Respectful Insolence

Of all the cranks, quacks, antivaccinationists, and pseudoscientists that I’ve encountered (and applied a bit of not-so-Respectful Insolence to) over the years, there are a few who belong in the top tier—or, if you prefer, the bottom tier. They stick out in my memory for a variety of reasons, either through their sheer crankitude on a variety of subjects (such as Mike Adams), sheer persistence on one subject (such as Jake Crosby or any of the denizens of the antivaccine crank blogs Age of Autism or The Thinking Moms’ Revolution), or fame for promoting quackery (Joe Mercola). One of these elite few, however, does something that’s very useful to quacks everywhere and results in tons of Facebook and Twitter memes that seem convincing to people who don’t know that they distort scientific studies to make it seem as though they support some quackery or other. In fact, with his his partner in woo, he forms a not-so-dynamic duo who run an entire website whose sole purpose is to list studies that can be spun to support pseudoscience and quackery and then, of course, to spin some of them to support pseudoscience and quackery.

I’m referring, of course, to Sayer Ji, and his website GreenMedInfo, a website that subverts legitimate research and misrepresents science in order to support “natural medicine.” Examples of the sort of “intellectual firepower” Ji brings to the issue of “natural medicine” include a post in which he described biotech and vaccines as “cannibalism” and another post in which he tries to represent evidence-based medicine as being no more reliable than a coin flip. The list goes on. I guess that the only consolation is that Sayer Ji (and, apparently Gary Null) really, really like me.

Recently, I became aware of a post that appeared on GreenMedInfo that attempted to use a recent study to claim something that the study doesn’t show. It’s a nice little case study of how science is routinely twisted by cranks to serve their own purposes entitled HPV Vaccine Maker’s Study Proves Natural HPV Infection Beneficial, Not Deadly. It’s written by Sayer Ji and, because seemingly Ji can’t drop such a turd on the world without help, Dr. Kelly Brogan. I haven’t actually dealt with Brogan before, as far as I can remember, but if she works with Sayer Ji, that tells me pretty much everything I need to know about her—well, that, and the panoply of misinformation she lays down in her articles for GreenMedInfo. There’s also her website in which she says she’s practicing “holistic women’s health psychiatry” (whatever that means). What it appears to mean is that she embraces all manner of non-evidence-based woo like homeopathy, acupuncture, antivaccine views, anti-GMO views, and pretty much every kind of medical nonsense I’ve come across. Indeed, her website is such a—shall we say?—”target-rich” environment that I suspect I will visit it again. In fact, this particular article implying that “natural” HPV infection is better at preventing cervical cancer than the vaccine—I kid you not!—is also posted on her website. Nice, job getting a co-authorship without even trying.

In any case, Brogan’s and Ji’s article is festooned with a picture of an attractive young woman holding her hand up as though she is a cop stopping traffic. Amusingly, the version of the article on Brogan’s website has a different woman holding her hand out in the “stop” gesture. Be that as it may, the article starts out by asserting:

Behind every vaccine is an assumption. That HPV causes cervical cancer, that cervical cancer causes death, and that a vaccine can effectively interfere with this linear relationship is the assumption to be examined in this article. Cervarix is a vaccine recommended to girls beginning as early as 9 years old, intended to protect against HPV strains 16 and 18 upon completion of a 3 dose series. It is an aluminum-containing product, with notable “immunogenicity”.

Actually, it’s not an “assumption” that certain serotypes of HPV can cause cervical cancer. Nor is it an “assumption” that cervical cancer can cause death. Nor is it an “assumption” that a vaccine can prevent HPV infection. It’s all science. It’s all been shown. I did notice, though, how she managed to slip in an antivaccine trope about “aluminum,” complete with a link to a bunch of scientific articles purporting to demonstrate the dangers of aluminum, in the classic manner of GreenMedInfo: Without context. Similarly, Dr. Brogan cites a paper that seems to suggest that the HPV vaccine isn’t that good at protecting against high-grade squamous intraepithelial lesions, dysplasias. Of course, it’s just one article, a retrospective study, and the authors themselves write:

…our findings are still consistent with the results of prelicensure and follow-up RCTs (reviewed in Lu et al5). Although the QHPV vaccine was shown to be effective (> 90%) against HPV 16/18-associated dysplasia, VE in practice is likely much lower because these types are only responsible for approximately half of HSILs [high-grade squamous intraepithelial lesions] and a quarter of LSILs [low-grade squamous intraepithelial lesions]. Moreover, these high VE estimates were only observed in per-protocol analyses that were typically limited to HPV-naive women who received all three doses.

And:

However, the allocation of vaccination was not random in this study, so confounding and bias because of differential uptake of screening (detection bias) cannot be ruled out. In our population, vaccinated women were more likely to undergo Pap screening after enrollment. The resulting detection bias tends to mask VE [vaccine effectiveness] because transient cervical abnormalities are more likely to be detected among the more screened vaccinated women.

So in other words, the design of the study tended to mask vaccine effectiveness, and a recent systematic review and meta-analysis showed the vaccine to be very effective in preventing infection with the HPV subtypes protected against by Gardasil (the quadrivalent HPV vaccine). In other words, Dr. Brogan cherry picked her data.

Now let’s see her analysis of the current study, a report on the PATRICIA study (Papilloma Trial against Cancer in Young Adults), entitled Risk of newly detected infections and cervical abnormalities in women seropositive for naturally-acquired HPV-16/18 antibodies: analysis of the control arm of PATRICIA. I’ll briefly boil down what the study showed. Basically, Castellsagué et al examined the risk of newly acquired HPV infection and cervical abnormalities and its correlation to antibody levels for HPV-16 anad HPV-18 antibodies in the control arm of the PATRICIA study.

