“I know you are, but what am I?”

That’s basically the child’s version of a familiar logical fallacy known as the tu quoque, which basically means, “You, too!” It’s a very simple and simplistic logical fallacy that tries to argue that, if one’s trait shares one or more of the same bad traits of the people he is criticizing, then his arguments can be dismissed. It’s sometimes very effective in that implied within the fallacy is a charge of hypocrisy. As a diversionary tactic, it can be very effective.

Not too surprisingly, I’ve found a doozy of an example of just this fallacy over at the other anti-vaccine crank site besides Age of Autism, namely Medical Voices. Remember Medical Voices? It’s nowhere near as active as our “friends” at Generation Rescue and Age of Autism, but, being number two, it appears to try harder. Truly, it’s a wretched hive of scum and quackery, and the post over there can be characterized as a combination of tu quoque and a massive straw man argument, in which the word “quack” is turned back on defenders of science-based medicine while simultaneously the positions and arguments of used to criticize quacks are misrepresented as straw men that go beyond Burning Man size and in the article produce a conflagration that could consume a small city as they are engulfed by burning stupid.

Of course, being such a wretched hive of scum and anti-vaccine quackery, Medical Voices has provided me, and more recently Mark Crislip, with blogging material. Dr. Crislip has had perhaps the most hilarious take on the anti-vaccine quackery being promoted over at Medical Voices in a three part takedown:

  1. Nine Questions, Nine Answers
  2. Mumps
  3. Medical Voices: Always in Error, Never in Doubt

Amusingly, as a result of Nine Questions, Nine Answers, Nick Haas, one of the founders of Medical Voices, decided to emulate all varieties of cranks, including 9/11 Truthers, HIV/AIDS denialists, Holocaust deniers, supporters of “alternative medicine”, and believers in ghosts and the paranormal, and challenge Dr. Crislip to a live, online debate. Also not surprisingly, just like Brave, Brave Sir Robin, Mr. Haas ran away from anything other than a “live” debate.

The looniness of Medical Voices Vaccine Information Center (MVVIC) does have an upside, though, and it’s an upside that I’ve unfortunately ignored for a while now. Basically, it, like Age of Autism or NaturalNews.com, should be a copious source of blogging material, and in this case it is. Specifically, it’s a massive case of the aforementioned logical fallacy of tu quoque in the form of an article by someone named Suzanne Humphries, MD entitled Quack. In the post, right is left, up is down, and wrong is right. She begins with one of my favorite quack attacks on science:

Mainstream medicine has hit a new low in its war against physicians who have become alternative healers. The battle has been going on for decades, but lately, in bully-like fashion, pharma’s minions are ramping up the vilification. They’re now discrediting any healing method not based in their version of accepted science – excuse me, I meant their religion of pharmaceutical belief which has been misnamed as “science”.

Hilarious! This is an example of the classic strategies of believers in pseudoscience to bring science down to their level by declaring it “religion.” After all, if science is nothing more than a religion, then its conclusions can be easily dismissed as having no more substance than the beliefs of a competing religion, much as Christians dismiss the beliefs of Buddhists, Hindus, or Muslims and vice-versa. It’s nothing more than doggerel. There are many differences between science and religion, but perhaps the most important is this: Science changes its conclusions on the basis of new evidence. Not only that, it actively seeks evidence that will falsify its current “dogma.” This is in marked contrast to religion, which not only doesn’t seek disconfirming evidence for its beliefs but actively attacks and rejects such evidence when it is presented. Yes, it’s true that scientists may be too fast to reject ideas that are out of the mainstream, but science itself continues. In science, sooner or later, evidence wins out. The process may be messy and contentious, because human beings who do science are, like most human beings, messy and contentious, out of the messiness and contentiousness the explanatory power of science improves. It’s a Darwinian process, in which hypotheses that best explain how nature works and make the most accurate predictions survive.

In fact, Humphries gets it totally wrong in so many ways that I almost feel tempted to leave this paragraph as an exercise for the reader:

They demand explanation and evidence when we reject their drugs, yet they never serve up true evidence or proof that drugs do more good than harm. They insist with religious fervor that vaccines are safe, effective and keep people healthy. They preach as gospel that antibiotics are better or safer than homeopathy, herbs, colloidal silver, vitamin D and natural support for non-life threatening infections, despite the fact that antibiotic adverse effects are common and well documented. Serious effects such as anaphylaxis (inflammatory shock), kidney failure, liver failure, Stevens-Johnson syndrome (a life threatening condition where the epidermis separates from the dermis), Clostridium difficile colitis (commonly referred to as C-diff), and the creation of drug resistant super-bacteria are but a few examples. And now, they’ve recruited some very bright (but not necessarily wise) minds to attack alternative practitioners. Their latest weapon is name calling – most notably, labeling them “quacks”.

Oh, hell. I can’t resist. First of all, I’m really interested in knowing what the heck Humphries means by “true evidence.” Apparently scientific evidence demonstrating that homeopathy is useless, nothing more than sympathetic magic, and her belief that vaccines cause autism doesn’t count as “true evidence.” One wonders what does to her. Anecdotal evidence? Probably? Revelation from on high? Possibly? Whatever it is, it doesn’t appear to be science, and clearly Humphries rejects science. Yes, real medicine has real risks and can produce real complications, but it produces real benefits too. Homeopathy does not. Neither does colloidal silver. Silver salts may have some value in treating superficial infections when applied as part of a cream or paste, the concentration they require to kill bacteria is too high to be useful in treating systemic infections. As for vitamin D, “alt-med” practitioners massively oversell its benefits, while “conventional” practitioners more and more do actually check vitamin D levels and recommend supplementation. The difference is that, unlike practitioners like Dr. Humphries, they’re doing it based on science and a realistic assessment of the potential benefits, risks, and the uncertainties involved in those calculations, rather than a pie-in-the-sky set of claims as vitamin D as a panacea.

