbing for contagion etc... Whatever the result may be, should be recorded. Right now, little Johnny gets his 6 vaccines in one visit, in infinite combination of vaccines (given all there is to choose from), isn't counseled properly on side-effects, or doesn't really know what to be looking for (for fault of clinician or parent, regardless) and then side effects go unreported. I would think those defending the current schedule would want the same.

"I have found this to be a misnomer of a topic -" what are you trying to say?

Because I think there has been a lot of obfuscation surrounding this disease, the vaccine, and it's declared eradication. The debate just turns into the never ending volley of spin, so I usually don't engage it.

I still refuse to be vaccinated. I am not a cow or a chicken - which by the way shouldn't be stuffed full of anti-biotics and steroids from the farmers either.

Vaccination is not coming my way and there is no way in hell a child of mine would recieve such a thing.

Besides what do have to be afraid of? I am more afraid of the shot than the flu itself. I can handle the flu:

Anyone interested in mother nature? Maybe some of you ELF terrorists out there? You know you protect my medicien every time you blow up a Hummer (why not a Prius, they're U.G.L.Y.)?

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By Dr. Smart (not verified) on 08 Jan 2010 #permalink

anon,

You may think you're fooling some people on here, but all you are doing is repeating the same, tired, anti-vaccine canards (we don't know the extent of vaccine reactions, too many too soon, vaccines didn't really stop diseases, etc.) in a more polite manner.

People a whole lot smarter than you have rebutted your lame assertions several times over.

But to be clear, vaccines save lives!

Yes, they do. It is especially true in places where nutrition and living conditions are less than optimal.

I don't remember Michigan in the 1960's being that bad so far as nutrition and living conditions went...but measles, mumps and chicken pox (and negative outcomes thereunto pertaining) were common back when I was a kid (cue the cane and ear-trumpet).

Go talk to the baby boomers. We remember the dark ages BV (before vaccines). We had clean air and water, good food, nice homes, hell we even had shoes! and we still got sick and many of us died or are living with disabilities because childhood diseases were, and still are, painful at best/deadly at worst.

(I've noticed that the parents who are ok with the idea of their children contracting MMR or chicken pox, never had any of these diseases themselves).

Shay:

(I've noticed that the parents who are ok with the idea of their children contracting MMR or chicken pox, never had any of these diseases themselves).

Many are under the age of forty-five and would have received either the single measles vaccine, or the MMR themselves. I think most of them had chicken pox, but don't remember it.

anon: ""I have found (the eradication of smallpox through vaccination) to be a misnomer of a topic...Because I think there has been a lot of obfuscation surrounding this disease, the vaccine, and it's declared eradication. The debate just turns into the never ending volley of spin, so I usually don't engage it."

"it's (sic) declared eradication" - what are you saying here? It hasn't been eradicated, and They are deceiving us? Or that smallpox up and vanished due to Hygiene or altered phases of the moon, and that widespread vaccination against smallpox was just a coincidence? What exactly are you terming "spin"?

The real reason why an antivaxer wants to avoid discussing smallpox is that the eradication of this killer disease is an obvious and irrefutable example of the value of vaccines. No wonder anon doesn't want to touch the subject.

By Dangerous Bacon (not verified) on 08 Jan 2010 #permalink

@Shay

Wow your're bringing back the memories. In the 60s, we couldn't open the door to our house because of all the bodies piled up outside from the chickenpox deaths. They couldn't make the coffins fast enough. Damn these antivaxxers! Damn them to hell!

By Sid Offit (not verified) on 08 Jan 2010 #permalink

Sid, you're really bad at the whole sarcasm thing.
Also, you've been sprung dissembling time after time - what on earth is the point of rambling on?

@Shay: I remember Michigan in the 60's...that's where I lived (I'm a contemporary, age-wise, of Orac). We did have good food, heat, electricity, city water and sewers, gosh, even cars! And TV! And we played outside on grass. But for some weird reason, our parents were still terrified of polio, making sure we got out vaccines, and even MMR when it was available. And they worried about tetanus and made sure we got those horrible DTP shots regularly..and we all had scars from the smallpox vaccines, too!!! Can't imagine why...after all, they obviously all survived those horrible diseases. /snark

@Sid Offal: True. Few of us died of chickenpox. After all, 1 kid infected my whole kindergarten class of 25 (and we went home and infected our siblings) and only 1 kid in my class died. We won't include the 2 kids who were scarred so badly from the pox or the 1 girl who went blind. They lived, so they don't count, at least in your opinion. 1 death in 25 kids...that's really OK, isn't it, Sid? My sister, who was an infant, had to be hospitalized because she was so ill, but the cost of the hospital was OK for my parents to have to handle, since she lived (even though they couldn't really afford the cost, and it strained their finances for YEARS till it was paid off - yes, my father even DID have health insurance, but it didn't cover 100% of the bills). My mother had to stay home with my brother and me; she couldn't be with her infant because my sister was in isolation and my mother might be carrying infection from my brother and me that would infect other people. Yeah, good times, Sid. My mother still chokes up when we talk about them, it was so stressful for her.

a-non@179: the same, tired, anti-vaccine canards (we don't know the extent of vaccine reactions, too many too soon, vaccines didn't really stop diseases, etc.) in a more polite manner.

That was helpful.

People a whole lot smarter than you have rebutted your lame assertions several times over.

Please tell me more about my education. If those rebuttals were worth a stitch, reasonable people would agree. Since they aren't, they don't. I might add that you've not presented any of them, you just keep claiming over and over that they exist. You're not the only one doing that either.

Shay @180: Go talk to the baby boomers.

I'm on the cusp of this generation, and talk to them I have. By an large, they haven't been vaccinated in decades either. Their exposure to disease naturally and defending against said disease, and / or marginal vaccination has contributed to herd immunity (assuming their vaccine-induced immunity hasn't waned), or they are sponging off of the children that keep disease at bay.

DB@182: what are you saying here? It hasn't been eradicated, and They are deceiving us? Or that smallpox up and vanished due to Hygiene or altered phases of the moon, and that widespread vaccination against smallpox was just a coincidence? What exactly are you terming "spin"?

I'm saying that statistics haven't been wholly reported by the eradicators, and the failures of this vaccine are largely ignored. Don't know who They are, but perhaps They are just not aware of the bad things that also happened.

The real reason why an antivaxer wants to avoid discussing smallpox is that the eradication of this killer disease is an obvious and irrefutable example of the value of vaccines.

Not really. Since I sport the lovely scar, this is one of the first diseases I actually studied. When WHO launched the worldwide eradication program in 1967, only 130,000 or so cases had been reported, being endemic in 31 countries. The US stopped vaccinating for it in 72, I believe - 8 years later WHO declared it eradicated. Then there was the whole monkey-pox confusion due to recombination of orthopoxviruses in general.

Historians have a different view than those in the modern medical establishment I guess. There is a tendency to flat out ignore any of the sanitation initiatives underway during this time period, and many reports indicate that a lot of countries stopped vaccinating against it after numerous reports of post-vaccinal diseases. The BMJ and Pediatrics documented numerous cases of post-vaccinal encephalomyelitis in the 50s and 60s. The lopsided focus on the outcomes of this vaccination program is something that the provaccine camp still refuses to acknowledge. Why should I think I can change that? I'm just content to agree to disagree.

anon: "I'm saying that statistics haven't been wholly reported by the eradicators, and the failures of (smallpox) vaccine are largely ignored. Don't know who They are, but perhaps They are just not aware of the bad things that also happened."

Good, so we've established that conspiracy theorizing is all you've got to offer here.

"Historians have a different view than those in the modern medical establishment I guess. There is a tendency to flat out ignore any of the sanitation initiatives underway during this time period"

It's obvious that you know little about smallpox and how it's transmitted. "Sanitation" cannot eradicate a highly transmissible infection like smallpox.

From the WHO:
"In the absence of immunity induced by vaccination, human beings appear to be universally susceptible to infection with the smallpox virus.

There is no animal reservoir. Insects play no role in transmission.

Smallpox is transmitted from person to person by infected aerosols and air droplets spread in face-to-face contact with an infected person after fever has begun, especially if symptoms include coughing. The disease can also be transmitted by contaminated clothes and bedding, though the risk of infection from this source is much lower. (bolding added).

And yes, through intensive surveillance and a worldwide vaccination campaign, the disease in fact has been eradicated. Again, from the WHO:

"Through the success of the global eradication campaign, smallpox was finally pushed back to the horn of Africa and then to a single last natural case, which occurred in Somalia in 1977. A fatal laboratory-acquired case occurred in the United Kingdom in 1978. The global eradication of smallpox was certified, based on intense verification activities in countries, by a commission of eminent scientists in December 1979 and subsequently endorsed by the World Health Assembly in 1980."

No word on whether "historians" (a.k.a. conspiracy theorists) were members of the commission, so you'll probably discount their findings.

Here's a site with some links for you on smallpox and its history, should you care to learn about the disease and not dismiss any facts you don't like because they come from "the medical establishment".

This discussion has furnished an excellent example of how even "reasonable"-sounding vaccine opponents use the same falsehoods, tactics of fear and appeals to paranoia as the overtly nutty antivaxers.

