In many ways, the anti-vaccine movement is highly mutable. However, this mutability is firmly based around keeping one thing utterly constant, and that one thing is vaccines. No matter what the evidence, no matter what the science, no matter how much observational, scientific, and epidemiological evidence is arrayed against them, to the relentlessly self-confident members of the anti-vaccine movement, it's always about the vaccines. Always. Vaccines are always the root many human health problems, be they asthma, autoimmune diseases, autism, and chronic diseases of all types. Everything else is negotiable. For instance, back when Andrew Wakefield ignited a scare about the MMR vaccine by publishing a fraudulent case series linking the MMR to a new syndrome consisting of regressive autism and enterocolitis, it was the measles vaccine that caused this syndrome. Here in the U.S., it was the mercury in the thimerosal preservative that used to be used in many childhood vaccines until 2001 that was the cause of all evil. However, as scientists did more and more studies, testing vaccines to see if they were associated with an increased risk of autism and found zero, nada, zip association with either vaccines or the thimerosal preservative in vaccines, the anti-vaccine movement was nothing if not mutable. Before long, Jenny McCarthy was declaring that it was the "toxins" in vaccines that were causing autism, and Generation Rescue was asserting that children were getting "too many too soon." Of course, as far as the anti-vaccine movement was concerned, the beauty of these ideas was (and is) that they are much harder to falsify scientifically because they are so much more vague.
Of late, the anti-vaccine movement has hit upon a new strategy. Specifically, they are demanding what they like to call a "vaxed versus unvaxed" study. Basically, their claim is that unvaccinated children are so much healthier than vaccinated children, and they think that such a study would prove it. Of course, they only hit on this message after making some rather embarrassing missteps. In particular, they didn't seem to realize that a randomized, double blind study of vaccination according to the currently recommended schedule versus unvaccinated children was totally unethical. So, they figured out another angle. They acknowledge that a randomized trial of unvaccinated versus vaccinated children would not be feasible (although they appear not to be able to admit just how unethical it would be), and blithely suggest instead an epidemiological study of the vaccinated versus the unvaccinated without realizing just how horrendously difficult it would be to overcome the confounders that would plague such a study or that ethical considerations still require sound scientific justification for such a study. That's why it's so cute to see anti-vaccine loons trying to justify such a study.
All of which is why it's pretty amusing that just such a study was recently reported in Germany. Can you guess what it found? Let's just say that, to those of us who accept the science showing that vaccines do not cause autism, autoimmune diseases, asthma, and the like, the results were utterly unsurprising:
In their study, the authors compare the occurrence of infections and allergies in vaccinated and unvaccinated children and adolescents. These include bronchitis, eczema, colds, and gastrointestinal infections.The evaluation showed that unvaccinated children and adolescents differ from their vaccinated peers merely in terms of the frequency of vaccine preventable diseases. These include pertussis, mumps, or measles. As expected, the risk of contracting these diseases is substantially lower in vaccinated children and adolescents.
Surprise, surprise! Unvaccinated kids differ from vaccinated kids only in having a much higher risk of vaccine-preventable disease! Who'da thunk it? But, as is my wont, I need to see the actual study, rather than a news report. So, as they say, let's go to the tape. Unfortunately, the authors feel obligated to lay out exactly why they did their study:
The benefits, efficacy, and safety of protective vaccinations are widely scientifically proven. Furthermore, modern vaccines are well tolerated (4, 5). In spite of all this, some parents and doctors have reservations against vaccinations. The fear is that vaccinations overburden, stress, or weaken a child's immune system and may therefore cause harm. As a result they think that vaccinated children are more prone to falling ill than non-vaccinated children. In addition, vaccinations are deemed to be responsible for the occurrence or increased incidence of other diseases, including chronic diseases (6, 7).
In other words, Generation Rescue, Dr. Jay Gordon, Jenny McCarthy, and others. They spread this misinformation.
Basically, what the German investigators did was to examine data collected aas part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which was conducted from May 2003 to May 2006 by the Robert Koch Institute. The data collected were primarily from a standardized, computer-assisted personal interview of the parents, but diagnoses reported and vaccination status were verified through medical records. Results were compared between vaccinated and unvaccinated children, defined thusly:
Children and adolescents were defined as unvaccinated if at the time of the KiGGS survey no documentation existed for any vaccination against diphtheria, pertussis, tetanus, Haemophilus influenzae type b, hepatitis B, poliomyelitis, measles, mumps, or rubella. By contrast, children who had by then received at least one vaccination according to their vaccination card were categorized as vaccinated. Immigrant families were excluded from the analyses in order to avoid misclassification because of the often missing or incomplete vaccination documents.
On the basis of the KIGGS data, investigators concluded that approximately 0.7% of nonimmigrant children and adolescents in Germany are completely unvaccinated. This is in line with estimates I have seen for the percentage of children in the U.S. who are completely unvaccinated, although this population is more difficult to ascertain in the U.S., at least on a national level. In any case, there was a vaccination card available for 13,453 children aged 1 through 17. Out of this group, for 94 children no evidence of vaccination could be found. Consistent with results in the U.S., the unvaccinated children tended to be from families of higher socioeconomic status. Less relevant, unvaccinated children tended to live in older German states than in the new German states.
Otherwise, the children in both groups were very similar, except in one way. This graph in Figure 1 tells the tale.
Basically, unvaccinated children had a much higher prevalence of vaccine-preventable infectious disease. The results were significant for pertussis, measles, and mumps, as described in the text:
The proportion of children and adolescents who had had pertussis, measles, mumps, and/or rubella was much higher in unvaccinated children than in those who had been vaccinated against the respective disease to a sufficient extent. For pertussis, the lifetime prevalence in unvaccinated subjects was 15.8% (95% CI 8.5 to 27.6, n = 11), in those with sufficient vaccination cover only 2.3% (95% CI 2.0 to 2.8), n = 184). For measles, the lifetime prevalence was 15.0 (95% CI 7.7 to 27.4, n = 10) in unvaccinated subjects and 5.2% (95% CI 4.7 to 5.8, n = 431) in sufficiently vaccinated ones. For mumps, the lifetime prevalence in unvaccinated subjects was 9.6% (95% CI 4.2 to 20.2, n = 7) and in vaccinated ones, 3.1% (95% CI 2.6 to 3.7, n = 305). For rubella, the lifetime prevalence was 17.0% (95% CI 9.4 to 29.0, n = 11) for unvaccinated subjects and 6.8% (95% CI 6.0 to 7.6, n = 642) for vaccinated ones. Differentiated stratified analyses confirmed the described higher proportions of subjects with the respective disease among unvaccinated subjects for boys and girls and for different age groups (data not shown).
It was at this point that the authors included an interesting control. One might imagine that if, for some reason, there were differences in infectious disease prevalence in general between the two groups, there might be differences in diseases against which we do not or cannot vaccinate, such as colds. What the investigators found was that there was no difference in the number of infections between vaccinated and unvaccinated children in any of the age groups studied:
In other words, as expected, the only difference in prevalence observed was in diseases for which vaccines make a difference, and those diseases were much less prevalent among vaccinated children than among unvaccinated children.
Finally, the investigators examined the hypothesis that vaccines increase the risk of allergies and immune system dysfunction by looking at atopic disorders. The authors examined the prevalence of three conditions, bronchial asthma, atopic eczema, and allergic rhinoconjunctivitis. Just like the case for diseases not currently vaccinated against, there was no difference in prevalence found between vaccinated and unvaccinated children, strongly suggesting that vaccines do not cause atopic disorders. This evidence is, of course, consistent with previous studies that have similarly failed to find evidence that vaccines increase the risk of asthma and other atopic disorders. Overall, this study is a near slam dunk against the idea that vaccines are in any way associated with atopic diseases, including this part:
In addition to atopic disorders, we further compared diseases--such as obstructive bronchitis, pneumonia and otitis media, heart disease, anemia, epilepsy, and attention deficit hyperactivity disorder (ADHD)--in unvaccinated and vaccinated subjects. No relevant differences in the lifetime prevalences were found, neither for different age groups nor between girls and boys. Schneeweiß et al. conducted a comprehensive literature review of vaccine safety, the central part of which was the evaluation of vaccine critical arguments on the basis of the current state of scientific knowledge. None of the hypotheses were found to be valid (5).
Let me repeat this again. None of the hypotheses were found to be valid.
It is true that, as large as it is, this study is relatively small given the low percentage of completely unvaccinated children. This made subgroup analysis impossible for some measures and limited the power of the analysis due to low numbers of unvaccinated children in several of the categories. After all, there were only 94 unvaccinated children, which makes it impossible to compare autism and ASD prevalence with the vaccinated cohort, because the expected prevalence of autism is only approximately 1 in 100 anyway. That means that on average roughly one autistic child would be expected in such a cohort. To look at differences in autism prevalence between the groups, many times more than 13,000 subjects would be needed, which would be a hugely expensive study, particularly if medical records and vaccination cards were reviewed for every child. This study also bolsters what I said before by showing how difficult it would be to do such a "vaxed versus unvaxed" study with sufficient subjects to provide adequate statistical power to detect even fairly large differences in prevalence. For diseases and conditions sufficiently prevalent to allow the detection of differences in the sample size the investigators had, though, there was no evidence of differences in conditions commonly blamed on vaccines between vaccinated and unvaccinated children. Certainly, this study provides no support for doing a larger study. For it to do that, there would have to be a hint of a whiff of an association between vaccinated status and the atopic diseases examined or the risk of infectious diseases not prevented by vaccines. There wasn't. If I were on an IRB, and someone proposed doing a larger study, this German study would be an argument that there is inadequate scientific justification to do a larger study, particularly in light of other studies like this, this, and this, which suggest that early vaccination might actually be protective against atopic diseases.
The wandering band of anti-vaccine propagandists over at, for example, Age of Autism say again and again that they want a "vaxed versus unvaxed" study. Indeed, after the recent Supreme Court decision in Bruesewitz v. Wyeth upholding the primacy of the Vaccine Court in disbursing compensation to children injured by vaccines, AoA seems to have lost what's left of its mind, posting multiple times about it as though it were some grave injustice and their rights had been completely stripped away. Add to that the picture of Barbara Loe Fisher comparing the anti-vaccine movement to Winston Churchill facing down Hitler, and the picture remains truly nauseating.
Be that as it may, I'd like to finish by offering our "friends" in the anti-vaccine movement a bit of advice. You keep saying you want the government to fund a "vaxed versus unvaxed" study. You keep repeating it until you're blue in the face. Based on this German study, you might want to be a bit more careful. In other words, be careful what you wish for. You just might get it. And, based on this study and the vast preponderance of evidence, if that study you so fervently wish for is well-designed and conducted properly, you probably won't like the results.
But why worry? If a "vaxed versus unvaxed" study is negative, the anti-vaccine movements will just ignore it. It's what they do.
REFERENCE:
Schmitz, R; Poethko-Müller, C; Reiter, S; Schlaud, M (2011). Vaccination Status and Health in Children and Adolescents: Findings of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) Dtsch Arztebl Int, 108 (7), 99-104
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I expect some loon with no understanding of error bars to come and try to point out triumphantly that there is a difference in the rates of infections, see? The bars on the graph aren't the exact same height! *eyeroll*
Nice article. It undermines the idea that heard immunity is protecting the children whose parents chose not to vaccinate - even at <1% of the population, they'll still contracting vaccine preventable diseases fairly regularly. Those prevalence rates are distinctly unfavourable in comparison to the rare incidence of adverse vaccination events.
@Sarah: the errorbars are NOT directly related to statistical significance, eg. representing 95% confidence intervals. That is, unless the authors did some highly unusual math.
Sadly I can see our ever ignorant anti-vax crowd suggesting that due to the ginormous error bars on the unvaccinated group compared to the vaccinated group (sample size, no doubt) that they need to get another 10,000 unvaccinated kids before they'll consider the results.
Then they'll say it's fake / big pharma lies / global conspiracy to poison their children.
Marius - I think Sarah knows that. That's why she said some "loon" ill come around and make that claim.
