Orac is the nom de blog of a (not so) humble pseudonymous surgeon/scientist with an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his miscellaneous verbal meanderings, but just barely small enough to admit to himself that few will. (Continued 
Don't worry, faithful readers, my blogging about the "Green Our Vaccines" rally last week is reaching its end. If my poor neurons can take it, there are still the speeches of Robert F. Kennedy, Jr. and Dr. Jay Gordon to be commented on in one more post (the latter of whom I used to consider somewhat reasonable albeit incorrect but who, if his speech and statements to the press at the "Green Our Vaccines" rally are any indication, has gone completely over to the dark side of antivaccinationism). Then that's probably about all I'll be able to take for a while. It'll be back to writing about cancer and other science next week. Maybe I'll even find the time to do a major update of the Academic Woo Aggregator, as I've been promising for a month now, although doing so might depress me even more than "Green Our Vaccines."
You may have noticed that, along with some parents who are suspicious of vaccines and could probably be persuaded, a few intrepid antivaccinationists have invaded the threads of my recent posts. One made a statement that is so typical of the unrealistic mindset of the people in the "Green Our Vaccines" movement that I thought it worth addressing with a brief post, given that I haven't written about this issue in nearly two years. A commenter writes:
Could someone please tell me what is so wrong about asking the vaccine companies to take the toxins out of vaccines? Whether or not you believe they cause autism, do you want to be injected with crap that hasn't been proven safe?Do you think it would be good for the auto industry to inspect their own cars and tell us that they are safe?
How about the food industry? Do you think Hormel should be in charge of telling us how safe their products are instead of food and drug?
Then why is it okay that big pharma gets to rate the safety of their own products?
These people are not crazy. They have been through a lot. Some of them are probably radical, yes. But most are not anti-vaccine.
I am one of them. I was there. I believe in vaccines.....but I don't believe they are 100% safe. Until they prove it to me, my child is having no more.
Here's my response:
Interesting. You demand "100% safety" before you vaccinate, but, like all parents whom I've encountered who demand that standard for vaccines, you're almost certainly curiously selective about what you apply your standard to. Let me ask you something: Do you drive your kids around in a car? My God, man, how can you do that? It's by no means "100% safe"! Do you know how many children die or suffer permanent brain injury in car crashes every year? Thousands! By your standards, then, shouldn't you should be demanding "100%" safety from your auto before driving them anywhere? Do you let your children swim? How can you be so irresponsible? 5,000 children a year are hospitalized for drowning or near-drowning. 20% die, and 15% suffer permanent neurological injury. Do you have a child who plays baseball or softball? Holy crap! 4-5 children a year in the U.S. die of injuries suffered playing baseball or softball. But deaths are only the worst injuries. Among children ages 5-14, well over 100,000 children are taken to the emergency room for injuries suffered playing baseball each and every year. These include sprains, contusions, fractures, dental injuries, head injuries and concussions, and internal injuries. In fact, although its overall rate of injury is fairly low, baseball has the highest child fatality rate of any sport. Helmets and face shields would reduce, but not eliminate fatalities. It's the very nature of the game, with high speed projectiles being launched in the general direction of kids. Some batters will fail to get out of the way of a wild pitch; some fielders will unfortunately catch a line drive with their heads.
Indeed, I really hope your children don't like sports, especially baseball. Clearly you, their father, by your demand for 100% safety must not allow them to participate in any of these activities, nor must you allow them to cross the street or go to school. All these activities are far more dangerous than any vaccine. Indeed, one can't help but note that if you applied the same standard to daily activities as you do to vaccines, your children would have to live in a hermetically sealed bubble, never venturing out. Oh, wait. That wouldn't be "100% safe" either. Life isn't "100% safe." Nothing is.
What you are practicing is a variant of what known as the "perfect solution" or "Nirvana" fallacy. It is an excuse for not doing something based on the assertion that the solution isn't perfect. The specific variant you are practicing is something I like to call the "100% safe fallacy." By any measure, vaccines are incredibly safe interventions, with a low risk of complications. The risk, however, is not and never will be zero. Nothing is absolutely, positively 100% safe, including vaccines. However, they are certainly far safer than allowing your children to be vulnerable to the diseases they prevent.
You're also adding some conspiratorial thinking into your mix. Do you honestly think that the drug companies are in charge of telling us how safe their products are? Whatever flaws there may be in the FDA, it is the FDA that approves any new drug, vaccine, or medical device, and the standards are pretty rigorous.
