Respectful Insolence

Over the last few years, depressingly, we’ve witnessed a rise in antivaccinationist activism. Beginning with the highly unethical activities of Andrew Wakefield and his bogus study in 1998 that set off a scare over the MMR vaccine supposedly causing autism that led to declining vaccination rates and skyrocketing measles and mumps rates in the U.K., it metastasized to the U.S. with hyped up concerns that the mercury-containing preservative thimerosal used in most vaccines until 2001 was a cause of autism. Over the last year or so, it’s been helped along by useful celebrity idiots like Jenny McCarthy who, while oh-so-seriously assuring everyone that she really, truly is “not antivaccine,” goes around the country spouting off every canard in the antivaccination playbook (some so stupid that it’s hard to believe anyone can believe them) and the media’s inability to understand that the Hannah Poling case was not a government concession that vaccines cause autism.

Even more depressingly it may well be having an effect in terms of decreased vaccination rates, and now the chickens may be coming home to roost. According to the CDC:

Measles, a highly contagious acute viral disease, can result in serious complications and death. As a result of a successful U.S. vaccination program, measles elimination (i.e., interruption of endemic measles transmission) was declared in the United States in 2000 (1). The number of reported measles cases has declined from 763,094 in 1958 to fewer than 150 cases reported per year since 1997 (1). During 2000–2007,* a total of 29–116 measles cases (mean: 62, median: 56) were reported annually. However, during January 1–April 25, 2008, a total of 64 confirmed measles cases were preliminarily reported to CDC, the most reported by this date for any year since 2001. Of the 64 cases, 54 were associated with importation of measles from other countries into the United States, and 63 of the 64 patients were unvaccinated or had unknown or undocumented vaccination status.


Antivaccinationists, of course, will likely just say, “So what? Measles isn’t dangerous. The MMR is more dangerous than measles.”

Wrong, wrong, wrong, wrong:

Before introduction of measles vaccination in 1963, approximately 3 to 4 million persons had measles annually in the United States; approximately 400–500 died, 48,000 were hospitalized, and 1,000 developed chronic disability from measles encephalitis (1). Even after elimination of endemic transmission in 2000, imported measles has continued to create a substantial U.S. public health burden; of the 501 measles cases reported during 2000–2007, one in four patients was hospitalized, and one in 250 died (1).

Moreover:

These cases remind us that it is important to vaccinate children and adults to protect them against measles. Even though the ongoing transmission of measles was declared eliminated in the U.S. in 2000, the disease is still common in other parts of the world and can be imported into the U.S. from many countries, including countries in Europe. Worldwide, 20 million cases of measles still occur each year, and the disease is a significant cause of vaccine-preventable death among children. In 2005, 311,000 children under age 5 died from the disease.

But, hey, those 311,000 weren’t Americans; so I guess they don’t matter, right? Never mind that according to the World Health Organization, measles is a leading cause of preventable childhood mortality. In any case, just because the vast majority of those who contract the measles survive it without long term complications doesn’t mean that for a significant minority it isn’t a deadly disease that can kill or cause serious permanent neurological sequalae. Just because The Brady Bunch did an episode where the Bradys contracted measles is not, as the Age of Autism in a statement of the highest level of neuron-apoptosing stupidity claims, reason to conclude that measles must not have been a major killer. (Hard as it may be to believe, the comments after the AoA post to which I linked are even more idiotic. They’re not just stupid; they’re scary stupid.) Worse, antivaccinationists tend to cluster, making it easier for the disease to be established and spread:

Many of the measles cases in children in 2008 have occurred among children whose parents claimed exemption from vaccination because of religious or personal beliefs and in infants too young to be vaccinated. Forty-eight states currently allow religious exemptions to school vaccination requirements, and 21 states allow exemptions based on personal beliefs.*** During 2002 and 2003, nonmedical exemption rates were higher in states that easily granted exemptions than states with medium or difficult exemption processes (7); in such states, the process of claiming a nonmedical exemption might require less effort than fulfilling vaccination requirements (8).

Although national vaccination levels are high, unvaccinated children tend to be clustered geographically or socially, increasing their risk for outbreaks (6,9). An upward trend in the mean proportion of school children who were not vaccinated because of personal belief exemptions was observed from 1991 to 2004 (7). Increases in the proportion of persons declining vaccination for themselves or their children might lead to large-scale outbreaks in the United States, such as those that have occurred in other countries (e.g., United Kingdom and Netherlands) (10).

Also, let’s not forget that no vaccine is 100% effective. People who have had the MMR but failed to develop immunity or who can’t be vaccinated for medical reasons depend on herd immunity. When the vaccination rate falls below a certain critical threshold (it is argued whether that threshold is around 90% or perhaps higher, but it’s probably different for different diseases and vaccines), the unvaccinated form a pool that can facilitate the spread of disease even in a population with a relatively high vaccination rate. In other words, antivaccinationists, by refusing to vaccinate, take advantage of herd immunity (at least while it lasts), while endangering the population among which they live. There’s a reason why vaccinations are required before school; unfortunately, states are prone to making religious and philosophical exemptions easier to get. Meanwhile pediatricians are under siege by parents frightened by this garbage.

One group of pediatricians, however, are taking a stand. All-Star Peditricians have issued a vaccine policy statement. They even take a stand:

Finally, if you should absolutely refuse to vaccinate your child despite all our efforts, we will ask you to find another health care provider who shares your views. We do not keep a list of such providers, nor would be recommend any such physician. Please recognize that by not vaccinating you are putting your child at unnecessary risk for life threatening illness and disability, and even death.