By Dangerous Bacon (not verified) on 09 Jan 2010 #permalink

DB: I think you are misunderstanding my position. I am fully aware of the information you've cited, BUT I do not think it is an adequate representation of the whole.

First Good, so we've established that conspiracy theorizing is all you've got to offer here.

So you deny that thousands of people died after vaccine initiatives were underway as a result of vaccination?

There is no animal reservoir. Insects play no role in transmission.

So you deny that genetic recombination of orthopoxviruses occurs? And that monkeypox and smallpox produce the exact clinical symptoms and that antibodies to monkeypox were detected in humans in 1976? This is the circular nonsense that ensues this topic.

This discussion has furnished an excellent example of how even "reasonable"-sounding vaccine opponents use the same falsehoods, tactics of fear and appeals to paranoia as the overtly nutty antivaxers.

Really? All it has illustrated to me (and very likely those that share my viewpoint... sorry, there are some), is that even reasonable sounding "provaxxers" (whatever that is) continue to deny any harm exacted from the small pox vaccination efforts. And the possibility that they could be wrong about the virus entirely. I don't care if you want to espouse victory for the program, otherwise I'd be vehemently attacking everything you say. I will simply research both sides of the issue, through verification of the arguments presented on BOTH sides and I will leave with the verifiable facts. Much of what you report is biased, though accurate. Collectively - it is lopsided.

Like many others in your camp, you are just incapable of acknowledging the negative aspects of this effort. Cries of paranoia are not only unfounded, they are simply wrong. It's rather tiresome to continue to fight the cries of tin foil hattery simply because I will not eat what is being spoon-fed to me. I am reasonable, and I am fully capable of realizing what is, and what isn't conspiracy. It is a mistake to always assume otherwise (regardless of whom you are engaging).

"The most shocking part of this video is that the dead girl's doctor didn't believe much in vaccinations and in fact encouraged her parents not to vaccinate. My recommendation: Sue the doctor for malpractice." Orac now dispenses legal advice. Do you also recommend malpractice lawsuits in the cases of vaccine injury? Why would the doctor be responsible for infectious disease injury/death but not responsible for vaccine induced injury/death? Also, patients in general, and parents in particular, must take responsiblity for their own decisions. Ultimately, these parents made the decision.

DB: I will concede that sanitation is not a factor in transmission. Multiple health reform activities were underway though and certainly did affect other diseases of the era that declined without a vaccine.

I just don't want a discount in the efforts of proper quarantine, etc. But as it applies to transmission of this disease, it's a rather minor point.

And that, my friend, is how reasonable discussion takes place. The concession of possible error, or a retraction when adequate reasoning is brought forth. I hope you'll agree.

@Bacon

Your smallpox article seems to be using made up information:

Overall, 2% to 3% of people who were variolated died of smallpox, but this practice decreased the total number of smallpox fatalities by 10-fold.

Variolation, 10 fold decrease in mortality. Hilarious.

By Sid Offit (not verified) on 09 Jan 2010 #permalink

A virus that has the ability to affect *more* hosts, by NOT killing them, is the more successful virus, in my opinion.

This is correct.

What I have a problem with is the implication in your original comment that "less successful" viruses, which do kill their hosts, could be expected not to exist, at least not in sufficient numbers that they should be discussed as a real and potent danger. This is completely false. To discuss "vaccines that cause autism" and not "viruses that cause death to their hosts" is intellectually dishonest, since the former have not been even shown to exist and millions of dead people testify to the existence of the latter.

By Antaeus Feldspar (not verified) on 09 Jan 2010 #permalink

Why would the doctor be responsible for infectious disease injury/death but not responsible for vaccine induced injury/death?

Because doctors are not expected to be able to see the future.

Magical doctors, the kind that some people here seem to think we are entitled to, would perhaps be able to look into a crystal ball for each patient, and tailor all health decisions for that patient with knowledge only available in the future. "Okay, if I give you a vaccine against the chicken pox now, Johnny, you won't catch it when the new kid who joins your second grade class turns out to have an active case of it. Oh, but you, Jimmy -- I see in the crystal ball that you have an allergy to eggs that no one will even suspect until next Easter, so you should not have this vaccine." With that perfect knowledge from the future, such doctors would always make perfect decisions.

The problem is, crystal balls that see the future are fairy tales and so too are doctors who can always make perfect decisions based on such perfect knowledge.

Therefore, in the real world, we only expect that doctors will make reasonable decisions based on the knowledge that is available.

Doctors who decide not to vaccinate a specific patient, based on knowledge of that specific patient's condition that contraindicates vaccination, are making a reasonable decision. So are the doctors who vaccinate a patient because they have no information that indicates they shouldn't. There is always the possibility that a reasonable decision will turn out to be a wrong decision, but the doctor cannot be held responsible for not knowing things it would take a crystal ball to know.

A doctor who decides not to vaccinate their patients because of an unscientific belief that vaccines are more dangerous than the diseases they prevent against is not making a reasonable decision. They are endangering their patients for no good reason, and there is no good reason why they should not be held responsible for their actions if it ends in tragedy for the patients.

By Antaeus Feldspar (not verified) on 09 Jan 2010 #permalink

AF @192: To discuss "vaccines that cause autism" and not "viruses that cause death to their hosts" is intellectually dishonest

That is a fair criticism. In my defense, I was simply making observations sans emotion, and certainly without malicious or dishonest intent. In retrospect, I can see where you may have taken this away from my statements. Apologies.

Your smallpox article seems to be using made up information:

Overall, 2% to 3% of people who were variolated died of smallpox, but this practice decreased the total number of smallpox fatalities by 10-fold.

Variolation, 10 fold decrease in mortality. Hilarious.

I probably shouldn't respond, since I believe Sid to be a "pure troll" (i.e., if we were all to change our minds, and Respectful Insolence became a hotbed of anti-vaccine activity, Sid would switch sides and preach vaccination just to annoy.)

But whether Sid really believes there's something wrong with the math or not, there isn't. If 20-30% of people who catch natural cases of smallpox die, and 2-3% of people who get weak cases of smallpox through variolation die, that's a 10-fold decrease in mortality rates in the variolated population. I don't know specifically what the mortality rate of smallpox was in late 1700s Europe but since the mortality rate of smallpox has at times been as high as 45% I find no reason to disbelieve that giving part of the population a fatality rate of only 2-3% could bring down the overall fatality rate of the disease drastically.

By Antaeus Feldspar (not verified) on 09 Jan 2010 #permalink

I don't recall a single news story about deaths or serious complications that could be directly attributed to the [H1N1] vaccine.

I am aware of one death which happened in Canada. A 93 years-old man died of an extremely rare delayed anaphylactic shock. He waited the recommended 15-20 minutes on the premises after the vaccine, went back home and had the anaphylactic reaction where nobody could help him.

There was also a cardiac arrest among the people waiting to get the vaccine (in a hospital) - getting there to have the vaccine probably saved that person's life.

So far in Canada, we have 1 death from the vaccine, 408 deaths from H1N1 - some of healthy adults like University of Ottawa's Prof. Keith Fagnou, 38 years old.

anon: "I am fully aware of the information you've cited (on smallpox), BUT I do not think it is an adequate representation of the whole."

Uh-huh. It's that nasty "medical establishment" providing information you don't want to hear. So what is this "whole" that you think disproves the eradication of smallpox and the key role that vaccination had in eliminating the disease? You haven't given us anything to back such claims, just distractions and unsupported allegations. For instance:

"So you deny that thousands of people died after vaccine initiatives were underway as a result of vaccination?"

What's this got to do with the insinuation that smallpox has not been eradicated? But alright, let's consider this statement. According to the CDC, vaccination has historically caused fatal complications in 1-2 people per million vaccinated. Regrettable, yes, as are any deaths associated with effective and life-saving medical care. Consider, however, that in the 20th century there were 300-500 million deaths from smallpox worldwide. And as recently as 1967, the WHO estimates 15 million cases of smallpox around the world for the year and two million deaths. Think about that toll.
Now, if the WHO's eradication campaign from the late '40s to the early '80s vaccinated billions of people, I supposed it's possible that your claim of "thousands" of deaths from vaccination could be correct (I'd like to see a link to reliable info, though). How many millions of deaths do you anticipate would have occurred had the WHO not acted? Would those deaths have been acceptable to you because they weren't vaccine-related?

The callousness of antivaxers continues to amaze me.

No one here "denies" that vaccine complications occur, though serious ones are rare. We do not obsess over them to the point of denying ourselves and our children life-saving preventative medicine.

"DB: I will concede that sanitation is not a factor in (smallpox) transmission...And that, my friend, is how reasonable discussion takes place. The concession of possible error, or a retraction when adequate reasoning is brought forth."

We do occasionally get small victories here - one other example being when Jay Gordon, peds antivaxer extraordinaire scuttled to take down AIDS denialist claptrap from his website after being challenged on it. At the end of the day though, he's still an unapologetic antivaxer, as are you.

When you can bring yourself to admit that numerous infectious disease scourges have been largely defeated or even eradicated (in the case of smallpox) thanks in overwhelming part to the development and use of vaccines, I'll be happy to congratulate you on opening your mind to facts and reason.