No one here is arguing against safer vaccines. That's a straw man argument that the GOV crowd tries to pin on us. In fact, a lot of money and effort are put into trying to make our vaccines as safe as possible, and that's a good thing. Nor do we argue that the parents in the GOV rally don't care about their kids or aren't trying to do what's best for them. What we do argue is that they are, alas, spectacularly mistaken about the science. Indeed, the entire "Green Our Vaccines" is based on a toxic mix of bad science, emotion, and dishonest misinformation about "toxins" that ignores chemistry, pharmacology, and even common sense, all tied together with the fallacy of the perfect solution. That's no basis for public policy, and the GOV movement has the potential to do real harm to public health.
But maybe I'm wrong. If that's the case, then I ask the GOV'ers who have been lurking and occasionally commenting here: How safe is safe enough? Be specific. (100% safety is completely unrealistic and unobtainable for any human activity, including vaccines, and in the case of vaccines it's a transparent excuse for not vaccinating, no matter what.) What, specifically, would it take for you to agree to vaccinate? (Vague platitudes about removing the "toxins" from vaccines don't count, as such a standard is meaningless. Which specific toxins need to be removed. Read this before answering, please, because answers based on a willful misunderstanding of chemistry, pharmacology, and toxicology or on misinformation about what's in vaccines don't help either.)
"Green Our Vaccines" is a nice slogan, but what does it really mean and could any vaccine ever be "green" enough for you? If the answer to the latter question is "no" or completely unrealistic and impractical then you're an antivaccinationist, your protestations otherwise notwithstanding.
THE "GREEN OUR VACCINES" COLLECTION:
- The Jenny McCarthy and Jim Carrey rally to "Green Our Vaccines": Anti-vaccine, not "pro-safe vaccine"!
- An Open Letter to Congress on Immunization
- "Green Our Vaccines": Further skeptical reading
- "Green Our Vaccines": Serendipity and schadenfreude as antivaccinationists go to war
- "Green Our Vaccines": Best comment EVAH! Or: How to preserve biological diversity through not vaccinating
- "Green Our Vaccines": Celebrity antivaccinationist ignoramuses on parade. Or: I didn't know that Dumb & Dumber was a documentary
- "Green Our Vaccines": "Pro-safe vaccine" or anti-vaccine? You be the judge!
- "Green Our Vaccines": "Pro-safe vaccine" or anti-vaccine? You be the judge! (Part 2)
- "Green Our Vaccines": The fallacy of the perfect solution
Medicine & Health
Comments
Wait a minute....Green Our Vaccines...GOV....hmmmm........... GOVERNMENT!!!!! This is all a government plot with big pharma to pour billions into pharmaceuticals to treat vaccine-preventable illness!!! Such is the thinly-veiled antivax rhetoric!!! That's it!!!! This has all been a reverse conspiracy..I KNEW IT!!! RFK,jr. you evil genius!!
Posted by: More Virchow-Bell | June 7, 2008 11:00 AM
Orac, you might want to close the italics tags.
Posted by: D. C. Sessions | June 7, 2008 11:07 AM
Here, let me:
Posted by: D. C. Sessions | June 7, 2008 11:14 AM
It might need an em tag. I wonder if this will work.
Posted by: Bob O'H | June 7, 2008 11:42 AM
A related question worth asking is:
How low does the concentration of a "toxin" have to be before you will consider a vaccine to be safe enough for human consumption? "Zero" is not an acceptable answer. Because of inherent physical limitations on purification, every substance known to man is present in trace levels in our air, water, and food. You can't eliminate toxins entirely, only reduce their levels.
Would you allow your children to be injected with a substance containing 2.5 parts per million of formaldehyde? If your answer is "no," then you are saying that you would not allow your child to receive a transfusion of his or her own blood--because the body makes formaldehyde, and that is the normal concentration in human blood.
Every one of the "toxins" that antivaccinationists complain about in vaccines is present in the water you drink and the air that you breathe. It is not possible to reduce the levels to zero, no matter what you do, or how much money you spend.
What is more, the closer you get to zero, the greater the expense becomes of reducing the level further. This is not merely the case for "toxins" in vaccines, or water, or air, but for everything. Risk can always be reduced a little bit, if price is no object. Would you be willing to pay an extra $100,000 for your car if it could be made just a bit safer, so that the risk of your child being injured in an accident is reduced by 1%? How about 0.1%? Or 0.01%? Why not? Don't you love your kids? Can you put a dollar value on the safety of your kids?
Posted by: trrll | June 7, 2008 11:46 AM
Got the markup. He opened with an em tag and tried to close with an a tag.
Posted by: D. C. Sessions | June 7, 2008 11:56 AM
How much money for vaccine research have they raised so far ? Thought so.
Posted by: _Arthur | June 7, 2008 11:58 AM
Once more into the breach, dear friends.
As far as the antivax crowd are concerned there is no safe level of any chemical in vaccines, period.
They don't want proof it's safe, they don't even care if government outlawed vaccines tomorrow. What they want is a convenient whipping boy. For those with autistic children, I understand their trauma at the discovery. They need to hear that it's fixable and or that it's not their fault.
