The ethics of vaccine refusal: Vaccine refuseniks as freeloaders

Vaccines have saved more lives and prevented more suffering than any medical invention ever conceived by humans. However, to be most effective, a large enough fraction of the population to produce herd immunity needs to be immunized. When the herd immunity threshold is reached, then the chances of anyone carrying a microorganism to cause disease drops, leaving no reservoir of infectious agent to facilitate disease spread. The end result is that the unvaccinated are also protected, which is important for children who can't be vaccinated because they are either too young, have a medical contraindication to vaccination, or are among the fraction of people for whom the vaccine doesn't produce lasting immunity. Herd immunity also, ironically enough, protects vaccine refuseniks, too.

The exact fraction necessary for herd immunity varies depending upon the vaccine and the disease, but it's usually somewhere around 90%. As long as the percentage of vaccinated children stays above herd immunity, there's no serious problem; outbreaks can't propagate. But, as vaccination rates fall, outbreaks become possible. In any case, the question of vaccine refuseniks raises an interesting ethical problem, namely how vaccine refuseniks obtain most of the advantages of vaccination without taking upon themselves any of the even tiny risk of being vaccinated.

Janet Stemwedel has written a lucid and nuanced piece about the bioethical questions involved in vaccine refusal and concludes that, yes, vaccine refuseniks are free riders.

Key quotes:

I understand that the decision not to vaccinate is often driven by concerns about what costs those who receive the vaccines might bear, and whether those costs might be worse than the benefits secured by vaccination. Set aside for the moment the issue of whether these concerns are well grounded in fact. Instead, let's look at the parallel me might draw:

If I vaccinate my kids, no matter what your views about the etiology of autism and asthma, you are not going to claim that my kids getting their shots raise your kids' odds of getting autism or asthma. But if you don't vaccinate your kids, even if I vaccinate mine, your decision does raise my kids' chance of catching preventable infectious diseases. My decision to vaccinate doesn't hurt you (and probably helps you in the ways discussed above). Your decision not to vaccinate could well hurt me.

The asymmetry of these choices is pretty unavoidable.

And:

But if a significant number of people disagree, and think the potential harms of vaccination outweigh the potential harms of the diseases, shouldn't they be able to opt out of this social contract?

The only way to do this without being a free-rider is to opt out of the herd altogether -- or to ensure that your actions do not bring additional costs to the folks who are abiding by the social contract. If you're planning on getting those diseases naturally, this would mean taking responsibility for keeping the germs contained and away from the herd (which, after all, contains members who are vulnerable owing to age, medical reasons they could not be vaccinated, or the chance of less than complete immunity from the vaccines). No work, no school, no supermarkets, no playgrounds, no municipal swimming pools, no doctor's office waiting rooms, nothing while you might be able to transmit the germs. The whole time you're able to transmit the germs, you need to isolate yourself from the members of society whose default assumption is vaccination. Otherwise, you endanger members of the herd who bore the costs of achieving herd immunity while reaping benefits (of generally disease-free work, school, supermarkets, playgrounds, municipal swimming pools, doctor's office waiting rooms, and so forth, for which you opted out of paying your fair share).

Which is what I've been saying all along: Sure, go ahead and don't vaccinate. But don't expect to go to public schools, day care centers, or any place else with high concentrations of people among which infectious disease can be spread. Isolate yourself geographically, if necessary. Anything less, and you are a freeloader. (Janet is too nice.)

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As long as the percentage of vaccinated children stays above herd immunity, there's no serious problem; outbreaks can't propagate. But, as vaccination rates fall, outbreaks become possible.

I thought that herd immunity meant that outbreaks would be rare and small, not nonexistent.

By Matthew Cline (not verified) on 08 Jun 2009 #permalink

I have been (mildly) amused by those commenters (there and elsewhere) who do not think they are part of the "herd" or should be part of the "herd".

Evolutionarily, humans have always been "herd" animals (or the more politically correct "social animals"). Very few humans can exist as a solitary being (or animal). Even anti-herd animals like cats need to interact with their own kind once in a while (and some like the African lion are social). Despite protestations of "freedom!" and "independence!", what one person does can effect another.

I, as a landowner, know this all too well when my uphill neighbor decided to cover her back yard with concrete. This then caused storm run off to flow off of her backyard and into my garage and basement. (sorry, nothing to do with disease spread, I just had to gripe)

Though, more seriously, I do have a child with several health issues. He needed to be protected by herd immunity for both pertussis and measles before he turned one year old (late 1988- early 1990). The former because of health issues, the latter just because of his age... and yet herd immunity for BOTH pertussis and measles did not exist!

Why should he be "selected" out due to the decisions of a few? While he was protected by diligent efforts of his parents from pertussis and measles, why should that have been necessary?

"It should be noted that "free-rider" is a pretty nasty name for an ethicist to call you!"

Free-rider is a technical term.

Doazic said "Free-rider is a technical term."

Please explain, por favor. I tried reading your web page but then realized my high school Spanish was insufficient (and then never pursued it any further since engineers don't have to be multilingual... well, unless you are from Chile and studying in the USA like the dad of one of my kids' classmates).

They know full well that they're free loading parasites. Sears even advises parents who don't vax to keep it quiet. Being antivax only works while the herd immunity is high, once it drops the dangers to everyone rise. They are in an unsustainable position, it only works for the freeloaders if the rest of us continue to vax so their kids can get a free ride. It will be hard to maintain the fantasy that A) vaccines don't prevent disease & B) VPD are harmless & only brown babies in faraway places die from them, when the outbreaks get bigger and more frequent.
Pertussis is harmless! just a bad cough, until your baby dies choking and turning blue.
Measles is healthy! we all survived, apart from the kids that died or were left disabled..Hib isnt a risk! no need to vaccinate!, just enjoy watching your child die a painful and preventable death.
I hope Dr Jay, Jenny mcjugs, Sears and the rest of the self promoting bigCam shills can live with themselves once the bodycount starts to rise. Might be facing a few difficult questions. Warrior moms, vain pompous fuckwitted physicians, blinded by the lure of fame and a spot on saint oprah's world of woo. you disgust me.

By flim flam (not verified) on 08 Jun 2009 #permalink

Practicing medicine in North Idaho I met an annual pertussis epidemic in the late 1990's. Not much fun for the patients or our clinic staff. The state then pushed vaccines harder and it has gone away. Marvel of marvels , vaccine rates do matter.

Unfortuantely we had an infant death from the disease before everyone got serious. When vaccines work, there is a natural loss of fear of these diseases, but when a baby dies, the fear returns quickly. I guess this is the natural order of things.

By ROLF A NESSE (not verified) on 08 Jun 2009 #permalink

Many anti-vaxers don't think they are freeloading parasites. They think they are pursuing "natural" interventions that will "boost their child's immune system". Presumably, they think that a healthy diet and supplements will be just as effective as vaccination in preventing childhood diseases.

This attitude mostly shows how little anti-vaxers know about the immune system. Highly contagious diseases tend to be highly contagious because they have tricks to enable them to gain a foothold in your body before your immune system can flush them out.

It doesn't matter how "boosted" your immune system is -- your kid *will* get sick and your kid *will* have a protracted course of illness before immunity is gained and the body is victorious. There are no vitamins, minerals, herbs, or lifestyle changes that can prevent the measles (aside from living in a bubble).

Only vaccines truly prevent disease.

I guess this now brings us back to the age old question of autonomy. I'm from the uk, and so may have a slightly different outlook to you guys, but it seems that two issues are at play here - the fact that it's the child's health at stake, and not the health of the parent who takes the oh-so-very-middle-class decision not to vaccinate, and the fact that that decision has wider implications.

If only it wasn't totally ethically bogus to bring in compulsory vaccination... Actually, is it? We have to report certain diseases, and we can compel patients (here, no doubt in america too) who have certain mental health problems to undergo treatment. Clearly, autonomy is not absolute; even less so when the decision maker is making ill-informed decisions for someone else...

alex, I think the timing now is all wrong for compulsory vaccination in the UK (or even the 'no vaccination, no school' version). The government has no political capital left to put a decision like this through, and it fits too well with its image as presented by the opposition parties - it would be a no-win. Ironically, as and when we have a Tory government (which I am pretty gloomy about, but am trying to be neutral!) they might be lobbyable on this one. It's often the party that is apparently politically opposed to the issue that will put something through, just because it only bothers their core voters, and just after an election win they can afford to do that.

I suppose I'm not actually that keen on compulsory vaccination, but it's easy for me as I would have been happy to give my son all the vaccinations available on day 2 of his life, and he appears to have excellent immunity.

By artsgraduate (not verified) on 09 Jun 2009 #permalink

For some time I have followed the work of Dr. Gary Null, who claims that the implication of large scale vaccinations coincided with increased sanitation standards, and that it was the higher level of sanitation that helped to stop the spread of diseases as much as the vaccinations.

He also claims that rates of autism and ADHD began to increase when vaccinations became more commonplace, which may or may not be related to the supposed mercury content of vaccinations.

I have not done any research myself to validate what he has said, but I am inclined to consider it, because Dr. Null seems to be a trustworthy source, at least in matters of nutrition (I believe his degree is in nutrition, but don't quote me on that).

I suppose that I must ask this: Are the fears that some people have about vaccinations unfounded? Or does the correlation between vaccinations and childhood diseases that Dr. Null supposedly found indicate that vaccine contamination could be causing these problems?

If we maintain this herd immunity, how do those who choose to not get vaccinated threaten those who have? I would guess that the reason is that vaccinations are not always 100% effective, but I am not particularly well-versed on this subject, which is why I ask.

How are those who choose to avoid vaccinations "free-riders"? It seems to me that it is most likely that most vaccinations are quite safe, and that the potential benefits outweigh the risks, but I would only consider someone a free-rider in this case, if they knew that vaccines were safe, yet still chose not to recieve them. Discussing refusal for religious reasons kind of gets into a different subject, and of course if there is some medical reason preventing vaccination, that's also different.

I do see the ethical implications here, but I think the issue is more medical in nature, i.e. it shouldn't be 'who is to blame for starting an epidemic by not vaccinating their children', so much as it should be 'why do people not understand that vaccinations are safe and effective'. To me, that seems to be the main concern of those who refuse vaccinations (they do not understand them).

Case in point: I understand very little of how vaccinations work. As far as I know, the flu vaccination works by introducing a deactivated virus into your body, so that it can quickly identify it and destroy it it a later time when exposed to the "live" virus. This doesn't make sense to me, as a deactivated virus would not be seen as a threat...It wouldn't try to inject cells with RNA to replicate itself.

If I was a M.D. I am sure I would understand this. Even though I am not, I am sure I could understand it better than I do, if a doctor would explain it to me. Unfortunately, at least in my experience, doctors are not very forthcoming about explaining how anything they do or use works.

Anyway, sorry for kind of rambling there. Very interesting blog! Thanks for your time, and sorry for all the questions!

"Freeloading parasites" sounds very like Ayn Rand, utopian stuff, which has been smashed down time and again. Just play the xbox game Bioshock, you'll see what I mean.

"For some time I have followed the work of Dr. Gary Null, who claims that the implication of large scale vaccinations coincided with increased sanitation standards, and that it was the higher level of sanitation that helped to stop the spread of diseases as much as the vaccinations."

An effective vaccine against measles was first introduced in the 60s which is considerably after the improvements in sanitation standards. It was not until the introduction of the measles vaccine that infection rates began to decrease.

Now general improvements in health, be it from improved nutrition or sanitation, will mean that those who became infected with measles may have been better able to fight the infection but they did not stop the spread of infection, and nor did they stop the severe complication measles can cause.

By Matt Penfold (not verified) on 09 Jun 2009 #permalink

Australia has taken the free-riding to the next level. The Australian Government offers a Maternity Immunisation Allowance paid as an incentive to have your children immunised.

You guessed it - the "Conscientious Objectors" also qualify and get the incentive payment - for doing the exact opposite of what the incentive is meant to encourage.

Is there a more nuanced view of vaccines or does it have to be a love-it-or-leave-it mentality?

Question asked four times by two people or one person using different screen names. Sowieso.

The mainstream view of vaccines IS the nuanced view. Some vaccines are simply no-brainers. MMR or measles? Easy. Hepatitis B vaccine or hep B infection with attendant risk of hepatocellular carcinoma and risk of spreading the virus to your loved ones? Easy. Rabies vaccine? Not so easy-at least not for everyone. If you're a vet or explore caves for a living, definitely. If you've been bitten by a rabid animal, the choice is get the vaccine or die. The average risk person with no exposure, probably not worth it. Small pox vaccine? Not needed any more-thanks to vigorous mandatory vaccination programs. It could be the same with measles and a number of other diseases which are human transmitted only. But ONLY if people cooperate and we get this freeloading problem under control.

And to build on Dianne's comment, one message I would like to see preached to the anti-vaxers is "Do it for your children's children."

If someone has decided that their child's well-being is paramount and they won't compromise anything for that (even if it means other people's children dying), you are not going to change their mind. However, perhaps their selfishness can be redirected? For viral vaccines, especially the highly effective ones like MMR, if vaccination rates stay high enough then nobody will have to get those vaccines anymore. If you are REALLY anti-vaccine, and forward thinking, then you should want vaccination rates (at least for highly effective virus vaccines) to be as high as possible, so that someday those vaccines won't be given to anyone.

By refusing to vaccinate your own child, you are cursing your children to have to make the same difficult decision as you when they start a family. That's not even selfish -- it's just short-sighted.

By James Sweet (not verified) on 09 Jun 2009 #permalink

I also want to add another response to claims that it is improvements in santitation that account for the reduction in diseases for which children are routinely vaccinated.

If vaccines played no role, then the providing santitation standards stayed the sane, we would not expect to see a change in the incidents of the diseases the vaccines are intended to prevent. Thus given no change in sanitation standards changes in the uptake of MMR would not result in a change of the incidence of measles, mumps or rubella.

Well we have tried that experiment, and the data is in. The evidence is conclusive. When MMR uptake decreases we see more measles, mumps and rubella. The experiment has been tried in both the US and the UK with same result, and in neither country have levels of sanitation changed significantly. The sanitation hypothesis is thus disproved.

By Matt Penfold (not verified) on 09 Jun 2009 #permalink

Case in point: I understand very little of how vaccinations work. As far as I know, the flu vaccination works by introducing a deactivated virus into your body, so that it can quickly identify it and destroy it it a later time when exposed to the "live" virus. This doesn't make sense to me, as a deactivated virus would not be seen as a threat...It wouldn't try to inject cells with RNA to replicate itself.

Your immune system is designed to detect and eliminate any foreign particles, whether they are currently a threat or not. Many viruses and bacteria are actually harmless until a certain number of them is reached, so your immune system tries to eliminate them before the disease-causing threshold is reached. Most vaccines also contain adjuvants which provoke an immune response and make it even more likely that your immune system will react to the foreign particles.

For some time I have followed the work of Dr. Gary Null, who claims that the implication of large scale vaccinations coincided with increased sanitation standards, and that it was the higher level of sanitation that helped to stop the spread of diseases as much as the vaccinations.

