Battling misinformed consent: How should we respond to the anti-vaccine movement?

As Vaccine Awareness Week, originally proclaimed by Joe Mercola and Barbara Loe Fisher to spread pseudoscience about vaccines far and wide and then coopted by me and several other bloggers to counter that pseudoscience, draws to a close, I was wondering what to write about. After all, from my perspective, on the anti-vaccine side Vaccine Awareness Week had been a major fizzle. Joe Mercola had posted a series of nonsensical articles about vaccines, as expected, but Barbara Loe Fisher appeared to have sat this one out, having posted nothing. Well, not quite. More like almost nothing. I noticed that the NVIC did publish a new post earlier this week that I had somehow missed entitled Plug Into New NVIC Advocacy Portal & Protect Vaccine Exemptions. What is this portal? Barbara Loe Fisher describes it thusly:

The weeklong series of articles about vaccination published on Mercola.com includes the launch of NVIC's Advocacy Portal, which is a free online interactive database and communications network that empowers citizens to protect and enhance vaccine exemptions in all 50 states.

And there you have it, the real mission of the anti-vaccine movement in general and the NVIC in particular, to discourage vaccination wherever possible under a false mantle designed to camouflage its true purpose, the mantle of "informed consent" and "health freedom." What, you say? Who could ever argue with the concept of informed consent or health freedom? I can, not because I don't support the right of individuals to determine what they will do with their bodies or what treatments they will or will not accept. Rather, it's because the "informed consent" that anti-vaccinationists promote should more properly be referred to as "misinformed consent." At every turn the anti-vaccine movement promotes pseudoscience, misinformation, and quackery to frighten parents into not vaccinating. After all, all informed consent is based on providing an accurate accounting of the risks and benefits of an intervention being proposed. The anti-vaccine movement and the NVIC downplay the potential benefits with frequent propaganda claiming that, for example, flu vaccines don't work. More importantly, they hype the risks of vaccination to make them seem orders of magnitude more severe than science does, and if they can't come up with a real potential complication, they make one up! After study upon study failing to find an association between vaccines and autism, they still promote the idea that vaccines cause autism. Heck, the head of Generation Rescue, J.B. Handley, was doing it just the other day!

In fact, if there's one thing I've learned over the years, it's that the idea behind the "informed consent" argument is not real informed consent. Rather, anti-vaccinationists hide behind the term to provide a set of information to parents consisting of cherry picked studies, misinformation, and pseudoscience that so completely demonizes vaccines and denies their benefits that the only rational response to such information, if the information is accepted as valid, would be to refuse vaccines. Because most parents don't have the scientific background to recognize the misinformation promoted by the anti-vaccine movement, many parents do tend to accept the propaganda as accurate--or at least as sufficient to sow fear and doubt in their minds about vaccines. This is what I meant by "misinformed consent." Couple the technique of promoting misinformed consent to an appeal to the idea that refusing vaccines is akin to freedom, and that combination produces a powerful appeal, particularly here in the U.S., where appeals to "health freedom" can be mixed into libertarian "get the government off my back" politics. Mercola and Fisher explicitly tap into that sort of sentiment in announcing the NVIC program:

"The national forced vaccination lobby is well organized and they have billions of taxpayer dollars plus billions more from Big Pharma at their disposal to persuade state legislators to approve more and more vaccine mandates," said Dr. Mercola, "That is why I am partnering with NVIC and encouraging everyone to join with us and take action now to protect vaccine exemptions in all states."

NVIC co-founder and president, Barbara Loe Fisher, said "Dr. Mercola and I know it is time to get serous about legally defending the human right to informed consent to medical risk-taking in America. Everyone who registers for NVIC's Advocacy Portal will learn how to work in their own state for the legal right to make voluntary vaccine choices for themselves and their children."

Note the "framing," if you'll excuse the term. To Fisher and Mercola, public health officials aren't referred to as public health officials. That's way too neutral a term. Rather, they're the "forced vaccination lobby." Even worse than that, they aren't just the "forced vaccination lobby" out to steal your freedom away; they're the "forced vaccination lobby" funded by an unholy cabal made up of the government and big pharma. Similarly, to Fisher and Mercola, undergoing vaccination to prevent disease is not, as science tells us, a high benefit/very low risk medical procedure. Oh, no. To Fisher and Mercola, it's "medical risk-taking," as though vaccinating were some sort of game of Russian Roulette. This is what I mean by "misinformed" consent, and Fisher's been playing the game of representing her anti-vaccine views as "pro-freedom" for a very long time. She's been quite good at rebranding the NVIC to be seen not as the crank organization that it is, but rather as a "vaccine safety watchdog." This framing allows the NVIC to represent its portal as a "one stop shop for vaccine choice advocates":

"The religious and conscientious/philosophical belief exemptions to vaccination are being targeted for elimination by drug company lobbyists and doctors and organizations with financial ties to vaccine manufacturers," said Dawn. "We wanted to create a one-stop shop for informing people in real time about what is going on with vaccine laws and policymaking in their states to help level the playing field. Now concerned families can make their voices heard and be represented in their own state legislatures."

Dawn emphasized that the NVIC Advocacy Portal, which took more than a year to develop, is still "a work in progress." "Even though the NVIC Advocacy Portal is in its infancy, we knew we needed to launch it now to give people a way to take immediate action," she said.

What does this portal offer anti-vaccine activists? A fair amount of stuff, including contact information for legislators, instructions for how to try to persuade legislators to expand vaccine exemptions, online training sessions on "vaccine choice" advocacy, a rapid response system that alerts anti-vaccine activists to legislation that the NVIC wants them to oppose or support, message boards, and online newsletters. Come to think of it, I'm half tempted to join the NVIC Advocacy Portal in order to keep tabs on them. And so I would have if they didn't ask for my address. On the other hand, I've been meaning to get a post office box for a long time.

Still not convinced that this whole project is anti-vaccine, not pro-freedom or pro-safe vaccine? Check out this flourish at the end:

"Barbara and I know that freedom is not free," said Dr. Mercola. "We need to organize and raise millions to fight Big Pharma and Corporate Medicine. We must fight the forced vaccination lobby that wants to enslave us and make us buy and use more and more vaccines so drug company stockholders make bigger and bigger profits. I have selected NVIC as one of my favorite charities because I want to win this war against forced vaccination in America."

Oh, goody. The NVIC and Joe Mercola, two crappy woos that taste crappy together--and endanger our children as well.

It turns out, though, that Barbara Loe Fisher and Joe Mercola aren't the only anti-vaccine loons getting in on the act. SafeMinds has apparently decided to break out a new anti-vaccine propaganda effort to persuade people not to be vaccinated against influenza this year. As Autism News Beat points out, now that the election is over, vaccine rejectionists are calling for a "fresh start" in persuading legislators to pass antivax-friendly laws. Besides having produced a new brochure and trying to get its followers to contact their legislators, SafeMinds is trying to raise money to show this video (among others) in movie theaters during the holiday season:

Note the intentionally inflammatory juxtaposition of images of pregnant women with toxic waste dumps, the implication being that injecting pregnant women with the flu vaccine is the equivalent to injecting them with toxic waste. SafeMinds makes a big deal over a claim that thimerosal can't be disposed of in a landfill. Actually, lots of drugs and medical waste can't be disposed of in a landfill either. There are special landfills for them. The utter intellectual dishonesty and sheer, neuron-apoptosing stupidity behind these images makes baby Jesus weep. Sure, they say in the ad dthat they only want to tell you "not to take the risk" and to demand "mercury-free" vaccines, but in reality, this is of a piece with SafeMinds' general anti-vaccine stance. This is made plain in a followup video SafeMinds released the other day. If the first video was the media-friendly mild plea, this one goes full-on conspiracy-mongering anti-vax crazy:

Let's see. Voice of doom narrator? Check. Montage of mainstream media and blogs arguing against SafeMinds as though in a conspiracy? Check. The narrator intones ominously, "Listen to mainstream science and the media, and you might think the vaccine-autism debate is over and done with. The 'vaccines don't cause autism' drumbeat is steady."

Why, yes. Yes it is. From a scientific standpoint, the vaccine-autism "debate" (in reality a manufactroversy or pseudodebate) is over and done with. It has been for a long time. In fact, even though I've criticized her for being a little careless with her facts from time to time, I really liked one of the clips in the video featuring Dr. Nancy Snyderman. In it Dr. Snyderman repeatedly and aggressively slapped down the annoying Matt Lauer when he kept referring to the vaccine-autism link as "controversial," telling him (quite correctly) it is not controversial--because it isn't controversial among scientists and physicians. As I'm wont to say from time to time, from a scientific standpoint, the vaccine-autism hypothesis is pining for the fjords. It's passed on! This hypothesis is no more! It has ceased to be! It's expired and gone to meet its maker! It's a stiff! Bereft of life, it rests in peace! (Except that it doesn't; it's a zombie that keeps rising from the dead.) Its metabolic processes are now history! It's kicked the bucket, it's shuffled off its mortal coil, run down the curtain and joined the bleedin' choir invisible!!

It is an ex-hypothesis, and, yes, I do so love Monty Python's Dead Parrot Sketch.

The room temperature nature and lack of scientific metabolic activity of the vaccine-autism hypothesis don't stop Bernadine Healy, though. How predictable. Ever since Bernadine Healy went over to the dark side in order to become Age of Autism's Person of the Year for 2008 for her increasing flirtation with the anti-vaccine movement, she's become the go-to woman for anti-vaccine crankery. I've discussed Healy on more than one occasion here; I don't feel an obligation to discuss her again other than to point out that she's become a hack of late. But because she was the Director of the NIH back in the 1990s, she's the best friends anti-vaccine loons could ever have because she grants them the patina of scientific respectability. In fact, she's the first person shown after the voice of doom intones that "not all scientists agree." Just as creationists and global warming denialists trot out scientists with no experience or training in evolution or climate science to attack the scientific consensus, SafeMinds trots out Bernadine Healy when the need arises, as it apparently did here. Elsewhere, it'll trot out Boyd Haley and other scientists from unrelated disciplines.

While viewing this video, like Autism News Beat, I felt as though I were taking a trip down memory lane to peruse the anti-vaccine movement's greatest hits. It's all there, the rebranding of autism as a mitochondrial disease in the Hannah Poling case, the Bailey Banks case, claims that the government has compensated children for vaccine-induced autism, and a number of anti-vaccine tropes. Given that Autism News Beat has refuted each of the points in the SafeMinds video, I'll refer you there. The video concludes with the voice of doom intoning, "So, as you see, vaccines don't cause autism, except for when they do." Bravo for the pure propaganda.

That SafeMinds even had to do this video is rather telling. Five years ago, which is when I got involved in refuting the lies of the anti-vaccine movement in a big way, news coverage of the vaccine-autism manufactroversy was nearly always credulous, giving far more credence to the proposed link than the science would indicate. SafeMinds and other anti-vaccine groups were given prominent coverage; even J.B Handley appeared regularly on TV and radio. Over the last year or two, I've noticed a welcome new trend in that the media is actually starting to demonstrate a bit of skepticism and, far more often than I can recall, getting the story right. Most likely this is because of outbreaks of vaccine-preventable diseases in populations with low vaccine uptake coupled with a continual drumbeat of scientific studies that have asked the question whether vaccines are associated with an increased risk of autism and come up with a resounding "No!" as the answer.

Even so, the question remains: How do we combat the problem of anti-vaccine propaganda. I came across an possibly depressing example of how badly we do it from Jason Goldman, who in a post entitled Vaccination, Confirmation Bias, and Knowing Your Audience described an event at GlaxoSmithKline's headquarters about vaccination:

For a corporation that depends on communicating science to the public, they did a terrible job of it! For a certified card-carrying data-whore like myself, the Powerpoint presentations (which broke every. single. rule. of effective presentations. I highly recommend that they hire my friend Les Posen to teach them how to present properly) did not have enough detail. They would present some statistic, but without the level of detail required for me to make any real sense of the data. I will grant that I was not the intended audience of the talk, so I will forgive them their lack of error bars and missing p-values. For a general audience without a scientific data-driven background, the presentation was even more useless! It was all statistics, bar graphs, and numbers. If you're going to communicate science to a general audience (and I'd like to think that I know a thing or two about communicating science to a general audience), you need to engage them emotionally. You need to tell a story, not drown them in statistics. The presenter might say something like, "Last year, three gazillion people died because they were not vaccinated against a Terrible Disease That Kills People In Gruesome Ways But Which We Could Eradicate In Less Than A Decade If Everyone Would Just Get Vaccinated." Everyone would agree that this is a Bad Thing, at least. More likely, it is a Terrible, Horrible, No Good, Very Bad Thing.

[...]

Giving us incidence and death rates and other such statistics doesn't really get the job done. It doesn't communicate what they want it to. Nor will glossy pamphlets (like the one they gave me) featuring Mia Hamm telling us to get vaccinated. What will get the job done is story-telling, appealing to emotion, and utilizing accessible analogies. Instead of telling us how many gazillions died last year, tell us how many airplanes full of people, or how many football stadiums full of people died last year.

The GSK corporate blog also provides an account of the visit, as do Nutgraf and Scrutiny by the Masses. Nutgraf emphasizes the technical aspect of vaccine production, in particular the absolute cleanliness required as does Mom to the Screaming Masses. Apparently last year GSK arranged a similar program.

As I thought about the NVIC initiative and the SafeMinds video propaganda program, these efforts by GSK seemed completely ineffectual for the very reasons that Jason outlined, but more than that. First of all, you have to consider the messenger. To anti-vaccine parents, pharmaceutical companies like GSK are Satan incarnate. No matter how much a company like GSK tries, it's unlikely to be trusted because, in the view of the anti-vaccine movement, it's only in it for the money and it's the entity that caused their children's autism. I understand why GSK might have wanted to try anyway, but in reality it is the worst possible messenger, no matter how good it is at PR (and apparently it wasn't that good). Put a sympathetic mother up against a pharmaceutical company for PR purposes, and the pharmaceutical company will lose every time. Worse, bloggers who accept trips like this risk being painted as in the thrall of big pharma.

Yet, at the same time, I really don't like Jason's solution, either. I understand that appealing to emotions is important, but matching the anti-vaccine movement story for story is a game that scientists are likely to lose at. We are constrained by the facts; the anti-vaccine movement is not. We feel vaguely dirtied by using manipulative stories the same way the anti-vaccine movement; that is to our credit. Yet, there's no denying that such methods can be extremely effective. There has to be a mix that provides the human impact, the emotional hook, necessary to combat the blatant emotionality of the anti-vaccine movement, but without betraying scientific accuracy. I just don't know what that balance is. I wish I did, but I don't.

So in the meantime, I soldier on in my own little way, hoping that my efforts have an effect.

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In response to your title question, how to respond to the anti-vaxers:

*With ridicule,* and derisive laughter, and a dismissive tone.

Most of the anti-vaxers are playing the follower game: going along with their social circle in order to strengthen their sense of belonging. Belief in wacko stuff strengthens belonging by requiring a greater degree of commitment in order to adopt and publicly espouse the beliefs. If I believe that the moon is made of rock, it's no big deal to go talking about it; but if I believe that the moon is made of green cheese, it's a very big deal to risk saying so in public, and taking that risk cements more strongly my relationship with my social group.

So.

When anti-vaxers find themselves subjected to major ridicule everywhere they go, they will be faced with a choice: opt for a greater degree of anti-vax extremism, or change their beliefs or at minimum not go spreading the pernicious memes.

Most do not have the energy to go to war over this issue, so they will opt for silence.

So let's assume that we don't change their beliefs but we do succeed at making it too embarrassing for them to try spreading their memes in public.

OK, now we've turned them from carrier/spreaders to carriers only, who are not spreaders. Excellent! This reduces spread. Meanwhile we keep up with our campaign to embarrass the antis, to the point where eventually they decline in number to below a threshold that has any effect or carries any risk to others.

I hear where you're coming from.

We've our own little Vaccine Awareness Week at sciblogs in New Zealand (click on my name and browse around the larger site).

An earlier article I wrote (just before the week) looked an issue raised by a local journalist and vaccine campaign that perhaps the medium matters too. Scientists in general (i.e. outside of science bloggers) don't use the social medium well, so perhaps this is another avenue to think about.

A comment I recently wrote there was that perhaps one way of viewing the anti-vaccine efforts scams, but rather than being based around a sales pitch, the emphasis is on using social media to build a "community with a bias". (And anger.)

A wider way to look at it might be a change in the "it must be real, I saw it on TV" thing. Mass-market "broadcasting" and writing (YouTube, blogs) are now in the hands of anyone, without the editorial control you'd hope to get in better newspapers or TV channels. (You hope that is, what you actually get is patchy...)

I'm going to leave this thought at this point for now. (I might later expand on it on my blog if I find time and am inclined). Thing is, I think understanding the marketing being used would go some way towards understanding how to counter it.

Before I leave: your efforts do contribute. I know many people who use your words as something that they can present to others.

I plan to respond with fact, more facts, and then some more facts on top of that, layered with some humor. They throw opinion at us. I'll fire back with facts. Since truth cannot dismiss truth, I think I'll be okay.

On the subject of engendering faith in vaccinations, Ben Goldacre did an article in the Guardian about how people perceive crimes against the individual as more serious than crimes against a group, even when it's the same crime with the same consequences, such as murder, fraud etc. ( sorry, no link as I'm on my phone)

Maybe this is what we need to do to persuade people of the benefits of vaccines - find some devastated parent who failed to vaccinate their child, said child then dying of some horrific, preventable childhood illness, and get them in an advert.

Nah, that's not ethically dubious at all...

Compare the anti-vaxxers to other anti groups - creationists, 9/11 truthers, anti global warmers, holocaust deniers. They all use virtually identical tactics.

They focus on small inconsistencies and nitpick. They abuse statistics. They misrepresent results. They quote mine. They rely on incredulity. They employ falacious reasoning. They compile lists of scientists or authority figures who "agree" with them. They argue to teach the "controversy". They ascribe underhand motives for those who choose to agree with the evidence supported explanation. They wrap the whole lot of a blanket of pseudo science. They lie, distort and oversimplify.

Basically any tactic that stops them having to address the evidence or even acknowledge it exists. They just parrot the same lies and untruths, one after the other. When one gets refuted they move onto the next and repeat. Forever.

The problem is:
"My kid didn't die from a horrible illness she never caught because she was vaccinated" just doesn't make a good story.
Ridicule is a good thing, knowing all their wonderful fallacies is good, too, but I've noticed in conversations that people get really pissed off if you give them facts. Suddenly you become a bully for saying A, B and C and this has been researched and proven by XYZ while all they sprout is "oooh them poor babies, don#t hurt them"

In my mind, I divide the US population into three groups: vaccine advocates; the persuadable middle; and vaccine rejectionists. A communications strategy for promoting vaccine should address each group.

Vaccine advocates need reliable data and up to date information on current events (disease outbreaks, research, AAP press releases, etc). Basically, we keep doing what we are doing.

The persuadable middle needs to be made more aware of the dangers of vaccine rejectionism. That's where our friends in the news and entertainment media come in. On the plus side, the media narrative has shifted dramatically over the last few years, from "some parents say vaccines injured their children" to "vaccine rejectionism threatens us all." The latter narrative needs to be repeated and enforced. On the negative side, we still have Oprah and Faux News.

Vaccine rejectionists, as g724 says, deserve scorn, and for the reasons described - to discourage the persuadable middle from hooking up with the malicia, and to discourage the fallen from boasting about their deviant predilections.

By encouraging the media and science drumbeat against rejectionism, we reduce the number of defections from the persuadable middle, and add more vaccine promoters to our side. By making it acceptable, fashionable even, to ridicule vaccine rejectionism, we thin the ranks of Jenny's angry mob, and turn her drumbeat into the annoying drip of a leaky faucet.

So why is Lyn Redwood presenting this in a MD's office/lab? I thought she was a nurse by profession.

You may not want to use GSK as your shining example of a drug manufacturer trying to save our children.

http://business-ethics.com/2010/10/26/1740-glaxosmithkline-to-pay-750-m…

They are nearing the legendary Johnson and Johnson when it comes to unethical business practices. If they are this sloppy with their drug production which they are liable for, what would make you think they'd be any better producing vaccines which they are indemnified from liability?

By Minnesota (not verified) on 05 Nov 2010 #permalink

In it Dr. Snyderman repeatedly and aggressively slapped down the annoying Matt Lauer when he kept referring to the vaccine-autism link as "controversial," telling him (quite correctly) it is not controversial--because it isn't controversial among scientists and physicians.

While I applaud Dr. Snyderman for stating the truth this bluntly, locka99 points out that this technique is not always effective--if it were, the creationists and global warming denialists would have long since vanished. People in the journamalism business, like Lauer, thrive on controversy, no matter what the facts are. Ridicule is a useful tool in the fight, but it cannot be the only tool.

By Eric Lund (not verified) on 05 Nov 2010 #permalink

Forget the rabid anti-vaxxers, we're never going to convince them. The trick is to convince the swinging vaccinators that they are unreliable or at least take away their forum. I personally play to my strengths - I'm a science teacher and have a minor following doing science for kids. Most of what I've seen from doctors goes way over the average parent's head, such as the difference between ethyl and methyl mercury. But take it back a step and the vast majority can understand that there is no mercury in vaccines. We all have strengths we can use, not just scientists or doctors.

The Stop the AVN campaign works on a similar principal, even though some outsiders don't seem to realise it. We haven't been trying to convince the AVN, what we are doing is shutting down their access to the media and changing their public perception. Rather than the go-to voice for balance, they now have a public health warning against them, have been done for copyright violations (incidentally stopping them distributing much of their material) and are facing possible fraud charges. They no longer appear trustworthy to media and the public.

Well said, Eric Lund. Ridicule and bluntness certainly have their place, but they cannot be the sole method.

Minnesota -- vaccine manufacturers are not actually indemnified from liability. They are partially protected by the Vaccine Court, which pays settlements out of a tax on vaccines. But no plaintiff is barred from suing the manufacturer directly after failing to obtain satisfaction from VICP.

By Calli Arcale (not verified) on 05 Nov 2010 #permalink

True to form, Mikey Adams ( NaturalNews; today) informs us that vaccination rates are falling among the " better educated", only the "ignorant" choose vaccination, and we shouldn't "start a needle habit". Gary Null constantly whines, " _We_ have the science!", followed by a BigPharma-BigGovernment conspiracy chaser (Braggadocio unemcumbered by higher mental processes!) How do we counter this? Our web woo-meisters perserverate that *they* are protecting the public - they are self-less, *good* people without ulterior motives, true scientists, valiant whistle-blowers, investigative reporters uncovering corruption, greed, and the lies of the "elites", ad nauseum. So we can show how they aren't. They are *corporations* earning millions of dollars. Their web sites (a/k/a Ads) include (over-priced) products for sale, listings of available jobs ( Mercola), photos of palatial estates( Adams and Null). Websites like manta.com and spoke.com provide estimates of annual sales figures ( e.g. Null at $10.9 million and $10 million, respectively). The governmental actions they decry as being detrimental to "The People" or "Health Freedom" are regulations which would cut into their sales.

By Denice Walter (not verified) on 05 Nov 2010 #permalink

You may not want to use GSK as your shining example of a drug manufacturer trying to save our children.

Or maybe you would. GSK is a large company consisting of lots of different people doing lots of different things. Strange as this may sound to the average anti-vaxer, drug companies aren't the Borg and there is no hive mind controlling them. GSK definitely screwed up with quality control. They may or may not have fixed it policy wise. But they're also doing useful work and apparently attempting to get their product to people who need it but can't pay. Treating them-and all companies-with due caution and funding oversight agencies to catch them when they screw up is a more productive approach then simply dismissing the whole company because of one incident.

The stories are important too. Thanks to vaccines, we now live in a time where most parents with 'immunizable' kids have little or no life experience with the diseases that vaccines protect from. People tend to be very bad at risk/benefit analysis, so when these parents go in for vaccines, the paperwork they must sign tells them (informed consent) there is a certain mathematical risk associated with the given vaccine. And parents read this simply as "risk." They also know there's a very good chance that after vaccination their child is going to be feverish and fussy: not necessarily risky, but not fun either. Opposed to this they must consider the 'risk' of the disease, and again, many parents read this as "no risk" because they simply have not seen it. Add to this that inaction is almost always easier than action, plus a certain amount of exposure to rumors that "vaccines cause autism" and you end up with a number of parents (not necessarily 'anti-vaxxers') who choose not to fully vaccinate their children.

Somewhere I once read a comment (from a nurse) to a post on vaccination; she described a child who had to have his legs amputated and the process he went through as he grew older and the leg stumps had to be re-opened again and again to allow for bone growth. I read science blogs and books a lot, and there's tons of vaccination information floating around in my head, but nothing has stayed with me as powerfully as that story did. It put a 'face' on the disease risk for me, even though I'm old enough that I had measles and mumps, my sister had scarlet fever, and even though I got chicken pox as an adult (horrible memory).

By Trish Gannon (not verified) on 05 Nov 2010 #permalink

@KWombles

Wow. That message from Dr. Jay reads as if he's telling people that if their kid has a persistent cough, don't bother checking it out because it probably isn't pertussis, and testing for it is really hard, so it's not worth the effort.

You know, even after reading all of these posts, I still don't understand why, at the most fundamental level, the anti-vax movement really exists. I kind of get what motivates, say, climate change deniers. In particular, I get what motivates the people who fund the movement. But why would anyone actively want to prevent people from getting vaccines? Is it really just money (to sell snake oil)? Is it just magical thinking? Are they just really, really stupid? Is it like a religious thing--they believe their own spiel so strongly that no contrary fact will ever change their minds? Sure, vaccines aren't absolutely perfect, but the risks are nothing like what they say, and they work. I don't get it.

Your implication that parents who choose not to vaccinate are gathering their information from bogus websites like mercola.com is as ludicrous and insulting as those who say parents are obtaining their parental views from celebrities like Jenny McCarthy. And regardless of where their information comes from, your argument that they shouldn't retain their parental rights because they are too stupid is outlandish. Scienceblogs has been as biased about the vaccine issue as the sites your referring too. There are a variety of actual risks associated with vaccinations that are recognized by both the science and medical community. Parents owe it to their children to assess their own child's health risks, not the health risks of the collective. Those that have contraindications to vaccines certainly should not be getting them. Unfortunately, pediatricians rarely find out if those contraindications exist before vaccinating. That leaves the burden up to parents, and while it may be exhausting to filter through all the biased and bogus vaccine information, I assure you that us college educated, successful, and responsible parents are very much capable of navigating through the bullshit. Oh, and I certainly hope the autism debate isn't really over for scientists, since 1 out of 90 boys is now being diagnosed with the disorder. While Science may not be able to link it to vaccines, they so far, aren't able to definitively link it to anything else either. So, I would say our work and debate is hardly over. If you want parents to be more knowledgeable when it comes to vaccines, maybe a healthy dialogue would be a good start.

Your implication that parents who choose not to vaccinate are gathering their information from bogus websites like mercola.com is as ludicrous and insulting as those who say parents are obtaining their parental views from celebrities like Jenny McCarthy. And regardless of where their information comes from, your argument that they shouldn't retain their parental rights because they are too stupid is outlandish. Scienceblogs has been as biased about the vaccine issue as the sites your referring too. There are a variety of actual risks associated with vaccinations that are recognized by both the science and medical community. Parents owe it to their children to assess their own child's health risks, not the health risks of the collective. Those that have contraindications to vaccines certainly should not be getting them. Unfortunately, pediatricians rarely find out if those contraindications exist before vaccinating. That leaves the burden up to parents, and while it may be exhausting to filter through all the biased and bogus vaccine information, I assure you that us college educated, successful, and responsible parents are very much capable of navigating through the bullshit. Oh, and I certainly hope the autism debate isn't really over for scientists, since 1 out of 90 boys is now being diagnosed with the disorder. While Science may not be able to link it to vaccines, they so far, aren't able to definitively link it to anything else either. So, I would say our work and debate is hardly over. If you want parents to be more knowledgeable when it comes to vaccines, maybe a healthy dialogue would be a good start.

How should we respond to the anti-vaccine movement?

Perhaps legally? IANAL, but it seems to me that one's free speech rights end when people suffer direct harm.

If a stranger walks up to you and asks for driving directions, and you deliberately send him against one-way traffic leading to a fatal accident, I'm thinking your actions would be liable for a civil suit if not criminal charges.

We now have ten deaths from whooping cough in California alone this year, most of which can be laid directly at the door of the anti-vax movement. These people have been informed by medical experts that their advice is scientifically invalid - this is not an issue of simple opinion. Their persistence to misinform the public is therefore deceptive, premeditated, demonstrably dangerous, and arguably directly responsible for morbidity and mortality.

It would be very interesting to see if an antivaxxer-influenced parent who has lost an unvaccinated child due to the deliberate misadvice of the anti-vax movement could successfully sue. One successful suit would be worth a thousand clinical studies.

