Some post-holiday antivaccine "science"

I hope that you and yours are having a fantastic holiday season thus far. Yesterday, we had a great family gathering, after which I settled down to watch the Doctor Who Christmas special; all in all, a most excellent Christmas Day. Unfortunately, towards the later part of the day, someone out there sent me an e-mail and, fool that I was, I actually read it. (Who is sending e-mails about bad science to random bloggers on Christmas evening, I ask?) So when I woke up this morning, fool again that I am, I actually read the danged thing.

Of course, I should have known that this was going to be truly, truly bad when I saw the names of the authors: Gary S. Goldman and Neil Z. Miller. You might remember them before, because they've published some spectacularly bad "science" in the past, papers so awful that I can't help but wonder how even a bottom-feeding journal would let such tripe pass peer review. For example, do you remember a study that purported to show that the number of vaccines received correlates with infant mortality rates? It was a truly putrid attempt to slime vaccines that cherry-picked the data years chosen to analyze, as well as the countries chosen, all topped off with the typical antivaccine tactic of trying to artificially pump up the number of vaccines children receive by, for instance, counting multivalent vaccines multiple times even if they are only given in one dose, as has been explained before with respect to their previous atrocity against science. There are a number of examples that can be found by simply typing "Goldman Miller vaccines" or "Goldman vaccines" into the Search box of this blog, the most recent of which occurred less than a month ago and involved Dr. Goldman going solo to dumpster dive the Vaccine Adverse Events Reporting System (VAERS) database in search of a fantastical correlation between the H1N1 vaccine and miscarriages.

Come to think of it, much of what Goldman seems to do involves dumpster-diving the VAERS database, and Goldman and Miller's latest antics are no exception, as you will see in a moment. The reasons should be obvious: VAERS data are publicly accessible and downloadable, and it's a passive reporting database to which anyone can report a case as an "adverse event" related to vaccination, whether it actually is related to vaccination or not. For instance, there are famous examples of skeptics opposed to the antivaccine movement that claims that vaccines cause autism entering reports in which it was suggested that vaccines turned someone into the Incredible Hulk or Wonder Woman and had those reports accepted. True, someone from VAERS did contact the author who reported the Hulk reaction, but if he had insisted on leaving the report in the database it would still be there today. Meanwhile the VAERS database has been hopelessly distorted by vaccine litigation in which unscrupulous lawyers have encouraged parents to report autism as an adverse reaction to vaccines. Truly, it cannot be repeated often enough that VAERS is a perfect example of the computer programming maxim: Garbage in, garbage out (GIGO). VAERS was only ever intended to be an early warning system; it was never intended to give accurate estimates of prevalence or incidence that could be followed over time. After all, one can never be sure of the denominator to apply to its reports, and even honest, scrupulous scientists can be tripped up by this. That's why VAERS, for all its usefulness as an early warning system, is the data source antivaccine activists pretenting to be researchers most love to dumpster dive.

So, with that background in mind (and, again, it's hard to repeat that background too many times), let's look at Goldman and Miller's latest attempt to prove that vaccines are the root of all evil. The article, not surprisingly, has been published in a trash journal that has over the last couple of years seemingly become the go-to "peer-reviewed" repository of all things antivaccine, having published the infamous vaccine/miscarriage article and the vaccine/infant mortality article, Human & Experimental Toxicology. This time around, Goldman and Miller entitled their article Relative trends in hospitalizations and mortality among infants by the number of vaccine doses and age, based on the Vaccine Adverse Event Reporting System (VAERS), 1990–2010.

As per usual, let's look at whether Miller and Goldman provide their conflicts of interest. This time around, they do a little better. Neil Z. Miller is listed as being affiliated with the ThinkTwice Vaccine Institute, and any readers familiar with that particular "institute" will know that it is a as wretched a hive of scum and antivaccine quackery as Generation Rescue and Age of Autism. On its website, you will find this particular study trumpeted, along with links to PDF of the study. The editors don't do so well with Gary S. Goldman, however, who is described as a "computer scientist," even though he is the president and founder of Medical Veritas, one of the most rabidly antivaccine groups out there. One also notes that the National Vaccine Information Center (NVIC) donated $2,500 for open access to the journal article (making it freely available to all researchers). The NVIC, as you recall, was founded by Barbara Loe Fisher and is one of the oldest and most influential anti-vaccine groups in the U.S., having recently teamed up with Joe Mercola to promote anti-vaccine views through ads on a JumboTron at Times Square.

Also, as per usual, I will point out that you can usually tell how good or bad a paper is going to be by its introduction. Although this paper's introduction is not quite as bad as past Goldman and Miller "epics," it does manage to cite a fair number of the "usual suspects" in the antivaccine literature, such as his own infant mortality rate paper and Gayle DeLong's execrably bad paper correlating autism prevalence with vaccine uptake rates. Other references later in the paper include some Geier nonsense. Actually, looking over this paper, I was seriously tempted just to recycle what I had written before about the previous Goldman paper in which he tried to correlate vaccination rates with infant mortality, because it's basically the same paper. Indeed, it even has the same graph, more or less, as you'll see in a second. Basically, what Goldman and Miller tried to do was to correlate the number of vaccines received concurrently with hospitalization and mortality rates, and they came up with a graph like this:

Which very much looks like the graph from their previous paper:

Goldman and Miller also include a graph in which they examine hospitalizations as a function of age from 0 to 1 year old:

Whenever I see analyses like this, my first question is: Why does the author assume a linear relationship? There is no compelling scientific or biological reason to do so, which always makes me suspect that the author was just to lazy to do a proper statistical analysis and instead defaulted to what is easy, namely doing linear regressions. In fact, I find it rather amusing that Goldman used Prism to analyze his data. I use Prism a lotto analyze lab data and produce publication-quality graphs. It's an excellent basic statistics program. However, the key word is "basic." While much better than using the built-in tools for Microsoft Excel, as a statistics package, Prism is still relatively basic. True, it can handle a lot, including ANOVA and even Kaplan-Meier survival curves, but it isn't really so hot for modeling non-linear relationships, and it's really not so hot for trying to analyze the effects of potential confounders. When all you have is a hammer, I suppose, everything looks like a nail.