Perhaps Gary can tell us what sanitary improvements happened in the USA in the 1960s to cause measles and polio to vanish so suddenly. I mean, did New York City finally get around to putting in water treatment and sewers or something?

Or how about the sanitation improvements around 1990 that caused the near-disappearance of invasive HiB infection. Why did the sanitation improvements of the 1960s have no impact on HiB?

Absent some answers to those (and other, but let's keep it simple) questions, Occam's Razor strongly suggests the rejection of the Null hyptothesis.

By D. C. Sessions (not verified) on 09 Jun 2009 #permalink

I agree with Cat @ #8. I don't think that many of the anti-vaxers believe that there IS such a thing as herd immunity. They really do believe that with better sanitation, and modern medical care, infectious disease is no big deal. People like JB Handley are certain that they have found the secret to decreasing the rate of autism in the population. It MUST be something about vaccines. That's why they keep looking for one scapegoat after another. First it was mercury, then aluminum, then it is too many too soon . . . They'd like to see everyone stop vaccinating, or vaccinate very minimally. That way, in their world view, autism rates would automatically fall. They have whipped each other up into such a frenzy about autism that they believe it is worse than any/all infectious diseases.

By Broken Link (not verified) on 09 Jun 2009 #permalink

I agree with Cat @ #8. I don't think that many of the anti-vaxers believe that there IS such a thing as herd immunity. They really do believe that with better sanitation, and modern medical care, infectious disease is no big deal.

They have to. They've come to their conclusion, and anything that casts even the slightest doubt on it must be forcefully rejected.

If that means that mathematics and the germ theory of disease must be false, then so be it. And, no, I'm not exaggerating.

By D. C. Sessions (not verified) on 09 Jun 2009 #permalink

"Vaccines have saved more lives and prevented more suffering than any medical invention ever conceived by humans."

I was taught that socio-economic changes (improved working and living conditions, better hygiene, better food, et cetera) did more for the decline in morbidity and mortality (in general) than specific medical treatments. That is, for the community at large. Am I wrong in saying that only on an individual level does your statement apply?

Or, if you disagree, would you say that anesthesia (extended the possibilities of surgery) and antibiotics have brought us less than vaccins?

By Tsutsugamushi (not verified) on 09 Jun 2009 #permalink

Merddin said "For some time I have followed the work of Dr. Gary Null"

That was your first mistake (he is not a real doctor). To add on to what DC Sessions said, if sanitation was the reason why are Japan, UK, Switzerland and other countries seeing an increase in measles? Is it related to the reduction of sanitation or vaccine uptake?

TexDoc, Orac wrote about that paper here:
http://scienceblogs.com/insolence/2009/05/one_more_time_vaccine_refusal…

"I was taught that socio-economic changes (improved working and living conditions, better hygiene, better food, et cetera) did more for the decline in morbidity and mortality (in general) than specific medical treatments. That is, for the community at large. Am I wrong in saying that only on an individual level does your statement apply?

Or, if you disagree, would you say that anesthesia (extended the possibilities of surgery) and antibiotics have brought us less than vaccins?"

Vaccines get to claim the eradication of Smallpox, which gives them a huge leg up on the contenders.

But really, when it comes down to a "Who is more awesome?" debate between antibiotics, clean water and vaccines, you're really just splitting hairs. The answer is they all have a profound impact on the modern world and our conception of health - and people only talk about getting rid of one of them. If you said "Yeah, I'm going to take a pass on antibiotics" or "We don't *really* need clean water" you'd rightly be regarded as a lunatic.

"Australia has taken the free-riding to the next level. The Australian Government offers a Maternity Immunisation Allowance paid as an incentive to have your children immunised".

Actually if you were really interested in understanding the concept between increased vaccinations and the increased rates of chronic diseases/autism (developmental issues)... Look no further than Australia. Australia would make a great case study. Their vaccination policies changed in approximately 1997. They put into place the "Immunise Australia Program" complete with payments for doctors and parents who fully vaccinated their kids, childcare rebates if you followed the rules, increased pressure for kids to be vaccinated before they went to school, they added a few vaccines, they had "immunisation days", etc. etc.

Sounds great, right? Until you realize that their rates of type 1 diabetes and autism skyrocked after that.... Wonderful, just wonderful.

ps. I'm sure that other medical conditions increased as well such as allergies, asthma, etc... but the two above are pretty obvious with a 'google search'. :)

By Parental Choice (not verified) on 09 Jun 2009 #permalink

The problem is some of the anti-vax dipshits have latched onto vaccines "shedding" and making kids sick. They love to counter the herd immunity concept with fears about how my vaccinated child will infect their little darling with scary bio-engineered diseases! Of course, their beliefs are completely evidence and science free, per usual.

To put their logic in proper perspective, they just spent a the weekend raving over Jock Doubleday's "Challenge". And one of the moderators ran off a couple people in the process for not "supporting" the crazies.

Thanks HCN. That one got by me.

Thank you Matt Penfold, Kierra, D.C. Sessions, HCN, and everyone for answering what might have sounded like some foolish questions. I had never questioned the safety of vaccines until I had heard of the supposed autism connection. I watched a speech that Mr. Null (I suppose I shouldn't say Dr. Null, heh) had made in which he talks about his concerns about vaccines. After that I hadn't really thought about it much until I stumbled upon this page. It's hard to know who to trust these days!

The problem is some of the anti-vax dipshits have latched onto vaccines "shedding" and making kids sick.

I wonder if any anti-vax parents will ever try suing some pro-vax parents because of this "shedding"?

"My neighbor's kid gave my kid autism via indirect vaccination!"

By Matthew Cline (not verified) on 09 Jun 2009 #permalink

Matthew Cline said: I wonder if any anti-vax parents will ever try suing some pro-vax parents because of this "shedding"?

I dunno, but myself and a few other parents have a long list of threads saved off that we intend to use should any local child die of a vaccine preventable disease. We need to make sure the anti-vaxers are properly associated with the fruits of their efforts.

ababa,

You are correct. Children that have been vaccinated with live viral vaccines are not measured for contagion, only seriopositivity. The measles-like side effects listed on the circular that result from MV are, well, pretty circular in this regard. And I do believe the insert states this shedding can last several weeks, I presume it's because the body is unable to fully eliminate the attenuated threat... no evidence to support that of course, as many suggest, they just lop every possible problem of vaccinating and none of it is actually real?

Speculation aside, the ethics of this are quite easy. Present legislation to your Congressperson that outlines a person's contractual obligation to participate in society. Present your evidence alongside. If it's as much of a no-brainer as we all seem to believe, it should pass through with flying colors.

I'm sure there is someone out there who is willing to sue an unvaccinated person claiming they infected either themself, or their child with disease causing agents for which there is a vaccine. I know plenty of defense attorneys who would gladly defend such a case pro-bono. Then maybe we can just get straight to brass tacks.

Seriously, continuing to talk about how all that is required is a single lawsuit, or dead children from outbreaks seems a little disingenuous. If we truly believe that mortality (not morbidity, which has a way of lending a bit of obfuscation due to confounders like heightened awareness etc...) shall rest on vaccine refusers, and they are free-riders of the benefits that vaccine participation affords, and there are mountains of evidence to support it, then surely some politician would agree. Because like it or not, medical doctors do not make the laws upon which our society is formed, the people do. There are plenty of medical lobby groups chomping at the bit for something of this magnitude I'm sure...

Let me know when it progresses to that point. Everything in the middle, doesn't really matter. We can all argue who is more important in society to protect and how that should be done, in the end, someone gets stiffed. The question is: who decides, and how. And while we're at it, let's have this legislation implement measures to keep people out of society with diseases for which there are NO vaccines or other public health measures for this as well. Because, if a compromised person (that can be challenged by the common cold) is infected by a person that doesn't care about their health, eats garbage, drinks a bunch of alcohol, smokes, etc... why shouldn't they have some sort of debt to society as well? Why stop at vaccines, for which we know some people do NOT seroconvert, or aren't protected anyway. It's specious to say that a person who becomes ill that wasn't vaccinated would have either been protected or protected others when you have no idea who they are anyway.

Because in order to initiate a personal injury tort against a person that isn't vaccinated you'd have to have some sort of proof of the above statement. Let's develop a testing measure after vaccine administration that not only measures seriopositivity, but also contagion levels as well. This will certainly aid a vaccinating person in prosecuting their case that they didn't gain immunity from the vaccine, and they themselves were not already sick.

For those too young to be vaccinated, or those compromised needing protection from others... well, I'm having difficulty understanding why they'd be overly exposed to disease causing agent in the first place. If my child were too young to be vaccinated against certain pathogens, I'd be needing to take special care not to expose him. Same with compromised children... yet, I'm supposed to rely on the herd to keep him free from disease? Clearly, there are exceptions here, and people behaving recklessly should be held accountable for their actions. I'm just not entirely convinced this rests solely upon those that don't vaccinate, or delayed/selectively vaccinate.

Back to my original point. If the above is the way it's to be (per the regulars here), there must be legislation defining a person's contractual obligation to participate in disease prevention. So let's get on it. Until then, more of the same.

By lurking with a… (not verified) on 09 Jun 2009 #permalink

@Parental Choice: do you have some citations that can be reviewed from medical literature supporting your statement re: the increase in DM Type 1 and autism?

The practical question: is the interest of the majority sufficiently threatened to bring about abrogation of individual rights? Seat belt laws are universal. Motorcycle helmet laws vary by state.

To date it does not seem like herd immunity has been compromised to the extent that enforcement is imminent. The impact of disease shown to be caused by, or even correlated with vaccine refusal can, thus, be assumed to be lower than that associated with motorcyclist head trauma.

It is certainly appropriate to scrutinize the arguments of refuseniks. It may be a bit Chicken Little (at this stage) to condemn them for epidemics which have not materialized.

The extension of benefits to those who cannot or will not contribute to the creation and maintenance of those benefits is built into social contract theory. The free-ride analysis works well for public transportation, but not so well for ambient conditions like herd immunity. It's quite workable to keep those without the appropriate fare off the bus.

Anyone have a workable suggestion for denying the benefits of herd immunity to refuseniks?

Keep up the rigorous scrutiny of their arguments. But a relaxed vigilance is all that's available, or even desirable about their impact.

MI Dawn, his/her more accurate name is "Parasitic Choice", and she/he is just echoing Meryl Dorey's unsupported line that was used in a couple of TV spots, see:
http://scepticsbook.com/2009/05/02/a-brief-report-from-todays-debate/

When Munro asked her to produce said papers, Dorey claimed she had sent them to one of the researchers for the show. She claimed she had sent over 30 studies to the studio in support of her arguments including evidence of vaccine damage. Munro looked decidedly unimpressed and asked her to provide evidence instead of just making all these claims.

There is more in this Australian Podcast (podcast link on top, and youtube link to television reports in the comments)

@HCN

Evolutionarily, humans have always been "herd" animals (or the more politically correct "social animals").

Your grasp of social psychology and ethology is as lacking as is your grasp of vaccination and infectious disease.

Herd animals and social animals are quite different. The fact that humans interact with one another does not make them herd animals. Herd animals mindlessly follow the lead of the group while humans have the capacity to think and act independently.

PS

Sorry about the basement

By Sid Offit (not verified) on 09 Jun 2009 #permalink

Wow, lurking that sure is some nice cut and pasting. Sounds like the anti-vax crew is fully aware of their responsibility in potential future epidemics. I believe I have read that post (with minor changes) before.

For me to sue, it would have to affect me or my family. Being that we are fully vaccinated that would be possible, but improbable. However, I did not once mention that I was suing - simply that I have a collection of postings from local message boards giving unlicensed medical advice and provably wrong information.

Of course, why worry? If anti-vaxers are completely without blame and vaccines are ineffective then they have absolutely nothing to worry about. Am I right?

@Chris: I know PC is trollish, but didn't realize those were quotes from the infamous Meryl. I figured they were made up information, which is why I asked for proof (but I thought PC made them up). He/She has made other claims like that before, and always vanishes when asked for proof that is not from places like whale.to or AOA. Thanks.

Regarding the clean water vs. antibiotics vs. vaccines thing, I gotta agree, the nod goes to vaccines -- at least historically. Maybe right now, if I had to live in a community in America in 2009 that could only have clean water or antibiotics or vaccines, it might not be so cut and dry a decision.. but only because the really nasty diseases don't have a foothold in America these days.

And that's the crux of this whole post, ain't it?

By James Sweet (not verified) on 09 Jun 2009 #permalink

ababa,
Save those threads. The anti-vax "leaders", are blissfully intent on hijacking public health policies without facts/figures; and most importantly without any accountability.

But thanks to you and others there will be an e-paper trail.

If the unsubstantiated rhetoric continues, what started out as a nice little niche industry may ultimately end up equated with global terrorism?

Think about it. Smallpox as a WMD was supposed to increase viral death rates, cause unnecessary suffering and tax an already strained health care system/economy? Sound familiar.

Forget about intentions, the endpoint is the same. You don't get to undermine civilization based on fanatical beliefs. Prove your point or face the consequences.

If the dangerous rhetoric continues, I hope the 3 J's (and "O"thers) get their day in court. At that point it won't be put up or shut up; it will be guilty or not guilty. Glad youâre keeping the list of defendants.

By Karma is a bitch (not verified) on 09 Jun 2009 #permalink

For those too young to be vaccinated, or those compromised needing protection from others... well, I'm having difficulty understanding why they'd be overly exposed to disease causing agent in the first place.

How about a well-baby visit to the paediatrician, not knowing that someone else had brought her (unvaccinated) kid with active measles to the same waiting room?

If my child were too young to be vaccinated against certain pathogens, I'd be needing to take special care not to expose him.

So everyone with a small child should stay locked up in quarantine for a year or so to avoid the minority who refuse to vaccinate?

I think you're making Dr. Stemwedel's point.

By D. C. Sessions (not verified) on 09 Jun 2009 #permalink

"But don't expect to go to public schools, day care centers, or any place else with high concentrations of people among which infectious disease can be spread."

Why not? Joe Biden told people this, and the politicians came out and said Joe Biden was an old grandpa, don't listen to him.

If the politicians want you to go out in crowded public places to spend money because the economy is bad, they will publicly lie about what you should do to prevent exposure to contagious diseases.

Sounds great, right? Until you realize that their rates of type 1 diabetes and autism skyrocked after that.... Wonderful, just wonderful.

Citation needed.

@ Gabbahey:

"would you kindly make all the free loaders vaccinate?"

Is there a more nuanced view of vaccines or does it have to be a love-it-or-leave-it mentality?

No, the article you point to is more of a "concern troll" view than a nuanced view. Look at the points:

"Pharmaceutical companies are a great boon but must have checks"

Duh. That's what the FDA is for, as well as many independent researchers that research risks and effectiveness of medications, including vaccines. The notion that a group of people who base their decisions on self-interest and scientific ignorance constitutes some kind of useful "check" is absurd.

"Vaccines are not harmless"

Duh again. This is a straw man. Who specifically has claimed that vaccines are harmless? For that matter, what in the world is harmless? That is the whole point of the "free rider" or "parasite" characterization. Vaccine refuseniks reap the benefits, while asking other people's children to bear the risks. Needless to say, there is nothing the least bit "nuanced" about setting up straw man arguments.

