Respectful Insolence

You know, I think I’ve found a bride for Steve Wilson.

You remember Steve Wilson, don’t you? He’s the local “investigative reporter” in my hometown who recently did a truly awful “report” (it actually makes me cringe to call it a “report,” but I couldn’t think of anything else to call it) a couple of weeks ago, in which he regurgitated just about every anti-vaccine talking point about mercury and thimerosal there is out there. I hadn’t seen anything like it, ever (at least not that I can recall). So bad was it that I feared the hyperconcentrated stupid might lower my blog bud PalMD’s IQ by a few points, given how close his home and place of work are to the TV station from which Wilson broadcasts.

Now the stupid’s gone national, with a blatant hit piece by Sharyl Attkisson of CBS News on Friday. In her eagerness to smear Dr. Paul Offit (a.k.a. Satan Incarnate, Darth Vader, or the Dark Lord of Vaccination, if you’re someone who believes that vaccines cause autism) Attkisson took a potentially legitimate point about potential conflicts of interest in science and turned it so stupid that she is worthy of nothing but ridicule.

And Orac’s just the guy to do provide it for her, too, by administering a heaping helping of some not-so-Respectful Insolence™.

Before I tackle what’s wrong with Attkisson’s piece, please join me, if you will, on a trip down memory lane. We’ve met Attkisson before on this blog, oddly enough, about a year ago. At the time, she was busily engaged in seeing how many logical fallacies and uses of the “pharma shill” gambit she could pack into a single story about the manufactroversy of whether vaccines cause autism. At the time, I characterized her story as “beautiful” or “classic crankery.”

Fast forward around 13 months, and it turns out that Attkisson is still at it, undeterred by anything resembling journalistic skill, logic, or ethics. She starts out ominously (I can almost imagine the sort of scary music used in horror movies to ramp up the tension before the monster strikes starting to play here):

They’re some of the most trusted voices in the defense of vaccine safety: the American Academy of Pediatrics, Every Child By Two, and pediatrician Dr. Paul Offit.

But CBS News has found these three have something more in common – strong financial ties to the industry whose products they promote and defend.

She then goes on to list what she considers to be slam-dunk evidence that the entire pediatrics and public health are in the pockets of big pharma. Ironically, enough, she demonstrates her great journalistic skills by finding this information out from publicly available sources, hectoring these organizations, and then insinuating dark conspiracies when they refuse to be interviewed with her. She reserves particular contempt for Dr. Offit:

Then there’s Paul Offit, perhaps the most widely-quoted defender of vaccine safety.

He’s gone so far as to say babies can tolerate “10,000 vaccines at once.”

This is how Offit described himself in a previous interview: “I’m the chief of infectious disease at Children’s Hospital of Philadelphia and a professor of pediatrics at Penn’s medical school,” he said.

Offit was not willing to be interviewed on this subject but like others in this CBS News investigation, he has strong industry ties. In fact, he’s a vaccine industry insider.

Offit holds in a $1.5 million dollar research chair at Children’s Hospital, funded by Merck. He holds the patent on an anti-diarrhea vaccine he developed with Merck, Rotateq, which has prevented thousands of hospitalizations.

And future royalties for the vaccine were just sold for $182 million cash. Dr. Offit’s share of vaccine profits? Unknown.

You know how I know where Attkisson’s coming from and that it’s not anything resembling objectivity? Its her use of the “10,000 vaccines at once” canard. It’s a favorite among the anti-vaccine crowd, because they use it to make it sound as though Dr. Offit is some sort of crazy ideologue who wants nothing more than to inject as many vaccines as possible into babies. Let’s take a look at what Dr. Offit actually said and see if it sounds so ominous:

“Children have an enormous capacity to respond safely to challenges to the immune system from vaccines,” says Dr. Offit. “A baby’s body is bombarded with immunologic challenges – from bacteria in food to the dust they breathe. Compared to what they typically encounter and manage during the day, vaccines are literally a drop in the ocean.” In fact, Dr. Offit’s studies show that in theory, healthy infants could safely get up to 10,000 vaccines at once.

The bottom line: It’s safe to give your child simultaneous vaccines or vaccine combinations, such as the five-in-one vaccine called Pediarix, which protects against hepatitis B, polio, tetanus, diphtheria, and pertussis (also known as whooping cough. Equally important, vaccines are as effective given in combination as they are given individually.

