Respectful Insolence

Three years ago, the influenza season was a really big deal. The reason, of course, is that the 2009-2010 flu season was dominated by fears of the H1N1 strain, so much so that it was a rare flu season that there were two recommended vaccines, one for the originally expected strains of flu and one for the H1N1 strain. Fortunately for all of us, the H1N1 fear mostly fizzled, but public health officials were in a bad place. Under-react, and if the pandemic turned out to be as bad as the worst case scenarios predicted before the pandemic, and they’d be crucified for not having done everything they could to prevent it and mitigate its effects. Over-react, and they’d be blamed for frightening the public unnecessarily and wasting resources. In the end, with the perfect hindsight of the retrospectoscope, we now know that the pandemic was not bad as anticipated, but there was no way to know that prospectively going in.

During the entire pandemic, not surprisingly there were a lot of articles about the flu in general and the H1N1 strain in particular. It was during that time that I came across an article published in The Atlantic by Shannon Brownlee and Jeanne Lenzer entitled Does the Vaccine Matter? The title referred, of course, to the flu vaccine. I was, to put it mildly, completely underwhelmed by Brownlee and Lenzer’s arguments that the flu vaccine was basically worthless. So were revere (who, I wish, were still blogging) and Mark Crislip, who has written multiple posts on the efficacy of flu vaccines, one of them basically a rebuke to the article in The Atlantic to go with his most excellent direct rebuttal to the article. The reason I bring all this up is because it was during that time that I first encountered (well, not encountered, more like “paid attention to”) a man named Tom Jefferson of the Cochrane Collaborative, who was the “star” of Brownlee and Lenzer’s article. Indeed, Jefferson was portrayed as the brave maverick scientist speaking truth to power and, in essence, supporting Lenzer and Brownlee’s thesis that the flu vaccine was, well, worthless. He is also the man whose example revere used to teach me a new word, “methodolatry,” defined as “the profane worship of the randomized clinical trial as the only valid method of investigation.” I love that word because it also nicely points out the blind spot of evidence-based medicine that allows quackademic medicine to take root.

Now, it would appear, Jefferson has revealed either his utter cluelessness or his true colors. Take your pick. Why do I say this? Because a couple of weeks ago, he appeared on the Gary Null Show. Mark Crislip is all over it, in particular regarding the issue of this year’s flu season, which appears to have hit earlier and harder than average. His deconstruction is quite detailed and long even Orac-ian standards.

None of that will, of course, stop me from taking my own swipe at Jefferson because I find it very disturbing that the head of the Cochrane Collaborative in charge of doing Cochrane systematic reviews and meta-analyses of flu vaccine efficacy and safety would agree to be interviewed by a quack much of whose quackery involves pure antivaccine nonsense. I suppose it’s possible that Jefferson didn’t know who Null was when he agreed to be interviewed, but come on! A quick Google search brings up the infamous documentary that Null made called Vaccine Nation and what Null says on his website about it:

At the end of the eighteenth century, British physician Edward Jenner, with highly questionable medical credentials, initiated the theory and practice of live virus immunization that continues to serve as the scientific basis for the ever increasing vaccination of the world’s citizens. With the number of vaccinations given to infants and children rising, kids are receiving doses of toxic mercury and other heavy metals well above environmental safety levels.

Yet the medical evidence is clear. Mercury, known as thimerosal, and other heavy metal additives are highly toxic and threaten children with neurological damage. The long-term efficacy of global vaccination remains controversial, inconclusive and is suspect in light of the powerful corporate interests, lobbying efforts, and profits associated with a multi-billion dollar vaccine industry..

In his documentary film Vaccine Nation, award-winning investigative film director Dr. Gary Null challenges the basic health claims by government health agencies and pharmaceutical firms that vaccines are perfectly safe.

You can watch the whole thing here if you can stand it. It’s propaganda every bit as blatant and idiotic as that presented in the anti-vaccine magnum opus The Greater Good, so much so that I think someday I’ll have to subject myself to the movie and review it, because people do mention it from time to time, and antivaccinationists use it as “evidence” that vaccines are the root of all evil. Amusingly, on my search at least, a post I wrote about Gary Null shows up on the first page of search results, in which he accidentally poisoned himself with his own Power Meal supplements. I love it when my posts show up high in Google searches on quacks like Null because it doesn’t happen very often. Seriously, Dr. Jefferson? You couldn’t even Google Gary Null along with the word “vaccine” to see what his views were on the subject. I don’t know which is worse: If he didn’t bother to Google Gary Null and agreed to an interview or if he did.

Strike that. The latter would be infinitely worse. In the first case, Jefferson would just be clueless. In the second case, he’d be blatantly antivaccine. Crislip might say that he’s reluctant to judge a person by the company he keeps, but in this case I’m not. There’s no excuse for someone as prominent in the world of influenza vaccines as Tom Jefferson is step foot into Gary Null’s studio or allow Null to call him on the phone. To anyone who is a serious scientist studying vaccines, Null should be like Kryptonite to Superman.

Of course, the flu vaccine is an easy vaccine to attack because, although it is incredibly safe, it is not one of the best vaccines. Typical effectiveness varies from year to year because it depends on how well the flu experts who try to prognosticate every year about what strains of flu virus will be circulating many months in the future did in their prognostications. If they guess right and there’s a good match, the flu vaccine can be quite effective. If they guess wrong and the match between the circulating strains and the strains used to make the flu vaccine then it’s not a very effective vaccine. This year, according to Crislip, it appears that the flu vaccine should be around 60-70% effective. Antivaccinationists seem to think that if a vaccine isn’t 100% effective it’s crap.

So what sorts of things did Jefferson say on Gary Null’s show?

Null begins by peppering Jefferson with a bunch of questions, the most prominent of which is a question about whether pregnant women really need to get the flu vaccine:

Thank you very much for hosting me on your show Gary. You’ve asked me about 15 questions in one, so let me just start from the first one on pregnant women. When you are talking about pregnant women you are of course not just talking about pregnant women but you are talking about a pregnant woman and the fetus, the unborn baby. Now a pregnancy woman is a healthy adult despite desperate attempts at transforming pregnancy into a deadly disease. Pregnancy is part of… is a physiological state. It is the reason why our race is still on the planet. So there is nothing wrong with pregnancy. That is, it is normal. Pregnancy women therefore are healthy adults and we do know what the performance of the inactivated influenza vaccine is in healthy adults because there are quite a number of trials, clinical trials, that’s experiments, we summarize them, and to give you some idea, we need to vaccinate about 33 to 99 people to avoid one set of influenza symptoms.

Yes, pregnancy is a normal condition and not a disease, but that doesn’t mean it doesn’t carry risks. Women die in childbirth. They lose children. Health problems that pregnant women suffer during their pregnancy can have direct and permanent effects on their babies. More importantly, however, pregnant women who get the flu suffer more complications that the possibility of death, as Crislip points out. The are at a higher risk of miscarriage, developing respiratory complications such as pneumonia from the flu, and having low birth weight babies, for example, and there is evidence that the flu vaccine decreases the risk of these complications. Jefferson, consistent with his modus operandi, focuses on a narrow, limited set of complications in which, at least in part due to the complexities of doing the study, the benefits of the flu vaccine are harder to show (mortality, for instance) and ignores all the other ancillary benefits. He even pulls out the naturalistic fallacy at one point.

I don’t want to respond point-by-point to everything that Jefferson has said. After all, Mark has done a fine job of that. What I do want to do is to take the view from five miles up and wonder what the hell Jefferson thinks he’s doing. It’s clear that he’s skeptical of the benefits of the flu vaccine. That isn’t what bothers me. What bothers me is how he insinuates that the flu vaccine doesn’t work while never actually saying that you shouldn’t get it. He maintains plausible deniability, while trashing the vaccine left and right. What he says in public also differs from what he says in his Cochrane reviews, as I’ve pointed out before. For his reviews, he has to stick to the evidence, and peer reviewers have to be satisfied. When he’s talking to journalists, he can let his freak flag fly higher and, as I put it, go full mental negative on the flu vaccine. Why he does it is anyone’s guess, but what is undeniable is that he can. He’s also become known as a “brave maverick,” which can be very seductive. To get an idea of how Tom Jefferson was portrayed and quoted, let’s go back to Brownlee and Lenzer’s article from 2009:

The most vocal–and undoubtedly most vexing–critic of the gospel of flu vaccine is the Cochrane Collaboration’s Jefferson, who’s also an epidemiologist trained at the famed London School of Tropical Hygiene, and who, in Lisa Jackson’s view, makes other skeptics seem “moderate by comparison.” Among his fellow flu researchers, Jefferson’s outspokenness has made him something of a pariah. At a 2007 meeting on pandemic preparedness at a hotel in Bethesda, Maryland, Jefferson, who’d been invited to speak at the conference, was not greeted by any of the colleagues milling about the lobby. He ate his meals in the hotel restaurant alone, surrounded by scientists chatting amiably at other tables. He shrugs off such treatment. As a medical officer working for the United Nations in 1992, during the siege of Sarajevo, he and other peacekeepers were captured and held for more than a month by militiamen brandishing AK-47s and reeking of alcohol. Professional shunning seems trivial by comparison, he says.

