Respectful Insolence

ResearchBlogging.orgOne of the claims of the anti-vaccine movement that most irks me is that their actions do not risk harm to anyone other than their own unvaccinated children. Given that vaccination against many infectious diseases also depends on the concept of herd immunity to provide protection to members of the population who either cannot be vaccinated for medical reasons, are too young to be vaccinated, or who belong to the minority who do not develop adequate immunity to vaccination, such claims are patently false. However, another frequently stated belief is that vaccines are ineffective, that they are not necessary to avoid the infectious diseases they protect against. They seem to think that good nutrition and good living will be enough. It’s not, of course, but that’s what they think.

Today a study was released in the June 1 issue of Pediatrics that demonstrates just that. A collaborative effort between the University of Colorado, Kaiser Permanente Colorado (KPCO), Johns Hopkins Bloomberg School of Public Health, and Community Health Services, Denver, it’s entitled Parental Refusal of Pertussis Vaccination Is Associated With an Increased Risk of Pertussis Infection in Children. It’s shown up in the media, including NPR, under titles such as Is Vaccine Refusal Worth The Risk?, Unvaccinated kids 23 times as likely to get pertussis, Kaiser study shows, and Whooping cough returns in kids as parents skip vaccines. Its conclusions are the kind of “well, duh!” conclusions that are painfully obvious. Unfortunately, the anti-vaccine movement has been successful enough in bringing back once rare or even virtually eradicated diseases back to threaten our children that studies of this sort do need to be done.

Colorado, unfortunately, is the perfect place to do a study of this sort. Boulder, CO has been one of the strongholds of the anti-vaccine movement for quite some time, as described in 2002 by Arthur Allen:

Boulder, which has the lowest schoolwide vaccination rate in Colorado, has one of the highest per capita rates of whooping cough in the United States. The problem started in 1993 when fifty-two people in Boulder County contracted the disease. Since then the county has seen an average of eighty-one cases a year. Although unvaccinated children are six times as likely as vaccinated children to get whooping cough during an outbreak, about half the cases in Colorado have involved vaccinated children; the whooping cough vaccine sometimes fails to produce effective immunity, and even successful pertussis immunity generally wanes by age ten. “At first we called it an outbreak, then we started calling it a sustained outbreak; now we just say it’s endemic,” Ann Marie Bailey, the county nurse epidemiologist when I visited Boulder last year, told me.

Glantz et al took advantage of this and Kaiser Permanente’s extensive database of patients in Colorado to perform a case control study of children enrolled in Kaiser Permanente between 1996 and 2007, determining vaccination status and pertusis status by chart review. Kaiser in Colorado has 430,000 current members, and children receive full vaccination coverage as recommended by the Advisory Committee on Immunization Practices. The study was designed to determine if children who contracted pertussis infection were more likely to have parents who refused pertussis vaccinations than a similar group of children who did not develop pertussis infection. All potential cases of pediatric pertussis were identified using KPCO’s database, and skilled medical abstractors, who were blinded to the vaccination status of the research subjects, examined the charts to identify which children carried a diagnosis of pertusis. Patients were classified as confirmed cases if they had a medical chart-verified positive PCR test or a positive culture for Bordetella pertussis, the bacteria that causes pertusis. Controls without for each case of pertusis were four randomly selected children controls matched by gender, length of KPCO enrollment, and age at the date of diagnosis. Vaccination status was then determined for each group, and parents were classified as “vaccine refusers” if they had refused one or more vaccines for nonmedical reasons.

The results? Glantz et al identified 156 laboratory-confirmed pertussis cases and 595 matched controls The relative risks of pertussis among vaccine refusers and matched controls are summarized in the chart below:

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The results are striking. Vaccine refusal is associated with a nearly 23-fold increased risk of developing pertussis. Indeed, it’s even more than that. In the vaccine refuseniks:

The percentage attributable risk in the vaccine refuser population was 99.5% (95% CI: 98.1%-99.9%), and the total population attributable risk was 11.0% (95% CI: 5.8%-16.0%). These estimates suggest that all 18 of the unvaccinated pertussis cases were attributed to vaccine refusal, and 11% of the pertussis cases in the total population were associated with vaccine refusal.

In other words, virtually all the risk of pertussis in the vaccine refusers came from being unvaccinated, and 11% of the pertussis cases in the total population can be attributed to vaccine refusal. One can only predict that that 11% figure will increase if vaccine refusal increases, thanks to the misguided and profoundly harmful campaign being waged by Generation Rescue, Jenny McCarthy, and other antivaccine activists, given that the only reason the number is that low now is because the vaccine is not 100% effective and the number of unvaccinated, although growing in many parts of the country, is still relatively small. In any case, what’s remarkable about this study is that it is the very first to use detailed individual-level data from well-maintained and detailed databases; previous studies have relied upon population-level data and school data. Those studies showed a six- or seven-fold increased risk associated with vaccine refusal, which is bad enough. This study, on the other hand, showed a higher risk probably because of more detailed, individual-level data, plus the fact that previous studies have shown that a significant proportion of children classified as vaccine exempt by schools may have actually been at least partially immunized. More importantly, though, school records don’t usually specify which immunizations were refused by parents when they claim a personal exemption. It’s impossible to know how many of those claiming exemptions actually did receive the DPT vaccine, which would tend to falsely depress the apparent relative risk of pertussis in the unvaccinated. This study pinpointed exactly which patients had refused the pertussis vaccine, allowing for a more accurate risk assessment.

The authors also tried to control for confounders. The most obvious confounder is obvious. Vaccine refusers often exhibit different health care choices and health care-seeking behavior when their children become ill. Specifically, they may be less likely to seek out “conventional” medical care when their children develop a cough or early symptoms that may be pertusis. Second, a child’s vaccination status, if known, can definitely influence how likely a physician is, when faced with a child with a severe cough, to test for pertussis. However, these two confounders would tend to act in different directions, with decreased visits to physicians tending to make a diagnosis of pertussis less likely for mild cases and the tendency of physicians to be more aggressive testing children who are unvaccinated tending to increase the likelihood of a pertussis diagnosis, especially in milder cases. The bottom line is that the net effect of these confounders was almost certainly small compared to the high relative risk found.

The authors conclude:

Despite high pertussis immunization rates in Colorado, herd immunity did not prevent a high relative-risk for pertussis in vaccine refusers. This is likely because of a combination of waning immunity to pertussis in adolescents and adults, ongoing endemic circulation, the highly contagious nature of the bacterium, and frequent asymptomatic infections. Of note, herd immunity to pertussis may increase over time because of the impact of the newly recommended adolescent and adult pertussis booster vaccines.

And:

These results have important implications for families and the physicians who care for them. We found that children of parents who refuse pertussis vaccination are at a greatly increased risk for pertussis infection. This result dispels one of the commonly held beliefs among vaccine-refusing parents that their children are not at risk for vaccine-preventable diseases. Future research should focus on the community impact of vaccine refusal and the risks to other vulnerable populations, including children who are too young to be fully immunized and older adults with waning immunity. Furthermore, our study highlights the need for effective risk communication between parents and physicians about vaccines and the diseases they prevent.

I agree that effective risk communication is important. Indeed, fence-sitters may be convinced by hard data showing that failing to immunize does result in potentially seriously harmful consequences for their children. In that, this study might well help. However, I doubt that this study will sway anyone in the anti-vaccine movement. Showing them evidence, such as this study provides, that the risks of not vaccinating are real and potentially serious isn’t the issue. The real issue that drives them is on the vaccine risk side of the equation. The anti-vaccine movement has systematically exaggerated the risks of vaccination, spreading misinformation that they contain all sorts of “toxins” and repeating the scientifically discredited hypothesis that vaccines cause autism and various neurodevelopmental disorders. They don’t, but that is the real side of the equation that is driving the fear of vaccines. As Arthur Allen described in Boulder:

Jia Gottlieb, a family practitioner who offers acupuncture and breathing exercises along with traditional medicine, said, “When I get parents who don’t vaccinate, I tell them, ‘When your boy gets a vaccination he takes on a risk for the public good, just like the firemen [at the World Trade Center] who went back into the buildings.’” But Gottlieb’s words usually tall on deaf ears. “These are probably people who donate a lot of money to good causes,” he said, “but their view is ‘I’m going to let everyone else’s child take a risk but not my own.’ That’s not avant-garde. That’s not enlightened. It’s pretty primitive. And ironically, in a town like Boulder the selfish strategy is probably not in the best interests of your child either.’”

Indeed it’s not. Moreover, the example Gottleib uses is vastly overblown, as it equates vaccines with death in a burning building. That’s the very problem with the antivaccine movement; it vastly inflates the risk of vaccines beyond all reason. Indeed, it’s true that there is a small risk being taken on for the public good, but it’s infitessimally small on the order of one or two in a million for serious side effects, nowhere near akin to firemen running back into the World Trade Center on 9/11, where they faced a very high risk of death and knew it. Moreover, it’s about more than risking oneself to save others. That’s an important consideration, but vaccination has always been far more about protecting one’s children from serious diseases at a very low risk to those children compared to that of the diseases being protected against. Ironically, this study in Pediatrics is strong evidence that the “enlightened self-interest” shown by parents of vaccine refusers is not only not particularly enlightened but, when you come right down to it, not even truly in the self-interest of the children of antivaccine parents. Unfortunately, that message won’t sink into some thick skulls, as one burningly stupid comment after this story demonstrates so painfully:

Those of us who do not vaccinate our kids do not “refuse” to do so. We make an informed decisions. What the article doesn’t say is that those of us who choose not to risk vaccinations, have a far less likely chance of seeing side effects from the vaccine such as high fever, days of discomfort, and even long-term brain damage. There is a risk. There is always the risk. The important question is whether the risk is worth the benefit.

In the case of most vaccines, including pertussis, the answer is no.

Pertussis is not a dangerous disease when compared to the risks of vaccine. The chances of dying or long-term health risk is greater than the chance of serious side-effect from the shot. To be clear, you have as much or greater chance of getting sick from the shot then you do from the disease.

My kids both had whopping cough last summer. They were very sick for about a week or so, the cough continued for 10 weeks on and off and now I don’t have to worry about them getting it again because they are naturally immune. Not real serious.

This is the most typical situation.

Serious illness for a week, followed by a lesser degree of illness for ten weeks, and this idiot thinks it’ “not real serious.” Maybe if one of her children had died of whooping cough, which most definitely can happen, this woman would still consider it “not that serious.” I don’t know about you, but I’d have hated to have a mother so callous about my suffering as this mother, who is saying in essence to her children: “Don’t mind that week of coughing that’s making your chest hurt so much that it feels like your lungs are going to come bursting out of your throat and the ten weeks after that of still more coughing. Just think of the fantastic natural immunity you’ll have after all that suffering is over! After all, that which does not kill you makes you stronger.” In the meantime, look for the antivaccine propagandists at Age of Autism to attack this study within the next day or two, using the same sorts of callous and scientifically ignorant arguments as this mother. Despite the appeals to the “mommy instinct” that anti-vaccine spokeswomen like Jenny McCarthy like to make, the “mommy instinct” is often wrong, and good intentions do not always result in good outcomes. In fact, there’s a reason for the saying “the road to hell is paved with good intentions.”

As I mentioned at the beginning of this post, qualitatively, its conclusions are the kind of “well, duh!” conclusions that are painfully obvious and completely expected. Even so, I was surprised at the magnitude of the increased risk observed in the children of vaccine refusers; it was at least twice as much as I would have guessed if you had asked me before the study came out. To put it in perspective, the relative of lung cancer in heavy smokers is only on the order of 10 or so. Since certain a certain pediatrician who is an apologist for the anti-vaccine movement likes to make specious comparisons betwee the vaccine industry and the tobacco industry, I can’t resist finishing with this analogy. Unvaccinated children are at a such a high risk of pertussis compared to vaccinated children that this increased risk is more than twice the increase in risk that smokers have of getting lung cancer compared to nonsmokers.

Vaccine refusal is to infectious disease as smoking is to lung cancer, only twice as much!

REFERENCE:

Jason M. Glanz, PhD, David L. McClure, PhD, David J. Magid, MD, MPH, Matthew F. Daley, MD, Eric K. France, MD, MSPH, Daniel A. Salmon, PhD, MPH, & Simon J. Hambidge, MD, PhD (2009). Parental Refusal of Pertussis Vaccination Is Associated With an Increased Risk of Pertussis Infection in Children Pediatrics, 123 (6), 1446-1451

Comments

  1. #1 Marita
    May 26, 2009

    That burningly stupid comment at OregonLive also makes the claim that it is “common” (common is repeated for emphasis) for the flu shot to cause paralysis. And also that the effectiveness is low.

    How do people develop this level of stupid? Even that parent’s anecdotal evidence should have pointed them in another direction (since the anti-vaccine brigade is so prone to buying into anecdotes, you would at least hope they could be swayed either way).

    Hmmm… my kids have been extremely sick for a week. Maybe pertussis is sort of a bad thing.

    Hmmm… I’ve never met anyone paralyzed by the flu shot. Maybe paralysis as a result of that vaccination isn’t really common after all.

    It’s painful. It really is.

  2. #2 LovleAnjel
    May 26, 2009

    “This is the most typical situation.”

    Isn’t this technically correct? Most people who contract a disease will manage to survive. I have an old medical text from the twenties, and I was surprised to learn that at the time, the response to appendicitis symptoms was ‘watch and wait’ because 70% of cases resolved harmlessly. So why do we have automatic appendectomy if the majority of people end up fine anyway?

    BECAUSE OF THE PEOPLE WHO DON’T. It’s not worth skipping if you’re one of the unfortunate 30%. Just because YOUR KIDS were LUCKY does not mean it is safe! PEOPLE WILL DIE, IT’S A FACT. You have no real way of knowing if your kid will be in the majority or the unfortunate minority. Is it really worth that risk?

  3. #3 Catherina
    May 26, 2009

    Pertussis immunity is not life long, neither vaccine acquired, nor disease acquired. All those flaming lungs for nothing…

    The level of stupid is incomprehendible to me. A child in my older child’s class has mumps. The same poor child had measles last year. I think these children should be told that at age 14, they can go and get vaccinated independent of their parents’ ideology (our old ped felt distinct pleasure “catching up” teens after an unvaccinated childhood).

  4. #4 Whitecoat Tales
    May 26, 2009

    This is the most typical situation.

    …have a far less likely chance of seeing side effects from the vaccine such as high fever, days of discomfort, and even long-term brain damage.

    … So, comparing the atypical effects of vaccines, to the typical effects of pertussis is a valid comparison.

    Thats disgusting.

  5. #5 techskeptic
    May 26, 2009

    effort between the University of Colorado, Kaiser Permanente Colorado (KPCO), Johns Hopkins Bloomberg School of Public Health, and Community Health Services, Denver…

    But…but… thats a worthless study… it was done by the major components of the EVUL DRUHG CORP’RASHUNS! Its junk science! Tehy does it for the coins! Orac you are a shill for them by presenting this are real!

    ohhh they conspiracies! They are all out to get me!

  6. #6 Dinah
    May 26, 2009

    The anti-vax people are so worried about supposed risks to their childrens’ brains from vaccines? How does this parent think 10 weeks of illness affects the child’s learning and development? How well are you learning, growing, developing, playing, interacting, and developing social skills when you’re busy coughing and feeling sick for 10-12 weeks? These are the children who will be falling behind.

  7. #7 techskeptic
    May 26, 2009

    virtually all the risk of pertussis in the vaccine refusers came from being unvaccinated, and 11% of the pertussis cases in the total population can be attributed to vaccine refusal.

    Can someone explain this better to me? if only 11% of the pertussis cases were vaccine refusers… were 89% of the cases…vaccinated people? Unvaccinated but not refusers? Babies? Is there something about the wording I am being dense on?

    Why do i see this study as a bigger case for Jenny than for medicine?

