Over the last three weeks, the British Medical Journal (BMJ) has been publishing a multipart expose by investigative journalist Brian Deer that enumerated in detail the specifics of how a British gastroenterologist turned hero of the anti-vaccine movement had committed scientific fraud by falsifying key aspects of case reports that he used as the basis of his now infamous 1998 Lancet article suggesting a link between the MMR vaccine and a syndrome consisting of regressive autism and enterocolitis. Indeed, Deer even went so far as to describe Wakefield’s fraud as “Piltdown medicine,” comparing it explicitly to the infamous “Piltdown man” hoax, and in an accompanying editorial the editors of the BMJ agreed. These revelations were not by any means new. Scientists had suspected that something wasn’t quite right about Wakefield’s work almost as soon as it had been published, and by 2004 Brian Deer had uncovered clear evidence of major undisclosed conflicts of interest on Wakefield’s part. Unfortunately, by that time the proverbial cat was out of the proverbial bag, and Wakefield’s fraudulent research, aided and abetted by his flair for self-promotion in the media and some truly execrable, credulous, and sensationalistic coverage by the British press, had ignited a major scare over the MMR vaccine. MMR uptake rates plummeted below levels necessary for herd immunity, and measles came roaring back with a vengeance in the U.K. By the time the British General Medical Council finally ruled about a year ago that Wakefield had committed research fraud and violated research ethics in the work reported in his 1998 Lancet article and recommended that he be “struck off” (i.e., have his license to practice medicine in the U.K. revoked) and finally was struck off, the damage had been done.
As important as Wakefield is to the genesis of the modern anti-vaccine movement, however, there is another force that acts far more “where the rubber hits the road,” so to speak. This force comes in the form of publications and online discussion forums that cater to new mothers, offering all manner of advice and support. Some of these are very good, but all too many of them are hotbeds of anti-vaccine pseudoscience, confidently proclaimed by “elder statesman” members of these forums and included in articles published in glossy, attractive magazines. As a rather ironic coincidence, just as news of Andrew Wakefield’s latest humiliation was finding its way out into multiple news outlets over the last couple of weeks, the first issue of 2011 of just such a glossy publication had hit the shelves a couple of weeks before. I’m referring to Mothering, whose tagline is “Inspiring Natural Families Since 1976.” In reality, it should read: “Inspiring quackery and anti-vaccine views since 1976.” Of course, in the world of “alt-med,” the two often go hand-in-hand. In any case, one of my readers sent me a link to the latest issue of Mothering. As I’ve pointed out before, Mothering is, particularly with respect to vaccines but not limited to vaccines. Taking into account its large and vigorous online forums, Mothering is major force for the promotion of anti-vaccine views and quackery among new mothers.
Mothering says: Don’t worry, be happy about pertussis
The cover of the January/February 2011 issue of Mothering asks, Whooping Cough: Is Your Family At Risk? Should You Vaccinate?, complete with the mandatory cute photo of a cherubic infant to drive home the point of how important these questions are. Now, it’s very tempting for me to cite the science-based answers and emphasize that the answers are yes and YES!, but, as you might imagine, that’s not what Mothering advocates. Far from it.
The article is by a physician named Lauren Feder, MD and entitled “Straight Talk on the 100 Day Cough: What are the Symptoms of Pertussis? Who’s at Risk? And Is the Vaccine Right for Your Family?” Again, the answers to the last two questions should be “Everybody, particularly the unvaccinated” and “Yes, unless your child has a medical contraindication to being vaccinated.” But that’s not what Dr. Feder says. In fact, her article is a mix of science and pseudoscience, which is not surprising because it turns out that Dr. Feder is a homeopath:
Lauren Feder, MD, specializes in homeopathy, pediatrics, and primary-care medicine. Known for her holistically minded approach, Dr. Feder is a frequent lecturer to parents and professionals. She is the author of Natural Baby and Childcare and The Parents’ Concise Guide to Childhood Vaccinations. Her website is www.drfeder.com.
One can’t help but notice how Dr. Feder says she specializes in “homeopathy” and then “pediatrics,” not the other way around, implying that she views herself as a homeopath first and pediatrician second. Just what I want taking care of my child, a physician so cluelessly unskeptical as to have devoted her life to pushing magic water. Perusing her website, I found that the Mothering article appeared to be very similar to this article on Dr. Feder’s website. In it, after the disclaimer urging parents who suspect their child has whooping cough to take the child to a physician because whooping cough can be life-threatening. Then she recommends various homeopathic remedies for whooping cough. I kid you not. Here are a couple of examples:
Drosera for violent coughing spells ending in choking, gagging, or vomiting. Sometimes these coughs are so strong that the child can hardly catch her breath. Drosera is indicated for barking coughs, whooping cough, croup, and coughs that are worse after midnight, commonly accompanied by a bloody nose and a hoarse voice.