Nope, nothing ominous there at all. Dr. Offit was simply pointing out that babies’ immune systems can handle far more antigens than are in any vaccines or combination of vaccines presently administered. I rather suspect he probably regrets using that exact turn of phrase, though, because it’s been a favorite whipping boy of anti-vaccinationists ever since he first said it back in 2005. If you don’t believe me, try Googling “Paul Offit 10,000 vaccines” or “Paul Offit 100,000 vaccines” sometime, although this post gives a flavor of the sorts of uses to which Dr. Offit’s quote has been used by anti-vaccine activists.

The obvious question is: Why did Attkisson include that quote? After all, it doesn’t really have anything to do with the story at hand, namely whether or not Dr. Offit has conflicts of interest that make him hopelessly biased. It’s just thrown in there to bias the reader right off the bat, to add to making the reader think that Dr. Offit is, as anti-vaccinationists seem to like to call him these days, a “biostitute.” It’s nothing more than the fallacy of poisoning the well.

Now don’t get me wrong. Potential conflicts of interest do matter. They matter a lot. However, a general principle is that undisclosed potential conflicts of interest (COIs) are of far more concern and potentially far more damaging to the scientific process than disclosed COIs. The reason is obvious. Disclosed COIs are out there and their disclosure makes it possible for any critical observer to decide how much they matter and whether or not they may have compromised the objectivity of the scientist or physician possessing them. In contrast, undisclosed COIs hide information necessary to evaluate a researcher’s objectivity. True, sometimes the disclosure these days can get carried to ridiculous extremes, so much so that at a recent meeting I recall a senior researcher, a veritable giant in our field, basically make fun of the requirement, where the pre-talk disclosures can sometimes seem longer than the talk. Personally, I tend to poke a little fun at the requirements by saying something along these lines before any talk I give, “I have no conflicts of interest to disclose because no company is interested in supporting my research or hiring me as a consultant.” Kidding aside, I believe that disclosure is better than non-disclosure.

Indeed, I’m all for transparency–for everyone! That’s why I’m hoping that Sharyl Attkisson, hot on the heels of this piece of journalistic brilliance, won’t stop just with the AAP, Every Child by Two, and Dr. Offit. That’s why I’m really hoping that I’ll soon see a followup news story by her about the undisclosed conflicts of interest that riddle the “vaccines cause autism” contingent. After all, COIs matter, and it wouldn’t be fair to concentrate only on one side of the “debate,” would it? After all, what happened to the journalistic meme of “tell both sides”?

For example, how much are Mark and David Geier making off of their chelation therapy, Lupron protocol, and their consulting for plaintiffs in vaccine lawsuits or claims against the Vaccine Injury Compensation Program? Or what about their attempt to patent their Lupron protocol? After all, if it’s incredibly suspicious that Dr. Offit patented his rotavirus vaccine, it must be just as bad that those warriors against vaccines, Mark and David Geier, tried to patent their protocol, mustn’t it? Or what about the way that the Geiers set up a dubious Institute and IRB to oversee their “clinical trials” designed to show that their quackery “cured” vaccine-induced autism but didn’t disclose that the IRB had been packed with their cronies?

Surely Attkisson would be interested in that, wouldn’t she? For the sake of the children?

Or how about Andrew Wakefield? Remember him? He not only received hundreds of thousands of pounds from law firms that sue vaccine manufacturers, but received the money while he was doing his “research” that led up to his infamous 1998 Lancet article. Not only that, but he failed to disclose this clear potential COI when he submitted his paper, and the payments weren’t discovered until years after the fact. That was a pretty blatant conflict of interest, so much so that the U.K.’s General Medical Council has in essence put him on trial. Indeed, arguably the resurgence of measles that has occurred in the U.K. can be laid right at Dr. Wakefield’s doorstep, including at least one death. Talk about “litigation-driven research” causing serious mischief and harm! I can’t help but note that no such injury to children can be attributed to any of the publicly disclosed potential COIs mentioned in Attkisson’s story. So why isn’t Attkisson railing against Wakefield’s far more blatant COI than anything Dr. Offit’s ever been accused of? I’m sure it’s just an oversight and that she’ll take care of it in a followup story.

