I don’t know if it’s confirmation bias, faulty memory, or if my individual impression is correct, but it seems to me that over the years I’ve been blogging that stories like this one seem to be becoming depressingly more common:

Getting inoculated for diseases such as whooping cough and measles used to be a childhood rite of passage that few questioned. Now with shifting parental attitudes about vaccine safety, a growing number of California children are entering kindergarten without shots.

The trend worries public health officials because of the link between immunization rates and infectious outbreaks. As they grapple with the worst whooping cough surge in half a century, they are fighting back with outreach campaigns to promote vaccinations.

The Watchdog Institute, a nonprofit investigative journalism center based at San Diego State University, found that waivers signed by parents who choose to exempt their children from immunizations for kindergarten enrollment have nearly quadrupled since 1990. California allows parents to opt out of some or all shots on the basis of personal beliefs, be it religious objections or distrust of the medical establishment.

That California is ground zero for vaccine rejectionism is not a surprise to me or anyone else who’s paid attention to the issue of the anti-vaccine movement. Indeed, when I last wrote about this a year and a half ago, I drily observed that when the outbreaks begin, they’ll probably start in California. At the time, I was writing about an LA Times article that described the skyrocketing numbers of “philosphical” exemptions being claimed by parents in California. The story laid out the problem in considerable detail. Affluent parents in affluent suburbs, never having seen the diseases against which vaccines would protect their children, decide that these diseases are not a threat, confident in the delusion that there’s no way their children could ever suffer from these horrible diseases. Oh, no! Those are diseases for children in Third World ghettos, not their precious children. After all, they’re affluent and can afford everything their children need, and they care so much about their children. Besides, Jenny McCarthy and her fellow travellers in the anti-vaccine movement tell them that vaccines cause autism. Obviously vaccines are nothing more than a plot by The Man to make lots of money and turn their children autistic! Last year, unvaccinated children were clustered in certain areas. For example, at Waldorf schools (or, as I like to call them, pathogen repositories), vaccine exemption rates can be as high as 82%. Otherwise, the highest exemption rates appeared to be in Sonoma County, although Los Angeles and San Diego Counties were also up there.

What about this year? This year, it looks as though San Diego County has an exemption rate consistently higher than the state average, just as it has been for quite a while. The Watchdog Institute found:

  • Personal-belief exemptions granted to entering kindergartners reached a record high of 10,280 in public and private schools statewide last fall, up from 2,719 in 1990.
  • San Diego County’s exemption rate is 2.64 percent, compared to 2.03 percent statewide. While those percentages seem small, public health officials are concerned that unvaccinated children tend to cluster in certain areas, creating pockets of vulnerability.
  • Schools with the highest exemption rates tend to be private schools, public charter schools, and traditional public schools in affluent areas. Among schools with 25 or more kindergartners last year, 14 had immunization opt-outs for more than 15 percent of their kindergarten class. The top was the Waldorf School of San Diego in City Heights, at 51 percent.

A 51% exemption rate implies that only 49% of the children at the Waldorf School of San Diego are vaccinated, far below a rate that even has a prayer of maintaining herd immunity.

Of course, anti-vaccine parents both demonize and have unrealistic ideas about what vaccines can do, which is part of the problem. They demonize vaccines as the cause of autism, autoimmune disease, and asthma, along with all sorts of other health problems, even though there is no scientifically credible evidence linking vaccines to autism or any of the other conditions attributed to vaccines. Yet, at the same time, they justify their refusal with the implicit belief that vaccines are 100% effective. I refer to this as an “implicit” belief because a frequent argument made by anti-vaccine parents when it is pointed out to them that they are endangering other children is that those other children are vaccinated; so how could their precious baby ever be a threat to other children? The reason, of course, is that no vaccine is 100% effective. Some, like the MMR vaccine, are “only” around 90% effective. Now, in medicine, 90% effectiveness is in general excellent, about as high as one can expect from any intervention. It’s not 100%, though. Worse, pockets of unvaccinated children provide a repository for vaccine-preventable disease that can infect other unvaccinated children, as well as vaccinated children who, for whatever reason, did not develop effective immunity due to their vaccination.

Failure to vaccinate also endangers the unvaccinated children as well. Last year, in fact, this risk was quantified in a study that found that unvaccinated children have a 23-fold elevated risk of catching pertussis compared with vaccinated children. Given how nasty and contagious pertussis is and how safe the vaccine is, there really is no good reason not to vaccinate at least against pertussis. Of course, parents have their reasons not to vaccinate, virtually all of which rely on either exaggerated fears of autism, a woo-ful belief that “natural” must be better, and, perhaps, one of the most common delusions among the “natural health” set.” This last delusion is one shared by Bill Maher and consists of the belief that if you eat the right foods, excercise, and keep yourself healthy “naturally,” you can’t get sick from vaccine-preventable diseases. In other words, good living (whatever that means) is as good as any vaccine in their view. In fact, one anti-vaccine mother named Yvonne Haines was interviewed in the article is quoted thusly:

“We do find that the unvaccinated kids are extremely healthy because their bodies have been allowed to develop their own immune system, rather than relying on vaccinations, which are like substitutes,” she said.

Uh, no. They aren’t any healthier than vaccinated children, and microbes don’t care how “healthy” your children are.

Yes, it’s true that it’s better to be well-nourished and in good physical shape than not. It will even help fight off disease. But it won’t protect your children the way a vaccine will. You can have the healthiest child in the world, but if that child is exposed to, for example, measles, which is highly contagious, chances are that your child will catch the measles. Ditto pertussis. Unfortunately, what public health officials are fighting against is attitudes like this:

Rebecca Estepp of Poway, a mother of two boys 12 and 10 years old, is familiar with that logic, but she cannot square it with her maternal instinct.

After her first son suffered adverse reactions from vaccines and developed autism, she decided to not to go through with the full schedule of immunization for her second son.

“I don’t know if there is an acceptable level of collateral damage in the war against infectious diseases,” said Estepp, who is also the government and media relations manager for SafeMinds, a nonprofit that investigates the link between vaccine ingredients and neurological disorders.

We’ve met Estepp before. She frequently lays down swaths of burning stupid about vaccines of this sort. She’s so utterly convinced that vaccines caused her child’s autism that nothing will convince her otherwise. Meanwhile, she continues to promote the false dichotomy that it’s a choice between “autism and the measles” and that she’d pick the measles. In actuality it’s a choice between measles and not getting the measles, given that the MMR vaccine is, by any measure, incredibly safe. It is also a choice of preventing measles at a very low risk versus the risk of getting the measles and its potential complications. Nonetheless, Estepp decided that she’d put her her son at high risk of contracting measles, which, contrary to the misconception, is not a benign disease. Worse, she did it because she believed in a myth promulgated by the anti-vaccine movement.

One aspect of this article that perfectly encapsulates the thinking of a lot of these crunchy anti-vaccine moms is an interview with Johannes Lasthaus, Waldorf’s administrator:

Schools that top the list of highest exemption rates in the county in 2009 are almost all either private or charter schools. The private Waldorf School of San Diego, where tuition ranges from $7,500 to $14,000 a year, has the highest exemption rate.

“Our parents are really educated. They are trying to make their own decisions, not being influenced by pharmaceutical companies,” said Johannes Lasthaus, Waldorf’s administrator.

His school, he noted, has had no outbreaks and maintains a policy of keeping sick children at home.

“It’s all about people’s right to choose what is right for their child and their family and really respecting people’s choices, whether they choose to vaccinate or choose not to vaccinate,” said Julie Joinson, Waldorf’s director of admissions, speaking for herself. She noted that her daughter, 14, who has never been vaccinated, is “super healthy.”

“It’s not that I think that vaccinations are terrible,” Joinson said. “If I lived in a third-world country with open sewage running down the streets, I would probably vaccinate my child. At this point, I really have concerns about what goes into vaccinations.”

With all due respect, Ms. Joinson has “concerns” because she doesn’t know what he’s talking about. Think of it this way. Before the polio vaccine, the U.S. was not a “Third World coutnry with open sewage running down the streets.” Yet, as recently as the 1950s, every summer there were polio scares in which public swimming pools were closed down. Periodically there were polio epidemics, and there were thousands in iron lungs. Does Ms. Joinson know what ended that? No, it wasn’t sanitation. Sanitation was just fine in the 1930s, 1940s, and 1950s. It was vaccines. Similarly, it was the vaccine that eradicated smallpox. The fact is that the single biggest source of microbes causing vaccine-preventable diseases is not raw sewage, as Ms. Joinson seems to think. It’s other children. These days, it’s unvaccinated children far more than vaccinated children.

As for the Waldorf school having had no outbreaks, it’s only a matter of time. In fact, Waldorf schools, which are widely known for their resistance to vaccines and scientific medicine, have had a number of outbreaks. For example, just this year there was a measles outbreak in Essen, Germany where the majority of cases were linked to a Waldorf school. In 2008, the East Bay Waldorf School was shut down due to a pertussis outbreak, and a Waldorf School in Salzburg, Austria was hit by a measles outbreak. There are numerous other examples, and, as vaccine uptake falls, Mr. Lasthuase is fooling himself if he thinks his school is not at risk, no matter how strict he is about sending children home when they appear to be sick.

I believe that we are approaching a tipping point. Although vaccine uptake is generally high throughout the U.S., there appear to be more and more pockets of vaccine refusal, leading to populations of unvaccinated children who can serve as vectors to result in outbreaks as herd immunity breaks down. Although I doubt that vaccination rates will fall to the point where mass epidemics are likely, although Generation Rescue and Jenny McCarthy are sure enough doing their best to make sure that happens (if you don’t believe me, just wait a while to see what sorts of comments appear on AoA after this post triumphantly trumpeting this article). There are likely to be more and larger outbreaks of vaccine-preventable diseases.

It’s the face of the future. I hope I’m wrong, but I fear I’m not.

Comments

  1. #1 Militant Agnostic
    August 29, 2010

    Raven @394 – It looks like you missed Big Blue’s comment @385 where he showed that falling tree limbs could be due to an infectious agent. Jay is even more wrong than you are suggesting he is.

  2. #2 Jay Gordon
    August 29, 2010

    Tree limbs media sensationalism equates nicely to pertussis outbreak sensationalism. I don’t don’t claim that the analogy is perfect or even great. Just that it’s worth a thought.

    And, lighten up, you guys! It’s a lovely Sunday out there. Let’s go out and play!!

    Best,

    Jay

  3. #3 Vicki
    August 29, 2010

    “Lighten up” meaning we should stop pointing out when you’re being stupid? That’s not going to happen. You say something stupid, people point out the problems, you back off and pretend you didn’t mean it, and then you get annoyed because people pointed out your mistakes. Let’s be grown-ups here, or try to. The grown-up response to being shown an error is to either apologize or thank the person, not blame them for listening to you in the first place.

  4. #4 Agashem
    August 29, 2010

    Dr Jay,
    Is your dog vaccinated? If so, why? If not, why not?

  5. #5 grenouille
    August 29, 2010

    Dr Jay,

    Why did you stop recommending the Hib vaccine? I almost died of orbital cellulitis caused by Hib as a two year old and it shocks me that you don’t recommend the vaccine.

    Since it seems to matter to you, I was breastfed as an infant, my parents fed me a healthy diet, we lived in a clean orderly house. My dad is an MD, and he made sure I went to the ER right away when my eye looked a little funny.

    Why do you leave kids in your practice vulnerable to such terrible things? How do you sleep at night?

  6. #6 Antaeus Feldspar
    August 29, 2010

    [Orac: We’re just pointing out to anti-vaccine loons that those side effects do not include autism.]

    Oh, but they do.

    [references to Hannah Poling]

    “Antivaxxers often do cite the case of Hannah Poling, claiming that it is a known case where vaccines triggered autism. However, anyone who examines the case closely realizes that this is not so. Hannah Poling had a rare mitochondrial disease (how rare? only four other cases are known) which resulted in some autism-like symptoms.

    It is not known why the mitochondrial disease abruptly got worse and produced the autism-like symptoms; the government elected to award compensation on the theory that it could have been a febrile reaction to vaccines that caused the abrupt worsening of the mitochondrial disorder. Consider that carefully. If a febrile reaction to vaccines could be the trigger for Hannah Poling’s autism-like symptoms, so could any other febrile reaction, including those induced by the diseases that vaccines protect against. Saying that what happened to Hannah Poling proves that vaccines cause autism is like saying “this child was in the middle of the street; a milk truck was unable to brake in time and the child was hit. This proves that milk is harmful to children.” What was actually harmful to the child was her pre-existing mitochondrial disorder.”