In any case, as usual, what Goldman and Miller look at are numbers without denominators. For instance, they don't even try to normalize their data to time-dependent trends in the outcomes that they're looking at. At the very least, they should have looked at their data by birth cohort in order to see whether the trends they claim to have found hold up when historical trends are controlled for. True, they'd be comparing to an outside dataset that might not be properly comparable, but at least such an analysis would give us a rough idea if the number of vaccines at a single sitting was actually correlated with a higher risk of hospitalization or mortality compared to age- and birth cohort-matched controls. As it is now, we can say nothing. Indeed, what Goldman and Miller have done is virtually meaningless because they're looking at a set of patients selected because their parents or lawyers thought they had had a vaccine reaction, without verification of whether or not their reaction was actually due to vaccines. Add to that the usual rather arbitrary and questionable way in which Goldman and Miller count the number of vaccines in multivalent vaccines, and truly we have another GIGO epic.

I mentioned historical trends, and that is perhaps the worst failing of this paper. Basically, Goldman and Miller grouped together 20 years worth of data. For example, the child mortality rate in the U.S. has been steadily declining since 1960 and has declined significantly since 1990, as has the infant mortality rate. No attempt to control for this appears to have been made, nor has there been an attempt to control for the overall rates of hospitalization over time. Indeed, the authors themselves seem to admit (inadvertently, of course) that they haven't controlled adequately for confounding variables:

A two-way ANOVA using the number of vaccine doses (2–8) and age, ranging from 0.1 to 0.9 years in 0.1 increments, was unproductive due to the too large an interaction between age and dose, particularly with those aged 0.6–0.9 years. When restricted to ages 0.1–0.5 years, the number of vaccine doses accounted for 85.3% of the total variation (F = 25.7, p < 0.001), the age factor was not significant at 1.4% (p = 0.64), and the residual was 13.3%.

Of course there is a huge interaction between the number of vaccines given at any one time and the age of a child. The vaccine schedule is set up so that children get different vaccines (or groups of vaccines) at different ages. Moreover that recommendation has changed over time. It is not at all surprising that that's what Goldman and Miller found. Taking that consideration one step further, let's go back to a particularly brain dead argument made by Vox Day, in which he correlated in VAERS the age at which the risk of mortality is the highest with the age of receiving multiple vaccines, namely a "death spike" at around three months. As I pointed out, the reason for that "spike" in the death rate between 2 and 4 months is because that's age of peak incidence of sudden infant death syndrome (SIDS), an age that's been known for decades and that hasn't changed even with all the changes in the vaccine schedule over the last 30 years. As I also noted before, there are at least nine good studies showing no correlation between vaccination and SIDS. Interestingly, there is a hint of SIDS in Table 6, which lists mortality rates by age from 0.1 to 0.9 years of age, with a high death rate between 0.0 and 0.3 years of ages (0 and 3.6 months), which rapidly tails off after that. One also wonders about how the highest death rates occur before significant numbers of vaccines are even given. In any event, it all makes me wonder whether part of what produced Goldman and Miller's result is the confusing of correlation between SIDS and the start of the vaccine schedule with causation. We can't know because Goldman and Miller didn't even try to control for some obvious potentially confounding variables, such as birth cohort.

None of this stops Goldman and Miller from concluding:

Studies have not been conducted to determine the safety (or efficacy) of administering multiple vaccine doses in a variety of combinations as recommended by CDC guidelines. Our findings show a positive correlation between the number of vaccine doses administered and the percentage of hospitalizations and deaths reported to VAERS. In addition, younger infants were significantly more likely than older infants to be hospitalized or die after receiving vaccines. Since vaccines are administered to millions of infants every year, it is imperative that health authorities have scientific data from synergistic toxicity studies on all combinations of vaccines that infants are likely to receive; universal vaccine recommendations must be supported by such studies.

Studies have not been conducted? Pretty much every epidemiological study done looks at adverse reactions examines vaccines administered according to the CDC-recommended schedule. This is just another antivaccine trope in which antivaccinationists try to claim that all vaccines must be specifically tested in every combination used in the manner that antivaccinationists think that they should be. As for the finding that younger infants are more likely to be hospitalized or die, well, that's very likely because SIDS incidence peaks around 3 months, which means that by random chance alone infants in that age range are more likely to be hospitalized after vaccination.

So in the end what we are left with is yet another sad attempt by antivaccine activists who think themselves to be serious epidemiological researchers to demonize vaccines by dumpster diving the VAERS database in a risibly incompetent fashion. Same as it ever was.

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Antivaxxers-- the gift that keeps on giving... stupidity and infectious diseases.

By Melissa G (not verified) on 26 Dec 2012 #permalink

@Orac - I also find that new parents (and even second time parents) tend to freak out in the first three months with every minor illness that comes along & will take their kids to the ER / Hospital at the drop of a hat.....also, illnesses that occur in that age band can be more serious & require hospitalization - such as the flu, for example, that wouldn't require hospitalization at a slightly older age (the "better safe than sorry" approach to medicine).

Using VAERS data for anything other than what is was originally intended - a means to identify potential reactions, with no information provided to let people know if a particular entry was in fact an actual vaccine reaction, means that you have no idea if you are analyzing "real" data.

What a giant crock of research this is.......

Definitely get the feel of cargo cult science. They do some mathy things with false assumptions, lack of controls, and so forth so that they can get a graph to wave around like a totem to convince the faithful.

Finally got that recent comments cookie problem everyone was talking about, so dropping this comment to fix it.

By Bronze Dog (not verified) on 26 Dec 2012 #permalink

Orac,

I have been thinking you've been using Star Wars as a template ("wretched hive of...."), but now with your Doctor Who admission, I'm impressed with your credentials. I mean, "Orac" itself should do that, but I was thinking the name was possibly a fluke. I hope the episode was good, I haven't watched it yet.