If only more pediatricians, group practices, and children’s hospitals would have the cojones to have a similar policy. Dr. Gordon, are you listening?

ADDENDUM: DrugMonkey agrees.

Comments

  1. #1 Bryn
    May 2, 2008

    What is with being both religious and willing to gamble with your child’s well-being? I found out a few years ago that the MMR shot I’d received fell into a time frame where there had been some failure rate with the measles portion “taking”. All it took was a simple blood test and a reinoculation. During the time I wasn’t protected, the only thing that saved me from getting the measles was “herd immunity” as you mentioned, it certainly wasn’t by the “grace of God”.

  2. #2 HCN
    May 2, 2008

    So the AoA are using a fictional TV show as evidence that measles is not a big deal?

    I found out that episode aired in December of 1969 (I missed it because I was living overseas, but I did get to see Star Trek in Spanish!). I then went to this site:
    http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/cases&deaths.pdf … and found a table with these stats for measles:

    Year —– Cases —— Deaths
    1969 22,231 24
    1970 47,351 41
    1971 75,290 90

    Then after 1971, the rates start to come down, where on the last line for 1981 the number of cases was 3124 and only two deaths. The MMR was introduced in 1971.

    What is interesting, is that when measles made a major comeback between 1989 through 1991, the death rate was much higher. From the measles chapter of the Pink Book (where the above stats came from):
    “From 1989 through 1991, a dramatic increase in cases
    occurred. During these 3 years a total of 55,622 cases were
    reported (18,193 in 1989; 27,786 in 1990; 9,643 in 1991)….
    A total of 123 measles-associated deaths were reported
    (death-to-case ratio of 2.2 per 1,000 cases). Forty-nine percent
    of deaths were among children younger than 5 years of age.
    Ninety percent of fatal cases occurred among persons with
    no history of vaccination. Sixty-four deaths were reported
    in 1990, the largest annual number of deaths from measles
    since 1971.
    The most important cause of the measles resurgence of
    1989-1991 was low vaccination coverage.”

    Is history going to repeat here in the USA?

  3. #3 Uncle Dave
    May 2, 2008

    Just heard the Television in the background this morning, another measles outbreak, now in Southern California.
    Didn’t get to many details, I was busy and going out the door at the time. Wife had measles as a small child, 105 fever, almost killed her.

    “Theodoric of York: Medieval Barber”

    Broom Gilda: [ feels patient ] She’s dead.

    Joan: Dead! Dead! I can’t believe it! My little daughter dead!

    Theodoric of York: Now, Mrs. Miller, you’re distraught, tired.. you may be suffering from nervous exhaustion. I think you’d feel better if I let some of your blood.

    Joan: You charlatan! You killed my daughter, just like you killed most of my other children! Why don’t you admit it! You don’t know what you’re doing!

    Theodoric of York: [ steps toward the camera ] Wait a minute. Perhaps she’s right. Perhaps I’ve been wrong to blindly folow the medical traditions and superstitions of past centuries. Maybe we barbers should test these assumptions analytically, through experimentation and a “scientific method”. Maybe this scientific method could be extended to other fields of learning: the natural sciences, art, architecture, navigation. Perhaps I could lead the way to a new age, an age of rebirth, a Renaissance! [ thinks for a minute ] Naaaaaahhh!

    Announcer: Tune in next week for another episode of “Theodoric of York: Medieval Barber”, when you’ll hear Theodoric say:

    Theodoric of York: A little bloodletting and some boar’s vomit, and he’ll be fine!

  4. #4 DT
    May 2, 2008

    The antivaxers argument is usually that measles in Westernised, First World countries is nothing more than a minor inconvenience, and never associated with complications.

    Tell that to the 8213 people in Europe who caught measles in 2006. Ten of them got encephalitis and six died.
    http://www.euvac.net/graphics/euvac/pdf/annual_2006.pdf

  5. #5 Paul
    May 2, 2008

    Know what? I NO LONGER care.If you do not get that, tough.+

    I’ve been a pediatrician for over 30 years. I have had the debates re: the usefulness of vaccinations for that entire time. This is NOT new.

    I have given up to trying to dissuade parents. I give them my reasons then stop. I tell them about the # of kids I’ve seen die from Hib, the kids I grew up with that had polio, etc etc etc. They do not listen anyway. Then they sign a statement saying they do not want vaccinations.

    That is their choice. If they lose a child to a preventable disease, I am sorry, but it is NOT my fault. It is THEIRS.

    YOU made the decision. YOU live with it. Not ME. No longer.

  6. #6 Paul
    May 2, 2008

    Oh for crying out loud.

    I have been a Peditrician for 34 years.

    Let’s STOP vaccinating for ANYTHING!

    When a few million babies and kids DIE, folks MIGHT get the point.

    They HAVE NEVER SEEN the ravages of the diseases we prevent.

    Let them.

  7. #7 The Ridger
    May 2, 2008

    @Paul: And if they bring their sick kid to you and infect your patients? I like the doctors Orac cites: YOU don’t want vaccines? Fine. YOU go elsewhere.

  8. #8 charles
    May 2, 2008

    “YOU made the decision. YOU live with it.”

    No, we all live with it.

  9. #9 Zipi
    May 2, 2008

    Orac, I thought you took pride in having a blog free of cursing. You know the meaning of the word “cojones”, don’t you?

  10. #10 AnnR
    May 2, 2008

    Nineteen years ago when my youngest son was to get his shots I inquired about the safety of vaccinations. I’d had my older son vaccinated, it wasn’t like I was not going to; I just ask about safety — probably because of anti-vac publicity.

    The reaction I got from my Pediatrician was swift. In his best “I am a Doctor” voice he told me that it was important and everyone in his practice was vaccinated.