    ..because they are naturally immune..
    What the hell do they think happens when they get a vaccination? All the natural processes that fight infection jump into gear. You are “naturally immune” whether the antigen came from a needle or you friend.

    orac,
    Since certain a certain pediatrician who is an apologist for the anti-vaccine movement

    Needs a little fix up.

  8. #8 James Sweet
    May 26, 2009

    I’ve always been baffled by the natural immunity thing. Yes, immunity acquired from the wild virus tends to be more effective and longer-lasting than immunity from a vaccine — so what?

    To me, the logic is akin to this: “If my car gets totaled, I won’t be able to drive it anymore. If I can’t drive my car, then my risk of me getting in a fatal accident goes to zero. Therefore, if I want to reduce my risk of a fatal accident, I should always drive as recklessly as possible in the hopes that I will total my car.”

    Um, no.

  9. #9 cbe
    May 26, 2009

    I have the same question as techskeptic. Were the controls vaccinated? did the controls have pertussis, too? and only 11% of those cases were attributable to vaccine refusal? The wording is confusing to me.

  10. #10 Brian
    May 26, 2009

    Tech
    That 11% of cases were not attributable to vaccine refusal is not to say that 89% of cases were among the vaccinated. Problematic is the fact that no matter what numbers we’re actually dealing with, 11% doesn’t sound all that bad.
    Consider, however, that proportionally speaking, the rate of incidence among vaccine refusers is not only higher, but also causes the ppilation incidence to increase, as well.
    And yes, while vaccination works by the principle of exposure to an antigen, the advantage is that in vaccination, that antigen is generally not attached to an entity that will also cause illness.

  11. #11 cbe
    May 26, 2009

    So only 1% of people in the USA refuse vaccines, yet they are responsible for 11% of the pertussis cases. I am reading that right?

  12. #12 Richard Eis
    May 26, 2009

    Every outbreak of a disease that we have a vaccine for on the news recently has involved unvaccinated people…and they have made up about 90% of those who have had to be treated. So this really doesn’t surprise me.
    It’s just kinda sad that the disease is so rife, that it’s simply part of the medical routine.

    A racking cough for 10 weeks…wait till the kids find out that all that pain and misery was pretty much avoidable.

  13. #13 Luna_the_cat
    May 26, 2009

    techskeptic: Pertussis immunity wanes after a few years, whether it is immunity from vaccine or illness. Part of the vulnerable population will be infants too young for vaccination (and pertussis is one of the earliest vaccinations given, precisely because 92% of the fatalities from pertussis were infants under a year old, before vaccination). However, immunity from vaccinations will also have waned by the age of 10, plus there are people who never develop a strong immune response to the vaccine in the first place — a fairly high percentage in fact. This vaccine is less efficacious than most, I think, in this particular regard.

    Pertussis is endemic amongst adults, here in the UK — which is why most it’s especially important for infants to get their jab on schedule. No-one wants to see infant fatalities mount, and they ARE exposed, from the indidence in the general population. The vaccine protects for the crucial first few years, when pertussis can kill most easily.

  14. #14 Pablo
    May 26, 2009

    I second Dinah’s question. The anti-vaxxers are worried about a couple of days of high fever from the vaccines, but then think that a serious cough for a week followed by 10 weeks of illness is not a big deal?

    My 6 mo old just had his shots last Thurs. He was pushing a little fever over the weekend, but it never spiked and didn’t affect his attitude (teething, otoh, did make him a lot more cranky than usual – but he cut both his lowers!)

    Compared to a week of coughing? This was nothing.

  15. #15 Jen
    May 26, 2009

    Pertussis is endemic amongst adults, here in the UK — which is why most it’s especially important for infants to get their jab on schedule. >>>>>>>>>>>>>

    Which is why I think it makes more sense to vaccinate adults, since most of the deaths from pertussis occur in babies less than 2 months old, and too young for the vaccine.

  16. #16 Catherina
    May 26, 2009

    Jen,

    most fatalities are under 4 months by which time an infant in the UK (and some continental European countries) will have had their 3rd DTaP.

  17. #17 Pablo
    May 26, 2009

    BTW, the article highlights a conclusion I drew last year, and one that I keeping bringing up: anti-vax people are extremely selfish, and it is all about themselves. They have absolutely no social conscience at all.

    Which, as is pointed out, is ironic that it happens in Boulder, which is supposedly such a progressive social community. It sort of calls into question their actual motives (and, having lived in motives, I can attest to that – there is a major self-grandizing attitude – IOW, they do it not to be useful or because it is right, but because it makes them feel better about themselves)

  18. #18 Raptor
    May 26, 2009

    Ahg, no, the 11% is how many people got it of the 100% of the population that could have gotten it (vaccines or not). And all those who did get it were traced back to the group of people who refused vaccines.

    Notice the 11% is total population attributable risk, as in, what’s your risk of getting the virus. And it’s 11%… but those numbers were artificially increased by the people who had refused the vaccine and thus ended up with the virus (which the rate among them for catching it was 99.5%). The 11% did not come from people who were vaccinated.

    In other words, had they been vaccinated, the % of risk would have been close to, if not at 0%.

  19. #19 Noadi
    May 26, 2009

    That mother really pisses me off. I was one of those unlucky people who contracted pertussis despite having been vaccinated. I have very vivid memories from when I was 6 and how my chest felt. I almost had to repeat 1st grade because I missed so much school. That a mother would dismiss her kids being so sick that casually is horrible.

  20. #20 Pablo
    May 26, 2009

    That a mother would dismiss her kids being so sick that casually is horrible.

    But at least they didn’t have to go through a mild fever for 3 days, right?

  21. #21 Lancelot Gobbo
    May 26, 2009

    A real world example – myself. I had all the vaccines available when I was a kid, but that was before immunisations against H. influenzae, pneumococcus and meningococcus. Apart from the more serious illnesses these three can cause (meningitis) they all cause ear infections. I had numerous ear infections as a child, and ventilation tubes/grommets were not invented. Consequently I was given the fashionable antibiotic regime of the early sixties for earaches, a single shot of streptomycin each time. Sadly, the streptomycin did what it often did, and destroyed my left auditory nerve completely, and the right in part. I have 50% hearing in my right ear and nothing in my left. Wouldn’t happen today, if you get the immunisations. There was no MMR then, either, not chickenpox vaccine. I had all of those, and didn’t enjoy mumps pancreatitis at all (I remember the feculent vomiting especially!) Wouldn’t happen today.
    I made sure my son had all his vaccinations, and don’t for one moment blame his autism on them – a quick glance at the family history will make it plain that genes were involved. I see pertussis quite often – even after immunisation there is often only partial immunity, but I have not seen and hope to never see a baby cough himself into cerebral haemorrhage. Remember one of the cardinal signs was ulceration under the tongue from coughing so hard that the lower teeth cut into the underside of the tongue. Doesn’t happen with the milder, modified form of pertussis you might catch after being immunised.
    I have seen people back in the seventies refuse pertussis vaccine because of the postulated risk of encephalitis. Then it became acceptable and I saw the measles vaccine refused in the eighties, and now it’s the MMR that gets refused and the standalone measles vaccine is preferred by the frightened parents. Funny how these things come and go in fashions. Watch out next for diphtheria – it came back quickly in Russia after the USSR broke up and immunisations weren’t given reliably for a couple of years. Around four thousand kids died in the 1990′s as a result. See http://www.cdc.gov/ncidod/eid/vol4no4/vitek.htm
    I hope I get to retire before I am called on to treat diphtheria!

  22. #22 FreeSpeaker
    May 26, 2009

    Speaking of how the media has picked up on this study…Dr. Nancy Snyderman was on the Today show, before 7:30 AM, with is. It was also a 7:00 AM tease.

  23. #23 FreeSpeaker
    May 26, 2009

    Speaking of how the media has picked up on this study…Dr. Nancy Snyderman was on the Today show, before 7:30 AM, with is. It was also a 7:00 AM tease.

  24. #24 Richard Eis
    May 26, 2009

    No antivaxxers flocking to Orac’s latest post yet. Must not be time to rise from their crypts to infect the living and feed off (the immunity of) others.

  25. #25 Natalie
    May 26, 2009

    Don’t mind that week of coughing that’s making your chest hurt so much that it feels like your lungs are going to come bursting out of your throat

    You’re not kidding. My best friend caught pertussis in high school (she had been vaxxed as a child so presumably it had worn off) and she coughed so hard and for so long that she got a six pack out of it. She occasionally jokes about the one positive side of pertussis – kickass abs.

  26. #26 techskeptic
    May 26, 2009

    Thank you raptor. But I remain confused. Perhaps I am a dope. I’m not trying to troll here (just visit my blog).

    there were 18 confirmed cases from refusniks. This was out of 156 confirmed cases.

    This does not seem to be 11% of the total population that could have gotten it. It was 11% of the population that did get it. no? Perhaps this is not the calculation they did to get 11%.

    So doesnt it still seem like, more people got it, who didn’t refuse the vaccine?

    Or am I missing some math that includes the controls. And if so, can you spell it out to me some more? Specifically how do they get 11%?

    Another problem I see here is that refusals were defined as refusing 1 or more vaccines. Wouldn’t it have been more relevant if they specifically refused dtap? I’m sure the numbers arent much different, rarely do we hear about someone jabbing MMR and not jabbing dtap. But still.

  27. #27 desiree
    May 26, 2009

    did the study say what the vaccination rate in boulder is? i would imagine that the 11% figure would vary with the vaccine-refusal rate, but not necessarily directly.

    my guess is that the refusal rate in boulder is pretty close to the rate where i live (which is going up even more, thanks to the opening of a chapter of the holistic moms network).

  28. #28 skeptiquette
    May 26, 2009

    The case population consisted of 156 children aged 2 months to 18 years that had laboratory confirmed (PCR or culture) of the BACTERIUM (not virus) B. pertussis. Of these 156 children 17 (11%) had 0/5 of the recommended pertussis vaccine injections and 1(.6%) had only 1 of the recommended series. So, 138 (88%) children were fully vaccinated, but still had a positive PCR or culture for the bacterium.

    From reading the study one obviously can’t see the statistical calculations (I mean the work not the results), I am just wondering how these calculations are made?

    It seems odd that the matched odds ratio was that much higher for unvaccinated, when clearly 88% of the cases studied were vaccinated against pertussis.

  29. #29 Sid Offit
    May 26, 2009

    @Marita
    That burningly stupid comment at OregonLive also makes the claim that it is “common” (common is repeated for emphasis) for the flu shot to cause paralysis. And also that the effectiveness is low.

    Yeah, that reminds me of the Today show’s resident vaccine cheerleader / ignoramus stating pertussis is “An easiliy to die from illness”

  30. #30 Denice Walter
    May 26, 2009

    I was in Boulder last year and found it to be the *ne plus ultra* of woo-everywhere you turned,an N.D.,a yoga studio, Buddhist temple,vegan cafe-and I’ve been in some pretty woo-infiltrated places. Ironically(for a place rife with anti-vaxers),Boulderites pride themselves on being “healthy”(they hike, bike, kayak;elite athletes train;green businesses are based there) and “educated”(the University of Co. is the major employer;scientific organizations and software companies are based there).

  31. #31 Pablo
    May 26, 2009

    Boulder also has a really good Ethiopian restaurant. :-)

    (actually, that is fairly rare for a city that small)

  32. #32 Interrobang
    May 26, 2009

    I had pertussis when I was nine. Ten weeks of coughing sounds about right. If her kids were anything like me, they had a few days there where even drinking water or taking anti-fever medication was tough, because they were coughing so hard they were vomiting every few minutes. My mom wasn’t working at the time, and my dad even took time off work as well, so that there was always someone around to make sure I was okay. I mostly remember feeling as though my ribs were going to break and that my back was totally sprung.

    If that’s “not real bad,” I’m really wondering what her kids have had that was so much worse. Now there’s a scary thought.

  33. #33 dmcw
    May 26, 2009

    Vaccinating your children is like crossing the road to help an old lady who has fallen over.

    You take the small risk of crossing the road, to provide a small help to society by looking after the old lady.

  34. #34 Sarah P
    May 26, 2009

    I remember using my “mom sense” when my kids were coming up for their vaccines. It was easy.

    Risk from vaccine – 1 in a million
    Risk from illness – depends on where you are, but at best 1 in a thousand, likely much higher

    The kids are fully vaccinated. It was a no-brainer. Reduces the risk by over 1000x.

    Our neighbour’s kids – also fully vaccinated – got whooping cough. Their mom said the unvaccinated kids got much sicker (2nd hand anecdote, ah well). Her kids were sick for a month, she said it was awful. Not vaccinating is akin to child abuse. How can you be proud of such stupidity and willful ignorance?

  35. #35 Terrie
    May 26, 2009

    Despite being vaccinated, I had a mild case of what we later found out was whooping cough. I was about 8 at the time. The idea that without the vaccine it likely would havebeen worse it scary. I coughed so hard that I would collapse. It lasted about two or three weeks. I’ll take a jab over that any day.

  36. #36 Mu
    May 26, 2009

    What this really points to is a fear of being responsible. The parent who vaccinates and is one of the few unlucky ones with a kid with adverse effects will have to ask him or herself “it was my fault, if I’d just not given in to the establishment”. If there kid gets whooping cough instead, well, that natural, not their fault, since they didn’t do anything active. The old “you don’t get shot for not doing anything” approach to dealing with a problem.
    That parent comment is the best case of active denial, 10 weeks of illness is preferable to a couple of days of vaccine effects, because it’s natural.

  37. #37 Pablo
    May 26, 2009

    Vaccinating your children is like crossing the road to help an old lady who has fallen over.

    You can’t say she has fallen over. That suggests the problem has occured. However, you can say that it is like crossing the street to help the old lady cross it herself.

    Although I don’t like that analogy, either, because there has to be a benefit for you in it, as well as for others.

  38. #38 AnnR
    May 26, 2009

    The girl I know who got Whooping Cough didn’t just have a “cough” for 6 weeks. She coughed so hard she broke the blood vessels in her eyes and she missed so much school she ended up a semester behind.

    I must agree that it represents a loss of community among people who’re probably very concerned about saving the earth and the societal effects of torture.

  39. #39 Chris
    May 26, 2009

    Some herd immunity arithmetic:

    Take 1000 people (ignoring the infants under 2 months who cannot be vaccinated, or babies under a year who can only be partially vaccinated), if 5% refuse vaccines then the numbers are:

    950 vaccinated persons (assuming full schedule)
    50 unvaccinated persons

    The pertussis vaccine is actually only 80% effective at worse, so the numbers are:

    760 protected persons
    190 vaccinated but vulnerable persons
    50 unvaccinated persons

    There is an outbreak and it gets spread to 20% of the population, then:

    760 protected persons without pertussis

    38 vaccinated persons get pertussis
    152 vaccinated person who may still get pertussis

    10 unvaccinated persons get pertussis
    40 unvaccinated persons who may still get pertussis.

    This is how more vaccinated persons get the disease than unvaccinated. Even if the infection rate was at 100%, there would still be more of the vaccinated getting the diseases because there are more of them!

  40. #40 r blakeman
    May 26, 2009

    The stats are confusing…but they may be because we are not reading the original paper. From the abstract, it appears that more than one study/analysis was done. Originally, they found 156 kids with a history of pertussis, and matched them with 595 controls. Of the kids with pertusis, 12% had refused the vaccine (or their parents had refused, I should say). Of those without without pertussis…only 0.5% had refused the vaccine. So refussing the vaccine resulted in a much higher likelihood of being in the pertussis group, vs. the control group. A “secondary case-control analysis of children continuously enrolled in Kaiser Permanente of Colorado” also found that “vaccine refusal was associated with a similarly increased risk of pertussis. In relation to the 11% figure, the abstract states “In the entire Kaiser Permanente of Colorado pediatric population, 11% of all pertussis cases were attributed to parental vaccine refusal.”

  41. #41 Kalldoro
    May 26, 2009

    My aunt has a son. The pregnancy was difficult, he was born too soon and was sick a lot as a child. He was one of the unlucky children who due to being sick to begin with just get the disease when vaccinated.