Spongia tosta for dry coughs that sound like a saw going through wood; often used for croup. Useful for croupy coughs that are worse before midnight, accompanied by a dry, barking cough that can sound like a seal.
The text for this section is very similar both on Dr. Feder’s website and in her Mothering article. Added to the sidebar of her Mothering article, Dr. Feder proclaims in addition, “Holistic medicine and homeopathy may shorten the course and severity of the illness.” There is, of course, no evidence presented (probably because there is no good scientific evidence to support such an assertion) that homeopathy can shorten the course of pertussis (or the course of any disease, for that matter), and to suggest as much is irresponsible in the extreme. Homeopathy is, after all, water. In the meantime, Dr. Feder makes exaggerated assertions about the whole cell pertussis vaccine that has largely been replaced by the acellular pertussis because of concerns that it caused a lot of neurological complications. Early reports in the 1980s suggested a high rate of neurological complications due to the whole cell pertussis vaccine, but more recent studies, as described by Steve Novella last year and by Paul Offit in his recently released book Deadly Choices: How the Anti-vaccine Movement Threatens Us All, have failed to confirm a link between seizures, neurological damage, and the whole cell pertussis vaccine. Perhaps the most telling aspect of Dr. Feder’s article is that nowhere does she state that all children without a medical contraindication to being vaccinated should be vaccinated against pertussis. Rather, she plays the game of saying “if you choose to vaccinate,” and then recommending this program of woo around the times of vaccinations:
In an attempt to use a more natural preventive approach, I prefer a different course of action. With any vaccination, I recommend administering the following vitamin and herbal remedy seven days before and after the shot, to generally strengthen the body. They may also help reduce any side effects of the vaccine.
Remember, your child should not receive a vaccination if she is cranky or ill. At our office, we prefer that, when possible, people take only one vaccine at a time. Contact your practitioner if unusual symptoms occur following the shot. You can use this protocol in conjunction with any other medications you give your child.
Each day, for seven days before and after the shot, give your child the following:
Briar Rose This gemmotherapy herb is a general immune strengthener.
Vitamin C Less than two years old, 100 milligrams, twice daily; two years and older, 250 mg twice daily.
She also recommends five homeopathic remedies be given before and after the shots, depending upon which remedy. Hilariously, she recommends giving three pellets of homeopathic DTaP 30C once a week for three weeks, beginning the day of the vaccination. She recommends the same thing for the Hib vaccine, homeopathic Hib given the same way. One wonders why Dr. Feder would even acquiesce to giving the vaccine if homeopathy is so great.
It occurs to me that, if Dr. Feder really believes in giving only one vaccine at a time and that parents should engage in all this woo before each vaccine, it would be a wonder if any parent manages to get through the entire vaccination schedule anywhere near on time in Dr. Feder’s practice. Maybe that’s the point. Also, such a regimen would require a whole lot of visits to the pediatrician, way more than the current vaccine schedule does, not to mention the purchase of a whole lot of homeopathic remedies to be given before and after the vaccines. Maybe that’s the point, too; it wouldn’t surprise me in the least. Be that as it may, perhaps the most disturbing part of Dr. Feder’s article is how, after actually conceding that pertussis is dangerous and can even kill, she then tries to downplay the danger of pertussis by citing her own anecdotal experience, much as our “old friend” Dr. Jay Gordon, who has of late been infesting the comments attacking Brian Deer, likes to do:
Thus far, the worst case of pertussis I’ve seen was in an eight-month-old girl who was hospitalized for a few days despite having had two DTaP shots. Following the hospitalization, the patient and her family came to my office for homeopathic treatment to expedite her healing. Now she is fine.
Note the implications. First is the implication that, because this child got two DTaP doses and still caught pertussis, the vaccine doesn’t work. Next, the implication is that homeopathy works. Testimonials aren’t just for cancer, apparently. After all, this child was treated with standard of care in a hospital for a severe case of pertussis. Her parents also gave her homeopathic remedies prescribed by Dr. Feder. Obviously, it must have been the homeopathy that cured her, or at least completed her healing! Worse, Dr. Feder appears to be implying, “Don’t worry so much about pertussis. I’ve never seen a child die of it; so it must not be so bad, and homeopathy can take care of it anyway. So you don’t really need those nasty vaccines.”