By Gingerbaker (not verified) on 05 Nov 2010 #permalink

Oh, and I certainly hope the autism debate isn't really over for scientists, since 1 out of 90 boys is now being diagnosed with the disorder. While Science may not be able to link it to vaccines, they so far, aren't able to definitively link it to anything else either.

Yes, the rate of autism is increasing. Yes, the cause is unknown and may be multifactorial. But one thing we know as surely as we can know anything is that it is NOT related to vaccination. Multiple studies have found NO link whatsoever. There is no plausible grounds for linking autism and vaccination. There is strong evidence against such a link. Why focus on practically the only thing we know doesn't cause autism?

Yet, at the same time, I really don't like Jason's solution, either. I understand that appealing to emotions is important, but matching the anti-vaccine movement story for story is a game that scientists are likely to lose at. We are constrained by the facts; the anti-vaccine movement is not. We feel vaguely dirtied by using manipulative stories the same way the anti-vaccine movement; that is to our credit. Yet, there's no denying that such methods can be extremely effective. There has to be a mix that provides the human impact, the emotional hook, necessary to combat the blatant emotionality of the anti-vaccine movement, but without betraying scientific accuracy. I just don't know what that balance is. I wish I did, but I don't.

I think the problem is that scientists can't be the ones telling the story. Or doctors. Or a drug company. They'll always have a problem putting a human face to the story in a way that doesn't seem patronizing, overly complicated or self-serving.

However, but there are parents out there telling the story of how their children were scarred for life - or worse - by a vaccine-preventable disease. It is those parents that need a forum to explain that withholding vaccines from children potentially have disastrous consequences. There is no equivalent organization for Generation Rescue for those families - and if there is, it's certainly not as media savvy.

@19:

You know, even after reading all of these posts, I still don't understand why, at the most fundamental level, the anti-vax movement really exists.

I've always said there is a cult element to the anti-vax movement. People who are susceptible to the claims and charms of the anti-vaxers aren't that dissimilar to those who could fall into any number of other cult-like entities. That makes it scarier, at some level, than other forms of denialism.

@Kelly

Orac, and the regular commenters here, would very quickly admit that vaccines have real risks. We would also readily agree that parents should be informed, and that doctors do not always do their due diligence in discussing vaccines with their patients/parents.

Part of the problem is that some parents do get their information from places like Age of Autism, mercola.com, SafeMinds, TACA, the NVIC, etc. Worse still, some media outlets also spread the same misinformation. And it can be very convincing. Some of the pieces sound quite rational, unless you have followed the arguments for quite a while or have read the actual scientific literature. Just a couple of examples of people who fall for the tripe at those sites, we have a troll that pops on here every now and then named Jen. She regurgitates whatever the latest post on AoA was, with no evidence of her having actually thought through or critically evaluated what she read. I personally have a friend who regularly shares news items from mercola.com, and that friend is a very smart, college-educated individual with a background in biology. It really hurts me when I see my friend post that kind of stuff, because I know how smart they are.

As to the autism debate, it is not over. The "vaccine-autism" debate, on the other hand, pretty much is, barring any new evidence to suggest any manner of connection. There is still considerable research and investigation into the cause(s) of autism, and that's not something that is going to end anytime soon, thankfully. Very complex set of disorders that it would be good to more thoroughly understand.

Kelly:

. There are a variety of actual risks associated with vaccinations that are recognized by both the science and medical community.

Okay, tell us what they are, and compare them to the very real risk of getting measles, mumps, Hib and pertussis. Four diseases that we are seeing again.

Please use that real science by telling us the journal, title, and date of the the studies supporting your claim. Please stay away from quoting random websites, news reports and package inserts.

Yes, there are contraindications to vaccines... some very real ones. But you cannot get away by arguing by blatant assertion that "pediatricians rarely find out if those contraindications exist before vaccinating. That leaves the burden up to parents, and while it may be exhausting to filter through all the biased and bogus vaccine information,"... you need to give the data you are basing that statement on.

If you want to argue that one contraindication is mitochondrial, you'll have to explain the risks in getting every child a tissue biopsy. Plus, go against the general rule that those with that disorder should be vaccinated because getting fevers through the disease is much worse.

If you want to argue that risk from autism is a contraindication, then you need to provide real evidence that getting vaccines poses a greater risk than getting pertussis or influenza. At the present the science shows that there is not "one autism" disorder, so there really is no "one cause of autism." Plus numerous epidemiology studies covering hundreds of thousands of children in over half a dozen countries show to casual link between autism and vaccines.

In short: provide evidence, not assertions.

@21:

That leaves the burden up to parents, and while it may be exhausting to filter through all the biased and bogus vaccine information, I assure you that us college educated, successful, and responsible parents are very much capable of navigating through the bullshit.

So in other words, you're suggesting that vaccines may play a role in autism despite all good evidence to the contrary - and you came to that conclusion without giving credence to Jenny McCarthy. Who happens to be the front person for the largest clearinghouse of autism-vaccine nonsense that I know of?

I call shenanigans.

And sorry, a college education doesn't mean that you're smart. Or able to understand good science from scientific crap. The "I'm a college educated parent" is the lamest appeal to authority ever, because most of the leading lights in the anti-vax movement are the allegedly college educated. They're not the yokels you are subtly implying they are.

There are a variety of actual risks associated with vaccinations that are recognized by both the science and medical community.

There are definite risks to vaccines. Autism is not one of them, but everyone acknowledges that there are risks. Some children and adults should not receive certain vaccines. This makes it all the more critical that healthy people without contraindications receive vaccines in a timely manner: the herd immunity helps prevent infection in people who can not be vaccinated. The anti-vax advise on herd immunity is basically "Screw them." Almost in so many words: Dr. Sears suggests "hiding in the herd" and I've seen several anti-vaxers write things like "Why should my child take a [nonexistent] risk for the sake of the community?" Not really the best role models altogether, people who don't care if children die as long as their fantasies are catered to.

Your implication that parents who choose not to vaccinate are gathering their information from bogus websites like mercola.com is as ludicrous and insulting as those who say parents are obtaining their parental views from celebrities like Jenny McCarthy.

No, the parents aren't all getting their misinformation from bogus websites and crappy books. Probably most of it is word-of-mouth from friends and relatives. Where do you think the "information" is coming from?

And regardless of where their information comes from, your argument that they shouldn't retain their parental rights because they are too stupid is outlandish.

Show me one place where anyone on this blog has called parents "stupid" for being mislead. This term is reserved for those who spread misinformation that is - well - stupid.

Scienceblogs has been as biased about the vaccine issue as the sites your referring too. There are a variety of actual risks associated with vaccinations that are recognized by both the science and medical community.

- and these have been acknowledged and discussed on this blog.

Parents owe it to their children to assess their own child's health risks, not the health risks of the collective.

Why is this an "either-or"? You could consider both. The "collective" includes your friends and family, too.

Those that have contraindications to vaccines certainly should not be getting them. Unfortunately, pediatricians rarely find out if those contraindications exist before vaccinating.

Citation needed.

That leaves the burden up to parents, and while it may be exhausting to filter through all the biased and bogus vaccine information, I assure you that us college educated, successful, and responsible parents are very much capable of navigating through the bullshit.

In your case, I am not assured.

Oh, and I certainly hope the autism debate isn't really over for scientists, since 1 out of 90 boys is now being diagnosed with the disorder. While Science may not be able to link it to vaccines, they so far, aren't able to definitively link it to anything else either.

Ummm...genetics?

So, I would say our work and debate is hardly over. If you want parents to be more knowledgeable when it comes to vaccines, maybe a healthy dialogue would be a good start.

Yes, it would. Care to join in?

By T. Bruce McNeely (not verified) on 05 Nov 2010 #permalink

Your implication that parents who choose not to vaccinate are gathering their information from bogus websites like mercola.com is as ludicrous and insulting as those who say parents are obtaining their parental views from celebrities like Jenny McCarthy.

So Kelly, tell us, where ARE those parents getting their information from? Presumably, because you imply that they have reputable sources, you should be able to name some.

Full disclosure: I am the blogger who writes the blog Mom to the Screaming Masses and the sideblog Scrutiny by The Masses. I was on the sponsored GSK trip and was quoted above.

----One thing that I am struck by again and again was powerfully illustrated above. Commenter #24, who is listed as a-non, states:
I think the problem is that scientists can't be the ones telling the story. Or doctors. Or a drug company. They'll always have a problem putting a human face to the story in a way that doesn't seem patronizing, overly complicated or self-serving.

However, but there are parents out there telling the story of how their children were scarred for life - or worse - by a vaccine-preventable disease. It is those parents that need a forum to explain that withholding vaccines from children potentially have disastrous consequences. There is no equivalent organization for Generation Rescue for those families - and if there is, it's certainly not as media savvy.---

This is exactly true. I am not speaking as a scientist, for I have no scientific background, but as a parent of six children, two of whom are on the autistic spectrum. I have many friends who are vehemently anti vax, and we've gone around the circuit again and again. I have never seen the effects of Mumps, Polio, Smallpox or Rubella firsthand. But having children on the spectrum gives me a first hand sighting into the fear that a parent feels when a child is being immunized. If you see something that you think may have caused a problem - it's going to make you think twice.

However. I have seen the effects of cervical cancer on my step daughter and niece, and that vaccine is a definite for my children - boys and girls. I have seen terrible bouts of the flu, and so that is a no brainer. Putting a face to the disease helps personalize it, and we all know from watching those tear jerker "Don't let me be euthanized" pet commercials - it's much more difficult to say no when it's not an abstract - which is what polio, rubella and the like are to the vast majority of us.

Talking with my mom and my father in law, both of whom remember diseases I've never seen, was educational for me.

The long term effects of not being vaccinated are not being discussed. What about the young girl, 20 years from now, who gets pregnant and contracts German Measles? thanks, mom! How thoughtful of you not to vaccinate me! How about the young boy who contracts mumps as a young adult and becomes sterile? thanks again! you didn't want grandchildren anyway, did you? Shingles, anyone? And with more and more unvaccinated children running around, this is can become a reality.

I absolutely agree that researchable statistics are key to assessing vaccine risk. Part of the problem is that the statistics generally used by the cdc on those ubiquitous handouts you get at the pediatrician's office state mostly worldwide statistics-like rotavirus killing 500,000 children annually. Well, if you go to the CDC's website and look for a number of fatalities among American infants, there isn't one. The estimation is less than 40. How many of those less than 40 deaths were otherwise healthy individuals? don't know. Meanwhile, I do know the FDA pulled the first rotavirus vaccine in 1999 for causing bowel obstruction in infants. That is incredibly fatal by the way and there were at least 23 confirmed cases. One of the two Rotavirus brands was also pulled by the FDA just this year for a pig virus contamination. I found it interesting that this wasn't covered by any mainstream media outlet and as a parent of two children under 2 years old with another on the way, I received no letter from Merk about the recall. Luckily for the estimated million children who recieved that vaccine, the virus was found to be benign in humans.
In 2008, VAERS received more than 25,000 reports of adverse events from vaccines in the U.S. 9.5% serious-causing disability, death, or life-threatening illness. In 2009 the CDC reports only 71 cases of measles in the U.S. They listed no reported deaths. The WHO states that 95% of measles deaths occur in low-income countries with weak health infrastructures.
Since 2006, the CDC reports HIB disease is estimated to occur in .11 cases per 100,000 in the U.S.
So the facts that I use as a parent to assess the risk to my own children are stats from the CDC, the FDA, VAERS, and other such reputable sources. While I do vaccinate my children for diseases I consider to be life threatening to them, like DTap, HIB, PCV, and MMR, I also choose not to vaccinate my newborns against HepB, and I don't vaccinate against Rotavirus as I feel, for my stay-at-home breast-fed children, its hardly enough of a risk. I haven't yet vaccinated my oldest against hepA or Chickenpox.
I struggle with my decision to vaccinate or not vaccinate daily. I admit that some of my fear is based on emotion, and I realize that while the numbers of disease outbreaks may be low now, that could change if If less parents vaccinate. Yet, I will only base my decision on what the stats are today. Not what they were 20 years ago or what they could be. I also won't put my child at risk of developing a high fever or any other adverse reaction simply because the CDC cannot get enough compliance from adults to be vaccinated-as is the case with HepB.
The real point here, is that I am a parent trying to assess risks, and unhealthy dialogue and banter from the medical community is far from helpful. I would love to have easier access to more statistics, trust me! I am less concerned with Autism and vaccines than I am with other documented side-effects like seizure, high fever, and respiratory ailment. Our children are plagued with chronic illnesses today and parents are going to be looking at all aspects of their child's environment-including vaccines. Whether you like it or not, the more vaccines that are added to the already packed schedule, the more stats and proof parents will want that their children really are facing life-threatening risks. One more thing to note, as the dialogue has become increasingly unethical on the medical side, so have the number of parents not vaccinating.

OH, and a new contraindication announced by the CDC this past June was dealing with Rotavirus and SCID. Rotavirus is routinely administered in 2 month old infants. SCID is rarely diagnosed this early.

Well, if you go to the CDC's website and look for a number of fatalities among American infants, there isn't one. The estimation is less than 40. How many of those less than 40 deaths were otherwise healthy individuals?

Meaning what? That a less than perfectly healthy individual had no right to live anyway? That you're ok with your kid getting rotavirus because you couldn't bother to take the 1 in 1 million risk of a bad reaction like a transient fever, cough on a sicker kid, and kill him or her?

@Kelly

One more thing to note, as the dialogue has become increasingly unethical on the medical side, so have the number of parents not vaccinating.

What's interesting to note, as well, is how the anti-medical side appears to largely get a free pass for its ethical lapses.

Kelly,

No where in this article has Orac suggested, as you claim, that:

they [parents] shouldn't retain their parental rights because they are too stupid [from your comment #20/21]

Orac's point is quite clear (I am citing from his post here):

And there you have it, the real mission of the anti-vaccine movement in general and the NVIC in particular, to discourage vaccination wherever possible under a false mantle designed to camouflage its true purpose, the mantle of "informed consent" and "health freedom." What, you say? Who could ever argue with the concept of informed consent or health freedom? I can, not because I don't support the right of individuals to determine what they will do with their bodies or what treatments they will or will not accept. Rather, it's because the "informed consent" that anti-vaccinationists promote should more properly be referred to as "misinformed consent." At every turn the anti-vaccine movement promotes pseudoscience, misinformation, and quackery to frighten parents into not vaccinating. After all, all informed consent is based on providing an accurate accounting of the risks and benefits of an intervention being proposed. The anti-vaccine movement and the NVIC downplay the potential benefits with frequent propaganda claiming that, for example, flu vaccines don't work. More importantly, they hype the risks of vaccination to make them seem orders of magnitude more severe than science does, and if they can't come up with a real potential complication, they make one up! After study upon study failing to find an association between vaccines and autism, they still promote the idea that vaccines cause autism. [Emphasis mine.]

To summarize:

  • Your claim: Orac is claiming that parents shouldn't retain the right to informed consent vis-à-vis vaccinating their children on account of some intrinsic mental defect.
  • Orac's claim: Parents' rights to informed consent are being disrupted by the anti-vaccine movement's continual dishonest misrepresentation of the risk/benefit profile of vaccines, a misrepresentation which the movement hides behind a smokescreen of support for informed consent and health freedom.
  • Your attempt to rebut Orac does not credibly advance your position when you argue based on something he did not actually claim.

Right Dianne. What I am saying is that I am not going to put my kid at risk of a fever, low-grade or high-grade if I don't feel there is risk of my kid getting rotavirus. 1 in 1 million chance? Where are your stats? the CDC says 1 in 20 children will get a fever over 101. In an infant that can quickly turn serious. In fact, my oldest daughter after receiving a HIB vaccine came down with a fever of 104. If that was a one in a million experience than I should play the lottery. I still vaccinate her. But that is for a disease I am actually fearful of her getting. Not so much worried about diarrhea.
And again, less than 40 isn't a number its an estimation. It could be 2 or it could be 39, who the hell knows, thats the point.
The Science and Medical community is using the over and done with Autism-Vaccine non-link to continuously promote the idea that vaccinations are safe and parents not only shouldn't be skeptical but are misinformed or irresponsible for being so. That is no more ethical than the "anti-vaxers" that use the autism-vaccine debate to oppose vaccinations.
How about then focusing on the myriad of other concerns that parents have about vaccines?

T. Bruce McNeely:

Show me one place where anyone on this blog has called parents "stupid" for being mislead. This term is reserved for those who spread misinformation that is - well - stupid.

And very few of those are actually parents. Those would include Little Auggie, Sid O, and the ever morphing "Medicien Man"/"Dr. Smart". The ever present "you are all stupid, vaccines are dangerous" argument by assertion is done by a couple of parents, one being "jen", and I don't think we've seen Common Sue for a while (she started with her name, then to Common Sense, and finally to several morphing names).

Two parents have been banned, John Best and Dawn Crim. But not for their views, but for their abject cruelty and total obnoxiousness when Orac wrote about personal tragedy. Kelly, I hope you do not condone such behavior.

Now, on a lighter note: isn't there supposed to be some really ground breaking news that will show how wrong we are? Hello, STY, are you there? We are all on pins and needles waiting for your big revelation where you claimed:

Something has been in the making since 2004 that is going to make many dead people roll over in their graves. It will be completed by about October/November 2010, but it may be a little bit after that when you all become very familiar with it. But once you do, you will all finally see where you went wrong, because you most certainly have, and even the worst of the worst of them, such as Paul Offit, will even finally acknowledge just how wrong he was once and for all.

(oh, Kelly, look at the first phrase of that full paragraph in the link, and tell us why we should be very very nice to STY)

The stories are important too. Thanks to vaccines, we now live in a time where most parents with 'immunizable' kids have little or no life experience with the diseases that vaccines protect from.

I'm really glad I paid attention to my grandmother (who grew up in the Great Depression) and the Mark Twain books I read in school. For them, disease was a fact of life. Sickness was intimately part of the natural order: Some of your childhood friends would inevitably die or become disabled from a childhood illness.

As many bloggers like Orac have said, vaccines have become a victim of their own success: The diseases they prevent are so rare, few people know how dangerous they can become. They don't listen to history, so they're unaware of the toll these "mild" childhood diseases can take on someone's life. Vaccines have been so successful, people take health for granted and act as if healthy humans are the natural order and disease is the aberration.

Makes it a lot easier for them to conjure up more "golden age" fantasies when there was some mystic culture that prospered for living in "natural" ways. Our health care systems are far from perfect (and some further from others), and they attribute those imperfections not to nature being red in tooth and claw (and microbe), but to our "sins" of using knowledge to live longer, healthier lives.

I also choose not to vaccinate my newborns against HepB,

Ever seen someone die of cirrhosis or liver cancer? It's not pretty. I sincerely hope your children never encounter hepatitis B or any other hepatitis. In fact, if I never see another case of hep B related liver cancer I'll be happy. IRIC, hep B is human carried only. The possibility of extinction of the virus in the wild is within reach...but only if people vaccinate.

"I also won't put my child at risk of developing a high fever or any other adverse reaction simply because the CDC cannot get enough compliance from adults to be vaccinated-as is the case with HepB."

You are, of course, putting them at risk of catching HepB instead- 30-40% of chronic infections are acquired during childhood.

http://shotofprevention.com/2010/05/06/why-infants-should-receive-the-h… :

"the virus remains viable and infectious in the environment for at least 7 days and can remain present in inanimate objects absent of visible blood. Since only 7 out of 10 infected adults show any signs or symptoms, and infected children under age 5 rarely show any symptoms at all, it is obvious how the infected population can easily, and unknowingly, be transmitting the disease to others."

When infected at a young age, HepB frequently leads to liver cancer and/or liver failure.

@Dianne

IRIC, hep B is human carried only. The possibility of extinction of the virus in the wild is within reach...but only if people vaccinate.

That's one of the things that really irks me about anti-vaccine folks. They complain about there being too many vaccines, yet the best way to eliminate a number of them is for everyone to get vaccinated so the damn diseases disappear! Polio is so close to being wiped out. Measles was to be next on the list. Diseases that only reside in humans, that have no other reservoir, can be done away with for good, thereby eliminating the need to vaccinate against them.

Kelly, regarding your note from comment #33:

Part of the problem is that the statistics generally used by the cdc on those ubiquitous handouts you get at the pediatrician's office state mostly worldwide statistics-like rotavirus killing 500,000 children annually. Well, if you go to the CDC's website and look for a number of fatalities among American infants, there isn't one. The estimation is less than 40.

Have you thought about what factors might result in there being such a disparity between US and worldwide rotavirus mortality in children?

Would it be reasonable to suggest the following?

  1. First, the rotavirus vaccine on the pediatric schedule in the US prevents the transmission of rotavirus, meaning most children don't get exposed to it to begin with.
  2. Second, when children are exposed to rotavirus and do come down with the disease (i.e. because they weren't vaccinated, weren't able to get vaccinated, or because the vaccine didn't provide immunity), the better sanitary conditions and medical technology reduces the mortality.

In fact, my oldest daughter after receiving a HIB vaccine came down with a fever of 104.

I'm not a pediatrician and I don't know anything about your daughter but what you've told me but that sounds like a potential contraindication to future vaccination. If it is, would you rather she, in her partially protected state, be surrounded by people who are vaccinated or by people carrying HiB, a formerly common cause of meningitis and other nasty infectious diseases?

Kelly:

In 2008, VAERS received more than 25,000 reports of adverse events from vaccines in the U.S. 9.5% serious-causing disability, death, or life-threatening illness. In 2009 the CDC reports only 71 cases of measles in the U.S. They listed no reported deaths.

What part of "Please use that real science by telling us the journal, title, and date of the the studies supporting your claim." did you not understand? Give us the study of the VAERS reports and compare ot to what happens in measles.

A bit of explanation: VAERS is a self-selected reporting system where the raw data is of the lowest form possible (that is Statistics 101). For instance here is an example of a parent in the UK (not where VAERS is supposed to work) reporting a vaccine turned his daughter into Wonder Woman.

Also, the rotavirus vaccines were not really recalled. So a bit of pig DNA was found, it was only during a very very deep PCR scan. Since they are both oral vaccines, consider them made better with a little bacon.

Kelly you ended with:

How about then focusing on the myriad of other concerns that parents have about vaccines?

Pray tell, what are those? What evidence do you have that they are issues? If you claim seizures, then I will ask you what is the risk of seizures from the actual disease. I have had a child have a Grand Mal seizure while he had a now vaccine preventable disease, so I am really interested in your educated and well documented answer.

@Kelly: so, your kids will not come into contact with any other children until they are school age? How will you know if any of their classmates have HepB? (My daughter was exposed to HepB when she innocently helped a classmate, who had falled down on the playground and had a bloody nose. Fortunately, she'd had her vaccines, although we did watch for any problems. No one at the school was aware, except for the part-time school nurse, that this girl was HepB positive.) You won't allow them to play with other kids, who may bite, spit, bleed, share food with your children?

Yes, vaccines are scary. But do you mean to tell me it's scarier to get your child vaccinated, knowing there is a fever risk so you can watch (and maybe prevent, with antipyretics) for a day or two, than to go wake up your baby and find them burning with a fever? Or that it's easier to stay at home for 21 days with your unvaccinated child who was exposed to someone with chicken pox, not knowing whether or not your child will get it? And will you be one of the lucky ones who has a child with a mild case? Or one of the unlucky ones whose child ends up in the hospital?

And what pediatrician do you have that they donât talk about contraindications? Mine asked me EVERY time about reactions to previous shots, family history of reactions to new vaccines. Iâd look for a new doctor, if yours isnât doing that.

Lastly, as has been pointed out to you, you ARE aware, arenât you, that anyone can report to VAERS? You could report your daughterâs 104 fever from her HIB to VAERS. In fact, you should, unless your pediatrician already did. That is what VAERS data can be used for â looking for trends that might need additional research. It does not, in and of itself, indicate true issues, because the data needs to be looked at compared to what is expected in the general population. But, say, if 100 people report that their child got a 104 fever from X HIB dose, on X date, and in the general population, you only expect 20 children to get a fever, then that form of HIB would be looked at. However, as has been pointed out, VAERS data needs to be reviewed. Since anyone can report to the database, and the information is not vetted for verifiability, caution needs to be used when looking at the data.

MI Dawn

By Triskelethecat… (not verified) on 05 Nov 2010 #permalink

Kelly,

Show me where the CDC says that "1 in 20 kids who get the rotavirus vaccine get a high fever". The only common risk of the rotavirus vaccine I'm aware of is mild diarrhea.

If you think rotavirus is mild, tell that to the 1 in 17 infants who end up in the ER because of it.

Well, I didn't say I was not going to vaccinate my children against hepB ever, I said not as infants and until the medical community can give me a good reason not to wait until they are closer to adolescence, than hoping I will be swayed by unproven risk of liver cancer in my newborn will not have much impact.
I also would like to address my comment about the implication that parent's rights should be removed because they are stupid, since that has gotten a lot of attention. My point was that the implication that parents cannot differentiate between biased and unbiased research when it comes to their child's health is basically calling them stupid. And because their is anti-vax rhetoric that is unethical does not mean that this is what parents who selectively vaccinate their child are using to make those decisions.
As I previously stated, my information comes from the CDC, the FDA, and VAERS. Not Jenny McCarthy regardless that some of you find that hard to believe-but again, thats part of the problem. I was simply trying to shed some light on the fact that many parents today just aren't convinced their child is at risk of serious injury from some of these vaccine preventable diseases. While that may infuriate some of you, it is the truth. It doesn't make us horrible people or bad parents. I am not afraid of Chickenpox, thats right, not in the least. Maybe because everyone I know got it and recovered from it. However, I do fear that if my kids don't obtain immunity from it as a child they have greater risks if they contract it as adults. So, I will immunize them if they have not yet contracted it naturally by school-age, as I suspect they won't.
And no, a college education does not equal a higher level of intelligence, I guess. I mean, I'm sure universities would like to think it does. People who have the capacity to do research, however, are unlikely to dismiss reasoning when it comes to the most important and valuable aspect of their lives - their children.
I often do wonder though, since parents who don't vaccinate are referred to so often as "mislead" or "misinformed" that if a study was done to find out how much time and resources a parent who doesn't vaccinate put into researching vaccines as opposed to a parent who does vaccinate, what the study would find. And yes, my implication is that parents who follow the CDC schedule to the letter have probably also done the least amount of vaccine research.
My objective in this discussion was to point out that parents have every right to be skeptical of all aspects of their child's life and health, especially when childhood chronic illnesses including asthma, obesity, learning disabilities, and mental health issues are on the rise. Whether this correlates with vaccines I don't know, and the point is, neither do you. So maybe if the geniuses of the science community, along with the medical community could spend less of their energy attacking parents, and more of it trying to figure out why our children's health has gone to shit, that might be more productive for society.

Okay, in retrospect, that last comment was awfully snarky. I don't doubt the medical and science community is very diligently trying to what's best for our children, just as parents are.

I know from personal experience rotavirus is best avoided. Not only are you dealing with rivers of diarrhea, but it sucks when you catch it too. I actually borrowed diapers from my kid! Oh, that is the disease that caused my kid's seizures and trip to the ER. Not a fun time.

Oh, and just in case you think chicken pox is no big deal: a pox story.

@Kelly

My point was that the implication that parents cannot differentiate between biased and unbiased research when it comes to their child's health is basically calling them stupid.

No, it is calling them human. As I pointed out before, some of the information put out by anti-vaxers can be very convincing and sound quite reasonable...until you actually look at the facts from scientific literature.

I'll take Wakefield as an example. This man is very suave. He speaks clearly and is quite engaging. The things he presents sound quite rational. Without knowing anything else about vaccine issues or immunology, it would be quite easy to believe that what he says is true. Despite all of that, the stuff that comes out of his mouth is pure drivel. I don't blame any parents for falling for his crap. They aren't stupid; they just fell for a con-man's line. As I also shared, a friend of mine with a biology background regularly posts nonsense from Mercola's site.

I am not afraid of Chickenpox, thats right, not in the least. Maybe because everyone I know got it and recovered from it. However, I do fear that if my kids don't obtain immunity from it as a child they have greater risks if they contract it as adults.

What about shingles?

Kelly:

As I previously stated, my information comes from the CDC, the FDA, and VAERS.

But you said:

the CDC says 1 in 20 children will get a fever over 101. In an infant that can quickly turn serious.

I am confused about what you are talking about. The Hib vaccine... the CDC Pink Book Hib chapter says:

Adverse reaction following Hib conjugate vaccines are not common. Swelling, redness, or pain have been reported in 5%â30% of recipients and usually resolve within 12â24 hours. Systemic reactions such as fever and irritability are infrequent. Serious adverse reactions are rare. Available information on adverse reactions suggests that the risks for local and systemic reactions following TriHIBit administration are similar to those following concurrent administration of its individual component vaccines, and are probably due to the DTaP vaccine.

And in the rotavirus chapter is says:

These data indicate the background incidence of intussusception in infants, as evidenced by its occurrence in infants who received a placebo. They also show that while intussusception is to be expected in recipients of rotavirus vaccine, the risk is no higher than among children who are not vaccinated.

and...