See? Not only is Jefferson a Brave Maverick Scientist, but he’s such a Brave Maverick Scientist that his fellow scientists don’t want to hang out with him. Either that, or he’s a very boring dinner companion, which is something I rather suspect after having listened to his conversation with Gary Null. Or maybe he’s just shy. I’ve sat alone to eat meals at many a conference, particularly when I’m in a strange city where I don’t know anyone or at a conference where friends that I usually hang out with decided not to attend. I’m a little shy in person myself; I’ve never been the sort just to step up to a group of people whom I don’t know well and ask if they mind if I join them. In other words, It does not follow from Tom Jefferson’s tendency to eat meals alone at scientific conferences that his fellow epidemiologists must be shunning him. I’ve met plenty of surgeons and scientists with—shall we say?—”outside the mainstream” opinions about various scientific issues who are quite gregarious and sometimes even the center of attention. Be that as it may, bucking the establishment is something the media loves. Being an “iconoclast” or a “maverick” can be very rewarding. It brings attention and fame. In recent years, Dr. Jefferson has become the go-to vaccine scientist for the “skeptical view” on the flu vaccine whenever a journalist is doing a story. I never thought he’d actually willingly appear on a show like Gary Null’s. What’s next? Alex Jones? At this point, it wouldn’t surprise me.

Three years ago, I was willing to give Tom Jefferson the benefit of the doubt. I thought he was just suffering from serious methodolatry, in which randomized clinical trials are the be-all and end-all of evidence (and not even all of them). The problem, of course, is that a lot of the evidence is epidemiological, as the questions being examined don’t always lend themselves to ethical randomized clinical trials. Jefferson typically fails to consider the totality of evidence into context and draw conclusions based on more than a very narrow set of observations. Whether he is antivaccine or not in his heart of hearts, I don’t know. What I do know is that his behavior certainly flirts with it, just as he did when he let an antivaccine quack like Gary Null interview him. There’s an old saying that if you lie down with dogs you’ll get fleas (although, quite frankly, I love dogs and don’t like to insult such noble creatures by making an analogy comparing Gary Null to them). Jefferson should be getting a bit itchy right about now.

Maybe Barbara Loe Fisher’s National Vaccine Information Center got it right when she wanted to award him the NVIC Visionary Award. Back then, Jefferson, after initially accepting it, ultimately decided to do the right thing and decline it before what was in essence the antivaccine awards ceremony, apparently finally figuring out that the NVIC is an antivaccine organization. After listening to him on Gary Null’s show, I can’t help but conclude that, if the NVIC were to offer the award to him today, I’m not sure he’d still the good sense to turn it down. On the other hand, maybe he’s finally learned his lesson, tweaked by a bit of itchiness.

I wouldn’t count on it, though.

Comments

  1. #1 Ren
    In a tunnel, under a city, moving fast, on a train
    January 25, 2013

    I, too, have been outspoken against the use of influenza vaccines, BUT it hasn’t been without reason. You just can’t use them to respond to an outbreak because they don’t work like the smallpox or the measles vaccines. They take a long time to kick in and are not as effective.

    They are, however, incredibly safe. If used before the flu season, by enough people at risk for complications, enough people taking care of those people at risk (e.g. healthcare workers), and enough people in the general population, we can stave-off a bad flu season, maybe even a pandemic if we know the strain and have the vaccine available before it sets in.

    But, to respond to it? Not in my opinion.

    This stance has already resulted in people giving me some looks at one of my (four, is it?) places of employments. I’m so outspoken about the benefits of vaccines that they must find it hard to reconcile with my view on the flu vaccine as an outbreak response tool.

    Now, if Tom Jefferson wants to be skeptical about vaccines, sure, go ahead. But he can’t be skeptical and ignore evidence, or bend the evidence to fit the PR machine. I have a feeling that he is out looking for validation, or fame, or adventure.

    A true Epi seeks not these things.

  2. #2 Eric Lund
    January 25, 2013

    He ate his meals in the hotel restaurant alone

    I consider this a warning sign, because there was a scientist in my field who was described thus in the media after he became known for a crackpot theory. (He was the “cometesimals” guy.) Others who knew him better than I did report that the guy had a reputation for stiffing the waitstaff at restaurants, and that he became so infamous that many restaurants near the site of our biggest annual conference would not serve any party that included him.

    The media were credulous in reporting his claims, which were contrary to a significant amount of geology and astrophysics. I never saw any popular coverage of the debunking of his claim: it turned out his “phenomenon” was due to noise artifacts in the images he was analyzing.

  3. #3 Science Mom
    http://justthevax.blogspot.com/
    January 25, 2013

    I have a lot of respect for Dr. Jefferson’s work but I don’t understand why he is intent on seeking such dubious company.

  4. #4 Heliantus
    January 25, 2013

    Mark Crislip is all over it,

    That he did, and a good job he did, I learned a-plenty on the flu. The world need more Mark Crislip.

    But back to Jefferson

    At a 2007 meeting on pandemic preparedness at a hotel in Bethesda, Maryland, Jefferson, who’d been invited to speak at the conference, was not greeted by any of the colleagues milling about the lobby. He ate his meals in the hotel restaurant alone, surrounded by scientists chatting amiably at other tables.

    Poor baby, no-one was coming to tell him how smart he is.

    There could be thousands of attendee and hundreds of presenters in any medium-size scientific conference, and many have never heard of you, sir. It’s easy to get lost in the crowd.
    But no, you are a special snowflake and everybody should notice you.

    From personal experience of scientific conferences, staying with close colleagues and friends (or compatriots) for lunch is sort of the default behavior. You have plenty of time during poster presentations and lectures to meet people from other labs. Lunches and dinners are for relaxation or tourism or (for the more serious) comparing notes on the high and low points of the past sessions. Pestering people from other labs during their meal is not exactly a top priority.
    Unless, you are very famous (like, the year’s Nobel prize) and people may indeed want to invite you for lunch, to share the aura of fame. But this sounds more sycophantic than scientific…
    Or maybe I’m completely wrong about what I should be doing at a scientific conference.

    You know what, Jefferson? Again, from personal experience, maybe all you needed to do was to go to someone’s table and ask if you could join.

  5. #5 Todd W.
    harpocratesspeaks.com
    January 25, 2013

    @Heliantus

    I had the same thoughts. People stick to the others they know. Even if you’re from the same place, your compatriots may leave you by your lonesome when they see someone else they haven’t talked to in a long time. And socializing can be rather difficult for those of us who are more socially reserved and introverted.

  6. #6 SkepticalBadger
    January 25, 2013

    Plus eating alone at a conference is an introverts dream! I get to people watch scientists

  7. #7 lilady
    January 25, 2013

    I’ve been more than a bit perturbed at Tom Jefferson’s outspoken comments about the flu vaccine. And no, I don’t agree that he was naive about Gary Null’s quackery, prior to his agreeing to appear on the Gary Null show.

    I’m thinking that Jefferson is a publicity hound who needs to feed his ego and if the interviews on mainstream media dry up, he will settle for any interview with any radio personality…including Null.

    Look at this YouTube interview and his rant about the definition of “pandemic”, as he reads from his copious notes. He draws some illogical conclusions about the changing “pandemic flu” definition:

    http://www.youtube.com/watch?v=FUFIH3TI114

    Jefferson would have to be brain dead to not understand the manner in which anti-vaccine anti-science bloggers quote-mine the Cochrane Collaboration analyses of influenza vaccine studies…and how his statements add fuel to the fires.

  8. #8 dandover
    About 1AU from the Sun
    January 25, 2013

    I’ll take Dr. Jefferson’s word for it that we have to vaccinate somewhere between 33 and 99 people to prevent one case of the flu. But what I’d really like to know is, how many people do we have to vaccinate with MMR in order to avoid one case of the measles? My guess is that number is a *lot* higher than 33 to 99. Probably something in the range of 100,000 or more, I would guess. Is that evidence that the MMR vaccine is not very effective?