  7. #7 Antalya Web Tasarım
    August 29, 2010

    It’s news like these that make me a little more worried that someone out there really is trying to bring about the end of the world as we know it, and, no, I don’t feel fine.

  8. #8 augustine
    August 29, 2010

    Ant, Ant ,Ant

    What you’ve said is nothing new. The old she would have been like that anyway. How very “scientific” of you. Very proveable, huh?

    [Ant the reacher of alternative hypotheses otherwise known as “the guesser”…”which resulted in some autism-like symptoms.”]

    as opposed to some definitive blood test that “other autistic kids get. Give me a break. Autism IS diagnoses by autism like symptoms.

    You wannabe scientist are bad with faulty analogies

    [is like saying “this child was in the middle of the street; a milk truck was unable to brake in time and the child was hit. This proves that milk is harmful to children.” What was actually harmful to the child was her pre-existing mitochondrial disorder.”]

    Moral of the story. Milk trucks ARE dangerous for kids in the street. Just like vaccines are dangerous for kids with underlying disorders (and others)

    So what you’re doing is blaming a child that was harmed from a vaccine by abdicating the vaccine. The child is inherently dangerous to vaccine program. There is absolutely nothing inherently wrong with the vaccine. It was the faulty child. Disgusting way to spin it. But I don’t blame you. You’re just repeating the same thing your friends say.

    Anything for the good fight. Collateral damage must be dehumanized.

  9. #9 Antaeus Feldspar
    August 29, 2010

    [is like saying “this child was in the middle of the street; a milk truck was unable to brake in time and the child was hit. This proves that milk is harmful to children.” What was actually harmful to the child was her pre-existing mitochondrial disorder.”]

    Moral of the story. Milk trucks ARE dangerous for kids in the street. Just like vaccines are dangerous for kids with underlying disorders (and others)

    GALLANT considers analogies carefully, looking at the components of the analogies and the relationships implied, in order to understand what the maker of the analogy is trying to convey.

    GOOFUS merely grabs up terminology he doesn’t understand and analogical components he hasn’t even tried to understand, and hurls it around indiscriminately like a monkey flinging feces. As a result he gets completely distinct propositions like “milk is harmful to children” and “milk trucks are harmful to children” hopelessly confused.

  10. #10 Big Blue
    August 29, 2010

    @ Dr Jay: “By the way, the “tree limb fatality/disease outbreak” analogy posts are meant to be read as semi-facetiously as possible. Hard to inject humor into this discussion, but the weight and incredibly serious topic of childhood fatalities speaks for itself and must allow occasionally lightening of the discussion.”

    So your argument is, “HAHAHAHA DEAD KYDZ SICK ADULTS BWAHAHAHA!”?

    Having personally had pertussis as an adult after my childhood vaccinations wore off, and having caught it from an unvaccinated lady coughing all over the ER where I was waiting for my spouse to be treated for a back injury, I really DON’T have a sense of humor about that subject. Neither do parents whose children suffer through the disease or die from it. I know this for a fact, because I asked my granny and the old biddies in the nursing home with her–they have absolutely no sense of humor about how a third of their kids died.

  11. #11 Enkidu
    August 29, 2010

    Augie @ 390

    Re-read the CDC report, especially the part that Todd highlighted as part of his post @ 384. Read it slowly if you have to, several times, until the lightbulb goes off.

    BTW, I pay attention, and can actually comprehend what I read.

  12. #12 dean
    August 29, 2010

    it seems that augustine, “dr” jay, and their ilk, ignore facts, demonstrate a complete lack of integrity, and show themselves to be habitual if not congenital liars, for one purpose: to prove to themselves that they are powerful enough to sway the behavior of others. they do not actually care about the health of others, but are trying to prove to themselves that they can “fight back” against some fictional bogeyman. (well, dr. jay may have some financial reason too, but that’s beside the point).
    keep throwing facts at them: they’ll keep distorting and ignoring them and throwing out crap. calling them on it doesn’t faze them, likely because they are surrounded by folks who have already swallowed what they spray.

    (I can predict augie’s response: “where are your facts? nothing you’ve said is supportable”.
    augie, read your own posts and note how completely at crossroads your interpretations are to the reality that’s been quoted to you.)

  13. #13 Jay Gordon, MD, FAAP
    August 29, 2010

    “Why did you stop recommending the Hib vaccine? I almost died of orbital cellulitis caused by Hib as a two year old and it shocks me that you don’t recommend the vaccine.

    Since it seems to matter to you, I was breastfed as an infant, my parents fed me a healthy diet, we lived in a clean orderly house. My dad is an MD, and he made sure I went to the ER right away when my eye looked a little funny.

    Why do you leave kids in your practice vulnerable to such terrible things? How do you sleep at night?”

    @ grenouille Not sure how old you are, but if you were two-years-old before the HIB vaccine you must be at least thirty-something. Maybe much older. Lots of medical problems and other dangerous things occurred before they were preventable. Infectious diseases treatable with antibiotics and automobile fatalities preventable with seat belts for instance.

    The HIB vaccine is a great vaccine. It works, has virtually eliminated meningitis and epiglottitis from pediatric practice and was a godsend back in the early eighties. Now, however, it may have outlived it’s usefulness as a universally given shot rather than being a vaccine reserved for those at highest risk. That high risk group no longer includes healthy Western children. Still, I do not want to change public health policy regarding the HIB vaccine; I merely want parents to know the relative risks and benefits for their individual children. Then they can make an informed choice. Most would still choose the shot but some might not.

    Vaccine side effect denialists are not real scientists. They just keep parroting the same tripe over and over again. I realize that the “denialist” label does apply to all of you here, just as no one here is dumb enough to label me “anti-vaccine” when I give vaccines every day and support their judicious use. But there are some denialists among you and they should be ferreted out and educated.

    Best,

    Jay

  14. #14 Jay Gordon, MD, FAAP
    August 29, 2010

    This set of waves is so fast and furious that more appear before I finish dealing with the previous.

    @Big Blue Unintelligent, facile post with an obviously intentional misinterpretation of my comments. You need a dictionary. Also, I tend to doubt a 33% mortality rate amongst the children of the nursing home “biddies” as you so disparagingly call them. You have no facts. And no respect for your elders.

    @dean Or should I call you “dean?” The “dr” is real but I won’t be “sensitive” about your use of the “quotation marks.” I only mildly object to your suggesting that I have a financial interest in not vaccinating. That’s just plain bad math. To repeat, doctors who claim that vaccines are not profitable are either fibbing or running their practices poorly. When you sell things for a higher price than you paid for them, you should be making a profit.

    Unless someone says something unbelievably foolish, inaccurate or insulting, I’ll take the rest of the Sunday off. Actually . . . I guess those inevitabilities mean I better check back in a couple hours. Sadly, I occasionally find myself enjoying the same tone of voice that the rest of you use. I need a bath.

    Best,

    Jay

  15. #15 Sauceress
    August 29, 2010

    “when I give vaccines every day and support their judicious use.”
    Just wondering..
    Would there be any interest, from those authorities who keep an eye on the conduct of doctors in general, in a pediatrician who did have a blanket refusal to administer any and all vaccines?

  16. #16 Science Mom
    August 29, 2010

    Now, however, it may have outlived it’s usefulness as a universally given shot rather than being a vaccine reserved for those at highest risk. That high risk group no longer includes healthy Western children.

    So what is your high risk group criteria? What were the health statuses of the children that have and still do acquire invasive Hib disease?

    Still, I do not want to change public health policy regarding the HIB vaccine; I merely want parents to know the relative risks and benefits for their individual children.

    Of course you don’t want others to stop vaccinating, which contradicts your ideas about Hib vaccination, given that ‘healthy Western children’ aren’t at risk for Hib disease. How else could you encourage parents to free-ride on herd immunity?

    You’re a real piece of work Dr. Jay.

  17. #17 Gordon
    August 29, 2010

    This is a disappointing blog article that is sensationalist, but very short on science.

    Herd immunity was a theory promoted by Fox (NOT the television company!)

    It is, however, still just a theory, and doesn’t hold true for all pathogens. Diptheria is a prime example where the theory doesn’t fit. Measles outbreaks in vaccinated populations should also raise a few eyebrows.

    The topic of vaccination has reached pseudo-religious status – from those on BOTH sides.

    Those against are wary of ALL vaccinations, while those in favour assert that they’re 100% safe, but refuse to put themselves on the line to back their opinions. (I say opinions, because until we can scientifically demonstrate how and why severe adverse reactions occur, making claims either way is only faith based)

    Maybe a law change is in order? When something is completely safe, then any harm a patient experiences must have been intentional, and a felony has therefore been committed.
    Would that instill confidence from the public?

    Such accountability is past due it seems. The “all care and no accountability” stance needs adjusting

  18. #18 Matthew Cline
    August 29, 2010

    @Dr Gordon:

    Now, however, it may have outlived it’s usefulness as a universally given shot rather than being a vaccine reserved for those at highest risk.

    Oh ho! So, we finally get a step closer as to how you “judiciously” use the HiB vaccine: only for high risk children. So, what counts as “high risk children” in this context?

    The HIB vaccine is a great vaccine. It works, has virtually eliminated meningitis and epiglottitis from pediatric practice and was a godsend back in the early eighties. Now, however, it may have outlived it’s usefulness

    What advances have been made in the past 30 years for the treatment of meningitis and epiglottitis to make it better (risk/benefit wise) to treat them after they happen rather than to prevent them from happening in the first place?

  19. #19 Toad
    August 29, 2010

    To repeat, doctors who claim that vaccines are not profitable are either fibbing or running their practices poorly.

    Hi Dr. Jay,

    I’m curious. Could you shed some light on all of this for those of us who aren’t doctors? Could you run some real numbers for us?

    Assume a family arranges an office visit for the sole purpose of getting their 4-year old current on immunizations prior to Kindergarten entry.

    1 – What is the actual realistic income for a typical board-certified pediatrician who takes insurance for adminstering recommended immunizations? Please account for realistic actual reimbursement for the visit (the office visit, plus the vaccines) to the doctor.

    2 – What are the real expenses?
    Proportion of all the total educational expenses from total career hours practiced (undergrad, medical school, residency, etc., CME’s, board certfication, you get the idea).
    Proportion of office overhead (rent, utilities, submitting claims, processing reimbursements, etc.).
    Malpractice insurance.
    Actual cost of the vaccines, and their related overhead.
    Reasonable cost for Pediatrician’s time (plus compensation and benefits for the likely medical assistant or nurse) during the office visit.

    Please give us some real numbers, and show us just how profitable it is to spend an office visit vaccinating for a pediatrician

  20. #20 dean
    August 29, 2010

    “The “dr” is real …”

    You may have passed courses, but you clearly failed anything to do with honesty, ethics, or possibly understanding, of the material.

  21. #21 Todd W.
    August 29, 2010

    Dr. Jay is clearly full of it. He claims that he didn’t cherry pick because he linked to the full document. Let’s recap, shall we?

    Jay posted this quote:

    Editorial Note:
    Despite record high vaccination coverage levels with 3 doses of DTaP among U.S. children aged 19–35 months (3), pertussis continues to cause fatal illness among vulnerable infants. During 1980–1998, the average annual incidence of reported pertussis cases and deaths among U.S. infants increased 50% (4).

    The clear implication being that the pertussis vaccine in children wasn’t doing a whole hell of a lot. Taken out of context like that (apparently hoping that people wouldn’t actually follow the link) certainly makes it sound like immunizing children against pertussis doesn’t help much. Very deceptive and dishonest, Dr. Jay, considering what that very same article actually cited as the reason for the increased incidence in infants, namely:

    As illustrated by these two cases, adult and adolescent caregivers and other family members have been linked epidemiologically as sources of pertussis infection for vulnerable infants (10).

    Even though you posted the link, Dr. Jay, you still cherry picked your quote in a rather blatant attempt to spin the article to support your argument that the pertussis vaccine isn’t really important.

    Vaccine side effect denialists

    Bwahahahahaha! Seriously, Dr. Jay? Hold on. Let me catch my breath. Whew! That had my eyes tearing up. You should do stand-up instead of pediatrics, Jay. You’d make a killing. Well, maybe not more than you might be contributing to if you keep up your anti-vaccine hand-waving ways.

    More soberly, though, what vaccine side effect denialists would those be? First, I suppose, you should define what you mean by a “vaccine side effect denialist”. Then I’m assuming that you can point out some concrete examples of such behavior.

