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 
We seem to have an infestation of a couple of very persistent anti-vaccinationist trolls. (It happens; every so often someone new thinks they can take me and my readers on. They're usually pretty quickly disabused of that notion.) That infestation is why I thought now would be an opportune time to refer my readers to a post that shows the world to which we could return if the anti-vaccine contingent gets its way. Written by the always irascibly sarcastic Dr. Mark Crislip of Quackcast, it's entitled Amanda Peet is My Hero (1).
Remember, Dr. Crislip is an infectious disease specialist. As he tells us, he doesn't "make dime one if people do not get infected." So he's hoping that Jenny McCarthy and her brain dead ilk are successful. Well, not really. Dr. Crislip is very good at sarcasm, so much so that I can't always tell when he is being sarcastic. This time I'm pretty sure he doesn't really mean it.
I think.
Oh, wait, he left a footnote to let us know it was sarcasm. All is well.
Medicine & Health
Comments
Oh, I'm sorry Orac. Did I piss you off when I pointed out that you posted an article on Gardasil when you hadn't even read the vaccine literature yet supplied by Merck (hint hint - the maker of the vaccine)? Me, the internet troll pointed out one very alarming fact?? Yes, you made a very grave error, but an admission of wrongdoing will do instead of this other childish post.
I think you might want to reconsider channeling your energy elsewhere...
Posted by: Dawn | August 14, 2008 4:57 PM
Dr. Orac, now why would we believe we could take you on? To do that we would need you to get in the ring first.
Instead you are linking to some other jerk.
But let me tell you again who I'd like to come on here and show me how irrational and ignorant I am: That cowardly excuse for a scientist, the Steven Novella dude. I imagine he would be just about the right size for breakfast.
Posted by: Undergraduate-gal | August 14, 2008 5:18 PM
As long as internet trolls like you do not even sport basic math skills (let alone reading skills and understanding for medical information provided) I guess nothing's gonna change anywhere soon. :)
I want to give Orac some applause for his energy channelings in his blog. Maybe you, Dawn, can open your own blog so your voice might be heard alongside the society (however, I would recommend not to opt for a scienceblog.com).
Posted by: Keenacat | August 14, 2008 5:21 PM
Dr. Orac, now why would we believe we could take you on? To do that we would need you to get in the ring first.
Instead you are linking to some other jerk.
But let me tell you again who I'd like to come on here and show me how irrational and ignorant I am: That cowardly excuse for a scientist, the Steven Novella dude. I imagine he would be just about the right size for breakfast.
But I guess John Moore wouldn't let him, cuz we all know AIDStruth shills don't debate denialists.
Posted by: Undergraduate-gal | August 14, 2008 5:22 PM
Not at all. It amused me how you made a mountain out of a molehill. I note that the Merck document only mentioned simultaneous administration of vaccines, which is not at all what I was talking about when I pointed out that vaccines are tested with the regular vaccine schedule.
The point stands that it is unethical to withhold standard vaccines in a vaccine trial. That's why new vaccines are tested in addition to (or on top of) the vaccine recommended vaccine schedule in place at the time of the test.
As for "Undergraduate-Gal," the only thing you've managed to do is to give me an acute case of the giggles--initially, that is, before you became profoundly boring just like all the other antivax trolls who came before you. You're just like all the other antivaccinationists, spouting off arguments as though they were shiny and new and will drive the dreaded pharma shills from the field of battle--as though we haven't seen them a million times before.
As for your taking on Steve Novella, that would be truly amusing. He's had tougher cranks than you as a light snack before bed. He demolishes them so thoroughly that they don't know what hit them, and he does it so politely that they can't even hate him for it.
Posted by: Orac | August 14, 2008 5:30 PM
In the spirit of true scholarship, Dr. Orac, perhaps you'd care to reference, preferably link, to one of the heroic Dr. Novella's vaunted debate victories over a "denialist" opponent?
BTW, have you figured out yet why HIV+ drug abusers have a shortened life expectancy compared to non-drug abusing HIV positives?
Posted by: Undergrad-gal | August 14, 2008 5:44 PM
Is it to get away from strident no-nothings Undergrad-gal? Because I know how they feel.
Posted by: Kev | August 14, 2008 5:54 PM
BTW, have you figured out yet why HIV+ drug abusers have a shortened life expectancy compared to non-drug abusing HIV positives?
Right, because the effects of heroin are completely benign when HIV is absent.
Posted by: Left_Wing_Fox | August 14, 2008 5:55 PM
http://www.theness.com/neurologicablog/?p=324
You were directed to that blog earlier, I see you did not post there.
Posted by: HCN | August 14, 2008 5:55 PM
"Dr. Orac, now why would we believe we could take you on? To do that we would need you to get in the ring first.
Instead you are linking to some other jerk."