They desperately want to know it was not just genetics.
Unfortunately, no one in the medical science community can as of yet tell them that. So, they seize on the next nearest invisible trauma -- their child being injected with a substance they do not understand and which scared them when they experienced it themselves.
I do not sympathize with their desire to wipe out vaccines. It's a nihilistic desire to cause misery.
not that anything I've said will make a gnat's weight of difference, but, I had to try.
Posted by: DLC | June 7, 2008 12:48 PM
Even after Title IX, there's still probably a lot more boys playing baseball than girls. For girls, parents should be wary of the dangers of cheerleading. See: http://pediatrics.aappublications.org/cgi/content/full/117/1/122.
Also, when children reach the age when they can bathe themselves, wearing a motorcycle helmet in the bath or shower will substantially lower the risk of head injury.
Posted by: Epi Wonk | June 7, 2008 12:57 PM
I just want to point out the somewhat 'awkward' position that some of us are in when it comes to this issue. I am 100% with Orac on this issue but I conflicted with the whole 'evil government agency' issue. No, I do not believe that the FDA and CDC are shills for big pharma. Unfortunately, I do argue (on other issues) that the Bush administration has corrupted some agencies and hence lost all credibility. I do feel like a hypocrite when I say, 'trust the CDC/FDA' on one thread and 'Bush/government blah/blah/blah' on another thread. Just another reason to be pissed about the collateral damage Bush has done (there can be no blind trust of government agencies).
Damn, I hate the mess he's created.
Posted by: rmp | June 7, 2008 1:11 PM
This is only a test to close the EM.
Posted by: rmp | June 7, 2008 1:15 PM
Maybe we could arrange for that poster to engage a homeopath in a cage match.
Posted by: Harry Eagar | June 7, 2008 2:04 PM
rmp: I agree with your words, but I don't feel awkward about these things. I worked for the CDC under Bush. (I'm retired now.) 95% of my co-workers were career Federal scientists who detested Bush and tried their best to get on with their work, despite constant interference from the White House and HHS political appointees. Julie Gerberding is undoubtedly the worst Director in CDC's history (although she was a good infectious disease epidemiologist once). The fact that most of the "leadership" of the CDC, FDA, and other Federal agencies are ignorant right-wing hacks doesn't negate the good work done by the scientists who work in those places. Life is complicated. Only 226 days left!
Posted by: Epi Wonk | June 7, 2008 2:09 PM
It seems you didn't bother to point out that *not vaccinating* is a long way from 100% safe... in fact, it's much more dangerous than vaccinating, which is why people do it.
No food product, drinking water, or even air is 100% safe. That doesn't mean you should starve or suffocate your children to protect them from those dangers.
When doing something and not doing it both have risks, you have to weigh the risks *against each other* in order to determine the safer course of action.
Posted by: chris | June 7, 2008 2:42 PM
It's just the flip side of homeopathy. Homeopaths believe that negligibly small concentrations of toxic substances can help you. "Toxin" phobics believe that negligibly small concentrations of toxic substances will harm you. Both ideas reflect the same kind of magical thinking.
Posted by: trrll | June 7, 2008 3:22 PM
I have a copy of the "Yearly Bills of Mortality" for London from 1657 to 1758 (Google Books PDF). Although they are not 100% complete and the author gripes about the lack of data for "dissenters and papists", it is under-reporting, not over-reporting.
For the years 1746 through 1750, 56,721 children under the age of 10 were buried. There were 72,480 christenings.
For the years 1748 through 1752 there were:
750 deaths from whooping cough
569 from measles
5341 from "teeth" (dehydration deaths in infants was usually blamed on teething or worms ... probably rotovirus, norovirus and other diarrhea causing viruses)
2774 "Abortive or stillborn"
10179 from smallpox (children and adults)
These were children getting all-organic foods, no cell-phone or wi-fi radiaiton, the water was not flouridated and none of them were vaccinated. about 1/3 didn't make it to their first year, and hgalf of them died before age 5.
**************
Someone tell me again why science is worthless. SCIENCE figured out that clean water and vaccinations could stop the carnage.
Posted by: Tsu Dho Nimh | June 7, 2008 3:40 PM
One other thing to point out: 100% free, apart from being unattainable, would also leave the body wide open to damage from far lower levels than normal should there be any contact: some contact is necessary for developing defense - this is what vaccination itself is all about, after all.
My Mother's words from the 50's: "A little dirt never did anybody any harm". I'm 60, never coddled, have lost maybe 5 days to flu in my life. Childhood mumps and measles. That's it. And vaccinated. in childhood for the rest, of course
Posted by: Gray Gaffer | June 7, 2008 3:44 PM
Thanks for your thoughts Epi Wonk. I just wish we could engage these arguments from the high ground/confidence that our government can be trusted. I certainly hope that 226 days from now, we can start regaining that trust.