    Now, however, it [Hib vaccine] may have outlived it’s usefulness as a universally given shot rather than being a vaccine reserved for those at highest risk.

    As others have mentioned, define “those at highest risk”. So, your recommendation, then, is that except for people who meet that definition, everyone else should not bother with the vaccine, correct?

    Let me tell you a little story, Jay. Not too long ago in a magical United Kingdom, there was a charming of manner, though vile and black of heart, man that we’ll call Shakefield. Now, he convinced the people of this land that the MMR vaccine caused problems in the poor, fragile little guts of their li’l ones and that those problems gave the li’l ones teh autismz. Oh, no! In fear, lest they lose their li’l ones to teh autismz, the people stopped immunizing against measles, mumps and rubella. Now, not long before all this happened, the rulers of this kingdom had announced that measles was no longer endemic to the land. However, when people stopped immunized out of the misplaced and misguided fear wrought by Shakefield, the total number of unimmunized li’l ones rose. It then happened that the li’l ones began to be infected by measles, thanks to the wonders of modern, international travel. It started slowly at first, but soon, the measles were able to infect enough li’l ones that it could survive and continue to spread throughout the kingdom. There were reservoirs everywhere in which the viruses could grow and multiple. So many, in fact, that the rulers had to deliver the stunning news to the people: measles was once again endemic. What had been eliminated had returned and was there to stay.

    Now, Jay. What is the moral of this story as regards stopping immunization?

  22. #22 Tsu Dho Nimh
    August 29, 2010
  23. #23 Tsu Dho Nimh
    August 29, 2010

    @333 Sid, O2 therapy is far older than the invention of the nasal cannula.

    http://www.lakesidepress.com/pulmonary/papers/ox-hist/ox-hist-intro.html

    http://www.perf2ndwind.org/html/news/2003/JanFeb/History%20of%20Oxygen%20Therapy.html
    Oxygen tents: 1922

    And the use of IV fluids is also old – it was used in the treatment of cholera in 1832. It didn’t get really successful until the late 1920s or so because they needed to understand a lot more bacteriology and physiology.

    *******
    And there are effective pre-1940s antibiotics mentioned in the medical books of the late 1800s and early 1900s.

  24. #24 Dangerous Bacon
    August 29, 2010

    I see that Jay Gordon has been busy not answering questions designed to enlighten us about his practice. I think you may have misread my inquiries, Jay – there’s nothing ad hominem about them. I’ll repeat them to give you another opportunity to respond.

    Since your website statement about staggering vaccines conflicts with your admission here (post #293) that your vaccine schedule for children is essentially zero, will you take down or revise the website statement and refrain from further public statements about how you have a staggered/reduced vaccine schedule?

    And since you’ve admitted having a vaccine schedule for children that essentially consists of no vaccines at all, why did you get upset at Penn & Teller for showing you saying “Children should not be vaccinated”, since that reflects your actual view as stated here?

    Thanks in advance for responding.

    Your recent remarks also raise a couple followup questions as others have noted.

    Who are the “vaccine side effect denialists” you claim to recognize here, and what are examples of this alleged denialism? (references to your non-evidence based belief that vaccines cause autism do not count).
    And I’d also like to know if you get your dog vaccinated against distemper, rabies, parvo etc. (I’d assume that rabies vaccine is legally mandated, but maybe California has an exemption if it’s against the doggie’s religion)?

    Lastly, let me assure you that in spite of temptation, I will never close any remarks to you here with the phrase “and your little dog, too!” 🙂

    Hope you had a nice day frolicking in the sunshine.

  25. #25 Jay Gordon
    August 30, 2010

    @Dangerous Bacon Yes, thanks, I will revise the vaccine content on my website to reflect my current views.

    P&T cut off the first part of my sentence. You do not have to be a sound editing expert to hear that. They reversed the meaning of the sentence.

    I support parents’ rights to vaccinate their children on a schedule which they feel is best for their individual child. I also support their right to give no vaccines at all. Public health and herd immunity are a part of any vaccination discussion I have with the parents of my patients.

    Many of the people posting here imply or state outright that they deny the possibility of certain vaccine side effects. They are not selective nor staggered in their comments.

    My dog has had the legally required vaccines. And I had a wonderful day today. I hope you did, too.

    Best,

    Jay

  26. #26 jenbphillips
    August 30, 2010

    Many of the people posting here imply or state outright that they deny the possibility of certain vaccine side effects. They are not selective nor staggered in their comments.

    If that’s the case, it should be really easy for you to find an example, right?

  27. #27 Jay Gordon
    August 30, 2010

    @Dangerous Bacon Thanks for your help.

    I will soon change all information on my website to reflect our discussions here.

    How does this look to you? Feel free to email me privately if that works better.

    Thanks.

    Jay

    I support parents’ rights to vaccinate their children on a schedule which they feel is best for their individual child.

    I also support their right to give no vaccines at all.

    Public health and herd immunity are a part of any vaccination discussion I have with the parents of my patients.

    The vaccine I give the most commonly is the DTaP.

    I think that vaccines and other environmental “triggers” may lead to large side effects in genetically susceptible children and adults. I think that autism is one of those possible side effects. I abjure the concept that the connection between autism and vaccines is proven but insist that observations of experienced doctors and involved parents carry weight and constitute evidence. The proper studies to prove a connection between vaccines and serious injury may never be done and we may have to rely on the evidence we have gathered and continue to gather.

    I don’t believe that all autism is caused by vaccines nor that every person receiving vaccines is endangered. I do, however, reject the idea that vaccination is an unequivocally beneficial medical procedure. At the very least, there is a small “sub-group” of individuals genetically predisposed to injury from vaccines. When we vaccinate every single child in the same way, ignoring family history, past medical history and behavioral differences this does not constitute the best practice of medicine.

    Again, herd immunity could be adversely affected if large scale changes were made in the current vaccine schedule. I am not suggesting this. I am suggesting that vaccines could be manufactured more safely, administered more safely by beginning later in a baby’s life and that herd immunity could be retained and public health strengthened by more judicious use of vaccines combined with educating parents about measures which will keep their children healthier. These measure include breastfeeding, excellent nutrition and much more.

    My point of view is held by only a very, very small minority of physicians and medical experts and parents certainly should not ignore the information given them by their own pediatricians.

  28. #28 Matthew Cline
    August 30, 2010

    @Dr Gordon:

    Either none or just a DPT in the first 24 months of life. I think that there’s a greater risk vaccinating males under 24 months and would prefer not to unless there are special circumstances. I use very few other shots except the Varivax as a child approaches ten years because teen and adult pox are nasty and even a little dangerous especially during pregnancy.

    Yes you also vaccinate children every day? You must serve an enormous number of children if you vaccinate children every day yet you give vaccines in so few circumstances.

  29. #29 carykoh
    August 30, 2010

    Dr. Jay:

    I think I understand your viewpoint, to a degree. But first I have to take you to task a bit. I find it completely unbelievable that you trained in the 80’s and saw no cases of HIB epiglottitis, periorbital cellulitis, occult bacteremia, or meningitis. I also take issue with the fact that you have only seen one case of bacterial meningitis in 30 years. This seems incredibly unlikely. The only way I can reconcile this is that you must employ a hospitalist that doesn’t keep you informed of your patients (likely), or you are the most fortunate doctor in any specialty that I have ever met. I mean, I know orthopedic surgeons that have had patients with meningitis.

    I’m trying to understand your point on vaccines. I guess you feel the risk out weights the benefit. I think you believe that in your practice you spend more time with your patients (I believe that), and therefore that gives you more insight to how best to manage their health (not unreasonable). However, you admit the HIB vaccine is a success, it’s effective. Man, honestly, one doctor to another, I’d feel AWFUL if a kid I recommended no vaccine to died of said disease. I mean, quit my job, move to Fiji bad.

  30. #30 Todd W.
    August 30, 2010

    I was pondering Jay’s assertion that he’s seen no patients with complications from vaccine-preventable diseases (I’m paraphrasing, here) except maybe once in his practice. It got me to wondering: how many of his patient parents, when their kid gets sick, decide to take their kid to a different doctor for treatment, knowing that Jay operates so far outside the standard of care? That would certainly explain his “not seeing” them. The hospitalist hypothesis would work, as well.

    That, of course, leads to another question: how many of his families switch to different doctors permanently due to his “brave maverick” stance?

  31. #31 Kristen
    August 30, 2010

    Now, however, it may have outlived it’s usefulness as a universally given shot rather than being a vaccine reserved for those at highest risk. That high risk group no longer includes healthy Western children.

    BS! I’ll admit the only time I heard of Haemophilus influenzae type b was when I read the vaccine info sheet. That is until I was talking to a co-worker who was pregnant about vaccines. She told me the story of how her first son died of meningitis courtesy of the Hib bacteria. Perfectly healthy and beautiful toddler to dead in a matter of days. He died in 2005, a month shy of his 2nd birthday.

    Maybe you would see them, Jay, if you uncovered your eyes and took your hands off your ears. When I started paying attention I started to see examples of children affected by vaccine preventable disease. Kind of like noticing all the red cars on the road when you are driving one.*

    *Cue hand-wringing trolls calling me a hypocrite for not considering children “damaged” by imaginary “vaccine injury” (I am not talking about ones injured by real vaccine adverse effects).

  32. #32 Militant Agnostic
    August 30, 2010

    Science Mom @413

    You’re a real piece of work Dr. Jay.

    I believe sociopath is the word you were looking for. Or was it parasite?.

  33. #33 Jay Gordon
    August 30, 2010

    Stop calling names, think harder, open your minds. You have, sitting in front of you, a person doing just that and you’re too myopic to see it.

    All doctors as old as I am have seen the diseases you list. But, I have not seen bacterial meninigitis in a child since 1982 or 1983. The HIB vaccine did that for us all just as the small pox vaccine did it’s job well. Now, the possible side effects of the vaccines have to be measured against the extreme rarity (non-existence of small pox) of those two illnesses. Not a perfect parallel by any means.

    No, Todd, parents don’t take their kids to other doctors to diagnosis HIB orbital cellulitis or meningitis. Do you think I’d still be”standing” if that occurred?? I do get plenty of second opinions from ID docs, eye docs, and every other specialty, but parents don’t run screaming from my care to see who might be better at diagnosing terrible infectious diseases. Please raise the quality of your thinking and your posts. They are just plain feeble.

    To answer your question very specifically, I care for thousands of families and in an average year two or three families leave my practice. Usually they leave for geographic reasons, but occasionally over differences of opinion in pediatric care. If they left in droves over missed or misdiagnoses, I would not be in business. I work really hard and am just as good at what I do as Orac is at what he does.

    Best,

    Jay

  34. #34 Science Mom
    August 30, 2010

    MA @429, Yes those would work too.

    What I find very telling is Dr. Jay’s refusal to answer any of the really hard questions that force him to think outside of his anecdotes and comfort zone. In other words, like real scientific methodology and shit. Instead, Dr. Jay likes to address those that he believes may be his allies, disregarding that many scientific discoveries and consensuses emerge from adversarial processes.

    P&T cut off the first part of my sentence. You do not have to be a sound editing expert to hear that. They reversed the meaning of the sentence.

    Oh still with this ridiculous assertion? They didn’t reverse the meaning of your statement Dr. Jay, stupid is as stupid does. You have had numerous opportunities to clarify yourself and offer what was edited that would make sense.

    You refuse.

  35. #35 Todd W.
    August 30, 2010

    @Jay

    Thanks for answering my idle, unimportant musings and ignoring my earlier, more substantial post. To wit:

    * What is your definition of a “vaccine side effect denialist” (VSED)?
    * You say that VSEDs exist here at RI. Please provide a concrete example of VSED behavior.
    * What is your definition of “those at highest risk”?
    * Am I correct that your recommendation is that except for people who meet that definition, everyone else should not bother with the vaccine?

  36. #36 Militant Agnostic
    August 30, 2010

    I missed another characteristic of anti-vaxxers that is similar to AGW denialists.

    AGW denialists like to point to a single snowstorm, season or location where the temperature has decreased while ignoring data over longer periods and and larger areas that indicates temperature is increasing.

    Antivaxxer’s believe anecdotes and elective samples trump larger studies.

    Notice how Jay calls us denialists while he uses every technique from the denialist playbook. The only question is whether he is completely unaware of his hypocrisy or he is being deliberately misleading.

