Respectful Insolence

I appear to have fallen into one of my ruts again. Or maybe it’s not a rut. I just feel as though I’ve been doing too many posts on the antivaccine movement, to the point where I wonder if I’m starting to fall into a rut. In actuality, it doesn’t really matter. If I feel as though I’m getting tired of a topic, then that’s enough. It’s just that the antivaccine movement, even as bottomless a font of stupidity, misinformation, pseudoscience, and quackery as it is, sometimes goes on a tear. When it does that, I have a hard time restraining myself from trying to blog about all of it, as impossible a task as that is. For example, we had antivaccine hero Dr. Bob Sears ranting about his patients’ parents who were justifiably concerned about the ongoing measles outbreak in southern California given that their children are unprotected because they are unvaccinated—not just once but twice. Then we had our old pal, pediatrician to the antivaccine stars’ children Dr. Jay “I’m not antivaccine but I trash them constantly with unscientific nonsense” Gordon “reassuring” the same kind of parents: Antivaccine parents who are getting a bit worried because their children are unvaccinated and the measles outbreak shows no signs of abating yet.

Now we have another antivaccine pediatrician being interviewed in Mother Jones in an article with the truly annoying title My Interview With a Pediatrician Who Thinks Vaccines Are “Messing With Nature”: Is She Right? The interview in question is with a pediatrician named Dr. Stacia Kenet Lansman, founder of a practice known as Pediatric Alternatives. The very name of the practice tells me everything I need to know about it. Well, actually, not entirely. This passage from the Mother Jones article describing it does:

In 1998, she founded Pediatric Alternatives, with the goal of combining Western medicine with nontraditional methods like homeopathy, herbalism, and dietary treatments. This approach, she hoped, would “start children and families out with healthy habits and routines so that they are more likely to stay healthy.” The practice flourished. Today, she and four other physicians at Pediatric Alternatives treat somewhere between 1,500 and 2,000 patients from around the Bay Area.

And here’s the interview:

So, basically, Dr. runs a crunchy “integrative medicine” practice in the Bay Area. Is it any surprise that she’s antivaccine? Not at all! Not only does “integrative medicine” integrate quackery with science-based medicine, but it frequently “integrates” unscientific antivaccine views with science-based medicine. And, boy, does her practice‘s website show it! Check it out:

Integrative medicine is the convergence of ancient healing wisdom with the medical practices of western medicine. At Pediatric Alternatives, through our combined training in western medicine, homeopathy, herbal medicine, naturopathic medicine and nutrition, we are able to treat more illnesses naturally without the use of antibiotics or other prescription medications.

Amusingly, one of the bits of “ancient healing wisdom” offered by Pediatric Alternatives is homeopathy, which isn’t actually ancient (having been invented by Samuel Hahnemann only a little more than 200 years ago) and is actually Western, having been invented in Germany. Regular readers know that homeopathy has two main “laws,” the law of similars, which states that to relieve a symptom you use a substance that causes that symptom in healthy people. It’s a totally unscientific law whose basis is far more rooted in concepts of sympathetic magic than it is in science—or even reality. Then there’s the law of infinitesimals, which states that serially diluting a substance (with vigorous shaking, known as “succussion,” between each step being absolutely essential to “potentize” the mixture) actually makes it more powerful. Unfortunately for homeopaths, they tend to dilute substance far beyond Avogadro’s number. A typical homeopathic dilution is 30C, where C = a 100-fold dilution. So 30C = 30 one hundred-fold dilutions, or an overall dilution factor of 1060. Given that Avogadro’s number is only on the order of 6 x 1023, you can see the problem. Homeopathic remedies are water in which the magical ingredients have been diluted to nonexistence.

Pediatric Alternatives also offers naturopathy, which I’ve described on numerous occasions as a cornucopia of quackery. And so it is. After all, you can’t have naturopathy without homeopathy, because homeopathy is considered what one might call a “core competency” of naturopathy and is a key component of the curriculae of schools of naturopathy. It’s even a major component of the naturopathy licensing examination.

Not surprisingly, pseudoscience like homeopathy and naturopathy goes together very well with antivaccine views, and Dr. Kenet Lansman demonstrates that:

Given all this, it might surprise you to learn that one of Pediatric Alternatives’ policies is extremely unorthodox: It suggests that families delay certain childhood immunizations—in some cases for years past the age recommended by the Centers for Disease Control and Prevention—and forego others entirely. A little less than 20 percent of the families the practice treats choose not to vaccinate at all. The rest use a modified vaccine schedule.

I’m not sure why the author of the article, Kiera Butler, is surprised (or thinks that it is surprising) to learn that Pediatric Alternatives “selectively” vaccinates. Knowing what I know about “integrative” medicine, naturopathy, and homeopathy, I’d have been surprised if the pediatricians there actually followed the CDC vaccine schedule. Shocked actually. It’s totally to be expected that the do not, nor is it surprising that her philosophy about vaccines is very much like that of Dr. Jay Gordon:

Kenet Lansman tells me she would never deny any vaccine to parents who request it for their child. But she does share her personal beliefs with her patients: She fears that vaccines have contributed to the recent uptick in autoimmune disorders and other chronic conditions. “I think we’re just messing with nature, and we really don’t know what we’ve created,” she says. “We’ve reduced or largely eliminated many infectious diseases. But in their place, we have an epidemic of chronic illnesses in children. The incidence of asthma, allergies, and autism spectrum disorders has dramatically increased since the 1990s. And the reason for this we don’t know. But my concern is that vaccines have played a role.”

Like Dr. Jay, Dr. Kenet Lansman apparently won’t vaccinated unless the parents badger her to do so. Of course, parents who want to do the responsible thing and vaccinate their children according to the CDC schedule would be highly unlikely to go to a practice like Pediatric Alternatives; so I’m guessing that the problem of parents demanding appropriate vaccines for their children is a problem that Dr. Kenet Lansman rarely encounters. Come to think of it, I bet that Dr. Jay rarely encounters the problem as well. Parents who want to vaccinate their children are similarly unlikely to seek out a pediatrician like Dr. Jay.

So what vaccines does Pediatric Alternatives administer? At least the practice gives the DTaP shot—which protects against pertussis, diphtheria, and tetanus—during the child’s first year. It’s not clear to me from the interview whether Pediatric Alternatives administers all three doses in the first six months or whether they also give it at 15-18 months, 4-6 years, etc., as the CDC schedule recommends. From the phrasing, I suspect not. The practice also administers the vaccine against meningitis. Predictably, however, given the antipathy towards this vaccine among the antivaccine crowd, Dr. Kenet Lansman doesn’t vaccinated against hepatitis B at all, pulling out the tired old trope about how babies don’t “engage in sex or intravenous drug use.” She also doesn’t administer the varicella vaccine, nor does she appear to administer the polio vaccine. Worst of all, there’s this. She delays the MMR vaccine until age 3, and here’s the reason:

The main reason for the delay, Kenet Lansman says, is that she still believes there could be a link between vaccines and autism. She acknowledges that the scientific community has rejected this theory, yet she says she has seen children from her own practice who begin to show signs of autism shortly after being vaccinated. “My feeling is that if there is any risk that the vaccine is associated with autism, we should delay the vaccine during this vulnerable developmental window,” she says.

Yes, I see a definite resemblance to Dr. Jay here as well. She relies on “personal clinical experience” above scientific studies to tell her what she’s come to believe, that vaccines cause autism. A little confirmation bias, in which she remembers cases that correspond to her pre-existing belief, mixed with some confusing of correlation with causation, and there you have it: A pediatrician who falls for the failed hypothesis that vaccines cause autism. Her belief in pseudoscience comes at a potential cost: Leaving her patients vulnerable to vaccine-preventable diseases like measles longer than other children. She brags in the interview how none of her patients have developed vaccine-preventable diseases—much as Dr. Jay brags that he’s never seen a case of the measles. That is, of course, because both her and Dr. Jay’s patients are sponging off the herd immunity of those who actually do vaccinate. However, given her location in one of the epicenters of antivaccine views in the entire US and how she’s contributing to the number of unvaccinated children, it’s likely only a matter of time before she won’t be able to brag about that any more. On the other hand, I noticed in her interview that she used some rather weaselly words. She didn’t actually say that none of her patients have ever had vaccine-preventable diseases. Rather, she says, “We’ve never had one patient get a serious, life-threatening vaccine-preventable illness because we gave them a vaccine at a later date.”

Hmmm. I bet she has had some patients get vaccine-preventable diseases. If I had been Butler, I would have called her out on that and asked her specifically if she had ever had any cases of measles among her patients? Pertussis? Varicella? My guess is that Dr. Kenet Lansman very carefully chose her words and that she, like many antivaccine pediatricians, dismiss the measles and other vaccine-preventable diseases as not being “serious.” Yes, that appears to be what she is doing.

Not surprisingly, Dr. Kenet Lansman is also big on confirmation bias in other areas. She claims that her office is “quiet during flu season,” which tells us little and that the children in her practice “actually seem healthier than most of their peers.” By what specific, objective measures? How would she know? This sounds suspiciously like the claim made by Mayer Eisenstein about his Homefirst practice in the Chicago area. Eisenstein, as you might recall, doesn’t vaccinate and claims that he’s never seen a single case of autism in his practice. Conveniently enough, he’s never actually published his numbers and can’t (or won’t) produce evidence to support his claims. Anyone want to bet whether Dr. Kenet Lansman can provide any sort of convincing data to support hers, either? I say she can’t, and I don’t blame you for not taking that bet.

Sadly, Butler’s interview, even though she says the right things about vaccines by quoting Paul Offit and other vaccine scientists who point out that there is no evidence that vaccines are correlated with autism or cause autism or that these “alternative” vaccine schedules do anything more than leave children unprotected against vaccine-preventable diseases, falls for “natural” trope:

At the end of my visit to Pediatric Alternatives, I found that I liked Dr. Kenet Lansman. I could tell that she was bright and caring and open-minded, and most impressively, she tried to think creatively about how to keep her patients healthy. She’s right that there is an epidemic of chronic autoimmune illnesses and autism among children, and a mounting body of research suggests that our aggressive pursuit of germs—both in our environment and in the human body—might have something to do with it: When we kill disease-causing germs, the theory goes, we kill beneficial bacteria, as well, making our bodies’ defense systems go haywire.

Well, I actually kind of like Dr. Jay, too, but that doesn’t stop me from ripping into his antivaccine-sympathetic views and his pseudoscience about vaccines. In any event, as I just wrote about the other day, there is no autism “epidemic.” It’s a zombie that just won’t die. Nor is there any evidence that the increase in prevalence of certain autoimmune diseases has anything to do with vaccines. As for the “hygeine” hypothesis, even if it’s correct it doesn’t justify antivaccine views or the use of naturopathy and homeopathy, the latter of which is the so obviously quackery that there’s good reason why it’s a favorite example used by skeptics to teach about quackery. Nor does it justify Dr. Kenet Lansman’s statement in her interview (on the video) that she believes that being exposed to such diseases “strengthens” the immune system and that we don’t need to be afraid of these illnesses. Yes, she’s just as irresponsible as Dr. Gordon and Dr. Sears.

