Respectful Insolence

The anti-vaccine movement versus the truth

My alma mater has let me down.

As many of you know, I went to the University of Michigan for both my undergraduate degree and for medical school. I still have a fairly strong attachment to the school, which is why I can still be disappointed when its faculty let me down. Unfortunately, it’s happened, and this time U. of M. has disappointed by inadvertently providing ammunition for the anti-vaccine movement. I’m referring to a poll released by the C.S. Mott Children’s Hospital (which is where I did my pediatrics rotations when I was in medical school). The poll results are being trumpeted across the anti-vaccine blogosphere as though they are vindication. The press release announcing the poll results starts out badly and goes downhill from there:

ANN ARBOR, Mich.–Each year, hundreds of millions of public and private dollars are spent on medical research to improve the health of children – yet parents have little input regarding how those dollars should be spent.

Apoll released by the C.S. Mott Children’s National Poll on Children’s Health shows that nearly 9 in 10 parents rank vaccine safety, and the effectiveness and safety of medicines, as the most important topics in children’s health research today.

The first thing that one has to realize is that this is not a study. It was not published in the pediatrics or other medical literature. Consequently, it wasn’t vetted through the process of peer review. In fact, as you will see, the poll is laughably thin gruel to base such conclusions on, as you will see. Instead of being published in the peer-reviewed literature, this poll was posted to the U. of M. Medical School website and entitled Parent Views on Medical Research: Safety of Vaccines & Medicines Top Priorities. It wasn’t too hard to find the full report, which is here. The report has a single figure, which is listed here. However, here’s the money link. Whenever you hear the results of a poll, it’s critical to go to the source and try to discover the actual questions that were contained in the poll, and that’s just what I did. Leaving aside questions about demographics, here is the actual meat of the survey:

i-dc9b167cd58318ca4d8fe5bdc9b5aa99-questions-thumb-480x323-57194.jpg

Yes, that really is all there is to the poll, as far as I can tell. No wonder this poll wasn’t published as a real study. Heck, if I had been a parent filling out this poll, I would have marked the “safety of vaccines given to children” as “very important,” and no one would ever accuse me of thinking that vaccines are unsafe, that they cause autism, or that we should be doing scientifically dubious studies of the sort currently demanded by the anti-vaccine movement.

All such an answer means is that, yes, people consider vaccine safety important. They should consider vaccine safety important, because it is very, very important! That’s why millions upon millions of dollars and person-hours have been spent–oh, I don’t know–actually studying vaccine safety. There are rigorous pre-marketing testing requirements and many regulations governing the production and marketing of vaccines. Meanwhile, the question of whether vaccines cause autism has been tested over and over and over and over again. The answer is always the same: When the study is done by reputable scientists using well-designed epidemiological methodology (in marked contrast to the way the anti-vaccinationists and antivaccine-sympathetic investigators do it), there is no evidence that vaccination is associated with a detectably elevated risk of autism–or any other adverse neurodevelopmental outcome, for that matter. In essence, no detectable association between vaccines, thimerosal-containing or otherwise, and autism greater than the noise inherent in such studies can be detected. We can say with a high degree of certainty that vaccines don’t cause autism. Is the certainty absolute? Of course not. No scientific certainty ever is. Our level of certainty that vaccines don’t cause autism is, however, about as high as we could ever ask for in epidemiological and clinical studies.

Sadly, the lead poller seems oblivious to how his poll results would be used and abused by the anti-vaccine movement. Worse, he extrapolated far beyond what this rather paltry poll could support:

“In this poll, parents overwhelmingly see the need for research on the safety of vaccines and medications given to children,” says Matthew Davis, M.D., director of the poll and associate professor of pediatrics and internal medicine in the Child Health Evaluation and Research Unit at the U-M Medical School. “Parental concerns about the safety of vaccines have increased markedly over the last decade, due to alleged but later disproven links between vaccines and autism and related concerns about mercury and other preservatives used in vaccines.

“Assurances from health care providers and government officials that vaccines are safe have been insufficient. Rather, it’s clear from this poll that parents want more research about the safety of vaccines for their young children and adolescents.”

Maybe. We have no way of knowing because, as far as I can tell, the poll didn’t actually ask parents some very important questions that might actually allow us to make some conclusions, questions like whether or not parents believe that vaccines are safe, that they cause autism, that the amount of research currently being done on vaccine safety is adequate, or that vaccines are safer than leaving children open to diseases that vaccines protect them against. Dr. Davis is reading far more into his poll results than is justified. I mean, come on! He didn’t even ask whether parents want more research into vaccines. Even if he had, that’s the sort of question that has to be carefully phrased or buried within several questions to make sure that the poll is actually measuring a real desire. After all, among lay people, it almost always makes sense to ask for “more research,” particularly if no mention of resource allocation is made. One way to control for that is to lay out situations that include how much further study would cost and then how strongly the respondents still want “more research.” Yet, instead of mentioning these problems and possibilities, the report concludes:

Similarly, the safety and effectiveness of medications given to children is viewed by parents as a very important area of research. These views may be prompted by high-profile recalls of medications, or by recent reports suggesting that some common over-the-counter medicines are ineffective for kids. Clearly, parents recognize the importance of continuing research about medications, and see the potential for research to help them be better informed about the potential benefits and risks of treatments for their children.

This is what’s known as a “well, duh!” conclusion. I’d be surprised if the vast majority of parents weren’t concerned about the safety and efficacy of medications. The real questions are whether that level of concern has changed, and, if it has, why. Moreover, another aspect of the poll results suggest that parents don’t actually judge relative risks very well. For example, the item that came in the lowest was “leading causes of injuries,” with only 46% of parents rating this item as “very important.” Yet injuries are a huge cause of harm to children. Certainly, childhood injuries harm far more children than vaccines. It’s not even remotely close.

Of course, the most pernicious problem with this poll is the utter cluelessness with which it was promoted, a cluelessness that has allowed an opening for the anti-vaccine cranks at Age of Autism to take full advantage of this poll. First up, we have Kim Stagliano posting Vaccine Safety: Why Parents Are Concerned in that wretched hive of scum and quackery The Huffington Post. In her HuffPo piece, Stagliano demonstrates once again that no tactic is too shameless for her to use in the cause of trying to convince people that parents all agree with her pseudoscientific belief that vaccines cause autism and all sorts of horrible things. Stagliano starts off calling this poll a “study” (it’s not) and then making the claim that currently there are now “48 vaccinations” on the vaccine schedule before age 6. Her audacity leads me to wonder once again at how it’s really amazing how antivaccinationists pump up the numbers each time I read; last I read the anti-vaccine propaganda literature it was 36 and the CDC schedule is clearly nowhere near 48. Next is the obligatory swipe at Dr. Paul Offit, who, unlike Stagliano or the rest of the merry band of anti-vaccine loons at AoA, has actually done something to protect children against infectious diseases. This is in marked contrast to AoA flacks like Stagliano, whose activities risk decreasing herd immunity to the point where vaccine-preventable diseases return, with potentially devastating results. Come to think of it, I admire Paul Offit. I have little but contempt for Stagliano and the crew at AoA because they deserve nothing more.

Then, Stagliano decides to try to appeal to the liberal tendencies of the HuffPo readership:

I imagine that many (perhaps a majority) of Huffington Post readers are pro-choice and respect a woman’s right to choose. Should a woman lose the right to make appropriate, safe medical choices in conjunction with her pediatrician for her child once she becomes a mother? If you are pro-life, does a mother’s right to protect her child end when the baby is born?

Nice try on Kim’s part. It was a nice try to appeal to the liberal tendencies of your readership. The two are not the same. For instance, the decision not to vaccinate is neither safe nor appropriate. Many anti-vaccine parents like Kim make the bad choice not to vaccinate, take advantage of the herd immunity due to children who are vaccinated, and then conclude that they must be right when their children are lucky enough not to come down with vaccine-preventable diseases. I have frequently said that adults have the right to choose whatever medical care they desire, even out-and-out quackery. They have every right to refuse medical treatment. That same right does not, however, extend to denying medical care to children or to endangering children. Make no mistake, failure to vaccinate is the same thing as denying recommended medical care to children. Worse, such a decision does not affect just the unvaccinated. It affects any children with whom unvaccinated children come into contact, which is why it’s entirely appropriate to require vaccination before day care or school.

Then, of course, the anti-vaccine propaganda blog AoA jumps on the bandwagon with a post entitled Alert your Lawmaker That Vaccine Safety Is an American Priority. Once again, this is not a study. It’s simply a poll, and it doesn’t even ask that many questions, much less the right questions. All it says is that, yes, parents think that vaccine safety is important, which it is. It doesn’t in any way validate the pseudoscientific views promulgated by AoA that vaccines cause autism that they don’t work, or that they do far more harm than good. Yet that’s what Kim Stagliano and AoA are trying to convince you and our legislators that this poll means. Worse, through their apparent inexperience in dealing with the anti-vaccine movement made it really easy for AoA and Kim Stagliano to do use this poll for their own antivaccine propaganda purposes.

And that’s just what they did.

Comments

  1. #1 Todd W.
    October 21, 2010

    Hit the nail on the head, Orac. I mentioned some of the same points (in particular, that I would also rate vaccine safety and med S&E as very important) when jen came in regurgitating what she read over at AoA.

    Definitely agree that the authors of this article overstepped in their conclusions.

  2. #2 cervantes
    October 21, 2010

    There is of course no reason why a pediatrician should be expected to be competent at doing survey research. This is actually a perpetual annoyance to me — that M.D.s think they can do all sorts of social science, just because apparently they think there is nothing to it and that any old knucklehead can do it.

    Sadly, no, as this proves.

  3. #3 Jack
    October 21, 2010

    Unfortunately, AoA will seize any thin thread they can to try to promote their lunacy. I don’t think it’s fair to expect people to account for AoA’s response when making a poll. True, the methodology was poor and the results may not be reliable but they never claimed that this was on par with a peer-reviewed study. I think the blame lies more with AoA.

    What I find particularly interesting is how parents underestimate the importance of injury prevention. Injuries are the leading cause of death in children after the neonatal period but apparently the poll respondents don’t realize this. I’d like to see if that finding could be replicated in a study with good methodology.

  4. #4 Jojo
    October 21, 2010

    I’ve only had two terms of statistics for my MBA, and even that was enough to educate me on how bad that poll is. I certainly wouldn’t make a business decision based on the results of it.

    I had the same thought as Jack @3 about how this really just shows that parents don’t understand the actual risks of injury harming their child as opposed to medications and vaccines.

  5. #5 Denice Walter
    October 21, 2010

    The poll may measure how well the anti-vaccinationists have spread their message : it might be interesting to compare *press coverage* given to each of the particular choices Davis lists ( stories about treatments, stories about injuries, etc.); I’d guess that vaccine stories have gotten the most coverage in the past 10 years. I’m sure if I compiled a list of unrealistic concerns ( based on talking points from woo-begone websites) there would be a similar result: worries about unlikely ( or unreal) events. Sometimes fear is “forefronted” or “highlighted” : your worries overshadow your understanding of probability ( people aren’t so great at probability any way). WMDs, remember them?

  6. #6 René Najera
    October 21, 2010

    Thanks, Doc. I now have a good example for how NOT to do a poll… Or draw conclusions from it.

  7. #7 Denice Walter
    October 21, 2010

    Speaking of fear-mongering, Mike Adams( NaturalNews, today) tells us to fear *cancer patients*( seriously, isn’t it the other way ’round? ) In the long history of stigmatization, past advances are being effectively erased by statements like his !

  8. #8 Todd W.
    October 21, 2010

    @Denice

    Mike Adams wouldn’t be saying that because of thyroid cancer patients receiving I-131, would he? That might explain the presence of Lucille in the Hollie Quinn thread talking about how thyroid cancer patients are exposing people to radiation.

  9. #9 Pablo
    October 21, 2010

    What I find particularly interesting is how parents underestimate the importance of injury prevention. Injuries are the leading cause of death in children after the neonatal period but apparently the poll respondents don’t realize this. I’d like to see if that finding could be replicated in a study with good methodology.

    This is in line with my response, as well. Actually, what this survey shows is moreso about how parents are being misled and getting their priorities distorted from real risks.

    What I’d like to see is a better version of this type of poll, but then to contrast it with a similar poll of pediatricians. What do parents worry about vs what are the experts worried about.

