As Vaccine Awareness Week, originally proclaimed by Joe Mercola and Barbara Loe Fisher to spread pseudoscience about vaccines far and wide and then coopted by me and several other bloggers to counter that pseudoscience, draws to a close, I was wondering what to write about. After all, from my perspective, on the anti-vaccine side Vaccine Awareness Week had been a major fizzle. Joe Mercola had posted a series of nonsensical articles about vaccines, as expected, but Barbara Loe Fisher appeared to have sat this one out, having posted nothing. Well, not quite. More like almost nothing. I noticed that the NVIC did publish a new post earlier this week that I had somehow missed entitled Plug Into New NVIC Advocacy Portal & Protect Vaccine Exemptions. What is this portal? Barbara Loe Fisher describes it thusly:

The weeklong series of articles about vaccination published on Mercola.com includes the launch of NVIC’s Advocacy Portal, which is a free online interactive database and communications network that empowers citizens to protect and enhance vaccine exemptions in all 50 states.

And there you have it, the real mission of the anti-vaccine movement in general and the NVIC in particular, to discourage vaccination wherever possible under a false mantle designed to camouflage its true purpose, the mantle of “informed consent” and “health freedom.” What, you say? Who could ever argue with the concept of informed consent or health freedom? I can, not because I don’t support the right of individuals to determine what they will do with their bodies or what treatments they will or will not accept. Rather, it’s because the “informed consent” that anti-vaccinationists promote should more properly be referred to as “misinformed consent.” At every turn the anti-vaccine movement promotes pseudoscience, misinformation, and quackery to frighten parents into not vaccinating. After all, all informed consent is based on providing an accurate accounting of the risks and benefits of an intervention being proposed. The anti-vaccine movement and the NVIC downplay the potential benefits with frequent propaganda claiming that, for example, flu vaccines don’t work. More importantly, they hype the risks of vaccination to make them seem orders of magnitude more severe than science does, and if they can’t come up with a real potential complication, they make one up! After study upon study failing to find an association between vaccines and autism, they still promote the idea that vaccines cause autism. Heck, the head of Generation Rescue, J.B. Handley, was doing it just the other day!

In fact, if there’s one thing I’ve learned over the years, it’s that the idea behind the “informed consent” argument is not real informed consent. Rather, anti-vaccinationists hide behind the term to provide a set of information to parents consisting of cherry picked studies, misinformation, and pseudoscience that so completely demonizes vaccines and denies their benefits that the only rational response to such information, if the information is accepted as valid, would be to refuse vaccines. Because most parents don’t have the scientific background to recognize the misinformation promoted by the anti-vaccine movement, many parents do tend to accept the propaganda as accurate–or at least as sufficient to sow fear and doubt in their minds about vaccines. This is what I meant by “misinformed consent.” Couple the technique of promoting misinformed consent to an appeal to the idea that refusing vaccines is akin to freedom, and that combination produces a powerful appeal, particularly here in the U.S., where appeals to “health freedom” can be mixed into libertarian “get the government off my back” politics. Mercola and Fisher explicitly tap into that sort of sentiment in announcing the NVIC program:

“The national forced vaccination lobby is well organized and they have billions of taxpayer dollars plus billions more from Big Pharma at their disposal to persuade state legislators to approve more and more vaccine mandates,” said Dr. Mercola, “That is why I am partnering with NVIC and encouraging everyone to join with us and take action now to protect vaccine exemptions in all states.”

NVIC co-founder and president, Barbara Loe Fisher, said “Dr. Mercola and I know it is time to get serous about legally defending the human right to informed consent to medical risk-taking in America. Everyone who registers for NVIC’s Advocacy Portal will learn how to work in their own state for the legal right to make voluntary vaccine choices for themselves and their children.”

Note the “framing,” if you’ll excuse the term. To Fisher and Mercola, public health officials aren’t referred to as public health officials. That’s way too neutral a term. Rather, they’re the “forced vaccination lobby.” Even worse than that, they aren’t just the “forced vaccination lobby” out to steal your freedom away; they’re the “forced vaccination lobby” funded by an unholy cabal made up of the government and big pharma. Similarly, to Fisher and Mercola, undergoing vaccination to prevent disease is not, as science tells us, a high benefit/very low risk medical procedure. Oh, no. To Fisher and Mercola, it’s “medical risk-taking,” as though vaccinating were some sort of game of Russian Roulette. This is what I mean by “misinformed” consent, and Fisher’s been playing the game of representing her anti-vaccine views as “pro-freedom” for a very long time. She’s been quite good at rebranding the NVIC to be seen not as the crank organization that it is, but rather as a “vaccine safety watchdog.” This framing allows the NVIC to represent its portal as a “one stop shop for vaccine choice advocates”:

“The religious and conscientious/philosophical belief exemptions to vaccination are being targeted for elimination by drug company lobbyists and doctors and organizations with financial ties to vaccine manufacturers,” said Dawn. “We wanted to create a one-stop shop for informing people in real time about what is going on with vaccine laws and policymaking in their states to help level the playing field. Now concerned families can make their voices heard and be represented in their own state legislatures.”

Dawn emphasized that the NVIC Advocacy Portal, which took more than a year to develop, is still “a work in progress.” “Even though the NVIC Advocacy Portal is in its infancy, we knew we needed to launch it now to give people a way to take immediate action,” she said.

What does this portal offer anti-vaccine activists? A fair amount of stuff, including contact information for legislators, instructions for how to try to persuade legislators to expand vaccine exemptions, online training sessions on “vaccine choice” advocacy, a rapid response system that alerts anti-vaccine activists to legislation that the NVIC wants them to oppose or support, message boards, and online newsletters. Come to think of it, I’m half tempted to join the NVIC Advocacy Portal in order to keep tabs on them. And so I would have if they didn’t ask for my address. On the other hand, I’ve been meaning to get a post office box for a long time.

Still not convinced that this whole project is anti-vaccine, not pro-freedom or pro-safe vaccine? Check out this flourish at the end:

“Barbara and I know that freedom is not free,” said Dr. Mercola. “We need to organize and raise millions to fight Big Pharma and Corporate Medicine. We must fight the forced vaccination lobby that wants to enslave us and make us buy and use more and more vaccines so drug company stockholders make bigger and bigger profits. I have selected NVIC as one of my favorite charities because I want to win this war against forced vaccination in America.”

Oh, goody. The NVIC and Joe Mercola, two crappy woos that taste crappy together–and endanger our children as well.

It turns out, though, that Barbara Loe Fisher and Joe Mercola aren’t the only anti-vaccine loons getting in on the act. SafeMinds has apparently decided to break out a new anti-vaccine propaganda effort to persuade people not to be vaccinated against influenza this year. As Autism News Beat points out, now that the election is over, vaccine rejectionists are calling for a “fresh start” in persuading legislators to pass antivax-friendly laws. Besides having produced a new brochure and trying to get its followers to contact their legislators, SafeMinds is trying to raise money to show this video (among others) in movie theaters during the holiday season:

Note the intentionally inflammatory juxtaposition of images of pregnant women with toxic waste dumps, the implication being that injecting pregnant women with the flu vaccine is the equivalent to injecting them with toxic waste. SafeMinds makes a big deal over a claim that thimerosal can’t be disposed of in a landfill. Actually, lots of drugs and medical waste can’t be disposed of in a landfill either. There are special landfills for them. The utter intellectual dishonesty and sheer, neuron-apoptosing stupidity behind these images makes baby Jesus weep. Sure, they say in the ad dthat they only want to tell you “not to take the risk” and to demand “mercury-free” vaccines, but in reality, this is of a piece with SafeMinds’ general anti-vaccine stance. This is made plain in a followup video SafeMinds released the other day. If the first video was the media-friendly mild plea, this one goes full-on conspiracy-mongering anti-vax crazy:

Let’s see. Voice of doom narrator? Check. Montage of mainstream media and blogs arguing against SafeMinds as though in a conspiracy? Check. The narrator intones ominously, “Listen to mainstream science and the media, and you might think the vaccine-autism debate is over and done with. The ‘vaccines don’t cause autism’ drumbeat is steady.”

Why, yes. Yes it is. From a scientific standpoint, the vaccine-autism “debate” (in reality a manufactroversy or pseudodebate) is over and done with. It has been for a long time. In fact, even though I’ve criticized her for being a little careless with her facts from time to time, I really liked one of the clips in the video featuring Dr. Nancy Snyderman. In it Dr. Snyderman repeatedly and aggressively slapped down the annoying Matt Lauer when he kept referring to the vaccine-autism link as “controversial,” telling him (quite correctly) it is not controversial–because it isn’t controversial among scientists and physicians. As I’m wont to say from time to time, from a scientific standpoint, the vaccine-autism hypothesis is pining for the fjords. It’s passed on! This hypothesis is no more! It has ceased to be! It’s expired and gone to meet its maker! It’s a stiff! Bereft of life, it rests in peace! (Except that it doesn’t; it’s a zombie that keeps rising from the dead.) Its metabolic processes are now history! It’s kicked the bucket, it’s shuffled off its mortal coil, run down the curtain and joined the bleedin’ choir invisible!!

It is an ex-hypothesis, and, yes, I do so love Monty Python’s Dead Parrot Sketch.

The room temperature nature and lack of scientific metabolic activity of the vaccine-autism hypothesis don’t stop Bernadine Healy, though. How predictable. Ever since Bernadine Healy went over to the dark side in order to become Age of Autism’s Person of the Year for 2008 for her increasing flirtation with the anti-vaccine movement, she’s become the go-to woman for anti-vaccine crankery. I’ve discussed Healy on more than one occasion here; I don’t feel an obligation to discuss her again other than to point out that she’s become a hack of late. But because she was the Director of the NIH back in the 1990s, she’s the best friends anti-vaccine loons could ever have because she grants them the patina of scientific respectability. In fact, she’s the first person shown after the voice of doom intones that “not all scientists agree.” Just as creationists and global warming denialists trot out scientists with no experience or training in evolution or climate science to attack the scientific consensus, SafeMinds trots out Bernadine Healy when the need arises, as it apparently did here. Elsewhere, it’ll trot out Boyd Haley and other scientists from unrelated disciplines.

While viewing this video, like Autism News Beat, I felt as though I were taking a trip down memory lane to peruse the anti-vaccine movement’s greatest hits. It’s all there, the rebranding of autism as a mitochondrial disease in the Hannah Poling case, the Bailey Banks case, claims that the government has compensated children for vaccine-induced autism, and a number of anti-vaccine tropes. Given that Autism News Beat has refuted each of the points in the SafeMinds video, I’ll refer you there. The video concludes with the voice of doom intoning, “So, as you see, vaccines don’t cause autism, except for when they do.” Bravo for the pure propaganda.