Anyway, I just wanted to say that more than liking your blog, I think it's important. So thanks.

@Lawrence--it's not just new parents who freak out with a sick infant. When are now 13-year old daughter was 4 months old, she spiked a fever and would not eat. Our pediatrician had us take her right to the ER at St. Louis Children's hospital. Within an hour they had taken blood and urine and done a spinal tap. Turns out she had a bladder infection and spent the next four days in the hospital getting IV antibiotics. It was really scary, especially when they were testing her for meningitis. It took 45 minutes to get an IV in her because she was so pudgy--they ended up putting it in her head.

Anyhow, it seemed to us that the doctors were more alarmed by her symptoms than we were. Once our kids became toddlers, fevers and lack of hunger didn't even warrant a trip to the doctor's office.

That was our only infant trip to the ER out of our three kids, but we made tons of trips to the ped's office.

Not being a Doctor Who fan, I thought your name came from this (See below)--I rather like the idea that you're out there neutralizing [sCAM] radicals.

What is the ORAC Value of a supplement mean?
ORAC stands for oxygen radical absorbance capacity. It is a measure of how well an antioxidant can neutralize free radicals in a test tube. Higher ORAC values usually are taken to mean that the antioxidant is “better.” ORAC values are sometimes cited in advertisements as “proof” for a supplement but there is a problem with ORAC values. ORAC values only tell us what happens in a test tube. Having a high ORAC value does not mean that the antioxidant would do the same thing in humans. Humans are much more complicated than test tubes.

Garbage In, Garbage Out, indeed.

It's Goldman & MIller's calling card.

re: "post-holiday"

In my book, the holidays are now effectively over ( although technically, we have until New Year's day is over- 6 days down...6 to go) thankfully. Let's be honest now, aren't many of you also *secretly* as glad as I am?
Rituals of over-priced, meaningless gifts being exchanged between adults, bacchanals of too many rich foods and too much alcohol; every year I attend at least one ( usually more) ridiculous party and another social event, see a 'serious' play or movie, visit one festive-looking village, need to get really dressed up several times and spend hours upon hours on the phone, talking to people I don't really bother with otherwise; the cousins near and far fill me in with detailed stories ( that I already know) about other cousins and THEIR cousins. It's endless. Yes, I know the season is supposed to be about family and friends but the ones who matter most are in touch all year long.

At least one person is seriously ill or injured ( one of each, this year) and someone else gets depressed ( of course). And there's a major argument ( so far, so good). And you work much less so you focus on all of the other things. And there seems to be a slowdown in other distractions- like world news- that might give you some interesting food for thought. Even the woo seems lightweight and forgettable.

Fortunately, it's over for another year. Hallelujah! However, I will have to now deal with people who are depressed BECAUSE it's over.

My holiday wish for Orac and my fellow and sister sceptics is that the woo doth flow like organic Manuka honey- thick and rich- so we'll have plenty before us this dreary winter. And good health, peace on earth and all the usual.

By Denice Walter (not verified) on 26 Dec 2012 #permalink

This is a question (thanks for another excellent post). I've been looking for a reference to the fact that the age band of SIDS has been known for years, long before the current vaccination schedule. I could not find it; can you direct me to such a source? Thank you!

Dorit, got to PubMed.gov, and then put in "sids review" in the search box. Go to the last page where you will find papers like:

Sudden and unexpected infant death. I. Review of the literature.
Acta Med Leg Soc (Liege). 1956;9(Spec No):117-31; passim. No abstract available.

Sudden and unexpected death in infancy: a review of the world literature 1954-1966.
Pediatrics. 1967 Jan;39(1):123-38. Review. No abstract available.

Then go to your local Medical School Library and ask the librarian to help you find those papers.

You might also try:
http://www.cdc.gov/SIDS/index.htm

By the way, a decade ago when I was on a listserv for my son's severe speech disability, there were speculation from some that the "Back to sleep" SIDS prevention strategy was to blame. I had to tell the person who asked me that my son was born before that program.

Go, Alain! Go! Skip the beer and guide your way to medical school. Go! Go! Go!

There is nothing to lose, and even if it doesn't work out it is always worth trying. While I dropped out from grad school twice due to other life issues, I always valued the time I spent there.

@ Dorit: Here's a bit of history about the origins of SIDS deaths.

I recall reading this book and the controversy surrounding the multiple SIDS deaths in one family...

http://www.sharonlbegley.com/the-nursery-s-littlest-victims

~ Fifty years a friend who was a few years older than me, had her first baby...a beautiful little boy...who died mysteriously in his sleep at 2 months of age. That really was the first case of a sudden infant death during sleep, I ever heard of. There was even less known about the cause of death then, than there is now.

IIRC, the first recommendation in the United States to decrease the risks of an infant dying from SIDS, was the "back to sleep" educational program, which was followed by other recommendations about firm supportive mattresses, tossing out of pillows from cribs and cautions about "bed-sharing".

Thanks Chris,

I do intend to do a lot of research before doing my med school application so that it would help me get into the med school admission comity. Furthermore, the med school program is designed so that we learn modules at a rate of one per 2 month so we're touching one subject every 2 month which help me out.

Alain

lilady - WRT that Begley article, the. opposite happened here in the UK. Mothers were jailed for murder, families were torn apart, one mother even died, all because an "expert witness" claimed that murder was the only possible manner for multiple infant deaths in one family.

http://en.wikipedia.org/wiki/Roy_Meadow#Expert_testimony

@elburto.
The blame doesn't "all" rest with Meadows. Clark had an atrocious defense team working for her, and they seemed incapable of challenging anything any witness said, including the expert witnesses, or presenting any evidence to exonerate their client. There was also the issue of crucial evidence not being presented that the child had died of Staphylococcal sepsis, quite an oversight you will agree. A great miscarriage of justice was done, but Meadows was only partly to blame for it.