  37. #37 Vicki
    August 30, 2010

    Jay–

    My question from Friday remains open. Maybe you didn’t see it on your way to the beach. I repeat:

    If your unvaccinated patients come down with the symptoms of something that might be contagious (such as measles or pertussis), do you have them come to the office, and risk infecting each other and anyone they pass on the way? Or do you make house calls, with gloves and mask so you don’t become a disease vector yourself?

    Some parents who don’t vaccinate are counting on herd immunity (and some will even say so). Do you warn those parents that visiting your office is a health risk, because their children will be exposed to infection from other unvaccinated children? Yes, there’s some risk just going out on the street, but you and they are choosing not to think about that: the risk is greater in a waiting room full of sick children who lack the same immunities.

  38. #38 augustine
    August 30, 2010

    [science Momma: I also noticed that you haven’t bothered to respond to measles-mortalities under-reporting. Try addressing the assertions at hand rather than trying to deflect attention from your ignorance of the literature.]

    I’ve already addressed it. Your 1:1000 measles death fantansy still doesn’t hold up. Unless you think there were thousands of unreported measles deaths compated to the avg. 500. And if that’s so then you must admit our government has massive surveilance innaccuracies.

  39. #39 Dianne
    August 30, 2010

    The HIB vaccine did that for us all just as the small pox vaccine did it’s job well. Now, the possible side effects of the vaccines have to be measured against the extreme rarity (non-existence of small pox) of those two illnesses. Not a perfect parallel by any means.

    Not even close to a perfect parallel. Quite askew in fact. Small pox is gone from the wild thanks to the vaccine. Thanks to everyone who safely could getting the vaccine. If there is any chance at all of getting rid of Hib (and I must admit to having my doubts-a bacteria must be harder to get rid of permanently than a virus) then an ad hoc refusal to take the vaccine is the worst thing you could possibly do at this point.

    Incidentally, “it’s” is short for it is, not the possessive. I rarely grammar cop, but that one bothers me for some reason. Possibly because of the meaning changing nature.

  40. #40 Todd W.
    August 30, 2010

    @Dianne

    If there is any chance at all of getting rid of Hib (and I must admit to having my doubts-a bacteria must be harder to get rid of permanently than a virus)

    It depends on where the organism lives, what kinds of reservoirs it has. For example, polio, smallpox and measles only infect humans. So, vaccinate enough people, the last of the viruses “die out” and there’s no need to vaccinate anymore. Something like influenza, on the other hand, can infect birds, pigs and horses, so it is unlikely that we’ll ever be rid of it.

    I’m not sure what the reservoirs are for pertussis, whether it only infects humans or if it can survive outside of humans for extended periods of time.

  41. #41 Dianne
    August 30, 2010

    I agree, Todd. I’m just not sure about Hib’s reservoir status. I’m pretty sure measles, at least, maybe mumps and rubella as well, is/are human specific, meaning that elimination of these pathogens is within our reach…if it weren’t for the anti-vax movement. Tetanus is definitely not since it grows in soil. Foregoing the DTaP or at least the T part, though, is suicidally stupid.

  42. #42 Dianne
    August 30, 2010

    Sorry about the double post. Could have sworn I only pushed submit once…but I guess I would have been wrong.

  43. #43 Jud
    August 30, 2010

    Todd W. writes:

    I’m not sure what the reservoirs are for pertussis, whether it only infects humans or if it can survive outside of humans for extended periods of time.

    Another species of Bordetella is responsible for the common disease “kennel cough” in dogs (most kennels and training facilities will require you to show proof of vaccination before they will board your dog), a related illness in pigs, and will even (rarely) infect humans. I surmise from this that even if the species that causes pertussis in humans died out, we’d still potentially be vulnerable in the case of mutations in species that infect animals. I suppose Michael Behe might disagree. 🙂

  44. #44 augustine
    August 30, 2010

    [I’m not sure what the reservoirs are for pertussis, whether it only infects humans or if it can survive outside of humans for extended periods of time.]

    No need in guessing if pertussis can be eradicated.

    http://www.sciencebasedmedicine.org/?p=516

    “Could we ever eradicate bacterial diseases? No way. Not ever.”

    He also shows the explanation of how vaccinated individuals can also spread pertussis.

    “Vaccine efficacy is 64% for cases defined by mild cough, 81% for paroxysmal cough, and 95% for severe clinical illness (11). Note the vaccine is good for attenuating the disease, not preventing it entirely.”

    So good luck in trying to prove that it is the unvaccinated middle class waldorf school mothers who are at fault for causing death.

    This is an argument coming from vaccine ideology not evidence.

  45. #45 Enkidu
    August 30, 2010

    Dr. Jay: “I work really hard and am just as good at what I do as Orac is at what he does.”

    Stuart Smalley: “I’m Good Enough, I’m Smart Enough, and Doggone It, People Like Me!”

    I’m sorry, it just popped into my head.

  46. #46 Dangerous Bacon
    August 30, 2010

    Jay Gordon: “I will soon change all information on my website to reflect our discussions here.

    How does this look to you?

    I support parents’ rights to vaccinate their children on a schedule which they feel is best for their individual child.

    So, instead of the statement already up on your site declaring how you advocate a reduced/staggered vaccine schedule, you’d substitute even vaguer language, to avoid committing yourself in any way on the subject. That’s an improvement? What kind of guidance does that give parents visiting your site?

    It’s hard to tell just what changes you might make in any case. True, you did remove the HIV denialist stuff you had up there before, but as I recall you told Orac that you’d stop hyping the formaldehyde VACCINE TOXIN nonsense, and there’s still scaremongering on that subject on your site.

    You know, seeing as I (and numerous other minions) on this site are suspected by you of collecting payments from Big Pharma in order to push vaccines, why is it you expect me to edit your website for free? I should be paid what it’s worth. I expect a check in the mail for at least $1.37.

    Jay: “Many of the people posting here imply or state outright that they deny the possibility of certain vaccine side effects.”

    Again, who, and what are they “denying”, apart from your anecdotal “evidence” about vaccines causing autism?

    Jay Gordon in a 2/16/09 Huffington Post article entitled “The Vaccine Court Was Wrong”: Vaccines as they are now manufactured and administered trigger autism in susceptible shildren.”

    Jay Gordon is post #424 above: “I think that vaccines and other environmental “triggers” may lead to large side effects in genetically susceptible children and adults. I think that autism is one of those possible side effects. I abjure the concept that the connection between autism and vaccines is proven but insist that observations of experienced doctors and involved parents carry weight and constitute evidence.” (bolding added)

    Um, Jay, are you going to appeal to the folks at HuffPo to edit your remarks there to reflect your newfound conviction that you’re unsure if vaccines cause autism?

    How do you keep your myriad, conflicting and ever-changing opinions straight?

    Jay: “My dog has had the legally required vaccines”

    What’s “legally required” apart from rabies vaccine? Does that mean your dog is unprotected against other, serious and potentially fatal infectious diseases? Kennels around here will refuse to board a dog unless it’s had its recommended shots. Do you take your dog everywhere you go, or utilize the services of a kennel whose philosophies on vaccination match your own? (if the latter, I pity the poor dogs).

  47. #47 Pablo
    August 30, 2010

    Jay: “Many of the people posting here imply or state outright that they deny the possibility of certain vaccine side effects.”

    Again, who, and what are they “denying”, apart from your anecdotal “evidence” about vaccines causing autism?

    That’s simple, DB: AUTISM.

    Don’t be fooled. This has been clear all the time: When Elmer Fudd here talks about “side effect deniers,” he means one thing and one thing only, and that is autism. It’s not that he thinks that we here deny the real side effects of vaccines. No, we deny the one big side effect that he insists occurs.

    By calling it “side effect denials” he can pretend that he is just taking the high road and playing the “safer vaccines” card. He’s not. It is a blatent anti-vaccination ploy to try to avoid the issue.

    And Jay, your crap about “using a vaccination schedule that parents feel is best” is bullshit. How do parents determine what is best? By listening to your imbecilic ramblings about all the side effects that vaccine proponents are refusing to tell them? I’m sure that really helps them make a great decision. Real decisions are only made when properly informed, and not when they are based on the ramblings of demonstratably blithering idiots.

    You are deceitful piece of shit who uses fluffery to prey on the sensibilities of parents to boost your own ego. Go away.

  48. #48 gaiainc
    August 30, 2010

    Reading Dr. Jay Gordon makes my blood boil.

    The HIB vaccine is a great vaccine. It works, has virtually eliminated meningitis and epiglottitis from pediatric practice and was a godsend back in the early eighties. Now, however, it may have outlived it’s usefulness as a universally given shot rather than being a vaccine reserved for those at highest risk. That high risk group no longer includes healthy Western children. Still, I do not want to change public health policy regarding the HIB vaccine; I merely want parents to know the relative risks and benefits for their individual children. Then they can make an informed choice. Most would still choose the shot but some might not.

    What constitutes a high risk child? So Japanese children should still get it? What about Australian or New Zealand children? How about Arabic children? What about Brazilian kids? And if so, WHY? How would you distinguish them from these so-called “Western children”. I was not born in North America, but I live here. Would you consider me a Western child? Do you have any idea how racist and bigoted your comment is? Your reasoning also will lead to a resurgence of Hib disease, sort of like WHO had polio nearly eradicated, then someone in West Africa freaked out about it, and now polio is back again. I have had the fortune of never seeing invasive Hib disease and really, I would like not to. However, given physicians like you, I may get the chance. Oh yeah.

    But, I have not seen bacterial meninigitis in a child since 1982 or 1983. The HIB vaccine did that for us all just as the small pox vaccine did it’s job well.

    I have a hard copy of the CDC Pink Book 11th edition on my desk. I looked up Hib. The first vaccine licensed for use was in 1985 and wasn’t effective in the under 2 year-old group. The conjugated vaccine was licensed in 1988 which can be use in the under 2 year-old group. Given that Hib would strike 1 in 200 kids in the US and two-thirds of those were under age 18 months, I would like to say simply that the man is full of hooey.

    Hib’s only reservoir is humans per the CDC Pink Book.

    If you go to the National Highway Traffice Safety Administration website, they have nice stats on how many people have died in the US each year in motor vehicle crashes. The last numbers from 2008 and 2009 (latter is estimated) are 37,261 and 33,963 respectively. Not injuries, DEATHS. Between 1988-2008 approximately 925 claims have been awarded to children harmed by vaccines. I look at those numbers and it seems blatantly clear to me that I put my child at greater danger every time I drive my child around than the danger my child faces with immunizations. So not immunizing my child makes no rational sense. However this isn’t about sense. This is about fear. Always has been, always will be.

  49. #49 Science Mom
    August 30, 2010

    I’ve already addressed it. Your 1:1000 measles death fantansy still doesn’t hold up. Unless you think there were thousands of unreported measles deaths compated to the avg. 500. And if that’s so then you must admit our government has massive surveilance innaccuracies.

    No you haven’t addressed it augie and I posted 3 references. So you are too stupid/lazy to read them. There are problems with surveillance systems and that goes for deaths as well as cases dipshit. Saying otherwise doesn’t make it so; provide actual evidence.

  50. #50 K0ilar
    August 30, 2010

    Wow, so having to spent the day in bed because of some minor sickness, I read all of the posts, some of the linked contents and made my “informed decision”: I’m gonna vaccinate the crap out of myself and my (future) family! For all I can see, the trolls like augie and sharron don’t understand the least bit of science whatsoever and dodge every paper thrown at them in a way that makes me wonder if they are even capable of thinking about anything that doesn’t fit their pre-concieved views. And doctor Jay, who gave me a good laugh recently at P&T, obviously enjoys all the fame and attention he gets from standing out from the crowd of science based MDs… and all the money he gets from overprotective and plainly scared parents who do not understand what’s best for their (and everyone elses!) children. Shame on you, scumbag!

  51. #51 Jay Gordon, MD, FAAP
    August 30, 2010

    Thank you all for your feedback.

    Bacon, I’m not unsure about the vaccine/autism connection, I just don’t think that it’s been proven to the satisfaction of most scientists. I think the evidence is there and my observational data and that of others is valuable, but the rigorous studies needed for proof have not been done. (I intentionally avoid quotation marks around the word proof.)

    No, Dangerous Bacon, I don’t expect you to work for free. Seriously, though, your feedback is valuable and if you really want to stop giving me something for nothing, stop talking to me. I hope that doesn’t happen.

    However, I would not miss Pablo’s vulgarity, Todd’s insults and lack of science nor some of the others’ comments completely lacking in civility. K0ilar, you stand out nicely in that offensive crowd. And you’ve also managed another fact-free post. Why?