  9. #9 Denice Walter
    January 25, 2013

    In the past, whenever I believed that one of Null’s guests had walked into his manure pit unawares- e.g. an economist I admire- I e-mailed the guest about the woo-meister’s true purposes.
    I didn’t do that with Jefferson because it seemed he was mostly in agreement. Therefore it’s *his* problem if his words are later used to support woo. And they have been: a recent article by Null and Gale points out TJ’s appearance and comments( @ ProgresssiveRadioNetwork.com).

    This illustrates how alt media inveigles its audience with tales about how they represent a reform movement that will clean up corrupt and useless science and medicine:
    realistic criticism is presented alongside outlandish Nirvana fallacies and wishful thinking. Later, a well-known name is paraded about as being truly in agreement with their own causes. Truth is stretched to the breaking point.

    People like Null and Adams represent themselves as ‘educators’ who host “classrooms on the air” or in e-book format, respectively, or through ‘documentaries’ and videos, also respectively:
    Null especially creates an image of his own professional status**, scientific** research and groundbreaking advocacies** over the years as well as his counselling** of “tens of thousands” of patients who SBM had failed.

    He would have the audience believe that his science** is indeed the *nouvelle vague* about to break over the crumbling foundations of entrenched medicine, washing away the rot and mire.

    And yes, educational reform is also in the playbook of this sorry lot: elitist universities must go.
    Jefferson, perhaps without realising it, gives him more cred and bio self-aggrandisement fodder.

    ** cough

  10. #10 Dangerous Bacon
    January 25, 2013

    Jefferson on Null’s show: “Now a pregnancy (sic) woman is a healthy adult despite desperate attempts at transforming pregnancy into a deadly disease.”

    What a ludicrous straw man.

    Jefferson either has seriously deformed thought processes, or he’s intent on being the go-to person for alt med quackery. Either way, he’s lost almost all remaining respect I had for him.

  11. #11 herr doktor bimler
    January 25, 2013

    It is like arguing that nonagenarians and infants are healthy adults (because neither old age nor infancy are diseases) and should not be special cases for vaccination policy.

  12. #12 Bronze Dog
    January 25, 2013

    I’ve seen that pregnancy straw man used in plenty of contexts, particularly on issues of contraception. What I find sad about it is that it treats the serious issue of pregnancy flippantly, as if women who want to plan their pregnancy responsibly, exercise control over their own lives, and be able to provide for the resulting child are stuffy sticks in the mud who need to loosen up and just let pregnancy happen whenever it does. Then, often in the same breath, they slut shame these women for wanting to have sex for reasons other than pregnancy.

  13. #13 Bill Price
    January 25, 2013

    #8 dandover

    how many people do we have to vaccinate with MMR in order to avoid one case of the measles? My guess is that number is a *lot* higher than 33 to 99. Probably something in the range of 100,000 or more, I would guess. Is that evidence that the MMR vaccine is not very effective?

    Your guesswork is evidence only of the effectiveness (or lack thereof) of your thought processes.

  14. #14 lovelyday
    January 25, 2013

    This blog is the funniest thing I ever saw connected to science. Jefferson reviewed the evidence.

    Top claim is flu jab halves winter deaths. Jefferson found that only 10% of winter deaths were attributed to flu like illness, that is not even lab confirmed flu.

    So this claim is a lie, doesn’t matter if you are pro or anti its a lie. He found that one would have to claim that the flu jab reduced road traffic accidents to claim 50% reduction.

    He did this for all the other top 10 claims and found the evidence for flu jab efficacy was implausible at best.

    You septic guys are like the Taliban. In fact worse because you have no logic to your madness. If one could issue an organic fatwa for the benefit of mankind Orac would be a suitable candidate, Offit a close second and well Mr Barrett of duck fame is fucked anyway. Oh don’t forget that horrible man that likes underage illegal alien Mexican boys, can’t bring myself to write his name.

  15. #15 lovelyday
    January 25, 2013

    It doesn’t work. Poland ignored claims officially to get on the swine flu bandwagon and nothing happened.

    I can’t believe you septic lot are actually trying to argue for the flu vaccine, of all the failures it is the worst and most obvious.

  16. #16 lovelyday
    January 25, 2013

    “how many people do we have to vaccinate with MMR in order to avoid one case of the measles? ”

    Well it depends on where you live. In the northern hemisphere the vaccine works really well. The nearer the equator you get it fails more and more.

    Basic math tells us it has nothing to do with prevention.

  17. #17 Narad
    January 25, 2013

    Your guesswork is evidence only of the effectiveness (or lack thereof) of your thought processes.

    That seems a bit harsh. The specific value is going to depend on the balance between susceptibles and infectious. At present, this is going to be a large fraction of the birth cohort.

  18. #18 Denice Walter
    January 25, 2013

    And for your reading pleasure, the article I mentioned above:
    go to Progressive Radio Network ( prn.fm) to articles to Gary Null articles to:

    Why You Should NOT Get a Flu Vaccine
    “The Great Vaccine Hoax”

    And there’s lots more related material around that sinkhole of un-reason.

  19. #19 lilady
    January 25, 2013

    “But what I’d really like to know is, how many people do we have to vaccinate with MMR in order to avoid one case of the measles? My guess is that number is a *lot* higher than 33 to 99. Probably something in the range of 100,000 or more, I would guess.

    All you really need to determine that, is to look how the disgraced former doctor Andrew Wakefield made three visits that we know of (two visits before the Hennepin County measles outbreak and one during the measles outbreak) where he met privately with Somali parents in Minneapolis to encourage them to not get the MMR vaccine…and to drum up support for his latest *theory* that MMR vaccinated Somali children are at increased risk for ASDs:

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6013a6.htm

    “….The patients included children aged 4 months–4 years and one adult aged 51 years; seven of the 13 were of Somali decent. Eight patients were hospitalized. Vaccination status was known for 11 patients: five were too young to have been vaccinated, and six (all of Somali descent) had not been vaccinated because of parental concerns about the safety of the measles, mumps, and rubella (MMR) vaccine. The most recent rash onset was March 28. An additional, unrelated case of measles was confirmed in a Hennepin County resident aged 34 years who was exposed in Orlando, Florida, sometime during March 1–10.

    The investigation determined that the index patient was a U.S.-born child of Somali descent, aged 30 months, who developed a rash February 15, 14 days after returning from a trip to Kenya. The patient attended a drop-in child care center 1 day before rash onset; measles developed in three contacts at the center and in one household contact. Secondary and tertiary exposures occurred in two congregate living facilities for homeless persons (four patients), an emergency department (two patients), and households (two patients). A virus isolate from the index patient was genotyped at CDC as B3, which is endemic in sub-Saharan Africa….”

    “Is that evidence that the MMR vaccine is not very effective?”

    But MMR vaccine is “very effective” dandover…unless of course, you have a link to a citation from a “reliable” source that primary vaccine failure or secondary vaccine failure (waning immunity) following the 2-dose MMR series has been implicated in measles outbreaks.

  20. #20 lilady
    January 25, 2013

    Just keep posting “lovelyday”…so we can laugh at your pathetic rants and so we can figure out whose sock puppet you are.

  21. #21 Narad
    January 25, 2013

    Basic math tells us it has nothing to do with prevention.

    Actually, basic math tells “us” that it has everything to do with prevention. But you are apparently too mentally slovenly to even bother presenting an actual argument.

  22. #22 Science Mom
    http://justthevax.blogspot.com/
    January 25, 2013

    But what I’d really like to know is, how many people do we have to vaccinate with MMR in order to avoid one case of the measles? My guess is that number is a *lot* higher than 33 to 99.

    Apples and oranges my friend. MMR is highly effective (the mumps portion less so) and effectiveness of the measles portion is 90% after one dose and 95% after the second. The reproductive rate of measles is much higher than influenza as well (12-18 for the former, 2-3 for the latter-wiki). There is also the genetic drift and shift of influenza annually as opposed to the very stable, albeit geographically distinct measles virus.

  23. #23 Narad
    January 25, 2013

    If one could issue an organic fatwa for the benefit of mankind Orac would be a suitable candidate

    Perhaps it’s just me, but I think threats of violence warrant disclosure of IP address.

  24. #24 Ren
    Not where you think
    January 25, 2013

    “You septic guys are like the Taliban.”

    Are we the ones calling for a fatwa, like the Taliban? No, we’re not:

    “If one could issue an organic fatwa for the benefit of mankind…”

    Laughable.

  25. #25 AdamG
    January 25, 2013

    Ah, an organic fatwa…where all violence is pesticide-free!

  26. #26 Orac
    January 25, 2013

    Just keep posting “lovelyday”…so we can laugh at your pathetic rants and so we can figure out whose sock puppet you are.

