Respectful Insolence

Menadiol-3D-balls

As prolific as I am, I have actually slowed down. Long time readers know this, as I used to have a post up seven days a week and sometimes two or more in a day. These days, I’ve made it a rule that I don’t post on weekends (except if something really catches my eye and I can’t control the blogging itch until Monday), and I almost never post more than once a day on weekdays. Heck, of late I’ve even been known to miss a weekday every now and then without even recycling posts from my not-so-super-secret other blog. It’s good, as I was a bit insane back then.

What I’m talking about is an article that appeared a week ago in Mother Jones by my old ScienceBlogs fellow blogger Chris Mooney. Now Chris and I might have had our differences over the years, but more often than not he’s right on, and even when we disagree we’re usually not so far apart that the gap is unbridgeable. In any case, a week ago, Chris published an article entitled Babies Are Getting Brain Bleeds—Are Vaccine Fears to Blame?, where he described a problem:

In May, the Tennessean reported on a truly shocking medical problem. Seven infants, aged between seven and 20 weeks old, had arrived at Vanderbilt University’s Monroe Carell Jr. Children’s Hospital over the past eight months with a condition called “vitamin K deficiency bleeding,” or VKDB. This rare disorder occurs because human infants do not have enough vitamin K, a blood coagulant, in their systems. Infants who develop VKDB can bleed in various parts of their bodies, including bleeding into the brain. This can cause brain damage or even death.

There is a simple protection against VKDB that has been in regular medical use since 1961, when it was recommended by the American Academy of Pediatrics: Infants receive an injection of vitamin K into the leg muscle right after birth. Infants do not get enough of this vitamin from their mother’s body or her milk, so this injection (which is not a vaccine, but simply a vitamin being delivered via a shot) is essential, explains pediatrician Clay Jones on the latest installment of the Inquiring Minds podcast (stream below). It’s also quite safe.

Mooney’s article was based largely on information supplied to him by a pediatrician, Clay Jones, who also happened to blog at my not-so-super-secret other blog about the efficacy and safety of neonatal vitamin K injections for preventing brain bleeds, in a post from last year entitled Separating Fact From Fiction in the Not-So-Normal Newborn Nursery: Vitamin K Shots… and an installment of the Inquiring Minds podcast. The long version is in Clay’s post, but the short version is that newborn infants are considered universally deficient in vitamin K because of poor transfer of the vitamin across the placenta, immaturity of the liver leading to decreased storage capability and inefficiency at using available vitamin K, and deficiency of vitamin K in breast milk. In addition, the gut of the newborn, which starts out sterile, doesn’t significantly contribute to vitamin K levels for several weeks. (Vitamin K is actually synthesized by bacteria in the intestines and then absorbed.) The primary function of vitamin K is in clotting, where it’s a cofactor necessary for the activity of several enzymes involved in the clotting cascade. Indeed, the mechanism by which the anticoagulant drug warfarin (Coumadin) is by blocking the conversion of inactive precursors into active vitamin K, which is why vitamin K is used to reverse the the effects of Coumadin, and patients are told to avoid foods rich in vitamin K.

Without supplementation, babies are at risk for a potentially life-threatening complication known as vitamin K-deficient bleeding (VKDB). It primarily occurs in breastfed babies who didn’t receive an intramuscular dose of vitamin K as a newborn. There are two forms, an early form that occurs in the first week of life with an incidence of 0.25% to 1.7%) and a late form (late VKDB) that occurs between 2 and 12 weeks of age. It is this late form that tends to be associated with brain bleeding. Worse, VDKB can occur in perfectly healthy babies spontaneously (i.e., no obvious trauma is necessary), and it can range in severity from mild to life-threatening. Bleeding commonly manifests itself as skin bruising, bleeding from the mucus membranes, bleeding at the umbilical cord stump, and, worst of all, bleeding into the brain. Although the risk of late VKDB in babies who don’t receive prophylaxis is low (4.4 to 7.2 per 100,000 children not receiving vitamin K prophylaxis, according to Clay), intramuscular vitamin K is virtually 100% protective, and oral vitamin K supplementation doesn’t work nearly as well, so much so that some countries who had previously switched from recommending intramuscular vitamin K to recommending oral supplementation switched back to intramuscular injection after they noted a spike in cases of VKDB. Moreover, the intramuscular vitamin K injection is about a safe an intervention as you can imagine. Even though the incidence of late VKDB without prophylaxis is very low, the consequences are so devastating and the prophylaxis is so safe and effective that it makes perfect sense to recommend it.

Whether vaccine fears or not are responsible for the increase in parents refusing the vitamin K injection for their newborns is unclear. The wag in me wants to point out that it’s probably not fear of vaccine that’s driving this phenomenon. After all, most antivaccinationist or vaccine-averse parents love vitamins, given the prevalence of “natural medicine” among those who tend to distrust vaccines. Rather, I tend to believe that it’s a similar phenomenon, the fear of injections driven by the naturalistic fallacy that assumes that an injection of “synthetic” vitamin K is somehow “unnatural” and therefore inferior or dangerous, that drives rejection of the vitamin K injection. However, a lot of the same fallacies that drive vaccine rejectionism drive vitamin K rejection. A great example of this comes from someone whom we’ve met before.