As much as I attack the “tell both sides” meme in journalism when it’s applied ot pseudoscience, alternative medicine, or antivaccine views, at least Butler bothered to point out just how wrong Dr. Kenet Lansman is about vaccines. The problem is, she diluted that criticism by expressing sentiments that buy into the same unscientific world view shared by her subject. In the end, Dr. Kenet Lansman is a a pediatrician dripping with arrogance as she expresses “concern” that children are getting “too many” vaccines at a too young an age based, of course, on no evidence other than her “concern” and her confirmation bias. She then has the temerity to say that she “examined each vaccine individually” and, apparently thinking her judgment to be superior to that of the expert panels who come up with these recommendations.

Comments

  1. #1 Julian Frost
    Gauteng East Rand
    April 4, 2014

    She fears that vaccines have contributed to the recent uptick in autoimmune disorders and other chronic conditions.

    I’d actually like to ask a question and I hope an immunologist will answer: is there a real uptick in autoimmune disorders? Or are we just getting better at detecting them?

    The incidence of asthma, allergies, and autism spectrum disorders has dramatically increased since the 1990s.

    As above, but for allergists: are allergies increasing? Or are we detecting more of them?

    She acknowledges that the scientific community has rejected this theory, yet she says she has seen children from her own practice who begin to show signs of autism shortly after being vaccinated.

    **facepalm** Post-hoc, ergo prompter hoc fallacy.

    She’s right that there is an epidemic of chronic autoimmune illnesses and autism among children…

    Is she?
    I think that some regulars here should write some letters to Mother Jones.

  2. #2 Ladybug
    April 4, 2014

    ” I just feel as though I’ve been doing too many posts on the antivaccine movement”

    From the perspective of this fan, that is not possible. Thanks for what you do.

  3. #3 The Smith of Lie
    April 4, 2014

    The whole “we’re messing with nature” trope infuriates me more than most of quack tropes out there. I don’t like nature very much, it scares me. I survive thanks to dozens of things that are unnatural. Going for “X is wrong because it is unnatural” as an argument should be punished by leaving the person naked in the woods to fend for themselves, fully naturally.

  4. #4 palindrom
    April 4, 2014

    One of my favorite bike routes takes me past a tiny, overgrown country graveyard.

    There are two heartbreaking aspects to this little plot of land — a whole lot of young men with death dates in the 1861-1865 range, and, even worse, many headstones of small children. The sorrow that each of those little stones represents is unimaginable.

    Messiing with Mother Nature, indeed …

  5. #5 herr doktor bimler
    April 4, 2014

    ancient healing wisdom
    You’d think that archeologists would have found more skeletons of long-lived ancients.

  6. #6 Julian Frost
    Gauteng East Rand
    April 4, 2014

    Re the “against nature” bit.
    If there is one thing that nature is good at, it’s controlling the numbers of a species. Most animals do not survive to breed. Those that do can have hundreds if not thousands of offspring because that is the only way to ensure species survival.
    “Mother Nature” is a misconception. Nature can be a mother, but in the other sense.

  7. #7 janerella
    April 4, 2014

    Yeah, we shouldn’t mess with Mother Nature. Well at least until Subacute Sclerosing Panencephalitis necessitates anticonvulsant and antispasmodic drug administration and possibly antiviral (isoprinosine and ribavirin) and immunomodulatory (interferon alpha) drugs on the faint chance that they will work before your child dies. Yeah, just then maybe we might intervene eh Mother Jones?

  8. #8 Kathy
    south of the tropic of Capricorn
    April 4, 2014

    This “Mother Nature” or “Mother Earth” meme is only possible to people who have little exposure to Nature or Earth as they actually are. Romanticism and stuff about “A host of golden daffodils” are very nice between the pages of a book but otherwise they’re about as real as Peter Pan. Whenever someone enthuses about Mother Nature I strongly suspect one thing about them: they don’t live in it. They live in a heavily humanised country where medicine, internet, good roads and democracy are the norm.

  9. #9 Spectator
    April 4, 2014

    “yet she says she has seen children from her own practice who begin to show signs of autism shortly after being vaccinated.”

    Parent brings kid to hippie doc.
    Kid shows signs of autism.
    There ya go, cause/effect.

    Kid caught autism from the hippie doc, perhaps from the office practice of homeopathy. Vapors or fumes of powerful adult homeopathic concoctions, being even more powerful than the undiluted dilutions, overwhelmed the little child’s delicate defenses.

    What other conclusion is possible, unless one is a shill for alt-med?

  10. #10 Dangerous Bacon
    April 4, 2014

    Taking your kids to a pediatrician and giving them access to modern drugs and surgery is one of the worst kinds of tampering with nature.

    Dr. Lansman could easily make the argument to parents that they need to have a few extra children in the anticipation that some of the young, weaker ones will die of trauma, burst appendices and the like (no interfering with natural processes permitted). The ones that make it will be too busy fighting off “natural” infections and building naturally strong immune systems to develop autoimmune problems, asthma etc.

    Though I worry that those “naturally” strong immune systems will also kill off “good” bacteria (aren’t we told that immunity from disease is always superior to that from immunization)? Won’t this make the problem worse?

    Regardless, using anything more than 19th century medicine on children is clearly irresponsible, leading to more cases of diabetes, asthma, autism etc. instead of letting the herd winnow itself out through natural selection.

  11. #11 Chris Hickie
    April 4, 2014

    It figured there were some other rat nests of pediatricians in California who don’t deserve to be pediatricians –just not (at least until now) as vocal as Gordon or Sears. But I suspect these anti-vaccine pediatricians are realizing that Drs. Sears and Gordon have profited very, very handsomely from their very public anti-vaccine antics, so now we will see more of them crawling out of their holes to tell naive reported vaccine lies.

  12. #12 Chris Hickie
    April 4, 2014

    “to tell naive reported vaccine lies.”–should be “to tell naive reporters vaccine lies.”

  13. #13 Chris Hickie
    April 4, 2014

    From the perspective of a pediatrician who sees every day the damage being done to vaccination rates by the increasing numbers of parents being fooled into not vaccinating, some other parts of this interview merit harsh scrutiny:
    This scene isn’t the only impressive thing about Pediatric Alternatives. The practice’s five physicians have impeccable credentials, having trained and completed residencies at some of the nation’s top medical schools and institutions. Several are fellows of the American Academy of Pediatrics.
    Strange how none of these “impeccable” physicians on their practice web site are willing to state such they are FAAPs. Maybe this group of quack doctors is a little sneakier than Sears/Gordon in hiding from the AAP (not that the AAP has any fortitude when it comes to speaking out against quack pediatricians).
    Given all this, it might surprise you to learn that one of Pediatric Alternatives’ policies is extremely unorthodox: It suggests that families delay certain childhood immunizations—in some cases for years past the age recommended by the Centers for Disease Control and Prevention—and forego others entirely. A little less than 20 percent of the families the practice treats choose not to vaccinate at all. The rest use a modified vaccine schedule.
    If we had 20% non-vaccination rates everywhere, we’d have measles and whooping cough everywhere, instead we just have measles and pertussis in NoCal and SoCal where these wretched anti-vaccine pediatric practices are. Coincidence? I think not.
    While the American Academy of Pediatrics discourages alternative vaccine schedules, it doesn’t forbid them for its members. And the insurers that contract with Pediatric Alternatives—which include Blue Cross, Blue Shield, Aetna, and Cigna—haven’t raised any protest. As Aetna puts it, “We don’t dictate care.” The California Department of Health simply requests that “parents ensure their children are immunized according to the schedule recommended by their physician.” The state of California, meanwhile, makes it relatively easy to opt out of vaccines: Parents are not required to follow the federally recommended schedule, and those who wish to skip shots entirely need only obtain the signature of their child’s pediatrician. (Rules vary in other states. See our map.)
    If these top-shelf pediatricians and the regulatory bodies that oversee them are willing to allow customized immunization plans for each patient, then is there a possibility they are onto something? Could it be that much of what we’ve heard about the importance of timely vaccines is wrong?

    I so wish the AAP would expel fellows who endorse and promote non-vaccination or any schedule that deviates from the ACIP/CDC schedule, but the AAP doesn’t. And NO, these “top-shelf pediatricians” (more like bottom feeding opportunists) aren’t onto anything other than absolute abandonment of one of the key tenets of pediatrics—prevention of infectious diseases through timely vaccination. –Chris Hickie MD, PhD

  14. #14 Chris Hickie
    April 4, 2014

    Clearly, html is not happy with me today—

    From the perspective of a pediatrician who sees every day the damage being done to vaccination rates by the increasing numbers of parents being fooled into not vaccinating, some other parts of this interview merit harsh scrutiny:

    This scene isn’t the only impressive thing about Pediatric Alternatives. The practice’s five physicians have impeccable credentials, having trained and completed residencies at some of the nation’s top medical schools and institutions. Several are fellows of the American Academy of Pediatrics.

    Strange how none of these “impeccable” physicians on their practice web site are willing to state such they are FAAPs. Maybe this group of quack doctors is a little sneakier than Sears/Gordon in hiding from the AAP (not that the AAP has any fortitude when it comes to speaking out against quack pediatricians).

    Given all this, it might surprise you to learn that one of Pediatric Alternatives’ policies is extremely unorthodox: It suggests that families delay certain childhood immunizations—in some cases for years past the age recommended by the Centers for Disease Control and Prevention—and forego others entirely. A little less than 20 percent of the families the practice treats choose not to vaccinate at all. The rest use a modified vaccine schedule.

    If we had 20% non-vaccination rates everywhere, we’d have measles and whooping cough everywhere, instead we just have measles and pertussis in NoCal and SoCal where these wretched anti-vaccine pediatric practices are. Coincidence? I think not.

    While the American Academy of Pediatrics discourages alternative vaccine schedules, it doesn’t forbid them for its members. And the insurers that contract with Pediatric Alternatives—which include Blue Cross, Blue Shield, Aetna, and Cigna—haven’t raised any protest. As Aetna puts it, “We don’t dictate care.” The California Department of Health simply requests that “parents ensure their children are immunized according to the schedule recommended by their physician.” The state of California, meanwhile, makes it relatively easy to opt out of vaccines: Parents are not required to follow the federally recommended schedule, and those who wish to skip shots entirely need only obtain the signature of their child’s pediatrician. (Rules vary in other states. See our map.)

    If these top-shelf pediatricians and the regulatory bodies that oversee them are willing to allow customized immunization plans for each patient, then is there a possibility they are onto something? Could it be that much of what we’ve heard about the importance of timely vaccines is wrong?

    I so wish the AAP would expel fellows who endorse and promote non-vaccination or any schedule that deviates from the ACIP/CDC schedule, but the AAP doesn’t. And NO, these “top-shelf pediatricians” (more like bottom feeding opportunists) aren’t onto anything other than absolute abandonment of one of the key tenets of pediatrics—prevention of infectious diseases through timely vaccination. –Chris Hickie MD, PhD

  15. #15 Denice Walter
    April 4, 2014

    Oh Orac, please don’t restrain yourself from discussing anti-vax: it truly is a bottomless pit of dangerous nonsense, a cesspit of mutual enablement involving parents and doctors like the three you’ve wriiten up.

    Since the announcement of the CDC figures last week and the start of Autism Awareness Month, we’ve witnessed the profusely bubbling vitriol of the AoA and TMR rant factories overflowing its cauldrons. Stagliano, Dachel, Goes, Olmsted, Jameson et al have ramped up their game, why not sceptics as well?

    AND Marin County.
    I should mention that I adore the place and have spent lots of time and money there. I get away from the cold and damp; it doesn’t rain. there are natural and cultural attractions as well as a laid back attitude without traffic jams. And I traipse amongst the hippies, naturalistas, artisans and new economy types and have a great time- they seem to like me. There are many smart, creative people there: but why oh why don’t they vaccinate their children?