By Dangerous Bacon (not verified) on 09 Jan 2010 #permalink

Consider, however, that in the 20th century there were 300-500 million deaths from smallpox worldwide.
-----------------
Of course almost none of these deaths occurred in the West

And I'd love to know the genesis of that oft mentioned 500 million number. It's probably as fantastic as other WHO estimates

By Sid Offit (not verified) on 09 Jan 2010 #permalink

Round and round we go.

So what is this "whole" that you think disproves the eradication of smallpox and the key role that vaccination had in eliminating the disease?

I'm not disproving anything, as I am not making the assertion - try as you may to stuff your own words in my mouth. I'm sorry I didn't provide links to the papers I referred to, by your definition, they don't matter anyway.

I've read the statistics quoted on smallpox from the WHO many times. In many places. I have also tried to validate them. This is where I stop. The CDC also very often quotes statistics providing little or no reference as to how they were obtained. As of late, they have "gone beyond lab confirmed cases" of H1N1 and changed the morbidity of this disease rather dramatically (purely example, I have no desire to discuss H1N1 nor was this a deflection). Estimation for disease incidence has created the propensity for further scrutiny. This is certainly not MY fault.

I made no such claims as to the "eradication" of small pox. I said the topic is misleading and it ends in a never ending circle he said - she said (yawn). THAT said, your blatant attempts to categorize my discoveries during investigations as callous are duly noted. I have stated already, and will continue to state no matter how many times that you ignore me, that everyone's life is valuable.

No one here "denies" that vaccine complications occur, though serious ones are rare. We do not obsess over them to the point of denying ourselves and our children life-saving preventative medicine.

In order to claim that something is rare, it must be monitored comparatively. Just like the best way to "not observe" something, is to not look for it. Wanting to observe an issue from all sides is certainly not obsessed, and trivializing the collateral damage that has occurred during vaccination programs is... callous.

We do occasionally get small victories here...At the end of the day though, he's still an unapologetic antivaxer, as are you.

I see you take them humbly. You are free to continue to incorrectly psychologically profile me and anyone else that disagrees with you if you think it adds heft to your argument. At the end of MY day, attempts to engage the scientific community, will remain fruitless.

As to the temporal association you've identified in your last comment... well, that's what it is...if you are really using facts and reason. Contributory? Obviously. Thanks in overwhelming part to? If you say so.

Sid Troll:

Of course almost none of these deaths occurred in the West

And again, there is Stone Deaf Sid showing us all that class. Who cares if it happens someplace other than in "the West"?

DB: So what is this "whole" that you think disproves the eradication of smallpox and the key role that vaccination had in eliminating the disease?

anon: "I'm not disproving anything, as I am not making the assertion - try as you may to stuff your own words in my mouth."

Nope. I'm reminding you of your own words earlier in this discussion, when you referred to the history of the successful fight against smallpox as a "misnomer", then went on to say:

anon "Because I think there has been a lot of obfuscation surrounding this disease, the vaccine, and it's declared eradication."

Obviously you were trying to insinuate that smallpox hasn't really been eradicated. So why the protest now that I'm putting words in your mouth? Either you think the medical establishment boogeymen didn't really eliminate smallpox (thanks largely to the vaccine) and have engineered a massive worldwide coverup, or you accept that despite the damage this success story does to your loathing of immunization, you're willing to accept the truth. Which is it?

All the dodging and insinuating just makes you look like someone without the courage of their convictions. And for an antivaxer who airily dismisses evidence because it comes from "the medical establishment" (the WHO is wrong, the CDC is concealing things, etc. etc.), where's your evidence? Got facts - post them. Don't hide behind innuendo.

Stop pretending you're trying to "engage the scientific community". The way to do that is with convincing evidence, not with rumor-mongering and conspiracy theorizing.

Try some compassion too. It'd be terrific if parents of vulnerable kids and other patients at risk didn't have to fear the mass return of preventable infectious diseases, due to the misinformation campaigns of antivaxers.

By Dangerous Bacon (not verified) on 09 Jan 2010 #permalink

anon,

I see you take them humbly. You are free to continue to incorrectly psychologically profile me and anyone else that disagrees with you if you think it adds heft to your argument. At the end of MY day, attempts to engage the scientific community, will remain fruitless.

Yeah, the person who thinks he/she is "engaging the scientific community" by making fact-free assertions about the ineffectiveness and dangers of vaccination programs is lecturing others on humility.

Look, let me break down your entire argument. It is that we cannot prove that vaccines aren't harmful. Is is that you cannot prove that some other external mechanism eradicated endemic diseases other than vaccination. You are asking us to prove a negative, which is the oldest, lamest logical fallacy in the book.

And yet you suggest we take you seriously. Please.

Former CDC Head Dr. Julie Gerberding Lands Vaccine Job At Merck

http://www.postchronicle.com/cgi-bin/artman/exec/view.cgi?archive=175&n…

That's wrong and that's one of the reasons why I don't trust vaccines or the people that make them.

Don't give people like me anymore shit about my fear of vaccine side effects until you tell the people at big pharma to stop making in-your-face moves such as the hiring of the former head of the CDC to head their vaccine division. It just wreaks of a conflict of interest!

By Anonymous (not verified) on 09 Jan 2010 #permalink

Exactly how would the H1N1 vaccine have protected the two little girls that were mentioned in this blog posting? Do you really think that each vaccine is identical to another?

I should be in bed, but I've just spent some ungodly amount of time reading through the comments and trying to understand anon. My head hurts.

Anon, just a suggestion. Try calling the CDC and ask them where they get their numbers. Seriously. I've had to call them asking questions and have gotten a great response each time, even when my first contact goes, "huh... no idea... let me send you to this person. She/He should know".

800-CDC-INFO (800-232-4636) TTY: (888) 232-6348, 24 Hours/Every Day

People vaccinated shedding pathogen... just to be clear, the only live vaccines that are used in the US schedule are the MMR, varicella, rotavirus, and the nasal version of the flu vaccine. Dtap, Hib, Prevnar (for seven serotypes of strep pneumoniae), polio, HPV (four serotypes of HPV), the flu shot, hepatitis A, and hepatitis B do not contain live virus or bacteria. They contain proteins bits (for lack of a better term) or killed/dead/deceased viruses or bacteria. I believe meningoccocal is either protein bits or dead bacteria (since you can give to pregnant women), but the VIS does not state, and I can't find the link yet on the CDC website. I will try to look and find later.

How to monitor for adverse reactions... I wonder how anon would like us to do that. For all patients who get the H1N1 vaccine this year, each have had to fill out a form that is sent to the public health department. For all my pediatric patients, when I give immunizations at my clinic, the information gets dumped into a statewide database. 1-2 times a year, a very nice lady comes to the clinic and lets us know how we're doing on our immunizations, mainly to conjole us to do better. Every time one of my patients get an immunization, they get a copy of the latest VIS which lists through reactions, advises them strongly to let their clinician know if there is a reaction, and even has information on the vaccine court. What more would anon like to see?

To the poster at 203 and 204, if BLF and the other members of the disease promotion league weren't screaming about how the H1N1 was a new untested vaccine and how scary vaccines are in general and ohmigod you can't trust the guvmint nor anyone including your clinician except me because I'm such a maverick and THE TRUTH is so being suppressed and OHMIGOD it's so awful you just can't imagine about just how horrible these vaccines are, then maybe people would get the vaccine and we wouldn't have a surplus. You know... just a thought.

Don't give people like me anymore shit about my fear of vaccine side effects until you tell the people at big pharma to stop making in-your-face moves such as the hiring of the former head of the CDC to head their vaccine division. It just wreaks of a conflict of interest!

First of all, you mean "reeks". Second, if you weren't coming into this thing with a bias against "Big Pharma" you probably wouldn't think there was anything unseemly about someone who needs a new job (I personally think Obama should have kept her on, but it was his decision to ask her and several others to step aside for the people he wanted to put in) seeking a new job in a field she's already familiar with. I mean, is there any company which could make full use of Dr. Gerberding's skills and experience which you couldn't push into the pigeonhole "Big Pharma"? What, were you thinking she should change her career focus from infectious disease to automobiles and try to find a job at Chrysler, just so that you won't perceive a conflict of interest?

By Antaeus Feldspar (not verified) on 10 Jan 2010 #permalink

DB: Obviously you were trying to insinuate that smallpox hasn't really been eradicated.

Uh, no. I wasn't. I'll be more clear, since your attempts to pin me down are failing and that appears to be your focus and source of contention. My use of the word misnomer directly applies to the obfuscation surrounding the incidence reporting of adverse reactions, contraction of the disease because of the vaccine and deaths attributed to the mass use of this vaccine. Dating back farther than 40s, there are allegations of misconduct, record alteration etc... Is it true? Well I don't know... but I'm not going to stick my head in the sand and pretend they aren't there.

You are simply attempting to make me take a position on this topic for your amusement and engagement, and I won't do it.

All the dodging and insinuating just makes you look like someone without the courage of their convictions.