    I think I know, but it will take a couple of more rants for me to be sure. Of course, I have the advantage of knowing what IP address “lovelyday” is posting from. It’s not the same as the one from which the sockpuppet whom I suspect used to post from, but it does map back to the same city. We shall see… :-)

  27. #27 herr doktor bimler
    January 25, 2013

    an organic fatwa

    That would be a non-trans-unsaturated fatwa.

  28. #28 Denice Walter
    January 25, 2013

    Perhaps a legal eagle might inform meas to what to call insinuating criminal exploitation of youth in writing without actual naming of the alleged culprit.
    Weak-tea libel?

  29. #29 Denice Walter
    January 25, 2013

    inform ME AS to…

  30. #30 Jay Gordon, MD, FAAP
    January 25, 2013

    “Why he does it is anyone’s guess, but what is undeniable is that he can. He’s also become known as a “brave maverick,” which can be very seductive.”

    There is nothing great about being a medical maverick. You get criticized by people on all sides of any debate for not standing with the crowd. There’s no profit motive and not a lot of fame and glory either.

    “Or maybe he’s just shy. I’ve sat alone to eat meals at many a conference, particularly when I’m in a strange city where I don’t know anyone or at a conference where friends that I usually hang out with decided not to attend. I’m a little shy in person myself; I’ve never been the sort just to step up to a group of people whom I don’t know well and ask if they mind if I join them.”

    And this part is downright sweet, David. Me, too.

    Have a great weekend old friends.

    Jay

  31. #31 Science Mom
    http://justthevax.blogspot.com/
    January 25, 2013

    There is nothing great about being a medical maverick. You get criticized by people on all sides of any debate for not standing with the crowd. There’s no profit motive and not a lot of fame and glory either.

    Well sure but pandering to alt-med wingnuts and their acolytes doesn’t do anything for one’s credibility. You stick with the evidence.

  32. #32 Jay Gordon, MD, FAAP
    January 25, 2013

    If seeking credibility means skipping over parts of the truth, then the group with whom you’re seeking to be credible might not be worth that effort.

    I really like Ren’s comment #1 above. I even agree with Ren’s comments about the flu shot being very safe. We just oversell it when flu season has already arrived.

    Jay

  33. #33 LW
    January 25, 2013

    “how many people do we have to vaccinate with MMR in order to avoid one case of the measles? My guess is that number is a *lot* higher than 33 to 99. Probably something in the range of 100,000 or more, I would guess.”

    I wonder how these numbers are figured. If all pediatricians decided to follow Dr. Gordon’s advice, we’d have millions of susceptible children added to the population every year and we’d soon have regular epidemics with hundreds dead every year and 95% of the population having had the measles by adulthood. Oh, and thousands of babies born dead or with severe birth defects due to rubella.

    How do you calculate the number you need to vaccinate to avoid one case of measles? It seems to me the number is about one, since if no child were vaccinated basically all children would get the measles.

  34. #34 Science Mom
    http://justthevax.blogspot.com/
    January 25, 2013

    If seeking credibility means skipping over parts of the truth, then the group with whom you’re seeking to be credible might not be worth that effort.

    But that’s the problem; Dr. Jefferson is operating outside the realm of the existing evidence and is tarting it up to pander to kooks. He doesn’t need to do that. He’s done some good work and yes, it’s going to be resisted but he had to know that going into this.

  35. #35 Jay Gordon, MD, FAAP
    January 25, 2013

    How do you calculate the number you need to vaccinate to avoid one case of measles? It seems to me the number is about one, since if no child were vaccinated basically all children would get the measles.”

    That’s not right. It doesn’t even make sense.

    And, by the way, my advice always includes an honest discussion about the fact that 99% of pediatricians and vaccine experts disagree with me.

    Jay

  36. #36 Science Mom
    http://justthevax.blogspot.com/
    January 25, 2013

    How do you calculate the number you need to vaccinate to avoid one case of measles? It seems to me the number is about one, since if no child were vaccinated basically all children would get the measles.

    LW, yes that would essentially be correct if in the pre-vaccine era and nearly everyone got measles by or in their teens.

  37. #37 LW
    January 25, 2013

    Science Mom, If the question “how many do you need to vaccinate to avoid one case?” is asked in the aggregate, “how many do you need to vaccinate to avoid four million cases per year?”, it seems to me that the answer is “everyone who can be vaccinated”. So the answer on average is one case avoided per immunized individual.

    If some pediatricians got their way we would go back to the pre-vaccine era when nearly everyone got measles by or in their teens.

  38. #38 Narad
    January 25, 2013

    That’s not right. It doesn’t even make sense.

    Actually, Dr. Jay, it makes perfect sense, as that’s the asymptotic value, which the current steady-state value would be more than happy to plunge toward were your Brady Bunch routine to be taken seriously in any significant measure.

  39. #39 Darwy
    Røde grøde med fløde
    January 25, 2013

    “Or maybe he’s just shy. I’ve sat alone to eat meals at many a conference, particularly when I’m in a strange city where I don’t know anyone or at a conference where friends that I usually hang out with decided not to attend. I’m a little shy in person myself; I’ve never been the sort just to step up to a group of people whom I don’t know well and ask if they mind if I join them.”

    Personally, I think that’s normal. We like what’s familiar to us; I know when I’m at lunch, I look for folks from either the nanotox or økotox labs; the folks I work with. If others are there that I don’t know, I tend to find a seat to myself somewhere and eat my lunch alone.

    I’d rather not disturb a group of people who are having a discussion at their own table – plus I can stop and think about work and whatnot without interruption.

    The same goes for being at a conference or seminar. If I see someone I know, great. If not, then I’ll fly solo and have more time to chew on the ideas, etc.

  40. #40 Narad
    January 25, 2013

    There is nothing great about being a medical maverick. You get criticized by people on all sides of any debate for not standing with the crowd. There’s no profit motive and not a lot of fame and glory either.

    I guess Dr. Jay has just self-classified himself as something other than a “medical maverick,” although “99% of pediatricians and vaccine experts disagree with” him.

  41. #41 LW
    January 25, 2013

    I believe I understand the claim that “we need to vaccinate about 33 to 99 people to avoid one set of influenza symptoms.” I’ve read that in an ordinary flu season even without the vaccine only about 3% of the population gets the actual flu (as opposed to a flu-like illness), so if everybody gets vaccinated with a perfectly effective flu vaccine then 33 people will be vaccinated to avoid one set of influenza symptoms. Of course the vaccine isn’t perfectly effective so the number will actually be greater.

    But with measles we know from experience that without the vaccine essentially everyone will get the measles but if everyone is vaccinated that almost no one will get it (actually if everyone in the world were vaccinated we could eradicate measles just like smallpox). Hence, every person who is vaccinated is a case avoided.

    Perhaps someone could explain to me why this “doesn’t even make sense”.

  42. #42 THS
    January 25, 2013

    Learning a lot going from link to link. I could read all night. Thanks, again.
    WTF an organic fatwa?? A sliming, perhaps.

  43. #43 Narad
    January 25, 2013

    Perhaps someone could explain to me why this “doesn’t even make sense”.

    It “doesn’t even make sense” because Dr. Jay was braying like an ass. But your own reckoning is mistaken if one wants to say something meaningful at the present time. When incidence is low but nonzero, one has to increase immunization to cover the population from unpredictable importatiions.

  44. #44 LW
    January 25, 2013

    “When incidence is low but nonzero, one has to increase immunization to cover the population from unpredictable importatiions.”

    I don’t understand. Do you mean we need to increase from the current rate, which of course isn’t 100%?

  45. #45 Narad
    January 25, 2013

    I don’t understand. Do you mean we need to increase from the current rate, which of course isn’t 100%?

    The original question was how many people had to be vaccinated to prevent a single case of measles. The answer, in the U.S., at the present time, is essentially everyone who can be. The “100,000″ estimate from dandover was low; the birth cohort is about 4 million.

  46. #46 LW
    January 25, 2013

    Ah, I see, you’re saying that because measles can still be imported we need to vaccinate the whole birth cohort — four million — if we want to prevent even one case from occurring. Got it. Thank you.

  47. #47 LW
    January 25, 2013

    Or more clearly, because measles can still be imported we need to vaccinate the whole birth cohort — four million — if we want to ensure that no cases at all will occur.

  48. #48 dedicated lurker
    January 25, 2013

    Pregnancy might be a normal process, but it’s not a harmless one. Look at how many women died in childbirth in the past. Even today it happens with the best of medical care. Pregnancy is dangerous.

  49. #49 Narad
    January 25, 2013

    Ah, I see, you’re saying that because measles can still be imported we need to vaccinate the whole birth cohort — four million — if we want to prevent even one case from occurring.