I’m referring to a woman named Megan from a woo-infused website LivingWhole.org. We first met Megan, who brags about being a naturopath, Certified Natural Health Educator, Registered Power Yoga Instructor, writer, and stay-at-home mama, when she wrote a mind-bogglingly ignorant antivaccine screed that later disappeared because Megan confused criticism for persecution and harassment. An example of the sort of pseudoscience Megan regularly lays down is her “classic” post, Dear parents, are you being lied to?, which is still periodically pops up on Facebook and Twitter. Regular readers here will have no problem deconstructing its many…issues.

Cut from the same cloth is her post from yesterday, Synthetic vitamin K shot for my baby? No thanks. The article declares its dedication to pseudoscience from the very first paragraph, but the second one is where the nonsense starts:

The about four babies who get vitamin K deficiency bleeding (VKPD) out of the four million babies born in the United States each year? That’s not due to the medications women take while pregnant, trauma women and babies suffer during a modern childbirth, early cord-cutting, the low levels of gut bacteria infants have because we wipe it out with antibiotics, infant circumcision, or the hep B vaccination given to your babe during its first 12 hours of life to “protect” it against a disease that’s transferred via sex and dirty needles. It’s just a coincidence that one of the many possible adverse reactions of all infant vaccines includes encephalitis, which coincidentally can cause hemorrhaging.

That’s right. Right off the bat, Megan is trying to insinuate that it’s the neonatal hepatitis B vaccine that causes VKPD, not vitamin K deficiency. Based on what evidence? None, of course! Not surprisingly, she zeros in like the proverbial woo-infused laser beam on just the brain bleeds, which are uncommon, ignoring the other forms of bleeding due to VKPD, which are much more common, with an incidence between 0.25%–1.7%. She also keeps claiming that there is little evidence for the efficacy of the neonatal vitamin K shot. The American Academy of Pediatrics would beg to differ, pointing out that it’s been the standard of care since 1961. When faced with the ill-informed opinion of a naturopath and “natural” mother (or father) and the opinion of a major medical society based on evidence, guess which one I’ll lend a lot more credence to.

None of this stops our Megan, who dives further and further into bad science. If early VDKB to her is caused by the hepatitis B vaccine right after birth, then what could possibly be causing late VDKB, which is what causes the the highest risk of intracranial hemorrhage. One wonders, one does… Actually, one doesn’t. Megan is as predictable as she is medically ignorant:

But what else happens between 2 and 12 weeks that could cause a hemorrhage? Breastfeeding in and of itself does not and cannot cause trauma that induces bleeding. Let’s see what can:

Between four and twelve weeks, we give babies twelve vaccines including a second dose of Hep B, and two doses of DtaP, IPV, Hib, and PCV, all of which can cause vasculitis and brain encephalitis that can induce a hemorrhage. Our children also get two doses of a live rotavirus vaccine that can shed, infect others, and cause hemorrhagic enteritis and thrombocytopenic purpura (a bleeding disorder). Have you read your child’s vaccine inserts?

Forget “Late-onset VKPD” (vitamin K deficiency bleeding). Let’s call it “Late-onset VIB” (vaccine-induced bleeding). When these babies get sick from their vaccinations, we then put them on antibiotics, which wipe out their gut flora hindering their ability to synthesize vitamin K from breast milk leaving them at risk for an uncontrollable bleed.

Yes, indeed. It has to be vaccines, too! But, then, you knew that that’s what it had to be, given Megan’s history. Never mind that she has not one shred of evidence to support this hypothesis. Like many antivaccinationists, she’s good at tying together disparate observations without having the scientific background to realize that what she is doing is complete and utter nonsense. I’ve discussed before what this sort of speculation reminds me of, but first I’ll give you another example of it:

You know what else “synthetic vitamin K” enthusiasts don’t understand? The thought that babies (and all animals for that matter) have lower levels of vitamin K at birth for a beneficial, protective, reason. I’m just going to throw these “common sense-based” thoughts out there but let’s consider them:

First, in order to absorb vitamin K we have to have a functioning biliary and pancreas system. Your infant’s digestive system isn’t fully developed at birth which is why we give babies breast milk (and delay solids) until they are at least 6-months-old, and why breast milk only contains a small amount of highly absorbable vitamin K. Too much vitamin K could tax the liver and cause brain damage (among other things). As baby ages and the digestive tract, mucosal lining, gut flora, and enzyme functions develop, baby can process more vitamin K. Low levels of vitamin K at birth just…makes…sense.

Secondly, cord blood contains stem cells, which protect a baby against bleeding and perform all sorts of needed repairs inside an infant’s body. Here’s the kicker, in order for a baby to get this protective boost of stem cells, cord-cutting needs to be delayed and the blood needs to remain thin so stem cells can easily travel and perform their functions. Imagine that, baby has his/her own protective mechanism to prevent bleeding and repair organs…that wasn’t discovered until after we started routinely giving infants vitamin K injections.