    We need to make listening to cranks and charlatans
    UNfashionable, UNcool and ANTI trendy. How can being misled by quacks be desirable?

  16. #16 Kristin Guilonard
    April 4, 2014

    I just want to clarify:
    The DtaP schedule is as follows:
    2 months, 4 months, 6 months, 12-15 months, 4-5 years old. The Tdap starts at 11 years old.

    If one follows the CDC schedule

  17. #18 Joanna
    April 4, 2014

    She acknowledges that the scientific community has rejected this theory, yet she says she has seen children from her own practice who begin to show signs of autism shortly after being vaccinated.

    I really find this hard to believe. If you aren’t vaccinating your patients, you aren’t going to see any results of vaccination in your practice. The only results you would see are parents who had their child vaccinated and then switch pediatricians after they think their child was harmed by the vaccination. I’m sure she sees a lot of patients who’s parents think the MMR gave their child autism, but she hasn’t seen it herself.

  18. #19 Lancelot Gobbo
    April 4, 2014

    For a slightly different approach to unorthodox vaccine administration, try this out. A Halifax NS paediatrician took to mixing vaccines to lessen the number of needle pricks (eg mixing the dried MMR with DPTP (a liquid) rather than with the diluent). His license to practice was suspended for two months, he is no longer allowed to give vaccines and this letter was sent out to all physicians:
    http://novascotia.ca/DHW/immunization-2013/
    If anything that strikes me as a bit harsh, but it sure does encouager les autres to get it right!

  19. #20 Lancelot Gobbo
    April 4, 2014

    ‘encourager’!

  20. #21 NumberWang
    April 4, 2014

    @HDB #5

    That’s because the “long-lived Ancients’ are still alive. They walk amongst us, guiding humanity and building pyramids. Or something.

  21. #22 JeffM
    Silicon Valley
    April 4, 2014

    ““I think we’re just messing with nature”

    That’s right. We are. Because nature wants to kill us.

  22. #23 Politicalguineapig
    April 4, 2014

    Julian: I’d actually like to ask a question and I hope an immunologist will answer: is there a real uptick in autoimmune disorders? Or are we just getting better at detecting them?

    I’m not an immunologist, but I think there are two short answers: one, we probably are better at detecting them, and we’re probably better at keeping immune-deficient kids alive.

  23. #24 Beth
    April 4, 2014

    Dr. Kenet Lansman doesn’t vaccinated against hepatitis B at all, pulling out the tired old trope about how babies don’t “engage in sex or intravenous drug use.”

    I’ve never understood the logic behind vaccinating babies for a STD. While you may consider it a ‘tired old trope’, for many people, it doesn’t make much sense to me to recommend vaccinating babies for Hep B when the parents don’t have it and it’s not recommended for them. Could someone here enlighten me on why it is in the babies best interest to vaccinate for that particular disease so young?

  24. #25 JCL
    April 4, 2014

    ‘and most impressively, she tried to think creatively about how to keep her patients healthy.’

    I’m not sure how ‘creative’ I want my GP or other doctors to be – ‘stone cold analytic’ seems a better place to start. I would save ‘creative’ for the ‘you’re dead anyway can we try this?’ scenario,
    but I think ‘creative’ in this context is cuddly wooy ‘making it up’ as opposed to the deep, original thinking that advances science (and art)

  25. #26 janerella
    April 4, 2014

    Beth – because you never know whose child…

    Failure of Centers for Disease Control Criteria to Identify Hepatitis B Infection in a Large Municipal Obstetrical Population
    MAUREEN M. JONAS, M.D.; EUGENE R. SCHIFF, M.D.; MARY J. O’SULLIVAN, M.D.; MARIA DE MEDINA, M.P.H.; K. RAJENDER REDDY, M.D.; LENNOX J. JEFFERS, M.D.; TAMARA FAYNE, R.N.; KATHRYN C. ROACH, M.T.; and BERNARD W. STEELE, M.D.

    Ann Intern Med. 1987;107(3):335-337. doi:10.7326/0003-4819-107-2-335
    http://annals.org/article.aspx?articleid=702123

    may bite yours at daycare….
    Hepatitis B virus transmission between children in day care.
    Shapiro C, McCaig L, Gensheimer K, et al.Pediatr Infect Dis J. 1989;8:870–5. [PubMed]

    A bite in the playroom: Managing human bites in day care settings
    Paediatr Child Health. 1998 Sep-Oct; 3(5): 351–353.
    PMCID: PMC2851373

  26. #27 Dangerous Bacon
    April 4, 2014

    These three pediatricians could be viewed as the antivax Three Stooges (with Jay Gordon screeching “Look at the BART! Look at the BART!”).

  27. #28 Beth
    April 4, 2014

    @ janerella

    Thanks for your response. Transmission via biting from other youngster can occur in daycare centers. I’m not sure how serious that problem is, but it is an exposure route adults wouldn’t be exposed to. Is that the reasoning behind the recommendation?

    If so, why is the vaccine recommended for all babies as opposed to being recommended just for those in daycare?

    And why is it recommended at an age before they are able to interact with other children? Maybe that’s changed but I thought it was recommended before children become mobile enough to play with others.

  28. #29 madder
    April 4, 2014

    To pile on with janerella–

    Beth, most people with Hep B don’t know that they have it. It can be transmitted through “ordinary” contact such as sharing a toothbrush, or through one of the routine cuts and scrapes that accompany childhood. Similarly, we do not force laboring women to be tested for Hep B, and if they do happen to be infected, they can pass the disease to the baby. The birth dose offers good protection against birth transmission.

    Unfortunately, if someone offered this “it’s an STD!” argument to you as a reason against Hep B vaccination at birth, they were either parroting information without checking it, or deliberately misleading you. Sexual contact is only one of many ways to get Hep B, and everyone who has contact with humans is at risk.

    But thank you for asking- you come across as genuinely interested, so hopefully these and the other responses you’ll get will be helpful.

  29. #30 madder
    April 4, 2014

    Meant to include this link to a handy info sheet (PDF):
    ht_p://www.immunize.org/catg.d/p4110.pdf
    It also points out that the very young are at increased risk of serious complications from Hep B, so early prevention is even more important.

  30. #31 Chris,
    April 4, 2014

    Beth: “I’ve never understood the logic behind vaccinating babies for a STD.”

    Because hepatitis b is not just sexually transmitted. So if you start understanding why kids become chronic carriers of hepatitis b, you might start understanding when the vaccine is given. Plus the fact that there are several thousand deaths per year in the USA from the cancer it causes.

    Here is where you can go learn about it:
    http://www.pkids.org/diseases/hepatitis/pediatric_hepatitis_report.html

  31. #32 Charles Krimm
    April 4, 2014

    Your intelligence should be questioned at every turn. Your anti vaccine propaganda is a true diservice to the children of our world. Shamew on you

  32. #33 NH Primary Care Doctor
    April 4, 2014

    So, they’ve got 5 physicians servicing 1500-2000 patients? How much do these people charge? Because I couldn’t run a practice with 400 patients.

  33. #34 janerella
    April 4, 2014

    Not just daycare Beth- -mother’s group/ the local playground/storytime at the library….and not just biting. Cuts scrapes, nosebleeds…etc.
    There’s a great easy to read evidence-based article here based on CDC and Immunization Action Coalition http://shotofprevention.com/2010/05/06/why-infants-should-receive-the-hepatitis-b-vaccine-at-birth/
    that may address some of your concerns and questions.

  34. #35 Beth
    April 4, 2014

    Thanks for the links. They were interesting. I’m aware that most (all?) STD’s can be transmitted via contact with blood (i.e. scrapes and cuts) and sometimes other bodily fluids not just sexual activity and sharing needles. I wasn’t aware that the disease was more dangerous when contracted at a young age.

    Is that the reason the vaccine is routinely recommended for babies but not their parents?

  35. #36 Calli Arcale
    http://fractalwonder.wordpress.com
    April 4, 2014

    There’s also the issue that the birth dose is the only way to prevent vertical transmission from the mother. Sure, you can ask the mother if she’s at risk for Hepatitis B, but will she even know? Forgiving for a moment that we know a lot of moms will lie about their past exposure (and that it’s not exactly the best environment to be asking questions like that in anyway), if the mom was infected at birth from *her* mother and became an asymptomatic chronic carrier, the only clue she’s at risk may be relatives having died of liver cancer.

  36. #37 Denice Walter
    April 4, 2014

    @ Beth:

    Also if you vaccinate babies- because most of them are born in hospitals- you get a chance to vaccinate nearly 100% of that population prior to most of the risks for acquiring hep B.
    Over years, most people will automatically be vaccinated.

  37. #38 janerella
    April 4, 2014

    5% to 10% of adults and children older than age 5 with hepatitis B infection go on to develop chronic infection, compared with 90% of infants. Approximately 25 percent of children who become infected with life-long hepatitis B virus would be expected to die of related liver disease as adults.

    Since routine Hep B vaccination, was started the number of new infections per year in the US has gone down by 82%.

    The greatest drop has been among kids born since 1991, when vaccinating children was first recommended.
    (CDC stats)

  38. #39 lilady
    April 4, 2014

    If you are looking for more blogging fodder Orac, have a look at Dr. Bob Sears’ “Vaccine Friendly Doctors” list. There are 42 separate practices listed for California, including Dr. Jay Gordon’s and Kenet Lansman’s

    http://www.askdrsears.com/topics/health-concerns/vaccines/find-vaccine-friendly-doctor-near-you

  39. #40 lilady
    April 4, 2014

    @ Beth: The reason why all infants (including babies whose mothers are not chronic hepatitis B carriers and who are not at risk for vertical transmission at birth), is because close family members and other caregivers may be chronic carriers of the virus. Certain groups within our society practice “pre chewing” (by the caregiver) of food that is fed to the baby and when a baby (or an adult) is exposed to hepatitis B infected blood, the risks for transmission of the virus is 40 X higher, than being exposed to HIV infected blood:

    Here, just a few of the unusual confirmed cases of transmission of the hepatitis B virus:

    http://www.immunize.org/catg.d/p2100nrs.pdf

  40. #41 SteveJ
    April 4, 2014

    @Beth Also, adults need twice the dose given to children, which increases the cost.

  41. #42 Ellie
    April 4, 2014

    Beth, just dropping in to say that back in 1972, shortly after my daughter was born, all parents received letters from the hospital informing them that their newborns may have been exposed to Hep. B in the nursery, and should be tested. Apparently, the hospital did not think it was solely an STD. As far as I know, all children were OK, but it was very frightening. When I heard, many years later, about the vaccine being routine after delivery, I was very glad and wished it had been available those many years before.

  42. #43 lilady
    April 4, 2014

    All pregnant women during each of her pregnancies are tested for the presence of hepatitis B virus.

    There were problems with certain doctors who mistakenly tested pregnant women for the presence of hepatitis B Surface Antibody, not hepatitis B Surface Antigen. Those doctors made notations in the pregnant women’s charts that were sent to the birthing hospital ~ 6 weeks before the EDCs that the women were negative for Surface Antigen…and infants became infected due to these mistakes:

    http://www.cdc.gov/hepatitis/hbv/pdfs/serologicchartv8.pdf

    In order to make certain that the correct test was done to determine carrier status, a copy of the actual lab test result is contained within the mothers’ hospital charts.

    http://www.health.ny.gov/diseases/communicable/hepatitis/hepatitis_b/perinatal/docs/program_manual.pdf

  43. #44 thor
    April 4, 2014

    5 Doctors treating 1500-2000 patients seems like a really low empanellment. Of course you can do that when most or all of your treatments are cash only since insurance will not pay for them.

