Sometimes, when it comes to the anti-vaccine movement, I feel as though I'm bipolar. There are times when I'm incredibly depressed that pseudoscience and fear mongering are winning out, leaving our children vulnerable to infectious diseases not seen in decades and believing that it's only a matter of time before we start seeing really major outbreaks. This mood tends to strike me when I see actual stories about plummeting vaccination rates and, well, small outbreaks of diseases associated with low vaccination rates and unvaccinated children.
There's a condition in surgery known as a "sentinel"--or "herald"--bleed, which is generally associated with something called an aortoduodenal fistula, which is an abnormal communication between "big red" (the aorta) and the duodenum. One condition in which aortoduodenal fistulae occur is when there is synthetic graft material in the aorta behind the stomach, which is generally the case after an open repair of an abdominal aortic aneurysm. However, they can also occur after pancreatic surgery, such as the Whipple pancreaticoduodenectomy. In both cases, scarring and chronic inflammation lead to the abnormal connection. In the context of such fistulae, a "sentinel" bleed is generally a relatively small, self-limited upper GI bleed. The patient bleeds, then stops. Everything appears to have settled down. Then, usually hours although sometimes days later, the patient suffers a massive exsanguinating hemorrhage from the fistulae. There are other examples of herald bleeds. One arguably more common example is the herald bleed that occurs with the rupture of a cerebral aneurysm. The patient will complain of a sudden onset of the worst headache he's ever had in his life, which will result in a workup. Often the CT will be negative, although a lumbar puncture will usually find blood in the cerebrospinal fluid. Then, when things appear to have settled down, the patient can suffer a massive subarachnoid hemorrhage that kills him or leaves him with permanent neurologic disability. Basically, the aneurysm will start with a small leak that seals itself off sometime before it ruptures and bleeds profusely.
The relatively small outbreaks, such as the measles outbreak in San Diego, could be viewed as being similar to sentinel bleeds, relatively small and self-limited. I fear the real outbreak, as well we all should. Thanks to the anti-vaccine movement, it's a matter of time unless current trends reverse themselves. When I think about this, I become very depressed.
Sometimes, though, I feel a bit at the manic end of the bipolar spectrum. These feelings tend to occur when very bad news, of which there's been more and more lately, strikes the anti-vaccine movement. Examples are much more common in the last year than before and include the fall of Andrew Wakefield. Also, happily, the media have been less and less sympathetic to the anti-vaccine movement, turning the narrative from that of plucky parents fighing The Man and the uncaring system to people who reject science when they don't like it and whose irresponsibility endangers every children. We saw this in Chris Mooney's Why Does the Vaccine/Autism Controversy Live On?, Amy Wallace's An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All, and excellent exposes by Trine Tsouderos and Pat Callahan on the autism biomed movement and how dubious autism "treatments" based on anti-vaccine beliefs refuse to die. The result is that, over the last year, I definitely get the feeling that the tide has turned. Reporters see a good story in the anti-vaccine movement, but anti-vaccine parents are no longer invariably the sympathetic figures in that story. This is a good thing indeed!
Not surprisingly, seeing their glowing press coverage evaporate, the anti-vaccine movement has gotten a bit...well, frustrated. Signs of that frustration are evident in anti-vaccine zealots' increasingly vicious attacks on those who have the temerity to point out that science is not on their side. Amy Wallace, for instance, was the victim of misogynistic attacks by J.B. Handley, while Steve Novella was at the receiving end of one of J.B. Handley's rants. Perhaps the most spectacular meltdown came when the anti-vaccine crank blog Age of Autism posted a crudely Photoshopped image of Trine Tsouderos, Steve Novella, Paul Offit, Amy Wallace, and Thomas Insel sitting around a Thanksgiving table preparing to feast on a baby. Meanwhile, a steady stream of invective likens those who stand up to science to Nazis, Stalin, and all manner of evil.
Given this background, I wondered what to expect after the airing of a FRONTLINE episode The Vaccine War, which I reviewed the other day. I didn't have long to wait. The chief spokescelebrity, Jenny McCarthy herself, weighed on--where else?--The Huffington Post with a little ditty called Frontline's "The Vaccine War" Misses Half the Story. Not to be outdone, on the very same day, that pediatrician to the stars, consigliere to the anti-vaccine movement with serious anti-vaccine tendencies that he refuses to admit, Dr. Jay Gordon, weighed in with an outraged screed of his own entitled PBS Frontline on Autism Resorts to Pseudo-Documentary, Tabloid Journalism. Both are pathetic--woo-ful, if you will--whines, and the very fact that they were written suggests the impotence of the anti-vaccine movement in the face of science that passed them by at least five years ago.
Of the two, Dr. Gordon's strikes me as the more pathetic. Here's the reason. Take a look at the introduction:
Tonight PBS aired a show called "The Vaccine War." I was interviewed at great length and in great depth about vaccines and my point of view and expressed my ambivalence about the polarization of this issue and the need for more calm reasoned discussion about the number one question that new parents have. I told Kate McMahon, the co-producer of the show, that there was a large group of doctors and others who cannot be dismissed with the facile label "anti-vaccine" because we still give vaccines and see a place for them in the practice of medicine but we do not agree with the current vaccine schedule nor the number of vaccines children receive all at one time.
A few days ago, Ms.McMahon emailed me to tell me that the decision had been made to omit my interview from the show. There would not be one word from me. She didn't tell me that she had also omitted 100 percent of Dr. Robert Sears interview. And that any other comments from physicians supporting the parents on the show in their ambivalence about vaccines or their decision to refuse all vaccines would also be omitted.
Well, boo-hoo! Cry me a river. Surely someone as media-savvy as Dr. Gordon seems to be must realize that lots of interviews are taped for documentaries and that often, out of two hours of tape, nothing or only one sound bite will end up finding its way into the final documentary. It's not malice. It's not necessarily bias. It's just the way it is. In fact, if Dr. Jay hasn't learned anything since some of his more spectacular examples of foot-in-mouth disease, such as his invocation of the formaldehyde gambit or his utterly risible comparison of vaccine science to tobacco companies' denialist tobacco science, McMahon may have done him a huge favor by cutting him from The Vaccine Wars. She saved Dr. Jay from an opportunity to dig himself in even deeper and make himself look even worse than he does now. Unfortunately, denied that opportunity for a national television audience, Dr. Jay tries to seize an opportunity to do so for a national blog audience with his open letter to McMahon. It is a highly target-rich environment, particularly his wounded sense of utter betrayal:
I trusted you by giving you two or three hours of my time for an interview and multiple background discussions. I expressed my heartfelt reservations about both vaccines and the polarizing of this issue into "pro-vaccine" and "anti-vaccine" camps. I told you that there was at least a third "camp." There are many doctors and even more parents who would like a more judicious approach to immunization. Give vaccines later, slower and with an individualized approach as we do in every other area of medicine.
What did you create instead?
"The Vaccine War."
A war. Not a discussion or a disagreement over facts and opinions, but a war. This show was unintelligent, dangerous and completely lacking in the balance that you promised me -- and your viewers -- when you produced and advertised this piece of biased unscientific journalism.
Project much, Dr. Jay? I wonder what I would find if I searched Age of Autism for wors like "war" and "battle" and other terms like that? Let's see, there's Are We Winning the Vaccine-Autism War?, complete with a picture of the Marines raising the American flag at Mount Suribachi on Iwo Jima. Then there's AoA's Kent Heckenlively opining, "The war has begun," not to mention a whole section on AoA devoted to Parent Warriors. Heck, Jenny McCarthy herself called one of her autism books peddling nonsense vaccine-autism Mother Warriors, fer cryin' out loud! From my perspective, it isn't so much public health officials, physicians, and scientists who are viewing the vaccine-autism manufactroversy as a "war" and therefore crafting their rhetoric accordingly. It's the anti-vaccine movement itself using martial language to describe the manufactroversy.
Remember how I've said on occasion before that I hate to be too harsh on Dr. Jay because he reacts like a whipped puppy when too much insolence, respectful or not-so-respectful, is applied? Well, this is what I mean, except that sometimes he reacts with wounded, righteous indignation. And when he gets righteously indignant, he becomes incoherent, at least when it comes to science, leading him to launch into a whole bunch of the same old scientifically ignorant blather that he has regaled us with so many times before in the past:
Autism. An epidemic caused by environmental triggers acting on genetic predisposition. The science is there and the evidence of harm is there. Proof will come over the next decade. The National Children's Study will, perhaps by accident, become a prospective look at many children with and without vaccines. But we don't have time to wait for the results of this twenty-one year research study: We know that certain pesticides cause cancer and we know that flame retardants in children's pajamas are dangerous. We are cleaning up our air and water slowly and parents know which paint to buy and which to leave on the shelves when they paint their babies' bedrooms.
The information parents and doctors don't have is contained in the huge question mark about the number of vaccines, the way we vaccinate and the dramatic increase in autism, ADD/ADHD, childhood depression and more. We pretend to have proof of harm or proof of no harm when what we really have is a large series of very important unanswered questions.
Dr. Jay seems so confident when he proclaims autism an "epidemic" caused by environmental triggers acting on genetic disposition. Unfortunately for him, the evidence thus far doesn't support such a sweeping statement. For one thing, as has been discussed time and time again, it is unlikely that the true prevalence of autism has increased as dramatically as the numbers make it appear. Diagnostic substitution and broadening of the diagnostic criteria have contributed, as has increased screening for autism. Whenever a condition or disease is screened for in a population, more of it will be found. Always. Be that as it may, there is considerable evidence that the true prevalence of autism and ASDs has not increased that dramatically, if it has increased at all. The "autism epidemic" is almost certainly mostly due to artifacts changes in awareness, diagnostic criteria, social implications. One dramatic indicator of this was a recent study that showed that the risk of being diagnosed with an autism spectrum disordercorrelates with social proximity to another family with a child with an ASD diagnosis, suggesting that the increase in ASD diagnoses is largely due to societal factors.
Note also how Dr. Jay is up to his old tricks again, comparing a questionable, probably nonexistent "epidemic" of autism to known diseases and known risk factors for harm, such as pesticides. He then likens vaccines to pesticides and flame retardants in children's pajamas with utter confidence, the result being that he can fool the unwary into thinking that, wow, vaccines really must be dangerous. (Does anyone really believe Dr. Jay's assurances that he is "not anti-vaccine" anymore? I sure don't.) He then does the denialist do-si-do and spreads fear, uncertainty and doubt by, in essence, demanding proof of no harm. Science can never give proof of a negative. The best it can do is to estimate how likely a positive is, and in the case of vaccines and autism numerous studies have failed to find a correlation. Based on current data, the likelihood that Dr. Jay's fevered, fear-filled fantasies of deadly vaccines causing autism is true is exceedingly low. Dr. Jay also points to a whole bunch of questions that--or so he claims--have not been answered. Too bad Dr. Jay didn't mention just what those questions are. Maybe it's because the questions have been asked and answered, but Dr. Jay didn't like the answers. Scratch that. There's no "maybe" about it.
The last part of Dr. Jay's open letter is just plain embarrassing. Really. I was actually embarrassed for him when I read this:
I base everything I do on my reading of CDC and World Health Organization statistics about disease incidence in the United States and elsewhere. I base everything I do on having spent the past thirty years in pediatric practice watching tens of thousands of children get vaccines, not get vaccines and the differences I see.
Vaccines change children.
Most experts would argue that the changes are unequivocally good. My experience and three decades of observation and study tell me otherwise. Vaccines are neither all good--as this biased, miserable PBS treacle would have you believe--nor all bad as the strident anti-vaccine camp argues.
Note what Dr. Jay doesn't say. He doesn't say that he bases his practice on the actual science-based recommendations of the CDC regarding vaccines. That much is painfully obvious. If you don't believe me, look at this Tweet he posted the other day:
That's right. Dr. Jay just told a mother not to vaccinate her son without ASD because his brother has autism. There is zero science to support such a reckless and potentially dangerous recommendation, yet Dr. Jay makes it anyway because he somehow believes that siblings of children with autism have some sort of genetic "trigger" that vaccines will set off, thus causing autism. For shame, Dr. Jay! For shame! There is no excuse for a pediatrician to make such an irresponsible recommendation for a child, and, if Dr. Jay is making this recommendation on Twitter, just imagine to how many of his patients' parents he is making the same irresponsible recommendation.
Also note how much Dr. Jay touts his 30 years of experience. Don't get me wrong; experience can be a good thing. However, personal experience that doesn't acknowledge current medical science becomes out of date, distorted by one's own beliefs, and often devolves into dogma- and anecdote-based, rather than science-based, medicine, prone to confirmation bias (which is almost certainly what Dr. Jay is refusing to acknowledge in his stories of so much autistic regression after vaccines). I've gone over this problem with Dr. Jay before ad nauseam, both on this blog and in prolonged e-mail exchanges with Dr. Jay, who complains most piteously when I point out that he is not a scientist and that he himself points out that he doesn't have any good scientific evidence to back up his fear of vaccines. Sorry, Dr. Jay. You're a nice guy and all, but you spread misinformation--dangerous misinformation, particularly when you say things like this:
The way vaccines are manufactured and administered right now in 2010 makes vaccines and their ingredients part of the group of toxins which have led to a huge increase in childhood diseases including autism.
There's only one word that describes such a statement: Bullshit. That's what Dr. Jay is full of in this post. I had some nits to pick with FRONTLINE over this show, but not about the science. The producers got the science right, and they were also right not to give time to a pediatrician who values personal anecdotes over science and blithely gives out irresponsible advice over Twitter and sounds like a mad scientist in a B-movie ranting "I'll show you all!" as he says, "The science is there and the evidence of harm is there. Proof will come over the next decade." Except that neither the science nor evidence of harm is there.
Jenny McCarthy's post is, believe it or not, even more brain dead. Since it quotes Dr. Jay and regurgitates the usual Generation Rescue talking points, I don't know that I want to spend a lot of time on it, particularly given that it piteously echoes much of the same complaints of Dr. Jay about FRONTLINE special being so unfair and mean to Generation Rescue. From my perspective, FRONTLINE bent over backwards to be fair. Not once did it call out GR for being anti-vaccine; heck, it even called GR a group of "concerned parents," ignoring the group's history of anti-vaccine activism.
No, being unfair to Generation Rescue is not a problem that FRONTLINE had.
Perhaps most telling is this remark by McCarthy:
For those who've watched the show, you know that the Frontline producers broke their promise and presented our entire community's position through my interview and just two other parents -- Barbara Loe Fisher and J.B. Handley.
Where are the doctors and scientists who support our community and support the idea that vaccines may be a trigger for autism? In Frontline's world, they don't exist.
Imagine how much more credible the countless stories of children regressing into autism after vaccine appointments would be if a doctor were saying the same thing.
This comment strikingly echoes similar comments by Anne Dachel whining about FRONTLINE on the anti-vaccine propaganda blog Age of Autism:
The claims of parents were noted and dismissed on Frontline.
Not exactly. The claims of parents regarding causation were noted and dismissed based on scientific studies. The show itself gave parents ample time to discuss their non-science-based fears and beliefs about vaccines. Dachel then continues:
A growing number of parents say that vaccines can cause autism and that more studies need to be done. Frontline reported that the science is in. There's no need for more research because multiple, large-scale studies from around the world have looked at the question and the answer is no.
Ten of thousands of parents report that their children were normally developing until they were vaccinated. They regressed and became autistic. Paul Offit, MD, Anthony Fauci, MD and Eric Fombonne, MD declared that regression following vaccinations is mere coincidence.
Not exactly. Drs. Offit, Fauci, and Fombonne didn't "declare" regression to be "coincidence." They merely pointed out that multiple large epidemiological studies have failed to find any evidence that autistic regression in temporal proximity to vaccination is not coincidence. There's a difference. It's subtle, I know, perhaps too subtle to penetrate the antiivaccine zealot's brain. It means that no association has been found at the statistical power level of the studies done. That means it is possible that there might still be a small correlation in a small number of children. However, even given that possibility, there is no good evidence that the "trigger" now claimed by anti-vaccine activists exists, and, even if it did, that would be hugely different thing than the hysterical claims that vaccines have been the primary cause of the "autism epidemic" over the last 20 years. If it were true that vaccines were such a major cause, then the studies performed would almost certainly have found a correlation strong enough to cause an "epidemic" by now. The incredibly shrinking vaccine-autism hypothesis has been reduced to saying that maybe in a small number of children, just maybe, the odd vaccine reaction might, if the child has the genetic predisposition, trigger autism. Vaccines have gone from the bogeyman causing thousands upon thousands of cases of autism in normal children to something that, if you squint real hard and make up genetic predispositions for which there are no good data, you might be able to paint a tenuous connection. The null hypothesis has not been disproven; according to the best science currently available there is no correlation between vaccines and autism, and FRONTLINE was correct to hammer that point home again and again.
I did like one thing that Dachel said, though:
I think a better name for the show would have been, "The Anti-vaccine Movement: Misguided and Dangerous."
That would have been an excellent title for the show, although I would have probably come up with something even more "insolent" if I were a FRONTLINE producer. Of course, that's probably why I'm not a FRONTLINE producer.
These days, for the first time in years, I'm optimistic about vaccination. I get the distinct sense that the power and influence of the anti-vaccine movement has peaked. It's crested and appears to be on the wane now. That doesn't mean the movement can't still do enormous mischief, nor does it mean that it is going away any time soon. After all, as long as there have been vaccines, there has been an anti-vaccine movement. What is encouraging is that increasingly the mainstream media is realizing that the anti-vaccine movement as embodied by Jenny McCarthy, J.B. Handley, Barbara Loe Fisher, and their ilk is made up of a bunch of cranks pushing pseudoscience. Some of them are even beginning to appreciate that a whole lot of autism "biomed" quackery produces a huge incentive for various "alt-med" practitioners to keep the myth that vaccine cause autism alive. And these are all good things. Unfortunately, I don't know if they'll be enough. If there's one thing that the anti-vaccine movement has shown, it's that it's always ready to come back, and, even if the latest setbacks destroy its ability to mobilize a mass message, I fully expect that anti-vaccine sentiments will return one day.
Damn. My manic phase appears to be ending.
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I feel no sympathy for Dr. Jay because he's such a nice guy. Being nice and civil are the tools he uses to give himself credibility and to spread his misguided information.
He's trying to play both sides of the issue so that he can capture the most positive attention. He wants the anti-vax crowd's attention for siding with him, and he wants the pro-vax side's attention for being cautious and civil. He might as well issue a press release saying, "can't we all just get along?"
Orac, you always say that no matter what the anti-vax side says, it's always about the vaccines. I'd like to add a corollary: No matter what Dr. Jay says, it's always about the attention.
As a parent, I find Dr. Jay to be one of the most repulsive players in this the anti-vax movement. I can understand parents of autistic children looking for causes to their child's situation. I can understand actresses seeking attention. But, when a medical doctor uses anecdotes and confirmation bias to scare parents and make them question their own pediatrician's abilities*, I can't feel anything but disgust.
*And yes, he is telling parents not to trust their children's doctors when he claims that his 30 years of experience trump the 100+ years of experience shared by the doctors at the practice where I take my son.
This distinction, in large part, reminds me of the inability of many theists to distinguish between an atheist and an anti-theist. Atheism is not a belief in no god(s), but a rejection of the positive claim for god(s) as unsupported. Anti-theism is a belief in no god(s). It is true that many people who are one may also be the other, but it is in no way a requirement.
That's the link to what you wrote: the science indicates not that there is zero link, but rather that the claim that there is a link is unsupported. The anti-vaxxers simply cannot admit that the claim is unsupported, so they assume all such responses to their claim are instead a claim in the opposite direction.
Orac--
Sorry to kick you when you're down, but there has been a particularly vapid bit of antivax stuff on the news in NM. A teenager has developed a seizure disorder, and her mother naturally sought a target to blame (Gardasil). Fortunately, the news station found a hero to save her. No critical evaluation of the causation claim, or of the proposed "treatment."
I love medical terminology. If there's a way to make "bleeding to death" sound even more terrifying than it already does, calling it a "massive exsanguinating hemorrhage" comes closest. And that's a wonderful piece of imagery for the consequences of the anti-vax movement's agenda.
Wait, Dr. Jay discussed a slower, more spaced-out vaccination schedule? I assume, then, that he has found some scientific evidence to support that such a slower schedule is safe and effective, since he criticizes the AAP/CDC schedule as unscientific? Certainly he wouldn't propose something not backed by science?
Oh, and cue Dr. Jay coming by to whine about you being mean in 3...2...1...
Todd @5. I'm sure Dr. Jay has support for his schedule. It's just that he can't fit it all into a 140 character post on Twitter.
@Jojo
I've asked Dr. Jay numerous times for the scientific evidence that he has to support his proposed schedule, but he has yet to present anything. I think he even might have admitted at one point that he didn't have any, though he did couch it in a tu quoque by claiming that the CDC schedule didn't have any scientific support either, which is untrue.
Best part of the frontline piece: Introducing Jenny as "Former Playboy Playmate, Jenny McCarthy"
Orac, I'd love to see your Frontline episode. The first time there's actual machine gun fire on the show.
As for Dr. Jay, of course he wants the shots spread out. If you get one shot every three months for 4 years, a temporal correlation between autism diagnosis and a vaccine shot is virtually guaranteed.
A reminder that Dr. Jay has not been "nice" or "civil" enough to avoid attacking his opponents here with insulting gibes and to suggest that they are paid pharma shills.
Nor has he hesitated to denigrate Dr. Paul Offit*, a distinuished vaccine researcher and inventor of a rotavirus vaccine, implying that his pro-vaccine stance is motivated by money (and telling Frontline that they should have featured the money angle).
This is not a "nice" guy in my book.
What's more important of course, are the people he places in jeopardy through his uninformed and irrational bias against vaccination.
*not to be confused with "Sid Offit", an antivax troll who frequently shows up in the comments section here.
Letâs think logically about what vaccines do. They insert foreign substances into the body, in order to make the immune system think itâs under attack. The immune system then mobilizes itself to fight back. Simple enough. Then, think about children in this modern age, who, from before birth, have been exposed to thousands of chemicals that our grandparents never had to contend with. Their fragile immune systems have been constantly under attack, fighting off countless foreign substances.
When it has too much to contend with, the immune system can sometimes go haywire, and go from attacking the foreign substances to attacking the body. The body will then develop an autoimmune disorder. However, not everyone exposed to toxic chemicals will develop an autoimmune disorder. It is estimated that only 25 percent of the population is genetically predisposed to autoimmune disorders.
It makes perfect sense to me that a child who has been exposed to environmental toxins would have a very fragile immune system, one that is about ready to âbreak,â and start attacking its own body. Enter the vaccine. Not just one, but multiple vaccines, given repeatedly to infants and toddlers. More foreign substances in the body, this time specifically designed to "goose" the immune system. These vaccines could be the straw that broke the camelâs back, inducing an autoimmune disorder in those children who are genetically predisposed. It could be MS in one child, lupus in another, and autism in yet another. I am not saying that autism is 100 percent an autoimmune condition, but I do think it has an autoimmune component to it. Autoimmune disorders are poorly understood in the medical community. Most doctors will say that they donât know what causes them. Itâs a mystery.
It seems to me that you are being very closed-minded when you say there is no possibility that vaccines could be part of the problem. I realize that not vaccinating children causes problems, as well. But thatâs no reason to put on the blinders.
@superdave I thought the best part was where she said, "I typed 'autism' into Google and found Generation Rescue..." So presumably if a site that claims vaccines and autism are caused by the machinations of our Evil Reptilian Overlords, she'd now believe that instead.
Robyn,
We are not being closed minded. We have not that vaccines cannot be the cause of anything. We say that vaccines have been studied and no link to autism was found. Repeatedly. None.
Do you not see the difference?
Well, Robyn, it seems to me you are being very close-minded when you assume it's probable they are part of the problem, based on little more than superficial speculation and hunches about how things might work.
Are you open-minded about the distinct possibility that anti-vaccination is simply garbage?
@madder,
Thanks for the comment. It's another example of why I generally prefer the local CBS affiliate for news. They're a little too accomodating of CAM practices at times, but generally the local heart surgeon who comments on medical issues is pretty good at explaining and advocating for science based medicine that is consistent with the standard of care.
I did a quick check on VAERS and found 36 reports of epilepsy or seizures related to one of the HPV vaccines over the last four years. One of those was in NM in 2008. I wonder if they applied to the VICP or just chose to sue Merck directly in court.
