I sensed a disturbance in the antivaccine (i.e, the dark) side of the Force yesterday. No matter where I wandered online and on social media, I kept running into a new article, an article by Neil Z. Miller about vaccines. For example, the merry band of antivaccine propagandists over at Age of Autism seem to like Miller’s article very, very much. So did the vaccine truthers over at—where else?—VacTruth.org. I kept seeing it on Facebook and Twitter, too.

Even though the current vaccine schedule is safe and effective as well as evidence-based and the claim that we give too many vaccines too soon is an antivaccine myth, that doesn’t stop Miller from claiming otherwise in an article just published in the Journal of American Physicians and Surgeons (JPANDS) entitled Combining Childhood Vaccines at One Visit Is Not Safe. Now, the first thing I think whenever I see an article published in JPANDS is that it must be so horrible that no reputable journal would touch it with a ten foot cattle prod. After all, JPANDS is the house organ of a group, the Association of American Physicians and Scientists (AAPS), best known for its extreme right wing politics, its members’ belief that they are brave maverick doctors who don’t follow the “herd,” and its utter disdain for any evidence that conflicts with its ideology.

As hard as it is for me to believe, I first discovered the AAPS over ten years ago and was astonished at its embrace of antivaccine views, HIV/AIDS denialism, and other forms of pseudomedicine and medical conspiracy theories. Examples abound. Basically, the AAPS is known for being against vaccine mandates, against Medicare (calling it “unconstitutional”), and against any form of regulation of health care by government. It’s called public health programs “tyranny.” The AAPS has also published bad papers claiming to find that abortion causes breast cancer, has promoted the vile idea that shaken baby syndrome is a misdiagnosis for “vaccine injury,” supported HIV/AIDS denialism, and (of course!) done what all crank medical organizations like to do, attack evidence- and science-based medicine as placing unacceptable limits on physician autonomy. Perhaps my favorite example of AAPS crankery is when it published a blog post (now removed, no doubt in embarrassment) claiming that then-candidate Barack Obama was possibly “deliberately using the techniques of neurolinguistic programming (NLP), a covert form of hypnosis.” The AAPS doesn’t even limit itself to medicine in that it’s also published papers attacking anthropogenic global warming, as though physicians had the necessary expertise to judge the science in that field. Truly, the crank magnetism and arrogance of the AAPS know no bounds. If you don’t believe me, consider this. JPANDS has published articles by the father-son team of antivaccine “scientists,” Mark and David Geier.

We’ve also met Neil Z. Miller before. Well do I remember an article by him and co-author Gary S. Goldman published five years ago that resurfaces from time to time. Basically, it was an “analysis” purporting to show that infant mortality correlates with the cumulative number of doses of vaccine in the childhood vaccination schedule. Let’s just say Miller and Goldstein’s rationale, methods, and analysis were rather suspect. No, wait. Strike that. Let’s just say it was a giant, drippy, stinky turd of an article—and amateurish to bood—whose conclusions were not at all supported by the data or analysis. He and Goldman also teamed up for an equally inept attempt to show that more vaccination correlates with more hospitalizations and deaths. They failed.

So, given how much antivaccinationists like this latest article by Miller, combined with the abysmal (and well-deserved) reputation of JPANDS and Miller’s track record, I was not optimistic that this wouldn’t be more of the same. My pessimism was justified. The main difference is that this latest article is not an attempt at an original investigation, but rather an attempt at a systematic review. Unfortunately, in a systematic review, one is supposed to review the existing literature as comprehensively as one can, discussing its strengths and weakness, not cherry pick a few studies to misinterpret and cite one’s own “studies” far more prominently than they deserve. Let’s take a look.

You can tell from the abstract that this article is basically going to be a rehash of Miller and Goldman’s previous “analysis”:

Although health authorities including the Centers for Disease Control and Prevention (CDC) claim that childhood vaccines are safe and recommend combining multiple vaccines during one visit, a review of data from the Vaccine Adverse Event Reporting System (VAERS) shows a dose-dependent association between the number of vaccines administered simultaneously and the likelihood of hospitalization or death for an adverse reaction. Additionally, younger age at the time of the adverse reaction is associated with a higher risk of hospitalization or death.

Which is basically what Miller and Goldman tried, and failed, to show four years ago.