A variety of other adverse reactions were reported during the 7 or 8 days after rotavirus vaccination in the clinical trials, including vomiting in 15% to 18%, diarrhea in 9% to 24%, irritability in 13% to 62%, and fever in 40% to 43%. However, the rate of these symptoms in vaccinated children was similar to the rate in unvaccinated children. No serious adverse reactions attributable to rotavirus vaccine have been reported.

(by the way, the percentages of actual reports, not all doses)

What you are saying, and what your "sources" are saying are two completely different things. We will need you to actually document and link to the sources of your claims.

And I repeat: VAERS is just self-selected raw data. It is not useful until the reports are actually investigated.

I would like to inject some unbiased information into this discussion. Please take a look at Vaccines ProCon.org.
It is produced by a 501 (c)(3) public charity called ProCon.org - an organization dedicated to providing the best possible pro and con information about controversial issues.
The site contains a wealth of information on the issue of vaccination and associated risks along with a good number of expert quotes on both sides of the vaccination issue and links directly to full PDFs of a number of important studies on the issue.
Did you know: About 30,000 cases of adverse reactions to vaccines have been reported annually to the federal government since 1990, with 13% classified as serious, meaning associated with permanent disability, hospitalization, life-threatening illness, or death. [23]

Last year, three gazillion people died because they were not vaccinated against a Terrible Disease That Kills People In Gruesome Ways But Which We Could Eradicate In Less Than A Decade If Everyone Would Just Get Vaccinated."

He's talking about the mumps, isn't he? Exploding cheeks and testicles, gruesome.

By Sid Offit (not verified) on 05 Nov 2010 #permalink

The VAERS statistics are EASILY checkable on the VAERS website. Its not from a journal. Just like the CDC claims I make are on the actual CDC website. But, since many of you seem to actually want to know why parents aren't vaccinating, obviously because you don't know, meanwhile accusing them of being misinformed, there was recently a study done by the oxford journal looking at exactly that. I suggest you take a look at it before you presume to know what parents are thinking and then criticizing them for it.
her.oxfordjournals.org/cgi/reprint/12/3/355.pdf
And, no my children will presumably not have classmates until they are school-age. Until then they aren't in any daycare setting either. While I agree that adverse events related to vaccines are "rare", HepB in an infant that does not go to daycare or have any immediate family with HepB is also "rare".
Yes, the 104 fever absolutely is a contraindication for her to receive another HIB vaccine, but that was her third in the series. To answer the question of whether I would feel as empathetic towards parents who choose not to vaccinate if my child could otherwise not be vaccinated, that is a question I have struggled with, but yes, I still maintain that parent's should make the best choice for their child. To expect that parents do otherwise is unnatural. So while I don't fear my kid contracting HepB as a newborn, I also don't fear her spreading it.
To composer99, of course I have taken that into consideration. Thats sort of my point. The risk of my American child, because my child lives in America, is less even if she does contract the rotavirus. I mean, really? I should give her a vaccine the FDA promoted as "safe" when it turned out to cause fatal bowel obstruction, simply because she may get diarrhea? You all seem to not want to acknowledge that the medical community and the FDA make mistakes, and have made mistakes in regards to vaccines, and could still make mistakes.

He's talking about the mumps, isn't he? Exploding cheeks and testicles, gruesome.

What about rotavirus? Or measles, which can kill infants? My parents grew up in the age of polio, what about that?

By Gray Falcon (not verified) on 05 Nov 2010 #permalink

Given Chris's rebuttal from the CDC Pink book, I have to ask Kelly: can you provide a more detailed source for your claim that the CDC says that 1 in 20 will get a 101 (or 104 or whatever it is) fever from the vaccine?

You attribute it to the CDC, but we need a more specific place to verify that.

Sadly, I fear you are only parroting what you say somewhere else, and didn't get it from the CDC. Show me that I'm wrong.

@Kelly

Re: VAERS, you may want to give this link a quick read.

Looking at the raw VAERS reports is not going to give you any really meaningful information. There is a combination of underreporting and unrelated reporting.

Well, I didn't say I was not going to vaccinate my children against hepB ever, I said not as infants and until the medical community can give me a good reason not to wait until they are closer to adolescence, than hoping I will be swayed by unproven risk of liver cancer in my newborn will not have much impact.

Sorry, I think I must have misunderstood you. You don't think that reducing your child's risk of liver cancer (since, as described in earlier posts, infants CAN and DO get exposed) is a good reason? That's what you seem to have just said, but I suspect that's not what you meant.

I also would like to address my comment about the implication that parent's rights should be removed because they are stupid, since that has gotten a lot of attention. My point was that the implication that parents cannot differentiate between biased and unbiased research when it comes to their child's health is basically calling them stupid.

No, it is calling them non-experts who, like everyone, can be susceptible to getting conned by people who seek to deceive them.

I was simply trying to shed some light on the fact that many parents today just aren't convinced their child is at risk of serious injury from some of these vaccine preventable diseases. While that may infuriate some of you, it is the truth. It doesn't make us horrible people or bad parents.

It does, however, make you factually wrong.

I am not afraid of Chickenpox, thats right, not in the least. Maybe because everyone I know got it and recovered from it. However, I do fear that if my kids don't obtain immunity from it as a child they have greater risks if they contract it as adults. So, I will immunize them if they have not yet contracted it naturally by school-age, as I suspect they won't.

SHINGLES.

I often do wonder though, since parents who don't vaccinate are referred to so often as "mislead" or "misinformed" that if a study was done to find out how much time and resources a parent who doesn't vaccinate put into researching vaccines as opposed to a parent who does vaccinate, what the study would find. And yes, my implication is that parents who follow the CDC schedule to the letter have probably also done the least amount of vaccine research.

Depends on your definition of "research." If we restrict it to research based on reliable sources, as opposed to whatever some schmuck can post online, I suspect we'd find that parents who decline vaccination have, for the most part, done NO research. REAL research would involve PubMed.

My objective in this discussion was to point out that parents have every right to be skeptical of all aspects of their child's life and health, especially when childhood chronic illnesses including asthma, obesity, learning disabilities, and mental health issues are on the rise.

Yet being skeptical of vaccination in that regard has no more foundation than being skeptical of, say, cargo pants. Should everyone avoid cargo pants because they might lead to learning disabilities?

Whether this correlates with vaccines I don't know, and the point is, neither do you.

Actually, on many of those points, we do know, or at least have strong evidence. Learning disabilities and mental health issues, for instance, appear more common because we're better at spotting them these days.

So maybe if the geniuses of the science community, along with the medical community could spend less of their energy attacking parents, and more of it trying to figure out why our children's health has gone to shit, that might be more productive for society.

Who attacks parents? Attacking those who deceive parents into harming their children, sure. That's done, and that's highly productive and important.

And the medical community puts an IMMENSE amount of effort into researching such issues; far more than the entire total amount of energy devoted to countering the antivax loons' attempts to kill off our children with infectious diseases.

He's talking about the mumps, isn't he? Exploding cheeks and testicles, gruesome.

Kelly, THIS guy is stupid.

By T. Bruce McNeely (not verified) on 05 Nov 2010 #permalink

Kelly, I did not ask how easy VAERS is. I wanted you to point out the studies that evaluate the raw data.

For the third time: VAERS is self selected RAW data.

Self selected data is by definition biased and worthless until the details are studied. It includes everything, even parent in another country reporting his daughter turned into Wonder Woman. Sometimes the cause of reaction is something else, like congenital heart problems or even in the case of a drug overdose in one teenager.

It is NOT valid for proving your statements. Which is why we are requesting studies from the VAERS data, not the data itself.

Okay, your child had a 104o fever after the Hib. It could have been something else, like a viral infection that you were not aware of. So your doctor played the odds and said no more Hib vaccine, which depending on the age is a good bet if herd immunity is high enough. That means you have a doctor who listens and responds to his clients, it is not evidence that the Hib vaccine often causes fever.

I do realize the VEARS stats are just "reports", but if 25,000 people a year, nearly 250 of them "report" a fatality or life-threatening illness that is certainly compelling to a parent. And I also know that most of these cases will not be substantiated by the vaccine courts. I also know that there is a vaccine injury compensation fund for a reason. And while, the U.S. medical community renounces over and over that the MMR is safe, Japan seems to feel otherwise. I guess that a whole developed country who is just "mislead". India's top pediatricians have continually lobbied against the introduction of the Pentacel vaccine in their current schedule. Why is that? Why do they still believe it's linked to those infant fatalities that the WHO discredits? I guess they too are misinformed anti-vaxers. I work in a hospital pharmacy and know that human error is and should be part of one's health risk assessment. You wouldn't take a medication without first being sure you needed it. All I ask for, as a parent, are more concrete localized numbers. I want to know what the rate of measles outbreaks are in my region of the country, I want to know what the risk of fatality is if my child contracts rotavirus, I want to know all of that. Unfortunately it is not a simple thing to find out, but that doesn't mean parent's should not have the right to seek out that information and make a decision based on their findings. If the medical community wants more input in the decision, they should offer more information and be more transparent- like giving media coverage to the fact that a pig virus was found in the rotavirus vaccine. That way, parents like myself don't happen upon that information without any commentary. Because I'm sure many people would freak if they saw "pig virus" with all the hype about swine flu.
OH, and for goodness sake, when is the medical community going to get off the whole dr. wakefield stuff? I mean, you have been discrediting the guy for years and parents still fear a link between autism and the mmr. It may be time to move on to a possibly more effective strategy.

@Bruce

Your ability to consistently contribute nothing to the conversation is remarkable

By Sid Offit (not verified) on 05 Nov 2010 #permalink

Just following your lead, Sid. Just following your lead.

By T. Bruce McNeely (not verified) on 05 Nov 2010 #permalink

@Ginger

now have ten deaths from whooping cough in California alone this year, most of which can be laid directly at the door of the anti-vax movement.

That's absurd. Care to provide evidence

By Sid Offit (not verified) on 05 Nov 2010 #permalink

From my laywoman's view, it seems like a major issue with people who are afraid of vaccines (or any of many other minor risk issues) is a lack of perspective on comparative risk. What I would love to see is a handy little chart:

Your child's risk of dying from [insert vaccine-preventable disease] if they and most of their community receives the vaccine: ....
Your child's risk of dying from [ ] if they don't receive the vaccine but others do:
Your child's risk of dying from [ ] if neither they nor the members of their community receive the vaccine:
Your child's risk of dying from vaccine complications:
Etc.

I think if it was more prominently displayed how small the risk of injury from a vaccine is, compared to how large the risk is from those illnesses if we are not vaccinated, at least some minds could be changed.

Kelly:

Japan seems to feel otherwise.

You are aware that Japan became a leading importer of measles to the USA? A few years ago they closed several schools due to a measles outbreak, which killed several people. It is now having a return to mumps.

By the way, their MMR vaccine used the Urabe mumps strain, and is not the same as the American MMR vaccine that has been in use since 1971. I suggest you learn a bit more before trying another uneducated "argument by assertion."

You can start with:
http://www.ncbi.nlm.nih.gov/pubmed/19209100
and
http://www.ncbi.nlm.nih.gov/pubmed/20847499

Newsflash: Other countries have other issues and use different vaccines. You cannot state that if the MMR (with Urabe mumps strain) caused a problem in Japan and the UK, that the MMR vaccine (with the Jeryl Lynn mumps strain) will cause the same issues in the USA and Canada.

I repeat: VAERS is not valid for proving your claims.

@Kelly

And while, the U.S. medical community renounces over and over that the MMR is safe, Japan seems to feel otherwise. I guess that a whole developed country who is just "mislead".

IIRC, the reason the combo MMR vaccine was discontinued in Japan was due to the particular strain of mumps they used. I believe it was the Urabe strain, which was associated with a number of increased adverse event risks. They stopped using MMR and witnessed an increase in measles incidence. Now, they administer the measles and rubella vaccines separately. I'm not certain what, if any, efforts are underway to get approval for a different MMR vaccine there that does not use Urabe strain of mumps.

India's top pediatricians have continually lobbied against the introduction of the Pentacel vaccine in their current schedule.

Do you have a citation for this?

I mean, you have been discrediting the guy for years and parents still fear a link between autism and the mmr. It may be time to move on to a possibly more effective strategy.

Evidence that we need to keep hammering home where the origin of the MMR myth came from, though, yes, perhaps other strategies would work better.

From Kelly:

"The VAERS statistics are EASILY checkable on the VAERS website."

From the VAERS website:

"When evaluating data from VAERS, it is important to note that for any reported event, no cause-and-effect relationship has been established. Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event."

"VAERS is a passive reporting system, meaning that reports about adverse events are not automatically collected but require a report to be filed to VAERS. VAERS reports can be submitted voluntarily by anyone, including healthcare providers, patients, or family members. Reports vary in quality and completeness. They often lack details and sometimes can have information that contains errors."

"DISCLAIMER: Please note that VAERS staff follow-up on all serious and other selected adverse event reports to obtain additional medical, laboratory, and/or autopsy records to help understand the concern raised. However, in general coding terms in VAERS do not change based on the information received during the follow-up process. VAERS data should be used with caution as numbers and conditions do not reflect data collected during follow-up. Note that the inclusion of events in VAERS data does not infer causality."

In short, VAERS is not a source of valid data on the prevalence or incidence of adverse reactions to data, nor does it give information about what adverse reactions are caused by vaccines. It wasn't set up to be a source of data; it was set up to be sensitive to indications of potential adverse effects that weren't detected in pre-approval trials. It is expected to provide a large number of "false alarms".

Prometheus

@Kelly

BTW, I just want to say that I am impressed that you actually go to the FDA and CDC web sites for your information, even if I take issue with some of the interpretations you draw from your reading. That's more than a lot of people will do, and far more honest than the folks from AoA, NVIC, etc. do.

Thank you, Kelly, you are finally learning. Did you notice it said Mild Problems?

Now we just have to get you to figure out the problems with the raw VAERS data. Obviously your college education did not include a basic statistics class.

@Composer

Orac's claim: Parents' rights to informed consent are being disrupted ...

If Orac is indeed claiming that parents have a right to "informed consent" I wonder if he supports states that do not allow parents to exercise these rights in regards to school attendance

By Sid Offit (not verified) on 05 Nov 2010 #permalink

@Kelly: but what you aren't admitting, that we are trying to point out to you, is that those 250 deaths may have had NOTHING to do with the vaccine. For example, one VAERS reported death, Gardasil vaccine, was a girl killed in an automobile accident on the way home from getting her shot. Care to explain how the vaccine was the cause of her death? Or the girl in England who died after a vaccine, and her autopsy showed she had a lethal cancer? Just because a death is reported after a vaccine, you can't determine the vaccine was the cause of death without further detail.

Yes, vaccines are not 100% safe. No medication is; if you work in a hospital pharmacy, you should know that. You should also know that medications are given to save lives, not (generally) kill them. But tell that to the husband whose wife died of malignant hyperthermia after an elective surgery. Or the parents whose child died from anaphylaxis after getting her/his first dose of penecillin. Drugs can kill. ANY drug. (Yeah, I'm ex-hospital, my husband is still in a hospital pharmacy).

Since you keep your kids home all the time, never take them to the store, the mall, the park, you can keep them from being exposed to diseases. But you never know. You never know who is sick, they may not be aware themselves at the time. How about the kid who exposed thousands of people to measles during the Canadian Olympics? Or the other kid, in California, who caused the measles outbreak there? All the children who caught it from him were at their doctor's office. Do you not take your children to the doctor either?

I won't even comment on your Japan and India statements,since others have already done so.

I'll just leave (going out tonight) with this: CITATION NEEDED for your statements.

By Triskelethecat… (not verified) on 05 Nov 2010 #permalink

If Orac is indeed claiming that parents have a right to "informed consent" I wonder if he supports states that do not allow parents to exercise these rights in regards to school attendance

Not a bar to informed consent. Parents have the option of private or home schooling if they really choose not to vaccinate their children.

Now, there ARE some people here (including myself) who believe that parents should NOT have that option, any more than they have the option to not feed their children. But that's not public policy today, and I get the impression that it's a distinct minority opinion even here.

"My point was that the implication that parents cannot differentiate between biased and unbiased research when it comes to their child's health is basically calling them stupid."

No, it's not. It's calling them "not experts in this field," which the majority of parents are not. I am no more an expert in children's health than I am an expert in childhood development just because I have a child. In the case of children's health, I rely on science-based experts to help me understand the issues. This includes sorting through the research.

"I was simply trying to shed some light on the fact that many parents today just aren't convinced their child is at risk of serious injury from some of these vaccine preventable diseases."

And the reason that so many parents are not convinced of risk is because vaccines have done their job in making many of these diseases relatively rare in the United States. Then anti-vaccination proponents stepped in to cast a pervasive net of fear that is out there, even if you did not actively seek it. Add these factors to a strange idea that a certain amount of suffering is tolerable and possibly even beneficial when it comes to children's illnesses, and sure, there are parents who are not convinced.

The fear net can get to even the most staunch supporter of vaccinations to become hysterical, during a stressful time with her extremely premature infant, when she had to decide what to do about the shots. Five months later she would find herself sitting at home with said infant, in January 2009, watching a news report about an HiB outbreak in Minnesota, which killed an unvaccinated infant (parents refused to vaccinate).

Yeah, that was me. By that January, I had come out of my cloud of fear, but my boy had only had the first shot in the HiB series.

You can think, My kid is probably not going to get polio, and I survived the chicken pox, so what's the big deal?" While chicken pox can seem like a mild disease, but it's definitely not a treat, people do wind up hospitalized, and some die. Plus, shingles can be dreadful, just ask my husband.

@Poogles

You are, of course, putting them at risk of catching HepB instead- 30-40% of chronic infections are acquired during childhood.

Yeah, if she or someone in the household had HBV.

Most early childhood spread occurs in households of people with chronic (life-long) HBV infection
http://www.ct.gov/dph/cwp/view.asp?a=3136&q=388322

By Sid Offit (not verified) on 05 Nov 2010 #permalink

I find it amusing how SBMers are attempting to "educate" and persuade Kelly.

*With ridicule,* and derisive laughter, and a dismissive tone.

Keep doing what you do so people can see who you really are and what you really care about.

By augustine (not verified) on 05 Nov 2010 #permalink

@Kelly:
"I do realize the VEARS stats are just "reports", but if 25,000 people a year, nearly 250 of them "report" a fatality or life-threatening illness that is certainly compelling to a parent."

What does that sentence mean? What do you mean by "compelling to a parent"? Are you saying that parents are more qualified at evaluating VAERS data than non-parents?

You seem to be arguing that you can understand why parents might become easily misinformed by VAERS data. The solution to this is to inform people, not to keep arguing that we can understand why they make those mistakes.

re: Japan and MMR, you write:
"I guess that a whole developed country who is just "mislead""

If the US CDC and the Japanese Ministry of Health say things that are contradictory, then, yes, one of them is wrong. Your sarcastic tone in suggesting how implausible it is for a "whole developed country" to be wrong speaks highly to your bias: Anybody thinking there are problems with a vaccine must be right.

By Gopiballava (not verified) on 05 Nov 2010 #permalink

Oh Sid, I am so sorry that you feel I have contributed nothing to the discussion, because as one of those "on the fence" parents in regards to vaccines you would think I would have some valuable contribution. One thing I think I have contributed is the oxford journal study that actually looks at why parents are turning away from vaccines. I mean, if your going to criticize parents, you should at least know the motives your criticizing.
And my point on here was not to defend my position or try to change anyone's about whether my decision is right or wrong. My point is that if a rise in unvaccinated children is a problem then there should be some insight into why this is happening despite the fact that the autism link has been refuted over and over again. I am trying to tell you that parents, like myself, are not vaccinating for a variety of reasons that are not linked to autism. While, you may find all the reasons to be "misguided", there should be more ethical discussion to convince parents that their fears are "unfounded". First, though, you have to know what those fears are.
Also, I don't know if anyone else has really countered with any statistical numbers to prove that HepB or HepA or Chickenpox is a real threat to my infant's life.
The fact that Japan discontinued the MMR and has not reinstated it, is simply meant to show that not all developed countries hold our medical communities views on vaccinations. Is that an incorrect assertion? Why can't parents disagree with you without being attacked? Do you think that is a helpful contribution?
OH, and yes I do think the responsibility to promote ethical dialogue on topics concerning medical debate falls to the medical community. They are after all, supposed to be the professionals.

@Midwife-O-death

"Exposure to quantities of blood sufficient to result in HBV transmission in day schools is rare."

By Sid Offit (not verified) on 05 Nov 2010 #permalink

@Kelly

The fact that Japan discontinued the MMR and has not reinstated it, is simply meant to show that not all developed countries hold our medical communities views on vaccinations. Is that an incorrect assertion?

Yes and no. Yes, in that other countries' priorities may be different than the U.S. No, in that their priorities are different due to different circumstances. For example, Japan has BCG as part of the childhood immunization schedule, yet the U.S. does not. Does that mean that the U.S. is right and Japan is wrong, or that Japan is right and the U.S. is wrong? Or is it merely reflective of different circumstances?

Interesting shift in goalposts:

Kelly @20: "Oh, and I certainly hope the autism debate isn't really over for scientists, since 1 out of 90 boys is now being diagnosed with the disorder. While Science may not be able to link it to vaccines, they so far, aren't able to definitively link it to anything else either. So, I would say our work and debate is hardly over."

Kelly @80: "My point is that if a rise in unvaccinated children is a problem then there should be some insight into why this is happening despite the fact that the autism link has been refuted over and over again."

So you know the autism link has been refuted. Thoroughly. Then why bring it up in comment 20?

@Kelly

@Bruce...
Your ability to consistently contribute nothing to the conversation is remarkable

The comment was directed at Bruce. I think your making some excellent points and find myself in agreement with all of them. I'm happy you're here!

By Sid Offit (not verified) on 05 Nov 2010 #permalink

Is this how you treat the "people in the middle"? The people who you think can be beat to their vaccinated senses?

She already said that she vaccinates! And she also says that she doesn't rule out not getting the other vaccines.

Kelly's mistake as far as "science" based bloggers are concerned is she questioned the necessity of some vaccines for her child whom none of you know about. What she did was akin to a Catholic questioning the Pope.

When you question a religions's high priest this is the type of treatment you'll get.

This is the type of rationality that was given to her:

false logic Accusations

[That you're ok with your kid getting rotavirus because you couldn't bother to take the 1 in 1 million risk of a bad reaction like a transient fever, cough on a sicker kid, and kill him or her?]

Condescension and doubt:

[Show me where the CDC says that "1 in 20 kids who get the rotavirus vaccine get a high fever".]

[Chris; Obviously your college education did not include a basic statistics class.]

[Thank you, Kelly, you are finally learning.]

Differential diagnosis without exam, history, or medical degree.

[Okay, your child had a 104o fever after the Hib. It could have been something else, like a viral infection that you were not aware of.]

By augustine (not verified) on 05 Nov 2010 #permalink

Oh, Sid...Why can't parents disagree with you without being attacked? Do you think that is a helpful contribution?

This is funny (in a real, not sarcastic sense). I've been articulating the same points you're making today for over a year yet you've got me confused with the Oracians.

Also in regards to the scourge of rotavirus

http://emedicine.medscape.com/article/803885-overview
Socioeconomic class also plays an important role as this disease is more prevalent among children with Medicaid insurance
Young children aged 4-24 months, particularly those in group daycare settings, are at increased risk for acquiring rotavirus.
Low birth weight and prematurity as well as the paucity of breastfeeding have been associated with hospitalization from rotavirus
The most significant risk factor for rotavirus infection appears to be participation in group daycare

By Sid Offit (not verified) on 05 Nov 2010 #permalink

@Sid: Can you connect the dots for me on rotavirus? What conclusions do you draw?

I'm guessing "End Medicaid" isn't one - I mean, there *is* a correlation, right? :)
And, "refundable tax credit for people in that income bracket to the level that has low prevalence" is probably also not a good strategy.

By Gopiballava (not verified) on 05 Nov 2010 #permalink

[Scott: Now, there ARE some people here (including myself) who believe that parents should NOT have that option, any more than they have the option to not feed their children.]

Well, this attitude would explain why you wouldn't want anyone to have informed consent. It wouldn't matter if they had it or not if they were forced. Maybe that is why some believe that parents should not question the vaccine schedule or vaccines at all. They don't believe they have that right or choice to that right.

I disagree, Scott. I believe this is the majority of SBMers opinion on policy. No choice. No true consent.

What if the state said that you can only vote for one political party? And then told you that voting for any other party (or researching) would be dangerous to the security of the nation. Then the state put out propaganda to it's citizens that anyone who argues is an enemy of the state's welfare just for arguing.

By augustine (not verified) on 05 Nov 2010 #permalink

Chris, no your right, I avoided math classes like the plague all through college so the statistics course wasn't in my agenda. However, I pretty clearly stated that I understand the VAERS data is not a conclusive analysis of how many people are adversely affected by vaccinations. What I said was that it was "compelling", the number of people who believe their symptoms to be linked to vaccinations. I realize that "compelling" does not have any scientific value, but parents are going to base their decision to vaccinate not only on science, but emotion and personal belief, as well. Nobody can prove whether a side effect was a cause of a vaccine, as it will always be able to be attributed to something else. So, someone has to determine the likelihood of the causal relationship, and there is doubt among parents whether this is done accurately. I mean, look how eagerly my child's fever was attributed to a possible virus that had nothing at all to do with the HIB vaccine. Scientifically, I can't prove it wasn't something else. Maybe it was. But I'm not going to risk giving her the vaccine again. Questioning my intelligence or trying to demean me isn't going to have much impact either, as I suspected when I submitted my first comment that I would probably be met with some insolence.

Well, this attitude would explain why you wouldn't want anyone to have informed consent. It wouldn't matter if they had it or not if they were forced. Maybe that is why some believe that parents should not question the vaccine schedule or vaccines at all. They don't believe they have that right or choice to that right.

Please don't put words into my mouth. Informed consent is better than uninformed consent.

But since no informed person can legitimately reach any other conclusion, and the person making the decision is making for another human being in their care (as opposed to themselves, for whom the standards are much looser), I believe that it's appropriate to enforce childhood vaccination.

I disagree, Scott. I believe this is the majority of SBMers opinion on policy. No choice. No true consent.

Given how much grief I've gotten over it, and how emphatically people have stated the opposite, I'm quite certain you're grossly wrong.

What if the state said that you can only vote for one political party? And then told you that voting for any other party (or researching) would be dangerous to the security of the nation. Then the state put out propaganda to it's citizens that anyone who argues is an enemy of the state's welfare just for arguing.

Not at all similar. Vaccine refusal is FACTUALLY and demonstrably putting the child at unnecessary risk, for no credible reason. Politics is a subject about which reasonable people can disagree; vaccination is not. It really is far more akin to the choice to not feed the child.

Kelly, just the fact you still call the VAERS data compelling means that you really need to update yourself on math and some basic statistics. You do seem to have an open mind and a willingness to learn new things.

I think you would enjoy a fun take on how statistics is used to mislead, and how to take a critical look at it by reading a tiny, classic, but very relevant book: How To Lie With Statistis.

And a bit longer, more recent and a good read is: Lies, Damned Lies and Science.

I am not questioning your intelligence. It was a bit frustrating for you to continue to cite VAERS as a source of information after being told by several here that it is not reliable. I did question your education on a subject, and you answered honestly that you, in fact, avoid math in school and did not understand basic statistics.

So you know the autism link has been refuted. Thoroughly. Then why bring it up in comment 20?

By refuted you mean never studied
----------------------
Speaking of Japan, Sweden also found it prudent to ban a vaccine. In their case DTP/DPT (I can never get them straight, sorry)
-------------
It's reassuring to learn VAERS is basically worhtless
---------------
A new theme emerges: shingles, the new polio. According to Vaccines 4th ed. P785:

If everyone lived into the ninth decade, only 15% would ever experience the singles. The immunocompromised are again at high risk. And this group certainly has the vaccination option.
--------------------

Yet being skeptical of vaccination in that regard has no more foundation than being skeptical of, say, cargo pants.

Good analogy except why No Cargo Pants court to prevent the Gap from being sued out of business?
------------------------------

Not a bar to informed consent. Parents have the option of private or home schooling if they really choose not to vaccinate their children.

One of the many things about which you are blithely unaware is that private schools are not immune from governmental interference regarding vaccination

By Sid Offit (not verified) on 05 Nov 2010 #permalink

By refuted you mean never studied

Interesting. You seem to believe that by pretending something doesn't exist, it ceases to exist. We referenced numerous studies.

Good analogy except why No Cargo Pants court to prevent the Gap from being sued out of business?

I thought the vaccine court had the opposite purpose. At least, until it was discovered that even with lowered standards of evidence, they still couldn't prove anything.

By Gray Falcon (not verified) on 05 Nov 2010 #permalink

@89

Going for the "slippery slope" fallacy there, augustine?