Perhaps to you, because you have unsuccessfully been able corner me and wrap me up in aluminum foil. I don't profess to have any novel conviction, despite repeated attempts to give them to me.

And for an antivaxer who airily dismisses evidence because it comes from "the medical establishment" (the WHO is wrong, the CDC is concealing things, etc. etc.), where's your evidence? Got facts - post them. Don't hide behind innuendo.

Innuendo? I'm not the one espousing statistics. When someone gives me statistics, I'm sorry, I like to verify them. A lot of the statistics quoted by public and international health agencies are very difficult to verify, at best. I haven't professed to having any facts, and have only tried to verify those that have been given to me. You seem to be incapable of understanding this very significant point.

The way to do that is with convincing evidence, not with rumor-mongering and conspiracy theorizing.

I'm not even sure I know what rumor-mongering is. And the tin foil hat is certainly predictable. Let me try again.

I am unable to fully verify the statistics brought forth in favor of your argument (s). You are free to continue to boast the eradication of small pox, I will not stop you, nor did I. By and large I didn't even disagree with you, only discussed the confusion that can be a result of this discussion. You will not be able to get me to join you by using statistics that are based upon mathematical modeling, or estimation. Why you are insistent upon sparring, I'm not exactly sure.

Try some compassion too. It'd be terrific if parents of vulnerable kids and other patients at risk didn't have to fear the mass return of preventable infectious diseases, due to the misinformation campaigns of antivaxers.

Compassion is a two way street. It would be terrific if parents of vulnerable kids and other patients at risk didn't have to fear the destruction of the health of their future children, by participating in a program that places the lives others above their own.

I'm not opposed to vaccination. I've conceded the benefits, as I see them. I just don't have tunnel vision and am capable of realizing that risks and benefits cannot be properly measured with the system we have. Vaccinating the very young is a practice that is in total infancy. No innuendo or conspiracy needed.

a-non: making fact-free assertions about the ineffectiveness and dangers of vaccination programs is lecturing others on humility.

This is almost laughable. I provided several citations to the only person that has engaged me in a thoughtful manner. I have simply called into question the current dogma surrounding the definition of immunity, and I'm using your OWN facts to do it. If you weren't so concerned with exposing my "true identity" and agenda by using skeptical talking points - you could see that.

is that you cannot prove that some other external mechanism eradicated endemic diseases other than vaccination.

I'm not making an assertion that vaccination is responsible for said eradication, therefore, I am not responsible for proving it.

You are asking us to prove a negative, which is the oldest, lamest logical fallacy in the book.

See previous statement. Perhaps you're just so determined to reveal debating flaws and appear to be ever so wise, that you've missed the part where DB claimed the eradication of small pox due to vaccination, then posted unverifiable statistics, and asked me to disprove the assertions made therein. If I make an assertion, then I'll do my best verify what I portray as fact. Since I don't pretend to have all the facts, and am simply questioning those being presented to me inadequately ad nauseum, I've not needed to do much.

Clearly you are not taking me seriously. Perhaps you should reconsider your stance, if you care to convince those that agree with me.

gaiainc @206: I've just spent some ungodly amount of time reading through the comments and trying to understand anon. My head hurts.

You are certainly, in no way, obligated to do so. It's apparent that some of those so determined to prove me wrong have selective reading, I guess I've come to expect it. And since you said:

How to monitor for adverse reactions... I wonder how anon would like us to do that.

I've already stated that a mandatory reporting system for all outcomes is a fine place to start. Those continuing to espouse the rarity of adverse reactions should want the same.

I'm clear on which vaccines are live, attenuated viral vaccines. Bacterial vaccines have their own issues, that we haven't really discussed, with the exception of pertussis (we did discuss a little bit). That was the only one I was requested to address. And I did. Replacement disease / serotype replacement is a real issue. I also question the necessity to continue to use diphtheria in conjugate vaccines, even though I understand why we do it.

Every time one of my patients get an immunization, they get a copy of the latest VIS which lists through reactions, advises them strongly to let their clinician know if there is a reaction,

Do you screen any of the lots you administer prior to doing so to see if they've been reported as "hot"? Do you administer motrin or tylenol prior to administering vaccines? I read a post on a parenting forum where the mother stated she called ahead of time to ask for the lot numbers so she could research them herself prior to getting the shots and she was admonished and then subsequently treated very unprofessionally for doing so.

Another parent said her child presented with an acute infection, was advised to get the shots anyway. (The subject of another post earlier, where I also present another fact-free assertion according to a-non, links and all) Four hours later the child was crying non-stop. When she called to report the problem to the doctor, they told her it was normal. Obviously, it's not. This incident went unreported - and is reprehensible. It not only demonstrates, rather adequately, that our current system is not indicative of revealing true adverse events, but that there is no desire to change it. That kind of crying, may likely contraindicate further administration of a vaccine - but when you give 6 of them... how do you know which is the culprit?

If people are incapable of grasping this very rudimentary issue surrounding side effects, this problem will only get bigger.

AF - I, too, am trying to understand what's wrong with Gerberding going to Merck.

The anti-vax claim is that the CDC is being controlled by Big Pharma. But this is the exact opposite happening - Big Pharma is being run by someone from the CDC!

Jeez, what else could you ask for? Here is a case where she can use her insight with the CDC regarding the big national health problems that the CDC is trying to solve to get Merck to help solve those problems. What's wrong with that? Isn't that what we want our companies doing? Trying to solve the problems faced by our national health programs?

Who do they want instead? Some MBA with no public health experience but with lots of expertise in the fields of marketing and sales? Someone who's #1 focus is on profitablity? That would be a far bigger concern than bringing in a public health expert.

anon: "Is it true? Well I don't know...You are simply attempting to make me take a position on this topic for your amusement and engagement, and I won't do it."

It'd give you some credibility if you admitted to your antivax beliefs and provided facts to back up your baseless insinuations. Your lack of willinginess to do so fatally damages your attempt to pose as a credible source.

By Dangerous Bacon (not verified) on 10 Jan 2010 #permalink

In the past month I've had seasonal flu and H1N1, and tetanus at a regularly scheduled Dr appointment. Never felt any adverse symptoms other than a very small amount of tenderness at the Tetanus injection site.

Following the news of H1N1, I was horrified to realize that evidently in England they have come to refer to a vaccination as a Jab! What a negative way to refer to a lifesaving medical intervention.

It is a solid fact that the most advanced medical treatment as far as saving lives is vaccination. Diseases have indeed been eliminated from the face of the earth (in the case of smallpox) or nearly so in the case of polio.

Polio would be gone - except for local politicians and shamans using UN vaccination programs as a fear-monger tool to manipulate voters in Africa - sort of like anti-vaccination zealots around here. Most of them are either unable to grasp the facts (terrified moms mostly, a little hard to blame them) or are deliberately using a big-lie technique for their personal profit.

These last ones, they are in-human in their lack of empathy, ruled by greed, lacking in morality, twisting truth to profit from lies.

DNACopernicus or whatever your tagname is, you are wasting your time studying biology or bio-technology. You won't be hired because you aren't vaccinated, which is a good thing, as you are too stupid to be good at hi-tech anyway. If you can't understand the world-wide racial benefits to humanity that modern medicine - including vaccinations - provides, you're going to be a burger-flipper. Until the boss tells you that a vaccination will be necessary, to protect the buger buying public.

Personally, I get every vaccination I can. It's good for you to stimulate your immune system. I believe everyone should have every available vaccination to protect their fellow humans. When I was a kid there were annual polio outbreaks. I had classmates who's very bones were twisted, who wrote illegably because their hands were so bad. The teachers gave them extra time, and worked with them individually to understand what the kids had written.

Thinking back, it was medieval horror, iron lungs, braces and wooden crutches - so my folks had me take the polio shots, and then when Sabin's oral vaccine came out, we did the whole series over again. Because being crippled and twisted was the GOOD outcome!! The bad ones were total paralysis or death.

My wife's family had a neighbor over for dinner in the early 50s while his wife was out of town. He didn't eat much, didn't feel so hot. The next DAY he died from polio!

So you anti-vaccination freaks, screw you guys, you're immoral, stupid, endangering everyone around you because you are deluded cowards! You deserve to die from easily preventable diseases, to flush the burning stupid out of the human race! Anon, that's you right there, Sid, you too!

I hope I haven't been confusing about where I stand in the vaccination debate, or left any doubt in anyone's mind about the local opinion about today's health care debate here at the Respectful Insolence blog.

Thanks for the venue!

JR

anon,

The premise that vaccines are safe, effective, and the primary reason diseases like smallpox have been eradicated is well-accepted by any credible science. Your questioning of those claims quite frankly falls under "extraordinary claims require extraordinary evidence" umbrella. Therefore, it is up to you to show why these things to be untrue, and no, suggesting that some of the evidence may or may not be verifiable does not meet that standard. Nor is the posting of anecdotes about alleged hot lots and vaccine reactions.

You might think you're clever, but at its core everything you're putting out there is just a variant of the "I'm just asking questions" fallacy, where someone throws out a bunch of unprovable assertions ("how do you know that vaccines really eradicated smallpox") and when called out on it claim that you're "just asking".

http://rationalwiki.com/wiki/JAQing_off

Let's repeat. You. Are. Fooling. Nobody.