That SafeMinds even had to do this video is rather telling. Five years ago, which is when I got involved in refuting the lies of the anti-vaccine movement in a big way, news coverage of the vaccine-autism manufactroversy was nearly always credulous, giving far more credence to the proposed link than the science would indicate. SafeMinds and other anti-vaccine groups were given prominent coverage; even J.B Handley appeared regularly on TV and radio. Over the last year or two, I’ve noticed a welcome new trend in that the media is actually starting to demonstrate a bit of skepticism and, far more often than I can recall, getting the story right. Most likely this is because of outbreaks of vaccine-preventable diseases in populations with low vaccine uptake coupled with a continual drumbeat of scientific studies that have asked the question whether vaccines are associated with an increased risk of autism and come up with a resounding “No!” as the answer.

Even so, the question remains: How do we combat the problem of anti-vaccine propaganda. I came across an possibly depressing example of how badly we do it from Jason Goldman, who in a post entitled Vaccination, Confirmation Bias, and Knowing Your Audience described an event at GlaxoSmithKline’s headquarters about vaccination:

For a corporation that depends on communicating science to the public, they did a terrible job of it! For a certified card-carrying data-whore like myself, the Powerpoint presentations (which broke every. single. rule. of effective presentations. I highly recommend that they hire my friend Les Posen to teach them how to present properly) did not have enough detail. They would present some statistic, but without the level of detail required for me to make any real sense of the data. I will grant that I was not the intended audience of the talk, so I will forgive them their lack of error bars and missing p-values. For a general audience without a scientific data-driven background, the presentation was even more useless! It was all statistics, bar graphs, and numbers. If you’re going to communicate science to a general audience (and I’d like to think that I know a thing or two about communicating science to a general audience), you need to engage them emotionally. You need to tell a story, not drown them in statistics. The presenter might say something like, “Last year, three gazillion people died because they were not vaccinated against a Terrible Disease That Kills People In Gruesome Ways But Which We Could Eradicate In Less Than A Decade If Everyone Would Just Get Vaccinated.” Everyone would agree that this is a Bad Thing, at least. More likely, it is a Terrible, Horrible, No Good, Very Bad Thing.

[…]

Giving us incidence and death rates and other such statistics doesn’t really get the job done. It doesn’t communicate what they want it to. Nor will glossy pamphlets (like the one they gave me) featuring Mia Hamm telling us to get vaccinated. What will get the job done is story-telling, appealing to emotion, and utilizing accessible analogies. Instead of telling us how many gazillions died last year, tell us how many airplanes full of people, or how many football stadiums full of people died last year.

The GSK corporate blog also provides an account of the visit, as do Nutgraf and Scrutiny by the Masses. Nutgraf emphasizes the technical aspect of vaccine production, in particular the absolute cleanliness required as does Mom to the Screaming Masses. Apparently last year GSK arranged a similar program.

As I thought about the NVIC initiative and the SafeMinds video propaganda program, these efforts by GSK seemed completely ineffectual for the very reasons that Jason outlined, but more than that. First of all, you have to consider the messenger. To anti-vaccine parents, pharmaceutical companies like GSK are Satan incarnate. No matter how much a company like GSK tries, it’s unlikely to be trusted because, in the view of the anti-vaccine movement, it’s only in it for the money and it’s the entity that caused their children’s autism. I understand why GSK might have wanted to try anyway, but in reality it is the worst possible messenger, no matter how good it is at PR (and apparently it wasn’t that good). Put a sympathetic mother up against a pharmaceutical company for PR purposes, and the pharmaceutical company will lose every time. Worse, bloggers who accept trips like this risk being painted as in the thrall of big pharma.

Yet, at the same time, I really don’t like Jason’s solution, either. I understand that appealing to emotions is important, but matching the anti-vaccine movement story for story is a game that scientists are likely to lose at. We are constrained by the facts; the anti-vaccine movement is not. We feel vaguely dirtied by using manipulative stories the same way the anti-vaccine movement; that is to our credit. Yet, there’s no denying that such methods can be extremely effective. There has to be a mix that provides the human impact, the emotional hook, necessary to combat the blatant emotionality of the anti-vaccine movement, but without betraying scientific accuracy. I just don’t know what that balance is. I wish I did, but I don’t.

So in the meantime, I soldier on in my own little way, hoping that my efforts have an effect.

Comments

  1. #1 Chemmomo
    November 7, 2010

    Kelly, I do have a question for you:

    The rotavirus vaccine-I believe- is too risky to give to my stay-at-home child because of its history

    Which rotavirus vaccine and which history? Once again, you’ve left me confused.

  2. #2 Kelly
    November 7, 2010

    Vicki, I suppose the reason I am scared of those vaccination induced fevers is due to my personal experience with my daughter’s post HIB vaccine fever that quickly escalated to 104 in less than 24 hours. That doesn’t mean the fever induced by chickenpox doesn’t worry me either, and it doesn’t mean that I’m not continuing to vaccinate her or my other children. With the chickenpox vaccine in particular, it does seem risky to me due to the fact that its relatively new. While I’m expecting that this comment is going to trigger all sorts of nasty comments about scientific evidence, citations, and so forth, I don’t like that some of these vaccines have no long-term studies. I will state clearly right now that I have NO scientific-based reason for that other than the issue with the rotavirus vaccine being recalled by the FDA in 1999. I mean, they obviously didn’t know before they started giving it to millions of children that it was going to cause a serious bowel twisting issue. And is there a possibility that a vaccine could become contaminated with an animal virus that could be potentially harmful to infants or adults? I am obviously asking because of the recent benign pig virus found in one of the two brands of the rotavirus vaccine. That causes me concern as well, even though again I don’t know if that’s a legitimate concern, I’m pretty sure there aren’t many people here who think any vaccine concerns are legitimate though.

  3. #3 Chris
    November 7, 2010

    Kelly: Visualize paragraphs. A line space between them would reduce the very hard to read “wall of text” effect. Also think about reading the links provided.

    Your questions on the extra bacon in the oral vaccines are answered in the podcast and blog writings here: http://www.virology.ws/?s=rotavirus

  4. #4 Kelly
    November 7, 2010

    Chemmomo, I believe any Rotavirus vaccine currently available (I believe there are two) is not necessary for my child/children. When I said its history I meant the history of the initial rotavirus vaccine, which yes is different, but I find the fact that any vaccine could potentially be put on the market to be used in infants before it was tested enough to know whether or not a baby’s bowel would fold in on itself makes me nervous regarding any new vaccines. So when I am more skeptical of vaccines like rotavirus, hepA, or chickenpox, it is because I’m not convinced there is adequate testing that ensures something like what happened with rotashield (i think that was the initial one) will happen again. Therefore, in my view, giving my child a newer vaccine is inherently riskier. I’m certainly open to any evidence that my fear of vaccine “newness” is misguided.
    If I have unclearly stated my views on this blogsite it may be due to the fact, at least, initially, that my intention wasn’t to argue that being selective or not vaccinating was either right or wrong. Also, being fairly unfamiliar with scienceblogs.com, I wasn’t expecting the onslaught of criticism.

  5. #5 Kelly
    November 7, 2010

    Thanks Chris, but I already read those I think, unless of course I’m missing the article that discusses whether or not the possibility that a vaccine could be contaminated with a harmful virus was overlooked by me. I see that GSK has determined they will be making the vaccine differently, since their’s is the vaccine that contained the intact virus, but that Merck has not yet decided whether or not they will be making a bacon-free vaccine.

    I already knew the virus was found to be benign from reading about the suspension initially. My question is whether or not that virus could have been potentially life-threatening. Did we just get really lucky?

    And while visualizing paragraphs is a good suggestion, as I realize my posts are always lengthier walls of text, In my own defense I’m typing these responses rather quickly, as I’m attempting to do a few other things with my day as well, and I haven’t actually ever posted comments on a blogsite before. I’m an incredibly inexperienced commenter. I know, I know, hard to believe.

  6. #6 Chemmomo
    November 7, 2010

    Kelly, I’ve wiped out several other comments for you since I’m spending so much time composing them some of them have become irrelevant. I will add the new CDC link about rotavirus and intusseption:
    http://www.cdc.gov/vaccines/vpd-vac/rotavirus/intussusception-studies-acip.htm

    I can understand being wary of “new” vaccines. But you put us into a catch-22. Exactly when does something stop being “new”? How much evidence do you need?

    What I’m hearing from you is: since post-approval surveillance worked, and a vaccine was removed from the market before deaths occured, therefore, you can’t trust any testing of any vaccine.
    What the Rotateq story should be telling you instead is that when the FDA finds a problem, it addresses it. Therefore: if there’s a problem with another vaccine, we will find it.

    Another–very much related–question for you: under what (if any?) circumstances would you volunteer to participate in a clinical trial? For anything?

    As for chicken pox: we disagree, and I have too many reasons for that to list here right now. Let’s just say that you should not assume that just because you don’t even remember having the disease when you were small does not mean it’s not a problem.

    And I’ll close with the fact that I’m not one of those people who don’t think there are any legitimate vaccine issues – but I do find interesting that we keep getting side tracked away from them.

  7. #7 Pablo
    November 7, 2010

    I am noticing that, plus a bit of goal post moving. She seemed willing to learn, but has now back peddled. I have a feeling she is not being totally honest, even with the claim of a college education (her rhetoric is confusing, my high school daughter writes much better). She keeps repeating the same points that she was corrected on multiple times, and seems to think they might be relevant.

    So you all still think my response was over the top?

    Neh neh, I say. I pegged her right on. She is a typical “me first” anti-vax slime, right up there with sid and jay.

    NOTHING pisses me off more than the attitude that I am the one who should sacrifice my child to protect theirs, but they needn’t bother. But that’s her.

    I’ve certainly heard what she’s said, and I’m not liking it.

    She’s not one of those on the fence. She is hardcore stuck.

  8. #8 Chemmomo
    November 7, 2010

    Pablo, I don’t think she is “antivax slime.” I think she’s a parent who witnessed a high fever after a vaccination, and has panicked over it. And that panic colors everything she thinks about vaccination (hence the confusion between HiB and rotavirus vax side effects). Which is understandable.

    She admitted to avoiding “math classes like the plague all through college.” If so, she also avoided all science classes, as well, since–apart from the fullfil-the-science-distribution-survey-class–science classes require math. Algebra, at least. Keep that in mind, and cut her some slack here.

    My impression is not that she’s trying to shift the risks–just that she’s overestimated the risks of the vaccine, and underestimated the risks of disease. This is because she witnessed the high fever post vaccination, and no one taking her fear seriously.

  9. #9 Chemmomo
    November 8, 2010

    Sorry the previous post went up before I was done due to checking unrelated websites (OK, yeah, it was football scores).

    The reason why she’s overestimating the risks is that her child IS the 1 in 20 who got the fever from HiB – and it was *higher* than advertised (104 vs 101).

    That doesn’t make her “antivax.”

    She’s not trying to get a free ride off of herd immunity if she believes her child is at higher risk from the vaccine than most other children (because of the previous incidence of high fever).

    What we need to do is to help her assess the risks.
    Please help.