What do you mean by "older German states" as opposed to "the new German states"? Is that the former West Germany versus the former East Germany? Not a great description if so as both parts have been German since the 1870s.
No idea. It's the authors' term, not mine. They refer to "old German states and the "new ones." It's quite a minor point, anyway.
Antivaxxers would simply shift the goalposts or pretend the study doesn't matter.
You see it time and again with supporters of outlandish beliefs (e.g. 9/11 truth movement) - they'll impose some arbitrary standard of evidence that they'll accept and if that evidence happens to be provided they'll shift the goalposts and demand something else.
Locka - of course they'll move the goalposts. It is expected. Or, at least half of them will. The other half will just ignore it.
I'm curious, Orac, what references are cited in 6 and 7?
Well, the antivaxxers will just ignore this study because it's not from the USA anyway.
@Ciaran: don't know how accurate this is, but per Wikepedia:
Ciaran, you are right.
"Older German states" and "the new German states" is directly translated from German - "alte und neue Bundesländer", which in fact means former West and East Germany states, respectively. The authors mention this because of the different vaccination policies in East and West Germany before the German reunification.
I hope Dr Jay drops in to share his thoughts.
Hear that? It's the sound of antivaxers covering their ears, closing their eyes, and repeatedly saying Wakefield's name hoping he'll come to their rescue.
The study's finding "Unvaccinated children and adolescents also tended to live in the old German states (former West Germany) to a slightly higher extent than in the new ones (former East Germany)" is consistent with the fact that former West Germany adopted a non-compulsory
vaccination policy whereas the vaccinations in former East Germany were mandatory. Nowadays, the immunization is not compulsory in Germany, but probably new parents from the former East Germany tend to fully vaccinate their children more than their counterparts in former West Germany states.
@ marius:
Actually, read the caption for figure 1. The error bars ARE actually the 95% CI.
Second, this is fairly common in biology (Ref: I'm a grad student and read a lot of papers?). Either the 95% CI or the SEM is the norm for error bars in my field. Both of which are directly related to the significance (the 95% CI being 1.96 times the SEM for a normal distribution).
Germany has a somewhat comparable recommended schedule to the U.S. http://www.euvac.net/graphics/euvac/vaccination/germany.html
I would have liked to see sub-group analyses of fully and partially vaccinated children in comparison to unvaccinated. Although the authors are probably unaware of the ever-shifting U.S. anti-vax hypotheses, particularly "too many too soon".
@Rene,
Hear that? It's the sound of antivaxers covering their ears, closing their eyes, and repeatedly saying Wakefield's name hoping he'll come to their rescue.
You know, if you say Wakefield's name three times in front of a mirror, he'll appear in your house and ask you to pay him for a lecture on how he was wronged by the Big Pharma conspiracy by being such a brave maverick.
I love the smell of science in the morning.
The gnashing of teeth over at GR & AoA ought to be heard for miles. I envision a minor resurrection of 'mommy science', which as we all know beats everything.
The anti-vaxers will not be satisfied with this study. I bet they will complain that the study didn't look at the vaccine status of the mother (and father).
They will then want the vaxed child vs unvax child + unvaxed mother + unvaxed father (+ unvaxed grandmother + ......) study.
After all, the toxins could be passed from mother to child....
While Orac is certainly right, this point isn't of any particular significance, I couldn't help but chuckle at that remark. You know, from "our" perspective here in the old world anything younger than a millennium (deliberately exaggerated) is quite new. Like that curious democracy thingy for instance or that whole freedom and free will business of yours. And since there have never been german federal states forming a state called Germany in any form before 1949, the first 11 were already really new states. But when even newer states came along around 1990, the former new states became older new states and the new new ones were the newest states. You might agree that such terminology tends to sound rather messed up, which is why it was decided to officially call the older states "older states" and the newer states "newer states". Well, that has worked quite nicely up until now and while one might say with some reason that "eastern states" and "western states" would have been a more obvious and comprehendible choice, that wasn't really considered at the time. Even now nobody would suggest such nomenclature (although for some purposes it makes sense, mostly if both older and newer states but not all 16 are referred to). Mostly for the reason that after some 40 years of iron curtain right through our very own countyry "east" and "west" aren't just two points of the compass but carry a whole lot of for the most part unintended meaning.
Please excuse my poor English (not fishing for compliments, if it's not that poor, ignore it) and the lengthiness of this comment, but being german and no physician I just had to take this opportunity to finally post something into this truly outstanding blog. And of course thank Orac for all of his insolence (respectful or otherwise) over the past couple of years, I've enjoyed every last bit of it. Keep it up. :-)
The anti-vax crowd won't believe anything that doesn't support their position, evidence be damned.
Excellent article with some interesting data collected and tabulated by the German study. It probably will not receive any attention in anti-vax websites...for obvious reasons.
And, we will probably be disappointed by the absence of any of the trolls and "experts" (Dr. Jay), on this particular issue. After all Dr. Jay has not changed his stance on Prevnar (after eleven years of licensing) because "it is too new for me to recommend."
Hello friends -
Overall, this study is a near slam dunk against the idea that vaccines are in any way associated with atopic diseases, including this part:
What a joke. This is a forum where the methodology of a study and the quality of the data is supposed to be important, regardless of what narrative is being supported or unsupported.
It is true that, as large as it is, this study is relatively small given the low percentage of completely unvaccinated children. This made subgroup analysis imposible for some measures and limited the power of the analysis.
Indeed.
Take Asthma, for example. In the entire study there were two unvaccinated children with asthma; all in the 10 - 17 age group (a vanishingly small 2% of the unvaccinated population). The rest of the asthma figures don't make any sense either, and the authors acknowledge that their rates of asthma are strikingly lower than other values found in Germany.
No doctorsâ diagnoses of bronchial asthma were reported for unvaccinated children aged 1-10 years. Because of the low incidence of asthma and given the fact that diagnosing asthma in this age group is difficult, no cases of asthma were to be expected within the small group of unvaccinated children. Furthermore, differences in the awareness of symptoms or parentsâ advice seeking behaviors may explain different prevalences in doctorsâ diagnoses. Studies that enumerated cases at the symptom level have continuously observed higher prevalences of asthma than KiGGS (17, 18).
Orac didn't post the abstract, but it should be noted that in almost every category, the autism group did trend towards reduced incidence; the fact that the values didn't reach significance is really more of a function of insufficient numbers.
Unvaccinated children aged 1-5 years had a median number of 3.3 (2.1 - 4.6) infectious diseases in the past year, compared to 4.2 (4.1 - 4.4) in vaccinated children. Among 11- to 17-year-olds, the corresponding figures were 1.9 (1.0 - 2.8) (unvaccinated) versus 2.2 (2.1-2.3) (vaccinated). The lifetime prevalence of at least one atopic disease among 1- to 5-year-olds was 12.6% (5.0%-28.3%) in unvaccinated children and 15.0% (13.6% - 16.4%) in vaccinated children. In older children, atopy was more common, but its prevalence was not found to depend on vaccination status: among 6- to 10-yearolds, the prevalence figures were 30.1% (12.9% - 55.8%) for unvaccinated children versus 24.4% (22.8% - 26.0%) for vaccinated children, and the corresponding figures for 11- to 17-year-olds were 20.3% (10.1% - 36.6%) versus 29.9% (28.4% - 31.5%).
Unvaccinated children in the 1-5 age group had a nearly 25% reduction in median infections diseases in the past year. Not posted in the abstract, for some reason, is the finding that asthma was twice as common in the vaccinated group than the unvaccinated group. Does anyone believe that these are meaningful findings? Or is it the case that we only ascribe findings to underpowered numbers when they support or meme, and conveniently forget to mention the instances when the same pitifully powered numbers seem to make our preferred conclusion?
These findings are amazingly dependent on microscopically small changes in absolute values in the unvaccinated side. In no breakdowns outside of vaccine preventable diseases did any classification of study contain more than four children without vaccines. For example, in children 1 - 5 with allergic rhinoconjuctivitis, there was one child in the unvaccinated group. Who is suprised that they were unable to find any statistically significant associations here? How could they?
One wonders if they age classifications were grouped into the 1-5 / 6-10 / 11-17 ranges for preventable diseases if the findings would have been significant or not; probably, and functionally it makes lots of sense, but generally I've seen a lot of skepticism on sites like this when studies slice and dice their populations depending on the measurement being made.
This study does do a good job of illustrating the very real problems with the type of epidemiological study that lots of people clamor for, but it's only a slam dunk if the agenda takes a back seat to quality of analysis.
Flame away.
- pD
Yes. I learned it the hard way when someone tricked me into saying his name by writing it backwards on a piece of paper, so I had to hold it up against the mirror to read it. I'll never make that mistake again.
passionlessDrone:
What autism group?
Sarah@1, less than 5 hours
@Orac
Other than sample size, what were some of the limitations of the study, esp. those that anti-vaxers might bring up?
@Greg Fish and Rene
If you say his name three times in front of a mirror at a birthday party, not only will he appear, but he'll take your blood.
The war on vaccines continues - *mutatis mutandis*- because they neatly demonstrate the efficacy of SBM : diseases have been eradicated no thanks to herbal treatment, vitamin/mineral supplementation, homeopathy, veganism, or chakra wheel-allignment. Alt med must similarly attack HAART for HIV/AIDS: they changed the landscape. Vaccines and ARV's show just how *wrong* alt med actually is.
Suppose one of our prolifically vile web woo-meisters were to *support* vaccination *while* still promoting his own line of products - the concept just wouldn't fit in: it would be an admission that SBM is actually useful and safe.( We couldn't have that!) It would concur that there are conditions which just are *not* amenable to lifestyle change. It would perhaps allow the idea of "germs" to enter the picture.
If you hate the message, you usually aren't perticularly fond of the messenger**. I *do* find it funny that alt med proponents invoke the word "fraud" by SBM while simultaneously peddling unproven nostrums and promising moon-shot cancer cures based on spit and sealing wax.
** Wear it as a bdge of honor. My mother always said that if an idiot insults you, it's really a compliment: they have poor taste and worse judgment.
It's true because you MUST invite him in before he can take your blood at home during a birthday party... I've heard.
@ Todd W. HAHAHAHAHA! wait a minute, aren't *we* supposed to be the "dark side"?
Haha, cool. I can't wait for Augustine et al to start their nonsense, I love the delicious tears of the stupid.
@passionlessDrone, I'll use your asthma critique as an excuse for a basic statistics lesson.
This study has 44 unvaccinated children aged 1-5 and 20 aged 6-10. Since there were thousands of children in the vaccinated samples we can assume their incidence rates are closer to the true incidences. 1.8% of vaccinated 1-5 year olds has asthma. If a 44 child sample has the same incidence rate then (0.982)^44=44% of the time you wouldn't see a single case of asthma in this small sample. For ages 6-10, with a sample size of 20 and an incidence rate of 4.6%, no asthma cases would appear 39% of the time.
This is a standard issue of studies of low incidence diseases with small sample sizes. The biggest real problem with this study is that the small unvaccinated sample sizes results in large error bars. That said, I'm glad the unvaccinated sample wasn't any larger.
The anti-vax crowd will complain that this study had "flaws", if they even admit that it exists. Sigh.
Thanks for the statistics refresher, bsci. I wish that you had time to expand on that to explain some of the other issues related to a "vaccinated vs. unvaccinated" autism study.
BTW, I think that pD meant "unvaccinated group" rather than "autism group."
I suspect it'll be claimed that they deliberately didn't look at autism because they knew they'd find a link. Either that, or the fact that a link was not found will be presented as prima facie evidence that the study was fatally flawed and meaningless.
Remember, this are the same people who can say with a straight face "We gave this study our highest score because it appears to actually show that MMR contributes to higher autism rates". The quality of a study is determined by whether it gets the results they want...
This bears repeating.
Remember, Jay Gordon knows what the science says. He just denies it, because he disagrees with it. Since he is right, it just shows that the science must be wrong.
@Rene
Don't worry, though. He'll give you £5. Downside, though, is that if you suffer any ill effects (fainting, nausea, vomiting), he'll laugh and joke about it in a room full of other people.