"Which vaccines?"

The implication here is that people are being required to be vaccinated against diseases that are only "a nuisance." This is simply false. Every disease for which vaccination is required has serious risks that are far, far greater than any remotely plausible risk of vaccination.

"Unknown Ecological Effect"

Now he descends into sheer, groundless FUD. Of course there is no way to exclude the possibility that any time we keep people from dying from a disease, whether by antibiotic or vaccination or sanitation, there could be some kind of unknown effect on bacterial ecology. No, there is no evidence of this, or even any remotely plausible hypothesis of how it could happen. But of course, one can never disprove the existence of an "unknown effect."

"All kids donât need the same schedule for vaccinating"

Says who? The very high safety that has been shown for vaccines is for the standard vaccine schedule. Use a different schedule? What schedule, based upon what scientific study? Antivaccine hysterics imagine that by monkeying with the validated schedule, they somehow make kids more safe. But of course, we don't know, and there are certainly plausible ways in which an altered schedule could make people less safe. Oddly enough, the same guy who was concerned about "unknown effects" in the previous paragraph is now advocating that parents and physicians should drag their kids out into the murky world of unknown effects by using an untested vaccination schedule. This is not nuanced, but simply stupid.

Dear lurking,
If pseudoscience persists and continues to sway public health attitudes, the first suit will be from one or more anti-vax parents. They, after loosing one or more children to a VPD will seek legal action against the very vocal and visible leaders of the anti-vax movement.
They will seek monetary compensation; but most importantly they will seek proof that they didn't sacrifice their children to narcissists. That proof, I'm afraid, will never come.

By Karma is a bitch (not verified) on 09 Jun 2009 #permalink

"I have not done any research myself to validate what he has said, but I am inclined to consider it, because Dr. Null seems to be a trustworthy source"

Null's misguided views on vaccination having already been covered, I'll point you to an article shredding his alleged qualifications, including the dubious PhD that allows him to promote himself as Dr. Null:

http://www.quackwatch.com/04ConsumerEducation/null.html

Null may be best known for co-authoring "Death By Medicine", a biased and misleading anti-mainstream medicine screed beloved by alt med advocates (one of his co-authors lost her license to practice medicine in a Canadian province because of substandard practices, which is rather ironic).

By Dangerous Bacon (not verified) on 09 Jun 2009 #permalink

"@Parental Choice: do you have some citations that can be reviewed from medical literature supporting your statement re: the increase in DM Type 1 and autism"?

In 2005 on the JDRF Australia website (premier type 1 diabetes organization). It was noted that:

"Incidence in children under 5 years of age has doubled over the
last 5 years - we don't know why".

The link is no longer there but I quoted it elsewhere and was able to retrieve it... (of course you would have to take my word for it). So, a disease in which you CANNOT blame any increase in numbers on 'better diagnosis' happens to double in numbers of children under age 5 in a short number of years after Australia implemented the 'Immunise Australia Program'. What a coincidence... :)

As for the autism numbers ... they have greatly increased since 1997 as well... Of course, I'm sure that's due to 'better diagnosis'... because you know, doctors in Australia suddenly figured out that when a child can't speak by age 5 - there's a problem. I wonder what took them so long?

When (or if) did Australia add the Prevnar vaccine to their recommended schedule? Anyone from Australia (or elsewhere) here who wants to do some digging - I don't. Prevnar vaccine is known to trigger type 1 diabetes in children. Yippppeeeee!

By Parental Choice (not verified) on 09 Jun 2009 #permalink

"@Chris: I know PC is trollish, but didn't realize those were quotes from the infamous Meryl".

Ah, that's because they are not quotes from Meryl (whoever that is...). Dopes.

By Parental Choice (not verified) on 09 Jun 2009 #permalink

You are right Karma, the first lawsuits will come from the misled flock such as this woman:

http://www.mothering.com/discussions/showthread.php?t=1077468

Wear your waders before you click though, because the manure is very deep. You can literally watch the goalposts shifting in that thread. Keep in mind that it was posted on a majorly anti-vax forum with hardcore moderation.

As for the autism numbers ... they have greatly increased since 1997 as well... Of course, I'm sure that's due to 'better diagnosis'... because you know, doctors in Australia suddenly figured out that when a child can't speak by age 5 - there's a problem. I wonder what took them so long?

@Parental Choice: Again, provide a citation. You don't get to make up your own facts. Not here.

BTW, that 'better diagnosis' straw-man is a candidate for a new law, like Scopie's Law.

And FYI - Most people diagnosed with ASD can speak. Plus, a lot of children who are late talkers haven't always been diagnosed with ASD. Two simple facts I thought you should be aware of.

Parasitic Choice said: The link is no longer there but I quoted it elsewhere and was able to retrieve it...

Bwahahahahhahahahahahaha!!!

Your proof is a quote of yourself citing an non-existent source?

That's Internet GOLD!!!

Isuppose that I must ask this: Are the fears that some people have about vaccinations unfounded? Or does the correlation between vaccinations and childhood diseases that Dr. Null supposedly found indicate that vaccine contamination could be causing these problems?

While there are rare serious complications from vaccination, the fears that some people have, and that are fed by profiteers like Gary Null, are indeed unfounded, as shown many scientific studies.

If we maintain this herd immunity, how do those who choose to not get vaccinated threaten those who have? I would guess that the reason is that vaccinations are not always 100% effective, but I am not particularly well-versed on this subject, which is why I ask.

Herd immunity means that there is enough resistance in the population that each infected person will on average infect less than one other person, which means that the disease will die out instead of being epidemic. So every unvaccinated person weakens herd immunity. Many vaccines are less than 100% effective in the individual; it is herd immunity that really protects us.

How are those who choose to avoid vaccinations "free-riders"? It seems to me that it is most likely that most vaccinations are quite safe, and that the potential benefits outweigh the risks, but I would only consider someone a free-rider in this case, if they knew that vaccines were safe, yet still chose not to recieve them.

A free-rider is somebody who receives the benefits, but refuses to share in the costs and risks. Vaccine refuseniks still enjoy the benefits of the herd immunity due to other people who have accepted the real but small risks of vaccination for the benefit of everybody.

I do see the ethical implications here, but I think the issue is more medical in nature, i.e. it shouldn't be 'who is to blame for starting an epidemic by not vaccinating their children', so much as it should be 'why do people not understand that vaccinations are safe and effective'. To me, that seems to be the main concern of those who refuse vaccinations (they do not understand them).

Unfortunately, there are people like the notorious Gary Null who make a living by selling quack cures and spreading fear and distrust of medicine

Case in point: I understand very little of how vaccinations work. As far as I know, the flu vaccination works by introducing a deactivated virus into your body, so that it can quickly identify it and destroy it it a later time when exposed to the "live" virus. This doesn't make sense to me, as a deactivated virus would not be seen as a threat...It wouldn't try to inject cells with RNA to replicate itself.

The immune system is not actually intelligent. It does not really recognize threat as such, but rather recognizes unfamiliar proteins. This is why you can have problems with rejection of organ transplant, which are not really a threat.

You are right Karma, the first lawsuits will come from the misled flock such as this woman:

(I refuse to repost the link)

Ouch. That is so sad. OTOH, I have to wonder, who is responsible for such ignorance?

Seriously, she has never heard of a non-vaxxed child being autistic? Another says the only study she's heard of (on autism rates in vaccinated and non-vaccinated) is by ... Generation Rescue? (I wouldn't be surprised if that were the "the Amish don't vaccinate and aren't autistic nonsense). But if it isn't vaccines, what is it? Mercury in mama's fillings? Fluoride? It has to be SOME toxin, of course.

"@Parental Choice: Again, provide a citation. You don't get to make up your own facts. Not here".

Please spare me. As if this is a site where science is of importance.... Nice try.

By Parental Choice (not verified) on 09 Jun 2009 #permalink

"Bwahahahahhahahahahahaha!!!

Your proof is a quote of yourself citing an non-existent source?

That's Internet GOLD!!!"

Sorry, I don't find humor in the fact that vaccines cause type 1 diabetes in children. Laugh all you want... it isn't funny. Europe has a similar situation:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60568…

I brought up Australia simply because that is so blatantly obvious (to a sane person) that such an abrupt increase had to do with their change in vaccination policy/schedule in 1997.

By the way, where's your 'source' for the safety of aluminum and mercury being injected into babies. I look forward to reading all about it :)

By Parental Choice (not verified) on 09 Jun 2009 #permalink

You think that's bad Pablo? They are currently cleaning up any reference to one of their frequent posters that has been arrested in a Muchausen Syndrome by Proxy incident:

http://www.examiner.com/examiner/x-7230-Atlanta-Special-Needs-Kids-Exam…

As bad as some can be on my local forums, at least the crazies tend to stick to a distinct corners and are in the minority. On sMothering.com, they seem to run the roost.

Please spare me. As if this is a site where science is of importance.... Nice try.

@Parental Choice: No, I won't spare you. You think it's fine to come and make up 'facts' out of thin air? The opinions you claim to have about this site have exactly zero relevance to your intellectually bankrupt actions.

"Please spare me. As if this is a site where science is of importance.... Nice try."

Thing is, it is exactly that. Of course, here we use the standard accepted definition of Science and its associated processes, so I can see where you might be confused.

Proof & reviewable data is important, not your attitude of "I said so, so it must be true."

By G Barnett (not verified) on 09 Jun 2009 #permalink

They are currently cleaning up any reference to one of their frequent posters that has been arrested in a Muchausen Syndrome by Proxy

Was she a respected poster there? Or just a member with a blog? While I realize that whacko is run of the mill for mothering.com, given a sufficiently large community, it would not be surprising to see the extreme. Then again, the fact that the newspaper article sees fit to reference her screen name suggests that she works with a fairly high profile there.

BTW, ababa, I've been around internet discussions for years and years (back to the old usenet days, before the days of web-based groups and blogging), so little I see shocks me anymore, but I have to say, your posts have, for the first time ever, made me think the phrase, "The stupid...it burns" (in response to that first link) and ask the question WTF? (in response to the "Muchausen Syndrome by Proxy")

As bad as some can be on my local forums, at least the crazies tend to stick to a distinct corners and are in the minority.

Yeah, I used to see some of that in the whattoexpect forums, but as you say, they were isolated and in the minority. Moreover, they weren't treated too kindly (although they tried to hide behind the "it's not nice to criticize other mommies" policy - however, there were some who had no qualms about calling out the BS). They weren't the reason I abandoned that forum, however (I got sick and tired of the constant attacks on dads)

Sid @#41,

The fact that humans interact with one another does not make them herd animals. Herd animals mindlessly follow the lead of the group while humans have the capacity to think and act independently.

ah, you're implying then that only conservatives are herd animals...?

(ba-doom ching! thank you, i'll be here all week...)

By Nomen Nescio (not verified) on 09 Jun 2009 #permalink

"Yes. Vaccines are arguably far and away the winner."

Anecdotaly speaking, I've never had surgery, and though I have had antibiotics, they were never for a remotely serious condition (and probably weren't appropriate for the condition I had anyway).

I have also never had measles, mumps, rubella, polio, small pox, diphtheria, tetanus, or whooping cough. If I had been born two or three decades later, I probably wouldn't have had chicken pox, and wouldn't have to worry about the possibility of shingles someday.

+1 for vaccines.

By Karl Withakay (not verified) on 09 Jun 2009 #permalink

Regarding an increase in diabetes type 1. How do we know it was not caused by the spread of home computers and other computer based electronics? Or the Internet?

Let's have a game. Come up with other possibilities.

I line rnb's game he/she suggests at #68.

I suspect that if you charted it on a graph, the number of newly diagnosed cases of autism in the last 20 years is inversely proportional to the number of videos played on MTV..?

By James Sweet (not verified) on 09 Jun 2009 #permalink

Pablo,
According to some of the Google cached pages, she was a fairly frequent poster (not a forum moderator) that alot of people listened to for advice. The issue at hand with their administration is that they are wholesale deleting threads that reference her or her situation. Note in this cached page:

http://74.125.155.132/search?q=cache:SKYuZDvHxW0J:www.mothering.com/dis…

Note that the person in question (irangel) posted on that thread. Also note the post right before her own, and the timestamp of that post (a year and a half ago). The original thread has obviously been deleted.

The problem that arises is, like with vaccination, they provide a forum for crazies to post advice, then cover up critique and repercussions of that advice.

My local forums similarly allow anti-vaxers to hide behind the "support" policy and silence any critics through moderation. While, in general, it is a decent forum for even mainstream parents - the heavy handed bias of a few of the moderators implicitly provide support for any nonsense anti-vaxers post. They aren't responsible for the information, they are simply responsible for giving it the appearance of validity. I've seen more than a few skeptical people driven off and sadly some of the more naive read and accept this information as if it was accurate. They simply have no balanced point of reference and results in very poor decisions.

The coolers, Parental Choice and crazy Dawns that post here at least have their "information" balanced by good critical thinking and accurate data. I believe that they have a right to speak their mind, but in a real debate they have little chance of gaining support from those of sound mind. On those forums, like sMothering, it is literally an echo chamber of bad advice. And any reference to places like this are moderated out.

And yes, Dads are routinely made the devil.

Or the Internet?

As I've noted, that's a plausible hypothesis in reality. The internet drives awareness. It explains the timing of administrative prevalence changes rather well.

Why is the growth exponential/viral-like? Changes in criteria alone can't explain this. It's more like "word of mouth" growth.

Why is the growth gradual rather than discrete, as you might expect if it's caused by the introduction of environmental factors at discrete times?

Why do more wealthy or populated regions have a higher administrative prevalence of autism? (But apparently not a higher screened prevalence.)

I've looked at some data on this. I might write about that sometime.

As far as I know, the flu vaccination works by introducing a deactivated virus into your body, so that it can quickly identify it and destroy it it a later time when exposed to the "live" virus. This doesn't make sense to me, as a deactivated virus would not be seen as a threat...It wouldn't try to inject cells with RNA to replicate itself.

Your immune system doesn't know from "threats". It knows only "you" and "not-you". It'll attack anything that it perceives as "not-you", whether it's ragweed pollen, urushiol, a transplanted kidney, your own islets of Langerhans, or for that matter a virus dead or alive.

And yes, Dads are routinely made the devil.

Sorry, ababa and I are running adrift here, but I appreciate the opportunity to talk about parenting issues (particularly these) with rational folk.

To your comment: my frustration comes in how one mom will go off on Dad because he doesn't do enough. The next will go off because he did something, but did it wrong so she had to do it herself. AHHHHHHHHHH!!!!!! And you wonder why Dad doesn't help? This is something I address when I do Dad's Boot Camp (in prenatal class) - that "team parenting" means more than just "dad does what mom tells him to do." Thankfully, the nurse instructor tells moms the same thing: if you constantly criticize dad when he tries to help, he will respond by not helping

On those occasions where Dad himself has shown up in the forums, we usually discover that there is another side to the story, and it wasn't quite as clearcut as Mom made it out to be. I got tired of having to stick up for Dad and probing around to try to find out what was really going on. All the other Moms just piled on. Moreover, any suggestion that I made that there might be more to the story was met with the old heavy "be supportive" hand of the moderators.