    He got pertussis when vaccinated and his mother called an ambulance every few days when he started coughing and didn’t stop. He almost died several times and it was an extremely difficult and frightening time for the family.

    He was unlucky. But healthy children shouldn’t have to suffer like that. It can and should be prevented.

    And parents who refuse to vaccinate their children are putting other children in danger too. Kids like my cousin who for some reason can’t be vaccinated are no longer protected by the fact that everyone else is vaccinated.

    Antivaxers aren’t just stupid, their dangerous to themselves and others.

  42. #42 r blakeman
    May 26, 2009

    The stats are confusing…but they may be because we are not reading the original paper. From the abstract, it appears that more than one study/analysis was done. Originally, they found 156 kids with a history of pertussis, and matched them with 595 controls. Of the kids with pertusis, 12% had refused the vaccine (or their parents had refused, I should say). Of those without without pertussis…only 0.5% had refused the vaccine. So refussing the vaccine resulted in a much higher likelihood of being in the pertussis group, vs. the control group. A “secondary case-control analysis of children continuously enrolled in Kaiser Permanente of Colorado” also found that “vaccine refusal was associated with a similarly increased risk of pertussis. In relation to the 11% figure, the abstract states “In the entire Kaiser Permanente of Colorado pediatric population, 11% of all pertussis cases were attributed to parental vaccine refusal.”

  43. #43 Rogue Epidemiologist
    May 26, 2009

    I’m gawking at how narrow the confidence interval is for the attributable risk among non-vax’d people. Wow.

  44. #44 Clare
    May 26, 2009

    My mother survived whooping cough (an appalling experience from what she tells me). Her brother and sister barely survived diphtheria, another brother died from it. All too many parents lived with the agony of serious illness and death among their children back in those fun-filled days when “natural” diseases could run rampant. I wish all those anti-vaxxers who blather on about their precious “research” would do some real research on that topic…

  45. #45 Gruesome Rob
    May 26, 2009
  46. #46 Marita
    May 26, 2009

    Another problem I see here is that refusals were defined as refusing 1 or more vaccines. Wouldn’t it have been more relevant if they specifically refused dtap? I’m sure the numbers arent much different, rarely do we hear about someone jabbing MMR and not jabbing dtap. But still.

    techskeptic – I’ll let others give better descriptions of the stats (Chris’s calculations are good), but as to your other point, they did know specifically what vaccinations had been refused. Previous studies were limited in that they only had access to whether or not any vaccines had been refused, without specifics. This is obviously a bit of a problem. For this particular paper, however, the researchers had access to actual medical records, and could identify whether pertussis vaccination was among the vaccines that had been refused for each individual. (It’s in the third paragraph of the discussion, if you have access to the actual paper).

  47. #47 Susannah
    May 26, 2009

    ‘Serious illness for a week, followed by a lesser degree of illness for ten weeks, and this idiot thinks it’ “not real serious.”‘

    No mention of whether the kid was quarantined for the entire 10 weeks, either. Did he end up passing on the disease to other kids?

    “… not real serious.” It never is, is it? Ideology trumps responsibility every time.

  48. #48 Tsu Dho Nimh
    May 26, 2009

    Let’s clean this up – this appears to be what they mean: “These estimates suggest that all 18 of the pertussis cases [among the children] were attributed to vaccine refusal, and 11% of the pertussis cases in the total population [adults and children] were associated with vaccine refusal.”

    The pertussis kids were all unvaccinated. The cases among the total population were apparently running 11% in persons known to have refused the vaccine and 89% in those where they were too young to be vaccinated, or their immunity had waned since vaccination.

    For developmental reasons, infants can’t be vaccinated successfully, and they are the most susceptible to death and serious side effects like ruptured blood vessels in the lungs, scarring from ruptured aelvoli (sp?), brain and eyes from the coughing (yes, it does happen) as well as brain damage from weeks of chronic low oxygen levels. They are the ones that vaccinations protect.

  49. #49 aravir
    May 26, 2009

    I’ve referenced your blog post in a diary at Daily Kos:

    http://www.dailykos.com/story/2009/5/26/735584/-Unvaccinated-kids-get-whooping-cough

  50. #50 samantha
    May 26, 2009

    This is off-topic, but I don’t know a single person who didn’t vaccinate their children (that I know of, at least), but I would say that at least half of the adults I know don’t get their recommended vaccinations (and most of my friends are college educated and not struggling financially). I think this is a real trend – adults not getting vaccinated, not because they’re anti-vaxxers or want to catch infectious diseases, but because it’s a pain in the ass, they’re not well-insured, they don’t see a primary care doctor (which are actually very hard to get an appointment with where I live), or their doctor isn’t on top of it. I actually met a grad student recently who had her children vaccinated, but wouldn’t get vaccinated herself because she was too terrified of needles. I don’t know how you get through pregnancy without, at the very least, having your blood drawn with a needle, but she was pretty insistent that she wouldn’t go through with the vaccinations.
    I’m curious, if anyone knows, to what extent these adults are posing a herd immunity problem. It seems like most of the vaccination focus is on kids. Is that because the diseases most vaccines prevent are more serious in children, or because adults have some lingering immunity from their childhood vaccinations?
    Would it make a serious enough difference to herd immunity to offer adults free vaccinations, like we do for kids?

  51. #51 samantha
    May 26, 2009

    This is off-topic, but I don’t know a single person who didn’t vaccinate their children (that I know of, at least), but I would say that at least half of the adults I know don’t get their recommended vaccinations (and most of my friends are college educated and not struggling financially). I think this is a real trend – adults not getting vaccinated, not because they’re anti-vaxxers or want to catch infectious diseases, but because it’s a pain in the ass, they’re not well-insured, they don’t see a primary care doctor (which are actually very hard to get an appointment with where I live), or their doctor isn’t on top of it. I actually met a grad student recently who had her children vaccinated, but wouldn’t get vaccinated herself because she was too terrified of needles. I don’t know how you get through pregnancy without, at the very least, having your blood drawn with a needle, but she was pretty insistent that she wouldn’t go through with the vaccinations.
    I’m curious, if anyone knows, to what extent these adults are posing a herd immunity problem. It seems like most of the vaccination focus is on kids. Is that because the diseases most vaccines prevent are more serious in children, or because adults have some lingering immunity from their childhood vaccinations?
    Would it make a serious enough difference to herd immunity to offer adults free vaccinations, like we do for kids?

  52. #52 samantha
    May 26, 2009

    This is off-topic, but I don’t know a single person who didn’t vaccinate their children (that I know of, at least), but I would say that at least half of the adults I know don’t get their recommended vaccinations (and most of my friends are college educated and not struggling financially). I think this is a real trend – adults not getting vaccinated, not because they’re anti-vaxxers or want to catch infectious diseases, but because it’s a pain in the ass, they’re not well-insured, they don’t see a primary care doctor (which are actually very hard to get an appointment with where I live), or their doctor isn’t on top of it. I actually met a grad student recently who had her children vaccinated, but wouldn’t get vaccinated herself because she was too terrified of needles. I don’t know how you get through pregnancy without, at the very least, having your blood drawn with a needle, but she was pretty insistent that she wouldn’t go through with the vaccinations.
    I’m curious, if anyone knows, to what extent these adults are posing a herd immunity problem. It seems like most of the vaccination focus is on kids. Is that because the diseases most vaccines prevent are more serious in children, or because adults have some lingering immunity from their childhood vaccinations?
    Would it make a serious enough difference to herd immunity to offer adults free vaccinations, like we do for kids?

  53. #53 samantha
    May 26, 2009

    Grrrr – so sorry Orac + readers for the triple-post. I kept getting error messages + had no idea that they actually went through. My bad

  54. #54 kierra
    May 26, 2009

    @ samantha

    Adult vaccinations aren’t emphasized because if you are up to date on your childhood ones and are healthy, there aren’t that many that you need. If you are 20-65 yrs old, the US schedule only recommends Tdap every 10 years, HPV for women under 26, and the flu vaccine each year. The other ones are only recommended if you have other conditions, other risk factors, or work in certain professions.

  55. #55 techskeptic
    May 26, 2009

    Thanks everyone for helping to try to clear up this study. Its not often the case for me that diving into the actual numbers makes it more confusing to me, but I am not a medical doctor, perhaps that is my problem. I realize its just stats (not a problem for me), but the lingo, acronyms and abbreviations make this look like greek.

    The pertussis kids were all unvaccinated. The cases among the total population were apparently running 11% in persons known to have refused the vaccine and 89% in those where they were too young to be vaccinated, or their immunity had waned since vaccination.

    Wouldn’t this study have been a whole lot clearer if it were more apples to apples. None of the refusniks were babies, so why include babies in the control? All the refusniks were “children”, were all of the controls?

    I cant download the actual article (its 12 dollars). Otherwise I would try to look myself.

    I’m still waiting for the GR headline:

    “89% whooping cough victims didn’t refuse vaccines!”

    Doesnt matter if that is true.

  56. #56 Parental Choice
    May 26, 2009

    Unfortunately, we can’t be sure that *all* vaccines are safe for *all* kids… therefore, it needs to be left up to individual parents to decide what is best for their child. While you may not like this… it is what it is. It’s not up to you to decide for my child… it is up for me to decide for my child. (especially considering the fact that you know nothing about my family history or my child’s specific health background.

  57. #57 Joseph
    May 26, 2009

    therefore, it needs to be left up to individual parents to decide what is best for their child

    Not really, no. It’s up to individual parents to decide what to do with their child. Unfortunately, that won’t always be what’s ‘best’ for the child.

  58. #58 HCN
    May 26, 2009

    Parental Choice: “Unfortunately, we can’t be sure that *all* vaccines are safe for *all* kids… therefore, it needs to be left up to individual parents to decide what is best for their child.”

    Do share where you find this information. Do you expect the diseases to be safe for those kids?

    And s/he/it continues “(especially considering the fact that you know nothing about my family history or my child’s specific health background.)”

    If your child has a reason for not getting the pertussis vaccine like mine was, you would be need to make sure herd immunity is kept HIGH!!! You would be telling anyone that vaccination is the best thing around, because keeping herd immunity up is better for your kid.

    My son was not allowed to get the pertussis vaccine as an infant, which was at the same time there was a pertussis epidemic in our county. I had to make sure what the vaccine status was for every child he came around to protect him.

    It was at about the same time over 120 Americans died from measles.

  59. #59 Orac
    May 26, 2009

    All the refusniks were “children”, were all of the controls?

    This was a case-control study, which means that, although it’s a retrospective study, controls were matched as carefully as they could be to age & sex of members of the study group. From the methods section on selection of controls:

    For each case, the date of pertussis diagnosis represented the index date. Each case was matched to 4 randomly selected controls by gender, length of KPCO enrollment, and age at the index date (within 7 days). The controls were selected from a pool of pediatric members enrolled in the KPCO health plan between 1996 and 2007. Eligible controls did not have a record of pertussis infection before the index date. Vaccination status was ascertained retrospectively from the index date (see below). This matching scheme helped to simultaneously control for age and season.

  60. #60 Mark Cook
    May 26, 2009

    What we do know is that *all* vaccines are safe for *virtually all* children, so overwhelmingly so that it is safer than not being vaccinated. And not only are you safer when you are vaccinated, so is everybody around you.

    And from a purely mercenary position, in the remote chance the vaccine does result in damage, there are recourses (such as the vaccine court).

  61. #61 Jim
    May 26, 2009

    so P.C. how do you decide which vaccine is safe enough for your kids? How many parents have enough medical knowledge to decide which vaccine is safe and which should be refused?

  62. #62 HCN
    May 26, 2009

    Jim said “how do you decide which vaccine is safe enough for your kids?”

    Just to clarify, my son’s doctor the determination that my son should only get the DT vaccine with protection from pertussis.

  63. #63 WRMartin
    May 26, 2009

    Parental Choice @56
    I have no problem with your beliefs as long as you and your children remain in your home at all times with the windows, chimney, dryer vent, exhaust vent for the stove, and all the doors sealed shut. No problem at all. Or you could build, launch, and then live in your very own space station far away from other worlds. No problem at all.
    Parent’s rights do not trump any one else’s rights – not your children’s, not mine, and not my children’s. Thanks for playing, though.

    Do you feel like spouting any more ignorance today?

  64. #64 WRMartin
    May 26, 2009

    Parental Choice @56
    I have no problem with your beliefs as long as you and your children remain in your home at all times with the windows, chimney, dryer vent, exhaust vent for the stove, and all the doors sealed shut. No problem at all. Or you could build, launch, and then live in your very own space station far away from other worlds. No problem at all.
    Parent’s rights do not trump any one else’s rights – not your children’s, not mine, and not my children’s. Thanks for playing, though.

    Do you feel like spouting any more ignorance today?

  65. #65 HCN
    May 26, 2009

    Just a suggestion folks: please read that error message.

    Your comment is getting through, the system is just too busy to immediately display it to you. Just go back to the page you commented on and hit refresh. Your comment should be on the page, so do not resend it.

  66. #66 khan
    May 26, 2009

    I was born in 1950 & possibly had whooping cough in 1997.

    No fun.

    Will have booster in ’13.

  67. #67 Sid Offit
    May 26, 2009

    @WRMartin

    What you don’t realize is I’m under no obligation to risk my health to “protect” your delicate little children. And who cares whether or not you have a problem with that?

  68. #68 HCN
    May 26, 2009

    So, Sid, you admit to dragging your germ spreading self all over the place? Are you a one man disease vector?

  69. #69 Natalie
    May 26, 2009

    Actually, Sid, you kind of are. Society – you know, the thing that has kept the human species alive, including your pathetic, freeloading self – has decided that you need to vaccinate. If you don’t like it, try living on your own for a little while.

  70. #70 Sid Offit
    May 26, 2009

    A “germ” isn’t a disease

  71. #71 peter syms
    May 26, 2009

    germs, not a disease. Wow, just wow.

    Anti vax arguments reach a new low. Semantics. Literally, pure semantics.

  72. #72 HCN
    May 26, 2009

    So, Sid, were the idiot parent who took the kid with measles to the doctor’s office that infected all those babies, including the one that had to go to the hospital?

    Hey, it is Sid The Parasite, leaching off of the herd immunity. All hail the clueless parasite!

  73. #73 khan
    May 26, 2009

    Given that a large number of idiots are not vaccinating their children, are there some additional vaccines that us older folks should be getting?

  74. #74 Sid Offit
    May 26, 2009

    No HCN, it wasn’t me. Why would I take a child with a harmless disease to see a doctor?

  75. #75 Sid Offit
    May 26, 2009

    @Khan

    I think you should get some diphtheria, tetanus, pertussis, influenza, swine flu (when it comes out), shingles, pneumonia and hepatitis A and B shots. And for God’s sakes man don’t wait till 2013.

  76. #76 Michael Ralston
    May 26, 2009

    Based on what people have said about the study, I think the numbers are thus:

    11% of the children who had pertussis had not been vaccinated, and 88% had. (The remaining child had been partially vaccinated).

    Of the children who did NOT have pertussis, only half a percent hadn’t been vaccinated, and the rest had.

    In other words, the pertussis vaccine isn’t great – as people are indicating elsewhere – but not getting it increases your risk by a factor of about twenty or so.

    Seems straightforward to me.

  77. #77 Sid Offit
    May 26, 2009

    @Khan

    Given that a large number of idiots are not vaccinating their children….

    What large number of idiots? Vaccination rates are at an all time high. I’m getting so much herd/ free rider protection I can’t stand it.

  78. #78 cooler
    May 26, 2009

    Wow 52 cases in Boulder county in 1993! I’m scared! Boulder county has a population of around 290,000! Jesus! It’s Jenny’s fault! Oh wait She wasn’t talking about Vaccines then! 52/290,000 with no fatalities! This is assuming that these are an authentic 52 cases, and not some Vaccine peddler trying to blow up mild cases. Wait, according to wikipedia Canada has very high rates of pertussis, even though they have high rates of vaccination.