    It’s a little trickier. Remember, the question was “how many to prevent one case,” by analogy with the flu routine. This is close to “even one case” by virtue of low incidence, but the former number is a bit different and could probably be calculated. For example, one could have two separate importations, only one of which is transmitted. This is hair-splitting, to be certain.

    Are you familiar with the notion of a ball atop a potential well?

  50. #50 lilady
    January 25, 2013

    Back again Dr. Jay?

    Still playing the role of the Brave Maverick Doctor?

    What’s your opinion about vaccinating a child where there is a family history of Multiple Sclerosis?

    What’s your opinion about vaccinating a child where there is a family history of autism?

    What’s your opinion about vaccinating a child where there is a family history of other neurological disorders and/or immune system disorders?

    http://www.youtube.com/watch?v=qAtDVabdru4

  51. #51 Pareidolius
    East Triskelion Brainwashing Salon and Dome Repair
    January 25, 2013

    Provider number 4 wagers 400 quatloos that Lovelyday = Leaf. The trembling, passive aggresive rage is palpable.

  52. #52 Pareidolius
    East of Wooville
    January 25, 2013

    Dr. Jay,

    So, what does it tell you that 99% of pediatricians and vaccine experts disagree with you? When I was a new age, alt med, worried well, card-carrying denizen of Wooville, it was fear that drove me to rail against vaccines and “western” medicine.
    What is the difference between you and Peter Duesberg? I don’t mean to insult you, this isn’t a personal comparison, but a situational one. The percentages of those in disagreement seem to be the same. 99% of the medical and biological sciences disagree with the HIV denialists. 99% of the pediatricians and vaccine experts disagree with you?

    Who do you think is wrong and why?

  53. #53 lilady
    January 26, 2013

    Marion County Oregon is reporting its first case of measles in 13 years.

    http://www.katu.com/news/local/Case-of-measles-reported-in-Marion-County-188290191.html

    The 5-year-old child had traveled to a foreign country and exposed people in crowded public places before he was hospitalized.

    How many people need to be immunized to prevent one or more cases of measles? Everyone who is age eligible and who doesn’t have a valid medical contraindication…to protect infants and those who have medical contraindications.

  54. #54 Khani
    January 26, 2013

    #23 Narad– I agree, that’s a death threat.

    Orac, please send this information with the ip address to the police so that if something happens to you, they know who to ask first.

  55. #55 Adam Jacobs
    http://dianthus.co.uk
    January 26, 2013

    This is all rather disturbing. A senior investigator from the Cochrane Collaboration really should know better than this.

    I wonder if it is part of a wider anti-pharmaceutical-industry mindset at Cochrane? They recently produced a quite startling biased review that dissed the pharmaceutical industry, based on a bizarrely twisted interpretation of the evidence. You definitely got the impression they wrote the conclusion first and then tried to make the evidence fit.

    More here:
    http://dianthus.co.uk/cochrane-review-on-industry-sponsorship

  56. #56 Militant Agnostic
    In the warmth of adiabatic compression.
    January 26, 2013

    I think dandover is trying to make an argument ad absurdum. Since measles is rare due to widespread vaccination there are few cases measles, so you would have to vaccinate a lot of people to prevent the few case that do occur and this large number can be used to make the MMR look ineffective.

    How old is Jefferson – I am wondering if this is the early manifestations of dementia.

  57. #57 LW
    January 26, 2013

    @Narad, you’re making an analogy to potential energy?

    Let’s go back to what Dr. Jefferson originally said: “we need to vaccinate about 33 to 99 people to avoid one set of influenza symptoms.”

    I read this like this: if the percentage of the population that would get the disease is X% when totally unvaccinated and Y% when totally vaccinated, then we need to vaccinate 100 / (X – Y) to avoid one set of symptoms. In the case of flu, X is 3, so if the vaccine is perfectly effective, Y is 0 and the number is 100 / 3 = 33, whereas if the vaccine is only modestly effective and Y = 2, then the number is 100 / 1 = 100.

    dandover at #8 then conflates that statement with “how many to prevent one case,” in an almost fully vaccinated population and comes up with,

    how many people do we have to vaccinate with MMR in order to avoid one case of the measles? My guess is that number is a *lot* higher than 33 to 99. Probably something in the range of 100,000 or more, I would guess. Is that evidence that the MMR vaccine is not very effective?

    But measles is so contagious that we know from history that the percentage of the population that would get the disease when totally unvaccinated, X%, is something like 95%, and the percentage when fully vaccinated, Y%, is close to zero. Hence, using Dr. Jefferson’s original reasoning, as best I interpret it, we need to vaccinate 100/95, or just a little more than one person to avoid one set of measles symptoms. 

  58. #58 dingo199
    January 26, 2013

    I don’t know if anyone else has mentioned it, but this week’s New England Journal of Medicine includes an analysis of pandemic flu in pregnancy, including vaccination. They looked at 117,000 preganacies. Vaccination cut the risks of having clinical influenza by 70% (and therefore probably virologically confirmed influenza by a whole heap more!)
    http://www.nejm.org/doi/full/10.1056/NEJMoa1207210?query=featured_home

    The conclusion?

    Pandemic influenza virus infection in pregnancy was associated with an increased risk of fetal death. Vaccination during pregnancy reduced the risk of an influenza diagnosis. Vaccination itself was not associated with increased fetal mortality and may have reduced the risk of influenza-related fetal death during the pandemic. (Funded by the Norwegian Institute of Public Health.)

    Not even pharma funded!!

  59. #59 lilady
    January 26, 2013

    @ dingo199: Your link unfortunately to the NEJM website is “undergoing maintenance”.

    Is this the Norwegian study you are referring to?

    http://www.healio.com/infectious-disease/vaccine-preventable-diseases/news/online/%7BF857A078-1D31-4387-A4EF-8D2ACDB2BA15%7D/H1N1-influenza-vaccination-unrelated-to-fetal-mortality

  60. #60 Denice Walter
    January 26, 2013

    You know, right after hearing Jefferson, I ran across two UPI reports about the severity of the flu in Europe and North America. Jefferson must be aware of these figures.

    I just found : “CDC admits to the flu vaccine’s ineffectiveness as a huge influx of flu victims fills hospitals…”,
    courtesy of Natural News’ Ethan Huff.

    I ask myself, “What’s wrong with these people?” What sort of bias do they have against a simple precaution ( the vaccine) and what prejudice do they have against pharmaceutical products? Why do they have to work so hard to build an edifice of spurious data against a vaccine?

    You have to remember that the audience of PRN or Natural News must already be biased ( or clueless) if they use these outlets for information about health. They are subjected to a barrage of bad information about the dangers and/ or inefficacy of all vaccines. Jefferson and reports about the CDC ( Huff twists the data a bit) add gravitas to whatever they’ve already learned from their instructors. And this material has been dense and thick these last few months at those sites.

    What bothers me is that these ‘brave mavericks’, in order to make a name for themselves or sell supplements**, risk the public’s health.

    ** both Null and Adams sell products and give information about how to avoid the flu.

    @ Militant Agnostic:
    I think Jefferson said he went to med school long ago or suchlike. Still, I wouldn’t call ‘dementia’ when we can attribute his ideas to ‘maverickitis incipientus’

  61. #61 lilady
    January 26, 2013

    @ Denice Walter: Jefferson is a medical doctor…which to me makes his remarks about flu vaccine even more offensive. His long rambling comments about ancient history and influenza outbreaks back then, were not germane to the discussion he had with Null. His remarks about the safety aspect of giving flu vaccine to pregnant women was so off-base and full of scare tactics, when multiple studies of fetal outcomes prove that the H1N1 vaccine and seasonal flu vaccines are safe for pregnant women and result in better fetal outcomes.

    He chooses to emphasize the downside of developing an effective trivalent seasonal flu vaccine every year using information about the prevalent circulating strains almost a years in advance….as if, we don’t know about those problems. He also chooses to emphasize the difficulties that the very young and the elderly have with mounting protective immune responses to the trivalent seasonal flu vaccine…as if we don’t know about these problems.

    Jefferson also claims that doctors, nurses and public health authorities are over-promoting the seasonal flu vaccine, by not informing the public about these problems…so, it “seems” that it is his *responsibility* to *educate* the public.

  62. #62 Denice Walter
    January 26, 2013

    Our brave mavericks would have us believe that the reason their ‘wisdom’ is not accepted by the mainstream is OBVIOUSLY because of malfeasance, skulduggery and interference by the powers-that-be guarding their own interests and income stream.

    Woo and conspiracy theories- a match made in heaven- the conspiracy explains exactly why brilliant hypotheses – and their creators- are not accepted by SBM.