Does anyone know if there have been any good studies of hyperbaric oxygen treatment for seizures? The CDC listed six references but they were mostly about seizures as a side effect of using respirators to protect medical workers from TB. A Google search showed some references about seizures as a side effect of hyperbaric oxygen treatment!
Mu, In addition to your statement we can also add:
As for Dr. Jay, of course he wants the shots spread out. If you get one shot every three months for 4 years then your doctor collects a lot of copays.
@Robyn
You're treading close to "one true cause" territory.
There were, initially, two proposed ideas for a vaccine-autism connection. The first, in the U.S., was thimerosal. It was a fine question to ask; we know mercury is a neurotoxin and thimerosal contains a mercury compound. We looked at it and found that there is no connection. The second (first in the U.K.) was the MMR combination vaccine. Slightly less biologically plausible than thimerosal, but worth a look, since it is given around the same time that symptoms of autism begin to appear. Again, we looked and found no connection.
No other plausible idea has been presented. "Too many, too soon" leads to too many what? Antigens? Preservatives? Adjuvants? What? Today's vaccines use way fewer antigens than they did back in the early days of vaccination. There are even fewer, IIRC, in the entire schedule than pre-1980s. So, if it is too many antigens, then we should actually see a decrease in autism rates. Too many preservatives or adjuvants? This idea conflicts with calls for combo vaccines to be split up (e.g., separate measles, mumps and rubella vaccines instead of the MMR). Furthermore, vaccine manufacturers are working to reduce this load already by combining even more vaccines into a single shot (e.g., MMR-V, which adds varicella to the MMR).
If you feel that the vaccines are the proverbial straw that broke the camel's back, then take a look at just how much antigen/preservative/adjuvant/"toxin" of your choice a child is exposed to from the current schedule and compare it to the amounts found in the vaccines of the past. It is not enough to simply say "we have X number of shots today, but only got Y back in the 60s".
The lack of a plausible mechanism by which vaccines would cause autism, combined with mounting evidence that genetics, epigenetics and parental age play significant roles, not to mention epidemiological studies that have looked at and found similar autism rates around the world (with varying vaccine schedules, mind you), it is becoming less and less likely that vaccines play a role.
And, even if vaccines do play a role in autism, does that still justify the risks associated with not vaccinating?
I don't know if you subscribe to Paul Offit's geek theory but if you do how do you explain those "geeks" and as Roy Grinker calls them "funny looking kids" interacting with one another in non-autistic like fashion at comic book and Dr. Who conventions? And why haven't all the geeks disappeared now that they've become autistic. And finally, are increases in autoimmune conditions such as type I diabetes and allergic diseases also artifacts of "increased awareness" and a gold rush to get government services?
And is there some reason vaccines would do this, but the diseases against which they protect would not?
Here's my alternative schedule:
Birth:No Vaccine
3 Months: No Vaccine
6 months: No Vaccine
1 year: No Vaccine
5 years: No Vaccine
12 years: No Vaccine
Robyn, there are many hypothesis on the causation of autism. The nice thing with science is, you can test them. People have theorized it's genetic, and indeed there's a strong grouping of autism incidences in families. People have looked at changes in brain development, and found them in areas of very early fetal development. People have theorized autism is due to the poor relation between parents and the developing child (the infamous refrigerator mom) and that turned out to be wrong. People have looked at immune system related effects, and haven't found anything.
So, right now, it looks like there is a genetic factor (call is predisposition if you like) and maybe an environmental trigger - but that one is way early in prenatal development. So looking at something happening at age 1 - 2 might miss the actual trigger by two years.
I'm sure those children who survive long enough to complete your schedule will be ecstatic at having suffered several completely preventable infections diseases, with all the suffering and potential complications that entails.
Yes, I think that's a well-known side-effect of HBOT. It seems completely imprudent to use it to treat seizures.
Actually,I'm feeling quite optimistic with the proviso that there will *always* be a contingent with *outre* views,contrarians,those who "march to a different drummer".I'll certainly drink to them being pushed, slowly and steadily, kicking and screaming,way out of the mainstream to the further reaches of internet ignominy.It will take time.In 2000,did many people really believe in the reality of Global Warming?(Readers: note that Orac's use of the term *bipolar* is purely a metaphor for "having mixed feelings" about the issue.)
I agree with Jenny.
26 is an imposter. Orac call security.
Sid,
Got any real science to back up that alternative schedule?
perfect circle - My Reptilian Overlords are not Evil.
Sid the Squid - yes, we have already established that you are a selfish asshole who insists that others "put their chilfren at risk" (in your mind) to keep your kids healthy. I'd prefer you just said thank you and shut the fuck up instead of boasting about being an ungrateful sponge.
Jojo, I was thinking that too, especially since Dr. Jay doesn't do copay, he gets full office visits paid cash.
Yeah, vaccines aren't beneficial enough to warrant their known and unknown risks
@Sid Offit-26:
"I agree with Jenny."
Really, Sid? When did you get your last Botox injection?
Besides I don't want my daughter to have to walk backwards into school like that poor Desiree Jennings
"Sid the Squid":
You're of course making reference to the highly intelligent nature of cephalopods
@ Pablo: I agree with you about our R.O.'s- "not evil", but misunderstood.
Sid Offit, there are numerous cases of infants dying of measles and chickenpox, mumps is incredibly painful, and rubella is a known cause of numerous birth defects. Preventing these are the benefits.
Robyn, the immune system goes haywire when it doesn't have enough to contend with, not when it has too much.
Our immune systems evolved to protect our ancestors from living in "the wild", where there was no soap, running water, or until faily recently, even cooking to kill bacteria in food.
Like most systems in physiology the immune system has automatic gain control. When it doesn't find "enough" to work on, physiology turns up the gain and turns it up until there is "enough" to work on. That is how autoimmune disorders occur, from not enough for the immune system to work on, not from too much.
That is the essence of the hygiene hypothesis, derived from the observation that in the rural undeveloped world things like asthma, allergies, and autoimmune disorders are rare to non-existent. That is why one of the best treatments for Crohn's disease is a gut full of worms.
@Joseph-24,
Yes, it does sound like a bad idea.
I also recall the doctor saying he hadn't treated a patient yet who didn't show a positive response. Sounds like massive confirmation bias.
Robyn:
Why would vaccines be worse than the real antigens from the various bacteria, viruses, parasites and fungi that exist all around them? How would a DTaP vaccine be worse than real diphtheria, tetanus and pertussis?
Since there has been an increase of infants dying from pertussis, it is very important that you give us real evidence.
And it has been looked into:
Childhood vaccinations, vaccination timing, and risk of type 1 diabetes mellitus.
DeStefano F, Mullooly JP, Okoro CA, Chen RT, Marcy SM, Ward JI, Vadheim CM, Black SB, Shinefield HR, Davis RL, Bohlke K; Vaccine Safety Datalink Team.
Pediatrics. 2001 Dec;108(6):E112.
I will join the others in asking you what are the real risks of the vaccines versus the actual diseases. Measles will cause bad things at least one out of thousand cases. These include things like deafness, blindness, and even a long prolonged death from SSPE. How is the MMR vaccine worse than that? Be sure to answer with real evidence not your "feeling" or what you "believe."
Robyn @12,
"Their fragile immune systems have been constantly under attack, fighting off countless foreign substances. "
Just because they are infants does not imply they have a fragile immune systems. Their immune systems are actually fairly robust, but naive. Their immune system hasn't encountered a lot of items to fight against until they pop out of mom, then they are bombarded by thousands of bacterial and viruses. Vaccines allow the immune system to develop the antibodies to diseases the system is naive about without having to encounter the actual disease; and this is a good thing.
Just because it isn't advisable to drop them on their little heads does not make an infant as fragile as a china doll, nor is it an indication that their immune system is tenuously fragile. Kids are damned robust.
@ daedalus2u
So are you saying that widespread vaccination's elimination of infectious disease has lead to the unintended consequence of some people developing an overactive immune system?
More importantly, Robyn, the "countless foreign substances" are not all dealt with by the immune system: The body is a complex, robustly self-correcting system and you're conflating entirely different biological processes -- filtration, histamine, etc. -- into some vague 'overload' which isn't supported by any science.
@Chris
Measles will cause bad things at least one out of thousand cases.
Do you incorporate risk factors into your narrative that the measles is deadly? After all, saying lung cancer affects 1 in 100 people may be true but when you pull smokers out into their own category, the risk for the population in general plummets
Denice - maybe we could get Gregory Maguire to write the story of the ROs? It could make a great Broadway musical with Kristin Chenowith and Idina Menzel.
Squid - I'm talking about the rubbery deep fried appetizer at TGIFridays
Denice - maybe we could get Gregory Maguire to write the story of the ROs? It could make a great Broadway musical with Kristin Chenowith and Idina Menzel.
Squid - I'm talking about the rubbery deep fried appetizer at TGIFridays
I think that anti-vax sentiment is no longer dependent on the anti-vax movement; it has become so mainstreamed that the individual fortunes of Wakefield, McCarthy et al. don't matter. There has been a tipping point into widespread anti-vax sentiment. Twenty years ago it was a fringe of hippies and weirdos. Now it's the run of the mill professional class white liberal. Soon it will be the working class, conservatives, nonwhites. The genie is out of the bottle.
The animal rights movement became mainstreamed years ago, particularly when it comes to testing. It's the default position of whole demographics, especially trendsetters within larger subcultures. How many celebrities, especially rock stars, are vocal supporters of animal testing? But there are many vocal opponents.
The independence of crackpot movements from hardcore activists and organizations has been immeasurably helped by the internet, especially the hive mind of Web 2.0 and social media in general. YouTube, twitter, Facebook. So opposition to animal testing and vaccines will continue to grow virally, even as more people die because of them. Can the tide be reversed? Sure. But it will have to be through social contagion rather than just accumulating victories against high profile activists and organizations.
No Sid. The number of antigens from vaccines is small, and for diseases that are vaccine preventable, there is long term immunity, whether from vaccination or from the natural disease.
Autoimmune disorders come from long-term chronic non-exposure to immunogenic things, like parasites.
The problem with vaccine preventable diseases is not the long term immunological effects, but rather the short term acute effects of the diseases, they kill people. Vaccines prevent the vaccine preventable diseases from killing people.
"Measles will cause bad things at least one out of thousand cases."
Even if Wakefield/McCarthy were right, vaccines will cause bad things in less than one in a million. (And they're not right, as increasingly greater piles of evidence indicate.) I don't know about you, but I like the odds of 1/1 000 000 much better than 1/1000.
Antivax arguments are increasingly looking like the old objections to wearing seatbelts in cars; driven less by sober examination of the odds and more by a core of people motivated by fears of annecdotal or hypothetical risks* plus a resentment of "the Man" telling them what to do... with some undecided folks getting bad information from the hard core of dissidents.
Seatbelts save lives. So do vaccines. Use them.
-- Steve
* The old, "what if I crash into a lake or the car catches fire and I can't unbuckle my belt?" was the leader... which failed to take into account that in such a crash an unbelted driver would be too dazed or injured to open the door promptly in any case. Oh, and the "it's safer to be thrown clear" argument which was pure wistful thinking about what happens to a human body hurled through a windshield and onto pavement and oncoming traffic.
Sid, after having been subjected to your incessant, cretinous trolling for months now, I have just one question for you: were you born this much of an asshole, or did you have to study?
He has an elegant proof for his theory, but it won't fit into the margin of the book?
@Offit-31:
In your opinion, at any point in human history has there ever been any vaccine where the benefits outweighed the risks? For example, if you had been alive back when smallpox was still running rampant, would you have taken the smallpox vaccine (the live cowpox virus)?
Also, I presume that you're talking generally (everybody getting vaccinated against mumps/measles/etc), and not about specific circumstances, like a veterinarian getting vaccinated against rabies, or someone who's just been bitten by a rabid dog immediately getting the rabies vaccine. Or do you think that even in those circumstances that the vaccines aren't worth the risks?
Their fragile immune systems have been constantly under attack, fighting off countless foreign substances.
Just as they were evolved to. The problem of modern life is not "too many too soon" but not enough and not soon enough. Hayfever and asthma may be related to excessive cleanliness and inadequate amount of immune stimulation (at least in some cases). Kids are supposed to roll around on the ground, eat dirt, and be exposed to all sorts of pathogens by the time they're 3. Honestly, you'd be better off arguing that vaccines cause problems by not allowing the immune system to "meet" enough "real" viruses-ie understimulating it. Don't worry about the inconsistency: no one will notice.
orac,
when you talk about the pushback from the anti-vaccine camp, you left out the frivolous legal actions by JB Handley and Barbara Loe Fisher.
Let's not forget the attempt to quiet Kathleen Seidel at neurodiversity.com.
I will try to respond to everyone who has asked questions regarding my post:
MikeMa #14 â
I do see the difference. The closed-minded part is in assuming that the book is closed, and there is no more need to look at this angle.
Joseph #15 â
âSuperficial speculation and hunches about how things might work.â Hmm. It seems to me that all great ideas had to start with hunches.
Todd W. #18 â
Thank you for your informative response. I did not know that there are fewer antigens in todayâs vaccines than in pre-1980âs vaccines. However, the child of today has to deal with far more chemicals, in food and in his environment, than any generation in the history of mankind. So even a small amount of antigens, preservatives, or adjuvants, injected into his body, could be the straw that broke the camelâs back.
You say there is a âlack of a plausible mechanism by which vaccines would cause autism.â I tried my best to put forth the idea that it is possible for the body to overreact to foreign substances. Is this not a plausible mechanism?
As to whether or not my suspicions justify the risks of not vaccinating â That is a good question. I am just glad that I do not have to make that decision at this point in time.
Martin M. #20 â
In fact, many people have developed an autoimmune disorder immediately after a bout of an infectious disease.
Mu #22 â
Yes, there are many hypotheses on the causation of autism. I am putting forth one of them. None of these has been completely proven or disproven.
Daedalus2u #36 â
Regarding the âhygiene hypothesis,â I would suggest that the rural undeveloped world has few autoimmune disorders because the people who live there are exposed to fewer chemicals.
Chris #38 â
Iâm not saying that vaccines are worse than real antigens. Iâm saying that it is all cumulative. The exposure to environmental toxins puts a strain on the immune system. Exposure to bacteria, viruses, parasites and fungi adds to that. A vaccination could just put a childâs system over the top. I am not discounting the real risks of childhood diseases. But these risks should not cause us to turn a blind eye to the possibility that vaccines could be a cause of disease in some susceptible children.
Gingerbeard #39 â
Point well taken. Children are not as fragile as they appear. In fact, many people do not develop autoimmune diseases until they are adults. However, autism is something that appears early in life, and thus, the assumption that it has something to do with the still developing or ânaïveâ immune system.
Ahistoricality #41 â
I understand that the "countless foreign substances" are not all dealt with by the immune system. But many of them are. And the complex, robustly self-correcting system sometimes turns on itself. Not all the time. But it happens.
Dianne #50 â
I agree that dirt and pathogens can strengthen a childâs immune system, as it was designed. The problem comes when you add in all of the chemicals that our children are now exposed to. Itâs just too much.
@Denise, pablo Yes I now realize the error of my ways. Our Reptilian Overlords (should they exist--this can be neither confirmed nor denied) are not evil. They are fairness and justice incarnate. I look forward to serving them, tending the eggs of their young in their secret underground incubators.
perfect circle - You "look forward to"? I guess this is the origin of the misconception. Those of us that are already tending the eggs of their young in secret underground incubators know the pleasure of serving them. Some day, hopefully soon, you will to.
A little off topic, but it fits in my argument about the internet being more important than high profile advocates and organizations on both sides. (Anti-vax, alt medicine, and anti-animal testing all overlap as anti-rational medicine.) As well as, I should mention, old fashioned media like PBS and Wired Magazine.
A homeopathy advocate on HuffPo calls skeptics "deniers" and "fundamentalists":
Dana Ullman: "I personally have no problem with "skeptics" of homeopathy, though most people who think of themselves as skeptics are really simply "deniers" or "medical fundamentalists.""
http://www.huffingtonpost.com/dana-ullman/medical-research-lies-dam_b_5…
(Turning the "denier" label on supporters of rational medicine is going to have some traction, I think. I warned years ago not to dilute "denier" and "denialist" beyond genocide deniers to encompass everyone from Intelligent Design proponents to free market libertarians. Too late now.)
A single HuffPo piece that is tweeted and mass/chain emailed might get more eyeballs than a Frontline episode on vaccines.
@Matt
has there ever been any vaccine where the benefits outweighed the risks?
For example, if you had been alive back when smallpox was still running rampant, would you have taken the smallpox vaccine (the live cowpox virus)?
Iâd go for TIG if I had a truly tetanus prone wound. Also if my baby momma tested positive for Hep B. As for smallpox lets say I was living in the 19th century I think Iâd have to consider my socioeconomic status. If I were in a place in Africa where the measles were as bad as advertised, probably
-----------------------------------
I presume that you're talking generally (everybody getting vaccinated against mumps/measles/etc), and not about specific circumstances, like a veterinarian getting vaccinated against rabies, or someone who's just been bitten by a rabid dog immediately getting the rabies vaccine
Good point about people in general vs subsets or groups. Thatâs why I place so much importance on those things that can lessen or worsen the severity of an infectious illnesses. It's not only those at greater risk (as in your examples) who should get vaccinated but those at lesser risk who should consider whether or not a particular vaccine is right for them - rather than blindly offering up their arm for any thing that comes their way
Robyn, you are entitled to your own opinions, but not to your own facts. Try producing some evidence to back up your contentions.
Racist Sid Troll, I ignore you on purpose.
I wonder whether this may backfire on them.
By creating a controversy (however small) about this episode, will they get other documentary groups to take on the subject?
This is likely one of their goals. Of course, they think that anyone who takes an unbiased look at this will side with them.
They need to accept the fact that they really are on the fringe.
@Offit-56
So your position is that the mortality rate for smallpox varied with socioeconomic status, so that, for example, a middle class American in 1800 would have had such a low smallpox mortality rate that it wouldn't be worth it to get the vaccine? In your opinion, how high does the mortality rate for a disease have to be to make getting a vaccine worth the risks?
@Sid: That's not Dr. Offit's theory, I'm quite sure. Assuming we can call it a scientific theory, it might be attributable to Dr. Baron-Cohen, although the right term for it is the assortative mating theory. A related theory of his is the extreme male brain theory.
Yes, yes. Why are there still monkeys around if they evolved into humans?
There's an argument to be made that we're healthier than ever and living longer (and even more intelligent than ever if you interpret the Flynn Effect that way) yet diagnosed with more conditions than ever before.
In terms of environmental toxins, tobacco is probably the worst thing we've ever encountered, followed perhaps by lead.
Advancing maternal and paternal age are also real, measurable causes of de-novo mutations.
I agree that dirt and pathogens can strengthen a childâs immune system, as it was designed. The problem comes when you add in all of the chemicals that our children are now exposed to. Itâs just too much.
Point 1: The immune system wasn't designed, it evolved. And a big messy bit of evolution it is too.
Point 2: What do you think is IN dirt? What do you think pathogens are? They're more or less complex chemicals. The only difference between "natural" and "artificial" chemicals is the purity. Why should the "natural" pathogens of, say, the full VZV be good for the immune system but the weakened, partial version in a vaccine somehow bad for it?
Point 3: It depends on what you mean by "good for the immune system". Sure, more exposure to dirt means lower risk of hay fever. But if an unvaccinated kid running around in the dirt steps on a nail and gets tetanus their lack of sniffles isn't going to be much of a comfort.
Point 4: Compared to all the natural antigens a child's immune system is exposed to, the number it is exposed to in vaccination isn't outside the noise. Vaccines are important because they produce antibodies against specific, dangerous pathogens, but as an immune load they are trivial. Your body sees more virus when you have a cold than when you receive a vaccine. It's not "too much": it's barely anything at all.
@Chris:
I don't think that what he was saying was necessarily racist. As far as I can tell, he's merely saying that poverty leads to ill-health, and that ill-health makes infectious diseases more deadly.
"The problem comes when you add in all of the chemicals that our children are now exposed to. Itâs just too much."
Robyn, I disagree strongly; the problem comes when we forget our history.
For all the "chemicals" in today's environment, child mortality is vastly lower than in any other time in history. (US: ~8/1000 die under the age of 5. Pre-modern rates were closer to 200/1000.) We have vastly fewer cases of disability from illness, too; how many kids have you seen walking with the assistance of leg braces lately?
The "good old days" never were; the image of healthy children frolicking in nature omits those who died from complications of diseases we no longer see, children who were mourned no less than those today but whose deaths were seen to be so routine that they were expected. The lack of children with developmental disabilities in those days came not from lack of occurance but rather from the patients' dying or from being shut away outside of public life.
Again, there is *no credible evidence* that any form of ASD results from innoculations. Compared with the *enormous* body of evidence showing the vast benefits of vaccination, the smart move for parents is to get their kids the shots.
-- Steve
Robyn - could you provide some reference showing that our children are exposed to more chemicals now than they were in the previous decades during which the vaccination contained more antigens (and thus, I assume, in your opinion a greater straw with which to break the camel's back)? Likewise, can you post some reference showing your presumed increase in autoimmune disorders or whatever it is you are claiming has increased?
Chris #57 -
I thought this was a forum for ideas, not a scientific paper. Do you want me to write a book, complete with citations for all of my references? If I do, will you buy it?
Middle class can cover a wide spectrum. One must also realize, in America, the smallpox was never close to what it was in Europe. Another point to consider is vaccine efficacy. In those days vaccination failures were common. Finally, back in the day, side effects (at least those that are known) were orders of magnitude worse than they are today.
I'm putting my think cap on regarding what mortality level (or risk of serious manifestations for that matter) would motivate a trip to the public vaccinator
A high proportion of MVA deaths are caused when victims get "thrown clear" and then the car rolls on top of them. Been there, done the autopsies.
Robyn @12 says:
"Then, think about children in this modern age, who, from before birth, have been exposed to thousands of chemicals that our grandparents never had to contend with."
Ah.....I don't know how you can make a statement like that. Believe me, your Grandparents were exposed to all kinds of deadly toxins. Mercury, Benzine, asbestos and a ton of different types of pesticides just to name a few. They didn't live in some type of utopian world and they would probably be the first one's to admit it.
Robyn, this may be a "forum for ideas", but unsupported claims will be challenged. Where is your support that children are exposed to more "chemicals" than ever before? Where is your support for the chemicals "straining the immune system" (as if it's a muscle)? Where is your support for the idea that autism is an autoimmune diseae? Hint: autism shows none of the pathologic findings you would expect in an autoimmune disease.
If you want to be taken seriously, you need better evidence than references to The Journal of Things I Pulled Out Of My Ass.
@Robyn
One thing you'll find when coming to places like Respectful Insolence, Science-Based Medicine, Bad Astronomy and the like is that if you make claims that seem a bit, well, pulled out of nowhere, people will ask you for some evidence to back it up. You might start by providing a link to where you got your information. Then, expect people to critique that source. Certain web sites will be torn to shreds in seconds: Natural News, whale.to, Age of Autism/Generation Rescue. This is because those sites have a track record of not only just making mistakes, but also twisting and distortion of facts and outright lies.
Good places to go are PubMed or PLoS, where you can find many peer-reviewed journal articles, but even then, you need to evaluate the source. Something like Medical Hypotheses is worth just about nothing, while the New England Journal of Medicine will get a more respectful hearing.
You may also want to take some time to read a few sites that cover the science of vaccines. A good site for high-level, general information is a href="http://antiantivax.flurf.net" rel="nofollow">antiantivax.flurf.net. Lots of links to further information there, and it addresses a lot of the common myths and misconceptions promoted by the anti-vaccine crowd. For blogs, in addition to the archives here, I recommend Science-Based Medicine blog. They have a topic-based reference section where you can find their articles covering the vaccine-autism issue.
Gah...html fail.
In regards to the comments by Robyn, one of the striking aspects of the Frontline episode in my mind was that the scientists all responded that claims such as thimerosal causing autism were worth considering - i.e. they are open-minded. In fact, with thimerosal, they went so far as to carefully study it and pull it out of almost all vaccines. However, this all turned out to be unnecessary - thimerosal was never a problem.