The first mistake Miller makes is the same mistake he’s made time and time again: Dumpster diving the VAERS database. Why do I call it “dumpster diving”? Easy. The VAERS (Vaccine Adverse Event Reporting System) is a problematic database, whose contents are useful for a very limited range of analyses. However, it is also a public database that can be freely downloaded by anyone; so naturally it attracts antivaccine “scientists” like catnip attracts cats. As longtime readers of this blog and vaccine science advocates know, VAERS is a passive reporting system. Anyone can report a suspected vaccine injury to the database. You don’t have to be a medical professional to do it, and there doesn’t even have to be a plausible relationship between the vaccine and the suspected adverse reaction. Indeed, it’s long been known that vaccine litigation distorts the VAERS database, with plaintiffs’ attorneys encouraging their clients to report their children’s cases to VAERS. Consequently, VAERS cannot be relied upon for anything close to the true incidence of specific adverse reactions. If you don’t believe me, let me just mention once again that reports of vaccines turning people into The Incredible Hulk and Wonder Woman have been successfully entered into VAERS.

Why would the government want to set up a system like this? Simple. It’s an early warning system. Even though the database can be distorted and even though its contents are not a reliable estimate of the incidence of vaccine injuries, it’s still useful in that when scientists notice an uptick in the reporting of an adverse event due to a vaccine in VAERS it’s an impetus to study it more deeply and see if the increase is real.

Of course, at some level, Miller must know this, as he spends much of the first page trying to convince the reader that VAERS is valuable and citing CDC studies using VAERS data. (Of course, VAERS is valuable and useful, just not in the way Miller thinks it is.) First, Miller tries to convince us that adverse events are underreported in VAERS:

Since 1990, the VAERS database has received more than 500,000 reports of suspected adverse reactions to vaccines. Although this represents a large number of people who may have been hurt by vaccines, under-reporting is a known limitation of passive surveillance systems. This means that VAERS only captures a small fraction of actual adverse events. In fact, shortly after VAERS was established, a large vaccine manufacturer, Connaught Laboratories, estimated “about a 50-fold under-reporting of adverse events in the passive reporting system.”3 Perhaps 98% of all adverse reactions to vaccines are not included in the VAERS database, and up to 25 million U.S. citizens could have been adversely affected by vaccines in the past 25 years. This well-known disadvantage of a passive reporting system, as opposed to an active surveillance system in which medical workers are trained to systematically collect all cases of suspected adverse vaccine reactions, is rarely acknowledged by health authorities when vaccine safety is discussed.

A better way of looking at this would be that certain kinds of adverse events are underreported and certain others are likely to be massively overreported, thanks to the way lawyers petitioning the National Vaccine Injury Compensation Program insist that their clients enter their suspected adverse reaction, no matter how implausible. Miller cites the Institute of Medicine’s report on vaccines to bolster his view, but this is what the IOM actually wrote:

Care must be taken in interpreting information from passive surveillance systems. The extent of underreporting cannot be known. Duplicate reports of the same event for the same patient are common and are not always easy to detect, making totals questionable. Medical information provided on reporting forms is often incomplete. In general, passive surveillance systems are useful in flagging potential problems and suggesting hypotheses. See Chapters 2, 10, and 11 for further discussion.

Which is exactly what I just explained above. The IOM also noted:

From a comparison of spontaneous reports with postmarketing surveillance data, the company estimates about a 50-fold underreporting of adverse events in the passive reporting system. The distribution of types of events, however, was found to be approximately the same; in both cases, the majority of reported events were local reactions or fever. The company has seen a marked decrease in adverse event reports since the inception of VAERS late in 1991, because physicians are now requested to send reports directly to the VAERS contractor.

Miller then cites three studies by the CDC using VAERS: a 2015 study looking at the MMR vaccine in adults; a 2014 study looking at live attenuated influenza vaccine (LAIV3); and a 2013 study examining intussusception after a rotavirus vaccine. The first study is described thusly:

Although 5% of reports were serious, including several deaths, CDC researchers concluded that “in our review of VAERS data, we did not detect any new or unexpected safety concerns for MMR vaccination in adults.”

Note the implication that the MMR vaccine is very dangerous. What Miller neglected to mention (almost as if he didn’t read anything more than the abstract) is that the medical records of patients suffering serious events were reviewed. Of the seven deaths, two were due to cardiovascular disease, one due to a drug overdose, one due to chronic preexisting myocarditis, one due to pulmonary embolus, one due to an arrhythmia. The last one was a patient who had had a renal transplant and was on immunosuppression who died of disseminated varicella. In other words, none of them appear to have been due to the MMR vaccine.