Interesting, Undergraduate Gal, that you didn't take the opportunity to post a comment to Dr. Crislip's blog, especially since Dr. Novella did. After all, here's your chance to Beard the Lion, assuming you can.
Oh, before discussing your views, please first take a look at the pictures Peter Bowditch posted at www.ratbags.com/rsoles/vaxliars/pictures.htm (Full disclosure -- that link is also available among the comments to Dr. Crislip's blog). If you click the pictures a description of each disease shown is made. As Dr. Crislip explains, those diseases used to be fairly common in the U.S., and several still are in many places in the world which do not commonly vaccinate against them.
So, U.G., looking forward to your attempt to challenge Dr. Novella -- or Dr. Crislip, or Orac.
Posted by: wfjag | August 14, 2008 6:08 PM
Off topic, did you see the piece on "bad science", some more "Woo", for you.
Posted by: Eric Blood Axe | August 14, 2008 6:26 PM
Orac, you always get the good trolls. I just stuck with Chuck.
Undergrad-gal, please study well for your epi exam. You have a little bit to learn.
Honestly, if a roomful of experts are telling you one thing, and a random undergraduate disagrees, it's really up to her to prove her point.
As a hint, you can start with this:
1) What is your hypothesis? (e.g. "HIV does not cause AIDS")
2) What evidence supports the hypothesis?
3) How can I further test this hypothesis/is it disprovable/is it plausible?
Go for it! Thank me later.
Posted by: PalMD | August 14, 2008 6:27 PM
Eric Blood Axe, that is old news:
http://scienceblogs.com/insolence/2007/01/your_friday_dose_of_woo_miraculous_quest_1.php
Posted by: HCN | August 14, 2008 6:30 PM
"BTW, have you figured out yet why HIV+ drug abusers have a shortened life expectancy compared to non-drug abusing HIV positives?"
"Right, because the effects of heroin are completely benign when HIV is absent."
Hehe, Foxie, that's precisely what I thoughtwhen I read Dr. Orac's learned ruminations:
"Being an IV drug abuser is good for the loss of around 10 years. It's unclear exactly why, although it's been speculated that the difference between IV drug abusers and those who do not abuse IV drugs may be due to poorer compliance with therapy in the former group."
HCN: I;ve already told you I was too stupid to sign up succesfully over at Novella's. I tried twice and wads given passwords, but they were not recognized when I tried to log on.
But that's all the same, because you're obviously not too clever either, or you would have understood that I was asking for proof that Novella engages in debate with HIV "denialists". Your link shows exactly the opposite.
Posted by: Undergrad-gal | August 14, 2008 6:43 PM
PAlMD, I think I'll just go ahead and thank you right now but no thanks. Surely I would flunk my exam if I tried to prove a negative.
But if a roomful of experts were to announce their presence, I might give it a go here.
Posted by: Undergraduate-gal | August 14, 2008 7:04 PM
This post is even more laughable than the previous ones....I guess Orac that YOU didn't know that many outbreaks have occurred due to the vaccinated and spread mainly among the FULLY vaccinated.
Polio in Nigeria is one example. The Internation Herald Tribune posted an article about the polio outbreak that has been ongoing since 2005. They have yet to get it under control. There are 2 types they reported....from the wild strain and from the vaccine. Article dated 4/21/08
The second is Wisconsin/Measles. Gee, it started with a FULLY vaccinated 5th grader. TMJ4 News did an article on 4/23/08. Although it started with a vaccinated child, authorities wish to keep the unvaccinated under house arrest. Um, o.k.. Why?
Please tell us how the unvaccinated can hurt your vaccinated population again?? I feel like I am talking to a really smart, but stupid person...if that makes any sense.
Posted by: Dawn | August 14, 2008 7:17 PM
If you go check the WHO stats on immunization coverage, you will see that Nigeria is one of the countries with lowest coverage of the Pol3 series. They seem to have started immunizing for it in the mid 1980s. Is it any wonder Polio is running rampant there?
I've actually checked these stats in some detail for another country with relatively low coverage and a considerable number of cases, India. I've detrended the data and done some other checks. There is no question the Polio vaccine prevents Polio (it sounds ridiculous that I'd even have to state this). Anyone who thinks the Polio vaccine doesn't work is not only a conspiracist, but clearly, they don't know what they are talking about.
Posted by: Joseph | August 14, 2008 7:48 PM
Oh please Joseph, let's keep WHO out of this friggin debate. They are one of the most corrupt organizations out there. Let's just stick to the facts. Contact the AP for more info on the Nigeria outbreak because they are the ones that report about such things...they are usually "pro-vax" which is totally surprising after reading this article. Not so, in this case. I guess that is why the article was pulled so quickly - as usual...a reporter "screwed up" and told the facts instead of the same "ole bullshit" that vaccines are safe and effective. HA-HA
Posted by: Dawn | August 14, 2008 8:08 PM
Well the experts are here...
And as far as proving a negative, hey, that's just an example. Don't like it? *You* state the question and set up the hypothesis. Go for it.