  10. #10 NZ Sceptic
    November 8, 2010

    We’ve been promoting Vaccine Awareness Week here in NZ too and our excellent Sciblogs site has done their very best, but as you will see, they’re now enduring a barrage of insanity from a person so unhinged, he believes vaccination is a plot to wipe out humanity. Read it if you’re feeling strong! http://sciblogs.co.nz/skepticon/2010/11/01/anti-vaccination-in-nz/

  11. For those of you worried about shingles, you can relax because now you can get a vaccine against it. Some sort of varicella booster.

    I think it’s generally recommended for people over 50. I had chicken pox as a child (pre-vaccine, not refuser parents) so I am personally very glad of this!

  12. #12 novalox
    November 8, 2010

    @210

    The post was a great read. Thanks for the link.

  13. #13 NZ Sceptic
    November 8, 2010

    Novalox, that’s a refreshing perspective, and I agree it’s a great read (in a strange way) from a comic perspective, but here in NZ it’s just a trifle depressing too. How can modern, educated people mangle science so badly?

  14. #14 Alan Meyers
    November 8, 2010

    As a general pediatrician who trained in the days before vaccines against pneumococcus and Hemophilus influenza were available, I am a big advocate for them and other vaccines that work incredibly well to protect children from preventable and potentially devastating infectious diseases. I can tell you from first-hand experience that we virtually do not see the cases of meningitis, sepsis, and other serious bacterial diseases that used to be commonplace. Now, as a socialist I have no illusions about either Big Pharma or corporations in general; I think distrust of Pharma is healthy. But it’s entirely a sidebar. In fact, Pharma makes very little profit on vaccines and it is increasingly difficult to find manufacturers for promising vaccines. I think there are two areas to emphasize in the response to irrational opposition to vaccination in general. One is this: yes it does appear that the incidence of autism is rising (although even that isn’t certain), but singling out increasing vaccine use as the culprit on its face makes no more sense than, say, blaming the increasing use of microwave ovens or Walkman-type stereos over the past two generations. Why not look to environmental pollution as a factor that actually has biological plausibility on its side? How about the fact that plastic baby bottles deliver a daily dose of Bisphenol A to newborns? That organophosphates have been linked to attention deficit disorder? Secondly: whatever you think about Big Pharma (and I probably share your view), pediatricians and other child health clinicians don’t want to use unsafe vaccines, and in fact there is a track record of pulling vaccines off the market when post-marketing data have shown uncommon but convincing associations with adverse outcomes, for example the first rotavirus vaccine that was pulled off the market when it turned out that the incidence of intussusception was increased in vaccinated babies. This is standard practice. And there are volumes of carefully-collected and -analyzed data refuting any connection between autism and vaccines – this research is not just from the U.S. and some of the most convincing comes from the Scandanavian countries that do a far better job of public health than we do.

  15. #15 Kelly
    November 8, 2010

    I’m sure if the common cold vaccine had ever been successfully created (I believe research for that finally ended in the early 90’s) then I would be sitting here defending myself against child abuse accusations for allowing my child to “suffer” needlessly through a cold when a vaccine is available. After all, 1% of cold victims suffer serious complications. Therefore, a few sacrificial children who suffer an adverse vaccine reaction is worth saving the 90 year old in the ICU who has come down with the common cold.

    Obviously, this is an exaggeration-I don’t quite underestimate the risks of the current vaccine preventable diseases quite that much, but where does it end? Where is the line scientists draw between considerable suffering and a stuffy nose?

    Um, the only science course I took during college was an astronomy course. I found it rather enjoyable but it was mostly theory and little math. I did however, post college, take a few chemistry courses for my job as an I.V. and Narc Tech at the hospital I worked at. That did involve some math. Regardless, I don’t really know how much evidence would suffice to make me afraid of HepA. Maybe a statistic that shows the number of children <5 in America that have been hospitalized or died from it?

  16. #16 Todd W.
    November 8, 2010

    @Kelly

    I, too, am curious when the “new” label gets dropped from a vaccine. After all, the varicella vaccine has been available since March 1995 (that’s 15 years on-the-market experience), with clinical trials on vaccine lots manufactured as early as 1982 (another 13 years of pre-market, in-human study). So we have 28 years of experience, at least, in humans. How many more years before it is no longer “new”?

    This information is available from the FDA’s web site here.

    Please bear in mind that I can totally agree with the nervousness involved with “new” products. I feel the same way, sometimes, and it is quite hard to get past the emotion and look at the issue rationally.

  17. #17 Kelly
    November 8, 2010

    Sorry, the number of children under age 5 that are infected in America. There are not enough numbers on the CDC sheets that allow a parent to calculate risks. Saying something is “very rare” means little to me since I don’t know what numbers the CDC considers to be “very rare”. I think if parents had better data to look at in regards to all vaccines and vaccine side-effects it would be helpful.

    Also, if there are outbreaks in particular regions, that knowledge would be very persuasive as well. As far as I know, the HepB and HepA are given to children simply because there isn’t enough compliance among adults to get vaccinated.

    And as far as the vaccinating parent vs. the non-vaccinating parent, I think it would also be helpful if parents who didn’t vaccinate understood why their unvaccinated children are more of a risk than all the unvaccinated adults. Doesn’t the data show that there are a lot more adults not getting boosters than there are children not being vaccinated?

  18. #18 Scott
    November 8, 2010

    Obviously, this is an exaggeration-I don’t quite underestimate the risks of the current vaccine preventable diseases quite that much, but where does it end? Where is the line scientists draw between considerable suffering and a stuffy nose?

    There is no line. A proper risk/benefit analysis is far more complex. Let’s take measles and the common cold as our examples, and assume for the sake of argument that efficacy is equal between the two vaccines.

    The risks of measles include 1/20 chance of pneumonia, and 1/1000 chance of encephalitis. Say that the vaccine carried a 1/10000 chance of encephalitis (still much more than the actual risk). Would that be an acceptable risk? Yes, because the risks of vaccination are much less than the risks of the disease.

    The common cold, on the other hand, doesn’t carry risks anywhere near those of measles. A 1/10000 chance of encephalitis would therefore be entirely unacceptable; the benefits would be much less than the risks.

    On the other hand, suppose that the vaccine for the common cold had, as its greatest risk, a 1/10M chance of, oh, having a runny nose for a week. Would that be acceptable? Absolutely.

    So the idea of a “line” is really quite misguided, as even this grossly simplified example shows. In reality, it’s a complex balancing act between the risks, costs, and efficacy of the vaccine vs. the risks associated with the actual disease. The greater the risk associated with the disease, the greater the risk associated with the vaccine may be and still remain acceptable.

  19. #19 Scott
    November 8, 2010

    Sorry, the number of children under age 5 that are infected in America. There are not enough numbers on the CDC sheets that allow a parent to calculate risks. Saying something is “very rare” means little to me since I don’t know what numbers the CDC considers to be “very rare”. I think if parents had better data to look at in regards to all vaccines and vaccine side-effects it would be helpful.

    This is again an oversimplification. The number of infections is a strong function of the vaccination rate; ergo one cannot accurately consider vaccination side effects simply in light of current infection rates.

    And as far as the vaccinating parent vs. the non-vaccinating parent, I think it would also be helpful if parents who didn’t vaccinate understood why their unvaccinated children are more of a risk than all the unvaccinated adults. Doesn’t the data show that there are a lot more adults not getting boosters than there are children not being vaccinated?

    Irrelevant. Lack of adult compliance is its own problem and does not excuse not vaccinating children.

  20. #20 Todd W.
    November 8, 2010

    @Kelly

    As far as I know, the HepB and HepA are given to children simply because there isn’t enough compliance among adults to get vaccinated.

    Re: HepB, while that is part of it, as I mentioned before, the increased risk of chronic infection in infants is also a motivating factor, since chronic infection is a near certainty in infants and puts the individual at risk for developing liver cancer and/or liver failure.

    Kelly, in your mind and as you understand it, what are the risks associated with the HepB vaccine given at/near birth? How does this compare to the risks of infection with HepB, keeping in mind that the tests to check for HepB are primarily only done on the mother and are not 100% accurate?

  21. #21 Kelly
    November 8, 2010

    Right, the only risk/benefit for scientists involve whether or not their is evidence that proves that if a vaccine can eliminate the common cold with the greatest documented risk being a week-long runny nose than in the scientists view the vaccine is the right thing to do. For parents, this doesn’t account for the actual risks they perceive in vaccinations. Like, risk of human error. Like, risk of an unknown side effect due to vaccine newness. Like, risk of allergic reaction (which always exists).

    The point is that just because there are risks that aren’t quantitative, that doesn’t mean those risks shouldn’t be taken into consideration. So while a cold can certainly be made to look worse on paper, the reality is that we don’t need a common cold vaccine. The fact that scientists didn’t give up trying until the 90’s to create one is, to a non-scientist, a little absurd. Imagine what those funds could have been used for.

  22. #22 Scott
    November 8, 2010

    Right, the only risk/benefit for scientists involve whether or not their is evidence that proves that if a vaccine can eliminate the common cold with the greatest documented risk being a week-long runny nose than in the scientists view the vaccine is the right thing to do. For parents, this doesn’t account for the actual risks they perceive in vaccinations. Like, risk of human error. Like, risk of an unknown side effect due to vaccine newness. Like, risk of allergic reaction (which always exists).

    PERCEIVED risks are relevant only insofar as they demand better educational efforts if they differ from the REAL risks. And yes, my example was oversimplified and disregarded risks that would actually exist in the real world; that’s not the point. The point is that, if the risks are sufficiently small, then a vaccine even for the common cold can be quite reasonable. And indeed, it can become quite irrational NOT to get it, if those risks are small enough.

    The point is that just because there are risks that aren’t quantitative, that doesn’t mean those risks shouldn’t be taken into consideration. So while a cold can certainly be made to look worse on paper, the reality is that we don’t need a common cold vaccine. The fact that scientists didn’t give up trying until the 90’s to create one is, to a non-scientist, a little absurd. Imagine what those funds could have been used for.

    You are the ONLY person I’ve ever heard suggest that. In my experience, the overwhelming majority of people (scientists and non-scientists both) would LOVE a vaccine for the common cold. It may not kill, but it causes quite a significant amount of misery.

  23. #23 Todd W.
    November 8, 2010

    @Scott

    Being in the tail end of a cold right now, I would be one of those who would appreciate never having a cold again.

    @Kelly

    I’m still interested in your response to my most recent post regarding newness.

  24. #24 Kelly
    November 8, 2010

    two decades of research would make the vaccine no longer “new”. When you change a recommendation from an older child receiving a vaccine to now a newborn (hepB), that makes the recommendation “new” and therefore, same risk of newness is involved. Also a problem for parents is that while in the last 20 years the rate of chronic childhood illness has gone up, there seems to be little scientific evidence pointing to any particular reason. Maybe obesity, but even that isn’t being attributed to the hormones in animal products. So while everyone seems to want to deny deny deny that it has anything to do with their products, children are living but they are also suffering more and more.