  44. #45 liz
    san diego
    April 4, 2014

    When my daughter was born some of my crunchie friends suggested Dr. Adema in Santee, CA. I took my baby/ toddler there for almost a year when I realized he put her on a “alternative” vaccine schedule without telling me. I was so upset. He also asked me if I belonged to a “good faith group”. Ack! Left him, left cruchie friends…and poor daughter had to get more shots every time I took her to the new doctor so she could be caught up. Can doctors do this legally? just make up a new vaccine schedule without telling a parent?

  45. #46 Narad
    April 4, 2014

    Is that the reason the vaccine is routinely recommended for babies but not their parents?

    “By the early 1990s, accumulating data showed that many children remained at risk for HBV infection because of incomplete maternal screening and because a substantial proportion of infections occurred in children of hepatitis B surface antigen (HBsAg)-negative mothers. Furthermore, hepatitis B surveillance data indicated that adults and adolescents who were at high risk of infection were not being vaccinated and that 30% of cases in adults were associated with no recognizable risk factors.With these data and a growing body of evidence that hepatitis B vaccination was safe, the Advisory Committee on Immunization Practices expanded its hepatitis B immunization recommendations in 1991 to include all infants, primarily to stop HBV transmission among children and eventually also to prevent HBV infections in adolescents and adults.”

    The estimate is that there were 16,000 nonperinatal infections in children aged 0–9 annually in the early 1990s.

  46. #47 lilady
    April 4, 2014

    And, the dumb nurse who thought that insulin pens can be used on multiple patients…as long as you don’t reuse needles:

    http://newyork.cbslocal.com/2014/03/12/l-i-hospital-warning-thousands-of-patients-of-possible-blood-contamination/

  47. #48 Calli Arcale
    April 4, 2014

    lilady — “All pregnant women during each of her pregnancies are tested for the presence of hepatitis B virus.” Many women in America still don’t get prenatal care during their pregnancies, so I’d say that “all” needs to come with a qualification. Even if all the doctors are being good about testing properly for Hep B, not all mothers receive care during their pregnancies, and of course the mothers at greatest risk of hepatitis are also the least likely to be getting prenatal care.

    So, there’s another thing for new mothers to think about.

  48. #49 palindrom
    April 4, 2014

    liz @45 — a “good faith group”? Can anyone explain what kind of code-speak that is?

  49. #50 Chris Hickie
    April 4, 2014

    I do wonder if health insurance companies might change their tune when they starting having to pick up more tabs for VPD hospitalizations. Many of these parents who won’t vaccinate are educated and middle to upper income, so it is private payer plans that will eat most of those bills.

  50. #51 Paul Browne
    April 4, 2014

    Great series Orac, I do love a good serving of crank magnetism on a Friday afternoon http://speakingofresearch.com/2014/04/03/aliens-adrs-and-animal-tests/

  51. #52 Bob G
    Los Angeles
    April 4, 2014

    Comment to Liz and others: If a doctor is doing something that is below the standard of care in the community, then that becomes a potential malpractice if the patient is injured as a result. The problem with this physician and the associated risk to the infants and to the community as a whole sounds real, but I don’t know whether the standard of care rule is strict enough to apply to this situation. However, you would think that the doctor should have an obligation to explain the traditional vaccination schedule and the proposed delay of the schedule, and to make sure that the parent is aware of the difference. It seems to me that this is one of those things that should be reported to the state board of medical examiners, so that the situation can be corrected. At the very least, the infant is being subjected to a substantial variation on the standard of care without the parent having true informed consent.

  52. #53 Vicki
    April 4, 2014

    There are two evasions in

    Rather, she says, “We’ve never had one patient get a serious, life-threatening vaccine-preventable illness because we gave them a vaccine at a later date.”

    It’s not just what counts as serious: it’s that it is literally true that her patients don’t get those diseases because she gave them a vaccine later. They get them because she didn’t give them the vaccine when she should have. If a child gets measles at age 2, giving them the MMR at age 3 doesn’t retroactively cause measles.

  53. #54 Eric Lund
    April 4, 2014

    @NH Primary Care Doctor: They can pull it off if they have enough of a nursing staff. I don’t know about California law, but for many years I went to my then nominal PCP’s practice (I’ve since been switched to a different practice), mostly for routine checkups, without actually seeing the PCP (unlike my current PCP, whom I saw on my first visit), so I have reason to believe it’s technically legal in New Hampshire. And it’s much easier to pull off if, as others have implied, they don’t take insurance, because they don’t have to pay staff to deal with insurance claims (a large part of the overhead for a “normal” practice).

  54. #55 lilady
    April 4, 2014

    @ Calli Arcale: If the pregnant woman arrives at a hospital in labor, there is a protocol in place to administer the hepatitis B vaccine at birth, draw blood to test the mother for the presence of hepatitis B chronic carriage and to provide HBIG to the infant within 7 days of birth, if the mother is a hepatitis B carrier (#1 hepatitis B vaccine and HBIG ideally should be administered within 12 hours of birth).

    (Thanks to Liz Ditz for the link to this doctor’s article which appeared in the Pediatric Annals about mommies refusing Vitamin K shots for their infants. Scroll down to see how this pediatrician excoriates Joe Mercola and his crappy science)

    http://www.healio.com/pediatrics/journals/pedann/%7Bb5ee598c-213c-4284-86b7-c7055e31f71a%7D/playing-newborn-intracranial-roulette-parental-refusal-of-vitamin-k-injection

    Dr. Block is my hero….second behind Dr. Chris Hickie…of course. :-)

  55. #56 Jessica S
    April 4, 2014

    “The whole “we’re messing with nature” trope infuriates me more than most of quack tropes out there. I don’t like nature very much, it scares me. I survive thanks to dozens of things that are unnatural. Going for “X is wrong because it is unnatural” as an argument should be punished by leaving the person naked in the woods to fend for themselves, fully naturally.”

    I totally agree with The Smith of Lie, here. Nature can be a cruel bitch, at best it’s indifferent. Or a cruel jerk-face, for a less gender-specific term. It doesn’t care what it tears down, within the human body or on the planet. If anything, we’re better off using our best ideas to outsmart it!

  56. #57 ken
    Paris
    April 4, 2014

    @beth
    Read the insert from pharma also -for a truly informed decision.

  57. #58 Calli Arcale
    April 4, 2014

    lilady — yeah, but my point is that there are antivaxxers who say “you shouldn’t need to vaccinate my special snowflake because I was tested during my pregnancy and I know I’m clean” when a mother could show up in the next suite with undiagnosed Hep B. Sure, she’ll be tested, but if she’s an antivaxxer as well, she’ll refuse the vaccine for her child and so we’ll have a window of time between the birth and the discovery of Hep B during which it could transmit in the nursery. It’s a pretty small risk, but Hep B has such serious ramifications for a newborn that I think antivaxxers are being Pollyannas when they rely on Hep B testing to decide whose baby gets vaccinated.

  58. #59 Chris,
    April 4, 2014

    ken: “Read the insert from pharma also -for a truly informed decision.”

    That is regurgitated bovine excrement. Those are lawyer written bits to cover their posteriors. She has been given much better references to read.

  59. #60 Darwy
    Røde grøde med fløde
    April 4, 2014

    @Ken #57

    What about the insert?

  60. #61 lilady
    April 4, 2014

    As if…Ken has the reading comprehension skills and science education to understand the big words (more than one syllable), contained in the package inserts.

  61. #62 Tsu Dho Nimh
    April 4, 2014

    she says, “We’ve never had one patient get a serious, life-threatening vaccine-preventable illness because we gave them a vaccine at a later date.”

    Because, by her definition, none of the vaccine-preventable diseases are “serious” or “life threatening”.

  62. #63 MikeMa
    April 4, 2014

    Just to fully recognize the other coast, I was driving down I95 near Newark or Trenton NJ and saw an NVIC billboard promoting anti-vax bullshit. Nearly wrecked the car yelling at it.

  63. #64 lilady
    April 4, 2014

    Just for you MikeMa…

    https://www.facebook.com/national.vaccine.information.center/posts/10151936289557931

    Scroll down to see this post. Holy Sh!t are the chiros raising money for Wakefield’s “research”…or to support his lush lifestyle?

    “Mindy Allen Judd Hannah, he is working on it. He is just mastering his research, so we will have to give him some time. What he shared with us was so amazing that in about 15 minutes a group of about 300 Chiropractors raised $50,000 to help him in his research journey. Friend me if you would like because as I get information I will be sharing it:)
    October 20, 2013 at 7:46pm”

  64. […] the most resistant, dogma-loving folks there are. An interesting blog post by Orac just today (Science Blogs – Respectful Insolence) about three PEDIATRICIANS who are themselves antivaccine makes the point very […]

  65. #66 Rob Cordes, DO
    Reading PA
    April 4, 2014

    “Dietary” therapies?
    I recommend that for all my patients…starting with breast milk then progressing the what I call a modified Mediterranean diet.
    Since the vast majority of my patients are under 21 no red wine.

    Chris Hickie you have my vote for AAP president.

  66. #67 dingo199
    April 5, 2014

    @Vicki

    There are two evasions in
    “Rather, she says, “We’ve never had one patient get a serious, life-threatening vaccine-preventable illness because we gave them a vaccine at a later date.”

    It’s not just what counts as serious: it’s that it is literally true that her patients don’t get those diseases because she gave them a vaccine later. They get them because she didn’t give them the vaccine when she should have. If a child gets measles at age 2, giving them the MMR at age 3 doesn’t retroactively cause measles.

    I think you have that wrong. What she meant by “later” was that the vaccine was given “later than it would usually be using the standard schedule”, and not as you have interpreted it “later on after getting the disease”.

  67. #68 Nat Philosopher
    http://whyarethingsthisway.com/
    April 5, 2014

    Pediatricians should read the scientific literature. There are dozens of mainstream journal papers showing early adjuvanted vaccines are dangerous, and there are no cogent papers showing they are not. There are hundreds of papers about MMR, but nothing good about early aluminum.

    In 2002 the National Vaccine Program Office (NVPO) convened an expert group to study safety issues with adjuvants in vaccines. Among their conclusions:

    “pervasive uncertainty [from] missing data on pharmocokinetics and toxicities of aluminum injected into humans… There seems to be abundant data concerning risk levels for ingested aluminum, but scant data about risk levels for injected aluminum. The oral minimum risk level, for example, appears to be in the range of 2–60 mg/kg of aluminum per day but there are no comparable data for injected aluminum.”[1]

    Since 2002 there is an extensive literature, and its all bad. For a detailed literature survey, with cites and links to over two dozen mainstream journal articles showing danger:
    http://whyarethingsthisway.com/2014/03/08/example-1-pediatrician-belief-is-opposite-the-published-scientific-evidence-on-early-vaccine-safety/

  68. #69 Dangerous Bacon
    April 5, 2014

    This has probably been mentioned somewhere on RI – but how many have contacted Chili’s to protest their donating money from Monday’s sales to the National Autism Association (which claims that vaccines cause autism)?

    http://www.businessinsider.com/chilis-autism-2014-4

  69. #70 lilady
    April 5, 2014

    Dangerous Bacon: Ken at Autism News Beat has an update on that fundraiser.