Megan thinks she is brilliantly synthesizing medical knowledge about vitamin K on the “just makes sense” model. I’m surprised, but relieved, that she didn’t invoke some sort of reason based in evolution. Still, I’m amazed at the turn Megan managed to make in invoking cord blood stem cells, and the alleged shortage of them due to premature clamping of the umbilical cord, as the “real reason” why low vitamin K in the newborn is adaptive, so that these stem cells can do what it is they do. Again, of course, there is no good evidence to support her speculations. How Megan comes to the remarkable conclusion that low vitamin K is natural and allows stem cells to prevent bleeding and “repair organs” is a brilliant example of the Dunning-Kruger effect, in which Megan relates diverse observations to each other without understanding the context of those observations or even the basic science that makes her conclusions from them incredibly implausible. To her they just “make sense”; so they must be right. Never mind whether they make sense from a scientific standpoint. It’s the sort of thing that the crews at antivaccine blogs like The Thinking Moms’ Revolution and Age of Autism routinely do do when they string together all sorts of scientific studies and observations willy nilly into a narrative that sounds compelling to a non-scientist but that scientists scoff or laugh at because they have a deep understanding of the actual science that provides them with an exquisite BS detector.

One other myth about vitamin K shots is that they cause childhood leukemia, and Megan hits this one as well. She cites studies that are over 20 years old, ignoring the mass of evidence since then that has shown that vitamin K injections are not associated with childhood cancer. As Clay pointed out, this question was thoroughly investigated after those small studies, and no association was found. Moreover, more recent science on the pathophysiology of childhood leukemia weakens the plausibility of a link to neonatal vitamin K injections, given that newer evidence strongly suggested a prenatal origin to the cancer. Megan even hits the package insert for vitamin K injections the same way that antivaccinationists mine the package inserts for rare adverse reactions to vaccines, leading her to wax fearful about rare anaphylactic reactions and the “toxicity” of aluminum, the latter of which can only reach toxic levels after prolonged intravenous administration, not a single intramuscular dose.

In the end, Megan pontificates:

When it comes to my children, I err on the side of biology, evidence, caution, and common sense. Whether you believe in God or biology, I don’t think either messed up, and the “data” hasn’t shown otherwise. Who’s with me?

Given that Megan is wrong on just about everything about vitamin K injections, her appeals to “biology” and “common sense” notwithstanding, the answer to that question should be crickets chirping.

Comments

  1. #1 herr doktor bimler
    August 5, 2014

    I’m sure that a homeopath could achieve the same result with C30 Warfarin.

  2. #2 Helianthus
    August 5, 2014

    The about four babies who get vitamin K deficiency bleeding (VKPD) out of the four million babies born in the United States each year?

    “about”?
    I guess the low yearly figures of “about 4″ over 4 million babies have nothing to do with near-universal vit K injection.
    Similarly, I guess the low incidence of measles and other infant illnesses have nothing to do with near-universal vaccination.
    /sarcasm

    she didn’t invoke some sort of reason based in evolution.

    She is getting close. She did say that “Whether you believe in God or biology, I don’t think either messed up,”

    Meh. I used to go for this fallacy when I was in my 20’s – if it’s this way naturally, then there should be a good reason for it.
    I eventually outgrow it. Mostly.
    For some biological trait to tag along, it just need not to have a good reason against it.

    Nature/god/evolution doesn’t seem to care if a few babies die, as long as enough of them survive into adulthood to reproduce and ensure the perpetuation of the species.
    So yeah, sorry, nature is a big mess. Or god was operating on a string budget. Or was drunk.

  3. #3 nz sceptic
    August 5, 2014

    Urghhh! This comment – posted on the Vit K rant by a fawning follower of the afore-mentioned Megan, says it all really:

    ‘Megan…

    Your write ups are so well written…..so thoughtful…..& contain so much truth!

    You conclude your posts with the words ‘I am not a physician and this is not medical advice. It is my humble, entirely uneducated, opinion as a parent’

    I’ve seen, over my entire life, probably around 50+ physicians (both at work, and through personal visits) – and the knowledge that they all possess collectively, doesn’t even scratch the surface in comparison with the knowledge that you possess…

    so essentially – you’re much more effective than a doctor…even though you don’t walk this earth with a professional looking document with gold stars/medals on it.

    you’re the doctor of planet earth and humanity.

    thank you for always following your inner light; and always keep on shining.

    ell-low-vee-ee’

  4. #4 Julian Frost
    Gauteng East Rand
    August 5, 2014

    Helianthus beat me to it. It’s the same reason why the risks of VPD’s are so low in countries that vaccinate properly.

  5. #5 Deb
    Oz
    August 5, 2014

    Whether you call it God or Nature it’s religious thinking – that every part of us is perfectly designed and intended.

    Reality is messier with a lot of trade offs. Vitamin K is made by bacteria. You can either have low vitamin K and a sterile uterus for the baby to develop in, or you can have bacteria in there. I think uterine infections vs extremely rare bleeding is a good example of a ‘strong selective pressure.’