  10. #10 Denice Walter
    October 21, 2010

    @ Todd W. Exactly! I also noticed the ref in the other thread. It nicely illustrates how woo-ful websites broadcast these ideas.

  11. #11 skeptiquette
    October 21, 2010

    I don’t see this poll as a bad thing.

    I think it is of utmost importance to:

    1. Characterize the immune response from vaccines in the general pediatric population.

    2. Characterize the immune response from vaccines in certain subpopulations, using various genetic and epigenetic profiles as our criteria.

    3. Understand the differences between the immune response generated by natural infection vs. vaccine.

    4. Study the impact of vaccination and the immune response during critical periods of brain development.

    5. Study the outcome of vaccination on various epigenetic parameters of immune activation.

    6. Study the outcome of vaccination on patterns of infant microbial colonization.

    7. Study the kinetics of immune activation in various subpops and the general pop. due to vaccination.

    8. Study the impact of vaccination on pregnant women, in particular maternal immune activation (MIA).

    9. Study the impact of the immune response generated by vaccines on various behavioral correlates.

    10. Study the impact of the immune response generated by vaccination on particular protein expression in the brain, I am most interested in understanding the potential impact on MHC I expression during postnatal development.

    This is a start.

    Orac, since you and others here think that future research on vaccine safety is important.

    What exactly do you think we should be allocating money to research in terms of vaccine safety?

  12. #12 wfjag
    October 21, 2010

    I would have answered “Very Important” on the vaccine safety question because:
    1. As the parent of an autistic child, I know he has limited communication skills. So, I need to know what possible side-effects or adverse reactions to look for;
    2. As the spouse of a teacher who has a weakened immunine system, my spouse ends up being exposed to whatever is going around. So, we need to understand possible side-effects or adverse reactions and weight them against the risk of exposure and consequences of catching various diseases from the students. So far, the risks and consequences of catching some disease have always out-weighed the risks of side-effects or adverse reactions; and,
    3. Vaccination is the most common medical procedure people face. So, understanding the possible side-effects or adverse reactions to vaccines received, and how likely those are, only makes sense.

    However, reading anything else into my response leads to false conclusions.

  13. #13 Calli Arcale
    October 21, 2010

    Nice try on Kim’s part. It was a nice try to appeal to the liberal tendencies of your readership. The two are not the same.

    Indeed, and I wonder if conflating “right to choose not to vaccinate” with “right to choose abortion” might not lose Kim some supporters. Anti-vax is not a purely liberal stance. Quite the contrary, in fact; historically, it’s mostly been conservatives and especially highly religious conservatives who have been opposed to it, often on the grounds of dabbling in God’s domain.

    Does Kim realize that to some readers, she has just equated not vaccinating to abortion? To actually killing an embryo or fetus? What a foolish thing to say, since it suggests not vaccinating is potentially lethal.

    Also, it betrays her level of respect for the child’s personhood. The right of choice for a pregnant woman is all about her body. The right of choice for a mother deciding about vaccinating her children is *not* about her body, but about her childrens’ bodies. There is a crucial distinction there. (Note: yes, abortion certainly affects the child’s body, but also the mother’s, and that’s the ground the pro-choicers generally rest their arguments upon. Once the child is born, that argument largely evaporates.)

  14. #14 jen
    October 21, 2010

    duh, it’s a poll not a study. You people (many of whom probably make their living off pharma monies) can not like the results all you want, but clearly, most people rate vaccine safety ahead of most all other child-health issues. That should tell the CDC,AAP and the media something, like it or not.

  15. #15 Sid Offit
    October 21, 2010

    This is outrageous! How could someone do something that could possibly hurt the vaccine program.Vaccines have saved millions of lives. This study puts children’s lives at risk.

  16. #16 gr8blessings
    October 21, 2010

    Skeptiquette, I like your list. I think there are a lot of details missing in our understanding of how vaccines work, but I don’t think those details jeopardize our ability to say vaccines are safe. To me, research into vaccine safety would be directed at how to make vaccines more safe and/or fall into “that’s cool to know” category.

    As a parent, I would like to not give the vaccine and also not have my kids get sick from the disease. Since I don’t have a magic ball to determine if or when my kids might be exposed to disease, vaccines are insurance to help protect my kids from the much worse disease. For this insurance, I pay a small risk of vaccine injury. If a vaccine could be made even more safe and lower the risk even more, that would be awesome. Who wouldn’t want the safest product knowledge could produce?

    I wonder if the lack of concern about childhood injuries is more related to fate, as in these types of injuries are “accidents” compared to deliberately giving your child medicine or vaccines. Since we view accidents as just plain old bad luck, research into how to prevent childhood injuries seems less important as these injuries don’t appear to be as preventable compared to having safer medicines/vaccines. The medicines/vaccines are man-made and thus man can control the risk associated with them with research, whereas childhood injuries just happen and thus uncontrollable.

  17. #17 jen
    October 21, 2010

    hey sciencemom, aren’t you oracbots going to bitch about the survey response rate, which was 57%? Which is probably pretty much average for a survey response rate. In fact, it might even be pretty good. You’d probably try to spin it if it were really high or low. Yeah, witch, you know it’s true.

  18. #18 Jojo
    October 21, 2010

    Jen, way to miss the point. We don’t have a problem with the results of the poll. As a parent who vaccinates her child, I care very much about the safety of vaccines and would have rated it high on the poll if I had taken it. But it wouldn’t have been for the reasons mentioned in the links Orac provided.

  19. #19 Todd W.
    October 21, 2010

    [insert exasperated sigh]

    @jen

    You people (many of whom probably make their living off pharma monies) can not like the results all you want, but clearly, most people rate vaccine safety ahead of most all other child-health issues. That should tell the CDC,AAP and the media something, like it or not.

    First off, enough with the pharma shill gambit. It’s old. It’s tired. And it’s irrelevant (e.g., I don’t make my living off of pharma money, and I’m willing to bet a good number of commenters here don’t either).

    As was explained to you in the other thread, the only thing that can be drawn from this is that the self-selected people who answered this poll (possibly skewing the numbers away from being representative of the general population) rated med and vaccine safety as important. It says nothing about why they think it is important. As I said in the other thread, and as Orac and others have mentioned here, they are important topics, but not because vaccines and meds are “not safe”, but because any medical intervention should be well-studied before it is administered to anyone.

    We should constantly strive to make every product as safe as possible. I would be totally behind research that looks at ways to reduce the already rare side effects of vaccines, making them even rarer still. But that doesn’t mean that I think that vaccines in their current form are “ZOMG! Teh evilles!”

    The poll does not say what you, or your teleprompters at AoA, think it says.

  20. #20 Ian
    October 21, 2010

    Jen… did you forget to take your meds today, sweetie?

  21. #21 Sid Offit
    October 21, 2010

    Many anti-vaccine parents …take advantage of the herd immunity due to children who are vaccinated

    As an anti-vaccine parent I’m not worried about mild illnesses so the whole depending on the herd is nonsense. Besides why should I not recognize the fact that because so many have been tricked or forced into vaccination there’s no reason for me to get vaccinated – even if I was worried about the mumps

    and then conclude that they must be right when their children are lucky enough not to come down with vaccine-preventable diseases.

    Luck what luck? Since,due to forced vaccination, it would be almost impossible for an unvaccinated person to contract polio how is my not contracting it luck?

    That same right does not, however, extend to denying medical care to children or to endangering children.

    Endangerment is pumping them up with drugs whose effects are still being investigated. And how is my child being endangered when the herd has wiped out these illnesses? Endangered by what?

    Make no mistake, failure to vaccinate is the same thing as denying recommended medical care to children.

    Sorry Orac the do-gooders don’t get to decide how children are raised. Parents do

    such a decision does not affect just the unvaccinated. It affects any children with whom unvaccinated children come into contact, which is why it’s entirely appropriate to require vaccination before day care or school.

    I didn’t get a flu shot at target last night (despite the temptation) but that has no “affect” on anyone with whom I have come into contact since. Affect? No, just another meaningless vaccine talking point

    I’m hoping for more cogent arguments during Vaccine Week

  22. #22 Sid Offit
    October 21, 2010

    Skeptiquette, you’re sounding unusually “antivaccine” on post #11. But in light of that post I’m wondering why would I risk vaccination in light of all the unanswered questions you raise

  23. #23 Calli Arcale
    October 21, 2010

    jen @ 14:

    duh, it’s a poll not a study. You people (many of whom probably make their living off pharma monies) can not like the results all you want, but clearly, most people rate vaccine safety ahead of most all other child-health issues. That should tell the CDC,AAP and the media something, like it or not.

    As I mentioned to you in the other thread (but which scrolled so fast you probably didn’t get a chance to see), I am unsurprised by the poll’s findings. I, too, would rate safety of drugs, including vaccines, at the top of the choices given. You can’t really draw conclusions about *why* the people think this is an important thing to study, because the poll did not explore the whys and wherefores.

    So I embrace the poll’s findings. Not it’s conclusions, which I found overly speculative, but the findings are plausible to me.

    By the way, I just got back from getting my flu shot. I asked the nurse to let me see the vial, because I was curious to know what exactly I was getting. I received FluLaval, in the multidose formulation, manufactured by ID Biomedical Corporation of Quebec, a subsidiary of GlaxoSmithKline. (And yes, it included thimerosal — 25 mcg per dose.)

  24. #25 Chemmomo
    October 21, 2010

    @Jen

    duh, it’s a poll not a study. You people (many of whom probably make their living off pharma monies) can not like the results all you want

    Actually, Jen, we think the results are fine. We, too, are “concerned about vaccine safety.”

    My objection is to your interpretation of the poll and its press release.

    There is no question in the poll asking parents if they consider vaccines unsafe.

    In fact, the question that is asked (“The following list contains different types of medical research.
    Please rate whether you think these types of research are important for children’s health”) is worded so poorly that we don’t know if it’s asking whether we think research money was well spent in the past, or if it’s asking how we want it spent in the future. That’s what makes this poll useless at best.

    It simply doesn’t tell us anything, and no amount of spin you try to put on it will change that.

  25. #26 Sid Offit
    October 21, 2010

    Jen… did you forget to take your meds today, sweetie?

    I know the vaccine debate can become quite heated but I’m becoming concerned about the increasingly misogynistic tone of some of the commenters

  26. #27 locka99
    October 21, 2010

    “As an anti-vaccine parent I’m not worried about mild illnesses so the whole depending on the herd is nonsense. ”

    People are not vaccinated for “mild” illnesses. They are vaccinated for potentially illnesses that are life threatening or debilitating.

    “Besides why should I not recognize the fact that because so many have been tricked or forced into vaccination there’s no reason for me to get vaccinated – even if I was worried about the mumps”

    No one is “tricked”. The benefits of vaccination are well documented as is the meaning of herd immunity. If you are selfish enough to deny your kids vaccination, not only do you put them at risk but you also put other kids at risk. That’s what it boils down to – pure unadulterated selfishness. You are a selfish person.

  27. #28 Sid Offit
    October 21, 2010

    Selfish in the sense that I put my interests and those of my family ahead of yours and those of the hive – absolutely.

  28. #29 jay.sweet
    October 21, 2010

    Moreover, even if that is what the poll had asked, the idea of asking laypeople whether research aims should be prioritized is laughable.

    Take the “common childhood diseases” vs. “rare childhood diseases” thing. First of all, I’m sure we all agree that, all other things being equal, more overall money should be spent on the former. But is the current reality reflective of a decent cost-benefit tradeoff? I have absolutely no idea, and I consider myself more knowledgeable than the average person-on-the-street about these sorts of topics, just because science-y stuff is a hobby of mine. But how would I know? Hell, I’d be surprised if Orac really had a good feel for how research dollars are being allocated in that regard, since it’s not his area of specialty.