The problem that arises is, like with vaccination, they provide a forum for crazies to post advice, then cover up critique and repercussions of that advice.

Doesn't this just show that even mothering.com has its limits? As I said, I realize it is hotbed for woo, but even in the woo world, there is the off the scale loons, and I think "feeding feces to your daughter" is looney even among the nutsiest people. Is there any indication in her postings that she was doing this stuff?

Keep in mind, they aren't removing reference to her because she was a general whack-a-loon, but because her whackiness went well beyond the norm, even for them. I think that could be said for a lot of websites, which will try to disassociate themselves from contributors who they discover to be misrepresenting themselves.

Parasitic Choice:

Sorry, I don't find humor in the fact that vaccines cause type 1 diabetes in children. Laugh all you want... it isn't funny. Europe has a similar situation:

And the Lancet article did not include any evidence, either. It was just that there is an increase, period. Nothing about vaccines.

Here this should help you: http://xkcd.com/552/

And so should this: Consequence or coincidence? The occurrence, pathogenesis and significance of autoimmune manifestations after viral vaccines.

I brought up Australia simply because that is so blatantly obvious (to a sane person) that such an abrupt increase had to do with their change in vaccination policy/schedule in 1997.

Actually, sane people usually recognize that post hoc ergo propter hoc is a logical fallacy. And the sources I've read say "We don't know why this is happening".

@Chris: Thanks for the pubmed abstract link. Very interesting. No proof of them causing DM1.

@rnb: I like your game. I know! I know! DM1 is related to car seat use! Obviously, as laws have mandated keeping children in car seats longer, childhood diabetes has increased. It's the car seats! The same thing with autism! Autism numbers have gone up with car seat requirements, so it's OBVIOUSLY the car seats.

Where's my Nobel prize for medicine for figuring this out?

"Parental Choice" comments:

Australia would make a great case study. Their vaccination policies changed in approximately 1997. They put into place the "Immunise Australia Program" complete with payments for doctors and parents who fully vaccinated their kids, childcare rebates if you followed the rules, increased pressure for kids to be vaccinated before they went to school, they added a few vaccines, they had "immunisation days", etc. etc.

Sounds great, right? Until you realize that their rates of type 1 diabetes and autism skyrocked after that [1997].... Wonderful, just wonderful.

Sorry, I don't find humor in the fact that vaccines cause type 1 diabetes in children.

Except, of course that the hypothesis of "vaccines cause type 1 diabetes" has only a weak temporal correlation to support it. It's not even remotely a "fact".

Here's a little something for "Parental Choice" to chew on. Type 1 diabetes appears to be caused by a virus - coxsackie virus B4, to be precise. Most people get a nasty gastrointestinal illness from this virus. Some people - probably based on their genetics - end up having their T-cells destroy the insulin-producing cells of their pancreas.

(see: Dotta, et al (2007). Coxsackie B4 virus infection of beta cells and natural killer cell insulitis in recent-onset type 1 diabetic patients. http://www.pnas.org/content/104/12/5115.long )

What if I propose a different hypothesis? The frequency of coxsackie virus strain B4 infections in young children went up some time after 1997 - completely unrelated to any vaccine or vaccine policy. As a result, more children are developing type 1 diabetes.

It could have been a novel introduction into the Australian continent or it could be that a more virulent B4 strain evolved in situ. It could have been that Australian population density reached a critical point. Either way, the incidence of post-viral type 1 diabetes will rise until the virus reaches a new equilibrium.

If the "new strain" hypothesis is true, we should be able to genetically track the new strain as it spreads throughout Australia.

Additionally, if this is a new strain or a mutation OR just a critical point in population density, then when the under-five cohort currently seeing an increase in type 1 diabetes reaches adulthood, we should see far fewer young-adult onset cases of type 1 diabetes (they are rarer, to be sure, but still detectable), since they already have type 1 diabetes (they got it as young children).

If the "vaccines cause diabetes" hypothesis is true, and the additional cases seen in the under-five set are NOT people who are susceptible to coxsackie B4, then the number of adult-onset cases should NOT change.

"Parental Choice" is jumping the gun - first show that the additional diagnoses of type 1 diabetes are due to vaccines, then generate your righteous indignation.

Prometheus

Another non-vaccine-related possibility for why Type I diabetes is going up in Australia: people putting off childbearing until later and later ages. I suspect that is a big part of the increase in autism incidence as well.

Let's see, what other factors/behaviors have increased a huge amount since 1997? Cell-phone use, TiVO use, DVD use, Internet use, sucralose ingestion, eating out at restaurants, eating pre-prepared foods, exercising less...there are just so many other things besides vaccines that you could have picked as your culprit, PC.

And why would it be limited to Australia? Why didn't the US or the UK see this spike in Type I diabetes too?

"Actually, sane people usually recognize that post hoc ergo propter hoc is a logical fallacy. And the sources I've read say "We don't know why this is happening".

You can stick your post hoc ergo propter hoc bullcrap where the sun don't shine. Sorry but... you are a dumbass if you can't minimally see the fact that it is a HUGE coincidence that the rates of type 1 diabetes have increased dramatically following the introduction of certain vaccinations or changes in vaccination schedules. This, my friends, is why I am proud to be a 'freeloader'. :)

By Parental Choice (not verified) on 09 Jun 2009 #permalink

"Here's a little something for "Parental Choice" to chew on. Type 1 diabetes appears to be caused by a virus - coxsackie virus B4, to be precise. Most people get a nasty gastrointestinal illness from this virus. Some people - probably based on their genetics - end up having their T-cells destroy the insulin-producing cells of their pancreas".

I have never discounted the virus theory in regards to type 1 diabetes. In fact, I believe that it is very likely a cause of type 1 in children. Notice that I said 'a' cause as I believe that there are likely many possible 'triggers' to the disease. For some, it may be viral for others toxins (vaccinations included)... On that note, we must also consider live virus vaccines. Just sayin' ...

I do find it fascinating that the vaccine portion of the debate is always muted out in the discussion... why is that? Why is that in almost every study that I read in regards to type 1 diabetes they mention environmental causes as triggers (because obviously it is not ONLY genetic) without bringing up the vaccination possibility. They will say it could be viral, milk protein, other environmental toxins but never any mention of vaccines? Pretty short sighted, wouldn't you say? God forbid you mention the possibility despite the fact that there are significant 'coincidences' surrounding the idea that vaccinations can cause type 1 diabetes. Such as the Australia 'coincidence'... The fact that the rates of type 1 diabetes in children in the US significantly increased starting in the late 1980's-1990's... I wonder what else changed back then? Hmmmm.. Then, never mind after the Prevnar vaccine approval in 2000... The rates? To the moon. Maybe someone should check out Dr. Classen's work in type 1 diabetes/vaccines. He predicted a huge increase in cases of type 1 diabetes with the approval of that vaccine. Signs point to him being right. But who really cares... right? No big deal... at least no one month old babies aren't getting Hep B.

By Parental Choice (not verified) on 09 Jun 2009 #permalink

"And why would it be limited to Australia? Why didn't the US or the UK see this spike in Type I diabetes too"?

... They have... Where have you been?

By Parental Choice (not verified) on 09 Jun 2009 #permalink

First off, as always, even if you were right that the incidence of IDDM rose in 1997, at the same time as some change in vaccination schedule occurred, this would prove nothing. As has been pointed out, correlation does not mean causation, and as you pointed out, this could be coincidence. Next, I can find no source to show that in 1997 there was a dramatic increase in incidence of IDDM in Australia. Incidence in IDDM is increasing, but this is a worldwide phenomenon and the increase has been going on since before 1997 as your citation nicely points out (it shows the rise from 1989-2002, for instance). Finally, it doesn't even look like there was a change in the schedule for vaccinations in Australia around that time. I could be wrong, so please point out the changes if they occured, but I could find none. A campaign was started, in 1997, to improve vaccination rates, but even then, that's in 1997, when the incidence supposedly starts to increase, which means it was something before that date that initiated it. Also, I would like to see the evidence the Prevnar vaccine triggers IDDM, since you state that as fact, this should be easy to provide. Finally, I hate the rhetoric that since we don't know what is causing something, like say autism or the increase in IDDM, you can't rule out that it's not vaccines. Fact is, we can rule out causes without knowing the underlying cause, it's really not that tricky to understand.

Looks like the countries with higher incidence of Type 1 diabetes are the Scandinavian countries. See here. Quick, call Generation Rescue.

(If that reference was obscure, GR claims that in countries like Sweden, Finland and Norway, the number of mandatory vaccines is low.)

Looking at some graphs, it appears that incidence of Type 1 diabetes has increased over time, but gradually and uniformly. There's nothing that would suggest there was a big change after the introduction of some vaccine.

Sorry but... you are a dumbass if you can't minimally see the fact that it is a HUGE coincidence that the rates of type 1 diabetes have increased dramatically following the introduction of certain vaccinations or changes in vaccination schedules.

As someone else pointed out, correlation does not equal causation.

This, my friends, is why I am proud to be a 'freeloader'. :)

Ah, the arrogance of ignorance. You must be so proud to help contribute to children's disease, suffering, and deaths by your stupidity and inability to outthink simple logical fallacies.

If vaccination with live viruses such as measles causes Type I diabetes, wouldn't infection with wild viruses do the same, only more so? Should we not therefore see a high rate of Type I diabetes prior to the mid-60s, corresponding to the high rate of vaccine-preventable diseases?

PC = Common Sue M.

The stank gave you away. Isn't your chiropractor calling?

Say "hi" to Handley's taint for us at your next Age of Autism / diabetes meeting.

Actually Adrienne, speaking as an Australian, I believe we can kill the TiVO use hypothesis. They only hit Australian shores in about 2005 or so and they still haven't really taken off all that much.

The rest... yeah pretty much.

By Knight of L-sama (not verified) on 09 Jun 2009 #permalink

Parental Choice (a.k.a. Jen),
Tylenol and glutathione depletion or vaccines leading to autoimmune diseases are complicated issues. Connecting scientific concepts does not make you a scientist.
Sorry.

By Karma is a bitch (not verified) on 09 Jun 2009 #permalink

@Parental Choice
Do you actually read the studies?

http://content.nejm.org/cgi/content/abstract/350/14/1398

"The development of type 1 diabetes in genetically predisposed children (defined as those who had siblings with type 1 diabetes) was not significantly associated with vaccination. Furthermore, there was no evidence of any clustering of cases two to four years after vaccination with any vaccine."

Adrienne said:

"...there are just so many other things besides vaccines that you could have picked as your culprit, PC."

PC: That is basically what Skemono meant by citing post hoc ergo propter hoc. As you said, "it is a HUGE coincidence that the rates of type 1 diabetes have increased dramatically following the introduction of certain vaccinations or changes in vaccination schedules." But, it may be just that; a coincidence. It seems to me that there may be a correlation between the rates of type 1 diabetes and changes in vaccination schedules/new vaccine introduction, but we have to remember that correlation does not equal causation.

I have been thinking about the ethical dilemma of this issue, and I see a potential problem. Lurking with a purpose submitted the idea of introducing legislation to mandate compulsory vaccination. I am not sure that such legislation would pass, even with great support from the medical community. To illustrate this, let me draw a parallel.

Many people in the United States choose not to recycle. To my knowledge, there are no communities that require you to recycle, although they may exist. Personally, I think everyone should recycle everything they can, but some people choose not to. Are they not violating a similar social contract? Think about it: We spend quite a lot of money, man-hours, resources, etc, to gather other natural resources, which are then refined or changed so they can be used in products. More resources are used to package and ship products to stores. Then we go and buy the product, and in many cases, use it once and then throw it out. All the effort and resources to bring that product to shelves are then wasted; left to rot in a landfill.

There is a possibility that we could run out of resources, like say, iron ore. Maybe there is more iron ore deeper down, but we lack the ability to mine it. This is happening currently. We can locate valuable minerals at a depth we can mine to, but the geothermal gradient prevents people from working that deep. Perhaps in the future, robotics will be able to fully replace human miners (which would be wonderful), but that hasn't happened yet.

I can imagine a not so distant future where we are mining landfills to recover resources we could have recycled or reused. Those who refuse to recycle effect all of us, just as anti-vaxxers do. I for one would like to see a future with fewer diseases and plentiful resources. So the clear choice here would be to recycle, just as the clear choice with vaccinations is to get them. Recycling isn't much harder than getting a vaccination, yet some people choose not to do it. They may have made a poor decision, but is mandating these things by law the proper course of action? We come upon unstable ground when we start to require things like this by law. It's not possible to require people by law to make good decisions, even if the question has a clear right or wrong answer.

Now, I can see the benefits of requiring recycling of vaccination by law, but I find it doubtful that such legislation would ever pass. Our country has long had very wasteful habits, and apparently it's too much of a hassle for some people to have a second trash can for recyclables. That is of course ridiculous, but even given a law requiring recycling or vaccination, we would just create a lot of law breakers. In continuing with that train of thought, maybe such laws would pass; governments might enjoy the extra revenue from tickets and fines paid by those who broke the law.

But I digress. My point isn't wether such legislation would pass, it's whether it is the right way to approach the problem. I think coming at the anti-vax crowd with the idea that they are unethical won't sway them from their position. People usually don't take kindly to being told they are unethical freeloaders. Maybe instead the push should be on illustrating the health benefits of vaccination. Of course the problem there is that the anti-vaxxers already have the preconception that the risks of vaccination outweigh the benefits. It seems that the only way to convince them that vaccinations don't cause diabetes, asthma, autism, ADHD, etc, is to find the root causes of these diseases. Here we have another problem. I have a feeling that these diseases are caused by a number of different factors, as Adrienne pointed out. Figuring out what role different substances or habits might have in these diseases would take a ton of research, studies, and so on, so we're not likely to find the culprits quickly. Maybe they're caused by synergistic effects of two or more normally innocuous substances, who knows?!

It's kind of like the Gulf War Syndrome. Some folks keep insisting that it was only exposure to the depleted uranium rounds that caused the syndrome (maybe classified as a disease now? I'll have to dig up that article). But a recent study indicated it was caused by many different factors.

Ah, yeah. Sorry I kind of rambled again there. I just wanted to share some ideas. I find this blog and the discussion quite interesting! Thanks again for your time.

Merddin

@ rkdemay

> The practical question: is the interest
> of the majority sufficiently threatened
> to bring about abrogation of individual
> rights? Seat belt laws are universal.
> Motorcycle helmet laws vary by state.

Saw you over at Janet's place, too, so I thought I'd point you to this thread:

http://blogs.discovermagazine.com/badastronomy/2009/06/03/should-vaccin…

We're going around the maypole over at Phil's on just this topic.

karma is a bitch said "Parental Choice (a.k.a. Jen)"

Actually, Jen has never gone as reactive as PC has, I am more inclined to think it is Common Sue M.

Here is some classic old time Sue:
http://leftbrainrightbrain.co.uk/?p=354

Having never seen this vaccine shedding nonsense before today--but having it seen suddenly at several websites-I did a google search and the first site I visited had this gem:

"Breast milk kills polio virus and meningitis and a whole host of other diseases."