Anon, a mandatory reporting system for all outcomes. Really? OK... how? Seriously. How do you propose to do this? Have parents/guardian report in? Have clinics ask patients who have received the vaccine how they did? Have someone from public health call all patients? If the latter two, how do you propose to fund the time necessary to make the phone calls? My office staff don't have down time until they have lunch. What if the patients don't have a working phone? Do you propose a written survey? If so, what if the survey comes back as undeliverable or no address? What if the patients don't respond to the survey? Whose responsibility will it be to make sure that the information is captured?

As for an adverse outcome, how would you define it? A sore arm? A fever (and if so, what is your cut-off)? A redness around the injection site? Not feeling right? More crying? I'm going to guess that my definition of an adverse outcome or event is not going to be the same as yours.

As for a lot being "hot" what do you mean? A lot that should not be given? Any reports of lots that should not be given go through my clinic manager and my hospital system and are caught at those levels. If they are not caught, incident reports are filed, patients are notified, and we do what we can to rectify the situation.

Tylenol or ibuprofen administration prior to immunizations is up to the parent. I am neither for nor against it. For the record, my son doesn't get anti-pyretics or analgesics before he gets his immunizations.

Your anecdote above? Parents can report to VAERS if they so desire. 4 hours of crying versus coming down with a vaccine-preventable disease? I'd take the 4 hours of crying, please. Thanks.

As for replacement disease/serotype substitution being a real problem, I need a citation, something, other than your assertion. The reason I need something more than your assertion is anecdotal, but to me it is powerfully anecdotal. I have never seen a case of invasive H influenzae type b disease in over 14 years of being in medicine. I take care of kids. Considering the pre-vaccine era incidence rates, I should have. I have studied at, trained at, and worked at tertiary care centers, regional medical centers, and medical centers that have dedicated children's hospitals. Taking out Hib hasn't seemed to cause the problems your assertion alludes to. This is the one situation of which I can think. Do you have a specific example instead?

Orac,

Didn't know where else to put this, but I noticed something rather strange when I clicked onto your blog today: the ads that are cycling through on the side of the page, one of them is for "Autism Speaks". That struck me as incredibly weird and oddly ironic. Just thought you might want to be aware of this, since you've done such fantastic take-downs of these types of autism organizations in my years reading this blog...

By medrecgal (not verified) on 10 Jan 2010 #permalink

"You might think you're clever, but at its core everything you're putting out there is just a variant of the "I'm just asking questions" fallacy, where someone throws out a bunch of unprovable assertions ("how do you know that vaccines really eradicated smallpox") and when called out on it claim that you're "just asking".

http://rationalwiki.com/wiki/JAQing_off

Let's repeat. You. Are. Fooling. Nobody."

Well said - but with the qualification that intelligent, rational people are not fooled. The kind who lap up what Glenn Beck and Jesse Ventura are saying might think anon's "questions" make sense and that it's up to physicians/public health experts to prove her/him wrong, not knowing or caring about the scientific method that requires that such assertions (especially ones that fly in the face of evidence and reason) be proved by the person making them*.

That's how you "engage the scientific community".

By Dangerous Bacon (not verified) on 10 Jan 2010 #permalink

@ JR

In australia and the UK we have always called them "jabs", with no negative connotations. Actually i think calling them "shots" like in the US is far more negative.

By bellastarkey (not verified) on 10 Jan 2010 #permalink

@JR 211

DNACopernicus or whatever your tagname is, you are wasting your time studying biology or bio-technology.
------------------------------------------------------------
...Or whatever your tagname is?!
That's hilarious. Typing out my entire tagname then writing "or whatever your tagname is" just right off the bat makes you seem childish and downright nonsensical.
How old are you? 53, 54 yrs old? Am I close?
I sense that you're a scared, bitter older guy that is too shortsighted to see the other side of any issue.
But I get it.
I have an idea where you're pigheadedness is coming from.
You've seen devastation from horrible diseases such as (Polio) firsthand and you're frightened.
It's okay little guy.
Keep getting every vaccine that comes out.
Make sure that you're up-to-date on all your boosters too.
Old Guys Rule, right?
----------------------------------------------------------
Personally, I get every vaccination I can. It's good for you to stimulate your immune system.
----------------------------------------------------------
It's real good for your immune system. Moron.
Your cells are about as intelligent as you are. Ha.
If vaccines are SO GOOD FOR YOUR IMMUNE SYSTEM then why are vaccinated boys and girls 120% more likely to have asthma than non-vaccinated?
That's just one aspect of vaccinated versus non-vaccinated.
I'm a burger flipper, right?
I'm just providing facts.
-----------------------------------------------------------
So you anti-vaccination freaks, screw you guys, you're immoral, stupid,
-----------------------------------------------------------
I'll just stop you right there. Immoral?!?
Who the hell are you to judge who is righteous or unrighteous? You're a simpleton.
Wait, what? Did you say that parents who choose not to vaccinate are stupid? Wow. Now, I'm confused because the majority of people choosing not to vaccinate are wealthy, white and college educated. I think the reason is because the highest percentage of children with Autism and ADD belong to the wealthy, white, college educated.
Need more studies?

Read and learn

That's all I do is provide new, concrete evidence and Orac, MI Dawn & co. are missing in action.
Rather than calling me a burger-flipping moron why don't you try to dispute my statistics?
What's the matter docksider...don't have the stamina to duke it out with pure facts? So you insult a college student instead? Bravo guy. Well played.
Take your dull thoughts and dim brain activity elsewhere Tommy Bahama.

By DNACopernicus (not verified) on 10 Jan 2010 #permalink

a-non@212: The premise that vaccines are safe, effective, and the primary reason diseases like smallpox have been eradicated is well-accepted by any credible science.

To this, I would agree. If you are suggesting that the "credible" science put forth is conclusive, I would disagree. The valid questions that have been put forth, have poked too large a hole for me to blindly dismiss. Obviously, I'd be the minority in this venue.

"extraordinary claims require extraordinary evidence" umbrella.

You will need to elaborate. I've merely discussed the medical definition of vaccine-induced immunity eg. titres, subclinical presentation etc...

but at its core everything you're putting out there is just a variant of the "I'm just asking questions" fallacy, where someone throws out a bunch of unprovable assertions ("how do you know that vaccines really eradicated smallpox")

You are seeing that, because that is what you want to see. I believe they call it confirmation bias. I didn't bring up smallpox, DB did. I have far too many questions for me have a conclusive opinion on it and tried to tell DB that before he/she engaged me on the topic. It just goes back an forth and back and forth. It's very difficult to verify information that was presented prior to 1900, I have taken painstaking steps to do so. At most, what you've engaged me with, are your perceptions of logical fallacies. What you really want to say is: stop asking questions and roll up your sleeve. You are focused on a very small percentage of what I've said here, this speaks volumes to me.

DB @213:Well said - but with the qualification that intelligent, rational people are not fooled. The kind who lap up what Glenn Beck and Jesse Ventura are saying might think anon's "questions" make sense and that it's up to physicians/public health experts to prove her/him wrong, not knowing or caring about the scientific method that requires that such assertions (especially ones that fly in the face of evidence and reason) be proved by the person making them*.

Jesse Ventura is nutters. I don't watch Fox out of principle, so I can't attest to much about Glenn Beck either, except that he appears to be on the soft side of conspiracy promotion. That said, I am FULLY aware of the scientific method, its operational use, and its limitations. What you and a-non, hell bent on using purely tactical maneuvers and trying to expose debating flaws, are continuing to misrepresent, is that the person making the assertion... is the person doing the proving. I make no assertion, merely question your own and show you why others do also.

gaiainc @21: How do you propose to do this? Have parents/guardian report in? Have clinics ask patients who have received the vaccine how they did? Have someone from public health call all patients? If the latter two, how do you propose to fund the time necessary to make the phone calls? My office staff don't have down time until they have lunch. What if the patients don't have a working phone? Do you propose a written survey? If so, what if the survey comes back as undeliverable or no address? What if the patients don't respond to the survey? Whose responsibility will it be to make sure that the information is captured?

Thank you for asking. There should be a follow up visit after receipt of vaccination specifically for this purpose. The follow up visit needn't take that much time, and it is in the very best interest of all involved. If there is no liability or duty to care, then the program is utterly flawed. As to capturing the data, obviously not the government, nor insurance companies... we already tried that, and we'll never get a look at that data again. Many agencies would fight to do the job, I can assure you.

As for an adverse outcome, how would you define it?

I think the current definitions that define adverse events are suitable, no need to re-invent the wheel.

As for a lot being "hot" what do you mean? ... If they are not caught, incident reports are filed, patients are notified, and we do what we can to rectify the situation.

Yes, a lot that's been associated with an unusually high number of serious adverse events. Either voluntarily announced by the vaccine maker or otherwise. What do you do to rectify the situation?

Tylenol or ibuprofen administration prior to immunizations is up to the parent. I am neither for nor against it.

