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Tara C. Smith is an Assistant Professor of Epidemiology. Her research involves a number of pathogens at the animal-human nexus. Additionally, she is the founder of Iowa Citizens for Science and also writes for The Panda's Thumb and previously for WIRED SCIENCE's Correlations. Please note the views expressed on this site are Dr. Smith's alone and may not be representative of the groups mentioned above.

"...a veritable expert on tawdry cosmetic procedures gone horribly awry..."--Kevin Beck

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Infectious Disease Series

« Why I'll be getting my kids their flu vaccines | Main | The consequences of refusal »

Fear & vaccines

Category: General EpidemiologyInfectious diseasePublic health
Posted on: October 21, 2009 11:23 AM, by Tara C. Smith

I realize that, despite the scientific evidence to the contrary, there is still a lot of fear and misunderstanding about vaccine safety. Two recent articles discuss this "epidemic of fear" and why it affects us all, the first here at Wired magazine, and the second here at the Gotham Skeptic. I especially like the second, which has some excellent points:

My pediatric practice is situated at the nexus of three Manhattan neighborhoods (the West Village, Chelsea, and the Meat Packing District) that seem to comprise just the right balance of wealth, edginess, and socio-cultural awareness that lends itself to this new mistrust of vaccines. But these neighborhoods are not unique. According to sources at the NYC DOH, the Upper West Side of Manhattan and Park Slope in Brooklyn are also hot-spots of parental vaccine resistance. What stands out about these neighborhoods, and others like them, is that they contain a high percentage of middle to upper middle class families that tend to be young, well educated, and liberal in their political and social views. Because I live in one of these areas, work in another, and fit this description pretty squarely, I can identify with the underlying tendencies at work behind the concerns of these parents. A healthy questioning of authority (doctors), an underlying mistrust in the competence of the government (the CDC), overt mistrust and a general level of cynicism of big business (the pharmaceutical industry), and a sense of empowerment that comes with one's social status, all contribute to this tendency to mistrust vaccines and those who recommend them. The difference between these concerned parents and myself (also a parent), is an understanding of the scientific method and the role it plays in this issue. One term that I have purposefully left out as a key element in this new epidemic is "skepticism." While many of these parents believe they are being skeptical of vaccines, their manufacturers and the agencies that recommend them, this couldn't be further from the truth. What they are being is misled and taken advantage of. They would actually be better characterized as anti-skeptics. To quote Brian Dunning of Skeptoid.com:

"The true meaning of the word skepticism has nothing to do with doubt, disbelief, or negativity. Skepticism is the process of applying reason and critical thinking to determine validity. It's the process of finding a supported conclusion, not the justification of a preconceived conclusion."

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Comments

1

Good to see you posting again, even if only sporadically.

Posted by: BGT | October 21, 2009 2:55 PM

2

Perhaps a better word would be "empiricism"? I suppose perhaps it's not a common enough word.

Posted by: Theron | October 21, 2009 3:02 PM

3

Do you think that there is an element of "fear itself" at work?

Given that there is something 'real' to be afraid of here - i.e. the H1N1 flu virus - what is it, exactly, that parents think they are protecting their children from? Government, physicians and BigPharma are not "outcomes" the way severe illness and death as a result of the flu are. What are the negative health effects that parents think they are avoiding by skipping the vaccine?

Autism would probably be the most likely answer, right? Does anyone have other thoughts as to the things parents are trying to avoid?

p.s. I'm think that the initial research claiming to connect vaccines with autism has since been debunked pretty thoroughly as scientifically unsound and politically-motivated.