Unfortunately, Dr. Feder’s article is not all that this issue of Mothering has in store for mothers. First, Dr. Feder’s article contains a link to an article by anti-vaccine-sympathetic pediatrician Dr. Jay Gordon, who has been featured on more than one occasion right here on SBM for speaking at Jenny McCarthy’s anti-vaccine rally, downplaying the severity of pertussis and launching ad hominems at Dr. Paul Offit, arguing that vaccination against H1N1 is not necessary and the flu isn’t so bad, becoming indignant at arguments that parents who refuse to vaccinate shouldn’t be held legally liable if their child infects another, and for arguing on The Doctors that vaccines cause autism. It’s not for nothing that both Steve Novella and I have concluded that Dr. Gordon, if not anti-vaccine, is at the very least anapologist for the anti-vaccine movement His article for Mothering, entitled “Behind the Scenes with Dr. Jay,” is in the same vein as much of his other parroting of anti-vaccine views. Indeed, he makes nonsensical claims such as, “If vaccines work–and I believe they do–then vaccinated children are not endangered by unvaccinated children.” Apparently Dr. Jay has forgotten that no vaccine is 100% effective and that highly contagious diseases, such as the measles, can infect a subset of vaccinated children who didn’t respond to the vaccine sufficiently to achieve immunity. He then devolves into his usual pharma conspiracy mongering, replete with evidence- and data-free assertions such as this:
The pharmaceutical industry has not earned my trust. They have promoted ineffective drugs and other medicines that they knew had dangerous side effects. They have paid many physicians to ghost-write “in-house” research, and then to speak and write about the benefits of these same medications. Even if I believed that vaccines were the greatest invention in medical care–and I do not–I would still argue that the way they’re manufactured and given to children is not anywhere near as safe as it could be.
Evidence that the way vaccines are manufactured and given to children is not anywhere near as safe as it could be? None is presented by Dr. Jay. As I’ve said before, Dr. Jay clearly holds many anti-vaccine views, as defined thusly. Just as annoyingly, of late, Dr. Jay has been showing up in my comments whining about how he “doesn’t believe” that Wakefield has committed scientific fraud, doesn’t trust Brian Deer, and thinks Brian Deer is biased. As is typical of Dr. Jay’s M.O., Dr. Jay never actually presents any evidence to counter Deer’s assertions or any arguments that convincingly tell us why Deer’s research does not support his conclusions. Instead, Dr. Jay calls Deer “biased” and then blithely dismisses his years of work because he doesn’t like Deer’s findings about Andrew Wakefield.
Also featured in the Jan./Feb. 2011 issue of Mothering is an article by — holy crap! — Barbara Loe Fisher, the Founder and President of the anti-vaccine group the National Vaccine Information Center (NVIC). Arguably, BLF is the grande dame of the current iteration of the anti-vaccine movement, having started her activism in the 1980s. In it, she regurgitates the same sorts of arguments that we’ve heard time and time again. In particular, she is upset that recent pertussis outbreaks have been linked to the unvaccinated, pointing out that rates of vaccination for pertussis are very high. That’s true when one looks at the overall population, but BLF neglects to note that there are pockets with high numbers of unvaccinated children that provide a nidus for outbreaks to occur because herd immunity has broken down, as Joe Albietz, Mark Crislip, and Steve Novella have discussed, while Dr. Albietz has discussed the complexities of the recent whooping cough epidemic in California. While it is not clear how much of the current outbreaks in California are due to low vaccine uptake rates versus other factors, it is clear that vaccination against pertussis is safe and effective, the attempts of Dr. Feder, Dr. Gordon, and BLF to paint it otherwise notwithstanding.
Mothering, HIV/AIDS, vaccines, and other quackery
Mothering magazine has been a hotbed of anti-vaccine rhetoric as long as I’ve been aware of it, which has been around six years now. Worse, as I pointed out earlier in a post from two years ago about the death of HIV/AIDS denialist Christine Maggiore of what appears all the world to look like a case of terminal AIDS, Mothering has supported HIV/AIDS denialism. Indeed, Maggiore was featured on the cover of an issue of Mothering several years ago when she was pregnant, her pregnant belly emblazoned with the word “AZT” in a circle with a slash through it. The issue featured Maggiore in an article entitled Safe and Sound Underground: HIV-Positive Women Birthing Outside the System. Other articles published in Mothering about AIDS include Molecular Miscarriage: Is the HIV Theory a Tragic Mistake?, AZT Roulette: The Impossible Choices Facing HIV-Positive Women, HIV and Breastfeeding: The Fear. The Misconceptions. The Facts. (of which only one out of three was correct, namely the fear), and AZT in Babies: Terrible Risk, Zero Benefit. So, in addition to irresponsible and non-science-based recommendations about vaccines, Mothering promotes irresponsible and non-science-based recommendations about HIV very similar to the misinformation that led Christine Maggiore and her daughter to their deaths. Hundreds of thousands of people in South Africa have died following this sort of advice.