Sid, sorry for the mix-up
Dianne, my points are not conflicting. Most parents recognize that the science and medical community have no research indicating a link between MMR and autism. The number of parents choosing not to vaccinate against one or more diseases is on the rise. Just maybe, there are more reasons than fear of autism to suggest why parents are not vaccinating and it may be helpful for the med community to look into those reasons so they are better equipped to help discuss parents' concerns. Regardless, there are still some parents who are not convinced there is not a link between MMR and autism due to the continuing rise in children with the diagnosis. Therefore, The medical community should focus their efforts more on finding a link and less on harping on the dr. Wakefield biased research stuff. Because, obviously until the med community knows something more about autism, the doubting parents aren't going to believe that the only thing they do know is that its not linked to vaccines-no matter how many times they say it.

Kelly:

Most parents recognize that the science and medical community have no research indicating a link between MMR and autism.

and

Therefore, The medical community should focus their efforts more on finding a link and less on harping on the dr. Wakefield biased research stuff.

There have been over twenty studies done looking for a link. It has been done. Why should more money be wasted on that wild goose chase?

Think about this: The MMR vaccine has been used in the USA since 1971, you may have received it if you are younger than forty years old. Where is the evidence it caused issues almost forty years ago?

That lots of people believe something doesn't make it true. Or false.

If the number of other people who believed in something was a compelling argument, you would have to accept astrology, Christianity, Islam, and Hinduism, among other things. You would have to accept not only that both the Democratic and Republican parties are evil (which is at least theoretically possible), you would have to simultaneously simultaneously believe that they are both virtuous.

And when I say they should focus on finding a link, I don't mean to vaccines, I mean to anything. There are multiple speculations put out there but no definitives. Vaccine manufacturers are not going to release a study that shows a link just as the beef industry is not going to release a study that shows a link between hormones in cows and early puberty in girls. Parents know the studies are done by the vaccine manufacturers so there is no point in trying to further convince untrusting parents to trust the studies done. Its a waste of time to both parents and the medical community.

@Sid:
"By refuted you mean never studied"

You're saying that the autism/vaccine link has not been studied?

By Gopiballava (not verified) on 05 Nov 2010 #permalink

Chris, why should more studies be done to try and find an autism link? Well, because 1 in 110 children (1 in 90 boys) is a lot of people! all those children diagnosed in the last 15 years are coming into adulthood and that obviously leads to some interesting questions, like who is going to take care of them? How will they function or contribute to society? What will the impact be on healthcare costs? I mean, my god, asking why more autism research should be done is like asking why more research into diabetes or cancer should be done. Hopefully, the research will lead to some solutions.

I would like to know why you all think that 25,000 people reporting adverse events after vaccination annually is happening? What is the motive? Why are a countless number of parents posting horror stories about their children's negative experience with vaccines?
And while I have been asked countless times for my citations on where I got my statistics, and after posting those citations, why haven't I gotten any citations that prove my American child is in imminent danger of life-threatening illness? Where are the statistics that support the idea that a non-immunized child is a huge health risk, more so than adults who haven't been immunized. I would love to have those actual numbers from scientists who have access to the information and the higher intellect to decipher the data that I apparently have failed to interpret correctly. Please educate me then, but use citations and specific numbers that are meaningful in my quest to assess my child's health risk.

Novalox: Going for the "slippery slope" fallacy there, augustine?

No.

By augustine (not verified) on 05 Nov 2010 #permalink

Chris, why should more studies be done to try and find an autism link? Well, because 1 in 110 children (1 in 90 boys) is a lot of people! all those children diagnosed in the last 15 years are coming into adulthood and that obviously leads to some interesting questions, like who is going to take care of them? How will they function or contribute to society?

Kelly, are you referring to a link to vaccines in particular, or do you mean an autism cause? The reason to not continue to look for a vaccine link is that all the reputable research to date has shown no link and to continue to try to "find" that link diverts resources from finding true etiologies and therapies for autism.

Kelly, I think that you are trying to present some logical arguments as to why certain parents are overly concerned about immunizations, but I'm not sure I agree with your assessment of how numerous the parents with those are. But really, we don't have any data concerning what sources most vaccine-refusers are using to support their decision, at least that I know of. I think that information is important, and obtaining that should be a part of the efforts to stop vaccine misinformation.

But I would be willing to bet that in a survey, the number one concern of parents who do not vaccinate their children is still autism, especially given that one in four parents in the general population think there is a link . Perhaps such data exists - folks here will no doubt point to it if it does.

Kelly

If your kids are not in "imminent danger" from from disease. It is because people like me choose to vaccinate my kids. You are the worsyt type of slime - people who let rely on others to (in your view) risk the health of their kids to keep your kids dafe.

You can choose to not vaccinate your kids if you want, buyt keep their asses away from mine. Although it is important that they interact with others so they can learn how not to be selfish, sponging assholes luike their mom.

Yes, you've pissed me off.

@Gopiballava

You're saying that the autism/vaccine link has not been studied?

Thimerisol has been. MMR has been. Aside from that nothing. Even your side concedes that fact when it laments how difficult and or unethical it would be to study an unvaccinated/vaccinated population. I'm not saying that vaccines cause autism just pointing out a fact. I'd like to see a number of other environmental avenues explored as well - I'm not fixated on vaccines - as opposed to trying to fit the square peg of genetics into the round hole of causality

By Sid Offit (not verified) on 05 Nov 2010 #permalink

[Scott: "But since no informed person can legitimately reach any other conclusion, and the person making the decision is making for another human being in their care (as opposed to themselves, for whom the standards are much looser), I believe that it's appropriate to enforce childhood vaccination."]
------------
Well then your version of consent is useless and pointless. It really isn't consent at all which is what Barbara Loe Fisher is arguing. If there is no choice then any information that appears to be informed consent is just fluff and window dressing. It's done to make the propaganda recipient feel like they've actually made the choice. When in actuality the choice has already been made for them.

By augustine (not verified) on 05 Nov 2010 #permalink

Here's some informed consent that you won't hear the doctor give voluntarily.

Doctor, what's my chance of not getting influenza this year?

If I get the flu shot what is my chance of not getting the flu this year?

By augustine (not verified) on 05 Nov 2010 #permalink

Kelly:

This is a quick response to some of your concerns.

Chris, why should more studies be done to try and find an autism link? Well, because 1 in 110 children (1 in 90 boys) is a lot of people!

A study was done in Britain recently that has found that the incidence of ASD in adult men is about 1/100. Sorry, no citation immediately at hand. This implies that the incidence of ASD has not actually increased over the last few decades. There is also evidence that there has been a marked reduction in the diagnosis of children as "retarded" that more or less parallels the increase in the diagnosis of autism. This again implies that the increase is more a result of diagnostic shift and increased awareness of ASD.
Again, my apologies for the lack of citations, I am pressed for time right now.

all those children diagnosed in the last 15 years are coming into adulthood and that obviously leads to some interesting questions, like who is going to take care of them? How will they function or contribute to society? What will the impact be on healthcare costs?

AFAIK, the majority of those diagnosed with ASD will reach adulthood able to live independently and support themselves. Even many of those who need assistance can contribute to society and their own care.

I mean, my god, asking why more autism research should be done is like asking why more research into diabetes or cancer should be done. Hopefully, the research will lead to some solutions.

Lots of good research is being done. There are great strides being made in childhood intervention. Research has also shown a hereditary factor in the cause of ASD.
What I'm against is false information that drains funds and energy towards wild-goose chases and bogus treatments (time to unleash the lawyers!).

By T. Bruce McNeely (not verified) on 05 Nov 2010 #permalink

Lots of thoughts here. I'll reply to them once I have a chance to read them â assuming the thread hasn't been derailed too much by now! â but in the interim here are some older thoughts I had in response to Ted Goertzel's article in EMBO Reports Conspiracy theories in science and his thoughts on how to address them.

You are the worsyt type of slime

Pablo, you sweet talker you. You confirm my belief that it's those with intellectually bankrupt arguments who have to resort to name calling.

PS
Is there a good kind of slime?
-----------------

If your kids are not in "imminent danger" from from disease. It is because people like me choose to vaccinate my kids.

You vaccinate for your own reasons. If you, those like you and those vaccinating because they're forced to create a lower "risk" of mild illness so be it.
----------------

people who let rely on others to (in your view) risk the health of their kids to keep your kids dafe.

Again no one is relying on you. Go ahead don't vaccinate. I dare you. I matters not to me. If others like you stop vaccinating and risk rises people like me will have to reconsider our position. Until then I'll calculate the risk based on the world that exists.
--------------------------

You can choose to not vaccinate your kids if you want, buy keep their asses away from mine.

You continue to be plagued by the delusion that you posses some right to restrict where people can go

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

Although it is important that they interact with others so they can learn how not to be selfish, sponging assholes luike their mom.

Your definition of selfish seems to be someone who refuses to sacrifice themselves for Pablito.

By Sid Offit (not verified) on 05 Nov 2010 #permalink

Well, Pablo, you obviously haven't read my posts because I do vaccinate my kids. I admit to not vaccinating my newborns to HepB until they reach school-age, yet I find it hard to believe that that puts your child at risk. Like i said, if you disagree, then at least offer some statistics to back your claim. what are the odds that my non-daycare attending child who doesn't have HepB is going to spread it to yours or anyone else's child? Every parent has the right to choose whether or not to vaccinate against a certain disease and if you doubt the efficacy of the vaccines you have given your child and fear they are still at risk because of unvaccinated children then maybe you should reassess why you choose to vaccinate. I thought your vaccinated children were protected? Do you even know how many parents don't vaccinate against each disease each year? Doubt it. The numbers are still incredibly small, and while some choose not to vaccinate there will always be children who medically should not receive vaccines. You can be angry at parents who don't vaccinate, but name-calling and vicious attacks aren't going to benefit anyone and while it seems many of you are willing to try, I don't think shaming parents into vaccine coercion has been or will ever be effective. I don't advocate vaccinating or not vaccinating, I advocate open constructive dialogue and informed consent. You can't force people to interpret information to fit your views. Parents will always do what they think is best for their child, not what's best for everyone else's and you are no exception. If you feared vaccines more than you feared diseases you wouldn't give them to your child either. But, you fear the disease more, so thats your choice. Nobody should take that choice away from you.

[Pablo: You are the worsyt type of slime - people who let rely on others to (in your view) risk the health of their kids to keep your kids dafe.]

Wait a minute Pablo. Are you saying that getting vaccinated is a risk? If you don't think it really is a risk then why are you angry?

[Pablo: You can choose to not vaccinate your kids if you want, buyt keep their asses away from mine. Although it is important that they interact with others so they can learn how not to be selfish, sponging assholes luike their mom.]

Your kids are safe why would you not want her kids around yours? Because you don't trust the vaccine or because you can't tolerate her analytical decision? What does that have to do with her children and your children's friendship? Is this a science issue or a moral one?

Maybe you can relate with Harriet Hall who said "If science is not the best way to determine whatâs moral, what is the best way?"

By augustine (not verified) on 05 Nov 2010 #permalink

Bruce, I don't know what your arguing with me about then. I never said more research should be done to try and prove a vaccine link, I said more research to prove any links to anything and it sounds like your saying research is being done, so ok then. I said repeatedly in my posts that I think the fact that the autism link is dominating the vaccine debate is misguiding the dialogue on both sides, medical and parental. I'm certainly not proposing that science do unnecessary repetitive research, I just don't understand the constant need to reassert the non-vaccine link to parents who obviously aren't going to be swayed by repetition.

Whoa, Pablo, that doesn't sound like you. Is the newb keeping you up a lot? That would certainly be a cause for excessive crankiness and understandable but I think you were rather harsh. /concerntroll

Kelly, I think you have made some valid points and have shed some light on what concerns the average parent regarding vaccines. And part of that is some of the sources that you attach an inordinate amount of importance to. I am actually putting together a blog post in honour of Vaccine Awareness Week that addresses the 'Kellys'. So, I cannot address some of the fallacies in any detail.

About Japan though; theirs is a business decision and not a response to the epidemiology that is actually present. They are (at present) not interested in granting licensure to MMR-II or Priorix. As a result, they have a considerable problem with measles, rubella and particularly mumps.

I think you may be mistaken about India and Pentacel, although I could be wrong. I believe their issue is with Hib vaccination. I am not being dismissive of your concern with your child's fever after Hib vaccination because we don't like to think that we have created that situation. But a fever, even a 104 F fever alone isn't a contraindication for future vaccination, nor is it a serious, or even moderate reaction in the grand scheme of things.

I'm glad to see that you are sticking it out and hope that people can settle down a bit and have a conversation. I don't see Kelly as being an anti-vaxxer and would benefit greatly from the fount of information that many here have.

@Sid:
"trying to fit the square peg of genetics into the round hole of causality"

Can you elaborate as to why you are convinced that genetics are not significant and/or are over-emphasized?

By Gopiballava (not verified) on 05 Nov 2010 #permalink

No, it wasn't the pentacel vaccine, it was the pentavalent vaccine in 2008, Sri Lanka. I realize that different countries have different needs regarding vaccines, but even the pediatricians in response to being called "anti-vaxers" after they lobbied against the vaccine in Sri Lanka were responding to the notion that they are not doing what was best for their country because they rejected that this vaccine should be added to their current schedule. Japan, likewise, after removing the MMR, was met with harsh commentary from the U.S. My point in bringing up these two events, is that our medical community acts with intolerance to whole countries when it comes to vaccines, not just individual parents. Vaccine concerns need to be met with some degree of patience and understanding if we, as a country, do not want to see a continued rise in unvaccinated children.

Kelly:

Japan, likewise, after removing the MMR, was met with harsh commentary from the U.S.

Citation needed. Really, link to that harsh commentary.

I did find this CDC report, but the harshest bit on it was:

The resurgence of measles in Japan in 2007 had wide-ranging effects, both domestically and internationally. Japanese residents with measles exported the virus into countries where measles elimination had been achieved, including the United States and Canada (4,5). Anecdotal reports also indicate that some visitors to Japan from the United States and Taiwan were infected with measles virus and developed measles upon return to their home countries. The international spread of measles virus from Japan provides a reminder that countries in regions that have eliminated measles need to maintain very high levels of vaccination coverage and high-quality surveillance to limit the spread of imported measles virus.

I should also remind you, again, the MMR used in Japan was different than the one that has been used in the USA since 1971.

It was noticed that Japan was the main source of imported measles to the USA. This actually caused embarrassment:
Measles exportation from Japan to the United States, 1994 to 2006.:

BACKGROUND: Imported measles cases and outbreaks involving Japanese travelers have been reported from the United States and other countries. For the United States, Japan is the top country of origin. The aims of this study were to analyze measles exportation trends from Japan to the United States and to suggest recommendations for improving monitoring and control in both countries.

CONCLUSIONS: Trend of exported measles cases from Japan to the United States has corresponded with the measles activity trend in Japan. Most of the cases were unvaccinated. This international health problem should be solved by strong leadership of Japanese public health professionals.

Chris: Good details.

It seems like Kelly is biased against vaccines: When there is a disagreement about whether a vaccine should be used or not, the assumption is that the country using the vaccine is ignoring concerns. I haven't seen Kelly express concern that a country not using a vaccine is exposing their citizens to disease risks.

"Vaccine concerns need to be met with some degree of patience and understanding"

Many of the high profile anti-vaccine advocates lie and distort. I am not tolerant of liars. When speaking with parents who have questions, concerns, or even who believe outright falsehoods, I'm patient and understanding.

When a high profile person states something that is a lie, calling them a liar is not the same as calling every person who falls for their distortions stupid. Kelly seems to believe that any criticism of anti-vax positions is equivalent to criticism of any parents who question anything about vaccines.

By Gopiballava (not verified) on 05 Nov 2010 #permalink

@Kelly

Re: HepB - Part of the CDC's recommendation to immunize newborns against HepB is that the younger an individual is, the greater the risk of chronic HepB infection, which greatly increases the risk of liver cancer and/or failure. Newborns who are infected are about 90% likely to develop chronic infection. By the time the child is 1-5 years, the risk is about 25%-50%. Over 5 years it's about 6%-10%. This is according to the CDC (click on my name, then click "HepB" or scroll down to that section and click on the "younger a person" linked text).

If your child only has contact with individuals you know for certain are not infected, then their likelihood of being infected is probably pretty low. Part of the issue, though, is that many individuals who are infected don't know it, so there may be friends or family members who are infected and may pose a risk to your child. Though rare, HepB can also be transmitted via contact with surfaces, since the virus can survive for several days outside a host. Sexual activity and IV drug use, while the most common forms of transmission, are not the only routes by which a child may be infected. Just some things to consider.

I thought your vaccinated children were protected?

Sadly, this is an argument that antivaxers often use. The problem with this line of argumentation is that vaccines, like all human endeavors, is not 100% in either safety or efficacy, much as we wish otherwise. Chris has posted a nice comment in the past illustrating how even with immunization, there will be a certain number of people who will contract the disease immunized against. I wrote a lengthier post at Silenced by Age of Autism discussing the "If vaccines work..." type of argument.

Kelly:

Chris, why should more studies be done to try and find an autism link? Well, because 1 in 110 children (1 in 90 boys) is a lot of people! all those children diagnosed in the last 15 years are coming into adulthood and that obviously leads to some interesting questions, like who is going to take care of them? How will they function or contribute to society?

Hmmmm... you had asked the earlier question like this:

Regardless, there are still some parents who are not convinced there is not a link between MMR and autism due to the continuing rise in children with the diagnosis. Therefore, The medical community should focus their efforts more on finding a link and less on harping on the dr. Wakefield biased research stuff.

Which read like you wanted a link between autism and the MMR studied.

I pointed out that it has been done.

Now, you just want research into autism. Well, here you go, it is being done. One of my children has even participated in one of the many autism studies at one of those listed universities.

Also, I do not need to be lectured on adult children with disabilities. My adult son is quite disabled. He may never be able to live on his own. It may or may not be associated with his history of seizures, especially the last major seizure while suffering from a now vaccine preventable disease.

One of the reasons I very much dislike the wild goose chases into studying anymore "vaccines cause autism or not" studies is that it takes away services my son needs.

Supertec and AutismNewsBeat are right on target:

Segment the market, just as advertisers do, and develop different messages for different segments.

Find families whose kids died of preventable illnesses because they were _not_ vaccinated. Get them to tell their stories on video. Find adults who have disabilities due to polio from before there were effective vaccines: get them to tell their stories. Same case with adults suffering from shingles because the chicken pox vax wasn't available when they were kids.

Also find examples of "iron lung" references in cartoons and such from the era before the polio vax. Use "fair use" provisions to excerpt a few seconds showing a character in an iron lung and then remind viewers that this was how it was before the vax.

MommaD: excellent examples. "You don't want grandchildren?"

Plenty of good stuff in the postings here.

Ultimately we have to confront the aggressive ignorance of science that has become the trademark of about 25% of the electorate, and by this I mean go after them relentlessly in every medium and give them no quarter. The root source of the problem is _dominionism_, which is the intellectual root of the entire religious right and the vast majority of anti-science attitude in the culture at-large. Keyword search "dominionism" and read up. That's the bigger battle we have to fight.

g724:

Find families whose kids died of preventable illnesses because they were _not_ vaccinated. Get them to tell their stories on video.

Done: http://pkids.org/im_videos.php

Yes, I left that sentence about researching a link ambiguous, which is why I clarified in my next post, almost immediately after. And I wouldn't attempt to "lecture" anyone on adult disabilities. Like I said, my problem with the continuous implied relationship between vaccine fears and autism, it takes away from discussing all the other vaccine fears parents have.
I am not against vaccinating at all, obviously since I do so, BUT I do struggle with my decision to vaccinate and I spend a lot of time trying to assess the risk of the disease vs. the risk of the vaccine. That doesn't make me an irresponsible or misguided parent. I use reputable sources to do so, not mercola.com or healthnews or any of the other anti-vax websites as they don't offer me reliable factual information. Likewise, even the CDC and vaccine information sites offer me little current statistical evidence that would lead me to be confident that my child's risk of contracting a disease is greater than suffering an adverse side effect. Like the previous comment in regards to HepB stats that offer me analysis of my child's risk of contracting chronic illness if my child actually had HepB. But my children don't so....
I also don't know why I am being categorized as an "anti-vaxer". Because I am skeptical?
It's very easy to criticize one's argument, meanwhile I have still been offered little statistical evidence that proves my child is at risk of contracting HIB or suffering a long-term effect if contracting chickenpox. The CDC says my child has a .11 per 100,000 chance of contracting HIB. What am I misinterpreting here?
What are the numbers regarding HIB adverse vaccine reactions annually? I can't find that statistic, the CDC just says severe reactions are "rare". Is rare less than .11 per 100,000? I think that info would certainly help parents make an informed consent decision.
I vaccinate against what I consider to be life-threatening diseases to my children. However, I don't find that all the vaccines on the vaccine schedule are worth the risk for my children. I don't know why some of you take offense to that since you haven't offered any numbers regarding what the risks actually are. I don't think anyone disputes that there are risks involved with vaccines so I don't know why you would think as a parent I would not attempt to do the best risk assessment possible for my child.
The vaccines I do give my children, I feel I am giving them out of blind fear, and that is what I struggle with. And I wonder if there will ever be a point where we are giving children too many vaccines.
Vaccinations have obviously saved countless lives and have lowered death from infectious disease, I don't dispute that. I think they are highly beneficial, but I think certain vaccines are not worth the risk. Some are very new, and for me, without long-term studies I consider my children part of the experiment group, that makes me uncomfortable not misguided. It makes the risk of the vaccine higher in my eyes. And I have yet to hear any acknowledgement that yes, the rotavirus caused fatal bowel obstruction in children when it was thought to be safe by the medical community. While that doesn't mean all vaccines are unsafe it does mean that human error has to be factored into a risk assessment, and the medical field is far from absence of human error.
I don't push for non-vaccination, I push for science and medicine to continue to look at studies, side effects, and safety and I suspect that as vaccines have been made safer numerous times in the past, they can continue to be held to higher standards that will result in even "rarer" occurrences of adverse events.

@Sid
I see you think that Sweden's removal of whole cell pertusssis vaccine somehow means it was a bad vaccine.
Yes, they did remove it, in 1979, after the unwarranted scare stories about encephalopathy from the vaccine.
The result was that pertussis re-emerged in Sweden, and in 1983 they had a huge outbreak with many deaths.

They eventually saw the light, and have re-introduced the vaccine as a routine childhood requirement.

Guess what? This has resulted in a decline in pertussis.

"The annual incidence of culture-confirmed B. pertussis was 89â150 per 100,000 before introduction of acellular pertussis vaccines and has dropped to 17â26 per 100,000. The data suggest that unimmunised infants and children who have received only one dose of pertussis vaccine were provided some protection. The decline is most obvious from the second dose onwards and remained stable for 4â5 years after the third dose in the absence of any booster dose. The first signs of waning immunity were observed at 6â7 years of age in the trial cohort. The short-term benefits reflect high vaccination coverage and high initial efficacy."

http://www.ncbi.nlm.nih.gov/pubmed/12706691

The CDC says my child has a .11 per 100,000 chance of contracting HIB. What am I misinterpreting here?

That's annual incidence, i.e. the odds for a given year, not the lifetime odds.

The distinction is not unimportant. What if I told you that the annual incidence of autism is about 1 in 10,000? Doesn't sound like a lot, and it's true (if you calculate it as whole-population birth incidence.)

I should also point out the obvious: That Hib incidence is for a largely vaccinated population. The odds of an unvaccinated child contracting the disease should be considerably higher.

So Todd- anybody who doesn't agree with you (and you could well be a paid blogger) about the studies /information currently out there is a moron? Wow it must be nice to be so sure about oneself. And by the way, I do consider many different sources-even science blogs. Your Callie spoke very eloquently on the dangers of off-label vaccine use several months ago. I also believe in the validity of what my parents of special needs kids say. Lastly, I'm not going to sell out AoA or Dr. Mercola or NVIC. Their points and research of the issues are as valid as say, someone who makes bucks off of vaccinating kids.

@Kelly:
"I also don't know why I am being categorized as an "anti-vaxer". Because I am skeptical?"

Because you are using a double standard. You are quick to assume that a vaccine has some suggested risks, but are far more skeptical about its benefits.

Your attitude towards the Japanese MOH vs. the US CDC was very illuminating: You scoff at the suggestion that a developed nation could be mislead - there has to be some basis for Japan's lack of vaccination. If the MOH is right and the risks of the vaccine outweigh the benefits, then, well, wait - a developed nation was wrong. You consistently play up the risks of vaccines and play down the risks of diseases.

"I have still been offered little statistical evidence that proves my child is at risk of contracting HIB or suffering a long-term effect if contracting chickenpox. The CDC says my child has a .11 per 100,000 chance of contracting HIB. What am I misinterpreting here?"

This is, I presume, the risk of contracting HIB with our current levels of vaccination? If you use the current incidence of HIB as a reason to not vaccinate you're freeloading on herd immunity. If there is a reason that the vaccine is contra-indicated for you, then it's perfectly reasonable to hope for herd immunity. If, however, you're just hoping that most other people will be vaccinated so you don't have to, well, that's not very nice.

By Gopiballava (not verified) on 05 Nov 2010 #permalink

Jen when are you going to prove you're not just a paid shill for Mercola and his ilk? How are you going to prove you stand nothing to gain by a return of vaccine-preventable disease?

JohnV: honest, I'm not a return-0f-vaccine-preventable-illness-shill. I only vaccinate my kids against the stuff I feel is worth it..
Both my kids had full blown chicken pox and swam in the toxic Great Lakes-amazingly they didn't suffer any secondary complications like flesh eating disease. Personally, I'll never forget the old ped I saw interviewed on t.v. (from the U.S.) about the new chicken pox vaccine-his take away point was that parents would need to take less time off work due to this great new vaccine. I wasn't too impressed.
Not gonna sugar coat it- the whole hep b vaccine at birth is a money grab, not to mention insane to do to a day old infant especially when they can test the mother for it. Ya ya I know, "what about father's who cheat" stories...

@Jen:
"I only vaccinate my kids against the stuff I feel is worth it.."

You include the current incidence of the diseases. Which are only low because so many people *do* vaccinate. That makes your decision selfish and one that, hopefully, very few other people will follow.

"Personally, I'll never forget the old ped I saw interviewed on t.v. (from the U.S.) about the new chicken pox vaccine-his take away point was that parents would need to take less time off work due to this great new vaccine. I wasn't too impressed."

I don't get it. This one old pediatrician provided poor justification for vaccination. You will never forget his reasoning. But you will forget the good justifications you've heard.

You may not be a run of the mill anti-vaxer, but your specious reasoning and constant special pleading indicate that you are an atypical anti-vaxer, but you're still doing many of the things that anti-vaxers do.

By Gopiballava (not verified) on 05 Nov 2010 #permalink

Actually, lots of drugs and medical waste can't be disposed of in a landfill either.

Wellll, they could be arguing that pregnant women should only take drugs that can be diposed of in a normal landfill. They probably aren't, but they could be.

By Matthew Cline (not verified) on 05 Nov 2010 #permalink

Sid@106 wrote
Thimerisol has been. MMR has been. Aside from that nothing

So, we know it's not any of the vaccines with Thimerosal in it. We know it's not MMR. Can you enlighten us which ones are left?

Gopiballava:

My "assumption" that vaccines cause side effects, first off, is not an assumption. Its a known fact. Second, The real contradiction here is your own. If your assumption is correct then "anti-vaxers" want to rely on herd immunity of parents who do vaccinate but at the same time want to spread false information to convince people they should not vaccinate. Hmmmm, that is one interesting and incredibly illogical assumption. Oh, and I will state again as I have numerous times in previous posts that I do actually vaccinate my kids. I think thats pretty clear evidence that contradicts your theory about me being more skeptical of the vaccine than of the disease. What I would appreciate though is your insight into WHY Japan continues to refuse the MMR despite the measles and rubella outbreaks? And since they do actually vaccinate against those things in that country with seperate vaccines, why do you think that if they did use the MMR it would be more effective? I'm not being sarcastic, I would like to know your take- despite that you have clearly shown you hold some illogical views in other areas of this debate.

Kelly @135
If your assumption is correct then "anti-vaxers" want to rely on herd immunity of parents who do vaccinate but at the same time want to spread false information to convince people they should not vaccinate. Hmmmm, that is one interesting and incredibly illogical assumption.
Why should antivaxxers be logical? Look at all the American "conservatives" who want to reduce the deficit and cut taxes without reducing spending on defense, medicare, social security etc. Also, they are different types of anti-vaxxers. The hard core altie whackaloons in the movement (Null, Mercola and Adams etc.) believe (or claim to believe - these guys are con men after all) vaccines don't work and have terrible side effects. In this case their position is logically consistent, it is the assumptions that are wrong. Others are purely hypocritical and cynical like Sears and Jay Gordon - discouraging their followers from vaccinating while counting on a high vaccination rate among those outside their in group to keep disease incidence low.