The statements by Robyn have some level of plausibility. The problem is that I could spout out thousands upon thousands of equally plausible hypotheses. What should we do, live in a box? Obviously, we can't investigate every single hypothesis that any person spouts out. What makes your hypothesis the one that deserves our attention? That is where we need actual evidence. That is where you fail.
@Robyn
BKsea brings up a good point. And, from reading your comments, wouldn't a more plausible place to look be all of the other chemicals to which children are exposed?
A thought experiment: if the vaccines play a role, then if we look at areas with the same level of other environmental chemicals, but fewer vaccines, we should see fewer autism cases. This, of course, assumes the same level of diagnostic and support services, controlling for societal influences on diagnosis, etc. So, we could look at representative samples from several developed nations that have differing vaccine schedules, but very similar use of other chemicals in the environment, as well as similar diagnostic tools, services, awareness, etc. We would expect that the countries with a lighter vaccine schedule would have lower rates of autism. If we find that the rates of autism are about the same, then we can safely say that vaccines are not a likely candidate.
And here's the corrected link to antiantivax.flurf.net if you wanted to look at it.
It may be a forum for ideas, but if they aren't new ideas, or if they completely misunderstand science, or if they invent new "science" without evidence, this is probably not a place where you'll feel comfortable.
That's why you should do what I do: offer no solutions to problems and just sit back and wait until there's someone to make fun of. It's good for the blood pressure (note: I have no evidence to support that claim).
Hey Jay-bo, I was also interviewed at length for the Vaccine War story, and also was left on the editing floor. In this day and age, I guess I should have made a big stink about it to draw attention to myself. However, having been a journalist for 20 years, I happen to know that perfectly good interviews get shitcanned for one reason or another. Suck it up, baby.
@Robyn
Sorry, one other thing. If you feel that autism is related to exposure to large amounts of chemicals, then why focus on vaccines? Why not focus on, say, household cleaners? Or materials found in furniture upholstery? Or granite countertops (which, IIRC, exude radon at varying levels)? Perhaps arsenic from carrots or other root vegetables grown in contaminated soil?
"The incredibly shrinking vaccine-autism hypothesis has been reduced to saying that maybe in a small number of children, just maybe, the odd vaccine reaction might, if the child has the genetic predisposition, trigger autism. "
And if this were the case, a child that predisposed would be as likely "triggered" by a peanut, a strawberry, a swig of Dr.Pepper, or a liberal application of Coppertone as a vaccine.
I just re-read my comment, and I sound like a total asshole. Sorry Robyn, that wasn't fair, you actually seem like a decent person with a few ideas that just happen to not be good ones. I will save future dicketry for those who are more deserving.
Robyn's mistaken belief that the chemicals people are exposed to today are somehow "new" makes me cringe. I wasn't trained as a doctor, but I was trained as a historian and archaeologist. The Romans used lead pipes for their water supply system, and used toxic chemicals like mercury (as did the California miners, come to think of it) to refine their ores and human urine to clean their clothes. Lead was used as solder for canned foods for a long time. Not to mention the prevalence and problems of lead paint in recent memory. Has Robyn actually seen the earliest photographs of London and other big cities and what they looked like in the heyday of coal burning plants? The soot you can see is not the only problem, either, as we know from our own dealings with acid rain. Arsenic was commonly used in dyes for various types of cloth, and a search through newspaper archives in the early 1800s alone show multiple examples of women dying from the fumes coming from their own clothes, let alone the problems for the factory workers. Don't get me started on sewage and its impact on the human race. Or how it's still possible to contract small pox on certain archaeological sites.
Well⦠Iâm surprised that so many of you are taking offense at my suggestion that an overabundance of man-made chemicals in our environment is a cause of autoimmune disorders. Would you take offense if I said that these chemicals cause cancer? Iâm not going to try to respond to any more posts, because some of you are really hostile. I do appreciate those of you who can respond kindly to something you disagree with.
One good book that I have read on the subject of environmental toxins is âThe Autoimmune Epidemic: Bodies Gone Haywire in a World Out of Balance--and the Cutting-Edge Science that Promises Hope,â by Donna Jackson Nakazawa. A good book, with plenty of references. Perhaps some of the evidence she cites might better explain the concept that I have so obviously failed to elucidate.
Ian â Thanks for the apology. Being scientific doesnât negate the fact that people have feelings.
Don't forget the historic use of Belladonna, a poison, as a cosmetic.
People should no comment on this issue if you do not have children. Everything changes when you have children. You have to consider - hmmm, how much toxins am I willing to have my 10 lbs baby endure? Sure vaccines are good. I'd vaccinate against all diseases and THEN SOME, if there were no toxins.
Amount of aluminum that a baby is injected with by 18 months is more that what the FDA recommends for a 200lbs man!!!! Read the facts, before you speak.
YEA read the factz!!111
"Offense" isn't the right word. Nobody is "offended" by a bad idea, I would hope. "Incredulous" is probably a better word to describe the reaction here - as in, "can you believe she's actually suggesting this as an idea?" The 'toxins' argument is an old one. As has been repeatedly demonstrated in this comment forum, it does not hold water. If children were as fragile as the idea assumes, then any antigen insult would cause autism, including falling down and skinning your knee.
The 'too many chemicals' idea fails to explain why specifically vaccination would act as the trigger, rather than any one of a million possible alternatives. The question is, now that you've been shown this, are you willing to admit that the idea is not a good one? Many people have ideas, but failure to abandon those for which there is no evidence (or indeed, evidence against)is the hallmark of the science-denying Forces of Stupid.
@Jfdkle
Define "toxin".
I assume you mean the FDA regulations on aluminum exposure from parenteral nutritional products. Such products are usually given in large volumes over the course of days or weeks, leading to potential build-up of aluminum in the system. Vaccines, by contrast, are a one-time exposure, with generally enough lag time between shots for all or nearly all of the aluminum to be expelled from the body before further exposures.
Please see the aluminum section at antiantivax.flurf.net and the links therein for more info. You can click the link in comment 73 or click my name to get there.
Right back at ya.
@Bruce
Stop acting as if the concept is made up.
Curr Opin Investig Drugs. 2009 May;10(5):463-73.
Autoimmunity in autism.
Enstrom AM, Van de Water JA, Ashwood P.
Increasing evidence of autoimmune phenomena in individuals with autism could represent the presence of altered or inappropriate immune responses in this disorder, and this immune system dysfunction may represent novel targets for treatment. Furthermore, in recent studies, antibodies directed against the fetal brain have been detected in some mothers of children with autism; these antibodies have the ability to alter behavioral outcomes in the offspring of animal models. A better understanding of the involvement of the immune response in early brain development, with respect to autism, may have important therapeutic implications.
False. The only thing that changes is you. Facts remain facts, and science remains science. Having popped out a kid doesn't make you immune from reality, it just makes you less likely to be willing to accept it.
People should not comment on this issue if they do not have facts. Use your brain before you speak, please.
Is it more than the FDA recommends for a 200lbs man over the course of 18 months? You're talking about the daily allowance, I bet.
See, I'm sure there are pretty smart people at the CDC. It makes no sense that they would not have thought of something you picked up in an anti-vax site run by a bunch of scientifically illiterate bozos.
Hmmmm... Aluminum was the 3rd most common element in the crust of the Earth before my children were born, and it's still the 3rd most common element in the crust of the Earth today.
Clearly everything has changed!!!!eleventy1111!!!
Moron.
I'm suddenly reminded of some of my art classes when we were given a list of acrylic paints to get. Titanium white was on the list, and the instructor mentioned lead white. There's one hypothesis out there that a chunk of Vincent Van Gogh's problems may have been due to a habit of his: Licking his paintbrushes.
There is a difference between proposing ideas and making stuff up. If you can't present the evidence that led to you to the idea, that essentially always means it falls under the "making stuff up" category. And when talking about serious science, making it up doesn't count for anything at all.
I had a anti-vaccine'er comment extensively on my blog post. I'm not Orac, but I think I responded decently.
Glad you keep posting this stuff, makes me think someone out there gets it.
jfdkle @82 Yes, things do change when you become a parent. You become responsible for the care and well being of another human. As a parent, I consider vaccinating my child against potentially debilitating and fatal diseases to be part of that. I also decided that breast feeding was a good decision, even though breast milk contains aluminum as well.
That said, not being a parent does not negate someone's ability to engage in this discussion in a meaningful manner. In fact, taking that emotional component out of the equation is an important part of collecting valid data to support the discussion.
If it were about chemical exposure, some developing countries should be harder hit than the US, because they have little or no environmental regulations to limit chemicals in their air and water. Further more, it raises the question of WHICH chemicals. There are numerous chemicals that are no longer used heavily used in industry the way they were previously (DDT, for instance. Going further back, there's the use of mercury compounds in manufacturing felt). "Chemicals" is a very hazy term.
Robyn, part of having ideas is being open to the fact that they may be wrong. The great thinkers of hisotry didn't just have hunches. They had hunches that they then proved.
As far as I can tell, what changes when you have children is your priorities. You might be willing to spend more to educate or protect them than you had expected to, and you might be more or less willing to let them take certain risks. You're probably paying more attention to product recall notices than I am.
But what risks are acceptable is a different question from what risks are real: you don't need to be a parent to know that lead paint is dangerous, for example. A faulty electrical appliance can catch fire in any home, whether or not it contains children. That a parent might be less willing to risk their own life, because they're thinking of their kids, doesn't mean it is more or less dangerous for a parent to drive fast than for a non-parent.
Birth: No Vaccine
3 Months: No Vaccine
6 months: No Vaccine ... rollicking good case of rotovirus, admitted to Neo-natal ICU for three days to treat dehydration and convulsions.
1 year: No Vaccine ... Hemophilus influenzae B infection, admitted to ICU for meningitis, luckliy escapes with no long-term complications.
5 years: No Vaccine ... starts kindergarten, catches measles, mumps and chickenpox during the next two years, misses 5 weeks of school and will need plastic surgery for the chickenpox scar on her forehead. Acquires the nickname of "Craterface".
12 years: No Vaccine ... Goes to national band camp, comes back with whooping cough. Spends the rest of the summer coughing to the point of vomiting.
18 years: No Vaccine ... Catches HPV from her cheating, sorryass boyfriend.
40 years: Diagnosed with liver cancer, physicians suspect that it is the result of chronic hepatitis B infection acquired in childhood from a household contact or in nursery school.
And I see while I was catching up and typing my previous comment, someone dropped the elitist postmodernist 'parents are infallible gods' meme.
Grow up.
Personal experience can easily deceive anyone. Siring and raising a baby does not strip you of your mortal fallibility. Everyone is vulnerable to self-deception by confirmation bias, post hoc fallacies, etcetera, etcetera, etcetera. The big reason we use science is to reduce those errors. Once you understand that, you might actually achieve actual open-mindedness.
Science requires that we always bear in mind that "I could be wrong" and make preparations to find out if we're wrong. All hypotheses and theories must be falsifiable.
You can't achieve open-mindedness if you believe something has magically made you immune to error. You are not a god.
I would like to honestly thank Robyn for showing up. She (?) represents a common way of thinking : "This idea seems plausible to me, why won't anyone pay attention?" The active response reflects the desire to educate on better ways of thinking, not an effort to be hostile or dismissive. Every once in a while someone says, "Ah, now I see" and I expect that makes it all worthwhile for Orac.
@Bronze Dog. I have an aritist friend who is really into historical pigments. It's always interesting to listen to her go "Toxic, toxic, toxic, safe, toxic, too toxic to use, but it was really pretty...." She said the general rule of thumb was that the brighter the color, the more toxic the pigment.
Exactly. Having a child made me far more aggressive in fighting anti-vaxxers, because their actions suddenly have a much bigger impact on me. Having a child made me far more aware of how their selfishness affects others.
Choosing to not vaccinate their child puts my child at risk. I have done my best to protect him by vaccinating him, but we rely on the cooperation of others to protect everyone.
In fact, it was having a child that got me more interested in RI than other places, because Orac talks a lot about fighting anti-vaxxers, and that is very important to me. That started when I had a child.
Robyn said, "Iâm surprised that so many of you are taking offense at my suggestion that an overabundance of man-made chemicals in our environment is a cause of autoimmune disorders. Would you take offense if I said that these chemicals cause cancer?
Man-made chemicals are far outnumbered by Nature's Own® brand of chemicals. Have you ever read any of Bruce Ames' papers - he's the one who developed the "Ames test" for carcinogens.
http://www.pnas.org/content/87/19/7777.full.pdf
OMG! Half the chemicals in plants cause cancer! (half the ones that were tested, anyway)
@Todd W - 76
Yes, granite is a source of radiation including radon gas because it has a significant quantity of uranium in it. Masonry is also bad for the same reason.
For an interesting read on various environmental sources of radioactivity, I suggest the following article:
http://depletedcranium.com/on-lnt-and-nuclear-energy/
Check suggestion #4.
Wow, David Mabus showed up here? And posting under his own name, no less. Orac, has a Mabus infection occurred before on RI?
Whoa. What the hell was that?
... as soon as we again relax into complacency and stop actively opposing them.
In other words, they're more like diphtheria or HiB than like smallpox or the measles.
@Orange Lantern
He's a loon that occasionally shows up on skeptical blogs and posts the same tired crap over and over.
Robyn -
The hypothesis that you said "makes perfect sense to me" (vaccines being the "straw," etc.) has actually been tested by careful statistical analyses of the detailed medical records of half a million schoolchildren (and many other studies as well, but the ones with half a million kids were the largest, and analyzed the most information), and was found **not** to be correct. Coming up with a hypothesis is just fine. But another part of good sense is that when something you think might be true is conclusively shown not to be, you accept that and try a different hypothesis, yes?
Arthur Allen,
good to "see" you again. I think I've seen you in comments elsewhere on this.
I wish I could see your interview.
A drive-by Mabusing. We've been Mabused.
Matthew Cline, I was going on Sid Troll's past history.
Jfdkle:
First, how does having children make someone more educated about the subject? Since my son suffered seizures from a now vaccine preventable disease, should I ask to not comment until that happens to your child?
Now about aluminum, it is the most common metal on the crust of this planet. It is everywhere, especially in the mineral that makes up most of the soil, feldspars. You might want to read some facts yourself. From http://www.atsdr.cdc.gov/tfacts22.html#bookmark04 :
# Virtually all food, water, air, and soil contain some aluminum.
# The average adult in the U.S. eats about 7-9 mg aluminum per day in their food.
Also, do you really think that aluminum is more toxic than the toxins made by the bacteria that cause pertussis, diphtheria and tetanus (the latter has two kinds!)? How well do you think your 10# baby would fair with pertussis? Or Hib?
Orange Lantern, search for Mabus here.
Robyn, do you think there is more lead or less lead in the environment since the introduction of lead-free gasoline?
Do you think children have more or less exposure from pesticides since the trucks that sprayed fogs of insecticides in neighborhoods went away? (I remember those from living in South Carolina)
Are children exposed to more or less cigarette smoke now than in the 1960s?
I went to a gardening talk on fruit pests last weekend, and in the discussion was information of the pesticides that were commonly used just up to a couple of decades ago. I listened to an interview of the author of The Poisoner's Handbook where she explained that some insect exterminator's would use their chemicals so wantonly that homeowner's actually died.
Also, I really hope you do not grow either castor bean or elephant ear plants in your garden (I just about gagged at a landscaping seminar when the presenter put a picture of those two plants together as an example of a good thing!). One of the reasons I have an edible garden is to prevent the kids from poisonous plants (though I did make an exception with delphiniums and daffodils).
"People should no comment on this issue if you do not have children."
Ok yes. Scientists with no kids? Shut up what do you know. Idiots who fell in a hole for 3 seconds?* Your contributions are welcome.
*A statement my dad made to my brother with respect to my brother's suggestion that we get him something for father's day.
the child of today has to deal with far more chemicals, in food and in his environment, than any generation in the history of mankind.
Have you ever read any of the history of occupational diseases? Just tetra-ethyl lead alone probably accounts for more toxicity than you seem to figure, but we (and large parts of the rest of the world) finally banned it eventually, even though the people who decided to put it into gasoline in the first place (as an anti-knock agent) knew it was toxic and would give some people lead poisoning, and just plain lead exposure to everyone else. Or if that's not enough, look at all the women who had their faces eaten away by radiation from working with radium paint between about 1920 and 1935 or so. I bet a lot of those women had children, and I'm further willing to bet that a lot of those children got exposed to high doses of radiation from their mothers. (While we're on the subject of radiation exposure, let's also talk about the people who were handling radioactive materials in heavy water in the 1950s while wearing only thin gloves, and what that did to their kids.)
Considering that we now have things like the Clean Air Act, and stringent environmental laws in most of the developed world; acid rain is going away, ambient contaminant lead levels are the lowest they've been since the early 20th C., it's positively ludicrous to say that kids today are more exposed to toxic chemicals than ever before. Comparatively speaking, I'm almost certain that today's children are growing up in a cleaner environment than any generation has since the Industrial Revolution.
In other words, given the amount of actually toxic substances put into the air, water, and bodies of people by corporate polluters, it's insane to be focusing on microgram levels in vaccines. That's panicking about motes in the eyes of strangers while completely ignoring the forest of beams in your own.
TDN, that's why we need to buy organic anise, apple, apricot etc, so we're safe from this stuff.
Robyn @#65: touche! you made me laugh, giving some insolence back to everyone.
we just like to know if an idea has some prior plausiblility or if it is one that sounds reasonable and is adopted uncritically.
the too-many-too-soon and "toxins" ideas fall into this category. they sound plausible to laymen, but to experts they are silly.
an example from the physics realm of this type of thinking is what is the cause of the seasons? a layman may think that the earth being closer to the sun in the summer makes perfect sense. however, that is not the case. it is due to the axial tilt of the earth.
You may be out of date. There appears to be some evidence that our ancestors have been cooking from far before anatomically modern humans (try 3 Ma). That makes for the interesting conjecture that the discovery of fire may have been the watershed event leading to modern humans.
That also leads to the Murray Leinster conjecture that woodsmoke was such a pervasive presence in our evolution that we've come to depend on it in some fashion.
Oh, absolutely. The ideas of a 15 year old who's dropped out of school to care for her kids are infinitely superior to those of someone like Paul Offit, who's spent the last 30 years researching children's health [1] or like Abbie Smith (20-something virologist researching HIV).
Our first pediatrician was a guy who could never have kids of his own. He made up for it by devoting himself to hundreds of others; if you look at the income figures for pediatrics vs. most specialties you'd get a hint as to what it cost him. I'll compare the years he spent to the time and effort that most parents invest prior to having kids, and as for the number of hours per week ... So tell me again why I should ignore what people like him think about children's health, hmmm?
[1] Yeah, Dr. Offit has kids. He regularly receives threats regarding them.
@Sid (#86):
I'm sorry, but I've read Enstrom's Brain, Behavior, and Immunity paper - and anyone who cites Andrew Wakefield's work as support for their theory that autism is an auto-immune disease needs to be looked at very, very critically.
@Robin (in general):
I am less inclined to dismiss the "environmental toxin" argument for autism than some, but I don't think that childhood vaccines play a role based on the available evidence. A more likely scenario is that enviromental factors vis-a-vis pregnant women may lead to those women having a higher risk of bearing an autistic child.
I do completely concede that there is little evidence to support my assertion, and base it mostly on the existing evidence that women who contract rubella during pregnancy have a higher risk of having an autistic child.
@Sid (#86):
I'm sorry, but I've read Enstrom's Brain, Behavior, and Immunity paper - and anyone who cites Andrew Wakefield's work as support for their theory that autism is an auto-immune disease needs to be looked at very, very critically.
@Robin (in general):
I am less inclined to dismiss the "environmental toxin" argument for autism than some, but I don't think that childhood vaccines play a role based on the available evidence. A more likely scenario is that enviromental factors vis-a-vis pregnant women may lead to those women having a higher risk of bearing an autistic child.
I do completely concede that there is little evidence to support my assertion, and base it mostly on the existing evidence that women who contract rubella during pregnancy have a higher risk of having an autistic child.
Sid, are fetal antibodies produced by the mother in any way connected to vaccines? Please explain.
"People should no comment on this issue if you do not have children."
Change that to "People should not comment on this issue if they have never suffered through the once-common childhood diseases*, or if they have no knowledge and understanding of what it means to fear infections like polio and whooping cough".
*I've had many of them (never rotavirus or Hib meningitis, thankfully). It's no fun at all. Kids today are fortunate not to have to face the specters that their great-great grandparents did. They are, however, increasingly afflicted by adults who have forgotten the past.
I have an analogy to add to that: Any bitch (ahem..as in a female dog)can have a litter - that doesn't make it a suitable mother.
Amazing how the antivaxxers tend to belong to the generation that got a pass on the nasty stuff like chickenpox, measles, etc. Since it didn't happen to them, it just didn't happen, I guess.
@Mu--
Is my sarcasm-o-meter on the fritz, or did you completely miss the point of Tsu Dho Nimh's post?
Wow, I came in late today--a great read. I truly hope Robyn stays around long enough to (and has a tough enough skin) to see that we do respect her and are only trying to bring her up to speed on the very basic basics of scientific thinking. Some of you were a bit harsh I think--she is new and needs tutoring not shaming.
------
@D.C. Sessions, #116
I think it's fair to guess that Anthropology is not your field and to me, an Anthropologist, you sound like Robyn. Reading National Geographic doesn't count.
@madder,
Mu can explain if I am wrong, but I think they were in agreement.
I've done a little reading on the organic versus standard farming issue lately. As I recall, there have been some comparisons of nutritional value and the results are mixed. I wonder if there have been any assay tests on the concentrations of natural pesticides and carcinogens for organic versus standard?
Tsu dho: nice try with the whole worst-case scenario thing with the no vaccine schedule. I'm pretty sure that many people of my generation (I'm 49) have lived through many of the diseases you named and were just fine. Nice try, though. Go back to your lab.
@squirrelelite:
You may be right. My question contemplated two interpretations of Mu's comment; I can think of several others as I sit here. I'll shut up about it until/unless Mu elaborates.
"Birth: No Vaccine
3 Months: No Vaccine
6 months: No Vaccine ... rollicking good case of rotovirus, admitted to Neo-natal ICU for three days to treat dehydration and convulsions.
1 year: No Vaccine ... Hemophilus influenzae B infection, admitted to ICU for meningitis, luckliy escapes with no long-term complications.
5 years: No Vaccine ... starts kindergarten, catches measles, mumps and chickenpox during the next two years, misses 5 weeks of school and will need plastic surgery for the chickenpox scar on her forehead. Acquires the nickname of "Craterface".
12 years: No Vaccine ... Goes to national band camp, comes back with whooping cough. Spends the rest of the summer coughing to the point of vomiting.
18 years: No Vaccine ... Catches HPV from her cheating, sorryass boyfriend.
40 years: Diagnosed with liver cancer, physicians suspect that it is the result of chronic hepatitis B infection acquired in childhood from a household contact or in nursery school.
Posted by: Tsu Dho Nimh | April 30, 2010 3:20 PM"
If stupid really could burn, Dave, we'd have all been badly scorched by that post.
Jay
So, Dr. Gordon, your saying that series of events posted by Tsu is 100% IMPOSSIBLE?
No, Peter. Just not an intelligent post. 100% unlikely.
Jay
"These feelings tend to occur when very bad news, of which there's been more and more lately, strikes the anti-vaccine movement."
I'm afraid that looks to me like confirmation bias; they'll be back. Ignorance is like a zombie - or the terminator - or yet another Freddy Kreuger movie.
If stupid really could burn, the computer I am typing on would be scorched beyond repair just for giving this blog a site hit.
Which is why I phrased what I wrote as "may be out of date." Glad to have someone who knows the field correct the facts. What is the current understanding of early use of fire and its influence on human evolution?
Jen, Jay & Jake. We're missing JB to have the full compliment of anti-vax "J's". The 4 jokers of the apocalypse.
Sid Troll posted the "no vax" schedule and Tsu posted a possible no vax schedule response timeline. That's the trouble with humans. Our genetics and circumstances make that and many other better or worse scenarios possible. That is why we vaccinate.
Oh, good. Dr. Jay's here.
Dr. Jay, perhaps you could address the advice I criticized you for, you know, where you told a mother not to vaccinate her five year old son because her other son is autistic? Please, Dr. Jay, educate us. Where is the data to support this advice? Where is the science?
You do realize, don't you, that imitation is the sincerest form of flattery. I'm glad you like my "burning stupid" meme enough to appropriate it.