Posted by: PalMD | August 14, 2008 8:11 PM
Please tell us how the unvaccinated can hurt your vaccinated population again??
It's called "the failure of herd immunity," versus a known risk of certain kinds of immunisations. You're conflating two separate phenomena, which is, incidentally, about trick #2 in the Denialist's Playbook. Please try to keep up.
I feel like I am talking to a really smart, but stupid person...if that makes any sense.
That's okay, I feel like I'm a really smart person talking to a really stupid, mendacious person. But some of us feel compelled to try making points anyway.
Posted by: Interrobang | August 14, 2008 8:11 PM
Oh really Interrobang, I guess that YOU JUST DECIDED to join this conversation on a whim.....in case you didn't know....MANY, MANY, MANY, outbreaks have been recorded throughout history among the VACCINATED populations. Do you want me to cite just a few for you?
Posted by: Dawn | August 14, 2008 8:28 PM
Oh, Dawn, you're caps are so precious. Interrobang is a regular around here...one that actually knows how to read.
Please do cite your evidence and its relevance...I'd love to discuss it.
Posted by: PalMD | August 14, 2008 8:32 PM
Orac stated: "Not at all. It amused me how you made a mountain out of a molehill. I note that the Merck document only mentioned simultaneous administration of vaccines, which is not at all what I was talking about when I pointed out that vaccines are tested with the regular vaccine schedule.
The point stands that it is unethical to withhold standard vaccines in a vaccine trial. That's why new vaccines are tested in addition to (or on top of) the vaccine recommended vaccine schedule in place at the time of the test."
I dunno. Are we reading the same vaccine literature? Again, read page 8.
http://www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf
Again Orack....you stated what?? "are tested with the regular vaccine schedule". Oh really? That is not what the drug manufacturer states.
Hello? Planet Mars or Earth...come in..
Why oh why can't you just admit that you made a boo-boo?? Are you really that egotistical?
Posted by: Dawn | August 14, 2008 8:38 PM
Are Dawn, Undergraduate-girl, and their ilk, scientifically illiterate
* because they think it is fashionable?
* because they are lazy?
* Because they don't have the ability to study science?
* Because they are simply stupid?
Given the evidence they present by posting screeds without trying to make any argument, point, or sense, I would weigh the choices at 10%, 20%, 30%, and 40%, respectively.
Posted by: Dean | August 14, 2008 8:39 PM
Any evidence of this? Even if it were true, I consider it a practical impossibility that they anticipated I was going to attempt a detrended cross-correlation analysis (with a 3rd-order polynomial fit, plus a bit of smoothing so the graph is more clear) on their time series. This is a technique that is virtually unheard of in the biological sciences AFAIK. Then again, I might be part of the Illuminati too. You never know.
Posted by: Joseph | August 14, 2008 8:40 PM
Dawn and UG-gal,
I guess I'm catching the middle of this debate. What exactly is the point that you're arguing? Are you trying to say that vaccines don't work? Or are you saying that vaccines cause some disease like autism? What is your point about AIDS, by the way, that it is not caused by HIV? I'd just like a concise statement of your hypothesis and a brief idea of why you think it's true.
Posted by: curious | August 14, 2008 8:42 PM
Um, Dawn, that product info link...I do not think it means what you think it means. It may be helpful to your argument if you quote the particular contraction you feel you've discovered.
Posted by: PalMD | August 14, 2008 8:42 PM
Dawn seems to have skipped over this section:
"Safety in Concomitant Use with Other Vaccines
The safety of GARDASIL when administered concomitantly with hepatitis B vaccine (recombinant) was evaluated in a placebo-controlled study. There were no statistically significant higher rates in systemic or injection-site adverse experiences among subjects who received concomitant vaccination compared with those who received GARDASIL or hepatitis B vaccine alone.
Post-Marketing Reports
The following adverse experiences have been spontaneously reported [via that reliable database VAERS] during post-approval use of GARDASIL. Because these experiences were reported voluntarily from a population of uncertain size, it is not possible to reliably estimate their frequency or to establish a causal relationship to vaccine exposure."
Posted by: ozzy | August 14, 2008 8:48 PM
Some context: Dawn believes vaccines are a plot to control the world's population. For more on this type of view, see this.
Posted by: Joseph | August 14, 2008 9:15 PM
Hey Orac,
When are you dopes going to catch up with us experts and learn how to cure autism? You're going to need another source of income when the government bans all smoking and there's no more cancer. I think DAN may have some openings if you want to join the good guys.
Posted by: Baltimore Bert | August 14, 2008 9:22 PM
Dawn, any comment on the progress of the broccoli-centered plot to put a lawn gnome in the White House?
Posted by: Azkyroth | August 14, 2008 9:35 PM
Given that the trolls haven't even been willing to state what it is they believe or don't believe, even with an explicit invitation, I think an ad hom attack is justified...