Basically, the investigators took advantage of the intensive followup of the control arm and the size of the trial to ask a question: Does the antibody response that occurs during natural infection result in any protection against newly acquired HPV infections and the development of cervical abnormalities. The study subjects included women aged 15-25 years old with no more than six lifetime sexual partners, who were randomized to receive either Cervarix or the control hepatitis A vaccine. They underwent frequent Pap smears, with a highly defined method of being examined for cervical changes. Cervical samples and biopsy materials were also tested for HPV DNA and serum samples collected were tested for antibodies to HPV-16 and HPV-18. Endpoints included incident infection (which could include newly acquired infections or recurrent infections present below detection levels at baseline), 6- and 12-month persistent infection, atypical squamous cell of undetermined significance or greater (ASC-US+), cervical intraepithelial neoplasia (CIN) grade 1 or greater (CIN1+), and CIN grade 2 or greater (CIN2+) associated with HPV-16 or HPV-18. (The various CINs are abnormalities of increasing severity between normal cells in the cervix and fully invasive cancer. The higher the grade, the worse the changes.) The analysis included only women who had potentially been exposed to HPV infection via sexual intercourse and those without current HPV infections at baseline. This was done to make sure that only newly detected infections after vaccination were analyzed. A total of 8,193 (1,246 HPV-16-seropositive [15.2%] and 6,947 HPV-16-seronegative [84.8%]) and 8,463 (916 HPV-18-seropositive [10.8%] and 7,547 HPV-18-seronegative [89.2%]) women were included in the analysis.

The authors found:

High titers of naturally-acquired HPV-16 antibodies and/or linear trend for increasing antibody levels were significantly associated with lower risk of incident and persistent infection, atypical squamous cells of undetermined significance or greater (ASC-US+), and cervical intraepithelial neoplasia grade 1, 2 or greater (CIN1+, CIN2+). For HPV-18, while seropositivity was associated with lower risk of ASC-US+ and CIN1+, no association between naturally-acquired antibodies and infection was demonstrated. Naturally-acquired HPV-16 antibody levels of 371 (95% confidence interval: 42–794), 204 (129–480) and 480 (250–5756) EU/mL were associated with 90% reduction of incident infection, 6-month persistent infection, and ASC-US+, respectively.

What does this mean? Basically, it means that the women in the study developed an antibody response to naturally acquired HPV-16 and/or HPV-18 infection, and in some of these women the antibody response appeared to protect against the precancerous cervical lesions caused by HPV infection. Specifically, the study results indicated that antibodies from natural infection against HPV-16 lowered the risk for a newly detected infection (i.e., re-infection with HPV of the matching subtype), atypical squamous cells of undetermined significance or greater (ASC-US+), and cervical intraepithelial neoplasia grade 1, 2 or greater (CIN1+, CIN2+). Moreover, this protection exhibited a dose-response effect. In other words, the higher the natural antibody level, the lower the risk of reinfection. The effect for HPV-18 was much less.

Hilariously, Dr. Brogan objected to the use of the hepatitis A vaccine as a control, intoning that because “there are no vaccine studies in existence using a true non-vaccinated control group, the natural incidence of a disease, as well as the true risks of a vaccine cannot be effectively assessed.” I just mention that because it’s yet more evidence of her and Ji’s antivaccine views. If both groups are vaccinated, even if the vaccines are entirely different, then the study is crap to them. More tellingly, Ji and Brogan (or is it just Dr. Brogan?) attacks a massive straw man:

Given that the entire justification for vaccination is based on the observation that surviving natural exposures to infectious challenges results in lasting immunity, this finding is not that surprising. HPV is no doubt one of countless infectious challenges the body’s elaborate and highly effective adaptive immune system countermands, often subclincally/asymptomatically[1] . Even the authors of the study acknowledged: “Naturally acquired antibodies can remain detectable for at least 4 to 5 years, albeit at much lower levels than those induced by vaccination.” Given the outcomes demonstrating protective efficacy of these lower levels of antibodies, questions may be raised about other elements of the immune system at play in successful pathogenic defense.[2]

The stupid, it burns. Notice the verbal prestidigitation. Brogan and Ji admit that “natural” infection results in antibody production at a much lower level than vaccination does. Yet they still try to imply that this observation, that these antibodies when produced, can be productive. Think of it this way. Only 15% of women continued to have a detectable antibody response to HPV-16 and only 11% to HPV-18. In those women, if you look at the graphs and tables in the paper, you’ll see that the women who were seropositive for HPV-16 had a relative risk of a new HPV-16 of only 0.67 (a decrease by about a third). In other words, only 15% of these women had an antibody response, and those who did only had their risk of reinfection decreased by one third. That’s the best result. For HPV-18, the protective effect of “natural” antibodies against reinfection barely registered.

Once again, Brogan and Ji are attacking the proverbial straw man. The justification for vaccination might be that surviving naturally acquired infectious disease can lead to long-lasting immunity, but the mechanisms by which that happens are different for different diseases, and antibody levels don’t always correlate closely with immunity. This is because other mechanisms might be at work, such as cell-mediated immunity, which doesn’t rely on antibodies the way that antibody-mediated immunity does. None of this stops Dr. Brogan from trying to twist the results of this study into some sort of repudiation of our understanding of immunology and implication that “natural” HPV infection is better than the vaccine, even though the vaccine produces antibody titers that are many-fold higher than even the highest levels of “naturally” acquired antibodies.

None of this stops the obfuscation:

The authors reference the acquisition of identifiable antibodies in only 50-70% of women infected with HPV-16 or 18. What is happening in the rest of the cases? The authors suggest that those with previous infection but without antibodies may have mounted a cell-mediated response that also conferred protection not assessed in this study (or acknowledge to be relevant by vaccine manufacturers). This is tacit acknowledgement of the biochemical individuality that underlies immune response, rendering a reductionist one-size-fits-all model inappropriate for preventive medicine.

OF course, these antibody responses tend to be transient. Moreover, this study shows that it’s the women in which these antibodies persist who are at lower risk for subsequent reinfection and cervical changes associated with the development of cervical cancer. The women who were not seropositive in this study were at the highest risk for reinfection by HPV-16 and HPV-18. Contrary to Brogan’s and Ji’s distortions, this study is actually pretty good evidence that antibody titers, at least for HPV infection, are a pretty good surrogate for immunity; yet Brogan and Ji appear to be arguing exactly the opposite. True, no correlation is perfect, but a dose-response curve in which the risk of HPV reinfection with the relevant subtype as well as the known complications of HPV infection falls as the antibody titer increases is pretty good evidence that antibody levels are important, at least for HPV. Also, it’s not uncommon that natural infection can result in immunity; that doesn’t mean that getting the disease “naturally” is better than preventing it with a vaccine. It is, however, a common antivaccine argument.