    On the pro-choice vs. anti-vax thing… There are so many more point that could be made tearing that one down. Stagliano doesn’t differentiate between “control over your own body” vs. “permanent control over everything that’s ever come out of your body”? Moreover, nobody is being forced to vaccinate if they don’t want to. (Yes, it’s a condition to being accepted to public schools, but then again, so is not being aborted, eh?) There’s also the legal/illegal vs. right/wrong distinction, which I won’t go into because I feel in order to properly present the distinction in the context of abortion would take too long (in brief: The discussion of hypothetical scenarios is complicated, because the scenarios in which I would consider an abortion to be indubitably ‘wrong’ are not particularly realistic — late abortions are virtually always done for medical reasons, and they must be universally protected because some theocratic dickwads definition of “medical reasons” could be obstinately different from that of a reasonable person)

  29. #30 skeptiquette
    October 21, 2010

    Skeptiquette, I like your list. I think there are a lot of details missing in our understanding of how vaccines work,but I don’t think those details jeopardize our ability to say vaccines are safe. To me, research into vaccine safety would be directed at how to make vaccines more safe and/or fall into “that’s cool to know” category.

    this last sentence seems to contradict the sentence before it. I will give you an example of why all these details matter. Let’s use MIA (maternal immune activation), the flu shot is indicated for all pregnant women without certain health conditions. SO a pregnant mother goes in gets the flu shot just like everyother pregnant mother, But this mother has several genetic factors which contribute to an abnormally high inflammatory rxn to the flu vaccine. She feels the typical maladies associated with being sick, but gets over it.

    Based on current epidemiology, MIA is a risk factor for both autism and schizophrenia?

    I think you have to ask yourself if you’re equipped with the data to back up the assertion that vaccination of a pregnant women does not result in MIA, or if it does, how intense and how long the immune activity lasts, what particular cytokines are elevated. You should be able to answer whether the particular timing of the MIA could be influential in future development of autism and/or schizophrenia.

    Are these questions taken into account when making the decision to vaccinate?

    would research help us make better decisions about this particular example?

    As a parent, I would like to not give the vaccine and also not have my kids get sick from the disease. Since I don’t have a magic ball to determine if or when my kids might be exposed to disease, vaccines are insurance to help protect my kids from the much worse disease. For this insurance, I pay a small risk of vaccine injury. If a vaccine could be made even more safe and lower the risk even more, that would be awesome. Who wouldn’t want the safest product knowledge could produce?

    I agree with all of this, nicely written. This is why I am throwing this list out and asking other medical professionals, who are vaccine safety advocates, to think critically about the question and do the same thing. Seemed like a good idea.

    The medicines/vaccines are man-made and thus man can control the risk associated with them with research, whereas childhood injuries just happen and thus uncontrollable.

    Bingo! Operative words “with research”

    Yes, lending from the example above, with research we will be able to determine if this particular women has a predispotion to an abnormal immune response from flu vaccine, and if the timing of this flu vaccine would be detrimental to fetal brain development and predispose to autism or schizophrenia.

  30. #31 Chris
    October 21, 2010

    The main problem with that list of questions is that it a couple of glaring omissions: studying developmental issues with children (that way parents like wfjag can just what is normal versus what is the behavior of a child with autism, or a like mine with seizure affected development), and childhood/teen psychological health.

    (why, yes… I did spend last night attending a high school PTSA meeting where ideas for parent educational seminars were discussed, from cyberbullies to recent teen suicides)

    (other note: Sid has no children, and Skeptiquette has always been anti-vaccine, so that is nothing new)

  31. #32 skeptiquette
    October 21, 2010

    Skeptiquette, you’re sounding unusually “antivaccine” on post #11. But in light of that post I’m wondering why would I risk vaccination in light of all the unanswered questions you raise

    Sid, I am trying to remain objective on the topic. Making decisions all depends on knowledge. Use my example above.

    Let’s say you are pregnant and contemplating a flu vaccine.

    Would you risk vaccination if after a relatively quick prescreen, the screening indicated no genetic predisposition to maternal immune activation, and that the timing of the vaccine administration would fall during a “low risk time frame” for fetal brain development?

    Would you risk vaccination if after a relatively quick prescreen, the screening indicated you had a serious genetic predisposition towards MIA and that the timing of this vaccine administration fell exactly during a “high risk time frame” for fetal brain development?

    You also have to take into consideration “what’s going on” with the disease that you are vaccinating against. Flu is very well capable of causing MIA and is epidemiologically correlated with subsequent psychological issues in the offspring. SO, if it is a serious flu season and many people around you are ill, then your chances of contracting influenza are greater. Likewise, if it is a relatively mild flu season, your chances of contracting influenza diminish. There are a lot more details to this end of the question also, how do genetics/epigentics, microbiota, nutrition, etc. factor into contracting disease.

    None of it is black and white.

  32. #33 Calli Arcale
    October 21, 2010

    Yeah, it’s a little bit of a catch-22 that some conditions can be triggered by both influenza *and* the influenza vaccine. The prime example is GBS. The flu vaccine is less likely to trigger it, because it is less likely to produce as large of an immune response, but that’s just playing the odds, not any kind of a guarantee. In the end, the choice is the patient’s.

    As for me, myself, I have no known predispositions to influenza risks apart from one: I am asthmatic. I have gotten the flu vaccine every year, even when I was pregnant. (Especially when I was pregnant; the second pregnancy in particular was aggravating my asthma, and I was due to deliver in the peak of flu season. Not the best time to have to go to a hospital.)

  33. #34 skeptiquette
    October 21, 2010

    Here is an article from the last few weeks that addresses MIA and development of autism.

    http://www.ncbi.nlm.nih.gov/pubmed/20924155

    Maternal Immune Activation and Autism Spectrum Disorder: Interleukin-6 Signaling as a Key Mechanistic Pathway.

    Abstract

    An emerging area of research in autism spectrum disorder (ASD) is the role of prenatal exposure to inflammatory mediators during critical developmental periods. Epidemiological data has highlighted this relationship showing significant correlations between prenatal exposure to pathogens, including influenza, and the occurrence of ASD. Although there has not been a definitive molecular mechanism established, researchers have begun to investigate this relationship as animal models of maternal infection have support- ed epidemiological findings. Several groups utilizing these animal models have found that activation of the maternal immune system, termed maternal immune activation (MIA), and more specifically the exposure of the developing fetus to maternal cytokines precipitate the neurological, immunological and behavioral abnormalities observed in the offspring of these animals. These abnormalities have correlated with clinical findings of immune dysregulation, neurological and behavioral abnormalities in some autistic individuals. Additionally, researchers have observed genetic variations in these models in genes which regulate neurological and immunological development, similar to what is observed clinically in ASD. Altogether, the role of MIA and cytokine dysregulation, as a key mediator in the neuropathological, behavioral and possibly genetic irregularities observed clinically in autism are important factors that warrant further investigation.

  34. #35 triskelethecat
    October 21, 2010

    @Sid: enough of the tone troll stuff. You’re getting more and more boring.

    @skeptiquette: actually, your questions are pretty good (much better than the poll!). You have clear points that you are asking for answers to, unlike the poll.

    How many of those parents, like me, would have agreed that research into vaccines is important? NOT that vaccines are unsafe and need more research, but that if we want to continue to improve vaccine efficacy, we need to continue to research new ones.

    I honestly feel that additional research into questions pretty much answered isn’t necessary unless new proof comes up that re-opens the question (thimerosol is a dead subject, as far as I am concerned, and I honestly don’t think we need to pour more money into researching it).

    However, I also want more research into leading causes of injuries in children. I know somethings are unavoidable; my kids had injuries and accidents. But have the leading causes changed in the past 20 years? Can we do things to prevent injuries? To me, this is as important as vaccines.

    @jen: again with the pharma shill gambit. Boy, are you boring. And no, I don’t get any money from pharma companies. Never have. And you are aware, aren’t you, that many of the BIG PHARMA companies also make and sell many of the supplements you cram down your kid’s throat? Go away.

  35. #36 Jarred C
    October 21, 2010

    Sid Offit @ 29 said,

    Selfish in the sense that I put my interests and those of my family ahead of yours and those of the hive – absolutely.

    I’ve heard this same argument before, albeit in other words, and it always left me wondering:

    If you put yourself above the needs of society, then why do you insist on living in the same society which supports you, protects you, and provides you with an economy? Don’t you feel any sort of obligation to help that society, to give back to the society, and to support the overall survival of the society?

    I mean, it really does seem like you’re saying that you don’t care what the society does for you or for anyone else, as long as you and yours get what you want out of it.

    I think this is what people see when they say you’re selfish. In this instance, you are not helping society combat and prevent border-crossing diseases which can be harmful, miserable, time-wasting, and life-threatening. However, even worse than simply not helping, you are actively fighting against the protection of society – by trying to convince others of your point of view, by spreading pseudoscience, and by intentionally misrepresenting the data at hand.

    I mean, really, if you dislike the society that much that you actively seek to harm it, why do you stay?

  36. #37 Poogles
    October 21, 2010

    “Sorry Orac the do-gooders don’t get to decide how children are raised. Parents do”

    My gawd, I hate seeing that argument. Yes, I believe parents rightfully have many rights when it comes to making decisions for their children – but by no means an absolute right to make all decisions. Such as withholding medical care in emergencies. Or deciding that “discipline” is “beating the devil out of them”. So I am very happy for the “do-gooders” (and why is that said as an insult? Who DOESN’T want to do good?!) who look out for children’s health and rights (yes, children also have rights. Imagine that), despite what their parents may want or believe.

  37. #38 passionlessDrone
    October 21, 2010

    Hi Skeptiquette –

    Very nicely detailed list.

    Have you seen this paper, that came out a little while ago?

    Altered Inflammatory Responses in Preterm Children with Cerebral Palsy

    The idea that the prenatal and early postnatal periods are timeframes of susceptibility to immune progrmaming is gaining a significant amount of evidence. Sooner or later, answering the questions you have listed above are going to force us to take a dispassionate look at our vaccination schedule for reasons other than the coolness factor.

    – pD

  38. #39 Science Mom
    October 21, 2010

    hey sciencemom, aren’t you oracbots going to bitch about the survey response rate, which was 57%? Which is probably pretty much average for a survey response rate. In fact, it might even be pretty good. You’d probably try to spin it if it were really high or low. Yeah, witch, you know it’s true.

    The incohate rage is palpable jen dear. It is what happens when you keep trying to pound a square peg into a round hole. I already raised the selection bias present in this poll. Response rates vary as to the poll type so that isn’t what is in question, it is the selection bias that occurs from what is of interest to the participants. You really need to get a grip; I am not the one you should be angry with, that should be you and the morons that you continue to defend and listen to.

  39. #40 René Najera
    October 21, 2010

    Man up, Sid Offit, you need to accept that we have a problem with Social Security. That’s right. I went there. Also, give me back my shirt, you’re stretching it!!!

  40. #41 Sid Offit
    October 21, 2010

    @Skeptiquette

    Skeptiquette, you’re sounding unusually “antivaccine” on post #11

    Sorry I had you mixed up with trisketthecat and or squirellete. Anyway you may have seen this but this 2007 article addresses the issue and in part the question of the risks of vaccination vs. those influenza

    http://www.washingtonpost.com/wp-dyn/content/article/2007/11/23/AR2007112301327.html
    —————————————————

    If you put yourself above the needs of society, then why do you insist on living in the same society which supports you, protects you, and provides you with an economy?

    Other people put their needs above mine. My neighbor had the temerity to send his child to college with money I could have used to put up a new roof. How dare he!

    Other people protect me. And they’re compensated and do it willingly (police, fire, army)

    The economy is an emergent system (of which I’m a part) that has it’s genesis in the voluntary cooperation among free people. Society does not provide it to me

    Society doesn’t support me. I support myself by productively interacting with the people who make up society. And as to the socialist argument that I could have never done it without all that society provides remember you need producers before you can tax that production to build roads

    Don’t you feel any sort of obligation to help that society, to give back to the society, and to support the overall survival of the society?

    Not an obligation but a reason to help others. Effective charity can be in my interest since it contributes to those who live around me. Additionally it can be personal satisfying. Keeping the money and putting someone to work could also contribute to society/another person.

    I mean, it really does seem like you’re saying that you don’t care what the society does for you or for anyone else, as long as you and yours get what you want out of it.

    Another “care” post. I don’t know what that means. I prefer to think in terms of actions

    you are not helping society combat and prevent border-crossing diseases which can be harmful, miserable, time-wasting, and life-threatening.