    Best,

    Jay

  52. #52 colmcq
    August 30, 2010

    but the rigorous studies needed for proof have not been done

    I think they have; Madsen, Honda, Fombonne etc, large scale epidemiological studies that failed to find a link. If there is a link, it is vanishingly small.

    best

    c

  53. #53 AnthonyK
    August 30, 2010

    Stop it gang! You’re upsetting Dr Jay, and he’s just been misrepresented on Penn & Teller, and it’s a travesty that you’re all making him out to be anti-vaccine, whereas all he does is not recommend them to his clients (his dog gets them though!)
    So let’s all be nice to him, not call him a disreputable peddler of nonsense to rich parents, not call him a denier of public health responsiblity, or suggest that he puts personal celebrity above the real health of his charges.
    And let’s really really, and most sincerely hope that one of his young patients doesn’t get sick from one of the disaeses that he says he thinks are so harmless…
    Or if not, he may never come back to play again.
    Besties!

  54. #54 Enkidu
    August 30, 2010

    Dr. Jay: “I’m not unsure about the vaccine/autism connection, I just don’t think that it’s been proven to the satisfaction of most scientists. I think the evidence is there and my observational data and that of others is valuable, but the rigorous studies needed for proof have not been done.”

    I love how you just KNOW there is a connection even though “rigorous studies” have not been done. Maybe that’s why you are a crappy scientist… you have your conclusion determined before the experiments are done.

    And where is this evidence that you speak of? Ancedotes on the web? Buried in a Hong Kong journal somewhere?

  55. #55 Sid Offit
    August 30, 2010

    @Science Mom

    I also noticed that you haven’t bothered to respond to measles-mortalities under-reporting. Try addressing the assertions at hand rather than trying to deflect attention from your ignorance of the literature.
    ———————-
    Stop making things up!

  56. #56 Drivebyposter
    August 30, 2010

    Dr. Jay,
    I was wondering if you had an estimate on the odds that a vaccine might cause autism (assuming that each child is equally likely to get autism from a/some vaccine/s). Also, in your personal experience, have you noticed any particular vaccine/s that you feel are more likely to cause autism than any others?

  57. #57 Science Mom
    August 30, 2010

    @Science Mom

    I also noticed that you haven’t bothered to respond to measles-mortalities under-reporting. Try addressing the assertions at hand rather than trying to deflect attention from your ignorance of the literature.
    ———————-

    Stop making things up!

    Hmm, statements supported with relevant citations that you can’t be bothered to read. I guess you also reside in the alternate universe of stupid. Too bad, you were ~1/8 interesting.

  58. #58 Sid Offit
    August 30, 2010

    Citations or figments of your imagination? If they exist let’s see them.

  59. #59 Science Mom
    August 30, 2010

    Citations or figments of your imagination? If they exist let’s see them.

    @ 337 moron.

  60. #60 Matthew Cline
    August 30, 2010

    @Dr Gordon:

    Now, the possible side effects of the vaccines have to be measured against the extreme rarity (non-existence of small pox) of those two illnesses.

    HiB is so rare now precisely because of the vaccine, and unlike smallpox it hasn’t been eliminated from the wild, so reducing HiB vaccination would lead to a resurgence.

  61. #61 Sid Offit
    August 30, 2010

    @Science Mom

    Sorry I missed them. I did review all your posts looking for the blue text indicative of a link before questioning their existence. Apparently hxxp links don’t appear in that way. Anyway they don’t address anything about the pre-vaccine era.

  62. #62 Dangerous Bacon
    August 30, 2010

    Jay Gordon on HuffPo 2/16/09: “Vaccines as they are now manufactured and administered trigger autism in susceptible shildren.”

    He’s sure!

    Jay Gordon in post #424 above: “I think that vaccines and other environmental “triggers” may lead to large side effects in genetically susceptible children and adults. I think that autism is one of those possible side effects. I abjure the concept that the connection between autism and vaccines is proven”

    Whoa, he’s not sure, it’s just possible.

    Jay Gordon in post #449 above: “I’m not unsure about the vaccine/autism connection, I just don’t think that it’s been proven to the satisfaction of most scientists.”

    Oops, he’s sure again! It’s those nasty scientists who are slow to grasp the significance of Jay’s anecdotes and those “bits of formalin”.

    Remember that sidebar they used to run on the Rocky & Bullwinkle show, with a grand parade proceeding across the screen? After it had passed, there’d be an irritable janitor type cleaning up the ticker tape, elephant dung and other garbage.
    Jay Gordon leaves behind so much refuse when he’s talking trash about vaccines, you’d need a whole army of maintenance men just to police his website and usual Internet hangouts and get his statements in some remote semblance of order and consistency.

    Facts and logic – forget about it.

    Maybe there’s a career to be had as Internet Woo Manager. You could sell your services to a variety of cranks and quacks, offering to police their sites daily to clean up grossly bizarre and conflicting statements before critics can preserve them in screenshots and the like, and embarrass them publicly.

    The problem with this potential career angle is that for the most part, the cranks and quacks’ followers devotedly lap up even the most ridiculous and offensive arguments without appearing to notice the absence of logic and decency.

    It’s probably an unbelivably rare occurrence, but every time one of Mike Adams’ groupies says “Mike, you’ve gone too far this time”, an angel gets his wings. 🙂

  63. #63 Sauceress
    August 31, 2010

    I just don’t think that it’s been proven to the satisfaction of most scientists.

    “To the satisfaction of most scientists”?
    ¿Qué??

  64. #64 Todd W.
    August 31, 2010

    @Jay

    Todd’s insults and lack of science

    Let’s see, the only place that I lobbed an insult at you, Dr. Jay, was saying that you should do stand-up instead of pediatrics. And that, really, was rather tame. Other than that, all I’ve done is correct you on the name of a vaccine (it’s DTaP, not DPT…two different vaccines, y’know) and point out that you cherry picked a quote.

    Oh, and then I asked some questions. In fact, since you hadn’t answered them, that was pretty much all that was in my last post. And I even used bullets to make them easier to read and answer. But, instead of actually answering questions, you choose to whine about people being mean and insulting (which is rather hypocritical, looking at some of your recent behavior here and in other threads).

    So, Dr. Jay, how about being constructive for a change and answering these questions:

    * What is your definition of a “vaccine side effect denialist” (VSED)?
    * You say that VSEDs exist here at RI. Please provide a concrete example of VSED behavior.
    * What is your definition of “those at highest risk”?
    * Am I correct that your recommendation is that except for people who meet that definition, everyone else should not bother with the vaccine?

  65. #65 Lynn Wilhelm
    August 31, 2010

    I did some checking in NC for vaccine requirements. I have an elementary-age child.
    I’m so happy to say that there are no “personal belief” exemptions allowed. Religious exemptions require “bona fide” religious reasons for exemption. The state only has forms for medical exemptions, not religious–so those people need to write a letter.
    So now, I’m going to try to find out if the state exemptions rules are really followed, or are they just “suggestions”.
    Sometimes I’m proud to live in NC.

  66. #66 Scott
    August 31, 2010

    I just don’t think that it’s been proven to the satisfaction of most scientists. I think the evidence is there and my observational data and that of others is valuable, but the rigorous studies needed for proof have not been done.

    Do you also think that the sky is pink, 1+1=3, and the earth is flat? These positions are just as defensible.

    Also, given the number of times you’ve been presented with the incontrovertible proof that you are grossly and completely wrong on all of these points, the only credible interpretations are (a) you’re deliberately lying through your teeth or (b) you’re so obsessed, with such a profound God complex, that you simply cannot conceive of any possibility you might ever be wrong and therefore cannot process any evidence to the contrary.

    Which is it?

  67. #67 Dianne
    August 31, 2010

    I’m not unsure about the vaccine/autism connection, I just don’t think that it’s been proven to the satisfaction of most scientists.

    On the contrary, it’s been disproven to the satisfaction of most scientists. See references others have posted or just go to Medline. The studies are clear: no currently available vaccine has any connection to autism.

    I think the evidence is there and my observational data and that of others is valuable, but the rigorous studies needed for proof have not been done.

    Anecdote and uncontrolled observation can be useful but they can also be extremely misleading. I would urge you to treat your own observations with extreme skepticism and be wary of making any change to practice based on your own anecdotal observations alone. This is not meant as an insult to your abilities: I’d say the same to any practitioner or scientist. Including myself.

  68. #68 Science Mom
    August 31, 2010

    @Science Mom

    Sorry I missed them. I did review all your posts looking for the blue text indicative of a link before questioning their existence. Apparently hxxp links don’t appear in that way. Anyway they don’t address anything about the pre-vaccine era.

    Better; next time please just ask.

    Not only are you shifting the goalposts, but you are doing so to your own detriment. It is known that measles (diseases in general) reporting is much lower when it is circulating at higher rates. http://www.ncbi.nlm.nih.gov/sites/entrez/17240285 So, the most recent large U.S. outbreak is going to have had better morbidity and mortality reporting than pre-vaccine. If you were also better acquainted with measles pathology, this would make sense.

  69. #69 Sid Offit
    August 31, 2010

    You seem to be taking a quite circuitous route to support your assertion that there were many more than the 500 measles related deaths per year in the pre-vaccine era. A such your is thesis remains unconvincing

  70. #70 Science Mom
    August 31, 2010

    You seem to be taking a quite circuitous route to support your assertion that there were many more than the 500 measles related deaths per year in the pre-vaccine era. A such your is thesis remains unconvincing

    Sid, you provide nothing more than unsupported drek. You haven’t even bothered to read the studies I cited and are taking this ridiculous tactic to deflect from that fact. You want just the facts, neatly provided for you in an abstract, ain’t going to happen. You also try to use the literature as a shotgun, it isn’t, it’s more of a roadmap. In order for you to be correct, measles reporting would have to have been better pre-vaccine, than post. Do you really believe that to be the case, even though we know it not to be?

  71. #71 Sid Offit
    August 31, 2010

    I think we’ve reached an impasse – besides everyone else has moved on. Let’s pick this up during the next vaccine-related blog.

  72. #72 T. Bruce McNeely
    August 31, 2010

    I think we’ve reached an impasse

    Trans: My butt has been thoroughly kicked.

    – besides everyone else has moved on.

    Trans: Everyone else has moved on because they’ve seen this movie many times before.

    Let’s pick this up during the next vaccine-related blog.

    Trans: With any luck, you’ll all have forgotten about this little exchange and I won’t have to answer any awkward questions..

  73. #73 Science Mom
    August 31, 2010

    @ TBM, for the win, yet again. Spot on mate, spot on.

  74. #74 Mu
    August 31, 2010

    I think this summarized Sid’s experience nicely

  75. #75 colmcq
    August 31, 2010

    Trans: My butt has been thoroughly kicked.

    yeah, take that you goalpost shifting twat.

  76. #76 Sid Offit
    August 31, 2010

    @Science Mom
    I was trying to be nice by letting you off the hook considering you had no support for your assertions. My mistake. So this is what you’ve said:

    It is actually true Dave, measles cases (and deaths) were vastly under-reported in the pre-vaccine era and even post.

    But where’s the evidence to support this recurring fantasy of yours??? And please don’t use a study of 11 people with SSPE in 1991 to support the idea that there were in the 60s vastly underreported measles deaths. And how do you define “vastly”

  77. #77 Science Mom
    August 31, 2010

    @Science Mom
    I was trying to be nice by letting you off the hook considering you had no support for your assertions. My mistake. So this is what you’ve said:

    It is actually true Dave, measles cases (and deaths) were vastly under-reported in the pre-vaccine era and even post.

    No, you weren’t being nice, you were being the usual shifty Sid. You don’t bother to read citations and then shift blame to the provider because it isn’t spoon-fed pabulum.

    But where’s the evidence to support this recurring fantasy of yours??? And please don’t use a study of 11 people with SSPE in 1991 to support the idea that there were in the 60s vastly underreported measles deaths. And how do you define “vastly”

    Shit you are thick. Read the citations I provided and follow their citations. The SSPE paper was included to demonstrate that SSPEs were ALSO underreported and have never been included in measles mortality estimates, they have a separate registry.

    So please paste portions of the studies (that do not appear in the abstracts) that you have a problem with.