There is a grain of a point in Brogan and Ji’s paper, one that’s discussed in the paper they try to misuse. Specifically, it’s the assertion that natural infection can result in immune responses against multiple other types of HPV that can cause cervical cancer. Remember, HPV-16 and -18 only cause about half of the cases of cervical cancer. Still, this is a distinction without a difference. Vaccine manufacturers are already hard at work trying to include more HPV types in new vaccines. Moreover, contrary to the implication made by Brogan and Ji, if there’s anything this study shows it’s that natural immunity for HPV is not something to be relied on to prevent reinfection. Indeed, Brogan and Ji even admit this, but then they go on to write something this dumb:

Given the possibility that HPV infection itself confers protection against HPV reinfection and its more serious health implications (e.g. CIN1+), and that the HPV vaccine may not offer the same level of protection that our inborn adaptive immune responses to natural HPV infection does, we should pause to question the dominant HPV memes circulating out there – via the CDC, the pediatricians, the mainstream media – that proffer HPV is a ‘vaccine-preventable’ disease that we are morally and socially obligated to engage ‘preventively’ through vaccinating every susceptible adolescent on the planet. This fear-borne meme driving the herd to vaccinate against HPV—and everything else —is at least as infectious as the very virus they falsely promise their bivalent and quadrivalent vaccines will defeat.

This is the usual antivaccine piffle. HPV is a vaccine-preventable disease. It makes sense in many populations to vaccinate against it. HPV vaccination itself is pretty crappy at preventing reinfection—according to the results of the very study that Ji and Brogan themselves try to use to claim that we shouldn’t vaccinated against HPV. Truly, in the antivaccine world of Brogan and Ji, up is down, left is right, right is wrong, and we have always been at war with Eastasia—and apparently a study looking at the correlation between antibody levels and reinfection tells us that vaccinating against a first infection is inferior to “natural infection.” Of course, if our immunity to a primary infection were so great, we wouldn’t need a vaccine in the first place. Either Ji and Brogan are incredibly ignorant, or they’re intentionally obfuscating. Take your pick. Neither possibility reflects well on them.

Sadly, Sayer Ji is apparently none too good at handling criticism. There was a meme designed to respond to Ji and Brogan’s torturing of this particular study into submission to the anti-HPV vaccine cause that pointed out the main point that I discussed here (that the study doesn’t show what Ji and Brogan claim that it does) and pointing out how deceptive Ji and Brogan’s article is. I’ve learned from the creators of that meme that Ji has been threatening legal action for defamation, leading them to take the meme down rather than put up with the irritation.

Bad analysis, bad science, and legal bullying from supporters of “natural” healing? Same as it ever was.

Comments

  1. #1 Spectator
    April 2, 2014

    “I’ve learned from the creators of that meme that Ji has been threatening legal action for defamation, leading them to take the meme down rather than put up with the irritation.”

    Suddenly, I’m curious about that meme. There must be a copy of that around somewhere, hosted in Russia or Norway, for example.

    A suit filed by a public figure claiming satire to be defamatory is not likely to go anywhere, but it would serve to amplify whatever the facist was trying to suppress.

  2. #2 Orac
    April 2, 2014

    I promised not to post it. Otherwise, I would have included it. It did use the word “quack,” and I’m guessing that’s what set Ji off. I’ve also seen some of the exchanges and threats between Ji and the creators of the meme. Pathetic doesn’t even begin to describe Ji’s threats.

  3. #3 Julian Frost
    April 2, 2014

    There is a grain of a point in Brogan and Ji’s paper, one that’s discussed in the paper they try to misuse. Specifically, it’s the assertion that natural infection can result in immune responses against multiple other types of HPV that can cause cervical cancer. Remember, HPV-16 and -18 only cause about half of the cases of cervical cancer.

    This is a bit ambiguous. Are you (and the study authors) saying that natural infection with HPV-16 and -18 can result in an immune response that can combat other HPV types?
    If so, wouldn’t the vaccine have the same effect?

  4. #4 John Evans
    Toronto, Canada
    April 2, 2014

    So frustrated by people who misrepresent research findings. I had a long, unproductive conversation last week with a person who insisted it had been proven that cannabis oil cured all cancers, while citing a half-dozen or so studies – all preclinical – that some growth-inhibiting or cytotoxic effects had been seen. Studies where the authors had concluded there was enough data to consider the topic worth researching further, and nothing more. When I pointed out to my conversational partner that his claims were contrary to what the actual study authors had concluded, he pulled the closed-minded gambit. FML

  5. #5 sullivanthepoop
    April 2, 2014

    No, the vaccine only has pieces of protein for specific antigens. See, that is really the only thing that makes some natural infections stronger than vaccine initiated immunity is that you get every possible antigen associated with the pathogen, though as we have seen with pertussis if you just throw everything but the kitchen sink in the vaccine you get the same effect.

  6. #6 Denice Walter
    April 2, 2014

    Brogan has another gig besides Green Med Info:
    she is part of “Fearless Parent Radio”.
    You might ask,”Why are these parents fearless and what are they doing on the radio? Isn’t that uncomfortable?”

    In truth, they aren’t fearless at all because they are afraid of just about everything: vaccines, toxins, ( Reuben’s) monsters under the bed, vaccines, GMOs, governmental interference, toxins, SBM, gluten, vaccines and chronic illness- amongst a myriad of other threats to life, limb and sanity which are largely products of their own fevered, undisciplined imaginations.

    “Fearless Parent” ( nee “Nuture Parenting”) was birthed naturally by Alison MacNeil (of TMR) and Louise Kuo Habakus ( of various anti-vaccine/autism projects) and started out as a website but has blossomed into a series of live events in each of its creators’ locales. The former social worker and former PR person (respectively) invited other experts into their web…uh… *enterprise*,such as writer Jennifer Margulies and Dr Kelly Brogan.