    We got the shots. I don’t know if he would have dismissed us from his practice if we hadn’t, but in hindsight I think that would have been OK.

    Adults who get these childhood diseases are often get much sicker than children do. Perhaps that’s something this crop of un-vaccinated children will find out when they grow up.

  11. #11 Kerry Maxwell
    May 2, 2008

    I’m hoping for a wave of litigation against the irresponsible parents who opt out of vaccinations. Let’s hope these dimwits are as unpopular as baby-tossing in the very near future. In fact, I’d like to see some numbers comparing the risks of the five-story-baby-drop VS opting out of vaccination, And of course the subtext is autism is a fate worse than death.

    K

  12. #12 HCN
    May 2, 2008

    AnnR said “Nineteen years ago when my youngest son was to get his shots I inquired about the safety of vaccinations. I’d had my older son vaccinated, it wasn’t like I was not going to; I just ask about safety — probably because of anti-vac publicity.

    The reaction I got from my Pediatrician was swift. In his best “I am a Doctor” voice he told me that it was important and everyone in his practice was vaccinated.”

    My oldest son is 19, and I thought about asking, but my doctor told me that with his history of seizures it would probably be best that he not get the DTP, but the DT instead. Then I found out my county was having an epidemic of pertussis, and that it kills babies.

    So I made it a habit to ask about the vaccine status of any kid he came into contact with. It was only at one mom/tot group that I tried once that I found a group of anti-vaxers, and well… not only did they scare me, their attitude was pretty obnoxious. So I never bothered with them anymore.

    Though, at a neighborhood kid gathering place I explained in joy that a new safer pertussis vaccine was going to be available. One other mom took it upon herself to tell me that pertussis kills babies, and I told her my son had seizures, and she demurred (she was scared that I was an anti-vaxer!).

    That happened to be around the time measles returned to this country, and killed over 123 Americans. I remember reading in the newspaper a mom whose child died from measles lament that she didn’t think they needed to vaccinate anymore (I tried to find in my newspapers digital archives, but couldn’t… it must have been from a national wire, but I read it again in Paul Offit’s biography of Maurice Hilleman). I was reminded of the importance of vaccines.

    Also, our family doctor gives us a flyer that explains the vaccine and the risks.

    My oldest son also has a severe genetic heart condition, so he is one of the first to get the influenza vaccine. And last fall he got the Tdap, the first time he has been protected against pertussis. That makes me feel much better. Since we live in one of the worst vaccine uptake parts of the country, I dread to think what would happen he got the “hundred day cough”! (he has hypertrophic cardiomyopathy with obstruction, which means if he exerts too much the enlarged heart muscle could block his mitral valve and kill him)

  13. #13 Ms. Clark
    May 3, 2008

    How’s this for a scenario. Jenny McDumdum and her boyfiend Jim Carrey and their antivax friends gather by the hundreds on June 4th in DC. They have a bunch of kids with them (this is what they are planning). In fact they have a bunch of unvaxed and undervaxed kids with them and they’ll all be together in the same room at the “meet and greet” they have planned so they can gush over Jenny and get their kids and their tourmaline rosary beads blessed by her ‘cuz she’s so spirichul..

    One of them brings measles or rubella or whooping cough or you name it, with them. And they all get it. And they spread it around. Local kids catch it from them, too because they are running around in public places spreading they little germs.

    How is this going to look for Jim Carrey and his agent for his next movie if kids die because he’s advocating the Generation Rescue approved vax schedule that has no measles mumps or rubella allowed on it. Jenny is pushing a vaccine schedule with NO measles vaccine on it at all.

    So they all want their kids to catch measles, and they all think that all other kids should just get it and get it over with…. never mind that kids die this way, but that’s the goal. In fact heck, they might even want to bring a measles infected kid with them so that all the kidlings can go back home with a nice case of measles to give to their friends, since it’s such an all fired healthy and natural way to die and it’s better than having them be autistic. Better dead than autistic right Jenny and Jim?

  14. #14 AndyD
    May 3, 2008

    Whilst I absolutely understand that desperation, even mild cases, can lead to muddled thinking and a willingness to believe almost anything, I’m astounded at the extent to which fear-based acceptance can win publicity.

    If these people were in a plane that hit turbulence, would they run into the cabin, push the pilot out of the way and take over the controls on the basis that pilots don’t know everything?

    Personal opinion is a valuable tool in many arguments where outcomes are subjective but when it comes to your own child’s life, or quality of life, is personal opinion really that strong a force? Even so, can it be so strong as to send you out to try and convince other parents to take the same risks you’re willing to take? Or is it just politics, power and money that drives it?

  15. #15 isles
    May 3, 2008

    AndyD, that’s an excellent analogy. I suppose if they’d been reading up on the Internet about how to fly a jumbo jet, and had been talking with like-minded people about how the government has been hiding the truth about the mechanics of flight, they actually would push the pilot aside.

    As for the driver of this behavior, I’m going to say it’s egotism more than anything else. They’re very proud of having figured out what those snooty doctors don’t understand, and they want everyone else to hear not only how smart they are but how heroic they’ve been in the face of their victimization by the medical-industrial-governmental machine.

  16. #16 Ms. Clark
    May 3, 2008

    I agree with isles. It’s so amazing how many vaccine, immunology and public health self appointed “experts” there are out there with a cargo-cult understanding of immunology, vaccinology and public health. They all know better than anyone with a PhD in the subject or anyone with an MD. It’s sickening; their megalonmania is palpable. And their kids and their neighbors suffer because they are deliberately trying to destroy public confidence in vaccines. How is this different than other kinds of domestic terrorism, I’d like to know.