    “Despite heavy vaccination efforts and universal health care, Canada remains as the only rich, industrialized nation in which pertussis is endemic, with 7,000 cases each year.[18]”

    Oh those vaccines work so well in Canada! God I’m so scared!

    http://en.wikipedia.org/wiki/Pertussis#cite_note-Gangarosa_1998-12

  79. #79 DuWayne
    May 26, 2009

    As much as I feel for the kids, as long as these vile morons keep their disease spreading spawn out of public places, I can support their right to make bad decisions for their kids. So Sid, you keep your children away from everyone else, no problem…Otherwise, then yes, you do have a responsibility to the society around you – responsibilities that include making sure your children don’t kill other children by spreading diseases that were nearly irradicated until idiots like you decided that those diseases are harmless.

  80. #80 Rjaye
    May 26, 2009

    Well, goodie for you, Sid. Now keep your grungy, grimey booger sausage full of germs you call a child away from mine, and we’ll be just okey doke. I don’t like seeing babies die from pertussis, and I have.

    And it ain’t pretty. Maybe you need to work in a neonatal icu to see the effects of RSV and pertussis and pneumonia. You seem unteachable and unreachable. Children getting these diseases and ending up in the hospital happen on a regular basis…in fact we prepare for these outbreaks. Or maybe that’s it-you don’t see the effects. Maybe that’s the problem. People don’t see it.

    I really don’t want to see us go to that place where it takes a serious public outbreak of pertussis or measles, but we’re heading there, aren’t we.

  81. #81 franklin
    May 26, 2009

    virtually all the risk of pertussis in the vaccine refusers came from being unvaccinated, and 11% of the pertussis cases in the total population can be attributed to vaccine refusal.
    Can someone explain this better to me? if only 11% of the pertussis cases were vaccine refusers… were 89% of the cases…vaccinated people? Unvaccinated but not refusers? Babies? Is there something about the wording I am being dense on?

    According to the paper:

    Children were classified as “vaccine refusers” if it was explicitly documented in the medical chart that their parents had refused 1 or more pertussis immunizations for nonmedical reasons. Children were classified as “vaccine acceptors” if they were age-appropriately vaccinated against pertussis at the index date. Children were also classified as vaccine acceptors if they were partially vaccinated against pertussis at the index date and the reason for lack of vaccination was not vaccine refusal. In many instances, a child was partially vaccinated (or not up-to-date) because the physician delayed immunizations due to an acute illness or the parent scheduled his or her child’s immunizations after the recommended ages. Cases and controls were excluded if they had a documented medical contraindication to vaccination or if the reason for lack of vaccination was not explicitly documented in the medical charts.

    By my reading of the paper, except for “vaccine refusers,” who must have missed at least one dose of the pertussis vaccine, the completeness of the vaccination status is not addressed for the cases or controls. Likewise, except for “vaccine refusers,” the relationship between the vaccination status of the children and risk of pertussis is not addressed in the paper. Some or even all of the children who are classified as “vaccine acceptors” may have been incompletely vaccinated, as long as the parents had not refused a pertussis vaccine for a nonmedical reason.

    The calculation of the percentage of risk attributable to vaccine refusal uses statistical techniques that are unfamiliar to me. The calculation is based on the odds ratios found in the regression analysis and uses techniques from these two cited references:

    Greenland S. Variance estimators for attributable fraction estimates consistent in both large strata and sparse data. Stat Med. 1987;6 (6):701 –708

    Szklo M, Nieto M. Measuring associations between exposures and outcomes. In: Szklo M, Nieto M, eds. Epidemiology: Beyond the Basics. Gaithersburg, MD: Aspen Publishers, Inc; 2000:91–121

  82. #82 Sid Offit
    May 26, 2009

    @Rjaye

    But aren’t your children living their lives inside their protective little vaccine cocoons? They have nothing to fear from me

  83. #83 Matthew Cline
    May 26, 2009

    The authors also tried to control for confounders.

    To play devil’s advocate for the anti-vaxxers: there’s also lifestyle choices. It’s theoretically possible that all of the vaccine refusniks also chose woo-ish lifestyles that increased the risk of pertussis, and if they had simply refused the vaccines while leading lifestyles similar to those who didn’t refuse vaccines (or chose the “correct” altie lifestyle) then the pertussis rates wouldn’t have increased.

    @Sid Offit:

    The fatality rate from measles for otherwise healthy people in developed countries is 3 deaths per thousand cases. And (if I recall correctly) about 1 in 5,000 cases leads to permanent brain damage. Doesn’t sound so harmless to me.

  84. #84 Mu
    May 26, 2009

    You should be scared Cooler

    * 7 deaths reported in USA 1999 (NVSR Sep 2001)
    * Pertussis (whooping cough) death statistics by worldwide region:
    o About 131,000 deaths from pertussis (whooping cough) in Africa 2002 (The World Health Report, WHO, 2004)
    o About 11,000 deaths from pertussis (whooping cough) in The Americas 2002 (The World Health Report, WHO, 2004)
    o About 46,000 deaths from pertussis (whooping cough) in Eastern Mediterranean 2002 (The World Health Report, WHO, 2004)
    o About 2,000 deaths from pertussis (whooping cough) in Western Pacific 2002 (The World Health Report, WHO, 2004)

    http://www.wrongdiagnosis.com/w/whooping_cough/deaths.htm

    You can guess what the vaccination rate in Africa is compared to the US (careful, might lead to forbidden conclusion at vaccinations save lives). I’m waiting for your statistic showing 10,000 death from dtap in the US every year.

  85. #85 Whitecoat Tales
    May 26, 2009

    Sid Offit – Poe? Or merely an idiot?

    Vaccines aren’t 100% effective, and while overall vaccine rates may be high, we are also at an all time high of pockets of antivaccers like yourself.

    Not that any of this matters since you either won’t change your mind, or don’t believe any of this to begin with.

  86. #86 Joseph
    May 26, 2009

    Wow 52 cases in Boulder county in 1993! I’m scared! Boulder county has a population of around 290,000! Jesus! It’s Jenny’s fault!

    @cooler: Let’s see. This insignificant incidence rate is 1.8 in 10,000 per year.

    Then you say:

    Canada has very high rates of pertussis… with 7,000 cases each year.[18]“

    Canada’s very high rate would be 2.1 in 10,000 per year.

    BTW, do you know what the incidence rate of autism is in the US roughly? It would be about 1 in 10,000 per year. If you need an explanation, let me know.

  87. #87 Parental Choice
    May 26, 2009

    “so P.C. how do you decide which vaccine is safe enough for your kids? How many parents have enough medical knowledge to decide which vaccine is safe and which should be refused”?

    I never said that these decisions were easy decisions nor is it a perfect science. That’s what makes it so difficult. Having said that… those who make the decisions on what to recommend for kids aren’t perfect either. Talk to parents whose children were killed or seriously maimed by the vaccine schedule that is ‘recommended’. Those doctors/experts didn’t have it right when it came to their kids health now did they? Nope, didn’t think so.

  88. #88 Sid Offit
    May 26, 2009

    @MU
    About 131,000 deaths from pertussis (whooping cough) in Africa 2002 (The World Health Report, WHO, 2004)

    When I move to Lagos I’ll start worrying

  89. #89 Sid Offit
    May 26, 2009

    @MU
    About 131,000 deaths from pertussis (whooping cough) in Africa 2002 (The World Health Report, WHO, 2004)

    When I move to Lagos I’ll start worrying

  90. #90 Parental Choice
    May 26, 2009

    “So Sid, you keep your children away from everyone else, no problem…”

    Not Sid, but… Why don’t you keep your kids away from my kids? Keep your kids locked up in your own house if you are so worried. My kids are fine. As we all know, unvaccinated kids are far healthier than vaccinated ones :)

  91. #91 Rogue Epidemiologist
    May 26, 2009

    @Parental Choice
    And you would be wrong. This paper has outlined only one reason why you’re so incredibly full of FAIL.

  92. #92 Parental Choice
    May 26, 2009

    “Parent’s rights do not trump any one else’s rights – not your children’s, not mine, and not my children’s. Thanks for playing, though.

    Do you feel like spouting any more ignorance today”?

    Oh really? So, I can’t choose NOT to inject my baby with aluminum and live viruses? Really? OK, Hitler. Sounds great….

    Sorry, Moron… I choose to keep my child safe from your toxic sludge.

    You Lose!

  93. #93 Sid Offit
    May 26, 2009

    @Matt

    The fatality rate from measles for otherwise healthy people in developed countries is 3 deaths per thousand cases. And (if I recall correctly) about 1 in 5,000 cases leads to permanent brain damage. Doesn’t sound so harmless to me.

    Plotkin / Vaccines 4th ed. P395
    Measles pre-vaccine era:

    500,000 reported cases w/ 500 dead from “measles associated” causes = 1 in 1,000 dead (from related causes).

    Same page:
    most cases were not reported / Each year the entire birth cohort of ~4 million were infected meaning 1 in 8,000 died. Other estimates show only 400 dead equaling 1 death in 10,000 – and the disease had fallen from dramatically before vaccination – are we to believe that drop would have stopped?

    And it’s well known that nutrition status (especially vitamin A) affects severity

  94. #94 Sid Offit
    May 26, 2009

    @Matt

    The fatality rate from measles for otherwise healthy people in developed countries is 3 deaths per thousand cases. And (if I recall correctly) about 1 in 5,000 cases leads to permanent brain damage. Doesn’t sound so harmless to me.

    Plotkin / Vaccines 4th ed. P395
    Measles pre-vaccine era:

    500,000 reported cases w/ 500 dead from “measles associated” causes = 1 in 1,000 dead (from related causes).

    Same page:
    most cases were not reported / Each year the entire birth cohort of ~4 million were infected meaning 1 in 8,000 died. Other estimates show only 400 dead equaling 1 death in 10,000 – and the disease had fallen from dramatically before vaccination – are we to believe that drop would have stopped?

    And it’s well known that nutrition status (especially vitamin A) affects severity

  95. #95 e.d.
    May 26, 2009

    Debate Godwin’d by Parental Choice, #92, at 7:11pm.

    I’ve noticed more and more alt-meds/vaxx refusers Godwin’ing lately debates lately. Rather difficult to talk with someone who is comparing the other side of the debate to the Nazi regime.

  96. #96 cooler
    May 26, 2009

    A whopping 7 deaths in 2001 in the USA, and since none of these have been written up in peer reviewed journals I’m wouldn’t be surprised they were all malnourished and had Crack Mommy’s. Nobody is saying not to get vaccinated, but you guys act like its the end of the world if a few people decide not to.

    As far as the deaths in Africa, it be nice if I could read the case studies that backed up your claims, regardless people in Africa die all the time of dirty water, starvation, and the vaccine pushers mislabel it as pertussis. All of this is up for speculation until you provide the evidence that so many people died of whooping cough and not other factors. It’s not surprising that death rates in general are higher in non industrialized countries. Oh look at this study, vaccines in Africa don’t even work against whooping cough.

    http://tropej.oxfordjournals.org/cgi/content/abstract/37/2/71

    An Outbreak of Whooping Cough in a Highly Vaccinated Urban Community

  97. #97 Whitecoat Tales
    May 26, 2009

    Oh really? So, I can’t choose NOT to inject my baby with aluminum and live viruses? Really? OK, Hitler. Sounds great….

    Firstly, as has been said, Godwin’s law, you lose.
    Secondly, as has been discussed thoroughly on the Hauser pages, the right to be a parent does not extend to child neglect, or the right to endanger the greater society. Most vaccine exemptions require a religious reason, or medical reason. The fact that people abuse the religious out does not mean they have a “right” not to do anything.

    Sorry, Moron… I choose to keep my child safe from your toxic sludge.

    Really idiot? You don’t seem to understand anything else here, so why would you understand this?
    Keep your unvaccinated, neglected child, away from our healthy, vaccinated children.

    Plotkin / Vaccines 4th ed. P395
    Measles pre-vaccine era:…

    most cases were not reported Each year the entire birth cohort of ~4 million were infected meaning 1 in 8,000 died. Other estimates show only 400 dead equaling 1 death in 10,000 – and the disease had fallen from dramatically before vaccination – are we to believe that drop would have stopped?

    I hate this argument, you vaccine denialists use it all the time. The prevaccine rates are not relevant. All of those rates require top rate medical care to keep that low. We no longer have the hospital bed capacity to maintain that many infectious disease patients in the hospital at once. Hell, most hospitals no longer have an infectious disease ward! They’ve become largely a thing of a past thanks to… wait for it…
    Vaccines!

    So we no longer have the capacity to respond to a large measles or pertussis outbreak the way we did before we had vaccines. Hospital systems in this country are by and large at their breaking points. My institution has literally been without a free bed 6 of the past 12 months, and at 98%+ capacity since last july. And we’re a frigging huge hospital system.

    Brief summary for the intelligence impaired: We don’t have the hospital beds/hospital stuff to maintain the figures you looked up in an old textbook. Congrats on failing to consider reality when responding though.

  98. #98 Chris
    May 26, 2009

    Parental Choice:

    As we all know, unvaccinated kids are far healthier than vaccinated ones :)

    Do you have any real evidence of that?

    Parental Choice then failed with a Godwin:

    So, I can’t choose NOT to inject my baby with aluminum and live viruses?

    Oh, wow it is the stupid aluminum argument? How exactly do you avoid the third most common element on the planet? Do you seriously avoid sandpaper, paint, aluminum cookware, pickles and all the other various ways that aluminum gets consumed (or into scratches which normal children get every so often).

    So why are the full strength form of a virus less dangerous than the weakened version in a vaccine?

    Now with this one you have two choices:

    Be a leech on society by depending on herd immunity for viral diseases like measles, mumps, rubella and chicken pox.

    Or

    Take you chances with the real disease, and with more and more idiots like you gathering together the chances your little brats will get the real disease is going up. With the real diseases, there is at least a one in thousand chances of something going wrong with measles and mumps, less so for varicella and rubella (unless your little brat infects a pregnant woman who also does not believe in preventing disease).

  99. #99 snerd
    May 26, 2009

    There’s little point debating anything with Common Sue, she has already demonstrate that no evidence will be sufficient to change her mind about this kind of thing.

  100. #100 Orac
    May 26, 2009

    Oh really? So, I can’t choose NOT to inject my baby with aluminum and live viruses? Really? OK, Hitler. Sounds great….

    Sorry, Moron… I choose to keep my child safe from your toxic sludge.

    You Lose!

    No, by Godwin’s law, you just lost.

    It is getting depressing, though. I’ve had to invoke Godwin’s law on antivaxers twice in one day. The bogus Hitler analogies are coming fast and furious. Such a lack of imagination! At least they could mention Stalin from time to time…

  101. #101 D. C. Sessions
    May 26, 2009

    they are the most susceptible to death and serious side effects like ruptured blood vessels in the lungs, scarring from ruptured aelvoli (sp?), brain and eyes from the coughing (yes, it does happen) as well as brain damage from weeks of chronic low oxygen levels.

    You missed the heart damage from the pertussis toxins. You know, the ones that Jenny doesn’t bother about because (like botox) they’re ALL NAZTURAL!!!!

  102. #102 Sid Offit
    May 26, 2009

    @Whitecoat Tales

    Did one of your miracle cures involve giving children with the measles aspirin, then misdiagnosing the resultant, and potentially fatal, Reyes Syndrome as encephalitis?

  103. #103 Clare
    May 26, 2009

    That’s an interesting point about how aware adults are about what they’ve been vaccinated against, what not, and when they need boosters. I’m extremely aware of all this because I travel regularly to places where the suggested shots used to constitute a list a mile long (my, was I glad when gamma globulin was replaced). AND I benefited from the national health as a kid in UK, and good health coverage in the US. When I consider the horrors of the diseases that vaccines protect against, I am profoundly grateful for each and every vaccination I’ve been lucky enough to receive.