    A lot of things can be xy or z. The bottom line is I’m happy to help just not at the expense of what I believe to be a risk to my health. In other words I don’t put others ahead of me. Nor do I expect them to put me ahead of them

    However, even worse than simply not helping, you are actively fighting against the protection of society – by trying to convince others of your point of view,

    The truth is what it is and people can follow it to their own end. Have all the vaccine you want just don’t force it on Americans

    by spreading pseudoscience, and by intentionally misrepresenting the data at hand

    I reject the assertion that I’ve done that. And if I truly believe in my position that vaccines are too risky for me, am I, in my mind not endeavoring to help others(and acting unselfishly) by sharing information which if accepted could lead to a reduction in herd immunity and a greater risk for me

    I mean, really, if you dislike the society that much that you actively seek to harm it, why do you stay?

    I’m not sure how you equate pursuing one’s own self interest as disliking/harming society[other people]

  41. #42 Scott
    October 21, 2010

    Yep, pure evil. Doesn’t care if he kills others through negligence as long as it doesn’t affect him personally.

  42. #43 Gray Falcon
    October 21, 2010

    Ah yes, the old attitude of “Why should I bother? It doesn’t affect me or my family?” I remember one guy who used to think that way. Name of Peter Parker…

  43. #44 skeptiquette
    October 21, 2010

    Hi Skeptiquette –

    Very nicely detailed list.

    Have you seen this paper, that came out a little while ago?

    Altered Inflammatory Responses in Preterm Children with Cerebral Palsy

    The idea that the prenatal and early postnatal periods are timeframes of susceptibility to immune progrmaming is gaining a significant amount of evidence. Sooner or later, answering the questions you have listed above are going to force us to take a dispassionate look at our vaccination schedule for reasons other than the coolness factor.

    – pD

    Hey pD,

    Thanks man!

    I hadn’t seen that paper yet, but it looks very interesting!! Yes, these ideas are very important indeed. I have to set off on my bike to get to class on time, so, I will have to address this in more detail later.

    -skeptiquette

  44. #45 Gray Falcon
    October 21, 2010

    On a less flippant note, there was a time when fire companies were privately owned and only put out fires on the properties of people who paid them to put it out. If they didn’t have the money, tough luck. Then, the winds would blow, fires would spread, and suddenly, everything was on fire and capitalism didn’t seem such a good idea anymore.

  45. #46 skeptiquette
    October 21, 2010

    Sid,

    quickly, nice article you’ve posted!

    this is a well balanced representation of the situation.

    Paul H. Patterson is an expert on this particular subject. He is one of the authors of the chapter “Alteration of Neurodevelopment and Behavior by Maternal Immune Activation” in my textbook entitled “The Neuroimmunological Basis of Behavior and Mental Disorders” (this is a great text for anybody interested in these topics). If you want to read a lot of current literature which is relevant, just type his name into pubmed.

  46. #47 Composer99
    October 21, 2010

    Let me put it this way, Sid:

    Why should any of those people you productively interact with have anything to do with you if they were aware that you are actively seeking to do them and their children harm by combatting vaccination and increasing the incidence of infectious diseases?

    Also, please review how contract law and impartial enforcement of property rights affect the economy, who does it, and why, before you go around throwing about weasel words like ‘socialism’ or denying that (like everyone else on this planet) you rely on the support of the society around you to function and flourish.

  47. #48 Dangerous Bacon
    October 21, 2010

    A poll question whose answers I’d like to see:

    “A cash-strapped autism research program has just received a ten million-dollar grant to use however it likes.

    Given that numerous published studies have failed to show a connection between vaccination and autism, would you prefer that

    1) the money be spent on more research into a vaccine-autism connection, or

    2) used to study the molecular genetics of autism and potential for treatment and cure.

    The question’s a bit loaded, of course, but I still think the answers would be useful and revealing.*

    *there could be another potential answer for the benefit of antivaxers:

    3) We don’t need no more steenking research, it’s gotta be the vaccines.

  48. #49 Calli Arcale
    October 21, 2010

    I don’t think anybody assigns a vaccination schedule for coolness factor. It’s more about attempting to cover populations when they are most vulnerable to the diseases in question. The vaccine schedule pertains mainly to young children; it’s not going to be altered by discoveries about vaccines affecting prenatal development, because not a lot of six-year-old girls are pregnant. It could, however, affect the ever-changing recommendations for pregnant women and flu shots. It could also affect Rhogam recommendations, although the consequence of rhesus disease are so severe for the fetus that it might still be decided to take the risk.

    I think for other vaccines, pregnant women are usually advised to wait until they deliver, so it may not be particularly relevant apart from influenza recommendations. Certainly it’s a tricky balance that deserves further study in order to make properly informed decisions.

  49. #50 jen
    October 21, 2010

    sciencemom, your post (107) back from the BLF topic said, “the response rate was only (ONLY, you said) 57%.” You really are a crabby person.
    Trisckelethecat: I don’t have a child with autism (maybe because I vacced selectively and certainly not while I was pregnant and then again maybe because of other reasons. I had my kids fairly late at 33 and 37 so if age is a factor then certainly I would be in a risk group, if anything). So therefore I don’t “cram stuff down my kid’s throat.” I definitely defend the parent’s right, though, to use bio-medical/chelation treatments to try and help their child. It has actually helped alot of children.
    Calli and others, I totally get your point about the conclusions of the study and agree that there would have to be more questions asked to really know the *whys* behind this.
    p.s. Calli, at the risk of sounding “religious,” I honestly believe that man has messed a bit too much with vaccination. Please know that I AM for surgery/ meds where necessary but God must have designed our bodies to function without this heavy-handed kind of assault. Laugh all you want and think that’s facile and stupid but that’s what I think. I also happen to believe that most of the studies supposedly “exhonerating” thimerosal are weak and it really does concern me that many of your own kind (science researchers and doctors) don’t believe that vaccines are harmless. Yes, and the monkey studies concern me, too. Alot.

  50. #51 Todd W.
    October 21, 2010

    @Calli Arcale

    Good points. In fact, there are vaccines that are contraindicated for pregnant women due to the risk to the fetus. Here is a list of the CDC’s vaccine recommendations for pregnant women. Note that live virus vaccines should not be given due to a theoretical risk to the fetus, even though we have no solid evidence that it is, indeed, harmful. This is the precautionary principle in action.

    Note, also, that the CDC specifically states that:

    Whether live or inactivated vaccines are used, vaccination of pregnant women should be considered on the basis of risks versus benefits – i.e., the risk of the vaccination versus the benefits of protection in a particular circumstance.

    At present, the evidence suggests that vaccinating against influenza carries less risk than not vaccinating and running the risk of infection. More research may change that.

  51. #52 Calli Arcale
    October 21, 2010

    jen:

    I don’t know if you’ve ever seen the Red Green Show, but I’m rather fond of it. Although they meant it to be funny (poking fun at the American character’s car obsession), I think you might like the way he put it:

    “When you look at the human body, you know you’re looking at something that was meant to be maintenance free. I mean, if the Good Lord had meant for us to get all this medical care, he’d have put a hood on it or something.”

    He also said something about how if you mess around too much, you might void the warranty with that big mechanic in the sky. ;-)

    It’s a valid point of view, but not one which I share. I do think we need to be cautious about tampering with the world, but I also believe that God did indeed give us the means to keep ourselves safe — including sophisticated brains. Also, to complain about vaccines as deviating from God’s order is to ignore the much larger changes we’ve made — like the massive changes we’ve made to the environment. Vaccines may occasionally cause problems, but it’s nothing compared to deforestation, which has the potential to eventually destroy entire civilizations. (It has happened before, and will happen again.) Whether that means the changes to our natural environment should supercede the changes we make to ourselves is less clear. Certainly there are religious groups which tend to agree with you, including a number which take it a good deal further.

    I personally believe God is okay with vaccination; I tend to think He’s more concerned with whether or not we are kind to one another, and things like vaccination are just details.

  52. #53 Scott
    October 21, 2010

    I honestly believe that man has messed a bit too much with vaccination. Please know that I AM for surgery/ meds where necessary but God must have designed our bodies to function without this heavy-handed kind of assault.

    God apparently also designed our bodies to die before we hit 30. Your point?

    I also happen to believe that most of the studies supposedly “exhonerating” thimerosal are weak

    Do you also believe that the evidence supporting the proposition that the sky is blue, or that 1+1=2, is weak? It really is at almost the same level at this point. If thimerosal had had any meaningful effect, autism rates would have dropped by now. Continuing to suspect thimerosal at this point is just not a credible position.

    and it really does concern me that many of your own kind (science researchers and doctors) don’t believe that vaccines are harmless.

    NOBODY at all informed on the subject believes that vaccines are harmless. It is well known that there do exist certain risks, and that a small fraction of vaccinees will be harmed by them. The risk of that is just far, far, far less than the risk posed by the diseases they prevent.

    Seriously, if your bar is “harmless,” then nothing at all passes the test. Every single thing any human has ever done carries some risk of harm.

    Yes, and the monkey studies concern me, too. Alot.

    At the risk of beating a dead horse, (a) they had to go to doses orders of magnitude higher than those seen in vaccines to produce ANY detectable effect, (b) said effect was NOT autism, and (c) even if they constituted conclusive proof that all autism were caused by thimerosal, it would be completely and utterly irrelevant because it’s almost completely gone!

  53. #54 Todd W.
    October 21, 2010

    @jen

    Please know that I AM for surgery/ meds where necessary but God must have designed our bodies to function without this heavy-handed kind of assault.

    Wait. You’re saying that surgery/meds where necessary are okay, but that vaccines are “heavy-handed…assault”? Vaccines involved significantly less “assault” than surgery, in case you didn’t notice. In fact, vaccines involve significantly less “assault” than infection with the wild virus or bacterium.

    And if you view everything we do as whether or not it was intended by God, then I assume you are also against travelling by any conveyance, since, if God intended us to go at 10/20/60 mph, he would have designed us to do so on out own, right?

    If God intended for us to not need various and sundry medical interventions, he would have made so that we don’t get sick and die from some pesky little bug.

    But, really, do you want to get into theologics on this? Frankly, I don’t. It gets very messy and heated and no one feels any better at the end.

  54. #55 Sullivan
    October 21, 2010

    Kim Stagliano and the groups represented by the Age of Autism blog are very keen to be seen as “mainstream”.

    What they gloss over is that people can be both interested in vaccine safety and appalled by the actions taken by their organizations.

    I count myself as one of those who is very interested in vaccine safety and appalled by AoA and it’s parent groups.

  55. #56 W. Kevin Vicklund
    October 21, 2010

    Don’t forget (d) half the control arm showed signs of abnormal brain development.

  56. #57 Sullivan
    October 21, 2010

    Kim Stagliano and the groups represented by the Age of Autism blog are very keen to be seen as “mainstream”.

    What they gloss over is that people can be both interested in vaccine safety and appalled by the actions taken by their organizations.

    I count myself as one of those who is very interested in vaccine safety and appalled by AoA and it’s parent groups.

  57. #58 martin
    October 21, 2010

    Sid@22

    Was it really you, Sid ? As a long-time resident tame troll on this blog you should do better.

    “As an anti-vaccine parent I’m not worried about mild illnesses so the whole depending on the herd is nonsense.”
    Ongoing epidemic of pertussis in California claimed lives of ten infants (CNN, today), I’ll bet that their parents would disagree with you. They might even have strong opinions about people who do not vaccinate their children because they bamboozled themselves into thinking that the whole depending on the herd is nonsense and share thus responsibility for the outbreak (of course you know how it is with infants and pertussis,Sid, it was discussed on this blog many times). If you live in California you do not want to meet those parents (risk of bodily harm etc.)

    “Luck what luck? Since,due to forced vaccination, it would be almost impossible for an unvaccinated person to contract polio how is my not contracting it luck?”

    If you want to put it that way, almost impossible, if there is good good herd immunity. Almost, not impossible. And if there is a lot of people like you in the population, you really need luck. See also above.

    “And how is my child being endangered when the herd has wiped out these illnesses? Endangered by what?”

    Not wiped out. See above.

    And so on .. . Do you enjoy infuriating the others especially if you have to bend the truth, Sid ? It’s a little perverse, but I suppose that it is the secret of good trolling.

  58. #59 Dr. Evil
    October 21, 2010

    Ongoing epidemic of pertussis in California claimed lives of ten infants (CNN, today)

    Car accidents claim lives too but I don’t fear driving

  59. #60 Dangerous Bacon
    October 21, 2010

    jen: “Please know that I AM for surgery/ meds where necessary but God must have designed our bodies to function without this heavy-handed kind of assault (vaccination).”