Or how about Laura Hewitson? She’s the primary investigator on a poorly designed and arguably unethical study of the effects of the vaccine schedule on monkeys reported at the International Meeting for Autism Research in May. It turns out that Dr. Hewitson not only has an autistic child, but is a plaintiff in the Autism Omnibus proceeding and that her husband works for Andrew Wakefield. Apparently, at least as far as I can tell, she never disclosed her status as a litigant when she submitted her abstract, even though her abstract appeared at an amazingly convenient time to be featured in Jenny McCarthy’s Green Our Vaccines rally and to be used as “evidence” in the Autism Omnibus, making it one of the best examples of “litigation-driven” research I’ve ever seen. I’m sure that’s an oversight on Attkisson’s part, too.

Or what about the latest unwitting hero of the anti-vaccination movement, Dr. Jon Poling, whose daughter is being used as a poster child for the contention that vaccines cause autism in the presence of mitochondrial disorders, even though her case shows nothing other than how much the claim that vaccines cause autism has shrunk lately? These days, he’s reduced to showing up on blogs and criticizing anyone who critically examines the claim that his daughter represents strong evidence that vaccines are a “trigger” that can cause autism in the background of mitochondrial disease. More relevant to discussions of potential COIs, Dr. Poling was a co-author on a case report in 2006 about a girl with a mitochondrial disorder who underwent developmental regression after being vaccinated, a case report that has been widely cited as “evidence” for the claim that vaccines can cause autism in the presence of mitochondrial disease (which, conveniently enough, we’re told is much, much more common than previously thought). He disclosed neither that he was a plaintiff in the Autism Omnibus nor that the subject of the case report for which he was co-author was in fact his daughter, both serious breaches of reporting potential COIs, as far as I’m concerned. No doubt it’s just another oversight, and Sharyl will leap to correct it.

Finally, let’s not forget the large and growing “biomedical” autism cure industry, which largely depends upon as many parents of autistic children as possible believing that vaccines somehow cause autism. Now there would be a great expose. I wonder if Sharyl’s up for it. Probably not, and more’s the pity. It’s a story that’s begging to be done. It has everything: Parents given false hope, children subjected to dubious treatments, at least one of whom died as a direct result of said dubious treatments, bogus lab tests, quacks galore. In the hands of a competent journalist, it could be awesome–a blockbuster! It could win many awards!

Almost everyone has potential conflicts of interest in science. This is particularly true when researchers work on projects whose end products need to be commercialized in order to become a drug, treatment, vaccine, or what have you. There’s no avoiding working with industry to accomplish this, and that involves commerce and filthy lucre. Indeed, it’s probably not even desirable to eliminate potential COIs even if we could, because doing so would also risk eliminating a major motivating factor for producing better medicines and better treatments. To prevent such COIs from warping scientific objectivity any more than is possible, transparency is the key, and, for the most part, faster and more detailed transparency is a good thing. The only problem is that the pseudoscientists on the “other side” are bound by no such requirement for transparency. They need have no fear that their potential COIs will ever be dragged out from under their rocks and exposed to the light of day. Certainly they have nothing to fear from reporters like Sharyl Attkisson. After all, big pharma is always big and bad; but these are “brave maverick doctors” bucking the system to cure autism, right? They couldn’t possibly be involved in clearly unethical behavior such as failing to disclose blatant potential COIs, could they?

But who knows? Maybe Attkisson will surprise me. Maybe she’s working in part 2 of her expose right now.

I’m not going to hold my breath waiting for it, though.

Comments

  1. #1 TomDunlap
    July 28, 2008

    Bride? Please don’t encourage these people to reproduce!

  2. #2 Christophe Thill
    July 28, 2008

    “Offit holds in a $1.5 million dollar research chair at Children’s Hospital, funded by Merck. He holds the patent on an anti-diarrhea vaccine he developed with Merck, Rotateq, which has prevented thousands of hospitalizations.”

    Prevented thousands of hospitalizations? What a disgusting man!

  3. #3 isles
    July 28, 2008

    Not to mention that it was surely not Dr. O’s prerogative to patent or not patent the rotavirus vaccine. These aren’t the days of the original March of Dimes, when the development of a vaccine could be charitably funded and so Jonas Salk was free to renounce a patent on it. All vaccine development today is done by vaccine manufacturers, and it’s expensive as hell, due in part to litigation concerns. Today, no patent, no vaccine.

  4. #4 llewelly
    July 28, 2008

    Indeed, I’m all for transparency–for everyone! That’s why I’m hoping that Sharyl Attkisson, hot on the heals of this piece of journalistic brilliance …

    heals => heels

  5. #5 Mary Parsons
    July 28, 2008

    It’s a small start but a very surprising newspaper did something like you are suggesting in the UK: The Great Autism Rip-Off…… How a huge industry feeds on parents desperate to cure their children.