Somehow I think you not having a stance on this topic will be a-okay, whereas my inability to commit to the one DB wants me to will not. Is this practice scientifically justified? I'd have to say no. The absence of clinical data showing this to be beneficial or harmless apparently is not an issue. These are the kinds of consistencies that do NOT exist, and when they are called into question... "You're just pulling the [I'm just asking questions gambit]"

Hypocritical, at best. (that wasn't for you directly gaiainc, as you can tell, this thread is approaching close to epic length)

Parents can report to VAERS if they so desire.

How does that help to accurately portray adverse events?

4 hours of crying versus coming down with a vaccine-preventable disease? I'd take the 4 hours of crying, please. Thanks.

Your choice. Inconsolable crying is highly indicative of encephalopathy and certainly would contraindicate further vaccines - if you could figure out which one created the problem. Being sick sucks. But since there's no way to know whether or not being vaccinated will have prevented being infected anyway (been reading a lot about mumps primary and secondary vaccine failure lately) this decision should be left to a parent. Not a public health agency.

As for replacement disease/serotype substitution being a real problem, I need a citation, something, other than your assertion.

Glad to offer it. I wasn't even really talking about Hib. The majority of what I've read is related to prevnar. And here PMID: 15183627 -

A trial with a 7-valent pneumococcal-conjugate vaccine in children with recurrent acute otitis media showed a shift in pneumococcal colonisation towards non-vaccine serotypes and an increase in Staphylococcus aureus-related acute otitis media after vaccination.

or here: JAMA. 2004;292:716-720.

Streptococcus pneumoniae carriage, specifically of vaccine-type strains, is negatively associated with S aureus carriage in children. The implications of these findings in the pneumococcal vaccine era require further investigation.

Sorry I didn't link the above, the last time I had more than one it got stopped in moderation.

As to Hib, well... this is an interesting topic no doubt. I will certainly concede that in a subset of people it can become invasive and damaging. But the problem with bacterial vaccines is that you can't just wipe a bacterium off the planet without adverse effects. Like here: PMID: 17304452

Nontypeable H. influenzae disease accounted for the greatest proportion of cases (35.8%-61.5%) in all but 1 age group. The number of cases of invasive nontypeable H. influenzae disease increased by 657%, from a low of 7 cases in 1996 to a high of 53 cases in 2004; as a proportion of annual cases, nontypeable H. influenzae disease increased from 17.5% in 1996 to 70.7% in 2004.

657%.

anon

i would like to ask a qustion about the whole smallpox thing. if vacnines played such a small role then where did it go. i want some details ie evidance. i want to know what the mechinism was. even in history if u want to turn conventional wisdom on it's head we need prof and all i have so far is the statics are funny. that is not enough for me. there has to be mechinism that would be global that existed outside of the WHO vacine progame and i just don't see what that would be. please enlighten me

By historygeek (not verified) on 11 Jan 2010 #permalink

Hi history geek,

I didn't say that vaccines played no role, a strawman that I didn't find the need to call DB on earlier.

i want to know what the mechinism was. even in history if u want to turn conventional wisdom on it's head we need prof and all i have so far is the statics are funny.

I wish I had better answers for you. I didn't try to turn conventional wisdom on its head. All I did was try to verify what I was being told, and I couldn't - statistically and biologically (recombination of pox viruses, etc...) It's really that simple. What I found is certainly not conclusive enough to dispute DB's evidence, but it's just enough to give me pause. Why isn't this acceptable?

@DNAC: Gee, I didn't know you would miss me so much. Unfortunately, I was quite busy this weekend, so couldn't respond. I'll look at your posts and try to respond when I have time at work today or this evening.

anon@208:

DB: Obviously you were trying to insinuate that smallpox hasn't really been eradicated.

Uh, no. I wasn't. I'll be more clear, since your attempts to pin me down are failing and that appears to be your focus and source of contention.

I humbly suggest to folks that since anon has now expressly stated that he/she has no intention of saying what he/she actually means, he/she is clearly not interested in actual discussion. It is therefore not worth attempting to engage in discussion with this person, since they don't appear to understand the point of exchanging ideas and instead apparently see it as some sort of contest. Which is rather sad, really.

By Calli Arcale (not verified) on 11 Jan 2010 #permalink

anon: "As to Hib, well... this is an interesting topic no doubt. I will certainly concede that in a subset of people it can become invasive and damaging."

Here is some "interesting" data on Hemophilus influenzae b, from the CDC:

"Sequelae
3%-6% of cases are fatal; up to 20% of surviving patients have permanent hearing loss or other long-term sequelae.

Yes, death, permanent deafness and other complications can be regarded as "damaging".

Here's the impact vaccination has had on this once relatively common disease:

"Due to routine use of the Hib conjugate vaccine since 1990, the incidence of Hib disease in infants and young children has decreased by 99% to fewer than 1 case per 100,000 children under 5 years of age. In the United States, Hib disease occurs primarily in underimmunized children and among infants too young to have completed the primary immunization series. In developing countries, where routine vaccination with Hib vaccine is not widely available, Hib remains a major cause of lower respiratory tract infections in infants and children."

anon wants to scare us by highlighting a very small number of cases attributed to non-vaccine strains of Hib (miniscule compared to the number of illnesses suffered by children before the Hib vaccine era).
The Hib vaccine has been an outstanding success story. anon detests that and wants to obfuscate the issue, as with the eradication of smallpox by vaccination.

anon: "I make no assertion, merely question"

As well as misinform and mislead, to support a blatant antivax agenda.

By Dangerous Bacon (not verified) on 11 Jan 2010 #permalink

@anon

As to capturing the data, obviously not the government, nor insurance companies... we already tried that, and we'll never get a look at that data again.

Citation to support your claim that "we'll never get a look at that data again". As far as the government goes, VAERS is a public database. Further, any other additional information not protected by HIPAA or other privacy laws can be obtained through a FOIA request.

calli arcale: It is therefore not worth attempting to engage in discussion with this person, since they don't appear to understand the point of exchanging ideas and instead apparently see it as some sort of contest.

That would suit me fine, what I've said here has been largely ignored anyway... If you think that not engaging me is the best way to prove the points made by those whom you agree herein, by all means. I disagree. The only ones trying to "win" here, are those that are focusing on debate strategy and telling me to disprove their points.

DB: Here is some "interesting" data on Hemophilus influenzae b, from the CDC: "Sequelae
3%-6% of cases are fatal; up to 20% of surviving patients have permanent hearing loss or other long-term sequelae.

Yes I know. I've read it. I also tried to validate it.

The Hib vaccine has been an outstanding success story. anon detests that and wants to obfuscate the issue... wants to scare us by highlighting a very small number of cases attributed to non-vaccine strains of Hib (miniscule compared to the number of illnesses suffered by children before the Hib vaccine era).

Detests? Your word, not mine. Yes, that's right... I'M obfuscating. Ignoring the changes and prevalence of non-typeable strains is obfuscation

In addition to the proportional increase in cases of non-type b Haemophilus influenzae disease in the post-H. influenzae type b vaccine era, the incidence of invasive H. influenzae disease was found to be approaching the rates of H. influenzae type b disease that were documented in the prevaccine period. Fifty-six percent of invasive disease now occurs in individuals aged >10 years.

Don't like that, how about the Pink Book?

They are approaching pre-vaccine estimates. Why might that be? Certainly can't blame non-vaccinators for that. Refusing to acknowledge the repercussions of an action is extremely common within the skeptical community. Then lecturing the lurkers about engaging the person addressing them is sure to follow.

@anon

Yes I know. I've read it. I also tried to validate it.

How? Did you contact the agencies involved to find out their sources/source data?

Hi Todd,

As far as the government goes, VAERS is a public database.

Yes it is, but since it is a passive system and doesn't represent the true amount of adverse events, I'm not entirely sure what good a FOIA request would be. As I understand it, this database is combed fairly regularly anyhow. If anyone can make a claim, for any reason, in an uncontrolled environment, I don't see how it helps to clear up the confusion or concerns over those who claim to have experienced injury or show more true numbers. Obviously, people should also be able to submit claims - but they should be identified as being submitted by the patient, etc... My argument is that VAERS is failing the program and many people like me agree.

I also understand that access to the vaccine safety datalink is not granted based on exemption from such regulations. I'd be most happy to be wrong here too. Based on the last Congressional briefing covering this topic, release of possibly relevant information still appears discretionary.

How? Did you contact the agencies involved to find out their sources/source data?

Yes. I was given direction to WHO, (also unable to validate), MMWR and the Pink Book. For the most part, the numbers are difficult to verify and will rely upon accurate incidence reporting within the states. Some states use estimation, or epidemiological disease models. When you put people on high alert for a disease, you will obviously report more cases.

@anon

You didn't really answer my question. You claimed that we would "never get a look at that data again". I asked you for a citation to support that assertion and provided a couple of ways of finding that data (e.g., exploring the VAERS database, including looking at followup case reports, FOIA requests for data that is not freely accessible online, etc.)

Obviously, people should also be able to submit claims - but they should be identified as being submitted by the patient

Where the identity of the reporting person is known, VAERS reports list something along the lines of "report received from patient (or physician, etc.)".