Then there’s vaccination.
If you Google for information on vaccination safety, mixed in with science-based sites like the CDC and CHOP and non-science-based sites like the NVIC, it doesn’t take long to find one’s way to the Mothering.com forums on vaccination, particularly if you Google “vaccine safety discussion.” If you then head to the Mothering.com Vaccination Forum, right at the top, you’ll find two discussions, Selective & Delayed Vaccination and I’m Not Vaccinating. The rules for the forums are stated thusly:
For I’m Not Vaccinating:
Posting to this forum will not be restricted only to members who do not vaccinate. However, we will actively restrict conversations in favor of mandatory vaccination or other topics that would be inappropriate for the forum. This is not a place for debate or discussions on the merits of vaccines or the dangers of not vaccinating, it is also not a place to argue against vaccines or selective and delayed vaccination schedules. Such discussions are already hosted in the main Vaccinations forum and posts in that vein are most welcome and appropriate there.
This forum is not a place to argue against selective or delayed vaccination or debate vaccination in general. Such discussions are already hosted in the main Vaccinations forum and posts in that vein are most welcome and appropriate there. Our purpose for this forum is to provide information that is helpful for parents who have made the decision to vaccinate and are not seeking discussion against their decision but rather support and information to help them proceed in the best manner. Please respect this and post at all times with this in mind.
In other words, don’t intrude on the comfy, self-reinforcing, supportive vibe. But what about the main vaccination forums, where, supposedly, in contrast to these two forums, it’s OK to debate the merits of vaccinating versus not vaccinating? Well, it doesn’t sound so friendly to anyone who wants to have a science-based discussion of vaccination, as evidenced by this notice about updated guidelines for the vaccination forum:
MotheringDotCommune is a community forum geared toward parents interested in Natural Family Living. On the issues of vaccinations we believe in informed consent. This means we look at both sides of the vaccine issue. However, one of our objectives, and for which members and guests come to our forum, is to bring to light the information that is not mainstream and readily available.
Recently, we have seen several members join MDC who seem to have an agenda to promote vaccinations. Though Mothering does not take a pro or anti stand on vaccinations, we will not host threads on the merits of mandatory vaccine, or a purely pro vaccination view point as this is not conducive to the learning process.
We will be contacting several members to discuss their sincerity on MDC. In the meantime, we are asking our members not to quote from this notice or address members within a thread as this is strictly prohibited. Instead, contact a forum moderator or administrator if you are concerned about a post and we will take appropriate action if need be.
And, from the guidelines themselves:
We embrace all parents, regardless of their choice. We uphold the Vaccinations forum as a place where they can come and discuss all aspects of all vaccinations, and find support in their desire to make an informed decision to not vaccinate, to vaccinate, to selectively vaccinate, or to delay vaccinations.
We expect and insist that all members post here with an open mind and a willingness to learn — even from the new member. There should be an understanding that a large number of Mothering community members are against vaccinations so when you do come here to post to ask your questions, and you have an intention to vaccinate, members here will feel a need to inform you of the concerns about vaccinations. While no one should be labeled as irresponsible or uninformed for deciding to vaccinate, neither should parents here who have chosen to not vaccinate be accused of irresponsibility, not caring for their child, or presenting a threat to others.
Elsewhere in the guidelines, it is spelled out:
That said, we will not tolerate new members who come to this forum with a focused agenda.
That “focused agenda” being, apparently, supporting vaccines and countering pseudoscientific arguments against them, which will get you booted off the MotheringDOTCommunity (MDC) discussion boards really fast if you persist after being warned. We don’t want to harsh the buzz of all those crunchy moms clucking about how vaccines are “unnatural” and “unnecessary.” Particularly revealing is this thread entitled Problem with ‘The Purpose of this Forum.’ One mother even asked, “Why does Mothering.com have to be so PC by stating Vaccinations Forum is neither pro-vax or anti-vax in policy??” Another mother wondered if the reason the MDC forum moderators don’t want to own up to being “anti-vax” is due to liability concerns. If you want to get a flavor of the discussions on these boards, though, check out the reaction to Andrew Wakefield. For example, macha10 writes:
Here’s how this issue boils down for me. In the grand scheme of things, I don’t care if this Wakefield guy falsified data. I don’t care if the study was good. I don’t even care if vaccines contribute to autism or not. I STILL will not vaccinate my children, for plenty of other reasons. Autism is not my only reason. And I am so sick of the media and the so-called “experts” out there telling the public that we crazy non-vac parents don’t vaccinate only because of autism. And now that the study is false, we can all just vaccinate our kids again. And everything will be great. UGGGG.