    Maybe next time, Chili’s will fully investigate groups that appeal to them for fundraising.

    http://autism-news-beat.com/archives/2172/comment-page-1#comment-42955

  70. #71 Vicki
    April 5, 2014

    Dingo199:

    That is presumably how she meant us to interpret it. My point is that her statement literally says that no child got the disease because she gave them the vaccine; she doesn’t say that the lack of vaccination didn’t lead to the disease. I don’t know whether that’s a deliberate ambiguity, of course, but it would go along with anti-vaxers talking about childhood diseases including measles and pertussis as not being “serious.”

    What we don’t have is a statement along the lines of “none of the children for whom we used the modified schedule got measles, mumps, rubella, or pertussis before they were fully vaccinated.” That, if true, would likely still be the result of herd immunity and simple luck, but it would be a stronger and less ambiguous statement.

  71. #72 anon
    April 5, 2014

    Interesting study-
    Self-Organized Criticality Theory of Autoimmunity
    http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0008382

  72. #73 anon
    April 5, 2014

    http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0008382

    Self-Organized Criticality Theory of Autoimmunity

    “Repeated immunization with antigen causes systemic autoimmunity in mice otherwise not prone to spontaneous autoimmune diseases. Overstimulation of CD4+ T cells led to the development of autoantibody-inducing CD4+ T (aiCD4+ T) cell which had undergone T cell receptor (TCR) revision and was capable of inducing autoantibodies. The aiCD4+ T cell was induced by de novo TCR revision but not by cross-reaction, and subsequently overstimulated CD8+ T cells, driving them to become antigen-specific cytotoxic T lymphocytes (CTL). These CTLs could be further matured by antigen cross-presentation, after which they caused autoimmune tissue injury akin to systemic lupus erythematosus (SLE).”
    Conclusions/Significance
    “Systemic autoimmunity appears to be the inevitable consequence of over-stimulating the host’s immune ‘system’ by repeated immunization with antigen, to the levels that surpass system’s self-organized criticality.”

  73. #74 Alain
    April 5, 2014

    Anon,

    We endure a lot of over-stimulation with actual viruses, bacteria and allergen already present in the atmosphere as compared to the minuscule dose of antigens in the vaccines.

    Alain

  74. #75 Sarah A
    United States
    April 5, 2014

    @Anon: Gee, I guess it’s a good thing we don’t vaccinate kids every five days with the superantigen that causes toxic shock syndrome (Staphylococcal enterotoxin B.) Try reading for comprehension next time – this experiment does not resemble actual vaccination in any way.

  75. #76 Narad
    April 5, 2014

    Interesting study

    Please explain, in your own words, what the “immunizations” consisted of. I’ll give you a hint: PLoS One does not have copy editors.

  76. #77 Narad
    April 5, 2014

    I see that Sarah beat me to it.

  77. #78 herr doktor bimler
    April 5, 2014

    PLoS One does not have copy editors.

    PLoS 1 does, however, have a Media feature to promote churnalism. The article in question has evidently come to the attention of Gaia Health, for whom it might as well have been tailor-made:
    Publication: Gaia Health
    Title: “Vaccinations Inevitably Cause Autoimmune Diseases: PLoS Study”

  78. #79 Alain
    April 5, 2014

    I wish to thanks everyone for the kind words regarding my internship. I am very hopeful it will change my life.

    Alain

  79. #80 herr doktor bimler
    April 5, 2014

    Should add that there is nothing in the paper to explain or justify the use of ‘self-organized criticality’, which was popular in the 1990s but in this context is a sciencey-sounding junk phrase which the authors have slapped on like cheap pebble-dash. I guess “chaos theory” and “fractal” were passé by 2009.

  80. #81 Narad
    April 5, 2014

    but in this context is a sciencey-sounding junk phrase which the authors have slapped on like cheap pebble-dash

    The thing is that there actually is relevant work, of which they seem unaware.

    Speaking of Gaia Health, have I mentioned that Christina England is down with the former but not the latter these days?

  81. #82 Narad
    April 5, 2014

    Oh, crap, Heidi Stevenson, sorry.

  82. #83 sid offit
    April 5, 2014

    Good thing the measles is just a mild illness

  83. #84 Mewens
    April 5, 2014

    You even trying anymore, Sudsy?

  84. #85 Narad
    April 5, 2014

    Good thing the measles is just a mild illness

    Bob, I’m at a loss trying to come up with any ideas for a person to whom the exhortation FOADIAF could be more appropriately applied.

  85. #86 LW
    April 5, 2014

    “Vaccinations Inevitably Cause Autoimmune Diseases: PLoS Study”

    Considering that the great majority of people in the developed world have received one or more vaccinations, I would think the fact that every single one of us suffers from autoimmune diseases would have been more prominently reported.

    Or maybe they don’t know what “inevitably cause” means.

  86. #87 lilady
    April 6, 2014

    “Good thing the measles is just a mild illness”

    And, good thing that your nascent career as a science radio personality was cut short, when you made an a$$ out of your self on BBC Radio, Offal:

    http://www.bbc.co.uk/news/magazine-15647434

  87. #88 Chemmomo
    Watching the moon, stars, and ISS
    April 6, 2014

    sid offit @82
    You know, Lucy Dahl was recently featured as a guest judge on Syfy’s reality show Face Off http://www.syfy.com/faceoff/episodes/season/6/episode/10/what_a_dahl
    Why don’t pass along your comment to her? Keep in mind Lucy never actually met her older sister. http://www.imdb.com/name/nm0001094/bio?ref_=nm_ov_bio_sm

  88. #89 Chemmomo
    Land Without Preview
    April 6, 2014

    ^Why don’t you pass along . . . .

  89. #90 Chemmomo
    Just checking
    April 6, 2014

    DId I italicize RI?

  90. #91 Stuartg
    April 6, 2014

    Beth @ 24

    Before vaccination was started, areas of New Zealand had HBsAg prevalence of over 50% before puberty. Hardly an STD.

  91. #92 Stuartg
    April 6, 2014

    Sorry, HBsAb.

  92. #93 Bill Price
    April 6, 2014

    #82, “sid offit”, April 5, 2014:

    Good thing the measles is just a mild illness

    Maybe you’d like to meet my wife’s favorite cousin, whom we can call R. Sixty years ago, they played as young girls play on the farm, running, jumping, climbing, throwing and catching outdoors; serving tea and otherwise imitating Momma indoors.
    Then, R came down with measles.
    She has not run, jumped, climbed, thrown, caught, served tea, nor helped around the house for sixty years. She hasn’t even walked without assistance for that time.
    Tell R, or anyone who loves her, that measles is harmless. When you do, be prepared to duck and exit the premises post-haste. R won’t be able to treat you as you deserve — throwing is not an option for her any more — but the rest of us actually care about R and about reality. That’s R’s reality, where measles is sometimes catastrophic, not your poor excuse for reality, where measles can be ignored.

  93. #94 lilady
    April 6, 2014

    @ Stuart G. You were right the first time about Hepatitis B surface antigen signifying acute onset or chronic carriage of the virus.

    Damn laboratories make the interpretation of hepatitis B serology so difficult, and don’t ask about the core antibody, viral loads, e-antigen or co-infection with the delta virus. :-)

    http://www.hepmag.com/articles/2511_18747.shtml

  94. #95 Colin Day
    April 6, 2014

    Dang, I thought sid offit #82 was being sarcastic. Did sid really mean it?

  95. #96 Bill Price
    April 6, 2014

    Dang, I thought sid offit #82 was being sarcastic.

    I did too, Colin, until I noticed that the comment was from “sid offit”.

  96. #97 lilady
    April 6, 2014

    My second comment, directed at Robert F. Kennedy, Jr., made it through moderation at Medical News Today…and still no reply from Bobby Kennedy:

    http://www.medicalnewstoday.com/opinions/174696

  97. #98 Chris,
    April 6, 2014

    Colin Day, “sid offit” is one of the persons mentioned in this blog article:
    http://thepoxesblog.wordpress.com/2014/04/02/some-things-are-no-joke/

    He is the guy who is behind the “Vaccine Machine” blog mentioned in the fourth paragraph. Read about him and form your own opinion.

  98. #99 Denice Walter
    April 6, 2014

    Sid has a blog but all of the activity occurs at his facebook page:
    – he has over 46K friends
    – he adds new material frequently – even daily
    – his partisans ask questions about how to avoid vaccination, where to find doctors amenable to their belief system, remedies to replace vaccines, how to deal with governmental requirements for school or travel etc.

    It’s quite an accomplishment : he’s developed a go-to social site for discussion and for ‘educating’ the masses which appears to be more popular than either AoA or TMR judging by the responses daily.

  99. #100 LIz Ditz
    April 6, 2014

    Narad @82:

    Oh, crap, Heidi Stevenson, sorry.

    I regret to inform you that Ms. Stevenson is no longer.

    Remembering Heidi Stevenson of Gaia Health
    Heather Callaghan
    Activist Post

    It is with great sorrow and a heavy heart to inform you that the world lost a dear and tenacious warrior for truth and freedom on March 12, 2014.

    If you didn’t know who she was, please take this time to get to know her, because all I can say is that the vast majority of us would be seriously lacking without her investigative articles exposing propaganda, lies and corruption.

    If you are even a passing reader on this site or many others in non-corporate media, you can be sure that you have benefited from her intensely thorough research and her tireless work at the website she founded in 2009 – Gaia Health.

  100. #102 Chemmomo
    The NSSOB
    April 6, 2014

    Colin Day and anyone else wondering about sid offit #82
    Check out this comment from Science Based Medicine
    First, the post it’s on: http://www.sciencebasedmedicine.org/smallpox-and-pseudomedicine/
    And going to his comment directly: http://www.sciencebasedmedicine.org/smallpox-and-pseudomedicine/#comment-68730

  101. #103 Phoenix Woman
    April 6, 2014

    By the way, here’s a restaurant chain to avoid:

    http://www.huffingtonpost.com/2014/04/06/chilis-vaccination_n_5101026.html

  102. #104 lilady
    April 6, 2014

    Phoenix Woman.. Autism News Beat is already “on it”, with a concession from Chilis Restaurant Corporate Headquarters

    http://autism-news-beat.com/archives/2172

  103. #105 Dangerous Bacon
    April 6, 2014

    And now Chili’s has canceled its plan for giving 10% of Monday’s receipts to the antivax National Autism Association. There are probably still a bunch of execs who can’t understand how quickly their plan to reap valuable publicity from the autism issue turned into a p.r. nightmare.

    AoA is predictably outraged (people are now supposed to contact Chili’s to berate them every time an autistic child wanders off and experiences harm).

  104. #106 Dangerous Bacon
    April 6, 2014

    The statement from Chili’s on their Facebook page:

    “Chili’s is committed to giving back to the communities in which our guests live and work through local and national Give Back Events. While we remain committed to supporting the children and families affected by autism, we are canceling Monday’s Give Back Event based on the feedback we heard from our guests.

    We believe autism awareness continues to be an important cause to our guests and team members, and we will find another way to support this worthy effort in the future with again our sole intention being to help families affected by autism. At Chili’s, we want to make every guest feel special and we thank all of our loyal guests for your thoughtful questions and comments.”

  105. #107 Narad
    April 6, 2014

    This has probably been mentioned somewhere on RI – but how many have contacted Chili’s to protest their donating money from Monday’s sales to the National Autism Association (which claims that vaccines cause autism)?