    Scott, its not really irrelevant if children continue to cease getting boosters into adulthood. The hope for disease eradication will go unfulfilled, and vaccinated children will still be susceptible. Pertussis is generally passed from older adults to children, not from child to child. I’m not saying it’s an excuse to not vaccinate, I’m saying it would be helpful though, if you could prove to non-vaccinating parents that their children are actually creating a risk that is greater than the one that already exists. Such as, for example, the HIB increase and the measles outbreaks where pockets of unvaccinated children reside. Those are helpful. Attacking parents based on assumptions about their possible Jenny McCarthy admiration or mercola affiliations isn’t going to be helpful.

    Todd W., being skeptical of a product because it’s new isn’t merely an emotional fear. Are you suggesting that long-term studies of medications have no value then? I mean, the FDA already assures its safety when they put it on the market for public use.

  25. #25 Todd W.
    November 8, 2010

    @Kelly

    two decades of research would make the vaccine no longer “new”.

    So, you would agree, then, that varicella vaccine is not “new”. If you accept this, what are your remaining objections to the varicella vaccine at the ages recommended?

    When you change a recommendation from an older child receiving a vaccine to now a newborn (hepB)

    Actually, the change was not from older children to newborns, but from older individuals and newborns at high risk to older individuals and all newborns. We already know that the vaccine is safe in newborns, and the thought, before, was that by vaccinating only those at high-risk, we would have sufficient coverage to reduce morbidity of the disease. That turned out to not be the case. In expanding coverage to include those newborns who are not at high-risk, morbidity was found to decrease appreciably. This info, again, can be found on the CDC’s site (I’ll note, though, that I am going by memory, here).

  26. #26 Kelly
    November 8, 2010

    Scott, I think its funny that I’m the only person you have heard who thinks a cold vaccine sounds absurd, when were basically discussing why so many parents don’t think a tdap or HiB vaccine is necessary. If the CDC put the common cold vaccine on our infants’ vaccine schedule tomorrow and you were shocked by the number of people skeptical or not vaccinating their children against it, then I would question your sense of reality.

  27. #27 Scott
    November 8, 2010

    Kelly,

    We KNOW that children not being vaccinated increases the risk beyond what there would be if they were vaccinated. Somewhat to those around them, greatly to them. So while we ought to do better with adult vaccination, that (if anything) INCREASES the urgency of childhood vaccination because it increases the overall risk of getting the disease.

  28. #28 Science Mom
    November 8, 2010

    Also a problem for parents is that while in the last 20 years the rate of chronic childhood illness has gone up, there seems to be little scientific evidence pointing to any particular reason. Maybe obesity, but even that isn’t being attributed to the hormones in animal products. So while everyone seems to want to deny deny deny that it has anything to do with their products, children are living but they are also suffering more and more.

    I agree that perceptions are focused on vaccines as causal for these conditions. However, don’t you think that is because the anti-vax organisations have been successful (along with the help of the media) at perpetuating this nonsense? There is, in fact, mounting scientific evidence suggesting causal factors that have nothing to do with vaccination. Can any rational person honestly think that childhood obesity is due to vaccinations even before consulting the scientific literature?

    But these findings aren’t very sexy so this information isn’t disseminated, leaving people to wallow in their confirmation biases. This is where public health needs to be more proactive at effectively communicating actual risks and scientific evidence. But tell us how to do that in a manner that doesn’t sound like denial? Why do you believe that it even is denial as opposed to information communication?

    PERCEIVED risks are relevant only insofar as they demand better educational efforts if they differ from the REAL risks. And yes, my example was oversimplified and disregarded risks that would actually exist in the real world; that’s not the point. The point is that, if the risks are sufficiently small, then a vaccine even for the common cold can be quite reasonable. And indeed, it can become quite irrational NOT to get it, if those risks are small enough.

    @ Scott, I think that part of the problem is that something like Hep A gets added to the routine schedule for children, when it is actually a ‘travel vaccine’ and recommended for certain at-risk groups, namely adults and is not highly endemic, with a low rate of complications: http://www.wrongdiagnosis.com/h/hepatitis_a/prevalence.htm

    And is very confusing to parents, particularly when they have never even heard of Hep A and suddenly it is given the same billing as Hep B or Hib or MMR, in their minds. Vaccination is still a medical intervention, and one administered to a healthy child so it becomes easy to see how and why risk assessment becomes very convoluted.

  29. #29 Kelly
    November 8, 2010

    Todd W., yes I will agree that the varicella vaccine is no longer new. I am only opposed to that particular vaccine at the current recommendation because I am not afraid of my children contracting chickenpox, however, I am still timid about them suffering a side effect from the vaccine, same as I worry when I take them for the tdap that they may suffer a side effect. They will be getting the varicella vaccine prior to school-age but not before they are two. This is just based on my irrational worry that they may suffer some neuroimmunological consequence for no good reason other than to avoid some discomfort. Meanwhile, they are getting lots of other vaccinations against really scary things like meningitis, tetanus, whooping cough, and polio.

  30. #30 Kelly
    November 8, 2010

    Sciencemom, I absolutely agree that if more vaccines are added to the schedule that parents find unnecessary, then they will not only begin to question those particular vaccines but will start to question all vaccines. Whether scientists think its rational or not, many parents view vaccines like they would any other drug or medication-as something that could be potentially harmful to their child. So there better be a really good reason for insisting that we inject them with it, especially at what we consider to be a vulnerable age. When the medical community starts to call a parent neglectful for refusing a hepA vaccine, it will inherently make parents question the rationality of the whole CDC schedule.

    It is also, I agree, simply the causal relationship in timing that has some parents questioning whether vaccines are contributing to the growing number of chronic illnesses. But, I think the fact that anti-vax websites point that out repeatedly, is only because they know parents are already questioning if there is a relationship. I mean, the schedule has undergone a pretty rapid increase since I was a child and I wondered why that was as soon as I saw the schedule, not after reading about it from a website.

    And I’m not suggesting those websites have no impact, I just suspect that the medical community is blowing their impact out of proportion. I think the fear of side-effects is the number one reason parents question the vaccine and the diseases. I think parents would fear risk of side-effects upon giving their child any drug.

    Also, I think there is a big problem when it comes to dialogue in pediatrician’s offices. Every time I had a question regarding a vaccine I was handed the same CDC fact sheets before being led out of the office. It made me feel like if my own pediatrician didn’t have the answers then what was I vaccinating them for? Anyway, I found a new pediatrician who has been helpful. When I questioned whether the fourth dose of HIB was necessary, she gave me an article studying the increase in invasive HIB prevalence following the shortage. That changed my mind.

  31. #31 Composer99
    November 8, 2010

    C. Sommers:

    At this stage, on this blog, augustine’s reputation for honesty is so shattered that if he claimed that the sun rose in the east, I would get up extra early on a clear day to check before I accepted his claim at face value. 🙂

  32. #32 Lawrence
    November 8, 2010

    Kelly – this is exactly the problem. I don’t understand why you are more fearful of the side-effects than the actual diseases themselves?

    So, you’re fine with your kids getting the chicken pox or shingles (later in life) but don’t want them to get a fever?

    My son has had his fair share of colds, the flu, and plenty of fevers (including some pretty scary ones), but at least those are ones that I couldn’t prevent. I can’t control the actions of the other parents whose kids are in my childs’ day care – I know that my son is going to be exposed to a variety of different bugs – but if I could prevent even one of them with a vaccine, it would be more than worth it.

    I remember conversations with my grandparents about what their childhood was like – the quarantines, polio, measles, mumps, etc & each of them saw fiends that died before their time. They were always very happy that I or my child weren’t going to live in that kind of world.

    That’s not to say that we shouldn’t continue to press for strict oversight for drug and vaccine safety – never is a good time to relax, but if you look at the history, the system works. When problems are found, they are investigated and corrected – and researches, doctors, and parents alike all have the same goal, to better protect our children.

    Because we can now identify many more conditions than in the past, doesn’t mean that those conditions didn’t exist (such as auto-immune disease, asthma or allergies) – but a lot more kids are surviving that wouldn’t have before, so we’re seeing more things that may also be treatable.

    Again, speaking as a parent of one and soon to the parent of another (in less than a month), my greatest concern is to make sure that my child is adequately protected – so that he doesn’t have to get just one more illness. Because the regular ones that kids get are scary enough – why add measles, mumps, chicken pox, HepB, and the other vaccinated diseases on top of that?

  33. #33 Todd W.
    November 8, 2010

    @Kelly

    You touch on an important issue, namely that parents have a certain view of the risks of a disease (typically as being relatively benign, based on their own experience) and at best an unclear view of the risks of vaccines.

    For example, with measles, many would, without further investigation, very likely state that it is a pretty harmless disease. Little do they know that there is a roughly 1 in 1,000 chance of encephalitis and about 2 per 1,000 death risk. The vaccine, by comparison, has encephalitis or severe allergic reaction grouped together at about 1 per million.

    Or, to use something a bit more pertinent to our discussion here, chicken pox is largely thought to be a benign disease. Sure, there’s some misery for a week, but then you’re okay. Doing a very quick Google search for “varicella complications risk”, I found this study from Germany that looked at hospitalizations from chicken pox nationwide within one year (1997) among immunologically healthy children. They found a complication rate of about 8.5/100,000 (based on theoretical population risk…the actual rate would probably be higher, because the at-risk population would be smaller than what they used for their calculation). Here are their results:

    The response rate to the surveillance questionnaire during the observation period was high: 93.4%. Of the 153 reported cases, 119 met the case definition. There was a seasonal distribution of reported complications with a peak in March. The majority of complications occurred in preschool-age children with a maximum age of 4 years. No gender predominance was found with a distribution of 56 female and 63 male patients. Multiple entries for complications were allowed. The most frequent complications were neurologic, which were reported in 73 children (61.3%); cerebellitis was the leading diagnosis (n = 48), followed by encephalitis (n = 22), meningitis (n = 2), and central facial palsy (n = 1). A total of 46 (38.6%) infectious complications were identified. Superinfections of the skin were present in 31 (26.0%), pyogenic arthritis was present in 5 (4.2%), osteomyelitis was present in 4 (3.3%), necrotizing fasciitis was present in 3 (2.5%), orbital cellulitis was present in 2 (1.6%), and pneumonia was present in 1 (0.8%). Streptococcus pyogenes was the leading cause of bacterial infections (18 cases [15.1%]), with invasive disease in 6 patients (8.4%) and linked to 4 of 8 cases with defect healing. Infectious complications were reported in the majority in younger children up to 4 years of age, whereas neurologic complications occurred more frequently in an older age range. Five children experienced thrombocytopenia or severe anemia. There was no bleeding disorder, no fatality, and no case of Reye syndrome reported during the 1-year observation period. In total, 8 (6.7%) of 119 patients reported having long-term sequelae, 6 attributable to infectious complications and 2 to persistent deficits after neurologic complications.