Of course, what’s really hilarious about this entire article is not so much that it’s a massive tu quoque fallacy. Yes, that’s funny enough in and of itself, but what’s really both hilarious and pathetic is that Humphries can’t even do a propoer tu quoque fallacy without reinventing the definition of what a quack is. After listing a dictionary definition of “quack,” she writes:

But from its current usage, I’d say they’ve added a new definition:

3. A physician or medical healer who does not profit from creating and maintaining disease, but rather respects the natural tendency of the body to heal itself; one who helps the body eliminate whatever toxins are causing illness, be they environmental, emotional or pharmaceutical; one who uses primarily non-toxic, non-surgical means for routine care, and uses pharmaceutical and surgical medicine as a last resort.

I do like how Humphries has expanded the definition of “toxin” to “emotional toxins.” I wonder what that means. Maybe she’s an advocate of the German New Medicine or Biologie Totale, where various forms of emotional trauma are postulated to be the cause of all disease, in particular cancer. In any case, Humphries goes far beyond just redefining the word “quack” as she does above, going on to write:

As a matter of fact, it seems a quack is apparently anyone in the healthcare industry who does not believe in and support the unharnessed proliferation of the pharmaceutical industry, with its virtually unlimited profits from its worldwide distribution of toxic medications and vaccines. When a physician has the ethical fortitude to reject these massive operations and label them as destructive, s/he will be considered a quack. And most definitely, any physician who no longer wishes to be a mercenary for the pharma-backed junta that has taken over medical schools and medical institutions will be tagged “quack”.

Funny, by this definition, friends of mine could be considered “quacks.” Mark Crislip, for instance, has recently written a post describing how he refuses to take anything from pharaceutical companies and has refused to do so for nearly three decades now. On various occasions over the years, I myself have criticized the pharmaceutical and medical device industry. Does that make me a “quack,” too? Probably not, I would guess. After all, I still accept the paradigm that science is the best way to guide and improve medical care. Humphries clearly does not.

Her view is a massive straw man as well, although it’s a telling one. Clearly the term “quack” stings Humphries more than she lets on. That’s why she has to redefine the word “quack” and turn it into a straw man parody in which defenders of science-based medicine are crazed minions of big pharma who desperately want to pump people full of pharmaceuticals in order to increase the profits of pharma to beyond obscene.

Most gratifying, I think, is this next passage, which appears to be evidence that my humble efforts, as well as those of my “friend” and his partners in crime, are having an effect:

This word “quack” has been turned into a weapon, unleashed on those who notice the scores of patients spiraling to their death at the hands of FDA-approved, CDC-sanctioned medical interventions of big pharma and their affiliated institutions. The self proclaimed authorities of “science-based-medicine,” the paid pharma bloggers, “Quack Watchers” and many others who proselytize the message of drug companies and attempt to discredit the time-tested healing methods used by alternative practitioners, are destined to fail. I take comfort in the fact that the masses are becoming increasingly disgruntled with the results of their conventional medical options. The public trust and confidence in what pharma and conventional medical doctors have to offer is, thankfully, dying.

Yes! The forces of science-based medicine are pissing off quacks like Dr. Humphries, so much so that she’s using the time-honored tactic of people who are losing and they know it:

Those who have attempted to warp our reputations by calling us “quacks” will not succeed. The primal wisdom of the masses is more powerful than all the propaganda promoted by the misnamed “science-based medicine” and “quack watchers.” The pillars that support the sick-care industry are cracking and its architects are getting desperate. In due time, the Yellow Pages will be abundant in so-called quacks. Quack watchers really should watch carefully. The revolution has begun.

Sounds as though Humphries is getting set to get a French revolution going with her very own Comité de salut public, if you know what I mean. Talk about delusions of grandeur! On the other hand, it is true that quackery such as the anti-vaccine movement championed by Humphries and MVVIC have seemed to be in ascendance for a while. Although I’ve been at times rather pessimistic regarding the anti-vaccine movement, of late I’ve seen encouraging signs of a backlash against Jenny McCarthy and the anti-vaccine movement. Whether that backlash will persist or not, I don’t know, but I do view complaints by supporters of quackery like Dr. Humphries to be an encouraging sign that we bloggers who relentlessly harp on medical pseudoscience and quackery are actually having an effect. There have been times when I truly doubted it, when I thought we were lone voices in the wilderness having no effect.

Thanks, Dr. Suzanne Humphries, for showing me that we’re having an effect.

Comments

  1. #1 Todd W.
    July 22, 2010

    @MI Dawn

    One problem with catching up with comments at work is that Little Augie isn’t killfiled.

    On the other hand, he/she/it is a great source for examples of logical fallacies, as well as examples of falsely claiming someone is engaging in a logical fallacy. See, for example, how quickly he/she/it jumped on Composer99’s statement about argument from authority, when Composer99 did not actually commit the logical fallacy of argument from authority.