    So, using scalpels and saws to cut out diseased and dead tissue fits in with God’s plan, but using vaccination to stimulate the body’s innate immune system to recognize and overcome infectious disease organisms is a “heavy-handed kind of assault”???

    “Laugh all you want”

    No laughter here. It’s sad that such tortured logic is preventing some parents from protecting their children from serious diseases, and placing other kids at risk as well.

  60. #61 Prometheus
    October 21, 2010

    Here’s a part of the puzzle that nobody seems to address (or maybe I’ve missed it):

    “…yet parents have little input regarding how those dollars should be spent.”

    As a parent and a researcher, I have to ask, “Why would we want parents to have input on how research dollars are spent?”

    Seriously.

    If a bunch of parents wanted to research the impact of cell-phones on the incidence of retinoblastoma, would that be a reason to study it? There are parents in my community who are convinced that AIDS (the disease) isn’t caused by HIV (the virus) – should we let them decide where to spend research dollars?

    I know this isn’t very “PC” or “empowering”, but parents with no education or experience in medicine or science really have no business trying to direct medical research. If it ever comes down to “Do we study X or Z first?” with “X” and “Z” being of equal importance, then some parental input might be nice, but the fact remains – as we have seen only too clearly on this very ‘blog – that people (including parents) who are not educated or experienced in science (and even some who are) are very easily swayed by irrational fear-mongering and baseless, unsupported “hypotheses”.

    Do we really want medical research directed by “Dr. Oz” and “The View”?

    Prometheus

  61. #62 Sid Offit
    October 21, 2010

    @Gray Falcon

    How’d Chicago’s public fire department fare in 1871. That aside, one argument for a public fire department might be the need to use force to in the commission of its duties

  62. #63 Jarred C
    October 21, 2010

    Apparently Sid thought my argument was based in socialism, when in actuality it was based in sociology. Those producers he’s talking about are still a part of society, and thereby lend to the potential of being supported by society; that section of society is supporting the produce (or whatever else they produce).

    I see his argument as a non-counter to my own, given this misunderstanding.

  63. #64 dedicated lurker
    October 21, 2010

    It’s funny Sid Troll doesn’t fear driving, when he’s much more likely to get in a car accident than suffer ill effects from a vaccine. But hey, cars are comfortable and those needles sure are scary.

  64. #65 Enkidu
    October 21, 2010

    @ Prometheus: “Do we really want medical research directed by “Dr. Oz” and “The View”?”

    Or Sarah Palin. Her belittling fruit fly research and saying we shouldn’t spend money on it made a long-time Republican co-worker of mine vote Democrat in that election.

  65. #66 Big Blue
    October 21, 2010

    [Actual Pharma Shill]
    I too am shocked that parents rated any of those things as unimportant. I would have thought they’d check everything under the sun as “very important” and write in a few more.

    Drug safety is of course my personal concern, seeing as how it’s my life’s work and all, but when it comes to kids, here’s what I wish had more funding:
    -Child abuse (the vast majority of which is inflicted by family members). We don’t have half enough social workers or safe homes for children.
    -Reforming the foster & adoption systems, which are screwed up in oh so many ways.
    -Early childhood education. Schools are forced to take on a great many parenting duties, often due to income inequalities in the communities they serve, and I would like to see a truckload more money devoted to this.

    Whoops, there I go being compassionate again. The MegaPharma programming BrainChip2000 must need an upgrade…
    [/Actual Pharma Shill]

  66. #67 Gray Falcon
    October 21, 2010

    How’d Chicago’s public fire department fare in 1871.

    Quite well, given the circumstances, among other things being that there was no building code preventing people from building a large number of wooden, flammable, buildings close together.

  67. #68 Jay Gordon, MD, FAAP
    October 21, 2010

    ORAC, why would you have such huge knee jerk reaction to a poll that parents are concerned about the safety of medicines and vaccines given to their children? And why further feed what you consider to be misuse of this poll by anti-vaccine pundits?

    Again, I enjoyed your presentation at the Lorne Trottier Symposium but wish you would pay a bit more intention to the real problems in medical care:

    http://www.propublica.org/

    Best,

    Jay

  68. #69 madder
    October 21, 2010

    Jay, are you really that dense? The complaint here is not about the survey, but about particularly ignorant interpretations of it. Such as yours.

  69. #70 https://me.yahoo.com/a/oCTtWpcLos1AluG7TfWegM5e0gCBvNv_LcRvaWc-#66f0b
    October 21, 2010

    @ Sid- you don’t seem to get it. You freely admit that you use the herd immunity of others to protect you, yet you don’t seem to make the connection with the fact that by “pursuing your own self interest” by not vaccinating, you actively reduce herd immunity and put at risk people who aren’t capable of getting vaccines for whatever reason. The tiny risk of a negative side effect (and the ZERO risk of autism) for you and members of your family is something that other families who are responsible go through all the time.

    Nobody’s arguing that vaccines are perfectly safe, but they’re better than the alternative diseases. It’s really a prisoner’s dilemma; if you don’t vaccinate but everyone else does, the general populace might suffer minor side effects and you will probably get away clean. But if no one vaccinates, we start to get major epidemics again, and that is definitely worse for everyone.

  70. #71 jen
    October 21, 2010

    Scott: “It’s (thim) almost completely gone.” Yeah but it is still here. In flu shots. And flu shots are given in combination with other shots-perhaps even off-label in that they haven’t been studied in combination with all other vaccines or say H1N1 shots in pregnancy and vaccines are unfortunately given to sick children. Some researcher lately has noticed a possible problem with yeast and or aluminum allergy for some women taking Gardasil. Cochrane reviews don’t look too promising as far as flu shot efficacy.
    http://www.cochranejournalclub.com/vaccines-for-preventing-influenza-clinical/pdf/CD001269.pdf
    I.m sorry but I just can’t look at all the damaged kids as “percentages” and feel confident that all the “known side effects” are “tabled” and therefore everyone is compensated fairly. I’m not buying it.

  71. #72 AnthonyK
    October 21, 2010

    Wait Dr Jay – you’re saying that “the real problem in medical care” in the USA is that some doctors paid to promote pharmaceutical products are less than competent as doctors?
    That’s it?
    Not poor universal healthcare?
    And certainly not the wilful ignorance of some doctors advising against proven interventions.
    Still, I guess they’re only kids, right?
    I suppose the intention is to smear Orac.
    And divert attention away from your own forprofit denialism.
    Clown.
    Best
    AnthonyK

  72. #73 T. Bruce McNeely
    October 21, 2010

    Wow, what an outbreak of stupid (I’m looking at you, jen, Sid and Dr. Jay)!

    Once again, the antivaxers demonstrate why it is so tempting to point and laugh.

  73. #74 Science Mom
    October 21, 2010

    sciencemom, your post (107) back from the BLF topic said, “the response rate was only (ONLY, you said) 57%.” You really are a crabby person.

    Project much? The low response rate does present a problem with the results, again due to selection bias. A group of people were given a pre-determined set of questions. Fifty-seven percent found it worthwhile to respond, while 43% did not. So these topics were important to those that responded. The interpretation of the results needs to be very measured. Do you know why we don’t put stock in polls?

  74. #75 Orac
    October 21, 2010

    Again, I enjoyed your presentation at the Lorne Trottier Symposium but wish you would pay a bit more intention to the real problems in medical care:

    http://www.propublica.org/

    Why don’t you tell me the results when you type my real name (which I know you know) into the search box, Dr. Jay? I asked you this question once before, and you never bothered to answer. Also, perhaps you should tell us what the result is when you type in Paul Offit’s name.

    I’ll wait.

  75. #76 Dangerous Bacon
    October 21, 2010

    We’re also still waiting for Jay Gordon to tell us, among other things, if he’s going to comply with the American Academy of Pediatrics’ recommendation for all health care providers to be vaccinated against influenza in order to protect vulnerable patients.

    Instead he’s trying to divert attention from those unanswered questions to his obssession with “pharma shills”, which he once again is insinuating includes commenters at this site. He’s done this before, then apologized, but just can’t resist returning to this smear against those with whom he disagrees.

  76. #77 jen
    October 21, 2010

    DB, according to the Cochrane review I mentioned above, Dr. Jay might just as well not bother to get the stupid flu shot.

  77. #78 JH
    October 21, 2010

    I completely agree, that this pole was taken out of context, and read into far more than it should have been. You can’t report on something and act like it’s the truth when you have no proof that it is. However, what angers me the most is that in making the mistake of writing a faulty press-release on the poll, U of M is giving ammo to groups that believe vaccinations are unsafe, as mentioned.

    I am the daughter of a father who has almost no immunity due to high dose chemotherapy and a stem cell transplant. My dad’s doctors have not allowed him to receive vaccinations, because they feel the vaccines could actually give him the diseases due to his virtually nonexistent immune system. My father did do his duty, and received the vaccinations as a child, however with them gone my family is now forced to rely on other peoples vaccinations of their children. This is NOT something we chose, and it has had a definite impact on my family. Only a year ago we were unable to take a family trip due to an outbreak of measles at the intended vacation spot.

    When people don’t vaccinate their kids they put people like my father, who have no choice about their situation, at risk. It is one thing to make a medical decision that impacts only you and your child, but please don’t make a decision that could harm my family. In not getting your child vaccinated you are puttin

  78. #79 JH
    October 21, 2010

    I completely agree, that this pole was taken out of context, and read into far more than it should have been. You can’t report on something and act like it’s the truth when you have no proof that it is. However, what angers me the most is that in making the mistake of writing a faulty press-release on the poll, U of M is giving ammo to groups that believe vaccinations are unsafe, as mentioned.

    I am the daughter of a father who has almost no immunity due to high dose chemotherapy and a stem cell transplant. My dad’s doctors have not allowed him to receive vaccinations, because they feel the vaccines could actually give him the diseases due to his virtually nonexistent immune system. My father did do his duty, and received the vaccinations as a child, however with them gone my family is now forced to rely on other peoples vaccinations of their children. This is NOT something we chose, and it has had a definite impact on my family. Only a year ago we weren’t able to take a trip due to an outbreak of measles at the intended vacation spot.

    When people don’t vaccinate their kids they put people like my father, who have no choice about their situation, at risk. It is one thing to make a medical decision that impacts only you and your child, but please don’t make a decision that could harm my family. In not getting your child vaccinated you are putting many of the people around you at risk something you do not have the right to do.

  79. #80 Coryat
    October 22, 2010

    “Sorry Orac the do-gooders don’t get to decide how children are raised. Parents do”

    “So what if I beat my kids? I certainly won’t allow none of them no good people-who-do-good to step in! My kidz is my property!”

    Also Sid, since you’re worried about tone, now might be a good time to remind you that you’re a cynical unctuous menace, free-loading off of herd immunity. I know that you’re already aware of this, but I thought I should probably re-emphasise it.

  80. #81 Mephistopheles O'Brien
    October 22, 2010

    I was looking over the choices in the poll for what to research, and have my own opinions:

    Leading causes of injuries in children: we really need to research that? It seems we already know a lot about what causes childhood injuries – they fall off of things, they swallow things they shouldn’t, they’re involved in automobile or bicycle accidents, people beat them, they are involved in contact sports, and so on. There should be plenty of statistics on this already, and they generally confirm what people already know. So it comes off as wasted effort.

    Effectiveness and safety of medicines: Just about everybody takes one medicine or another. Medicine safety studies could directly affect my children – regardless of whether I think that medicines are proved generally safe. I expect medicine safety to be studied as part of that “safe and effective” thing.

    Safety of vaccines: See previous answer.

    New treatment for a common childhood disease: Sounds like a reasonable use of research dollars, assuming that new treatment will be more effective, more safe, and less costly than existing treatments. Not necessarily as important as other research depending on the disease and what treatments are already available.

    New treatments for a rare childhood disease: This will sound awful, but if it’s really a rare disease then my child will likely never get it, nobody I know will likely ever get it, it will be difficult and expensive to get a large enough sample to make a useful study, and it will benefit very few people. So – a great use of dollars from a compassionate standpoint, but has less impact than other choices.

    Foods that might cause cancer: Every time someone studies whether a food causes cancer, the answer seems to be yes if the food tastes good and no if it doesn’t. Plus you need to eat 17 times your body mass each day for it to affect you within 20 years. If you’ve already got some kind of strong correlation, maybe. Otherwise, the answer’s going to be “eat less meat and more broccoli”. And I hate broccoli; there isn’t enough cheese sauce in the world.