    I suspect it was equally a case of the antivax brigade’s revealing just how deranged they are in response to criticism on Chili’s FB page, but anyway, the company has decided to look elsewhere (FB link).

  106. #108 lilady
    April 6, 2014

    Holy sh!t…Liz Ditz posted the NAA’s balance sheet, which includes some real dicey groups and individuals. Great Job Guys !!!

  107. #109 Bob
    United States
    April 6, 2014

    Blah, blah, blah. If you care about evidence-based medicine, all we have to do is see if there is less or more autism and/or autoimmune disorders in the children in these doctors’ practices. Everything else is just conversation. What we where from doctors like this is that autism is practically nonexistant in their practices. That’s evidence that can’t be ignored. You can plead “correlation is not causation” all you want, but statistically, it’s impossible that it would be “coincidence.” A true scientist is never afraid to question orthodoxy, and reevalute deeply held beliefs when real-life evidence proves them incorrect.

  108. #110 ABC
    April 6, 2014

    Sorry for the offtopic, but I came across this: http://www2.kenes.com/Autoimmunity/Scientific/Pages/3rdInternationalSymposiumonVaccines.aspx

    Among the speakers are Shaw and Tomljenovic who we know pretty well. I checked the scientific programs from the previous years and only this congress seems to be entirely focused on vaccines. Is this a pseudoscientific congress?

  109. #111 palindrom
    April 6, 2014

    I just heard very good NPR report
    about vaccinations in Marin County and elsewhere in which a number of pediatricians in Marin County were interviewed — but only sane ones! They also had an interview with a woman who has an immunocompromised son, who forcefully made good points about herd immunity. Finally some responsible journalism!

    http://www.npr.org/blogs/health/2014/04/06/299910441/how-public-health-advocates-are-trying-to-reach-non-vaccinators

  110. #112 herr doktor bimler
    April 6, 2014

    Everything else is just conversation. What we where from doctors like this is that autism is practically nonexistant in their practices. That’s evidence that can’t be ignored.

    Conversation is a bad thing, unless it’s conversation from antivax doctors in which case it’s incontrovertible proof. OK.

  111. #113 ann
    April 6, 2014

    What we where from doctors like this is that autism is practically nonexistant in their practices. That’s evidence that can’t be ignored. You can plead “correlation is not causation” all you want, but statistically, it’s impossible that it would be “coincidence.”

    No, it’s not.

    And there also might be other factors in play, anyway.

  112. #114 herr doktor bimler
    April 6, 2014

    Is this a pseudoscientific congress?
    Comment in moderation.

  113. #115 Chris,
    April 6, 2014

    Bob: “If you care about evidence-based medicine, all we have to do is see if there is less or more autism and/or autoimmune disorders in the children in these doctors’ practices”

    Which doctor’s practices? If you mean Sears and Gordon, remember they cater to a certain type of client (with $$$$). And we know at least one patient of Dr. Gordon had at least a seizure disorder, Jenny McCarthy’s son.

    But the issue has been looked at in several large health maintenance organizations in the USA through the Vaccine Safety Datalink. Here is a list of some of those studies, where you will see some on autoimmune diseases like diabetes:
    http://www.cdc.gov/vaccinesafety/library/vsd_pubs.html

    It would seem your introduction of “Blah, blah, blah.” was self referential.

  114. #116 Narad
    April 6, 2014
    Is this a pseudoscientific congress?
    Comment in moderation.

    Stanisław Lem?

  115. #117 herr doktor bimler
    April 6, 2014

    autism is practically nonexistant in their practices. That’s evidence that can’t be ignored

    Remember the enthusiastic proclamations that “autism is practically nonexistant” among the Amish? Until someone bothered to look, and found the autistic Amish. People like Bob were happy to ignore the evidence then.

  116. #118 herr doktor bimler
    April 6, 2014

    Is this a pseudoscientific congress?
    Comment in moderation.
    Stanisław Lem?

    My love for “The Futurological Congress” is quite immoderate.

  117. #119 Narad
    April 6, 2014

    This is merely a weak rehash of the dead-common Mayer Eisenstein/Homefirst® routine.

  118. #120 herr doktor bimler
    April 6, 2014

    This Mayer Eisenstein?
    These days he seems to have moved on from pediatrics and part-time lawyering (purused by creditors), to pimping a HGC Weightloss Diet.

  119. #121 lilady
    April 6, 2014

    Kristen Whatshername and her pro football star husband aren’t vaccinating because of Eisenstein:

    http://articles.chicagotribune.com/2014-03-14/health/chi-kristin-cavallari-jay-cutler-vaccinations-20140314_1_kristin-cavallari-vaccines-and-autism-children

    She’s quite confused (“more mercury”) about vaccines and it has nothing to do with “pregnancy brain”.

  120. #122 Krebiozen
    April 7, 2014

    Bob #109,

    What we where from doctors like this is that autism is practically nonexistant in their practices. That’s evidence that can’t be ignored. You can plead “correlation is not causation” all you want, but statistically, it’s impossible that it would be “coincidence.”

    Where can I find this evidence Bob? I can’t seem to find any stats from Dr. Gordon, nor even any claims that he sees fewer cases of autism than other doctors. He claims to be a scientist, and says that:

    I have observed thousands of children and families and kept records about their health

    If he has published these figures, I can’t find them. Looking at his more recent writings, he seems to support the idea that flame retardants cause autism, rather than vaccines.

    A search of the Pediatric Alternatives website finds no mention of autism, so there is nothing to support your claim there.

    To complete that “trio of antivaccine-sympathetic California pediatricians”, what about Dr. Bob Sears? Sears is a DAN doctor who specializes in treating children with autism (using unproven biomedical approaches), so it seems extremely unlikely to me that “autism is practically nonexistant” [sic] in his practice.

    So where is this “evidence that can’t be ignored”? Or did you just invent it?

    A true scientist is never afraid to question orthodoxy, and reevalute deeply held beliefs when real-life evidence proves them incorrect.

    Can I take it from this that you will be having a long hard think about your deeply held beliefs regarding vaccines and autism?

  121. #123 Narad
    April 7, 2014

    This Mayer Eisenstein?

    I just got a fair trade in entertainment for 70 cents by looking at recent activity in the case. On March 31, Eisenstein’s attorney moved to withdraw.

    “Irreconcilable differences have developed between your movant and the Defendant on various issues including, but not limited to, Defendant’s failure to pay movant for services provided in connection with Adv. Proc. No. 13-01050.”

  122. #124 herr doktor bimler
    April 7, 2014

    various issues including, but not limited to, Defendant’s failure to pay movant for services provided

    Browsing through the Chicago Tribune article, it is difficult to find anything that Eisenstein didn’t lie about… from his qualifications, to his non-existent malpractice insurance, to accusing all other doctors of shilling for Big Pharma while pimping his own drugs, to the legal shinnenigans designed to let him welsh on his debts (resulting from the non-existence of that malpractice insurance) while keeping his assets safe from seizure.
    It can’t have been too much of a shock for his lawyer to discover that the guy had no intention of paying him.

  123. #125 Rebecca Fisher
    April 7, 2014

    Age of Idiocy has reposted one of John C Stone’s dribbling rants today: “Emily Willingham, Dorit Rubinstein Reiss and the Barmy Army”

    Is it just me, or does anyone else get a little uncomfortable with the way Stone insists on including Dorit’s middle name? It’s almost as though he were deliberately trying to suggest some sort of Zionist plotting. There seems to be fairly frequent anti-semitic overtones to a lot of the AoA stuff.

    Or is that just me?

  124. #126 lilady
    April 7, 2014

    Stone has a sick fascination with Dorit, perhaps because she’s young, attractive, is well educated, actually is employed, is a law school professor…everything that the old fool isn’t.

    It’s a good thing that the old fool resides 6,000 miles away from Dorit, so that she has no worries that the old fool will stalk her…he’s that sick.

  125. #127 dingo199
    April 7, 2014

    Is it just me, or does anyone else get a little uncomfortable with the way Stone insists on including Dorit’s middle name? It’s almost as though he were deliberately trying to suggest some sort of Zionist plotting. There seems to be fairly frequent anti-semitic overtones to a lot of the AoA stuff.

    Perhaps he really like middle names.
    Like his own, for instance ;)

  126. #128 Jeff1971
    April 7, 2014

    What a state they are in.

    They have that self-regarding asshole Stone dribbling on, introducing his previous dribble, like it is some sort of wisdom that needs repeating,

    They have Olmstead repeating his previous amazing discoveries that, though lacking any degrees, training or intelligence, allows him to solve the mysteries of infectious disease so as to cast his light amid the darkness of science.

    And, incredibly, their new authority with the breakthrough proof that “vaccines cause autism” has been dead for about ten years.

    It sure is hold the front page time at Age of Autism.

  127. #129 Shay
    April 7, 2014

    “Or is that just me?”

    No, I think that’s typical of what our esteemed box of blinky lights calls crank magnetism.

    (Remember during the 2008 presidential campaign when Faux News would only refer to the Democratic candidate as
    Barak Hussein Obama, just to reminder voters that he was a seekrut commie Muslim?)

  128. #130 Shay
    April 7, 2014

    Crap. “Remind,” not “reminder.”

    I can spell, I just can’t type.

  129. #131 Mephistopheles O'Brien
    April 7, 2014

    the way Stone insists on including Dorit’s middle name

    Perhaps he’s channeling her mother?

  130. #132 Politicalguineapig
    April 7, 2014

    Rebecca: no, it’s not just you. Remember when they were going after the admin of the Poxes blog? They were all but running up the German flag and saluting it. And yes, there was a lot of ‘illuminati’ this, and ‘Rothschilds’ that.

  131. #133 Denice Walter
    April 7, 2014

    Whilst Orac is away,
    the minions will play… or perhaps do somethng useful.

    Jeff1971 is correct.
    Reading posts and comments at that virulent vat of frothing, fermenting altie mash, I have come to the conclusion that they REALLY don’t like us:
    John is bothered ( you may read whatever you like into that) by Dorit because she is attractive, intelligent and successful- in other words, what he’s not- and people like her simply remind him of his own lack of ability. Similarly, Reuben, Orac and probably, the rest of us.

    One of the commenters makes the hilarious accusation that Dorit, Art Caplan and Brian Deer are not scientists.
    Right. They’re not scientists. They shouldn’t be talking about vaccines. Apparently, the anti-vaxxers don’t even like when Dorit refers to blogs by scientists like Orac or Reuben.
    -btw- they hate Reuben too.

    In other anti-vax news:
    -TMR’s ( and AoA’s) Cat Jameson is very unhappy that that restaurant chain pulled its support so she writes about how marvelous NAA is. And Mikey attributes the restaurant’s new position to the action of the Medical Mafia.

    Take a bow, minions: we’re like the Corleones, the Krays or the Sopranos. Notice that I choose characters who are either entirely fictional or who have been depicted in films and comedy skits rather frequently.

    -A few days ago, the vexatious G–g showed up at AoA, discussing his infention to “hold ( vaccine advocates’) feet to the fire” or suchlike. Isn’t that illegal?

    In other news:
    – at PRN’s Talkback of yesternight, I witnessed a truly alarming event. TWICE ( archived; last 15 minutes):
    the mind-boggled, woo-spouting host took audience calls and gave what I can only describe as foolhardy, ignorant and dangerous medical advice.
    – a man said that his 90 year old female friend had swollen ankles. The cavalier woo-meister prescribed supplements/ herbal/ food remedies that she should take to control the condition.
    – the host pays nutriitonists to “counsel” customers at his health food store. Both the employee and her client spoke: it seems that his doctor gave him a prescription for insulin and the nutritionist then put him on a regime which he followed religiously and NEVER had to fill the prescription: his diabetes has vanished.