My argument is that VAERS is failing the program and many people like me agree.

No argument that VAERS needs improvement (e.g., mandatory reporting by health care providers, not just manufacturers), but that was not the topic of discussion. Your claim that we would "never get a look at that data again" was where I was questioning you.

Yes. I was given direction to WHO, (also unable to validate), MMWR and the Pink Book. For the most part, the numbers are difficult to verify and will rely upon accurate incidence reporting within the states. Some states use estimation, or epidemiological disease models.

Where you had difficulty verifying the data, did you contact the appropriate organization again to request clarification? Did you submit any FOIA requests?

anon's misinformation campaign continues.

The only working link in your last post is to an abstract of a study in Manitoba. We can't tell exactly what it's referring to, but there's a statement in the abstract about H. flu invasive disease in persons greater than 10 years old (H. flu is an uncommon pathogen in adults, and mostly affects the immunosuppressed).

For good information on the significance of serotype replacement in H. influenzae, here's a report that talks about H. flu incidence before and following the introduction of the vaccine in the group most severely affected by H. flu.

"Before a vaccine became available in 1988, the annual attack rate of invasive Hib disease was estimated at 64-129 cases per 100,000 children younger than 5 years. By 2000, the number of cases in children younger than 5 years decreased by more than 99%. With the success of the Hib conjugate vaccine, at least half of invasive H influenzae infections are now caused by the nonencapsulated (less virulent) strains, and Hib meningitis has almost disappeared in the United States and Canada.

In 2006, the Active Bacterial Core Surveillance Report for H influenzae infection reported the following prevalences in 10 studied states (with a total study population of 35,599,550 persons):

Hib infection - 0.04 cases per 100,000 general population
Non-Hib infection - 0.36 cases per 100,000 general population
NTHi infection - 0.99 cases per 100,000 general population (NTHi infections accounted for 353 of the 551 H influenzae infection cases reported in this series.1 )
The prevalence of Hia infections has increased in some countries since the advent of the Hib conjugate vaccine. However, in the United States, the number of Hia infections reported has remained constant."

So - before the vaccine, invasive Hib infection was responsible for 64-129 cases per 100,000 children. That number dropped to 0.04 cases by 2006. And the nontypable Hib cases not covered by the vaccine, which you'd have us believe are such a problem? 0.99 cases per 100,000.

The Hib vaccine has been a spectacular success.

anon will probably counter now that she/he can't "verify" this information from the Big Bad Medical Establishment (though it's interesting that she/he cited a BBME research paper that superficially seemed to offer support to her/his antivax views). Or we'll hear more about how anon isn't asserting anything, "just asking questions".

Calli Arcale: "I humbly suggest to folks that since anon has now expressly stated that he/she has no intention of saying what he/she actually means, he/she is clearly not interested in actual discussion.

Sadly true. anon's "contributions" have however demonstrated clearly the callousness and disregard for human suffering that permeates the mindset of antivaxers, which was the central focus of Orac's article. Highlighting this attitude should be an important part of future efforts to educate the public about immunization and its opponents.

By Dangerous Bacon (not verified) on 11 Jan 2010 #permalink

From anon:

Thank you for asking. There should be a follow up visit after receipt of vaccination specifically for this purpose. The follow up visit needn't take that much time, and it is in the very best interest of all involved. If there is no liability or duty to care, then the program is utterly flawed. As to capturing the data, obviously not the government, nor insurance companies... we already tried that, and we'll never get a look at that data again. Many agencies would fight to do the job, I can assure you.

*facepalm* So your solution is a second visit. Really? With whom? Will this be covered by insurance? Paid for out of pocket by the patient? When should they come in? A day? Two days? Four days? A week? Do the patients have to put in a co-pay? If yes, my patients are not coming in. Do they actually have to show up and thus take off more time from work? If yes, my patients are not coming in. If they can just phone in instead of visiting, when do you expect my office staff to take the phone calls on top of the phone calls that they already take?

I have no idea why you think there is no liability or duty to care. There is.

And what agencies do you think are going to fight for the job? I would love to know whom you think is going to jump all over this and how you think they aren't going to swallow up the data and never let it out. How do you propose to fund the increase in resources that are going to be necessary to keep track of all this new data or even do anything with the data?

Your proposal from my POV as a clinician in a busy clinic is onerous and likely to lead to the clinic not giving vaccinations or patients not receiving vaccinations, which really, I think is horrible.

I can't believe you guys are still at it. Anyway as to JR:

Polio would be gone - except for local politicians and shamans using UN vaccination programs as a fear-monger tool to manipulate voters in Africa

Maybe you can tell me about these massive polio outbreaks that were plaguing the people of Africa before the UN vaccine program. I'm not saying they didn't happen. I just can't find anything about them.

By Sid Offit (not verified) on 11 Jan 2010 #permalink

Orac gives the death of a young girl as an example of âthe price exacted by the anti-vaccine movementâ. Though it is a sad story, is this death really attributable to the anti-vaccine movement? Upon closer examination the answer appears to be no. As always, it pays to heed the fine details.

After watching the video of the bereaved parent I note that some significant details are lacking and those that are revealed do not justify vilification or legal action directed at the dead childâs pediatrician. The mother states the child died in February 2001, 2 weeks shy of her 6th birthday. Pneumococcal conjugate vaccine was licensed in 2000. It was not added to the ACIP Recommended Childhood Immunization Schedule until January, 2001. (The PCV was not recommended universally for all children under 5 until 2008.)

The child who died was almost 6 years old (about 5 years, 10 months) when PCV was first added to the recommendation schedule in January, 2001, and therefore she would not have been in either of the under 5 recommended age groups (unless she was at high risk): the 2-23 month group for universal vaccination or the 24-59 month group for those at high risk. It is not revealed if she was at high risk. Note that the 2001 immunization schedule doesnât specify timing for âcatch upâ vaccination, but the 2002 schedule shows the âcatch upâ period for PCV ends at age 5, so she would not have been included in the catch-up group. The pneumococcal polysaccharide vaccine (PPV) is recommended only for older children in certain high risk groups.

The mother says her pediatrician encouraged them not to vaccinate. Unless the child was in a high risk group, the pediatrician was following ACIP recommendations. Figure 1 of this article http://www.medscape.com/viewarticle/571344 shows the pre-vaccine rate of invasive pneumococcal disease in 4 years olds (no stats for 5 years olds) was about 20 per 100,000, or 0.02%. A doctor who recommended not vaccinating with a new vaccine for which the child was not in the recommended vaccination group and for which there was only a 0.02% risk of contracting the disease can hardly be called negligent.

Who generated this video? Are we to presume the woman wearing a stethoscope is a physician (or is she an actor portraying a physician)? It doesnât appear that this video was produced by a news agency, there is no identification of the source.

Oh yeah, a whole series of those videos, some with the same actress/physician....watched the pertussis clip, shame on the mother who blames the unvaccinated friend of her son for giving her pertussis and then saying "it was completely preventable" without acknowledging that she could have prevented it by getting herself vaccinated. Shifting the blame from herself to a child while admitting that her childhood immunization had "worn off". It is well known that pertussis is endemic in the adult population, and that the vaccine is only 85% effective at best. I don't think I can stomach watching anymore of those set-pieces. The emotional manipulation while omitting key facts is nauseating.

"Chance of encephalitis from a measles shot: 1 in 1,000,000.
Chance of death from getting the measles: 1 in 2,000."

What's the odds of a 12 month old child getting injured riding down the road in the back of a pick-up truck? Or one standing in the middle of a field during a thunder storm? Odds are you wouldnt allow your child to do either, yet you'd shoot toxins into it with no problem.

@bensmyson

"Chance of encephalitis from a measles shot: 1 in 1,000,000.
Chance of death from getting the measles: 1 in 2,000."

What's the odds of a 12 month old child getting injured riding down the road in the back of a pick-up truck? Or one standing in the middle of a field during a thunder storm? Odds are you wouldnt allow your child to do either, yet you'd shoot toxins into it with no problem.

A couple questions:

1) What are the specific "toxins" involved with the measles shot? Please be detailed, explaining how each ingredient with which you have issue is toxic, providing citations to quality scientific studies that show the ingredient to be toxic in the amounts found in the vaccine.

2) Why would you allow your child to contract encephalitis and/or die from measles, rather than prevent the disease? Please provide citations to quality scientific studies showing the risk (both probability and magnitude of harm) from the measles vaccine is greater than the risk (again, both probability and magnitude of harm) from measles infection, as you appear to claim.

When you reply, please do not use anecdotes. I already know a bit about your background, and that you believe your son was injured by a vaccine. While I do feel for you, your story, by itself and without any access to complete knowledge of your son's case, does not carry scientific weight, unfortunately.

Todd, what do you have against anecdotes? Just out of curiosity. Orac used the PKIDS video link pneumococcal anecdote as a example of anti-vaccine related death, which was erroneous upon closer examination. Yes, "access to complete knowledge" is key when examining anecdotes.

Todd W.:

While I do feel for you, your story, by itself and without any access to complete knowledge of your son's case, does not carry scientific weight, unfortunately.