Next, Miller characterizes the LAIV3 study thusly:

Although 8.9% of reports were classified as serious (e.g., cardiovascular events, neurological debilities, and fatalities) CDC researchers concluded that “review of VAERS reports are reassuring, the only unexpected safety concern for LAIV3 identified was a higher than expected number of Guillain-Barré syndrome reports in the Department of Defense population, which is being investigated [sic].”

Note again how Miller tries to paint the LAIV3 as dangerous. This paper is actually a bit more nuanced. For one thing, the rate of serious adverse events reported was generally under 2 per 100,000 doses, which one would note if one reads the whole paper. Be that as it may, this paper only found a possible increased incidence of Guillain-Barré syndrome in the Department of Defense population, which is being investigated—which is exactly what VAERS is for: Early warning and hypothesis generation.

Finally, the last paper cited looked at intussusception after rotavirus. This one was interesting in that it looked at the number of days after vaccination that reports of intussusception were made and found a clustering between 3-6 days, which suggests that there might be a causal relationship based on what is known about intussusception and rotavirus. Also:

In summary, after distribution of 47 million doses of RV5 in the United States, we observed a persistent clustering of intussusception events during days 3 to 6 after the first-dose vaccination. When we combined all 3 doses of RV5, we estimated a small overall excess risk of ∼0.79 intussusception event for every 100 000 vaccinated infants. This level of increased risk in the United States would translate to 33 excess annual intussusception events after rotavirus vaccination with the coverage expected for a fully mature rotavirus vaccine program. This is substantially lower than the number of diarrhea hospitalizations prevented annually (∼40 000) since rotavirus vaccine introduction.

Emphasis mine. Risks versus benefits. Risks versus benefits.

Perhaps the most hilarious part of Miller’s paper is this:

These studies and others confirm that CDC considers VAERS an important post-marketing vaccine safety surveillance tool. Therefore, nobody should be swayed into believing the VAERS database does not contain immensely valuable raw data to be used by independent researchers conducting studies that evaluate the safety of U.S. mandated vaccines. For example, Mark Geier, M.D., Ph.D., independent researcher and former professional staff member at the National Institutes of Health (NIH), published several studies utilizing the VAERS database showing that vaccines containing thimerosal (mercury) significantly increase the odds of developing neurological disorders, including autism.

That’s right. Miller actually cited the Geiers as though they were real researchers and not antivaccine advocates pretending to do research. There’s a reason why I refer to anything the Geiers do with VAERS as “dumpster diving.” In fact, numerous studies have failed to find an association between thimerosal-containing vaccines and autism or other neurological conditions.

All of this, of course, was just a lead up to Miller regurgitating his 2012 “study.” I deconstructed that incompetently performed study in detail back when it was originally published; so I don’t really feel the need to go into too much detail, given that you can simply click on this link if you want to go into the truly Oracian-length Insolent deconstruction. there were some truly hilarious abuses of statistics, a seeming fetish for trying to fit Miller’s data to a straight line in the absence of a plausible rationale why it should fit to a straight line, a failure to control for historical trends in infant mortality, and a failure to control for obvious potential confounders, such as birth cohort. It was truly a crappy “study.”

Of course, to Miller, his Truth is being suppressed by The Man:

Our study showed that infants who receive several vaccines concurrently, as recommended by CDC, are significantly more likely to be hospitalized or die when compared with infants who receive fewer vaccines simultaneously. It also showed that reported adverse effects were more likely to lead to hospitalization or death in younger infants.

No. It. Doesn’t. In actuality, the current vaccine schedule is both safe and effective, and, contrary to claims by antivaccin activists, are evidence-based. Nothing Miller has published changes that.

Why is The Truth being suppressed by The Man? I think you know. It’s big pharma, of course:

These findings are so troubling that we expected major media outlets in America to sound an alarm, calling for an immediate reevaluation of current preventive health care practices. But 4 years after publication of our study, this has not happened. Could it be because, according to Robert Kennedy, Jr., about 70% of advertising revenue on network news comes from drug companies? In fact, the president of a network news division admitted that he would fire a host who brought on a guest that led to loss of a pharmaceutical account. That may be why the mainstream media won’t give equal time to stories about problems with vaccine safety.

Boo hoo.