  2. #2 agashem
    July 22, 2010

    @Todd W:
    Having just written the Public Service of Canada’s french test (a requirement for certain positions within the federal public service) I need to correct you; it would be monsieur not messieurs as this would be the plural. Although with a troll, who can tell how many personalities are living within?

  3. #3 Joseph
    July 22, 2010

    An argument from authority is not a logical fallacy if the authority is an expert in the subject under consideration (the National Cancer Institute, to use your example).

    That’s not quite right. If the argument is solely a because-I-say-so argument, then it’s an argument from authority, regardless of the relevance of the credentials of the arguer.

    Let me see if I can find an authoritative source to support my claim above 🙂

    OK, this treatment of the topic looks very reasonable.

  4. #4 Todd W.
    July 22, 2010

    @agashem

    Thanks for the correction. I suspected I was wrong (don’t speak French, myself), but went ahead anyway. Again, thank you for the correction.

    Which reminds me, that’s another thing you will not find from augustine: acknowledgment of an error.

  5. #5 Marya
    July 22, 2010

    In response to the HPV discussion: I am merely indicating that there is a viable alternative to prevention — discussing safe sexual practices with your child, which is really predicated on the work of establishing a trusting long-term relationship with him/her.
    There are a couple of other point about HPV vaccine worth mentioning:
    1. Diane Harper of the University of Missouri is a prominent researcher who was heavily involved in the Gardasil development program. Recently she has cast serious doubt on both the cost-effectiveness and the risk-benefit profile of the vaccine. One of the facts she pointed out at the recent 4th International Public Conference on Vaccination in VA was that, though the drug is marketed to girls as young as 11 years old, the vaccine has never been formally evaluated in girls under the age of 16 years. Neither its safety nor efficacy, let alone effectiveness, is known in the younger population.
    2. HPV vaccine does not contain all of the serotypes of the virus that are frequent causes of genital warts. So what, right? It does address those that cause warts 70% of the time (if memory serve correctly) right? Well, in a slightly different area, we have successfully reduced the incidence of invasive pneumococcal disease in children over the years using the so-called PCV-7 vaccine, which contains 7 of the frequent culprit serotypes. The alarming thing is that the CDC has reported (http://www.ncbi.nlm.nih.gov/pubmed/19947881) a rise in infections caused by serotype 19A, which is not included in the PCV-7. The alarming aspect is that 19A is highly multidrug resistant and developing new resistance all the time. Granted, the solution is forthcoming with the inclusion of this serotype in the new PCV-13. However, this illustrates the opportunism of microorganisms to fill a vacant niche. Since viral behavior in someways is even more malleable than bacterial, we should be very vigilant for emergence of disease not covered by the current HPV vaccines.

  6. #6 Todd W.
    July 22, 2010

    @Marya

    You bring up salient points and ones for which we need to keep constantly vigilant, striving at all times to make products safer and more effective. One thing, though:

    discussing safe sexual practices with your child

    You can have all the discussions you want, but it will not matter one jot when that child is grown up and has their first encounter, whether before or after getting married. In particular, should the child decide that he or she wants a child of their own, unless they are using IVF, there is going to be some contact and the risk for transmission of the virus.

    What I’m trying to say is that although such discussions are good and very important to have, they ultimately will not affect whether the individual becomes infected or not if their partner carries the virus. Arguments like this really do not belong in a discussion over the safety or efficacy of the vaccine; they do not carry enough weight to bear on whether one should or should not get the vaccine.

    Just a minor nitpick.

  7. #7 augustine
    July 22, 2010

    TODD W.: “Which reminds me, that’s another thing you will not find from augustine: acknowledgment of an error.”

    If I make one I’ll acknowledge it.

    If acknowledgement of mistakes were a hallmark of scientific thinking then ALL pharmaceutical companies and almost ALL medical doctors would be called unscientific quacks. Not saying sorry is often a legal strategy for medical error.

  8. #8 augustine
    July 22, 2010

    Brucy @192,
    “I assume you know this already, Composer99.
    As usual, Augie gets it wrong.”

    You should reread and comprehend more closely before you accuse. composer accused him/herself.

    Using faith,aka authority, as a means for truth is a good method (85% of what we are taught before 18 comes from faith/authority) but it relies on the impeccability of the source. The source could be right or could be wrong. Is NCI impeccable? Have they been wrong before? Any COI? Are their agents moral?

    You can cite authority but be prepared to answer back the same way if I cited an authority without providing original citations. Fair is fair.

    “You would have to be irrational to conclude otherwise. But then, we knew that already, didn’t we?”

    You use of the term is strictly pejorative.

  9. #9 Antaeus Feldspar
    July 22, 2010

    How many women acquire HPV this way?

    1) Some;

    How many women actually get cervical cancer this way?

    2) Some;

    How many clear the virus without vaccination?

    3) Not all; and —

    How many women die from cervical cancer by this way?

    4) Some.

    Put facts 1-4 together, augie, and the fact that the vaccination can prevent the virus and it means the vaccination saves lives. So when you say

    There is no ACTUAL evidence that Gardasil prevents cervical cancer.

    you’re blowing smoke. The burden of proof is on you to show that Gardasil does not prevent cervical cancer; science has already shown that it does.

  10. #10 augustine
    July 22, 2010

    John V. @147 “You’ve done more than watch the video of the Kittyhawk, presumably you double checked the Wright brother’s numbers in order to make sure that DC-7 you flew in last month wasn’t going to drop out of the sky?”