I like the first graph, it's missing the zero vaccine point, and if I don't ignore the one vaccine point (which oddly enough doesn't have an error bar), a horizontal line at about 12 would probably cover 1 -6 just fine, maybe with a hockey stick up to 8.

@ Elburto: I linked to the article for Dorit who posed questions about the origin of the terminology SIDS. The article states that one particular article, written by the doctor who cared for two of the Hoyt children, published in 1972, claimed that SIDS "runs in families". It had a profound effect on that lack of thorough investigations of infants who died suddenly:

".. the deaths of the last two Hoyt babies became the basis for a SIDS paper so influential that it put blinders on pediatricians and researchers for 25 years, preventing most of them from considering homicide when babies died for no apparent reason. In that paper, published in the journal Pediatrics in 1972, Dr. Alfred Steinschneider, who had cared for Molly and Noah Hoyt, argued that SIDS runs in families and is caused by prolonged sleep apnea (a cessation of breathing for 15 seconds or more). The paper became an instant classic. It gave birth to a multimillion-dollar apnea-monitor industry. But it also provided cover for families where more than one child died of SIDS. A quarter-century later, Dr. Jerold Lucey, editor of Pediatrics then and now, writes in the October issue, ""We should never have published this article . . . [S]ome physicians still believe SIDS runs in families. It doesn't--murder does...."

I'll be off line for a few hours, but you can look at newer articles about SIDS deaths...the decrease in SIDS deaths due to the "back to sleep campaign", recommendations about infants' sleeping environment...and the unfortunate deaths of babies, who were inadvertently smothered by parents who "bed share".

Post-Christmas cookie, please.

Oops, I guess I dropped the cookie. Please sir, may I have another?

More post-holiday anti-vaccine "science":

AoA discusses Prevenar 13 and finds it lacking.
Of course this doesn't match the recent anti-psychiatry contribution of the fraudaudacious AJW but it's a start.

By Denice Walter (not verified) on 27 Dec 2012 #permalink

FRAUDACIOUS?

By Denice Walter (not verified) on 27 Dec 2012 #permalink

Fraudulacious?

Can someone graph the decline in SIDS deaths over the last 20 years against the rise in vaccine usage please?

I think there is definitely a paper in there for the Journal of Human and experimental Toxicology, showing how this proves vaccination prevents sudden infant death.

@ THS:

Yes, Andy is such a special case I thought that he deserves a new word to describe him, which I thought up last night.

adj. fraudacious- ( n. fraudacity/ adv. fraudaciously)

A fraud who has the audacity to label** whomsoever calls him out a fraud.

** libel

By Denice Walter (not verified) on 27 Dec 2012 #permalink

@DW OK. Good term! Well done, as it build on the root, audacious.
Can we fraudulacious for claims, etc. so laced with fraud and woo that it's not clear where even to start? This would be kin to the "not even wrong" category. One might argue would be that "fraudulent" is sufficient. Coining the *right* term can be fun, though.

@ THS:

*fraudULacious* describes fraudacity that invokes adulation from your followers- e.g. "The fraudulacious Andy has scores of admirers at AoA."

By Denice Walter (not verified) on 27 Dec 2012 #permalink

@DW Good. Thanks for clarifying this one. There was an old Saturday Night Live bit where some office-dude type would take a word & run with permutations. The Frauderator, etc.

In addition, younger infants were significantly more likely than older infants to be hospitalized or die after receiving vaccines.

To Goldman and Miller:
Younger infants are more prone to hospitalization because of less mature immune systems, which makes them more susceptible to sepsis and other illnesses, you ridiculous persons. It could be a simple virus, but because very young infants don't put up a good immune fight yet, pediatricians are more likely to hospitalize and monitor if they become ill. Obviously, you are not interested in the real reason for hospitalizations of infants and ways to protect them.

As for an increase in hospitalizations - yeah, things have changed. In CYA medicine, it's safer to hospitalize overnight and monitor than to send home with "keep an eye on them and let me know if they get worse". Or, as back in my childhood, when almost everything (including my brother's pneumonia) was treated at home...

In addition to MI Dawn's open letter to Goldman and Miller, here's a link to the reasons why neonates and young infants are hospitalized and undergo full sepsis workups to rule out invasive bacterial infections...

http://emedicine.medscape.com/article/1834870-overview#aw2aab6b2b2

Just another in a long line of bogus studies produced by the VAERS dumpster-diving Goldman-Miller turds.

Something doesn't stack up here. In the UK there is the highest incidence of whooping cough for decades but there is according to the health protection agency also the highest vaccine uptake too. They are also pointing out that this has nothing to do with antivaxxers. Has anyone considered that the vaccine doesn't work?

By Notsosure (not verified) on 27 Dec 2012 #permalink

Can someone graph the decline in SIDS deaths over the last 20 years against the rise in vaccine usage please?

U.S. SIDS data are readily available, but putting together the NIS-based coverage axis would probably be a pain in the tokhes.

@Narad - I believe you mean "tuchis".

@Narad – I believe you mean “tuchis”.

They may mean the same thing, but no, the spelling was chosen deliberately.

@Narad - I once had a gaming character called Kushmeer Intokhes. People would ask "Are you from India?". Ah, good times.

Dingo -

I think there is definitely a paper in there for the Journal of Human and experimental Toxicology, showing how this proves vaccination prevents sudden infant death.

Definitely. It can run alongside the companion piece that illustrates thimerosal's protective effects against the development of ASDs.

I'd like to see NVIC, AVN, et al. explode in delicious, foamy fury as they run around in circles trying to explain that correlation does not imply causation , but only for those two hypotheses.

I settled down to watch the Doctor Who Christmas special

I am obliged in the interests of random pedantry to point out that the last full moon of 1892 was on the night of Dec. 4th. This is contrary to the Dr Who Special in which the action takes place in the lead-up to Christmas Eve of that year, and there is a full moon (illuminating the scenes of a spiral staircase to the clouds).
Imagine my disappointment that Dr Who episodes depart so far from physical reality.