I wonder if Miller knows just how pathetic it is to whine about how a paper he wrote four years ago failed to catch the attention of the press or the scientific community when it was originally published. I wonder if he knows just how much more pathetic it is that he published his complaint in JPANDS, one of the crankiest of crank journals. Obviously, it never occurred to Miller that maybe—just maybe—the reason that his “study” wasn’t picked up by major media is because it was a stinking heap of crap. Unfortunately, so far, it’s worked because memories are short and antivaccine activists don’t care about any evidence that doesn’t support their ideology. Hopefully, this post will serve as a reminder of why Miller’s study is not evidence that the current vaccine schedule is unsafe.

Comments

  1. #1 Concerned
    The 99%
    July 28, 2016

    This would be like in the analogy above that the guy saying you can fire the 100,000 lead bullets and breath the air with no harm was actually a lead representative of the bullet manufacturer and he sat as a chair person of the government entity that regulates the safety and efficacy of the bullet manufacturer and he then uses his position to suppose this statement to help his employers on both sides with this statement without testing or peer reviewed science to prove this assumption. All the while noting that due to his position his opinion will hold much weight in the public and media arena and can help market share for the companies involved which includes himself. And help the government agencies with their uptake rates that ensures their year over year budgets to purchase these bullets…lol

    • #2 Guy Chapman
      United Kingdom
      July 29, 2016

      @Concerned:

      This would be like in the analogy above that the guy saying you can fire the 100,000 lead bullets and breath the air with no harm was actually a lead representative of the bullet manufacturer and he sat as a chair person of the government entity that regulates the safety and efficacy of the bullet manufacturer and he then uses his position to suppose this statement to help his employers on both sides with this statement without testing or peer reviewed science to prove this assumption. All the while noting that due to his position his opinion will hold much weight in the public and media arena and can help market share for the companies involved which includes himself. And help the government agencies with their uptake rates that ensures their year over year budgets to purchase these bullets…lol

      Not in any meaningful sense, no.

      So now we have a teachable moment. The Offitt 100,000 claim is and always was bullshit,what he said is abundantly clear, as is the way it has been wilfully distorted by anti-vaxxers.

      When one is presented with conclusive evidence that a statement is wrong, one has two main options:

      1. Acknowledge the error and don’t repeat the statement;
      2. Denial and doubling down.

      Looks like you went for 2. That’s the standard approach of course, but it ensures that when you are wrong, you will not only remain wrong, but you will become more wrong over time.

      Anti-vax is a quasi-religious ideology, it does not adapt to facts. Vaccine science is, well, science. All conclusions are provisional, all evidence is open to rigorous test and debate. And when science finds itself to be wrong, it admits the fact. Have you read Offitt’s “The Cutter Incident”? It was not antivaxers who identified the issue with the polio vaccine, it was not antivaxers who fixed it, and it certainly was not antivaxers who moved on beyond it to bring polio to the brink of eradication.

      Being open tot he possibility that you are wrong is the most basic essential of good science. That’s why Andy Wakefield’s science is junk, and that’s why you are failing to persuade in this discussion. Immutable certainties are for religion, not science.

  2. #3 Dangerous Bacon
    July 28, 2016

    Concerned: “In fact, Dr. Offit’s studies show that in theory, healthy infants could safely get up to 10,000 vaccines at once.”

    No, they don’t. And he has never said this. His statement (twisted and misrepresented endlessly by antivaxers) related only to the infant’s immune system being able to handle the antigenic stimulus contained in that many vaccine. Offit never proposed giving anyone 10,000 vaccines at once or suggested that would be safe and/or desirable.

    “I rather suspect he probably regrets using that exact turn of phrase”

    If anything, he regrets that antivaxers are so stupid and/or devious that they’d twist his words in that fashion.

  3. #4 herr doktor bimler
    July 28, 2016

    Veterinarian Patricia Jordan, states that the World Health Organization named aluminum hydroxide, a component of most of the currently used veterinary vaccines, a grade 3 out of 4 carcinogen, with 4 being the most carcinogenic.

    Goofle shows the claim to be circulating through the whackosphere, passed from loon to loon in the manner of a well-sucked lolly, and endowed with the status of holy scripture. No-one seems to have a primary source. But if some true believer states rather than just repeats something she read on the Intertubes, well, it must be true.

  4. #5 James Castle
    July 28, 2016

    Aluminum Hydroxide is a lot of things, but it is not carcinogenic.