You also appear to not understand the law of large numbers. If a very large number of people get vaccinated then it is inevitable that a large number of bad events not caused by the vaccinations that will occur shortly after vaccination by random chance. It is human nature to then attribute these unrelated (other then temporally) events to the vaccination that proceeded them. Even if there were no side effects ever from vaccines there would still be plenty of reports in VAERS.

How many posts before someone claims I just said that vaccinations have no side effects?

By Militant Agnostic (not verified) on 06 Nov 2010 #permalink

@Pablo: Regarding your baby, do what your heart tells you. Many on this site may not have children or may have had them so long ago that their child did not receive the amount that is on the current schedule. If baby is sick don't vaccinate and choose carefully. Best of luck to you.

Jen at 130: Not gonna sugar coat it- the whole hep b vaccine at birth is a money grab, not to mention insane to do to a day old infant especially when they can test the mother for it.

Except that the test is not close to 100% reliable.

Kelly really illustrates the narcissistic, me first culture that we are left with in the 21st century. She continues to demand individualized statistics for her children's risk/benefits, all well assuming that she can take a free ride on herd immunity.

Guess what, we don't only get vaccinated for ourselves, but to protect the vulnerable in the population (the old, those with auto-immune problems) and keep up the herd immunity that ultimately protects us collectively. A disease that is too mild to kill a health youth could certainly harm vulnerable populations. But who give a damn about them.

By Agent Smith (not verified) on 06 Nov 2010 #permalink

I think the Mark of the Beast technology is here. Thousands, if not even a few million, already have the chip embedded in their body. I think we are much closer than we realise to that technology becoming mandatory. All we need is one more big catastrophe which they will engineer and "Oh, everyone come down and get a microchip. We've got too many illegal aliens and, you know, too many terrorists crossing the border".

By augustine (not verified) on 06 Nov 2010 #permalink

augustine -I think the Mark of the Beast technology is here. Thousands, if not even a few million, already have the chip embedded in their body. I think we are much closer than we realise to that technology becoming mandatory. All we need is one more big catastrophe which they will engineer and "Oh, everyone come down and get a microchip. We've got too many illegal aliens and, you know, too many terrorists crossing the border".-

I'm relatively new to the discussions here, but I thank you for giving me an indication as to which side of the sane/nutcase area you fall into.

By C. Sommers (not verified) on 06 Nov 2010 #permalink

No Agent Smith-Kelly demonstrates critical thinking and good parenting. With all the regressive autism going down she is trying to navigate her children through without needlessly becoming one of the vulnerable with an auto-immune condition. Services needed to help those children are massive. Pharma represents the narcissistic ,me culture ( or capitalism gone crazy) very nicely.

Agent Smith:

Kelly really illustrates the narcissistic, me first culture that we are left with in the 21st century. She continues to demand individualized statistics for her children's risk/benefits, all well assuming that she can take a free ride on herd immunity.

I am noticing that, plus a bit of goal post moving. She seemed willing to learn, but has now back peddled. I have a feeling she is not being totally honest, even with the claim of a college education (her rhetoric is confusing, my high school daughter writes much better). She keeps repeating the same points that she was corrected on multiple times, and seems to think they might be relevant.

Like this little gem:

And I have yet to hear any acknowledgement that yes, the rotavirus caused fatal bowel obstruction in children when it was thought to be safe by the medical community

Obviously my copying the paragraph on that subject from the CDC Pink Book chapter on rotavirus was totally ignored. Oh, and what evidence did she present that it was fatal? That is the first I heard it caused any deaths. So I looked it up here:

Intussusception is a rare type of bowel obstruction that occurs when the bowel folds in on itself. Intussusception is most common among young children. The most common place in the intestine for intussusception to occur is where the small bowel joins the large bowel. However, intussusception can occur in many parts of the intestine. With prompt treatment, almost all patients fully recover.

A quick look at the reference at the bottom of the page,
Intussusception Among Recipients of Rotavirus Vaccine -- United States, 1998-1999
, shows that there were a total of fifteen reports. It says (emphasis added):

Intussusception was confirmed radiographically in all 15 patients. Eight infants required surgical reduction, and one required resection of 7 inches (18 cm) of distal ileum and proximal colon. Histopathologic examination of the distal ileum indicated lymphoid hyperplasia and ischemic necrosis. All infants recovered.

Where did Kelly get the notion that the RotaShield vaccine was fatal? The same place where it is said that was the vaccine developed by Dr. Paul Offit? (for the record, Kelly, it wasn't) For some reason, she still does not see the need to provide citations to her assertions.

She is getting tiresome, so I'm going to ignore her for now.

C. Sommers, the troll you responded to should be ignored. Just scroll past any of its remarks.

After reading all 141 comments on this post the easiest answer to the question "How do we respond to the anti-vaccine movement?" would simply be that you shouldn't.

In the end everyone forgets the fact that these are people who have already made a decision on this topic and have willingly put on the blinders so that no amount of evidence/dialogue is going to convince them that they are just flat out wrong. Trying to argue with people like this is a total waste of time and rather pointless. They will always have a come back response that sounds something like this, "Well, yes I concede that point but what about [insert some piece of information taken out of context here]?"

For example, can anyone honestly say that they have changed Kelly's mind in any way? Probably not and that's not unexpected. All that was accomplished is a rather neat hijacking of the post comments. Going from "how do we respond to the anti-vaccine movement" to posters defending the use of vaccines was rather neat trick. (Please note, I am not criticizing anyone who responded to Kelly. I am just saying this seems to be a well used tactic to throw off the comments for a post that seems to be used with some effectiveness on Scienceblogs.)

By The-Cynic (not verified) on 06 Nov 2010 #permalink

No Agent Smith-Kelly demonstrates critical thinking and good parenting. With all the regressive autism going down she is trying to navigate her children through without needlessly becoming one of the vulnerable with an auto-immune condition. Services needed to help those children are massive. Pharma represents the narcissistic ,me culture ( or capitalism gone crazy) very nicely.

So you equate good parenting with vaccine refusal and/or flawed risk assessment. This isn't critical thinking jen; it is just another demonstration that you like what you hear so it must be good. You have also set up the false conclusion that vaccines cause autism and auto-immune disorders with not a shred of evidence to support that. It is so very sad that you ignore the more obvious in favour of emotional rantings from biased and very wrong parental recall. That is not critical-thinking, nor scepticism so don't credit yourself with either.

Science Mom, I am getting convinced that Jen has stock in a hospital supply company.

The-Cynic, you are correct. It does seem to be the standard tactic of many anti-vaxers. It looks like Kelly wanted this thread to be all about her, and it was never her intentioned to have her questions answered. Especially since she is ignoring those answers.

There is no way to have an honest discussion when one side is being deliberately obtuse and/or dishonest. The only hope is to sway the fence sitters.

Finally made the decision and killfiled jen (I hope she enjoys being with Sid and Augie). She never has anything new to say and never learns from what we have pointed out.

I, too, thought Kelly wanted a discussion. But she clings to her interpretation of the VAERS database. She is obviously young, and had all the vaccines as a child so probably never knew anyone who had mumps, measles or rubella (I had all 3...).

Sure, chicken pox is generally a mild childhood disease. But sometimes it isn't so mild. And, while it's nice for the stay at home moms to not have to worry about the financial cost of not being able to work, for many families, having to take of 2-3 weeks after CP exposure to watch their kid (not counting the additional time if the child develops CP on day 21...) IS a big deal, so that "old pediatrician" she saw on TV is correct, the CP vaccine's benefit is, to a large extent, financial.

In fact, Kelly, the benefit of MOST vaccines is financial. Yes, they prevent a child and/or adult from catching a disease. But, more importantly, they are cheaper than the costs of the disease. 1 CP vaccine at approx $16/dose vs the financial cost to a household of losing 1 parent's pay for (let's be generous and have the kid break out 3 days after known exposure) 7 days lost income - maybe a few hundred dollars. Could be a HUGE deal for that family. And then, multiply that by the fact that the usual incubation stage for chicken pox is 14-21 days, and a child with CP is usually not allowed to daycare/school for another 7 days. Who can afford to lose a month's worth of pay? Oh, and, if there are other children in the family, who get sick AFTER child #1...perhaps 6 weeks?

I can recall when CP when through our house. My mom was dealing with sick children for 3 weeks. She didn't work at the time, so it didn't effect the family income. However, 20 years later, when I went through the same thing, the 3 weeks lost income (actually, pool time used up, so we could not take any vacations that year) was a big deal.

I wish the vaccine had been available 3 years earlier so my kids would not have had to worry about shingles in the future.

By triskelethecat (not verified) on 06 Nov 2010 #permalink

Triskelethecat, and what of the cost of all the autism, allergies,diabetes and other auto-immune problems? Not that we are sure if they are linked since you good people in the research field are doing your damnedest to either a) not study it (vacced VS unvacced study) or b) prevent any research that threatens the status quo to be published, or c) talk- up the shitty "safety studies" that do make it in the journals, I mean pharma publications.

Jen, look up the term: killfile

Oh, and exactly which hospital supply company do you have stock it?

No studies? REALLY?? A quick search on my EBSCO host subscription and I find 26 studies that directly corroborate the MMR vaccine study that Wakefield was doing. These are peer reviewed and multinational, independent studies.

1. Gastrointestinal abnormalities in children with autistic Disorder
2. Colonic CD8 and γδ T-cell infiltration with epithelial damage in children with autism
3. Intestinal Lymphocyte Populations in Children with Regressive Autism: Evidence for Extensive Mucosal Immunopathology
4. Immune activation of peripheral blood and mucosal CD3+ lymphocyte 3 cytokine profiles in children with autism and gastrointestinal symptoms
5. Antibodies to Myelin Basic Protein in Children with Autistic Behavior
6. Elevated Levels of Measles Antibodies in Children with Autism
7. Dysregulated Innate Immune Responses in Young Children with Autism Spectrum Disorders: Their Relationship to Gastrointestinal Symptoms and Dietary Intervention
8. EVALUATION OF AN ASSOCIATION BETWEEN GASTROINTESTINAL SYMPTOMS AND CYTOKINE PRODUCTION AGAINST COMMON DIETARY PROTEINS IN CHILDREN WITH AUTISM SPECTRUM DISORDERS
9. Autistic enterocolitis: Fact or fiction?
10. Clinical Presentation and Histologic Findings at Ileocolonoscopy in Children with Autistic Spectrum Disorder and Chronic Gastrointestinal symptoms
11. Phenotypic expression of autoimmune autistic disorder (AAD): A major subset of autism
12. Celiac Disease Presenting as Autism
13. Gastrointestinal Symptoms in a Sample of Children with Pervasive Developmental Disorders
14. Autism and Clostridium tetani.
15. Short-term benefit from oral vancomycin treatment of regressive-onset autism.
16. Alpha-1-antitrypsin, autism, and coeliac disease.
17. Malabsorption and cerebral dysfunction: a multivariate and comparative study of autistic children.
18. Colonic CD8 and gamma delta T-cell infiltration with epithelial damage in children with autism.
19. Small intestinal enteropathy with epithelial IgG and complement deposition in children with regressive autism.
20. Focal-enhanced gastritis in regressive autism with features distinct from Crohn's and Helicobacter pylori gastritis.
21. Intestinal lymphocyte populations in children with regressive autism: evidence for extensive mucosal immunopathology.
22. Immune activation of peripheral blood and mucosal CD3+ lymphocyte cytokine profiles in children with autism and gastrointestinal symptoms.
23. Increased serum levels of glutamate in adult patients with autism.
24. Gastrointestinal microflora studies in late-onset autism.
25. Real-time PCR quantitation of clostridia in feces of autistic children.
26. Differences between the gut microflora of children with autistic spectrum disorders and that of healthy children.

Ewww... titles. No indication of journal, or any kind of way to find them. None look like they even mention the MMR vaccine. Many could just be case studies (like #12). It is a pretty bad Gish Gallop.

Here is a better Gish Gallop:

Pediatr Infect Dis J. 2010 May;29(5):397-400.
Lack of association between measles-mumps-rubella vaccination and autism in children: a case-control study.
Mrozek-Budzyn D, Kieltyka A, Majewska R.

Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study.
Hornig M et al.
PLoS ONE 2008; 3(9): e3140 doi:10.1371/journal.pone.0003140
*Subjects: 25 children with autism and GI disturbances and 13 children with GI disturbances alone (controls)

Measles Vaccination and Antibody Response in Autism Spectrum Disorders.
Baird G et al.
Arch Dis Child 2008; 93(10):832-7.
Subjects: 98 vaccinated children aged 10-12 years in the UK with autism spectrum disorder (ASD); two control groups of similar age: 52 children with special educational needs but no ASD and 90 children in the typically developing group

MMR-Vaccine and Regression in Autism Spectrum Disorders: Negative Results Presented from Japan.
Uchiyama T et al.
J Autism Dev Disord 2007; 37(2):210-7
*Subjects: 904 children with autism spectrum disorder
(Note: MMR was used in Japan only between 1989 and 1993.)

No effect of MMR withdrawal on the incidence of autism: a total population study.
Honda H, Shimizu Y, Rutter M.
J Child Psychol Psychiatry. 2005 Jun;46(6):572-9.

No Evidence of Persisting Measles Virus in Peripheral Blood Mononuclear Cells from Children with Autism Spectrum Disorder.
DâSouza Y et al.
Pediatrics 2006; 118(4):1664-75
*Subjects: 54 children with autism spectrum disorder and 34 developmentally normal children

Immunizations and Autism: A Review of the Literature.
Doja A, Roberts W.
Can J Neurol Sci. 2006; 33(4):341-6
*Literature review

Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links with Immunizations.
Fombonne E et al.
Pediatrics. 2006;118(1):e139-50
*Subjects: 27,749 children born from 1987 to 1998 attending 55 schools

Relationship between MMR Vaccine and Autism.
Klein KC, Diehl EB.
Ann Pharmacother. 2004; 38(7-8):1297-300
*Literature review of 10 studies

MMR Vaccination and Pervasive Developmental Disorders: A Case-Control Study.
Smeeth L et al.
Lancet 2004; 364(9438):963-9
*Subjects: 1294 cases and 4469 controls

Age at First Measles-Mumps-Rubella Vaccination in Children with Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta.
DeStefano F et al. Pediatrics 2004; 113(2): 259-66
*Subjects: 624 children with autism and 1,824 controls

Prevalence of Autism and Parentally Reported Triggers in a North East London Population.
Lingam R et al.
Arch Dis Child 2003; 88(8):666-70
*Subjects: 567 children with autistic spectrum disorder

Neurologic Disorders after Measles-Mumps-Rubella Vaccination.
Makela A et al.
Pediatrics 2002; 110:957-63
*Subjects: 535,544 children vaccinated between November 1982 and June 1986 in Finland

A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism.
Madsen KM et al.
N Engl J Med 2002; 347(19):1477-82
*Subjects: All 537,303 children born 1/91â12/98 in Denmark

Relation of Childhood Gastrointestinal Disorders to Autism: Nested Case Control Study Using Data from the UK General Practice Research Database.
Black C et al.
BMJ 2002; 325:419-21
*Subjects: 96 children diagnosed with autism and 449 controls

Measles, Mumps, and Rubella Vaccination and Bowel Problems or Developmental Regression in Children with Autism: Population Study.
Taylor B et al.
BMJ 2002; 324(7334):393-6
*Subjects: 278 children with core autism and 195 with atypical autism

No Evidence for a New Variant of Measles-Mumps-Rubella-Induced Autism.
Fombonne E et al.
Pediatrics 2001;108(4):E58
*Subjects: 262 autistic children (pre- and post-MMR samples)

Measles-Mumps-Rubella and Other Measles-Containing Vaccines Do Not Increase the Risk for Inflammatory Bowel Disease: A Case-Control Study from the Vaccine Safety Datalink Project.
Davis RL et al.
Arch Pediatr Adolesc Med 2001;155(3):354-9
*Subjects: 155 persons with IBD with up to 5 controls each

Time Trends in Autism and in MMR Immunization Coverage in California.
Dales L et al.
JAMA 2001; 285(9):1183-5
*Subjects: Children born in 1980-94 who were enrolled in California kindergartens (survey samples of 600â1,900 children each year)

Mumps, Measles, and Rubella Vaccine and the Incidence of Autism Recorded by General Practitioners: A Time Trend Analysis.
Kaye JA et al.
BMJ 2001; 322:460-63
*Subjects: 305 children with autism

Further Evidence of the Absence of Measles Virus Genome Sequence in Full Thickness Intestinal Specimens from Patients with Crohnâs Disease.
Afzal MA, et al.
J Med Virol 2000; 62(3):377-82
*Subjects: Specimens from patients with Crohnâs disease

Autism and Measles, Mumps, and Rubella Vaccine: No Epidemiological Evidence for a Causal Association.
Taylor B et al.
Lancet 1999;353 (9169):2026-9
*Subjects: 498 children with autism

Absence of Detectable Measles Virus Genome Sequence in Inflammatory Bowel Disease Tissues and Peripheral Blood Lymphocytes.
Afzal MA et al.
J Med Virol 1998; 55(3):243-9
*Subjects: 93 colonoscopic biopsies and 31 peripheral blood lymphocyte preparations

No Evidence for Measles, Mumps, and Rubella Vaccine-Associated Inflammatory Bowel Disease or Autism in a 14-year Prospective Study.
Peltola H et al.
Lancet 1998; 351:1327-8
*Subjects: 3,000,000 doses of MMR vaccine

Exposure to Measles in Utero and Crohnâs Disease: Danish Register Study.
Nielsen LL et al.
BMJ 1998; 316(7126):196-7
*Subjects: 472 women with measles

Immunocytochemical Evidence of Listeria, Escherichia coli, and Streptococcus Antigens in Crohnâs Disease.
Liu Y et al.
Gastroenterology 1995; 108(5):1396-1404
*Subjects: Intestines and mesenteric lymph node specimens from 21 persons from families with a high frequency of Crohnâs disease

Childhood vaccinations, vaccination timing, and risk of type 1 diabetes mellitus.
DeStefano F, Mullooly JP, Okoro CA, Chen RT, Marcy SM, Ward JI, Vadheim CM, Black SB, Shinefield HR, Davis RL, Bohlke K; Vaccine Safety Datalink Team.
Pediatrics. 2001 Dec;108(6):E112.

No studies? REALLY?? A quick search on my EBSCO host subscription and I find 26 studies that directly corroborate the MMR vaccine study that Wakefield was doing. These are peer reviewed and multinational, independent studies.

As far as I know, no one has been able to come up with a single study that may be considered an independent replication of Wakefield et al.

The titles of some studies can't be evaluated to see if they are independent replications. Matt, why don't you just name one (the best one in your view) that is clearly an independent replication, and we'll go from there?

@Matt

Interesting list. I picked 1 article from it to see if it met the criteria you gave it. You state "studies that directly corroborate the MMR vaccine study that Wakefield was doing."

"Autism and Clostridium tetani" Med Hypotheses. 1998 Aug;51(2):133-44. Bolte ER. PMID 9881820.

So right off the bat let's point out that MMR does not stand for C. tetani, tetanus or tetanus neurotoxin (TeNT) and the vaccine that confers protection from tetanus is not the MMR vaccine. So I'm not sure how a study on C. tetani and TeNT corroborate's Wakefield's vaccine work.

Had you read the abstract (tough, I know) you would have seen this statement in the first sentence "This paper outlines the possibility of a subacute, chronic tetanus infection of the intestinal tract as the underlying cause for symptoms of autism observed in some individuals."

Note: it says tetanus infection. This has nothing to do with MMR. Also note that the tetanus vaccine uses a tetanus toxoid, it isn't whole cell and it's not live cell. Unless you disagree with the law of biogenesis it is literally impossible for the tetanus vaccine to cause a C. tetani infection.

Extra credit for the article being from Medical Hypotheses.

All in all, as a result of my meta study of this steaming turd you dropped on us, I found that you're either amusingly wrong or a liar, that your EBSCO search sucks and that you fail. Try harder next time.

@120

Also find examples of "iron lung" references in cartoons and such from the era before the polio vax. Use "fair use" provisions to excerpt a few seconds showing a character in an iron lung and then remind viewers that this was how it was before the vax.

Then inform audience that the many cases of bulbar poliomyelitis occurred as a result of the medical professions obsession with tonsillectomy and adenoidectomy i.e the removal of a portion of a child's immune system

By sid offit (not verified) on 06 Nov 2010 #permalink

@DT

The result was that pertussis re-emerged in Sweden, and in 1983 they had a huge outbreak with many deaths.

Define "many"

By sid offit (not verified) on 06 Nov 2010 #permalink

@Kelly

The CDC says my child has a .11 per 100,000 chance of contracting HIB.

Kelly, are you an Eskimo or living on an Indian reservation? If not you're probably safe

By sid offit (not verified) on 06 Nov 2010 #permalink

Going through Matt's list:

1. No mention of MMR.
2. No mention of MMR.
3. No mention of MMR, and Wakefield is one of the authors.
4. No mention of MMR, and Wakefield is one of the authors.
5. No mention of MMR.
6. Maybe. It needs to be replicated.
7. No mention of MMR.
8. No mention of MMR.
9. Two case studies, no mention of MMR.
10. It was in "Autism Insights", a vanity journal, it can be ignored.
11. Maybe. Same guy as #6. "Brain State International Research Center"? Oh, it is a bio-feedback company.
12. Just what I thought, a case study. No mention of MMR.
13. No mention of MMR. Oh, wow... kids with tummy aches are more irritable than kids not in pain. Alert the media!
14. Tetanus is not the MMR. Matt, look up what "hypothesis" means.
15. No Mention of MMR. Includes this in abstract: "Unfortunately, these gains had largely waned at follow-up."
16. From 1972, celiac is not the MMR. Also it is a UK study, they didn't even have the MMR then (it was introduced in the USA in 1971).
17. From 1971, no mention of the MMR.
18. No mention of MMR. Includes Wakefield as one of the authors.
19. No mention of MMR. Includes Wakefield as one of the authors.
20. No mention of MMR.
21. No mention of MMR, includes Wakefield as one of the authors.
22. No mention of MMR, includes Wakefield as one of the authors.
23. No mention of MMR.
24. No mention of MMR, which is not bacteria.
25. No mention of MMR, again which is not bacteria.
26. No mention of MMR, again which is not bacteria.

Science Mom:

One guess where Matt got his Gish Gallup.

Which is pretty similar to here:
http://www.callous-disregard.com/research.htm

I repeat, you cannot have a discussion with people who are dishonest.

Oh, and pertussis in Sweden: Marked decline in pertussis followed reintroduction of pertussis vaccination in Sweden.

In the most recent epidemic year (1994) 13 142 cases of culture confirmed pertussis were reported, compared with 1463 in 1998. The overall incidence of pertussis in Sweden (per 100 000 population) rose from 113 and 132 in 1992 and 1993, respectively, to 150 in 1994 then fell in successive years - 121 in 1995, 86 in 1996, 40 in 1997, and 16 in 1998. The age specific incidences for 1992-95 and 1998 are given in figure 1.

I would be very interested in seeing Matt go through his own list and justify their inclusion. It seems as though he has no idea what his own list talks about.

BTW: did you lie when you said you searched EBSCO host yourself? I found this exact same list posted in May 2010 here:
http://beyondvaccination.com/archive/index.php/t-1900.html

So either that was you posting it then or one of you is copying the other. Though I think it is likely you both found the list elsewhere and simply parroted it. Either way, it must have been a terrible search seeing how little relevance they have on this topic.

Matt, one more thing. You should remember that many of us here are familiar with academic journals. No one will be amazed if you say you searched EBSCO Host yourself to find articles. Especially when it looks like you do no such thing.

Geez he even fails at the gish gallop since it took me all of 5 minutes to completely trash 1 of his items and Chris covered them all in like 2 hours.

What's interesting is how the idiot antivaccine crowd think they can just lie (stupidly at that) and the rest of us will just go "oh ok you're right I guess". Like what does someone think they'll accomplish with something that idiotic?

JohnV:

Chris covered them all in like 2 hours.

While watching a DVD on my laptop on this dreary rainy day.

Then inform audience that the many cases of bulbar poliomyelitis occurred as a result of the medical professions obsession with tonsillectomy and adenoidectomy i.e the removal of a portion of a child's immune system

Please provide citations for claims like that. I could just as easily say that most of the cases of autism these days are due to your practice of sorcery.

By Gray Falcon (not verified) on 06 Nov 2010 #permalink

Well Chris, I do agree with you that I have done exhaustive research on the topic on my own time, reading all sorts of biased articles from both extremes here, and at this point there probably isn't much that could be said that could change my mind. I have already decided what vaccines I think are necessary for my kids and which one's aren't. BUT there hasn't really been any attempt to "educate" me on anything. I asked very specific questions that I honestly still would like answers to but haven't received any. Again, why hasn't Japan reinstated the MMR? Where is the data that shows numbers regarding adverse reactions to each vaccine annually? And most importantly, in dealing with the topic of the article, where is the evidence that points to the assumption that these bogus anti-vax websites are having a real effect on parents' decision not to vaccinate? Where are your citations that show the number of these website followers that are not vaccinating across the board? What study do any of you have in regards to parental reasons for opting out of vaccinations? Since I did give a cited source-the oxford journal study I provided a link to- to actually show you what concerns parents who choose not to vaccinate- I am just wondering if you took a look. I mean, since you want to criticize parents, I would think you would first want to know what your criticizing them for. If it doesn't matter what their reasoning is, which I suspect it really doesn't, than your little group of blogging scientists or doctors or whatever you are, are no more helpful or ethical than those your criticizing. But hey, maybe my writing is too nonsensical for you to grasp what I am saying here.
And your right, the fact that my husband makes a shit-ton of money that allows me to stay home and sit on my ass all day trying to make the right health decisions for my kids does play into the scheme of things. And luckily he makes enough money that I can feed them organic food and buy them organic clothing too.
Since some of you believe the right to decide whats best for children should not belong to their parents, I wonder who then, would do a better job. The government? I mean, they've obviously been doing so well with their current responsibilities. Oh, how about Pablo, who apparently isn't too emotionally vested to be rational or reasonable. Or the infallible medical community? What kind of socialist, communist, or dictatorship are we talking about here? While you may think I don't have the intellect required to make an informed decision regarding my children then who do you think would do a better job? I don't understand why your community of scientists have to resort to such demeaning dialogue if you actually have the proof and evidence that the risks of disease outweigh the risks of vaccines.
And if it is narcissistic to do what's best for my child, then thats not an insult, but nice try.
The fact is that most of you want to pick apart every argument I make without trying at all to grasp the bigger picture of what I have been trying to say since I first commented. Which is that parents should be given credit for being skeptical. The bottom-line is that it is our right to decide whats best for our kids and threats, name-calling, and insults will only put up a wall between the med community and those parents. I also suspect that as this happens, more and more parents will be opting out of vaccinating their kids.

Oh, and Chris, while I'm not so much offended by your constant referral to my lesser intellect- as I suspect you probably hold this opinion of anyone who doesn't come to see things your way- I do hope that you at least realize through my persistence on this blog that I do actually care about my kids, and this topic is important to me. I care enough to at least try and look at all sides reasonably (even if I haven't done a good job at it). I believe that when it comes to most people, their kids are the most important aspect of their lives and to assert that they are merely falling for the first line of fear-mongering they hear is probably absolute bullshit.
And yes I am young, 28, to be exact. But my mother isn't and she agrees with me, so does my grandmother

Kelly if you're willing to admit there's little to change your mind, why should any of us bend over backwards to placate you?

Actually, Kelly, I was not referring to your lack of intellect but lack of education. Look up both words in the dictionary, they mean different things.

Also, I called you a liar. From now on if you make an assertion (like the rotavirus vaccine being fatal) it will assumed you made it up unless you provide references.

Kelly:

Again, why hasn't Japan reinstated the MMR?

Which version? Show that you actually read the replies and tell us what is the major difference between the Japanese MMR and the American MMR.

It is tiresome to answer your repetitive questions when you show no willingness to actually read the responses.

Uh, first off nobody has bent over backwards, they have merely challenged just about every sentence I have posted, and sorry I didn't realize that asking for YOUR citations was asking you to bend over backwards.
And Chris, whether you say intelligence or education, we both KNOW your implication. But really, I don't know who you think you are. I need to give you references for all my assumptions? REALLY? or else I'M a liar? Well, then I fit right in on this blogsite. Where are the references I have asked for? Oh, i don't get those b/c you don't have to go out of your way to try and convince someone who can't be convinced. Meanwhile your so open-minded.
Chris, I am starting to really doubt YOUR education and intelligence since you keep saying I said the rotavirus vaccine is fatal. Please site that because I never said it. I stated that bowel obstruction in infants can be fatal. It often is BTW and I'm not even going to entertain the assertion by you that maybe it isn't. I did get the number of cases wrong though, so thanks for correcting that error, however, I stand by my implication that in my view, the initial rotavirus vaccine caused more injury to its recipients than the possibility of a serious complication from contracting rotavirus. Even if those children were lucky enough not to be killed, I doubt anyone would think bowel surgery in an infant is not a severe side effect.
I am sure at this point that I am letting my argumentative nature get the better of me, since we both know there is no point in continuing a discussion. However, if I had another free hour or so, I could list the numerous assertions without reference that you have made in your posts. For one, your assertion that I am not as educated as I say certainly can't be proven by you, and your assertion that I am a liar for asserting something I didn't assert just makes you a really bad reader. Oh, and lets not forget what that leads to: being "misguided".
Ok, I really am done now - before my husband does a scienceblog intervention

I'm afraid I haven't gone through all the comments, so I don't know if this has been suggested, but I'm betting not.