In other words, don’t bother me with facts and science. In fact, if you want to get a flavor of the entire attitude of the MDC towards vaccines, you can’t do better than a conversation I monitored about five and a half years ago, specifically, this disturbing challenge about vaccines posted by someone using the ‘nym Jen123, which led to a discussion of how they’d “dismantle the vaccine industry ingredient by stupid ingredient if we have to.”
This is the sort of the sort of antivaccination rhetoric that “vaccine safety proponents” try to hide from view. These mothers claim they are not “anti-vaccination,” and probably most of them honestly believe that they aren’t. However, right beneath the surface of all their attacks on mercury, just out of sight to the casual observer, full-blown antivaccination paranoia and conspiracy theories lurk, and certainly their “anti-mercury” advocacy provides aid and comfort to those who have more global problems with vaccination. The bottom line is that MDC is anti-vaccine to the core.The few brave souls who try to post science-based information will rapidly find themselves under attack from a swarm of anti-vaccinationist cyber sisters. If they persist after being “informed” of the forum’s guidelines or “counseled,” they will be rapidly banned by the forum moderators.
Misinformed consent on MotheringDotCommunity
Mothering and Mothering.com claim to be all about “informed consent” when it comes to vaccination, alternative medicine, “alternative” childbirth practices such as the various forms of “natural” childbirth, and even homeopathy. They are in reality about misinformed consent in that the risks of vaccination are grossly exaggerated, while the severity and danger of the diseases vaccines protect against are minimized, as are the ability of vaccines to protect against these diseases. Thrown into the mix are articles like Dr. Feder’s, which “informs” readers that, while pertussis is bad it’s really not that bad, that the vaccine isn’t so good, and that homeopathy can be used to treat pertussis. In other articles, readers are “informed” that there is doubt over whether HIV causes AIDS, whether AZT can decrease the transmission rate of the virus between HIV-positive mothers and their children, and whether antiretrovirals can prevent the progression of HIV to AIDS. In still other articles, parents are told that they can manage colds, asthma, the flu, earaches, and lots of other conditions with homeopathy.
Perhaps the best example of “misinformed consent” found in Mothering.com can be found at this link to Vaccine Safety Awareness. Right there is a “Physician’s Warranty of Vaccine Safety” that plays the “toxin” gambit and demands in essence absolute safety from vaccines. Elsewhere, prominently featured is a link to the monthly VAERS Report. Never mind that VAERS is a database to which anyone can report an adverse event after vaccination, whether the event is related to vaccination or not. Worse, VAERS is highly subject to publicity. Indeed, trial lawyers have in the past gamed the database by encouraging their clients to report that vaccines caused their children’s autism. Amusingly, a parent by the name of Jim Laidler entered a report into VAERS that a vaccine turned him into the Incredible Hulk, and Kev Leitch did the same in a report claiming that the flu vaccine turned his daughter into Wonder Woman. The point is that anyone can enter a report, and there is no verification that the adverse event reported is actually due to vaccination. VAERS has the potential to be useful as a sensitive “early warning” system that could alert health officials to a problem, but it is useless for estimating actual rates of vaccine injury, and the ease with which it is gamed diminishes its usefulness even as an early warning system.
In fact, the entire Vaccines section of Mothering.com is full of dangerous misinformation. For example, chicken pox parties are recommended, even though as a result of the party described one child had the “worst case his doctor had ever seen,” with “hundreds of lesions, even in his mouth and down his throat.” Another article, entitled Poison in our vaccines, played the toxin gambit in huge, bold letters, complete with blinking neon.
Mothering and MDC represent themselves as places to obtain accurate information about child care, health care, and childbirth. Because the magazine’s circulation is healthy and the community is very large, links to these sites all too often appear high in Google searches, leading young mothers to fonts of misinformation that leads to misinformed consent. Andrew Wakefield and his fellow travelers promoting unscientific information about vaccines are definitely to blame for providing the raw material for the anti-vaccine movement, but it’s communities like MDC and magazines like Mothering that spread the message to the masses, all in the name of protecting “freedom of conscience.” Unfortunately, freedom isn’t free when it’s based on misinformation, pseudoscience, and quackery.
ADDENDUM: Surprise! Surprise! Mothering has a fawning interview with Andrew Wakefield featured in a recent podcast.