    Until I started combating anti-vax nonsense, I hadn’t a clue what the actual risks were for many childhood diseases. Like you, I felt that chicken pox vaccine was completely unnecessary. But as I discovered, and hopefully illustrated here, is that it can have some very serious complications, even in healthy children, and at much higher rates than I imagined. According to the CDC, the vaccine has reported (though not necessarily causally related) serious adverse events at around 2.2 per 100,000 from the first 48 million doses. Based on this admittedly limited information, it would appear that the vaccine has a slightly more favorable risk:benefit profile than natural infection. I haven’t done a more thorough search for more recent info, but it is conceivable that the safety of the vaccine has been improved even more since those first 48 mil. doses.

  34. #34 augustine
    November 8, 2010

    composer :aAt this stage, on this blog, augustine’s reputation for honesty is so shattered that if he claimed that the sun rose in the east, I would get up extra early on a clear day to check before I accepted his claim at face value. 🙂
    ——————————————————
    Because you are not interested in truth, honesty, or justice. You are interested in arguing and attacking.

  35. #35 Todd W.
    November 8, 2010

    @Lawrence

    Just to get this before Kelly brings it up: she is going to vaccinate her kids against varicella, the caveat being if they do not contract it by a certain age. While I’d say that that is risking it (got a post in moderation going a bit more in depth on this), it is certainly better than not vaccinating at all, considering how bad chicken pox can be if contracted as an adult.

  36. #36 augustine
    November 8, 2010

    Lawerence: my greatest concern is to make sure that my child is adequately protected – so that he doesn’t have to get just one more illness. Because the regular ones that kids get are scary enough – why add measles, mumps, chicken pox, HepB, and the other vaccinated diseases on top of that?
    ————————————————
    Mine too. It just doesn’t involve vaccines.

  37. #37 Kelly
    November 8, 2010

    Lawrence, why am I more fearful of the side-effects from vaccines then the diseases? Well, I guess it isn’t so much that I am more afraid of the side-effect from the hepB or hepA vaccines and more an issue of not feeling like my child is at risk of contracting those two diseases in the near future. If they were in a daycare setting, I agree with you, all the kids in that daycare should be vaccinated. I wouldn’t put my child in a daycare that didn’t have that requirement. Hell, my dog goes to a daycare and I made sure when I enrolled him there that they too check to see that all the other dogs are up to date on their vaccinations and flea control.

    The only vaccine I have outright refused is the rotavirus vaccine. The hepB vaccine and the chickenpox vaccine they will be getting prior to school-age. HepA I’m still on the fence about.

    I’m actually not afraid of my kids getting sick, I guess I just have more trust that their bodies are equipped to handle most illnesses without having to worry about the possible side effects of a drug or vaccine. Of course I don’t want them to get serious diseases like meningitis or polio. I think the problem is that people keep referring to the time of polio as though thats going to make people fearful of chickenpox.

  38. #38 Chemmomo
    November 8, 2010

    Kelly, why do you “just have more trust that their bodies are equipped to handle most illnesses without having to worry about the possible side effects of a drug or vaccine”? This makes no sense to me at all! The whole purpose of vaccination is to help their bodies become better equipped to handle the illness. Why turn this offer down?

    I’ve seen my children suffer through serious illnesses. I’ve cared for them through several days and nights of high fevers. I’d much rather risk vaccine side effect fever one day than go through a week of it, not knowing when it will end.

    Have your kids actually ever been sick at all yet?

  39. #39 Kelly
    November 8, 2010

    Chemmomo, other than that HIB induced fever my oldest had around 15 month, no I can’t say I have dealt with any other sickness. Maybe a very minor cold and diaper rash here and there. I’ve been very lucky thus far.

    Again, I’m not less afraid of the disease in most of these cases, just less convinced that they are going to contract it or suffer from it. Like, Sciencemom pointed out, they are going to contract rotavirus, like we all do, hopefully like the majority, they won’t be severely damaged from it. I don’t know what else to say about the chickenpox. You had a bad experience with it and that heightens your fear just as the vaccine fever thing heightens my fear in regards to vaccines.

    Maybe part of my lack of disease fear is also because I’ve never really been sick. I never got the flu vaccine until I was in my twenties, and only then because I worked at a hospital, and I can honestly say that if I have ever gotten the flu I have no recollection of it. I’m partly hoping that there may be some theory that supports the idea that parents with strong immune systems produce children with strong immune systems 🙂 But let me be very clear, I don’t in any way think that contracting immunity naturally is any more superior than gaining it through a vaccine. I just wish i didn’t read things about vaccines containing pig viruses, that maybe benign this time, but maybe not so much next time.

  40. #40 augustine
    November 8, 2010

    Here’s where the fearmongering among SBMers begin.

    If someone says they are not afraid of a disease like chicken pox, the vaccine evangelists make sure that they BECOME afraid of it (as evidenced here). They use numbers in the name of fear. If those numbers don’t work they use bigger numbers in the name of fear. They use stories in the name of fear. They use history in the name of fear. They use science in the name of fear.

    When fear doesn’t work on the unfearful, then they resort to ANGER. Get the rest of society angry at them. Say they lie. Say they put your children in danger. Say they are selfish. Say they are killer. Say they are the slime of the earth.

    Emotion is the trademark of vaccine evangelists.

    Guess what? I’m not afraid of polio, diptheria, malaria, measles, meningitis, mice, common cold, cholera, syphillis, HPV, tetanus, mumps, ebola, HIV, etc.,etc.

    Now proceed to tell me that the only reason I’m not afraid is because I’m ignorant so I’ll agree and THEN become afraid.

    Fearmongering. That is all this is.

  41. #41 Sid offit
    November 8, 2010

    @Gray Falcon

    http://www.jpeds.com/article/S0022-3476(45)80208-1/abstract

    Poliomyelitis and recent tonsillectomy*

    John A. Anderson, Ph.D., M.D.
    Summary
    During three months of the ascending part of an epidemic of poliomyelitis in Utah in 1943, 43 per cent of the bulbar and bulbospinal cases were preceded by a tonsillectomy within thirty days of the onset. The incidence of poliomyelitis in recently tonsillectomized children was found to be 2.6 times greater than in the general child population. The incidence of the bulbar and bulbospinal type of poliomyelitis was found to be sixteen times greater in recently tonsillectomized children than in the general child population.

    And

    http://aje.oxfordjournals.org/content/66/2/131.extract

  42. #42 Sid offit
    November 8, 2010

    there is such a thing as a circumstance in which the government “coercing” the population (also known as governing) is a good thing, will be more powerful than you realize, once you get over your own self-conscious uneasiness with the principle.

    Thus Spake the Sheep

  43. #43 Todd W.
    November 8, 2010

    @Kelly

    Glad to hear your children have remained healthy! Based on my friends who are recently new parents, I can sort of understand the anxiety of raising a child and dealing with all the various info out there relating to what to expect and how to deal with what does occur.

    I just wish i didn’t read things about vaccines containing pig viruses, that maybe benign this time, but maybe not so much next time.

    Likewise. There will likely always be aspects about medicine that we cannot foresee. In the rotavirus vaccine/PCV case, it was a novel screening method that improved upon previous methods that found the issue. All we can do is take what we learn, improve what we do and forge on. If we were to live in constant fear of what “might” happen that we don’t know about yet, we’ll never get anywhere.

    Although we may disagree on some issues, I have to say that it is very refreshing to talk with someone like you. Most of the time, we end up butting heads with folks like jen, augie, Sid, etc.; people who just want to poke buttons and have no interest in rational discourse.

  44. #44 Chemmomo
    November 8, 2010

    Actually, Kelly, my own bout of chicken pox wasn’t that bad. However, unlike your community, in my community there was a death. Of an otherwise healthy ten year old. And, yes, that does color my perception of how serious the chicken pox can be.

    However, in my case, when I’m assessing the risks of chicken pox vaccine vs disease, I also have to factor in one additional concern most folks don’t have. My husband, in spite of multiple exposures, never got it, and we don’t know why not. My kids are vaccinated.

    As for hoping for strong immune systems – once your kids get to kindergarten, you’ll find out.

  45. #45 Prometheus
    November 8, 2010

    Kelly makes a curious claim:

    “I’m sure if the common cold vaccine had ever been successfully created (I believe research for that finally ended in the early 90’s)…” [emphasis added]

    and

    “…the reality is that we don’t need a common cold vaccine. The fact that scientists didn’t give up trying until the 90’s to create one is, to a non-scientist, a little absurd.” [emphasis added]

    This is curious because what is popularly known as “the common cold” is caused by several virus types – rhinoviruses (over 100 serotypes), coronaviruses (15+ serotypes), adenoviruses (50 – 55 serotypes) and miscellaneous other minor players. It’s also curious because I wasn’t aware that there was any serious research into a vaccine. Of course, I don’t know everything about virus research and vaccines, but it seems strange that despite going to several conferences a year on viruses and anti-viral therapies, I wouldn’t have at least heard about it.

    In fact, when I went to the Source of All Knowledge (the Internet), the first five “hits” were to statements that “there isn’t a vaccine against the common cold and there isn’t likely to ever be one”. The sixth was a news article about how a “vaccine against a common cold virus” might help treat brain cancer. The virus turned out to be cytomegalovirus (HHV-5), one of the “minor players” in the common cold team.

    I’d appreciate it if Kelly could provide a source for her information about the research into a vaccine against the common cold. I’m curious which virus(es) they were targeting.

    Also, as you might guess, some of the viruses implicated in the common cold are more serious than others. Coxsackieviruses – which are sometimes lumped into the “common cold” group – are far more serious, as is respiratory syncyial virus (RSV), especially in infants. So, a vaccine against one of these might be referred to as a “common cold vaccine” in the popular press.

    I’m also a bit puzzled by the concept – repeated by Kelly and others – that somehow vaccines present more of a challenge to the immune system than the wild-type disease. If they did, the symptoms from vaccination – fever, rash, aches, malaise, anorexia, etc. – would be worse than the actual disease. As it turns out, this isn’t the case.

    Even though some people have post-vaccination symptoms and complications that are similar to the disease, the overall frequency of those symptoms and complications is lower with the vaccine than it is with the disease, usually by several factors of ten. And although this is untestable, it is reasonable to suspect that those people who react badly to the vaccine would also react badly (and probably worse) to the disease.

    Prometheus

  46. #46 Sid Offit
    November 8, 2010

    @Science Mom

    they are allowing 1/1000 that contract mumps become deaf

    Textbook of pediatric infectious diseases, Volume 2 By Ralph D. Feigin P2310
    Deafness is a rare …complication of mumps virus infection. Its incidence has been estimated at 0.5 to 5.0 per 100,000 cases of mumps

    Come on now Science Mom, I debunked your silly 1-1000 assertion months ago.

  47. #47 Kelly
    November 8, 2010

    Prometheus, I believe I first read about research for a cold vaccine on the weather channel website. I don’t remember because I read it in passing awhile ago and was simply using the attempt at a common cold vaccine as an example of medical absurdity. I do believe also that it was in 1991 or 1992 that research for a “common cold vaccine” stopped in England because there were too many separate viruses to have hope of producing one. I do know for sure if you google cold vaccine that there is an old Time magazine article that discusses the medical communities attempt to create one. I thought it was funny that anyone would be trying.