    So, for your ‘enlightment’, chance would have it that GN extrapolated upon how his own rising star was shot down yesterday ( prn.fm/ Gary Null Show, 012513/ 26-32 minutes in):

    he tells the tale of how a heavy, bald man in a small car informed him about how his important work was sabotaged and how he was targetted by “plants”- operatives- who sought out dirt on him, tampered with his manuscripts and interfered with his possible contracts for television shows… perhaps even his annihilation would be in the cards because he DARED go against the cartel. Vicious lies were spun and women were used to try to sully his immaculate image and reputation. The poor, compromised fellow had a conscience after all: he warned Null because he found nothing wrong in his past.

    (32-46 minutes in) John Rappoport ( seen at Natural News)continues with his own investigation about how the same was done to Peter Duesberg who DARED uncover the truth about hiv.

    Operatives “cultivated” sources at the NCI etc who then instilled the “correct’ information for the media in order to keep the truth OUT of the mainstream and to make Duesberg appear foolish and mis-informed. It appears that experts and reporters are all in on the fix.

    Yes, it sounds so familiar:
    it was done to AJW and we’re doing it now to Jefferson.
    Shame on us!

  63. #63 Science Mom
    http://justthevax.blogspot.com/
    January 26, 2013

    DW, doesn’t anyone question the competence of these so-called operatives that they can’t even keep their ‘targets’ off the interwebz?

  64. #64 Narad
    January 26, 2013

    Hey, could anybody with institutional access swing me a copy of this? (Yes, I could write Fisman, but I’m bashful.)

  65. #65 Denice Walter
    January 26, 2013

    @ Science Mom:

    Oh, I know!
    I have heard the fat-bald-operative-in-a-small-car story several times and it keeps changing. It’s hilarious and I’m glad to have noted the date and time so others may enjoy it.

    Alt media writes about the encroachment of the ‘police state’ and censoring ON THE INTERNET and they BROADCAST their tales as well.

    There are however people who live in REAL police states and who suffer ACTUAL oppression and censorship in both the past and the present. These woo-drenched idiots compare themselves to those who are unfortunate victims of unfairness and criminality.

  66. #66 Narad
    January 26, 2013

    I read this like this: if the percentage of the population that would get the disease is X% when totally unvaccinated and Y% when totally vaccinated, then we need to vaccinate 100 / (X – Y) to avoid one set of symptoms.

    I’m not trying to give you a hard time, LW, but that’s a faulty calculation. For one thing, you’re assuming a time-independent, linear continuum between “endemic” and “eradicated.”

  67. #67 herr doktor bimler
    January 26, 2013

    Hey, could anybody with institutional access swing me a copy of this?

    Grabbed a copy. You got a temporary e-address to send it? Or some preferred site to upload it?

  68. #68 Narad
    January 26, 2013

    Grabbed a copy. You got a temporary e-address to send it? Or some preferred site to upload it?

    Let’s try vawlwkpx@sharklasers.com.

  69. #69 herr doktor bimler
    January 26, 2013

    Done.

  70. #70 Narad
    January 26, 2013

    Received, thanks. Would you like an ack from a real address?

  71. #71 Grant
    Trying to dig up stats on careers for PhD graduates
    January 26, 2013

    Narad, HDB,

    Looks an interesting paper, that, but I’d better try not get distracted… :-)

  72. #72 Grant
    January 26, 2013

    Narad,

    Isn’t Orac’s place a real place ;-) (JK)

  73. #73 herr doktor bimler
    January 26, 2013

    Would you like an ack from a real address?

    You might as well, to speed up the provision of other papers in the future.

  74. #74 Science Mom
    http://justthevax.blogspot.com/
    January 26, 2013

    Darn, I should have read ahead. Oh well, it’s a good one for me to have.

  75. #75 lilady
    January 26, 2013

    dingo199′s link to the NEJM article abstract on safety and fetal outcomes for pregnant women who received the H1N1 pandemic flu vaccine is now “up”:

    http://www.nejm.org/doi/full/10.1056/NEJMoa1207210?query=featured_home

    “Dr” Gary Null’s interview of Dr. Tom Jefferson is not the first time…nor, I fear, the last time, when Jefferson uses his bully pulpit to disparage the WHO and the CDC with his rants. (Special *thanks* to the pig farmer at whale.to for this link)

    http://www.spiegel.de/international/world/interview-with-epidemiologist-tom-jefferson-a-whole-industry-is-waiting-for-a-pandemic-a-637119.html

  76. #76 Narad
    January 26, 2013

    Looks an interesting paper, that, but I’d better try not get distracted…

    I’m only ~20% in, but it indeed is. I’m finding it particularly helpful in laying out some SIR concepts in plain terms. It had never really sunk in for me that coverage and efficacy are interchangeable in the basic equations, for example.

  77. #77 Mr Magoo Jr
    January 26, 2013

    Narad,

    Do you have any idea why the CDC wants you to be dumb? Here is the reason.

    “Currently, the Centers for Disease Control and Prevention (CDC) recommends that a positive IgM result from a person who has received measles vaccine between 6 and 45 days prior to testing cannot be interpreted (8). ”

    ht_tp://www.ncbi.nlm.nih.gov/pmc/articles/PMC121349/

    I just laughed at you guys trying to be smart.

  78. #78 Narad
    January 26, 2013

    I would note in passing that things get a bit stranger with a link to the Epoch Times on the Cochrane site.

  79. #79 Lawrence
    January 26, 2013

    Damn, insano-troll is really getting desperate for attention…..

  80. #80 Science Mom
    http://justthevax.blogspot.com/
    January 26, 2013

    “Currently, the Centers for Disease Control and Prevention (CDC) recommends that a positive IgM result from a person who has received measles vaccine between 6 and 45 days prior to testing cannot be interpreted (8). ”

    ht_tp://www.ncbi.nlm.nih.gov/pmc/articles/PMC121349/

    Why is it the more foolish people are, the more they tend to “laugh”? This should be pretty straight forward; it’s really not complicated.

  81. #81 Narad
    January 26, 2013

    I just laughed at you guys trying to be smart.

    Sorry, assmunch, that’s a fail.

  82. #82 Narad
    January 26, 2013

    Anyway, Cochrane indeed calculate NNV from extracted risk difference (and VE from extracted risk ratio). It’s timeless.

  83. #83 Narad
    January 26, 2013

    Am I missing something, or should the lc ital l‘s in Tuite & Fisman’s eqs. (2.0)–(3.2) be I‘s?

  84. #84 Narad
    January 26, 2013

    Freaking sans serif. The question is whether they should be cap ital ‘eye’ rather than lc ital ‘ell’.

  85. #85 herr doktor bimler
    January 26, 2013

    Why is it the more foolish people are, the more they tend to “laugh”?
    Doctors Dunning and Kruger might be able to help you there.

  86. #86 Chris
    Neither here nor there...
    January 27, 2013

    Science Mom:

    Why is it the more foolish people are, the more they tend to “laugh”?

    I saw this quote on JustTheVax from brave “Anonymous.” It is obviously Thingy trying to reply because she got banned here.. again.

  87. #87 al kimeea
    www.quackademiology.com
    January 27, 2013

    ‘maverickitis incipientus’ all coyote-like, no doubt has an Acme points card

  88. #88 dingo199
    January 27, 2013

    In view of the evidence that influenza vaccines prevent flu in pregnant women and are associated with a reduction in fetal death, perhaps we should address anyone who advises against vaccination as “Baby killer”?

  89. #89 Science Mom
    http://justthevax.blogspot.com/
    January 27, 2013

    @ Dingo, that study did not find any statistical significance between the groups and foetal deaths. I don’t think that kind of language is helpful and sounds every bit as histrionic as anti-vaxx claims.

  90. #90 lilady
    January 27, 2013

    @ Science Mom: I think dingo199 was being facetious.

    I hope that Dr. Jefferson is pleased with himself, because his interview is the subject of “Dr.” Null’s blog. He’s in the company of many of the luminaries of the anti-vaccine world…Sherri Tenpenny, Randall Neustaeder and Vera Scheibner:

    http://gna.squarespace.com/home/gary-null-a-forgotten-medical-truth-flu-vaccination-is-not-e.html

  91. #91 dingo199
    January 27, 2013

    Yes, I was being a bit tongue in cheek.
    You are of course quite right scimom.
    But it’s still worth keeping up one’s sleeves if the rabid antivaccine claims espouse the opposite view.