Enough to give one an idea of the credibility of the source.

Dear ParentalChoice:

I am so glad that there are people like you. With a little bit of luck, your spawn will develop something like Mumps or Hib and will not be able to pass down the stupid gene. You will help improve the breed.

And, of course, you are precisely the person that Amanda Peet was referring to when she called you a parasite.

@65 - irangel is listed as a "Senior Member" Join Date: Aug 2005 Posts: 2,160

She was at least active, if not hyperactive, and was definitely handing out advice about preemies and getting support for her while she coped with the sick kids ... attention seeking, yes.

By Tsu Dho Nimh (not verified) on 09 Jun 2009 #permalink

You can stick your post hoc ergo propter hoc bullcrap where the sun don't shine.

You can curse all you want, but that doesn't change the fact that your argument thus far boils down to a logical fallacy. It doesn't change into something valid just because you're the one making it.

Sorry but... you are a dumbass if you can't minimally see the fact that it is a HUGE coincidence that the rates of type 1 diabetes have increased dramatically following the introduction of certain vaccinations or changes in vaccination schedules.

But that's all you've shown it to be--a coincidence. A coincidence similar to the ones that Adrienne lists. You randomly jump to the conclusion that it's vaccines for no damn reason at all.

This, my friends, is why I am proud to be a 'freeloader'. :)

Because you make idiotic logical fallacies that you should have learned about in grade school?

ababa,

thank you for your thoughtful reply? Next time, might I suggest you provide evidence in your attempt to character assassinate, while ignoring the majority of what I say... you might have heard what I've posted a lot(in different variations), because it's been said a lot. And ignored.

DC,

A child brought in for a well baby visit, is in a doctor's office where sick patients also go. Vaccinated people get sick too, and do their fair share of spreading disease (vaccine-available or otherwise). As for those too young, and compromised... well, I find it interesting that the rest of the world is supposed to be responsible for their care? I mean, if my kid and your kid were standing at a street corner (with both of us escorting them) - roughly 25 feet apart from each other (to ensure no spreading of "scary germs") and a car came around the corner headed toward mine, are you supposed to throw your kid in the car's path to save mine? No, you grab your kid and get out of there. Yet, we are saying that the robust have a societal obligation to protect others that cannot protect themselves. Where do we draw the line? Does it stop at vaccines? If people are intent upon taking their young children (or compromised children) into society, then *they* must understand that there is not a guarantee they'll be spared from being exposed to disease and that this action carries risk. This, to me, is simply logical. As I stated previously, there is obviously no excuse for reckless behavior regardless of vaccination status.

Vaccine defenders are evidently of the opinion that vaccinating is a societal obligation. If a susceptible person becomes ill after being exposed by someone that is vaccinated... I guess that's alright? Cos they at least got jabbed and tried?

By lurking with a… (not verified) on 09 Jun 2009 #permalink

Karma writes:

Parental Choice (a.k.a. Jen),
Tylenol and glutathione depletion or vaccines leading to autoimmune diseases are complicated issues. Connecting scientific concepts does not make you a scientist.
Sorry.>>>>>>>>>>>>>>>>>>>>>

(chuckles)

Did you hurt yourself with that leap?

(Jen, who is painfully aware of her lack of scientific credentials, and who always posts here under the same name.)

BTW, your detective skills are about as lacking as my scientific skills. ;)

lurking said: thank you for your thoughtful reply? Next time, might I suggest you provide evidence in your attempt to character assassinate, while ignoring the majority of what I say

What part of my reply to you was a character assassination? The part where I called you out on re-using cut-and-paste material spoon fed to the anti-vaxers by their leaders for deflecting responsibility for causing spread of vaccine preventable disease? I'm sorry, I don't see it - are you suggesting it says something about your character? I'll take your word for it.

Ok, I'll address "your" post. You say defense attorneys would be jumping at a chance to defend that case pro-bono? An attorney would be happy to defend a jury trial against a plantiff that consists of grieving parents over the loss of their child due to the dissimination of completely evidence free nonsense and use of creative exemptions to get into school? Yeah, sure.

Why don't you ask the Omnibus parents how well the anti-vax "evidence" is tolerated by the justice system? You know a judge is less than impressed when they bust out Alice in Wonderland on you in their decision.

And while we are at it, why is it that there are so few attorneys even willing to take on a "vaccine causes autism/etc" cases? Because they are holding out for the big pro-bono defense case?

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

This site could be valuable but it long ago degenerated into a parody of itself.

The goal is not a discussion of science and differing points of view but rather who can jump in and be the most unpleasant to the "other side."

Look above: You see lots of made up data and hypothetical scenarios but the actual number of doctors contributing information can be counted on the fingers of one hand.

The reason: The doctors are busy taking care of real patients and real problems not theoretical epidemics caused by loss of "herd immunity." Remove the sarcastic, insulting posts and the place could become a ghost town.

Jay

... but the actual number of doctors contributing information can be counted on the fingers of one hand.

The reason: The doctors are busy taking care of real patients and real problems...

If having doctors participate is necessary for the discussions to be useful, but doctors are too busy to blog, then how could any blog discussion on vaccination ever possibly be useful?

By Matthew Cline (not verified) on 09 Jun 2009 #permalink

You really are blind to irony aren't you Dr Gordon?

The above post just proves that what Jay Gordon said is correct. I haven't seen that new Ben Stein film (nor do I plan to), but the one thing I heard about it is spot on: One of the biggest problems with academia today is that it's too full of itself. It's not enough to point out that someone is incorrect, you have to rub their faces in it. Because that high school graduate could never possibly learn something that a Doctor hasn't. Then, when you're wrong, or aren't the expert in something, you talk out your asses just like Noam Chomsky did when speaking about 9/11. Or attack those who consider a possibility to be true when there is no evidence to support their position, even though there is no evidence to indicate what caused said possibility at all, making all assumptions plausible, even complex ones-Occam's Razor doesn't always point to the real cause. Because nothing ever existed or was true before a scientist discovered it, right?

There, I made a sarcastic, insulting post, and I'm out.

This site could be valuable but it long ago degenerated into a parody of itself.

The goal is not a discussion of science and differing points of view but rather who can jump in and be the most unpleasant to the "other side."

Look above: You see lots of made up data and hypothetical scenarios but the actual number of doctors contributing information can be counted on the fingers of one hand.

The reason: The doctors are busy taking care of real patients and real problems not theoretical epidemics caused by loss of "herd immunity." Remove the sarcastic, insulting posts and the place could become a ghost town.

Dr. Jay, do I have to repeat yet again that the whole "we're too busy taking care of patients to do or learn science" is about the lamest justification there is? Really. You don't want to associate yourself with it.

In any case, perhaps you should set Janet Stemwedel right. She's a science/medical ethicist, after all, and what could she possibly know about these issues, right?

Gabbahey wrote: "Because that high school graduate could never possibly learn something that a Doctor hasn't."

Sure they could, but in this case they haven't. The connection between autism and vaccines has been looked at, and very thoroughly discredited. The seductive lure of the autism-vaccine hypothesis is that is had some biological (e.g. thiomersal) and temporal plausibility. That's why scientists took the time to examine it in many different ways. It has been shown, again and again to be totally unlikely, but that doesn't stop the high school graduate from continuing to find it plausible. That's because the high school graduate doesn't really have the background to honestly evaluate the methodology of these studies. It's completely natural to think to oneself "I don't really understand what this study is saying, and I can never understand it, so I'm going to fall back on my personal experience to continue to hold onto my beliefs." That's what you see over and over. Autism-vaccine advocates discrediting studies based trivial reasons (e.g. perceived COI) while arguing: "Thousands of parents have witnessed vaccine regression. Don't they count for anything?"

If Dr. Jay was honest with himself, he should admit that he uses exactly this argument. C'mon Dr. Jay. You claim to understand science, don't you? Could you please take one of the autism-vaccine studies, i.e. Fombonne and Quebec, read it through carefully, and then argue about the specifics of that study, without bringing in your own personal experience?

By Broken Link (not verified) on 10 Jun 2009 #permalink

"karma is a bitch said "Parental Choice (a.k.a. Jen)"

Actually, Jen has never gone as reactive as PC has, I am more inclined to think it is Common Sue M".

How many times does HCN try to call someone out? Why the game, HCN? Remember what happened the last time you tried to do that....? LOL... You got it totally WRONG. Fail.

By Parental Choice (not verified) on 10 Jun 2009 #permalink

"Dear ParentalChoice:

I am so glad that there are people like you. With a little bit of luck, your spawn will develop something like Mumps or Hib and will not be able to pass down the stupid gene. You will help improve the breed.

And, of course, you are precisely the person that Amanda Peet was referring to when she called you a parasite".

-------------------------------------------------------------------

It's comments like these that show me what kind of SCUM some of you people really are. I have never wished illness, sickness or neurological diseases on your kids. Got it? The fact that you do so on my kids is quite telling. Dirtball.

I have two children who were vaccine injured... Got it, scumbag. I have made the decision NOT to vaccinate my third child (or limited vaccinations) due to my valid concern for his health. Frankly, there are some who have made that same decision... Think HCN... How many times have I heard from HCN that his/her child couldn't have the DTP shot due to fears of safety for his/her child (in reference to why the herd is so important, blah, blah, blah). Somehow it's ok for HCN and his/her doctor to make that decision but when I do it - based upon my children's MEDICAL RECORDS - in consultation with my new pediatrician - somehow I am messing it up for the herd?

Sorry dumbass, the HERD is sick and getting sicker by the day. The fact that you can't see why just shows your stupidity/ignorance.

By Parental Choice (not verified) on 10 Jun 2009 #permalink

If Dr. Jay was honest with himself, he should admit that he uses exactly this argument. C'mon Dr. Jay. You claim to understand science, don't you? Could you please take one of the autism-vaccine studies, i.e. Fombonne and Quebec, read it through carefully, and then argue about the specifics of that study, without bringing in your own personal experience?

I like that idea. Dr. Jay fancies himself a scientist. Let's put it to the test. One thing that scientists do is analyze/deconstruct each other's papers. So, Dr. Jay, if you're still reading (and I know you are; you marched off in a huff a couple of days ago but are now back), pick a paper. Fombonne's Quebec study would be a good one, but I can suggest others. Read it and then explain to us, analyzing the paper's methodology, why its evidence doesn't support its conclusions that there is no detectable link between vaccines and autism. No personal anecdotes.

Do that credibly, and I'll be less dismissive of your claims of being science-based.

"Thanks Orac. I chose Fombonne's Quebec study because the full text is readily available. Go ahead, Dr. Jay. It's here:

http://pediatrics.aappublications.org/cgi/reprint/118/1/e139"

Consider me shocked. I can't believe that you are suggesting a study in which Fombonne was found to have confused the Canadian cities of Montreal and Quebec City. He made an error which in fact rendered his study useless (due to different vaccine schedules of the two cities). Good job guys... even for you, that's BAD.

How about that "science"....

By Parental Choice (not verified) on 10 Jun 2009 #permalink

Sorry but... you are a dumbass if you can't minimally see the fact that it is a HUGE coincidence that the rates of type 1 diabetes have increased dramatically following the introduction of certain vaccinations or changes in vaccination schedules.

Even removing the egregious insults, this is a rather vague statement. Which vaccines or changes in vaccine schedules do you think correlated with the rise in DM? What evidence do you see for this being anything other than a coincidence? Why not blame high fructose corn syrup or increased computer use or cell phones? They also increased in the last decade. Or for that matter, the increase in the size of the Atlantic Ocean: the Atlantic increased in size over the past 20 years. Can you PROVE that that didn't cause the rise in type I DM? In other words, what plausible mechanism is there for connecting diabetes to vaccines? Which specific vaccines? Is there a close correlation that can be isolated from other factors? If you can get a testable hypothesis together that wouldn't involve experiments that any reasonable IRB would reject, you might get some interest. Or send it to the NIH and you might even get some funding.

The criticism of Fombonne's study was discussed intelligently over at Iterverbal.

When it comes to this type of study, any criticism is basically theoretical. Is there any doubt that autistic kids are still around after removal of thimerosal from vaccines? In the blogsphere we were analyzing autism caseload databases and announcing there's no change after removal of thimerosal a year or two prior to papers appearing in the literature. See for example, this post of mine from Q1 2006.

It's clear that in Canada nothing happened after removal of thimerosal. The administrative prevalence of autism among Kindergarten kids there is about 1%. If in fact Dr. Fombonne confused cities (not clear if this criticism is valid, and it was not accepted by the journal) I don't see how this changes reality.

But if you want a different study of the same type, try Schechter & Grether (2008).

The goal is not a discussion of science and differing points of view but rather who can jump in and be the most unpleasant to the "other side."

Project much, Dr.Gordon?

I've been asking polite, on-topic questions. You ignore them in favor of pursuing flamage. One might think that you were inviting punishment out of a sense of guilt.

By D. C. Sessions (not verified) on 10 Jun 2009 #permalink

ababa,

I think it's interesting that you find the need to tell me that I'm repeating what's been told to me, where you, yourself seem to repeat the same ole vaccine enthusiasm that you've been told here. Over and over again. Yes, I've read your posts here and you seem to repeat the same pro-disease, wait-til-there-are-dead-children stuff in different variations, but there really is no need to point that out to you... unless I'd like to detract from what it is you're actually saying.

If you think it was a cut and paste job, then you should have no trouble providing evidence of that claim. Isn't that what we do here at RI... balk for evidence? Guilt by association doesn't seem to work as well as it used to.

I'll address "your" reply.

You seem to be confused over what a personal injury tort entails, because you're comparing it to the Omnibus proceeding. In the case of injury, with the culprit being infectious disease of some sort facilitated by a natural person, you'd need to provide adequate proof that the injured party was infected by the defendant. We'll do this how? With epidemiology? Epidemiology will lend itself to deconstruction pretty quickly. So, how might you do that? Which "science" will you use to support the claim that the unvaccinated defendant "gave" the plaintiff disease? While you're at it, please point me to the unvaccinated "science"... I'm interested to read it. How will you prove that the defendant would have NOT injured the plaintiff if they had been vaccinated, and that remaining unvaccinated IS THE REASON for the injury? I've already stated that reckless behavior, like NOT quarantining and taking your infectious child, or self, to a populated place is reckless... and I'll say it again, there are exceptions.

I'm not aware of any follow-up testing that occurs after vaccination to test for immunity (absent titres, which seems to be discouraged) OR for contagion levels (and perhaps any other significant bio-markers)? While we're on this subject, I think it'd be a good idea for ALL vaccine recipients to have a mandatory follow-up appointment to do just that. I think each and every physician that administers a vaccine should be REQUIRED to submit their findings to a database, and that the parents should have to understand what they are reporting. Then maybe, just maybe, we can have a system that accurately tracks and reports what happens to vaccine recipients. Surely we'd all like to have an accurate, reliable, MANDATORY system, so we can do away with the inaccurate, unreliable, passive, VAERS? As long as the target group of vaccinees are pre-verbal infants under the age of two, this seems to be a responsible approach. It's not like your six month old will be able to actually tell you how they feel.