Oh, goody. The clueless Th1Th2 spouting, yet again, its same, sad old misunderstanding of what constitutes infection. Folks, please do not reply to Th1Th2 or engage it in any way. That would just make it bolder and repeat the same garbage ad naseam.
I'll give passionlessDrone one thing: jen would have just popped on, complained about 'flaws' without actually enumerating any, and been on her merry way.
I wonder how long it is 'till someone appears here and claims that this study is invalid for no other reason than because the words '[German] Federal Ministry of Health', 'Sanofi-Pasteur' and 'Glaxo Smith Kline' appear in the list of joint funders?
Vaccines have never prevented the vaccinated from getting the disease. On the contrary, they have already acquired the infection from the inoculation itself in order to effect primary immune response. It is a must. Therefore, they can let themselves get infected for as long as they want and anytime they like, i.e. repeated vaccination. The vaccinated as always, lead the pack when it comes to infection-promoting agenda.
This study is not about the unvaccinated. It's all about the vaccinated and the prevalence of them contracting different infections.
May I also say that, given the hilarious exchange on making an Andrew Wakefield equivalent of Bloody Mary, that we should all do our damnedest to make it an actual urban legend. :)
For the same reason they have, this study is all about the vaccinated.
When I saw that study, I immediately thought of that wacky person Dawn Winkler, and her idea that all vaccinated kids have continuous dripping snot (see the link on my 'nym). It's one of those images that stays with you.
When I found that quote, I had another epiphany. Is it possible that Dawn, with her focus on Th1/Th2 balance, is really our friend Th1Th2?
Point, set and match. Not that that hasn't already been the case a hundred times before.
If you put your ear to the ground you can hear it. No, it's not horses in some Spaghetti Western. That's the feet of oodles of loonies busy shifting the goalposts South across the Mexican border in the dead of night.
Although this article is painted as an "either or," the fact is that not all vaccines are created equally. There are certainly "good" vaccines, and reasons for children to get vaccinated against an array of preventable illnesses. But, that is not to say that ALL vaccines are appropriate or desirable.
A better approach would be to strive for the least amount of needed vaccines, coupled with good public heath policy.
There is, of course, plenty of reason to be leery of over-vaccinating, over-medicating, and under-educating. In particular, there is reason to question the blanket flu vaccinations for all people over the age of 6 months (as espoused by the CDC), in the United States. http://flucrazy.blogspot.com/2011/02/should-you-get-flu-shot-probably-n…
Th1Th2:
So, are you arguing that once someone comes down with something, they never recover? They are always and permanently diseased? That's the best as to what I can figure out what you're saying.
This is why nobody takes you seriously. You're operating out of an entirely different reality than the rest of humanity.
While I expected to see small, fringe blogs such as LBRB rejoice over this study I'm surprised to see you, a great supporter of good science, embrace this "study".
My suspicion was first raised when it appeared in the Artzeblatt International, a bottom tier journal with an impact factor of 1 (compared with the Lancet and JAMA at 28 and 30) perhaps they're trying to use a few manufactured conclusions to crawl up the rankings ladder
They ascertained the number of colds by questionnaire? Who can say how many colds a child had over a year? Does a sniffle count as a cold? Or is it two sniffles?
So the study is, in the authors own view, too small when it doesn't support their conclusion yet when it is supportive it's not an issue
So unvaxxed get more measles. Scary. So now we don't have to hear anymore drivel about taking advantage of the herd and freeriding since were not getting the protection they vaxxers are?
Also a single vaccination counted as much as the entire schedual
Finally I think pD is referring to the unvaccinated group when he says autism group. You Megaminds should have been able to figure that out on your own
@brian #35,
I think there are two very challenging additional issues with this type of analysis for an autism study. First, the autism incidence is under 1%. http://www.nimh.nih.gov/statistics/1AUT_CHILD.shtml
This means it would be even more challenging to find good numbers in a small population sample.
Second, unlike most of the other aspects of this study, it's hard to make a proper diagnosis of autism. To do it right, you need more than to just have parents fill out a general survey and glance at medical records. You can't just ask parents whether their child is autistic in the same way you can ask if they have asthma. A health professional would need to look at each child or at least interview each parent specifically about autism symptoms.
Lets say you could find 1000 unvaccinated children and somehow matched them to 1000 vaccinated children with similar age/socioeconomic profiles. Even then, you'd expect less than 20 cases of autism total. Given the existing science showing the link between autism & vaccines to be incredibly unlikely, to do such a study well would cost immense sums of money and time.
I was wondering why the text read like the script for a vaccine infomercial
No, much as you might wish to redefine the words to conform to your personal obsessions, I'm afraid that they already have scientific meanings. In particular, there is a big distinction between developing an immune response to a disease organism and getting the disease. "Getting the disease" means that the causative organism is actually growing and reproducing inside the body, but many vaccines contain either killed organisms or fragments of organisms that are incapable of growing or multiplying.
The illnesses that we vaccinate against are those that produce damaging effects that go far behind the normally mild symptoms that are associated with the body mounting an immune response. Many of them secrete biological toxins that have been well-characterized in the laboratory and shown to produce damaging effects on cells that have nothing at all to do with the immune system.
Gray Falcon,
Both the vaccinated and the unvaccinated can contract something that can lead to disability. Every one is susceptible only that the vaccinated always get a head start in acquiring infections they are not supposed to have. Then they would be compared to the unvaccinated like in this study. For example, a recently vaccinated child who had been inoculated with measles virus would be compared to an unvaccinated child for the prevalence of measles, as if the vaccinated was characterized as someone who was also naive to measles virus, which is wrong. Thus, the usual claim by pro-vaccines that vaccines have prevented infections and diseases is very unscientific. Therefore, if the unvaccinated catches measles, that is equivalent to the primary immune response to that of the vaccinated since the vaccinated got the measles virus first.
I believe most vaccinators know what what I'm talking about since they also know when to shut up when science prove them otherwise.
Th1Th2
The odds are very different for both. If you can't understand basic probability, you cannot join this discussion.
You're still making the same claim, and if vaccination did have long-term effects like you claim, then the study would have picked them up, preconceived notions or not.
Or, they notice someone who makes statements their pets know are wrong and decide he's too much of a fool to bother engaging.
My cats don't just know more about immunology than the fool. My lava lamp does. Heck, a single electron knows more.
This is why nobody takes you seriously. You're operating out of an entirely different reality than the rest of humanity.
I believe most vaccinators know what what I'm talking about since they also know when to shut up when science prove them otherwise.
Where's augustine, we're one loon short of the full set.
trrll,
Hence, they use vaccines to infect the host with killed and inactivated pathogens in order to bring about an immune response against that infection. There won't be any resultant immune response if these dead microorganism are left unaided, i.e. incapable of invasion, penetration and colonization.
To vaccinate against is a misnomer let alone an outright lie. It really means to inoculate with, and you know what I'm talking about about.
Sid: I guessed at what pD meant, but you and he are assuming what you want to prove. There is no "autism group" here. There are vaccinated and unvaccinated groups, and no evidence that autism rates differ between them.
Calling one of them the "autism group" is no more accurate than calling one of them the "hockey group."
FluGuy: The appropriate goal is the optimum number of vaccines for health. That number may not be the lowest number: chicken pox is rarely fatal in the United States today, but it's still well worth avoiding.
Yes, it's possible to over-vaccinate. Doctors understand this, which is why smallpox vaccination is no longer routine, and I won't get a yellow fever vaccine unless I travel to someplace where that disease is endemic.
It is also possible to under-vaccinate, either by giving too few doses of some vaccines, or by not giving a vaccine to people who would benefit from it.
For example, has your doctor asked if you want a hepatitis vaccine? Mine hasn't. Neither specifically or as a more general question about whether there are any vaccines I want/think I might need. The CDC guidelines suggest that a significant fraction of the adult population should be getting that one. It's possible that your (generic you) doctor could know that you're in the demographic for that, but virtually impossible that they could know you aren't: it's recommended for anyone who is sexually active with more than one person. That's not something a doctor can know isn't true of someone without asking (and maybe not then).
My cats don't just know more about immunology than the fool. My lava lamp does. Heck, a single electron knows more.
Yeah, but they are always SO negative ...
It's good to see anti-vaxers getting their talking points shot down regularly these days, at least more people seem to be taking their threat more seriously. Local anti-vaxers posted some random crap about Brian Deere this morning, trying to prop up her hero Wakefield (she once said she thinks he is soo charming after she met him). Even in that overly "natural" area of the forums, where rarely there is any dissent allowed, someone spoke up and asked why she was defending him still.
The bad news for anti-vaxers is that their raising awareness on vaccines has had the exact opposite effect they wanted. It is making them have to answer questions.
@Sid
No, the unvaxxed had a greater prevalence. You may want to read EpiRen's post on incidence and prevalence.
Now there's a new one. Antivaxers ask for a study looking at completely unvaccinated vs. vaccinated. Such a study is done. Now the argument is that the study should be unvax vs. completely vax vs. every combination in between? Seriously?
Th1th2:
Which is why nobody has ever suffered an immune reaction to a perfectly innocuous substance. Oh wait, they have! They're called allergies! So the body can react to things that to things "incapable of invasion, penetration and colonization". In other words, you're wrong. Deal with it.
No we don't. Please explain. Of course, if you're right, then that means nobody in the history of humanity has ever recovered from a disease. Ever.
So what are you proposing? Parents who get their kids vaccinated are less likely to recognize a cold. Sounds like a bit of a stretch.
Come on Sid. I know that your understanding of probability is nearly zero, but surely even you can see the fallacy in your argument: the only way to measure the magnitude of the herd immunity protection would be to compare the frequency of the disease in unvaccinated individuals in vaccinated population to the frequency in a completely unvaccinated population. Nobody imagines that herd immunity provides absolute protection, which is implausible on a purely theoretical basis. Herd immunity just means that each infected person infects less than 1 other person, so the disease eventually peters out and never goes epidemic. But if the average number is just below that threshold, a disease could still spread through a fair number of people before running out of steam. Or to put it even more simply: the question is not whether unvaccinated people are at greater risk than vaccinated ones in a mostly-vaccinated community--obviously they must be. The question is whether they are at less risk than they would be if most of the people around them were not vaccinated.
This is actually rather generous to the anti-vaccine hypothesis. What if all it took was one vaccination to cause disease?
The bottom line of the study is clear--while the limited number of unvaccinated individuals limits the resolution of the study, the error limits are certainly tight enough to exclude the large deleterious effects that antivaccine zealots have been claiming. Note that the study certainly has adequate sensitivity to detect a significant protection for 3 out of 4 vaccine-preventable diseases, even in a population with herd immunity. So we can say with some confidence that any deleterious effect with respect to atopic diseases must be less than the protective effect vs. infectious diseases.
And in fact, the study is generous to the antivaccine hypothesis in another way, because they break out specific conditions and age groups. In Table 2, they are looking at 3 age groups times three conditions. With that many comparisons, it would be fairly likely to find a statistically significant increase in the vaccinated population just by chance, even if there were no real difference--and it would obviously be even more likely if there were some real adverse effect of vaccination.
Oh, Thingy is baaaack; with some more drivel.
I've been slumming again, at Age of Autism and still no reporting/editorial about the infant deaths in Japan. Posted this AM however, is a new video of a radio interview between Robert Kennedy, Jr. and Boyd Haley. IMO, RFK Jr. is embarking on a his "rehabilitation" campaign after being disgraced and debunked in the media for his extensive paper on the thimerisol-autism link.
(I couldn't view the video and linked to Kennedy's "Ring of Fire" website which featured the 2 part video. After viewing 40 minutes of the video on Ring of Fire my computer had an attack of spam indigestion. The 2-part video is available on You Tube at "Ring of Fire Boyd Haley interview.")
It is the same old same old crap with the addition of some new garbage.
I'd much rather watch the Charlie Sheen videos...much more fun.
I rather hate to ask, but I must: given the mentioned issues that tend to prohbit vaxed-vs-unvaxed studies, how was the efficacy of the current vaccine schedule established in the first place?