By herr doktor bimler (not verified) on 28 Dec 2012 #permalink

HDB,

Imagine my disappointment that Dr Who episodes depart so far from physical reality.

Random pedantry of such caliber surely deserves some sort of award. Or therapy.

By Krebiozen (not verified) on 28 Dec 2012 #permalink

Now that Orac has mentioned housewives (The Long Island Medium), who are propelled to fame, has anyone seen "The Real Housewives of New Jersey"? The NJ Housewives are part of the franchise on Bravo TV (Real Housewives of New York, Miami, Beverly HIlls, etc.). If you thought that "Jersey Shore's Snookie" was a lowlife...she's a class act compared to all the "NJ Housewives".

http://www.tvguide.com/News/Jacqueline-Laurita-Autism-Son-1052242.aspx

Laurita is scheduled to appear at the 2013 Autism One Quackfest, on the Keynote Panel.

http://www.autismone.org/Keynote-Address-Autismone-Conference-2013

Something doesn’t stack up here. In the UK there is the highest incidence of whooping cough for decades but there is according to the health protection agency also the highest vaccine uptake too. They are also pointing out that this has nothing to do with antivaxxers. Has anyone considered that the vaccine doesn’t work?

I'd really like to get a link to the actual words of the health protection agency saying "this [the high rate of pertussis] has nothing to do with antivaxxers" because that seems to me a very, very counter-intuitive conclusion, and I'd like to know how they reached it, if in fact they did.

In fact, it's so very counter-intuitive that I have to side-eye anyone who understands the nuances of the English language choosing the phrase "pointed out" to describe the making of such a claim. You use "pointed out" for something that can be trivially verified: e.g., she pointed out that his fly was down; the chairman pointed out that the firm was still in the black despite the downturn in revenue. You don't use "pointed out" for the making of an extraordinary claim, such as "the incidence of an infectious disease has gone up and it has nothing to do with the kind of people who scorn well-established protective measures against infectious disease, sometimes going so far as to deliberately infect their children with disease."

By Antaeus Feldspar (not verified) on 28 Dec 2012 #permalink

Can I point out that "Real Housewives of AoA" is unlikely to be a major ratings success?

By Dangerous Bacon (not verified) on 28 Dec 2012 #permalink

Something doesn’t stack up here. In the UK there is the highest incidence of whooping cough for decades but there is according to the health protection agency also the highest vaccine uptake too. They are also pointing out that this has nothing to do with antivaxxers. Has anyone considered that the vaccine doesn’t work?

There is no doubt that the vaccine works. This study of the epidemiology of pertussis in the UK (PDF) found that vaccine efficacy was 97.6% among infants 6–11 months of age and 83.7% among children 12–16 years of age . Before routine vaccination was introduced the UK saw around 170,000 cases each year, and now we get fewer than 10,000 cases each year and more than 80% of these are in teenagers and adults whose immunity after vaccination (or natural infection) has waned. Pertussis is not spread through poor hygiene, in case anyone suggests that improvements in hygiene caused the decline - they didn't.

The pertussis vaccine scare in the late 70s led to a fall in vaccine uptake which was followed by large outbreaks of pertussis (one of which resulted in my son spending weeks in the hospital, incidentally) of around 60,000 cases each year with several deaths - see the graph in the first link I gave. That vaccine scare proved to be unfounded, by the way, and pertussis cases fell again as vaccine uptake increased. That's pretty persuasive evidence that the vaccine works, and that antivaccine misinformation can have serious consequences.

I hadn't heard of the recent move to vaccinate pregnant women in the UK against pertussis (see my second link):

At the end of September, the Department of Health announced that pregnant women would be offered whooping cough vaccination to protect their newborn babies, who do not usually start their vaccinations against whooping cough until they are two months of age. The aim of the vaccination programme is to help to boost the short term immunity passed on by women to their babies while they are still in the womb.

It is too soon for this vaccination campaign to have had an impact on the case numbers we are seeing, however, the Department of Health recently reported an uptake of around 40 per cent in pregnant women.

That's good news for babies, but I'm sure it will get antivaxxers frothing at the mouth.

By Krebiozen (not verified) on 29 Dec 2012 #permalink

@Dangerous Bacon--

Hey, if hoarders are worth repeated episodes (how many times can one watch variations on "I'm fine, there's nothing wrong with carefully climbing over mounds of mouldering garbage inside my house," anyway?) then the comic stylings of AoA would certainly warrant a season or two... *SIGH*

By Scottynuke (not verified) on 29 Dec 2012 #permalink

If you're looking for antivaxxers in the news, Jenny McCarthy made Cracked.com's list of "4 Dangerously Influential Dimwits."

(All right, I have an overly-broad definition of "news".)

About the statistics. Usually if a lineal correlation is above 0,95 you don't need to search to a non-linear correlation or some polynomial fitting. The scarcity of figure 1 seems to high. Certainly a sigmoid fitting would be much better but probably the authors didn't know how to discuss it.
On the top of that we find the same issue as always confusing correlation with cause-consequence. As pirates disappeared from the world contagious dissease related deads decreased, so pirates where main responsibles of contagious dissease related deads?
They should have shearched for "hospitalization the few days after vacinnation" versus "hospitalization for non vaccination".
It has been shown that when a vaccine is applied it is because, eventhough that vaccination may have some % of negative reaction, non-vaccination is much risky.

For funding, research and peer finding please refer to the non-profit Aging Portfolio.

@Healthy

For funding, research and peer finding please refer to the non-profit Aging Portfolio.

Is this some sort of lame attempt at spam? You posted the exact same sentence for an entirely different comment, context and on another blog post too.

Ah, never mind. I see the sentence has also been posted on a third and fourth blog post too. Definitely spam.

@Orac

You might want to check up on this...

Ah, never mind. I see the sentence has also been posted on a third and fourth blog post too. Definitely spam.

It's rather odd, but seems to be in burst mode lately. It did the same thing, as "2Healthy," over a year ago at SBM and as "Felipe Contreras" at Nature. A hallmark seems to be that it's a one-off. In this regard, it's at least more original in content than Anne Dachel.