    Foods that might protect against cancer: Maybe, if you’ve got some strong correlation. Otherwise, see previous answer.

    Things in the environment that can lead to health problems in children: This is something everyone can feel some connection to and could have a big impact. So yeah.

  81. #82 Dangerous Bacon
    October 22, 2010

    JH: “I am the daughter of a father who has almost no immunity due to high dose chemotherapy and a stem cell transplant…When people don’t vaccinate their kids they put people like my father, who have no choice about their situation, at risk.”

    This should make an impression on people who care about the welfare of others. Unfortunately there are those who are proud about not giving a damn.

    Sid: “Selfish in the sense that I put my interests and those of my family ahead of yours and those of the hive – absolutely.”

    Of course everyone’s interests suffer when wilful ignorance triumphs over both reason and compassion.

  82. #83 Vicki
    October 22, 2010

    Dangerous Bacon–

    Yes. These are arguments that work on people who care but don’t have the facts. When my friend Mike died, his companion pushed a lot of people to sign up as organ donors in his memory, because his last few years had been made much better by a kidney transplant. I’m signed up, in the “use any and all useful parts” category. By definition, this won’t do me directly any good. (Some of us were already registered; others just hadn’t thought about it, and listened when Elise asked them to do this.)

    Thinking about Mike is also a bit of why I keep my vaccinations up to date: for the other transplant recipients who are particularly vulnerable to infection because of the anti-rejection drugs. And for the people who are immunocompromised for other reasons. It costs me so little, and it could save a life.

    I’m not urging major self-sacrifice: I live a comfortable life, and I’m putting more money in my savings account than goes to Medecins sans Frontieres, Oxfam, and the United Negro College Fund. But I do give them some, and I do take a little time and trouble in the name of public health.

    Sid: Do you cover your mouth when you cough or sneeze and none of your immediate family are present?

  83. #84 jen
    October 22, 2010

    well I’m not getting any vaccines to “help” anybody. Read the flu shot Cochrane review. I am eating healthy, keeping stress levels down, socializing with friends, getting good sleep, taking good omega 3’s, etc., hand washing and I.m pretty sure that will keep me (and therefore anybody else I’m in contact with) in good shape. That’s bullshit to think everyone should take vaccines when they are so poorly safety-tested. The defensiveness about it is frightening. And no vacc VS unvacc studies make me very skeptical.
    I could just as easily argue that if I got shot up (and my children) that I could become sick (my nana got GB immed after her flu shot) and be a burden on society due to the shots. You can argue that both ways and no one is going to make me get a frickin’ shot. (not least because they aren’t even necessarily effective).

  84. #85 Sid Offit
    October 22, 2010

    Sid: Do you cover your mouth when you cough or sneeze and none of your immediate family are present?

    You know Sid never gets sick.

  85. #86 Todd W.
    October 22, 2010

    @jen

    to think everyone should take vaccines when they are so poorly safety-tested

    What, in your opinion, is the minimum requirement for safety testing? Please be as detailed as you can.

    What is the ideal (as opposed to minimum) for safety testing, in your opinion?

    I could just as easily argue that if I got shot up (and my children) that I could become sick (my nana got GB immed after her flu shot) and be a burden on society due to the shots.

    Yes, you could argue that. However, you need to argue in the context of what we know. For example, the risk of GB after a flu shot is about equal to the general background risk of GB overall for the population in general. In other words, it is extremely rare. Further, GB can also be triggered (again, about the same rate) by general infection. Finally, some (many? don’t have stats on hand at the moment) GB cases resolve on their own and are not permanent, regardless of cause.

    Your example illustrates the poor grasp of statistics and risk that humans have. The risks of serious, permanent injury or death from vaccines is demonstrably lower than the risks of serious, permanent injury or death from the diseases they prevent.

  86. #87 Jarred C
    October 22, 2010

    Jen @ 85 and Todd W. @ 87,

    I just looked up some statistics on GBS, and found that the general prevalence is about 1 in 100,000. On the other hand, the Cochrane Review Jen cites says the influenza vaccine may pose about a 1 in 1,000,000 risk for GBS.

    And according to the CDC, “In 1976, vaccination with the swine flu vaccine was associated with getting GBS. Several studies have been done to evaluate if other flu vaccines since 1976 were associated with GBS. Only one of the studies showed an association. That study suggested that one person out of 1 million vaccinated persons may be at risk of GBS associated with the vaccine.”

    I would figure that if the influenza vaccine could truly trigger GBS as a typical infection would, we’d see a similar rate of infection with the vaccine as we would with the normal rate. Or am I completely misunderstanding the statistics, here?

  87. #88 Todd W.
    October 22, 2010

    @Jarred C

    Thanks for looking that up. Yeah, I recall that the only flu vaccine that was found to have GB as an adverse effect was the 1976 vaccine, but even then, the rate was so low that researchers had a really hard time detecting it above the background rate in the population. So, even that one is questionable. Still, because of that, it is listed as a possible event, however rare.

  88. #89 jen
    October 22, 2010

    well here’s some truth for you (evidence-based medicine):

    my link didn’t work so much *%$! but the 2010 Cochrane review, “Vaccines for preventing influenza in healthy adults,” concluded that influenza vaccines have a modest effect in reducing symtoms and working days lost but there is no evidence that they effect complications such as pneumonia or TRANSMITTION. Under ideal conditions (vaccine completely matching circulating viral configuration) 33 healthy adults need to be vaccinated to avoid 1 set of influenza symtoms. In average conditions (partially matching vaccine), 100 people need to be vaccinated to avoid 1 set of influenza symtoms.
    An earlier Cochrane review of healthy adults showed reduced flu risk by only 6% with vaccination (not sure if that is under ideal conditions?). Vaccines reduced missed work days by less than a single day. Vaccines did not reduce the number of people who sought medical help or took time off work.
    A Journal of Resp study noted no decrease in deaths from influenza and pneumonia despite vaccine coverage among elderly having increased from 15% in 1980 to 65% now.
    A 2006 Lancet study showed influenza vaccine was not associated with a reduced risk of pneumonia in older people. Sorry for the lack of links but I don’t seem to have much luck with that.

  89. #90 muteKi
    October 22, 2010

    This is pretty funny: I notice the poll has absolutely no mention of “autism” anywhere in it. If the people at AoA say anything about being a site about autism rather than being anti-vaccine, we can certainly use this in support of the contrary!

  90. #91 Chris
    October 22, 2010

    Looking at this page on children’s health, that poll has no mention of these issues: asthma, obesity, healthy diet and depression.

    Now I know Dr. Jay only has children who are slim and who only eat healthy organic fruit and veg, but does he treat any kids with asthma and/or depression?

  91. #92 Jay Gordon, MD, FAAP
    October 22, 2010

    Why don’t you tell me the results when you type my real name (which I know you know) into the search box, Dr. Jay? I asked you this question once before, and you never bothered to answer. Also, perhaps you should tell us what the result is when you type in Paul Offit’s name.

    I’ll wait.

    David, I don’t understand this comment.

    Jay

  92. #93 Chris
    October 22, 2010

    Jay, he is asking if you found those names among the doctors on the list. Basically, if you are going to play the Pharma Shill Gambit you need to prove it.

  93. #94 ababa
    October 22, 2010

    Interesting read for those that think they can hide from Measles:

    http://www.msnbc.msn.com/id/39768249/ns/health-infectious_diseases/

    85 cases of the Measles and counting in Canada from the Olympics. Remember that Chicago was in the running for the Olympics recently, isn’t that where the big anti-vax convention is held? Hmm, makes you think.

    “Some parents refuse to vaccinate their children for fear of adverse reactions, Naus noted, and the post-Olympic outbreak is a reminder that infection remains just a plane ride away.” and you don’t have to always be the one on the plane. Sometimes it will come to you.

  94. #95 jen
    October 22, 2010

    what, you science types don’t like the evidence-based medicine? Anyone??

  95. #96 Chris
    October 22, 2010

    jen, read this.

  96. #97 Unc Dave
    October 22, 2010
  97. #98 Jay Gordon, MD, FAAP
    October 22, 2010

    Aaaaah, now I see why you wanted me to Google your real name!!

    Thank you.

    This is kinda’ disgraceful, isn’t it?

    http://bit.ly/draOgm

    Jay

  98. #99 Todd W.
    October 22, 2010

    @Jay

    Bwahahahahahaha! Seriously, Dr. Jay? Really? Apparently, Dr. Jay is just as clueless as young Master Jake about conflicts of interest.

  99. #100 Chris
    October 22, 2010

    I did not say google, it was the link you posted which listed physicians who get pharma money. Are you the real Dr. Jay or an impostor trying damage his already shaky reputation?

  100. #101 Orac
    October 22, 2010

    Wow. I sincerely didn’t believe that Dr. Jay could sink that low or delve into the depths of ignorance as deeply as Jake Crosby. Seriously, the thought that he would parrot Jake Crosby’s nonsense and accept it as a valid criticism never even crossed my mind! Damn if Dr. Jay didn’t go and prove me wrong! Sad, I’ll now have to ratchet my opinion of him down even further.

    Seriously, Dr. Jay. I’m embarrassed for you.

  101. #102 Todd W.
    October 22, 2010

    @Dr. Jay

    BTW, we’re still waiting for your response to, among other things:

    a) the AAP recommendations and how you distorted them;
    b) the California Dept. of Health’s statement that the number of pertussis cases is particularly high, contrary to your statement that the number of cases is “usual”; and
    c) your opinion on whether or not you, as a fellow of the AAP, will get immunized against the flu as the AAP recommends.

  102. #103 AnthonyK
    October 22, 2010

    Celebrity’s kids’ doctor, vaccine denilialist, profiter in so many ways from the health of others, paid shill for Jay Gordon PLC: finally the truth is out.
    You are so intellectually and morally bankrupt, and you have such a large – but fragile – ego, that you have to accuse a cancer surgeon of being in the pay of the pharmaceutical companies.
    Which is, as you know, a lie.
    And all because his criticism of your narcissistic, money-driven, ignorance got to you.
    You really are a slime ball, aren’t you Dr Jay?

  103. #104 jen
    October 22, 2010

    thankyou for the link, Chris. I have to say after reading it (which was during the making of lunch for 3 kids), I am left wondering why Oract used up so many paragraphs to purely speculate on why Tom Jefferson ended up not attending some NCIC event. The RCT talk was interesting but I ended up thinking, after reading this that I am glad there are people out there like him looking into things like flu vaccination. It takes tremendous courage for these guys to question the holy vaccination schedule. The article I tried to link to is from 2010. From a cost/benefit perspective one has to wonder if flu vaccination is worth it, never mind concerns about ingredients such as thimerosal or adjuvant.

  104. #105 Jay Gordon, MD, FAAP
    October 22, 2010

    Good ploy guys: The anti-anti-pharma shill gambit. Oh, never mind. Jake Crosby took a legitimate very biased shot at ORAC and struck a nerve. Choosing to polarize this discussion further is not good judgement on anyone’s part.

    Dear David,

    When one practices medicine and especially when one does research, there are a lot of financial entanglements and accidental conflicts of interest. Honestly, I would never seriously accuse you of being a shill for the pharmaceutical industry.

    On your blog, I watch you assume the persona of “ORAC” and I wear my persona as “unworthy adversary” with equanimity. I have always been certain that in real life you knew that we all have conflicts of interest: Yes, when I have spoken for autism groups I pay my own airfare and hotel bill but, of course, my practice does benefit from the publicity I receive from taking the positions I take. That certainly was not the original reason for my medical philosophy evolving to this point but I don’t mind benefiting from being outside the mainstream. Sometimes it’s just not worth it, but I am sincere in my beliefs and practices.

    The types of conflicts you and I might have are not the same as those documented by the proPublica and I really do take them with a grain of salt.

    I take great joy in some of the self-deprecation allowed on RI and just can’t take myself as seriously as “they” think I do. I might be stone cold 100% wrong! Vaccines might have nothing to do with autism and the distraction might be harmful. I don’t really believe that, but the possibility still is there.

    I just don’t understand how you can keep up the ORAC persona day in and day out and even into FB, private email and everywhere else. You see, you might be wrong.

    And no, you haven’t been “too easy” on me. You and your friends have been unfairly harsh, biased, nasty and often illogical in your comments.