These two are a couple of idiotic, perhaps insane, trolls with a low level of literacy and numeracy who shouldn't be trusted to operate heavy equipment...they need a cork on the fork to avoid auto-enucleation.
Posted by: PalMD | August 14, 2008 9:41 PM
I guess we have a couple of "extra special" people that don't understand some things...
I dunno. Are we reading the same vaccine literature? Again, read page 8.
http://www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf
Again Orack....you stated what?? "are tested with the regular vaccine schedule". Oh really? That is not what the drug manufacturer states.
Hello? Planet Mars or Earth...come in..
Why oh why can't you just admit that you made a boo-boo?? Are you really that egotistical?
I am not going to give up you egomaniac, are you>
Posted by: Dawn | August 14, 2008 10:16 PM
Dawn, please don't give link-only assertions...what is the quote from your link that seems to contradict the assertion?
Posted by: PalMD | August 14, 2008 10:18 PM
Thank you PalMD.. sometimes I DO like to repeat myself....just to hear myself, ya know?
Good ole Orac stated that Gardasil was tested in conjuction with other vaccines given....well Orac WAS WRONG and refuses to admit it. Please refer to page 8 of the following link.
http://www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf
Again Orack....you stated what?? "are tested with the regular vaccine schedule". Oh really?
Posted by: Dawn | August 14, 2008 10:52 PM
Dawn, you're an idiot....what statement within your link contradicts orac's?
Posted by: PalMD | August 14, 2008 11:11 PM
PalMD..Check the section "use with other vaccines"...
Good ole Orac stated that Gardasil was tested in conjuction with other vaccines given....well Orac WAS WRONG and refuses to admit it. Please refer to page 8 of the following link.
http://www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf
Again Orack....you stated what?? "are tested with the regular vaccine schedule". Oh really?
I don't appreciate the "idiot" term from you PalMD. That is not very nice and totally unwarranted under the circumstances (Orac is the idiot, not me). I would like an apology.
Posted by: Dawn | August 14, 2008 11:18 PM
Orac stated in an earlier blog: "This is all nonsense, and it should have been flagged as such by Medscape. Vaccines are always tested with the rest of the routine vaccination schedule; this nonsense about Gardasil not being tested with other vaccines is just that--nonsense. It's nothing more than the standard antivaccine trope that it's some undescribed "interaction" between different dreaded vaccines that causes all those horrible problems--except that there really aren't horrible problems to be found when one looks at the data dispassionatedly".
PalMD..Check the section "use with other vaccines"...
Good ole Orac stated that Gardasil was tested in conjuction with other vaccines given....well Orac WAS WRONG and refuses to admit it. Please refer to page 8 of the following link.
http://www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf
Again Orack....you stated what?? "are tested with the regular vaccine schedule". Oh really?
I don't appreciate the "idiot" term from you PalMD. That is not very nice and totally unwarranted under the circumstances (Orac is the idiot, not me). I would like an apology.
Posted by: Dawn | August 14, 2008 11:24 PM
...will someone please fix that record player?
Posted by: Azkyroth | August 14, 2008 11:26 PM
Because I tire of Dawn's disingenuous antics, here's the quote from the document above that she refuses to cite because she knows that if she did it would show that she doesn't know what she's talking about:
So Gardasil was specifically tested with the hepatitis B vaccine administered simultaneously.
What Dawn steadfastly refuses to understand is that new vaccines are always tested against the background of the regular vaccine schedule. Once again, it is unethical not to provide subjects in clinical trials the full, regular, medically recommended vaccine schedule. Instead she perseverates over one small paragraph in a package insert, not realizing that there are certain standards of medical care and for clinical trials that you won't find in a product-specific document published by a drug company. No doubt she will continue to perseverate over that one small paragraph to the exclusion of all else because she does not have the knowledge base to know how clinical trials are conducted or the understanding of medical ethics to know why her perseveration is nonsense.
Truly, Dawn is Ferrous Cranus.
Posted by: Orac | August 14, 2008 11:26 PM
Ferrous Cranus: Were is YOUR evidence? Gee, cause the manufacturer of Gardasil just updated his in 2008?? Do you mean to tell me that the manufacturer is not aware of his product being tested in conjunction with others recently?
Posted by: Dawn | August 14, 2008 11:42 PM
Thanks for the rejoinder, Orac. The perseveration was becoming truly nauseating. These two trolls do, at least, justify Pope's assertion: a little learning is a dangerous thing.
Posted by: TexDoc | August 14, 2008 11:44 PM
Sadly, I didn't end Dawn's perseveration. She will continue. I've dealt with her kind before. they truly are Ferrous Cranus. Nothing gets through, no reason, no science, nothing that contradicts their fixed beliefs.
Posted by: Orac | August 14, 2008 11:48 PM
Oops...too many beers. I just realized that I was just speaking to the moron that started this thread...Orac. Oh well, same sentiments as stated before, just different person.