    We are as we are because of a fascinating history where every turn has consequences, not a grand design. The type of hubris that can’t accept that is also the type that thinks it can know better than doctors because it just. makes. sense.

  6. #6 Chris Hickie
    August 5, 2014

    That disclaimer at the end of her rant: ‘I am not a physician and this is not medical advice. It is my humble, entirely uneducated, opinion as a parent’

    Humble? Not by a long shot.

    Entirely uneducated? Bingo.

  7. #7 Dangerous Bacon
    August 5, 2014

    “Whether you believe in God or biology, I don’t think either messed up”

    Megan needs to be transported back into the 19th century to get an idea of how well Nature managed childhood mortality.

  8. #8 Dorit Reiss
    August 5, 2014

    @dangerous Bacon: it’s a little different when we talk about God, but I really don’t see why the nature adherents believes Mother Nature prefers us over germs. If my anthropomorphic ideal was nature, is assume that like the Childish Empress, she accepts all her children as they are, with no favorites.

  9. #9 Adam
    August 5, 2014

    Anyone dumb enough to err on the side of biology with Megan should go the whole distance. Forget about delivering in a sterile environment, forget about having medical treatment available for mother and/or baby. Just let rip anywhere at all without any particular precaution with regards to sanitation or hygiene. Just squeeze it out and cut that cord with anything sharp layout around. And if the baby / mother suffer complications up to including death during delivery then hey, that’s just biology. It’s all natural. It’s all good.

  10. #10 lilady
    Looking at Megan's Facebook page
    August 5, 2014

    Good grief. What an ego-driven, science-illiterate individual Megan is. Scroll on down to see the “Mommy Lionesses” who post their inane comments.

    https://www.facebook.com/LivingWhole.Org/timeline

    “We’re not just “anti-vaccination.” Apparently we’re also “anti-vitamin.” Good one. Here’s my take on the vitamin K shot. Fair warning…I call it what it is…a patented, synthetic, non-naturally occurring substance (complete with additives and preservatives) associated with death, cancer, and brain damage.”

    BTW, that G-d fearing naturopath is also a proven pathological liar:

    http://www.skepticalraptor.com/skepticalraptorblog.php/papa-scared-shmeasles-measles/

  11. #11 Eric Lund
    August 5, 2014

    I presume it’s called VKDB because it’s been established that it’s caused by vitamin K deficiency–otherwise, it would be called neonatal hemorrhage, or [insert medical researcher’s name here] Syndrome, or something of that sort. And perhaps it did have such a name long ago, before the cause was determined. I’ve seen this process in my own field, which like medicine is driven strongly by observational results. Megan seems not to have considered this notion.

    As for the hepatitis B vaccine being a possible cause: If that were true, VKDB incidence should have increased dramatically with the introduction of the neonatal hep B vaccine, which wasn’t available when I was born. I’m not seeing that correlation; if there is one, it’s in the wrong direction (i.e., greater VKDB incidence because vaccine-averse parents refuse the vitamin K injections for their newborns).

  12. #12 Helianthus
    August 5, 2014

    We’re not just “anti-vaccination.” Apparently we’re also “anti-vitamin.”

    Well, if the shoe fits…

    non-naturally occurring substance

    Oh gosh, that a maroons and proud of it.
    Megan, if you really believe the sh!t you are spewing, go eat some Nux vomica (not in homeopathic form), strychnine is a all-naturally occurring substance.
    Kids, don’t try this home.

  13. #13 Liz
    August 5, 2014

    Oh gawd! The stupid, it burns! I have lost all patience with these lunatics. To people who believe as Megan does, they do indeed need to go the whole distance: if you refuse a Vitamin K shot for your newborn and your newborn develops a brain bleed, then your newborn doesn’t get any treatment for it. You get to live with the consequences of your “beliefs”, OK?

  14. #14 Denice Walter
    August 5, 2014

    ” they string together all sorts of scientific studies and observations willy nilly into a narrative that sounds compelling to a non-scientist” wrote Orac.

    Exactly. This is the fruit of their *research* ( i.e. shuffling googled pages into a semblence of confabulated order) which sounds like what woo-meisters have been doing in their ‘scholarly’ tomes ( see Skyhorse Publishing).This is what Jake does when constructing his conspiracies and what Mikey does when he forecasts upcoming evils nearly ripened and about to befall upon unwary mankind. And what Teresa Conrick does as she infinitely plays upon the many permutations and variations of neurology and toxicology as interlocking parts in the autism puzzle.

    Here’s a hint, oh anti-vaxxers and woo-meisters:
    just because you can think something doesn’t mean that it has to be real.

  15. #15 Sara
    August 5, 2014

    Adam, you really don’t even need to cut the cord according to this philosophy:
    http://en.wikipedia.org/wiki/Lotus_birth

  16. #16 Politicalguineapig
    August 5, 2014

    Do anti-vaxxers dislike their kids or something? They gamble with the kid’s health on a daily basis, and the loudest ones don’t seem capable of caring about anyone but themselves.