I think the proper way to respond to people who say you are taking away their freedom with "mandatory vaccinations" is to agree with them. Yes, we are doing that, yes it might kill you (or your child, your INFANT!) but it will prevent the spread of communicable disease, so we don't care. Trying to convince them they need to be vaccinated for their own benefit isn't working because it is a lie. Public vaccination is for the protection of the population threatened by epidemics, not the individual threatened with infection. (The probability of any one person catching any one disease is actually very low, even for diseases which were great scourges and have killed millions. Those millions died over decades, not all at once.) Owning up to that, teaching people the truth of it, is the only way, ultimately, it will work. Convincing the most misinformed to get vaccinations can potentially be a luxury we can't afford, so I don't think we should use it as an opening gambit. Acknowledging that, yes, this is one of those times when the government is doing the right thing coercing the population, hell, just being able to acknowledge that there is such a thing as a circumstance in which the government "coercing" the population (also known as governing) is a good thing, will be more powerful than you realize, once you get over your own self-conscious uneasiness with the principle.

It really figures that someone like Kelly would be feeding her kids "organic" food. Typical yuppie household- questioning the scientific evidence for one of the most successful medical interventions in the history of humanity, but has no questions for the organic food scam and its complete lack of scientific evidence.

Just surprised she hasn't pulled out the old naturalistic fallacy yet. Comeon, Kelly, please provide a post about how hunter-gather society lived in peace with nature, had huge lifespans (hint: throw in a post w/ biblical reference), and never got cancer (hint: throw in mummy evidence). Then go on to claim modern science and chemicals are responsible for the world's fall from the golden ageTM.

By Agent Smith (not verified) on 06 Nov 2010 #permalink

I'm afraid I haven't gone through all the comments, so I don't know if this has been suggested, but I'm betting not.

I think the proper way to respond to people who say you are taking away their freedom with "mandatory vaccinations" is to agree with them. Yes, we are doing that, yes it might kill you (or your child, your INFANT!) but it will prevent the spread of communicable disease, so we don't care. Trying to convince them they need to be vaccinated for their own benefit isn't working because it is a lie. Public vaccination is for the protection of the population threatened by epidemics, not the individual threatened with infection. (The probability of any one person catching any one disease is actually very low, even for diseases which were great scourges and have killed millions. Those millions died over decades, not all at once.) Owning up to that, teaching people the truth of it, is the only way, ultimately, it will work. Convincing the most misinformed to get vaccinations can potentially be a luxury we can't afford, so I don't think we should use it as an opening gambit. Acknowledging that, yes, this is one of those times when the government is doing the right thing coercing the population, hell, just being able to acknowledge that there is such a thing as a circumstance in which the government "coercing" the population (also known as governing) is a good thing, will be more powerful than you realize, once you get over your own self-conscious uneasiness with the principle.

Don't worry, Kelly, if they can't change your mind then they want to fit you into a box of some sort, like Agent Smith just did. And Chris has a superiority complex bigger than her ass-which must be huge from sitting around doing all that paid blogging, although she is very,very,very,very (there are not enough verys to describe how very) educated. nobody is quite as educated as Chris. Same with science mom ;)

Ultimately, I think the only way is to teach people just how bad the diseases used to be -- that at one time, kids dying young was almost *expected*...

How to get that information out there, though...

By intercostal (not verified) on 06 Nov 2010 #permalink

Also find examples of "iron lung" references in cartoons and such from the era before the polio vax. Use "fair use" provisions to excerpt a few seconds showing a character in an iron lung and then remind viewers that this was how it was before the vax.

I'm afraid I haven't gone through all the comments, so I don't know if this has been suggested, but I'm betting not.

I think the proper way to respond to people who say you are taking away their freedom with "mandatory vaccinations" is to agree with them. Yes, we are doing that, yes it might kill you (or your child, your INFANT!) but it will prevent the spread of communicable disease, so we don't care. Trying to convince them they need to be vaccinated for their own benefit isn't working because it is a lie. Public vaccination is for the protection of the population threatened by epidemics, not the individual threatened with infection. Owning up to that, teaching people the truth of it, is the only way, ultimately, it will work. Convincing the most misinformed to get vaccinations can potentially be a luxury we can't afford, so I don't think we should use it as an opening gambit. Acknowledging that, yes, this is one of those times when the government is doing the right thing coercing the population, hell, just being able to acknowledge that there is such a thing, will be more powerful than you realize, once you get over your own self-conscious desire to be free of government coercion.

Jen if you're unable to prove you don't have a financial interest in the perpetuation of vaccine-preventable disease(or the promotion of the perpetuation of vaccine-preventable disease) why should anything you say have merit?

Also are you trying to be ironic by saying the rest of us will put people in a box then following it up with your standard "anyone who disagrees with me is paid by a drug company" routine?

Also are you trying to be ironic by saying the rest of us will put people in a box then following it up with your standard "anyone who disagrees with me is paid by a drug company" routine?

Jen is such a caricature of the typical, hysterical, obtuse anti-vaxxer, that I'm going to go with pro-vax shill. I mean can anyone with her inept diatribes think that she is lending any credibility to the anti-vax crusade?

I asked very specific questions that I honestly still would like answers to but haven't received any. Again, why hasn't Japan reinstated the MMR?

http://www.ncbi.nlm.nih.gov/sites/entrez/19209099

As I explained, it appears to be a business protection decision, rather than a response to the actual epidemiology of measles, mumps and rubella. All three are alarmingly high in prevalence there.

Where is the data that shows numbers regarding adverse reactions to each vaccine annually?

Kelly, these are statistics that are published as population-based, rather than annually. For a summary, with references, you can visit here: http://www.sciencebasedmedicine.org/?p=186

And most importantly, in dealing with the topic of the article, where is the evidence that points to the assumption that these bogus anti-vax websites are having a real effect on parents' decision not to vaccinate?

Again, here: http://www.sciencebasedmedicine.org/?p=8007#more-8007

Where are your citations that show the number of these website followers that are not vaccinating across the board?

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5936a2.htm?s_cid=mm5936a2_w

And if you click on my name after tonight, I will have a new blogpost up that goes into some more depth on this.

I couldn't read every single post, but no one seems to have refuted (refudiated for all you Caribou Barbie fans) Kelly's autism numbers. Two words explain the "epidemic:" diagnostic substitution.

I used some handy graphing at Thoughtful House, of all places, and some data from the US Census, and have found the following.

In 2000 there were 637,876 diagnoses of mental retardation in the US (ages 3-22) and 93,650 diagnoses of autism. By 2008, there 337,795 diagnoses of autism! Holy epidemic, Rainman!

Not so fast. In 2008 there were only 488,534 diagnoses of mental retardation. Wow, we won the war on mental retardation. So in 2000 there were 731,526 diagnoses of mental retardation + autism and in 2008 there were 826,329 (again for ages 3-22). The population growth for that age group was 4.1% for that time and the diagnoses increase was 13.0%. So, yes, there's been some growth, but it is not the epidemic it's made out to be. Much of that growth is probably due to broadening of the diagnostic criteria.

To use an analogy, nobody dies of consumption anymore, but people do die of tuberculosis.

By The Gregarious… (not verified) on 06 Nov 2010 #permalink

Yeah, I guess Kelly isn't much for reading the responses.

Let us review what she said about rotavirus:

rotavirus killing 500,000 children annually. Well, if you go to the CDC's website and look for a number of fatalities among American infants, there isn't one.

and

I do know the FDA pulled the first rotavirus vaccine in 1999 for causing bowel obstruction in infants. That is incredibly fatal by the way and there were at least 23 confirmed cases.

... followed by:

And I have yet to hear any acknowledgement that yes, the rotavirus caused fatal bowel obstruction in children when it was thought to be safe by the medical community.

Which I interpreted as the rotavirus vaccine, since the disease actually causes death by dehydration.

Okay... she said the vaccine was dangerous for causing fatal bowel obstruction. She was corrected by both the number, and lack of fatality. So she decided to reinterpret what she wrote. That is considered dishonest.

As far as not finding out how many kids died from rotavirus, she didn't look very hard. From the Pink Book Chapter on Rotavirus it clearly says:

In the prevaccine era rotavirus infection was responsible for more than 400,000 physician visits, more than 200,000 emergency department (ED) visits, 55,000 to 70,000 hospitalizations each year, and 20 to 60 deaths. Annual direct and indirect costs were estimated at approximately $1 billion, primarily due to the cost of time lost from work to care for an ill child.

So that averages to forty deaths a year. But it is not trivial. Is she thinking that the only bad outcome can be death? Dehydration can cause all sorts of problems, why would she think that is trivial.

Also, she has not answered the difference between the American MMR and the one that had been used in Japan.

As for Jen, she made this gaff a few days ago here:

What a pile of crap. vaccines are causing more problems than they are helping. Who pays for all this âseed mediaâ stuff? Pharmacy?

Somehow she thought the Sciblogs site in New Zealand was Scienceblogs. She is pretty funny. Always putting in little fact free quips with the Pharma Shill Gambit for flavor.

Just to clarfiy Chris's quoting of Kelly above, so there's no question about Chris's interpreting that Kelly meant the rotavirus vaccine, not the disease, here's more of that paragraph:

It makes the risk of the vaccine higher in my eyes. And I have yet to hear any acknowledgement that yes, the rotavirus caused fatal bowel obstruction in children when it was thought to be safe by the medical community. While that doesn't mean all vaccines are unsafe it does mean that human error has to be factored into a risk assessment, and the medical field is far from absence of human error.

This was Post 125, Posted by: Kelly | November 5, 2010 8:49 PM

Yes, Kelly, you did say it, and yes, you were wrong about it.

[I'm relatively new to the discussions here, but I thank you for giving me an indication as to which side of the sane/nutcase area you fall into.]

Post #143 Augustine is another imposter Augustine. Deceit is a strong suit of pharma.

By augustine (not verified) on 07 Nov 2010 #permalink

I posted earlier with answers to some of Kelly's questions but it seems to be hung up in the spam folder because it had 3 links. If it doesn't show up in a spell, I will re-post.

augustine: "Post #143 Augustine is another imposter Augustine. Deceit is a strong suit of pharma."

But which augustine posted this comment?

Paranoia
Will destroy ya.

By Mark o' The Beast (not verified) on 07 Nov 2010 #permalink

- Post #143 Augustine is another imposter Augustine. Deceit is a strong suit of pharma. -

You're not a big fan of using actual science to back up your claims, are you? Much easier to just call the other side a liar.

By C. Sommers (not verified) on 07 Nov 2010 #permalink

@191

That's pretty much his MO.

Parents aren't vaccinating their kids against hepB at birth, are continuing to try and take their kids to pox parties, and aren't vaccinating against HepA or Rotavirus because as parents born in the late 70's or in the 80's, we never got those vaccines and we never knew anyone who had serious complications from those illnesses. We got hepB prior to adolescence and so that still seems appropriate to us. We don't believe HepA or chickenpox is the next polio so while we have no scientific evidence to support our belief that the vaccine is more harmful than the disease, we also have no long-term studies proving it isn't. What we do know is that chickenpox isn't scary. While it may be uncomfortable we are hoping our kids get it young and don't remember having it, like we did. If I were traveling overseas with my kids when they were infants I would have given them the rotavirus vaccine. I actually did give my first child the first two doses because I hadn't researched it prior to that. When I was a kid I got Rabies inoculations because I lived in Egypt for a few years. Rabies is a threat there, that doesn't make it a threat here. I think a lot of parents probably feel that way about some of these vaccines. And I suspect that some parents wonder if the medical community would ever admit that there are too many vaccines on our infant's schedule, as I'm positive that by the time my children are having children there will be many many more. As for parents who aren't vaccinating across the board, I would hope that they aren't really getting their info from naturalnews or mercola.
Sciencemom-thanks for the links. I actually liked the article with the amanda peet reference even though I still don't understand the need professionals feel to be degrading to parents. His bias also is, I'm sure, the reason he didn't list all the adverse reactions and corresponding numbers. Because while some people may believe a 1 in 20 chance of my infant contracting a fever over 99.9 is no biggie, I don't take it lightly. And I still think the oxford journal study did a better job of assessing how parents were coming to the conclusion to not vaccinate. The last link didn't prove anything in regards to those bogus website followers. All it looked like to me was that you all are the ones blowing this whole Anti-vax movement out of proportion.
Tmax01 is on to something though. At least it's an honest post, I mean, basically I've been attacked for my views since I began posting my comments. Most of you seem interested in only trying to shame parents into agreeing with you and since that probably isn't going to work-I mean it isn't working-than the best you can hope for is legislation that forces parents to vaccinate their children. Since that's as likely as the government legalizing marijuana I guess you all can continue on your rants with your narcissistic attitude that allows you to be so delusional as to think you may actually be able to one day make health decisions for everyone.
Until that day, I will continue exercising my parental rights to the fullest degree without having to convince any of you to agree with me :)

@Kelly,
I think you have been "attacked" because you came here with some very incorrect views about vaccine reactions/vaccinations, and despite clear and incontrovertible evidence that you were mistaken (eg rotavirus, or views on Japanese MMR) you have failed to acknowledge you may be wrong, but instead just serenely move onto another topic, shifting goal posts without a care in the world.

dt, I have stated numerous times since starting my comments that I have been wrong, actually. And what's really interesting about the whole Japan thing is I never actually made any argument in regards to the fact that they don't have the MMR on their vaccine schedule, I simply pointed to the fact that their medical community obviously has a different opinion of that vaccine. I don't know, nor did I assert to know, whether their opinion was right or wrong. So I'm not sure what I was mistaken about there. The rotavirus vaccine-I believe- is too risky to give to my stay-at-home child because of its history, and the low risk-I believe-my child has of contracting the rotavirus, and the low risk-I believe-my child has of sustaining a long-term negative side effect if she did in fact contract the rotavirus. I never came on the post to ARGUE that I was factually or scientifically correct in my decision to selectively vaccinate my kids. My argument was that I don't think parents who are choosing not to vaccinate are doing so simply because of anti-vax websites that are obviously biased. Then, I proceeded to say that I made my decision based on info I obtained from the CDC, WHO, and VAERS- since then, I have been attacked for my interpretations of that info. Therefore, It is obvious that the bloggers here don't actually care what reasons or info people are using to decide against certain vaccinations, they only care to try to criticize parents regardless of where they get their information. That's why the article itself is meaningless.
Oh, I did state that Japan received and continues to receive harsh commentary from the U.S. medical community for their decision not to add MMR but I didn't make any judgement based on that statement. Then I asked why they didn't reinstate the MMR.

The rotavirus vaccine-I believe- is too risky to give to my stay-at-home child because of its history, and the low risk-I believe-my child has of contracting the rotavirus, and the low risk-I believe-my child has of sustaining a long-term negative side effect if she did in fact contract the rotavirus.

While rotavirus is an optional vaccine and while your conclusion may not be wrong, how you reached that, is. Your child WILL get rotavirus by the age of 5 years old. Staying at home is not a factor for preventing this. Extended breastfeeding may help attenuate or postpone rotavirus disease is something that should be weighted. I just don't want you to believe that your child won't contract this, it's a question of when and how bad.

Oh, I did state that Japan received and continues to receive harsh commentary from the U.S. medical community for their decision not to add MMR but I didn't make any judgement based on that statement. Then I asked why they didn't reinstate the MMR.

Japan is receiving harsh comment because they are allowing 1/1000 that contract mumps become deaf and because babies are being born with congenital rubella syndrome and they are exporting measles all over the place. This all because they don't want (in all likelihood) to allow a 'foreign' vaccine on the market, even though they have good safety and efficacy profiles and certainly superior to what they had in the past.

This is peripheral to the vaccine refusal discussion that you may find of interest: http://www.jmir.org/2005/2/e17/

Parents aren't vaccinating their kids against hepB at birth, are continuing to try and take their kids to pox parties, and aren't vaccinating against HepA or Rotavirus because as parents born in the late 70's or in the 80's, we never got those vaccines and we never knew anyone who had serious complications from those illnesses. We got hepB prior to adolescence and so that still seems appropriate to us. We don't believe HepA or chickenpox is the next polio so while we have no scientific evidence to support our belief that the vaccine is more harmful than the disease, we also have no long-term studies proving it isn't. What we do know is that chickenpox isn't scary.

You're misinformed, based on misinformation. No one is saying "hepA or chickenpox is the next polio" (except you) it's just that we would rather that children didn't get these disaeses. And we have the means to make sure they don't.

It's called vaccination.

And yeah, you think it's not that serious, after all, these disaeses are (quite by coincidence, eh?) rarer so...
Look I'm 52 now. I had measles when I was 8 - and can still remember the panic of my parents, the darkened room and so forth, but for me what was much worse was getting chicken pox in my early 30s (didn't get it as a child).
Now that was nasty. I was ill for about 3 weeks, and still bear the scars: also, I may get shingles later, and might even, like my grandfather, never get over it.
You want to put your children through that?
Yes, you do - 'cos it's natural, yeah?
You may not be stupid, Kelly, but you are ignorant, misinformed, and wrong.

I hope your children don't suffer through your inability to understand medicine. I fear the worst though.

Sciencemom, yes I read the link you sent, and if I lived in Japan I would absolutely want my children to get the MMR vaccine. In fact, they are all getting it anyway. But, I didn't bring up Japan in any attempt to say that since they don't implement it, we shouldn't either. Never said it. And yes, I realize the rotavirus is carried all over the place, and I too hope when they come into contact with it they will fight it off without issue.
AnthonyK, many bloggers have used the success of the polio vaccine to try and make some sort of connection to the importance of all vaccines. They have also stated if they could convince people of how deadly it was, as if anyone doesn't know, then we would concede that all vaccinations were as important. Thats where my statement stems from. Also, I previously stated that my children will most likely end up getting the chickenpox vaccine prior to entering school, because I suspect they will not contract the disease with the high rates of vaccination. I realize chickenpox is scarier in adulthood and no, I don't want my children to contract it later on. I too, hope my children don't suffer through my inability to understand medicine.

Kelly, thank you for finally presenting some of your views in a logical and coherent way.

I think the reason you were "attacked" is because although I think your comments over the last few days included some important points, you shot yourself in the foot with your presentation.

If your major concern is about side effects to vaccines beyond whatâs listed under âMild to Moderate Side Effectsâ by the CDC, donât mention autism. If it's not an issue for you, don't bring it up. And avoid parroting anti-vaccination arguments (my emphasis):"more vaccines that are added to the already packed schedule." Using the âtoo many too soonâ theme suggests you are included among the unreachable.

Stick to the issue that is important to you. I personally agree with you on one point (and I hope I'm not putting words into your mouth): parentsâ concerns about real side effects of vaccines do not get the attention needed. However, even in spite of the fact you think they're unimportant, it's the fact that the anti-vaccination movement generates so much noise that real concerns end up dismissed. And we already know that trying to ignore the anti-vaccination movement will not make them go away.

The other problem you had is some of your arguments came out so confused I at least could not figure out what you were talking about (was it rotavirus or HiB with the 1 in 20 fever risk?), plus you presented some information that was factually wrong. If you want to participate in a dialog, please listen as well as talk. And when you find that maybe you've misconstrued something, be gracious while backing down.

I hope you continue to participate here. You don't have to agree with everything everyone says to make a positive contribution. And I think you've already found that you might learn something from some of us, too.

Kelly @193:

I don't see how you can argue both that a 1 in 20 chance of a fever >100°F is a big deal, and that the certainty of chicken pox, whose symptoms include a significant chance of fever between 100 and 102°F, isn't scary.

Sure, with luck the child won't remember the chicken pox. They're also unlikely to remember the fever that they have a chance of getting with the vaccination, because people remember more of what happens at age 4 or 5 than at 12-15 months. (I'm using 5 as an example because I didn't have a fifth birthday party because I had the chicken pox.) And because a fever is less memorable than a fever and several days of severe itching.

Kelly, I do have a question for you:

The rotavirus vaccine-I believe- is too risky to give to my stay-at-home child because of its history

Which rotavirus vaccine and which history? Once again, you've left me confused.

Vicki, I suppose the reason I am scared of those vaccination induced fevers is due to my personal experience with my daughter's post HIB vaccine fever that quickly escalated to 104 in less than 24 hours. That doesn't mean the fever induced by chickenpox doesn't worry me either, and it doesn't mean that I'm not continuing to vaccinate her or my other children. With the chickenpox vaccine in particular, it does seem risky to me due to the fact that its relatively new. While I'm expecting that this comment is going to trigger all sorts of nasty comments about scientific evidence, citations, and so forth, I don't like that some of these vaccines have no long-term studies. I will state clearly right now that I have NO scientific-based reason for that other than the issue with the rotavirus vaccine being recalled by the FDA in 1999. I mean, they obviously didn't know before they started giving it to millions of children that it was going to cause a serious bowel twisting issue. And is there a possibility that a vaccine could become contaminated with an animal virus that could be potentially harmful to infants or adults? I am obviously asking because of the recent benign pig virus found in one of the two brands of the rotavirus vaccine. That causes me concern as well, even though again I don't know if that's a legitimate concern, I'm pretty sure there aren't many people here who think any vaccine concerns are legitimate though.

Kelly: Visualize paragraphs. A line space between them would reduce the very hard to read "wall of text" effect. Also think about reading the links provided.

Your questions on the extra bacon in the oral vaccines are answered in the podcast and blog writings here: http://www.virology.ws/?s=rotavirus

Chemmomo, I believe any Rotavirus vaccine currently available (I believe there are two) is not necessary for my child/children. When I said its history I meant the history of the initial rotavirus vaccine, which yes is different, but I find the fact that any vaccine could potentially be put on the market to be used in infants before it was tested enough to know whether or not a baby's bowel would fold in on itself makes me nervous regarding any new vaccines. So when I am more skeptical of vaccines like rotavirus, hepA, or chickenpox, it is because I'm not convinced there is adequate testing that ensures something like what happened with rotashield (i think that was the initial one) will happen again. Therefore, in my view, giving my child a newer vaccine is inherently riskier. I'm certainly open to any evidence that my fear of vaccine "newness" is misguided.
If I have unclearly stated my views on this blogsite it may be due to the fact, at least, initially, that my intention wasn't to argue that being selective or not vaccinating was either right or wrong. Also, being fairly unfamiliar with scienceblogs.com, I wasn't expecting the onslaught of criticism.

Thanks Chris, but I already read those I think, unless of course I'm missing the article that discusses whether or not the possibility that a vaccine could be contaminated with a harmful virus was overlooked by me. I see that GSK has determined they will be making the vaccine differently, since their's is the vaccine that contained the intact virus, but that Merck has not yet decided whether or not they will be making a bacon-free vaccine.

I already knew the virus was found to be benign from reading about the suspension initially. My question is whether or not that virus could have been potentially life-threatening. Did we just get really lucky?

And while visualizing paragraphs is a good suggestion, as I realize my posts are always lengthier walls of text, In my own defense I'm typing these responses rather quickly, as I'm attempting to do a few other things with my day as well, and I haven't actually ever posted comments on a blogsite before. I'm an incredibly inexperienced commenter. I know, I know, hard to believe.

Kelly, I've wiped out several other comments for you since I'm spending so much time composing them some of them have become irrelevant. I will add the new CDC link about rotavirus and intusseption:
http://www.cdc.gov/vaccines/vpd-vac/rotavirus/intussusception-studies-a…

I can understand being wary of "new" vaccines. But you put us into a catch-22. Exactly when does something stop being "new"? How much evidence do you need?

What I'm hearing from you is: since post-approval surveillance worked, and a vaccine was removed from the market before deaths occured, therefore, you can't trust any testing of any vaccine.
What the Rotateq story should be telling you instead is that when the FDA finds a problem, it addresses it. Therefore: if there's a problem with another vaccine, we will find it.

Another--very much related--question for you: under what (if any?) circumstances would you volunteer to participate in a clinical trial? For anything?

As for chicken pox: we disagree, and I have too many reasons for that to list here right now. Let's just say that you should not assume that just because you don't even remember having the disease when you were small does not mean it's not a problem.

And I'll close with the fact that I'm not one of those people who don't think there are any legitimate vaccine issues - but I do find interesting that we keep getting side tracked away from them.

I am noticing that, plus a bit of goal post moving. She seemed willing to learn, but has now back peddled. I have a feeling she is not being totally honest, even with the claim of a college education (her rhetoric is confusing, my high school daughter writes much better). She keeps repeating the same points that she was corrected on multiple times, and seems to think they might be relevant.

So you all still think my response was over the top?

Neh neh, I say. I pegged her right on. She is a typical "me first" anti-vax slime, right up there with sid and jay.

NOTHING pisses me off more than the attitude that I am the one who should sacrifice my child to protect theirs, but they needn't bother. But that's her.

I've certainly heard what she's said, and I'm not liking it.

She's not one of those on the fence. She is hardcore stuck.

Pablo, I don't think she is "antivax slime." I think she's a parent who witnessed a high fever after a vaccination, and has panicked over it. And that panic colors everything she thinks about vaccination (hence the confusion between HiB and rotavirus vax side effects). Which is understandable.

She admitted to avoiding "math classes like the plague all through college.â If so, she also avoided all science classes, as well, since--apart from the fullfil-the-science-distribution-survey-class--science classes require math. Algebra, at least. Keep that in mind, and cut her some slack here.

My impression is not that she's trying to shift the risks--just that she's overestimated the risks of the vaccine, and underestimated the risks of disease. This is because she witnessed the high fever post vaccination, and no one taking her fear seriously.

Sorry the previous post went up before I was done due to checking unrelated websites (OK, yeah, it was football scores).

The reason why she's overestimating the risks is that her child IS the 1 in 20 who got the fever from HiB - and it was *higher* than advertised (104 vs 101).

That doesn't make her "antivax."

She's not trying to get a free ride off of herd immunity if she believes her child is at higher risk from the vaccine than most other children (because of the previous incidence of high fever).

What we need to do is to help her assess the risks.
Please help.

We've been promoting Vaccine Awareness Week here in NZ too and our excellent Sciblogs site has done their very best, but as you will see, they're now enduring a barrage of insanity from a person so unhinged, he believes vaccination is a plot to wipe out humanity. Read it if you're feeling strong! http://sciblogs.co.nz/skepticon/2010/11/01/anti-vaccination-in-nz/

By NZ Sceptic (not verified) on 07 Nov 2010 #permalink

For those of you worried about shingles, you can relax because now you can get a vaccine against it. Some sort of varicella booster.

I think it's generally recommended for people over 50. I had chicken pox as a child (pre-vaccine, not refuser parents) so I am personally very glad of this!

@210

The post was a great read. Thanks for the link.

Novalox, that's a refreshing perspective, and I agree it's a great read (in a strange way) from a comic perspective, but here in NZ it's just a trifle depressing too. How can modern, educated people mangle science so badly?

By NZ Sceptic (not verified) on 07 Nov 2010 #permalink

As a general pediatrician who trained in the days before vaccines against pneumococcus and Hemophilus influenza were available, I am a big advocate for them and other vaccines that work incredibly well to protect children from preventable and potentially devastating infectious diseases. I can tell you from first-hand experience that we virtually do not see the cases of meningitis, sepsis, and other serious bacterial diseases that used to be commonplace. Now, as a socialist I have no illusions about either Big Pharma or corporations in general; I think distrust of Pharma is healthy. But it's entirely a sidebar. In fact, Pharma makes very little profit on vaccines and it is increasingly difficult to find manufacturers for promising vaccines. I think there are two areas to emphasize in the response to irrational opposition to vaccination in general. One is this: yes it does appear that the incidence of autism is rising (although even that isn't certain), but singling out increasing vaccine use as the culprit on its face makes no more sense than, say, blaming the increasing use of microwave ovens or Walkman-type stereos over the past two generations. Why not look to environmental pollution as a factor that actually has biological plausibility on its side? How about the fact that plastic baby bottles deliver a daily dose of Bisphenol A to newborns? That organophosphates have been linked to attention deficit disorder? Secondly: whatever you think about Big Pharma (and I probably share your view), pediatricians and other child health clinicians don't want to use unsafe vaccines, and in fact there is a track record of pulling vaccines off the market when post-marketing data have shown uncommon but convincing associations with adverse outcomes, for example the first rotavirus vaccine that was pulled off the market when it turned out that the incidence of intussusception was increased in vaccinated babies. This is standard practice. And there are volumes of carefully-collected and -analyzed data refuting any connection between autism and vaccines - this research is not just from the U.S. and some of the most convincing comes from the Scandanavian countries that do a far better job of public health than we do.

