Respectful Insolence

Superstition ain’t the way

An excellent op-ed article by Michael Fitzpatrick characterizes quite well the hysterical fear based on no evidence that Andrew Wakefield and his accomplices started in the U.K. over the MMR vaccine and the unfounded claim that it causes autism and bowel disorders:

The rise of a combination of extreme scepticism towards established sources of authority in science and medicine and anxiety about environmental threats to our wellbeing has led many to put their faith in self-proclaimed mavericks and alternative healers and charlatans. The recent outbreaks of measles, which resulted last year in the first childhood death for 15 years, shows how dangerous this credulity can be.

He’s right. Be it antivaccination lunacy such as that stoked by Andrew Wakefield or the rejection of evidence-based medicine in favor of non-evidence-based woo. He’s also spot on with this statement:

The object of immunisation policy is not to provide a “pick and mix” selection to the public, but to provide a coherent programme for the prevention of infectious diseases. A strong body of scientific evidence confirms that MMR provides the best protection for both individual children and for society. As a consequence of ill-informed choices made in a climate of fear irresponsibly cultivated by antivaccine campaigners and vested interests, we now face outbreaks of measles. The choice to refuse MMR to avoid an entirely speculative risk of autism results in children being exposed to the real risks of measles.

Exactly. Once again, the problem is that vaccines have been so successful in eliminating disease. Few people, even among doctors, remember just how serious a disease measles can be. Few parents have seen a case personally, either among their own children, relatives’ children, or children of friends. Consequently, the risks of vaccines, whether the very minuscule real risks or the imagined risk hyped by the antivaccination forces who falsely linked the MMR to autism, seem not worth the price. However, as I mentioned yesterday, the price will eventually be paid sooner or later. In the case of the MMR scare, even nearly nine years later, the scare continues, and the result is suffering and at least one death.

None of this is to say that we should uncritically accept what medical authorities tell us. However, when evaluating what antivaccinationists say, it is important to examine their evidence, such as it is, critically. When that is done, it becomes clear just how weak the evidence is upon which they base their fears compared to the evidence for the safety of vaccines.

Comments

  1. #1 bigTom
    September 3, 2007

    Another thing that makes the selling of vaccination to an indivdual harder, is that a big part of the benefit is systemwide. By that I mean that if some critical proportion of the population is vaccinated, the disease will die out (or decline to a new lower prevalance level if some other reservoir exists). Once this threshold has been crossed the benefit to the individual of his personal vaccination is small.

  2. #2 James
    September 3, 2007

    bigTom: its called the free-rider effect, a lot of public health (as distinct from primary health care) goods have the same characteristics. The case from government-provided public health is stronger than for health care generally.

  3. #3 John Fryer
    September 3, 2007

    Orac

    Your comments about Dr Andrew Wakefield are partial and at times false. Andrew does not and is not anti-vaccine. His paper and the publicity enabled my daughter to opt for safer single vaccines and in the event 1 of the 3 was deemed by other UK doctors to be totally and completely inappropriate for a 1 year old girl.
    More importantly the single vaccines are just that: 1 shot immunity. Multiple vaccines are just that: multiple vaccines are necessary to get immunity.
    Andrew found inflammation in his patients where other doctors from both USA and the UK found no problems.
    Andrew never found measles or parts of measles as this is not his part of medicine.
    If there is an error, Andrew cannot be blamed.
    The MMR vaccine was the third and last one to be in UK use, the others were proven to be harmful.
    Single vaccines have a long and safe UK pedigree.
    A new MMRV vaccine has been introduced into the USA on Sep 6th 2005 and has like the two others been shown to be possibly harmful but by the makers just no longer orderable – a subtle difference? – Who can tell? But what interests me is that the vaccine contained 10 times the amount of active material than in the single shots.
    It doesn’t need to a rocket scientist to know that if you need ten times the amount what are the interactions in these mixes?
    Then you ask yourself what is the effect of 20 or more different vaccines given by force of law to anti-vaccine parent’s children on one day when such combinations haven’t been checked out?
    Stupidity, malevalence and even criminality come into my mind.
    Kind Regards
    John Fryer M Sc B Sc Advanced Analytical Chemist and not some anonymous possibly highly paid mandarin of the pharmaceutical industry or even the medical-legal fraternity that incarcerates parents of vaccine killed children to protect money and power bases – in loving memory of Mrs Sally Clark dead at 42 from possibly mercury laced injections while in UK prisons and with known genetic susceptibility to such products?