Posted by: rmp | June 7, 2008 5:06 PM
rmp: Fortunately, the Bush misadministration's attempts to suppress science don't extend beyond our borders. The entire developed world produces and researches vaccines, so you can get reasonably suspicion-free information from other countries' equivalents of the CDC.
Posted by: ebohlman | June 7, 2008 5:48 PM
Well, this is a bit of an overstatement. The body does have a system for developing antibody defenses to low levels of molecules, but it is pretty specific to large, biological-type molecules such as proteins. And in fact, is a quite remarkable system, with a very high degree of amplification built into it. Ironically, considering the fears of toxin phobics, your body has "make an effort" to have any kind of reaction to foreign substances at such tiny levels. Most of the "toxins" they fear are small molecules that normally do not trigger immune responses.
Posted by: trrll | June 7, 2008 6:05 PM
Posted by: Cath the Canberra Cook | June 7, 2008 7:51 PM
Ah bugger. Failed to close blockquote. My words start at "Brilliant, trrl!" Sorry.
Posted by: Cath the Canberra Cook | June 7, 2008 7:53 PM
Good thought. Maybe we it is just a matter of relabeling. Instead of vaccine, we can label the box "Homeopathic protection against toxins and disease"
Posted by: trrll | June 7, 2008 8:52 PM
Every one of the "toxins" that antivaccinationists complain about in vaccines is present in the water you drink and the air that you breathe.
Exactly. Idiots who live in Los Angeles and breathe the air there have no business worrying about a few parts/million of some "toxin" in a once-in-a-lifetime injection. Especially not if they are breathing every day.
Posted by: Marcus Ranum | June 7, 2008 10:23 PM
Water is toxic, in high enough doses. "Removing all toxins" makes no sense.
Posted by: Samantha Vimes | June 7, 2008 10:34 PM
http://celebsmokers.altervista.org/albums/userpics/10001/Jen_McCarthy_2.jpg
Jenny started smoking when she was 11. There are different stories about whether or not she stopped smoking when she was pregnant. She's had one of the world's most toxic substance injected into her face several times. She's made some kind of joke (or maybe not) about using street drugs. Now she's all concerned about toxins in vaccines? What about that hair dye and all that makeup?
Posted by: Thanks Jenny | June 7, 2008 10:45 PM
I got a question for Orac or anyone else interested:
True, there is no perfect solution, and the element of risk seems to have completely disappeared from woo science. However, should we be bothered by the fact that iatrogenic causes are the third largest cause of death in the United States (after cancer and heart disease)? About 225,000 people die each year from causes related directly to the administration of healthcare -- 106,000 of those deaths from negative drug effects alone.
Posted by: Jeff Read | June 7, 2008 10:49 PM
I don't know how worried to be about iatrogenic diseases and deaths. If you are waiting for perfect pharmacists, perfect doctors and perfect nurses before you seek medical care, you'll die waiting. Does anyone think that this question would even be raised in areas where there is little available medical care? Personally, I expect medical personnel to make mistakes. Just like I'd expect to make mistakes if I worked in medicine.
How many children are killed every year by parental mistakes? Mom gives junior the wrong medicine. Dad puts baby in the car with no seat belt? Gramma put's baby in the back yard near the pool and leaves baby to answer the phone? Baby falls down a well...
Parents find some way to forgive their own stupid errors, usually.
Posted by: Nobody's Perfect | June 7, 2008 11:13 PM
Jeff Read said " However, should we be bothered by the fact that iatrogenic causes are the third largest cause of death in the United States (after cancer and heart disease)?"
Where is this listed? Because the cause of death is very much dependent on age. For certain ages the first cause of death is by accident (usually vehicular).
Let's go through some of the stats of the top three causes of death by age available from http://www.disastercenter.com/cdc/ ...
Age 1 to 4:
1 Accidents and adverse effects 2,155
. . . Motor vehicle accidents 834
. . . All other accidents and adverse effects 1,321
2 Congenital anomalies 633
3 Malignant neoplasms, including neoplasms of lymphatic and hematopoietic tissues 440
Age 5 to 14:
1 Accidents and adverse effects 3,521
. . . Motor vehicle accidents 2,002
. . . All other accidents and adverse effects 1,519
2 Malignant neoplasms, including neoplasms of lymphatic and hematopoietic tissues 1,035
3 Homicide and legal intervention 513
Age 15 to 24:
1 Accidents and adverse effects 13,872
. . . Motor vehicle accidents 10,624
. . . All other accidents and adverse effects 3,248
2 Homicide and legal intervention 6,548
3 Suicide 4,369
Age 24 to 44:
1 Accidents and adverse effects 26,554
. . . Motor vehicle accidents 14,528
. . . All other accidents and adverse effects 12,026
2 Human immunodeficiency virus infection 22,795
3 Malignant neoplasms, including neoplasms of lymphatic and hematopoietic tissues 22,147
Age 45 to 64:
1 Malignant neoplasms, including neoplasms of lymphatic and hematopoietic tissues 132,805
2 Diseases of heart 102,510
3 Accidents and adverse effects 16,332
. . . Motor vehicle accidents 7,659
. . . All other accidents and adverse effects 8,673
Age 65 and over:
1 Diseases of heart 612,886
2 Malignant neoplasms, including neoplasms of lymphatic and hematopoietic tissues 386,092
3 Cerebrovascular diseases 140,938
There is also a very interesting table of deaths from 113 causes for all ages:
http://www.disastercenter.com/cdc/Age%20of%20Deaths%20113%20Causes%202005.html
Some of the interesting lines are:
Whooping cough (A37) 31 28 (the last number is for children under age 1).