@Jen #127
My grandpa lived through WWII and was just fine.
Okay, Dr. Gordon, here's a more likely scenario, in five words: "Crib for sale. Barely used."
Except in the alternative medicine universe, in which the outcome is
@Jay Gordon#131
C'mon, Dr.Jay. Of course, the scenario as a whole is unlikely, it was a tongue-in-cheek response to an antivax post - surely you can see that. The point is that each of the episodes would be enough and that unvaccinated individuals have a significantly higher chance to be affected by these conditions. I hope that you do not deny that. That would be, err ... just not intelligent.
Martin
@127 Jen said, "I'm pretty sure that many people of my generation (I'm 49) have lived through many of the diseases you named and were just fine.
You are estimating risk based on the wrong population - everyone you know is by definition a survivor. How many didn't survive, survived a severe bout of the illness, or survived with long-term effects? How many coffins have already been filled by your generation? How many of your parents' generation lost children from vaccine-preventable illnesses?
Many people of my generation lived through those diseases too. (I'm old enough to be your mom.) In any school of "my generation" there would be one or more students or teachers with crutches and leg braces (for life) because they had polio. I visited one of my classmates while she was in hospital, in an iron lung, from polio. It scared the shit out of me. There was my partner in crime, my tomboy soul-mate, unable to move her arms or legs, locked in a mechanical monster. She survived, but the physical therapy took months and she never ran as well again.
My older sister got measles and was on IV fluids, antibiotics, and O2 ... she would have been in the hospital except they were full up with kids sicker than she was. My parents had both been in the medical end of the Navy during WWII so with the help of both my grandmothers they did home health care. She lived, but not all families were that lucky.
In high school our class social work activity was the AZ School for the Deaf and Blind ... many of their students were there because measles encephalitis left them deaf or blind. The school has far fewer students now, post-vaccine.
I've also seen what it does to parents when they lose the childhood disease lottery. One of my tenants decided to skip vaccinating her girls for chickenpox and both were in NICU with IVs and O2 because the pustules filled their throats. They couldn't swallow and breathing was getting difficult. They survived.
Even as a medical technologist, not front-line patient care, I've seen enough premature deaths from vaccine-preventable diseases to make me a vehement supporter of vaccines. I want people to die old, die peacefully, die in bed at home, with family and friends around them. I don't want to see children suffocating with whooping cough, rotting away from HiB, or retarded from measles/mumps encephalitis. I've seen enough of that shit to last several lifetimes.
Dr Jay ... Your assumption is that the unvaccinated child will be protected by the far larger herd of vaccinated children. The true test of whether something is a good idea is not whether a few can do it with no consequences, but what happens if everyone does it.
What would you see if everyone followed Sears or your advice, lengthened the vaccine administration schedule, and skipped the ones they thought they didn't need?
Jfdkle - Funny thing, becoming a parent didn't suddenly cause me to become so selfish that I wouldn't consider the harm that not vaccinating can cause to other people. I have a close friend who is HIV positive. According to the anti-vaxxers, I should only worry about my child, and to hell with everyone else. So what if my son gets pertussis and passes it to my friend with a weakened immune system. I mean, it could kill him, but choosing not to vaccinate is a personal choice that only affects me, right? (/sarcasm)
I still worry that my 8 month-old could get the measles or the mumps, because he isn't old enough to have his MMR yet. I lived in fear of H1N1 until he was 6 months old and able to have the vaccine. Why is it suddenly okay to ignore our societal obligations to each other?
@jen (#127)
As pointed out above, "many" doesn't mean "all" or even "most"... and if we're talking only about proportions here, then we wouldn't be talking about ASD either as vastly more people get vaccinated and don't experience any adverse effects at all.
Also as a counter, I'm in my early 40s and I can remember two children in my primary school who suffered debilitating effects of childhood illness to the point of having to wear leg braces; one was a polio survivor, the other had CNS damage from HIB. I also know of a coworker at a job I used to have coming down with pertussis after working with an unvaccinated population... and since he was a smoker, it damned near killed him. All three of these diseases are easily preventable now.
(And the above is leaps and bounds better than what my mother saw growing up in post-war Montreal. She comes perilously close to worshipping Dr. Salk as an intervenor saint.)
-- Steve
Orac: Dr. Jay, perhaps you could address the advice I criticized you for, you know, where you told a mother not to vaccinate her five year old son because her other son is autistic? Please, Dr. Jay, educate us. Where is the data to support this advice? Where is the science?
Dr. Jay did say the following on his website:
"I base everything I do on my reading of CDC and World Health Organization statistics about disease incidence in the United States and elsewhere."
So there you have it. Jay must know some super-secret data from the CDC and WHO that no one else has ever seen, that tell him a five-year-old brother of an autistic boy should not be vaccinated. Please, please Dr. Jay - share this vital information with us! We, as well as the parents who support your practice need to know, for the children's sake.
You couldn't have just made it up, right?
A suggestion for Dr. Jay (and the other Js):
Take a walk through an old cemetery. You will see a lot of tombstones for infants and children there. A large proportion are there because of those "harmless" childhood illnesses and complications thereof.
There's a small but fascinating museum that I visit every year with my daughters in a town (Cumberland BC) near the beach where we go every summer. One of the exhibits is a child-size iron lung. It's great to be able to tell them that they don't have to fear ending up in one of those things because of those Horrible Toxic Brain-Damaging Immune-Straining Polio vaccines.
...and the ones who didn't are awfully quiet for some reason.
The antivax movement has become a lot more relevant to me recently. I've recently been diagnosed with psoriatic arthritis; the treatment is weekly injections of an immunosupressant. Without the drug, I'll be in a lot of pain with seriously reduced mobility and possible long-term joint damage. With the drug, I'll be at increased risk from communicable diseases, despite being vaccinated against them.
Now more than ever, I have to rely on herd immunity to stay healthy.
Up until now the antivax movement has been a minor annoyance, dishonest advocates for an anti-science worldview and a general
public health hazard. It has now become a tangible threat to my personal health.
Science. Science is ALWAYS completely infallible, especially when it comes to pharmaceuticals. Science is our friend. Antiwarvaxsciencemovementscheduleblahblahblah. As a child I had measles, whooping cough, mumps and the dreaded chicken pox. I'm fine. BUT THE SCIENCE you say! People believe what they know to be true. Welcome to the human race. My kids shall remain vaccine free. Am I playing with a loaded it gun? Science would certainly say that I am. Can I sleep at night? Yes. Am I an idiot? Well, if you say that I am...it must be so.
@Hal Jordan;
Your children shall play with that loaded gun every single day, not you.
That says all that needs to be said about your intelligence level.
Hal Jordan:
You don't mention polio, tetanus or diphtheria. Think about why that is.
You are an idiot, and not just because I say so.
@Hal Jordan
Straw man. No one says that science (I assume you mean the people doing the science, not the process of science itself) is always infallible. By this statement, we can assume that you do not understand science very well at all.
@Dr Jay Gordon...
I for one would like very much to see your answer to Orac's very reasonable question.
Thanks.
Wow -- first we get Jay Gordon and now Green Lantern.
I'll add to our superhero visitor that while growing up I never wore a seatbelt, nor did any of my friends or acquaintances. No problem -- they're a waste of time and annoying to boot.
"People should no comment on this issue if you do not have children. Everything changes when you have children." from Jfdkle at post 82.
I'm a mother of 2, so I assume I am allowed to comment.
I was so eager to have my kids vaccinated I booked them for the day they hit each age. Of course, that may be because I saw my infant sister (too young to be fully vaccinated) nearly die of whooping cough when I was 4, then another sister hospitalised for nearly a week due to rotovirus when she was an infant. Then there was my next door neighbour, 4 years older than me, who had numerous problems including near deafness and very poor eyesight due to the fact her mother contracted German measles while pregnant with her. When I was little, I thought that meant she'd been sick in Germany. Now I know better and made sure my kids were vaccinated so my daughter would not have that worry when she grows up and has children and my son will not pass on the disease to any pregnant women.
I will never be able to understand why any parent thinks leaving their child vulnerable to a preventable, possibly fatal, illness is a good idea. Most of the anti-vax mums I know would never consider just skipping the car seat or not ensuring their child is sleeping in a safe environment, but leaving them vulnerable to these preventable illnesses is actually preferable to preventing them in their minds.
Good Morning David, et al--
The diseases are mostly gone because of vaccination. In 2010 we have the luxury of not dodging horses and buggies and not fearing other dangers of the past. Parents and doctors should discuss these diseases and vaccines against them and make decisions in the best interests of individual children and with strong consideration of public health, too.
When there's a family history of a disease--cat allergies, perhaps--I recommend that the family not get their child a cat.
A family history of autism, which might (or might not!) be triggered by vaccination, warrants much greater caution. The benefit of a hepatitis B vaccine to a child is virtually nil and I judge the risk to be significant. I know that most experts disagree.
I also know that you choose to view my three decades of observing tens of thousands of children as a series of anecdotes. You're not a real scientist: You just play one online. I'm guessing your quite good at surgery though.
The hyperbole and unpleasant comments at this site continue unabated. Even mine.
Best,
Jay
"Posted by: Jay Gordon | May 1, 2010 1:31 AM"
He can't answer you as a doctor because he has finally acknowledged that he isn't a real one.
@Hal Jordon:
Based on my previous experience with countless other antivaxxers and conspiracy nutjobs, I think I can reasonably say "Pot. Kettle. Black." because there's a >90% chance you buy into the anecdotalist notion that you are an infallible god who could never, ever make a mistake in connecting cause to effect.
Science is built on the premise that it's fallible. What do you think falsification is about?
But since, like other tinfoil nutjobs, you probably think science is about moving colored liquids between funny shaped glasses, I'm probably overestimating you by asking about 5th grade concepts like falsificationism.
Science is a process of enforced humility and double-checking for errors. Woos of all stripes, antivaxxers included, are all just whining about how real life isn't like the movies. Real science is hard work and not easy on the ego. A scientist has to be a hard critic of himself, accounting for all his possible errors and limitations and then he has to submit to scrutiny from other scientists.
All of this is done to reduce (but never completely eliminate) the chance of human error. And that's for ANY scientific study in ANY field. Multiply that level of diligence several fold for using something on human lives.
Alties don't like the prospect of bruised egos. That's why they reject diligence in favor of sloth and faith. Why go through all those hurdles when you can perform sloppy unregulated experiments directly on the market? They want to be immune to the tight restrictions we try to keep on "Big Pharma." They want a double standard. They want to be above the law. They also want to place themselves above humanity. Just look at the anecdotalism rhetoric and read between the lines: They think they're gods.
Hal, you aren't the one playing with the loaded gun. Your innocent children are. People like me and Bob who take immunosuppressant therapy are ceing forced to. Babies not old enough for vaccination are also potential innocent victims of your selfishness. What makes you, or any of the antivax lunatics think you have the right to force OTHERS to play Russian roulette at YOUR whim.
If I was a less kind person I would hope that your unimmunuzed children brought home pertussis to infect you...not them, of course...I suuport immunizations because I don't want innocent people to suffer.
"I also know that you choose to view my three decades of observing tens of thousands of children as a series of anecdotes."
That's because they are.
You have been informed of this before.
Please refer to your local academic library for literature on the various hierarchies of evidence.
I was going to comment on our grandparent's toys, since children's toys in the twenties through the fifties could contain not just lead or unregulated toxic chemicals, but things like radium. Then I got stuck browsing old ads and it's three hours later.
Nice job dodging complications from chicken pox, Hal. I did too. Of course, the virus is still in your body, and if you get immunocompromised (possibly by your sick kids) you're at risk for shingles. It can also happen just because you aged with the virus in your system. There's a vaccine out to prevent that, just so you know; I'll be getting it in a few decades when I reach the age bracket of those at risk.
@ Jay Gordon 157
And good morning to you too.
"In 2010 we have the luxury of not dodging horses and buggies and not fearing other dangers of the past."
Exactly. That's why I will never teach my children to look before going across a street.
More seriously, last summer at my parents' place there was a "farmers' fair" with real horses and buggies, right next to the visitors. Finally, your analogy is well choosen, doctor.
Bug(ies) are a thing of the past, but may reappear suddenly.
"When there's a family history of a disease--cat allergies, perhaps--I recommend that the family not get their child a cat. "
I happen to be allergic to pollen. Should I start shooting all cats on sight? (beware, trick question)
BTW, peoples in Toronto are developping a vaccine to cure allergies to cat. Would you recommend one to a child with cat's allergy?
"The diseases are mostly gone because of vaccination. In 2010 we have the luxury of not dodging horses and buggies and not fearing other dangers of the past."
This isn't true at all, quack. Vaccination has had little to no effect on the eradication of diseases.Vaccines only cause autism, like what it says on your site.
@Dr. Jay: This is completely abstract non-data. Like I've said before, you never put any of your claims into numbers, so it's impossible for us to assess your "experience." For all we know, you're lousy at math and probability theory, you're naive about issues like recall and self-selection bias, so you simply lack the skills to even being to interpret your own experience at all.
MK, you'll find that Dr. Jay is too busy to answer polite and relevant questions as demonstrated by the rather long history of his participation on RI.
I got chicken pox before there was a vaccine and did fine, well, you know, other than the huge weight loss and three weeks of suffering and missed school, plus the scars. But the shingles I got during medical school made me want to die.
I took the oral typhoid (prior to the injectable one coming available) vaccine, thinking 30% protection is better than none. I still got typhoid. I lost 40 lbs, missed 2 months of work, and had to relearn how to walk. I'd do the same thing again, because the vaccine was a much smaller risk than the sickness.
Whoever it was who was talking about "chemicals" needs to take a chemistry class. Especially if she believes that rural folk /old timers were exposed to fewer "chemicals" than today's kids.
Mercury? You mean actual toxic mercury like the effluvia from a pulp and paper mill? Not the stuff your kidneys can clear i a couple of days? Yeah, lots of rural places have not great environmental controls and get big exposures to mercury, with terrible ill effects. Read some Margaret Lock, to see what real mercury poisoning looks like: hint- not autism.
Pesticides? Like DDT? Which is still used in most third-world countries, partly to protect crops but also to combat malaria. It's not very nice. You lucky girl, you'll never need to see it. They use buttloads of permethrin as well. Oooh evil. But better than malaria.
Leaded gasoline, paint, and glass? Yeah I remember. Hm. No autism though.
Actually, here's one nobody mentioned: in the rural area where I was a kid, they used to spray spent engine oil on the roads to keep the dust down. Nowadays, you have an oil leak in you car around here, the council gets up in arms you might be contaminating the groundwater.
But oooh way more chemicals THESE days.
Seriously, I'd be more concerned about those sanitising handwashes. What the hell is IN those things?
@Tsu Dho Nhim
Birth: No Vaccine
3 Months: No Vaccine
6 months: No Vaccine ... (denied protective breastfeed and moved to Africa were rotovirus is dangerous) rollicking good case of rotovirus, admitted to Neo-natal ICU for three days to treat dehydration and convulsions.
1 year: No Vaccine ... (family returns to America and settles on Indian reservation where poor socioeconomic conditions predispose for Hib; takes up passive smoking) Hemophilus influenzae B infection, admitted to ICU for meningitis, luckliy escapes with no long-term complications.
5 years: No Vaccine ... starts kindergarten, catches measles, mumps and chickenpox during the next two years (enjoys the needed time off from school)
12 years: No Vaccine ... Goes to national band camp, comes back with whooping cough. Is told by pro-vaccine zealot that she will spend the rest of the summer coughing to the point of vomiting. Does own research and finds to her relief:
In older children and adults with whooping cough, the symptoms are often far milder and the condition is often not diagnosed
18 years: No Vaccine ... Catches HPV from her cheating, sorryass boyfriend. (virus cleared immediately with no ill effects)
40 years: Diagnosed with liver cancer, physicians suspect that it is the result of chronic hepatitis B infection acquired in childhood from a household contact or in nursery school. Later discovered that long-time heroin habit acquired at band camp is genesis of Hepatitis infection
@Dr Jay Gordon...
That's interesting. You did not answer the question. Why not?
Oooh, DDT. On the one hand you have those who claim that not only is DDT harmless, but malaria would have been completely wiped out worldwide if it hadn't had been banned within the United States. On the other hand you have those who claim that paralytic polio was caused by DDT (and other pesticides), and that the polio virus itself either causes no lasting harm or is non-existent. I'd like to see those two sides get into an argument.
@Dr Jay Gordon:
And it seems you're doing your best to amend that crime against biodiversity.
@118 119
I'm sorry, but I've read Enstrom's Brain, Behavior, and Immunity paper - and anyone who cites Andrew Wakefield's work as support for their theory that autism is an auto-immune disease needs to be looked at very, very critically
Sid, are fetal antibodies produced by the mother in any way connected to vaccines? Please explain.
My point was not to support the theory but rather demonstrate that it's point of origin lies far from "The Journal of Things I Pulled out of My Ass"
And Enstrom is not alone in his interest in the immune system. See The Neurobiology of Autism, Ch 27. Strangely the book has no chapters on the cardiovascular system or for that matter french fries
100% unlikely.
Statistics fail.
@Dr Jay Gordon:
"Anecdotes" is such a loaded term, Doctor. I prefer to give the evidence of your thirty practitioner-years the weight it deserves proportional to the comparable experience accumulated over the last two centuries by thousands of homeopathic practitioners.
164 is a fake Sid Offit
Or perhaps 175 is.
Battling sock puppets!
@Matt Cline
On the other hand you have those who claim that paralytic polio was caused by DDT (and other pesticides), and that the polio virus itself either causes no lasting harm or is non-existent
Don't you think it's just a coincidence that polio, being the only vaccine-preventable disease that was non-existent in epidemic form prior to the 1880s, and the advent of these neurotoxins occurred almost simultaneously both temporally and geographically?
#168:
"enjoys the needed time off from school"
Yeeeah, I currently have the most average regular ordinary common cold, and I feel terrible. I also remember the chicken pox as not fun, and that I'd much rather be in school than sick.
Dr. Jay (in this comment section): "A family history of autism, which might (or might not!) be triggered by vaccination, warrants much greater caution."
Dr. Jay (on his website): The way vaccines are manufactured and administered right now in 2010 makes vaccines and their ingredients part of the group of toxins which have led to a huge increase in childhood diseases including autism.
This illustrates part of the reason we find it so difficult to take Dr. Jay and his anecdotes seriously. He declares on his website for the parents of his patients to see that vaccine "toxins" are responsible for autism and other diseases, no doubt about it. Then he comes in here and says, well, maybe not.
He can't even maintain a consistent opinion from one moment to the next. How are we supposed to trust his recall of observations made many years ago?
It's kind of telling that when Dr. Gordon finally responds, he chooses to respond to a deliberately obviously over-the-top joke post, ignores everything else of substance in the thread, and them prompty vanishes again.
@178
http://tvpog.com/simpsons/394574-simpsons-dont-waste-mumps.html
Yeah, that must be it. It couldn't possibly be something like, oh, sanitation.
Hint: polio has been around at least since the Pharaohs (characteristic skeletal evidence found in mummies.) It just didn't become epidemic because it was in constant circulation thanks to fecal contamination of drinking water. Once we cleaned up the water, people could go for years without being exposed.
Jay is a thoughtful and considerate type, and would never dream of deviating from the style that his audience has come to expect. I mean, imagine Robin Williams doing a Rodney Dangerfield schtick -- it just wouldn't work.
Same thing for Jay and substantive replies -- they're not his style.
Robyn, in a forum of ideas, if you make a claim, you are of course not expected to immediately provide ALL your references.
However, if someone later asks you for a reference, you are expected, as a courtesy, to provide at least one.
If you have no references to begin with, and the claim is an unusual one that is not considered part of common knowledge, it is expected that you would acknowledge so in the original post.
But it doesn't. The immune system is an adaptive system, and the inherent property of adaptive systems is the more it is challenged, the stronger it gets.
Thus, the scenario wherein the immune system is weakened by environmental stressors because certain aspects of its fundamental structure is compromised, and the competing scenario wherein the immune system is strengthened by environmental stressors as a result of the accrual of experience, as both equally sensible a priori from a logical point of view.
To distinguish one from the other therefore REQUIRES the accumulation of scientific evidence for each and every specific type and class of stressor. And we should expect that the results will NOT be generalizable across the spectrum. Each individual stressor will have its own unique effect, and some will be beneficial and some will be harmful.
For vaccines, this has been done. And there are both beneficial effects (the ability of the vaccinated immune system to deal efficiently with certain antigens is MASSIVELY improved), and harmful effects (autism has been tested and found to be not one of them). The known beneficial effects to date far outweigh the known harmful effects. The magnitude of this difference is such that any future discovery of a harmful effect would have to be absolutely HUGE to change the overall recommendation in favor of vaccination.
How huge? That is something of an individual judgment call. But for me, given the overall rates of autism and the average morbidity associated with it, compared to the overall rates of the vaccine-preventable diseases and the morbidity and mortality associated with them, and the degree of effectiveness of vaccination in preventing them, even if vaccination was the sole and only cause of 100% of all autism in all susceptible individuals, that amount of harm is still not sufficiently large to outweigh the benefit of vaccination.
@Offit:
So then you have evidence that paralytic polio was much more common among farm workers who were directly exposed to the pesticides than those who merely ate the pesticide laden vegetables? Care to cite it?
@Sessions:
Didn't sanitation possibly make polio worse? I've heard the theory that it used to be that babies would get polio while maternal antibodies would still give them some protection against it, making it much less severe, but as sanitation improved children would be exposed to it when they were older and all the maternal antibodies were gone.
I recall reading some "DDT -> polio" people saying that the polio effects found in the mummies could have been caused by arsenic/lead/mercury/something-or-other. Strange that such a specific toxic effect can be caused by such a wide range of toxins...
The mummy had polio? That must be why he moved so slowly in the movies. Anyway see Dirt and Disease: polio before FDR By Naomi Rogers P15
âPolio cases appeared in both overcrowded slums and sparsely populated suburbs."
Seems all that slumminess wasn't all that protective
And was rural Rutland Vermont all that dirty before, and was then a new water treatment plant built right before the outbreak of 1884?
Correlation doesn't equal correlation
177 Sid is also a fake Sid.
Additionally, does anyone know why PZ Loser's list of trolls posted above (http://scienceblogs.com/pharyngula/plonk.php) doesn't include me? I mean I have put many years and hours of hard work into trolling skeptical blogs with asinine comments- and I don't even get a honorable mention? Disgusting. PZ is likely taking money from big pharma, preventing humanities return to golden age nature.
That is easily the most profound thing that Sid has given us.
Since Fake Sid Offit continues to post, I'll ask everyone to use literary analysis to differentiate us.
@D.C. Sessions, #134
I was mostly referring to the end of your post:
"That also leads to the Murray Leinster conjecture that woodsmoke was such a pervasive presence in our evolution that we've come to depend on it in some fashion."
ML was a science fiction writer. I can't find anything that says where he was educated, but he published before the age of 20, so I'm not sure he went to college at all. Doesn't mean he's stupid or unread, but certainly no expert on human evolution. I've never heard of the woodsmoke theory, but I'll look into it just to make sure I'm not picking on you for no reason. Now, Isaac Asimov wrote sci-fi as well, but his was based on a strong science background. Many sci-fi writers come from anthropology backgrounds. Jean Auel (Clan of the Cave Bear took a lot of anthro classes, but only those that interested her. Some of what she writes is based on some theories, but much of it is, indeed, dated.)
You are basically correct that fire has been around a long time--it wasn't so much "discovered" as it was our first technological advance (or use of energy). It is a valid theory that cooked flesh was responsible for "jump starting" the process of brain development that eventually differentiated us from earlier hominids (by making more protein available). Keep in mind that we are talking mostly scavenged meat accidentally "cooked", not brave hunters slaying lions and tigers and bears, oh my! Fire was also used to improve toolmaking,but I'd have to look up some references to tell where that fits on the timeline--it's not something I have studied in detail. Anyway, thanks for asking. Anthropology is a fascinating field and prone to much oversimplification by PBS science programs (as I'm sure many other fields suffer from as well).
So, Offit, no evidence that farm workers with direct exposure to pesticides suffered from paralytic polio at a greater rate than anyone else?