    It’s surprising because the Daily Mail is notorious for its anti-MMR, pro-Wakefield stance.

    In this burgeoning market, private doctors and clinics have sprung up across the UK claiming they can treat or even ‘reverse’ the disorder.

    Recent research published in the Journal Of Developmental And Behavioural Paediatrics found that a third of parents of autistic children have tried unproven ‘alternative’ treatments.

    Worryingly, the study claims one in ten has used what the experts class as ‘a potentially harmful approach’.

    The Autism Omnibus hearings have been replete with too many instances of parents paying for dubious tests from labs that weren’t accredited or lost their accreditation in such a way as to cast doubt on reposing any confidence in their findings (e.g., Professor Bustin’s report on Unigenetics and the recent revelations about Immunosciences).

  6. #6 Dianne
    July 28, 2008

    Personally, I tend to poke a little fun at the requirements by saying something along these lines before any talk I give, “I have no conflicts of interest to disclose because no company is interested in supporting my research or hiring me as a consultant.”

    I’ve had to sign or state disclosures so often that I’ve taken to saying, “I have no conflicts of interest…despite my best efforts.” Which is true. But rather flippant.

    One issue that I’ve never seen addressed properly is whether all this disclosure is helpful. Does disclosing COI make listeners/readers more skeptical and less likely to overlook errors and biases (conscious or unconscious) that the author or speaker might have? Questionable, at best. I’ve heard the claim that disclosures actually make people read/listen less critically because they think that the disclosure means that the speaker/author is super-honest. (Sorry, I don’t have a better source than conversation at the EHA meeting.)

    I agree that COI are important and limiting/disclosing them is a worthy goal. However, I’m concerned that the efforts we currently make towards limiting COI are not effective or even counterproductive. We need to develop metrics to measure how much bias and COI are problems and which interventions are effective in limiting them. (And if it sounds like I’m running for office, that’s because I am: I am nominating myself for the ASH educational committee next year with the intention of working on this problem through ASH as my primary statement of what I would bring to the committee.)

  7. #7 Dianne
    July 28, 2008

    Finally, let’s not forget the large and growing autism cure industry, which depends upon as many parents of autistic children as possible believing that vaccines somehow cause autism.

    Excuse the stupid question, but why is the “cure industry” dependent on parents believing that autism is caused by vaccines? If my child were severely autistic*, I’d want her to be “cured” or at least have some of the symptoms alleviated, regardless of what caused the autism. Of course, there is no cure for autism and the quacks promoting chelation, etc depend on, at least, parents’ believing that heavy metal poisoning is involved, but research efforts at a cure and behavioral interventions to improve autistic children’s ability to interact with people seem less dependent on etiology. Does the cure industry refer only to the people promoting chelation et al?

    *As it happens, I’m actually worried at this point that my child will be TOO neurotypical and I won’t be able to communicate easily with her because of that. Maybe I should give her some more vaccines. (Don’t panic: I’m just joking.)

  8. #8 Orac
    July 28, 2008

    How about I rephrase it to “which largely depends upon as many parents…”? That is clearly true.

  9. #9 AutismNewsBeat
    July 28, 2008

    The sentence would be more clear if it read “let’s not forget the large and growing bio-med autism cure industry.”

  10. #10 Calli Arcale
    July 28, 2008

    Yes, in this case “cure industry” is referring to the people promoting chelation, etc.

    It’s not exactly dependent on the vaccines-cause-autism thing, but it *is* dependent on having some sort of a common story that can be used as the basis of marketing schemes. A great many of these folks have latched on to vaccines. It could as easily have been flouridation, and in fact, some dubious practitioners have indeed targeted that.

    This has the same hallmarks as a lot of older scams. For it to work, the reputed cause has to be something that practically everybody gets exposed to. That way, the practitioners can be sure of this aspect of their patients’ histories and thus can exploit it in the same manner as fake psychics. They can say, in an ominous voice, “tell me, was he vaccinated?” knowing that the answer will almost certainly be “yes”, thus earning a bit of credibility in the eyes of unsuspecting parents.