  17. #17 Eric Lund
    August 5, 2014

    PGP@16: There is reason to think the ones who blame vaccines for their children’s autism hate their kids–consider the Spoudourakis case, or the rhetoric about their kids being “damaged”. I’m not prepared to extend that claim to all anti-vaxers. However, I would say that not caring for anyone but themselves is a fair cop. Many people, and not just anti-vax types, view their kids as extensions of themselves. That’s wrong, too, but it’s a different sort of wrong.

  18. #18 Shay
    August 5, 2014

    How does this dippy wench reconcile her beliefs with her husband’s employment? The last time I checked the DOD mandates vaccination for all active duty personnel for damned near everything.

  19. #19 Andreas Johansson
    August 5, 2014

    @Sara: Someone told me, how seriously I don’t know, that the proper natural thing to do is for the mother to sever the cord with her teeth.

  20. #20 KayMarie
    August 5, 2014

    I’m not sure if hate is the right word, but I wonder if there is some narcissism involved where the parents believe they deserve only the most perfect of children. Add to that they, of course, are smarter and better than all the scientists and experts in the world so must find the one true cure for their child no matter how painful it is to restore them to the glory that was due the parent.

  21. #21 Denice Walter
    August 5, 2014

    @ Andreas Johansson:

    That is correct if you are a cat.

  22. #22 Andreas Johansson
    August 5, 2014

    @Denice: What about catgirls?

  23. #23 Narad
    August 5, 2014

    I guess the low yearly figures of “about 4″ over 4 million babies have nothing to do with near-universal vit K injection.

    Actually, it comes from “Dr.” Megan Heimer’s being too boneheaded to even understatnd her own source. That figure is for eight months. In Nashville.

  24. #24 Politicalguineapig
    August 5, 2014

    Shay: The husband’s Air Force, I believe, and DOD lets the Air Force get away with a lot.

    Eric Lund: Your summary seems spot-on to me.

    KM: Certainly seems to be the case with Ms. Megan Heimer and the infamous Dachel. A lot of anti-vax people seem to be living in a parallel universe and are blithely oblivious to facts.

  25. #25 Narad
    August 5, 2014

    The husband’s Air Force, I believe, and DOD lets the Air Force get away with a lot.

    Whether he’s finished his residency is not something I’ve checked, but please elaborate on how the Air Force has a carefree attitude about the vaccination status of their commissioned physicians.

  26. #26 Helianthus
    August 5, 2014

    @ Narad

    it comes from “Dr.” Megan Heimer’s being too boneheaded to even understatnd her own source. That figure is for eight months. In Nashville.

    Ah. Indeed. From the article you linked to:

    During February–September 2013, four confirmed cases of late vitamin K deficient bleeding were diagnosed at a children’s hospital in Nashville, Tennessee.

    These “about 4″ infants were described as otherwise healthy until they developed VKDB symptoms.
    No mention of antibiotics or other action which could have destroyed the infants’ gut flora, if one wanted to check Megan “hypothesis”. However, this is something which would have to be specifically confirmed.

    Also of note:

    Parents of the four infants with VKDB were asked why they declined vitamin K prophylaxis for their neonate. Reasons included concern about an increased risk for leukemia when vitamin K is administered, an impression that the injection was unnecessary, and a desire to minimize the newborn’s exposure to “toxins.”

    Another good question to ask these parents would be, in their desire to minimize exposure to “toxins”, did they also forgo or delay vaccination shots?
    Not to blame them. Again, just to check on Megan’s hypothesis of vaccine-induced bleeding. If these poor babies received fewer vaccines than their fellows newborns but were the ones to become nonetheless sick…

  27. #27 lilady
    August 5, 2014

    Just in case you missed any of my posts on the Mother Jones article…Brisbane Coroner’s report about a 33-day-infant whose parents refused a Vitamin K shot:

    http://www.motherjones.com/environment/2014/07/vitamin-k-injection-infants-safety#comment-1511101374

    Senseless and needless death of a baby from multiple brain bleeds…sad.

  28. #28 Shay
    August 5, 2014

    I will refrain from maligning a sister service (reluctantly) and merely point out that the USAF’s embrace of acupuncture has not, so far, led them to abandon immunizations.

  29. #29 Johnny
    127.0.0.1
    August 5, 2014

    I’ve been out of the AF for a few years, but in the 8 years I served, I received 34 immunizations. You could say I’m a bit of an outlier, because I was in a unit that traveled a great deal (typically over 100 days per year), including overseas, so we had to stay current on everything. I don’t remember it being optional.

    Say what you will about PGP, but you gotta admit she has a very active imagination.

  30. #30 LW
    August 5, 2014

    “if you refuse a Vitamin K shot for your newborn and your newborn develops a brain bleed, then your newborn doesn’t get any treatment for it. You get to live with the consequences of your “beliefs”, OK?”

    Unfortunately, the child lives with the consequences. The parent only deals with them.

  31. #31 Narad
    August 5, 2014

    OT: In addition to the incredibly stupid problem with setting a freaking cookie to autofill the comment fields, some yahoo has been playing around with the character encoding for the recent-comments widget today.