I appreciate you shifting this topic to autism, of which I've said nothing.

By lurking with a… (not verified) on 10 Jun 2009 #permalink

Parasitic Choice, what makes you think I care a flying frak what you think or who you think I think you are? Maybe you are Common Sue, or not. So what? You are still a clueless parasite and no one here will take your word about anything... unless you provide real evidence. Which you have not.

lurking,

You seem to be either hard on the uptake or have an issue with your reading skills. If that's how you summarize my posts then that speaks plenty to your general level of understanding.

My family is vaccinated with no medical issues, not sure why you keep referring to me in particular. You may want to address others like HCN, who's child cannot be vaccinated and would be at risk. Or, like the posts you also ignored, the parents that are deceived to not vaccinate and put their children at risk. They are going to be expecting some pretty big explanations. Again, with those reading skills.

Anti-vaxers are reckless. They have chicken pox and measles parties (sometimes in public places). They give out unsupported medical advice. They actively attempt to undermine public vaccination programs. All of that would tend to give migranes to lawyers.

Sure, I'll bet you can come up with something to explain it all away, but in the end you have to convince 12 non-lawyers that the grieving parents do not deserve compensation.

At which point you can move right on up to appeals. A place where the pseudoscience anti-vax nonsense will be received about as well as the Omnibus. Yes, Omnibus is different. It was alot easier to convince them. You can't get much more friendly than that court. And if you need me to pull up the "science" presented then you apparently read that about as well as you did things here.

Don't worry though, I'm sure those pro-bono defense lawyers will be willing to spend years trying this case through appeals for free. Not to mention all of the "experts" those defense lawyers would call that are well known for their large "appearance fees" for testifying.

Shift the topic to autism? I mention it ONCE in a quote that also contains "etc". Whoa, watch out for the aftershocks. Are you fishing for sympathy?

That's OK, nitpick the words all you want. Don't worry, you have definitely convinced me you have nothing to worry about! You have dazzled me with lawyer-speak and big words! From your posts though, I wonder if you have convinced yourself.

@Parental Choice: you say your children are vaccine injured. Injuries reported to the VAERs database? Recognized injuries known to be caused by vaccines? Or the false "injury" known as vaccine-caused-autism (VCA)?

As for those too young, and compromised... well, I find it interesting that the rest of the world is supposed to be responsible for their care?

I think that comments like this reveal the accuracy of the "parasite" characterization of vaccine refuseniks.

Of course, the sad irony is that while they are indeed fact free-loaders, enjoying the benefits of herd immunity without contributing to it, they are nevertheless placing their own kids at increased risk of death and severe disability, including brain damage. Sadly, it is the children who suffer from the foolishness and selfishness of the parent.

"Montreal and Quebec City do not have different vaccines schedules"

That may in fact be true. Having said that... it doesn't change the fact that the Fombonne study is fatally flawed because while I may have made an error in WHY it was fatally flawed... it is in fact the case :). Apparently Fombonne actually used the PDD rates in children from Montreal but he used the MMR coverage data from Quebec City... OOPS!:

"The earlier study also reported PDD rates in children from Montreal, but MMR coverage data was taken from Quebec City located 265km from Montreal. The researchers confirmed MMR coverage rates actually increased in Montreal along with PDD, noting a sharper rise in rates after the number of required MMR shots doubled".

http://tinyurl.com/kwwvno

By the way, before anyone tries to attack the people who note the problem... let's keep in mind that it was your guy who didn't know the difference between Quebec City and Montreal... What a meticulous researcher that Fombonne must be... Huh?

He should be offered a job with the CDC.

By Parental Choice (not verified) on 10 Jun 2009 #permalink

PC, could you please point out to me where the article shows the data coming from two different cities, as I've read it, it takes it's data from the whole province of Quebec. You may be getting confused by the fact that Quebec City is often referred to as simply Quebec, and both Quebec City and Montreal are in the province of Quebec. It looks like to me the data is taken from the entire province, this is probably why the link you cite was never published in a journal. The link also does not show where the article's data was wrong, just states that it was. If there is a fuller explanation, please provide it and I'd love to see how the study was wrong.

Also, you still have not provided the proof of Prevnar vaccine triggering IDDM, though you seem quite sure of it. I also have not yet seen the data that shows a dramatic increase in the incidence of IDDM in Australia in 1997. You seem to have ignored this and moved on to some other topic without evidence.

Dr. Jay whines:

This site could be valuable but it long ago degenerated into a parody of itself.

The people reading and commenting on this 'blog seem to disagree with you, Dr. Jay. Why are you still coming here, if this 'blog is so bad?

The goal is not a discussion of science and differing points of view but rather who can jump in and be the most unpleasant to the "other side."

Mr. Pot, meet Mr. Kettle...

Look above: You see lots of made up data and hypothetical scenarios...

Please cite the "made up data", Dr. Jay. Be specific - saying "above" is not specific.

...but the actual number of doctors contributing information can be counted on the fingers of one hand.

I'm a "doctor", Orac is a "doctor" - there are probably at least another four MD/DO/PhD types in the comments above, not including your illustrious self. And your point...? While I'm glad to see you've moved away from your "wisdom of the masses" position (at least when Ms. McCarthy and Mr. Carrey aren't reading), I'm surprised to see you acknowledge that education is relevant to a discussion of medicine. This seems to be at odds with some of your previous statements.

The reason: The doctors are busy taking care of real patients and real problems not theoretical epidemics caused by loss of "herd immunity."

Ah, yes - the inevitable "We're too busy saving lives!" gambit. Yet that fails to explain your presence here, Dr. Jay. Are you not "busy taking care of real patients and real problems"? And the "theoretical epidemics" will become all too real if immunity in the population drops enough - we have historical data to show that.

I realize that Dr. Jay isn't trying to tell everybody to not vaccinate their children - or even to be selective about vaccination. He reserves that advice for his clientele, safe in the knowledge that the rest of the population is taking the (very small) risk in order to keep his part of the "herd" safe.

Remove the sarcastic, insulting posts and the place could become a ghost town.

Wishful thinking, Dr. Jay. But, if you'd like to test that hypothesis, you could start by not posting any more sarcastic, insulting comments. I know that I would appreciate less snark and more substance from you. You could start by actually answering the questions that polite people have been asking you.

Your ball, Dr. Jay.

Prometheus

Dr. Jay: "This site could be valuable but it long ago degenerated into a parody of itself.

The goal is not a discussion of science and differing points of view but rather who can jump in and be the most unpleasant to the "other side.""

Hmmm...like accusing other commenters of being paid Pharma shills with zero evidence? Wait, that was Dr. Jay himself.

Maybe Dr. Jay means the flinging of insults. Like this for example:

"You can stick your post hoc ergo propter hoc bullcrap where the sun don't shine. Sorry but... you are a dumbass"

Nope...that's Parental Choice, antivaxer.

Dr. Jay has odd standards of decorum. They apparently apply only to him and people who agree with him. And when he focuses on his horror at snarky remarks, he gets to dodge questions from numerous commenters who've patiently provided valuable information and asked him specific on-topic questions. Dr. Jay's is a common tactic among Internet posters who like to duck inconvenient inquiries.

I would also like to see Dr. Jay single out one or more of the many research papers that've debunked a vaccine-autism link and explain why they're all wrong (without reference to ad hominems). That is, if he's not too busy healing the sick by waving his FAAP membership at them.

By Dangerous Bacon (not verified) on 10 Jun 2009 #permalink
Look above: You see lots of made up data and hypothetical scenarios...

Please cite the "made up data", Dr. Jay. Be specific - saying "above" is not specific.

I think he's referring to the 'facts' Parental Choice made up.

I agree with Dr. Gordon; this site would be improved if people refrained from gratuitous insults such as this (comment #122 on "Orac gets comments: Dr. Jay tries the 'pharma shill' gambit on him yet again"):

This has made me realize that it's downright dangerous to post among people with venom in their hearts and minds, no consciences and a dishonest attitude about science.

"You may be getting confused by the fact that Quebec City is often referred to as simply Quebec, and both Quebec City and Montreal are in the province of Quebec".

No, I am not confused... Fombonne was in fact "confused". The link pretty much sums up what happened.

"Also, you still have not provided the proof of Prevnar vaccine triggering IDDM, though you seem quite sure of it. I also have not yet seen the data that shows a dramatic increase in the incidence of IDDM in Australia in 1997. You seem to have ignored this and moved on to some other topic without evidence".

In regards to the Prevnar vaccine.... Dr. Classen testified in front of the FDA in 1999 in regards to the Prevnar vaccine. He believes/believed that the Prevnar should not be approved until it was found not to trigger type 1 diabetes in children. He believed that the vaccine could be 7x as toxic as the HiB vaccine and could cause an estimated 400-700 children to develop type 1 diabetes per 100,000 children immunized with the vaccine. It was approved anyway. Here's the bottom line. Where the hell are the people watching/tracking the numbers? Are you confident that Dr. Classen is wrong and there is no reason to worry about the vaccine (in regards to type 1 diabetes)? If you are confident, WHY are you confident in that? Where are the numbers? Spell it out for me... I think he's right. Every endocrinologist that I have spoken to (ok, two) believe that the numbers took a big jump since 2000. They didn't know why... I think that I do know why. My problem is God forbid that my child gets the measles... Heads would roll, people would be pissed, the ND blogs would have a field day... Any yet, hundreds of kids being diagnosed with a long-term chronic disease every year... Crickets. Shame, shame....

By Parental Choice (not verified) on 10 Jun 2009 #permalink

No, I am not confused... Fombonne was in fact "confused". The link pretty much sums up what happened.

The specific claim is that MMR coverage data was from Quebec City, not Montreal. Couple points:

1) This is irrelevant to the part of the paper dealing with thimerosal removal.

2) The web page does not provide raw data that may be looked at to see if any of its claims are correct. It's simply making assertions that are unverifiable.

You see, in peer-reviewed papers, even if you can't see the raw data (and I do think raw data needs to become more accessible), you can at least assume that peer reviewers did a reasonably good job of looking at the claims and analysis in some detail.

When you discuss data in web pages, on the other hand, you should be clear as to where the data comes from. If you don't provide the data yourself, at least give instructions on how the data may be obtained independently. I make a point of this in my own posts.

PC wrote:
Dr. Classen testified in front of the FDA in 1999 in regards to the Prevnar vaccine. He believes/believed that the Prevnar should not be approved until it was found not to trigger type 1 diabetes in children. He believed that the vaccine could be 7x as toxic as the HiB vaccine and could cause an estimated 400-700 children to develop type 1 diabetes per 100,000 children immunized with the vaccine. It was approved anyway. Here's the bottom line. Where the hell are the people watching/tracking the numbers? Are you confident that Dr. Classen is wrong and there is no reason to worry about the vaccine (in regards to type 1 diabetes)? If you are confident, WHY are you confident in that?

But you haven't answered certain important questions put to you:

1) What is the mechanism by which Prevnar supposedly triggers DM1?

2) Do children who become infected with HiB show a greater than average incidence of also developing DM1? Because, as someone on here already pointed out, you would expect that the wild type disease pathogen would also cause the same effect (causing DM1) as the vaccine supposedly does.

Please cite peer-reviewed scientific literature addressing the previous two questions.

Aha, after doing about ten minutes of research on my own using Google, I can report back that although Classen did some studies finding a correlation between vaccination and development of DM1 in children, other studies have not provided support for this hypothesis.

Note also that it is MUCH harder to prove causation than statistically significant correlation in any case.

Also, it seems that Dr. Classen has some very questionable credentials and seems to have some monetary conflict of interest of his own in terms of promoting his own pet theories/treatments for illness instead of vaccinations: http://www.geocities.com/issues_in_immunization/fearmongers/john_b_clas…

So he's part of BigAltMed, looking to line his pockets with money from gullibles like PC. Very sad.

Parental Choice wrote:
Every endocrinologist that I have spoken to (ok, two) believe that the numbers took a big jump since 2000. They didn't know why... I think that I do know why.

More "arrogance of ignorance". Yes, because you, PC, with no medical training save your "intuition", have come to a brilliant conclusion that all of these endocrinologists who spent years in graduate or medical school (or both) studying their fields and performing original reasearch still somehow missed completely...oh, and never mind the fact that medical studies have not borne out your (or Classen's) hypothesis. Yes, you are right, all of these learned endocrinologists are fools compared to you.

ababa,

Your vaccination status and that of your kids don't really matter in this discussion. Using such statuses to guilt others is a futile tactic, and it's not working. You saw fit to accuse me of something (whether you'll admit it or not), lumping me into some category that by default would hopefully negate anything I might have to say.

You first mentioned the Omnibus proceedings (autism related, yes?), drawing a parallel to a personal injury tort. You then reacted to my comment that there are lawyers that would defend a person in such a case, using autism as an example again. I'm not talking about autism, never have.

There are lawyers willing to defend this kind of personal injury tort for free, because 1) it would obviously be an extremely important case and 2) there is absolutely no judicial precedent to rely upon. No need to discuss evidence (or lack thereof) at this point I guess, but any critically thinking lawyer is capable maneuvering through the literature and coming out clean on the other side.

The fact of the matter is, unvaccinated people presenting proper symptoms to disease tends to land them in the index seat, right or wrong. 12 reasonable people, when presented with why that is, are capable of realizing that when people become ill from disease causing agents, vaccination status is a discriminating mechanism. We can certainly continue to volley back and forth attempting to decide who is being the snarkiest... or more illiterate, in the end it probably doesn't serve the discussion well.

trrll,

I understand that you believe that those declining vaccines are taking advantage of something (herd immunity) and putting "others" (general) at risk. You are imposing a duty upon "others" to protect those that are too young or compromised, as a societal contract, at least that's what I gather from Dr. Freeride's post, and this one. I am unclear on how the duty of "others" to protect these vulnerable populations overrides that of the caregiver and why this is limited to vaccines. What do the "others" get in return for alleged protection? Vaccine-induced herd immunity is not a tangible item.

That said, you don't know my vaccination status, and it's foolish to assume that just because I don't agree with the freeloading-parasite gambit that I'm not vaccinated. I am. That doesn't mean I can't make a child that is too young to be vaccinated sick. Why shouldn't I be liable if I spread disease, why shouldn't you?

Scapegoating vaccine critics because a subset of humans haven't conquered the viruses they want to, or the bacteria (opportunistic or otherwise) they want to, doesn't make sense to *everyone*. If people see value in a vaccine, they should be allowed to choose it. If they don't, they should be allowed to decline it. These choices should surround the person taking the vaccine. However, if that's not the way it's to be, sadly, it all starts on a politician's desk.

By lurking with a… (not verified) on 10 Jun 2009 #permalink

I have a prevention tip: I heard about a great program called Germy Wormy Germ Smart that teaches kids to understand how germs spread and how to NOT spread germs. My child learned it at school. It was so much fun for her, and it was amazing how quickly the kids learned healthier hygiene habits!

Bree Hill, you spamming your program is not useful.

How exactly do you prevent airborne virus from being breathed in? Especially one that is as contagious as measles?