Posted by: FDR | October 21, 2009 5:44 PM

4

Tara,

Please get educated because you are being used. I recovered my son from vaccine-induced Autism. My brother was recently rushed to the hospital with yet again, viral meningitis and encephalitis (hint - Coast Guard - numerous vaccines - another hint - learning disabled/ADD/vaccine damaged as a child already!). Come on, are doctors really this clueless? Read "Fear of the Invisible" by Janine Roberts for a catch up session on all of the government meetings that have taken place over years regarding the vaccine contaminants.....they are causing all of these "new diseases"! Breast cancer - caused by the SV40 virus, HPV - vaccine contaminant - I could go on, but I think you have some reading to do. Your patients are counting on people like you to do their homework.

Dawn

Posted by: Dawn Crim | October 22, 2009 5:34 PM

5

Dawn, I prefer to read the primary literature rather than sensationalistic books by HIV-deniers. I also have been involved in a number of "government meetings" (was just on the phone with senate staffers today, in fact) and all the allegations of this huge scientific cover-up are absolutely absurd to a scientist. Do you have any idea how competitive a field science is? Do you really think the government could "muzzle" every single researcher in the US--and even if they could, foreign researchers certainly aren't covered and could easily publish these results in international journals, so lying to US scientists would be futile anyway.

I am glad to hear your son is doing better, but how can you be sure that he recovered due to your actions/treatments, when other autistic children also have been reported to be diagnosed with autism at one point, and to have "lost" the diagnosis later in childhood, without any active treatment program? To me, it seems these are cases of either 1) misdiagnosis, or 2) a process that we simply don't understand yet, but I don't see evidence of science-based programs to "heal" autism.

Posted by: Tara C. Smith | October 22, 2009 6:21 PM

6

There are plenty of primary sources that link Vaccines to brain damage. Monkeys injected with the Thimerosal containing Hepatitis b vaccine get brain damaged while the controls don't. (Hewitson et al)

3 different studies show urinary poryphrins pattern that has a pattern of mercury poisoning in autistic patients and not in controls (Nataf et al geier and Geier, one more forgot the name but I referenced it before)

Of course there is also the Hannah Poling case where it was clearly proven that vaccines played a major role in triggering autism. Hannah had no symptoms besides mild ear infections and was developing normally, she received many vaccines and became autistic right after.

Science is not democratic anymore, that is why huge blunders are possible. Science is now run by a small number of very powerful public health officials and drug companies. Their influence is much more than financial, they also are able to convince millions through indoctrination campaigns (note they aren't trying to convince people with compelling experiments) as we see today with their flu vaccination campaigns.

Posted by: cooler | October 23, 2009 12:29 AM

7

Hi Tara,

Thank you for som very interesting references. I can see that the debate in the States is so much more heated than here in Denmark. I would likew to point everyone who believes that there is a connection between autism and vaccination to a Danish study that includes almost one tenth of the population. It was publisked in The New England Journal of Medicine in 2002 (KM Madsen, et al.: A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism, NEMJ Vol. 347:1477-1482, No. 19). The abstract says it all:

ABSTRACT

Background It has been suggested that vaccination against measles, mumps, and rubella (MMR) is a cause of autism.

Methods We conducted a retrospective cohort study of all children born in Denmark from January 1991 through December 1998. The cohort was selected on the basis of data from the Danish Civil Registration System, which assigns a unique identification number to every live-born infant and new resident in Denmark. MMR-vaccination status was obtained from the Danish National Board of Health. Information on the children's autism status was obtained from the Danish Psychiatric Central Register, which contains information on all diagnoses received by patients in psychiatric hospitals and outpatient clinics in Denmark. We obtained information on potential confounders from the Danish Medical Birth Registry, the National Hospital Registry, and Statistics Denmark.

Results Of the 537,303 children in the cohort (representing 2,129,864 person-years), 440,655 (82.0 percent) had received the MMR vaccine. We identified 316 children with a diagnosis of autistic disorder and 422 with a diagnosis of other autistic-spectrum disorders. After adjustment for potential confounders, the relative risk of autistic disorder in the group of vaccinated children, as compared with the unvaccinated group, was 0.92 (95 percent confidence interval, 0.68 to 1.24), and the relative risk of another autistic-spectrum disorder was 0.83 (95 percent confidence interval, 0.65 to 1.07). There was no association between the age at the time of vaccination, the time since vaccination, or the date of vaccination and the development of autistic disorder.