By Alan Meyers (not verified) on 08 Nov 2010 #permalink

I'm sure if the common cold vaccine had ever been successfully created (I believe research for that finally ended in the early 90's) then I would be sitting here defending myself against child abuse accusations for allowing my child to "suffer" needlessly through a cold when a vaccine is available. After all, 1% of cold victims suffer serious complications. Therefore, a few sacrificial children who suffer an adverse vaccine reaction is worth saving the 90 year old in the ICU who has come down with the common cold.

Obviously, this is an exaggeration-I don't quite underestimate the risks of the current vaccine preventable diseases quite that much, but where does it end? Where is the line scientists draw between considerable suffering and a stuffy nose?

Um, the only science course I took during college was an astronomy course. I found it rather enjoyable but it was mostly theory and little math. I did however, post college, take a few chemistry courses for my job as an I.V. and Narc Tech at the hospital I worked at. That did involve some math. Regardless, I don't really know how much evidence would suffice to make me afraid of HepA. Maybe a statistic that shows the number of children <5 in America that have been hospitalized or died from it?

@Kelly

I, too, am curious when the "new" label gets dropped from a vaccine. After all, the varicella vaccine has been available since March 1995 (that's 15 years on-the-market experience), with clinical trials on vaccine lots manufactured as early as 1982 (another 13 years of pre-market, in-human study). So we have 28 years of experience, at least, in humans. How many more years before it is no longer "new"?

This information is available from the FDA's web site here.

Please bear in mind that I can totally agree with the nervousness involved with "new" products. I feel the same way, sometimes, and it is quite hard to get past the emotion and look at the issue rationally.

Sorry, the number of children under age 5 that are infected in America. There are not enough numbers on the CDC sheets that allow a parent to calculate risks. Saying something is "very rare" means little to me since I don't know what numbers the CDC considers to be "very rare". I think if parents had better data to look at in regards to all vaccines and vaccine side-effects it would be helpful.

Also, if there are outbreaks in particular regions, that knowledge would be very persuasive as well. As far as I know, the HepB and HepA are given to children simply because there isn't enough compliance among adults to get vaccinated.

And as far as the vaccinating parent vs. the non-vaccinating parent, I think it would also be helpful if parents who didn't vaccinate understood why their unvaccinated children are more of a risk than all the unvaccinated adults. Doesn't the data show that there are a lot more adults not getting boosters than there are children not being vaccinated?

Obviously, this is an exaggeration-I don't quite underestimate the risks of the current vaccine preventable diseases quite that much, but where does it end? Where is the line scientists draw between considerable suffering and a stuffy nose?

There is no line. A proper risk/benefit analysis is far more complex. Let's take measles and the common cold as our examples, and assume for the sake of argument that efficacy is equal between the two vaccines.

The risks of measles include 1/20 chance of pneumonia, and 1/1000 chance of encephalitis. Say that the vaccine carried a 1/10000 chance of encephalitis (still much more than the actual risk). Would that be an acceptable risk? Yes, because the risks of vaccination are much less than the risks of the disease.

The common cold, on the other hand, doesn't carry risks anywhere near those of measles. A 1/10000 chance of encephalitis would therefore be entirely unacceptable; the benefits would be much less than the risks.

On the other hand, suppose that the vaccine for the common cold had, as its greatest risk, a 1/10M chance of, oh, having a runny nose for a week. Would that be acceptable? Absolutely.

So the idea of a "line" is really quite misguided, as even this grossly simplified example shows. In reality, it's a complex balancing act between the risks, costs, and efficacy of the vaccine vs. the risks associated with the actual disease. The greater the risk associated with the disease, the greater the risk associated with the vaccine may be and still remain acceptable.

Sorry, the number of children under age 5 that are infected in America. There are not enough numbers on the CDC sheets that allow a parent to calculate risks. Saying something is "very rare" means little to me since I don't know what numbers the CDC considers to be "very rare". I think if parents had better data to look at in regards to all vaccines and vaccine side-effects it would be helpful.

This is again an oversimplification. The number of infections is a strong function of the vaccination rate; ergo one cannot accurately consider vaccination side effects simply in light of current infection rates.

And as far as the vaccinating parent vs. the non-vaccinating parent, I think it would also be helpful if parents who didn't vaccinate understood why their unvaccinated children are more of a risk than all the unvaccinated adults. Doesn't the data show that there are a lot more adults not getting boosters than there are children not being vaccinated?

Irrelevant. Lack of adult compliance is its own problem and does not excuse not vaccinating children.

@Kelly

As far as I know, the HepB and HepA are given to children simply because there isn't enough compliance among adults to get vaccinated.

Re: HepB, while that is part of it, as I mentioned before, the increased risk of chronic infection in infants is also a motivating factor, since chronic infection is a near certainty in infants and puts the individual at risk for developing liver cancer and/or liver failure.

Kelly, in your mind and as you understand it, what are the risks associated with the HepB vaccine given at/near birth? How does this compare to the risks of infection with HepB, keeping in mind that the tests to check for HepB are primarily only done on the mother and are not 100% accurate?

Right, the only risk/benefit for scientists involve whether or not their is evidence that proves that if a vaccine can eliminate the common cold with the greatest documented risk being a week-long runny nose than in the scientists view the vaccine is the right thing to do. For parents, this doesn't account for the actual risks they perceive in vaccinations. Like, risk of human error. Like, risk of an unknown side effect due to vaccine newness. Like, risk of allergic reaction (which always exists).

The point is that just because there are risks that aren't quantitative, that doesn't mean those risks shouldn't be taken into consideration. So while a cold can certainly be made to look worse on paper, the reality is that we don't need a common cold vaccine. The fact that scientists didn't give up trying until the 90's to create one is, to a non-scientist, a little absurd. Imagine what those funds could have been used for.

Right, the only risk/benefit for scientists involve whether or not their is evidence that proves that if a vaccine can eliminate the common cold with the greatest documented risk being a week-long runny nose than in the scientists view the vaccine is the right thing to do. For parents, this doesn't account for the actual risks they perceive in vaccinations. Like, risk of human error. Like, risk of an unknown side effect due to vaccine newness. Like, risk of allergic reaction (which always exists).

PERCEIVED risks are relevant only insofar as they demand better educational efforts if they differ from the REAL risks. And yes, my example was oversimplified and disregarded risks that would actually exist in the real world; that's not the point. The point is that, if the risks are sufficiently small, then a vaccine even for the common cold can be quite reasonable. And indeed, it can become quite irrational NOT to get it, if those risks are small enough.

The point is that just because there are risks that aren't quantitative, that doesn't mean those risks shouldn't be taken into consideration. So while a cold can certainly be made to look worse on paper, the reality is that we don't need a common cold vaccine. The fact that scientists didn't give up trying until the 90's to create one is, to a non-scientist, a little absurd. Imagine what those funds could have been used for.

You are the ONLY person I've ever heard suggest that. In my experience, the overwhelming majority of people (scientists and non-scientists both) would LOVE a vaccine for the common cold. It may not kill, but it causes quite a significant amount of misery.

@Scott

Being in the tail end of a cold right now, I would be one of those who would appreciate never having a cold again.

@Kelly

I'm still interested in your response to my most recent post regarding newness.

two decades of research would make the vaccine no longer "new". When you change a recommendation from an older child receiving a vaccine to now a newborn (hepB), that makes the recommendation "new" and therefore, same risk of newness is involved. Also a problem for parents is that while in the last 20 years the rate of chronic childhood illness has gone up, there seems to be little scientific evidence pointing to any particular reason. Maybe obesity, but even that isn't being attributed to the hormones in animal products. So while everyone seems to want to deny deny deny that it has anything to do with their products, children are living but they are also suffering more and more.

Scott, its not really irrelevant if children continue to cease getting boosters into adulthood. The hope for disease eradication will go unfulfilled, and vaccinated children will still be susceptible. Pertussis is generally passed from older adults to children, not from child to child. I'm not saying it's an excuse to not vaccinate, I'm saying it would be helpful though, if you could prove to non-vaccinating parents that their children are actually creating a risk that is greater than the one that already exists. Such as, for example, the HIB increase and the measles outbreaks where pockets of unvaccinated children reside. Those are helpful. Attacking parents based on assumptions about their possible Jenny McCarthy admiration or mercola affiliations isn't going to be helpful.

Todd W., being skeptical of a product because it's new isn't merely an emotional fear. Are you suggesting that long-term studies of medications have no value then? I mean, the FDA already assures its safety when they put it on the market for public use.

@Kelly

two decades of research would make the vaccine no longer "new".

So, you would agree, then, that varicella vaccine is not "new". If you accept this, what are your remaining objections to the varicella vaccine at the ages recommended?

When you change a recommendation from an older child receiving a vaccine to now a newborn (hepB)

Actually, the change was not from older children to newborns, but from older individuals and newborns at high risk to older individuals and all newborns. We already know that the vaccine is safe in newborns, and the thought, before, was that by vaccinating only those at high-risk, we would have sufficient coverage to reduce morbidity of the disease. That turned out to not be the case. In expanding coverage to include those newborns who are not at high-risk, morbidity was found to decrease appreciably. This info, again, can be found on the CDC's site (I'll note, though, that I am going by memory, here).

Scott, I think its funny that I'm the only person you have heard who thinks a cold vaccine sounds absurd, when were basically discussing why so many parents don't think a tdap or HiB vaccine is necessary. If the CDC put the common cold vaccine on our infants' vaccine schedule tomorrow and you were shocked by the number of people skeptical or not vaccinating their children against it, then I would question your sense of reality.

Kelly,

We KNOW that children not being vaccinated increases the risk beyond what there would be if they were vaccinated. Somewhat to those around them, greatly to them. So while we ought to do better with adult vaccination, that (if anything) INCREASES the urgency of childhood vaccination because it increases the overall risk of getting the disease.

Also a problem for parents is that while in the last 20 years the rate of chronic childhood illness has gone up, there seems to be little scientific evidence pointing to any particular reason. Maybe obesity, but even that isn't being attributed to the hormones in animal products. So while everyone seems to want to deny deny deny that it has anything to do with their products, children are living but they are also suffering more and more.

I agree that perceptions are focused on vaccines as causal for these conditions. However, don't you think that is because the anti-vax organisations have been successful (along with the help of the media) at perpetuating this nonsense? There is, in fact, mounting scientific evidence suggesting causal factors that have nothing to do with vaccination. Can any rational person honestly think that childhood obesity is due to vaccinations even before consulting the scientific literature?

But these findings aren't very sexy so this information isn't disseminated, leaving people to wallow in their confirmation biases. This is where public health needs to be more proactive at effectively communicating actual risks and scientific evidence. But tell us how to do that in a manner that doesn't sound like denial? Why do you believe that it even is denial as opposed to information communication?

PERCEIVED risks are relevant only insofar as they demand better educational efforts if they differ from the REAL risks. And yes, my example was oversimplified and disregarded risks that would actually exist in the real world; that's not the point. The point is that, if the risks are sufficiently small, then a vaccine even for the common cold can be quite reasonable. And indeed, it can become quite irrational NOT to get it, if those risks are small enough.

@ Scott, I think that part of the problem is that something like Hep A gets added to the routine schedule for children, when it is actually a 'travel vaccine' and recommended for certain at-risk groups, namely adults and is not highly endemic, with a low rate of complications: http://www.wrongdiagnosis.com/h/hepatitis_a/prevalence.htm

And is very confusing to parents, particularly when they have never even heard of Hep A and suddenly it is given the same billing as Hep B or Hib or MMR, in their minds. Vaccination is still a medical intervention, and one administered to a healthy child so it becomes easy to see how and why risk assessment becomes very convoluted.

Todd W., yes I will agree that the varicella vaccine is no longer new. I am only opposed to that particular vaccine at the current recommendation because I am not afraid of my children contracting chickenpox, however, I am still timid about them suffering a side effect from the vaccine, same as I worry when I take them for the tdap that they may suffer a side effect. They will be getting the varicella vaccine prior to school-age but not before they are two. This is just based on my irrational worry that they may suffer some neuroimmunological consequence for no good reason other than to avoid some discomfort. Meanwhile, they are getting lots of other vaccinations against really scary things like meningitis, tetanus, whooping cough, and polio.

Sciencemom, I absolutely agree that if more vaccines are added to the schedule that parents find unnecessary, then they will not only begin to question those particular vaccines but will start to question all vaccines. Whether scientists think its rational or not, many parents view vaccines like they would any other drug or medication-as something that could be potentially harmful to their child. So there better be a really good reason for insisting that we inject them with it, especially at what we consider to be a vulnerable age. When the medical community starts to call a parent neglectful for refusing a hepA vaccine, it will inherently make parents question the rationality of the whole CDC schedule.

It is also, I agree, simply the causal relationship in timing that has some parents questioning whether vaccines are contributing to the growing number of chronic illnesses. But, I think the fact that anti-vax websites point that out repeatedly, is only because they know parents are already questioning if there is a relationship. I mean, the schedule has undergone a pretty rapid increase since I was a child and I wondered why that was as soon as I saw the schedule, not after reading about it from a website.

And I'm not suggesting those websites have no impact, I just suspect that the medical community is blowing their impact out of proportion. I think the fear of side-effects is the number one reason parents question the vaccine and the diseases. I think parents would fear risk of side-effects upon giving their child any drug.

Also, I think there is a big problem when it comes to dialogue in pediatrician's offices. Every time I had a question regarding a vaccine I was handed the same CDC fact sheets before being led out of the office. It made me feel like if my own pediatrician didn't have the answers then what was I vaccinating them for? Anyway, I found a new pediatrician who has been helpful. When I questioned whether the fourth dose of HIB was necessary, she gave me an article studying the increase in invasive HIB prevalence following the shortage. That changed my mind.

C. Sommers:

At this stage, on this blog, augustine's reputation for honesty is so shattered that if he claimed that the sun rose in the east, I would get up extra early on a clear day to check before I accepted his claim at face value. :)

Kelly - this is exactly the problem. I don't understand why you are more fearful of the side-effects than the actual diseases themselves?

So, you're fine with your kids getting the chicken pox or shingles (later in life) but don't want them to get a fever?

My son has had his fair share of colds, the flu, and plenty of fevers (including some pretty scary ones), but at least those are ones that I couldn't prevent. I can't control the actions of the other parents whose kids are in my childs' day care - I know that my son is going to be exposed to a variety of different bugs - but if I could prevent even one of them with a vaccine, it would be more than worth it.

I remember conversations with my grandparents about what their childhood was like - the quarantines, polio, measles, mumps, etc & each of them saw fiends that died before their time. They were always very happy that I or my child weren't going to live in that kind of world.

That's not to say that we shouldn't continue to press for strict oversight for drug and vaccine safety - never is a good time to relax, but if you look at the history, the system works. When problems are found, they are investigated and corrected - and researches, doctors, and parents alike all have the same goal, to better protect our children.

Because we can now identify many more conditions than in the past, doesn't mean that those conditions didn't exist (such as auto-immune disease, asthma or allergies) - but a lot more kids are surviving that wouldn't have before, so we're seeing more things that may also be treatable.

Again, speaking as a parent of one and soon to the parent of another (in less than a month), my greatest concern is to make sure that my child is adequately protected - so that he doesn't have to get just one more illness. Because the regular ones that kids get are scary enough - why add measles, mumps, chicken pox, HepB, and the other vaccinated diseases on top of that?

@Kelly

You touch on an important issue, namely that parents have a certain view of the risks of a disease (typically as being relatively benign, based on their own experience) and at best an unclear view of the risks of vaccines.

For example, with measles, many would, without further investigation, very likely state that it is a pretty harmless disease. Little do they know that there is a roughly 1 in 1,000 chance of encephalitis and about 2 per 1,000 death risk. The vaccine, by comparison, has encephalitis or severe allergic reaction grouped together at about 1 per million.

Or, to use something a bit more pertinent to our discussion here, chicken pox is largely thought to be a benign disease. Sure, there's some misery for a week, but then you're okay. Doing a very quick Google search for "varicella complications risk", I found this study from Germany that looked at hospitalizations from chicken pox nationwide within one year (1997) among immunologically healthy children. They found a complication rate of about 8.5/100,000 (based on theoretical population risk...the actual rate would probably be higher, because the at-risk population would be smaller than what they used for their calculation). Here are their results:

The response rate to the surveillance questionnaire during the observation period was high: 93.4%. Of the 153 reported cases, 119 met the case definition. There was a seasonal distribution of reported complications with a peak in March. The majority of complications occurred in preschool-age children with a maximum age of 4 years. No gender predominance was found with a distribution of 56 female and 63 male patients. Multiple entries for complications were allowed. The most frequent complications were neurologic, which were reported in 73 children (61.3%); cerebellitis was the leading diagnosis (n = 48), followed by encephalitis (n = 22), meningitis (n = 2), and central facial palsy (n = 1). A total of 46 (38.6%) infectious complications were identified. Superinfections of the skin were present in 31 (26.0%), pyogenic arthritis was present in 5 (4.2%), osteomyelitis was present in 4 (3.3%), necrotizing fasciitis was present in 3 (2.5%), orbital cellulitis was present in 2 (1.6%), and pneumonia was present in 1 (0.8%). Streptococcus pyogenes was the leading cause of bacterial infections (18 cases [15.1%]), with invasive disease in 6 patients (8.4%) and linked to 4 of 8 cases with defect healing. Infectious complications were reported in the majority in younger children up to 4 years of age, whereas neurologic complications occurred more frequently in an older age range. Five children experienced thrombocytopenia or severe anemia. There was no bleeding disorder, no fatality, and no case of Reye syndrome reported during the 1-year observation period. In total, 8 (6.7%) of 119 patients reported having long-term sequelae, 6 attributable to infectious complications and 2 to persistent deficits after neurologic complications.

Until I started combating anti-vax nonsense, I hadn't a clue what the actual risks were for many childhood diseases. Like you, I felt that chicken pox vaccine was completely unnecessary. But as I discovered, and hopefully illustrated here, is that it can have some very serious complications, even in healthy children, and at much higher rates than I imagined. According to the CDC, the vaccine has reported (though not necessarily causally related) serious adverse events at around 2.2 per 100,000 from the first 48 million doses. Based on this admittedly limited information, it would appear that the vaccine has a slightly more favorable risk:benefit profile than natural infection. I haven't done a more thorough search for more recent info, but it is conceivable that the safety of the vaccine has been improved even more since those first 48 mil. doses.

composer :aAt this stage, on this blog, augustine's reputation for honesty is so shattered that if he claimed that the sun rose in the east, I would get up extra early on a clear day to check before I accepted his claim at face value. :)
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Because you are not interested in truth, honesty, or justice. You are interested in arguing and attacking.

By augustine (not verified) on 08 Nov 2010 #permalink

@Lawrence

Just to get this before Kelly brings it up: she is going to vaccinate her kids against varicella, the caveat being if they do not contract it by a certain age. While I'd say that that is risking it (got a post in moderation going a bit more in depth on this), it is certainly better than not vaccinating at all, considering how bad chicken pox can be if contracted as an adult.

Lawerence: my greatest concern is to make sure that my child is adequately protected - so that he doesn't have to get just one more illness. Because the regular ones that kids get are scary enough - why add measles, mumps, chicken pox, HepB, and the other vaccinated diseases on top of that?
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Mine too. It just doesn't involve vaccines.

By augustine (not verified) on 08 Nov 2010 #permalink

Lawrence, why am I more fearful of the side-effects from vaccines then the diseases? Well, I guess it isn't so much that I am more afraid of the side-effect from the hepB or hepA vaccines and more an issue of not feeling like my child is at risk of contracting those two diseases in the near future. If they were in a daycare setting, I agree with you, all the kids in that daycare should be vaccinated. I wouldn't put my child in a daycare that didn't have that requirement. Hell, my dog goes to a daycare and I made sure when I enrolled him there that they too check to see that all the other dogs are up to date on their vaccinations and flea control.

The only vaccine I have outright refused is the rotavirus vaccine. The hepB vaccine and the chickenpox vaccine they will be getting prior to school-age. HepA I'm still on the fence about.

I'm actually not afraid of my kids getting sick, I guess I just have more trust that their bodies are equipped to handle most illnesses without having to worry about the possible side effects of a drug or vaccine. Of course I don't want them to get serious diseases like meningitis or polio. I think the problem is that people keep referring to the time of polio as though thats going to make people fearful of chickenpox.

Kelly, why do you "just have more trust that their bodies are equipped to handle most illnesses without having to worry about the possible side effects of a drug or vaccine"? This makes no sense to me at all! The whole purpose of vaccination is to help their bodies become better equipped to handle the illness. Why turn this offer down?

I've seen my children suffer through serious illnesses. I've cared for them through several days and nights of high fevers. I'd much rather risk vaccine side effect fever one day than go through a week of it, not knowing when it will end.

Have your kids actually ever been sick at all yet?

Chemmomo, other than that HIB induced fever my oldest had around 15 month, no I can't say I have dealt with any other sickness. Maybe a very minor cold and diaper rash here and there. I've been very lucky thus far.

Again, I'm not less afraid of the disease in most of these cases, just less convinced that they are going to contract it or suffer from it. Like, Sciencemom pointed out, they are going to contract rotavirus, like we all do, hopefully like the majority, they won't be severely damaged from it. I don't know what else to say about the chickenpox. You had a bad experience with it and that heightens your fear just as the vaccine fever thing heightens my fear in regards to vaccines.

Maybe part of my lack of disease fear is also because I've never really been sick. I never got the flu vaccine until I was in my twenties, and only then because I worked at a hospital, and I can honestly say that if I have ever gotten the flu I have no recollection of it. I'm partly hoping that there may be some theory that supports the idea that parents with strong immune systems produce children with strong immune systems :) But let me be very clear, I don't in any way think that contracting immunity naturally is any more superior than gaining it through a vaccine. I just wish i didn't read things about vaccines containing pig viruses, that maybe benign this time, but maybe not so much next time.

Here's where the fearmongering among SBMers begin.

If someone says they are not afraid of a disease like chicken pox, the vaccine evangelists make sure that they BECOME afraid of it (as evidenced here). They use numbers in the name of fear. If those numbers don't work they use bigger numbers in the name of fear. They use stories in the name of fear. They use history in the name of fear. They use science in the name of fear.

When fear doesn't work on the unfearful, then they resort to ANGER. Get the rest of society angry at them. Say they lie. Say they put your children in danger. Say they are selfish. Say they are killer. Say they are the slime of the earth.

Emotion is the trademark of vaccine evangelists.

Guess what? I'm not afraid of polio, diptheria, malaria, measles, meningitis, mice, common cold, cholera, syphillis, HPV, tetanus, mumps, ebola, HIV, etc.,etc.

Now proceed to tell me that the only reason I'm not afraid is because I'm ignorant so I'll agree and THEN become afraid.

Fearmongering. That is all this is.

By augustine (not verified) on 08 Nov 2010 #permalink

@Gray Falcon

http://www.jpeds.com/article/S0022-3476(45)80208-1/abstract

Poliomyelitis and recent tonsillectomy*

John A. Anderson, Ph.D., M.D.
Summary
During three months of the ascending part of an epidemic of poliomyelitis in Utah in 1943, 43 per cent of the bulbar and bulbospinal cases were preceded by a tonsillectomy within thirty days of the onset. The incidence of poliomyelitis in recently tonsillectomized children was found to be 2.6 times greater than in the general child population. The incidence of the bulbar and bulbospinal type of poliomyelitis was found to be sixteen times greater in recently tonsillectomized children than in the general child population.

And

http://aje.oxfordjournals.org/content/66/2/131.extract

By Sid offit (not verified) on 08 Nov 2010 #permalink

there is such a thing as a circumstance in which the government "coercing" the population (also known as governing) is a good thing, will be more powerful than you realize, once you get over your own self-conscious uneasiness with the principle.

Thus Spake the Sheep

By Sid offit (not verified) on 08 Nov 2010 #permalink

@Kelly

Glad to hear your children have remained healthy! Based on my friends who are recently new parents, I can sort of understand the anxiety of raising a child and dealing with all the various info out there relating to what to expect and how to deal with what does occur.

I just wish i didn't read things about vaccines containing pig viruses, that maybe benign this time, but maybe not so much next time.

Likewise. There will likely always be aspects about medicine that we cannot foresee. In the rotavirus vaccine/PCV case, it was a novel screening method that improved upon previous methods that found the issue. All we can do is take what we learn, improve what we do and forge on. If we were to live in constant fear of what "might" happen that we don't know about yet, we'll never get anywhere.

Although we may disagree on some issues, I have to say that it is very refreshing to talk with someone like you. Most of the time, we end up butting heads with folks like jen, augie, Sid, etc.; people who just want to poke buttons and have no interest in rational discourse.

Actually, Kelly, my own bout of chicken pox wasn't that bad. However, unlike your community, in my community there was a death. Of an otherwise healthy ten year old. And, yes, that does color my perception of how serious the chicken pox can be.

However, in my case, when I'm assessing the risks of chicken pox vaccine vs disease, I also have to factor in one additional concern most folks don't have. My husband, in spite of multiple exposures, never got it, and we don't know why not. My kids are vaccinated.

As for hoping for strong immune systems - once your kids get to kindergarten, you'll find out.

Kelly makes a curious claim:

"I'm sure if the common cold vaccine had ever been successfully created (I believe research for that finally ended in the early 90's)..." [emphasis added]

and

"...the reality is that we don't need a common cold vaccine. The fact that scientists didn't give up trying until the 90's to create one is, to a non-scientist, a little absurd." [emphasis added]

This is curious because what is popularly known as "the common cold" is caused by several virus types - rhinoviruses (over 100 serotypes), coronaviruses (15+ serotypes), adenoviruses (50 - 55 serotypes) and miscellaneous other minor players. It's also curious because I wasn't aware that there was any serious research into a vaccine. Of course, I don't know everything about virus research and vaccines, but it seems strange that despite going to several conferences a year on viruses and anti-viral therapies, I wouldn't have at least heard about it.

In fact, when I went to the Source of All Knowledge (the Internet), the first five "hits" were to statements that "there isn't a vaccine against the common cold and there isn't likely to ever be one". The sixth was a news article about how a "vaccine against a common cold virus" might help treat brain cancer. The virus turned out to be cytomegalovirus (HHV-5), one of the "minor players" in the common cold team.

I'd appreciate it if Kelly could provide a source for her information about the research into a vaccine against the common cold. I'm curious which virus(es) they were targeting.

Also, as you might guess, some of the viruses implicated in the common cold are more serious than others. Coxsackieviruses - which are sometimes lumped into the "common cold" group - are far more serious, as is respiratory syncyial virus (RSV), especially in infants. So, a vaccine against one of these might be referred to as a "common cold vaccine" in the popular press.

I'm also a bit puzzled by the concept - repeated by Kelly and others - that somehow vaccines present more of a challenge to the immune system than the wild-type disease. If they did, the symptoms from vaccination - fever, rash, aches, malaise, anorexia, etc. - would be worse than the actual disease. As it turns out, this isn't the case.

Even though some people have post-vaccination symptoms and complications that are similar to the disease, the overall frequency of those symptoms and complications is lower with the vaccine than it is with the disease, usually by several factors of ten. And although this is untestable, it is reasonable to suspect that those people who react badly to the vaccine would also react badly (and probably worse) to the disease.

Prometheus

@Science Mom

they are allowing 1/1000 that contract mumps become deaf

Textbook of pediatric infectious diseases, Volume 2 By Ralph D. Feigin P2310
Deafness is a rare ...complication of mumps virus infection. Its incidence has been estimated at 0.5 to 5.0 per 100,000 cases of mumps

Come on now Science Mom, I debunked your silly 1-1000 assertion months ago.

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

Prometheus, I believe I first read about research for a cold vaccine on the weather channel website. I don't remember because I read it in passing awhile ago and was simply using the attempt at a common cold vaccine as an example of medical absurdity. I do believe also that it was in 1991 or 1992 that research for a "common cold vaccine" stopped in England because there were too many separate viruses to have hope of producing one. I do know for sure if you google cold vaccine that there is an old Time magazine article that discusses the medical communities attempt to create one. I thought it was funny that anyone would be trying.

Kelly - yes it is very refreshing to be able to have a civil conversation that does deal with some of the other fears and risks with another parent and excahnge reasonable ideas and information as well.

I just received my seasonal flu and vaccine boosters, since my wife and I are expecting next month. For me, it is worth it, just in case.

I also remember my own bout with Chicken Pox, when I was around 8. I was sick for three weeks, then my sister got it (about two weeks in) & was sick for another three weeks & then my younger brother got it (two weeks in again), so my parents had sick kids for about eight weeks - plus my brother was much sicker than either my sister or I. Definitely not a pleasant experience & wish we all could have avoided it, but the vaccine wasn't available at the time.

When I was in Junior High, we had a mumps outbreak - there were several cases & at least one friend of mine had some fairly serious complications. It was quite some time ago, so I'm not sure where the outbreak started, but it was definitely quite a big deal at the time.