    Then, they went on the “radio”- note that it isn’t just any old radio but “radio”, i.e. INTERNET radio. A few months ago they started a weekly Wednesday woo-fest on (where else?) the Progressive Radio Network. Yes. PRN is Gary Null’s vanity network and guarantee of airtime for his informercials when he’s denied free access to other venues because of disputes over ‘artistic differences’. He has enlisted a muddle of altmed prevaricators, political ranters and conspiracy axe grinders to fill up his schedule.

    So they are neither “fearless” nor on the radio bit they ARE parents. Brogan chimes in on medical issues and I believe, is also given one show a month of her own.

    If you have an errant wish to hear an hour’s worth of the result of the intersection of bastardised psychotherapy, high level woo and endless self promotion on a grand scale,you should go either to their website or to PRN’s where their broadcasts are enshrined for posterity.

  7. #7 Julian Frost
    Gauteng East Rand
    April 2, 2014

    Thanks sullivanthepoop.

  8. #8 Shay
    April 2, 2014

    Denise, these are the sort of people who brag that they speak truth to power. If in fact there was a massive and powerful government / Big Pharma cabal, they would all be sleeping with the fishes. But hey, let’s not ruin such a beautifully self-aggrandizing fantasy.

  9. #9 Yvette
    April 2, 2014

    Thanks for this article. The Greenmedinfo (also known as Greenmedmarket where they make their money selling supplements) article is appalling. A few other skeptics have taken on the good Dr. Brogan before. Here is an article about vaccines:

    http://sciblogs.co.nz/diplomaticimmunity/2013/08/20/dr-kelly-brogen-and-the-case-of-the-misplaced-science/

    Here is something on her trying to make women feel bad about getting an epidural.

    http://hatepseudoscience.com/2014/03/15/epidural-guilt-trips-and-natural-birth-bullies/

    But I do admire Dr. Brogan’s willingness to be independent from the pharma industry and corporate medicine. Oh wait, no I don’t.

    https://www.youtube.com/all_comments?v=qp1lP3Cyb80

  10. #10 Roadstergal
    April 2, 2014

    HPV vaccination itself is pretty crappy at preventing reinfection—according to the results of the very study that Ji and Brogan themselves try to use to claim that we shouldn’t vaccinated against HPV

    Was that supposed to be “HPV infection itself”? Took me a minute.

    “Fearless Parent” ( nee “Nuture Parenting”) was birthed naturally

    Well done.

  11. #11 Narad
    April 2, 2014

    I promised not to post it. Otherwise, I would have included it. It did use the word “quack,” and I’m guessing that’s what set Ji off. I’ve also seen some of the exchanges and threats between Ji and the creators of the meme. Pathetic doesn’t even begin to describe Ji’s threats.

    Standard advice: Check with Ken at Popehat to see whether he thinks it’s worth a savagely mocking post.

  12. #12 Denice Walter
    April 2, 2014

    @ Shay:

    If what they said were true, we’d all be driving Maserati and wearing Bulgari and Versace.

    HOWEVER, one well-known idiot claims that he was targetted for black ops (and worse) but the guy who was tailing him felt the pangs of conscience- because he observed how incorruptible the woo-meister was- and confessed all whilst issuing Dire Warnings for his Safety.

    But SERIOUSLY then they turn around and tell us that the US and UK are both “police states”-which they broadcast and post WITHOUT any repercussions by the Stalin-esque dictators.

  13. #13 Denice Walter
    April 2, 2014

    @ Roadstergal:

    Thanks.
    That should be NURTURE parenting. Which is rather clumsy- not to say that ‘Fearless Parent’ is slick.

  14. #14 Eric Lund
    April 2, 2014

    A suit filed by a public figure claiming satire to be defamatory is not likely to go anywhere, but it would serve to amplify whatever the facist was trying to suppress.

    That’s generally true in the US, but not necessarily so elsewhere. (Disclaimer: IANAL.) Especially if Ji and the creator of the meme are both outside the US (I’m not sure where Ji lives, and Orac hasn’t told us anything about where the other guy lives), Ji may have access to courts in a plaintiff-friendly jurisdiction, such as the UK. And even if US law is applicable, the guy who created the meme may reasonably conclude that it isn’t worth the expense to fight the lawsuit (there is no guarantee he would be able to recover expenses even if he won). So it’s harder for the Streisand Effect to work its magic.

  15. #15 Narad
    April 2, 2014

    and that the HPV vaccine may not offer the same level of protection that our inborn adaptive immune responses to natural HPV infection does

    Well, there are murine models of cervical cancer, right? And antibody-deficient mice. Seems possible to roughly test how well that works in practice.

  16. #16 Narad
    April 2, 2014

    Ji may have access to courts in a plaintiff-friendly jurisdiction, such as the UK.

    IIRC, everybody has access to UK libel actions. But there’s a loser-pays rule, and the decisions aren’t enforceable in the U.S. But this is putting the cart before the horse.

    The Streisand Effect works for bumptious legal threats, too.

  17. #17 The Grouchybeast
    April 2, 2014

    But SERIOUSLY then they turn around and tell us that the US and UK are both “police states”-which they broadcast and post WITHOUT any repercussions by the Stalin-esque dictators.

    I think the only logical conclusion is that they must all be paid government disinformation agents, covertly acting to make their associates look really, really stupid.

  18. #18 Darwy
    Røde grøde med fløde
    April 2, 2014

    @Narad

    Oh, I hope Ken gives it his ‘taint’ of approval.

    I still giggle when I read that post.

  19. #19 lsm
    April 2, 2014

    How long has Ken had the tag “govern yourselves accordingly” at the top of all of his posts? Ahhh, those were the days. Would love to see him address this as well.

  20. #20 skeptiquette
    April 2, 2014

    Julian,

    Actually, wrt pertussis if you just throw every thing but the kitchen sink (aP) in you DO NOT get the same result. I explained this a few weeks back on another thread.