    Sometimes they do.
    anyway…
    Good luck in trying to prove a negative. Know one knows if the vaccine prevents anything for any single individual. Unless you claim you can predict the future like a prophet.

  11. #11 Marya
    July 22, 2010

    @Todd W: Actually, since I am bringing up a potential comparator to the HPV vaccine, this is exactly an argument that belongs in the safety/efficacy discussion. What I am not familiar with/aware of is the evidence that compares the two approaches. Are you? One of the issues is funding — who would fund a study of such intensive personal intervention?

  12. #12 augustine
    July 22, 2010

    TODD W. “You demand of us flawlessly science-based statements, yet do not apply the same standard to yourself.”

    You chose your own standards, not me. You will be judged by those standards.

  13. #13 augustine
    July 22, 2010

    MI Dawn,

    You provided no actual evidence that gardasil prevents cervical cancer. You’re wasting your time. The evidence does not exist.

    avg. age of cervical cancer patient 49. gardasil target age 12. Age of the vaccine 3 years. Now you tell me what the problem is when MERCK implies that it actually does prevent cervical cancer. From an EBM perspective the actual evidence will not be available for 20 years or more.

    In theory it should work.In theory a lot of drugs should have worked. But the evidence is not in. If one is coming from an evidence based background then they should realize this instead of speaking of the theory and surrogate endpoints as the ACTUAL evidence.

    If you believe this is evidence then that just speaks for your critical thinking ability.

  14. #14 augustine
    July 22, 2010

    @204 Feldspar,

    Are you serious? Some, some, not all? Are you sure you’re a science based skeptic?

    You just made a mockery of yourself.

  15. #15 T. Bruce McNeely
    July 22, 2010

    Re: Safe sex instruction vs. HPV vaccination.

    Why not both?

  16. #16 mikerattlesnake
    July 22, 2010

    @auggie

    Put up or shut up time again, dude. You are presented with the following:

    1) a type of cancer for which a virus is a known risk factor (and not an insubstantial one at that).

    2) a vaccine that can vastly reduce cases of that virus and is shown to be safe.

    How do you proceed?

  17. #17 Science Mom
    July 22, 2010

    Why, thanks, @Science Mom (BTW, what kind of science? I have been to your blog, but cannot tell).

    Infectious diseases; the nasty kind with (mostly), no cure and no vaccine.

    Care to weigh in on the risk stratification thoughts? Would love to hear how others approach this vis-a-vis different vaccines. Another question I have is how is the decision made to abolish a required vaccination? I mean specifically the case of small pox — anyone aware of the history and science behind that? How small a risk of disease was deemed small enough to say that we no longer needed to vaccinate? What was the risk benefit trade-off?

    I don’t know specifically what the criteria were to discontinue vaccination for smallpox but undoubtedly involved extensive, longitudinal surveillance. It’s an interesting topic though and one which you would have no problems finding numerous publications on.

    Let’s see, risk stratification. Since I read ahead before answering this, I can address your post about HPV and Dr. Harper. When you say ‘behaviourally-mediated’, yes it is, but think about the particular behaviour and the fact that even stringent condom use doesn’t always protect against HPVs, other means of prevention are viable. I agree with Dr. Harper that this vaccine is being too aggressively marketed and some of the claims are over-reaching to date. Given the latency of the virus in terms of cervical cancer, it will be some time before really hard data can be collected. But with the preliminary data that has been collected during clinical trials (efficacy) and post-marketing surveillance for both pre-cancerous lesions and genital wart reduction (partial effectiveness), the only way to gather this information is with long-term, high-uptake.

    Varicella: This vaccine was invented in Japan in ~1975 (I believe) for leukaemic children and introduced in the U.S. in 1995 as an optional vaccine. In my opinion, it should have stayed that way. If I recall correctly, the decision to make it mandatory had more to do with economics (parental loss of working days) than serious sequelae of the disease.

    The use of PCV is concerning and interesting to me because of the serotype and even genotype replacement that has occurred and the former a possibility (N. meningiditis). Strain 19A is contained in the new PCV-13 but again, surveillance is a must to track the effectiveness and potential for replacement disease given there are >90 S. pneumoniae serotypes.

    So yes, not all vaccines should be treated equally and there is certainly ‘wiggle room’ for some of them. Hep A is another example of a mandatory vaccine that shouldn’t be and on the flip side, I would like to see more effort for adolescent/adult uptake of Tdap.

  18. #18 Todd W.
    July 22, 2010

    @Marya

    Since you are comparing HPV vaccine to PCV-7/PCV-13, let’s actually compare the safe sex discussion on whether or not to be vaccinated.

    First off, PCV is only recommended for children under 5 (unless they have certain medical conditions or are older than 65), so discussions of a similar nature to the safe sex discussion aren’t going to play a role. Let’s just assume, though, that you can have the discussion, they can understand it and put into practice what you say.

    Suppose that you discuss with your child about proper hand hygiene. You explain and instill in them a respect for properly washing one’s hands, for staying home if sick, using their elbow instead of hands to cover their mouth when coughing or sneezing, avoid cigarette smoke and so on. While such a conversation can be had and taking these actions may reduce their risk of contracting pneumonia, if they are exposed to a bacterium, virus or fungus that causes the disease, the discussion isn’t going to matter much whether it was a good idea to get the vaccine or not. The discussion will not change their susceptibility to the disease insofar as the vaccine is concerned. The vaccine will lower their risk, regardless of the conversation. Without the vaccine their risk will be higher.