The supplemental clerk's record in the Wakefield case came in on the 14th, so Friday is the due date for the brief.

Orac, Gorski is sponsored by pharmaceutical companies himself, drug money behind him. so lets take particular data from that publication by Goldman (what Gorski avoids), e.g. injecting infants with hepB shot at birth (or take anything else from that publication to adress it, to prove it wrong)

"A disproportionate number of hospitalizations were due to the administration of the at-birth dose of the hepatitis B vaccination: 809 (73%) of the 1115 VAERS cases reported the receipt of hepatitis B vaccine; 242 (30%) of these 809 were reported as hospitalized. Several studies provide evidence of correlations between hepatitis B vaccination and serious adverse reactions, including pediatric multiple sclerosis.6⇓⇓⇓⇓⇓–12 Thus, the newborn dose of hepatitis B vaccine, administered at a time when the immune system is most immature, may be contributing to increased vulnerability to serious adverse reactions causing disproportionately high rates of hospitalizations during the neonatal period. "

Chemist,

In your own words, what are the drawbacks to using VAERS as a source for such data?

@Orac...

Orac, Gorski is sponsored by pharmaceutical companies himself, drug money behind him.

I LOL'd at Chemist's comment...I mean...Doh!

Can anyone find the article Chemist is quoting? I'd love to look at the references.

@ Chemist:

You assert that Dr G is suspect because he is funded by Big Pharma : how are we to be assured that you yourself are not similarly compromised-i.e. being sponsored by the competition, Big Supplement & Chelators United?

By Denice Walter (not verified) on 01 Jan 2013 #permalink

Chemist,
could you clarify your point?

Could you provide a link or at least a reference to the specific material you quoted (if it's one of the Goldman articles linked in the lead post - tell us which)?

An unsourced quotation is not an argument for anything - much less proof that something is wrong.

Did you perhaps accidentally leave off the rest of your post?

Is it just me, or is the fact that Gary S. Goldman, "Computer Scientist," is still using a RoadRunner address for professional contact consistently amusing? (Drop me a line, Gary; I haven't technically been a Computer Scientist for a couple of decades, but I can get you set up for a very modest fee.)

BTW, Chemist, do you understand what the passage that you quoted was attempting to explain away? I do not think it is was you think it is.

^ "is what you"; perhaps I'll resume wearing my glasses.

Yes i am pharmaceutical chemist and this is issue of vaccine safety in children. My first post here was adressing another issue downplayed by Orac: ethylmercury in thimerosal formerly used in child vaccines. Orac claimed that ethylmercury is completely bening as to neurotoxicity. Thats very ignorant, outrageous claim from neurotoxicological point of view, by Orac.

Now i would like to discuss this from that Goldman piece: Vaccination by hepB at birth, its safety. Notice that use Goldman for it due to lack of any other statistics, you are asked to argument against it. concretely this, "Single-dose outlier, point 2.":

2. “A disproportionate number of hospitalizations were due to the administration of the at-birth dose of the hepatitis B vaccination: 809 (73%) of the 1115 VAERS cases reported the receipt of hepatitis B vaccine; 242 (30%) of these 809 were reported as hospitalized. Several studies provide evidence of correlations between hepatitis B vaccination and serious adverse reactions, including pediatric multiple sclerosis.6⇓⇓⇓⇓⇓–12 Thus, the newborn dose of hepatitis B vaccine, administered at a time when the immune system is most immature, may be contributing to increased vulnerability to serious adverse reactions causing disproportionately high rates of hospitalizations during the neonatal period. “

notice that we are discussing concretely that Goldman piece Orac is blogging actually about. I am not interested in discussion with jerks.

Relative trends in hospitalizations and mortality among infants by the number of vaccine doses and age, based on the Vaccine Adverse Event Reporting System (VAERS), 1990–2010

http://het.sagepub.com/content/31/10/1012.full

Otherwise i appreciate Oracs blog very much (e.g. his posts on cancer are very good), just i dont like his jerking around vaccine safety and downplaying it. Also i appreciate that my posts are not censored. As to Oracs COI, citizens can ask his institution if there is Sanofi-Aventis (Pasteur), a vaccine manufacturer, funding some of his drug research, or Orac to disprove it.

Notice that use Goldman for it due to lack of any other statistics, you are asked to argument against it. concretely this, “Single-dose outlier, point 2.”

He's throwing away the data point and is forced to concoct an explanation other than "it would completely screw up my trademark graph."

Chemist:

Yes i am pharmaceutical chemist and this is issue of vaccine safety in children.

Something you failed to prove at Just the Vax, where you commonly spammed silly statements and refused to provide educated documentation. Your reliance on annt-vax websites at "proof" showed that you have no scientific education and the highest level of "chemist" you are is the person who unloads the supply truck.

Chemist, perhaps it was lost on you but the dose make the poison. Did you happen to compare how much methylmercury there is in a can of tuna vs how much ethylmercury there is in a single dose of vaccines? Bonus point if you list the quantity of single dose vaccine who doesn't contain ethylmercury.

Alain

Orac claimed that ethylmercury is completely bening as to neurotoxicity

Oh yes?

By herr doktor bimler (not verified) on 02 Jan 2013 #permalink

Does anyone understand why Goldman calculated "hospitalization rates"? This is the number of hospitalizations expressed as a percentage of the children reporting a reaction to that vaccine. If it was a percentage of children being given that vaccine it would make a sort of sense, but not as a percentage of reactions.

It means that although there were more than twice as many hospitalizations in children given 5 vaccines as in those given 8, because there were a lot more reactions reported in the younger children, the percentage of hospitalizations was lower. This doesn't measure anything meaningful at all, as far as I can see.

For example, if a vaccines given at a particular age resulted in a lot of minor reactions, perhaps local pain or fever, that would push down the percentage of hospitalizations, apparently making the vaccine safer. It makes no sense to me at all.