    This is why we need to prospectively monitor the immune reactions to vaccines, so that we can more rationally design vaccines and improve their safety and efficacy profiles.

    This is not a completely novel idea amongst vaccinologists and immunologists and there is a push in these disciplines to change the strategy when it comes to vaccine design.

  21. #21 skeptiquette
    April 2, 2014

    Julian,

    To clarify this more, when a vaccine is injected the antigens activate very ancient innate immune pathways through pathogen recognition receptor (PRR) activation. PRR’s are both intra and extra cellular complexes that recognize conserved motifs from pathogens. There are a number of different PRR’s and the particular pattern of activation is what elicits the cell to make proteins that initiate the immune response.

    Think of it like a piano, certain keys are pushed and they make a chord. Well if different keys are pushed, would you expect the same chord to be played? No.

    Just like in the immune system, if a certain set of PRR’s are activated you are going to get a specific immune response, whereas, you change the set of PRR’s that are activated and a different immune response is elicited.

    The immune response that I am talking about is the inflammatory immune response which is spoken in the language of cytokines.

    These cytokines direct the immune system to make an adaptive response. The adaptive response does not just magically appear, there always, always has to be an innate immune response that tells the immune system what to do in a naive individual.

    In the case of Pertussis vaccination, the aP results in a totally different cytokine response than both the wP and natural infection. This is just being discovered and researchers are speculating that it is the lack of a Th17 response that allows a vaccinated subject to contract and have a problem clearing the pertussis bacteria, which allows the individual to not have symptoms, but still carry the bacteria for greater than 30 days allowing transmission to unprotected individuals.

    This is why the rational design of vaccines will be dependent on better characterization of the immune response to vaccines.

  22. #22 herr doktor bimler
    April 2, 2014

    DW: bastardised psychotherapy, high level woo and endless self promotion

    But you repeat yourself.

  23. #23 Sarah A
    April 2, 2014

    @skeptiquette: I’m pretty sure the “everything but the kitchen sink” remark was referring to the whole-cell pertussis vaccine, which, of course, contained all of the same antigens as the natural infection (over 3,000 IIRC.) That’s why it produced an immune response more similar to that of a natural infection than the acellular vaccine, but also had more severe side effects.

  24. #24 Matthew Cline
    April 2, 2014

    See, that is really the only thing that makes some natural infections stronger than vaccine initiated immunity is that you get every possible antigen associated with the pathogen,

    Doesn’t the fact that you’re exposed to more of each antigen also account for the stronger immune memory?

  25. #25 Narad
    April 2, 2014

    I’m mildly amused by the juxtaposition of Sayer Ji’s bio,* his Twitter ID, and this hare-brained attempt to attack the Dalai Lama over polio vaccination.

    Then again, his “tenure” at the monastery seems to have been rather abbreviated.

    * WARNING: Apparently includes bachelor’s thesis in philosophy.

  26. #26 Narad
    April 2, 2014

    ^ P.S. Synchronistic in the lesser sense, as I only first heard of Maurice Merleau-Ponty this very afternoon on the bus, in a footnote to the last chapter of something I’ve been reading.

  27. #27 Narad
    April 3, 2014

    Oh, no:

    “Merleau-Ponty has thematized this corporeal logos, from the macroscopic perspective of his own body as living subject….”

    Even I can guess where this leads in the long run: Taking an attack (as though an extra one were particularly necessary) on Cartesian mind-body dualism and ultimately turning it into a pseudo-empire built on branding anything that can be labeled “skepticism” as an instantiation of the same principle.

    Key concept: Merleau-Ponty is only useful, as far as I can tell, in the Zen context as a needlessly elaborate response to those who reckon that enlightenment constitutes being reduced to some weird precognitive state. What do you think all that “30 blows” stuff is about?

  28. #28 Julian Frost
    Gauteng East Rand
    April 3, 2014

    Skeptiquette, firstly, I wasn’t the one who made the “everything but the kitchen sink” remark w.r.t. pertussis.
    Secondly, this thread is about HPV, not pertussis, so how is your comment even relevant to the situation?

  29. #29 herr doktor bimler
    April 3, 2014

    Synchronistic in the lesser sense, as I only first heard of Maurice Merleau-Ponty

    STRAIGHT AFTER D.W. mentioned “bastardised psychotherapy, high level woo and endless self promotion”!

  30. #30 Lurker
    April 3, 2014

    Central Casting in Hollywood couldn’t come up with names like these: Sayer Ji as in Soothsayer, and Gary Null as in Null Results.

    Spectator @ 1: If you’re looking for a meme with the word ‘quack’ in it, how about: ‘If it ducks like a quack, it’s a quack.’

    Shay @ 8 and Denise @ 12: Alties aren’t the only ones with persecution complexes and exaggerated self-importance. Check out all the people who are beside themselves about NSA and GCHQ: many of whom believe that they themselves are important enough to deserve any attention whatsoever from any such agency. So sad to let them down, but they aren’t.

    There is also the ‘We Are All XYZ’ meme, where XYZ = the name of an historically-important personage, usually a victim of persecution or oppression, or a famous rebel. Lately it’s been ‘We Are All Edward Snowden!’, which is frankly a pain in the arse because if it’s even .01% true, those ‘We Are Alls’ should be arrested post-haste, and there aren’t enough cells to keep all of them.

    Yvette @ 9: I’m too squeamish to read that article, but are you telling us that some of these alties object to women getting anaesthetics whist giving birth? Do they also object to novocaine in dentistry? Is it chemophobia or something else, and if they’re so scared of chemicals, what do they think their bodies are made of, fairy-dust?

  31. #31 Ken Maxwell
    NY
    April 3, 2014

    Denice Walter said: “Then, they went on the “radio”- note that it isn’t just any old radio but “radio”, i.e. INTERNET radio. A few months ago they started a weekly Wednesday woo-fest on (where else?) the Progressive Radio Network. Yes. PRN is Gary Null’s vanity network and guarantee of airtime for his informercials when he’s denied free access to other venues because of disputes over ‘artistic differences’. He has enlisted a muddle of altmed prevaricators, political ranters and conspiracy axe grinders to fill up his schedule. ”

    So very very true. No matter what anyone tries to do to stop him or take him off the air, Saint Gary always returns. He was forced off WBAI in NY several years ago(this is why he created the PRN), yet he’s back on and as conspiratorial and woo-pushing as ever. Still, there is a lot of opposition to GN among WBAI listeners, who see him as the businessman broadcasting thinly veiled infomercials on what is supposed to be commercial free radio.