  104. #104 Sid Offit
    May 26, 2009

    @Whitecoat

    …or is this the lifesaving treatment that can’t be replicated today?

    http://www.faqs.org/health/Sick-V3/Measles.html
    There is no treatment that can kill the measles virus or stop the course of the disease. Treatments instead are used to make a patient feel more comfortable during the disease

    Anyway breastfeeding protects the vulnerable young from both measles and pneumonia while smoking does the opposite. So while a whopping 1 in 85 of those with the measles did go to the hospital even that small percentage is inapplicable to me because I’ll provide a healthy environment for my child. Yes environment matters. So you can have my hospital bed. I won’t be needing it

    Conditions that allow pneumonia-causing infectious organisms to circumvent the upper airway defense mechanisms include the following:

    SMOKING

  105. #105 Sid Offit
    May 26, 2009

    Sid Offit logging off for the night

  106. #106 Whitecoat Tales
    May 26, 2009

    @Sid

    Did one of your miracle cures involve giving children with the measles aspirin, then misdiagnosing the resultant, and potentially fatal, Reyes Syndrome as encephalitis?

    Firstly, even the first year med students know not to give aspirin to peds patients.
    Secondly, when did I talk about miracle cures?

    So while a whopping 1 in 85 of those with the measles did go to the hospital even that small percentage is inapplicable to me because I’ll provide a healthy environment for my child

    Ignoramus
    Do the math.

    How many hospital beds in your local area?
    Consider how many of their beds are free now.
    Consider how many beds would be needed if you had a measles outbreak, where in 1/85 needed hospitalization.
    Consider how many of the support staff are trained in pediatric care.
    Consider how much capacity the ER has to work with the tide of parents who haven’t SEEN measles taking their kids in.
    Consider, basically, how this affects anyone other than your arrogant, ignorant, idiotic self.

    So you can have my hospital bed. I won’t be needing it

    Are you a teen parent? You certainly have the teenage “Me and my family are INVINCIBLE” vibe going.
    The reality is, anyone can be hospitalized. Even if you talk in percentages, it’s never 100% “oh he smoked, thats why his child is in the hospital.”

  107. #107 Whitecoat Tales
    May 26, 2009

    Incidentally, do all antivaccers use the Reye’s syndrome gibberish? I’ve seen the comment made multiple times. I don’t understand why they do so.
    On peds, it was drummed into me from here to hell not to give aspirin. This can’t be all that common a mistake.

    I’ve only ever seen one case of Reye’s by the way, but thats because a poor kid who had Kawasaki disease came down with something after starting aspirin, and the parent’s didn’t call into the hospital until their child was stuporous.

  108. #108 AutismNostrum
    May 26, 2009

    I’ve also had pertussis, and I wouldn’t wish it on anyone. It was hardly a mild cold. And I had a comparatively mild case as a healthy 17 year old. I can’t imagine how horrible it would be to be a younger kid with this.

  109. #109 Sid Offit
    May 26, 2009

    @Whitecoat

    Incidentally, do all antivaccers use the Reye’s syndrome gibberish? I’ve seen the comment made multiple times. I don’t understand why they do so.
    On peds, it was drummed into me from here to hell not to give aspirin. This can’t be all that common a mistake.

    It wasn’t a mistake back in the day it was a recommended treatment. You’ll find that in the old textbooks of the era

  110. #110 Whitecoat Tales
    May 26, 2009

    And?
    Why would I care about textbooks of that era? I practice medicine today. Historical perspective is important to have respect for the past, and learn from it.
    We don’t practice from it. I don’t get my guidelines on trauma surgery from the Edwin Smith papyrus, and I don’t taste my patient’s urine to monitor their diabetes. Hell, I hardly use leechs at all!

  111. #111 Pareidolius
    May 26, 2009

    Why is it that I hear Cartman’s mom’s sugary, prim voice whenever I read any of Parental Choice’s insufferably smug-yet-incredibly-lame posts? I think she’s most likely posting from somewhere along the Axis of Me-ville (said axis runs between Sebastopol and Malibu in California). She’s probably a big-time magical thinker and though she’s fairly smart (in a mushy pseudointellectual NPR kind of way), has poor critical thinking skills. Mix this with a good dose of conspiratorial neurosis and arrogance and voila, Parental Choice!

  112. #112 Sid Offit
    May 26, 2009

    @Whitecoat

    Give a kid with the measles aspirin. Kid dies from Reyes syndrome but since Reyes Syndrome is unknown its diagnosed as measles encephalitis. Those deaths would not occur today because we no longer prescribe aspirin. This makes the (400-500) measles deaths seems higher than they actually were. So if you add up smoking related, aspiring related, vitamin a related and overcrowding related complications etc the risk from measles melts away

  113. #113 Matthew Cline
    May 26, 2009

    @chris:

    Take you chances with the real disease, and with more and more idiots like you gathering together the chances your little brats will get the real disease is going up.

    You shouldn’t call them brats; it’s not their fault that their parent is an anti-vaxxer.

    @Whitecoat:

    Secondly, when did I talk about miracle cures?

    This is just a guess, but I think what was meant was something like: if a child died from the measles, the only thing which could have prevented that death would to have been to make them measles free. But it’s impossible to make someone measles free once they have it. Thus, when children with measles end up in the hospital, it’s never to prevent their symptoms from getting so bad that they suffer permanent damage, but is rather merely to ease their suffering.

  114. #114 Sid Offit
    May 26, 2009

    Miracle cure

    The prevaccine rates are not relevant. All of those rates require top rate medical care to keep that low.

    You’re arguing the reason the measles was rarely fatal was due to “top rate medical care” or as I called it a miracle cure

    I’m unaware of the top rate treatment that brought deaths down from 10,000 to 500 from 1900ish to 1963

  115. #115 Dan S.
    May 26, 2009

    Not Sid, but… Why don’t you keep your kids away from my kids? Keep your kids locked up in your own house if you are so worried.

    Pointless, but – of course, that’s what would be required, for everyone else to keep their kids (and anyone else at risk) locked up. Otherwise- well, first off, all parents (etc.) in your children’s vicinity would need to know that your kids were unvaccinated, wherever you go (if traveling, etc.) or wherever they go (if visiting/passing through). That’s tricky enough – to go with your GodwinFail, one possibility would be requiring them to wear distinctive badges, but just maybe not the best idea? Even then, though, one would have to constantly supervise their kids to ensure they don’t wander off and, not realizing the risk, play/beat up/otherwise interact with yours. And how would school work?

    No. There are some choices you have both a right and a duty (however badly met) to make, but the same goes for us, including the right and duty to hold you to the consequences of these choices insofar as they would otherwise harm us and ours (while hoping only that the true cost isn’t paid by your children.

  116. #116 Sid Offit
    May 26, 2009

    Good night to all my good friends at scienceblogs.com

  117. #117 DuWayne
    May 26, 2009

    Good damned grief, I thought you were “signing off” for the night Sid.

    PC -

    Not Sid, but… Why don’t you keep your kids away from my kids? Keep your kids locked up in your own house if you are so worried.

    Not my kids I’m worried about moron, it’s kids who have immune deficiencies and either can’t be vaccinated or never developed the antibodies. You know, the kids who are most at risk for the very worse effects of diseases that morons like you think are just friggin peachy. I had my boys vaccinated. They aren’t a risk to those kids.

    You are a menace and because they have the misfortune of having a parent like you, your children are a menace too.

  118. #118 DuWayne
    May 26, 2009

    Damn you chairman Orac!!! Damn you and all your Maoist poison peddlers to hades!!!

    Feel better now?

  119. #119 happeh
    May 26, 2009

    “Serious illness for a week, followed by a lesser degree of illness for ten weeks, and this idiot thinks it’ “not real serious.”

    Ahhhhh. You just have to love the western physician. Calling people idiots.

    Do you ever think about how that sounds to people you do not know? Do you think of the impact on a prospective patient of knowing that people who do not agree with you are “idiots” in your opinion?

    You have no empathy. You are working on human beings for a living, but you don’t care for them or their feelings. They are objects you are supposed to attain certain results with.
    —————–

    Why is having whooping cough a big deal? Is it a big deal because it strengthens your pro vaccine stance if you make it sound like whooping cough is a big deal?

    Being sick for a week does not sound like a big deal to me. If I felt strongly about vaccines, and my choice was a mild illness for my child for one week or what I considered to be a dangerous vaccine, I would let my child endure a mild illness. What is the big deal?

  120. #120 DuWayne
    May 26, 2009

    happeh -

    You folks aren’t idiots because you disagree, you’re idiots because you seem to be fond of ignoring the deaths these “mild” illnesses cause. Or the blindness. Or any of the other permanent disabilities that they can cause. You’re idiots because you ignore the reams of evidence and pretend that it simply doesn’t exist, doesn’t matter or is all a big plot by big pharma…

    You’re called idiots because, well, you’re idiots…

  121. #121 T. Bruce McNeely
    May 26, 2009

    Happeh, you truly are a piece of work. You bleat on about empathy, yet you consider pertussis a “mild illness for one week”.
    Face it, you don’t know Jack Shit. You are a fool.

  122. #122 Pareidolius
    May 26, 2009

    Oh, DuWayne, you don’t know HOW idiotic happeh is unless you go visit his/her/it’s website. To visit happeh’s site is to venture into the Pöebius Strip—is it a parody or is it real? You decide.

  123. #123 alison
    May 26, 2009

    happeh said Being sick for a week does not sound like a big deal to me. If I felt strongly about vaccines, and my choice was a mild illness for my child for one week or what I considered to be a dangerous vaccine, I would let my child endure a mild illness.

    Oh heck, I know I shouldn’t… Happeh, the original comment was that the child was seriously ill for a week, & ill for a further 10 weeks after that. The choice, for pertussis, is not a choice between vaccination & a ‘mild’ illness. Pertussis, as others have already said, can & does kill, particularly in infants.

  124. #124 D. C. Sessions
    May 26, 2009

    I’m unaware of the top rate treatment that brought deaths down from 10,000 to 500 from 1900ish to 1963

    So since you’re not aware of them, they obviously couldn’t have existed. What a nice, comfortable Universe you must live in.

    Here are a few of the treatments that took US measles case mortality from 10% (per Meakins, 1940) down by two orders of magnitude:

    * Oxygen
    * IV fluids and other supportive care.
    * Antibiotics for secondary pneumonia (the #1 killer)

    I’m sure that others can name a few I’ve missed.

    Current measles case mortality is running about 2/1000. That may be a bit high thanks to a higher percentage of patients being unusually vulnerable, but it’s in the same range as the rates since the 1950s.

    I’m especially amused by the “my kids are breastfed, so they’re safe” idiocy. What does this genius think their mothers were feeding all of those dead kids in Africa? Pedialyte?

  125. #125 Mu
    May 27, 2009

    DCS, you heard the judgment of “the cooler”, you don’t die of diseases in Africa, it’s all malnourishment.

  126. #126 AutismNostrum
    May 27, 2009

    My breastfed son (never had a drop of formula) developed bronchitis severe enough to necessitate a stay in the hospital. I breastfed him in the hospital, too.

    Too bad I apparently didn’t make the magical kind of breastmilk that offers 100% protection from any disease known to man, cures pinkeye, and revives kittens from the dead. I just made the kind that offers a decent passive immune system for babies under six months and good nutrition with perhaps some immune benefits thereafter.

    And since I don’t have super powers in my mammary glands, I’m very glad my kids were vaccinated.

  127. #127 Matthew Cline
    May 27, 2009

    you don’t know HOW idiotic happeh is unless you go visit his/her/it’s website.

    Oh, wow, happeh supports phrenology. Wow.

  128. #128 Chris
    May 27, 2009

    Matthew Cline:

    You shouldn’t call them brats; it’s not their fault that their parent is an anti-vaxxer.

    So sorry, but I figured when a parent was a selfish leech, their children would reflect their parent’s attitude. Plus I had just read this blog posting: They say this about every generation, which is about how some forms of parents have rude children.

    I was kind of reacting, especially since I have always worked hard to respect my children, and make sure they respect others. My oldest who is disabled has always been known as a kind child, my middle child was voted as “Most Chivalrous” this past weekend at marching band camp, and my youngest is still a work in progress (yes, she does think of others!).

    These parents who are getting a free ride on herd immunity seem to be the type who feel they are entitled. They have closed minds, and do not think of the effect they have on others. I read that the parents who started the measles outbreak in San Diego had no remorse, even though one baby ended up in the hospital, and several other children had to be quarantined (listen to Ruining It for the Rest of Us). This is not the type of parent who raises a kind and considerate child.

    Further evidence of the type of parent they are is Evil Dawn, JB Handley, the rantings of the one who will not stick to one ‘nym, Sid “The Parasite” Offit, and of course the Godwin evoking “Parental Choice”.

  129. #129 Esther
    May 27, 2009

    I recall one antivaxer on a mommyboard I used to post on once put it this way (she might have been quoting an antivax article; I forget):”Sorry, we won’t be contributing today”. They know they’re being selfish, but in their stupidity, they don’t realize their selfishness will ultimately come back to bite their own children’s hide.

    And I’ll add my own anecdotal experience to that of AutismNostrum’s – breastmilk is a somewhat successful health intervention against some infectious diseases, but somehow my longest-breastfed child (21 months) was also the only one of my 3 kids hospitalized with neonatal fever, and had numerous ear infections and pneumonia during his first 2 years of life. I actually once attempted to do the math regarding how much more effective vaccines were in preventing deaths as compared to breastfeeding, thanks to a Moron with an MD who posts as a medical authority over at babycenter.

  130. #130 luna1580
    May 27, 2009

    “happeh”

    is one of science blogs resident woo-meisters.

    just plug his name into the blog specific “search” box at your upper left to see what he’s been advocating here.

    it has also been implied that “happeh” is the nom-de-blog of one mike adams, woo-meister extraordinaire. this may or may not be true, but that removes none of “happeh’s’” anti-science illogical rhetoric.

    why even bother with him any more? he is tantamount to a woo-troll.

  131. #131 Laser Potato
    May 27, 2009

    [A "germ" isn't a disease]
    Oh. So Rocky Mountain spotted fever, Lyme disease, Malta fever, Leigonnaire’s Disease, tetanus, listeriosis, salmonella, bacterial meningitis, gonorrhoea, pneumonia, staph, syphilis, and cholera don’t exist. Silly me.

  132. #132 Parental Choice
    May 27, 2009

    “Not my kids I’m worried about moron, it’s kids who have immune deficiencies and either can’t be vaccinated or never developed the antibodies”.

    I worry about the children with immune deficiencies as well… those who are injured by vaccines, those who can’t handle toxic exposures and live virus vaccines. I don’t know where you guys get off thinking that you have the moral high ground on this issue. What part of…. BABIES are injured from vaccines everyday is it that you don’t understand?

  133. #133 Whitecoat Tales
    May 27, 2009

    You’re arguing the reason the measles was rarely fatal was due to “top rate medical care” or as I called it a miracle cure

    I never said anyone cured measles. It’s top rate supportive care. you need trained staff and hospital beds to give appropriate supportive care.

    I’m unaware of the top rate treatment that brought deaths down from 10,000 to 500 from 1900ish to 1963

    Of course, since I didn’t say anything about 1900, to 1963, that’s irrelevant.
    I said NOW we don’t have the hospital capacity to handle a large infectious disease outbreak. Whatever happened in 1900 to 1963 is irrelevant, it was a different world. A different hospital system. They had actual infectious disease wards where children could be isolated. We generally don’t have those now, even in many very large hospitals.

    Give a kid with the measles aspirin. Kid dies from Reyes syndrome but since Reyes Syndrome is unknown its diagnosed as measles encephalitis. Those deaths would not occur today because we no longer prescribe aspirin. This makes the (400-500) measles deaths seems higher than they actually were. So if you add up smoking related, aspiring related, vitamin a related and overcrowding related complications etc the risk from measles melts away

    … And you can’t do math.
    The peak reported incidence of Reye’s syndrome was 6.3 cases per million children, and the vast majority of those had nothing to do with measles, and can be related to a number of viruses, including chicken pox, and a variety of upper respiratory infections. Since even you claim a death rate of measles as 1 per 1000 Reye’s syndrome accounts for… almost nothing.
    Vitamin A related, and overcrowding is relevant in Africa, however it has not been documented as a significant issue in this country, that doesn’t drop you below your initial 1/1000 figure.
    I haven’t seen a single study about your smoking gibberish. Not even on the websites you linked too. As far as I can tell you made that up.