Conclusions This study provides strong evidence against the hypothesis that MMR vaccination causes autism.

Posted by: Jan Helldén | October 23, 2009 3:55 AM

8

I am troubled by Dr. John Snyder's description of his neighborhood: "What stands out about these neighborhoods, and others like them, is that they contain a high percentage of middle to upper middle class families that tend to be young, well educated, and liberal in their political and social views. " Dr.Snyder goes on to state: "The difference between these concerned parents and myself (also a parent), is an understanding of the scientific method and the role it plays in this issue."

By no means are all vaccine refusers "young, well educated, and liberal." And all of those folk are not vaccine refusers. Dr. Snyder does not give figures (he does cite a NEJM article which gives state figures in the range 1-2.5%, with some counties in Washington state with 26.5% refusal) for his neighborhood, but I seriously doubt the suggestion that the well educated are lacking in "an understanding of the scientific method." The well educated are the ones most likely to understand scientific method. And I suspect the vast majority of them, including Dr. Snyder's patients, get vaccinations. They might ask a lot of questions, and perhaps Dr. Snyder grows weary answering them. If he's too busy to deal with their questions, perhaps he should hire someone to answer such questions. I'd be happy to send him my resume.

Posted by: Paul Heikkila | October 26, 2009 2:53 PM

9

The New York Times this evening is reporting that from 5 to 50 percent of public school children are signing up for the H1N1 vaccine. http://www.nytimes.com/2009/10/29/nyregion/29vaccine.html?_r=1&hp
The Times does not attribute this rather low acceptance rate to the youth, middle class status, educational level, or liberalism of the parents.

Posted by: Paul Heikkila | October 28, 2009 7:44 PM

10

Unfortunately swine flu came to Turkey. And There are a question every person's mind. Should I get vaccine or not?
Because We don't know about the risks of vaccine. I think we should, but Nobody know repercussion of swine vaccine.
What do you think this situation?

Posted by: Furkan | November 5, 2009 9:33 AM

11

Much of the vaccine debate has become rather tedious, I know - especially in these comment threads, which are so routinely hijacked by the Konspiracy Kru. I was wondering, though, if you'd be good enough to share your thoughts on something I've discovered recently.

I live in a European country where the usual hysteria about vaccines (esp mmr) seems to have little foothold. Rejection of all flu vaccines, though, is almost universal - especially so among doctors. Is this because the costs of flu (to the individual) are so much lower in a country with near-socialized madicine? Is it mere fashion/faddism in the medical community? I'm really mystified...

Posted by: outeast | November 8, 2009 7:44 AM

12

It's been ages since I've visited her, Tara. I see the anti-vax crowd still lurks in the shadows.

I read somewhere (maybe Orac's place) that one doctor reports his immigrant patients are the ones who most want vaccinations, because they have experienced first hand what communicable diseases can do. Most other Americans haven't a clue, because it's been so long since polio, whooping cough, etc., have been subdued by vaccinations.

I'm living in China now, and there was a small outbreak of H1N1 on our campus, principally among students in our college. One of our profs was out for a week with it, too. So we faculty were expected to get our flu shots, which all of us (save one from the UK with a bad cold) did. There were no negative reactions, other than sore arms.

China is serious about containing the pandemic. With 1.3 billion people, many living in close quarters, not controlling H1N1 would be an epic disaster.

Posted by: wheatdogg | November 12, 2009 9:17 AM

13

I did read your post from today, as suggested, referencing the articles from Wired and The Gotham Skeptic. You suggest in your reply to me that it is frustrating for Doctors to address parental concern that frequently come from "misinformation they've heard in the media or from celebrities." The Bill Maher video seems to illustrate this point clearly, but I'm not sure that's what you meant.