    Anyone here who wants to listen to GN just out of curiosity, be careful. The amount of woo you will have to put up with, even if you listen for just 5 minutes is painful to endure, and that’s assuming he’s not talking about how “young” and “sexy” everyone tells him he looks. Of course, it’s all “natural”, because he is on the ultimate “anti-aging” organic vegan diet and takes so many “Super Food” supplements.

    Perhaps even more aggravating to skeptics are the callers who address him as “doctor” or “Dr. Null”. This happens rather often, and for obvious reasons, he never bothers to correct them. Sometimes they seem to be ordinary people who have been duped, while other times they are associates or employees shilling for GN. Sometimes his underlyings can be so sycophantish toward doctor/Saint/scientist/inventor/film-maker/writer/super athlete/civil rights fighter/genius/polymath Gary Null, it can be quite nauseating!

    Although I can’t prove it, I suspect that more people tend to call him “doctor” whenever there’s a sales slump.

    This is just the tip of the iceberg!

  32. #32 Denice Walter
    April 3, 2014

    @ Ken Maxwell:

    But is it the ‘tipping point’?

    There have been new developments in Null’s Woo-topia:

    - he is OFF Pacifica in LA and Washington- he’s been on and off in NY: he keeps telling his thralls to copy phone numbers where they might listen in ” if something happens”.
    He is considering law suits against WBAI.
    -his Florida estate is up for sale- but not his”home”- the zoning boards won’t let him create a ‘health resort’ there.(see paradisegardensnaplesfl.com/ Ines Flax) for 6 million USD.
    - he sells 12 million USD worth of crap annually and has 60 employees ( manta.com)
    - Sky Horse Publishing gave him his own imprint.
    - he’s developing a health retreat outside of Dallas or Austin( not clear) that will open in “two months”.
    It will include: an “anti-aging village”, a “veterans’ village” ( where he’ll treat veterans), a homesteading project, an “artisans’ village”( for artists), a hydroponic farm and a cooking school.
    Various treatments and classes will offered to consume your cash or credit- your choice.
    - there are photos of the aforementioned properties at his eponymous website ( see ‘ health retreats’- those in the summer/ fall are in Texas/ winter in Florida).
    - his you-tube channel features his commercials, full length films and videos of his “dance parties” c.1980s- showing his skills on the dance floor.
    - he has many articles up at PRN: the newest is “Manufacturing Madness” ( or How to scare patients away from psychiatric meds in 3 easy steps).

    In addition, I’ve noticed his increasingly pressured speech, weaker, less sophisticated analogies and his need to search memory for simple idioms/ common terms( e.g. substituting “work dogs” for “work horses” in reference to hard working people) alongside his habitual malpropisms, mispronunciation and uncontrolled bursts of anger.

    I encourage readers to look at his websites-with their films, articles,shows, photos and merchandise for sale-
    it’s a school for sceptics.

  33. #33 Yvette
    April 3, 2014

    @ Lurker:

    Read the article I linked to. It is by a “I F-cking Hate Pseudoscience” writer responding to Dr. Brogan’s belief that pain relief in childbirth robs women of “psychospiritual transcendence.” And no, I did not make up that phrase.

  34. #34 Denice Walter
    April 3, 2014

    @ Yvette:

    There are easier ways of attaining “psychospiritual transcendence” that don’t involve childbirth, pain or woo-ful womyn’s wisdomising.
    Might I suggest alcohol? if more tightly governmentally controlled substances are not how you roll.

  35. #35 skeptiquette
    April 3, 2014

    @Sarah and Julian, Yep you are completely correct… please disregard my OT rambling.

    I think, though, that we should adjust message in response to “make vaccines safer and/or more efficacious” to

    This is what is currently happening, it’s just that the science supporting changes takes time to figure out; and then discuss the science that is taking place for reassurance.

  36. #36 Narad
    April 3, 2014

    STRAIGHT AFTER D.W. mentioned “bastardised psychotherapy, high level woo and endless self promotion”!

    “Freud had a wedge of the human pie down pat, I would say, and anyone who thinks otherwise is a wishful thinker. Jung, on the other hand, had nothing down pat but he stuck his fingers in a lot of pies and identified a lot of stuff, including synchronicity, which, not being a solipsist, he didn’t understand at all.”

  37. #37 ann
    April 3, 2014

    @Lurker –

    Check out all the people who are beside themselves about NSA and GCHQ: many of whom believe that they themselves are important enough to deserve any attention whatsoever from any such agency. So sad to let them down, but they aren’t.

    I’m beside myself about the NSA for a combination of pretty much the same reasons as the Electronic Frontier Foundation, Amnesty International, Human Rights Watch, and the ACLU.

    But if I had to pick just one, I’d probably be closest to the last. The First and Fourth Amendments are both personal favorites.

    There is also the ‘We Are All XYZ’ meme, where XYZ = the name of an historically-important personage, usually a victim of persecution or oppression, or a famous rebel. Lately it’s been ‘We Are All Edward Snowden!’, which is frankly a pain in the arse because if it’s even .01% true, those ‘We Are Alls’ should be arrested post-haste, and there aren’t enough cells to keep all of them.

    I haven’t seen that meme used wrt Snowden. But I agree that it would be ludicrous-to-offensive if it were. He’s the exception, not the rule.

    I don’t know that he deserves valorization. But I don’t think he so plainly deserves to be locked up that it’s a foregone conclusion, by any means.

    And there are some — even many — iterations of “We are all XYZ” that I’d very much like to see catch on. An injustice anywhere is a threat to justice everywhere.

    @TheGrouchybeast –

    I think the only logical conclusion is that they must all be paid government disinformation agents, covertly acting to make their associates look really, really stupid.