  78. #78 Sid Offit
    August 31, 2010

    See, the below is an example of what scientists like to call a “citation”. Citations are used to support a point of contention arising during a debate or disagreement. Ideally the “citation” should, in some way, pertain to the aforementioned point of disagreement.

    http://www.edcp.org/html/measles.cfm
    In the pre-vaccine era in the United States, an estimated three to four million cases of measles occurred annually, and approximately 500,000 cases and 500 deaths were reported annually, with epidemic cycles every two to three years

  79. #79 Sid Offit
    August 31, 2010

    Let’s try this. How many measles related deaths do you believe occurred each year prior to vaccination? And show your work.

  80. #80 Science Mom
    August 31, 2010

    Let’s try this. How many measles related deaths do you believe occurred each year prior to vaccination? And show your work.

    Funny you would demand that, especially in light of the fact that I provided relevant citations with the methods included, when your own citation didn’t ‘show the work’. That is where you will fail each and every time when you just mine for something that you think supports your biases.

    Again, provide excerpts from the citations I provided that you don’t believe are relevant to the pre-vaccine era that don’t appear in the abstracts. Would pre-vaccine measles mortality rates, say 1960 be a.)less than b.) equal to or c.) greater than those in say, 1990?

  81. #81 Sid Offit
    August 31, 2010

    They’d be lower since the group affected in 1990 was poor and the age at which children were infected was younger – and those young children had inferior maternal antibodies due to universal vacciantion.

    See Epidemiology & Prevention of Vaccine Preventable Diseases 3rd ed 1996

  82. #82 Sid Offit
    August 31, 2010

    Page 95

  83. #83 Prometheus
    August 31, 2010

    Science Mom’s question needs a bit of clarification before it can be answered. By “mortality” rates, do you mean “deaths per ten thousand population”, “measles deaths as a percentage of all deaths in that age group” or “case fatality rate”?

    The first two are probably pointless, since measles is not (yet) endemic in the US (and probably not yet in the UK, either) and certainly wasn’t in 1990. As a result, the number of measles cases – and thus measles deaths – will reflect random chance (a contagious case entering the country and encountering other susceptible individuals).

    More important is the case fatality rate, which is 2 per 1000 cases in measles. Just to round out the figures, measles also has non-fatal complications like pneumonia (6% or 60 per 1000 cases) and encephalitis (1 per 1000 cases).

    Sid and others of his ilk like to pretend that measles is a completely benign childhool illness and that it’s the vaccine that is the danger, but the data don’t support that conclusion. Measles is a “benign childhood illness” to the ~94% of children who are “only” sick for a couple of weeks, not to the 6% who end up with pneumonia or the 0.3% who die or suffer permanent neurological sequelae.

    Sid may argue that the death rate wasn’t anything like 2 per 1000 in measles’ prime and maybe it wasn’t. It could be that recent outbreaks in the US and other developed countries have selectively affected the “weak”, artificially elevating the case fatality rate.

    Certainly, one large group of people who don’t have immunity to measles are those with immune deficiencies, who would also be more likely to die from measles. Add to that the very young and the very old – always more susceptible to disease – and there is a plausible argument that the case fatality rate in a population where everybody – not just the sick, aged and infirm – gets wild type measles would be lower than what we’ve seen in recent outbreaks.

    Still, whether measles has a case fatality rate of 2 per 1000 or 2 per 10,000, that is still higher than the fatality rate from the vaccine – currently less than 1 per 1,000,000.

    Of course, there are those still clinging hopefully to the dead-parrot hypothesis that the measles vaccine causes autism.

    Here’s something that Sid and “Dr. Jay” and the rest of the dead-parrot deniers apparently haven’t thought through (imagine my surprise) – if the vaccine is capable of causing serious side effects in children, imagine what full-on measles will do.

    If – as “Dr. Jay” suspects, based not on “observational data” but his recollection of what that “data” might be if he ever bothered to go through his records – the measles vaccine causes autism in “susceptible children”, what would be their reaction to the actual disease?

    Children currently get their first MMR vaccine at between 15 and 18 months of age. In the days of endemic measles, it wasn’t uncommon for children that age – especially if they had school-age siblings – to get measles. If these “susceptible children” that “Dr. Jay” hypothesises are becoming autistic from the vaccine strain, what will happen to them if they get measles?

    Isn’t it at least possible that there is some outcome worse than autism?

    Prometheus

  84. #84 Militant Agnostic
    August 31, 2010

    Prometheus – I think the chemistry illiterate (ischemistic?) “Dr. Jay” would blame “toxins” in the vaccine – you know like formaldehyde or aluminum or maybe he would play it safe and not specify which one.

  85. #85 augustine
    August 31, 2010

    Science Mom, you cannot comprehend your links in context. Sid has shown you. Your friends know it. They are embarrassed for you . Promotheus is trying to help you out by steering the conversation away from your argument into something other argument.

    I read your links. You’ve confused yourself.

    No matter how many links you provide, if there were 4 million measles cases (prevacccine era) and the death rate were 1-3:1000 then there would be 4000-12,000 deaths not 500 per year. There would also have been over 600,000 thousand hospitalization from measles per year. Didn’t happen. Not even close. You have no evidence to support your fantasies. Zero. Zilch. It’s your own personal theory. Nothing wrong with that but you should expect to have your feet held to the fire just like those you burn yourself.

  86. #86 Tsu Dho Nimh
    August 31, 2010

    @430 The HIB vaccine did that for us all just as the small pox vaccine did it’s job well. Now, the possible side effects of the vaccines have to be measured against the extreme rarity (non-existence of small pox) of those two illnesses. Not a perfect parallel by any means.

    The smallpox virus is extinct in the wild.

    Is Haemophilus influenzae type B equally extinct, or is it still around in asymptomatic carriers? It’s an active disease in much of the world, so what’s to prevent someone from bringing it back and passing it on to an infant or toddler.

  87. #87 AnthonyK
    August 31, 2010

    In the pre-vaccine era in the United States, an estimated three to four million cases of measles occurred annually, and approximately 500,000 cases and 500 deaths were reported annually, with epidemic cycles every two to three years

    Ummm…ummm…sorry, Sid (and I say this with extrememe prejudice) but….
    [wordfail]

    The highly infectious nature of measles meant that before vaccination became widespread, the UK was subject to regular epidemics, with cases frequently exceeding half a million in a single year.
    The first vaccination against measles was licensed in 1963, and immunisation has been available in the UK since 1970. Increased uptake of measles vaccines has coincided with a dramatic decline in prevalence of the illness. Annual measles notifications have not exceeded 4,000 since 1996, and have not exceeded 100,000 since 1983.
    Deaths from measles since 1990 have never exceeded 4 in a single year, and these have typically occurred in older individuals suffering from the late effects of measles infections contracted in the 1980s, or before. In 2006 there was one measles death in a 13 year-old male who had an underlying lung condition and was taking immunosuppressive drugs. Prior to 2006, the last death from acute measles was in 19921.

    Source: http://www.parliament.uk/briefingpapers/commons/lib/research/briefings/snsg-2581.pdf

    Utter moron. You haven’t been taking your education boosters, have you?

  88. #88 AnthonyK
    August 31, 2010

    And, of course:

    4 December 2008 | ATLANTA/GENEVA/NEW YORK/WASHINGTON –- Measles deaths worldwide fell by 74% between 2000 and 2007, from an estimated 750 000 to 197 000. In addition, the Eastern Mediterranean region*, which includes countries such as Afghanistan, Pakistan, Somalia, and Sudan, has cut measles deaths by a remarkable 90% during the same period. By reducing measles deaths from 96 000 to 10 000, the region has achieved the United Nations goal to reduce measles deaths by 90% by 2010, three years early.

    Why could that be, do you think?

    All regions of the world except Southeast Asia have met their goal of a 90% reduction in deaths by 2010 two years early. The vaccinations have prevented about 4.3 million deaths from the disease. In Southeast Asia — primarily India, Indonesia and Bangladesh — measles deaths declined only 46%, largely because of delays in implementing vaccination campaigns in India

    Or not, according to you.

  89. #89 AnthonyK
    August 31, 2010

    The vaccinations have prevented about 4.3 million deaths from the disease

    Thought I’d repeat that. And the prevelance of autism is…

  90. #90 Militant Agnostic
    August 31, 2010

    But how many of those 4.3 million were rich and white, the only people who really matter in Sid’s world.

  91. #91 AnthonyK
    August 31, 2010

    Big fat 0 (+or – 0.001%) correct? Numbers exaggerated for idiot.
    Correct?

  92. #92 AnthonyK
    August 31, 2010

    Sorry, only half correct.

  93. #93 Sid Offit
    August 31, 2010

    AnthonyK

    Are you feeling alright?

  94. #94 Science Mom
    August 31, 2010

    They’d be lower since the group affected in 1990 was poor and the age at which children were infected was younger – and those young children had inferior maternal antibodies due to universal vacciantion.

    See Epidemiology & Prevention of Vaccine Preventable Diseases 3rd ed 1996 p. 95

    Not necessarily. Did poor people not exist before the administration of widespread measles vaccination? What emphasis do you place on the poor and why? Also, why are you using a reference that is 14 years and 7 (almost 8) editions out and not quoting the relevant passage?

    As for transplacental immunity, very short-lived and did not seem to have an impact upon infant case-fatality rates (per 1000 cases) as evidenced by a survey done from 1971-1975 (plenty of pre-vaccine maternal antibody) which was 5.38 as opposed to 3.90 from the 1987-1992 measles outbreak. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1619577/?tool=pubmed and Acute Measles Mortality (link in post 337)

    The highest case fatality rate (per 1000) was not in infants less than 1 year old either, see Table 3 in Acute Measles Mortality in the U.S. 1987-2002. Now Sid, how many measles fatalities have there been in the U.S. in the last decade?

  95. #95 K0ilar
    August 31, 2010

    @449 Dr Jay

    You see, I wasn’t very sure about my post and the offensiveness it contained myself and felt a bit bad, especially if it should be enough for you to leave this conversation, which was never what I intented. I didn’t have a lot of time to write it though and was already enfuriated with the thickness of some other posters here (augie, I’m looking at you) and that made me lose it a bit.
    Anyways I want to explain why I do hold a grudge against you as well:
    In this conversation, as in so many others I witnessed, we have two opposing fronts: Science and Conspiracy.
    We have brilliant people here, like science mom, who argue on the bases of facts and concordance. And we have indoctrinated fanatics, like augustine, who wont have any of it but rather fall back on hearsay and conspiracy. Now, fortunately, professionals are usually agreeing with the rational group, a fact which keeps the irrational group rather small and unimportant, but they in turn always have THE ONE (or few):

    THE ONE historian who says the holocaust didn’t happen.

    THE ONE ex-NASA official who says nobody ever went to the moon.

    THE ONE geologist who says the world is 6000 years old.

    THE ONE ex-Air Force guy who says he knows about UFOs.

    THE ONE biologist who says evolution is fake.

    THE ONE… do you get the pattern?
    Unfortunately it seems to me, that you became (at least in the US) THE ONE MD who says that Vaccines are bad. And some people actually believe you! Now what makes you stand out from the crowd is this: Although creating a more rational society would be much easier without the loons, it doesn’t really matter what people believe about the moon-landings, evolution, UFOs etc. But it DOES matter what people believe about vaccination! I don’t care if somebody goes to the super-market with a tin foil hat on, but wearing tin foil hats is not contagious for crying out loud!

    That’s why (and this time in a much more gentle tone) I want you to really think about your position on vaccination again and please think hard! Because if you publically stated a change of views on vaccination, you could save lives.

    So, I hope I made my point clear and would be happy to apologize for my offenses if came to a more science based point of view.

  96. #96 Sid Offit
    August 31, 2010

    Not necessarily. Did poor people not exist before the administration of widespread measles vaccination? What emphasis do you place on the poor and why?

    The outbreak was almost entirely in a poor population while pre-vaccine outbreaks occurred in a more socioeconomically diverse population.
    ————————-
    Also, why are you using a reference that is 14 years and 7 (almost 8) editions out

    Is the edition in error?
    ———————-
    The highest case fatality rate (per 1000) was not in infants less than 1 year old either

    In 89-91 it was. 21% of deaths occurred in those under one

  97. #97 Science Mom
    August 31, 2010

    Not necessarily. Did poor people not exist before the administration of widespread measles vaccination? What emphasis do you place on the poor and why?

    The outbreak was almost entirely in a poor population while pre-vaccine outbreaks occurred in a more socioeconomically diverse population.