  134. #134 Whitecoat Tales
    May 27, 2009

    What part of…. BABIES are injured from vaccines everyday is it that you don’t understand?

    The math part.
    How many babies are injured by vaccines? Very few.
    Very
    Very
    Few.

    How many babies were injured when everyone had these childhood vaccines? Lots. Orders of magnitude more.

    those who are injured by vaccines, those who can’t handle toxic exposures and live virus vaccines

    So, they can handle the live virus… But the live virus vaccine will hurt them? Your logic is abyssmal.

    Toxic exposures by the way, is bull. Name a toxin, or go home.

    For any toxin you attempt to name, we can show you that you’re wrong about it’s actually being in vaccines, or that it’s not actually a toxin or dangerous and you don’t know what you’re talking about.

  135. #135 Whitecoat Tales
    May 27, 2009

    How many babies were injured when everyone had these childhood vaccines

    that should read
    How many babies were injured when everyone had these childhood diseases

    Sorry, I’m post call, and cranky.

    Incidentally, overnight, I just saw a teenage girl who didn’t get vaccinated with MMR pregnant and infected with Rubella.

    Antivaccers, what’s your answer to that kind of situation? Those parents and children don’t fit well into your little world do they?

  136. #136 MIDawn
    May 27, 2009

    Well, have to go back to the other name just in case “evil” Dawn shows up again.

    @WT: PLEASE, PLEASE tell me that the pregnant teen was past her first trimester! OMFSM, I would hate for her baby to have CRS.

    Anyone who thinks pertussis isn’t dangerous should have it. I had it, and didn’t see a doctor until very late in the disease when he couldn’t really help me. I thought it was “just a bad cold” until the coughing didn’t stop after 2 weeks. Coughing until you are breathless and vomiting is not fun. Being afraid to speak because it will lead to the afore name coughing/vomiting is not fun. Breaking a rib due to the coughing is not fun. Hurting all over your body because of the non-stop coughing is not fun. Needing to take cough syrup with codeine every 3 hours to somewhat suppress the cough so you can eat, drink and sleep is not fun. EVERYTHING caused me to cough non-stop otherwise. And I was a 40+ year old adult. I can’t imagine inflicting such a disease on my children or an infant. (Thankfully, my kids are fully vaccinated and up-to-date so they never got it).

  137. #137 Rev. BigDumbChimp
    May 27, 2009

    I thought Happeh was parody?

  138. #138 Whitecoat Tales
    May 27, 2009

    @MIDawn
    Sadly I only brought it up because she was NOT past her first trimester. It’s still not 100% for CRS, i think the stat is a little over 50%. Niether she nor her family were vaccine denialists persay, but “Lapsed Mennonites”, who were not appropriately educated when they changed religions.

  139. #139 Travis
    May 27, 2009

    The double, triple, and quadruple postings have not been as bad here as over at PZ’s place but I am going to guess that is probably mostly due to volume than anything else.

    Please read the whole error message, it clearly states not to repost it, but to go back and refresh the page as it most likely has been posted.

  140. #140 Laurel
    May 27, 2009

    It would take a maniac with a heart of stone to call this “not real serious:”

    http://www.youtube.com/watch?v=dZ5jf-5MobE

    I’m not a parent, and it hurts me to look.

  141. #141 Rjaye
    May 27, 2009

    Just checking in…I see the antivax folks won’t give it up, but no surprise there.

    A friend of mine sent info on a website that promotes “natural immunity.” Lots of Vit. D, and rhubarb and nonsense, and how “natural immunity” is better than immunization.

    I had to remind her that the flu or whooping cough could kill me as I have an autoimmune disorder, and I’d really like to avoid going through that again.

    What is so magical about rhubard, except in pie? Garlic is nummy, but how does it boost the immune system to superhuman levels? I was raised “all natural,” with no refined foods and lots of sunshine and things that now are considered wonderfoods but used to be hillbilly cookin’, and I have an ASD (didn’t get vaccinated until second grade which was after dx), and my sister was in the hospital for nearly two weeks with the measles (encephalitis) with two dozen other kids. My mother died of a disease that is now prevented with vaccines (post-polio syndrome, which is a horrible way to die).

    That’s got to be it. These people have never seen these diseases or what they can do. They have no idea.

    It’s a cult, and Orac has them pegged.

  142. #142 Travis
    May 27, 2009

    Sorry about posting that comment, I had looked at this thread last night and finished reading it today, but I forgot I had not refreshed the page so I made my comment thinking the last one was samantha’s post, however when I refreshed I saw there were many more posts, and I was just repeating what others had already said.

  143. #143 e.d.
    May 27, 2009

    Rjaye, you pegged it. My generation (the current parent generation) has never seen these diseases. Why? Because all of our happy butts were vaccinated against them. They aren’t a “real threat” anymore in their eyes.

    If you’ve noticed, it’s become trendy in first world countries to FIND things to be paranoid about and so that they might “protect the BABIES/CHILDREN” (your choice of caps here)…why? Because the maternal/paternal instinct to protect your child from dangers is still there…but there’s nothing to immediately at hand to protect the BABIES/CHILDREN from because we, as a society, have pretty much created a lovely little bubble for our BABIES/CHILDREN.

    Parents have to FIND something to be worried about and this is the latest and greatest “horror/terror/scary thing”.

    “Natural” is also the trendy thing. Unfortunately “natural” =/= best/better. It’s just another way to feel superior to all the rest. I’ll take a vaccine virus over the wild type any day of the damn week. We’ve got a whooping cough outbreak out here and I’m bleaching down my counters at work every time a patient comes in with an uncontrollable cough.

  144. #144 Parental Choice
    May 27, 2009

    “The math part. How many babies are injured by vaccines? Very few. Very Very Few”.

    That’s where we run into issues. I disagree. I believe that MANY children are injured by an unsafe vaccine schedule. Many, many, many….

  145. #145 JohnV
    May 27, 2009

    Is this merely a belief or is there documentation to support it?

  146. #146 Parental Choice
    May 27, 2009

    “Is this merely a belief or is there documentation to support it”?

    There’s plenty of documentation to support it. Whether or not to choose to believe it is another thing… Having said that, where’s your documentation to support the safety of injecting babies with toxic sludge :)

  147. #147 sophia8
    May 27, 2009

    There’s plenty of documentation to support it. Whether or not to choose to believe it is another thing… Having said that, where’s your documentation to support the safety of injecting babies with toxic sludge :)
    You show us yours first, then we’ll show you ours. :D

  148. #148 Parental Choice
    May 27, 2009

    “You show us yours first, then we’ll show you ours. :D”

    I think that you should be able to show that injecting babies with toxic sludge is safe before I should have to show you anything :)

    Good luck with that…

  149. #149 Sid Offit
    May 27, 2009

    @D. C. Sessions

    Antibiotics arrived about 40 years after deaths began their dramatic decline. Must be that “supportive care” that did it

    As too breastfeeding, you aware that lifestyle is somewhat different in Africa than in the US

  150. #150 ababa
    May 27, 2009

    What does injecting of “toxic sludge” have to do with vaccines? Oh I see, you are giving scary names to things to make your point!

    Define sludge and quantities that make it toxic.

  151. #151 Whitecoat Tales
    May 27, 2009

    I disagree. I believe that MANY children are injured by an unsafe vaccine schedule. Many, many, many….

    Your belief is irrelevant.
    As for my evidence, I’ve documented it clearly, with citations on my blog, starting here.
    @Sid
    Scare quotes around supportive care don’t change it’s value. Yes, Supportive care is key.

  152. #152 Sid Offit
    May 27, 2009

    @Whitecoat

    Aren’t they teaching you anything at that medical school down in Grenda? Or have you just not gotten to the classes on vaccines and infectious diseases? Overcrowding not a factor in measles? You can’t be serious? Vitamin A only in Africa?

    http://books.google.com/books?id=sbNvTSXo5Y8C&pg=PA38&dq=measles+overcrowding

    http://emedicine.medscape.com/article/966220-overview
    Risk factors for severe measles and its complications
    Malnutrition
    Underlying immunodeficiency
    Pregnancy
    Vitamin A deficiency

    (Pediatrics in Review. 1998;19:70-71.)
    © 1998 American Academy of Pediatrics
    Measles and Malnutrition

    Peter R. Belamarich, MD1It had been suspected that malnutrition increased the morbidity and mortality of childhood measles as early as 1885 by Drinkwater, who investigated an epidemic in Sunderland, England, that had an unusually high case fatality rate of 10%. He attributed this finding to “semi-starvation among the poor.” Drink-water’s hunch has been supported by a number of other workers on different continents who have found higher fatality rates among malnourished children who have measles

    Are we to believe there are no children living in overcrowded malnourised conditions today in America?

    Measles deaths fell not due to lots of hospital beds but to improved living conditions

    Gotta go – We’ll work on pneumonia and smoking and Reyes later

  153. #153 Calli Arcale
    May 27, 2009

    Of course overcrowding and malnutrition are gonna increase mortality and morbidity due to measles. Duh! How does that translate into “vaccination against measles is unnecessary”? Or are you saying that just getting the measles rate down a *bit* is enough? That it’s okay for kids to die or suffer lifelong disabilities because of measles encephalitis as long as it’s not too many of them?

    Huge improvements in mortality/morbidity can be made by improving the general quality of life. But that doesn’t eradicate the illness, nor reduce mortality/morbidity down to acceptable levels. If you want to actually wipe out a disease like measles, you have to go further and vaccinate against it.

    And if you’re gonna work on pneumonia, does that mean you’re gonna use that old canard that measles doesn’t kill anybody — it’s the pneumonia that does it? That’s a bit like saying that bullets don’t kill; all they do is make a hole. It’s not the bullet’s fault that all the blood pours out and the person actually dies of exsanguination. Or, perhaps more accurately, that a gunshot wound to the gut doesn’t kill — the person actually dies of a massive infection. (Go ahead; try that one in criminal court.) If a measles patient contracts a secondary pneumonia infection which kills him, preventing the measles in the first place would’ve prevented his death. That’s what matters. Not some stupid semantic game.

    The measles fatality rate is much lower among the wealthy, yes. But it’s still a lot higher than I’m okay with. A 95% vaccination rate can drop that fatality rate to zero, with very few side effects.

  154. #154 Kelly
    May 27, 2009

    Pareidolius
    I’m a bit lat to the party but curses! I clicked into Happeh’s website after you suggested DuWayne do so. ARGHH! I mean you *did* indicate that it would be delusional so I should have been forewarned. But, in this case, forewarned was not forearmed!
    As for the rest, I don’t know how you posters manage to engage the anti-vaccers without losing your minds — hats off to you. I find myself wanting to become violent when reading some of the same old canards again and again and again…

  155. #155 Whitecoat Tales
    May 27, 2009

    @Sid Offit

    We are talking about today. Not pre vac. So saying measles rates fell for X reason is completely irrelevant, as I’ve said multiple times.

    I have said that the measles death rate NOW will rise because of our inability to provide sufficient supportive care. You have not even pretended to dispute this.

    Are we to believe there are no children living in overcrowded malnourised conditions today in America?

    Oddly enough, Vitamin A def is very rare in america. Overcrowding in the sense discussed regarding measles is also not present in america. Even our inner city poor generally have access to vaccination, and suffiecient housing not to be overcrowded.

    You need to go to inner city Mumbai, where in a slum, an area the size of a small college dorm room will be home to 20 people. That’s overcrowding in the infectious disease sense. Since measles deaths are specifically overrepresented among the homeless, the only population in the US that has real potential to be “overcrowded”, yea, we don’t have overcrowding here. On the other hand, tuberculosis is much more common among the homeless, another disease more common in overcrowded, malnourished individuals.

    In this country, the poor are more likely to be obese than starving, and the malnourishments we see are more often the water soluble vitamins, and vitamin D, NOT vitamin A.

    Aren’t they teaching you anything at that medical school down in Grenda?

    Clever… except even in med school in “Grenda”, I’d have learned what I just typed above.

    So yea Sid, argument by assertion = full of crap
    Argument ad hominem = full of crap

    Sid’s arguments = full of crap.

  156. #156 T. Bruce McNeely
    May 27, 2009

    Another aspect to the “measles only kills poor kids” canard:
    Yes, most infectious diseases are more severe in the low-income population. This, of course, makes the attitude of the well-off vax refusers even more reprehensible – maybe (in their minds)their kids are only risking a relatively mild illness, however, they are keeping the infection thriving in the community to infect and cause more severe disease in the poor. Hardly a “progressive” attitude…

  157. #157 Sid Offit
    May 27, 2009

    @Whitecoat Tales

    #1
    Obseity and malnutrition are not mutualy exclusive – there are no nutrients in white flour and sugar

    http://emedicine.medscape.com/article/126004-overview
    United States – VAD is uncommon in the general population, but subgroups of patients …Vegans, persons with alcoholism, toddlers and preschool children living below the poverty line, and recent immigrants or refugees from developing countries all have increased risk of VAD

    #2
    I have said that the measles death rate NOW will rise because of our inability to provide sufficient supportive care. You have not even pretended to dispute this.

    I haven’t tried to dispute it because it is so ridiculous. First hospitals aren’t the reason almost no one dies from the measles. Second are you suggesting everyone will stop vaccinating on the same day leading to 4 million measles cases that would overwhelm the hospital system? If not are you saying capacity could not be increased to cope with a gradual increase. If so I don’t know what we’ll do when that killer flu pandemic comes.

    Finally I can’t believe I wasting my time trying to convince you the measles isn’t serious. People used to take kids to measles parties – and that was before Jenny McCarthy

    So I’ll see you all on the next topic

  158. #158 dt
    May 27, 2009

    Sid, just for the record, can we have your opinion on which of these diseases is “serious”?
    1. Case fataity rate = 1:10
    2. Case fatality rate = 1:100
    3. Case fatality rate = 1:1000
    4. Case fatality rate = 1:5000
    5. Case fatality rate = 1:10,000

    Just tell us the numbers. Then we know where you draw your cutoff.

  159. #159 Whitecoat Tales
    May 27, 2009

    @Sid
    I was explicitly making a connection between obesity and malnourishment, AND telling you which kinds of malnourishment they tend to get.

    If so I don’t know what we’ll do when that killer flu pandemic comes.

    This is exactly why the flu pandemic scares the crap out of us.

    First hospitals aren’t the reason almost no one dies from the measles.

    Numbers
    Do the math.
    If a hospital is at 98% capacity, how much increase is necessary to overflow the hospital… not much.

    Second are you suggesting everyone will stop vaccinating on the same day leading to 4 million measles cases that would overwhelm the hospital system? If not are you saying capacity could not be increased to cope with a gradual increase.

    How the hell do you think an “outbreak” works? Do you thnk you avoid a vaccination, and then a certain time later, like clockwork you get the disease? It breaks out in large groups. And “coping with a gradual increase” won’t matter if there just isn’t money to do it.

  160. #160 HCN
    May 28, 2009

    Just popping in for a moment: Has anyone (including Sid the Parasite) posted any cogent evidence that shows that the DTaP is more dangerous than diphtheria, tetanus and pertussis?

    This seems to be an important point when the number of American babies who die from pertussis are increasing. The study that is the topic of this blog posting seems to illustrate the reasons: unfounded fears that prevent children from getting the vaccine.

    Is there justification for not getting the DTaP? Does a child getting a sore arm and a slight fever for a day or so a greater harm than a baby too young to get the vaccine spending weeks in the hospital trying to get a breath (or taking their last breath as a long drawn out w-h-o-o-p because of the effects of the pertussis toxin)?