    I wouldn’t be surprised if a few of them were agent provocateurs, tbh.

    It’s probably what I’d do, if I were the FBI.

    @My aspirational role model, Denice Walter

    If what they said were true, we’d all be driving Maserati and wearing Bulgari and Versace.

    I’d never be able to make that work. I just don’t have the right natural foundation for it.

    Do you think it would if be okay if I were driven in a Lincoln Towncar while wearing Hermes and Prada instead?

  38. #38 Narad
    April 3, 2014

    Dr. Brogan’s belief that pain relief in childbirth robs women of “psychospiritual transcendence.”

    Defiles the sacred experience. Might as well just adopt.

  39. #39 Denice Walter
    April 3, 2014

    To whom it may concern- on synchronicity:

    Narad and I run on entirely different tracks but occasionally wind up at the same locus so much so that for a brief instant in time I wondered if he might indeed be the baby that I misplaced in Victoria Station while I was a young violet saleperson outside the Opera and studying economics simultaneously. He’s too close in age though.

  40. #40 Denice Walter
    April 3, 2014

    @ ann:

    I don’t go for those either although I like the sound of their names.

    I currently drive a black, weathered vehicle that would look at home tooling across the savanna in search of wildlife.
    My own foundation choices are either Rimmel in ‘Nearly Dead’ or Shiseido’s “Hello White”. And I often wear Calvin Klein menswear-influenced neutrals with Burb.trimmings.
    And what I find at the sportng goods shop.

    I’m flattered to be a role model.

  41. #41 ann
    April 3, 2014

    My own foundation choices are either Rimmel in ‘Nearly Dead’ or Shiseido’s “Hello White”.

    :)

    I meant the kind you put foundation garments on. Speaking of Agent Provocateur.

    And I often wear Calvin Klein menswear-influenced neutrals with Burb.trimmings.
    And what I find at the sportng goods shop.

    You lucky.

    I couldn’t carry that off, either, being more on the olive than the violet end of the young-salesperson-outside-the-opera spectrum. Neutrals make me look sallow.

  42. #42 Sarah A
    April 3, 2014

    I think, though, that we should adjust message in response to “make vaccines safer and/or more efficacious” to: This is what is currently happening, it’s just that the science supporting changes takes time to figure out; and then discuss the science that is taking place for reassurance.

    Absolutely, but don’t forget that the “we need to make vaccines safer and/or more efficacious” statement is usually made in the context of an extremely misinformed idea of what the risk/benefit ratio of current vaccines actually are. It’s more urgent to convince parents that the vaccines we have available now are safe and effective than to talk about how much more safe and effective they’ll be in the future.

  43. #43 skeptiquette
    April 3, 2014

    Good point, Sarah!

    However, I am not sure if you are going to be able to convince them of that.

    I think that if you can provide direct evidence to show that progress in the direction of “safer and more effective” is what is happening and explain in relatively non-scientific terms how this is happening, you may quell some fear or even better some misunderstanding of where we are at and where we are going. Baby steps.

  44. #44 Ken Maxwell
    NY
    April 3, 2014

    @ Denice Walter

    Wow, what a list! A lot of that I did not know, and it’s difficult to keep track of which stations he’s on these days. No, I don’t believe it is possible to completely stop people like GN, or that we are anywhere close to a tipping point. The health claims for his products are too vague, so no one can claim he is actually practicing medicine if he isn’t selling things to treat specific illnesses. He still has enough fans/customers to help keep him on the air at WBAI, for now.

    I’m starting to recall many years ago, GN’s most pathetic moments. This was when WBAI management decided to cancel his show altogether, and GN was pulling out all the stops to get them to reverse this decision. He sounded so desperate, a mixture of sad and angry, and kept appealing to his audience to revolt against the WBAI bosses.

    Nothing seemed to work, so his last tactic was to play the race card. At far-far-left, pro-minority, pro-diversity WBAI, being white is something of a liability; never mind a rich white businessman, which, in essence is what GN is. That is pure evil to most of WBAI’s far-left listeners, even if GN regularly boasted of his civil rights activism.

    So GN played the race card. “How?” you may ask. By saying he isn’t actually white! Yes he may look white, but he is actually a Native American of I think the Cherokee nation(I could be wrong), and comes from a long line of Native American healers, supposedly. While it is possible there is some truth to this, it was such a silly, underhanded way to plead with his audience, to downplay his obvious whiteness and claim he is really a Native American by race.

    No one was dumb enough to fall for this last-minute trick, and GN was canned soon after. He eventually returned a few years ago after new management took over.

    BTW, I just finished reading the book “Charlatan”, and the parallels between GN and Brinkley are disturbing. Certainly Brinkley was far worse since he killed and maimed hundreds of people, but his use of the radio to promote his quackery, conspiracy theories, and anti-authoritarianism provided the template the alt-med quacks use to promote themselves to this very day.

    Thanks Denice and thank you Orac for all that you do!

  45. #45 Narad
    April 3, 2014

    No one was dumb enough to fall for this last-minute trick, and GN was canned soon after. He eventually returned a few years ago after new management took over.

    Null was fired in 2004 (he sued and lost) and was brought back in syndicated form in 2010.

  46. #46 lurker
    April 4, 2014

    Denise @ 32, seems that Doctor Null Results is starting to exhibit signs of cognitive decline, despite his regimen of ‘remedies.’ What’s the difference between his ‘health retreat’ and all the ‘health spas’ that exist in places like California?

    Yvette @ 33: B—– hell, Brogan sounds like a monster. He needs to experience some psychospiritual transcendence of his own, in the dentist’s chair, preferably for a root canal. Strictly speaking, overwhelming pain can induce an altered state, and physical trauma is often used as an initiation ritual. Meditation is quite a bit safer and more pleasant, or for that matter a few puffs of marijuana as long as one isn’t pregnant.

    Ann @ 37: I’d happily debate that subject matter all day, but in this forum it’s a digression so I’ll just agree to disagree.