I know they are effective, except I feel bad saying I "know" it because in almost every area of life, I believe strongly in the principle that our beliefs should be falsifiable and correspond to strict tests and observations, not just "what makes sense", as is the case with woo-based thinking. It seems like everything in medicine but vaccines can point to specific studies demonstrating their effectiveness. (Hence the tremendous power of scientific medicine.) I know I'm probably wrong about that, and simply ignorant. Can someone please enlighten me?
Okay, come to think of it, an obvious answer to my question would be the massive drops in vaccine-preventable diseases after the vaccines' introduction. But how, for each specific vaccine, did we get to the point where we know they would work in actual humans, if they weren't subjected to double-blind trials? That's what I'm wondering.
Darn, when did Th1Th2 find its way over here from SBM??? Boy, am I late to the party!
I said Andrew Wakefield's name three times. He offered me a zagnut and changed into a giant striped sand-worm before my eyes.
Gray Falcon,
Nah. It's called vaccine failure.
You don't need to be paralyzed just to get a diagnosis of poliomyelitis. The mere inoculation of the poliovirus itself is a living proof of an induced infection regardless of the symptoms.
So, there were about 285 vaccinated for every 2 unvaccinated and they are looking for the prevalence of infection among the two groups, is this correct?
I hope Dr Jay drops in to share his thoughts.
This is an excellent presentation.
Jay
Th1Th1:
Are you claiming allergies are vaccine failures? What?
Calling something an infection does not make it an infection, any more than calling you a duck makes you a duck. It's up to you to prove otherwise.
Besides that, if what you're claiming is true, and vaccines cause infections, then why aren't they causing the mass waves of infant death that would be caused by full infections?
Gray Falcon,
Of course, the odds only apply to those groups with infection-promoting agenda, that is, pro-vax and pro-pox, for they ride in the same boat riddled with holes.
Hence, this study is all about the vaccinated.
Jen popping in here. The "study" does sound like a bit of a joke and yes, the pharmaceutical involvement probably explains that. I'll be merrily on my way now ;)
Gray Falcon,
So, calling something like asymptomatic poliomyelitis, which represents more than 95% of poliomyelitis cases, not poliomyelitis, is this what you mean?
Was there a time when poliomyelitis not considered an infection?
I'm afraid, the burden of proof lies upon you.
By the way,if I stepped in here with a study with "n=7, 10, or 11" you'd probably be rightfully unsatisfied. Nonetheless, the topic is incredibly well presented, Orac.
Is that incorrect?
Jay
@trrll
You are aware of the dose-response relationship concept? If vaccines were responsible for atopic disease and a dose-response relationship were in effect, including a child who has received one vaccine into a group of children having received 15 would artificially decrease cases of atopy on the vaccinated side.
I'm proposing that relying on a questionnaire and recollections to ascertain the number of colds a child may or may not have had is no better than guesswork
Uh, no. Your current stance was like the prosecutor at a murder trial asking the defense "Are you saying murder does not happen?" I'm not denying the existence of asymptomatic poliomyelitis, I'm saying that it's not caused by vaccination. Can you provide evidence that asymptomatic poliomyelitis occurs whenever someone else is vaccinated, preferably with actual documented studies? For example, have vaccinated people caused polio in others through exposure?
In the interest of integrity, I have to agree here. Although, I don't think the authors are aware of the American anti-vaccine goalpost-shifting.
They weren't relying solely upon parental reporting; they did validate with medical records. If minor illnesses such as colds were included, I can't tell.
Of course it's going to be a joke to you jen, because not only won't you read it but it doesn't conclude what you want it to. Two of the four authors declared conflicts of interest (and notice that they actually declared them, unlike your sympathetic wannabe scientists), I guess the other absorbed all that pharma corruption by osmosis [/end eyeroll].
Gray Falcon,
Intentional transmission of poliovirus occurs whenever someone submits to inoculation regardless of symptom manifestation. Don't you read vaccine labels? Do you actually think by inoculation you really are preventing poliovirus transmission from happening?
Ever heard of VAPP and VDPV infections? And besides, why depend on host-to-host transmission when they can actually infect every one else through widespread inoculation. If it makes dollars, then it makes sense.
You're denying to call it infection.
Excellent study. Good solid methodology. Crappy sampling technique. I hope they controlled for other lifestyle differences between vaccinated and unvax kids, too. In the US in particular (although this may not be true in Germany), most preschools require vaccinations, and everyone knows that preschools are horrible little germ highways (which would explain vaccinated children being sick more often with other diseases). I hope this study gets repeated with an oversample of the subpopulation in question, as that would address the problem of those awful p values.
Julie, (does statistical analysis for fun and yuks).
Sorry to pile on here, but the study really is not good enough. Again, the excellent exposition, the charts and graphs . . . make it look elegant. But it's really not very good at all.
Jay
@ lilady: re "slumming". You're right but I prefer to call it "reporting" or "gathering information"**. Perhaps it would be more precise to call it, "thanking my lucky stars" ( for my sophisticated, no-nonsense family and the best education I could wrangle ).
**sounds better, no?
Really? Why? (I'm honestly interested in why it isn't a good study, and I'm not trying to be sarcastic).
Where on the vaccine label does it is say what you're claiming? Be very specific, and give examples.
Seeing as it has stopped happening, yes.
Th1Th2, I never said that doesn't happen, I said it doesn't happen by vaccination. Also, people made more money off the disease than the vaccine.
Than provide evidence otherwise! I can claim that you're out to drive humanity to extinction by bringing back infectious diseases, but without evidence.
You keep dancing around your claims and the evidence, but you never actually provide it. At this point, it's become clear you're too arrogant for sincere discussion. Goodbye.
So Th1/Th2, what do subunit vaccines like DTaP or killed virus like IPV do? No organism, no infection by any definition of the word.
Jared--
The study has too few subjects in the unvaccinated group and is based on a questionnaire given to parents. Parents don't sleep much for quite a while and this isn't a good enough way to gather important information. This most definitely does not mean that it's untrue. Just that it really isn't a very good article to present as any sort of proof.
To quote: "Their data are based on the results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)."
It's a polished presentation of a not-good-enough journal article.
Jay
It is not a good study for a number of reasons.
1. Information solely on a questionaire from the parents is not very scientific or accurate.
2. A vaccinated vs unvaccinated sutdy means totally vaccinated or totally unvaccinated for that age level. This study counted those who had only one vaccine as vaccinated. That is not a proper vax vs unvaxed study.
3. The results that interest me(especially relating to possible autism-would be the epilepsy and ADHD. But I think even that is rather meaningless given that we have no idea of the total vaxed and unvaxed.
Gray Falcon,
Simple. The pathogenic agent is conspicuously written on the vaccine package and on the insert. It is printed there so the vaccinator would know what to give.
Are you sure?
------------------------------
You still have time to reconsider your statement. Of course, with every vaccine-induced infections there's a lot more money to be made.
CG,
How did it get into the host's system?
Gray Falcon,
Vaccine package and the insert.
Are you sure?
------------
There's still time to reconsider your statement. Of course, there's more money to be made from vaccine-induced infections in addition to vaccines alone.
Maurine "Information **solely on a questionaire** from the parents is not very scientific or accurate."
But the study wasn't based solely on the questionnaire.
"The data collected were primarily from a standardized, computer-assisted personal interview of the parents, but **diagnoses reported and vaccination status were **."
I suspect that the researchers used the questionnaire approach as a sorting mechanism. They were going to check records for vaccination histories regardless. The questionnaire approach saved them from having to examine all records for all diagnoses themselves. Remember we're looking at 13000+ plus children with an expected number of routine health check visits. That's a lot of hours to find that most children, most of the time, see doctors regularly for reasons other than illness.
The vaccines are injected into muscle, where dendritic cells are stimulated. They then migrate to the regional lymph node where they present antigens are presented to T and B cells which are activated and cause immunity to the pathogen.
An infection means there's a parasitic organism attempting to colonize/replicate in the host. You'd could argue live vaccines cause infections, although short lived and very mild ones compared to the wild type organism.
But there's nothing alive in subunit or killed vaccines.
Oh dear, didn't checking the copied line.
".... diagnoses reported and vaccination status were verified. through. medical. records."
Remember, according to Th1Th2:
1) If your immune system is exposed to the antigens of an infectious pathogen, then you will get the disease that pathogen causes, regardless of whether or not the antigens come from a dead pathogen. It's just that if the pathogens are dead, you'll most probably get an asymptomatic case of the disease.
2) If an immune cell envelops a pathogen, digests it, and then presents the digested pathogen bits on its surface, then that immune cell has been infected by the pathogen. Doesn't matter if pathogen is a dead virus, a dead bacteria, or even acellular proteins, the immune cell is still infected. Thus vaccines always cause infections, even if made from dead/acellular components.
So Th1Th2 uses such bizarre definitions for vaccine related terms that talking with him/her is pretty futile (as another example, according to Th1Th2, the stabilizers and preservatives in vaccines count as adjuvants). This is even ignoring the fact that s/he is probably a troll, evidenced by the following claims:
1) Toddlers know that they should walk on the nice clean sidewalks instead of on dirt.
2) If you're a competent and loving parent, your toddler will never get a scraped knee while learning to walk or while playing.
3) It's easy for a parent to keep all asymptomatic carriers away from their children.
@Jay Gordon:
One of the points Orac made was how difficult it to do a large-scale study of this sort, because there's so few unvaccinated children. Out of 13,453 children, they could find only 94 whom they were sure were completely unvaccinated.
CG,
Well, that usually happens when there's a breach of the innate barrier. In fact, the inoculation of these subunit particles is necessary to breach mucosal immunity--the protective barrier that is primarily involved in repelling such pathogenic products from establishing infection in the blood, muscles, brain, CSF etc. and therefore elimination.
Why do you think they MUST be given thru injection and into the muscles, if they can be repelled mucosally? What are you promoting by such inoculation into areas which are physiologically sterile like the muscles, that is, free of any microorganisms not to mention pathogenic products?
Matthew Cline,
So you're saying it's better for a newborn to acquire HbsAg soon before hospital discharge than none at all?
Matthew Cline,
Care to answer number 68? What do you think is wrong with the study?
CG,
Actually that does not happen all the time. Any pathogenic product can induce the intended infection even if given alone.
@Th1Th2:
I'll use your terminology/definitions, in which case it's infecting a newborn with an asymptomatic non-chronic case of hepatitis in order to reduce the chance of acquiring a case of symptomatic chronic hepatitis in the future, which still means it's a good idea.
#68:
It means that there's so few completely unvaccinated children that you'd have to do an enormous study to get enough unvaccinated children for the study to have real statistical significance.
Matthew Cline,
So the infection-promoting nature of vaccines, based on what you said, is a good idea and is beneficial to the newborn?
Let's apply it then. Would you accept blood donations from HbsAg+positive blood even in the absence of HBV?
Do you think the unvaccinated group is indeed irrelevant in the study?
This might be a "real" study but it's not real good.
@Th1Th2:
First off, even using your weird definition of "infection", I only agree that the hepatitis B vaccine is "infection-promoting" to the degree that it causes a non-chronic asymptomatic infection by HBsAg. If you mean by "infection-promoting" you mean that it weakens/deranges the immune system, and/or lets in infectious pathogens aside from the one in the vaccine, I don't agree with that.
That said, even using your definition of "infection" and "infectious", yes, it is a good thing, since it reduces the future chance of chronic symptomatic infection at the cost of a non-chronic asymptomatic infection. Infections aren't intrinsically bad, but are bad because of the symptoms they cause. If an infection causes no symptoms and reduces the chance of future chronic symptomatic infection, then it's a good thing.
Assuming I have no allergic reaction to HbsAg, I'd be perfectly happy to.
I have no idea what you mean.
Every time Th1Th2 posts, I feel like I'm watching the bit where Lister teaches Kryten to lie. An infection is a small off duty Czechoslovakian traffic warden!
Because throwing dead proteins at a mucous membrane will do absolutely nothing. There's a reason nasal and oral vaccines are attenuated. To actually activate immunity, a pathogen essentially has to break that barrier.