Measles (B05) 1 - 1 (that was for a child between 1 to 4)
Meningitis (G00,G03) 669 57 (the last number is for children under age 1)
Pneumonia (J12-J18) 61,189 246 (again, that is for a child under age 1).
Looking at it, the top three major categories are:
Major cardiovascular diseases (I00-I78) 856,030
Malignant neoplasms (C00-C97) 559,312
All other diseases (Residual) 217,632
Well, it is a long and very detailed table. I would like you to tell me which lines are the ones that would considered "iatrogenic". Are they the ones listed under all other diseases? Thank you.
Posted by: HCN | June 8, 2008 12:26 AM
Thanks for this article.
Posted by: PTCB Exam | June 8, 2008 2:09 AM
I would assume that all of the "Complications of medical and surgical care" are considered iatrogenic; as for all other diseases, who knows? Thanks for showing me this table, btw.
Posted by: Jeff Read | June 8, 2008 5:40 AM
I'd like to find some way to compress the data Tsu Dho Nimh posted into a poster that I can parade in front of any anti-vaxers that attack my neighborhood. Thanks for that post.
Posted by: Oldfart | June 8, 2008 8:28 AM
How about (Front Side):
*London, 1748-52: no modern "pollutants"
Population: 750,000+/-
750 died from whooping cough
569 died from measles
10179 died from smallpox
---------------------------
Science is worthless because?
*Yearly Bills of Mortality
and (Back Side):
*USA, 2005: all modern "pollutants"
Population: 300,000,000
30 died from whooping cough
1 died from measles
0 died from smallpox
---------------------------
Science is worthless because?
*Table 10, www.disastercenter.com
Posted by: Oldfart | June 8, 2008 8:56 AM
Probably not. Imagine a world in which medicine has been literally perfected: there is no illness, no injury that cannot be completely cured, so long as the patient is given care correctly, and in time. We can even eliminate the latter condition by imagining a medical computer which monitors your health and instantly teleports you to the nearest hospital should you require assistance. In this medical utopia, humans are near-immortal - and fully one hundred percent of all deaths are iatrogenic.
High rates of iatrogenic events can be indicative of a very bad health care system, but they can also be indicative of precisely the opposite.
Posted by: MartinM | June 8, 2008 8:59 AM
Mortality tables. Wonderful things. This link brought to you by the CDC tabulation of all deaths in the United States, set up for rather detailed queries.
Yup, you got it: death, sliced diced and dissected.
Posted by: D. C. Sessions | June 8, 2008 9:38 AM
How does anyone who demands 100% safety ever make the decision to have a child in the first place? The entire process from conception to birth is fraught with potential disasters from deformity to death.
Posted by: AndyD | June 8, 2008 10:43 AM
"A statement of fact cannot be insolent."
THE FACTS
•No study exists evaluating the General health of the vaccinated vs. non vaccinated populations. There is a bill currently in front of congress, HR2832 to accomplish just this. Please support it, if it makes the senate floor.
•No study exists evaluating of the long term impact of 26 vaccines by age 2 on the immune system or overall health.
•No study exists evaluating of the safety of multiple shots being given in one day. Our current program requires that as many as 5 shots be given in one day containing 7 vaccines. Existing safety studies only evaluate individual vaccines.
•No studies exists addressing Causation or tracking of the 1,322 brain injured children that have been paid settlements by VAERS (Vaccines Adverse Events Reporting System) since 1991.
•Thimerosal has not been removed from all vaccines. A full compliment still exists at 10 times the EPA acceptable limit, in all but one brand of Flu vaccines and the tetanus shot, with traces still existing in other vaccines. Also it is still used, as before, in the manufacture of vaccines but is supposed to be removed by filtration by the manufacturer. The FDA only inspects this process at the time of licensure. There are no follow-up inspections conducted and when the filtration process is being used correctly trace amounts of mercury are still allowed. There may well be subsets of children who can not tolerate even trace levels of mercury.