  48. #48 Todd W.
    November 8, 2010

    @Sid

    Hey, look! A study from 2009 that found a hearing loss rate of about 1/1000! They even mention your .5 to 5.0 per 100,000 rate.

  49. #49 Science Mom
    November 8, 2010

    Too bad for you Sid, there is a whole ‘nother world out there.
    http://www.ncbi.nlm.nih.gov/sites/entrez/19209100
    Even higher than 1:1000 here: http://www.ncbi.nlm.nih.gov/pubmed/15917168

    It’s so fun to watch a cocksure jerk pat himself on the back and miss.

  50. #50 Lawrence
    November 8, 2010

    Kelly – yes it is very refreshing to be able to have a civil conversation that does deal with some of the other fears and risks with another parent and excahnge reasonable ideas and information as well.

    I just received my seasonal flu and vaccine boosters, since my wife and I are expecting next month. For me, it is worth it, just in case.

    I also remember my own bout with Chicken Pox, when I was around 8. I was sick for three weeks, then my sister got it (about two weeks in) & was sick for another three weeks & then my younger brother got it (two weeks in again), so my parents had sick kids for about eight weeks – plus my brother was much sicker than either my sister or I. Definitely not a pleasant experience & wish we all could have avoided it, but the vaccine wasn’t available at the time.

    When I was in Junior High, we had a mumps outbreak – there were several cases & at least one friend of mine had some fairly serious complications. It was quite some time ago, so I’m not sure where the outbreak started, but it was definitely quite a big deal at the time.

    Some people claim pro-vaccers are using fear as a tool to encourage vaccinations – but aren’t the anti-vax crowd doing the exact same thing?

    At least on the pro side, we know how scary these diseases can be, and people have and do die – whereas the anti-side have nothing but suposition and belief, with no real facts.

    Are vaccines 100% safe? No, they aren’t. Are they better than the dieases they prevent? Absolutely.

    From one parent to another, don’t turn a blind eye to the scientific evidence and listen to your pediatrician.

  51. #51 Calli Arcale
    November 8, 2010

    Kelly, your heart is definitely in the right place. I just want to say that right off the bat. You did not deserve to be labeled “antivax”; we’re just a little skittish around here on that subject.

    This is just based on my irrational worry that they may suffer some neuroimmunological consequence for no good reason other than to avoid some discomfort. Meanwhile, they are getting lots of other vaccinations against really scary things like meningitis, tetanus, whooping cough, and polio.

    It sounds reasonable to wait until after age 2; in fact, it is not unusual to wait a bit on varicella, and my state’s recommendations suggest two possible courses, depending on whether it is started before age 2 or not. I think if your child is not in daycare or preschool yet, it is not as important to get it so early, but you should try and complete the series before the child starts school, so he/she is fully protected.

    Chickenpox as just a little discomfort….

    You can miss two weeks of school with that. Depending on when those two weeks occur, that can be a problem, academically. More to the point, even though chickenpox is seldom lethal, well, that’s also true of waterboarding. Death is not the only outcome that matters.

    My case of chickenpox was mild. I itched like the dickens, and of course the initial phase felt like a mild flu or strep throat that seemed to go away on its own (before I broke out and we all figured out what had really happened). I passed it to my brothers, one of whom passed it to a good friend of mine, who actually had pox in her *throat*. Ew. And then there’s what happened recently to one of my relatives. About five years ago, she got shingles. The left side of her face is still paralyzed, and doctors now say it always will be; it’s been long enough that nerves should have begun regrowing if they’re ever going to. She’s a very self-conscious lady, so this has been difficult for her to adjust to. She’s lucky, though; she escaped the neuralgia that plagues some patients. That can be one of the worst tortures imaginable.

    I don’t worry as much as I probably should about getting shingles; I’ve had chickenpox, so it’s quite likely I’ll get shingles one day. I plan on getting vaccinated anyway; the varicella vaccine does protect people like me, by retraining our immune systems so it’ll smack the bugger down the moment it rears its ugly head again. And my children got vaccinated on the earlier schedule. (My eldest didn’t enter a daycare situation until she was 3 and a half, but I didn’t see any point in waiting.)

    Upthread, you mentioned that you struggle daily with your decision to vaccinate or not vaccinate. I hope this was hyperbole. Whatever you choose, always remember this: you are acting in your children’s best interests, and that is very good indeed. You may not have perfect information; nobody does. But you are doing the best you can with that. Do not struggle with yourself, and do not *blame* yourself if your choices ever turn bad (if your child is injured by a vaccine, or your child falls ill with a vaccine-preventable disease that you did not vaccinate against). Evolve your strategies over time, as you find new information, but don’t ever beat yourself up over the past.

    I may not agree with everything you’ve said here, but one thing is clear — you are making a hell of a lot of effort to do what is best for your children, and that puts you ahead of an awful lot of other parents. Not others here; I think everybody here cares quite deeply. But elsewhere, I have met people who . . . I don’t have very nice words for.

  52. #52 Calli Arcale
    November 8, 2010

    Jen @ 130:

    Your Callie spoke very eloquently on the dangers of off-label vaccine use several months ago.

    I’m my Calli, not anyone else’s. 😉 (Well, except CallisHubby. I’m his.)

    I don’t recall exactly what that was about; I do remember a while back talking about the new area of ethical dilemmas as the customized vaccines (immune therapies) come out for things like prostate cancer. These are not off-label uses, of course, but they raise very interesting ethical problems, mostly because they are excruciatingly expensive and, at least in the current target population, produce only moderate improvements in longevity and quality of life — on the order of six months. A million bucks for six months. Hard to say whether that’s worth it, but it’s a question we’ll soon have to answer, whether we want to or not.

    Off-label use of anything is a concern. It’s not automatically bad, but it’s always a little dicey because there is less research in that area. One thing I am concerned about is people inadequately vaccinating. If the science shows that Vaccine X is most effective if given in three doses two years apart, then it’s a problem if it is given in two doses five years apart. That could be an offlabel use, and in that case, the patient may be accepting risk for no real gain, because they have taken the small risk of vaccinating but not reaped the benefit of sufficient protection to avoid the diease. Maybe that’s what I was talking about; I honestly don’t remember. 😉 (I have two small children, so occasional memory loss is probably normal.)

    Lastly, I’m not going to sell out AoA or Dr. Mercola or NVIC. Their points and research of the issues are as valid as say, someone who makes bucks off of vaccinating kids.

    It shouldn’t be about loyalty. They haven’t done anything more to earn your loyalty than I have or Orac has or your local pediatrician has. Their points and research on the issues are as worthy of a fair hearing as those of a local pediatrician or the AAP or a CDC epidemiologist. But that doesn’t mean they are as valid. Claims should stand or fall on their own merits, and who brings them should (ideally) be immaterial. Don’t worry about selling Mercola or NVIC out; they can fend for themselves, and I wouldn’t expect it to matter one way or the other.

  53. #53 Calli Arcale
    November 8, 2010

    One last comment, I promise — then I’m on the hook to finish some documentation. 😛

    A point to those petitioning in favor of vaccination to protect the population….

    Although the vaccine schedule is designed from a epidemiogical perspective (to control the spread of disease, and thus to assure sufficient coverage to prevent outbreaks), the individual vaccines are not. The vaccines are approved by the FDA to protect the vaccinated patient from specific diseases, not to control the spread of those diseases. CDC recommendations, school entrance criteria, government underwriting of vaccines, the vaccine court . . . . those things are where the community fact becomes significant. But it is always subordinate to the needs of the individual patient. That is why all states have a medical exemption clause (though not all have a philosophical or religious exemption clause) — if the risk to the individual exceeds the benefit, then the social benefits can go take a flying leap. That is actually what the medical community thinks.

    (Exceptions: employers can make vaccination a condition of employment in certain roles, because it may be neccesary in order to carry out the job. An animal control officer could be required to be vaccinated against rabies, for instance, and if this is not possible, relocated to a position where animal bites are less likely, such as bookeeping.)

    The CDC recommendations, and other vaccine schedule recommendations, are an evolving effort to find the best balance between the best individual protection and the best social protection (i.e. the best way to control or prevent epidemics). The individual is never subordinated to society; the intent is to balance both needs.

    Why, then, Heptatis B for infants? The answer is actually statistics. The CDC did not recommend this on the basis that too many adults don’t vaccinate, so the child needs to be protected right away. They recommended it on the basis of statistics on Hep B infection in infants compared to various vaccination strategies. Statistically, this strategy has resulted in the fewest Hepatitis B infections in young babies, and very few complications. Statistically, babies are safer getting routinely vaccinated than not. Obviously, that’s not enough to predict which babies will benefit, but if we knew that, it’d change everything.

    Short version: vaccination is done to protect the population, yes, but only as a bonus. It’s done first and foremost to protect the individual.

  54. #54 JohnV
    November 8, 2010

    “I thought it was funny that anyone would be trying. ”

    Yeah how funny to want to 1) make a gazillion dollars and 2) improve the quality of life for all of humanity forever :p

  55. #55 Scott
    November 8, 2010

    @ JohnV:

    True. While you’d have to be AWFULLY clever to pull it off (assuming it’s even possible, which I decline to rule out), even partial success would be hugely important.

  56. #56 augustine
    November 8, 2010

    [SBMer: Some people claim pro-vaccers are using fear as a tool to encourage vaccinations…]

    BUT…

    [At least on the pro side, we know how scary these diseases can be, and people have and do die – ]

  57. #57 Trish Gannon
    November 8, 2010

    247 comments have produced a fascinating discussion but no solution to the question initially posed by Orac – how to best respond to the anti-vaccine movement.

    I think science bloggers have made a great start. At least now when a parent goes to the Internet to find information about vaccines, or when news writers are looking for source material, they have a chance of learning something that didn’t come out of Mercola. Obviously, though, there’s more that that needs to be done.

    Kelly made some good points – for example, the vaccine handouts that simply don’t cut it for many parents looking for information. People are not always good at understanding big numbers, and for many, there’s not much difference between a 1 in 10,000 chance and 1 in 100,000. Besides, many obviously think even enormous odds are still ‘likely’, otherwise they wouldn’t buy lottery tickets. ;0)

    Orac has stated before that scientists are constrained by having to tell the truth, and the truth about vaccines (and other medical issues) is often more complex than many people have the education for (or even the interest in) understanding.

    A long time ago I read a book about virus hunters in the CDC that not only kicked off a lifetime of fascination with public health issues, but likely set me on a path of appreciation for science-based medicine. (As a Mother Earth News fan, I suspect that without that input I might have ended up squarely in the Mercola camp, thereby throwing the baby out with the bath water.)