By bypassing it, you can activate the immune system without a living pathogen.
Matthew Cline,
Newborns with no evidence of HbsAg in their system is not something weird. That is something you will expect from a healthy and unvaccinated newborns. What is weird is the claim that vaccines have prevented any infection and diseases.
The effector phase of infectious diseases begins with pathogenic clearance by the host and is manifested through production of symptoms such as rash, cough, fever, etc. Tell me then, how is the lack of symptoms from immunocompromised patient beneficial?
Fine. How about an HIV+positive blood in the absence of the virus?
OK. Let's break it down one more time. 142 vaccinated for every 1 unvaccinated. Does this study make sense at all?
Well, there exists an immune system other than the adaptive that helps prevent infection from establishing in the first place. However, vaccines promote and support the infection itself and does not prevent it from happening.
@Th1Th2:
Using your definitions, vaccines prevent symptomatic infectious diseases, rather than preventing infectious diseases in general.
If there was a complete lack of symptoms throughout the entire course of the infection, as with the case of immunocompetent asymptotic carries, there wouldn't be any problem. That's what I mean by an asymptotic infection. By "asymptotic infection" I do not mean the absence of symptoms from a just a single phase of the infection, but with the presence of symptoms from other phases of the infection. If that's what you mean by "asymptotic infection", then even for the sake of the argument I'm not going to use your definition.
If the blood was tested using a test with 0% false negatives, which not only tested the blood plasma but could somehow also guarantee the complete absence of CD4+ T cells which had been taken over by the virus, then yes, I would accept such a blood donation/transfusion.
Yes, and we all know why no epidemiological study will ever be good enough, don't we ?
A double-blind placebo controlled study is never going to happen, so we're stuck with the best we can do, within the legal and ethical framework.
@Th1Th2,
How can "Infected" possibly be the right term if the bits of the pathogen that are used are dead? I can just about see where you're coming from with attenuated vaccines, but otherwise you're just assigning completely new meanings to words.
> 142 vaccinated for every 1 unvaccinated. Does this study
> make sense at all?
That differential follows straight on from this being a cross-sectional study (thus making unbiased selection) and a 0.7% prevalence of "complete non-vaccination". To get the numbers on more completely unvaccinated people, you'd have to run a bigger study with more people overall - if you were to interview the parents of 143,000 kids, for instance, you'd expect to get data on about 142,000 vaccinated kids and 1,000 unvaccinated, with considerable statistical power to see differences in all but very rare conditions. The trouble is that such a study would be prohibitively expensive and would still risk reporting bias.
Dr Gordon @74:
By the way,if I stepped in here with a study with "n=7, 10, or 11" you'd probably be rightfully unsatisfied.
Reading the paper reveals it to be reporting prevalences of 7, 10 and 11 out of 94. IOW, n=94 throughout. I doubt that Orac would complain if you reported data of that quality.
What are your views on n=12 (Wakefield et al., 1998)?
My suspicion was first raised when it appeared in the Artzeblatt [sic] International, a bottom tier journal with an impact factor of 1 (compared with the Lancet and JAMA at 28 and 30) perhaps they're trying to use a few manufactured conclusions to crawl up the rankings ladder
From the Deutsches Ãrzteblatt International website (my emphasis):
Of course all journals want to "crawl up the rankings ladder", but the one way of doing so that is better than publishing "manufactured conclusions" is to publish non-manufactured conclusions. Readers will assume that this is a case of the latter, unless they have decided in advance that the study's undesirable conclusions mean that it must be bogus.
@Jay
You do know that the authors discuss the limitations of survey questions for gathering data, right?
I mean, you did actually read the study, didn't you? After all, Orac provided the link to the full, free article. I'm sure you're not making assumptions without actually reading, like you did with the preemie study that you said was "unethical".
"However, vaccines promote and support the infection itself and does not prevent it from happening."
Wrong, wrong, wrong. A vaccine generates an immune response that destroys an actual infection before it can cause disease.
"What are your views on n=12 (Wakefield et al., 1998)?"
Dr. Wakefield's results should have been a letter to the editor and not a major article in one of the world's leading medical journals.
Jay
So, based on Dr Jay's post (#110,) fraudulent study results are perfectly OK as long as they are disseminated via a letter to the editor rather than a major article.
I guess it's all in how you lie, not in whether you lie. . .
An observation from a medical professional...
When you transplant a heart into a child under 1 years old, you don't have to use an organ that is type specific. Why? Because the infant's immune system is not fully developed therefore, it won't reject the heart. Also, the infant's brain blood barrier is not closed until 6 months.
So, can someone tell me why we are stimulating an undeveloped immune system with vaccines at birth, two months, four months and six months? Could this be causing the rise in autoimmune diseases in children that we did not see twenty years ago?
Mercury was still in vaccines until 2004 or 2005 because they did not recall any of the vaccines with mercury.
IMHO, the 12.5 mcgs of mercury injected into my 6 pound child on the day of birth contributed to his downward spiral in his physical and emotional health.
I don't see any followup from passionlessDrone explaining her contention that the German study is both a) statistically irrelevant, and b) nonetheless "trending" in favor of antivax views. Of course, we are also still waiting for pD to present evidence about her favorite antivax bugaboo, the "inflammatory cytokines" that vaccines supposedly evoke to horrific consequences, while everyday subinfectious antigenic challenges and full-blown infections somehow don't pose such risks.
If one could ignore the lack of statistical relevance and conjure up a "trend" in the German study towards more colds and such in the vaccinated group (as pD is postulating), it's surprising that she and other antivaxers aren't hailing this as evidence of the value of vaccines. After all, antivaxers have long been telling us how important it is for children to contract dangerous, vaccine-preventable diseases so that they don't risk asthma, allergies, autoimmune illnesses and the like. You'd think any possible increase in infectious disease would be viewed as a wonderful, positive thing.
But no, consistency (never mind logic) is not important in the antivax movement.
I agree to some extent with pD and Jay Gordon that the small size of the unvaccinated cohort in this study makes arriving at firm conclusions about health in vaccinated vs. unvaccinated populations difficult. One would expect, however, given the antivaxers' assurances about how terrible vaccines are, that some significant benefits to being in an unvaccinated state should have cropped up. We're left without proof of any significant differences between the groups, excepting of course that historically, unvaccinated kids have sickened and died in vastly greater numbers from dangerous infectious diseases than those vaccinated against them.
We should also recognize that it's a tribute to the intelligence and community-mindedness of German parents that the unvaccinated group there is as small as it is.
Gray Falcon,
Th1Th2 refuses to play with the definitions of terms like "infection" that are mutually agreed upon by the scientific(or even sane) community. I see sincere attempts to impart reason being dashed upon the rocks by the equivalent of religious fundamentalists(it's true because it's in the bible because it's true because it's in the bible because it's true.....ad nauseam).The lack of replicated virus in the host inoculant is an irrelevance to the faith of believing that any breach of the body is an infection.
And yet you ran with it like a looter with a television under your arm when it appeared. Not running with this one? or is it simply about confirming a pre-existing bias?
@SCR,
Are you referring to a specific baby or all of them? The reason to 'stimulate' the immune system is to give it a faster and more robust response to the vaccine target. Do you have evidence to show mercury caused a problem or are you stirring the pot with that?
Infant immune systems are quite capable of mounting both cellular and humoral immune responses. In some cases however, they lack the capacity to form antibodies to some proteins like polysaccharides. In either case, there are numerous diseases, that if acquired as an infant, can have very serious consequences, hence the benefit of prevention via vaccination.
There is no evidence, to date that indicates that. There are more likely avenues being explored such as the hygiene hypothesis and poor/over nutrition.
No, TIVs expired prior to that and very few physicians even had TIVs as of 2002.
And that would be your opinion indeed.
Given the unfortunate events in Japan, being current on vaccinations like typhoid, tetanus and even diphtheria are flashbulb moments in a lifetime.
Also having supplements like N-acetylcysteine, iodine, vitamins D3 and C on hand might be life enhancing, too.
Science Mom,
Something is wrong with your statement.
Th1Th2:
Change "like polysaccharides" to "and polysaccharides", and her statement is accurate.
@Paddy,
According to Th1Th2, if an immune cell engulfs a pathogen, digests it, and then presents the digested bits on its surface, that cell has been infected by the pathogen, even if it's a bacteria or dead virus. Or even if its an acellular protein. And since, according to this definition, all vaccines infect those types of immune cells, all vaccines are infectious.
Dr. Wakefield's results should have been a letter to the editor and not a major article in one of the world's leading medical journals.
What level of prominence is appropriate for n=94?
"Dr. Wakefield's results should have been a letter to the editor and not a major article in one of the world's leading medical journals."
"And yet you ran with it like a looter with a television under your arm when it appeared. Not running with this one? or is it simply about confirming a pre-existing bias?"
I was wrong. Plain and simple. Yes, it confirmed what I believe and I was uncritical in my analysis of the quality of the study. I don't agree it was fraudulent, I disagree with the Board's findings and Deer's harsh judgements, but I was certainly wrong to use this small study as being anything close to confirmatory of my preexisting biases.
Jay
He's finally said it instead of dancing around it. Good for you Dr. Gordon. And that is sincere.
@Jay Gordon:
Among the GMC's findings:
Which of these findings do you disagree with, and why?
142 vaccinated for every 1 unvaccinated. Does this study make sense at all?
If you are a researcher and your population is such that you are comparing two groups of different size, then the limiting factor for the statistical power of the comparisons is the number in whichever group is smaller. So you could (in this case) randomly throw out 141 out of every 142 cases in the larger group, to bring the two groups back to equal size; this would slightly weaken the statistics, but it would prevent illiterate nimrods from insinuating that your research is somehow bogus.
Instead the illiterate nimrods would accuse you of selectively throwing out cases to obtain the results you wanted.
Good for you Dr. Gordon. And that is sincere.
seconded.
Thank you Gray Falcon, yes, a grammatical error but I don't think that was what Th1/Th2 was referring to. You see, we have had this conversation before and given Th1/Th2's "unique" understanding of immunology, fails to grasp this aspect of infant immune function.
Dear Jay,
saying you were wrong took a lot of courage.
I admire you for doing so.
I saw several questionable aspects in this study design. Haven't had time to read the comments so my apologies if these were already noted. (1) A control group many tens of times larger than the test (unvaccinated) group means that no particular trend can emerge. Doing this weakens the statistical likelihood of seeing the trend you are testing for. If getting equal size groups to test is impractical for some reason, then having twice as many controls as test kids is workable - but having many thousands more in the controls versus less than 100 kids in the unvaccinated group assures a weak finding if any. (2) The paper is vague on exactly what the vaccine records were. If kids got newborn hepatitis B shots, that usually resides only in the hospital (birth) record, and not in the pediatrician's office record. Were some of the unvaccinated kids actually vaccinated? It's not really clear - a potentially huge confounder. (3) It's a retrospective, not prospective design; considerably weaker (4) I see errors on kids' vaccine records in my practice regularly, which makes me further question the reliability of reviewing records and retrospectively at that (5) The German vaccine schedule is not the same as the US schedule, so we can conclude nothing about our schedule in the US from this (6) The authors appear at one point to lump "illness" all together, and count discreet illnesses like measles as they do chronic conditions like asthma, which is directly counter to the purpose of the study. Discreet infections like measles don't equate allergic illness/inflammatory conditions that last a lifetime. ... Long short this is a weakly designed study that looks like it intended from the outset to satisfy the bias of the authors.