  92. #92 lilady
    January 27, 2013

    I had difficulty understanding what Dr. Jefferson’s objections are to vaccinating pregnant women…aside from unsupported by-science and unsupported-by-studies of adverse events using the VAERS and the Vaccine Safety Datalink reporting systems:

    http://www.cdc.gov/flu/protect/vaccine/qa_vacpregnant.htm

    Here’s another article that supports immunization of pregnant women with flu vaccines because of the protective maternal immunities that are transferred to infants:

    http://japha.org/article.aspx?articleid=1043984

  93. #93 Denice Walter
    January 27, 2013

    @ lilady ( #90):

    That’s the same article I mentioned @ #18 above. He has a ton of similar dreck floating about the internet written over the past 2-3 years.
    See also prn.com articles; the mouldy oldie articles at Gary Null.com are missing.

    I’m sure his trash will wash ashore at one of our fave anti-vax sites.

    It’s hard to estimate how much influence or how many readers/ listeners GN has- for a few reasons-
    1. he claims “millions’ of followers via prn. Right.
    2. his facebook numbers are low ( 6K- unlike Adams’ or Mercola’s 250K) However he probably has an older cohort who may not use fb as much.- so not the best measure.
    3.Also his stuff plays over real radio/ tv ( fundraisers) as well as internet radio; other sites cite him frequently. He writes books and gives lectures.
    His new tact is to offer his shows over phone apps by dialing a number using minutes for a fee.

  94. #94 Science Mom
    http://justthevax.blogspot.com/
    January 27, 2013

    Sorry dingo, that one obviously zoomed right passed me.

  95. #95 inearlychokedonyourcrap
    uk
    January 27, 2013

    You guys do realise that Ben Goldacre is in Jeffersons camp in the fight againts pharma BS, along with the editor of the BMJ and many other very prominent phycisians and researchers. The amount of adhomien attacks and fallacical arguements here is astounding…you guys are just as bad as the sCAM people and its pathetic really. I suggest you all go read bad pharma before its too late and you end up labelled as defenders of bad science. Too late for that imo.
    Ps. Would love to see orac take on goldacre on the tamiflu debacle and hear his thoughts on goldacres book bad pharma. I doubt he will fair any better than that other numpty Whitehead of the ABPI. How embarrasing it must have been for all you shills to read goldacres reply in new statesman.

  96. #96 flip
    January 28, 2013

    Which regular was it who said that people have been co-opting Goldacre into being against Big Pharma?

    They win an internets cookie…

  97. #97 Krebiozen
    January 28, 2013

    Which regular was it who said that people have been co-opting Goldacre into being against Big Pharma?

    I think that was Denice. To be fair, Ben Goldacre is very outspoken against the bad behavior of pharmaceutical companies of which there is, unfortunately, no shortage of examples. The sCAM folks seem to misunderstand this to mean that Goldacre shares much wider conspiracy ideas and a general mistrust of conventional medicine. He doesn’t and has, for example, said that he would take Tamiflu in the event of a pandemic and has also stated that “As a doctor, I am passionate about ‘evidence-based medicine’”.

  98. #98 dandover
    Near the end (?) of a long comment thread
    January 28, 2013

    @MilitantAgnositc (56):

    Thank you. That is precisely what I was getting at. Dr. Jefferson is spouting off nonsense like, “we need to vaccinate about 33 to 99 people to avoid one set of influenza symptoms”, under the pretense that it somehow demonstrates the vaccine’s ineffectiveness. It doesn’t.

    I can’t believe that my comment was interpreted such that I was assumed to be anti-vaccine by some folks here. How embarrassing. I’ll have to be much more careful in the future.

    The MMR works, I know it works, and Dr. Jefferson is a dope. (Hopefully that can’t be misconstrued. :)

  99. #99 Science Mom
    http://justthevax.blogspot.com/
    January 28, 2013

    @ 95, I don’t know how you derived your conclusions about what is going on here but it looks pretty warped. I highly doubt that Dr. Goldacre would support your wild-eyed interpretation of his mission either. And I have thoroughly read “Bad Pharma” and really enjoyed it.

    Dr. Jefferson has done some very good work and has shone a light on a problem with influenza vaccine studies. However, he does his credibility no favour by appearing on shows and associating with frauds and liars and making ludicrous statements that go beyond the scope of his work.

  100. #100 dingo199
    January 28, 2013

    Jefferson: “We need to vaccinate about 33 to 99 people to avoid one set of influenza symptoms”

    This entirely misses the point.

    We are not trying to stop people getting “influenza symptoms”, any more than when we vaccinate against measles we are trying to “avoid symptoms of a rash”.

    We are trying to avoid influenza (and even Jefferson concedes that the vaccines are around 70-75% effective when matched for the prevalent strains).

    So what is his problem? Just because some people (including him) like to lump viral respiratory symptoms from whatever cause under the banner of influenza, or because estimates of flu mortality are innacurate, or there are fewer cases of confirmed/true flu than some statistics suggest, or because some pharma companies like to talk up the risks of flu to sell their drugs…… none of this negates the fact that there is a vaccine that offers a degree of protection against influenza that any sCAM/alt med/integrative health outfit would positively kill for in order to claim a similar degree of proven efficacy.

    Oh, and the flu vaccine saves babies lives and keep pregnant women (and their babies) alive too. What’s not to like?

  101. #101 Dangerous Bacon
    January 28, 2013

    The obvious conclusion is that Dr. Jefferson cares far less about his credibility in the world of science, than he does about garnering maximum publicity by being the alties’ go-to Brave Maverick who defies the Establishment.

    He can’t get anywhere near as much attention solely by turning out sober reviews for the Cochrane Collaboration. And if he plays his cards right, books and lucrative speaking tours could be in the offing.

  102. #102 LW
    January 28, 2013

    I was talking to someone last night who said he didn’t bother getting the flu vaccine because “it’s only about 70% effective”. I absolutely don’t understand that. Half a loaf, or in this case 70% of a loaf, is better than none.

  103. #103 Todd W.
    harpocratesspeaks.com
    January 28, 2013

    @LW

    “Which would you rather have: no chance of additional cash or a 70% chance of getting $100,000?”

    - or conversely -

    “Would you rather a 0% chance of preventing a bullet shot at you from causing harm or a 70% chance of preventing injury?”

  104. #104 LW
    January 28, 2013

    “Which would you rather have: no chance of additional cash or a 70% chance of getting $100,000?”

    I think $100K is too much for the analogy, but even a 70% chance of getting $100 would be nothing to sneeze at. The vaccine would cost him nothing — he’s on Medicare — and it’s hardly inconvenient to get when every grocery store around here has signs offering flu shots (he’s retired so wouldn’t get it at work as I did). As I said, I just do not understand that decision.

  105. #105 Antaeus Feldspar
    January 28, 2013

    You guys do realise that Ben Goldacre is in Jeffersons camp in the fight againts pharma BS, along with the editor of the BMJ and many other very prominent phycisians and researchers. The amount of adhomien attacks and fallacical arguements here is astounding…

    Sorry, but you lost from the moment you started talking about who is in whose “camp,” because that’s not the way science works. If Goldacre looked at the evidence and it put him against all those “many other very prominent phycisians [sic] and researchers,” he’d adhere to the evidence and not to the people. And they’d disagree (civilly, one expects) until the disagreement on the interpretation of the evidence was resolved.

    That doesn’t mean, of course, that Goldacre would ally himself with the sort of people who constantly spout illogical contrarian BS, as long as they happened to agree with him on that one issue. That is what distinguishes Goldacre from Jefferson; in the very best-case scenario, Jefferson has made exactly that short-sighted mistake, not realizing that having Gary Null on your side does absolutely nothing to establish credibility in the eyes of the scientifically minded.

  106. #106 Denice Walter
    January 28, 2013

    I’ve heard Goldacre mentioned a few times by alt med folk ( GN, someone else- don’t recall who) which I’ve reported here.

    Here’s how they weave realistic SB criticism into their imbroglio of confabulation and ‘bad science’:
    they’ll take a statement from BG – or someone similar- listing the negative aspects of a particlar drug or pharmaceutical company, leaving out the reasons why the drug is useful. Then they add pseudo-scientific so-called studies and opinions which they hint are the SB person’s opinion as well, making it appear that there is much more agreement than is based in reality.

    They probably assume that most fo their audience will not read the whole paper/ book which BG (or another critic )wrote or understand his MO and aims.

    This tendency to selectively quote and use SB material and researchers’/ writers’ opinions has led to some truly ridiculous episodes as when they solemnly quote the “editor of the BMJ” WITHOUT mentioning her name because some of the faithful might identify her as being firmly rooted in SBM contra one of their ‘best boys”- AJW- and much despised in Woo-topia. Another episode involved talking about the how dangerous Vioxx was to someone who *investigated* the pharmaceutical company responsible. Hilarity reigns again.

    It should be noted that the one gaping hole in their audience’s knowledge base involves a historical fact:
    SBM has eradicated much of the UN-TREATED progression of cancer, hiv/aids and SMI, as well as VPDs’ sequelae, so they never see what un-treated illness looks like.