Were is YOUR evidence Orac? Gee, cause the manufacturer of Gardasil just updated his in 2008?? Do you mean to tell me that the manufacturer is not aware of his product being tested in conjunction with others recently?
I know. Blah, blah, blah. At least you have some smart people working this thread...like Tsu Dho Nimh. This is THE ONLY PERSON that checks anything out. Wow....one person. That is truly sad.
Posted by: Dawn | August 14, 2008 11:55 PM
...that explains a lot.
Posted by: Azkyroth | August 14, 2008 11:57 PM
Indeed it does. It explains a great deal about Dawn.
Posted by: Orac | August 15, 2008 12:01 AM
Alas, Orac, I fear you are correct. Maybe Dawn is evolving towards Terminator 2 of Stupid: She can't be reasoned with, she can't be bargained with, she absolutely will not stop, ever, until our brains are dead.
Posted by: TexDoc | August 15, 2008 12:04 AM
Dawn,
Get a clue! In the link you posted, and what Orac has already posted about, the insert on page 7 states:
"Studies with Other Vaccines
The safety and immunogenicity of co-administration of GARDASIL with hepatitis B vaccine
(recombinant) (same visit, injections at separate sites) were evaluated in a randomized study of 1871
women aged 16 to 24 years at enrollment. Immune response to both hepatitis B vaccine (recombinant)
and GARDASIL was non-inferior whether they were administered at the same visit or at a different visit."
You really need to stop drinking.
Posted by: ozzy | August 15, 2008 12:08 AM
Alas, Orac, I fear you are correct. Maybe Dawn is evolving towards Terminator 2 of Stupid: She can't be reasoned with, she can't be bargained with, she absolutely will not stop, ever, until our brains are dead.
LOL
BTW, since this post has devolved away from any discussion think someone could tell me how to get the cool quote indentations? I would really appreciate it.
Posted by: Abstruse | August 15, 2008 12:08 AM
Orac stated in an earlier blog: "Vaccines are always tested with the rest of the routine vaccination schedule; this nonsense about Gardasil not being tested with other vaccines is just that--nonsense. It's nothing more than the standard antivaccine trope that it's some undescribed "interaction" between different dreaded vaccines that causes all those horrible problems--except that there really aren't horrible problems to be found when one looks at the data dispassionatedly".
HELLO? Are you guys really that stupid? Is Hep B ALL of the routine vaccinations? You guys need to go to the CDC's website for further info. Shit. And I thought I needed another beer. I guess I might.
Posted by: Dawn | August 15, 2008 12:18 AM
Just show with real evidence that any of the vaccines are worse than the actual disease. Like show DTaP is worse than diphtheria, tetanus and pertussis, or that the MMR is worse than measles, mumps and rubella. But the caveat is that you must use real scientific evidence.
No commercial websites, no information from a Yahoo group, no anecdotes, no news reports, no books to read and no minutes from meetings. Real science, with at least a link to the abstract.
In the meantime, an amusing website to read about the risks of the vaccine versus the disease:
http://www.sciencebasedmedicine.org/?p=186 ...
... and a reproduced list of good disease/vaccine posts made a while ago:
http://holfordwatch.info/2008/07/19/a-paediatricians-series-on-vaccinations
Posted by: HCN | August 15, 2008 12:30 AM
Oh for heavens sake Dawn, get a clue...
For one thing, it's almost impossible to discern what position you are arguing, so I'll have to rely on intuition a little. What I think you are trying to argue is that Gardasil has not been tested with other vaccines. From the document you linked to (it really would have been easier had you provided a quote as well as the reference):
"Results from clinical studies indicate that GARDASIL may be administered concomitantly (at a separate injection site) with hepatitis B vaccine (recombinant) (see CLINICALPHARMACOLOGY,Studies with Other Vaccines). Co-administration of GARDASIL with other vaccines has not been studied."
Concomitantly means at the same time. Now...sit down for a moment, scratch your head and ask yourself "what age were the participants in the clinical trial?"... the document you linked to contains the answer: 16-26.
Now, engage that noddle of yours and ask yourself: "at what age are routine vaccinations generally administered?" consult the Google! In the US, the CDC (are they as corrupt as the WHO, or simply in cahoots?) recomends shots between the ages of 0-6. See:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm
Now, ask yourself, "why would there be the imputus test the Gardasil (or other HPV vaccines) concomitantly when, for the purposes of the clinical trial, Gardasil was administered 10 years or more _after_ the administration of routine childhood shots?". Hmmmmm...
In short, your complaint is stupid and the document you provided in no way invalidated Orac's claims. It really makes you look like a nong that you thought it did.
I also can't help myself in responding to your claim about Polio vaccination in Nigeria. As a disclaimer, I'm not an epidemiologist... I'm a simple mathematician...and what is happening in Nigeria is textbook example of the mathematics of mass immunisation.