I saw several questionable aspects in this study design. Haven't had time to read the comments so my apologies if these were already noted. (1) A control group many tens of times larger than the test (unvaccinated) group means that no particular trend can emerge. Doing this weakens the statistical likelihood of seeing the trend you are testing for. If getting equal size groups to test is impractical for some reason, then having twice as many controls as test kids is workable - but having many thousands more in the controls versus less than 100 kids in the unvaccinated group assures a weak finding if any. (2) The paper is vague on exactly what the vaccine records were. If kids got newborn hepatitis B shots, that usually resides only in the hospital (birth) record, and not in the pediatrician's office record. Were some of the unvaccinated kids actually vaccinated? It's not really clear - a potentially huge confounder. (3) It's a retrospective, not prospective design; considerably weaker (4) I see errors on kids' vaccine records in my practice regularly, which makes me further question the reliability of reviewing records and retrospectively at that (5) The German vaccine schedule is not the same as the US schedule, so we can conclude nothing about our schedule in the US from this (6) The authors appear at one point to lump "illness" all together, and count discreet illnesses like measles as they do chronic conditions like asthma, which is directly counter to the purpose of the study. Discreet infections like measles don't equate allergic illness/inflammatory conditions that last a lifetime. ... Long short this is a weakly designed study that looks like it intended from the outset to satisfy the bias of the authors.
Paddy,
They are termed dead simply because these pathogenic products are not capable of replication in vivo. However, vaccines contain pre-determined amount of pathogenic materials which then are meant to be inoculated to the host bypassing the innate immune system. And that breach in the barrier is infection.
Ah, yes. I wondered how long it would be before an antivaxer pulled the, "But it's Germany and not America" gambit. Of course, the German schedule is actually fairly similar to that of the U.S.; so this gambit is not nearly as devastating a critique as you apparently think it is.
Regarding the differences in sizes between the control group and the rest, there's not much you can do about that in a retrospective study in which only 0.7% of the population is completely unvaccinated. Your complaint isn't exactly valid, anyway. The problem with the uneven groups is that the smallest group drives the statistical power of the study. The only way around that would be a cohort design of some sort, which may or may not be feasible, or a randomized trial, which most definitely would not be ethical.
As for your claims about errors in vaccine records, that's pure speculation on your part based on your own anecdotal tale. In other words, without evidence that there is a high rate of errors on German vaccination records, it's a worthless observation that tells us nothing. Also remember that, unlike the U.S., Germany has national health insurance and more centralized data collection. Also I fail to see where the authors are vague on what the vaccine records are. Here's a quote from the paper:
In other words, they looked at the vaccination card. A little Googling told me that Germans all have private vaccination cards. Vaccinations are documented on the card and in the doctor's or hospital's medical record. That's not vague at all if you know a little about how the German health care system works. In fact, the only reason it's vague to you is that you apparently didn't bother to look because you were so anxious to cite it as a flaw in the study.
Basically, this isn't a perfect study, but it's a good preliminary study. It's also light years better than anything the "too many too soon" crowd has ever produced.
Very impressive, Dr. Jay. It's tough to admit you're wrong. Bravo! You've come at least half way by admitting you were wrong about Wakefield's study.
I must be honest and point out that I still think you're mistaken in clinging to the view that Wakefield's study wasn't also fraudulent, because the evidence that it was is so overwhelming. Still, you've taken the first step, and for that you are to be commended. Who knows? You might even come further along the path. At least, I hope you will.
Science Mom,
Grammatical error? Are you going to revise your previous statement or not?
If you can't figure it out Th1Th2, she stated my correction was right, and her sentence was meant to be "In some cases however, they lack the capacity to form antibodies to some proteins and polysaccharides." Argue that sentence, and deal with the fact the honest people actually admit error.
@75 Sid
One of the distinguishing characteristics of the crank is the ability to hold two contradictory opinions simultaneously if both can be used to support their obsession. As Sid well knows, there have been studies in the past that have compared children who received different numbers of vaccines (or vaccinations with a particular ingredient, such as thimerosal), and found no relationship between the number of vaccinations and any adverse effect. The antivax response to these studies has been, "What if there is some threshold, and you need just one or two vaccinations to produce an adverse effect? You to compare vaccinated kids to ones that are completely unvaccinated" This report has now managed the far more difficult (difficult because people who are crazy enough not to vaccinate their kids at all are fortunately rare) task of assembling a group of unvaccinated children, which, while not huge, is sufficiently large to detect with high statistical significance the increased risk of vaccine preventable diseases in the unvaccinated population (and thus should be adequate to detect a reduction of similar magnitude in suggested adverse effects of vaccination). So now, the antivaxxers are suddenly believers in linear dose-response relationships.
Of course in real life, a dose response relationship can be linear, or it can show saturation, so it is worthwhile to do both kinds of studies--and neither approach reveals any evidence for adverse effects of vaccines beyond the rare acute effects that are already well known.
Antivaccine zealots are great believers in the ability of parents to remember exactly when relative to vaccination their children started to show symptoms of autism or ADHD. Yet somehow, parents are complete morons when it comes to remembering whether they nursed their kids through many colds or only a few--there's no point even in asking them, it is no better than guesswork
No, no need. You are the only one here that doesn't understand so carry on in your own little bizarro world.
That's an injection, not an infection, dumbass.
herr doktor bimler,
Well, that one unvaccinated individual does not even represent a group since the individual is virtually non-existent. This study is embarrassing to say the least. I wonder why this discussion have to go a distance before they can even realize the obvious mistake.
Judy, maybe while writing your lengthy comment you didn't see the explanation in a recent comment about why the disparity in sample sizes is not a problem.
As to your insinuations about whether some of the unvaccinated subjects actually had been vaccinated, do you have any reason to believe this is so, other than your own wishes?
Retrospective vs. prospective design: And do you actually think a prospective study involving the withholding of vaccines from children could ever ethically be done?
Your point #5 is reaching so far as to be simply sad. This study doesn't apply at all to anywhere outside Germany? No, Judy, I think you've lost the plot.
The whole point of this is that the incidence of chronic diseases is not affected by vaccination, while the incidence of vaccine-preventable diseases is affected. I don't see at all how you think these are muddled together.
And finally - you accuse the authors' judgment of being colored by bias - well, hello there, Pot, how ya doin'?
Gray Falcon,
@140 Nah. She knew exactly what I meant.
Non-specific immunity is activated as a result of infection. But, "That's an injection, not an infection, dumbass." is a much better response.
Although the authors do not display data summaries, they do make the following statement, "In addition to atopic disorders, we further compared diseasesâsuch as obstructive bronchitis, pneumonia and otitis media, heart disease, anemia, epilepsy, and attention deficit hyperactivity disorder (ADHD)âin unvaccinated and vaccinated subjects. No relevant differences in the lifetime prevalences were found, neither for different age groups nor between girls and boys."
The total number of vaccinated and unvaccinated subjects is given as 13,359 and 94, respectively. This was a large enough number to identify the increased risk of in the unvaccinated population with p lest than 0.5 (in some cases, much less) for 3 out four vaccine preventable diseases. Clearly if vaccination imposed an increased risk of comparable or greater magnitude, this study would have had sufficient power to detect it.
W. Kevin Vicklund,
Oh I see. So what do you think of this? Injection, infection or both?
Science Mom,
So what? That doesn't mean a thing.
W. Kevin Vicklund,
Tick, tock, tick, tock,
Some problems:
They fail to define what constitutes a diagnosis of pertussis.
They don't address the fact that vaccination status affects the diagnostic process
Finally, since the study from which the above quote is taken found 23 times greater rate of pertussis in the unvacciated (much higher than found in the German study)the German study may be picking up differences, just not at an accurate rate. Perhaps similarly there is a difference in atopy, just at a smaller rate than this study can detect
In the German study, the risk of pertussis shows up as 6, rather than 23 times as great in the unvaccianted
The same applies in the case of the measles. An oft quoted US study shows a 35 times greater risk in the unvaccianted, while the german study show only a three times greater risk
Definitely injection. If the abstract is correct, not an infection. See how easy that was? Granted, that's based solely on an abstract from a 20-year-old paper, so that's a big if.
Jay Gordon:"I was wrong. Plain and simple. Yes, it confirmed what I believe and I was uncritical in my analysis of the quality of the study. I don't agree it was fraudulent, I disagree with the Board's findings and Deer's harsh judgements, but I was certainly wrong to use this small study as being anything close to confirmatory of my preexisting biases."
It's good to see Jay acknowledge this. It remains to be seen however if Jay is willing to concede that flawed evidence in general (including anecdotes and substandard "research" common to the antivax movement) makes a very poor basis for his views about vaccination - or if he's merely making this statement now as a means of chiding Orac and others from seeing any significance at all in the findings of the German study under discussion.
Still up on Jay's website are comments which are laudatory of Wakefield and primarily blame the Lancet and others for the debacle surrounding his MMR study. These include a statement of fervent support for Wakefield based on seeing him at an autism conference in Chicago.
If Jay Gordon updates his website to reproduce the statements made here, I will join with others in congratulating him.
Th1Th2:
Sorry, when I say you highlight "proteins like polysaccharides" I assumed that that was the error you were pointing out. My apologies for thinking you had some understanding of science.
Th1Th2 comes across as your typical Internet self-proclaimed genius. Has an idea that makes sense, and decides he's so smart that he doesn't need to do anything so mundane as test his ideas, and anyone who suggests he does so is trying to insult his obvious brilliance. Problem, knowledge can't be gained through pride, only humility.
Except that they detected an increased rate of not just pertussis, but also measles and mumps (and a near significant increase in rubella). Given the confidence limits, trying to put a number on the factor by which pertussis is increased is statistical nonsense; the most that can really be said is that there was an increase. Of course, in any study, there is always the possibility of an effect too small to see. What is clear is that any such hypothetical increase in risk in the vaccinated population would have to be much smaller than the increased risk of vaccine preventable diseases in the unvaccinated population.
I don't even see autism being looked @ in this study. Is it hiding perhaps?
Babs: With the number of unvaccinated children found by the study, it couldn't say much of anything about autism anyway.
Unless being unvaccinated HUGELY boosted the chances of autism, there simply would not be enough unvaccinated autistic children in the sample to compare to the vaccinated sample - which almost certainly has a "normal" level of autism, since even if you believe that unvaccinated children NEVER get autism, you'd still expect the vaccinated group of this study to have a normal level.
This is interesting
www.wnd.com/?pageId=35079
shows decrease in autism after thimerosal removal from vax
@159
WorldNutDaily? You might as well be citing whale.to.
From Wikipedia:
I don't think there is anything wrong with vaccines themselves, but the fact they can be contaminated with retroviruses (i.e. from chick embryo cells) makes me think.
Can a recombinant retrovirus infect human cells? Well, the answer is yes, but there is still no answer to whether this could trigger disease (immediate or future).
But if something like this is happening, it would definitely shake the medical establishment.
Yes Jess (159) very interesting indeed......
http://en.wikipedia.org/wiki/Association_of_American_Physicians_and_Sur…
Zero credibility for that study methinks...
If Bigfoot's ghost was shown to cure cancer, the medical establishment would be shaken!!111!11!1!11!
@ The Analyst
Yes and no.
In order for a contaminant retrovirus to be a concern in vaccines, it will need all the following:
1 - It needs to survive the process of vaccine production. If the vaccine is made of live attenuated viruses (e.g. flumist), it's possible. Very unlikely with an inactivated vaccine.
There was some months ago a report of contamination of a anti-rotavirus vaccine with pork retrovirus DNA. As far as I know, only the DNA was found, in quite minute amounts, not the full live virus.
2 - It needs to be able to infect humans. However, most viruses are very species-specific. The flu virus is an exception. The farther apart the concerned species, the lesser the risk. I am more concerned about pig vs human than chicken vs human. A recombinant or mutated virus may be able to attack human cells, but it has to come to existence first.
3 - It needs to be present in quantities big enough to survive the immune response and establish itself in enough cells to represent a threat, either medium- or long-term. And as the local trolls keep reminding us, most people will clear most of these small infections without any issue.
I'm not going to ask the withholding of a vaccine targeted against a common disease with a known, albeit small, risk, because of the possibility of the presence of an unknown retrovirus with a much smaller risk.
That being said, I'm all for medical manufacturers (and independent academic scientists) looking for unknown viruses piggybacking with their products. But I'm not going to lose my sleep over the potential hazard of unknown retroviruses. Let's address known risks first.
Go for inactivated or acellular vaccines if you are really concerned.