By Krebiozen (not verified) on 02 Jan 2013 #permalink

Does anyone understand why Goldman calculated “hospitalization rates”? This is the number of hospitalizations expressed as a percentage of the children reporting a reaction to that vaccine. If it was a percentage of children being given that vaccine it would make a sort of sense, but not as a percentage of reactions.

I had to read the relevant sentence repeatedly. It still seems opaque every time I look at it. Something else I don't get is this: "Of the total 327,331 cases contained in the downloaded VAERS files, 28,707 (8.7%) cases specified no age and another 10 cases (0.003%) specified an age of 100 years or older and thus were discarded."

WTF cares? You're also discarding everyone over the age of 1 year, remember?

I also don't get the motivation for assigning Poissonian confidence intervals, which further don't seem to be exact* in Table 2, at least, aside from having something to plot. These aren't really estimates of anything in particular to start with.

* I'm getting wider values of 15.2–17.4, 9.0–13.3, 10.9–14.1, 13.2–15.6, etc.

I am not interested in discussion with jerks.

Damn! How am I going to waste time now?

By herr doktor bimler (not verified) on 02 Jan 2013 #permalink

One might also note that if the VAERS mortality figures are confined to events within a week of vaccination, about a third of Goldman's cases melt right away. At three days, it's 54%. For the hospitalizations, it's about 1/4 and 1/3, respectively.

I think this paper is a sort of anti-fractal. The closer you look, the less there is in it.

By Krebiozen (not verified) on 02 Jan 2013 #permalink

Pharmacist cited this bit of the Goldman paper:

Several studies provide evidence of correlations between hepatitis B vaccination and serious adverse reactions, including pediatric multiple sclerosis.6⇓⇓⇓⇓⇓–12

Now don't ya just hate it when people lie?

First thing to note is that references 6 through 12 do not all refer to MS; One refers to GBS and one to a single patient with encephalitis. One paper is just a single MS case report in a Chinese journal. So what about the other papers? Well none provide strong evidence (and the papers suggesting a link have been criticized for poor methodology). One of the cited papers didn't show a relationship with HB vaccine until a subgroup analysis was done on one type of Hep B vaccine (Engerix B), and the same authors of that study also published another larger analysis (not cited by Goldman) which showed no relationship.

The scientific consensus is that the supposed link between Hep B vaccine and MS is spurious (not that this stops the antivaxers stating otherwise).

CDC publish an overview of some of the evidence:
http://www.cdc.gov/vaccinesafety/Vaccines/multiplesclerosis_and_hep_b.h…

First thing to note is that references 6 through 12 do not all refer to MS;

Second thing to note is that there are, unsurprisingly, exactly zero VAERS entries, all told, mentioning MS and Hep B for ages 0–5 and 14 for ages 6–17. What the hell is this babbling supposed to have to do with ignoring a data point regarding infant hospitalizations?

The cited paper also mentions "A positive association found between autism prevalence and childhood vaccination uptake across the U.S. population." Written by a professor of economics at Baruch College/City University of New York.
OK, non medical types can analyze information, it's only statistics.
So, I look for some reviews of the work.
http://neuroskeptic.blogspot.com/2011/05/vaccines-cause-autism-until-yo…
Couldn't argue with the reviewers math and results, whereas one had to go through some interesting math to arrive at the cited author's statistics.
Of course, the press all goes to the professor, not the peer reviews or examinations by real scientists in neuroscience.
Yet another citation "Developmental regression and mitochondrial dysfunction in a child with autism."
Muscle fiber mitochondrial dysfunction.
Peer review: "“3 . . 2 . . 1 . . Impact [Factor]: Target [Academic Career] Destroyed!”
Just Another Statistical Casualty" by Roger A. Brumback, MD, Creighton University School of Medicine.
http://jcn.sagepub.com/content/27/12/1565.abstract

The only places I find the papers referenced in the bird cage liner "research" are antivax sites.
Three were additional reviews of the cited papers, all equally scathing and utterly debunking the tripe that built other tripe.
And so begins another year of GIGO.

Also, Goldman's follow-on point:

3. Infants who were sensitive to their first vaccine might have been urged by the child’s physician or concerned family members to avoid subsequent vaccines, especially multiple doses administered concomitantly.

So f*cking what? You're not excluding anything with this.

The cited paper also mentions “A positive association found between autism prevalence and childhood vaccination uptake across the U.S. population.” Written by a professor of economics at Baruch College/City University of New York. [...]
So, I look for some reviews of the work.

Orac had a whack at it too:
http://scienceblogs.com/insolence/2011/06/08/more-bad-science-in-the-se…

By herr doktor bimler (not verified) on 02 Jan 2013 #permalink

I will further note that "Table 1" betrays incompetence both in assembly and typesetting. We can make a show of aimlessly pruning the centenarians but not skip the table entries that don't exist in the "sample"? I could take two pages of gas off the setting of this thing without a second thought.

Thanks, herr doktor bimler. I'm relatively new here. Only found the site in mid 2012.

To be honest, I had grave reservations quite along the lines that Orac has expressed, just in the mere abstract. Still, I've found a few papers over the years that not only passed peer review, but became full mainstream science. So, I persevered. Barely.
Orac caught a lot of things I failed to catch, but our field of expertise are vastly different. My medical expertise is based upon either primary trauma care in a military environment, epidemic response at initial response in a military environment, health care in a primitive environment without a medical professional available, etc. In short, an SF medic. I've learned enough pharmacology to be conversant with a pharmacologist. I'm fluent in speaking with a physician. I'm quite good at diagnostics, be it in medicine or other fields, as it really comes down to Boolean thinking. With large subsets.
I'm comfortable with subsets and large subsets, I was educated under the "new math" program, with elements still present of the old math program.
The last part of Orac's entry I had already considered far less verbosely, as I'm familiar with such things. I considered it in the two words of, "Population Density". Which, sums it up to an epidemiologist, of which I've worked quite closely with CDC epidemiologists at times. One rather learns a bit, if one wishes to and asks questions in order to learn more.