    People who study disease and history can tell you what those looks like- thus they are not susceptible to tales about how meds CAUSE those terrible illnesses and complications. If you’re old enough, you can remember when there were no mesd for hiv/aids and the awful progression of the virus consumed the lives of many victims, quickly and terrifyingly.

  107. #107 Denice Walter
    January 28, 2013

    edit:
    what those LOOK like
    MEDS

    sorry, I was in a rush.

  108. #108 THS
    January 28, 2013

    Not only am I old enough to remember no medicine for HIV/AIDS, I’m old enough & educated enough to remember when there were no anti-viral drugs and the development of anti-viral drugs was regarded as a very difficult task, darn near impossible – something for the future. The defense against viral disease was vaccination. Still is – ironic that, in the case of HIV, effective anti-viral drugs have been developed before an effective vaccine — and that is a both tribute to the determination and smarts of biochemists, molecular biologists & related ilk, and also a reminder of the complexities of immune function and viral strategies.

    Don’t like Pharma? Google Gertrude Elion. An inspiration to us all, doing Nobel Prize work (no Ph.D., either) in a pharma lab. She’s one of my favorite scientists.

  109. #109 Rogue Medic
    http://roguemedic.com/
    January 28, 2013

    inearlychokedonyourcrap,

    Ignorance is bliss in the antivax world.

    Dr. Goldacre writes about the bad things the drug companies do, but he also writes about the fraud of the people who claim that vaccines are bad.

    Orac writes about the bad things the drug companies do, but he also writes about the fraud of the people who claim that vaccines are bad.

    Others here, and I, write about the bad things the drug companies do, but he also writes about the fraud of the people who claim that vaccines are bad.

    The only camps are those of the quacks, who seem to value fraud over reality.

    Perhaps you could actually read what people write, rather than attempting to project your ignorance onto others, then you wouldn’t spend so much of your time choking on crap. The crap you will get here is your own crap returned with a rebuke, or several.

    .

  110. #110 flip
    January 29, 2013

    @Krebiozen

    I think that was Denice. To be fair, Ben Goldacre is very outspoken against the bad behavior of pharmaceutical companies of which there is, unfortunately, no shortage of examples. The sCAM folks seem to misunderstand this to mean that Goldacre shares much wider conspiracy ideas and a general mistrust of conventional medicine. He doesn’t and has, for example, said that he would take Tamiflu in the event of a pandemic and has also stated that “As a doctor, I am passionate about ‘evidence-based medicine’”.

    Repeated for goodiness …

    Also, these people who jump to conclusions obviously never spend time in the glorious Bad Science forums, or his blog. Both quite clearly throw flames over much of what woomeisters love.

  111. #111 steve m
    January 29, 2013

    Sorry to derail this commenthread but mentions of flu vaccines for pregnant women (above) reminded me of a report I saw a few months ago correlating fever during pregnancy to higher incidence of autism. I was looking for Orac to address this claim but never saw one. To me, that report’s saying ANTI-vaxers are INCREASING the incidence of autism by convincing women to avoid flu vaccines and suffering fevers during pregnancy. Thus, vaccines are correlated to autism; just ANTI-correlated not PRO-correlated. So Wakefield was not just wrong but inverse wrong.
    Still, I’m so ignorant, I’d really like Orac to write a piece about this study and educate me (and us) a little. I tried to write to Orac directly (requesting this) but could not find his email. Please, Orac, please. Thanks, regardless.

  112. #112 Todd W.
    harpocratesspeaks.com
    January 29, 2013

    @steve m

    The folks over at the Thinking Person’s Guide to Autism or Just the Vax may have covered that. You might also check Left Brain Right Brain.

    As for contacting Orac, if you click on his name, it’ll take you to the “About” info, which includes his email.

  113. #113 Bob W.
    LA
    January 30, 2013

    Hello to all.
    I’m new here, but have been looking at the blog for some time. Love the Orac pieces and the commentary. Nice to see such rational folks take on the world of quackery! Got to run (darned job) but will have some questions for you fine folks soon. (My sis has descended into true “woo” stuff. Guess it goes with the turf out here in LA). Anyway, keep up the fine work!

  114. #114 Ron Law
    Auckland, New Zealand
    February 1, 2013

    Dingo says, “We are trying to avoid influenza [original highlighted] (and even Jefferson concedes that the vaccines are around 70-75% effective when matched for the prevalent strains).”

    Dingo, what Jefferson is rightly saying is that the vast majority of what people talk about as being influenza is not INFLUENZA but rather influenza-like. Even when doctors diagnose influenza most people test negative to the influenza virus.

    About 1/3rd of people infected with the influenza virus have no symptoms at all. About 1/3rd have symptoms other than hyperpyrexia, and only about 1/3rd have symptoms including high temperature.

    The PR-Doktors promote ILI stats when promoting the flu vaccine, yet only use confirmed influenza cases when touting effectiveness. Isn’t that a double-standard?

  115. #115 Ron Law
    February 2, 2013

    Orac, I find it interesting that you have laid into Jefferson just because he spoke with Null. Why don’t you try critiquing his meta-analysis and dissect his science? Have you actually read the Cochcran Reviews paper? If so, why don’t you critique the science?

    You say, “Fortunately for all of us, the H1N1 fear mostly fizzled, but public health officials were in a bad place. Under-react, and if the pandemic turned out to be as bad as the worst case scenarios predicted before the pandemic, and they’d be crucified for not having done everything they could to prevent it and mitigate its effects. Over-react, and they’d be blamed for frightening the public unnecessarily and wasting resources. In the end, with the perfect hindsight of the retrospectoscope, we now know that the pandemic was not bad as anticipated, but there was no way to know that prospectively going in.”

    But ignore the inconvenient trust that countries such as New Zealand and Australia had survived their winter of Panic Flu with far fewer deaths than normal… the health systems had coped well… mainly because many of the patients admitted were admitted “just in case” not for clinical reasons.

    US health officials new full well that the H1N1 influenza virus masquerading as a pandemic has a very low death rate and was not as bad as the worst case scenarios predicted before the pandemic… so no retrospectoscope was needed in Aug, Sep, Oct before the vaccine became available in the usa…

    I thought you were an objective commentator…

  116. #116 Antaeus Feldspar
    February 2, 2013

    we need to vaccinate about 33 to 99 people to avoid one set of influenza symptoms.

    Two things that strike me about this…

    I’m sure that I’ve put on my seatbelt easily 999 times to prevent one instance of getting into an accident without it. Doesn’t strike me as a bad ratio.

    Since it’s well-known that herd immunity only kicks in when you have a critical mass, I wonder if the “33 to 99″ figure is what most people would assume it to be, a representation of what the “effort to effect ratio” is as it scales up … or a deceptively reported representation of what the ratio is at its worst point, at the very beginning. (If you were a sophist caveman trying to decry the use of that dangerous “fire” stuff, you might sneer that it required *four people* collecting kindling and brush to maintain a fire to keep *one* person warm… and ignore the fact that the same fire that keeps *one* person warm will warm two, or four, or eight… it doesn’t require four people *per* one person warmed.)

  117. #117 Science Mom
    http://justthevax.blogspot.com/
    February 2, 2013

    Orac, I find it interesting that you have laid into Jefferson just because he spoke with Null. Why don’t you try critiquing his meta-analysis and dissect his science? Have you actually read the Cochcran Reviews paper? If so, why don’t you critique the science?

    Because this is a post about a seemingly reputable investigator pimping himself out to nutters like Gary Null, not his actual reviews. Dr. Jefferson may be a heretic but if you want to ultimately come down on the “right” side of things, you stick to the evidence, not go attention-whoring via quack-peddling loons.

    I have read all of the Cochrane influenza vaccine reviews and I take them very seriously; they highlight the tremendous gaps we have in influenza vaccine and influenza epidemiology. It’s hard to take Dr. Jefferson the persona seriously when he behaves this way.

  118. #118 dingo199
    February 4, 2013

    And yet another publication hits the streets to show influenza vaccination is safe and is associated with a 32% reduction in perinatal mortality.

    http://www.bmj.com/content/346/bmj.f393

  119. #119 lilady
    February 4, 2013

    @dingo199: So, when Tom Jefferson goes off on a rant about influenza vaccine for pregnant women…should we be referring him to this newly published study?

    Jefferson will not be pleased that the researchers on that study keep discussing *pandemic influenza*, because he’s upset that the WHO changed the definition of “pandemic” without consulting him. (at 1:45 minutes into the video):

    http://www.youtube.com/watch?v=7HdJ4n0Ewu4