    Ken @ 44: Cherokee today, perhaps Chinese tomorrow? I just looked up Brinkley on Wikipedia. Goat bollocks eh? I wonder what would happen if someone rang up Null’s radio medicine show and asked him about goat gland extracts, and then escalated to asking about goat gland transplants. Would he go for it?

  47. #47 Denice Walter
    April 4, 2014

    @ Ken Maxwell:

    Believe it or not, there’s a lot more but I only mention what is easily verifiable through the web. Doug Henwood ( Narad’s second link) has other material. Also see Kalichman’s book, ‘Denying AIDS’.
    (-btw-”tipping point” was my snark as GN often uses that concept to frighten his thralls in regards to AGW or personal illness ‘catching up to them’ because of their sordid lifestyle choices).

    @ lurker:

    Interestingly, he’s now shilling a book about countering cognitive problems( “Re-boot Your Brain”). AFAIK, he’s been sloppy about language for a long time but he seems especially tongue tied / ‘searchng’ recently. My fave moment was when, discussing his expertise in physio, he pronounced ‘amygdala’ entirely wrong and hesitatingly sounded out ‘serotonin’- which speaks volumes. Almost as good as his discussions about Voltaire .

    True, spas cater to affluent folks and charge exorbitate fees.
    Null ran winter health retreats in Florida but in the past year, he has tied retreats ( summer/ fall in Texas; winter in Florida) to fund-raising efforts for Pacifica stations @ 2000 USD a week. There are photos of both luxe settings at GN.com.

    How I understand it, he wanted to create a resort in Florida but wasn’t allowed by the town so he started developing a place in Texas- he notes that the ‘REAL progressive people’ live near Dallas and Austin. His retreats feature exercise, diet, juicing, skin care, energy healing, yoga, cooking classes, meditation, counselling by his woo-tinged RN and lectures from the Master.

    In addition, he’d add quasi-medical services like IV vitamin C, ozone et al which his nurse has worked with in NY.
    The new place will have the aforementioned ‘villages” for artists, veterans, homesteaders, hydroponics et al.

    Now I’ve never been to a spa but I read about them constantly in fashion magazines and I don’t think that his
    style and background will play well to sophisticated, educated women who have excess money. Showcasing a few marble statues and columns around a pool does not Tuscany make. The hard sell, cult mentality is especially unatractive as well. All too obvious and deeply rooted in lower middle class aesthetics tarted up with spiritualistic window dressing and meticulous landscaping.

  48. #48 herr doktor bimler
    April 5, 2014

    he started developing a place in Texas- he notes that the ‘REAL progressive people’ live near Dallas and Austin.

    Null sounds like a bank-robber explaining that that’s where the money is.

  49. #49 K
    April 8, 2014

    HAHA Mike Adams does it again. He just came out of the closet as an antiscientist… unreal and his followers are eating it up. he’s about to make the big bucks now.. as L. Ron Hubbard supposedly said “You don’t get rich writing science fiction. If you want to get rich, you start a religion”

  50. #50 Somebody
    Somewhere, CA
    April 18, 2014

    I’m a supporter of Sayer Ji, Gary Null and I’m sure whoever else you’ve slammed. You seem to me to be an overly righteous, non-informed, quack yourself. Why don’t you keep your opinions to yourself instead of trying to make others look bad? Does it make you feel better about yourself to misinform the public about what you obviously DON’T know. Articles like yours have no interest because all you want to do is people bash. What an asshole!!!!

    • #51 Orac
      April 18, 2014

      Apparently they have enough interest that you took the time to write a paragraph-long rant about them.

  51. #52 novalox
    April 18, 2014

    @somebody

    Ther, there little one. Does it feel better now that you got that little fact-free temper tantrum out of the way?

  52. #53 Alain
    April 18, 2014

    Hi nobody, are you trying to convince us that you are a somebody using your rant? You need to improve that rant if you want to be considered as a somebody.

    Alain

  53. #54 Chemmomo
    Land of procrastination
    April 18, 2014

    Somebody @50

    I’m a supporter of Sayer Ji, Gary Null and I’m sure whoever else you’ve slammed.

    Why?
    No, really, this is a serious question: I’d like to know why you support them.

    Why don’t you keep your opinions to yourself

    So, somebody, does your guy whom you support – Gary Null – keep his opinions to himself?
    No?
    What’s with the double standard?
    Are you suggesting that anyone who disagrees with your opinion should be censored? I’m only asking because that’s how your post reads.

  54. #55 Todd W.
    http://www.harpocratesspeaks.com
    April 18, 2014

    @Somebody

    Like Chemmomo, I, too, would like to know why you support them.

    Also, did you have anything specific to say about Orac’s post? You know, specific details he got wrong. What misinformation is there, and what evidence do you have to support your contention?

  55. #56 Crystal 14030706
    April 19, 2014

    “it’s not an “assumption” that certain serotypes of HPV can cause cervical cancer. Nor is it an “assumption” that cervical cancer can cause death. Nor is it an “assumption” that a vaccine can prevent HPV infection”

    Why would anybody even begin to believe what is posted by Ji and Brogen when there is clear evidence of the power of the HPV vaccine and that it does save lives. Some people seek attention in the wrong ways, and instead make themselves look relatively irrelevant.

    This is a very informative post. Thank You Orac.

  56. #57 Krebiozen
    April 20, 2014

    Does it make you feel better about yourself to misinform the public about what you obviously DON’T know.

    I never cease to be amazed and amused by people making accusations of ignorance when they clearly haven’t the first idea what they are talking about. I don’t see how anyone can read Orac’s post and come away thinking it is he, and not Sayer Ji et al, that is misinforming people.

  57. #58 herr doktor bimler
    April 20, 2014

    No, really, this is a serious question: I’d like to know why you support them.

    I don’t think you’re going to get a carefully-reasoned explanation. ‘Somebody’ claims to be “a supporter of whoever else Orac has slammed”. The reason for slamming them is evidently irrelevant… if Orac has criticised them, that is reason enough for Somebody to support them.

  58. […] this somehow) who shoves anti-science “alternative medicine” woo onto her patients. These two shills for the antivaccination movement have pushed junk papers before, where Orac ripped their “conclusions” […]

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