    A few other things make vaccines a particularly appealing target for fraudsters. They are government-mandated, so there is the “conspiracy” angle as well as the incompetent or uncaring government angle. They are also painful to children, and most parents would be very happy if they didn’t have to subject their children to them. Lastly, vaccines *do* have rare side-effects, many not well understood, and that uncertainty provides an easy place to start digging at parents’ doubts.

    There is a marketing principle called FUD: Fear, Uncertainty and Doubt. Among the more notorious users of the principle are IBM in the 1980s and Microsoft in the 1990s, but it is by no means exclusive to them. It is extremely effective, but unethical because it involves misinformation. The idea is to sow fear, uncertainty, and doubt in the minds of your potential customers. Make them afraid to go with any other option than yours. There is a great deal of FUD out there pertaining to vaccines, and anyone wishing to make a quick buck can exploit that.

    It’s not as if vaccines are the only thing they use, though. Most of the trappings of modern life have some forms of FUD attached to them. Food processing, microwave ovens, cell phones, high tension power lines, cars, television, computers, air conditioners, RFID chips, soap….. Pretty much anything.

  11. #11 ThoJ
    July 28, 2008

    For what it’s worth–in her exhaustive search of the internet for public information about Dr. Offit (ably assisted by emails from the good people of Generation Rescue, we can bet), she got a minor bit wrong–

    The endowed chair Dr. Offit holds is $2M, not $1.5M. His institution contributed $500k to the endowment, in addition to the $1.5M that Merck contributed.

    Not a big deal, but it just goes to the idea of (a) how much detail effort went into this and (b) the fact that it was the Merck money that she wanted to focus on.

    It wasn’t a very difficult search to get information about the chair.

    Frankly, the statement (besides having odd grammar) by her on Dr. Offit’s chair is not at all bothersome to anyone who understands endowed chairs.

  12. #12 Orac
    July 28, 2008

    I agree. It’s not bothersome. Once a chair is endowed, the faculty holding the chair can do pretty much anything he wants with the investment/interest income that the endowment generates.

  13. #13 ThoJ
    July 28, 2008

    Exactly–the endowed chair makes him more independent. I guess that concept didn’t fit with the story.

  14. #14 Genevieve
    July 28, 2008

    Superb, powerful statement. You hit the nail on the head.

  15. #15 Diego
    July 28, 2008

    I’ve been reading a galley proof of Dr. Offit’s upcoming book and he openly discusses the issue of the conflicts of interest. Regarding the patent for the rotavirus vaccine, it was his mentor Stan Plotkin who suggested they get the patent, otherwise no company would ever manufacture they vaccine they had just invented. It is common sense. Besides, all the profits, according to him, go back to his lab, not to his personal bank account.

  16. #16 Orac
    July 28, 2008

    I have a galley proof of his book, too, but I’ve only read a couple of chapters. I need to get cracking.

  17. #17 RJ
    July 28, 2008

    We all understand inventor ship, patents, and licensing issues.

    But most of American does not.

    Since when is it an indication of a conflict of interest when an inventor licenses his/her invention, particularly one that can save lives?

    The problem is that this is a case being tried in the court of public opinion. And regardless of the facts, the implications that are made, coupled with the flashy graphics and sound bites will incriminate whoever they chose to implicate. There are those who already are convinced. Others, who are on the fence. Regardless, the facts do not matter as much (you can ask Socrates about this one).

    The strategy is to recruit as many sheep as possible so that the ‘rule by majority’ credo can be used.

    I guess the one comforting fact that, in the long run, nature laughs last. Evolution never turns off. We’ll see the resurgence of these diseases in those populations and they will be adversely affected. The unfortunate outcome, however, is found in every war: the effect on the innocent. The unnecessary collateral damage that affects those who have no part in this. First, and most tragic of which will be these peoples’ children.

  18. #18 Regan
    July 28, 2008

    The PR Playbook
    Sharyl Attkisson
    Seemed like it might be helpful for background in where Ms. Attkisson might be coming from.

    4. Science Sleight-of-Hand (about 2/3 down the page). and related to the current article
    8. Funding Fudge, page 2.

    It still doesn’t handle the matter of why she is not applying the questions evenly to those who might not align with what seems to be a pre-determined point of view/news angle, and examining their COI.

  19. #19 mike stanton
    July 28, 2008

    Dianne wrote,
    One issue that I’ve never seen addressed properly is whether all this disclosure is helpful

    I did address this issue in my blog, Conflict of Interest – censoring the autism debate? back in May. Whether I did it “properly” is another matter.