Frankly, all papers concerned would be worthy of use as toilet paper, save that electrons can be so excited at times and hence, irritating.
So, I'd not inflict that to the poor bird confined to a cage.

Any reaction at all to the story of the nurse fired for refusing to get a flu shot?

Yes: bogus religious exemptions are still bogus.

Khani, it is covered here and there. The consensus is that any nurse proclaiming some fake religion doctrine or starts going off about "toxins" should not be working with sick patients, especially the hospice nurse.

@ lilady, 666 degree of separation isn't too far for Jake ;)

Didn't bother to read Stone's magnum opus except the last line: "Delivered to all sponsors via e-mails". If I'd receive some spam like that, it would have went to /dev/null (the dustbin) pretty fast :)

Alain

Then there are those who take a paper and literally lie about what it says: Mumps Vaccination INCREASES Risk. Um, no, not what this paper says:

The epidemiologic features of this outbreak suggest that intense exposures, particularly among boys in schools, facilitated transmission and overcame vaccine-induced protection in these patients. High rates of two-dose coverage reduced the severity of the disease and the transmission to persons in settings of less intense exposure.

I could not believe she'd bothered becoming a nurse at all, personally. If you don't believe in science why go into a scientific field?

@ Chris: The blog you linked to is written by a chiropractor!

@ Khani: No matter when nurses had their training, they were required to have proof of immunization against vaccine-preventable diseases, at the time of admission to their nurse training program or university.

Prior to being hired by a hospital, nurses and all health care workers are tested for immunity against VPDs...no immunity and refusal to receive a vaccine...you aren't hired.

Immunizations requirements for employment in a hospital...or continued employment in a hospital...change...based on newer vaccines become available, such as the varicella vaccine and the Tdap booster vaccine.

Refusal to get the varicella vaccine, after a blood test shows you have no immunity and you're fired "for cause".

HCWs are required to get the Tdap booster now and no blood tests are ordered because the vaccine boosts immunity against the readily transmissible B. pertussis bacterium. You refuse...you're history.

The Goshen Hospital now requires yearly seasonal immunizations for all their employees, based on epidemiological studies of outbreaks of influenza in hospitals.

The hospital has the right, indeed the duty, to protect their patients from every vaccine-preventable disease by firing their employees who refuse flu vaccine.

@ lilady:

Seriously... over the past few days I have have been scanning the daily dreck and reading atrocious
literary shrieking and snarling , e.g. Stone, Jake, Larson, Lewis et al @ AoA and ESPECIALLY MacNeil @ TMR ( "Goodnight Autism")

It cause me to wonder: are they all fired up because AJW's suit in Texas is past due?

By Denice Walter (not verified) on 05 Jan 2013 #permalink

Well, the pjstar.com website seems to think that I've already signed up for an account to comment at their site, but won't give me an option to have a password reminder sent to me. As a result, I can't post my comment; if anyone wants to post it for me, you have my blessing:

"Even if Andrea Forget-Schnowske's factual claims about vaccines were all correct, which they aren't, her argument is still utterly incorrect as a matter of basic mathematics.

If we looked at all those who contracted mumps in a given outbreak, we'd almost certainly find that right-handed people outnumbered left-handed people by about 4 to 1. Is it logical to conclude from this that right-handedness "increases risk of the disease," or does it just reflect the fact that right-handed people are more prevalent in the general population?

Polydactyly (extra fingers and toes) happens in about 1 of 500 live births, so in any outbreak we would find that people born with regular numbers of fingers and toes VASTLY outnumber those born with extras. Is it logical to deduce from those numbers that NOT being born with extra fingers and toes is a big risk factor for disease??

Epidemiology, the study of outbreaks, requires a solid grasp of mathematics. Those who don't have that solid grasp of mathematics shouldn't play around at being epidemiologists."

By Antaeus Feldspar (not verified) on 05 Jan 2013 #permalink

@ Antaeus Feldspar

I tried to register but never received the confirmation email to be allowed to post.

Alain

Alain, check you junk mail folder.

Interesting that there comment policy says "Be honest and accurate.", yet that author just write blatant lies.

Whoa! What kind of comment policy do they have that only one comment got through? Though the person does not accuse the author of lying and is too diplomatic, unlike myself.

It cause me to wonder: are they all fired up because AJW’s suit in Texas is past due?

It's not, the appellant's brief was predictably in on the 4th (apparently with a request for a dog-and-pony show oral argument), and BMJ et al. have until February 4 in turn. I would be quite pleased if the latter turned this around with alacrity.

@ Chris,

The junk mail folders is empty. I wonder if it has to do that my email address end in .ca?

Alain

I guess that proves you don't live there!

@ Narad:

I'm glad you struck off "dog-and-pony show" because the comparison would be unkind to actual dog-and-pony shows.
Their oral argument would have to be decidedly worse.

By Denice Walter (not verified) on 06 Jan 2013 #permalink

Their oral argument would have to be decidedly worse.

We may well find out, as it's looking as though J. Woodfin "Woodie" Jones favors default granting of this exercise.

Ah what a surprise, lilady and Alain obsessing on Jake again...

Um, it was one comment each two days ago. You have a very weird definition for "obsessing."

I could be off base because I am only addressing this blog. I have not seen what happens at the Huffington Post recently. It is a silly place.

@ Chris...Jen posted her same old, same old comment about her grandmother who was diagnosed with GBS after receiving a flu vaccine.

Chris,

Didn't went to AoA lately so all my "obsession" about Jake has been posted here.

Jen,

Yawn....

Alain

You know, anti-vax campaigns are really, really cool. They exhibit every known logical fallacy known to man. Eventually, they'll create new logical fallacies to document.
As a survival trait, they lack any other recommendation, so eventually they'll become extinct.

Ironically, my eldest daughter was vaccinated for the current projected influenza strains, she has influenza. Oops.
When she recovers, we'll chuckle over the 60% effectiveness rate and hope for superior performance and happily let our tax dollars support said research.