    So, as with the safe sex discussion and HPV vaccine, I agree that it is a good conversation to have, but it does not enter into whether the vaccine is efficacious or not. The facts remain that the vaccine will reduce their risk of infection.

    Perhaps you are trying to argue that the HPV vaccine is not a substitute for the conversation, and I’d agree with that. As T. Bruce McNeely said, and as I tried to say earlier, they should both occur.

    That was the extent of my nitpick. As I said, the two main points you brought up are good ones and are topics that should be monitored and studied.

  19. #19 Chris
    July 22, 2010

    Marya, do you have access to some kind of device which can tell me who my daughter will marry in the next ten to twenty years so that I can have that “safe sex practices” talk with him? Since that is not available, she had her HPV series.

  20. #20 Antaeus Feldspar
    July 22, 2010

    Would love to hear how others approach this vis-a-vis different vaccines. Another question I have is how is the decision made to abolish a required vaccination? I mean specifically the case of small pox — anyone aware of the history and science behind that? How small a risk of disease was deemed small enough to say that we no longer needed to vaccinate? What was the risk benefit trade-off?

    I would recommend reading “Inside the Outbreaks” by Mark Pendergrast; it goes into detail about the decades of the smallpox eradication effort.

  21. #21 augustine
    July 22, 2010

    Chirs: “Marya, do you have access to some kind of device which can tell me who my daughter will marry in the next ten to twenty years so that I can have that “safe sex practices” talk with him? Since that is not available, she had her HPV series.”

    Chris,

    What statistical evidence did you base this on since I’ve never seen the statistics on monogamously acquired cervical cancer.

  22. #22 Science Mom
    July 22, 2010

    Composer: “I suppose one could accuse me of making an argument from authority.”

    You accuse yourself.

    I’ll say it again LOUDER:

    There is no ACTUAL evidence that Gardasil prevents cancer.

    You can put faith in your authority all you want. The evidence does not exist. It won’t exist until another 20 years. Then you’ll see that it was all a psychological scam. After all of the money is spent you won’t see much of a difference except for what can be statistically manipulated.

    But that’s OK. The newblood scienceblogger types will say “see, science changes with evidence. That’s how science works!”

    Ad hoc.

    I find it interesting and hypocritical (albeit typical) that you can, in the very same post proclaim that the evidence is 20 years out that HPV vaccines can prevent cervical cancers, whilst proclaiming that they conclusively won’t.

    There are reasonable proxy measurements for HPV vaccine effectiveness, i.e. reduction of pre-cancerous lesions and genital warts, the latter alone, perhaps, being well-worth it to many to justify the vaccines’ existence. Yes, it will be several more years before an actual estimate can be made regarding the duration of protection and effectiveness for preventing cervical cancer. So what do you have to support your conclusion again? Ad hoc indeed.

  23. #23 Chris
    July 22, 2010

    Science Mom, HepA is a food borne virus. Why should the vaccine not be required for that? Since the vaccine has come along we no longer hear news announcements that a food handler in a certain restaurant was diagnosed with HepA, and that anyone eating there needed to see their doctor for an injection of gamma-glo (oh, what ever… it has been years since I heard a news announce, and know that once my husband had to go into the doctor for that injection). I do remember a couple of years ago some were possibly infected at a celebrity party.

  24. #24 Science Mom
    July 22, 2010

    Chris@113, I’m fine with having the vaccine (particularly for travellers to and from endemic countries) but it shouldn’t be a mandatory school vaccine for children for which it is almost always an asymptomatic or mildly symptomatic illness and very, very rarely results in fulminant liver disease. It is far more serious for adults, so they should be getting it, especially yes, food service employees.

  25. #25 Marya
    July 22, 2010

    @Science Mom: thanks for your measured and thorough response! I could not agree with you more on every point. I too am under the impression that the Varicella vaccine was mandated for economic expediency rather than for its clinical risk-benefit trade-off. As for HPV vaccination, perhaps we can agree that at this point there is still some room for opinion-based practice, as the base of evidence grows? Although there are discussions in the US to make it mandatory, I do not believe that there is that much excitement behind them yet.

    Loving the finely nuanced discussion, thanks!

  26. #26 MI Dawn
    July 22, 2010

    @Science Mom: interesting thought about HepA. My children had both been vaccinated (as grade school children) against HepB. Child #1 just got a booster when she started a medical program in June and was also required to get HepA since she may come into contact with persons with the disease (actually, probably not the persons but their blood/body fluids). I have not been vaccinated nor have I ever had HepA (had a close enounter with Botulism years ago – the restaurant we had eaten at at lunch had problems with the dinner crowd due to some improper home canning methods).

    Should spouse and I speak to our MD about HepA? Spouse has Type II diabetes.

  27. #27 Todd W.
    July 22, 2010

    @Marya

    On HPV vaccine, I agree that it is premature to make it “required”, since we don’t know fully what is the long-term effectiveness. I would still recommend it, though, as it does appear to have a pretty good safety profile and, at least short-term, is effective. Seems like a good bit of insurance.

    @MI Dawn

    Re: HepA. At my last physical, my doctor mentioned that with my previous blood tests, they check both HepB and HepA titers and found that I didn’t have evidence of immunity (coupled with the fact that the vaccines weren’t around when I was a kid). So, they recommended I get them, even though my risk is relatively low. I’ll be finishing up the series shortly. What I’d say is, it wouldn’t hurt to discuss it with your doctor. If it isn’t recommended, nothing lost.