It's Mark and David Geier, the same father-son not-so-dynamic duo who use a drug that causes chemical castration to treat autistic children and who are well known for dumpster-diving and bottom-feeding when it comes to publishing their "science."
http://scienceblogs.com/insolence/2009/05/why_not_just_castrate_them_pa…
http://scienceblogs.com/insolence/2006/06/antivaccination_warriors_vs_r…
Then there's JPANDS:
http://scienceblogs.com/insolence/2009/02/the_journal_of_american_physi…
Th1Th2,
Do you understand the difference between intoxication and infection? You cite tetanospasmin and endotoxins as causing infections... What about botulinum toxin? You know, the stuff old ladies inject in their face to tighten wrinkles? This injection DOES cause an 'intoxication' which paralyzes certain nerves/muscles. It DOES NOT cause a proliferation (infection) of C. botulinum (the organism which produces botulinum toxin)... if it did, the old ladies would die. Plain and simple.
Understood, but this is what got me thinking.
http://www.virology.ws/2011/02/17/xmrv-infection-of-rhesus-macaques/
I'm not claiming that this retrovirus causes infection in humans (while still being studied, the evidence is currently stacked against that), but if this is an unlikely lab recombinant from nude mice (which it looks like it is) can survive in human cell lines, who's to say there couldn't be another "unlikely" recombinant that is quite pathogenic?
Am I the only one that thinks Autism looks like a retrovirus? Perhaps my thoughts we be considered on the fringe, and that's fine. I don't like to belong to groups or participate in groupthink (medical culture, political parties, or otherwise). Whatever it is (virus, retrovirus, genetics, environmental factors, vaccinations, etc), I just hope this gets sorted out, because if you know children with Autism, it can be quite a devastating disease for both the child and parents.
I just feel there is too much attention being diverted to bashing anti-vaxxers when people could be doing more productive things â such as finding the cause of Autism. These people just want their children well, so these groups will continue to create more unsubstantiated theories about Autism until a cause and treatment are found. You aren't going to change peoples minds about vaccines, and if you do, the number of people you "convert" will be miniscule in my opinion. Their opinions are deep rooted, and it can be very hard to get around the groupthink. I think it is possible to increase the convert ratio, but I think it would take a kind, gentle campaign rather than bashing these people and calling them baby killers.
Sigh.
You write here as if no one was trying to find the causes of autism, or as if there was only room for one course of action: that trying to counter the dangerous disinformation constantly propagated by anti-vaxxers, for example, could not be conducted without pulling resources away from a search for the causes of autism.
The fact is that anti-vaccination lies are responsible for scaring many parents out of giving their children adequate protection against vaccine-preventable diseases, and that leads to children who catch those diseases dying and being maimed. Those lies need to be countered, period; I don't see how anyone can legitimately suggest otherwise. To be frank, your suggestion sounds to my ears much like someone saying "There is too much focus being placed on stopping looters who take advantage of the chaos of natural disasters; it would be so much more productive to just figure out a way to stop all natural disasters ahead of time." No, anti-vaxxers are not taking malicious advantage of the fact that we have not yet achieved the Herculean task of completely eliminating an entire category of human tragedy, but that's about the only point of disanalogy I can see.
The Analyst
Huh? In that study you cited, they found that one of the previously infected monkeys developed viremia again after it was immunized for the same virus. That doesn't show contamination of the immunization at all.
Here's the relevant bit:
So I've got no clue what you're going on about.
while the german study show only a three times greater risk
For anyone who is not completely ignorant of statistics, the study's results show that the ratio between the prevalence of measles in the non-vaccinated group and the prevalence in the vaccinated group is significantly greater than one, but the authors cannot and do not say how much greater than one. They do not talk about "risk".
The German vaccine schedule is not the same as the US schedule
There is little difference between "receiving no vaccinations in Germany" and "receiving no vaccinations in the US".
[blockquote]Huh? In that study you cited, they found that one of the previously infected monkeys developed viremia again after it was immunized for the same virus. That doesn't show contamination of the immunization at all.[/blockquote]
I wasn't referencing a study about contaminated vaccines. I was just pointing out something that made me think.
My comment really wasn't supposed to be completely related to my last post. I was really just talking about a recombinant retrovirus. And then some rambling.
And then I rambled.
Damn me mixing up forum tags and HTML tags. :)
too much attention being diverted to bashing anti-vaxxers when people could be doing more productive things â such as finding the cause of Autism.
The anti-vaccine lobby is vociferous about (1) persuading people not to participate in public-health measures; and (2) transferring autism-research funds away from productive lines of research and into the one area that is known categorically not to cause autism.
But apart from that, no, there's no reason to argue with them.
@herr doktor bimler
It seems I'm in good company with my statistical ignorance
Courtesy of Orac:
And ScienceDaily courtesy of Orac
Probably not, but I bet all of them don't know much about retroviruses. The problems with your hypothesis are pretty obvious. A virus would be unlikely to give such a strong identical twin concordance, for example.
@ Dangerous Bacon: I too, doubt Dr. Gordon's statement of regret for supporting Wakefield, when Dr. Gordon's website has a "statement of fervent support for Wakefield."
Dr. Gordon made that statement after returning from Chicago after attending the 2010 conference sponsored by Autism One/Generation Rescue.
The 2011 Autism One/Generation One Conference is scheduled in Chicago again this year (May 25th-May 29th, 2011). The Keynote Speaker scheduled for Saturday May 28th is Jenny McCarthy...Dr. Wakefield and Dr. Gordon are also scheduled to speak that same day. Other "experts" and luminaries are listed as well, including Dr.Geier referenced in Orac's post at # 165 above.
Ah, it's like shooting fish in a barrel, whenever Dr. Gordon posts here.
re Andy: on the Conference roster, he's listed as "MBBS"** ( although the twit twitters as "Dr Wakefield")
On a more serious note, how does this guy support himself? He can't do research or teach. His book obviously failed to produce revenue. He speaks at free conferences and events ( Autism One/ the NYU meet-up). He supposedly grew up in a posh household- which can be a hinderance in tough times.
BTW : two businesses in Austin, TX are registered to him: " Strategic Autism Initiatives" and "Callous Disregard", a Llc. ( via manta.com)
** we know about the BS part." Member British...... ( only joking, I know what it is)
@lilady:
It isn't (necessarily) a contradiction: he says that Wakefield's paper is too small to have any statistical significance, and isn't really a research paper but a collection of case studies, and thus he shouldn't have taken the paper as support of his beliefs about vaccines and autism. However, he still support Wakefield in that he thinks that Wakefield is an honest person who didn't commit fraud, and also that Wakefield shouldn't have had his medical license revoked.
whendrick,
Yes, I do. One precedes the other such as infection precedes toxigenesis.
Yes.
What about botulinum toxin?
Yes.
You won't be needing the bacilli (natural infection) when there is BOTOX (injection) already available. Of course BOTOX can kill, it's one of the most toxic substances known to man.
Indeed, it seems the anti-vaccination crowd has moved the target.
This was news to me, and as a scientist myself I'd hope we waste no (ZERO) more time and money on such a subject, but now we'll go even further and (re-)establish that vaccines actually work because some people deny even that ....
http://www.polkmoms.com/forum/topics/various-graphs-that-prove
(it's pretty amusing to go to Canada's raw data:
http://www.phac-aspc.gc.ca/im/vpd-mev/tables/vpd-measles-cig2006-lrg_e…)
Head, meet desk.
Orac,
Great post! As a High School Student, I hate shots, and I do admit I cry every time I receive one because they hurt. However, all I have to do is ask myself, "Would I rather get a shot or be in the hospital getting multiple shots because I have the disease that the shot I did not get was preventing?" However, a short while ago, I saw a video on a "Flu Shot gone wrong," and this video freaked me out, making me more scared of shots than ever and, in a way becoming "anti-vaccination." Here is the video: http://www.youtube.com/watch?v=E4MIm1mB7GM
How do you explain this? Yes, most shots are good for you and help your immunity to many diseases, but according to this video, some can go way wrong.
Sarina
@Dr. Jay #85: So Dr. Jay, if it is a problem using parental reporting because of inherent inaccuracies therein, why is it legit to use it as the basis for your claims on vaccination? How are their reports verified by medical records any different than your 30 years of experience, other than the statistical rigor applied in the former case? I'm curious for your response.
@Susan
See: http://scienceblogs.com/insolence/2010/03/the_intellectual_dishonesty_o….
The gambit behind the graphs you linked to is utterly intellectually dishonest, and an old antivaxer trick. Seriously, there's so much burning stupid contained in the links that you posted that I might have to do an update to the post in my link above.
@Dr. Jay #85: So Dr. Jay, if it is a problem using parental reporting because of inherent inaccuracies therein, why is it legit to use it as the basis for your claims on vaccination? How are their reports verified by medical records any different than your 30 years of experience, other than the statistical rigor applied in the former case? I'm curious for your response.
Why not?
vaxed, unvaxed, antivaxer
All terms that I'd never heard about before crashing this article.
All terms I hope to cleanse from my brain by the time that I wake up in the morning.
The first step to healing the sick is to quit conjuring up these ridiculous, almost purely political, recess-time pet names and focus on the issue at hand (health) rather than making this serious situation look like a circus/US Presidential primary. All of you need serious help. This whole article and the bulk of the comments can't possibly be the best that society has to offer.
Justin, shut up. And change your friggin' name - you besmirch one of the greatest video games of all time.
I know how you feel Justin. Group think to the max. I don't get along with anyone here. I don't like politics. I don't like medical countercultures. I don't like blog pseudocultures.
It's mostly a bunch of immature males who couldn't quite get laid. Of course, I am the exception. I am an anesthesiologist.
Haha, kidding. I thought the anesthesiologist joke was a good one though.
Sarina - Desiree Jennings condition was not dystonia. It was either psychogenic (she was fooling herself) or an outright hoax. Every neurologist who looked at the video of her concluded she did not have dystonia. And acquiring a bad Australian accent as result of a vaccination - really? See the Youtube video below.
http://www.youtube.com/watch?v=QOmNuIYFD7g&feature=related
You should learn to never trust Fox News - they make stuff up all the time.
If you think finding all the causes of autism will make all the anti-vaccinationists change their minds, you're living in a fantasy. There are still people who deny the link between HIV and AIDS, FFS. When people are heavily emotionally invested in their position, they'll find reasons not to look at the contrary evidence.
Actually, the people whose opinions are deep-rooted are few in comparison to the people who are at various stages of sitting on the fence. The latter need to be provided with information that effectively counters falsehoods coming from the anti-vaccinationist side.
You have no evidence that this is true, and yet you choose to preach at Orac. No, your personal common sense is not enough for making fact claims and telling people to change their behavior.
Because there's no reason why a virus should affect identical twins significantly more than ordinary siblings. As opposed to genes.
Huh???
So a kid getting a single Hep B vaccine and nothing else is categorized as "vaccinated", and appears in the charts as a child who is vaccinated against measles, mumps, rubella?
No wonder the lifetime prevalence for measles is so high in "vaccinated" children - many of them had no immunity to the diseases they were exposed to.
(This also explains why there would appear not to be much herd immunity protection for the "unvaccinated" group (15% mealses lifetime prevalence). If in reality the specific measles vaccine uptake rate is only 80% overall then there will be insufficient immunity to protect them).
PS: Good Herd Immunity video here:
http://www.youtube.com/watch?v=KBFe7sbK3Us
@dt: yeah, it can skew the prevalences for the vaccinated group, but at least it gives a very clear definition of the unvaccinated group. It would have been interesting if the authors had broken down the "vaccinated" group (x had 1 vaccine only, y had 2 vaccines, and so on), even if they didn't specify what vaccines the group DID have. Probably would have been way too much bookkeeping to break the group into x had 1 dtap, y had 1 HepB, z had 1 HIB, etc. But I would have liked some breakdown as to the composition of the "vaccinated" group - at least what percentage was fully vaccinated according to German schedule, and what percentage was only partially vaccinated. (And if that info was in the article, I missed it.)
Correction - It appears they did calculate the specific vax rates for the individual diseases.
They give no indication in the text, but the chart captions do give total numbers, which would indicate that for example only 10120 out of 13453 were vaccinated against measles (75.2%).