However, in my full blog comment I specifically cited my source as one of many respected M.D.s who have grave concerns about the vaccine controversy. Dr. Stephanie Cave, M.D. M.S. FAAFP. She is neither a member of the media nor a celebrity. Dr. Cave received an M.S. in clinical chemistry in 1978 and an M.D. in 1983 from LSU Medical School. She is board certified in family medicine and has been in private practice for 23 years...etc.

As I mentioned, I approached my family pediatrician with respect, concern and above all scholarship garnered from months of dedicated research on both sides of this issue. The resistance I received was not frustration; to my surprise, it was unpreparedness. By her own admission my ped was unfamiliar with the data I was referencing from Dr. Cave, Dr. Sherri Tenpenny and Dr. Mayer Eisenstein. (again, no celebrities or media) The primary source of the (mis)information I wanted to discuss is directly from the CDC's own literature and website. Also, to your point about having to repeat the same thing "over and over" She stated that she had NEVER been questioned by anyone as prepared. I gave her my 3 books and she offered to get back to me...2.5 years ago.

With all due respect Tara the Wired article and Dr. John Snyder's article are simply peddling the same old fear without addressing the core issue. The overriding theme of the physicians I'm citing is caution and proper science via double-blind placebo-controlled trials on previously NON-VACCINATED subjects which does not happen in the vaccine aproval process today.

These physicians introduce valid concerns that I need answers to. I do not apologize for any frustration it may cause my well paid pediatritian to professionally address these concerns with me. For each and every article by respected doctors like Dr. John Snyder (The Gotham Skeptic) there is an equally qualified M.D. with valid concerns who, for the most part, are NOT anti-vaccine but rather pro caution and freedom of choice.

Again, I say, I am not anti-vaccine...I certainly do not know more than you or any doctor for that matter. I am however, an intelligent, caring concerned father who simply cannot understand why I cannot find a pro-vaccine doctor willing to address my concerns within the CDC's own literature. In light of this, I can only come to the conclusion that... why should they? when there are so many of us willing to line up for our shots without questioning a thing.

By the way, any plumber or electrician I contract better know their subject and be able to explain their bill. You picked two professions to cite (Freudianly or not) that frequently capitalize on the ignorance of their customers. I choose to NOT be that person...not with the maintenance of my home, and certainly not when it comes to the health of my family.

Posted by: porno sex izle | November 22, 2009 8:26 AM

14

I mentioned, I approached my family pediatrician with respect, concern and above all scholarship garnered from months of dedicated research on both sides of this issue.

Posted by: red pepper | November 24, 2009 1:55 PM

15

I am glad to hear your son is doing better, but how can you be sure that he recovered due to your actions/treatments

Posted by: kilo aldırıcı | November 24, 2009 2:03 PM

16

Their influence is much more than financial, they also are able to convince millions through indoctrination campaigns (note they aren't trying to convince people with compelling experiments) as we see today with their flu vaccination campaigns.

Posted by: açai | November 24, 2009 2:10 PM

17

We did not have our son vaccinated yet. We are not sure if we will or not, but the thought of injected so many foreign substances into his little 2 month old pure body was insane. I did tons and tons of research as well and concluded that it is hard to figure out what is true and what is being told as truth because it is profitable.
In talking with our pediatrician, she said more and more doctors are supporting informed vaccination. It seems the CDC is pushing vaccines to an extreme that there is naturally going to be a resistance growing amongst the American public.

The h1n1 vaccine is the most concerning to be now. It has not been properly tested because it has been fast tracked, the manufacturers only claim UP TO a 50% efficacy and the CDC has recommended that pregnant women get it, yet it has not been studied on pregnant women and there have already been over 20 reports of miscarriages days after the mother received the vaccine. I don't want my body to be the testing ground for the vaccine.

The concern is real, is too much too much?

Posted by: E-cigarette | November 29, 2009 3:55 PM

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