  4. #4 John Fryer
    September 3, 2007

    Why do we need only one single vaccine but multiple mixed vaccines? The benefit seems lost? And why do we need ten times the amount of active ingredient in a mixed vaccine? Again the benefit seems to be Alice in Wonderland like?
    Almost as Mad as a Hatter? But there is no mercury in MMR.
    However there is neomycin a drug associated with hearing problems a generation ago that seems not to have been eliminated like mercury in new vaccines for our children.
    All very odd. Does autism involve problems with hearing?

  5. #5 John Fryer
    September 3, 2007

    I would like to comment but am barred. Why?

  6. #6 Iain Walker
    September 3, 2007

    I would like to comment but am barred. Why?

    Well, that doesn’t seem to be true, because your comments are showing up fine. I don’t think Orac bars commenters just for rambling.

  7. #7 PlanetaryGear
    September 3, 2007

    Seems to be a bunch of misunderstanding here…

    MMR is just 3 individual jabs mixed into a single jab. It’s no different than going to the doc for your vaccinations and getting a single shot with 3 meds vs getting 3 individual shots. THere is no difference other than the reduced trauma to your child. With single shots you still may require boosters later on, that is not affected by the mixed vs the individual shots.

    I am not an authority, but I’ve read a lot about this stuff and I believe that Dr Wakefield did indeed think he found measles in his patients. Isn’t that the whole point of checking the completely lacking controls for his DNA work? Let me summarize what I think I understand and you can correct me where I’m wrong. He went looking for Measles DNA in his patients surmising that the inflammation was caused by the shot allowing large or other strange proteins to get into his patients blood streams. The problem is that the DNA he found cannot possibly have been really there given his testing procedures. So everything else based on that has to be wrong too. Had a second lab been able to duplicate his test results then there might have been something to it, but nobody will be able to duplicate his results because they were in error. His testing procedures were simply wrong, his results the result of contamination and evidently a misunderstanding of how you’re supposed to run the test.

  8. #8 notmercury
    September 3, 2007

    John Fryer said: “Andrew found inflammation in his patients where other doctors from both USA and the UK found no problems.
    Andrew never found measles or parts of measles as this is not his part of medicine.
    If there is an error, Andrew cannot be blamed.”

    Other doctors, including Arthur Krigsman, have reported gut inflammation but only Wakefield and his associates claimed to have detected measles DNA in the guts of autistic patients. Or at least he is the only one to publish these claims.

  9. #9 HCN
    September 3, 2007

    John Fryer, please answer this question…

    First a bit of information:
    The MMR in question is the same one that was introduced in the USA in 1971 (it was developed by Merck by the subject of this biography: http://www.amazon.com/Vaccinated-Defeat-Worlds-Deadliest-Diseases/dp/0061227951/ ). It was introduced in the UK in 1988 to replace what had been used there earlier which was deemed inadequate (20 measles deaths each year, plus the mumps vaccine with Urabe strain caused menigitis… the Merck MMR uses the much safer Jeryl Lynn strain).

    Now the question: The MMR has been used in the USA since the early 1970s, why did it only become a problem after it was introduced in the UK about 17 years after its development?

  10. #10 Dr Aust
    September 3, 2007

    Planetary Gear:

    You are broadly right – though there is more to it.

    First series of experiments in Wakefield’s own lab totally failed to find measles virus genetic material. Ever. In any sample. Wakefield buried the results.

    Later series: claimed “positive” result, flawed because they were actually picking up a false positive, i.e. the genetic material they claimed was measles virus was actually something totally different – “A.N.Other piece of RNA, unrelated to measles”. They never did the controls to check.

    Final series, done by company Wakefield set up with Prof O’Leary in Dublin and which sucked a million pounds of public money out of legal aid: this is the one you are thinking of, different error to (2) above, this time the lab “hygiene” procedures were so poor that the samples were hopelessly contaminated with measles genetic material. The procedural ineptitude, and half-witted data interpretation, was so blatant that it would be a struggle to attribute it solely to ineptitude.

    To a scientist, any one of these alone would make the guy “fast and loose”, two would be “seriously incompetent and/or untrustworthy”, but all three taken together… well, draw your own conclusions.

  11. #11 Lucas McCarty
    September 4, 2007

    “Does autism involve problems with hearing?”

    A third of Autistics are thought to have perfect pitch. How’s that?