  17. #17 David Marjanović
    May 3, 2008

    sequalae

    Sequelae.

    Worse, antivaccinationists tend to cluster, making it easier for the disease to be established and spread:

    Darwin Award.

  18. #18 AnnR
    May 3, 2008

    Gosh HCN – I wonder if my son had seizures if the Ped would have told me to vaccinate anyway? I hope not.

    I haven’t know anyone with a child who died from Whooping Cough, but I do know a teen who missed a whole lot of school because of it – and she’d been vaccinated. It’s nasty.

    As a girl I remember reading books set in the past and inevitably there would be a sibling in the fictional family who’d gone blind, been disabled or died by some childhood sickness.

    Maybe modern writers of children’s books need to quit with the “my father and his ‘friend’” story lines and bring back the sister who went off to a school for the blind or deaf theme.

  19. #19 Michael
    May 3, 2008

    Vaccination may not be perfectly safe but it is an example of harm reduction, inasmuch as it reduces the risk of serious disease. Those who are concerned for the effects of mercury may wish to treat the potential exposure homeopathically with submolecular potencies. This may not be generally accepted medicine but it is at least perfectly safe. By regarding the concerns and alleviating them by such a manner we may gain acceptance of vaccination among those otherwise resistant.

  20. #20 KYJurisDoctor
    May 3, 2008

    You are NOT allowed to say ANYTHING about chickens coming home to roost. Remember, the thought police is watching!

  21. #21 KYJurisDoctor
    May 3, 2008

    You are NOT allowed to say ANYTHING about chickens coming home to roost. Remember, the thought police is watching!

  22. #22 HCN
    May 3, 2008

    Though you are allowed to read the “Having problems commented? (UPDATED)” link below the quote box.

    Ignore the Server 500 error. It just means the blog system failed to display, not that your comment failed to go in.

  23. #23 ozma10
    May 3, 2008

    AnnR-You are right and all we need to do is look at Helen Keller who was sick with a childhood disease causing ‘brain fever’. When my daughter was born 29 years ago many people in the rural community where I lived were not vaccinating their children. I was told all the scary stuff and there was a certain amount of pressure not to vaccinate. But I thought about all the children I grew up with and realized they almost all were vaccinated and how many were ill from it….zero. So I went with the vaccinations.

  24. #24 Bob the Microbiologist
    May 3, 2008

    Jenny was in Detroit a few weeks ago talking about her son and his diet, which she said played a large role in his autism and his “recovery” once he was put on a new diet. Then she said that she could “turn him autistic again within a few weeks” by switching him back to his old diet. ??!!! And people listen to this ditz? She really is funny and sweet and very cute but what gives her the right to put thousands of kids at risk of death?

  25. #25 Orac
    May 3, 2008

    Yes, Jenny McCarthy has been saying she could turn Evan autistic again just by giving him the wrong diet or by vaccinating him.

    Really.

  26. #26 themadlolscientist
    May 3, 2008

    You are NOT allowed to say ANYTHING about chickens coming home to roost.

    OK, can we say that there’s a definite possibility that the chickenPOX may be coming home to roost?

  27. #27 LP
    May 3, 2008

    Yeah this sucks. lol.

  28. #28 Linda
    May 3, 2008

    Meanwhile, on other forums I’ve seen people claim that autism is better than being “neurotypical,” social skills are sour grapes, we’d all be sheep and still in caves if not for autism, etc.

    Then of course there’s the “you shouldn’t want to waste time making friends, just STUDY STUDY STUDY STUDY STUDY!!!” crowd, who seem like they’d rather be raising autistic savant kids than raising non-autistic kids.

    Do any of these people also think vaccines cause autism, and do they ask you to overdose their kids?

  29. #29 Joe
    May 3, 2008

    @Michael, you wrote “Those who are concerned for the effects of mercury may wish to treat the potential exposure homeopathically with submolecular potencies. This may not be generally accepted medicine but it is at least perfectly safe. {snip}”

    I find what you wrote a bit difficult to fathom; homeopathy is not medicine at all, and it is wholly unrelated to vaccination. Furthermore, mercury in vaccines is not an issue now.

    As for safety, homeopathic “vaccines” leave recipients at risk of infection. Moreover, there is no quality control for homeopathic preps and they can contain contaminants.

  30. #30 Linda
    May 3, 2008

    “@Michael, you wrote ‘Those who are concerned for the effects of mercury may wish to treat the potential exposure homeopathically with submolecular potencies. This may not be generally accepted medicine but it is at least perfectly safe. {snip}’

    “I find what you wrote a bit difficult to fathom; homeopathy is not medicine at all, and it is wholly unrelated to vaccination. Furthermore, mercury in vaccines is not an issue now.

    “As for safety, homeopathic ‘vaccines’ leave recipients at risk of infection. Moreover, there is no quality control for homeopathic preps and they can contain contaminants.”

    When I read that, I got the impression that Michael’s idea was suggesting to the parents that they get normal vaccinations for the kids and then “treat the mercury exposure” with “homeopathic medicine.”

  31. #31 HCN
    May 3, 2008

    Just saw on AoA Olmsted blaming the CDC for the recent outbreak… so I have left this as a comment, which will not be posted there:

    As it happens in many blogs where moderation is not so tight, many folks who refuse to vaccinate for MMR (something Generation Rescue does NOT have on their revised schedule) often cite for proof Wakefield or Olmsted’s Age of Autism series.