  20. #20 DLC
    July 28, 2008

    You know, I usually point at most science reporting as being, in a word, awful. However, this isn’t even science reporting — it’s propaganda for the antivax crowd.

    Remember what happened to Dan Rather after he reported on George W Bush’s lackluster performance in the Air National Guard, and how he was more or less forced out of the Anchor chair at CBS because he used faked documents in the story?
    Where’s Les Moonves now ? Bleating out antivax canards and labeling it a piece of journalism should get you fired.

  21. #21 Hey Zeus is my Homeboy
    July 28, 2008

    I just read her piece over lunch and it’s so pathetic it’s actually funny.

    Her stuff is more like girl-crying-wolf-attention-whorism, much worse than journalism-in-quotes.

  22. #22 TheProbe
    July 28, 2008

    “Remember what happened to Dan Rather after he reported on George W Bush’s lackluster performance in the Air National Guard, and how he was more or less forced out of the Anchor chair at CBS because he used faked documents in the story?”

    The real problem is that the faked documents took away from the real stories, the story where he skipped over lines to get into the ANG, the stories where he was AWOL, the stories where he refused a direct, written order, the stories where he was never courts-martialed for these things.

    Same thing in the Austism arena. Too much time defending personal attacks, not enough time showing the facts.

  23. #23 Oldfart
    July 29, 2008

    In my area (Kansas City) I could swear this was part of the Katie Couric news show. I sent off a quick ugly email to her pointing out many of the same objections posted here (but not so well written). Am I confused or did Ms. Attkisson present it rather than Couric?
    Doesn’t Couric have any control over the content of her own show or any responsibility for it?

  24. #24 isles
    July 29, 2008

    Couric is the main news anchor and read the lead-in. The story itself was reported by Attkisson. I doubt Couric has much editorial influence – I suspect she just reads the news she’s told to read – but I really don’t know much about how these shows work.

  25. #25 Janet Keith
    August 4, 2008

    I have a question. It may sound totally naive, but if as Paul Offit says infants have a huge capacity to handle challenges to the immune system – perhaps to even handle the equivalent of 10,000 immunizations…I don’t understand why we don’t just let them deal with the possibility of getting the diseases. Chances are they won’t get or even be exposed to nearly what they have been vaccinated for – at least not all at one time, and not by the age of two. If they can handle being exposed to 10,000…why are we so afraid that they cannot handle getting chicken pox or measles or mumps? If they got these diseases, chances are they would not get them all at once, and probably not even within months of each other. At least then they would only be fighting off one disease at a time, and their bodies would have a chance to build a life-time immunity. They would also have a chance to recover from the disease before they were exposed to another disease. Why throw several diseases at them at once? Why bombard their immune systems like that? Why do pediatricians warn us to sterilize nipples for infants and to be so careful not to expose them to crowds when they are only a few days old – and yet inject them with a hepatitis vaccine when they are hours old? It seems rather contradictory to me…given that their immune systems are strong enough to handle 10,000 or so pathogens. Why are we not just trying to allow their immune systems to develop and stabilize – why not allow the blood-brain barrier to form and strengthen before we inject them with heavy metals that will accumulate in the brain? Just a thought. It always seemed so strange to me that my pediatrician was warning me about sterilizing nipples, etc., and turning around and injecting my tiny infant with live viruses and bacteria. Just a thought. Janet

  26. #26 HCN
    August 4, 2008

    Janet Keith said “…I don’t understand why we don’t just let them deal with the possibility of getting the diseases. Chances are they won’t get or even be exposed to nearly what they have been vaccinated for – at least not all at one time, and not by the age of two. If they can handle being exposed to 10,000…why are we so afraid that they cannot handle getting chicken pox or measles or mumps?”

    Here, try reading the actual article:
    http://pediatrics.aappublications.org/cgi/content/full/109/1/124

    Then go to the CDC Pink Book and read the chapters on each disease, but mostly go to the slide sets and appendices that are linked here:
    http://www.cdc.gov/vaccines/pubs/pinkbook/ … notice that pertussis is returning, and on the pertussis slide set the 9th slide shows that in latest three years there is information at least 69 infants under the age of three months died from pertussis. Do you want those numbers to increase?

    Then also check Appendix G where there is a list of cases and deaths from various vaccine preventable diseases from 1950. Do you want us to go back to those numbers?