    We have to lighten up a little.

    OK?

    Jay

  105. #106 Jay Gordon, MD, FAAP
    October 22, 2010

    Just one last question: David, AnthonyK and the rest of you, you all seem so comfortable being vicious and scurrilous in your attacks from the anonymity of your RI persona. Would you mind actually using your real names like I do? It might tone down your rhetoric, force you to stop being so uncivil and actually lead to a higher level of civil discourse on this important blog. You accuse me of being sensitive and all “Mr Nice Guy.” Well, that’s actually who I am in real life. Who the hell are the rest of you??

    Jay

  106. #107 dedicated lurker
    October 22, 2010

    Hey Jay, you rarely comment on the blog where he uses his real name. No one’s stopping you.

  107. #108 ababa
    October 22, 2010

    Real names to “tone down the rhetoric”? More like real names so the anti-vaxers can hunt down and attempt to harrass them into silence, much as has happened to Orac and Rene Najera among others.

    Are you completely unaware that people that speak in favor of vaccines like Offitt have to suffer through death threats and have their livelihood threatened based on irrational fear? People that go up to him and creepily say “now I know what you look like”? Ever had anyone call your house and tell you they know where your kids go to school? You chose to put your foot into the arena, but do you have bodyguards and fear reprisal from doctors that disagree with you? Have you ever had a pro-vaxer threaten you with harm personally? Mean words on a blog don’t count, there is fierce support for vaxing, but “pharma shills” don’t resort to guerilla tactics as far as I have heard.

    There is a reason people do not put their neck out like that. The side you support is well known for harboring the crazy.

  108. #109 Jay Gordon, MD, FAAP
    October 22, 2010

    Ababa, what you call putting “their neck out” I call courage and integrity.

    I offer no support to anyone in the anti-vaccine camp who makes threats or harasses Dr. Offit, ORAC or anyone else. I have said that before. I have had pleasant conversations and email exchanges with Dr. Offit. We disagree but I respect his sincerity. I do not feel the same way about anonymous attacks, insults and threats from those on any side of the issue. Read the trash above and ask yourself if “slime ball” and other clever epithets have any place in a discussion among civil intelligent adults.

    Jay

  109. #110 Todd W.
    October 22, 2010

    @ababa

    Nailed it, mate.

    @Jay

    Vicious? Chuckling while you make a fool of yourself is not “vicious”, my friend. Pointing out that you are wrong is not “vicious”, either.

    Vicious is what ababa describes.

    And scurrilous? Please point out where anyone has been grossly or obscenely abusive. Scurrilous is the kind of thing that you regularly find at AoA, like their use of words like “whore” or their Thanksgiving portrait of vaccine supporters sitting down to eat a baby.

    Now, about those unanswered issues:

    a) the AAP recommendations and how you distorted them;
    b) the California Dept. of Health’s statement that the number of pertussis cases is particularly high, contrary to your statement that the number of cases is “usual”; and
    c) your opinion on whether or not you, as a fellow of the AAP, will get immunized against the flu as the AAP recommends.

  110. #111 Dangerous Bacon
    October 22, 2010

    Jay says: “You accuse me of being sensitive and all “Mr Nice Guy.””

    I guarantee that I’ve never accused you of anything of the sort. :)

    Really, Jay, this goes beyond tiresome. You duck questions and resort to personal nastiness (going back to making unfounded pharma shill accusations after having it backfire on you previously and finding it necessary to apologize). Then you have the gall to gripe about how mean and nasty we all are and call for niceness.

    If (as I suspect) you show up here because you just can’t stand the idea of being disrespected by most of your colleagues and the thinking public (and having the debunking of your pitifully lame antivax views show up on Google searches), try to achieve something beneficial. Debate in good faith, present the latest antivax nuttiness, trade snarks with the locals, whatever entertains you.

    But try and be consistent. The way you come across now is like a petulant fifth-grader who’s been left off the cheerleading squad.

  111. #112 madder
    October 22, 2010

    @Dangerous Bacon:

    That’s Jay’s modus operandi. Come in, throw around a few baseless allegations, see his hypocrisy pointed out, accuse people of incivility, repeat pointing-out of hypocrisy, flounce off in a huff.

    He has done this time and again on this blog. Given previous experience, he only has a couple more posts in him before he slinks away.

  112. #113 jen
    October 22, 2010

    Ababa: People who take the stance of questioning vaccines don’t get anything creepy or have “guerilla tactics” employed to them, do they? No siree, people like Desiree Jennings don’t get harassed by anyone, people like Barbara Loe-Fisher, Wakefield (silenced by pharma), Jefferson, etc. etc. Most of the time,you guys are so biased it is scary. I have seen a few examples of humility and allowance for the possiblity that you are wrong- I remember one interchange when Calli talked about off-label usage of vaccines where it seemed like there was open-mindedness happening. Another time, somebody did aknowledge that there could be longer post-vaccine sureveillance with animals (I forgot what the person called it- extended phase 4?). Recently some one did aknowledge a posters concern re. pregnant women being given vaccines that the poster was speculating as to specific biologic avenues of harm. Maybe I’m naive but it would be nice if there was more open-mindedness.

  113. #114 Todd W.
    October 22, 2010

    @jen

    Re: Jennings, Loe Fisher and Wakefield, what kind of guerilla tactics have been employed against them? I don’t recall hearing about people calling Jennings at home or pestering her at work (other than the media, which, frankly she brought on herself, since she took her case to the media in the first place). Nor do I recall hearing of Loe Fisher receiving the kind of treatment that Offit or Rene Nejera have received. In fact, she tried to silence her critics with a frivolous libel suit. As to Wakefield, perhaps you could provide evidence that pharma silenced him, rather than him shooting himself in the foot with all of his unethical antics.

    I’m willing to be shown that I am wrong, and I certainly do not condone harassment, but seriously…the majority of the stories that I hear are about people against vaccines making death threats, making complaints to pro-vaxers’ workplaces in an attempt to get them fired, and so on.

    As to vaccines, yes, we all might be wrong. I doubt that anyone here who supports vaccines would say that we are 100% right, without a doubt. What we do say is that, barring any further evidence, certain claims made by antivaxers are highly unlikely. For example, it is extremely unlikely, given the evidence that we have, that thimerosal has any connection to autism. But, we may be wrong about that. Nothing in science is 100%, either for or against. Absolute certainty is a standard that seems to be demanded, unreasonably, by those opposed to vaccines.

    When it comes down to it, we keep asking for antivaxers to produce some good evidence in support of their claims, but they never do.

  114. #115 Chris
    October 22, 2010

    jen:

    Wakefield (silenced by pharma)

    Oh, really?

    (and yeah, I did not expect you to understand that article)

  115. #116 novalox
    October 23, 2010

    Honestly, whoever can take Wakefield seriously after all of the violations he did in his “research” can’t really be taken seriously.

  116. #117 g724
    October 23, 2010

    If only for that pesky herd immunity issue, I’d say let the idiots go unvaxed, and let Darwin have them and their offspring too. That may sound terribly callous, but the world is overpopulated anyway, and scientific literacy is a perfectly good Darwin test for staying in the gene pool.

    But alas, their Typhoid Mary behaviors can take down the rest of us. So perhaps we should let them have an entire state to set up as their little theocracy, and quarantine the hell out of the place. In a generation or two nature will run its course, and the place will be wide open for redevelopment, plus or minus spraying to get rid of the mosquitos and plague fleas.

    BTW, I got my flu shot last week.

  117. #118 Chris
    October 23, 2010

    g724:

    I’d say let the idiots go unvaxed, and let Darwin have them and their offspring too.

    I have child with both a seizure disorder and a genetic heart condition. I want you to specifically detail why these two boys deserved their fate. Explain clearly, and include well researched documentation.

  118. #119 Chemmomo
    October 23, 2010

    Chris @119,
    chill and read his whole post, will you?

    So perhaps we should let them have an entire state to set up as their little theocracy, and quarantine the hell out of the place

    I see nothing wrong with that picture.

  119. #120 AnthonyK
    October 23, 2010

    Hay Jay – really, if you don’t like the heat, don’t post here. Why bother anyway – you’ve got your nice little practice, reeling in the money, and forgive me if I’m wrong, but as a pediatrician it’s not like you have to do anything is it?
    I mean, you never have to stop kids dying or anything like that, do you – heck some days ago you said you had a patient who might have had pertussis, but you didn’t even bother to run the tests (!). And presumably, presented with a genuinely sick kid, you just refer them to someone else who’s an expert on (that kind of) medicine – correct?
    So…..apart from the salary why…..you’re hardly a doctor at all, right?
    But you still give your patients advice which ignores the opinion of those who, unlike you, are experts in the field of child health.
    And they say: vaccinations are responsible for a massive decline in child disaeses/mortality and are as safe as any intervention can possibly be.
    You say…..I don’t know, I don’t understand, I make money by being anti-vax….and stop being mean to me.
    Hey, you’ve just accused Orac (oh so subtly) of being a Pharma Shill, and then of having a COI a la Jake Crosby.
    And now your feelings are hurt by the nasty anonymous commentators.
    Awwwwww………
    Clown
    Best,
    AnthonyK

  120. #121 squirrelelite
    October 23, 2010

    I also think g724 was only being sarcastic or at least sardonic, but like Chris, I wouldn’t wish the consequences on the unfortunate children.

  121. #122 Kristen
    October 23, 2010

    Dr. Jay

    Would you mind actually using your real names like I do? It might tone down your rhetoric, force you to stop being so uncivil and actually lead to a higher level of civil discourse on this important blog.

    For me, Dr. Jay it is out of fear of retaliation. It is rare IRL that I get to talk about these issues at all because I don’t want to be blacklisted by the other mothers of children in my son’s class (and elsewhere I am in contact with other parents of autistic children). I don’t know who I come in contact with will turn out to be anti-vaccine, but it seems this issue has become almost as heated as abortion (I have actually had a woman tell me I was abusing my son because he isn’t on a GFCF diet).

    Now that we know our four-year-old daughter is on the autism spectrum (not as affected as her brother) I am even less inclined to “rock the boat”. I try very hard to be reasonable here but I must admit sometimes trolls push my buttons in a very personal and hurtful way. Ask Ms. Stagliano or Ms. McCarthy how a mother is apt to react to such comments (I actually think my reactions are very mild compared to theirs).

    I have a very unique last name and if you google my name there only two people come up from the US and it is pretty easy to tell which is not me. My life is extremely complicated as it is, I don’t need more to deal with.

    I don’t mean to inflate my importance, I don’t think I am worth the waste of time it would take to harass me. But it is not outside the realm of possibility and therefore not a risk I am willing to take.

    On a positive note: the three younger children got their flu vaccines (flumist) on Wednesday. The baby needs another dose in a month, but it is nice to have that chore crossed off my list (it is not exactly easy to get anything near Gabriel’s face, much less up his nose (apparently it takes two nurses and me) the middle girl didn’t take it very well either, but the baby just giggled through the whole thing). Teen is getting hers Nov. 2 and she will be done with her Gardasil soon (thank all that is holy).

  122. #123 Composer99
    October 23, 2010

    Echoing other statements regarding Dr Jay’s comments re: anonymity & civility:

    (1) Considering what Jake Crosby attempted to do to Orac (e.g getting him fired) and what Paul Offit has gone through thanks to anti-vaxxers: no, I don’t think everyone using their real names would be a good idea.

    (2) This is the Internet. If you’re being concerned about anonymous people saying mean things to you, don’t surf it. There’s far worse places (almost any gaming forum, for instance).

    (3) There is, in fact, no guarantee that people would be any more civil to you if we all used our real names on this blog.

    To sum it up (and to use some gamer lingo), Dr Jay, you appear to be engaged in some n00b QQ because you don’t like getting pwned. (And that, I can assure you, is very mild.)

  123. #124 dean
    October 23, 2010

    Jay, why do you think ignoring best practices and science in the “treatment” (there’s an abuse of a word to describe what you do) of your patients is a good thing? And why would you expect to be considered a decent person, let alone a decent physician, because of it. Your whines about attacks are a childish response to the scorn you deserve.

  124. #125 a-non
    October 23, 2010

    Would you mind actually using your real names like I do? It might tone down your rhetoric, force you to stop being so uncivil and actually lead to a higher level of civil discourse on this important blog

    Yeah, ok. Like I’d going to give my real name to people that have no problem calling other people’s employers, harassing family members or threatening (or actually filing) spurious lawsuits. No thank you.