    My knowledge was informed through the powers of some incredible writers: people like Laurie Garrett, John M Barry, Steven Johnson, Dr. William Close, Molly Caldwell Crosby, Maryn McKenna… I could go on and on. Unfortunately, however, these writers and their ability to tell a story are the exception rather than the rule when it comes to popular media. And most of them are book authors… I would love to find a source for really great storytellers who understand science and its impact on health, and who write frequently about issues in the news today. (Let me plug coldtruth.org here because Andrew Schneider is trying.)

    Science blogs is a great place for finding information, but the writing style is often over the heads of many people, especially those whose eyes glaze over when they hear ‘science.’

  58. #58 dt
    November 8, 2010

    Some comments on the interesting discussion about what makes parents vaccinate their kids. Primarily it is fear, which may or may not be rational.

    A common disease with rare side effects is usually feared far less than a rare disease with frequent complications, even though at the end of the day the morbidity/mortality burden might be greater with the common, less feared disease. (eg Meningococcus incidence rate was about 5 per 100,000 with a 15% mortality rate – less than 1 death per 100,000; Measles (without vaccination) would affect 90,000 per 100,000 with a 1 in 5000 fatality rate – ie 18 deaths per 100,000)

    This is why measles was not a particularly fearsome illness, because although common, its complications were not, and you needed to know an awful lot of kids to have known one who got encephalitis, or who died. Meningo is a rare disease (even without vaccination) but is more feared because there are always media stories of how little Jack was playing in the garden on Monday, and dead on Tuesday.

    So a meningitis vaccine (be it MenC, or HiB) is seldom refused, but measles vaccine may be. Parents had this as kids themselves and this allays their fears of the disease.

    As the vax schedule turns to diseases that are less and less feared by parents, they begin to mistrust the logic behind vaccination programmes. Our (SBMers) efforts to inject a rational risk benefit equation into the issue falls on deaf ears.

    Before introducing new vaccines, there must be a thorough and honest appraisal of their necessity, or parents will just raise the fearmongering justification.

  59. #59 dt
    November 8, 2010

    Re the “common cold”.

    Interestingly, the rhinovirus genome has been recently sequenced, and this may help attempts to develop a vaccine against it. Vaccine work continues for this pathogen. Some may feel vaccines are unnecessary, but the overall morbidity from the cold is significant, and it is a very very expensive disease in terms of its overall economic burden through sick leave.
    http://www.medwire-news.md/48/80875/Respiratory/Human_rhinovirus_genome_sequencing_opens_up_antiviral,_vaccine_potential.html

    Now people claim vaccines are the “cause” of asthma. Yet paradoxically, rhinovirus is increasingly being recognized as a common cause. Strange, huh?
    http://www.sciencedaily.com/releases/2008/10/081001093045.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29

  60. #60 PMSrocks!
    November 8, 2010

    @Kelly

    Most of you seem interested in only trying to shame parents into agreeing with you

    I mostly lurk on this site. When I first started to read this blog and its comments, I was quite confused about all the talk surrounding vaccines. I even brought questions up with my pediatrician and she dismissed them with an amused smile and a simple “no”.

    I have learned much in this past year from this website. I love the detailed explanations, even when they’re way over my head. I even enjoy the troll bashing. But never once have I felt shame for not knowing the nitty gritty of all things vaccine. The fact that there are people out there who know much more about vaccines than I do, does not shame me, it brings me great relief. And so when my educated nurse-of-a-neighbour tells me all the reasons she hasn’t vaccinated her toddler yet, I give her my pediatrician’s amused smile. But unlike the doctor, I don’t stop there. Slowly, I harp away at my neighbour’s factoids. Thank you “Respectful Insolence” for giving my arguments substance.

  61. #61 MadScientist
    November 9, 2010

    Let’s make a pro-antivax ad showing the true consequences of a low vaccination rate and vaccine-free world. It shouldn’t be difficult (just a little expensive to fly around the world). There are still many people mutilated and suffering from various diseases which many people in the USA are probably not aware of. We can start with Polio in Kenya and Nigeria. I can’t find any reports at all about smallpox though, much less any reports of a widespread outbreak – damned vaccines. We’ll have to rely on newsreels from the 1930s-1950s to show the smallpox stuff.

  62. #62 ShowMe
    November 10, 2010

    Wow, “science” gods, your uniformly smug, rude, dismissive treatment of Kelly is just illustrative of why you have trouble “getting the word out”, why people don’t necessarily believe your positions, and does nothing to dispel the stereotype of a holier-than-thou medical/pharmaceutical complex more intent on giant profit than any other factor. Kelly has made earnest, logical, surprisingly well-researched and thoughtfully-presented points. She is the quintessential well-informed PARENT that ought to be your target “focus group.” Yet rather than engaging in constructive conversation, you ridicule her conclusions, her education, and her, personally, at every turn, always in your apparently characteristic bombastic and sarcastic tone (“citation please”. Oh pleeez!)

    Maybe your “we know everything as a FACT” club forgets that your “FACTS” tend to be proven wrong over and over again. Hormone replacement therapy? Vioxx? How about the swine flu “pandemic” last year, characterized by lower-than-ever vaccine usage, accompanied by a lower-than-ever flu rate. We don’t know what percentages of those who did contract the flu were vaccinated or un-vaccinated, because you “science guys” didn’t even bother to collect that data. It is a well-known FACT that around 300,000 people die every single year in the US from avoidable medical error, roughly 100,000 each of pharmaceutical error, surgical error, and acquired hospital infections. (AMA’s own statistics). The US is something like 48th in the world now in effectiveness of healthcare, down from 37th. Do you really think your pronouncements from on-high about vaccinations or any other medical/pharmaceutical issue should be simply accepted without skepticism? Of course you do, you’re the “science” gods!

    It does not help your position to lump everyone who questions the exploding rate of vaccination in this country with “creationists”, “global-warming deniers”, and “loons.” Any accomplished medical person who disagrees with you (eg Healy) is suddenly a “hack.” I read this entire blog, and you never actually address the central issue: that you as a community ARE trying to remove by law even the small religious and conscientious exceptions to mandated vaccination schedules. This IS a “forced-vaccination lobby” whether you like the title or not. There actually ARE pediatricians out there who do not support all recommended vaccines, and don’t fully vaccinate their own children, because I know one. You turn the controversy on its head, implying that “anti-vax” people are trying to stop all vaccinations, whereas the reverse is true, you are trying to force unwanted vaccinations on all. And it is disingenuous for you to state that total vaccination would result in eradication of the underlying disease. The vaccines themselves carry the disease. For example, there will always be the percentage who contract polio from the vaccine – like my friend, who has been crippled her entire life, as a result of receiving her polio vaccine as a child.

    Then finally, follow the money. There are the billions upon billions of profit dollars from the ubiquitous pharmaceutical corporations and their lobbies, against who? Concerned parents, informational websites, alternative medicine websites – do you seriously contend that selling a few supplements is the entire “financial incentive” behind the anti-FORCED-vaccination groundswell? I don’t think so. It really is about consent.

  63. #63 Todd W.
    November 10, 2010

    @ShowMe

    I can’t speak for others, but myself, I am totally unaffiliated with the pharma industry. My job does not entail health care, nor am I a scientist by trade. I am, like Kelly and you, a lay person. I feel that I was critical, yet fair in my addressing Kelly, but please point out where I was not.

    For example, there will always be the percentage who contract polio from the vaccine

    This is only an issue with the live polio vaccine. It cannot happen with the inactivated version (unless, by some chance, the inactivation process is completely botched). In fact, you cannot contract the disease from any inactivated/dead vaccine. Live virus vaccines do carry a very small risk of the vaccine strain of the virus reverting to a pathogenic state. I’m sorry to hear that your friend was one of those rare exceptions.

    Then finally, follow the money.

    Ah, yes. Let’s do. It costs quite a deal more money to treat a disease (i.e., more money for the medical complex) than to give a vaccine that prevents the disease. Further, it is only because there is some protection of vaccine makers that they even bother making them at all. In fact, before the VICP, there was a very real threat of the few vaccine makers stopping completely due to the threat of mostly frivolous law suits. They are not nearly as profitable as other drug ventures.

    You know, for someone bleating on about a holier-than-thou attitude among those of us who appreciate the medical advancement that are vaccines, you take a very self-righteous attitude. Perhaps if you calm down some, we can have a civil conversation.

  64. #64 JohnV
    November 10, 2010

    @ShowMe

    “always in your apparently characteristic bombastic and sarcastic tone (“citation please”. Oh pleeez!)”

    You may not realize this, because you’re just some dumbass with an internet connection, but just asserting something doesn’t make it true. Interesting that you didn’t see that she also asks for citations.

    “Then finally, follow the money.”

    Indeed. And just what nefarious purpose do you and your ilk have in removing the vaccine safety net?

  65. #65 Seb30
    November 10, 2010

    Wow, “science” gods, your uniformly smug, rude, dismissive treatment of Kelly is just illustrative of why you have trouble “getting the word out”,

    It’s about the only part of ‘Showme’ post I could almost agree with.
    Almost. ‘Uniformly’? Calli Arcale was diplomatic and great as usual (how do you manage to stay so calm? I was following your discussion with Th1Th2 on the other blog, you amaze me).
    Prometheus was bringing light to us, as is his role. He may be a bit brusk sometimes, but not dismissive.

    But I do think we are becoming too used of battling trolls and entrenched opponents. Some of the first answers to Kelly were assuming the worst and were not that nice. Maybe it was a bad Friday to engage in constructive discussion.
    And of course, the usual trolls came around to pour oil on fire, vindicated in their beliefs.
    I know I tend too much to erupt into flame in my posts. It’s too easy to get upset in front of a computer screen. Maybe a few of us should reflect on this. I think we missed an opportunity here.
    Not that I would have done any better. As my previous posts have shown, I’m not very skilled in debating.

  66. #66 Gray Falcon
    November 10, 2010

    @ShowMe
    That Kelly asked for citations was one of the main reasons that people’s respect for her increased. If she had simply dismissed our statements out of hand, like so many others, she would have not have fared well.

    @Kelly
    Sorry for the bad experience. We once dealt with an angry mother who insisted that if one didn’t have children of their own, they had no right to contribute to the discussion. Some of us are still a little shell-shocked.

    @Sid
    I hadn’t yet responded to Sid’s comments on polio, but I may as well. The article he posted did suggest a connection between tonsillectomy and polio, but did nothing to show that it was the only issue involved, just one issue. Also, it was mainstream medicine that uncovered this issue, not a bunch of people shouting “Unnatural” at anything they deemed unfit. Finally, none of this changed the fact that the disease didn’t really go away until the vaccine was perfected.

  67. #67 Joseph
    November 10, 2010

    Maybe your “we know everything as a FACT” club forgets that your “FACTS” tend to be proven wrong over and over again.

    Such as? (Actually, the above is a very good description of the anti-vax movement. Remember thimerosal, MMR, the Omnibus Hearings, the “hidden horde” argument, multiple wagers that they were going to be proven right, that kids were going to be cured in 2 years with chelation, that autism and mercury poisoning are one in the same, that Wakefield was going to be cleared of the charges, and so on?)