  28. #28 Composer99
    July 22, 2010

    augustine troll says:

    The same has been argued for measles even when it’s been pointed out, using CDC references, that 99.9999+ of U.S citizens will not die or have permanent sequelae of measles

    To which an appropriate reply is that augustine’s pants are on fire.

    In the unlikely event that anyone reading this deep into the thread is not aware of this particular deception, what augustine neglects to mention is that this present happy state of affairs is the result of the measles vaccination program.

    So what augustine is doing is arguing against measles vaccination by relying on mortality/morbidity rates that are possible because of measles vaccination.

    A better idea of what would happen if we stopped vaccinating for measles can be found here: http://www.iayork.com/MysteryRays/2010/03/19/measles-week-part-v-what-about-the-vaccine/

    The troll is, politely put, misrepresenting the evidence. Less politely, the troll is making a false statement. Less politely but more satisfying, the troll is lying.

  29. #29 MI Dawn
    July 22, 2010

    @Todd W: Thanks, Todd. However, given my track record (I had the 3 HepB shots and didn’t show immunity when I was tested a few years later when I got pregnant…I have a weird immune system), I’ll ask my MD at my annual exam about the 2. I imagine I’ll be looking at 6 shots…oh joy. 🙁

  30. #30 Chris
    July 22, 2010

    Thanks, Science Mom. It is completely the opposite than for HepB, which is more dangerous for children and not so much for adults. Though from listening to the This Week in Virology (twiv.tv) podcasts I have learned they are completely different kinds of viruses.

    (Composer99, I believe that was pointed out to him a few months back, but it was ignored and/or misinterpreted by him, which is why I ignore him)

  31. #31 Science Mom
    July 22, 2010

    I have not been vaccinated nor have I ever had HepA (had a close enounter with Botulism years ago – the restaurant we had eaten at at lunch had problems with the dinner crowd due to some improper home canning methods).

    Should spouse and I speak to our MD about HepA? Spouse has Type II diabetes.

    Blimey, botulism? One of my fears. Anyway, absolutely, I would talk to your physician about Hep A vaccination (2 dose series). You can have a titre pulled if you want or just go for the jabs.

    Chris@220, Yes, Hep B infection in infants and children is much more dire. All of the hepatitis disease are from different genre of viruses. They are just so named due to the disease produced.

  32. #32 Matthew Cline
    July 22, 2010

    @Tabitha Little:

    The treatment for smallpox (now known as monkeypox)

    Virologists would tell you that the genomes of smallpox and monkeypox are different enough for them to be different species. But, hey, they’re just virologists, what would they know about it?

  33. #33 augustine
    July 22, 2010

    Composer: “So what augustine is doing is arguing against measles vaccination by relying on mortality/morbidity rates that are possible because of measles vaccination.”

    Try again. Those are prevaccine statistics.

    Not a lie. Not a misrepresentation. Just the fact’s ma’am.

    You’ve just feel in your emotional heart that it MUST be worse than that because you’ve been fed a bunch of propaganda.

  34. #34 Science Mom
    July 22, 2010

    Composer: “So what augustine is doing is arguing against measles vaccination by relying on mortality/morbidity rates that are possible because of measles vaccination.”

    Try again. Those are prevaccine statistics.

    Not a lie. Not a misrepresentation. Just the fact’s ma’am.

    You’ve just feel in your emotional heart that it MUST be worse than that because you’ve been fed a bunch of propaganda.

    Yes Augie, a misrepresentation as you didn’t include more relevant statistics. By the way, 99.999+ is an irrelevant number. U.S. pre-vaccine, it could be expected that entire birth cohorts would become infected so ~4 million, of those:
    Pneumonia ~25%
    Encephalitis ~1:1000 measles cases
    Deaths due to measles complications: ~1-3:1000 measles cases
    Deaths due to SSPE: ~7-11:100,000

    Are you saying that we should end vaccination for measles?

  35. #35 Joseph
    July 22, 2010

    To be precise, those are incidence rate statistics, not prevalence. The distinction matters, because it’s misleading to treat the numbers as prevalence. For example, a 1 in 100,000 annual rate doesn’t mean that your chances of getting the disease are only 1 in 100,000. That’s for 1 year only. Whole population incidence rates can also be misleading in that incidence is probably different at different ages.

  36. #36 Rogue Medic
    July 22, 2010

    @ 207 augustine,

    TODD W.: “Which reminds me, that’s another thing you will not find from augustine: acknowledgment of an error.”

    If I make one I’ll acknowledge it.

    You are a liar, augustine.

    You never admit your mistakes, no matter how much evidence is provided.

    Do you deny that you make errors out of ignorance, deceit, or some combination of the two?

    When corrected, you just change the subject.

    This suggests that you are aware of the lies.
    .

  37. #37 Composer99
    July 22, 2010

    Augustine’s argument would seem more persuasive but for the unfortunate fact that the vast majority of measles cases each year occured among children – before the vaccine almost everyone got measles before they were 15.

    Adults would have almost universally had measles before any given date you care to name and would therefore not be at risk (unless they were immunocompromised) of reinfection.

    So, I will conclude that I can safely stand behind my conclusion of misrepresentation on augustine’s part.

  38. #38 augustine
    July 22, 2010

    Composer: “Augustine’s argument would seem more persuasive but for the unfortunate fact that the vast majority of measles cases each year occured among children – before the vaccine almost everyone got measles before they were 15.”