No wonder there was so much measles in circulation, with such poor levels of herd protection.
Fascinating!
I always thought, vaccination would keep misers like me alive, those who died in the before-vaccination times, and therefore the high numbers of infant deaths.
But this study shows not even that...
I'll be impressed when Jay says [b]on AoA[/b] that he was wrong.
But no, that could actually be seen by people whose opinion he cares about (i.e. who pay him).
Forgive me if I, like Dangerous Bacon and Illady, don't fall over myself commending jaybo for his admission of his "mistake." Not that I don't think he is sincere, but I am wondering, what is he really admitting? As has been kind of hinted at, perhaps best by Matthew Cline, the "mistake" that he admits to consists of using the Wakefield study as support for his preconceived (non-scientific) belief that vaccines cause autism.
But why shouldn't he have used it? Not because it was fraudulent garbage, but because the sample size was too small to use for a legitimate conclusion. Not that jay disagrees with the conclusions, or doesn't think that it wouldn't be born out if it were done with a large enough sample size. No, this was all well and good, just not big enough to use to bolster his claims. Then again, he has to make that concession, because if he didn't, he knows he couldn't honestly criticize the current work, which he has to do because it disagrees with his assertions. Better to throw out all science and stick with his contention that his observations from his 30 years of clinical experience trump all.
Color me underwhelmed.
"vaccination would keep misers like me alive"?
What does vaccination have to do with miserliness?
Jay Gordon,
Your remark that this study was really very poor does not appear to have been followed up on. I'm curious to know what you think was bad about this study. You've posted twice with very little content; do have any actual criticisms or interest in discussion, or are you just trying to increase your site's page rank on Google?
@ Pablo: Underwhelmed and unimpressed with Dr. Gordon's statement about the debunked scientific study of Wakefield, when his website still lauds praise on the now disgraced Wakefield.
I'm still waiting for an revision on Dr. Gordon's site about regarding Prevnar to prevent the small incidence of meningitis and its (primary) use to prevent otitis media. As I have stated in previous posts, the vaccine was licensed and recommended for use 11 years ago and was developed to protect infants against "invasive" (meningitis and septicemia). Yet, Dr. Gordon still has maintains that it prevents otitis media and a small number of meningitis cases.
Five years after the widespread use of Prevar the incidence of deadly invasive diseases plummeted more than 95 % from a level of 13,700 cases. Yet Dr. Gordon, continues to state on his website that Prevnar is "too new for me to recommend".
What about an ERV?
And if it comes to some type of trigger, identical twins obviously have the same genetic susceptibilities.
I still don't see why it's unlikely.
What about an ERV?
Then it's a standard part of the human genome that we all have, and you might as well call it a genetic or a genetic / environmental cause.
The Analyst (#167) asks:
No, there are a number of people claiming that autism is caused by XMRV. However, none of those people appear to know anything about retroviruses.
I'm curious - what is it about autism that looks like a retrovirus? Is it the progressive nature of the disability? Is it the tumors resulting from retroviral integration? What exactly about autism looks like a retroviral infection?
I'm quite serious - I can't see it, so it's obviously something I'm missing.
Prometheus
It's actually looking less likely that XMRV has anything to do with chronic fatigue syndrome, the association which brought XMRV to public attention to begin with. At least that's the impression I'm getting.
what is it about autism that looks like a retrovirus?
The elevated level of reverse-transcriptase activity that no-one's reporting.
For that matter, I'd like to know which kind of retrovirus "The Analyst" thinks autism looks like.
This sort of comment - like Th1Th2's immunological ravings - is proof positive that the commenter knows nothing about the topic on which they are opining. It's like hearing someone claiming to be a sports expert waxing eloquent about "home-runs" and "base hits" while discussing football (either type): you know immediately that they are fake.
Prometheus
Slightly off-topic, but related, I've got some posts up discussing the ethics/legalities of a prospective, randomized, placebo-controlled vax vs. unvax study over at Harpocrates Speaks. Here is the list of posts so far. I have one more planned. Parts 1 and 2 are background material, part 3 applies some ethical considerations and part 4 (up tomorrow) will talk about legalities. Okay. Done with the shameless plug. I beg all of your indulgence.
XMRV -- I thought I remember reading recently that there's some controversy over whether it's even a real virus at all, much less causing massive epidemics of seemingly unrelated chronic conditions.
Ah yes, that was over at ERV's blog:
http://scienceblogs.com/erv/2011/02/xmrv_lab_contaminant.php
ERVs-->disease are not the result of genetics. The diseases they are involved with are not associated with the genes, but disregulation of the genes via disregulation of epigenetic control. Thus, identical twins and non-identical twins and siblings raised in the same household are all at the same risk-level. Its the common environment, not the common genetics.
And thanks for the links, guys :P XMRVs got jack to do with anything.
False.
I never claimed to know which kind, and never claimed to know it was a retrovirus. If I knew these things, I'd probably be rolling in money.
But you seem to already know that it couldn't be a retrovirus or ERV.
What do you think causes the immune dysfunction, oxidative stress (amongst many other things) present in autism?
I don't have the answer, but do you?
The Analyst -- what makes you think immune dysfunction and oxidative stress are obligate features of autism rather than just things that happen to sometimes exist in the same person?
I mean, when you say "present in autism," that seems to imply you believe them to be features of autism rather than comorbid conditions. I have heard you mention this before, but have not heard it anywhere else apart from certain dubious sources who seem ill-equipped to explain what they mean. You seem to be more knowledgable than them, so I think you're my best chance of finding out if there is any meat to this. You might also want to be more specific; what precisely do you mean by "immune dysfunction" and what do you mean by "oxidative stress"? They seem rather vague categories without more context.
The study leaves out a very critical piece of data in undergoing potentially risking biological tinkering.
The actual outcome of the infected and the prognosis long term post infection. the result of the infections rate aren;t suprising for such a small sample group. No vaccine is 100% effective and no population is 100% suceptiable particularlly to something as common and mundane as measales mumps rubella. All of which self resolve with nero zero complications in most case. Mumps being the one to be concerned about however if cuaght during adolsecents but even the study data only really shows a very small decline in infection rates. Extroplated without fuzzy math its a 6% reduction in infection. Hardly worth noting or consider in light of efficacy. If anything this study prove how rampantly ineffective vaccines actually are and how resistant the population is at large to common viral infections.
Its doesn;t make the case of the OP if the data is examined with a critical eye.
the data would mean more if both sample group were equally sized and I am fiarly sure the results would be more evenly divided amongst the 2 groups at such a point.
Oh, I see why you are "AntiVaccine", it has something to do with your lack of reading ability. You obviously did not understand why the pool of totally unvaccinated persons was so small.
"AntiVaccine" appears to claim that the Schmitz et al (2011) study showed only a small decrease in vaccine-preventable diseases in the vaccinated group:
The "real" numbers from Schmitz et al 2011:
Pertussis: unvaccinated 11%; vaccinated 1.8%
Measles: unvaccinated 11%; vaccinated 4.3%
Mumps: unvaccinated 7.5%; vaccinated 3.1%
Rubella: unvaccinated 12%; vaccinated 7.0% *
*not a statistically significant difference.
I can't see how this works out to a "6% reduction in infection" unless "AntiVaccine" is making the common error of subtracting one percentage from another.
Truly, this was the only area in the study where the unvacinated children "outshone" the vaccinated children: their significantly higher incidence of vaccine-preventable diseases. If you're anti-vaccine, I'd think you'd want to revel in this; "Yay! Unvaccinated kids rule!**"
** in getting vaccine-preventable diseases
After all, isn't that what the anti-vaccinistas are always claiming - that "natural" immunity is so much better that we'd all be healthier if we got our immunity the "old-fashioned way"? And, if 2 per 1,000 kids who get measles end up with permanent brain injury (a known, well-documented complication of measles, as opposed to autism, which hasn't been shown to be associated with vaccines), well, that's just the cost of being "natural", right?
Sheesh.
Prometheus
TheAnalyst @ 209:
{Citation needed.}
Looking at the material and method of the paper:
1- By contrast, children who had by then received at least one vaccination according to their vaccination card were categorized as vaccinated.
One vaccine only? This hardly is a true vaccinated representative population.
2- n=94 (unvaccinated) versus n=13359 (vaccinated at least once)- You must be kidding.
3- Table 2 does not seem to fit with the statistical conclusions reached.
4- Dr Schlaud was the lead investigator of an epidemiological study of deaths in children aged 2â24 months (TOKEN Study) in 2004â2009, which was jointly funded by the Federal Ministry of Health, the Paul Ehrlich-Institute, Sanofi Pasteur, and Glaxo Smith Kline.
Looking at the material and method of the paper:
1- By contrast, children who had by then received at least one vaccination according to their vaccination card were categorized as vaccinated.
One vaccine only? This hardly is a true vaccinated representative population.
2- n=94 (unvaccinated) versus n=13359 (vaccinated at least once)- You must be kidding.
3- Table 2 does not seem to fit with the statistical conclusions reached.
4- Dr Schlaud was the lead investigator of an epidemiological study of deaths in children aged 2â24 months (TOKEN Study) in 2004â2009, which was jointly funded by the Federal Ministry of Health, the Paul Ehrlich-Institute, Sanofi Pasteur, and Glaxo Smith Kline.
Looking at the material and method of the paper:
1- By contrast, children who had by then received at least one vaccination according to their vaccination card were categorized as vaccinated.
One vaccine only? This hardly is a true vaccinated representative population.
2- n=94 (unvaccinated) versus n=13359 (vaccinated at least once)- You must be kidding.
3- Table 2 does not seem to fit with the statistical conclusions reached.
4- Dr Schlaud was the lead investigator of an epidemiological study of deaths in children aged 2â24 months (TOKEN Study) in 2004â2009, which was jointly funded by the Federal Ministry of Health, the Paul Ehrlich-Institute, Sanofi Pasteur, and Glaxo Smith Kline.
Looking at the material and method of the paper:
1- By contrast, children who had by then received at least one vaccination according to their vaccination card were categorized as vaccinated.
One vaccine only? This hardly is a true vaccinated representative population.
2- n=94 (unvaccinated) versus n=13359 (vaccinated at least once)- You must be kidding.
3- Table 2 does not seem to fit with the statistical conclusions reached.
4- Dr Schlaud was the lead investigator of an epidemiological study of deaths in children aged 2â24 months (TOKEN Study) in 2004â2009, which was jointly funded by the Federal Ministry of Health, the Paul Ehrlich-Institute, Sanofi Pasteur, and Glaxo Smith Kline.
SM69:
Kindly elaborate on your objections, preferably with reference to principles & techniques of statistical analysis to support your position.
In particular, your objection #4 seems to be little more than an ad hominem (of the sort I suggested might happen back on comment #41) fallacy. If this study was conducted with sufficient rigour then it is of little moment who funded some 2004-2009 study. Likewise, if this study was conducted poorly, sloppily, etc. then it is of little moment who funded some 2004-2009 study.
1. Shift goalposts much? When dose-response studies are done, the reaction is "dose doesn't matter, one is enough, you have to do it completely unvaccinated vs. everyone else!" Then when that's done, all of a sudden the number matters again.
2. 94 is smaller than ideal, but all available. The fact that it's so much smaller than 13359 is not a problem in the least. Think about it - if you want to claim that it would be better if the numbers were more equal, you are necessarily claiming that throwing away data makes results more reliable.
3. Details are required when making such a statement.
4. So?
Orac's minions-
Suggest you read @116 from@SCR-
@md1970
Suggest that you stop necroing old posts, idiot.
Here's an unvaccinated - vaccinated study.
"When DTP was first introduced into Guinea-Bissau, despite the absence of herd immunity, mortality was 5.1 deaths per 100 person-years among children who did not receive DTP but 11.3 deaths per 100 person-years among children who did receive DTP"
That's not to hard to understand is it ?
I don't understand this line "Consistent with results in the U.S., the unvaccinated children tended to be from families of higher socioeconomic status." Why are rich people not vaccinating their children? Do they hear something at Davos that the rest of us don't have access to?