A concept in mathematical epidemiology is "herd immunity". I would spell it out for you, but it would be a waste of time because you'd obviously claim that RAND corporation had gotten to me and implanted such nonsence in my head. Anyhoo...during the late 90's early 00's, a large push was made to reach the herd immunity threshold for polio in Nigeria.
That was until August, 2003, when several Muslim leaders in north of the country banned the immunisation program, alleging that the US was introducing HIV or sterilising drug into the vaccine in a crusade against Islam.
During the next 10 months, the reduction in immunisations led to a fall in the immunised population that was great enough to allow polio to become endemic within Western Africa. 12 countries who had long been free of the disease, like Cote d'Ivoire, experienced their first polio cases in years.
After 10 months, the immunisation program was restarted. By the end of 2006, the number of polio cases within Nigeria had halved. Increasing immunisation and political control in other West African states led to polio being declared According to that evil WHO and it's partner in crime UNICEF, 1,500 children were paralysed thanks to the ban. The mutant vaccine virus you refered to, was only able to spread thanks to the reduction in immunisations...and still accounted for less than 5% of polio cases.
Please...get a clue
Posted by: ChrisC | August 15, 2008 12:55 AM
Dawn doesn't think anything in her link contradicts Orac's statements - she's baiting all of you,
OR
she doesn't understand the difference between a "vaccine schedule" and "co-administration."
Take your pick - either way, it's not worth the effort you're all putting into arguing with her.
Posted by: Jo | August 15, 2008 12:59 AM
Dawn, get help. You are clinically insane.
Posted by: StuV | August 15, 2008 1:25 AM
Wow, this is just amazingly stupid. Gardasil is administered in early adolescence. All of the other standard vaccines are administered in childhood. So the only other vaccine that an individual is at all likely to receive close to the same time is HBV, and it was tested with that.
Think about it rationally for just a moment, if you can. Do you seriously imagine that they somehow managed to find a population of adolescents to test Gardasil upon who somehow missed all of the normal childhood vaccines? That's pretty crazy, don't you think? Where would they have found them? One of those mythical Amish populations that supposedly don't vaccinate? And if you actually were crazy enough to image that that's what they did, you could have easily checked it out by looking at the Methods sections of studies of Gardasil safety. For example, this one, which reads
Nothing at all about excluding people who received the normal vaccines in childhood.
I mean, like, DUH
Posted by: trrll | August 15, 2008 1:32 AM
StuV said "Dawn, get help. You are clinically insane."
Really, she is not insane. She is just very close minded, and will only read or attempt to read stuff that is fed through through specific websites. She cannot be bothered with anything that contradicts her opinions, which she gets from other people.
Even if primary source material goes against what she has been told. This is illustrated by her refusal to even look at original research. Noted in her plea here:
http://scienceblogs.com/insolence/2008/08/why_medscape_why.php#comment-1052286
... where she screams "For this discussion - let's leave PubMed OUT OF IT."
Posted by: HCN | August 15, 2008 1:51 AM
PAlMD
The argument regarding Gardasil is that it's been hyped up by Merck. It has not been shown to be worth the hassle and the cost. It has not been shown to be safe nor effective. In the interest of the marketing campaign, the possible consequences of the results from study 013, showing increased risk of precancerous lesions in already infected women, have been ignored and/or suppressed. As a separate issue, the efficacy and safety in children is only "inferred". Likewise, the long term efficacy and safety of the vaccine have not been established.
Although we cannot assume that the study participants haven't received (or been offered) childhood vaccines, the authors nevertheless pointed out that it has only been tested with Hep B. In many instances there was no placebo group receiving aluminum-free placebo (feel free to disabuse me on this one, because the reports are not always clear on that. I can find only one example where they specify a third group given saline solution with the expected reduction in immediate side-effects).
It is only an assumption, a shaky assumption, that HPV is exclusively sexually transmitted. There are indications from the FDA that HPV "infection" in itself should not be viewed as a disease, and that the risk is negligible in the absence of "cofactors" whose presence is marked by "persistent infection". From the 2007 petition: "It is the persistent infection, not the virus, that determines the cancer risk."
etc. etc. etc.
If you go through the different document, there are just too many unknowns, too many assumptions heaped on assumptions to close the book on HPV, Gardasil and cervical cancer. And it's certainly not worth touting th vaccine and forcing it down people's throats via lobbied lawmakers.
So if one doesn't want to close the book what can one do? On one hand, you have Merck, not exactly the most reliable of self-reporters, on the other VAERS, which you guys think is totally discredited. So what option does one have? Should we just wait and see if the Vioxx scenario repeats itself?
PAIMD, I am not sure why you keep asking for my hypothesis or points concerning HIV?AIDS here. I have stated several of my objections to Novella's and Orac's points in the appropriate thread. My point here was that Orac's chest thumping about "Taking him on" is BS. He and particularly Novella don't have the guts for a fair fight.