Sid at 178: "18 years: No Vaccine ... Catches HPV from her cheating, sorryass boyfriend. (virus cleared immediately with no ill effects)"
Oh really you shit? HPV is linked to cervical cancer, you lying sack of shit. Sorry for the profanity, usually I like to keep it classy, but fuck you right in the eye Sid.
How about we just call you Bruce?
Because you're even a failure at trolling.
If you really want to make it into Major League Trolling, you need to do some time in the farm teams. Try starting with news.admin.net-abuse.usenet and see if you can at least get a KOTM. With that on your CV, you may have a shot at Pharyngula.
@ Sessions
Update
FYI: This isn't a scientific paper, but interesting, nonetheless. There are points I would argue, but I'm not a professor at Harvard. I've read his book and liked it.
http://www.flatrock.org.nz/topics/drugs/we_are_all_addicted.htm
Scroll down to:
The Human Recipe
by Richard Wrangham (Professor of Biology and Anthropology, Harvard)
No farming evidence just this:
Lead arsenate ...was first used as an insecticide in 1892 for use against gypsy moths invading hardwood forests in Massachusetts.
Efforts to combat the attacks of the gypsy moth
in New England forests led in 1892 to the use of lead arsenate
http://www.agclassroom.org/gan/classroom/pdf/embed1_seeds.pdf
In 1894, the nation's first polio outbreak was identified in the Rutland Vermont area of New England
The element [Pb] enters the food-chain through many sources including aerial fall-out and the use of pesticides
containing lead in agriculture
Differential diagnosis for polio caused AFP is lead - Vaccine 4th ed. P657 Plotkin
Nothing on farmers though
re: fake Sid
Whoever's being the Sid Offit sockpuppet, knock it off or be banned. I happened to have been "lucky" enough to have been at a strategic planning retreat for our cancer center all day; otherwise, I would have posted a warning earlier.
@Offit:
So the exact same collection of symptoms can be caused by both heavy-metal poisoning and organic pesticides?
Also, from what I've been able to find on the Internet, lead poisoning doesn't lead to paralysis, and the symptoms of polio has no more in common with the symptoms of lead poisoning than there are commonalities between the flu and lead poisoning.
Finally, if paralytic polio was somehow caused by pesticides, wouldn't it's clustering around farm have been so blatant that it would be easy to find evidence for it?
As much as I enjoy reading Orac's lengthy deconstructions, it's almost more satisfying when he doesn't respond at all to certain comments left for him. Jay, your weird, evasive ad hominem eats itself, no insolence required.
jen, do you know who Olivia Dahl was? Do you know why she cannot chime in with her measles experience? My mother had two uncles she never got to meet. I only learned about them I came into possession of her grandmother's Bible. One page had a temperence pledge signed in a very cute scrawl from one when he was six years old. The next page listed his death a year later. His younger brother was alreadly listed since he had died when he was ten months old.
Dr. Jay:
So what will happen when enough of your patients stop vaccinating? Why are measles and mumps now endemic in the UK? Why did dozens of peoeple die from measles in Japan?
Oh, Leinster (William F. Jenkins, 1896â1975) wasn't making a serious suggestion. It was a throwaway idea for a short story (Plague on Kryder II), where colonists on another world were showing strange symptoms. The protagonist accidentally lights a fire and has the inspiration to check whether the symptoms might be the result of the colony having such a clean environment that they never used open combustion.
Even if it turns out that he scored a lucky hit, there's no way to justly credit him with any kind of deep insight. At the time the prevailing belief was off from today's in two key ways:
1) Fire was thought to be a recent development, and
2) Human biological evolution was thought to be a much slower process.
FWIW he published his first story in 1919, roughly 22-23 years old at the time.
@Robyn...
"I thought this was a forum for ideas, not a scientific paper. Do you want me to write a book, complete with citations for all of my references? If I do, will you buy it?"
Classic straw man fallacy.
Nobody's asking for a bloody Ph. D. thesis. But you are being asked to back up your bloody claims! What is so sodding hard in that for you to understand? Eh?
Make a claim? Back it up!
Seriously simple! Even J. B. Handjob's got to understand that one!
Thank you for admitting that you have zero scientific evidence to support your irresponsible and even dangerous recommendation, a recommendation that would leave the child vulnerable to measles, Hib, pertussis and all sorts of other harmful and sometimes even deadly diseases, all based on a fantastical fear that the child is at a higher risk of having a vaccine turn him autistic based on having a sibling with autism. You have no evidence. You have no science. You don't even have any epidemiology. Your recommendation makes zero sense and has the potential to harm children.
That's because your three decades of observing tens of thousands of children are little more than a series of tens of thousands of anecdotes. In fact, in your case they're probably worse, because you clearly can't understand the concept of confirmation bias, which leads you to remember what you want to remember and forget the rest. Not just you, confirmation bias is a cognitive problem all humans have. We're all prone to being fooled. A perfect quote on the matter comes from Richard Feynman: "The first principle is that you must not fool yourself - and you are the easiest person to fool."
Dr. Jay, you are the easiest person to fool; you are fooling yourself; and you are too stubborn and arrogant to realize or admit it.
Because as humans we are so easily misled by anecdotes and our own personal experience, that's why we need science and epidemiology. It's probably even worse with you because you can't seem to see the problem with your having become a magnet for antivax parents due to your sympathy with their views and your unfounded belief that vaccines cause autism. Parents who believe likewise flock to you, worsening your confirmation bias.
The reason you are not a scientist is that you don't recognize that this is true. We've been through this time and time again, both in comments of various posts here and in previous e-mail exchanges, yet you stubbornly cling to the idea that you are somehow immune to confirmation bias, confusing correlation with causation, and all the other cognitive problems to which we mere mortals are prone. I"m sorry to have to say this, but hopeless, and you're not a scientist. You don't even understand why you aren't a scientist.
Oh, why do I even bother?
Because deep down in your motherboard of motherboards, you still hold on to the faint hope that by calmly explaining science to adults, much in the same way science was calmly explained to you, those adults will let the scales of pride fall from their eyes and recognize that science follows where the evidence leads, and nowhere else.
But alas, such things shall not come to pass. Much as they accuse the pharmaceutical industry of doing, their investment in the "vaccine injury" hypothesis is so profound that they cannot afford to abandon it at any cost.
@Orac--
You bother because there actually are interested and openminded people who just don't know how very strong is the evidence in favor of vaccination, and against the claims of the antivaxers. They haven't read enough blog comments to see just how childishly so many of the antivaxers can behave when confronted with facts.
But if it were me, I'd be strongly tempted to write a post about "Why I will no longer bother replying to Jay Gordon's codswallop in the comments," with lots of examples of his mendacity. My favorite is his claim to have a different hierarchy of scientific knowledge that gives more weight to anecdotes than to real data, but there are also many, many examples of people challenging him to provide evidence in support of his claims, only to have him dismiss them or disappear altogether.
Then you could write a script that automatically placed a link to that post whenever he put up a comment.
For all of the flattering reasons that others have cited. Plus, you have as much of a mean streak as I do (more or less) and Jay Gordon gives you splendid guilt-free excuses to beat the shit out of him for a worthy cause. Sometimes bad examples are the best kind, after all.
Guilty pleasures -- as long as you keep them on a leash.
Exactly. Notice that, for instance, he never, ever directly (much less honestly) addresses anything Orac posts.
Not to muddy the waters, but......
Unwillingness to even recognize one's own fallacies in thinking/refusal to accept overwhelming evidence/"belief" in the value of anecdotal "evidence"/"faith" in one's own long-held beliefs/"apologetics"/etc.....
Sound familiar to any of us? (Do I hear religion?)
You do realize, don't you, that imitation is the sincerest form of flattery. I'm glad you like my "burning stupid" meme enough to appropriate it.
David, yes, not only do I like your "burning stupid" meme, but I respect the incredible success of this website. You have gathered a group of serious acolytes to repeat the same thoughts over and over again. Generating huge traffic, reasonable revenues and very serious ego gratification.
Same thing for Jay and substantive replies -- they're not his style.
My reply was substantive: I really believe it's in the best interests of a child with an ASD sibling to either receive no vaccines or the fewest possible. Those of you here who claim to be scientists can do the math. Because autism has genetic origins, there's a greater chance that a sibling will develop autism if exposed to an environmental trigger. Vaccines are among the prime suspects for being that trigger along with toxins and viruses. Do you really need a more direct reply than that?
Oh really you shit? HPV is linked to cervical cancer, you lying sack of shit. Sorry for the profanity, usually I like to keep it classy, but fuck you right in the eye Sid.
Derelicthat, classy post. Pap smears prevent cervical cancer. The HPV vaccine is not a very vaccine at all. You know that, right?
As much as I enjoy reading Orac's lengthy deconstructions, it's almost more satisfying when he doesn't respond at all to certain comments left for him. Jay, your weird, evasive ad hominem eats itself, no insolence required.
Orac already mentioned that he wasn't here. Ad hominem? Pot--Kettle.
Dr. Jay, you are the easiest person to fool; you are fooling yourself; and you are too stubborn and arrogant to realize or admit it.
I"m sorry to have to say this, but hopeless, and you're not a scientist. You don't even understand why you aren't a scientist.
Oh, why do I even bother?
Orac, I know what I know. I'm also a good listener and a good learner. You're not. You just talk. And talk, And talk . . .
Exactly. Notice that, for instance, he never, ever directly (much less honestly) addresses anything Orac posts.
Yes I do. Just did.
I do have another unrelated question: How do you HTML code blocks? And how do you change the background to various shades of gray?
Thanks, all.
Jay
My comments are now being "held for approval??"
Please! Nobody spoil it by telling Jay what's happening.
You can't censor the boldtext!
Jay: it's possible you tripped a spam filter with links or some other coding flag.
Relax, Jay. Orac is not singling you out.
It's a new feature all over ScienceBlogs. When comments made by a physician are repeatedly so evasive and nonsensical as to bring ridicule upon the commenter and embarrassment to his profession, the system automatically kicks in to hold his remarks, so that he may reconsider and devise a reply that makes at least a few shreds of sense.
This is your big opportunity!
Choose wisely.
So, I'm a little chemistry challenged. What are these toxins that babies are bombarded with in the last few decades that they haven't been exposed to in the past that has lead to an explosion in developmental disorders. I keep hearing about these, so I would like to know, which toxins and why are babies more exposed to them now? Also, what part of the immune system is overwhelmed by these toxins?
Indeed, relax, unlike another website I can think of *cough* Age of Autism *cough* this site is moderated with a rather light touch and generally when comments get caught up and must wait for approval the problem is just some spam filter thinking there is an issue. I think it has probably happened to most anyone who has been here for a while and if it has not I think most have heard about it happening to others.
I also didn't know that ridding the body of toxic chemicals was something the immune system was involved in but then again I neatly failed biochem. I need someone to explain!
Dangerous Bacon, thank you. I was worried that I had committed a faux pas of some sort.
I knew you and Sessions would have the answer.
Jay
Jay, since you're commenting here, I recall a while ago you saying that you thought that some of the regular commenters here were in the pay of Big Pharma. How do you tell the difference between pro-vax commenters who are in the pay of Big Pharma versus those who aren't?
Matthew, great question!
You can't
Jay
P.S. I don't believe there are many pharma-shills here at RI. Maybe none.
J
Jay Gordon (#209)
Based on what data? Orac asked you: "Where is the data to support this advice? Where is the science?" Simply repeating your previous baseless assertions and making inappropriate analogies to cat allergies does nothing to provide Orac with the scientific data--the substance--he requested. Until you cough up that data, your replies, by definition, won't be substantive.
You might "really believe" what you're saying is true, but that's not good enough. Truth is not determined by how earnestly someone believes in something. You can be wrong about things you're certain you've got right. In the case of vaccines and autism, you are very, very wrong. You're so wrong you're putting other people's lives at risk. Shame on you.
How good of a listener can you be when you failed to heed Orac's very plainly stated request? He asked you how you know what you know (ie. what the data is). If you can't provide the answer, then you merely show you are confusing knowing with believing. And how good of a learner can you be when people here say they've tried multiple times to explain to you why your anecdotes are not adequate to support your beliefs (hence the requests for scientific data)? Of course, this won't penetrate, because a poor listener and learner who assumes himself a good one is incapable of hearing anything that contradicts him or working to get better.
<blockquote>Stick quotes in brackets like this.</blockquote> And you don't get to be dark grey; that's the color for the blog owner and only the blog owner. The lighter grey is assigned by default to alternating posts to make the thread easier to read. If you want to stand out, I suggest you cough up the scientific data that supports your earnest beliefs about vaccines and how they trigger autism. Then you'll get a whole batch of shocked and amazed replies pointing to the post where you did it. Till then (shortly after never), your oversized ego will have to grab after attention in boring old bold.
Am I being too presumptuous in assuming that you meant to post here rather than on Gary Hull thread Orac?
http://scienceblogs.com/insolence/2010/04/too_deliciously_ironic_for_wo…
I forgot to mention that Joe Albietz at Science-Based Medicine is none too pleased with Dr. Jay either:
http://www.sciencebasedmedicine.org/?p=4960
Posted by: Orac | May 1, 2010 9:29 PM
Am I being too presumptuous in assuming that you meant to post here rather than on Gary Hull thread Orac?
http://scienceblogs.com/insolence/2010/04/too_deliciously_ironic_for_wo…
I forgot to mention that Joe Albietz at Science-Based Medicine is none too pleased with Dr. Jay either:
http://www.sciencebasedmedicine.org/?p=4960
Posted by: Orac | May 1, 2010 9:29 PM
@Jay:
Wait, you mean that the arguments that the pharma-shills use are indistinguishable from those used by people who are genuinely pro-vax? If so, how can you make any more than a wild guess as to the percentage of pro-vaxxers who are shills? Furthermore, since most vaccines have a low profit margin, wouldn't it be more productive for them to shill for other pharmaceuticals?
Well that was weird! My next/last post should have been..
The question I had for Jay Gordon re..
..was to be "Is this proclamation also based on your anecdotal evidence"
But I see A.Noyd has already covered the answer in the above post.
Absolutely no idea how the post re Orac reproduced itself!
Dr. Gordon, not to sound superior or anything, but if vaccines somehow did cause autism spectrum disorders, how would this on the whole be a good thing? From how people with Asperger's tend to act and the general mentality, it seems like they attempt to fit in with society yet cannot understand the various arbitrary social customs and rituals, leading them to screw things up on a frequent basis. On the flip side, they tend to approach things a lot more rationally.
So...if you're right, removing vaccines could easily contribute to holding society back. If we could eliminate some of the more confusing and arbitrary customs, approach things a bit more rationally for a change...wouldn't that be a good way to make the world better and eliminate a lot of the pointless fighting and crap that goes on? Just saying...
I've heard epidemiologists refer to them as Sentinel Outbreaks. I always thought it vaguely ominous, now I know why.
It would appear that Dr Jay and others are running a eugenics program to rid the world of autistics.
No vaccination promotes disease. In a few years those unvaccinated populations will be decimated from disease epidemics. Certainly one way to 'cure' autism. I'd try a more direct approach but...
@205 madder
Wow, at that link Jay Gordon says:
In his email response to Kate McMahon he states:
I have a couple of questions about Dr. Gordon's advice.
My first question is a request for clarlfication of claims. A lot of the people who have been vigorously defending the "vaccine-autism" idea claim that the issue is the "assault on the fragile, undeveloped immune system". I would think that by the time the child is five, he'd be past that. I also thought that autism manifested earlier than five, thus vaccinating at this point would be safe. Does Dr. Gordon have evidence of five-year-olds lapsing into autism after vaccination?
And my second question grows out of the first. Does Dr. Gordon believe that the childhood vaccines should be given, ever? Specifically, does he recommend vaccination against rubella for a currently unvaccinated teen-age girl, to protect her future children against the possibility of fetal rubella?
(real?)Sid,
I breastfed my two oldest children (18 months each) and they both were hospitalized with Rotovirus by the time they were two. In fact they were so sick they were unable to keep the milk down. My daughter lost 20% of her body weight and we will never know if she had slight brain damage from the ensuing electrolyte imbalance. Neither of them ever had a bottle.
Dr. Jay
Very complex: Google "HTML block quote". The background cycles different shades, Orac's comments are darker so we know it is his reply.
Substantive. You keep using that word. I do not think it means what you think it means, Dr. Jay.
Direct. You keep using that word. I do not think it means what you think it means, Dr. Jay.
Math. You keep using that word. I do not think it means what you think it means, Dr. Jay.
(Rule of Three wins again!)
Dr. Jay, I asked you: Where's the science to support your recommendation not to vaccinated the sibling of an autistic child? There is none that I'm aware of, and apparently there is none that you're aware of either. because, despite being asked multiple times, you have been unable to point to any. All you can say is that you "believe" and then do some hand waving obfuscation about "do the math." Even worse, despite having been slapped down time and time again over your invocation of the "toxin gambit," you are the one who is perseverating about the "toxins" in vaccines. It's pathetic, Dr. Jay.
So I ask you again: Where's the science to support your dangerous and reckless recommendation not to vaccinate the sibling of an autistic child?
You keep complaining whenever it is pointed out to you by me or someone else that you don't understand science and aren't a scientist. Indeed, you even seem to fancy yourself a scientist. Yet, you can't point to any science to back up your recommendation, and, worse, you can't understand why personal experience in medicine can be extremely misleading if it is not informed by science. You are not a scientist, and, if your recommendation not to vaccinate the sibling of an autistic child is any indication, you aren't even a practitioner of science-based medicine. You're a practitioner of anecdote-, dogma-, and belief-based medicine.
If you could point to any convincing science, I would perhaps be less harsh, but you don't. You keep repeating the same nonsense time and time again, despite my lengthy attempts in the past to educate you over the nature of science and how personal experience can so easily mislead. Yes, even physicians as brilliant as you appear to think yourself to be.
"I really believe it's in the best interests of a child with an ASD sibling to either receive no vaccines or the fewest possible."
With all due respect, Dr. Gordon, I have two boys on the spectrum, one of whom is completely unvaccinated. (Also with asthma and allergies to milk and wheat)
So, as far as I'm concerned, you and Jenny and the rest of the anti-vaccine camp can take your pseudo advice and shove it.
Thirty years of practicing medicine.
I'm not sure what word Dr. Gordon meant to include after "very," but I suspect it doesn't matter much. While it's unfortunate that Dr. Gordon practices medicine at all, and more unfortunate that he practices as a pediatrician...how happy are we that he's not a gynecologist? Screening tests prevent by reducing incidence; they don't outright prevent, and the existence of a screening test doesn't invalidate the HPV vaccine.
It's also unfortunate that Dr. Gordon seems to think that "nice" makes arguments work. I hypothesize that that's a California thing, but I don't have the energy to do reliable research on that, so I am forced to admit that my evidence is anecdotal and that I am, therefore, no better than you.
They're just words, Dr. Gordon, and your calling out other posters for using words you don't like--in the "classy" example, words used in obvious anger over a dismissal of the significance of HPV (hey, ring a bell?)--is weak. You don't like the words the poster used, so the argument is invalid? Ad hominem is kinda like libel--it's not so bad when it's true.
I personally believe that probably would've been a lot funnier if I had added "you fuckstick" to the end, but I wanted you to give me a moment's thought before dismissing me. Have a nice day!
To about the same extent that seat belts prevent auto accidents. Of course, since neither Dr. Gordon nor his patients get routine cervical exams he can be excused for being ignorant of the distinction.
In the highly unlikely off-chance that he admits the possibility of being wrong and the even greater improbability of his actually taking steps to remedy the situation, he could consult Stephanie Zvan.
Dr. Jay, your pointless mockery of my anger was already well handled by Landru. And your ridiculous display of ignorance about gynecological practice is so flagrantly pitiable that I actually did a double-take in front of my computer screen. I used to believe you were a genuinely nice guy, albeit suffering from Nice Guy Persecution Complex, who just didn't quite get the scientific method. Now I know that you genuinely don't have a clue at all. Thank the FSM that you're are not a gynecologist, but it is too sad that you peddle your ignorance in any form of medicine.
Oh look, I insulted you without using any swear words at all. You sanctimonious asshole.
If pap smears prevented cervical cancer, we wouldn't have it anymore at all, ever, because everyone would just get one and get on with their lives.
Pap smears are a detection tool, not a... well, the word that springs to mind is "vaccine."
I'm very disturbed that someone who has a degree does not know this, and I do.
(Also, I hope you're clear on why the spam filter held your post for moderation: profanity in the body of the post. There is not, so far as I know, a filter that tells quotes from your own words.)
Jay said, "My reply was substantive: I really believe it's in the best interests of a child with an ASD sibling to either receive no vaccines or the fewest possible.
Your beliefs are not substantive of themselves. Nor is the fervency of your belief.
Physicians believed that bleeding and purging would balance the humours and bring a patient to health, and they believed it very firmly. They didn't test whether it worked, all their ideas went towards futzing with the purgatives and the bleeding techniques.
True, but that he is a pediatrician is no consolation.
A couple of questions, Dr. Gordon:
First all, no one CHOOSES to view your observations as a series of anecdotes, they ARE anecdotes by definition.
The question is, since there is a goodly number of other paediatricians with 3 decades of observing tens of thousands of children, why aren't they noticing the same effects that you are noticing?
Second, you may not remember that part of Pap screening for cervical cancer includes followup of atypia and neoplasia. This involves increased frequency of cervical smears, colposcopic examinations and biopsies, and cervical cone biopsies (which may result in cervical incompetence, increasing the risk of miscarriage and premature birth).
HPV vaccine will reduce the number of atypical and neoplastic Pap smears, thus reduce all of the followup measures I described.
In light of this, do you still think that Pap smears on their own are better than the HPV vaccine?
"Dr. Jay" whines:
Actually, "Dr. Jay", they aren't even a series of anecdotes, since you haven't bothered to analyse them. All you really have is your recollection of what those "tens of thousands of children" demonstrated.
And, since humans are much better at seeing patterns (even where none exist) than they are at seeing a preponderance of occurance (which is the norm in non-primate mammals), your unassisted interpretation of your memory of those "tens of thousands of children" doesn't even rise to the level of "a series of anecdotes".
If you really wanted to put your three decades of experience to worthwhile use, you could go back into your records and tabulate - for example - the time between vaccination and the onset of signs of autism. That would give you a "series of anecdotes" - the second lowest form of data (a single anecdote being the lowest).
What "Dr. Jay" provides now is not even the lowest form of data - he is providing his interpretation of a pattern he has discerned in his recollection of the tens of thousands of children he has treated. An interpretation coloured and biased by what he expects to find in recollections that are also coloured and biased by his expectations.
I hope that short explanation will help "Dr. Jay" understand why his "vast clinical experience" isn't held in such high esteem on this 'blog.
BTW, I just had to comment on yet another massive blunder in "Dr. Jay's" reasoning:
Is he really a doctor? Pap smears detect early cervical cancer (and pre-cancerous lesion) - they don't prevent or treat anything. Whatever "Dr. Jay" might have been trying to say about the HPV vaccine, that vaccine provides the chance to prevent infection with HPV, the predominant cause of cervical cancer.
With knowledge like that, he still expects us to bow to his superior "clinical experience"?
Prometheus
@Dr. Jay: The first part is theoretically plausible, even though I don't believe any environmental factor has been found to increase the risk of autism in siblings. I'm not aware of any science showing this.
Siblings of autistic children are many times more likely to be diagnosed with autism than children in the general population. But I think the odds are high not because of anything in particular that was done by the parents. Regardless of what they do, the odds are what they are.
BTW, as far as autism risk factors go, being a sibling is probably the biggest one known to date.
Now, vaccines are actually among the least likely suspects for being an autism trigger. There's absolutely no support for your assertion, other than your "experience", which you haven't even elaborated on.
If Dr. Jay was able to think like a scientist (or as logically as the average physician, for that matter), he'd consider this:
If (despite the lack of evidence) there's reason to fear the "assault" on a child's immune system from disease antigens and "toxins" in vaccines - shouldn't there be far more reason to fear the much higher amount of antigenic stimulus and toxins a child's system is exposed to when he gets sick with a vaccine-preventable disease?
Dr. Jay may have never have seen the comparison of the antigenic stimulus present in modern-day vaccines to the much higher levels of antigenic stimulus produced by coming down with the actual diseases (it's been the subject of articles on such sites as Science-Based Medicine). But it's hard to believe he slept through all his microbiology classes and later lectures and seminars that dealt with the aspects of disease caused by microbial toxins (actual toxins, not the imaginary ones concocted by antivaxers).