  68. #68 Triskelethecat Midwife of Death
    November 10, 2010

    Gee, ShowMe sounds like both STY and the troll from SBM, Th1Th2. Anytime someone brings in the Pharma Shill gambit, it automatically makes their post tl;dr to me.

    @JohnV: I think that all anti-vaxxers have a lot of money in Big Hospital and Big Medical Supplies, because you can spend a heck of a lot more money treating illness than preventing it. Preventing illness means doctors LOSE money; they’d make tons more money if diseases were still so prevalent.

  69. #69 Chris
    November 10, 2010

    Showme:

    that you as a community ARE trying to remove by law even the small religious and conscientious exceptions to mandated vaccination schedules.

    “Mandate”… you keep using that word, but where in the USA does that happen? Even in Mississippi and West Virginia there is no requirement that you send your kids to public school. And many school districts are not concerned with vaccines that only protect infants like rotavirus and Hib.

    Please, if you are going throw out numbers like “300000”, etc., provide the actual paper for that value. As I recall you made many assertions, but provided nothing to back them up.

    By the way, I was nice to Kelly at first. I gave her suggestions on books to help her understanding of the statistics and science. But I get irritated when I continue to provide answers with links and they are ignored.

  70. #70 Jen
    November 10, 2010

    callie @ 252- I don’t have long to reply but when you talked about off-label use of vaccines concerning you it was not to do with custom vaccines or under-vaccinating. You mentioned vaccinating sick children as potentially a prob and also vaccinating in combinations that haven’t been studied. ( this really was a few months ago) and I am sure that Todd entered into the discussion and was taking the info in, too. I really do like to try and learn and even though I may not be able to look at all the studies right away I will try and do what I can to make informed decisions.
    Another time somebody did see what I meant about longer animal trials (they referred to what I was suggesting as something like an extended phase 4?) when studying vaccine effects on animals.
    For me, even if I didn’t try and look at some of the studies, I know that lots of scientists and doctors have looked at all those same studies and come away with the exact opposite view of most of you guys. that’s pretty concerning to me.

  71. #71 Science Mom
    November 10, 2010

    For me, even if I didn’t try and look at some of the studies, I know that lots of scientists and doctors have looked at all those same studies and come away with the exact opposite view of most of you guys. that’s pretty concerning to me.

    Jen, it would be so much more helpful to get on the same page if you would post some studies that concern you and the authorities that you claim reject the conclusions. If you really want discussion, then that would be a great first step.

  72. #72 Pablo
    November 10, 2010

    So Jen puts herself right up there with the creationists. They are always very anxious to tell us about all those scientists who are creationists, and therefore have come to a very different conclusion than the scientific establishment.

    And the comparison is apt. The anti-vaxxers have similarly come up with their “list” of people who “question vaccines.” And like the creationist lists, they play fast and loose with the credentials of the people that they include on the list. Things like “public health specialists” and nurses, trotted out as experts that should make us reconsider our position because they do. Shoot, IIRC even Jenny McCarthy was on the list!

    That you can find 500 people that you can put on a list (note these people are not all ones who would agree with the characterization that they “question vaccines,” but have been added to the list maybe because of something that they said that some anti-vaxxer distorted) is not a shock or surprise. There was just recently a conference of people who believe in an earth-centered universe. There were legitimate PhD scientists that contributed (one guy did his PhD thesis in the field – not geocentrism, of course – but not at a diploma mill). According to Jen, this should give us a reason to doubt the heliocentral model of the solar system.

  73. #73 Calli Arcale
    November 10, 2010

    Jen:

    callie @ 252- I don’t have long to reply but when you talked about off-label use of vaccines concerning you it was not to do with custom vaccines or under-vaccinating. You mentioned vaccinating sick children as potentially a prob and also vaccinating in combinations that haven’t been studied.

    I’m not doubting you; I just have a memory like a sieve sometimes. 😉 Thank you for refreshing my memory what it was about; I do remember now. I was indeed talking about how nurses/doctors who vaccinate sick patients may be outside the standard of care. (There are exceptions, of course, but in general they’re not supposed to vaccinate you if your immune system is already busy. IIRC, this is not just because of increased potential risk but also because a weakened immune system will not develop immunity as well, reducing the benefit of the vaccine.) And that’s something that people *should* complain about, because we shouldn’t have to accept sloppy care. Especially not now that so many “minute clinic” type places are getting into the vaccine business. Routine vaccines may not be big money-makers for a primary care provider, but for a walk-in clinic attached to a drugstore or supermarket, it’s a great way to draw in more customers.

    Part of me says “great!” but part of me is worried. On the one hand, having vaccination be part of a routine shopping trip means it’s not so inconvenient for a patient to go in, be deferred, and come back later when they’re over their cold or whatever. (I suspect that motivates a lot of primary care providers to vaccinate anyway, reasoning that it’s inconvenient for their patients to have to go out of their way to come back.) On the other hand, walk-in clinics routinely lose patients to follow-up, so they may be less aware of the consequences. (Intellectually, they would know, but if you don’t *see* it, it’s hard to remember it.)

    For me, even if I didn’t try and look at some of the studies, I know that lots of scientists and doctors have looked at all those same studies and come away with the exact opposite view of most of you guys. that’s pretty concerning to me.

    Realistlcally, you’re going to find disagreement on anything. It is not actually that surprising that some scientists look at the same data and come up with contrary views. This isn’t necessarily meaningful; scientists are not perfect, scientists make mistakes, and scientists are, well, human — prone to the same natural foibles and biases as the rest of us. This is also good. That scientists are allowed to disagree, even about things which a vast majority agree about, shows that the system is healthy. They need to be able to disagree freely. It’s fair to be concerned when a scientist looks at the data and concludes that vaccines may cause autism. But it’s worth looking to see what proportion of scientists disagree, and it’s worth looking to see whether the mavericks have any real meat to their claims. We who are not experts in the field often have to rely on consensus, since we lack the expertise to seriously evaluate their claims (though we can look at obvious stuff, like whether or not the findings were ever reproduced). If 99 scientists agree but 1 disagrees, it may not be time to take the outlier seriously yet. He may prove to be right in time, but most people who contradict the consensus ultimately prove to be wrong. The Galileos of the world are justly famous, but the magnitude of their fame makes it difficult to realize how many non-Galileos there are. Sometimes the consensus is wrong, but usually it isn’t, and it takes a lot of work to demonstrate when it’s wrong.

    All that’s a fancy way of saying it’s difficult to know who to trust, so I do understand where you’re coming from. It is very hard to be objective, and harder still to accept taking any sort of gamble, where our children are concerned. We just have to try our best.

  74. #74 Bruce Gorton
    November 10, 2010

    I have a bit of a fight going on vaccines on my blog at the moment – check out the link in my name.

    Hopefully I am doing an okay job at this but I am basically just a journalist, with all that entails, anyone here want to come over and help battle vaccine denial?

  75. #75 Todd W.
    November 10, 2010

    @Bruce Gorton

    Interesting, paul5of6 posted the exact same study on your blog as here. Ooh, and you got Tony “I ain’t seen no unvaccinated autistics” Bateson.

    You may want to post links to Science-Based Medicine’s “Vaccines and Autism” resource. My site (linked by my name) may also help a bit.

    Chris, you want to take a crack at commenting over there?

  76. #76 Chris
    November 10, 2010

    Depends. I have things to do, I was just taking a short break. Perhaps I’ll ask Bateson one more time why Sallie Bernard could find DTaP with thimerosal in 2001.

  77. #77 Bruce Gorton
    November 11, 2010

    Thanks hey Chris – it took a while to get up because of time zones and I have to approve new commenters.

  78. #78 Julian Frost
    November 11, 2010

    Hi Bruce,
    This fellow Saffer just left a comment. I became interested in this after Andrew Wakefield was convicted. Glad to see you’re also fighting the good fight.

  79. #79 Julian Frost
    November 11, 2010

    Hi Bruce,
    This fellow Saffer just left a comment. I became interested in this after Andrew Wakefield was convicted. Glad to see you’re also fighting the good fight.

  80. #80 Coryat
    November 14, 2010

    Augustine said:

    “They use numbers in the name of fear. If those numbers don’t work they use bigger numbers in the name of fear. They use stories in the name of fear. They use history in the name of fear. They use science in the name of fear.”

    OOGA BOOGA!

  81. #81 Werdna
    November 26, 2010

    @Kelly:
    Right, the only risk/benefit for scientists involve whether or not their is evidence that proves that if a vaccine can eliminate the common cold with the greatest documented risk being a week-long runny nose than in the scientists view the vaccine is the right thing to do.

    That’s a pretty incredible over-simplification. First of all, generalize much? Scientists do not have some unified mind-set. Might as well claim that Nazi scientists performing horrific human experiments implies that other scientists would do so. Secondly I’m not aware of any documentation on the development of a cold vaccine, how much was spent, etc… This is still pretty far removed from the topic at hand. Attempting to develop a vaccine, succeeding, making it available to the general public and making it mandatory are four dependent but rather different things. An attempt is just that, someone is trying something out perhaps it’s a new technique for vaccines that are more likely to handle mutations. The cold would be a good target since it’s variability is the main reason we don’t have a vaccine. Your assumption that just because we have a vaccine implies that people would be required to take it regardless of the risk/benefit. Again, that’s utterly untrue. Anthrax has a vaccine. Do you see any consensus of Scientists or Medical professionals telling you to take that?

    For parents, this doesn’t account for the actual risks they perceive in vaccinations. Like, risk of human error. Like, risk of an unknown side effect due to vaccine newness. Like, risk of allergic reaction (which always exists).

    I’m not sure what ‘for parents’ means (I’m a parent and really that statement means nothing to me) but when you do safety testing you actually do account for pretty much all of that.

    The point is that just because there are risks that aren’t quantitative

    I think you mean “that they (the parents) don’t quantify” that’s different than saying something isn’t quantitative (which implies “not quantifiable”).

    that doesn’t mean those risks shouldn’t be taken into consideration.

    How would you ‘take that into consideration’ which means, to me anyway “compare with other objective data”. What useful way is there to evaluate…say your feeling that VAERS data is more representative than it actually appears.

    So while a cold can certainly be made to look worse on paper, the reality is that we don’t need a common cold vaccine.

    See for a second there you sounded like you were advocating the fact that different people have different…what that statistician in me would call “value functions” the subjective way we evaluate certain experiences. Which is fine…I get that some people value the flu less than the flu shot but now you seem to be telling us that nobody can value a cold vaccine above having a cold. Aren’t you making decisions for everyone else on earth now?

    Imagine what those funds could have been used for.

    Considering you don’t seem to supply any information as to how much was spent, by whom or the funding model and every scientific discovery that resulted from it (even failed experiments educate us). I’m not sure you have any right to imply that the money could be better spent.

    No offense but despite your claims I don’t really see how you are promoting much of an open and informed debate especially when invoking narrow minded prejudice like you did above.

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