    Come on Parasitic Siddy and Parasitic Parental Choice, show us the honest to goodness real actual factual evidence that the DTaP is more dangerous than pertussis (and diphtheria and tetanus). Show us the data of your convictions! And I mean real data, not made up data, nor do I mean stuff written “Medical Hypothesis”… only stuff that is published in real medical journals.

  161. #161 dt
    May 28, 2009

    HCN, they argue with the arrogance of ignorance – I wouldn’t really expect any useful answer to our questions. Just a form of gish gallop as they throw dozens of new fallacies at us to deal with.

    One of the problems about risk assessment is to determine the true extent of the risk. For diseases like tetanus, it is by no means certain that an unvaccinated individual will be exposed to tetanus in their lifetime. If they are lucky they might not be. The risk-benefit calculation favours vaccination because the disease is always serious and life-threatening, so it’s a no brainer – even if your lifetime risk was only 1 in 100 of being exposed, it makes sense to vaccinate. Similarly diseases like HiB and meningococcal disease – low lifetime risk of developing invasive disease, even if not protected, but very high risk of disability/death if you get infected. Once I had an argument about condom use and risk of catching HIV on another forum, where I said condoms should always be used. He argued that this was unecessary in situations where HIV was low risk, rather like carrying around an umbrella even when no rain was forecast. I replied that if a single drop of rain could be lethal, I’d rather have my umbrella thanks very much.

    With diseases like chickenpox, rubella, measles, mumps, and probably pertussis, the lifetime chance of being exposed and infected is nearly 100% (in prevaccination times). So without the protection of vaccination, everyone would get measles, usually as a child. This means that although it is less serious than meningitis or tetanus, the risk-benefit calculation still favours vaccination.

    Parasite Sid claims measles is not serious. Well the figures emerging from outbreaks in Europe this century indicate case fatality of about 1 in 1000. What the mortality was in the 60s is quite irrelevant. This is mortality in a westernised, modern health care setting, now.

    Unless the risk of death from vaccination is greater than 1 in 1000, it is sensible to vaccinate. (AFAI recall, risks of severe anaphylaxis are in the order of 1 in several million, and death is even less likely)

  162. #162 HCN
    May 28, 2009

    dt said “Well the figures emerging from outbreaks in Europe this century indicate case fatality of about 1 in 1000. What the mortality was in the 60s is quite irrelevant.”

    Except even in the 1950s the case fatality rate was near 1 in 1000 for reported cases of measles. I took the CDC’s Pink Book Appendix G data and made a little chart:
    Measles:
    Year_Cases_Deaths__Year___Cases____Deaths
    2000____86___ 1____1950__319124____468
    2001___116___ 1____1951__530118____683
    2002____44___ 0____1952__683077____618
    2003____56___ 1____1953__449146____462
    2004____37___ NA___1954__682720____518
    2005____66___ NA___1955__555156____345
    2006____55___ NA___1956__611936____530
    Total__460___3 or more__3831277___3624

    Also, we know that measles, mumps and rubella were causes of permanent disability in at least the one in a thousand cases, even if they were not reported. And of course I do present the data.

    First for measles and rubella (oh, and Hib and some other diseases), “Impact of specific medical interventions on reducing the prevalence of mental retardation.”:
    http://archpedi.ama-assn.org/cgi/content/full/160/3/302

    And because Japan has made mumps vaccination voluntary (they insist on using the Urabe strain instead of the Jeryl-Lynn strain), they have had enough cases to show that mumps causes deafness at a higher rate (1 in 1000), “An office-based prospective study of deafness in mumps.”,
    http://www.ncbi.nlm.nih.gov/pubmed/19209100 (clicking on the commentary link brings up on the the title, but it is very special: “Commentary: Is Japan deaf to mumps vaccination?”)

    Which explains why in 2006 when there was an outbreak of mumps in the American Midwest that out of about 2600 cases of mumps, four people lost their hearing (from the CDC MMWR of May 26, 2006 / 55(20);559-563 ). Not to mention that at least 27 had orchitis, which is very painful complication for one out of a mere hundred cases!

    Of course there is no such thing as herd immunity for tetanus. Something that as a gardener I always make sure that I keep up to date (and the next time I will get the Tdap). So Sid cannot be a parasite for that, so I wonder how he protects himself and kids from that. Does he keep everyone inside all the time, hires out household tasks like hanging pictures on the wall, and has all food delivered to keep from cutting themselves on a knife while preparing food… and not have a stapler in the house? (I once got a tetanus booster at work when I stapled my finger! Oh, that reminds me, the facility nurse got a good giggle at my expense when I returned a couple of months later when I got stung by a hornet in a windowless office. Tetanus is also transmitted by bug bites, and bugs can get indoors, a hornet nest was found in the area above the ceiling.)

  163. #163 dt
    May 28, 2009

    With you 100%.

    Parasite Sid will claim that deaths/cases from the 1960s underestimate the true number of measles cases, so death rate is likely to be less than 1 in 1000. This is probably true, but begs the question why he thinks a universal disease that kills say 1 in 5000 kids is “not serious”. He also will not have accounted for all the other nasties measles can cause as you say, including SSPE which is horrible and slow way to die (1 in 10-20 thousand cases).

    My point to him was that even with 21st century 1st World health care the fatality rates are roughly 1 in 1000. And this is “not serious”????

    I’d like to know if he recommends any vaccines actually.

  164. #164 Rev. BigDumbChimp
    May 28, 2009

    Finally I can’t believe I wasting my time trying to convince you the measles isn’t serious. People used to take kids to measles parties – and that was before Jenny McCarthy

    Stunning rebuttal.

  165. #165 sophia8
    May 28, 2009

    Finally I can’t believe I wasting my time trying to convince you the measles isn’t serious. People used to take kids to measles parties – and that was before Jenny McCarthy

    In my part of the world (UK), it was actually GERMAN measles – aka rubella – parties. Parents sent their pre-teen daughters over to any house where there was a German measles case. I was one of theose cases, and it was no party for me, I can tell you.
    This was before rubella vaccinations, and the idea was to get girls to catch it and acquire immunity well before they were old enough to get pregnant; everybody knew that catching “the German” while you were pregnant was really bad news.
    Funny how nobody holds these measles parties any more – wonder if its anything to do with the availability of rubella vaccination?

  166. #166 JohnV
    May 28, 2009

    “There’s plenty of documentation to support it. Whether or not to choose to believe it is another thing… Having said that, where’s your documentation to support the safety of injecting babies with toxic sludge :)”

    So no, there isn’t any, is your answer?

    Presumably if there was, you’d provide it. Note that anecdotal “my autistic baby got a vaccine then I noticed his autism” is not documentation, and in any case can be countered with “my non-autistic baby got a vaccine and remained non-autistic” claims.

    Furthermore, as was asked already, what’s your definition of toxic sludge? Aside from any disingenuous rebranding you might be engaged in, the dictionary supplied definition of sludge would suggest that no one thinks it is safe to inject it into anyone, let alone babies.

  167. #167 Momma Wuzzi
    May 28, 2009

    I’m commenting before I read comments, because I cannot contain the “Aha!” that happened when I started reading this.

    I was absolutely astonished when my cousin, a man in his late 30s at the time, came down with whooping cough (he lives near Littleton, Colorado, and has had more than ample opportunity to run into an unvaccinated person from Boulder). Another terrible thing about unvaccinated people running around is that older adults can have their immunization-derived immunity weaken over time and CATCH diseases they were originally immunized against.

    The refuseniks risk not only their own children but immunized adults who may be unaware that their immunity has weakened with time. They recommended to my cousin that he and his wife get boosters, and they, in turn, suggested the same to friends…

  168. #168 Momma Wuzzi
    May 28, 2009

    I’m commenting before I read comments, because I cannot contain the “Aha!” that happened when I started reading this.

    I was absolutely astonished when my cousin, a man in his late 30s at the time, came down with whooping cough (he lives near Littleton, Colorado, and has had more than ample opportunity to run into an unvaccinated person from Boulder). Another terrible thing about unvaccinated people running around is that older adults can have their immunization-derived immunity weaken over time and CATCH diseases they were originally immunized against.

    The refuseniks risk not only their own children but immunized adults who may be unaware that their immunity has weakened with time. They recommended to my cousin that he and his wife get boosters, and they, in turn, suggested the same to friends…

  169. #169 Nashville
    May 28, 2009

    A few notes to the anti vaccination clan (esp. Jenny McCarthy) on the growth of Autism.
    1) Autism includes five sub-disorders under the name autism spectrum disorder. This was not always the case. In the early 90’s the new definitions for “autism” meant greater inclusion for children previously ignored (CDC 2007). The new Autism dx definitions allow for a much larger number of individuals with “autism”. Perhaps this scenario is more likely to explain the increases in “autism” dx than the vaccination scenario.
    2) According to a 2006 study (Shattuck), there is a correlation between the increased dx of “autism” and the decrease of dx of mental retardation and learning disabilities. Perhaps the increase of “autism” is that children previously considered MR and LD are now under the umbrella dx of “autism”. This seems like a more likely scenario than the vaccination scenario.
    3) The anti vaccination element have not really defined which spectrum disorder they believe is caused by vaccinations. Rhetts? Aspergers? Pervasive developmental disorder? These disorders do not present themselves similarly and it is unlikely the causation of the disorders is the same. Rhetts only presents itself in females, meaning that at least one form of autism is genetically related; Childhood disintegrative disorder onsets after three years of age, so this one is unlikely to be caused by vaccinations. Point being that you can’t use blanket terms such as “autism” and assume it includes all autistic children in the same boat, but it seems the anti vaccination element make no distinction when using “autism”.
    4) Increased dx of “autism” is also directly correlated to the medical and educational community’s greater understanding and increased knowledge regarding “autism”. Perhaps the recent jump has more to do with this than it does with vaccination.
    5) The age of onset “appears” around when these children get their vaccinations. This also corresponds approximately to the age children start developing socially. It is when you would start to notice bizarre social behavior which is an indicator of “autism”
    6) So when does a woman who got famous for being naked for money become an expert on anything other than getting naked for money? Anti vaccination clan please find someone with a modicum of knowledge about the subject for which he/she advocates. Having a child with autism makes you an expert about your child, not the disorder or other individual’s children.

  170. #170 Jen
    May 28, 2009

    “Autism includes five sub-disorders under the name autism spectrum disorder. This was not always the case. In the early 90’s the new definitions for “autism” meant greater inclusion for children previously ignored (CDC 2007). The new Autism dx definitions allow for a much larger number of individuals with “autism”. Perhaps this scenario is more likely to explain the increases in “autism” dx than the vaccination scenario.”
    >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

    @Nash:
    Pick up a copy of Stephen Schultz’s “Autism Risk” and view the graph on page 38, for a more plausible scenario.

  171. #171 HCN
    May 28, 2009

    Stephen Schultz is a dentist, and his little tiny book (about 140 pages) was published in a vanity press that regularly solicits graduate students to print their papers.

    Jen, Nashville referenced more and better sources of information.

  172. #172 Sid Offit
    May 28, 2009

    @HCN

    (I once got a tetanus booster at work when I stapled my finger!

    You’ll do just about anything to get your hands on some vaccine won’t you

  173. #173 HCN
    May 28, 2009

    Speaking of parasites, this is the book Jen wants people to buy, from Amazon:
    Autism Risk (Paperback)
    by Stephen Schultz (Author)
    No customer reviews yet. Be the first.
    List Price: $93.07
    Price: $93.07 & this item ships for FREE with Super Saver Shipping. Details

    So, Jen, are you related to Dr. Schultz, DDS? Trying to get back some dignity after being scammed by VDM Verlag? (a little googling shows you pushing the book at Phil Plait’s blog) Read all about them here:
    http://ask.metafilter.com/67149/What-kind-of-unsolicited-publishing-query-is-this

    (Sid the Parasite demonstrates he is an unfunny idiot)

  174. #174 HCN
    May 28, 2009

    Sorry, I made a mistake. Jen was pushing that very expensive essentially self-published book on Chris Mooney’s blog (both he and Phil Plait are at Discover Magazine).

  175. #175 Nashville
    May 29, 2009

    Hey Jen,

    Thanks for reading my comment! I would suggest you pick up any books on Autism Spectrum Disorders (ASD) from the American Association for Individuals with Developmental Disabilities (AAIDD) or the Council for Exceptional Children (CEC) or the Centers for Disease Control (CDC) or the text book, An Introduction to Special Education: Making a Difference (Deborah Deutsch Smith)or the text book How Children Develop (Siegler, DeLoache, Eisenberg) or the federal act, Individuals with Disabilities Education Act (IDEA 1997) or the federal act, No Child Left Behind (NCLB 2005) as each of these acts and organizations are responsible for defining and researching ASD. I work with children with ASD as well as other developmental disabilities. We, as educators, are given a stringent set of local, state, and federal guidelines that define and describe ASD, as this is remarkably necessary to create effective and functional learning programs. These guidelines and programs are created by individuals who are more qualified than Stephen Schultz, DDS, as these individuals have devoted their life to researching ASD, not for the money (there is none in ASD research) and not for big pharma (there are no quality medications for ASD), but because they have a calling to help the most vulnerable children. I appreciate Dr. Schultz (a dentist and PhD) trying to make sense of a senseless disorder, but his book is $93 for a 132 page paperback and published by VDM Verlag (a print on demand German Publisher). I will use my $90 to maintain my membership to AAIDD and CEC (which weekly send me journals and publications about ASD) and I will continue to better understand this disorder. Just a note, the abstract on the book points out how the author believes “autism” cannot be genetic. As I pointed out in my previous comment “autism” ,according to federal guidelines, consists of five sub-disorders, not one as he indicates and Rhetts Syndrome (which is an ASD) only occurs in females, thus it is a genetic disorder as it only attacks individuals with two X chromosomes. Please, Please, Please better inform yourself with the powerful arsenal of validated research and tested knowledge that is available to those who seek it (all of the federal stuff is even free of charge).

  176. #176 Nashville
    May 29, 2009

    Interesting note, Childhood Disintegrative Disorder (an ASD), according to Mayo Clinic, has been associated with the contraction of a measles virus which in turn causes Subacute Sclerosing Panencephalitis. And note, not attributed to the vaccination virus but the actual virus itself. But I guess the anti-vaccination clan will either ignore the research or just exclude Childhood Disintegrative Disorder as a form of “autism”. Sometimes it is easier to attempt to force the evidence into a pre-formulated conclusion rather than derive your conclusion from the evidence. But the scientific method is for wussies, girly man scientists and manly girl scientists.

  177. #177 Jen
    May 29, 2009

    “Just a note, the abstract on the book points out how the author believes “autism” cannot be genetic. As I pointed out in my previous comment “autism” ,according to federal guidelines, consists of five sub-disorders, not one as he indicates and Rhetts Syndrome (which is an ASD) only occurs in females, thus it is a genetic disorder as it only attacks individuals with two X chromosomes.”>>>>>>>>>>>>>>>>>>>>>>>>>>>

    Correction: He believes that the *increase* in autism cannot be genetic. In the book, he clearly points out that some cases of autism *are* genetic, such as Rett Syndrome, tuberous sclerosis, congenital rubella syndrome, fragile X, etc. (If you’d actually read the book, you’d know this.)

    Most of the autism that we’re seeing today doesn’t fit into any of these categories, and has no known cause.

    “Sometimes it is easier to attempt to force the evidence into a pre-formulated conclusion rather than derive your conclusion from the evidence”>>>>>>>>>>>>>>>>>>>>>

    I’m laughing here, because that is *exactly* what I think many autism researchers are trying to do…they so want to believe that autism is genetic, (or merely broadening of the diagnostic criteria) and therefore, spend all their time and research dollars into finding the gene responsible. It’s so much more palatable to believe that autism is genetic, because then there’s no one to blame…it’s just faulty genes! Tough noogies!