What we'll never see from Dr. Jay is a logical explanation of why parents should fear antigens and pseudo-toxins in vaccines, but not worry in the slightest about what happens when vaccine-preventable diseases strike. If the sibling of the autistic child whose parents Dr. Jay misadvised actually has a genetic susceptibility to autism that could be triggered by disease antigens, wouldn't it make far more sense to vaccinate and lower the risk of his getting hit with a big dose of those antigens by contracting the disease(s)?
I'm sure there's a refresher course available in microbiology and immunology that'd get Dr. Jay up to speed on these topics, at least adequately enough to conduct an evidence-based pediatric practice. It'd be a far more worthwhile use of his time than spouting gibberish to Frontline, or taking ludicrously uninformed potshots at commenters on a blog posting.
I think that people (including the producers of Frontline) learned all they needed to know about Jay Gordon when they saw him sitting by Jenny McCarthy. As an outside observer, how can you take anyone associated with her seriously?
I mean, what is Jay going to say? "I taught Jenny everything she knows!" at which point the producers of the show are rolling on the floor in laughter.
But, but, haven't you forgotten, Dangerous Bacon, that the natural antigens and bacterial toxins are beneficial, unlike those nasty artificial ones in the vaccines?
(/sarcasm)
No need. after all, he has thirty years of experience.
I think it's vital that people remember that just because a proposition makes sense does not mean that it is true. It must make sense in order to THEN be EVALUATED as true or false, and that requires EVIDENCE.
It certainly makes sense that vaccines contain chemicals that damage the brain and result in autism disorders. I can easily imagine such a state of affairs happening. However, taking the step from imagining a coherent proposition to actually testing it for evidentiary support leads to the conclusion that there is NO evidence that supports it, and thus should be rejected.
This is a basic logical point that many anti-vaccine loons forget. They imagine that just because they can kind of visualize a state of affairs that provides them with emotional satisfaction, then that trumpts all other considerations. However, they have forgotten that the conceptual coherence of a proposition is not the end of inquiry, but only the beginning.
@Dr Jay Gordon...
You advised a mother to not vaccinate one of her children because one her other children has autism. If the unvaccinated child dies from measles would you feel at all responsible?
http://www.mayoclinic.com/health/measles/DS00331
dguller, I find that is a pretty common problem with conspiracy theorists as well. In a politics group I take part in one of the commenters would come up with paranoid fantasies about the actions of various governments and politicians. They were coherent in that it was possible (in a very loose sense of the word) that the chains of action could happen. For instance, he was convinced that Obama could be planning to exterminate people, that he was setting up camps, etc. but what he was unable to understand was that one needs to actually demonstrate these things are occuring and find out whether or not they are true or not. For him it was enough to come up with a plot. Coming up with a scenario was enough to give it credibility.
Seconded.
@ MK: It's actually irrelevant whether Dr. Jay might *feel* responsible if said child died of measles, was made sterile by mumps, had any other preventable injury based on his advice and non-vaccination.
He would certainly be medico-legally liable, having given inacurrate and incomplete information resulting in harm.
"Oh look, I insulted you without using any swear words at all. You sanctimonious asshole."
Again, thank you Derelict for keeping this conversation on a level most here appreciate.
Pap smears are far more important than the HPV vaccine. (Which is not a very good vaccine.) They detect early signs of cervical dysplasia and therefore help prevent morbidity and mortality from this disease. The HPV vaccine might keep a generation of women away from Pap smears. That would be a disaster.
There have been no fatalities from measles in the USA in over a decade. You semanticists and "scientists" exaggerate the dangers of these illnesses for your own purposes. You do a disservice to readers here who actually believe your detailed, repetitive, hyperbolic pseudoscience.
Best,
Jay
@Dr Jay Gordon: No woman in her right mind is going to skip her pap smear just because she got a HPV shot. Drop the strawman. She is not being told, "you don't need a pap, you had the vaccine". I realize that you are not involved with gynecology at all, but for pete's sake, you ARE an MD, aren't you? Where is your brain? Do you hate all your medical colleagues that much? Or do you think they are that stupid? Come on, now.
So fatalities that occur from measles that don't occur in the US aren't important, huh? And the fact that one of your unvaccinated patients might bring home measles from a trip and expose possibly hundreds of others, some of whom might become very ill, suffer from deafness, blindness, or other effects, is OK because they didn't die? After all, that baby in the ICU with pertussis didn't die, so that's OK too. What on earth do you tell parents when their baby is in the ICU and eventually goes home? Hey, don't worry about the baby. He/she didn't die, did he/she?
I am SO glad that 1) my children are fully immunized, 2) you were never my pediatrician. I want a doctor for my children who CARES about me and my children and practices GOOD medicine, not touchy-feely medicine that makes everyone feel good but doesn't protect my children from diseases that can be deadly. I'd rather have a living, autistic child over a dead child, any day. /rant.
@Jay:
Why isn't the HPV vaccine a very good vaccine?
Matthew, remember, Jay has 3 decades of experience, that is evidence enough.
But seriously, that was my thought as well. My guess is that it is yet another unjustified claim made by Dr. Jay that he is going to be asked to back up, but will likely not provide any actual evidence or real reasoning.
Actually, there is some discussion in the literature as to whether or not the HPV vaccine would steer women away from Pap smears. However, Pap smears are not 100% sensitive/specific, Jay. They fail to detect real positives at a rate that far outstrips even the rosiest predictions of vaccine-genetic-trigger-predisposed-autstic-like-disorder that you can come up with. I don't have the papers in front of me right now, but the most conservative mathematical models suggest that the Pap rate would have to drop by about 50% in a Gardasil-vaccinated population before the risks of such a drop outweigh the vaccine benefit.
Jay, why are you making stuff up? It's one thing to pretend that you can't read the multitude of responses and only cherry-pick the fights you think you can win, but it's quite another to simply lie. Pap smears are what we have now. To say that Pap smears are an effective way of preventing (your words, not the words of anyone who knows what "prevention" means) cervical cancer is denying the fact that thousands of women a year in your country alone are dying from this disease. This says nothing of the burden worldwide where women die at a far greater rate.
You, sir, are a sanctimonious braggart who revels in his contemptible ignorance. The fact that you were granted a medical license makes me hope against all hopes that standards for such a degree have been raised in the past 30 years. Your incompetence as a physician and your utter disgrace as a human being would be beneath the notice of intelligent society, if you were not working hard every day to undermine public health. I wish all of the vaccine-preventable illness that you knowingly inflict upon innocent children whose credulous parents you have managed to dupe to be heaped upon you one-hundredfold. This is unlikely, because your parents assumedly had you vaccinated as a child. You sir, are a figurative and literal pox on society, and I hope bad things happen to you and those of your progress-retarding ilk.
You said you wanted it classy. I got it like that.
Jay, your ignorance continues to be alarming as well as embarassing to the medical community.
Dr. Jay: "The HPV vaccine might keep a generation of women away from Pap smears. That would be a disaster."
Dr. Jay is apparently unaware of the latest Pap smear guidelines that call for continued screening of women regardless of whether they've been vaccinated against HPV. The shots currently available, while representing a level of protection against cervical dysplasia and malignancy caused by HPV, are not 100% effective in preventing infection, nor were they ever touted to be, partly because a minority of HPV strains responsible for cervical dysplasia are not covered by the vaccine. Surveillance will continue; still many women will be spared invasive procedures, potential infertility and the fear of developing cervical cancer through the vaccine.
Dr. Jay: "There have been no fatalities from measles in the USA in over a decade. You semanticists and "scientists" exaggerate the dangers of these illnesses for your own purposes."
Our "own purposes"? What might those be? A selfish desire to avoid returning to the days when measles was endemic in the U.S.. we averaged 400 deaths from measles a year and many more hospitalizations and serious injuries? Or by alluding to our "own purposes" are you back on the pharma shill kick again?
Lest you forget, Dr. Jay, we continue to be at risk for measles outbreaks because of antivax hysteria shills like you, who scare parents such as the ones whose kids paid the price in the recent San Diego measles outbreak:
"Although the rate of two-dose immunization against measles was 95% in the area, a single case of measles from a 7-year-old child returning from overseas sparked an outbreak that exposed 839 people and sickened 11 other children, according to David Sugerman, MD, MPH, of the CDC's Epidemic Intelligence Service, and colleagues.
None of the 12 children, who ranged in age from 10 months to 9 years, had been vaccinated -- nine because their parents had refused the vaccine and three because they were too young, the researchers reported in the April issue of Pediatrics.
Although the virus was not spread extensively, it came at a substantial cost of $176,980 for investigation, containment, and healthcare.
In San Diego, the overall rate of vaccine refusal -- predominantly because of safety concerns -- was low at 2.5% in 2008, but it had been rising since 2001.
The possibility that increasing rates of intentional undervaccination could lead to a rise in outbreaks of vaccine-preventable diseases is "a monumental concern," according to Anne Gershon, MD, a pediatric infectious disease expert at Columbia University Medical Center in New York City.
"It's very important for parents to understand that the disease itself is always more serious than a true reaction to the vaccine," she said in an e-mail."
The outbreak was caused by a 7-year-old's acquiring measles abroad. His parents had signed a "personal beliefs" exemption refusing vaccination for their kids.
"In the study area, parents who refused vaccines for their children tended to be white, well-educated, and from the middle and upper classes...In discussion groups and surveys, most parents who refused vaccines for their children were concerned about possible adverse effects, including autism, ADD/ADHD, asthma, and allergies. They expressed skepticism about the government, pharmaceutical industry, and medical community."
In addition, "they believed vaccination was unnecessary, because most vaccine-preventable diseases had already been reduced to very low risk by improvements in water, sanitation, and hygiene and were best prevented by 'natural lifestyles,' including prolonged breastfeeding and organic foods," Sugerman and his colleagues wrote."
And some believe vaccination is unnecessary because they put their trust in antivax physicians who preach against vaccines for their "own purposes". What are those purposes? I don't think the antivax docs necessarily are in it just for the money to be obtained catering to this credulous and fearful patient population, or for the publicity they can get by their stance. Some may actually believe vaccines are useless and harmful. That doesn't lessen their culpability in putting all of us at risk from vaccine-preventable diseases.
@Jay Gordon--
Children have died of measles in the UK as a direct result of the efforts of the antivaccine propagandists. Is their medical care that much worse than what's available in the US?* You know about those children, and you also know that the most recent outbreaks in the US were brought into undervaccinated communities by people who had been visiting foreign countries.
But you wanted to be able to claim that measles presents little or no risk in the US, so you made sure to limit your claim to this country, rather than actually considering reality and the very real risks of your advice. Kids in this country will die of that stupid disease-- if not in the next outbreak that comes along, then soon after. It's only a matter of time, and probably not much.
And I'd invite you to tell the parents of kids still suffering from measles complications that it's not so bad because it wasn't fatal in their case. Let me know how that works out for you.
What makes this so utterly frustrating to most of us is that we had a very real chance at eradicating measles from the earth, the way we did with smallpox, until this wave of antivaccine sentiment came along.
I predict that you will ignore the substance of this comment (that you deliberately ignored the UK deaths and the present reality of air travel in order to paint measles as not so bad). Go ahead, prove me wrong.
*I do not wish to derail the thread into a discussion of how various countries pay for health care. I am referring to the level of care available, and nothing more.
"There have been no fatalities from measles in the USA in over a decade."
You've clearly not been paying much attention to what the supposed "detailed, repetitive, hyperbolic pseudoscience" actually is then, have you?
If you have been , you will explain why this factoid is relevent to determining wheter or not the preventative measures are no longer needed.
Remember - you cannot use lack of cases or deaths as an arguement against vaccination, unless you have additional evidence that suggests the lack would exist without the preventative measures. You cannot use a posistive outcome measure for preventative measures as a negative arguement.
Now why do you suppose measles fatalities have declined to that point Dr. Jay? Now let's suppose that not only are more families declining MMR for their children but tend to cluster geographically. What do you suppose may happen then? Before you answer, you may want to take a look at Switzerland and Austria measles and encephalitis stats and congenital rubella syndrome in the Netherlands. Countries that have very high quality healthcare but have pockets of low or no vaccine uptake. Sound familiar?
Oh and why just mention measles for deaths? Is that the only outcome that should be of interest? Also, what about pertussis or Hib? You do tell parents to delay or forego those don't you? So how does relaying statistics 'exaggerate' the dangers of some VPDs? Really Dr. Jay, please bring examples and evidence to the discussion.
I guess to Dr. Jay the pain of cervical biopsy and the fear a woman experiences waiting for the results is unimportant. After all, he can minimize the benefits of not having an abnormal pap, being as he doesn't have a cervix. But for some of us, our daughters having fewer worrisome test results is important.
To play devil's advocate, it's entirely possible that women who've been vaccinated against HPV will ignore the recommendations because they feel the vaccination means they have nothing to worry about.
Well, Dr Jay,
I couldn't quickly find any data to contradict your claim, so I will assume you are correct when you assert that "There have been no fatalities from measles in the USA in over a decade."
But, measles hasn't gone away yet. Maybe the fact that despite your best efforts, a lot of brave parents are still choosing the tiny risk of a vaccine over the known and significant risks of the actual disease.
But the fight is far from won. According to the CDC,
"During 2008, more measles cases were reported than in any other year since 1997. More than 90% of those infected had not been vaccinated, or their vaccination status was unknown."
But, I'd advise the parents of your patients not to go on any overseas trips and keep their kids away from world travelers. The CDC also points out that
"Measles remains a common disease in many parts of the world. Worldwide, an estimated 10 million cases and 164,000 deaths from measles occur each year. Measles is a leading cause of vaccine-preventable deaths among young children. Measles outbreaks are common in many areas, including Europe. Although the risk for exposure to measles can be high for many U.S. travelers and citizens living in other countries (expatriates), the illness can be prevented by a vaccination."
164,000 deaths a year worldwide doesn't sound like a group I would choose to join.
Fortunately, we've only had sentinel outbreaks so far, but keep trying. You may succeed in bringing back a real measles epidemic. Ah, the Happy Days of the 50's!
I could also harp on the incidence/morbidity versus mortality as the better measure of success in reducing or eradicating diseases but we've already beaten that one to death in other blogs. Still, I worry about incidence, not just mortality. Get enough incidence and you'll get mortality.
Jay's "substantive" replies here speak louder than words to his lack of credibility and lack of evidence based information supporting his anti-vax ideology.
Here's hoping that those who may be vulnerable to buying into his anti-vax sales spiel are carefully reading all the questions put to him along with his replies.
Keep trying, Jay. You can do it.
As for cervical cancer, the CDC notes that
"In 2006, 11,982 women in the United States were told they had cervical cancer, and 3,976 died from the disease."
Pap smears can help some with detection, early treatment, and preventing death or at least delaying it. However, they are hardly a panacea.
HPV vaccination will be a huge step in reducing those numbers.
Jay:
Women are indeed aware that it's not a cancer vaccine, it's a HPV vaccine. Women are not going to think they're immune to cancer because they've been vaccinated against one disease, especially if health care providers who know what they're talking about do the public-education work needed to support the vaccine.
Science Mom, I'm a big believer in the Law of Intended Consequences. (No, that's not a typo.)
The Law states that if an informed and intelligent party takes an action X which they have reason to believe would result in consequence Y, then it is reasonable to conclude that they intended Y. Jay Gordon isn't an idiot; you don't survive med school without being able to reason. Med school certainly provides its graduates with the information required to forsee the consequences of reduced vaccination rates, and the pediatric literature over the past 30 years has plenty of material to refresh that introduction.
Therefore, it's silly to assume that Jay Gordon doesn't understand the consequences of his advocacy -- and according to the Law, that's what he means to accomplish.
PS: many moons ago I pointed out to Dr. Gordon that his "if kids aren't dying of X then don't vaccinate against it" policy is a control algorithm which will, if followed, maintain a desired death rate from X. Whereupon I asked what he considered the optimal death rate from (for instance) measles -- how many deaths a year from measles does it take to justify vaccinating against it. Alas, at that point Dr. Gordon got stuck on an escalator for several months and has yet to find time to answer the question.
Dr. Jay:
Why do you want to change that? If vaccination rates go down, the USA will repeat the experience of the just two decades ago when over 120 Americans died from measles. Seriously, are you purposely ignoring what happened in Japan?
Plus you are wrong. According to the CDC Pink Book Appendix G, there was one death from measles in 2000, 2001, 2003 and 2005. Plus there were two deaths from mumps in 2000, and one from mumps in 2002. There were also three deaths from rubella in the previous decade, and over a dozen cases of Congenital Rubella Syndrome from 2000 until 2006.
If you are going to make statements that can be looked up, look them up first! You come out looking completely clueless, or worse like a deliberate liar.
D.C. Sessions:
How does someone get stuck on an escalator? Hmmm, that might explain some things.
Thanks for the numbers, Chris.
I downloaded a big pdf file on morbidity and mortality, but didn't see any mortalities for measles. But, perhaps I had the wrong file or just overlooked them. It was a big file.
Feeling good about the beating the anti-vaccination movement has taken is like feeling good about McCain and Palin losing the election. Fox news or some other idiots in the media will find a way to make money off the anti-vaccine folks the way they are making money off Palin.
This movement is the result of frustration and stupidity, and those two ingredients are not going to fade away any time soon. The general populace is just to dumb. And quacks, assholes and washed up playboy bunnies just do a damn good job of promoting their bullshit to these people.
This is the file:
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/cases&…
It is an image pdf, so no cut and paste allowed.
Thanks for the link, Chris.
Well, Dr. Jay has convinced me!! There hasn't been a case of rabies in Washington since 1942, therefore I will no longer get my cats and dogs vaccinated. The scare tactics of Big Vetta will have no further effect on me! Dr. Jay has opened my eyes!
When I hear Dr. Jay brandish his "30 Years of Experience" I am reminded of the following line from the movie "Flight of the Phoenix" The model airplane designer who has figured out how to make a smaller airplane out the airplane that has crashed in the desert is arguing with the experienced pilot.
I drifted into my specialization of pressure transient analysis of oil/gas well tests because shortly after starting my engineering career I discovered that nearly everything that petroleum with many years of "experience" was bullshit or applied to only a minority of well tests. I had to go the peer reviewed literature to find out what pressure buildups were really telling me. It was clear that the selective memory of confirmation bias was a strong component of "experience".
Jay Gordon @157
If you actually followed this blog you would no that Orac has a PhD and actually has done scientific research. But then you wouldn't recognize real science if it bit you on the ass.
You know, all this talk about the lack of deaths from diseases we have a vaccine for makes me wonder why the anti-vax groups seem to avoid speaking out against the polio vaccine. I see MMR going around, complaints about the flu vaccine, Hib, et cetera, but strangely enough I haven't seen any complaints against the polio vaccine...
It's interesting, Dr. Jay wants us to take his 30 years of experience as testimony to how amazing, awesome, and infallible he is; however, he demonstrated up thread that he isn't even astute enough to detect the very simple alternating pattern of white and gray background comments. Dr. Jay, your observational skills are lacking.
Oh, they're there. In fact, polio is one of Jay's favorites. He points out that the USA hasn't seen a non-imported case of wild in polio in all the time he's practiced medicine. Therefore we should, like Nigeria, stop vaccinating against it.
@madder
Several years ago, there was also a large outbreak in Germany, where three children died from measles and many more individuals were hospitalized. Again, low vaccination rates played a leading role.
@Dr. Jay: I'll ask a direct question about your experience, although you typically refuse these questions.
Of the tends of thousands of children you've seen, how many have had an immediate (within a day or two) serious vaccine reaction, meaning disability or death? Note that I'm not talking about children referred to you - after the fact - because of your reputation. I'm also not talking about a child who eventually was found to be autistic, after months or years. I'm referring to children who were completely normal when you vaccinated them, but either died or became disabled immediately after you vaccinated them.
Without a specific answer, I'm going to presume that's zero.
Pap Smears prevent cervical cancer?
I have to make sure and tell that to my friend who was diagnosed with cervical cancer shortly after having her first --and now only--child. I myself tested positive for HPV had several irregular pap smear results, ultimately leading to a cone biopsy which has weakened my cervix and could cause problems in any future pregnancies. Thankfully, my last several checks seem to indicate that the virus has finally been purged from my body. You better believe I'll have my daughter vaccinated against HPV...just as she has been and will continue to be vaccinated for everything else.
As the daughter of a polio survivor and the mother of a child on the spectrum, you could say I've "looked at clouds from both sides now". I'll take overwhelming scientific consensus over emotional conspiracy theories, thanks.
The Very Reverend Battleaxe of Knowledge:
Which Washington? Because there has definitely been cases of rabies in the State of Washington in the last twenty years. From http://www.doh.wa.gov/ehsphl/factsheet/rabiesfct.htm:
And, of course, once we cease to vaccinate against polio, none of the imported cases will spread to the local population because... because...
Because of Jay's 30 years of medical experience?
Because of the wonderful things he does we have indoor plumbing now?
Why does this look like a cascade in the making?
Dr. Jay, I am thoroughly chastened. Even though beginning students of microbiology seem to have a better handle on immune system responses to antigens than you, I'm sure you can keep your career going as a sort of bio-med-lite Dear Abby, and keep us from swearing on the internet. With your 30 years of medical experience (I sense a meme starting here).
That could either be a repetitive punchline, or we could end up with "Chuck Norris" type jokes featuring Jay Gordon.
This seems a good point to re-iterate that "Dr. Jay" doesn't have "tens of thousands" of anecdotes, he has one anecdote - his synoptic impression of his "30 years of medical experience".
If "Dr. Jay" were to go back through his records and systematically review them for autism onset after vaccination or even autism prevalence vs. vaccination rate, then he would have a "series of anecdotes". If he did it correctly, he might even have a "case series".
However, as it currently stands, all "Dr. Jay" brings to the table is his impression of what the "tens of thousands of children" he has seen over his "30 years of medical experience" might show if he bothered to systematically review the records.
Unless and until "Dr. Jay" systematically reviews his records, all he has to offer is a "narrative" of his impressions of what he can remember about his past experience. Not "30 years of medical experience", but a story based on "30 years of medical experience".
Prometheus
You say that like it's a Bad Thing. Medicine got by for thousands of years on exactly that: the recollections of what practitioners found to work and not work. Without that vast body of experience we wouldn't know to protect measles patients from light (to prevent blindness) or when to bleed and when to purge patients. We wouldn't know the right phase of the moon for gathering medicinal herbs, not to mention the phase for planting them.
Dr. Jay is carrying on a proud tradition.
more of an etiquitte question for Dr. Jay:
My uncle is/was a great physician (though a bit of an oddball) for 20 years. He helped build clinics in Kenya, worked for cheap in poor communities, and had a good relationship with his patients. Recently he turned to German New Medicine (or some variant of whatever that garbage is called) and told my mom her breast cancer was caused by her relationship with her mother. Is it disresepectful of his decades of experience to tell him that's bullshit?
If so, i think my mom was pretty disrespectful.
And, of course, once we cease to vaccinate against polio, none of the imported cases will spread to the local population because... because...
...we no longer spray children with DDT when they get home from school and compromise their immune system by indiscriminately removing their tonsils
Orac says:
For medications, there are tight regulations that make a manufacturing problem exceedingly unlikely. Do you notice that by far most reported problems with pharmaceutical drugs are not due ... a manufacturing screwup ...but rather due to side effects from the drugs that weren't detected or may have been covered up in the clinical trials leading up to the approval of the drug. That's because the manufacturing process for drugs is heavily regulated and policed.
...but the reality is:
A division of Johnson & Johnson is recalling 43 over-the-counter medicines made for infants and children -- including liquid versions of Tylenol, Motrin, Zyrtec and Benadryl -- after federal regulators identified what they called deficiencies at the company's manufacturing facility.
@Matt
Also, from what I've been able to find on the Internet, lead poisoning doesn't lead to paralysis,
----------------------
Which internet are you using?
http://health.yahoo.com/emergency-poison/lead-poisoning-symptoms/health…
Neurological symptoms (caused by effects of lead on the nervous system)
Weakness in hands and feet
Paralysis
That was quite the unsupported leap. Are your legs tired?
I knew that we could count on Sid -- whichever one.
This lovely display of crank magnetism beautifully illustrates one of the later stages of antivaxxism: it eventually leads to germ theory denialism. Inflate the scare quotient all you will, the downsides can't be made big enough to outweigh the Iron Lung Factor.