    Here’s a hint: ISO-8859-1 is ALWAYS WRONG in the present day. This might be trivially inferred from the fact that THE MAIN PAGE IS USING A DIFFERENT ENCODING, DIMWITS.

  32. #32 Comrade Carter
    August 5, 2014

    I myself need Warfarin to get by, I think I’ll leave the C30 Warfarin “shots” to the homeopaths.

  33. #33 Politicalguineapig
    August 5, 2014

    Narad: 1) he’s a chiropracter, I think, not an actual MD. 2) Air Force has an awful lot of fundies- he says he wants a religious exemption, he’ll get it.

  34. #34 Narad
    August 5, 2014

    Narad: 1) he’s a chiropracter, I think, not an actual MD.

    No, he is not. He is a D.O. (which is an “actual MD”) who is doing (or did) a residency with a family practice. This stuff is trivially verifiable, so there’s no need for this kind of assignation.

  35. #35 Johnny
    127.0.0.1
    August 5, 2014

    Air Force has an awful lot of fundies- he says he wants a religious exemption, he’ll get it.

    It takes a bit more than that-

    See http://www.anthrax.mil/resource/archive/qna/waiver.asp

    Applicants forward the following information through the appropriate authority: full name, rank and SSN; name of recognized religious group and the date of the applicants affiliation; supporting certification signed by an authorized personal religious counselor. The counselor must attest that the applicant is “an active member in good standing of the espoused religious group, adheres to tenets consistent with the espoused religious beliefs and the religious group has a tenet or belief opposing immunizations”.

  36. #36 Narad
    August 5, 2014

    In fact, his residency goes until 2015, at which point he will presumably become a commissioned as a captain in the USAF. This appears to represent a delay, from what I recall of the original timeline.

    I trust that nobody will mind that I’m leaving out the personal details.

  37. #37 ann
    August 5, 2014

    She’s a frightening person, that blogger. She’s so sure of herself. And she doesn’t have enough common sense to avoid being suckered by Thomas M. Cooley Law School.

    She’s a danger to herself and others. It’s painful to contemplate.

  38. #38 Narad
    August 5, 2014

    And she doesn’t have enough common sense to avoid being suckered by Thomas M. Cooley Law School.

    She had a reason for being up there to start with. I’m willing to ridicule any attempt on her part of legal argumentation, but not doing the program itself.

  39. #39 Ken
    August 5, 2014

    @ Andreas Johansson: the proper natural thing to do is for the mother to sever the cord with her teeth.

    I’m reminded from a line by Terry Pratchett, to the effect that if you want to live naturally you should sit in a tree and eat your dinner while it’s still wriggling.

    The argument that nature must have a reason for the low levels of vitamin K in infants reminds me of another Pratchett line: “She rescued baby birds that had fallen out of the nest, then cried over them when they died, which is the fate that kindly Mother Nature has reserved for baby birds which fall out of the nest.”

  40. #40 Narad
    August 5, 2014

    ^ I should have added a “now” in my preceding comment; I have little doubt that I’ve made fun of Cooley more than once.

  41. #41 Shay
    August 6, 2014

    Religious exemptions, for anything, are damned difficult to get in the military. And if Captain Hubby deploys its a lead-pipe cinch he won’t get one.

  42. #42 Pareidolius
    August 6, 2014

    Oh, why did I read Megan’s F’book page? Why? Why? Why? The combination of weapons-grade, syrupy sweetness, creepy religiosity and passive/aggressive self-righteousness is almost too much to stand. I really wanted to throw my iPad out the window. Thanks, thanks a lot . . .

  43. #43 kruuth
    August 6, 2014

    What is with all these people citing scientifically ancient studies? It seems like the anti-vax/autism/VitK/etc people love to dredge up these studies that have been thoroughly debunked or are so old as to be irrelevant.

  44. #44 TMM
    August 6, 2014

    Regardless of the Air Force’s immunization policy, it only applies to active duty service members themselves, not their dependents. So it doesn’t really matter what the AF says about shots, because she and her kids aren’t in the AF. I’m a Navy wife, and use the military health care system, and I have no obligations for yearly physicals or vaccinations like my husband does. I get them anyway, but the Navy can’t require me to since I’m a civilian.

  45. #45 brewandferment
    August 6, 2014

    PGP, you continue to make off-the-cuff guesses that are simply absurd and then guess what? it makes you look as idiotic as the people who are rightfully ridiculed here.

    ALL active duty members (and in theory but not always in practice due more to constraints of civilian life than any foolish principles) are required to maintain themselves ready to deploy on short notice. Obviously, that’s a continuum and is not attained as well as it should be in an ideal world–pregnancy and broken bones being two very obvious and self-limiting conditions for which there are temporary exemptions. Weight issues are another. But having spent 20 years on active service, you get your shots, dental care, and other physical care (including pap smears for women, finger checks for men) with increasing levels of hassle from your chain of command until you do. People who are found to be deliberately avoiding deployment ready status can, in some cases if it’s bad enough, be sent home with bad paper. Since your whole value and purpose in military service is to be, by definition, deployment ready, you are a liability if ytou are not ready; vaccinations are a huge part of it. There was a huge ruckus some years ago over anthrax refusers and generally, IIRC, refusers did not fare that well. Haven’t followed that particular issue since retirement, but there were a few precedents there that made the anthrax vaccines more of an unusual case. However, refusal of routine CDC shots will do your career great harm. Even if it doesn’t send one home, it limits career advancement greatly–type and location of assignments, reputation as a kook, etc.