•Aluminum is used in excessive levels in childhood vaccines. No studies exist that determine these levels to be safe. I say excessive because the FDA recommends no more the 25mcg injected per day in preemies and those with impaired kidney function via other IV medications. However, on day one of life a newborn receives 250 mcg in the Hep B Vaccine and at each of the 2, 4 and 6 months visits and infant receives 295 mcg to 1225 mcg, depending on the combination of brands.
While the expectation of 100% safety is unrealistic our government agencies, who by the way MANDATE vaccines, should always set a standard of safety as the highest goal. The previous list certainly does not reflect that they are doing that.
Posted by: Pamela | June 8, 2008 2:24 PM
Pamela -
No study exists evaluating the General health of the vaccinated vs. non vaccinated populations. There is a bill currently in front of congress, HR2832 to accomplish just this. And whose babies and toddlers will be given placebo injections to make this study possible? One assumes they will denied vaccines and be studied for their entire lifetime.
•No study exists evaluating of the long term impact of 26 vaccines by age 2 on the immune system or overall health. You know, compared to the thousands of antigens that a newborn is exposed to during the trip down the birth canal, the stay in the nursrey, and coming home to the family dog or cat ... it's really irrelevant. Contrary to what you may think, the human immune system is not that easy to overwhelm.
•No study exists evaluating of the safety of multiple shots being given in one day. As opposed to meeting granny for the first time, and having her purse pooch slobber all over the baby and shed anumal dandre? As opposed to going to a petting zoo and being exposed to kangaroo poop, horse dander, duck feathers, etc. ?? See previous paragraph.
Posted by: Tsu Dho Nimh | June 8, 2008 3:36 PM
Posted by: ebohlman | June 8, 2008 4:17 PM
Ah, marvelous retrodiction.
The Francis Field Study found that of the four groups (vaccine, placebo, refuse, and observe) the "refuse" group had a lower rate of polio than either the placebo or observe groups. They were not surprised, since that was a common pattern for the reasons you cite.
Posted by: D. C. Sessions | June 8, 2008 5:12 PM
What I'm consistently failing to grok is what anti-vaxers would do to ethically decrease the already very small risk of vaccines. Along with public health measures in general, and germ theory (including antibiotics), vaccination has been one of the greatest successes of medical science. Not all public health actions are easy and none(?) are risk-free; incorrectly used antibiotics can be dangerous; and there are assorted risks with vaccines in some people. Excepting the mis-use/over-use of antibiotics, the risks are so small sensible people accept them.
Yes, it'd be nice if the risk could be further reduced. But how? As pointed out by previous commenters, ethical double-blinded trials are impossible. So how?
Posted by: blf | June 8, 2008 5:18 PM
Never underestimate the power of human self-deception.
If you start from the presumption that vaccines are never justified, then it follows that they don't work and never did. From there you can deduce all sorts of interesting things, such as the harmlessness of smallpox, the necessity of measles to the developing immune system, the discovery that polio was going away on its own before the vaccines were introduced, and so on.
Posted by: D. C. Sessions | June 8, 2008 5:27 PM
To Tsu Dho Nimh
From Pamela
You failed to make a single valid point.
• The vaccinated vs. unvaccinated population study would evaluate the general health of people vaccinated in our current program vs. those who never have been. There would be no placebos and there are ample unvaccinated people in the Amish community and in the home school community where parents have chosen not to vaccinate. No one who wants their children vaccinated would be denied the opportunity. I pray the proposed bill is passed.
• Regarding natural exposure and antigens. The number of vaccines is not about excessive antigens. There are actually fewer antigens in our entire schedule than used to exist in the small pox vaccine. The issue is the toxins contained in the shots and the lack of studies to determine appropriate safe limits. For example the aluminum and the fact that safe limits are set at roughly 50mcg by the FDA for adult IV medications but a 2 month old will receive 225 mcg to 1200 mcg in one visit based on the combination of brands. The FDA sets no limit on aluminum exposure in vaccines and safe thresholds have never been determined through studies. Aluminum is used specifically to activate the immune system. Logic would dictate there should be some limit.
• To your last attempted point, regarding studies of multiple vaccines in one day. Again, this is not an antigen issue it is a toxicology issue and a question of drug interaction and interaction of the multiple components in the vaccines. Also you fail to recognize that pooch slobber is a natural exposure allowing the immune system to go through its natural process, where as a vaccine is an injection straight into the blood stream containing many additives aside from antigens. This is not a logical comparison.
Better luck next time. Though this has been fun I'm done here... you folks are grossly uneducated on the nature of the concerns.