    To be fair, that’s likely what *I’m* trying to do as well. I see a clear association between Tylenol and autism, therefore, I’m more likely to seek out evidence that supports that association. (So far, though, there is no evidence that *refutes* it, so I’ll continue to believe it until proven otherwise.)

    http://www.blacktriangle.org/figure2.jpg

    Remember the Tylenol poisonings of 1982 and 1986? In the above graph, autism rates clearly plateaued and even dropped a little when Tylenol was briefly removed from the market.

    (Of course this could be just a coincidence, too, just to be fair.)

  178. #178 HCN
    May 29, 2009

    Jen said “(If you’d actually read the book, you’d know this.)”

    Jen, no one in their right mind is going to shell out over $90 to buy that little self-published book by a dentist!

    Here is a hint: Reference the original research that is at http://www.pubmed.gov … it is much easier to get that stuff in a library, and many of the papers are becoming available online for free.

    Also, Nashville, I appreciate what you are saying. But I would appreciate it more if you would use paragraphs. The wall of text is hard to read.

  179. #179 HCN
    May 29, 2009

    Jen, why did you just link to a graphic in the blacktriangle site? Did you not know that Anthony Cox wrote an editorial about Dr. Schultz’s little study, especially about his shady recruitment methods (from two internet autism parent groups, a self-selected group)? Also that graph was from Dr. Cox’s blog posting dated January 23rd, 2008, titled (and this is very funny that you decided to use it): “A case study of a graphical misrepresentation: Drawing the wrong conclusions about MMR vaccine.”

    Jen, you do have your heart in the right place, but I fear you have found one little study, and are running away with it (and I suspect the $93 book is actually Dr. Schultz PhD thesis, because that publisher specializes in finding graduate students to do a print on demand their dissertations). You could have just as easily pointed us to the Autism journal that his paper was published in (Autism. 2008 May;12(3):293-307, “Acetaminophen (paracetamol) use, measles-mumps-rubella vaccination, and autistic disorder: the results of a parent survey.”), plus we could have also looked up the reply from Dr. Cox (Autism. 2009 Jan;13(1):123-4; author reply 124-5).

    I have an idea, Jen. Go to the back of that little book of yours and just list out the PubMed references that support Dr. Schultz’s main ideas.

    Because, trust us… we are not going to buy that little expensive book by a dentist when there are much better books around. Like:

    Unstrange Minds by Roy Grinker , there is a website at http://www.unstrange.com/ … this author also has an autistic child, but as an anthropologist he studies the cultural perceptions of autism in other countries like Korea and India. It is still available at my local library.

    Not Even Wrong by Paul Collins, he also has an autistic son, but he is more of a literary historian. So he goes back into time to find stories in the literature on people who would now be considered autistic. No longer available at my local library, but it may be at another library (and a used copy could be had for less than $5 at Amazon)

    The Science and Fiction of Autism by Laura Schreibman, her office webpage at UC San Diego is http://psy3.ucsd.edu/~autism/ , which is where Dr. Schulz got his PhD (what is that PhD in? And why is he now working for the Navy?). Also still available at my local library.

    I would also strongly suggest you read this book on how to understand the bias and interpretation of scientific studies:
    Lies, Damned Lies, and Science by Sherry Seethaler (also available from my local library)

  180. #180 Nashville
    May 29, 2009

    Jen,
    The increased in “autism” couldn’t possibly be an increase in diagnoses due to an increase in recognition, it is due to one of the safest and most tested drugs on the market drugs. You have made my day. Forget whooping cough, I’m gonna die from laughter.

    The dentist and you are both using VERY specious reasoning. Here is a suggestion; Volcanoes were responsible for the drop in “autism” in 1982-1983. My hypothesis is that the ash that fell from Mount St. Helen got into the lungs of women and pregnant women preventing an increase in autism. Maybe that is just a coincidence.

    How about the invention of video games, maybe that causes “autism”. There is a direct correlation between the increase of “autism” and the increased popularity of video games. Maybe that’s just a coincidence.

    Maybe it was the birth of my brother. Since my brother was born there has been an exponential increase in “autism”. Maybe that’s just a coincidence.

    Maybe it’s books about how vaccinations cause autism. Since these pieces of tripe have been published, we’ve seen “autism” diagnosis increase.

    As I have stated, “autism” dx’s have increased, but mental retardation and learning disabilities have decreased (Shattuck 2006). So the autism increase is either an actually increase in the dx of children previously considered not autistic who would have been dx as mentally retarded or vaccinations increase “autism” but decrease mental retardation and learning disabilities. The later sounds pretty ridiculous to me, but then again vaccinations do prevent diseases that cause brain damage.

    There is also some fairly interesting abstracts on the site HCN recommended http://www.pubmed.gov about how there is, in fact, no correlation between the increase in autism and vaccinations. But that doesn’t fit in your mental model so I am pretty sure you’ll just ignore or dismiss those.

  181. #181 Nashville
    May 29, 2009

    Sorry, meant ‘latter’, not ‘later’. And sorry to HCN about paragraphs, I use them when I compose in Word but the indents and line spacing don’t translate to the HTML of the posting forum. It won’t happen again.

  182. #182 Jen
    May 29, 2009

    “it is due to one of the safest and most tested drugs on the market drugs.”

    Now, you’re making me laugh. Tylenol safe? That surely speaks to the power of marketing. Who says it’s safe? Johnson and Johnson? “Nothing’s safer?” Bah!

    Why don’t YOU go to pubmed and type in “acetaminophen and asthma” or “acetaminophen and liver failure” and then come back and tell me how “safe” you think Tylenol is.

  183. #183 Bronze Dog
    May 29, 2009

    It’s been a while since someone brought up the decrease in mental retardation diagnoses. I remember a graph from somewhere that showed it over time alongside ASD’s. The decrease in mental retardation diagnoses pretty much exactly matched the increase in ASD diagnoses. I need to look that up, sometime, though I’m sure one of you will know what I’m talking about right offhand.

  184. #184 Nashville
    May 29, 2009

    Tylenol was taken off the market, not all Acetaminophen was. It remained in use in hospitals and in generic form. Or are you suggesting the little red “Tylenol” on the pill is responsible.

  185. #185 Jen
    May 29, 2009

    Jen, you do have your heart in the right place, but I fear you have found one little study, and are running away with it >>>>>>>>>>>>>

    Not exactly. I started suspecting Tylenol was causing problems in my older son before I even came across that study.

  186. #186 Jen
    May 29, 2009

    There is also some fairly interesting abstracts on the site HCN recommended http://www.pubmed.gov about how there is, in fact, no correlation between the increase in autism and vaccinations.>>>>>>>>>>>>>>>>>>>

    You must have me confused with someone who believes that vaccines cause autism. I don’t. I believe that TYLENOL causes autism, with or without vaccines.

    Clear enough?

  187. #187 nottylenol
    May 29, 2009

    Tylenol doesn’t cause autism, Jen. Clear enough?

  188. #188 dean
    May 29, 2009

    “I believe that TYLENOL causes autism, with or without vaccines.

    Clear enough?”

    Yes – you believe in something for which there is absolutely no scientific support. Do you believe in unicorns too?

  189. #189 notmercury
    May 29, 2009

    Hey, no need to bring the poor defenseless unicorn in to this.

  190. #190 Rev. BigDumbChimp
    May 29, 2009

    (So far, though, there is no evidence that *refutes* it, so I’ll continue to believe it until proven otherwise.)

    And what evidence other than your confirmation bias, anecdotal retelling and one questionable study is there?

    I believe that TYLENOL causes autism, with or without vaccines.

    Which means nothing if you can’t show some things that actually backs that up. You can believe a lot of things, but that is not the same thing as saying, “Look what I’ve found this shows that Tylenol is responsible for Autism”.

    cum hoc and post hoc gone wild!!

  191. #191 Jen
    May 29, 2009

    Which means nothing if you can’t show some things that actually backs that up.>>>>>>>>>>>>>>>>

    I know that.

    ::sigh:: I give up.

  192. #192 Rev. BigDumbChimp
    May 29, 2009

    I know that.

    ::sigh:: I give up.

    Then why do you “believe” it?

  193. #193 Jen
    May 29, 2009

    “Then why do you “believe” it?”>>>>>>>>>>>>>>>>>>>

    I cannot “show” anyone here how my autistic son behaves when he ingests Tylenol. I can describe it, which I have done in the “We Support Andy Wakefield?” thread from February. But even then, it’s only my own anecdote, which I am well aware is not sufficient evidence for anyone but me.

    All I *can* do is show the evidence that acetaminophen is being linked to asthma and allergies, likely d/t glutathione depletion, and hope that others will see a similar parallel wrt autism.

    But, I do understand that until it’s written up in a peer-reviewed journal and verified by other researchers, no one here is going to just take my word for it.

    That is what I meant when I said, “I give up.”

  194. #194 Chris
    May 29, 2009

    A little bit of a timeline:

    Two things happened in the early 1970s:

    1) The MMR was introduced.

    2) Acetaminophen was introduced.

    Then in the 1980s aspirin, or salicylic acid was discovered to contribute to Reye’s Syndrome, so starting in 1980 there were recommendations to not give children aspirin. (I confess I used Wikepedia)

    One can assume that children started to be given acetaminophen/Tylenol with their vaccines in the early to mid-1980s. I wouldn’t know… I just collected a stockpile of the little tiny baby Tylenol bottles with the droppers. My kids never really needed the stuff.

    Personally, I think the increase in autism diagnoses more closely corresponds to both the change in the DSM and IDEA definitions in the early to mid-1990s.

  195. #195 Jen
    May 29, 2009

    Personally, I think the increase in autism diagnoses more closely corresponds to both the change in the DSM and IDEA definitions in the early to mid-1990s.>>>>>>>>>>>>>>>>

    Then how do you explain the very clear increase in the 1980′s as shown in the graph I referenced?

    BTW, acetaminophen has been around for years…(I think the children’s version was introduced in the 1950′s.)

  196. #196 Dedj
    May 29, 2009

    Explain what Jen?

    Your graph details the number of people with autism enrolled in Regional Centres – not the incidence of autism as you implied above.

    Without additional context your graph explains nothing, nor does it provide a challenge to anything, thus it requires no explanation.

    Except from you.

    Off you go then.

  197. #197 HCN
    May 29, 2009

    Jen, the graph you referenced was from this blog posting:
    http://www.blacktriangle.org/blog/?page_id=1701

    (I would have linked to it earlier, but I was at my URL limit).

    Did you notice the title of that blog posting? Did you read what the authors wrote about that graph?
    It says:
    “The authors of the California report were making the case to the legislature for increased departmental funding- theirs was not an academic study.”
    and:
    “Instead of using a time-series graph, the authors of the California report should have used a bar chart. In fact, they should have used a specific kind of bar chart: a histogram.”

    Also, the owner of BlackTriangle, Dr. Anthony Cox (who I first “met” on Usenet years ago), has responded to Schultz’s article on MMR and acetaminophen: It was a poorly done survey. I’m sure you will be able to to get a copy from your local library (or medical school library, also some therapists who deal with autistic children get the Autism journal):
    http://www.ncbi.nlm.nih.gov/pubmed/19176580

  198. #198 Joseph
    May 29, 2009

    Jen, the graph you referenced was from this blog posting:

    Hmm, I have that autism data. As reported in 2007, it looks a little different. It’s more smooth. The rise starts in about 1981.

    As reported in 1995, it looks more like that graph. Basically, a number of autistics born in those years have been registered with DDS as autistic since that graph was made. Bigger caseloads have made the series more smooth, as expected. The noisiness of the older graph has to be an artifact of the low caseload numbers.

    If you want to do a more proper analysis, you need to calculate caseload (and then prevalence) by age across report years, e.g. number of 3 year olds from report years 1980 to the present.

    Since the trends could be (read: are likely) coincidental, you need to control for that. In a multivariate model, you could include ‘year’ as a variable. Another way is to detrend the series.

  199. #199 Jen
    May 31, 2009

    “The rise starts in about 1981″

    So we agree that autism rates start spiking one year after Reye’s Syndrome’s link to aspirin in 1980?

    That’s quite a coincidence, eh?

    “As reported in 1995, it looks more like that graph. Basically, a number of autistics born in those years have been registered with DDS as autistic since that graph was made. Bigger caseloads have made the series more smooth, as expected. The noisiness of the older graph has to be an artifact of the low caseload numbers.”

    Actually, I think that graph I referenced is more telling, because it likely only included cases of full-syndrome autism, and not the milder cases. (PDD, Asperger’s)

  200. #200 Daniel
    June 2, 2009

    I would love to see the anti-vax movement succeed completely, if only for the satisfaction of seeing how they like the results.

  201. #201 Joseph
    June 2, 2009

    So we agree that autism rates start spiking one year after Reye’s Syndrome’s link to aspirin in 1980?

    That’s quite a coincidence, eh?

    Excuse me? It’s also one year after the discovery of Janus, a moon of Saturn. Of course it’s a coincidence.

  202. #202 Dedj
    June 2, 2009

    “So we agree that autism rates start spiking one year after Reye’s Syndrome’s link to aspirin in 1980?

    That’s quite a coincidence, eh?”

    Well, yes. Reyes’ Syndrome has been around for quite a while, as has aspirin use.

    Funnily enough, diseases exist before they’re discovered. There is thus no reason to associate incidence of one with discovery (or discovery of aetiology) of another.

    So tell me – what factor in 1980 could possibly have linked the two? It cannot be the discovery of the aetiology of aspirin-induced Reyes – that’s an academic , not environmental change

  203. #203 Jen
    June 2, 2009

    So tell me – what factor in 1980 could possibly have linked the two? It cannot be the discovery of the aetiology of aspirin-induced Reyes – that’s an academic , not environmental change>>>>>>>>>>>>>>>>>

    The *increase* in the use of acetaminophen as a result of aspirin’s link to Reye’s Syndrome is the environmental change.

  204. #204 Chris
    June 3, 2009

    Jen, you might find this helpful:
    Correlation

    and this:
    Statistics

  205. #205 flim flam
    June 3, 2009

    hmmm…1980, what other environmental factors might we consider… how about mc hammer pants? might lead to an increase in sperm levels or something leading to use of paracetamol..leading to..that’s right! autism!. Doh, how could we have been so blind?. Or maybe big old dynasty style shoulder pads putting pressure on womens shoulder nerves, leading to them take paracetamol, getting pregnant to the men in mc hammer pants and producing children who then become instantly autistic after having paracetamol!. We need more studies! quick ,call the American journal of shit i made up! ( the AJoSIMU)

  206. #206 Joseph
    June 3, 2009

    Something that started to pick up in the early 1980s was the number of internet hosts. In 1979 there were 188 hosts. By 1983, there were 562 hosts. By 1989, there were 159,000 hosts. Of course, it just exploded after that, especially after the invention of the world wide web in 1992. Similarly, the number of autism diagnoses started to explode in the early 1990s, but the late 1990s and early 2000s were the period of biggest growth (both for autism and the internet).

  207. #207 Jen
    June 4, 2009

    Very amusing, Chris, Joseph and flim flam…

    I do realize that an association between Tylenol and autism might be quite a slap in the face for modern medicine as a whole, after hearing for so many years that “nothing’s safer!” from the good folks at Johnson and Johnson.

    Believe what you like, but there is a *definite* association between acetaminophen and asthma and allergies, (also on the rise since the 1980′s) and I can provide PLENTY of evidence of that.

    Hopefully, this dangerous drug will be permanently removed from the market soon.

    I won’t hold my breath, though.

  208. #208 dean
    June 5, 2009

    ” I can provide PLENTY of evidence of that.”

    Do it Jen, or stfu.

  209. #209 Joseph
    June 5, 2009

    Very amusing, Chris, Joseph and flim flam…

    I was being half serious, actually. What people call the “autism epidemic” could easily be an artifact of the information age, and enabled by an ever-broader understanding of what autism is. This hypothesis explains several aspects of the “epidemic” that other hypotheses cannot.

    Jen, do you even have something as basic as data on Tylenol sales by year?

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