    Predominantly and almost entirely aren’t the same Sid. Now you seem to be using ‘poor’ synonymously with ‘poor health’. Lower socioeconomic classes were disproportionately stricken due to barriers of access to prevention. That pretty much flies in the face of your beliefs.
    PMID:1580601
    PMID:1408483
    PMID:1470100
    ————————-
    Also, why are you using a reference that is 14 years and 7 (almost 8) editions out

    Is the edition in error?

    Considering we are on the 11th ed. and that is what is available, the 3rd ed. was available in hardcopy only and my uni doesn’t even have that and you haven’t bothered to quote the relevant passage, forgive me if I don’t think that you are particularly factual or genuine.
    ———————-
    The highest case fatality rate (per 1000) was not in infants less than 1 year old either

    In 89-91 it was. 21% of deaths occurred in those under one

    Completely meaningless without the proper context; try again. You have also completely dodged the rebuttal of your assertion that loss of maternal antibody contributed to a higher case-fatality rate of under 1 year olds post vaccination. You have also dodged the question of how many measles-related fatalities there have been in the U.S. in the last decade. Gee, colour me surprised.

  98. #98 Chris
    August 31, 2010

    the 3rd ed. was available in hardcopy only

    I wonder if Sid actually has a copy, or just checked to see the most recent edition that was not available to subscribers online. Though I do recall that Prometheus had a hard copy of either Sid’s or Augie’s reference, and he noted that the claim was not in the copy on his shelf (I am sorry, this is from memory so I could be wrong).

    As far as the three PubMed references, I noticed that after 1992 that my county would send reminders to vaccinate my youngest. I believe it also included locations of public clinics for free vaccines.

    I believe that the reaction to that outbreak was to make sure under represented populations received vaccines. California is one state that did this, though with its recent financial problems there may be cracks in the program (plus the focus is on children and not adults for pertussis).

  99. #99 Dangerous Bacon
    September 1, 2010

    You know, if Sid keeps blathering until 500 comments are reached, Orac wins a pony.

  100. #100 carykoh
    September 1, 2010

    This is nothing against you Jay, but you clearly have a hospitalist work for you if you haven’t seen a case of bacterial meningitis since 1982.

  101. #102 colmcq
    September 1, 2010

    orac wins pony

  102. #103 Sid Offit
    September 1, 2010

    @Guess who

    http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf
    In addition, measles susceptibility of infants younger than 1 year of age may have increased. During the 1989–1991 measles resurgence, incidence rates for infants were more than twice as high as those in any other age group. The mothers of many infants who developed measles were young, and their measles immunity was most often due to vaccination rather than infection with wild virus. As a result, a smaller amount of antibody was transferred across the placenta to the fetus, compared with antibody transfer from mothers who had higher antibody titers resulting from wild-virus infection. The lower quantity of antibody resulted in immunity that waned more rapidly, making infants susceptible at a younger age than in the past.

  103. #104 Science Mom
    September 1, 2010

    @ Sid “goalpost shifting” Offit,

    That does nothing to address your contention that case fatalities were increased in the infant population post-vaccination, that measles fatalities weren’t under-reported and the question of how many measles-fatalities in the last decade have there been.

    You and augie are quite the pair. Maybe let him fight his own battles next time.

  104. #105 augustine
    September 1, 2010

    @Science Mommy

    Dear you are digging. You NEED to move the goalposts on this one. read 483.

    Pre vaccine error measles case fatality ~1:7000. After vaccine 1-3:1000.

    According to the CDC numbers it appears that measles has become more deadly post vaccination era.

  105. #106 Science Mom
    September 1, 2010

    Augie, I’m beginning to wonder if you even possess a brainstem. The whole thrust of the argument is how measles-related deaths are also under-reported, along with cases. You keep using the same tired, unsubstantiated figure.

    Tired of getting your ass kicked by a chick yet?

  106. #107 Science Mom
    September 1, 2010

    And because augie has set the tone, I will add some insult to injury.

    Science Mom, you cannot comprehend your links in context. Sid has shown you. Your friends know it. They are embarrassed for you . Promotheus is trying to help you out by steering the conversation away from your argument into something other argument.

    Sid has shown nothing but his own ignorance of the subject. Prometheus pointed out the need for clarification and he was absolutely right, hence I did just that. He is entitled to his own observations, so why you would deign to twist that into a deflection is pathetic. Of course you need to believe that ‘my friends’ are embarrassed for me, how else can you compensate for your own ignorance. You remind me of a scene from Monty Python and the Holy grail

    King Arthur:[after Arthur’s cut off both of the Black Knight’s arms] Look, you stupid Bastard. You’ve got no arms left.
    Black Knight:Yes I have.
    King Arthur:*Look*!
    Black Knight:It’s just a flesh wound.

    I read your links. You’ve confused yourself.

    No, you didn’t read past the abstracts.

    No matter how many links you provide, if there were 4 million measles cases (prevacccine era) and the death rate were 1-3:1000 then there would be 4000-12,000 deaths not 500 per year. There would also have been over 600,000 thousand hospitalization from measles per year. Didn’t happen. Not even close. You have no evidence to support your fantasies. Zero. Zilch. It’s your own personal theory. Nothing wrong with that but you should expect to have your feet held to the fire just like those you burn yourself.

    Such rookie mistakes. Measles case estimates roughly correspond with birth cohorts and occurred in epidemic cycles, this leaves us with a range of estimated cases, not a point estimate. No where have I claimed any estimate for pre-vaccine measles case-fatalities, that is a strawman, thus it is impossible to determine what the actual under-reported value is, only that we know they were under-reported. Although you seem to think it is perfectly acceptable to use an estimate of non-reported cases as the denominator for the reported deaths to calculate a case fatality ratio. Pure dumb. And you call my supported statements fantasy?

    If what you think you did is holding my feet to the fire, I can’t see it. You’re great to have around though augie, your representation of the average anti-vaxxer truly is parody and you deserve to be marginalised. Now run along and play with your [imaginary] friends.

  107. #108 DPSisler
    September 1, 2010

    Yeah!!!!! Orac gets a pony!!!!!

  108. #109 augustine
    September 1, 2010

    [Momma: You keep using the same tired, unsubstantiated figure.]

    I gave the reference. Its the CDC’s quote. It’s unsubstantiated because it is an estimate. Measles was so overwhelmingly widespread and mild that they knew they could not just use the 500,000 figure and pretend that were the only cases. Especially when they estimate that the real number of cases was 6-8x that confirmed number. Or… they just threw that number in to make it seem like measles was worse than is reported. The problem is they screwed the numbers up. They use 1-3:1000 case fatality but also use 3-4 million cases. They don’t go together. It’s CDC math.

    As opposed to your personal theory? Do you believe your theory actually changes the case fatality that is so commonly used as a fear tactic?

    [Science mommy: Tired of getting your ass kicked by a chick yet? ]

    You’re a chick?

    “Mama says that alligators are ornery because they got all them teeth and no toothbrush”

    “Well, folks, Mama’s wrong again.” Bobby: “No, Colonel Sanders, you’re wrong. Mama’s right. You’re all wrong. Mama’s right. Mama’s right!”

  109. #110 Alan Kellogg
    September 1, 2010

    After all the claims regarding autism and vaccines I have to ask, just what the heck is autism and how is it diagnosed? Where is a good place to learn this?

    I ask because I have been assessed with Aspergers and I’d like a good introduction to autism and autism spectrum disorders.

  110. #111 triskelethecat
    September 1, 2010

    I don’t know why little Augie thinks there would have been that many hospitalizations pre-vaccine era. Most people didn’t go to the hospital if they could avoid it; it was expensive, had very limited visiting of your children (would you like to see your sick child for maybe 15-30 minutes a night, after having traveled 20-30 minutes? Or would you have wanted to be with them? Not allowed) and very strict rules. A lot of doctors kept the kids at home if the moms were at all willing. I can readily recall my brother being at home with pneumonia – oxygen tent, IV, antibiotics and all (in the late 1960’s).

    So, no, you would not have seen

    “There would also have been over 600,000 thousand hospitalization from measles per year. Didn’t happen. Not even close.”

    Hospitals tried very hard NOT to admit people during epidemics (and still try today) if the people can be treated at home. (Of course, we are rather out of the days when you would probably treat pneumonia at home with O2, IVs and antibiotics… but neither do you have the doctors making home visits and the neighborhood nurses who were more prevalent then.)

    Do you REALLY think your doctor has YOUR wallet in mind when he tells you to go home, go to bed, rest, take plenty of fluids and antipyretics for the flu? Unless you are very ill, they want you at home so the hospitals have beds available for the really sick people.

    @Alan Kellogg: there are a lot of books out there, but I am not sure I would recommend many. If you are near a medical library, a copy of the diagnostic criteria (DSM-IV) will help you. You can also google “dsm criteria for autism and asperger” and get several sites that give the DSM criteria for both Autism and Asperger’s syndrome.

  111. #112 Denice Walter
    September 1, 2010

    @ Alan Kellogg, for a start, fire up the google and see : Autism Information Page, NINDS, NIH.gov and NIMH, Autism Spectrum Disorders. ( Also for a discussion about the differences between AS and other conditions see pages on NVLD.)

  112. #113 augustine
    September 1, 2010

    [I don’t know why little Augie thinks there would have been that many hospitalizations pre-vaccine era.]

    In a piece by the CDC called

    “What Would Happen If We Stopped Vaccinations?”

    http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm#measles

    they say:

    “In the U.S., up to 20 percent of persons with measles are hospitalized.”

    the propaganda assumption is that this is “what would happen if we stopped vaccinations.”

    All we have to do is look back at what DID happen when we didn’t have the measles vaccine to see if what “will happen” did happen. It didn’t.

  113. #114 MI Dawn
    September 2, 2010

    @Little Augie: yes, nowadays, probably up to 20% of people who get measles would be hospitalized because society is different now. You don’t have the stay-at-home moms, the doctors making house calls, the neighborhood nurses visiting daily that you had pre-MMR. More people are more likely to use the hospital for care. But hospitals don’t have the beds to handle up to 20% more people (many are running at 80-90% capacity NOW, without any major epidemics).

    Again, Augie, you didn’t take societal changes in account between then and now. You are too young to know how things were back then, and too uneducated to understand when people point things out to you.

  114. #115 Rogue Medic
    September 2, 2010

    If we are going to look at the information, why look only at augustine’s excerpt? Here is all of the section on measles:

    Before measles immunization was available, nearly everyone in the U.S. got measles. An average of 450 measles-associated deaths were reported each year between 1953 and 1963.

    All we have to do is look back at what DID happen when we didn’t have the measles vaccine to see if what “will happen” did happen. It didn’t.

    In the U.S., up to 20 percent of persons with measles are hospitalized. Seventeen percent of measles cases have had one or more complications, such as ear infections, pneumonia, or diarrhea. Pneumonia is present in about six percent of cases and accounts for most of the measles deaths. Although less common, some persons with measles develop encephalitis (swelling of the lining of the brain), resulting in brain damage.

    they say:

    “In the U.S., up to 20 percent of persons with measles are hospitalized.”

    the propaganda assumption is that this is “what would happen if we stopped vaccinations.”

    That is not stating that this is what would happen if we stopped vaccinating.

    That is stating what is happening now, with vaccination.

    In the U.S., up to 20 percent of persons with measles are hospitalized.

    Part of reading comprehension is understanding the difference between are and could be expected.

    If that is the percentage of people with measles being hospitalized now, why should we believe that things would be better without vaccines?

    Oh yeah! The Good Old Days. Living in the past, that wasn’t as good as the nostalgist imagines.

    Back when people had big families, because we needed to have some spares – if we wanted to have some children live long enough to take care of us in our old age, or just wanted some of our children to outlive us.

    Why augustine is using a computer (and using Al Gore’s Internet/) if augustine is so nostalgic?

    Back when a lot of bad things were just not reported. Priests and children getting Biblical! We can’t report that!

    Better to pretend it never happened. It is a new development. Blame it on the women, or the immigrants, or the commies, or the transgendered.

    So it seemed that things were better, that people were more moral, as long as you close your eyes and click your silver slippers together augustine, you can go to that home!

    Home to the land of the illness/complication/whatever that is underreported/unrecognized.

    As many as three of every 1,000 persons with measles will die in the U.S. In the developing world, the rate is much higher, with death occurring in about one of every 100 persons with measles.

    Measles is one of the most infectious diseases in the world and is frequently imported into the U.S. In the period 1997-2000, most cases were associated with international visitors or U.S. residents who were exposed to the measles virus while traveling abroad. More than 90 percent of people who are not immune will get measles if they are exposed to the virus.