Thus it becomes necessary to insist that the diseases really were going away on their own (for mysterious reasons), weren't that bad, or were even necessary for healthy childhood development. When even that gets hard to maintain, it's time to pretend that polio (Egyptian mummies and pre-industrial records notwithstanding) and other diseases are the result of something recent and now rare such as DDT, with the Francis Field Trials being part of a gigantic conspiracy to cover up for Big Insecticide.
All of this naturally presumes that Sid isn't a Moe (that's to medicine what a Poe is to politics.) By their nature Moes are hard to spot for sure, especially since Sid appears to be relatively sane compared to people like Scudamore.
When were kids ever sprayed with DDT? (And wasn't it stopped when it was realized it quickly created resistant insects?) Are you thinking of DEET, Sid?
Nope. The "polio is caused by DDT" dogma is Received Truth in antivaxx circles. You can find plenty of examples over on whale.to (not that finding mishegoss on whale.to is noteworthy -- but at least Scudamore is pretty good about citing his sources.)
big enough to outweigh the Iron Lung Factor.
-----------------
In the most severe cases (bulbar polio), poliovirus attacks the motor neurons of the brain stem - reducing breathing capacity .... Without respiratory support, bulbar polio can result in death...people with polio affecting the respiratory muscles were immobilized inside "iron lungs"
Time Magazine 1954
Last week the A.M.A. Journal called the attention of U.S. family doctors to growing evidence that polio victims who have lost tonsils, adenoids, or both, at any time in their lives, are more susceptible to bulbar and bulbo-spinal attacks.
---------------------
The "polio is caused by DDT" dogma is Received Truth in antivaxx circles. You can find plenty of examples over on whale.to
To paraphrase Tom Friedman
Some things are true even if whale.to believes them
--------------
@Lurker
Twice each day, flatbed trucks would rumble through the streets, spraying the chemical [DDT] from large hoses while children danced innocently in the mist that trailed behind. Polio: American Story P3
Sid, that's not equivalent to spraying it on kids. Sorry.
@Lurker
www.life.com/image/50513630
Really?
I see that by killfiling Sid I may be missing the odd cranberry among the steamers. Fortunately, one can always pick up the context from responses.
I first ran across the DDT-polio meme a few years ago, when I was researching the history of DDT. For the record, it is every bit as boneheaded as it sounds.
@ Chris:
I'll take my medicine and apologize to everyone. Obviously my statistic about rabies in the state of Washington was old. Maybe vaccination rates are going down since people stopped seeing reports of rabies in people for 50 years or so? I should have added a [sarcasm] tagâyou're right.
setar: I can think of at least two reasons why antivaxers don't generally talk about polio:
1) Polio still has a very scary reputation. That's in part because most laymen didn't recognize non-paralytic polio as actually being polio, so when people think of polio, they think only of the paralytic or fatal cases. Contrast that with, say, measles, where you can point to plenty of stories of uncomplicated cases.
One problem with this analysis is that the antivaxers don't take the same attitude toward pertussis, even though the popular perception of pertussis is also that the most severe cases predominate. Which brings us to:
2) At the time most of the antivaxers got their polio vaccinations, it was oral and didn't involve needles.
As strange as it may seem, "Sid Offit" is correct about something. No, not the DDT/polio thing, but the contribution of tonsillectomy to the prevalence of bulbar polio.
One thing that "Sid" might not have had time to notice was that the largest contribution of tonsillectomy to the risk of bulbar polio was when the operation was done during the incubation period of the virus. However, repeated epidemiological studies (mostly done in the 1940's to 1960's - guess why) have shown that having had your tonsils and/or adenoids removed raises your risk of bulbar polio.
Unless, of course, you have been vaccinated, in which case your risk is essentially zero.
But, before we let "Sid" off the hook, it should be noted that we see bulbar (and bulbospinal) polio in countries where tonsillectomy/adenoidectomy is extremely rare (2% and 19% of total paralytic polio infections, respectively). In addition, it was also seen in the early 1800's, when tonsillectomy/adenoidectomy was not only rare, it was practically unheard of (see: Anesthesia, first use of, 1842).
Also, despite the irrefutable authority of "whale.to", I was unable to find a single published study linking polio to DDT. This isn't terribly surprising, since polio is caused by a virus, not a pesticide.
I think I can guess the cause of the confusion down at "whale.to", however.
DDT works by opening sodium channels in insects (and crustaceans, fish, cats, etc.) and causing paralysis, much in the same way as aconitine and ciguatoxin do. It is an easy - if incorrect - leap from paralysis by sodium channel agonist to paralysis by inflammation of motor neurons, if you don't know much about medicine or biology.
In short, there is no connection between DDT and polio.
Prometheus
My parents always sprayed us with DDT every day when we came home from school before we were allowed to drink our mercury and eat our lead snacks.
Prometheus, I just spent an hour or more on your site, photon in the darkness.
It's really superb. I disagree with some of your points of view but your statistical teaching is worth anybody's time. The tone is sharper and much smarter than on this site and I compliment you for that. I have read and reread your excellent post about measles:
http://photoninthedarkness.com/?p=187
Thanks for the calm elaboration of data and the extremely pleasant tone as you answered those who questioned you.
Best,
Jay
But, Dr. Jay, will you actually pay attention? You keep saying you've "learned a lot." You've even said several times that you've "learned a lot" reading this very blog. Yet you never change. You still insist that vaccines cause autism based on no evidence. You still recommend to a mother that she should not vaccinate her child because his brother is autistic. You still claim there are all sorts of "toxins" in vaccines that cause autism. You still claim that your not-even-anecdotal experience (informed as it is with your own confirmation bias, selective memory, and anti-vaccine views) over 30 years trumps sound science and epidemiology.
If you've learned anything, either here or at Prometheus' blog, you sure don't show any signs of having internalized what you've learned. That's what makes you so frustrating. You give every appearance of being unteachable. Lord knows I've tried. I've tried being snarky. I've tried being nice. I've tried being straightforward. Nothing works, because you believe what you believe (that vaccines cause autism) and no amount of data or science will convince you otherwise.
Dr. Jay likes to make the occasional comment about learning from us, probably to appear reasonable to those who follow Google or other external links to sites like this (nearly half of the first page of links you get when you Google "Jay Gordon vaccination" take you to ScienceBlogs or Science-Based Medicine, neither of which are flattering to Jay's delusions about vaccines).
What's not reasonable is his continued refusal to address the questions asked of him and the rebuttals to his uninformed views on immunization, including remarks made by Prometheus about Jay's reliance on anecdotal memories instead of science.
One good thing about using Google to check out Jay Gordon's views, is that you can come up with gems like this Gordon article, in which he connects-the-dots to explain that the response to a potential swine flu epidemic was engineered on behalf of former Secretary of Defense Donald Rumsfeld (a bogeyman whom the conspiracy theorists also link to use of aspartame, another in their roster of "toxins").
Sorry Jay, I just couldn't get the dots to connect up. Could you explain how you've concluded that Don Rumsfeld is behind efforts to increase our preparedness to handle infectious disease outbreaks?
And while you're at it, maybe you could explain to your followers the difference between a vaccine and an anti-flu drug (Tamiflu).
On the side-topic of DDT. It is a common story of children following mosquito control trucks (I did it myself, though by then, they were spraying malathion).
DDT is a complicated story. It's not the wonder weapon supporters make it out to be. Instead, it's fairly average, but was the first out of the gate, so it made a big splash. Compared to many other insecticides, it is not as toxic nor carcinogenic. It's hazard is very-long term environmental persistence and ability to bioaccumulate. DDT is still a detectable residue on US 38 years after use was discontinued. It is currently allowed by WHO only for malaria vector control when other control methods are not available and local populations are not resistant.
There are safer ways to vaccinate if one is going to vaccinate.
Reading here and at Prometheus' site (and elsewhere) helps me to sort through the many opinions and facts and fill in the large gaps in my knowledge base about statistics and a fair amount of basic science. I was trained, many years ago, as a physician. As you know, science changes quite a bit over the years and refreshing my out-dated understanding of data analysis and basic science is very helpful. That's why I continually ask for a calmer tone: It's so much easier to listen.
Rumsfeld? A serious participant in the profits from the sales of Tamiflu. Plain and simple. I doubt some sort of massive conspiracy. A fun fact though.
A vaccine creates an antibody response which may protect against an illness. Tamiflu is merely an antiviral medication which works to prevent or shorten a few viral illnesses.
Orac, yes, my views change slowly when they change at all. But the issue of vaccines, harm, childhood illnesses and autism is a very, very small piece of a larger issue. I have no idea why you are fixated on this. You could be talking about the recent medication recall and what it says about quality control in the industry, psychiatrists who actually are pharmashills, or the science involved in your line of work. Instead, you keep returning to this one issue.
Polio will not return to the USA, measles will not overwhelm herd immunity, pertussis is over- and under-diagnosed and the "epidemics" often are not what they seem. We don't need a rotavirus vaccine in America and should focus our efforts on making it affordable and available to the Third World.
I know, I know, you don't give a "rodent's posterior" for what I think you could be doing. No one tells you what to write about . . . et cetera.
Think of the good you could be doing with a broader focus instead of sitting here at the center of this circle jerk of scientists and wannabe scientists talking about the same thing over and over again.
Oh, well. Have a look at http://photoninthedarkness.com/ as an example of a site that teaches, doesn't perseverate and keeps a welcoming tone for disagreements.
Have a good day.
Jay
@Jay
Polio could return, if people stop vaccinating against it and someone brings it with them from overseas. Measles will overwhelm herd immunity if enough people stop vaccinating against it. How pertussis can be simultaneously over- and under-diagnosed, you'll have to help me understand.
For polio and measles, at least, just imagine if everyone in the world were vaccinated against those two diseases. you know what would happen? We wouldn't need to vaccinate against them ever again, most likely, since we are the only known reservoirs for those diseases. They would be gone, much like smallpox.
We have good care for those who contract the disease, but wouldn't it be better to not need that care in the first place? And even with high quality care available, there will be those who suffer needlessly and, potentially, fatally.
Agreed, but there's nothing to say that we cannot do both at the same time.
"Circle jerk"? Classy choice of words there, Dr. Gordon. But, to turn it back on you, think of the good you could be doing with a science-based focus, instead of brown-nosing to the likes of Jenny McCarthy, Age of Autism, etc.? Rather than telling a woman not to vaccinate her 5-year-old, based on nothing by your unfounded beliefs and thereby endangering that child and anyone with whom the child comes in contact, you could actually be helping to fight the spread of infectious diseases. You know, actually preventing people from getting sick in the first place.
@Dr. Jay:
Why not?
We won't have herd immunity anymore if the vaccination rate drops enough.
"Not what they seem"? Do tell.
As others have asked before: why don't you take continuing education courses to keep yourself up to date? The fact that a practicing medical doctor seems to be keeping himself up to date on science via blogs and websites is worrisome.
Dr. Jay Gordon,
It's nice to see you here again. I'd like to take the opportunity to ask you if you had a chance to read the Autism Omnibus transcripts yet. I recall that some months ago I recommended them to you, and you said you would try to read them. I wonder if you have read them - have they changed your opinion at all? Do you have any comments? For someone who is clearly deeply interested in this issue, I think you'd find them enjoyable and informative. Actually everyone reading this page probably would.
I've linked to the page with the transcripts through my 'nym above. I'd particularly recommend the Cedillo transcript, since it starts from the beginning of the arguments.
I keep returning to this issue because it's important and I care about it. Vaccines, however, are not by any means the only thing I blog about, not by any stretch of the imagination.
In fact, you statement shows that you are not a regular reader here. You seem only to show up when I write something about vaccines that mentions you in a highly critical fashion. Funny that. If you only look at the posts I write that mention you (Google Alert, Jay?), then of course it will seem to you as though vaccines and the vaccine-autism manufactroversy are all I write about. You only bother to read a small, very select sample, namely posts about you or Jenny McCarthy, virtually all of which for obvious reasons will tend to be also about the vaccine-autism manufactroversy.
Come to think of it, that's probably a lot like your pediatrics practice, where you see a lot of patients whose parents seek you out because they are antivaccine or think that vaccines somehow injured their child. Your practice, I'd be willing to bet, is a very select subset of the children out there, which makes your "30 years of experience" even more likely to be tainted by patient selection, confirmation bias, and your own biases.
Not that you'll understand that.
In any case, read some of my posts about the pharmaceutical industry, mammography, screening for cancer, and surgeries with little or no evidence to support them, such as vertebroplasty for osteoporotic spinal fractures. When I say I support science-based medicine, I mean science-based medicine, regardless of what the treatment is. You'd know that if you were a regular reader.
As for whether your views change, I see no sign of their changing over the nearly five years since I first encountered you. (Yes, it really was that long ago, back when you showed up on my old Blogspot blog.) If they have changed, then it's been imperceptible to me. You remain blissfully unaware of how the scientific method works; you continue to claim that your personal clinical experience trumps basic, epidemiological, and clinical science. Perhaps the only two things that I may have convinced you of is chelation therapy for autism is quackery--and dangerous quackery at that--and that the "formaldehyde gambit" about vaccines is really, really dumb because formaldehyde is a natural byproduct of metabolism.
You mean like the way measles didn't return to the U.K. Oh, wait. It did return! Thanks to Andrew Wakefield and his sensationalistic enablers in the British press, MMR uptake rates fell precipitously, and guess what? Measles came roaring back. In fact, in 1994, vertical transmission of measles in the U.K. had been viewed as virtually halted. In 2008, Health Protection Agency (HPA), the public health body of England and Wales, declared that measles was again endemic in England.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18919
Hmmm. If we give antivaccine activists another five or ten years, maybe we could replicate that result. True, it's unlikely that we'll get to the levels in the developing world, where measles still kills close to a couple hundred thousand children per year, but we could go back to the bad old days in the U.S. where measles killed some children but left a whole lot more brain-injured (really brain injured, not "vaccine" brain-injured") from measles.
If you don't think that could happen, given that measles is one of the most highly infectious diseases there is, you are either ignorant or fooling yourself, take your pick.
I've been reading Photon in the Darkness for nearly five years now--since nearly its very beginning. Go back and look at the archive of my old Blogspot blog (http://oracknows.blogspot.com), and you'll see that I had his blog in my blogroll. In fact, Prometheus has on more than one occasion inspired a post by me, and I frequently link to him in my posts about vaccines or autism.
In fact, I know a bit about Prometheus' history. Guess what? He is a parent who believed that vaccines had caused his child's autism but, through examining the science, determined that there was no "there" there, that vaccines didn't cause his child's autism, and that all the biomedical woo he was using to treat his child's autism didn't work.
I'm still curious about Dr. Jay's first-hand experience with serious vaccine injury, but he's not very forthcoming. I'm beginning to think the only cases of alleged vaccine injury he's seen are those of children referred to him after the fact (like the 8-month-old who was somehow determined to be autistic) or cases of alleged "late onset" vaccine injury.
Here's something to find out if Jay applies what he learns: what is his current advice to parents who want to use chelation to treat their autistic child?
Remember, he used to support it, then after being schooled 14 ways to Friday about it HERE, of all places (he supported it despite not knowing anything about how it worked), he admitted that he had been wrong about it.
So the question is, since then, have any parents consulted Bozo the Jay about chelation, and, if so, what has been his advice?
Was that the one that he initially described as having been first hand observed, where the child "immediately stopped talking to his brother" or something like that (an 8 mo old>)? And then when called out on it, backed off with the full story that it wasn't really that way, and where the full story was convoluted...
Same old classiness from Dr. Jay.
The guy who opines how he doesn't think there are "many" pharma shills here and indulges in sneering insults whenever he's in the mood, is again urging adoption of a "calmer" tone.
Except that the calm and civil inquiries directed his way continue to go unanswered. For instance:
Dr. Jay: "There are safer ways to vaccinate if one is going to vaccinate."
I've lost count of the number of times you've been asked what evidence backs your alleged "safer vaccine schedule", and you never respond.
As to your Rumsfeld theory, how is it that we are supposed to connect-the-dots from supposed Tamiflu sales to the CDC and other health agencies' recommendations regarding swine flu? This is just another example of the conspiracy mongering which antivaxers cling to in lieu of science.
Rather than complain about how the spotlight is occasionally shined on your foolish antivax activities (and other pseudoscience like your flirtation with AIDS denialism), why not broaden your own outlook to take advantage of evidence-based advances in medicine? Here's a listing of continuing medical education courses in the field of immunization. In particular, note the course on countering vaccine misinformation offered by the American Academy of Pediatrics, with the following listed objectives:
To discern the factors that contribute to vaccine hesitancy.
To understand that valid scientific information is needed but not sufficient to reassure immunization-hesitant parents about vaccine safety.
To formulate a tailored response to parental immunization concerns.
To explore the vaccine safety monitoring system in the United States and the role of pediatricians in it.
To identify reliable sources of vaccine safety information for concerned parents.
I'm sure they'd welcome your participation.
The comment is here.
It was an 8 month-old when he first told the anecdote. Later I believe it changed to 9 months. The most glaring problem with the anecdote is that even pushing the envelope considerably, no one can diagnose autism at 8 months with any accuracy. Most diagnoses occur at age 3. Diagnoses at age 18 months are probably the earliest diagnoses in practice -- that's the state of the art. Diagnoses at age 2 or earlier seem to be rather unstable, according to recent papers.
Jay Gordon:
Dr. Jay knows about the UK's loss of herd immunity against measles. This makes his statement above a lie.
red rabbit @ 167:
Mainly ethanol. The one I've got at my desk is 60% ethanol. This is why many jails have had to stop supplying sanitizer -- the inmates were eating it to get drunk. And yes, it will get you drunk. (It's equivalent to 120 proof liquor.) As 120 proof liquor, it's also an effective antiseptic -- sorta like pouring whiskey on something to disinfect it. Not perfect, but it does kill a lot of stuff. The base is basically hand-lotion type stuff -- something to make it gel, and something to moisturize your hands and make it feel nicer than smearing vodka on yourself. Going back to the one on my desk, the inactive ingredients are water, glycerin, propylene glycol, carbomer, TEA, an unspecified fragrance, and aloe. I imagine the inmates who got drunk on sanitizer ended up with diarrhea; that stuff would tend to lubricate the digestive tract.
Jay Gordon @ 157:
You do know, don't you, that family predispositions to allergies do not determine what you'll actually be allergic to? Allergies run strongly in my family, yet I am the only one with a cat allergy. Still, at least allergies are something which are known to occur, so the advice, while a bit overcautious, isn't totally unreasonable.
Unlike allergies, a vaccine-autism connection is hypothetical, so this strikes me as not just overcautious but downright paranoid. At least, absent any evidence that the vaccine-autism connection is real and not merely hypothetical. Compare the hypothetical risk of vaccine-induced autism with the known risk of communicable disease. I do not understand why you rate the former so much higher than the latter.
What risk does the HepB vaccine pose to the average child? Why is it safe to assume the child will not contract HepB? Are you aware that children bite one another? Are you aware that 1 in 4 American women will be sexually assaulted in their lifetime? Do you still deem this risk insiginficant compared to the tiny risk of a HepB vaccine?
Kristen @ 262:
Forget the pain of a cervical biopsy and the subsequent fear; what about the actual treatment? When a pap smear actually does prevent mortality due to cancer, the usual price is infertility, and quite possibly also severe sexual dysfunction, depending on how much has to be removed, the skill of the surgeon, what kind of reconstructive surgery is required/sought, and how well the woman heals up afterwards. And it's no guarantee -- the woman could still develop more cancer from the HPV later.
The current HPV vaccine offers only partial protection; that is my biggest criticism of it. Thus, women will still need to get regular pap smears, and some women may think "oh, I had the HPV vaccine, I'm fine" and skip that unpleasant experience. I can't say I'd blame them, but they'd be making a mistake. Nevertheless, I will get my daughters vaccinated, and hopefully by the time they're old enough, a more comprehensive vaccine will be available.
@madder:
Not necessarily. He could think that there's differences between the UK and America that will prevent America's MMR uptake rate to fall as low as the UK's. Or maybe he thinks that if it could ever happen, it would have happened during the height of the MMR scare, and since it didn't happen then it will never happen.
Yep. Classy. Urge calm rationality in a conversation, then refer to the conversation as a "circle jerk" and dismiss those who did remain calm and rational.
So here you are, Dr. Gordon. You've stripped yourself of your last weapon. Are you going to answer the reasonable, polite questions various posters are asking you, or are you going to continue to dodge and weave? Because the nice guy schtick is, for you...exsanguinated*.
*Thanks Orac!
I'm leaning toward Door #3, which is that he is fully aware of what happened in the UK but doesn't think that a few cases of the measles are all that much of a problem to worry about. Especially since his Beverly Hills clients will have the money to pay for the best care once it does.
Matthew Cline--
Perhaps he does have some UK/US differences in mind: in that case, I maintain that he's lying via a deliberate half-truth. As far as I can tell, he absolutely does not want to acknowledge the UK's loss of herd immunity against measles, and will not expose any claim of such a difference to scrutiny.
As to your second possibility, surely he realizes that his efforts will extend the scare and continue to keep uptake rates lower than they could be. So I guess in that case, he would be tacitly acknowledging his own impotence, and that seems unlikely.
I usually lurk and don't comment, but Dr.Jay has finally got me mad enough to say something.
Jay, I don't know what kind of readership you imagine this site having, but chances are, you're wrong. I, for example, am a liberal-arts educated stay-at-home mom in Texas, not a "wannabe" or any other type of scientist. I found this site in the way I'm sure many other parents have, by googling some dubious claim and being intrigued by the title to one of Orac's posts. One of the reasons I keep coming back is for the "tone" you keep criticizing. Some things are worth getting angry and speaking up about. Callous disregard for children's safety is one of them, and you better believe my tone will be none too polite if I feel someone is threatening my child.
Before I came to this blog, I had never even heard of you. Your smug condescension was the first impression you made on me and, I'm sure, on many other parents. To be honest, I don't particularly care for your tone. You're like someone who wanders into the middle of a lively debate, farts loudly, and then acts wounded when other people complain about the stink.
I know I probably shouldn't bother to reason with you since you'll probably dismiss me as an Orac acolyte or a big pharma shill, if you even bother to read this comment at all. I just thought I'd give you a heads up that you're alienating the people you're trying to get through to.
@Jay
Since you seem to disdain scientists, perhaps you would prefer to read something written by a non-scientist. For a layperson's view, try reading antiantivax.flurf.net. A lot of the misconceptions you hold are addressed, with evidence (that's the stuff that you don't use) so back up the information there. There are a lot of links to click through to for further reading, so it could keep you occupied for quite a while. Included there are links to articles about measles outbreaks and information on polio.
Also, in case you are unfamiliar with some of these diseases and what they look like, under the Additional Resources section is a link to "Vaccine Information for the Public and Health Professionals". That site has photos and videos of these diseases. Well worth a look, though some of the materials may be a mite bit disturbing.
@312 Jay says, "There are safer ways to vaccinate if one is going to vaccinate."
Ok, what are these ways and what repeatable, verifiable data supports your claim to these ways being "safer"?
Or maybe that those kind of things only happen in nasty foreign places, not in the modern, sanitary Utopia of the United States.
Jay's opinion is on record that vaccination rates should be reduced until more kids die of measles (and presumably other diseases as well.) He has not answered when asked (repeatedly) what he thinks our target rate of measles deaths should be.
Unlike in the UK, where almost nobody has health insurance! Over there, some of the kids get measles encephalitis and SSPE, which I'm sure none of his patients ever would.
Oh, well.
I'm still curious about Dr. Jay's first-hand experience with serious vaccine injury, but he's not very forthcoming. I'm beginning to think the only cases of alleged vaccine injury he's seen are those of children referred to him after the fact (like the 8-month-old who was somehow determined to be autistic) or cases of alleged "late onset" vaccine injury.
I can't prove vaccine injury for any of the children I've seen. Evidence and temporal relationship are not proof. More investigation is warranted.
I apologize for my impolite post. Frustrated, I guess, but that's no excuse for rude comments.
@han: I loved your post
Orac: Bingo. I have to read more of your posts and not just the vaccine posts. Thanks.
Dr. Gordon, would your safer way to vaccinate include recommending that an unvaccinated teen-age girl be vaccinated against rubella, to protect her future children?
Ummm... wow.