    So here it is that measles is coming back, perhaps to the levels of the days when the Brady Bunch series was first broadcast (between 20 to 75 thousand cases per year, with up to 90 deaths per year), or to the more recent past between 1989 and 1992 when over 123 Americans die from measles… Dan Olmsted will be there pointing fingers elsewhere, and not on his own crappy journalism.

  32. #32 kathleen
    May 3, 2008

    one can agree that vaccination is a good thing (who wants their kid to get polio?) and still think the present recommended schedule of more than a dozen shots before the first birthday may be overkill.
    (especially if any of the shots contain mercury)
    i believe more parents would be persuadable if a sane vaccine schedule could be worked out.

  33. #33 Katharine
    May 3, 2008

    “Meanwhile, on other forums I’ve seen people claim that autism is better than being “neurotypical,” social skills are sour grapes, we’d all be sheep and still in caves if not for autism, etc.

    Then of course there’s the “you shouldn’t want to waste time making friends, just STUDY STUDY STUDY STUDY STUDY!!!” crowd, who seem like they’d rather be raising autistic savant kids than raising non-autistic kids.

    Do any of these people also think vaccines cause autism, and do they ask you to overdose their kids?”

    Ma’am, you place entirely too much importance on social skills. Has it ever occurred to you that there is more to life than socializing?

    Bloody sheep you are.

  34. #34 elly
    May 3, 2008

    umm…i’m a nonvaxer and kathleen-you are right sister. it is overkill to pump developing immune systems full of viruses before the first year of life is over. i love my kids. but diseases are natural population controls. perhaps i am fatalistic, but i do my best to feed my kids well and keep them healthy by supporting their immune systems with, oh i don’t know, NUTRIENTS instead of viruses. my little guys never get the flu or colds, have few allergies, no asthma, and don’t y’all think that a varicella (chicken pox) vaccine for children is a little overboard? i can see for adults, but really, it is just for convenience and not safety…we do not know the long term effects of multiple vaccinations and i will no longer be a guinea pig. in centuries past, vaccines were used only in the face of major epidemic. yes, sad to think my kids might die preventably, but, that’s life and god’s way…no i don’t think they will get autism.

  35. #35 elly
    May 3, 2008

    umm…i’m a nonvaxer and kathleen-you are right sister. it is overkill to pump developing immune systems full of viruses before the first year of life is over. i love my kids. but diseases are natural population controls. perhaps i am fatalistic, but i do my best to feed my kids well and keep them healthy by supporting their immune systems with, oh i don’t know, NUTRIENTS instead of viruses. my little guys never get the flu or colds, have few allergies, no asthma (compare children of with no vaccines to children with vaccines, i bet the findings will be interesting), and don’t y’all think that a varicella (chicken pox) vaccine for children is a little overboard? i can see for adults, but really, it is just for convenience and not safety…we do not know the long term effects of multiple vaccinations and i will no longer be a guinea pig. in centuries past, vaccines were used only in the face of major epidemic. yes, sad to think my kids might die preventably, but, that’s life and god’s way…no i don’t think they will get autism.

  36. #36 Zoo Knudsen
    May 4, 2008

    Hey elly, good thing your kids’ immune systems aren’t challenged by any viruses since you keep them safe and sound free of vaccines and holed up in that sterile containment unit provided by NASA.

    “but diseases are natural population controls.” Wow elly, I find it hard to come up with a more racist statement. Should we not have fought with blood sweat and tears to eliminate smallpox from undeveloped nations around the world. Just let ‘em die is your motto. Well I can think of a few billion people that probably wouldn’t sign up for your newsletter.

    So what component of their immune system do you support with nutrients? Complement? Humoral? B cells? T cells? Macrophages? Your best is irrelevant to the millions of years that evolution has had to fine tune our immune system. My daughter has never had the flu. She’s never had more than a very mild runny nose. No allergies. No asthma. And she’s so full of holes from vaccines I swear one day I’m gonna see her non-organic hormone-laden cow’s milk squirt out of a thousand little holes every time she downs a glass.

    So, pray tell, where do you think that the adult and immunocompromised population got chicken pox from? Other adults? Chickens? And the kids I’ve seen die from invasive strep pyogenes secondary to varicella might also have disagreed with your conclusions.

    You don’t need to be a guinea pig anymore. You are doing such a great job being an ass anyway.

    And if your comment was parody, great job. You nailed it.

  37. #37 HCN
    May 4, 2008

    kathleen said “(especially if any of the shots contain mercury)”

    Since this blog posting is about the return of measles, could you please tell us how much mercury is in the MMR?

    And then elly said “but diseases are natural population controls.”

    So you are into eugenics? So if one of your kids does not manage to survive pertussis, tetanus, measles or pneumonia — you’ll be okay with that. You are not fatalistic, you are evil.

  38. #38 themadlolscientist
    May 4, 2008

    I’ve said it elsewhere before, and I’ll say it here. I’d really like the antivaxxers to tell me:

    If mercury in vaccines causes autism, why isn’t half the pre-Bactine generation sitting in a corner rocking back and forth from having merthiolate (=thimerosal, AKA “that red sting-y stuff”) slopped all over every cut and scrape we ever had (and possibly having it all topped off with a mercurochrome-pad Band-Aid)? Not to mention that at least one kid in every family dropped a thermometer and broke it, then played around with the mercury glob beause it was such cool stuff…..

    And why does the rate of autism keep going up even though mercury has been all but eliminated from vacines?

    Bleepin’ idjits.

  39. #39 Natalie
    May 4, 2008

    “in centuries past, vaccines were used only in the face of major epidemic.”

    To quote from the surprisingly intelligent and under appreciated sitcom Newsradio: “In the olden days, people used to die of ptomaine poisoning and blamed it on ghosts.”