Some ideas on why type 1 diabetes incidence is increasing:

"Why this rise in type 1 diabetes over the past few decades? The rapid and significant changes within genetically stable populations cannot be explained by the increased transmission of diabetes genes from one generation to the next. They more plausibly suggest some changes in the environment that may have accelerated the disease process by overloading the pancreatic beta cells â the âoverloadâ hypothesis. Thus, the condition develops in younger and younger people â the âspring harvestâ hypothesis â and in genetically less susceptible children. These environmental changes include an overall increase in the rate of childrenâs growth, overfeeding and increased levels of body fat, and the decreasing age of puberty."

http://www.diabetesvoice.org/files/attachments/article_499_en.pdf

Could there be other "environmental factors"? Well, let's see...lack of physical activity...pesticide residues...atomic radiation...plastics...VACCINES!!! IT'S GOTTA BE THE VACCINES!!! THEY GOT ETHER! ANTIFREEZE! ABORTED HUMAN FETUSES! MERCURY!!! (o.k., scratch the mercury) VACCINES!!! AUGGGGHHHHH!!

That's the "science" according to antivaxers. When all you've got is a hammer (increasingly battered and rusted) everything looks like a nail.

By Dangerous Bacon (not verified) on 10 Jun 2009 #permalink

I'm fully aware that I cannot guilt others into vaccinating to protect those that cannot protect themselves. That's kind of the point of this whole conversation.

lurking, really, your concern trolling convinced me! You have nothing at all to worry about, no one could possibly hold anti-vaxers responsible. I see the error of my ways!

They should soldier on, handing out unsupported and dangerous medical advice, selling biomedical "treatments" and downplaying severity of diseases that kill. No reason they should ever need to answer for that! I mean doctors have to be licensed and carry malpractice insurance to do those sorts of things, but they never need to use that do they?

ababa,

I'm not trying to convince you of anything, that's the difference between you and me. You simply refuse to believe there is any logic to the other side. It sure is easier to accuse them of plagiarism and trolling. This discussion is about contractual obligations, and I've asked you some pretty valid questions that you've iced right on over with one debate tactic after another.

Most discussion boards contain disclaimers, if they don't, they're reckless. Who in their right mind seeks medical advice on the internet?

By lurking with a… (not verified) on 10 Jun 2009 #permalink

"Could there be other "environmental factors"? Well, let's see...lack of physical activity...pesticide residues...atomic radiation...plastics...VACCINES!!! IT'S GOTTA BE THE VACCINES!!! THEY GOT ETHER! ANTIFREEZE! ABORTED HUMAN FETUSES! MERCURY!!! (o.k., scratch the mercury) VACCINES!!! AUGGGGHHHHH!!"

Fascinating. Actually, if you know anything about how the "experts" explain what may be happening it goes something like this: There are environmental triggers to type 1 diabetes. Those triggers could be pesticides, milk protein, Vitamin D deficiency, etc...

(Never ever a mention of vaccines).

It's an attempt to ignore the very real possibility that vaccines are a contributing factor.

By Parental Choice (not verified) on 10 Jun 2009 #permalink

Parental Choice wrote:
It's an attempt to ignore the very real possibility that vaccines are a contributing factor.

Except that the possibility that vaccines could be a contributing factor has already been studied and discounted due to lack of evidence.

lurking said: This discussion is about contractual obligations

Contracts? Where? You focused on liability of the people that do not vaccinate. I was focused on those that give medical advice and take actions against public health. There is a clear difference.

I haven't iced over your points. I presented several real world scenarios I have personally witnessed. If you don't think they are a problem then I will honor your opinion that they have nothing to worry about. Of course, it's not my opinion or yours that matters.

You are dealing with perfect world mechanics, I was addressing real world.

lurking said: Most discussion boards contain disclaimers, if they don't, they're reckless. Who in their right mind seeks medical advice on the internet?

Exactly. Your words, not mine.

And while we are at it, where is that disclaimer on Age of Autism? Not sure I saw one when I glanced through Jenny McCarthy's books at the bookstore. Generation Rescue? Nope.

Reckless. You and I completely agree.

Perhaps insurance companies should be the ones acting in their own best interests, which would coincide with the public's best interest -- vaccinate your kids or we won't pay for your kid to be hospitalized due to complications arising from preventable childhood disease. At the very least, public health plans could make such rules.

But they won't. Insurers are getting into woo and pseudoscience. Harvard Pilgrim sent me a brochure offering me a discount on all sorts of unproven crap.

@Parental Choice: I know you have been busy talking to others, but could you answer my simple questions about your kids' vaccine injuries? (comment #120, in case you missed it)

"@Parental Choice: I know you have been busy talking to others, but could you answer my simple questions about your kids' vaccine injuries? (comment #120, in case you missed it)"

No, I won't because it's none of your business.

By Parental Choice (not verified) on 11 Jun 2009 #permalink

"Except that the possibility that vaccines could be a contributing factor has already been studied and discounted due to lack of evidence".

Oh really... I must have missed all those studies. Please post them.

By Parental Choice (not verified) on 11 Jun 2009 #permalink

PC, someone earlier in the thread posted a reference to one. It's not hard to use Google to find others. In any case, where is your evidence that vaccines are linked to DM1? There's Classen's claims and....what else? Where are all the replications of his findings?

What is the mechanism for how vaccines supposedly trigger DM1, anyway?

Perhaps insurance companies should be the ones acting in their own best interests, which would coincide with the public's best interest -- vaccinate your kids or we won't pay for your kid to be hospitalized due to complications arising from preventable childhood disease.

One word: denial.

Two more words: poster child.

Insurance companies have to market themselves, and stories of parents (who never believed that those diseases could happen to them) with horribly ill kids and the heartless insurer who wouldn't cover them are not good for business.

By D. C. Sessions (not verified) on 11 Jun 2009 #permalink

All right, for studies showing no relation to vaccines and IDDM, let's use:

http://content.nejm.org/cgi/content/full/350/14/1398

http://pediatrics.aappublications.org/cgi/content/abstract/108/6/e112

http://www.bmj.com/cgi/content/abstract/318/7192/1169

Just for 3.

Now, for the last time, where is your proof that the Prevnar vaccine triggers IDDD? I'll take any article really, just for a start, as you've provided none.

Then, if you'd please, could you show me the proof that the incidence of IDDM dramatically increased in 1997? This should be easy to find, and I will require the data from a reliable source, as this would be written about extensively if true. Or you can just admit you thought you remembered reading this somewhere, but you were wrong.

Then, I'm still waiting for the data to show that Fombonne confused Quebec City and Montreal in his data, I again think you are confusing the province of Quebec with Quebec City and would like to see the hard numbers, as Fombonne seems to be taking stats from the province of Quebec, not Montreal and Quebec city separately.

Reviews from the last decade that discuss the lack of supporting evidence for vaccination as a causitive force in the development of diabetes (using PubMed IDs): 15917108, 11334504, 11334497, 15274538

"PC, someone earlier in the thread posted a reference to one. It's not hard to use Google to find others. In any case, where is your evidence that vaccines are linked to DM1? There's Classen's claims and....what else? Where are all the replications of his findings"?

Oh trust me, I'm an expert in 'The Google'. I've read all the studies, I was just interested in seeing which ones were posted :) Every study that I have read (re: vaccines and type 1 diabetes) deal with one vaccine and the increase/no increase in type 1 diabetes. For example "MMR vaccine not found to trigger type 1 diabetes", "Hep B vaccine not found to trigger type 1 diabetes", etc... (made up examples but you get the idea). One vaccine out of a large schedule of toxic waste does me no good... Then, there's the studies out of Denmark by Hviid... Which considering how that was a complete scam with the Autism/vaccines studies why would I trust them for type 1 diabetes studies? Not trustworthy.... AT ALL.

Give me a vaccinated vs. unvaccinated study and then come back and we can chat.

By Parental Choice (not verified) on 11 Jun 2009 #permalink

PC said "Then, there's the studies out of Denmark by Hviid... Which considering how that was a complete scam with the Autism/vaccines studies why would I trust them for type 1 diabetes studies?"

Is there an echo in here? Because that sounds very familiar.

If you are not Common Sue, you are definitely a clone.

(FYI: Sue M. has two children, neither autistic. One has celiac and the other has Type 1 diabetes. Whenever the Danish studies were mentioned she would go nuts saying how they were horrible scams)

Give me a vaccinated vs. unvaccinated study and then come back and we can chat.

Well, time to mention the phone survey by your good friends at Generation Rescue. Let's look at the aggregated data for boys and girls.

15 of 991 (1.51%) of completely unvaccinated children had Juvenile Diabetes vs. 95 of 14900 (0.64%) of fully vaccinated children (OR=0.42).

It should be noted that the cultural and biological biases of the survey as they pertain to autism would not apply so much to diabetes, under the assumption that the vaccine hypothesis of diabetes is not as well known as the vaccine hypothesis of autism.

"Well, time to mention the phone survey by your good friends at Generation Rescue. Let's look at the aggregated data for boys and girls".

Hee hee... I am dying with LOL's right now. If GR is good enough for your diabetes information, they need to be good with your autism information also. You don't get to use their information when it's convenient and not use it when it isn't. So sorry...

By Parental Choice (not verified) on 11 Jun 2009 #permalink

" Whenever the Danish studies were mentioned she would go nuts saying how they were horrible scams)"

Well, it is a known fact that the Danish studies were frauds... Right? That's old news.

By Parental Choice (not verified) on 11 Jun 2009 #permalink

If GR is good enough for your diabetes information, they need to be good with your autism information also. You don't get to use their information when it's convenient and not use it when it isn't. So sorry...

Nonsense. First, clearly the GR phone survey is something I like to use to beat anti-vaxers over the head with. It's very much fun to do so.

Second, their autism information (which they don't admit to) is this: 3.01% of fully vaccinated children had an ASD diagnosis vs. 3.73% of all completely unvaccinated children. (Yes, both rates are very high, and there's a reason for this.)

Third, even if data is collected poorly (and I have explained why the survey is poorly designed) it's still data. If for nothing else, it can be used to study what poor data collection does to data. Only if you think the data was fabricated might it be considered useless.

Finally, I care about data and methodology, not so much personalities. I don't dismiss data outright based on the source of the data, except in the case of guys who are known to commit various types of deliberate fraud (e.g. the Geiers or Wakefield.)

"@Parental Choice: I know you have been busy talking to others, but could you answer my simple questions about your kids' vaccine injuries? (comment #120, in case you missed it)"

No, I won't because it's none of your business.

- Then why in Hell did you bring it up in comment 109?

By T. Bruce McNeely (not verified) on 11 Jun 2009 #permalink

@155: Simple! It's our business so long as it helps her arguments and makes her sound more credible, but it's none of our business if we try to get the information necessary to address her arguments.

See, she's perfectly consistent - nothing is secret unless it would hurt her claim, in which case everything is secret.

By Michael Ralston (not verified) on 11 Jun 2009 #permalink

PC said "Well, it is a known fact that the Danish studies were frauds... Right? That's old news."

Actually, only in Sue M's mind, and perhaps in the mind of Handley and the rest of the Generation Revenue folks, oh and Mister 777 (Kevin Champagne), Wade Rankin and the EoH crowd. It is not the opinion of those who actually understand biology, epidemiology and science.

This is old stuff, and you still have not changed your tune.
http://leftbrainrightbrain.co.uk/?p=346 .... "Interesting that you said that you read the science⦠arenât you just now getting to the reasons why the Danish studies are bogus. Had you read EoH you may have been able to figure that out about a year ago. Simple."

Still, the same dismissive bullheaded attitude. Which would work better if you actually provided some real evidence to the snark.

I'll repeat a question by the owner of that blog, Kev, made in 2005: "Iâm interested (as I donât know) â which scientists not affiliated with the thiomersal/autism link think that the Danish studies are deeply flawed enough to be irrelevant?"

Do you mind telling who thinks that the Danish studies are so flawed as to be called fraudulent, that is not associated with Generation Rescue, SafeMinds, NVIC and the other folks who are in the "vaccines are evil" camp? Make it someone with real relevant credentials (like not Bernadine Healy or Jeff Bradstreet, and definitely not Marcel Kinsbourne).

"I do find it fascinating that the vaccine portion of the debate is always muted out in the discussion... why is that?"

For the same reason that the sunspot portion of the debate is always muted out, you troll.

By DiscomBob (not verified) on 11 Jun 2009 #permalink

@T. Bruce (155) and Michael (156)...I rather figured she wouldn't answer my question, or would say it's none of my business. After all, if it was a REAL vaccine-caused injury, reported to VAERs or not, I'm sure she would at least say so (and that's all the information I asked for. I did not ask for specifics). However, since she obviously believes in vaccine-caused-autism, she refuses to say so because she knows VCA has not been proven scientifically to exist.

"Do you mind telling who thinks that the Danish studies are so flawed as to be called fraudulent, that is not associated with Generation Rescue, SafeMinds, NVIC and the other folks who are in the "vaccines are evil" camp?"

Anyone with a few brain cells knows that the Danish studies are so flawed as to be called fraudulent. Are you telling me that a group like this - supposedly considered to be a group based on 'science' alone cannot figure out that the Danish studies are bogus? Unbelievable. I'm going to bring up ONE point here (although there are MANY faults with the various studies that would/should be enough to toss the studies in the trash... Again though, due to time constraints, let's just stick with one.

In one of the Danish studies (Madsen), they changed the parameters during the time of the study. Blaxill notes:

"Autism counts were first based on hospitalized, inpatient records and then changed in the middle of the study period to add in outpatient records. This new outpatient registry was introduced in 1995. Therefore, their purported increases after 1994 can be explained entirely by the registration of an existing autism population that did not require hospitalization".

Despite the fact that you don't trust Blaxill... How would it ever be legit to do a study and then change the parameters in the middle of the study? Clearly, the supposed 'increase' in numbers after 1994 have to do with the change of the parameters... and yet they try to suggest that the fact that the numbers went up after 1994 somehow means that thimerosal isn't linked to autism (due to the time frame in which they removed thimerosal). Oh My.... This is Science 101 and yet, you don't understand why I consider the Danish studies to be flawed... WTF?

By Parental Choice (not verified) on 11 Jun 2009 #permalink

PC, Blaxill has a Masters in Business Administration... and is not qualified.. I am more inclined to believe Dr. Mark Crislip, who is an infectious disease doctor. He occasionally posts at ScienceBasedMedicine. He did not seem to find a problem with the Danish studies here:
http://www.sciencebasedmedicine.org/?p=466 (oh, and the last comment by someone who did a pseudoscience analysis is silly... she is also a global warming denialist!).

Could you at least try to find information outside of the Generation Rescue websites? Perhaps even try thinking for yourself and read some actual literature from people who actually have trained in science, and are not trying to make a buck off of desperate parents by pushing cures or being professional court "experts"?

Also, it is a Danish study on vaccines and diabetes, not autism. So the stuff on thimerosal does not apply.

Going back to the link, http://content.nejm.org/cgi/content/abstract/350/14/1398 (since you seem to have mixed up which study is being referred to)... there is a list of papers that cite that study. Can you tell how Blaxill is more qualified than the authors on the following list?