  12. #12 Evan
    September 4, 2007

    More importantly, it is a certainty that if enough kids get measles, some will get subacute sclerosing panencephalitis. And then the parents of this poor, unvaccinated child will pray to whatever woo-gods they wish to that rather than have the progressive, fatal, SSPE, the child could have a disease like autism.

  13. #13 notmercury
    September 4, 2007

    The contribution of single antigen measles, mumps and rubella vaccines to immunity to these infections in England and Wales
    http://adc.bmj.com/cgi/content/abstract/92/9/786

  14. #14 John Fryer
    September 9, 2007

    The issues in MMR and vaccines in general are not simple and I must tackle one at a time.
    Thimerosal has no place in vaccines.
    Thimerosal is a known brain nerve destroying toxic chemical. There is no denying this, except that the ex CDC epidemiologist Dr Verstraeten can show it protects infants by some mysterious process.
    If you can pull the work of Andrew Wakefield to pieces so easily then have a go with this piece of peer reviewed work?
    It is my contention that it is fatally flawed to the extent of fraud.
    However you look at it, Dr Verstraeten originally said to his mates at the CDC “We have a Problem”. His mates variously said: I am going to ring to make sure we don’t get my grandson vaccinated; to others who said “We need to handle this;” to others who said “This work should not have been done.”
    It was done, it was repeated and the upshot was that Dr Verstraeten now works for a Vaccine company.
    If this isn’t conspiracy then tell me what is?
    If you deny a problem then others will believe there is no problem. Hence as at Sep 2007 we have recommendations for flu vaccines with mercury still present in them. We send vaccines with mercury around the world to others saying this stuff is fine.
    Look at the VAERS records and what do they tell us? They tell us that flu vaccine is killing those who receive it. Because it is the only common mercury containing vaccine it is the Number One killer vaccine and has claimed to date 429 deaths that are logged onto the VAERS which is variously admitted to underreport at least ten fold.
    I looked at ten at random one after the other and discovered deaths for half occurred in one day. Eg Fit and aged 52 fully healthy so no immediate problems except his heart stops, he stops breeathing and there’s one more dead person just in case he might catch a cold. This is the 2007 preferred preventative for the flu. Catch it before it gets you. This guy is dead but he never got another cold.
    And thalidomide – well that was the doctor’s 1960′s safest method for combatting the cold.
    Times have changed in that today we cure before the illness but is safety any better than the old cures?
    John Fryer M Sc B Sc Advanced Analytical Chemist

  15. #15 HCN
    September 10, 2007

    John Fryer,

    If you had read my post in Sciencebase, you would know that there is NO thimerosal in the MMR, especially if you had read the measles chapter of the CDC Pink Book!

    Here it is:
    http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf

    Never the less… what evidence is there that thimerosal is a problem in any vaccine? The amounts are too small. Plus there is a an influenza vaccine withOUT thimerosal. Check it out: http://www.fda.gov/cber/vaccine/thimerosal.htm

    Also, only one American woman took thalidomide, and she got that in Germany. Why is that? Why was thalidomide a non-issue in the USA?

    By the way, you are allowed two web links in responding to Scienceblogs. How about you try using some to bolster your statements?

  16. #16 HCN
    September 10, 2007

    John Fryer said “Look at the VAERS records and what do they tell us? They tell us that flu vaccine is killing those who receive it. Because it is the only common mercury containing vaccine it is the Number One killer vaccine and has claimed to date 429 deaths that are logged onto the VAERS which is variously admitted to underreport at least ten fold.
    I looked at ten at random one after the other and discovered deaths for half occurred in one day. Eg Fit and aged 52 fully healthy so no immediate problems except his heart stops, he stops breeathing and there’s one more dead person just in case he might catch a cold. This is the 2007 preferred preventative for the flu. Catch it before it gets you. This guy is dead but he never got another cold.”

    If you looked at them, there should be a link to this most damaging evidence. Can you provide it?

    Oh, wait… here is one on the VAERS reports after the HepB vaccine:
    http://sids-network.org/experts/poa9078.pdf

    You will notice that the vaccine was most likely not the cause of death in many of the cases the child was already very sick (physical heart defects), or how about this one:
    “34 wk gestation; apnea of prematurity, feeding problems
    of prematurity; hospitalized 18 d after birth, discharge
    weight 2100 g; co-slept with mother on couch, found on back on floor beside couch”… did the vaccine cause that child to fall off the couch?

    As a reminder, you are allowed to post links. Try to do that!

  17. #17 Joseph
    September 10, 2007