  40. #40 HCN
    May 4, 2008

    To continue on elly’s brilliance with “but diseases are natural population controls.”

    Can we all assume that you also refuse to use seatbelts, not babyproof the house, fence ponds or pools and let your toddlers run free through the neighborhood. Because kids flying through car windows, falling into pools of water, drinking cleaning fluids and getting hit by cars is also natural population control.

  41. #41 Orac
    May 4, 2008

    Re: elly

    I don’t get too many antivaccinationists on my blog anymore, other than the same old ones, like John Best, who is so vile and over-the-top that he is nothing more than a troll that I (barely) tolerate. I don’t know if it’s because I’ve managed to run them all off or they’ve decided I’m inconsquential.

    However, in elly, what we see is the out-and-out religious variety of antivaccinationist. To her, vaccines are unnatural and somehow against God, who will decide who lives or dies and she is apparently OK with it if her child catches some vaccine-preventable disease and dies or suffers serious neurologic injury. I could never understand this line of thinking, even when I was a pretty devout Catholic attending a Catholic high school and going to Mass regularly. Our motto then was “God helps those who help themselves” and we considered modern medicine to be a gift from God that was given to us through God’s gift of intellect and curiosity to humans. It was therefore sinful not to use it to save your life or to prevent your children from becoming ill. In terms of vaccines, the Church even tolerates the use of cell lines derived from aborted fetuses some 45 years ago to grow the virus used to make the vaccine because of the distance from the evil and because of the great good vaccines do. In other words, it suggests that parents vaccinate while urging pharmaceutical companies to find a way to make vaccines without using those cell lines.

    True, the Catholic Church doesn’t view all forms of medicine that way (abortion, for instance). It also frowns on assisted reproduction, taking the same sort of line of logic that elly does: If you can’t have a child it’s because God doesn’t want you to have a child. Ditto birth control. Even so, applying elly’s rationale to all disease is profoundly puzzling to the vast majority of Christians, including Catholics. It is, in essence, advocating a return to centuries ago, before there was medicine, when epidemics that killed large numbers of people were viewed as God’s will that nothing much could be done about. I find her attitude ignorant, hateful, and despicable, particularly her callousness towards her own children given that if they die of some vaccine-preventable disease she will simply accept it.

  42. #42 daedalus2u
    May 4, 2008

    Spoken like a true curbie.

    “sad to think my kids might die preventably, but, that’s life and god’s way…no i don’t think they will get autism.”

    Better dead from a preventable disease than to get autism.

  43. #43 MMOToole
    May 4, 2008

    The best evidence that thimerasol/mercury in vaccines has nothing to do with autism is this: since thimerasol was taken out of vaccines in 2001, the rate of diagnosis of autism has not dropped—even in children born after the ban.

    The so-called “epidemic” of autism is more likely to be due to increased awareness and diagnosis, as well as the inclusion in the statistics of kids who have variants such as Asperger’s, who years ago would have just been considered “weird”. And the fact that children with recognized disabilities are at least supposed to get appropriate assistance through the public school system, so there’s a real reason to get a child tested who’s not behaving according to age-related “norms” (some of which I suspect are dictated for the convenience of teachers, not from any actual data about how kids really behave; we keep hearing horror stories about three-year-olds considered abnormal because they’d rather run around and play than work intensively on letters and reading skills). There’s more incentive to get a child evaluated, so more are diagnosed.

    At least we’re getting away from blaming “poor parenting/mothering” as the cause, as we have with schizophrenia. If environmental toxins are to blame, I’d like to see all the crap we’ve been pumping into the water and air for the past 50 years, especially the herbicides, pesticides, and the vehicles for same that are slathered on 3/4 of the suburban lawns in the country, investigated. We know many of those interfere with sexual development in other animals; why not with brain development in humans?

  44. #44 Chris Mitchell
    May 4, 2008

    I highly commend All-Star Pediatricians for their statement. Their statement goes above even vaccines; they’re saying if you don’t follow sound medical practice, they then you’re in the wrong place. Your unvaccinated kids will come into their office exposing the staff and other patients to the latest virus in the wild. It’s also a statement that if the parents aren’t following vaccination schedules there’s a possibility of not following other recommendations.

    I think this is laudable and I think it’s worthy of a national campaign for health care providers to consider signing up for as well.

  45. #45 Zoo Knudsen
    May 4, 2008

    No jokes this time.

    The question of when to fire patients who don’t vaccinate or follow medical advice is not a new one by any means. I disagree that firing all patients who choose to not vaccinate is a good idea, nor is it ethical in most instances.

    The families that choose to avoid all vaccines are, so far, few and far between. What is more common are those that wish to pick and choose vaccines based on misinformation not a irrational and dogmatic antivaccine belief systems. Many of these can be reached with appropriate education over time. Many can come to a compromise of using a slightly different schedule. Should we pediatricians kick them all to the curb, thus pushing them into the open arms of quacks where they will get no vaccinations for their children? Where they will not have an appropriate resource in the event of a serious medical problem.

    Ultimately, if you fire all of these families without putting effort into weeding out the few rotten apples, you are punishing the children for the mistakes of their parents, mistakes that may not be beyond correction.

    Here is the AAP policy statement on this issue, which is very rational, and I hope that you all read it:

    http://aappolicy.aappublications.org/cgi/content/full/pediatrics;115/5/1428

    “In general, pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child. However, when a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists, the pediatrician may encourage the family to find another physician or practice. Although pediatricians have the option of terminating the physician-patient relationship, they cannot do so without giving sufficient advance notice to the patient or custodial parent or legal guardian to permit another health care professional to be secured.27 Such decisions should be unusual and generally made only after attempts have been made to work with the family. Families with doubts about immunization should still have access to good medical care, and maintaining the relationship in the face of disagreement conveys respect and at the same time allows the child access to medical care. Furthermore, a continuing relationship allows additional opportunity to discuss the issue of immunization over time.”