Posted by: Pamela | June 8, 2008 9:10 PM
Again, you miss the concept of confounders. There are also numerous other differences between the general population between home-schoolers and the Amish that would be incredibly difficult to control for. (Besides, the Amish do vaccinate at a fairly high rate.) Mr. Bohlman is correct, and you have no clue difficult such a study would be to do and still control for the numerous huge confounders.
This is the dumbest thing you''ve written yet. IV administration is hugely different from intramuscular administration. It produces a much higher and immediate level; the two are not comparable. Moreover, there is no compelling evidence that aluminum in vaccines causes any harm and plenty of evidence that it is safe.
Finally, spare me the "toxins" gambit. It's nothing more than a transparent moving of the goalposts now that epidemiology and science are failing to find evidence of a link between thimerosal-containing vaccines and autism. You'll have to do better than that.
No, it isn't. If you don't believe me, consider the difference between an intramuscular injection of morphine versus an intravenous injection. Intramuscular injections sit in the muscle and are slowly released. That is very different than an injection straight into the vein. An intravenous injection of a vaccine would very likely not produce much of an immune response because the components would be eliminated from the body too quickly.
Posted by: Orac | June 8, 2008 9:30 PM
It appears that Pamela has declared victory and gone home.
Posted by: Tsu Dho Nimh | June 8, 2008 9:40 PM
http://img363.imageshack.us/my.php?image=toomanyjennycf5.jpg
Posted by: Epidemics love Jenny and Jim | June 8, 2008 11:19 PM
O.K. so I came back for a peek and since you responded to me directly Orac...I'll play.
Regarding confounders in a vaccinated vs. unvaccinated population study, there would certainly be a good number of confounders between the Amish population and the rest of us. However I do not believe this would render a valid study impossible or not worthwhile. Also there are certainly enough unvaccinated Amish to include in such a study, confounders aside. I did not say that all Amish were unvaccinated. However, I fail to see how this would be true for the Home School community and would love for you to elaborate on what you think those confounders are.
Regarding aluminum -I do stand corrected on the intramuscular vs. IV administration statement. I can admit when I err but please don't respond to me as though I am a regular visitor to your site who repeatedly makes dumb comments. This is disingenuous as I have never visited your blog before today and one misstatement does not completely negate the point. But I have the sense that disingenuous vicious might be your M.O.
I am well aware there is no compelling evidence that aluminum in vaccines causes harm. Science doesn't find something it doesn't look for and I would challenge you to find and post safety studies concerning the use of aluminum in vaccines, specifically ones that address tolerable limits. I am always in search of reasons to restore my trust in the CDC, NIH and IOM.
Regarding toxins - I am not hung up on the thimerosal issue. Mercury is a known neurotoxin. Whether it causes autism or not is yet to be fully proven. However I am tired of the lie that it has been removed from all vaccines.
What I am more concerned about is the general lack of studies regarding the vast toxins in vaccines. Is there any excuse for not doing the science? Former Director of the NIH, Bernadine Healy just came out in support of all of us who have questions about our vaccine program when she said on CBS News that "There is a completely expressed concern that they (government officials) don't want to pursue a hypothesis (link between vaccines and autism) because that hypothesis could be damaging to the public health community at large because it might scare people away...However, if you know the susceptible group you can protect them."
She ends the interview with, "The more you delve into it...and you look at the individual cases and the evidence that there is no link, what I come away with is that the question has not been answered."
Regarding Pooch Slobber - let me correct my original statement and leave it this way... Also you fail to recognize that through pooch slobber one experiences natural exposure allowing the immune system to go through its natural process, where as a vaccine in the form of an injection by-passes the natural immune process and contains many additives aside from antigens... additives which lack proper safety studies. Pooch slobber and vaccines are not apples and apples.
My ultimate point is that there are many basic unanswered questions. If you want to reference specific studies regarding vaccine toxins and administration of multiple vaccines in one day, I will definitely read them. I would love to have my faith restored.
Posted by: Pamela | June 8, 2008 11:19 PM
Your point about vaccines bypassing anything because they are injected is really no point at all. Show how it is that the body reacts differently to a virus that enters from a scratch or through the mouth or nose and through an injection. I'm dying to get the details. Vaccines are not full of toxins, dear heart. Get a grip.
Posted by: Epidemics love Pamela, too! | June 8, 2008 11:26 PM
More religious, more attention from parents, more of a tendency towards a "crunchy" lifestyle with organic foods and such, a tendency towards higher socioeconomic status (one parent has to be able to stay home full time to teach the children, and most lower income families can't afford not to have both parents working), and those are just ones that come to mind off the top of my head.
A comment as blatantly wrong as using the "IV aluminum" canard (it's such a common antivax canard that I gave it a name) needs only be stated once to demonstrate that you don't know what you're talking about. If you did know what you were talking about when it comes to some very basic issues in medicine and immunology beyond antivaccinationists talking points, you would have recognized it immediately as a completely irrelevant red herring. Sorry to be harsh, but think of it as tough love. If I didn't think you were at least semireasonable and thus worth a passing attempt at persuasion, I would have just ignored you as I do most antivaxers who infest my comments.