But ok, if you want a simple one:
"HIV" has never been purified, consequently there is no viral gold standard for the HIV tests.
Of course you sexy science guys don't consider that a problem, so I guess there's not much to discuss
Posted by: Undergraduate-gal | August 15, 2008 2:58 AM
Whoa" steady there Trrll. Sprinkle some ARVs on your cornflakes and take a deep breath. I know it must be exciting for you to think you have finally scored a point on a denialist, but the point has already been made. Of course nobody thinks they tested this on girls in the age group the marketing campaign is actually targetting.
But since you are here, I think your expertise would be more gainfully employed if we could persuade you to comment on the controverversial study 013, which seems to suggest a role for "cofactors" in cervical cancer almost greater than the one they play in AIDS - if that is possible?
Posted by: Undergraduate-gal | August 15, 2008 3:24 AM
"It is only an assumption, a shaky assumption, that HPV is exclusively sexually transmitted."
*Slaps self*
For one, you're not even wrong... five minutes with pubmed found this:
Sonnex C, Strauss S, Gray JJ, Department of GU Medicine, Addenbrooke's Hospital, Cambridge, England.
Sexually Transmitted Infections 1999 Oct;75(5):317-9:
Detection of human papillomavirus DNA on the fingers of patients with genital warts.
There are multiple, non-sexual routes for HPV infection. However, the fact is the vast majority of HPV infections stem from sexual activity:
Rice PS, Cason J, Best JM, Banatvala JE
Rev Med Virol 1999 Jan-Mar;9(1):15-21:
Non-sexual transmission makes liekly makes up a tiny number of cases. If anything, a higher prevalance of non-sexual transmission cases would add wieght to the case for early childhood immunisation.
Then we get this:
"It is the persistent infection, not the virus, that determines the cancer risk."
Teh stoopid...it burns us...
Most cases of cervical cancer are require a HPV infection to cause cell changes. See:
-Walboomers JM, Jacobs MV, Manos MM, et al (1999). "Human papillomavirus is a necessary cause of invasive cervical cancer worldwide". J. Pathol. 189 (1): 12-9.
-Lowy DR, Schiller JT (2006). "Prophylactic human papillomavirus vaccines.". J. Clin. Invest. 116 (5): 1167-73.
There is no "assumptions" about HPV as a risk factors, any more than there are "assumptions" about HIV as a risk factor for AIDS. Your argument is akin to saying that a rabies vaccine doesn't prevent encephalitis, or that a flu vaccine doesn't prevent pnuemonia. HPV is a necessary, yet not a sufficient condition for most cases of Cervical cancer.
"The argument regarding Gardasil is that it's been hyped up by Merck"
I tend to agree... I think the way Merck has aggressivly marketed is product, while keeping the costs extrodinarily high, is disgracefull. This doesn't mean that I jump at shadows, make stuff up and otherwise turn my cognitive abilities off for the day, simply because I don't like the way Merck has behaved.
Posted by: ChrisC | August 15, 2008 3:43 AM
As for Novellas Ass kicking of denialists, I refer you to his blog, for example this post
http://www.theness.com/neurologicablog/?p=65
or indeed this article co authored with Tara Smith
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0040256&ct=1
Cheers
Soren
Posted by: Soren | August 15, 2008 4:00 AM
Chris,
It seems we agree om most of the "facts" about transmission, sexual or otherwise. However, we don't agree about the implications of them.
I take exception to you calling the FDA stoopid.
I don't think they wrote anything stoopid in this particular quote about persistent infection.
It may very well be that, "Most cases of cervical cancer are require a HPV infection to cause cell changes". But if that is so, they forgot to demonstrate it in your reference:
-Walboomers JM, Jacobs MV, Manos MM, et al (1999). "Human papillomavirus is a necessary cause of invasive cervical cancer worldwide". J. Pathol. 189 (1): 12-9.
I have never called HPV a risk factor. Presumably this is again the FDA, which you have quoted inaccurately. I may have, however, have called HPV a marker pending better proof of causation.
Soren,
I am aware that Steven Novella has smeared rethinkers, or cherry-picked and misrepresented "arguments" such as those from Truthseeker, then triumphantly "rebutted" them. Bill O'Reilly does the same with reader mail 6 days a week. Do you consider that "asskicking"? If this is your definition of fair debate, no wonder you're all so smug about nothing.
Posted by: undergraduate-gal | August 15, 2008 6:26 AM
My guess is that he's doing it because your comments show muddled thinking and it's not clear exactly what you are arguing. You're all over the place. His request is simply a device to try to get you to focus and make a coherent point.
Clearly, PalMD has failed in his endeavor. You are steadfastly refusing to focus.
Posted by: Orac | August 15, 2008 8:00 AM
Hi, Orac. Can I change my name so I am not associated with the idiot using my name? You know, the anti-vax one who threatens. Her comments are getting really depressing, especially when people think it's me who's that dumb....