    According to the World Health Organization (WHO), nearly 900,000 measles-related deaths occurred among persons in developing countries in 1999. In populations that are not immune to measles, measles spreads rapidly. If vaccinations were stopped, each year about 2.7 million measles deaths worldwide could be expected.

    In the U.S., widespread use of measles vaccine has led to a greater than 99 percent reduction in measles compared with the pre-vaccine era. If we stopped immunization, measles would increase to pre-vaccine levels.

    .

  115. #116 Dr. Frankie
    September 2, 2010

    That these waivers exist in the first place is a mockery of the Law.

    Yes! You read that right: The Supreme Court of the United states decided this stuff is…1905!! See or ask any friend who’s a lawyer to pull up the Jacobson v Commonwealth case for your reading pleasure.

  116. #117 LW
    September 4, 2010

    adelady begged, “I know you’re talking about MMR and pertussis here, but please, please tell me these people are vaccinating against polio. ”

    Sorry adelady, but apparently Dr. Gordon doesn’t even vaccinate against polio:

    My vaccine schedule? Either none or just a DPT in the first 24 months of life. I think that there’s a greater risk vaccinating males under 24 months and would prefer not to unless there are special circumstances. I use very few other shots except the Varivax as a child approaches ten years because teen and adult pox are nasty and even a little dangerous especially during pregnancy. I give Hep B vaccines to nursing student/moms and dads, other medical moms and dads and higher risk teens and college kids.

    You’ll notice he doesn’t vaccinate against rubella either, although even I, a non-doctor, know that rubella is “a little dangerous especially during pregnancy”. More than chicken pox, I believe.

  117. #118 NZ Sceptic
    September 6, 2010

    What is ‘Dr’ Jay thinking of? When I was child in the very early 1970s my mother took us to meet an old friend of hers – in an iron lung.I have NEVER forgotten that experience and I thank God – or would if I was religious – for the wonderful gift of vaccines. My kids are fit as fleas – in fact the youngest had her first ever sick day from school (aged 9)last week, and it was really just an excuse to hang out with Mum and do some baking!

  118. #119 Prometheus
    September 7, 2010

    Jeez! I go away for a short holiday and when I come back I find that “Augustine” has been distorting my statements again (or has severe reading comprehension “issues”).

    Augustine claims:

    “Science Mom, you cannot comprehend your links in context. … Promotheus is trying to help you out by steering the conversation away from your argument into something other argument.”

    Ummm, no. What I was trying to do show that attempts by “Sid”, “Dr. Jay” and “Augustine” to compare measles death rates today and measles death rates prior to vaccination are not valid unless you compare case-fatality rates. Since we don’t have a good handle on the number of cases prior to the vaccine – since there were certainly more cases than were reported or even diagnosed – all we can know is the minimal case-fatality rate for that time.

    The “problem” with Science Mom’s question was that it had multiple “correct” answers, some of which would have been highly misleading (and which I predicted would be provided by “Augustine”, “Sid” and others of their ilk.

    “Augustine” further shows his/her true nature by quoting a CDC “What if?” paper out of context (and, apparently, not reading it very carefully”):

    “In the U.S., up to 20 percent of persons with measles are hospitalized.”

    The little word “are” is in contrast to “were”. People with measles in the pre-vaccination era weren’t hospitalised as often for several reasons, not the least of which is simple logistics.

    If 20% of people with measles had been hospitalised in the prevaccination era, that would have been between 30,000 and 150,000 people per year, based only on the reported cases. Since the number of measles cases per year would actually have averaged out to to the number of births per year (figure it out for yourself – if 95+% of all people had clinical cases of measles in their childhood, the number of cases over any length of time will be roughly equal to the number of births – new victims – produced in that time), those numbers would have been even higher.

    For example, in 1960 there were 441,703 cases of measles reported. That year, there were 4,257,850 births – a number in keeping with the preceding decade. So, if the number of reported measles cases is accurate, we are left with the conclusion that only about 10% of the population ever contracted measles, a conclusion completely unsupported by the data (which, to remind, indicate that 95+% of the population had measles in their childhood prior to vaccination).

    Now, plugging in the “new” numbers, it looks like hospitalising 20% of measles patients would result in about 800,000 admission per year. Even if these were spread evenly throughout the year (they wouldn’t be), that works out to almost 2,200 measles admissions per day, 365 days a year.

    It would appear that “Augustine” needs to take a “reading for comprehension” class.

    Prometheus

  119. #120 Jay Gordon
    September 25, 2010

    ” Since we don’t have a good handle on the number of cases prior to the vaccine – since there were certainly more cases than were reported or even diagnosed – all we can know is the minimal case-fatality rate for that time.”

    You can’t possibly support that with scientific evidence, Prometheus.

    Jay

  120. #121 Sauceress
    September 25, 2010

    you can’t possibly support that with scientific evidence

    Well anecdotal evidence rates higher than scientific evidence in your world…doesn’t it Jay?
    I’ve spoken a large number of people whose children suffered through measles prior to vaccine availability and their experiences of the outbreaks support Prometheus. According to this same stream of anecdotal evidence, there were only a few cases where there was a medical diagnosis.

  121. #122 Sauceress
    September 25, 2010

    In fact, those I’ve spoken to on this issue all appear that they would be only too willing to recall their experiences of such diseases for a public record. Perhaps I’ll start seeking permission to record such conversations on my little you-beaut mp3 voice recorder.

  122. #123 LW
    September 25, 2010

    Of course he can support it. 

    1) it’s been pointed out more than once that upwards of 95% of Americans over the age of 18 showed immunological evidence of having had the disease. Therefore, on average, in each year the number of cases was at least 95% of the number of births, whether or not all those cases were recorded.  

    2) you’re old enough to actually remember when measles was endemc. Do you seriously contend that only one person in ten got the measles in their whole life?

    3) Measles was a “childhood disease” when it was endemic, not beause it is only contagious to children — it isn’t — nor because it is more dangerous to children than to adults — it isn’t — but because it circulated almost exclusively among children.  Whenever an endemic disease is highly contagious, like measles, and produce lifelong immunity, like measles, then it becomes a “childhood disease” precisely because all the adults have had it and are immune, and it circulates almost exclusively among the non-immune children.  The mere fact that measles *was* a childhood disease proves that nearly all adults had had it, whether their illnesses were recorded or not.     

  123. #124 Prometheus
    September 27, 2010

    “Dr. Jay” comments (at #518):

    “You can’t possibly support that with scientific evidence, Prometheus.”

    Ummm, I think that my point was that there wasn’t any scientific evidence available for the time period.

    The problem (as I stated) is that measles was clearly under-reported in the pre-vaccination era (as LW puts so succinctly above). Additionally, it is reasonable to assume that – in those days prior to interlinked computer databases and mega-conglomerated insurance companies and HMO’s – that the same under-reporting was also seen in the attribution of deaths to measles.

    Finally, given the measles case-fatality rate we see today (2 per thousand cases), we are left with two alternative interpretations of the historical data:

    [1] Children today are much more likely to die from measles, despite significant improvements in pediatric critical care.

    [2] Deaths dues to measles in the decades prior to the introduction of the vaccine (when about 10% of measles cases were reported) were more often attributed to “pneumonia” (the most common complication of measles, affecting up to 6% of cases, and the proximal cause of death) rather than “measles”.

    Since many states only relatively recently expanded their death certificates to include multiple causes or contributing causes, logic suggests that option [2] is more likely.

    Of course, I can’t guess what “Dr. Jay” might think – for all I know, he’ll favor the idea that humans have become “weaker” because of our exposure to “toxins” and vaccines, none of which were present back in the pre-industrial 1950’s and 1960’s.

    Prometheus

  124. #125 MI Dawn
    September 27, 2010

    I know Dr Jay is a very busy doctor who probably doesn’t have a lot of time to read old books. But, I can point out numerous books where measles is greatly feared (one book obviously reflects the fears that measles brought, when the characters were(paraphrase)rejoicing that the children were recovering and did not suffer from the consequences so frequently seen with the disease.

    Yes this was written in the late 1800s, but the characters were presented as wealthy, well-fed, healthy individuals. So, fear of measles was prevalent.

    @Sauceress: I have to dig through the letters, but if you would like written memoirs of children ill with mumps and measles, I can send you the letters my grandmother wrote to my overseas during WWII grandfather about the events when my mother (age 7) and uncle (age 3) had them. My uncle was quite ill and my grandmother was unable to get his fever down. My mother’s report card for that marking period had a comment that no children (in the entire school!!) would receive grades due to excessive illness (mumps, measles and chicken pox decimated grades K-6 for several months). And the boy across the street from my mother, had pneumonia and other problems after the measles. (My grandmother’s comment – if he hadn’t been a strong, husky child, she doubted he would have lived; as it was he was now quite frail).

    My grandfather LOVED vaccines; he gave his patients every one that he could. Sure, he had fewer home visits to make, and less money, but healthier patients. He happily made that trade.

  125. #126 smoky mirror
    March 7, 2011

    So Orac, if the Cochraine Collaboration in England concluded after a 96 season study that the flu jab had no evidence base to support its use where do you get your stats on vaccine efficacy? All vaccines are exempt from RCT placebo follow up studies, there are none that show efficacy.

    It’s not about anti or pro it’s about evidence, and there isn’t any as it is not required to go to market. The Amish community in the US has total non compliance, where are the death stats to support your position? The WHO studied measles fatalities in Africa and found at autopsy that the ones who died invariably had very low vitamin A reserves in the liver. In a trial all the kids and adults in one village were given a carrot a day, when the disease struck the region not one child or adult in this village died, the surrounding region the stats stayed unchanged. The WHO concluded that measles is fatal only in the malnourished, plenty of them in the western world living of the Maccy D.

    Ok eating a carrot a day is not sexy, granted, but selling the idea that all these disease states can only be fought with knights is the sort of conspiracy that ordinary citizens would get locked up for under the new terror laws, shame on you.

  126. #127 smoky mirror
    March 7, 2011

    Oh and maybe you heard of the ‘Wakefield effect’, the measles rates in the uk 10 years before compared with 10 years after Wakefield show a 85% fall in the rate of measles in England, that’s with the vaccine rate falling to the lowest on record.

    Just where do you get your facts from? And what is this silly red dot map thing below?

  127. #128 a-non
    March 7, 2011

    I *heart* trolls who dredge up six month-old threads and spew a bunch of ridiculous nonsense. But I’m not sure if “smoky mirror” is a new troll, or a familliar one under a new handle. This is about the only intrigue.

  128. #129 Travis
    March 7, 2011

    And I see it is still leaping from one old post to another. I wonder when it will come back here to spew some more now that someone has responded.

  129. #130 the truth
    August 19, 2011

    vacinnes are bs straight up. If there was a thing as evolution we wouldnt need vaccines. If God wanted us to be born with all that shit in those needles we wouldve been. Scientifically the avg person cant test what is going in their kids arm so you are surrendering all your faith to someone you do not know to inject some poison into your kids. Face the facts we all live to die its not like you can stop that fact of life and if you only extend your life till the point when you cant even take care of yourself is it really worth living. Luckily we live in America and even though the media says you dont have rights untill we are all brainwashed the people who still fight for thier rights will always win the battles vs the zombies who can only obey without using thier own brain.

  130. #131 the truth
    August 19, 2011

    vacinnes are bs straight up. If there was a thing as evolution we wouldnt need vaccines. If God wanted us to be born with all that shit in those needles we wouldve been. Scientifically the avg person cant test what is going in their kids arm so you are surrendering all your faith to someone you do not know to inject some poison into your kids. Face the facts we all live to die its not like you can stop that fact of life and if you only extend your life till the point when you cant even take care of yourself is it really worth living. Luckily we live in America and even though the media says you dont have rights untill we are all brainwashed the people who still fight for thier rights will always win the battles vs the zombies who can only obey without using thier own brain.

  131. #132 Rogo5
    August 19, 2011

    I wonder who “the truth” really is.

    He could be a government agent masquerading as a troll…

  132. #133 lilady
    August 19, 2011

    Well we have a poop storm of troll posts and sock puppet posts today. Just ignore (Rule #14) all the posts.

  133. #134 Chris
    August 20, 2011

    Well, it is kind of humorous where “the truth” totally screws up how evolution works, that everyone here lives in America, and that God really cares about kids — because the last time I looked it wasn’t any god that reduced child mortality from less than a century ago when almost every family had a funeral for child.

  134. #135 Chemmomo
    August 20, 2011

    I think the zombies already got the poster who signed as “the truth.”

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