  46. #46 Linda
    May 4, 2008

    “The so-called ‘epidemic’ of autism is more likely to be due to increased awareness and diagnosis, as well as the inclusion in the statistics of kids who have variants such as Asperger’s, who years ago would have just been considered ‘weird’.”

    Lately the “I don’t care what anyone else thinks, how dare hot girls not care enough what I think to give me casual sex!!!” crowd seems to be self-diagnosing themselves with autism and Asperger’s, so maybe that adds to the perception of an epidemic?

  47. #47 HCN
    May 4, 2008

    MMOToole said “The best evidence that thimerasol/mercury in vaccines has nothing to do with autism is this: since thimerasol was taken out of vaccines in 2001, the rate of diagnosis of autism has not dropped—even in children born after the ban. ”

    Which actually has nothing to do with measles vaccination because:

    1) The MMR vaccine has never contained thimerosal because it is a live virus vaccine.

    2) The MMR vaccine was approved for use in the USA in 1971. In 1978 a Measles Elimination Program was initiated, using the MMR in the USA. There does not seem to a marked increase of autism started in the 1970s.

  48. #48 BlackOrchid
    May 4, 2008

    we keep hearing horror stories about three-year-olds considered abnormal because they’d rather run around and play than work intensively on letters and reading skills

    This actually happened to us, with our daughter, in a Pre-K program for three-year-olds at our parochial (Catholic) elementary. They wanted her – A THREE YEAR OLD – evaluated for ADHD cos she:
    - got up the first day and left the class looking for me
    - said “no” to her teacher – ONCE, and I made her apologize and she never did it again
    - would look around the room (not get up! just look around) instead of doing her worksheets.

    Yes they had worksheets, with letter-writing activities. for THREE YEAR OLDS. that’s what they did! the teacher stood at a BOARD and drew the letters and the THREE YEAR OLDS were supposed to sit at a table and write the letters.

    When I demurred, saying that she was a normal three year old, they pointed out that there were already several THREE YEAR OLDS in the class on Ritalin or Adderall, so it was nothing to be ashamed of. We took her out and she’s thrived in a non-idiotic preschool.

    It’s the schools, and some parents, who are behind the rise in ASD diagnoses. I feel like I’m at Ground Zero in the greater Philadelphia area – Autism diagnoses are quite the trendy thing here lately. Kid doesn’t talk a lot? Autism. Kid talks too much? Autism. ADHD is soooo yesterday. I mean everyone has THAT.

    I’m not making light of Autism. It’s a serious disorder and people who are affected should be given whatever support they need. If there’s a way to mitigate the negative effects, I hope that is found. But I don’t understand how a “cure” or even effective therapy can be found when you don’t even know what you’re exactly talking about. It would be like trying to find a cure for the measles, but instead of just testing people with the measles, you test everyone. And you define “measles” as anything with a fever and a rash.

    Not defining what Autism is, over-diagnosing it, doesn’t that make it harder to effectively treat actual Autism? It would seem to me that it would. I’m not a doctor tho! Just a new fan of you, Orac.

  49. #49 Zoo Knudsen
    May 4, 2008

    Diagnosing a 3-year-old with ADHD is like diagnosing a plant with chocolate pudding…..it don’t make no sense. Pediatricians throwing stimulants at parentally challenged toddlers in pre-school because they color outside the lines are hopefully rare but based on my experience I bet they aren’t.

  50. #50 Phoenix Woman
    May 4, 2008

    RE: elly –

    Three words. Firefox. Greasemonkey. Killfile.

  51. #51 HCN
    May 5, 2008

    BlackOrchid said .. umm… well, lots of stuff…

    I understand what you are saying. With all the media reports on the disorder of the year, new parents are hyper-sensitized to different catch words. For a while ADHD was the thing every kid had, and then it was hypersensitivity or non-verbal learning disability… now it is autism (which takes in a bunch of the other previous things).

    I was filling out the co-payment check at the pediatric clinic before my son’s appointment with his cardiologist when the receptionist got a phone call. I am afraid I overheard a bit… she said that the pediatric clinic did have an ADHD specialist, and then inquired which primary care doctor referred them to the clinic… then she said that it is more usual to get a referral from a pediatrician or a family, and then asked the age of the child… She listened and then said, “I’m sorry but Dr. xxx does not see children who are two years old!”. I looked over to her, and told her all two year olds are hyper!

    Though, on the other side of the fence: I had a two year old who could not talk. He could not even make the sounds to make words. This was at a time when lots of pediatricians had a “wait and see” attitude towards speech and language disorders. But since he had had seizures, and our family doctor was a bit more on the ball than some, we were referred to a speech and language clinic when he was about 2.3 years old. He was diagnosed with oral motor dyspraxia, which a speech production disorder centered near Broca’s area of the brain. After ten years of speech therapy he can speak, but it is not normal. He also has some minor language issues (dysphasia), and some functional dysarthria. It does add up to some learning disabilities (mostly in expressive communication, his math skills are pretty normal).

    Oh, and he is not autistic. At least by the standard in the DSM when was seen by a child neurologist 16 years ago. During his last year of high school the school psychologist mentioned that he might have Asperger’s. Just goes to show how the diagnosis changes.