# Caicedo, R. A., Li, N., Atkinson, M. A., Schatz, D. A., Neu, J. (2005). Neonatal Nutritional Interventions in the Prevention of Type 1 Diabetes. NeoReviews 6: e220-e226 [Full Text]
# Silverstein, J., Klingensmith, G., Copeland, K., Plotnick, L., Kaufman, F., Laffel, L., Deeb, L., Grey, M., Anderson, B., Holzmeister, L. A., Clark, N. (2005). Care of Children and Adolescents With Type 1 Diabetes: A statement of the American Diabetes Association. Diabetes Care 28: 186-212 [Full Text]
# Carrier, J. (2004). Routine childhood vaccinations did not increase the risk of incident type 1 diabetes in Danish children. Evid. Based Nurs. 7: 121-121 [Full Text]
# (2004). Other articles noted. Evid. Based Med. 9: e5-e5 [Full Text]
# Wasfy, J. H. (2004). Childhood Vaccination and Type 1 Diabetes. NEJM 351: 298-298 [Full Text]
# Varma, S. K. (2004). No Link Between Childhood Vaccination and Type 1 Diabetes. AAP Grand Rounds 12: 4-5 [Full Text]
# (2004). Minerva. BMJ 328: 1024-1024 [Full Text]
# Odigwe, C. (2004). Researchers find no link between vaccination and type 1 diabetes. BMJ 328: 854- [Full Text]

I'm not sure why Madsen et al. thought it would be a good idea to base their study on inpatient data, and would be very concerned if they had not changed their parameters during the study.

At the current moment, none of the commentators on this change can point out a single reason for WHY this change is not a reasonable adjustment (given that it's possible to receive a diagnosis and then go on to not have an inpatient admission before the upper age limit). Not including outpatient data could potentially have skewed the data to only include people with autism that had been hospitalised.

We all know what Blaxhill et al. would be claiming had they not done so.

Yes that's right: "You didn't include the rest! Fraud! Shills!"

Someone better explain how and why they think this makes the Madsen study flawed. Assertion that you don't change parameters during study (nonsense in itself - it's part of the process of dealing with confounders and other factors that you're supposed to do) is merely pure assertion.

Someone better explain how this weakens their numbers and figure, assertions of flaws doesn't cut it.

Anyone with a few brain cells knows that the Danish studies are so flawed as to be called fraudulent.

Clearly Sue M.

Despite the fact that you don't trust Blaxill... How would it ever be legit to do a study and then change the parameters in the middle of the study?

Nothing about that is fraudulent. As Dr. Novella explains, the data sources studies depend on often have changes in the data collection methods they use over time.

That's true of most autism studies. There's no active surveilance system for autism that is uniformly the same over time in terms of both criteria and case-finding. Typically they are passive systems (like CalDDS) that rely on people voluntarily registering with the system.

More importantly, the authors were well aware of this limitation, and they analyzed inpatient data separately.

In other words, Sue, you got nothing.

Dedj said "I'm not sure why Madsen et al. t"

Why even mention Madsen on the cited study? He is not one of the authors! The study posted is:
Childhood Vaccination and Type 1 Diabetes
Anders Hviid, M.Sc., Michael Stellfeld, M.D., Jan Wohlfahrt, M.Sc., and Mads Melbye, M.D., Ph.D.

PC is just doing a knee jerk on the basis of it being Danish!

Sorry, I temporarily forgot that PC still has questions to answer regards vaccines and DM1, and naively assumed that he/she was trying to make a serious point and not shamelessly trying to divert attention away from thier inability to answer a direct and clear question.

Why even mention Madsen on the cited study?

Sue's argument is that if one Danish study is bad, they're all bad. Let's keep having fun, though. What are the serious flaws in Hviid et al.?

"PC, Blaxill has a Masters in Business Administration... and is not qualified.. I am more inclined to believe Dr. Mark Crislip, who is an infectious disease doctor. He occasionally posts at ScienceBasedMedicine".

Again, I don't care who Blaxill is in this case. The reason: Anyone with a few brain cells can read the studies and then can read the critiques to understand that whether Blaxill is a neurosurgeon or a 8th grade science student... He's CORRECT. It's as simple as that. Are you saying that it doesn't matter that the parameters/data were changed in the middle of the study? You're out of your mind...

Dr. Mark Crislip is an idiot if he can't figure out why the Danish studies are bogus. Honestly, I don't mean to be a jerk... but it's true in this case. I'm sure that if I asked my 9 year old about this study, she would understand why it is a complete fraud. Now, it may take some time to go over the issues with her (she's 9 afterall) but she would get it in the end. If Crislip or anyone else can't see that... Sorry, but your just not intelligent enough to discuss it with.

By Parental Choice (not verified) on 12 Jun 2009 #permalink

Uh, oh... that should be *you're* just not intelligent enough to discuss it with.

Crap... making a mistake in a sentence about intelligence. Duh@me.

By Parental Choice (not verified) on 12 Jun 2009 #permalink

"Why even mention Madsen on the cited study? He is not one of the authors! The study posted is:
Childhood Vaccination and Type 1 Diabetes
Anders Hviid, M.Sc., Michael Stellfeld, M.D., Jan Wohlfahrt, M.Sc., and Mads Melbye, M.D., Ph.D.

PC is just doing a knee jerk on the basis of it being Danish!"

HCN, I had moved on, ok... The point is... Madsen and Hviid have both done studies which turned out to be based on incorrect/incomplete information. They have both been proven to be untrustworthy as researchers due to the ridiculous claims of the autism studies. Therefore, why would I trust either one of them for a study involving type 1 diabetes? What kind of tricks could they manage with that information.... :)

By Parental Choice (not verified) on 12 Jun 2009 #permalink

Dedj:

Sorry, I temporarily forgot that PC still has questions to answer regards vaccines and DM1, and naively assumed that he/she was trying to make a serious point and not shamelessly trying to divert attention away from thier inability to answer a direct and clear question.

Joseph:

Sue's argument is that if one Danish study is bad, they're all bad. Let's keep having fun, though. What are the serious flaws in Hviid et al.?

I see Parasitic Choice is still not answering direct questions, and is just lobbing insults. It is best to ignore this person, as its mind is welded shut and will never change its mind.

Do not feed the troll.

Proving how one can accuse people of being untrustworthy [i]when the alledged untrustworthy persons identified both thier actions and the possible effect of their actions in the original paper[/i], has so far been utterly beyond the ability of those making the claims.

That's all that needs to be said.

It's as simple as that. Are you saying that it doesn't matter that the parameters/data were changed in the middle of the study? You're out of your mind...

You're not paying attention, PC/Sue. The authors analyzed inpatient data only in a separate analysis, because they understood the inpatient/outpatient issue, and found the same results. This completely invalidates Blaxill's critique. You. Got. Nothing.

"Incidence in children under 5 years of age has doubled over the
last 5 years - we don't know why".

This is a typical out-and-out lie from parasitic choice.

From 2000 to 2006 in Australia, the incidence of Type 1 diabetes rose less than 3 percent per year. The increase in children under 5, and between 5 to 9 did not even reach statistical significance. There was a statistically significant increase in those aged 10 to 14.

http://www.aihw.gov.au/publications/cvd/iot1dia00-06-fr/iot1dia00-06-fr…

All I saw from PC was excuses, but no real answers to the simple questions she was asked. One of those questions was what qualified persons had a dispute to the Danish vaccine/autism study, and all she could produce was Blaxill waxing on about a completely different paper. The only common element is that they were from the same country.

Sorry, lat at night.. I meant to say "One of those questions was what qualified persons had a dispute to the Danish vaccine/DIABETES study,"

Sorry for the delay ababa,

you said: "Contracts? Where? You focused on liability of the people that do not vaccinate. I was focused on those that give medical advice and take actions against public health. There is a clear difference."

? Dr. Freeride's post (that Orac is praising in this post, linking to and copying from) specifically relates to social contracts and the perceived benefit of vaccine induced herd immunity. There have been a few posts on this blog, elsewhere not specifically in this thread, that have said (and I'm paraphrasing): "All it will take is for someone to sue an unvaccinated person for infecting another and this antivaccine movement will stop"... something like that. There are some severe scientific limitations here, and I've listed them in my handful of posts. And it all starts with defining one's contractual obligations, social or otherwise.

Truth be told, I don't read Age of Autism, and I don't know much about Jenny McCarthy so I'll defer to others. If anyone dispenses "advice" of any kind, not necessarily limited to medical, it should be clear that they are espousing their opinion. And people that read message boards and other publications that are not academic should be well aware that anything contained therein is anecdotal.

By lurking with a… (not verified) on 15 Jun 2009 #permalink

Socioeconomic, hygiene and sanitation factors were indeed the major reasons for the dramatic decline in childhood infectious disease mortality in the first half of the 20th century. A 2000 Pediatrics paper states this:

âFor children older than 1 year of age, the overall decline in mortality experienced during the 20th century has been spectacular. In 1900 >3 in 100 children died between their first and 20th birthday; today, <2 in 1,000 die. Nearly 85% of this decline took place before World War II, a period when few antibiotics or modern vaccines and mediciations were available.â

âThe major declines in child mortality that occurred in the first third of the 20th century have been attributable to a combination of improved socioeconomic conditions in this country and the public health strategies to protect the health of Americans. These public health measures included the establishment of local health departments in nearly all of the states. State and local health departments implemented these public health measures including water treatment, food safety, organized solid waste disposal, and public education about hygienic practices. These improvements in water and food safety and purity are linked to the major decline in diarrheal diseases seen in the early years of the century. Similarly, improvements in housing and decreased crowding in US cities are linked to the reductions in mortality to tuberculosis and other diseases attributable to person-to-person airborne transmission. Vaccination, while first used in the 18th century, become more widely implemented in the middle part of the century. Vaccines against diphtheria, tetanus, and pertussis became available during the late 1920âs but only widely used in routine pediatric practice after World War II. Thus vaccination does not account for the impressive declines in mortality seen in the first half of the century.â

Annual Summary of Vital Statistics: Trends in the Health of Americans During the 20th Century, Guyer B. Freedman MA Strobino DM and Sondik EJ, Pediatrics 2000; 106;1307-1317

Look up the data yourself: http://www.cdc.gov/nchs/products/vsus.htm

Sorry I cut off the first paragraph of the Pediatrics paper, here it is in its entirety:

âFor children older than 1 year of age, the overall decline in mortality experienced during the 20th century has been spectacular. In 1900 >3 in 100 children died between their first and 20th birthday; today, <2 in 1,000 die. Nearly 85% of this decline took place before World War II, a period when few antibiotics or modern vaccines and mediciations were available.â

I'll try again, "...today, less than 2 in 1,000 die. Nearly 85% of this decline took place before World War II, a period when few antibiotics or modern vaccines and mediciations were available.â

Annual Summary of Vital Statistics: Trends in the Health of Americans During the 20th Century, Guyer B. Freedman MA Strobino DM and Sondik EJ, Pediatrics 2000; 106;1307-1317

diatom:

Socioeconomic, hygiene and sanitation factors were indeed the major reasons for the dramatic decline in childhood infectious disease mortality in the first half of the 20th century.

That is true for many hygiene associated diseases like cholera, typhus and several not associated with vaccines like various bacterial infections.

What is really weird is that increased sanitation is what caused the rise of polio after the first few years of the 20th century. Typically children got infected with polio as infants when they were more able to fight it off. But later, when they were older they would encounter the virus in a lake they would get infected and then get very ill (summer was polio season, do you know why?).

The sanitation argument falls with recent events in Europe and Japan, and even the USA. When measles vaccination was made voluntary in Japan, it came back with a vengeance (with several dozen people dying), and it is now a problem in Europe, especially in the UK.

Also, it is not fair to compare cases versus deaths between the first and second half of the 20th century. In the latter half of that century more very sick kids were kept alive with better hospital equipment. Though while they were kept alive, it does not mean they were unaffected (because mumps is now endemic in Japan, it has been realized that mumps actually causes deafness in one out of a thousand cases... see An office-based prospective study of deafness in mumps).

What you must look at is incidence, not deaths. You can see the dramatic drop in incidence of several diseases just by looking at the tables at CDC Vaccine Data and Statistics Appendix of the Pink Book.

Oh, and the CDC Pink Book Appendix G has the information in a better to digest form than the entire set of American health trends. Can we say "baffle with bodacious amount of baffling babbity babbling?"

Appendix G is fine if youâre only interested in the 15% of the 20th century decline in infectious disease mortality that occurred post-1950 and not the 85% decline that occurred pre-1950.

I like your comment about fairness when citing data from the first half of the century vs. the latter half. So often vaccine proponents cite the high disease mortality rates from the beginning of the century and label them as "pre-vaccine". Not fair (perhaps inaccurate is a better description), when mortality rates declined by 85% before vaccine development.

Mortality and incidence rates both have their shortcomings. Incidence rates can be misleading for diseases like polio, with 95% of infections inapparent according to the CDCâs Pink Book. Also many diagnoses in the past were made clinically without lab confirmation.

Figure 4 of the paper cited below shows that the decline in mortality during the first half of the 20th century occurred in several diseases, not just the âsanitationâ diseases you refer to. Pneumonia, influenza, diphtheria, pertussis, measles all experienced the same dramatic decline. From 1937 to 1953 the annual decline in infectious disease mortality accelerated. The disease categories that contributed most to this decline were pneumonia, influenza and tuberculosis. According to the authors, these accelerated declines coincided with the first clinical use of sulfonamides, antibiotics, etc.

Trends in Infectious Disease Mortality in the United States During the 20th Century, Armstrong GL, Conn LA, Pinner RW, JAMA 1999;281(1):61-66

Doctors are not God. Who ever wrote this article is no prophet (the author presumed vaccination has saved more lives). Vaccines can not be proven good or bad. It takes as much faith to take them as to not take them.
Who do you believe? Take my vaccine elixar and you will have more abundant life and a sick free society. The fact remains, the blind will lead the blind into a pit. How can a slop of animal DNA and toxic chemicals save anyone? It's mad...like boiling you in oil to make you a stronger person.
Take this test, follow the money. You will then see why you must take a vaccine.
Governments wants people to die or have shorter lives...The world, according to them, cannot sustain you and them. Don't follow the herd mentality. Most cattle get slaughtered in the end.

By Dealcrusher (not verified) on 01 Sep 2009 #permalink

Shorter Dealcrusher: "WHARRGARBL!"

By Scientizzle (not verified) on 01 Sep 2009 #permalink

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...

I think the biggest reason antivax is so successful is small reference pools. According to the last vaccination post on here, Hib used to infect 1 in 200 children, of which 1/2 to 2/3 developed meningitis. So that's 1 in 300-400 children with Hib meningitis. A *huge* number, in the whole population. But who actually knows 300 children? Even with a rate that bad, the average person won't know anyone who suffered from it.

It's even worse for something like measles; if it's a very common disease and a few victims in a thousand die, *everyone* will know lots of people for whom it was mild, and relatively few people will know anyone it was crippling or fatal for. (Also, with the older diseases, we only know the people who survived...)

In a population the size of the US, you can get a pretty horrific number of deaths/year before it becomes noticeable to the average person...