    Though I’m not a medical professional, even I know that swollen ankles in the very elderly can signal a serious problem like heat failure AND when a doctor writes a script for insulin, the patient usually has a high level of blood sugar because there are dietary, exercise and oral medication means to control blood sugar. A prescription also tells me that IMMEDIATE action needed to be taken. Which wasn’t.

    OBVIOUSlY the mark stepped into the woo-meister’s lair of his own free will and followed that bad advice BUT isn’t there something very criminal** about what is going on here?

    ** search as I did, that’s the word which keep popping up.

  132. #134 Denice Walter
    April 7, 2014

    OBVIOUSLY….. sigh.

  133. #135 Narad
    April 7, 2014

    They have Olmstead repeating his previous amazing discoveries that, though lacking any degrees, training or intelligence, allows him to solve the mysteries of infectious disease so as to cast his light amid the darkness of science.

    He recently rehashed his insanely stupid, noxious attempt to pin psychogenic blindness in Cambodian refugees on mercury (and maybe malnutrition, except the mercury was from all the fish they were eating; the commentariat then devolves into random frothing about vitamin A and vaccines).

    “Were there other scenarios that needed to be ruled out before this exotic, almost poetic, etiology was accepted as fact?”

    Gee, Dan, I think it might be called “checking to see whether there’s actually anything wrong with the patient’s vision.”

  134. #136 Narad
    April 7, 2014

    John is bothered ( you may read whatever you like into that) by Dorit because she is attractive, intelligent and successful- in other words, what he’s not- and people like her simply remind him of his own lack of ability.

    Perhaps explaining how he could still not have figured this little problem out:

    “the public vaccine compliance lady who cannot make up her mind whether she is simply a concerned mother or a nationally ambitious tort lawyer

  135. #137 Shay
    April 7, 2014

    How dare she try to be both?

  136. #138 Narad
    April 7, 2014

    How dare she try to be both?

    The thing is that Dorit’s not a member of the California bar (or anywhere else in the U.S., as far as I know). Stone’s too slovenly to bother checking before rolling out this element of his conspiracy theory.

  137. #139 Lawrence
    April 7, 2014

    @Narad – lawyers are only the good guys when the troll for ant-vax groups, didn’t you know that?

  138. #140 herr doktor bimler
    April 7, 2014

    Among the speakers are Shaw and Tomljenovic who we know pretty well. I checked the scientific programs from the previous years and only this congress seems to be entirely focused on vaccines. Is this a pseudoscientific congress?

    I tried reposting a comment, without links or even obscenities, but it still went into moderation. Must be some trigger words.

  139. #141 Denice Walter
    April 7, 2014

    @ herr doktor:

    Next time, spell it “bollox’.

  140. #142 SteveJ
    April 7, 2014

    @Rebecca
    [quote]Or is that just me?[/quote]No, it isn’t just you. He didn’t use Emily Willingham’s middle name.

  141. #143 herr doktor bimler
    April 7, 2014

    Next time, spell it “bollox’.
    The Scienceblogs template has probably been set to block my Commonwealth spelling of alumin[i]um.

  142. #144 herr doktor bimler
    April 7, 2014

    He recently rehashed his insanely stupid, noxious attempt to pin psychogenic blindness in Cambodian refugees on mercury

    It is gratifyingly self-referential. Olmstead’s account of a cluster of psychogenic blindness ignores and distorts enough evidence to display psychogenic blindness itself.

  143. #145 Rebecca Fisher
    April 8, 2014

    @Denise – I prefer to think of us as more like the Piranha Brothers.

  144. #146 Rebecca Fisher
    April 8, 2014

    “Denice” – sorry. :-(

  145. #147 Oh Really?
    April 8, 2014

    The only reason you do so many posts on vaccines is that it is the only thing that brings traffic to your site. Without it… you would get zero people here which would upset your god-complex mentality.

  146. #148 Denice Walter
    April 8, 2014

    @ Rebecca Fisher:

    My point exactly.

  147. #149 Chris,
    April 8, 2014

    Yet another Sock Puppet: “The only reason you do so many posts on vaccines is that it is the only thing that brings traffic to your site.”

    Aw, poor baby. Is your quack site being ignored?

  148. #150 Shay
    April 8, 2014

    “The only reason you do so many posts on vaccines is that it is the only thing that brings traffic to your site.”

    We’re pharma shills; don’t you realize we’re paid to come here and comment? I’m working on my second Lexus now.

  149. #151 Shay
    April 8, 2014

    (Six will get you ten that someone will take my post @150 seriously).

  150. #152 LIz Ditz
    April 8, 2014

    SHAY! What are you doing that I am not? My checks NEVER arrive.

  151. #154 Renate
    April 8, 2014

    @ 150 I’m still waiting for the money to buy TONTO
    http://vimeo.com/23970696

  152. #155 Denice Walter
    April 8, 2014

    Now Todd’s finally gone and done it, revealing everything which has always been suspected about us – the jig is up, the beans are spilt; the die is cast, the toast is burnt:
    we might as well ALL ‘fess up.
    Mike Adams is correct. ( see his podcast today) We bad.

    We may languish in indentured servitude but the pay is super. Just the other day, I thought, as I stroked my brand new, pearl grey iguana Lagerfeld limited edition bag and shifted my Jag into first, “This is living! And all I had to do is sell my soul to the Pharmacorporatocratic Police State”.
    I get clothes, gems, trips, cars and lovely, similarly compromised gentlemen who are just as corrupt- and pretty- as I am. What’s so bad about that?

    Do you REALLY think that I would waste my time being a Truth Telling Internet Journalist, a Paradigm-shifting, Maverick-y Scientist, a BOLD Mother Warrior Person or suchlike? Those people are boring, uncorruptible and what’s more- they have absolutely NO style whatsoever. They just fight, fight, fight for their Children, the People or the Truth – what’s fun about that? Do they get to go the islands, drink chanpagne and stay next door to David Bowie. I’ll bet not.

    Of course, I’m not greedy and I realise that a few of my colleagues ( read ‘partners in crime’) have got bigger perks than I have – but that’s alright with me, as long as they invite me over to their castle or aboard their newest jet I’m OK. Do you hear me, Paul?

    I know that as a psychologist, I could probably write this up and confess that this is all a joke: we aren’t in the pay of the powers-that-be, there is neither PharmaCom nor a “person” named Draconis, no grand parties on the Grand Canal. We have great fun attacking and elaborating upon the fantasy systems** dreamt up by alties and anti-vaxxers with axes to grind against reality.
    But you wouldn’t believe me, would you?

    ** which rival those of LoTR or GoT in their convoluted structure- except that they’re poorly written and lack all relation to human motivation in real life.

  153. #156 Helianthus
    April 9, 2014

    #147

    The only reason you do so many posts on vaccines is that it is the only thing that brings traffic to your site.

    1 – I disagree. Speaking only for myself, I actually look forward for posts by Orac on topics outside of vaccines, if only for a change of pace, but more importantly for the chance to learn something about cancer, or about some weird quackery, or any other topic he feels sharing some thoughts on.
    Not that’s Orac fault if I feel blasé on vaccine topics: antivaxers cannot give up on beating dead horses and it’s getting boring to watch them rehashing the same canards every other month.

    2 – if having some fame solely for one’s writings or actions on a specific topic is, by your metrics, no reason to be famous, I guess we can throw away about half our libraries and remove three-quarters of the names from history books.
    Benjamin Franklin? Peuh. If he hadn’t jumped on the bandwagon and talked about freedoms, no-one will have been interested in this guy.

    3 – re: god-complex mentality
    Humans are social animals. To some degree we are all attention-seekers, dude.
    Example: your own post.

  154. #157 akshelby
    United States
    April 9, 2014

    I posted a harmless get yourself vaccinated post on FB and an herby naturalist annoying friend posted this response. I am assuming she doesn’t know what the fuck she is talking about but I really don’t know how to respond. Any pointers from anybody?

    ” In 96 a serious discussion followed about the assumed rates at which ‘herd immunity’ would fully eradicate a disease because Canada had hit the ‘ideal’ rates and there was a major outbreak. This time Dr’s point the fingers at ‘anti vaxer’s’ although there has been a multitude of studies that show that break through out breaks are normal (because active virus lives in our environment) and will actually increase as acquired immunity goes down (causing concern for the elderly population and for infants who do not receive benefit from a vax’d mother where they would from a mother with acquired immunity.)

    This is because a percentage of people who get vaccines produce low titers to attenuated virus. Their titers have a tendency to drop below the ‘immune’ level well before boosting is recommended, they are significant enough to always make sure that the theory of ‘herd immunity’ and completely eradicating a virus from the human population cannot fully happen. So, we have set up a situation where people will need to be boosted for life. And unfortunately, unless you pull the titers of everyone pre-viral out break you cannot determine what segment of the population in that area is susceptible despite vaccines or even targeted boosting.

    In a 1990’s outbreak a blood drive had been conducted at a university campus just a few weeks before the outbreak was confirmed. They had the good look of viewing the titers, the a typical cases, those with full blown measles. The a typical cases were in the majority with people who had been vaccinated and not vaccinated (in this case only a fraction of the cases) presenting with only headache and a cough and fever. The theory then sproughted that there are far more a typical cases of the measles than what is reported and even among the vaccinated. Vaccines have a short history, the theory of herd immunity does as well. We need solid tracking of titers and variances in order to get a true picture. But this is trending to not happen because of reactive and non reflective articles like this which are pedestrian in their understanding of disease and immunology (which is not the study of the immune system but the study of vaccine intervention.)

    Measles is not a life threatening disease to those with healthy immune systems. It has similar side effects and rates of morbidity as chicken pox. Of the 222 cases in the USA in 2011 there were zero deaths. The rate of death increases within populations who have no access to health care (IV drips etc.) The rate of complications (dehydration etc) are lower than the influenza virus. It is a disease that requires that newborns and elderly or immune challenged individuals who have not had the illness be quarantined because they run the greatest risk of complication particularly due to their low immune function. A newborn simply does not yet have a fully developed immune system and the elderly are considered immune impaired because all functions of the body slow. It also can impact the health of fetus’ in utero.

    http://jid.oxfordjournals.org/…/sup…/S549/T3.expansion.h
    tml

    “The least-efficient vaccine responders (bottom 5%) had their PRN titers fall below 120 units within 5-10 years after the second MMR shot. This percentage of vaccinated children is expected to have full-blown, clinically identifiable measles upon exposure when they get a bit older. This is the reason why vaccinated (and even twice-vaccinated) people show up as disease cases in numbers equal to or even exceeding the unvaccinated cases in communities with very high (>95%) vaccination coverage. Rapid loss of vaccine protection in low responders is the reason for the paradox of a “vaccine-preventable” disease becoming the disease of the vaccinated in highly vaccinated communities. Such disease cases (and outbreaks driven by them) are not due to random vaccine failures, they are anticipated vaccine failures.”

    You will notice on the CDC guidelines being born before 1957 actually exempts you from the vaccine. The Study I posted will show you titers from women born before that date. This in particular was because of the high rate of acquired immunity where exposure is assumed to be guaranteed. Titer numbers were drawn post BU outbreak where people where also vaccinated, those numbers would be naturally higher as many of those people had exposure + were vaccinated. The lowest Titer numbers were among school children and blood samples taken at the blood drive at BU previous to the known outbreak which show that even among the vaccinated population their titers had fallen to well below immune levels.