    Now go to the the scientific literature (it is PubMed), and look and look and look… please find the papers that show that the DTaP is more dangerous than tetanus, diphtheria and pertussis (especially after you check out the table where pertussis kills babies, and has been increasing in frequency for the last decade).

  27. #27 Tsu Dho Nimh
    August 4, 2008

    Janet … Offit said ANTIGENS, not pathogens. There is a huge difference between the two.

    A pathogen is any bacteria or virus capable of invading and damaging you. An antigen is any substance capable of causing your immune system to recognize it and produce a specific defensive antibody to it. A typical harmless Lactobacillus from the mothers vagina has several hundred distinct antigens on it. The dander from a dog has hundreds of antigens. The saliva from granny’s kiss has hundreds more. The house dust has even more hundreds of antigens from pollen, dust mites,and the like. This is what Offit was talking about.

    It takes time for the process of “see invader, make antigens, disable invader” to get moving. If the invader is a pathogen, it causes damage, sometimes permanent damage, or even death before the defenses can get it under control. The next time the invader shows up, a few cells “remember” it and the antibody production is a lot faster – it’s called the anamnestic response. You still get infected, you have a shorter,milder case because the defenses are faster enough. Often you never know you were invaded.

    The whole idea of vaccines is to use killed, weakened, or just bits of the pathogens to get the body past the “see invader, make antibodies” part. With vaccines, the first time the pathogenic invading bacteria or virus shows up the response is similar to that from a person who survived a real first invasion.

    ************
    Washing (even a dishwasher or handwashing will do, sterilization is over-reacting) feeding equipment prevents the buildup of bacteria on the equipment … some normal body bacteria in a protein-rich environment like formula can produce enterotoxins that cause diahhrhea in babies.

    ************
    Avoiding crowds is just reasonable disease prevention.

    ************
    The HebB vaccine is a single antigen from the virus, not even a whole virus. Yet, that single antigen is capable of protecting most babies of HepB-positive mothers from getting the disease. Hepatitis B kills some babies quickly, and some die later of liver cancer if they can’t fight off the infection.

    ************

    Here’s the real criteria for vaccination: When the risk of clinical illness, permanent damage and death from the pathogen is higher than the risk from vaccination, vaccination is indicated. Natural measles is survivable, but it inevitably leaves small percentage of it’s victims blind, deaf and retarded. How many children do you want to knowingly allow that to happen to?

    When the cost of caring for the infected person in order to prevent death and disability is greater than the cost of vaccination, vaccination is indicated. Rotavirus may only kill 20-50 children a year in the USA, but that’s because we have excellent medical care. It kills hundreds of thousands in other countries. About 60,000 children are hospitalized from rotavirus in the USA every year … with IVs for the dehydration, isolation rooms to prevent the virus spreading, and major medical expenses for the parents, insurance companies and taxpayers. How many families and children do you want to knowingly allow that to happen to?

    To date, there is no evidence for the hypothesis that vaccines are more dangerous to children than the natural diseases. Looking at autism rates from countries with different vaccine formulas and schedules than the USA … the rates of autism and the related PPD-NOS, ASD, and Aspergers rose with the changes in diagnostic criteria, not the changes in vaccine formulation.

  28. #28 ebohlman
    August 4, 2008

    Janet: Offit was talking about the number of antigens that an infant’s immune system can develop a response to, not the number of pathogens that an infant can fight off. Antigens, by themselves, don’t cause infectious disease. You can’t interchange the two concepts.

    Your assumption that few kids would be exposed to the diseases anyway is based on current prevalence rates for those diseases, which are in fact low. But the only reason they’re that low is that most kids get vaccinated. If we stopped vaccinating, the prevalence rates, and therefore risk of exposure, would go way up.

  29. #29 ozzy
    August 4, 2008

    Janet,

    I’ll take the bait. By looking at the tone and substance of your post, it’s obvouis that you have spent way too much time at anti-vax websites. You should try to do your own research, using truly scientific sources, so you don’t regurgitate tired and unsubtantiated arguments from the mercury/too many-too fast/toxins militia.

    “I don’t understand why we don’t just let them deal with the possibility of getting the diseases.”

    To do that you have to accept the REAL possibility of them DYING. Children die from the diseases that they are vaccinated against. There may be very few or no deaths from some of these diseases at the present but you know why…Vaccinations. If enough parents stop vaccinating their kids, these diseases WILL come back and WILL kill kids. By the way, these diseases can often result in life-long disabilities besides death.