You want to impress me? Stop spouting easily debunked antivaccinationist talking points about aluminum and vague "toxins" and say something that makes sense. For example, what evidence do you have that all these "toxins" at trace levels are unsafe? Remember, it's impossible ever to remove "all the toxins" from vaccines or any other medicine. They'll always be there in trace amounts. So the question becomes: Are they safe at trace levels. Babies are exposed to more formaldehyde, for example, in a day from household products (plastics, furniture finishes, plywood, and the like) than from any shot.
I did. True, it was an indirect link, but it was a link to a large Cochrane review and a Pediatrics article. There are numerous other articles supporting the safety of vaccines in their current formulation. However, I'm guessing that no matter how many references I were to come up with you'd find a reason to discount them. I sense skill at moving the goalposts in you. These questions have been looked at, just not in the way you want.
Besides, the whole "toxins" thing is a canard, too. Read this, as I explained why a long time ago.
She ends the interview with, "The more you delve into it...and you look at the individual cases and the evidence that there is no link, what I come away with is that the question has not been answered."
Healy has become a bit of a crank in her old age. She's made over-the-top and ridiculous criticisms of evidence-based medicine and has been commenting in embarrassing ways on cases like that of Terri Schiavo. She isn't always a crank, but she's said some pretty dumb things often enough that I no longer trust her. Remember: Authority matters little, and heads of the NIH are as often politicians as they are competent researchers. Healy was a political hack, and quoting her means little.
Do tell. This is another common antivax canard with a grain of truth (but not nearly enough to make it a valid argument against vaccines). Perhaps you can explain exactly what the difference is. How about humoral immunity? Or antibody-mediated immunity?
Posted by: Orac | June 8, 2008 11:49 PM
Pamela: What I am more concerned about is the general lack of studies regarding the vast toxins in vaccines. Is there any excuse for not doing the science?
"Vast Toxins"?
FYI, the normal formaldehyde level of human blood is about 2.5 ug per ml ... it is produced naturally and is needed for some critical processes. By your standards of "must be formaldehyde free", I couldn't set up a crossmatch for a baby because of the formaldehyde.
a vaccine in the form of an injection by-passes the natural immune process and contains many additives aside from antigens As opposed to the accidental "vaccinations" I have had when a cat sank its fangs into my hand, when a splinter of mesquite wood went through the web between my thumb and forefinger, or when I stepped on a nail and it came out the top of my foot? Care to estimate the hit my immune system had to take for those subcutaneous injections of cat spit, mesquite resins, and all the stuff on that nail?
Posted by: Tsu Dho Nimh | June 8, 2008 11:59 PM
Also, Pamela, you consistently refer to the ingredients in vaccines as "toxins". I prefer to reserve that name for things like rattlesnake or scorpion venom, botulin and other genuinely toxic substances.
Posted by: Tsu Dho Nimh | June 9, 2008 12:05 AM
I am kind of curious of how you figure out which kids you leave in the placebo group. Exactly how do you choose which ones get to be more vulnerable to Hib, measles, tetanus and pertussis?
Oh, and forget the Amish... as mentioned before, they are not exactly unvaccinated, and they have some interesting genetic differences (look up Maple Syrup Urine Disease).
Pamela said "If you want to reference specific studies regarding vaccine toxins and administration of multiple vaccines in one day, I will definitely read them. I would love to have my faith restored."
Here, from one review (Pediatric Combination Vaccines:
Their Impact on Patients, Providers, Managed Care Organizations, and Manufacturers by S. Michael Marcy, MD, VOL. 9, NO. 4 THE AMERICAN JOURNAL OF MANAGED CARE, April 2003).... Which starts with:
BEGIN Quote
Objectives: To review the potential benefits of pediatric combination vaccines to children, parents, providers, managed care organizations, and manufacturers and to discuss the scientific, social, and economic issues that need to be addressed to provide optimum uptake of these vaccines.
Results: Combination vaccines provide multiple advantages
for children, parents, and providers; however, their development involves considerable research and expense to ensure efficacy and safety. As the complexity of these vaccines increases, more extensive laboratory and clinical trials will be needed to ensure antigen compatibility, immunogenicity, and acceptable reactogenicity.
END Quote
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Posted by: HCN | June 9, 2008 12:16 AM
Tsu Dho Nimh said "other genuinely toxic substances."
Like spasmogenic toxin or tetanospasmin...
(your name looks familiar... like from Usenet --- you know Jan Drew has paid me the best compliment, she claimed I was you! ... http://groups.google.com/group/misc.kids.health/msg/343a6958dd95668f )
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