Some people claim pro-vaccers are using fear as a tool to encourage vaccinations - but aren't the anti-vax crowd doing the exact same thing?

At least on the pro side, we know how scary these diseases can be, and people have and do die - whereas the anti-side have nothing but suposition and belief, with no real facts.

Are vaccines 100% safe? No, they aren't. Are they better than the dieases they prevent? Absolutely.

From one parent to another, don't turn a blind eye to the scientific evidence and listen to your pediatrician.

Kelly, your heart is definitely in the right place. I just want to say that right off the bat. You did not deserve to be labeled "antivax"; we're just a little skittish around here on that subject.

This is just based on my irrational worry that they may suffer some neuroimmunological consequence for no good reason other than to avoid some discomfort. Meanwhile, they are getting lots of other vaccinations against really scary things like meningitis, tetanus, whooping cough, and polio.

It sounds reasonable to wait until after age 2; in fact, it is not unusual to wait a bit on varicella, and my state's recommendations suggest two possible courses, depending on whether it is started before age 2 or not. I think if your child is not in daycare or preschool yet, it is not as important to get it so early, but you should try and complete the series before the child starts school, so he/she is fully protected.

Chickenpox as just a little discomfort....

You can miss two weeks of school with that. Depending on when those two weeks occur, that can be a problem, academically. More to the point, even though chickenpox is seldom lethal, well, that's also true of waterboarding. Death is not the only outcome that matters.

My case of chickenpox was mild. I itched like the dickens, and of course the initial phase felt like a mild flu or strep throat that seemed to go away on its own (before I broke out and we all figured out what had really happened). I passed it to my brothers, one of whom passed it to a good friend of mine, who actually had pox in her *throat*. Ew. And then there's what happened recently to one of my relatives. About five years ago, she got shingles. The left side of her face is still paralyzed, and doctors now say it always will be; it's been long enough that nerves should have begun regrowing if they're ever going to. She's a very self-conscious lady, so this has been difficult for her to adjust to. She's lucky, though; she escaped the neuralgia that plagues some patients. That can be one of the worst tortures imaginable.

I don't worry as much as I probably should about getting shingles; I've had chickenpox, so it's quite likely I'll get shingles one day. I plan on getting vaccinated anyway; the varicella vaccine does protect people like me, by retraining our immune systems so it'll smack the bugger down the moment it rears its ugly head again. And my children got vaccinated on the earlier schedule. (My eldest didn't enter a daycare situation until she was 3 and a half, but I didn't see any point in waiting.)

Upthread, you mentioned that you struggle daily with your decision to vaccinate or not vaccinate. I hope this was hyperbole. Whatever you choose, always remember this: you are acting in your children's best interests, and that is very good indeed. You may not have perfect information; nobody does. But you are doing the best you can with that. Do not struggle with yourself, and do not *blame* yourself if your choices ever turn bad (if your child is injured by a vaccine, or your child falls ill with a vaccine-preventable disease that you did not vaccinate against). Evolve your strategies over time, as you find new information, but don't ever beat yourself up over the past.

I may not agree with everything you've said here, but one thing is clear -- you are making a hell of a lot of effort to do what is best for your children, and that puts you ahead of an awful lot of other parents. Not others here; I think everybody here cares quite deeply. But elsewhere, I have met people who . . . I don't have very nice words for.

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

Jen @ 130:

Your Callie spoke very eloquently on the dangers of off-label vaccine use several months ago.

I'm my Calli, not anyone else's. ;-) (Well, except CallisHubby. I'm his.)

I don't recall exactly what that was about; I do remember a while back talking about the new area of ethical dilemmas as the customized vaccines (immune therapies) come out for things like prostate cancer. These are not off-label uses, of course, but they raise very interesting ethical problems, mostly because they are excruciatingly expensive and, at least in the current target population, produce only moderate improvements in longevity and quality of life -- on the order of six months. A million bucks for six months. Hard to say whether that's worth it, but it's a question we'll soon have to answer, whether we want to or not.

Off-label use of anything is a concern. It's not automatically bad, but it's always a little dicey because there is less research in that area. One thing I am concerned about is people inadequately vaccinating. If the science shows that Vaccine X is most effective if given in three doses two years apart, then it's a problem if it is given in two doses five years apart. That could be an offlabel use, and in that case, the patient may be accepting risk for no real gain, because they have taken the small risk of vaccinating but not reaped the benefit of sufficient protection to avoid the diease. Maybe that's what I was talking about; I honestly don't remember. ;-) (I have two small children, so occasional memory loss is probably normal.)

Lastly, I'm not going to sell out AoA or Dr. Mercola or NVIC. Their points and research of the issues are as valid as say, someone who makes bucks off of vaccinating kids.

It shouldn't be about loyalty. They haven't done anything more to earn your loyalty than I have or Orac has or your local pediatrician has. Their points and research on the issues are as worthy of a fair hearing as those of a local pediatrician or the AAP or a CDC epidemiologist. But that doesn't mean they are as valid. Claims should stand or fall on their own merits, and who brings them should (ideally) be immaterial. Don't worry about selling Mercola or NVIC out; they can fend for themselves, and I wouldn't expect it to matter one way or the other.

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

One last comment, I promise -- then I'm on the hook to finish some documentation. :-P

A point to those petitioning in favor of vaccination to protect the population....

Although the vaccine schedule is designed from a epidemiogical perspective (to control the spread of disease, and thus to assure sufficient coverage to prevent outbreaks), the individual vaccines are not. The vaccines are approved by the FDA to protect the vaccinated patient from specific diseases, not to control the spread of those diseases. CDC recommendations, school entrance criteria, government underwriting of vaccines, the vaccine court . . . . those things are where the community fact becomes significant. But it is always subordinate to the needs of the individual patient. That is why all states have a medical exemption clause (though not all have a philosophical or religious exemption clause) -- if the risk to the individual exceeds the benefit, then the social benefits can go take a flying leap. That is actually what the medical community thinks.

(Exceptions: employers can make vaccination a condition of employment in certain roles, because it may be neccesary in order to carry out the job. An animal control officer could be required to be vaccinated against rabies, for instance, and if this is not possible, relocated to a position where animal bites are less likely, such as bookeeping.)

The CDC recommendations, and other vaccine schedule recommendations, are an evolving effort to find the best balance between the best individual protection and the best social protection (i.e. the best way to control or prevent epidemics). The individual is never subordinated to society; the intent is to balance both needs.

Why, then, Heptatis B for infants? The answer is actually statistics. The CDC did not recommend this on the basis that too many adults don't vaccinate, so the child needs to be protected right away. They recommended it on the basis of statistics on Hep B infection in infants compared to various vaccination strategies. Statistically, this strategy has resulted in the fewest Hepatitis B infections in young babies, and very few complications. Statistically, babies are safer getting routinely vaccinated than not. Obviously, that's not enough to predict which babies will benefit, but if we knew that, it'd change everything.

Short version: vaccination is done to protect the population, yes, but only as a bonus. It's done first and foremost to protect the individual.

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

"I thought it was funny that anyone would be trying. "

Yeah how funny to want to 1) make a gazillion dollars and 2) improve the quality of life for all of humanity forever :p

@ JohnV:

True. While you'd have to be AWFULLY clever to pull it off (assuming it's even possible, which I decline to rule out), even partial success would be hugely important.

[SBMer: Some people claim pro-vaccers are using fear as a tool to encourage vaccinations...]

BUT...

[At least on the pro side, we know how scary these diseases can be, and people have and do die - ]

By augustine (not verified) on 08 Nov 2010 #permalink

247 comments have produced a fascinating discussion but no solution to the question initially posed by Orac - how to best respond to the anti-vaccine movement.

I think science bloggers have made a great start. At least now when a parent goes to the Internet to find information about vaccines, or when news writers are looking for source material, they have a chance of learning something that didn't come out of Mercola. Obviously, though, there's more that that needs to be done.

Kelly made some good points - for example, the vaccine handouts that simply don't cut it for many parents looking for information. People are not always good at understanding big numbers, and for many, there's not much difference between a 1 in 10,000 chance and 1 in 100,000. Besides, many obviously think even enormous odds are still 'likely', otherwise they wouldn't buy lottery tickets. ;0)

Orac has stated before that scientists are constrained by having to tell the truth, and the truth about vaccines (and other medical issues) is often more complex than many people have the education for (or even the interest in) understanding.

A long time ago I read a book about virus hunters in the CDC that not only kicked off a lifetime of fascination with public health issues, but likely set me on a path of appreciation for science-based medicine. (As a Mother Earth News fan, I suspect that without that input I might have ended up squarely in the Mercola camp, thereby throwing the baby out with the bath water.)

My knowledge was informed through the powers of some incredible writers: people like Laurie Garrett, John M Barry, Steven Johnson, Dr. William Close, Molly Caldwell Crosby, Maryn McKenna... I could go on and on. Unfortunately, however, these writers and their ability to tell a story are the exception rather than the rule when it comes to popular media. And most of them are book authors... I would love to find a source for really great storytellers who understand science and its impact on health, and who write frequently about issues in the news today. (Let me plug coldtruth.org here because Andrew Schneider is trying.)

Science blogs is a great place for finding information, but the writing style is often over the heads of many people, especially those whose eyes glaze over when they hear 'science.'

By Trish Gannon (not verified) on 08 Nov 2010 #permalink

Some comments on the interesting discussion about what makes parents vaccinate their kids. Primarily it is fear, which may or may not be rational.

A common disease with rare side effects is usually feared far less than a rare disease with frequent complications, even though at the end of the day the morbidity/mortality burden might be greater with the common, less feared disease. (eg Meningococcus incidence rate was about 5 per 100,000 with a 15% mortality rate - less than 1 death per 100,000; Measles (without vaccination) would affect 90,000 per 100,000 with a 1 in 5000 fatality rate - ie 18 deaths per 100,000)

This is why measles was not a particularly fearsome illness, because although common, its complications were not, and you needed to know an awful lot of kids to have known one who got encephalitis, or who died. Meningo is a rare disease (even without vaccination) but is more feared because there are always media stories of how little Jack was playing in the garden on Monday, and dead on Tuesday.

So a meningitis vaccine (be it MenC, or HiB) is seldom refused, but measles vaccine may be. Parents had this as kids themselves and this allays their fears of the disease.

As the vax schedule turns to diseases that are less and less feared by parents, they begin to mistrust the logic behind vaccination programmes. Our (SBMers) efforts to inject a rational risk benefit equation into the issue falls on deaf ears.

Before introducing new vaccines, there must be a thorough and honest appraisal of their necessity, or parents will just raise the fearmongering justification.

Re the "common cold".

Interestingly, the rhinovirus genome has been recently sequenced, and this may help attempts to develop a vaccine against it. Vaccine work continues for this pathogen. Some may feel vaccines are unnecessary, but the overall morbidity from the cold is significant, and it is a very very expensive disease in terms of its overall economic burden through sick leave.
http://www.medwire-news.md/48/80875/Respiratory/Human_rhinovirus_genome…

Now people claim vaccines are the "cause" of asthma. Yet paradoxically, rhinovirus is increasingly being recognized as a common cause. Strange, huh?
http://www.sciencedaily.com/releases/2008/10/081001093045.htm?utm_sourc…

@Kelly

Most of you seem interested in only trying to shame parents into agreeing with you

I mostly lurk on this site. When I first started to read this blog and its comments, I was quite confused about all the talk surrounding vaccines. I even brought questions up with my pediatrician and she dismissed them with an amused smile and a simple "no".

I have learned much in this past year from this website. I love the detailed explanations, even when they're way over my head. I even enjoy the troll bashing. But never once have I felt shame for not knowing the nitty gritty of all things vaccine. The fact that there are people out there who know much more about vaccines than I do, does not shame me, it brings me great relief. And so when my educated nurse-of-a-neighbour tells me all the reasons she hasn't vaccinated her toddler yet, I give her my pediatrician's amused smile. But unlike the doctor, I don't stop there. Slowly, I harp away at my neighbour's factoids. Thank you "Respectful Insolence" for giving my arguments substance.

By PMSrocks! (not verified) on 08 Nov 2010 #permalink

Let's make a pro-antivax ad showing the true consequences of a low vaccination rate and vaccine-free world. It shouldn't be difficult (just a little expensive to fly around the world). There are still many people mutilated and suffering from various diseases which many people in the USA are probably not aware of. We can start with Polio in Kenya and Nigeria. I can't find any reports at all about smallpox though, much less any reports of a widespread outbreak - damned vaccines. We'll have to rely on newsreels from the 1930s-1950s to show the smallpox stuff.

By MadScientist (not verified) on 08 Nov 2010 #permalink

Wow, "science" gods, your uniformly smug, rude, dismissive treatment of Kelly is just illustrative of why you have trouble "getting the word out", why people don't necessarily believe your positions, and does nothing to dispel the stereotype of a holier-than-thou medical/pharmaceutical complex more intent on giant profit than any other factor. Kelly has made earnest, logical, surprisingly well-researched and thoughtfully-presented points. She is the quintessential well-informed PARENT that ought to be your target "focus group." Yet rather than engaging in constructive conversation, you ridicule her conclusions, her education, and her, personally, at every turn, always in your apparently characteristic bombastic and sarcastic tone ("citation please". Oh pleeez!)

Maybe your "we know everything as a FACT" club forgets that your "FACTS" tend to be proven wrong over and over again. Hormone replacement therapy? Vioxx? How about the swine flu "pandemic" last year, characterized by lower-than-ever vaccine usage, accompanied by a lower-than-ever flu rate. We don't know what percentages of those who did contract the flu were vaccinated or un-vaccinated, because you "science guys" didn't even bother to collect that data. It is a well-known FACT that around 300,000 people die every single year in the US from avoidable medical error, roughly 100,000 each of pharmaceutical error, surgical error, and acquired hospital infections. (AMA's own statistics). The US is something like 48th in the world now in effectiveness of healthcare, down from 37th. Do you really think your pronouncements from on-high about vaccinations or any other medical/pharmaceutical issue should be simply accepted without skepticism? Of course you do, you're the "science" gods!

It does not help your position to lump everyone who questions the exploding rate of vaccination in this country with "creationists", "global-warming deniers", and "loons." Any accomplished medical person who disagrees with you (eg Healy) is suddenly a "hack." I read this entire blog, and you never actually address the central issue: that you as a community ARE trying to remove by law even the small religious and conscientious exceptions to mandated vaccination schedules. This IS a "forced-vaccination lobby" whether you like the title or not. There actually ARE pediatricians out there who do not support all recommended vaccines, and don't fully vaccinate their own children, because I know one. You turn the controversy on its head, implying that "anti-vax" people are trying to stop all vaccinations, whereas the reverse is true, you are trying to force unwanted vaccinations on all. And it is disingenuous for you to state that total vaccination would result in eradication of the underlying disease. The vaccines themselves carry the disease. For example, there will always be the percentage who contract polio from the vaccine - like my friend, who has been crippled her entire life, as a result of receiving her polio vaccine as a child.

Then finally, follow the money. There are the billions upon billions of profit dollars from the ubiquitous pharmaceutical corporations and their lobbies, against who? Concerned parents, informational websites, alternative medicine websites - do you seriously contend that selling a few supplements is the entire "financial incentive" behind the anti-FORCED-vaccination groundswell? I don't think so. It really is about consent.

@ShowMe

I can't speak for others, but myself, I am totally unaffiliated with the pharma industry. My job does not entail health care, nor am I a scientist by trade. I am, like Kelly and you, a lay person. I feel that I was critical, yet fair in my addressing Kelly, but please point out where I was not.

For example, there will always be the percentage who contract polio from the vaccine

This is only an issue with the live polio vaccine. It cannot happen with the inactivated version (unless, by some chance, the inactivation process is completely botched). In fact, you cannot contract the disease from any inactivated/dead vaccine. Live virus vaccines do carry a very small risk of the vaccine strain of the virus reverting to a pathogenic state. I'm sorry to hear that your friend was one of those rare exceptions.

Then finally, follow the money.

Ah, yes. Let's do. It costs quite a deal more money to treat a disease (i.e., more money for the medical complex) than to give a vaccine that prevents the disease. Further, it is only because there is some protection of vaccine makers that they even bother making them at all. In fact, before the VICP, there was a very real threat of the few vaccine makers stopping completely due to the threat of mostly frivolous law suits. They are not nearly as profitable as other drug ventures.

You know, for someone bleating on about a holier-than-thou attitude among those of us who appreciate the medical advancement that are vaccines, you take a very self-righteous attitude. Perhaps if you calm down some, we can have a civil conversation.

@ShowMe

"always in your apparently characteristic bombastic and sarcastic tone ("citation please". Oh pleeez!)"

You may not realize this, because you're just some dumbass with an internet connection, but just asserting something doesn't make it true. Interesting that you didn't see that she also asks for citations.

"Then finally, follow the money."

Indeed. And just what nefarious purpose do you and your ilk have in removing the vaccine safety net?

Wow, "science" gods, your uniformly smug, rude, dismissive treatment of Kelly is just illustrative of why you have trouble "getting the word out",

It's about the only part of 'Showme' post I could almost agree with.
Almost. 'Uniformly'? Calli Arcale was diplomatic and great as usual (how do you manage to stay so calm? I was following your discussion with Th1Th2 on the other blog, you amaze me).
Prometheus was bringing light to us, as is his role. He may be a bit brusk sometimes, but not dismissive.

But I do think we are becoming too used of battling trolls and entrenched opponents. Some of the first answers to Kelly were assuming the worst and were not that nice. Maybe it was a bad Friday to engage in constructive discussion.
And of course, the usual trolls came around to pour oil on fire, vindicated in their beliefs.
I know I tend too much to erupt into flame in my posts. It's too easy to get upset in front of a computer screen. Maybe a few of us should reflect on this. I think we missed an opportunity here.
Not that I would have done any better. As my previous posts have shown, I'm not very skilled in debating.

@ShowMe
That Kelly asked for citations was one of the main reasons that people's respect for her increased. If she had simply dismissed our statements out of hand, like so many others, she would have not have fared well.

@Kelly
Sorry for the bad experience. We once dealt with an angry mother who insisted that if one didn't have children of their own, they had no right to contribute to the discussion. Some of us are still a little shell-shocked.

@Sid
I hadn't yet responded to Sid's comments on polio, but I may as well. The article he posted did suggest a connection between tonsillectomy and polio, but did nothing to show that it was the only issue involved, just one issue. Also, it was mainstream medicine that uncovered this issue, not a bunch of people shouting "Unnatural" at anything they deemed unfit. Finally, none of this changed the fact that the disease didn't really go away until the vaccine was perfected.

By Gray Falcon (not verified) on 10 Nov 2010 #permalink

Maybe your "we know everything as a FACT" club forgets that your "FACTS" tend to be proven wrong over and over again.

Such as? (Actually, the above is a very good description of the anti-vax movement. Remember thimerosal, MMR, the Omnibus Hearings, the "hidden horde" argument, multiple wagers that they were going to be proven right, that kids were going to be cured in 2 years with chelation, that autism and mercury poisoning are one in the same, that Wakefield was going to be cleared of the charges, and so on?)

Gee, ShowMe sounds like both STY and the troll from SBM, Th1Th2. Anytime someone brings in the Pharma Shill gambit, it automatically makes their post tl;dr to me.

@JohnV: I think that all anti-vaxxers have a lot of money in Big Hospital and Big Medical Supplies, because you can spend a heck of a lot more money treating illness than preventing it. Preventing illness means doctors LOSE money; they'd make tons more money if diseases were still so prevalent.

By Triskelethecat… (not verified) on 10 Nov 2010 #permalink

Showme:

that you as a community ARE trying to remove by law even the small religious and conscientious exceptions to mandated vaccination schedules.

"Mandate"... you keep using that word, but where in the USA does that happen? Even in Mississippi and West Virginia there is no requirement that you send your kids to public school. And many school districts are not concerned with vaccines that only protect infants like rotavirus and Hib.

Please, if you are going throw out numbers like "300000", etc., provide the actual paper for that value. As I recall you made many assertions, but provided nothing to back them up.

By the way, I was nice to Kelly at first. I gave her suggestions on books to help her understanding of the statistics and science. But I get irritated when I continue to provide answers with links and they are ignored.

callie @ 252- I don't have long to reply but when you talked about off-label use of vaccines concerning you it was not to do with custom vaccines or under-vaccinating. You mentioned vaccinating sick children as potentially a prob and also vaccinating in combinations that haven't been studied. ( this really was a few months ago) and I am sure that Todd entered into the discussion and was taking the info in, too. I really do like to try and learn and even though I may not be able to look at all the studies right away I will try and do what I can to make informed decisions.
Another time somebody did see what I meant about longer animal trials (they referred to what I was suggesting as something like an extended phase 4?) when studying vaccine effects on animals.
For me, even if I didn't try and look at some of the studies, I know that lots of scientists and doctors have looked at all those same studies and come away with the exact opposite view of most of you guys. that's pretty concerning to me.

For me, even if I didn't try and look at some of the studies, I know that lots of scientists and doctors have looked at all those same studies and come away with the exact opposite view of most of you guys. that's pretty concerning to me.

Jen, it would be so much more helpful to get on the same page if you would post some studies that concern you and the authorities that you claim reject the conclusions. If you really want discussion, then that would be a great first step.

So Jen puts herself right up there with the creationists. They are always very anxious to tell us about all those scientists who are creationists, and therefore have come to a very different conclusion than the scientific establishment.

And the comparison is apt. The anti-vaxxers have similarly come up with their "list" of people who "question vaccines." And like the creationist lists, they play fast and loose with the credentials of the people that they include on the list. Things like "public health specialists" and nurses, trotted out as experts that should make us reconsider our position because they do. Shoot, IIRC even Jenny McCarthy was on the list!

That you can find 500 people that you can put on a list (note these people are not all ones who would agree with the characterization that they "question vaccines," but have been added to the list maybe because of something that they said that some anti-vaxxer distorted) is not a shock or surprise. There was just recently a conference of people who believe in an earth-centered universe. There were legitimate PhD scientists that contributed (one guy did his PhD thesis in the field - not geocentrism, of course - but not at a diploma mill). According to Jen, this should give us a reason to doubt the heliocentral model of the solar system.

Jen:

callie @ 252- I don't have long to reply but when you talked about off-label use of vaccines concerning you it was not to do with custom vaccines or under-vaccinating. You mentioned vaccinating sick children as potentially a prob and also vaccinating in combinations that haven't been studied.

I'm not doubting you; I just have a memory like a sieve sometimes. ;-) Thank you for refreshing my memory what it was about; I do remember now. I was indeed talking about how nurses/doctors who vaccinate sick patients may be outside the standard of care. (There are exceptions, of course, but in general they're not supposed to vaccinate you if your immune system is already busy. IIRC, this is not just because of increased potential risk but also because a weakened immune system will not develop immunity as well, reducing the benefit of the vaccine.) And that's something that people *should* complain about, because we shouldn't have to accept sloppy care. Especially not now that so many "minute clinic" type places are getting into the vaccine business. Routine vaccines may not be big money-makers for a primary care provider, but for a walk-in clinic attached to a drugstore or supermarket, it's a great way to draw in more customers.

Part of me says "great!" but part of me is worried. On the one hand, having vaccination be part of a routine shopping trip means it's not so inconvenient for a patient to go in, be deferred, and come back later when they're over their cold or whatever. (I suspect that motivates a lot of primary care providers to vaccinate anyway, reasoning that it's inconvenient for their patients to have to go out of their way to come back.) On the other hand, walk-in clinics routinely lose patients to follow-up, so they may be less aware of the consequences. (Intellectually, they would know, but if you don't *see* it, it's hard to remember it.)

For me, even if I didn't try and look at some of the studies, I know that lots of scientists and doctors have looked at all those same studies and come away with the exact opposite view of most of you guys. that's pretty concerning to me.

Realistlcally, you're going to find disagreement on anything. It is not actually that surprising that some scientists look at the same data and come up with contrary views. This isn't necessarily meaningful; scientists are not perfect, scientists make mistakes, and scientists are, well, human -- prone to the same natural foibles and biases as the rest of us. This is also good. That scientists are allowed to disagree, even about things which a vast majority agree about, shows that the system is healthy. They need to be able to disagree freely. It's fair to be concerned when a scientist looks at the data and concludes that vaccines may cause autism. But it's worth looking to see what proportion of scientists disagree, and it's worth looking to see whether the mavericks have any real meat to their claims. We who are not experts in the field often have to rely on consensus, since we lack the expertise to seriously evaluate their claims (though we can look at obvious stuff, like whether or not the findings were ever reproduced). If 99 scientists agree but 1 disagrees, it may not be time to take the outlier seriously yet. He may prove to be right in time, but most people who contradict the consensus ultimately prove to be wrong. The Galileos of the world are justly famous, but the magnitude of their fame makes it difficult to realize how many non-Galileos there are. Sometimes the consensus is wrong, but usually it isn't, and it takes a lot of work to demonstrate when it's wrong.

All that's a fancy way of saying it's difficult to know who to trust, so I do understand where you're coming from. It is very hard to be objective, and harder still to accept taking any sort of gamble, where our children are concerned. We just have to try our best.

By Calli Arcale (not verified) on 10 Nov 2010 #permalink

I have a bit of a fight going on vaccines on my blog at the moment - check out the link in my name.

Hopefully I am doing an okay job at this but I am basically just a journalist, with all that entails, anyone here want to come over and help battle vaccine denial?

@Bruce Gorton

Interesting, paul5of6 posted the exact same study on your blog as here. Ooh, and you got Tony "I ain't seen no unvaccinated autistics" Bateson.

You may want to post links to Science-Based Medicine's "Vaccines and Autism" resource. My site (linked by my name) may also help a bit.

Chris, you want to take a crack at commenting over there?

Depends. I have things to do, I was just taking a short break. Perhaps I'll ask Bateson one more time why Sallie Bernard could find DTaP with thimerosal in 2001.

Thanks hey Chris - it took a while to get up because of time zones and I have to approve new commenters.

By Bruce Gorton (not verified) on 10 Nov 2010 #permalink

Hi Bruce,
This fellow Saffer just left a comment. I became interested in this after Andrew Wakefield was convicted. Glad to see you're also fighting the good fight.

Hi Bruce,
This fellow Saffer just left a comment. I became interested in this after Andrew Wakefield was convicted. Glad to see you're also fighting the good fight.

Augustine said:

"They use numbers in the name of fear. If those numbers don't work they use bigger numbers in the name of fear. They use stories in the name of fear. They use history in the name of fear. They use science in the name of fear."

OOGA BOOGA!

@Kelly:
Right, the only risk/benefit for scientists involve whether or not their is evidence that proves that if a vaccine can eliminate the common cold with the greatest documented risk being a week-long runny nose than in the scientists view the vaccine is the right thing to do.

That's a pretty incredible over-simplification. First of all, generalize much? Scientists do not have some unified mind-set. Might as well claim that Nazi scientists performing horrific human experiments implies that other scientists would do so. Secondly I'm not aware of any documentation on the development of a cold vaccine, how much was spent, etc... This is still pretty far removed from the topic at hand. Attempting to develop a vaccine, succeeding, making it available to the general public and making it mandatory are four dependent but rather different things. An attempt is just that, someone is trying something out perhaps it's a new technique for vaccines that are more likely to handle mutations. The cold would be a good target since it's variability is the main reason we don't have a vaccine. Your assumption that just because we have a vaccine implies that people would be required to take it regardless of the risk/benefit. Again, that's utterly untrue. Anthrax has a vaccine. Do you see any consensus of Scientists or Medical professionals telling you to take that?

For parents, this doesn't account for the actual risks they perceive in vaccinations. Like, risk of human error. Like, risk of an unknown side effect due to vaccine newness. Like, risk of allergic reaction (which always exists).

I'm not sure what 'for parents' means (I'm a parent and really that statement means nothing to me) but when you do safety testing you actually do account for pretty much all of that.

The point is that just because there are risks that aren't quantitative

I think you mean "that they (the parents) don't quantify" that's different than saying something isn't quantitative (which implies "not quantifiable").

that doesn't mean those risks shouldn't be taken into consideration.

How would you 'take that into consideration' which means, to me anyway "compare with other objective data". What useful way is there to evaluate...say your feeling that VAERS data is more representative than it actually appears.

So while a cold can certainly be made to look worse on paper, the reality is that we don't need a common cold vaccine.

See for a second there you sounded like you were advocating the fact that different people have different...what that statistician in me would call "value functions" the subjective way we evaluate certain experiences. Which is fine...I get that some people value the flu less than the flu shot but now you seem to be telling us that nobody can value a cold vaccine above having a cold. Aren't you making decisions for everyone else on earth now?

Imagine what those funds could have been used for.

Considering you don't seem to supply any information as to how much was spent, by whom or the funding model and every scientific discovery that resulted from it (even failed experiments educate us). I'm not sure you have any right to imply that the money could be better spent.

No offense but despite your claims I don't really see how you are promoting much of an open and informed debate especially when invoking narrow minded prejudice like you did above.