    Furthermore, let’s say hubby got an assignment to a plum overseas location that his family wanted to go to. No shots, no family, because they wouldn’t qualify physically. So either hubby deploys for 2 years unaccompanied (and in some cases if the tour is intended as an accompanied length tour, usually 3 years but the family chooses not to go, hubby still goes 3 years without his family)—or they get their shots. It’s really pretty simple.

  46. #46 Colin
    www.violentmetaphors.com
    August 6, 2014

    “I’m surprised, but relieved, that she didn’t invoke some sort of reason based in evolution.”

    In addition to being a beloved medical expert and lawyer, she speaks with the voice of God Almighty. I’m not sure evolution is high on her list of acceptable sciences.

  47. #47 lilady
    August 6, 2014

    Why do I think that Megan’s participation on this curiously named website is the appropriate spot for her?

    http://www.nutopia.cc/the-collective-co-op/open-door-wisdom-blogs/alternative-medicine-a-holistic-wellness-blog/item/megan-heimer

  48. #48 Mephistopheles O'Brien
    August 6, 2014

    I note with some sympathy that Megan’s Mind has been removed. At least that’s what it says when I click on the link to her blog listed in the link lilady provided.

  49. #49 Ellie
    August 6, 2014

    Megan Heimer spreads misinformation and endangers public health.

  50. #50 Patrick Arambula
    August 6, 2014

    @ 19,; “Someone told me, how seriously I don’t know, that the proper natural thing to do is for the mother to sever the cord with her teeth.”
    Wonderful. Now I have to worry about one of these “mother lionesses” giving her baby Herpes or an anaerobic infection.

  51. #51 NZ Sceptic
    August 6, 2014

    #45 – I don’t think Megan would be wanting to go anywhere overseas anyway. Time and again in her blogs she refers to the fact that the USA is all that counts, and that the rest of the world apparently doesn’t exist – or at least doesn’t matter. See how dismissive she is about Ebola.

    I’ve just found a post I missed from May and having read it, I’m sure she must surely be in line for some sort of Mike Adams Special Award for Services to Pseudoscience. She’s even surpassed him for cramming so much woo into a relatively small space:
    http://www.livingwhole.org/a-vaccine-detox-for-adults/

  52. #52 friend
    August 6, 2014

    so scary

  53. #53 doug
    August 6, 2014

    I’ve been trying to find info on exactly what is in Vitamin K injectable preparations, since an assortment of strange things have been claimed on various web sites. It has been surprisingly difficult.
    Benzyl alcohol, at 0.9%, is found in most mfr’s product. This is the typical concentration found in multi-dose vials of things like water and saline. But the vitamin K is supplied in an ampoule. Can anyone tell me why a preservative would be used in an ampoule? I’ve always considered ampoules to be single-dose packages, with the intent that the contents be used immediately on opening.
    Hospira mentions aluminum on their sheet in the warnings section, but makes no mention of anything that would contain aluminum in the ingredients list. Is this just a posterior covering warning because the Vitamin K ampoules might have caught a glimpse of a vial of something with an aluminum seal, or because the water used might have residual aluminum content of a few ppb?

  54. #54 doug
    August 6, 2014

    The kook’s detox recommendations are … kooky.
    Apparently she is unaware that bentonite is aluminum silicate. I would have though she would shriek in terror of the dreaded aluminum.

  55. #55 lilady
    August 6, 2014

    doug: Here, probably the best researched article on Vitamin K injections for newborns. Make certain you open the link to the blog about baby Olive who suffered a brain bleed, but appears to progressing nicely after brain surgery:

    http://evidencebasedbirth.com/evidence-for-the-Vitamin-K-shot-in-newborns/

  56. #56 squirrelelite
    August 7, 2014

    @doug,

    You’re right about the kooky recommendations.

    I see she’s also into coffee enemas and Gerson therapy.

  57. #57 doug
    August 7, 2014

    lilady: I ran across the article you linked a few days ago after Salon had a piece prompted by the same MoJo article Orac cites. It is very good, except that her descriptions of the purpose of propylene glycol is not really right (it would be solvent, rather than a humectant), and she kind of misses a bit on the concept of an acetate-acetic acid pH buffer. I’m sure she gets labeled a pharma shill because she relies on science rather than “belief” or “feeling.”

    I found a doc from USP that seems to be the source of the warning about aluminum in the K from Hospira. Any product that might be used in total parenteral nutrition is require to have the specific wording used. Since K would likely be used for such, it gets the warning.
    In the comments at Salon, one woman reported rejecting the K shot for her premature baby based on the warning and consultation with her doctor, who was surprised to find the aluminum warning. With only the warning to go on, I would say she made a reasonable decision, even it was most likely quite wrong and put her baby at much greater risk than probably less than about 130 picograms of aluminum that might have been in the K shot (I base that on the 0.25ug/l allowable limit for large volume parenterals for an injection volume of half a millilitre). This is just one more case of the dubious “information” on product sheets – like the mention of autism on vaccine sheets.