Posted by: Not THAT Dawn | August 15, 2008 8:40 AM
Use these tags:
blockquote , /blockquote
in angle brackets >
Posted by: chris | August 15, 2008 9:02 AM
Dr. Orac, are you still here?!
Since you're in the guessing mode, as usual, tell me have you figured it out yet? You know the one about why HIV positive drug addicts have a shorter life expectancy than non-drug using HIV positives.
Or is that question not focused enough for you?
Posted by: Undergraduate-gal | August 15, 2008 10:47 AM
What a friggin moron.
Did it ever occur to you that being a drug addict isn't particularly good for you? Ignoring HIV, drug addicts have shorter lives than non-drug addicts. The question itself is idiotic.
UG, keep practicing your "would you like fries with that?"
Posted by: PalMD | August 15, 2008 10:49 AM
Ah, but Undergraduate-gal apparently thinks that the reason IV drug abuse is bad for you is because it, not HIV, is The Real Cause of AIDS, aside from the fact that sharing needles is a great way to transmit HIV from one person to another.
Posted by: Orac | August 15, 2008 11:08 AM
Tsk tsk PA, you should have learned by now that you need to check before you call somebody a "friggin moron". These are your boyfriend ORAC's words, not mine:
"Being an IV drug abuser is good for the loss of around 10 years. It's unclear exactly why, although it's been speculated that the difference between IV drug abusers and those who do not abuse IV drugs may be due to poorer compliance with therapy in the former group."
I think it's pretty moronic as well, but I don't think it's very nice of you to use that kind of language about your loved ones, or anyone else for that matter.
Dearest Orac, I think drug use can be bad for you for a number of reasons, but what has that got to do with HIV transmission? Is your hypothesis that when HIV is transmitted via needlestick it kills you 10 years faster?
BTW., needles don't seem to be such a great way to transmit HIV and especially AIDS among health workers.
Posted by: Undergraduate-gal | August 15, 2008 11:44 AM
That couldn't be because they don't actually take the needle out of a patient, fill it up with the latest drug and inject it into themself... could it.
Posted by: Evinfuilt | August 15, 2008 12:13 PM
The point that I am making is just how crazy denialist thinking actually is. Even an instant of rational thought would have told Dawn how unlikely it is that Merck somehow found a test group of young women who had not received their normal childhood vaccinations. Why would they do such a thing? It would be hard to find such a population, and since such a group would not be representative of the target population expected to be vaccinated in practice, it would not help Merck with their FDA application.
Well, let's check and see what age group the marketing campaign is actually targeting.
Here's what Merck's web site says in its "Information for Parents" section
Here is what it says in the Prescribing Information for Gardasil
The same prescribing information gives data from the groups they tested it on. What were the ages? 9 to 26.
Now the stupidity here really is comparable to that in Dawn's posts. Think about it rationally for a moment, if you can The FDA maintains tight control on the marketing of pharmaceuticals. Do you really imagine that the FDA would permit Merck to market Gardasil to an age group in which it has not been tested?
Possible? Obviously. Axiomatically, it is always possible, for any disease, that there are unidentified cofactors. Clearly, HPV is an important determinant of disease in the study populations, based on the vaccine's clearly demonstrated efficacy. But if you could find a cofactor of equal or greater importance, and develop a treatment against it, then you could go into competition with Merck.
Posted by: trrll | August 15, 2008 12:16 PM
UGG:
First, you're either accidentally mistaking or intentionally conflating what the lower lifespan means. There are many other third factors that could confound the relationship here; drug users may have a lower rate of compliance with antiviral therapy, for example, or may just be in poorer physical condition in general prior to infection. Both of those would adversely effect lifespan in this group.
Second, health care workers don't share used needles with their patients, health care workers especially don't use needles on themselves (most exposure is through accidental cutaneous sticks and cuts), and sharps are very strictly controlled and carefully handled to minimize exposure. Even then, the risk of contracting HIV in this manner is somewhere around 1%.
Posted by: N.C. | August 15, 2008 12:20 PM
Let me add to NC's comment. I've read that IV drug users are prone to drawing blood into the syringe and re-injecting it to get as much drug as possible out of it. This seems like a practice tailor made to transmit blood borne disease. If someone with better information could confirm or deny that I'd appreciate it.
You can't do that with the needles used for blood drawing; they don't have plungers. Since a needle known to be exposed to blood is more hazardous, not having a means of forcing the contaminated material deeper into the tissue in the event of an accidental stick seems kind of important, no?
Similarly, since the needles used to inject drugs in a medical setting are used once, the plunger is already depressed in the event of an accidental stick with a used needle and cannot force the needle contents deeper. If the plunger was not depressed, the needle is not contaminated and while you may have to treat the effects of any drugs it contained, it's not a disease transmission risk.
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