    Oh, and as far as measles diagnosis goes, there are actual laboratory test for the presence of the virus:
    http://www.cdc.gov/vaccines/pubs/surv-manual/downloads/chpt19_lab_support.pdf … BUT autism is tested only through behavior. Not quite the same criteria.

  52. #52 Linda
    May 5, 2008

    “We took her out and she’s thrived in a non-idiotic preschool.”

    Great! :)

    “I’m not making light of Autism. It’s a serious disorder and people who are affected should be given whatever support they need.”

    Exactly! That includes the support of parents who accept who they are. Imagine being a kid with Asperger’s who wants to, and struggles to, pass her classes and make a few friends. That’s hard enough without parents pressuring her to be a prom queen (as if social skills are everything) or an autistic savant (as if social skills are nothing) instead. That goes for other conditions too – imagine being a kid who’s hard of hearing and being too deaf or not Deaf enough for his parents.

    “But I don’t understand how a ‘cure’ or even effective therapy can be found when you don’t even know what you’re exactly talking about. It would be like trying to find a cure for the measles, but instead of just testing people with the measles, you test everyone. And you define ‘measles’ as anything with a fever and a rash.”

    So true.

  53. #53 Ranson
    May 5, 2008

    @Zoo

    Well, that line just got added to my sigfile.

    @ BlackOrchid

    I can relate; my dad still talks about being called into a parent-teacher conference because I was coloring outside the lines. Sure, I could read and do most basic math at three, but at five I still COLORED outside THE LINES, and the school felt that this required some discussion. Is it possible to laugh a teacher out of her own classroom? If ADHD had been in fashion, my school might have tried to push a diagnosis on me, but I was bored, not hyper. Teaching letters and numerals to a kid that can read and do multiplication is a recipie for restlessness.

    I’m not on the spectrum, but when Asperger’s became more well-known, there was a hard look taken. It was decided that I was, in fact, just weird.

  54. #54 Scotty B
    May 5, 2008

    “Among the 64 confirmed measles cases, prior vaccination could be documented for only one person.”

    That one person could be one of my kids and thats what really pisses me off. (Sorry for the language, but its true.)

  55. #55 Monado, FCD
    May 5, 2008

    If the children who are old enough get their vaccinations, the younger ones will likley escape measles. It’s passed only from person to person, which means we can wipe it out!

    I know it’s cruel of me, but I believe that the best cure for anti-vaccination activism is to pick the leading advocate in each country, and when a child dies of measles in that country to go to him and lay the child’s body on his or her desk.

  56. #56 Ms. Clark
    May 6, 2008

    Monado, FCD,

    I agree. Maybe the parents of the dead child wouldn’t mind doing it themselves. Maybe there could be effigies of the dead children piled in front of certain antivax bloggers’ doors or on their driveways, if any die in this country. Their neighbors should be able to see what these people have done.

    There’s a measles outbreak in the Seattle area. I wonder if JB Handley would drive his unvaxed kid up there to see if he could get her exposed so she would have that lifetime immunity without vaccination. He advocates for no measles vaccine on his website. So I wonder what is the best age to get your kid exposed. Should there be dozens of guys like JB Handley rushing their kids to the site of the outbreak to see if he can get their pre-schoolers in contact with the virus?

    If JB Handley’s youngest kid is too young, in his opinion, to catch measles now, what will he do? Put a plastic bubble over his house to make sure no one comes or goes from it until… until she’s old enough to catch the measles according to what his “gut” or some guru tells him? And I guess he would think it would be impossible for her to have any bad effects from catching the measles. I’m not sure how reality based that is, though.

  57. #57 HCN
    May 6, 2008

    Ms. Clark said “There’s a measles outbreak in the Seattle area.”

    Actually it is in Grant County, which is in the middle of the state near Moses Lake, on the other side of the Cascades. The number of measles cases there is up to 12:
    http://www.kxly.com/Global/story.asp?S=8275267

    “Health officials can’t confirm the source of the infection, but they can confirm all 12 people weren’t vaccinated.
    …The Grant County Health District has posted signs at the schools that are part of the measles outbreak outlining an executive health order that demands anyone who is not yet vaccinated to stay home. Moses Lake Christian Academy reports that 17 students won’t be allowed back to school until the end of the month.”

  58. #58 Ms. Clark
    May 6, 2008

    Thanks, HCN. I should have known. I have driven past Moses Lake, probably stopped there, on the way from Spokane to Seattle but it’s been a while ago. I got confused by this report. Maybe there will be an outbreak in the Seattle area since this girl with measles visited there.

    “KING COUNTY, WASHINGTON – Local public health officials have learned that a Grant County young girl who visited King County as part of a school trip on April 29 has tested positive for measles. Measles, also known as rubeola, is a potentially severe disease.
    Persons who were at the following King County sites on April 29 were possibly exposed to measles:
    11:00 a.m. to 1:30 p.m., Krispy Kreme Doughnuts, 6210 E Lake Sammamish Pkwy SE, Issaquah
    Noon to 4:45 p.m., Experience Music Project/Science Fiction Museum (EMP|SFM) (Seattle Center), 325 5th Avenue North, Seattle
    3:45 to 6:30 p.m., McDonald’s Restaurant, 1305 NW Gilman Blvd, Issaquah”

  59. #59 HCN
    May 6, 2008

    I forgot that she, and members of the original family had been in the area. It may another week before someone on this side of the Cascade Curtain will get measles.

  60. #60 Rupert
    May 23, 2008

    “Measles Isn’t a nasty disease”. Oh yeah?

    Anecdotal rather than statistics, but stories are powerful: account of an adult catching measles on BBC: http://news.bbc.co.uk/1/hi/health/7385020.stm