  58. #58 Calli Arcale
    http://fractalwonder.wordpress.com
    August 7, 2014

    My father-in-law just retired from the Air Force; he got vaccinated against basically everything. Regarding religious exemptions, they exist, but in a typically bureaucratic form. There’s no sense of “well, you attest you believe this, so it’s okay”; instead, there are explicitly allowed exemptions associated with formally recognized religions. The military maintains a list of recognized religions; if your religion isn’t on it, it doesn’t exist as far as they’re concerned and you won’t get any accommodation for it. Given that there aren’t any religions on the list that have any issues with vaccination, I think we can safely and categorically state that you can’t get a religious exemption for vaccination in the US military. After all, if you tried, they’d look up the list, see that none have a problem with vaccination, and order you to go get your damn shots. You might be able to get a medical exemption, though depending on the nature of that, it might come with early discharge papers.

  59. #59 JJ
    Still in the US (for now)
    August 7, 2014

    I was in the bookstore a few weeks ago and picked up (despite a gut-feeling I shouldn’t), Alicia Silverstone’s new book. Knowing her cluelessness regarding vaccination (couldn’t resist), I turned to her pages on Vitamin K. Wanted to throw the item at whoever actually put the book on the shelves. Ms. Silverstone actually advocated forgoing the shot, asserting that her vegetarian diet proved enough for her baby. At least she acknowledged that whatever doctor she was consulting on her book did not agree.

    I think I need to have a chat with whoever orders books for this place. It’s really the only English language bookstore where I live, so I can’t just take business elsewhere, although my e-reader helps. They will happily stock the clueless one, the recently fired “view” person, and the so-called pediatrician with his pulled from the nether-regions vaccine schedule, but not books by people who actually know what they are talking about. Do not even mention gluten-free idiocy-I think I counted a dozen different titles there last time I was in. I know it’s a business decision, but still, a vague nod in the general direction of actual expertise would be nice.

  60. #60 shay
    August 7, 2014

    You might be able to get a medical exemption, though depending on the nature of that, it might come with early discharge papers.

    As I remember, in the case of the anthrax vaccine refusers in ’96*, it came with an all-expense paid trip to scenic Ft. Leavenworth, Kansas.

    (*Yes. I’m dating myself).

  61. #61 Kiiri
    August 8, 2014

    This woman pisses me off. To needlessly risk your child’s life because you are an idiot then advocating others do the same. If she believes in an afterlife she better be willing explain her choices. I think that the deity or deities in charge will not be amused. This sort of cavalier disregard for children gets my hackles up way more than it should as I spent so long to conceive my son that the thought of anything happening to him leaves me in a cold sweat. I could never forgive myself if anything happened to him through action (or inaction) of my own. He is 100% vaccinated. I want to slap these women.

  62. #62 Bobby Fischer's Pawn
    August 11, 2014

    You have really missed the boat on this one, Orac. You quote an NNT for serious bleeding of 20,000. Twenty thousand! That guarantees that on the order of 50 peripheral nerves will be transsected (by geometrical arguments), and a considerable number of fatty embolisms of muscle arteries will occur.

    Those risks are unconscionable in the absence of proof that no possible oral dosing would work. At the most, vitamin K injections can only be justified while an emergency research program in improved oral dosing is carried out. Naturally, doctors have not bothered to carry out such a program—they are barely more mathematically capable than the woo artists.

  63. #63 Julian Frost
    Gauteng East Rand
    August 11, 2014

    Bobby, you are making a lot of unstated assumptions. As a maths teacher would say, “Please show all your calculations.”

  64. #64 Calli Arcale
    http://fractalwonder.wordpress.com
    August 11, 2014

    Indeed, Julian. Akin’s First Law: “Analysis without numbers is only an opinion.”

  65. #65 Chris
    August 11, 2014

    Especially since this quote is near the beginning of the article: “Seven infants, aged between seven and 20 weeks old, had arrived at Vanderbilt University’s Monroe Carell Jr. Children’s Hospital over the past eight months with a condition called “vitamin K deficiency bleeding,” or VKDB.”

    So, Pawn, what would you have advised the parents of those seven infants?

  66. #66 novalox
    August 11, 2014

    @pawn

    [citation needed]

  67. #67 Narad
    August 12, 2014

    You quote an NNT for serious bleeding of 20,000. Twenty thousand! That guarantees that on the order of 50 peripheral nerves will be transsected (by geometrical arguments)

    Shouldn’t “pawn” be replaced by “en passant” here on general principles? (I’ll admit to finding anything more than entertainment in chess to be death in life. And I find no entertainment.)

  68. #68 herr doktor bimler
    August 12, 2014

    on the order of 50 peripheral nerves will be transsected (by geometrical arguments)
    I can almost hear the clinking of ball-bearings rolled in the hand. Did someone steal your strawberries?

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