    Precisely and they didn’t have to get adult boosters either. And, as your point avoided, a U.S. citizen had a 99.999+% of not having permanent sequelae from measles….before the vaccine. Plenty of reason to not get a measles vaccine and be comfortable with the decision.

    You gave nothing to counter that.

  39. #39 augustine
    July 22, 2010

    Pneumonia ~25%
    Encephalitis ~1:1000 measles cases
    Deaths due to measles complications: ~1-3:1000 measles cases
    Deaths due to SSPE: ~7-11:100,000

    Might want to recheck your statistics and how those numbers were derived, Science Mom. If not is that your final answer? Are you sure?

  40. #40 T. Bruce McNeely
    July 22, 2010

    If I make one I’ll acknowledge it

    BWAHAHAHAHAHAHAHAHAHAHAHAHA!!!!!!!!!!!

    You crack me up!

  41. #41 T. Bruce McNeely
    July 22, 2010

    You use of the term is strictly pejorative.

    – and well deserved.

  42. #42 Antaeus Feldspar
    July 23, 2010

    Good luck in trying to prove a negative. Know one knows if the vaccine prevents anything for any single individual. Unless you claim you can predict the future like a prophet.

    Goofus (I made the mistake of not referring to augie by his proper title previously) is committing an interesting fallacy here, called the fallacy of composition. This is the fallacy of decreeing that a trait which is true of the parts of a whole, must be true of the whole as well. Can a Boeing 747 fuselage by itself fly? No. Can a single 747 engine by itself fly? No. Can one wing of a 747 by itself fly? No. So therefore, claims the fallacious arguer, obviously a 747 composed of a fuselage and two wings and multiple engines could never fly!

    Similarly, Goofus is arguing here that because for “any single individual” we will never know if the vaccine will keep that individual from getting fatal cervical cancer they would otherwise get, we therefore know nothing about whether any individuals at all will be kept from getting cervical cancer that they would otherwise get.

    But again, this is the fallacy of composition. Events that are highly unpredictable on the individual level can be highly predictable en masse; that’s a basic fact of probability. You don’t know whether any single coin flip is going to come up heads or tails, but you know that the ratio between heads and tails is going to approximate 50/50 closer and closer as the total of flips gets higher. Anyone who tells you “Oh, we can’t point to any individual coin flip and say ‘that’s going to come up tails’; therefore it’s totally plausible that we might flip the coin millions of times and it would never come up tails!” is either displaying massive ignorance or just blowing smoke.

    And, likewise, anyone who says “Oh, we can’t point to any single individual and say ‘that’s someone who would develop a fatal cancer from an HPV infection if they had not been vaccinated against the infection,’ therefore it’s totally plausible that out of millions of people who are going to go out and live their lives not one of them would contract an HPV cancer!” … again, either massively ignorant, or massively dishonest.

  43. #43 dt
    July 23, 2010

    “either massively ignorant, or massively dishonest”

    I vote both.

  44. #44 Joseph
    July 23, 2010

    And, as your point avoided, a U.S. citizen had a 99.999+% of not having permanent sequelae from measles….before the vaccine.

    @Augustine: That’s not a reasonable view. Odds of getting pneumonia after measles are non-trivial. They are at least 3%. Even if pneumonia doesn’t kill you, it damages your lungs. Right there you’re looking at a decrease in life expectancy.

  45. #45 augustine
    July 23, 2010

    JOSEPH: “@Augustine: That’s not a reasonable view. Odds of getting pneumonia after measles are non-trivial. They are at least 3%. Even if pneumonia doesn’t kill you, it damages your lungs. Right there you’re looking at a decrease in life expectancy.”
    ———————————————————
    Not reasonable? It’s perfectly reasonable to forgo a vaccine for a virus that one’s body can handle 99.9999+% of the time. The vaccine is not needed.

    So tell me how many people get pneumonia from measles. Citations please. Science mom says 25%. You say 3%. That’s a pretty big difference.

    A decrease in life expectancy just for getting pneumonia? I’ve never heard that. Can you reference that also?

  46. #46 Antaeus Feldspar
    July 26, 2010

    As for the benefit of the community at large, herd immunity theory has yet to be proven as well.

    In the context of this sentence, it seems as nonsensical to talk about “herd immunity theory” as it does to talk about “chain reaction theory.” It’s not some rarefied hypothetical occurence, it’s what can be deduced by anyone with basic knowledge of the subject and a passing familiarity with the concept “actions have consequences.”

  47. #47 Science Mom
    July 26, 2010

    Not reasonable? It’s perfectly reasonable to forgo a vaccine for a virus that one’s body can handle 99.9999+% of the time. The vaccine is not needed

    What mindless drivel. What in the bloody hell is, “a virus that one’s body can handle 99.9999+% of the time.” as if it’s a mosquito bite. Even an uncomplicated case of measles is most unpleasant. So tell me how many can’t ‘handle’ it and what happens to them?

    So tell me how many people get pneumonia from measles. Citations please. Science mom says 25%. You say 3%. That’s a pretty big difference.

    The U.S. rate is 1-6% http://www.ccjm.org/content/77/3/207.long

    A decrease in life expectancy just for getting pneumonia? I’ve never heard that. Can you reference that also?

    You really need this spoonfed to you too? I really don’t think that you should be arguing pro-disease when you don’t have a clue of disease sequelae.