    Considering the low morbidity of Measles and other routine childhood illnesses the question of cost vs benefit has begun even among the research community with the rise of ASIA in infants.

    http://www.ncbi.nlm.nih.gov/pubmed/23557271

    There are hundreds of studies that have been done on this risk v benefit question. Many of them can be found on pubmed. Many of them conclude that further study is needed particularly in cases of routine illnesses where we vaccinate not for the benefit of that particular child but to protect a small portion of the population with low immunity. That basic idea is the principle behind the epidemiological construct called heard immunity. Or it was at its inception…I think it has evolved into something else.”

  155. #158 Lawrence
    April 9, 2014

    @ask – I would point out that Measles has no disease reservoir besides human beings – so it can be eradicated (much like Smallpox has been & Polio soon will be)…..so if enough people got vaccinated, then we could eliminate the disease entirely.

    There is also no current evidence that shows that a booster for the Measles part of the MMR (or MMRV) is necessary. And far from a mild disease, over 120,000 people still die of the Measles every year, and in the last large outbreaks recently in Europe, over 25% of the infected individuals required hospitalization.

  156. #159 Chris,
    April 9, 2014

    akshelby’s herby friend: “Considering the low morbidity of Measles and other routine childhood illnesses the question of cost vs benefit has begun even among the research community with the rise of ASIA in infants. ”

    Except the MMR does not have any adjuvants. And the costs have been thoroughly studied:
    Pediatrics. 2014 Mar 3. [Epub ahead of print]
    Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009.

    And she is lying about the severity of measles, in more recent outbreaks almost 20% need hospital care:
    http://jid.oxfordjournals.org/content/189/Supplement_1/S4/F3.expansion.html

    akshelby, you should ask your friend why a kid should suffer with a high fever and a high risk of pneumonia instead of getting an MMR vaccine. Ask her for data showing it is more dangerous than measles, and to make sure to not post papers on stuff that vaccine does not contain.

  157. #160 lilady
    I need a preview function !!!
    April 9, 2014

    @ ashelby: Your first link leads to a publication from the IDSA and is behind a paywall. I located this study about presumed MMR vacccine secondary vaccine failure (waning immunity against measles), which was published in the IDSA “Journal of Infectious Diseases”, 2011.

    http://jid.oxfordjournals.org/content/204/suppl_1/S549.long

    Laboratory Characterization of Measles Virus Infection in Previously Vaccinated and Unvaccinated Individuals

    Carole J. Hickman1,
    Terri B. Hyde2,
    Sun Bae Sowers1,
    Sara Mercader1,
    Marcia McGrew1,
    Nobia J. Williams1,
    Judy A. Beeler3,
    Susette Audet3,
    Bryan Kiehl4,
    Robin Nandy2,
    Azaibi Tamin1 and
    William J. Bellini1

    Scroll down to see the conclusion of studies of measles outbreaks in the RMI (Republic of the Marshall Islands) and in the United States, the milder type of measles infection in those individuals who experienced SVF (Secondary Vaccine Failure) and the (non) role of SVF cases for transmission of measles during outbreaks:

    “….Although we do not know the initial PRN titer or immune status of the RMI or US SVF case patients, it is significant that a few were RT-PCR positive for wild-type measles virus, which suggests that these cases have the potential to shed and spread virus to susceptible contacts. It is important to note, however, that there was no known or documented transmission from the SVF cases in RMI. Likewise, an investigation of 2 US SVF cases did not reveal secondary spread of measles to other students within their college community [10]. Similarly, measles in 2 fully immunized (2-dose recipient) siblings exposed during an airplane flight [26] was mild, and these children did not subsequently transmit measles even though a nasal swab sample from 1 of the children was positive for measles virus RNA by RT-PCR. Together, these data suggest that viral transmission from those with SVF cases to other susceptible individuals may be very limited or may not occur at all.

    In conclusion, we have characterized measles SVF in 2 populations: in the RMI, which represents a fairly typical international setting as countries move from enhanced control and mortality reduction to regional elimination, and in a highly vaccinated US population with broad 2-dose MMR coverage. SVF in both situations was characterized by documentation of prior measles vaccination, the presence of high-avidity anti-measles IgG, and markedly elevated levels of PRN antibodies. Elevated PRN titers appear to represent a biomarker for SVF, and additional studies are needed to determine whether elevated titers persist and whether they can be used to identify SVF cases within a highly vaccinated society. The duration of MMR vaccine-induced immunity in the absence of circulating virus is not well understood and may be significantly impacted by age at first vaccination, as well as by the timing of the second dose. Consistent implementation of a 2-dose schedule is also needed to maintain high population immunity against measles, to minimize disease, and to prevent subsequent outbreaks. Because SVF cases are generally mild, they may be missed unless they are seen within an outbreak setting and linked to an acute, severe measles case. Until the transmission capacity of SVF cases has been fully established, the presence of measles disease in twice-vaccinated persons illustrates the need to (1) closely monitor levels of measles antibodies in adolescents and adults in the US population, (2) be vigilant of modified disease presentation during outbreaks, and (3) evaluate vaccinated close contacts when investigating sporadic unknown source cases that have no apparent link to importation. Based on accumulating evidence, and as reported by Rota et al [48] in this supplement, patients with SVF cases do not appear to efficiently transmit virus, and their occurrence will likely not impede measles eradication efforts.”

  158. #161 Narad
    April 9, 2014

    So, we have set up a situation where people will need to be boosted for life.

    One might note that there’s no good reason to think that this doesn’t apply to disease-based immunity as well: one of the cases in the latest New York outbreak was 63. The quote, by the way, is from Tetyana Obukhanych, not JID. That item is here.

    There is only one documented case of transmission to other vaccinated individuals by virtue of secondary vaccine failure, with no further spread; circulating antibody levels aren’t the whole story. Moreover, we’ve been vaccinating against measles for nearly half a century, and it ain’t happened yet.

    There are a couple of papers out there that examined a second MMR booster and didn’t find it warranted; I’ll try to dig them up.

  159. #162 Narad
    April 9, 2014

    ^ “an additional booster,” that is.

  160. #163 JGC
    April 9, 2014

    antivaxers cannot give up on beating dead horses

    At this point, after more than a decade of study, it’s more like they’re swinging their fists wildy at the empty air at a place where rumor has it a horse may possibly have once been standing.

  161. #164 Narad
    April 9, 2014

    Looks like I was thinking of mumps, so scratch that.

  162. #165 herr doktor bimler
    April 9, 2014

    at the empty air at a place where rumor has it a horse may possibly have once been standing
    Ah, “Pin the Tail on the Dead Donkey”. Not as popular at children’s parties as one might expect., but that’s another story.

  163. #166 Dangerous Bacon
    April 9, 2014

    As we all know, the most popular activity at children’s birthday parties is having their blood drawn for antivax research.

  164. #167 ann
    April 9, 2014

    Measles is not a life threatening disease to those with healthy immune systems.

    That’s not true.

  165. #168 Mephistopheles O'Brien
    April 9, 2014

    Ah, “Pin the Tail on the Dead Donkey”. Not as popular at children’s parties as one might expect., but that’s another story.

    Far more popular is the educational “Pin the Ear on Van Gogh”.

  166. #169 Mephistopheles O'Brien
    April 9, 2014

    Measles is not a life threatening disease to those with healthy immune systemswho survive the disease.

    FTFY

  167. #170 Vicki
    April 9, 2014

    Measles is not a life threatening disease to those with healthy immune systems.

    That’s not true.

    Even if it were, that’s someone who is effectively telling a nontrivial number of people that their lives and/or their children’s lives aren’t worth saving.

    Yes, there’s a strong eugenicist streak in the anti-vax movement: it’s worth pointing it out. It’s worth reminding people that those “it’s not a problem if you’re healthy” people don’t care if children with diabetes die of measles. We can save the lives of children with cancer, but not if the anti-vaxers have their say.

  168. #171 Mephistopheles O'Brien
    April 9, 2014

    The problem with a statement like “xx is not dangerous if you have a healthy immune system” is that there is no good measure of how healthy your immune system is except when you catch (or don’t catch) a disease. If you survived, you were healthy. If you didn’t, welll…

  169. #172 ann
    April 9, 2014

    Besides which, once you have measles, your immune system won’t be so healthy.

  170. #173 janerella
    Sunshine! Fresh Air!
    April 10, 2014

    Measles is not a life threatening disease to those with healthy immune systems.
    Really? Sunshine! Fresh Air! Exercise! Organic food! Whatever did those Aussie aboriginies do wrong…
    estimated mortality rates of over 30% for smallpox epidemics and 20% for measles epidemics.
    http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/handbook10-3-1

  171. #174 Krebiozen
    April 10, 2014

    I don’t understand how anyone can read that Oxford Journals study and come away from it thinking it is evidence that the measles vaccine doesn’t work, or that secondary vaccine failure is an important factor in the recent US outbreaks. It says the exact opposite!

  172. #175 Calli Arcale
    http://fractalwonder.wordpress.com
    April 10, 2014

    Mephistopheles et al:
    Yes, it’s a special kind of victim-blaming, isn’t it? It carries the implication that if measles hurts you, obviously you let your immune system weaken. Except, of course, that in addition to not really being able to know just how strong you are, even if their premise was true, you never know when you’re health will be challenged by something. Let’s just assume, for argument, that eating right and getting regular exercise is all it takes to be healthy. How do you know you aren’t going to be hit by a bus tomorrow? That’ll weaken you. Or bitten by a mosquito carrying West Nile Virus?

    The whole idea of “well, I don’t need vaccines if I’m always healthy” has a lot of unwise assumptions underlying it; it’s a bit like saying “I don’t need car insurance as long as I don’t get into a car accident.” The whole *point* is that you don’t know that the second part of the statement is true, and really can’t ever know until someone invents a time machine (at which time no doubt we’ll have entirely new problems).

  173. #176 Narad
    April 10, 2014

    I don’t understand how anyone can read that Oxford Journals study

    Minor point: Oxford doesn’t own CID and JID; they’ve published them under contract for the Infectious Diseases Society of America since 2011.

  174. #177 AnnB
    April 14, 2014

    A striking and simple infographic anyone can understand. Apologies if this is redundant.

    How Vaccines Have Changed Our World In One Graphic

  175. #178 brewandferment
    way behind the reading power curve
    April 21, 2014

    My apologies for such a late comment, but having fled California some years ago, I got curious about the pedatricians on Bob Sears’ vaccine (un)friendly list. IMHO the attitudes towards vaccinations is the lesser problem: the sheer number of ND (not-a-doctor) persons on the list is by far more appalling. Sears’ whines about vaccinations notwithstanding, why on earth is he referring parents to ND practitioners???

  176. […] an antivaccine pediatrician in the Bay area called Dr. Stacia Kenet Lansman, which I described in a post just this month. This particular poor excuse for a pediatrician thinks that vaccines are “messing with […]

  177. #180 Julian Frost
    Gauteng East Rand
    April 23, 2014

    Sadly, a new person has joined the antivaxx club.
    Alicia Silverstone has a new parenting book out. Her son has “never had a drop of medicine”, and she won’t be vaccinating him against measles and chicken pox.
    It seems oddly appropriate that “Clueless” was the film that made her famous.

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