Exactly, because it seems when the full story comes out there seem to be important bits of information missing. One case was recently published on the US Federal Court Autism Omnibus site. Reading it one can see that the poor child had more obvious reasons for his developmental delays than vaccines, especially this paragraph:

He was delivered by a cesarean section because labor âfailed to progress.â Id. at 46. during delivery, Andrewâs âskull reportedly became wedged,â Petâr ex. 6 at 4, and Andrew required resuscitation at birth, id. His APGAR scores were three at one minute and eight at five minutes.

@diatom

Todd, what do you have against anecdotes?

While anecdotes can be useful to suggest avenues of research, they are not adequate for establishing anything as true or false. There are several reasons for this:

1) Sample size is too small to determine whether it was a fluke or fact.
2) No controls to distinguish between coincidence, correlation and causation.
3) No controls to prevent biases to creep into the report. I.e., people make mistakes in observation, in recall, etc. They remember what fits with their preconceived notions and ignore what does not fit or what is not deemed important. Sometimes, they even make up (though not necessarily intentionally) memories of what happened.

Put more simply, anecdotes are not reliable.

While it is very true that the PKIDs videos are just anecdotes, they are reminders of what the diseases cause. Plus they are backed up by real science, there are plenty of studies that show that the vaccines are safer than the diseases.

Also, it should be made clear what the letters in PKIDs stand for: Parents of Kids with Infectious Diseases

While it may be true that the PKIDS videos are somewhat âbacked upâ by science, that doesnât justify the significant gaps of information as presented which serve to support the biases of the funding organizations. The pneumococcal death was not attributable to ant-vaccine sentiments or physician negligence as the child was already past the ACIP recommended age for vaccination and for catch up vaccination. The pertussis mother blames another child for the fact that she passed pertussis to her new born, attempting to assign responsibility to another parent rather than taking responsibility herself as an undervaccinated parent. The undervaccinated adult population and the 85% vaccine efficacy rate are the significant factors perpetuating endemic pertussis in the US, not undervaccinated children in a population with >95% kindergarten vaccination rates. This is why all anecdotes, even those âbacked upâ by science, should be approached with caution.

PS As a sometime reader of this blog and a believer in the practice of respectful insolence, I am becoming wary of Orac's sometimes premature and vitriolic judgments based upon questionable citations. As Todd says, and as Orac undoubtedly knows, anecdotes are unreliable. Yet Orac recommended a malpractice suit against the dead pneumococcal childâs pediatrician based upon the âunreliableâ and incomplete information contained in an anecdote. He also repeated his recommendation to âsue his assâ. Either Orac didnât watch the video, or most probably, because Orac is neither a pediatrician nor an infectious disease specialist, he didnât understand the importance of the dates in the anecdote. This is one important reason for doctors to stick to their own specialties when it comes to passing judgment on other âmembers of the tribeâ.

I don't understand why you don't get it. I am the mother of Desiree Jennings, the NFL cheerleader who has neurological damage after having the flu shot. The damage to her was caused by Mercury/Thimerisol in the vaccine. Unknown to many is the undiagnosable auto-immune disorder of my youngest who was injected with 7 vaccines in one day. The Polio vaccine contained "acceptable levels" -what a joke - of formaldahyde and 2-phenoxyethenal. You cannot tell me that these are not toxins! Both of my daughters had life threatening illnesses caused by not being able to tolerate dangerous toxins injected into their bodies. I am not an "anti-vaccine nutcase". I just want the toxins eliminated from the nations vaccine supply because some people cannot tolerate "acceptable levels of "poison". The mothers who don't vaccinate their children do run risk of their children being harmed, however, many of them feel that this risk is less than the risk of injecting their child with toxins. I don't understand why you have to be so hateful to those who object to the vaccines. They are not ignorant people like you would easily categorize them as. If the dangerous toxins were removed, maybe then the public would consider vaccinations. Until that time, you will continue to have to attack those who don't want to vaccinate their children. Is this really what you want to spend your time doing? It is obvious to many that this is driving you "crazy".

By Renee Wyler (not verified) on 17 Jan 2010 #permalink

The damage to her was caused by Mercury/Thimerisol in the vaccine.

On what is this claim based?

I guess, Ms Wyler, that you are not aware that our bodies make much higher levels of formaldehyde than your child would EVER get through vaccination. And that our bodies can process and eliminate it quite well. And that many foods also contain much higher levels than any vaccine. Are you/did you (since Ms Jennings is fully adult) raising/raise your children in a bubble? They never played outside and got hurt? One scratch from outdoor play equipment can inject many many more "toxins" than any vaccine contains. Heck, one scratch from an artificial fingernail can inject innumerable "toxins", far more than a vaccine contains.

Please, give me a break. Go to Todd W's page and read and learn. (And I won't even ask for the proof that you ARE Ms Jenning's mother).

Pablo @ 247 and MI Dawn @ 248:

"Renee Wyler" is about as genuine as a 33.00 bill.
The claim that the damage was caused by thimerosol/mercury in the vaccine is based on the impostor's poor reading skills.

Renee Wyler - are you sure it was the vaccine that caused the problem for your youngest, and not a "undiagnosable auto-immune" problem?

There is a story on this page that suggest that Splenda might have caused her problems... http://www.splendaexposed.com/articles/2006/07/how_to_report_a.html about 3/4 down it says -

Posted by: Renee Wyler on November 24, 2006 12:23 PM
My five year old daughter broke out in red welts and splotches after having ice tea and cheesecake with Splenda in it. We took her to the emergency room since the welts were taking over her entire body. She had continual runny stools and could not sleep at night. After she was put on steroids to try and control the rash (benadryl didn't work) we tracked it back to the Splenda my husband and I had used on the South Beach diet. My husband also had numbness in his tongue and trouble sleeping. This is a very dangerous product that we fell in love with until we realized it was poisoning our bodies. South Beach diet recommends Splenda.

In fact, Splenda might have caused Desiree's problems if she was exposed to it.

Renee Wyler @ 246 --

If you are the mother of Desiree Jennings, then you will be able to greatly enhance her credibility simply by answering a simple question we've never gotten an answer to:

Who are the mainstream doctors who diagnosed her with dystonia and said it was induced by the flu shot?

We keep getting assured that this in fact happened -- that it was "doctors at Johns Hopkins" or "doctors at Fairfax Inova" or "doctors at the Mayo Clinic". But if we never find out who those doctors were, we can never confirm that it actually happened. We are left with the conclusion that the only doctor who ever thought that your daughter had dystonia and that the flu shot was responsible was Rashid "Prettybeads" Buttar, who has very little credibility to begin with and especially lacks credibility when he diagnoses "mercury toxicity".

I don't understand why you have to be so hateful to those who object to the vaccines. They are not ignorant people like you would easily categorize them as.

Oh, but some of them definitely are. Remember, "Ignorance is the state in which one lacks knowledge, is unaware of something or chooses to subjectively ignore information." Many of those who object to vaccines definitely lack important knowledge about vaccines -- for instance, those who insist that any amount of formaldehyde or mercury in a vaccine must be toxic frequently are unaware of the fact that a can of tuna contains more mercury and a pear has over 50 times more formaldehyde. And there's no question that many of those who argue against vaccines choose to willfully ignore information, such as those who completely ignore the death and misery caused by diseases such as measles, mumps, rubella, pertussis, HiB, tetanus, and polio, just so that they can argue that the risks of the vaccines are greater.

If the dangerous toxins were removed, maybe then the public would consider vaccinations.

No, that wouldn't happen. What actually happens is called "moving goalposts." The anti-vaccine contigent screams "Such-And-Such is a dangerous toxin! It's causing all this autism! We demand that you take this dangerous toxin out! When it comes out, you'll see that it was responsible for all that autism because autism rates will plummet!" When that doesn't happen, the anti-vaccine contingent doesn't do the responsible thing and say "Wow, we were so sure it was Such-and-such, but we were wrong. What else are we utterly sure of that we may be wrong about?" Instead, they just say "It must be Thus-And-Such that's the dangerous toxin doing all the damage! You're responsible for all this misery because you haven't taken it out of the vaccines!" Even if every ingredient except the antigens was taken out of vaccines (which would make them far more expensive, less effective, and almost unusably impractical) then anti-vaccine activists would simply declare that it's getting too many antigens that are making people sick (despite the fact that with advances in vaccine technology, vaccines actually contain fewer antigens than they did before.)

It is obvious to many that this is driving you "crazy".

Which "many" are you referring to? The same "many" who think that measles and mumps and HiB are no big deal, who even throw "pox parties" to try and induce "natural immunity"? Good Lord, am I expected to care whether Rashid "gemstone energy medicine" Buttar thinks I'm "crazy"? Sorry, I only care about people's opinions if I have reason to respect those opinions.

By Antaeus Feldspar (not verified) on 17 Jan 2010 #permalink

Dear Mom: You said "Unknown to many is the undiagnosable auto-immune disorder of my youngest who was injected with 7 vaccines in one day." Elsewhere, you mentioned that this was when she was 5 years old so you could have attend school. As far as I am concerned, this is an outright admission that you ARE an anti-vaccinationista, and, the rest of your woefully uninformed comments only prove it.