  48. #48 Calli Arcale
    July 26, 2010

    Considering that pneumonia is a not uncommon cause of death, yes, it most certainly can decrease life expectancy. Yet you don’t often hear of people dying of pneumonia; this is because people will instead talk about whatever it was that left them vulnerable to pneumonia. My aunt died of pneumonia — but really, that was just how her breast cancer ended up killing her. By that time, it was practically a kindness, though pneumonia is really a miserable way to go.

    My daughter’s had pneumonia, and made a complete recovery. Not everyone does; some get hospitalized, and that carries it’s own risks. Sitting around during the illness can cause injury. Chest tubes aren’t without risk, even if they do save a life by draining off fluid. Ventilators have their own problems. If alveoli perish, one ends up with reduced lung volume, and that’s going to compromise your ability to live a long and healthy life.

    Pneumonia ain’t just a bad cold. It should always be taken very seriously, and treated promptly.

  49. #49 Chris
    July 26, 2010

    Little Augie:

    The vaccine is not needed.

    Sigh. What a tool.

    From http://www.census.gov/prod/99pubs/99statab/sec31.pdf
    Year…. Rate per 100000 of measles
    1912 . . . 310.0
    1920 . . . 480.5
    1925 . . . 194.3
    1930 . . . 340.8
    1935 . . . 584.6
    1940 . . . 220.7
    1945 . . . 110.2
    1950 . . . 210.1
    1955 . . . 337.9
    1960 . . . 245.4
    1965 . . . 135.1
    1970 . . . . 23.2
    1975 . . . . 11.3
    1980 . . . . . 5.9
    1985 . . . . . 1.2
    1990 . . . . .11.2
    1991 . . . . . .3.8
    1992 . . . . . .0.9
    1993 . . . . . .0.1
    1994 . . . . . .0.4
    1995 . . . . . .0.1
    1996 . . . . . .0.2
    1997 . . . . . . 0.1

    The preceding are data on the incidence of measles in the USA from 1912 to 1997. Answer this question: What happened between 1960 and 1970? And only that decade, no others.

  50. #50 Travis
    July 26, 2010

    I though auggie might have left (and maybe they have, I have not seen any posts for a few days). It saddens me to think how much time is wasted in countering these posts, but I understand and think it is good everyone does it.

    Sadly, while Calli Arcale makes a good point it is pretty clear augustine will not get it. The reality of diseases is simply not their concern.

  51. #51 T. Bruce McNeely
    July 27, 2010

    A decrease in life expectancy just for getting pneumonia? I’ve never heard that. Can you reference that also?

    Here you go, Augie. I found this citation from the University of Maryland in about 5 minutes, thanks to Google:

    Small children who develop pneumonia and survive are at risk for developing lung problems in adulthood, including chronic obstructive pulmonary disease (COPD). Research suggests that men with a history of pneumonia and other respiratory illnesses in childhood are more than twice as likely to die of COPD as those without a history of childhood respiratory disease.

    I’m surprised that you’ve never heard this, you being such an expert in infectious disease and all. All sarcasm aside, I’m not surprised at all. I’m also not surprised that you couldn’t be arsed to Google it yourself. Dear me, you might learn a fact or two. You can’t have that!

  52. #52 Rogue Medic
    July 28, 2010

    @ 245 augustine the unapologetic liar,

    Number of deaths for leading causes of death:
    1. Heart disease:…………………………616,067
    2. Cancer:…………………………………562,875
    3. Stroke (cerebrovascular diseases):..135,952
    4. Chronic lower respiratory diseases:.127,924
    5. Accidents (unintentional injuries):..123,706
    6. Alzheimer’s disease:……………………74,632
    7. Diabetes:………………………………..71,382

    8. Influenza and Pneumonia:…………..52,717

    9. Nephritis, nephrotic syndrome, and nephrosis:.46,448
    10. Septicemia:…………………………….34,828
    Source: Deaths: Final Data for 2007, tables B, D, 7, 30
    http://www.cdc.gov/nchs/fastats/deaths.htm

    Why would augustine the omniscient not realize that such a lethal disease has an effect on life expectancy?

    Probably because augustine appears to filter everything through his biases, before deciding to believe.

    augustine rejects the scientific method. The scientific method is a way of minimizing the influence of our biases on our understanding. augustine does not appear to think think that his biases lead to mistakes. Or is it that augustine does not believe that he has any biases?

    augustine seems to think that pneumonia is safer than a vaccine.

    @ 207 augustine,

    TODD W.: “Which reminds me, that’s another thing you will not find from augustine: acknowledgment of an error.”

    If I make one I’ll acknowledge it.

    Will augustine admit this mistake, or admit any of his other mistakes?

    I’m not holding my breath.
    .

  53. #53 Chuck Beretz
    August 4, 2010

    It is called “alternative medicine” because if it wasn’t, it would just be called “medicine”!

  54. #54 Rogue Medic
    August 4, 2010

    It is called alternative medicine because it is an alternative to real medicine. This alternative only appeals to those who do not understand medicine.

    Real medicine is capable of healing real patients.

    Alternative medicine is capable of taking money from people under false pretenses – that is with the expectation that whatever they have will go away on its own or that the placebo effect will help.

    If they told customers the truth, would the alternative medicine customers really waste all of that money?

    Alternative medicine is fraud.
    .

  55. #55 Chuck Beretz
    August 25, 2010

    @Rogue I completely agree. That was my lame joke :o]

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