  125. #126 Chris
    October 23, 2010

    Chemmono:

    chill and read his whole post, will you?

    I admit to not completely reading the whole post, and I do get the same knee-jerk reaction when I read the “Darwin eugenics” argument. But setting up their one state does not make all better.

    I am presently reading a book on the 1960s rubella pandemic, and it is not a happy fun good time book. The effects were devastating on families, the institutions (which is where kids were almost automatically sent, and they became crowded), and the kids (especially the ones who languished in those institutions). So seeing what happened with one disease before there was a vaccine, the mind boggles at what could happen in an entire state without vaccines.

  126. #127 Orac
    October 23, 2010

    @a-non

    Oddly enough, now that so many people know my real identity, I’ve found it oddly liberating. Jake Crosby and his idiotic cohorts at AoA may have inadvertently done me a favor in that their threats to “out me” have now been carried out, and I’m still standing.

    However, I’m fortunate. It could have gone the other way. I fully understand–better than most!–why others would prefer pseudonyms.

  127. #128 AnthonyK
    October 23, 2010

    Yes Orac and I think it’s time you were properly outed on your own blog.
    You are in fact Dr JAY GORDON, a pediatrician from California.
    Sorry, but it’s time for you to come out and confess it to the world.
    Now, doesn’t that feel better?

  128. #129 Joseph
    October 23, 2010

    The poll does show something. There’s probably more media coverage of vaccine safety than any of the other issues listed in the poll, such as foods that might cause cancer. Obviously, there’s well-funded PR as well, with full-page ads in major news papers, and so forth. The results are therefore unsurprising.

  129. #130 Prometheus
    October 23, 2010

    “jen” makes an interesting claim:

    “…Wakefield (silenced by pharma)…”

    Funny, Dr. Wakefield doesn’t seem too silent to me. Apparently “pharma” couldn’t block publication of “Callous Disregard”.

    Frankly, the argument that “pharma” (Big, Little or Medium) can “silence” anyone flies in the face of reality.

    Prometheus

  130. #131 Sauceress
    October 23, 2010

    Would you mind actually using your real names like I do? It might tone down your rhetoric, force you to stop being so uncivil and actually lead to a higher level of civil discourse on this important blog

    Jay
    Would you mind actually addressing the critiques, questions and concerns addressed to your anti-factual proclamations, instead of focusing on the language and names of the posters? It might tone down your use of unsupported assertions, force you to stop employing disingenuous evasion tactics and actually lead to a higher level of civil discourse.

  131. #132 Prometheus
    October 23, 2010

    Sauceress,

    Unfortunately, when “Dr. Jay” says “civil discourse” what he really means is “stop asking me to support my claims with data – just take my word for it”. He actually relishes pseudonyms and harsh language because they allow him to “concern troll”. What he’s trying to do is distract us from his many unsupported assertions.

    “Dr. Jay” is fully aware that many of the people using pseudonyms do so because the anti-vaccine, pro-“alt-med” folks are quick to use harassment, threats, intimidation and even lawsuits to silence their critics. He knows this, but he chooses to pretend he doesn’t. As I said, it’s all about distracting his critics from his lack of data.

    Prometheus

  132. #133 Orac
    October 23, 2010

    Yeah, I don’t buy Dr. Jay’s excuse for a minute that the reason he doesn’t post at my other blog is because he “doesn’t have time.”

    Let’s put it this way: Given his limited time (which actually doesn’t seem to be that limited), Dr. Jay could have easily decided to comment where I post under my real name instead of posting here. Also, given his claim that he wants “civility,” I point out that the tone is clearly less “nasty” there. Yet he never makes that choice. Instead, he always posts on RI, where I use a pseudonym and the tone is more “militant,” if you will. He does that because at RI he can play the martyr and don the mantle of the voice of “reason” compared to all the chattering skeptics who (in his apparent view) are so very, very nasty compared to the über-nice Dr. Jay Gordon, who never, ever says anything nasty (except, of course, when he accuses those who disagree with him of conflicts of interest and dishonest motivations).

  133. #134 MI Dawn
    October 23, 2010

    Dr Jay: Although I don’t use my full name, Dawn is my real first name. It wouldn’t take someone really determined a lot of work to figure out who I am, where I work and a lot of other data. However, I have had to deal with a stalker in the past and I prefer NOT to use my full name or any version of it because he is still around and occasionally pops up to scare the hell out of me. So, no, thanks, Dr Jay. I am NOT going to use my full name. But you can call me Dawn.

    (For those newer to the blog, I use MI Dawn because there was another Dawn who used to post; you may see references to “Crazy Dawn” that refer to her and I didn’t want to be associated with her. Sometimes posts from me will get posted with my google log in from Pharyngula; in that case you will see triskelthecat instead. I try to remember to sign those posts if I am aware that I am signed in but don’t always catch it in time.)

  134. #135 Chemmomo
    October 24, 2010

    @Chris re 119 & 127
    I understand the knee jerk – my response qualifies as one as well. You’ve been dealing with the crazies waaaaaay longer than I’ve even known they exist, and you do it much better than I do. But I didn’t think g724 numbered among the crazies.

    You’ve mentioned the books on rubella before – would you be willing to repost the titles and authors? I am finishing up John Barry’s the Great Flu (on your recommendation) now, but I’m due back at the library at the end of the week, and I think I’d like to read that one too.

  135. #136 Chris
    October 24, 2010

    Sorry about the knee jerk reaction. I know he did not number among the crazies, but everyone needs to realize that simple solutions do not fit complex issues. And thanks.

    The book is Dangerous Pregnancies by Leslie Reagan. I am only at chapter two, and have learned that many of the kids at the infamous Willowbrook School were there because of rubella. For a book that is really about legal history, it is quite readable. It is much much easier to read than William O’Neills Plagues and Peoples.

    (I am amazed that fascinating subjects can be written about in a manner so dreary that I give up. This is what I encountered when I read about the World War II predecessor to the CIA, a biography of Ada Lovelace and the stories of the Buffalo Soldiers, including that of a woman who served while posing as a man. It must take a special talent to turn something so interesting into an incredibly dry boring read!)

    My library did not have Dangerous Pregnancies, so I bought it from Amazon (along with Arthur Allen books Vaccine and Ripe, the latter being on tomatoes — I’m a gardener). I will be asking my poor financially scrapped library to purchase some copies (it did not buy Wakefield’s Callous Disregard, but did buy a few copies of Age of Autism by Olmsted and Blaxill — ugh!… my local branch’s copy of Evidence of Harm is gone).

    I’m am happy to see you use your library! I recently wrote an article about Library Love.

    I was given a gift certificate for a bookstore for my birthday. So I actually bought my own personal copy of The Great Flu and Vaccinated the biography of Maurice Hilleman (which has several references to Willowbrook!) even though I had already read the library versions.

  136. #137 ScienceCat
    October 25, 2010

    This article was dishearetening at first but now I am grateful.

    I’m profoundly grateful to be living in an era where it is worthwhile to do research on the cause and prevention of childhood injuries (surely this is nothing new? Dr. Louis Francescutti’s been doing injury research in general for decades and he isn’t the only one) because almost all kids are now surviving the diseases of infancy and living long enough to *get* injured. I am profoundly grateful to be living in an era where my lifetime odds of getting cancer somewhere along the line have increased because I’ll probably live longer and am not as likely to die from other things(I didn’t die of typhoid at age 2) and where there actually are treatments that might prolong my life if I should get cancer and ease my death if it’s not possible to cure me. I’m grateful that most kids these days don’t have to deal with mumps and chickenpox like I did, even though I didn’t have too bad a time with them personally. Sick isn’t ever fun and there were risks. Some of the kids in the neighbourhood weren’t as lucky as I was and ended up with long-term damage. I’m grateful that my odds for polio and measles were less than faced by my parents because I had a vaccine. I’m grateful that the smallpox vaccination I received may be one of the last ever. I’m even profoundly grateful to be living in an era where it is actually possible for the selfish to freeload off the herd immunity created by vaccines and where woo-espousers can credit their recoveries to whatever new age nonsense they substituted or added on to their conventional treatment (instead of admitting that they simply beat the odds). The fact that they can sometimes get away with this nonsense is a sign that overall, things are pretty dang amazing medically in this modern era of ours.

    But… I still hate that they do it and I hate it even more when they spread it around. It’s like listening to termites chewing at your house – you always have to wonder if they will eventually do enough damage to bring it down. It won’t be to their benefit if they actually succeed but it won’t be to my benefit either. Do antivaxxers also boycott fire drills? They aren’t risk-free either.

    In my deepest darkest fantasies sometimes I wonder what this spoiled, privileged society that I live in would be like if basic risk analysis and critical thinking were taught in grade school.

  137. #138 chemchemchem
    October 25, 2010

    This is quite an interesting topic to discuss.
    I’d have to agree that the poll that was taken was very broad and shouldn’t really be looked into that much for conclusions or information. As far as vaccines go I have to say that they have done much help to us today, they do help prevent many different disease that we are exposed to today. However, there are many other people out in the world who do not exactly believe that much comes out of vaccines. I feel that many people begin to look for negative arguments about vaccines such as that vaccines can cause autism; statements such as these should always be looked into for information supporting the idea or going against it.
    The poll released by C.S. Mott Children’s Hospital does begin to look into the important ideas of research for diseases, safety of vaccines and medications which is a step in the right direction. Obviously more research is exactly what is needed in this situation, and with more research will come more discoveries and answers.

  138. #139 Chris
    October 25, 2010

    chemchemchem:

    I feel that many people begin to look for negative arguments about vaccines such as that vaccines can cause autism; statements such as these should always be looked into for information supporting the idea or going against it.

    Here you go. It looks like you have some reading to do.

  139. #140 Chris
    October 26, 2010

    Todd:

    Nor do I recall hearing of Loe Fisher receiving the kind of treatment that Offit or Rene Nejera have received.

    Have you seen this? It’s brilliant.

  140. #141 Todd W.
    October 26, 2010

    I’ve seen variations of that argument around, though never with the same style. Heck, I’ve even half-jokingly suggested the idea, not to mention giving some ammunition for the idea with my admittedly basic research into costs on my site.

    Thanks for sharing.

  141. #142 Calli Arcale
    October 26, 2010

    chemchemchem:
    I’m curious; do you think that vaccine safety should be studied *only* because some people are worried they might cause autism? I disagree strongly — I think vaccine safety (and all medicine safety) needs to be studied urgently totally apart from any concerns about autism. It’s a worthy topic in and of itself, which is why this poll cannot possibly show us anything about whether or not parents trust vaccines or think they may cause autism.

  142. #143 T. Bruce McNeely
    October 26, 2010

    Slightly OT:

    Jenny McCarthy says she would pose naked for $2 million for “autism research”:

    http://www.mnn.com/lifestyle/arts-culture/blogs/jenny-mccarthy-would-get-naked-for-charity

    Shudder.

  143. #144 ababa
    October 26, 2010

    Slightly OT:

    Jenny McCarthy says she would pose naked for $2 million for “autism research”:

    At least she would finally be doing something in which she has expertise…

  144. #145 Todd W.
    October 26, 2010

    Re: McCarthy harking back to her Playboy days to raise money for research

    Hey, if she wants to, more power to her. At least then her crew would actually be ponying up some money to research the questions they feel the rest of the science community hasn’t answered. Whether it will be quality research is an entirely different matter. Hopefully they’ll give the money to a reputable scientist/lab instead of Mr. Wakefield or the Geiers.

  145. #146 Art Tricque
    October 29, 2010

    The Economist has a recent (October 14, 2010) article “A smarter jab” with the sub-headline “Big drugs companies see a bright future for vaccines” http://www.economist.com/node/17258858

    For decades vaccines were a neglected corner of the drugs business, with old technology, little investment and abysmal profit margins. Many firms sold their vaccine divisions to concentrate on more profitable drugs. This troubled public-health experts because vaccines are a highly effective way of dealing with diseases.

    Happily, a renaissance is under way.

    Thank goodness! The article mentions work by Crucell on a “universal” [quotation marks sic] flu vaccine, by Novartis and Synthetic Genomics Vaccines on “seed” [again quotation marks sic] viruses to speed up making seasonal flu vaccines, and other innovations.

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