Pressed for evidence for his antivaccination stance, Dr. Jay says:
Conveniently omitting the fact that the issue has been "more investigation"-ed to death. The results are in, Dr. Jay: your vaccine injury notion is an ex-hypothesis. Bereft of life, and all that. D. C. Sessions' portrayal of your position as desiring more incidence and complications of measles is absolutely accurate. Think about that, Dr. Jay: you are a doctor, and you are actively campaigning for the resurgence of a serious and preventable disease.
Speaking of omitted facts, you still have not responded to Orac and the others asking why the UK's loss of herd immunity against measles is not instructive for other countries.
We get a nice little apology for a rude post (presumably "circle jerk"), but not for your entry into this thread, in which you called another comment stupid. Of course, politeness would not matter at all if you weren't constantly focusing on the impolite aspects of others' comments, in order to distract attention from the fact that you have no substantive reply to valid criticism.
Jay, you do not even have evidence of the temporal relationship, you just have self-selected memories of that. Unless you have detailed records of this that were taken down for all of your patients you are prone to bias when it comes to remembering this.
I am with madder and the second half of his post. Do you plan on actually addressing the questions posed to you? Your post has an apology but that is the last thing I am interested in. I really could not care less about an getting an apology for saying rude things, I want content that directly answers the criticisms that have been made. I, and others who have said these things would like you to address the actual content of the posts. So I would recommend doing what I always recommend in these cases (because many people have the same problem you seem to be having). When you are getting dogpiled on by lots of people some of those will say mean things. Ignore the tone of the posts and just reply to the content. Lots of people on here have been pretty generous and have set out reasonable questions that need to be answers, have pointed out problems with your statements, and you have ignored those points and made other statements.
Arg. Please excuse the spelling errors and grammatical issues. I should get some sleep apparently.
@Dr. Jay:
How do you tell when it's been investigated enough?
Travis, would you care to hazard a few quatloos? Mine are on Jay continuing exactly as he has for years. If he responds to your message at all, it'll be some totally superficial "thank you" with absolutely no substantive followup.
Thanks for apologizing for the generalist comment about this forum, Dr. Gordon, but frankly, your apology more of the same. I'd much rather you vented your frustration and engaged the substantive issues that people are raising directly with you here. Given your lack of propensity for substance in this forum, I think that's unlikely, and I suspect that any discussion with you is probably exactly what you said it was.
I don't care either if Jay occasionally apologizes for one of his insults or insinuations (he'll just do it again while complaining about the "tone" here). It's his failure to address substantive issues that's disturbing.
Jay: "I can't prove vaccine injury for any of the children I've seen. Evidence and temporal relationship are not proof."
Selective memories and anecdotes are not evidence, Jay.
@Dr. Jay: We realize that, of course. But I think you're still dodging the question. You previously said the following:
This very much suggests you haven't seen cases of immediate apparent vaccine injury first-hand (except for that baby who was not your patient when the alleged injury occurred, but was referred to you.)
When Dr. Tayloe was interviewed by Larry King, he said that his practice sees 100,000 children every year, and they have never referred a single child to the Vaccine Injury Compensation Program. Dr. Jay, is this your experience as well?
Do you seriously not see that this is equivalent to "I have absolutely no basis to suspect anything at all?" And that more investigation is therefore most emphatically NOT warranted?
The only "more investigation" needed is Aunt Jay to read the scientific literature instead of trying to base his conclusions on observations in his office.
"More investigation" has absolutely been done, and the answer is clear.
Oh I know, Jay will cry, "But but but but they didn't test the Hep A vaccine in combination with the polio vaccine during the full moon, and I have a parent who INSISTS that is what caused her son's autism." It is true, but all of the reasonable associations that have been suggested have been investigated.
Correction: he's not even basing his opposition to vaccines on his own observations. By his own account, he's basing it on the opinions of parents. He then lends his "thirty years of experience" to what amounts to hearsay. His contribution, when you add it all up, is that he's acting as a publicist for the antivaxx movement.
Just like any other woo-pushing MD. Jay is doing a Mercola.
@ Matthew Cline
I'd have thought that that was obvious. You know a subject has been adequately investigated when you're discovered the support you'd been seeking for your a priori conclusions.
Pablo,
You may think this is tangential, but when you decide to address someone clearly male as "Aunt Jay" as a way of putting him down, that is an insult to women as a group (even that subset of us who aren't aunts). It works, if it does, because of the implication that "aunt" is a put-down, that it's worse to be an aunt than an uncle. It's right down there with someone saying "but I wouldn't expect you to understand the science, you're Hispanic."
Vicki
Over the last three days, I have referred to Jay Gordon as
Uncle Jay
Bozo the Jay
Aunt Jay
You still want to call me sexist? How about "clownist"?
A superb article:
http://www.psychologytoday.com/blog/strange-tongue/201005/autism-the-nu…
"Dr. Jay" prognosticates:
And this claim is based on.....? Polio was endemic in the US until the 1960's, when a vaccine was discovered. Because of that vaccine, we have reached the point where there is no domestic polio in the US.
However, because of irrational vaccine fears in other countries, the final eradication of polio from the planet has not yet happened. For that reason, we need to keep a large portion of our community immunised in order to prevent imported polio from spreading.
Epidemics are - to quote a supporter of "Dr. Jay" - "simple", in the sense that all you need is a large enough susceptible population in close enough contact to spread the disease among themselves. Once you have that, it's like having a pile of wood soaked in petrol - all it needs is a spark.
"Dr. Jay" continues his foretelling:
And this claim is based on...? I can only suppose that "Dr. Jay" thinks that the innate immunity of the US population is radically different from that of the people in the UK, where they are currently having uncontained outbreaks of measles. However, the data supporting that sort of conclusion seems to be lacking.
Measles (and mumps and rubella) are particularly nasty problems in public health because they are spread person-to-person by respiratory droplets and have a high infectivity. The only "up" side to them is that they generally leave their victims permanently immune (the major "down" sides being a case-fatality rate of 2 per 1000 [measles] an encephalitis rate of 1 per 1000 [measles], meningitis rate of 10% [mumps], etc.).
Make no mistake, if there is a sufficiently large population of non-immune people in contact with each other, there will be an epidemic. If that population reaches the endemic threshold (generally thought to be about 250,000 people), measles will become endemic. Again.
"Dr. Jay" is simply wrong.
The prophesy continues with:
I'm not sure exactly what "Dr. Jay" means by pertussis being both under- and over-diagnosed, but I can take a stab at it. Microbiologists know that many people carry Bordetella pertussis in their nose - this is known as asymptomatic carriage. So, if you do nasal cultures of a large group of people, you will "over-diagnose" pertussis (the disease) based on the mere presence of Bordetella pertussis (the bacteria).
However, from a public health standpoint, much pertussis (the disease) is missed because [a] physicians aren't used to thinking about it and often don't recognise it in adults and older children and [b] people who have been vaccinated a long time ago will have a milder presentation of the disease.
However, pertussis (the disease) in adults and older children (and the milder cases in vaccinated individuals) will still lead to Bordetella pertussis (the bacteria) being sprayed into the air and all over susceptible individuals, primarily infants who are too young to be vaccinated (and who are most likely to suffer respiratory compromise - i.e. suffocation - from pertussis).
The epidemics of pertussis (the disease) haven't materialised yet because there are still a lot of immune and partially immune people in the population and because Bordetella pertussis isn't as contagious as, say, measles or influenza.
However, as more and more people avoid getting their children (who are notorious for not covering their coughs or staying away from infants when they are ill) vaccinated against pertussis, we will see more and more very young infants in hospital with pertussis and dying from the disease. This may not reach true "epidemic" proportions, but that will not keep it from being a vaccine-preventable tragedy.
"Dr. Jay" makes one final pronouncement:
An admirable sentiment, that. I might add that we also don't need Porsches, California wines, DVD movies, deodorant, Nike running wear or Hollywood. However, if uncontrolled vomiting, simultaneous diarrhea, fever and dehydration are something that you'd like to avoid in youself or your children, then the rotavirus vaccine is certainly one of those "nice to have" things that make living in an industrialised nation more bearable.
It also needs pointing out that selling rotavirus vaccines in wealthy, industrialised nations (like the US) helps to pay for the research needed to develop the rotavirus vaccine, which in turn makes it possible for the manufacturers to make the vaccine available to the "Third World" below cost.
To put it bluntly, if the manufacturers couldn't sell their product at a profit in the industrialised nations, they never would have devloped the rotavirus vaccine.
It's not pretty or "socially correct", but it is the reality of the situation.
In summary, "Dr. Jay" has made a lot of assertions about vaccines and epidemics, all of them demonstrably false. It strikes me as a bit of "whistling through the graveyard" - a brave face put on a deeper fear. Perhaps "Dr. Jay" fears that "the big one" (epidemic, not earthquake) will happen during his lifetime, leaving him humiliated, vilified and despised.
I applaud his willingness to return over and over to this 'blog (and, apparently, to my humble 'blog) to take his medicine, but I begin to wonder if he's learning what he needs to learn from these visits. Frankly, I don't expect much scientific thinking from physicians, since that is not the thrust of their education, but "Dr. Jay" seems especially resistant to learning how to think scientifically, despite our best efforts.
Let me leave with some advice for "Dr. Jay" from the 12-step community:
"Keep coming back!"
"Don't leave before the miracle!"
Maybe Orac could start a 12-step program for addiction to pseudo-scientific thinking.....?
Prometheus
@Prometheus
Don't forget boosters for adults. People need to remember that whether they got the pertussis vaccine or were infected with pertussis, their immunity will wear off. Infection with pertussis does not lead to life-long immunity.
You're slipping, Dr. Jay, if you think that article is "superb." (Or maybe you like it because he mentions you favorably.) You may, however, have inadvertently provided me with blog fodder for tomorrow, although I already have something I was thinking of blogging. Time will tell later tonight whether the mood strikes me to take this on. After all, I've taken on the same nonsense so many times that even I get tired sometimes.
That Psychology Today article is full of nonsensical and incorrect statements. At pet peeve of mine:
You see why that makes no sense at all?
Joseph,
The assumption made in the Psychology Today article would be true only if nobody was ever re-evaluated following their early childhood.
That would mean that if someone were diagnosed as "not autistic" (or, more simply, weren't recognised as being autistic) in 1985, that no pediatrician, psychologist, psychiatrist, family practitioner, general practitioner, teacher, etc. could ever have them reclassified.
Ever.
Of course, that's nonsense. Today, even adults are being newly diagnosed as autistic. It's not that they recently developed autism, just that they had a different diagnosis (or none) and were belatedly recognised as being autistic.
It's this sort of poor grasp of statistics that causes people to make strange and illogical claims.
Prometheus
Case in point being one of my children who (at 26) is finally developing social skills that most children have mastered by the time they're ten.
The statement in the Psychology Today article is a tad confusing and muddled, actually. The way I interpret it, I'd say the problem is not just that. (Young children also seem to get diagnosed more frequently as time goes by.)
It's like introducing a new product into the market, say, a hi-tech cellphone. Sales are not going to be stable the day after the cellphone is introduced. There's going to be a curve of adoption (a diffusion of innovation curve, if you will.) This will look roughly exponential at first, and eventually it will level off. (Technically, it's an S-curve -- or roughly logistic -- function if you're talking about prevalence, and presumably quasi-gaussian if you're talking about incidence rate of diagnoses.)
Theoretically that's how it should work, and from what I've seen in passive autism databases, this is roughly how it does work, at least so far.
There are other issues, like the fact that not only criteria has changed, but also diagnostic tools. Presumably, the subjective view of psychiatrists about autism also evolves over time, even if DSM-IV doesn't change.
The author of this PT article appears to imply that the change in diagnostic criteria only occurs after they are listed in the DSM IV. Not true. In most cases, revisions to the DSM reflect current psychiatric practice, with the revised diagnostic criteria often being established in the literature years before they are listed in the DSM.
The author is a linguist. This would not provide him with any expertise in evaluating vaccine safety or the diagnosis of autism.
Is Dr. Jay still commenting? If so, I would like to remind him that he still has to prove to me that he's sincere about the apology he offered me on LiveJournal.
And since some people such as Dr. Jay like to rely on anecdotes for evidence, here's a little story for you.
I'm a Canadian adult, and our H1N1 vaccine contains the "dreaded" thimersol, which I received. Oh yeah, and I'm autistic. By the reasoning of vaccines-cause-autism myth, it would be reasonable if I regressed and became "more" autistic, right? Except... I didn't. Still just as autistic as when I was born.
~Corina
Orac said: "You're slipping, Dr. Jay".
I don't understand how this is possible.
Dr. Jay Gordon has descended so far into the promotion of antivaccination myths and pseudoscience, that the only way he could possibly slip further is if he was to go the whale.to route and embrace conspiracy theory as an explanation for why immunization is promoted as a benefit to public health.
Oh, wait...Jay has already begun bizarre conspiracy-mongering (see comment #310).
There's no low ground left to which he can slip. Unless he follows the example of Dr. Buttar and other autism "healers" to rake in money from parents of autistic kids through useless and potentially dangerous treatments.
Speaking of Dr. Buttar...guess who's lining up with Jay Gordon to protest how his expert opinions were left off the Frontline program on vaccination?
Birds of a feather...
Another question for Dr Jay: If you had a client who was travelling with their children to an area of the world where measles or polio was a risk, would you suggest vaccination? If you had a client who went to the UK with an unvaccinated child, and that child contracted measles, and there were complications, what would your defense be when they sued you for malpractice for giving them such shitty advice?
"Thirty years of experience."
It's the medical equivalent of "9-11!!!!!"
May I propose the Jay Gordon drinking game?
Every time Jay tells us "thirty years of experience" someone replies "DRINK!"
@363
Can I apply this drinking rule retroactively? I just opened a bottle of Doppel-Hirsch and I would like to drink it as part of this game.
I like the "Chuck Norris facts" version of the idea:
How did the ancient Egyptians build the pyramids?
With Dr. Jay's 30 years of medical experience.
I'll play the drinking game, but I'll stick to water. I had better watch out for hyponatremia, though.
Matthew: I like that. "Dr Jay has so much experience, diseases ask him for advice."
"Case in point being one of my children who (at 26) is finally developing social skills that most children have mastered by the time they're ten."
Perhaps he could teach the fine people at the Age of Autism some social skills most people have mastered by the age of 10? They seem to be lacking in those.
Are you kidding, Jay? Before pertussis vaccine, I went to camp for a week. A couple of days in, I came down with a cold. I learned how to sweep my glasses, flashlight, and kleenex box under me in my sleep so I could turn over in a sleeping bag. There were five others in my tent. And when I came home, my "cold" developed into whooping cough. At some times I coughed so hard I thought, indeed hoped, that I'd die and get it over with. I probably gave it to at least my tent-mates if not others.
Todd and Robyn, children immunized now are getting less than 4% of the toxins that I got in the 60s. I posted a chart here.
And I will remind trolls that when the U.S. government proposed reinstating the smallpox vaccine because of the slight possibility of germ warfare, Paul Offit opposed it because the smallpox vaccine has too many side effects. It's not about automatically supporting vaccination; it's about weighing the FACTS.
Smallpox variolation preceded vaccination. The original prophylaxis observed by Lady Mary Wortley Montagu in the hareems of Turkey was done with serum from mild cases of smallpox. People chose the 10% chance of dying from variolation with a mild case over the 30% chance of dying from an average case. I believe that the practice spread to England and then was improved by Jenner when he noticed that dairymaids who had had cowpox seemed immune to smallpox. That's where all the songs about meeting a beautiful milkmaid come from.
Speaking of autoimmune disorders, I know two people who developed Type 1 diabetes after a "flu-like" and presumably viral illness. I hypothesize that the infection triggered an autoimmune reaction against their islets of Langerhans, leaving them dependent on insulin to prevent death. If scientists ever pin down the cause, I'd like a vaccination against that disease, please.
Just to show how well Dr. Gordon learns, I will post an email he sent me almost five years ago (the all CAPS part is Dr. Gordon (fun, eh?), and so was the email verification required for the reply I sent, which I refused to participate with,.. oh well). By the way, take note how he deals with the question about the diphtheria outbreak in the former USSR states, he neglects to mention why they are "GONE":
>> Subject: vaccines
>> Date: Thu, 09 Jun 2005 01:09:18 -0700
>>
>> Thanks for your comments.
>>
>> I will be more rigorous in constructing and publishing my posts.
>>
>> Most vaccines protect against illnesses American children can no longer
>> contract
>
> Like measles and mumps?
WELL, YES, AS YOU KNOW, MEASLES CASES NOW NUMBER 35 OR SO IN THE USA EACHYEAR. MUMPS SOMEWHAT MORE AT 200-300. BOTH DISEASES CAN PRODUCE SERIOUSCOMPLICATIONS BUT RARELY DO. WHEN THE INCIDENCE OF A DISEASE DROPS TO THESELOW LEVELS, THE RISK/BENEFIT ANALYSIS CHANGES.
>
> Pertussis? Chicken Pox?
THE DPT IS A REASONABLE SHOT AND I GIVE IT TO THE MAJORITY OF KIDS IN MY PRACTICE. VARICELLA IS AN INNOCENT CHILDHOOD DISEASE WHICH WE HAVE NOWTRANSFERRED INTO ADULTHOOD. I TELL ALL FAMILIES TO EITHER GET THE DISEASEOR THE SHOT BY AGE TEN YEARS.
>
> Haemophilis influenza b?
ALMOST GONE, AS YOU KNOW. I STARTED PRACTICE WHEN HIB WAS AROUND A LOT.NOW, AGAIN, THE RISK/BENEFIT ANALYSIS FAVORS LOOKING HARDER. I DO GIVE LOTSOF THESE SHOTS, THOUGH.
> Tetanus?
AGAIN, UNDER 50 CASES/YEAR INTO HE USA--PROBABLY OWED IN LARGE MEASURE TO VACCINATION BUT NOT COMPLETELY
>
> Kids in the US still get those... and they are only an airplane ride away.
XENOPHOBIA DOES NOT SERVE THIS ARGUMENT WELL
> Diptheria? (see what happened in Russia)
GONE
> Polio... So you don't think anyone will fly in from Yemen or Indonesia to
> the USA ever again?
NO, I DO NOT THINK SO. AS YOU FAMILIARIZE YOURSELF WITH THE HISTORY OF POLIO, YOU CAN SEE THAT THERE HAS NOT BEEN WILD POLIO IN THE USA FOR OVER 25 YEARS AND THE LIKELIHOOD OF AN IMPORTED CASE BEING ACTIVE AND SPREADING IS NIL
> The drop in hepatitis B was only after infants started to be vaccinated
> against it.
TRUE. BUT EACH PARENT HAS THE RIGHT TO DECIDE. THIS SHOT MAY BE OF GREAT BENEFIT TO PUBLIC HEALTH BUT OFFERS NO BENEFIT TO EACH INFANT
>
> This is a county in the USA, it lists the incidences of disease:
> http://www.metrokc.gov/health/epilog/vol4505.htm ... the only thing that is
> missing from the present vaccine schedule is polio, diptheria and mumps ---
> all three of those are still occuring only an airplane ride away. Chicken
> Pox is also not listed, but it is still occuring -- and it does maim and
> kill every year in the USA:
> http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5223a3.htm> >
> and must therefore be subject to different risk/benefit analyses
>> that in other times or in other countries where these diseases are still
>> endemic.
>>
>
> Should this be done by lawyers or by health professionals? You should> perhaps speak to the public health folks in Indiana about that.
DOCTORS AND PATIENTS TOGETHER AGAIN,
THANKS FOR MAKING ME THINK HARDER.
BEST, JAY GORDON
@Prometheus
Polio was endemic in the US until the 1960's, when a vaccine was discovered.
The polio vaccine was given the stamp of approval in 1955
Very good Sid, except it wasn't "the polio vaccine" that was approved in 1955 - it was the Salk inactivated polio vaccine. From 1955-57, polio cases in the U.S. fell 85-90% due to that vaccine. Further reductions and eventual eradication of wild-type polio from the U.S. (in 1979) occurred after the introduction of Sabin's oral polio vaccine in 1961.
Timelines on vaccine introduction and major advances against vaccine-preventable diseases here.
"Sid Offit",
You are correct that the Salk inactivated vaccine was approved in 1955. However, there was a lag between the approval of the vaccine and the time when polio was no longer endemic. In addition, the Sabin vaccine not only made polio vaccination easier, it eliminated GI carriage of the virus.
To be more clear, that sentence should read:
In 1955 - the year the Salk vaccine was approved, there were 13,850 cases of paralytic polio; by 1960, this had dropped to 2,525. By 1966 - five years after the approval of the Sabin oral vaccine - that number had dropped to 106. From that point onward, the number of polio cases has continued to decline.
I am encouraged to see "Sid Offit" acknowledging that the polio vaccine was what ended domestic polio in the US (and UK, Europe, etc.). That's the first step in what I hope will be a many such steps toward reality and scientific thinking.
Keep coming back, "Sid".
Prometheus
Orac (in comment #316, addressing Jay Gordon): "Perhaps the only two things that I may have convinced you of is chelation therapy for autism is quackery--and dangerous quackery at that--and that the "formaldehyde gambit" about vaccines is really, really dumb because formaldehyde is a natural byproduct of metabolism."
When did Jay's supposed rejection of the "formaldehyde gambit" occur? It must have been really recent, because a "Q&A Interview"* featuring Jay on his website, dated 2/24/10 has Jay saying the following:
"Right now weâre creating vaccines using ingredients that are cheap preservatives, but it could be done better. It means, letâs see if we can get the aluminum out of them. Letâs see if we can get the formaldehyde out of them."
Seems as if Jay is still pushing the idea that formaldehyde is a harmful ingredient in vaccines, in addition to other misinformation.
*I don't see any identification of who the "interviewer" is - sounds like Jay is talking to himself.
@Dangerous Bacon and "Prometheus"
Already down ~40 before the Salk vaccine, it's hard to believe declines into 55-57...
(From 1955-57, polio cases in the U.S. fell 85-90% due to that vaccine.)
...were due to vaccination since the Cutter incident ruined the 1955 vaccination season and as vaccine enthusiast Arthur Allen states in Vaccines P205
âBy 1957, the National Foundation was having trouble getting people to vaccinate their children,â lamenting that, â⦠vaccine was gathering dust on warehouse shelves.â
Amazing! That's exactly the language he used in 2008 and for which he was slammed here:
http://scienceblogs.com/insolence/2008/07/dr_jay_gordon_pediatrician_to…
Watch his bobbing and weaving in that comment thread:
@ #100:
@ #157:
@ #200:
Shameless.
From "Sid Offit":
It's not about belief, it's about the data.
And before "Sid" goes on with the "whale.to" candard about "Polio was declining before the vaccine.", here are the numbers for the years around the introduction of the Salk vaccine:
1951 ..... 10,037
1952 ..... 21,269
1953 ..... 15,648
1954 ..... 18,308
1955 ..... 13,850 (Salk vaccine introduced)
1956 ...... 7,911
1957 ...... 2,499
1958 ...... 3,697
1959 ...... 6,289
1960 ...... 2,525
1961 ........ 988 (Sabin vaccine introduced)
1962 ........ 792
1963 ........ 396
1964 ........ 106
1965 ......... 61
[Note: prior to 1951, the CDC records combine paralytic and non-paralytic cases of polio - this may be the source of the "Polio was declining before the vaccine." canard. The numbers above are for paralytic cases only, but the non-paralytic cases declined in parallel.]
What's harder to believe, that the Salk vaccine reduced the US incidence of polio by almost 82% in five years (1955 - 1960) or that "hygeine", "sanitation" or "nutrition" in the US improved so much in the same time period that the incidence of polio dropped by 92% "naturally"?
If you ask me, it takes more "belief" (i.e. willful suspension of reason and logic) to believe the latter.
Really, how many times do we have to show "Sid" (and others of his ilk) the data about polio or measles or smallpox, etc.? How much mental contortion and fingers-in-the-ears-singing-la-la-la-I-can't-hear-you! must it take to not see what is right before your eyes?
That's the difference between reality and fantasy - fantasy requires that you ignore the data.
Prometheus
Prometheus, you can find Sid's 40% by comparing 1952 to 1955 and (as Sid did) counting 1955 as unvaccinated. If you recall the recent Canadian example, the antivaccination crowd has no problem with cherry-picking data to create the illusion of trends.