    A4: Not classifiable as a human carcinogen. /Aluminum metal and insouble compound/

    https://toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/~q7uMHH:3

    https://toxnet.nlm.nih.gov/cpdb/pdfs/ChemicalTable.pdf

  5. #6 Gilbert
    July 28, 2016

    @herr doktor bimler,
    OK, then.

  6. #7 JustaTech
    July 28, 2016

    Concerned, I just want to be sure that you understand the difference between febrile seizures (caused by a fever) and seizures caused by epilepsy. They are two very different things, with very different causes and outcomes.

  7. #8 Antaeus Feldspar
    July 28, 2016

    This would be like in the analogy above that the guy saying you can fire the 100,000 lead bullets and breath the air with no harm was actually a lead representative of the bullet manufacturer [useless stupidity snipped]

    So basically, you’re not only not honest enough to admit “okay, Dr. Offit did NOT say what I claimed he said,” you don’t even have the intellectual courage to deal with the analogy honestly. In the analogy, sir, you are the one trying to debunk an exaggerated scenario of harm.

    Are you trying to tell us you aren’t intellectually capable of imagining yourself on that side of the situation? If so, then why would anyone think you intellectually capable of evaluating vaccines realistically?

    Or are you just so craven that you look and say “Wow, people who try to inject calm reasoning into discussions tainted by screaming hysteria sure have a difficult path – so I’ll just take the cowardly, safe route and side with the screaming hysteria-spreaders”?

  8. #9 herr doktor bimler
    July 28, 2016

    Concerned, serving as human centipede to Joey’s earlier effluvia:
    But Dr. Offet says you can get 10,000 vaccines at once with no adverse effects…
    As far as the comment above about Offit and 10,000 I found this from Orac.

    Let’s see what Paul Offit actually said [… .]
    In fact, Dr. Offit’s studies show that in theory, healthy infants could safely get up to 10,000 vaccines at once.

    Alas, the original source here is a Beth Howard, writing for “Babytalk” magazine, whose words are reprinted on a parent-support website at the Children’s Hospital of Philadelphia (then cited in turn by Orac):
    https://web.archive.org/web/20060920014914/https://www.chop.edu/consumer/jsp/division/generic.jsp?id=81553

    So it is not Dr Offitt’s claim, or even his way of dramatising the situation, but some completely independent other person.

  9. #10 herr doktor bimler
    July 28, 2016

    Reformatting.
    Concerned, serving as human centipede to Joey’s earlier effluvia:
    But Dr. Offet says you can get 10,000 vaccines at once with no adverse effects…
    As far as the comment above about Offit and 10,000 I found this from Orac.

    Let’s see what Paul Offit actually said [… .]
    In fact, Dr. Offit’s studies show that in theory, healthy infants could safely get up to 10,000 vaccines at once.

    Alas, the original source here is a Beth Howard, writing for “Babytalk” magazine, whose words are reprinted on a parent-support website at the Children’s Hospital of Philadelphia (then cited in turn by Orac):
    https://web.archive.org/web/20060920014914/https://www.chop.edu/consumer/jsp/division/generic.jsp?id=81553

    So it is not Dr Offitt’s claim, or even his way of dramatising the situation, but some completely independent other person.

  10. #11 Concerned
    The 99%
    July 28, 2016

    So this statement never came from Paul Offit. And it was not twisted by anti vaccine groups but rather used by pro vaccine entities such as the children’s hospital of Philidelphia and used just as I supposed earlier to convince people with fear of multiple vaccine injections at the same time. This was then reported many and used many times by the media and became attributed to Offit not because it was made up by anti Vaxxed to help their cause but because it was created and used by pro vax facilities to help their programs.

    “But it should be the least of your worries. “Children have an enormous capacity to respond safely to challenges to the immune system from vaccines,” says Dr. Offit. “A baby’s body is bombarded with immunologic challenges – from bacteria in food to the dust they breathe. Compared to what they typically encounter and manage during the day, vaccines are literally a drop in the ocean.” In fact, Dr. Offit’s studies show that in theory, healthy infants could safely get up to 100,000 vaccines at once.”

  11. #12 Concerned
    The 99%
    July 28, 2016

    What do you guys know about interleukin17a?

    In biochemistry and biology, there are “signalling pathways” that have multiple steps connected in a chain. There can be many steps in a signaling pathway. Cytokines often act this way. So, when we say that “IL-6 causes autism”, it could mean that IL-6 acts directly, or that the IL-6 triggers something else that causes autism.

    “The new discovery is that IL-17a acts downstream of IL-6 to cause autism. In other words, IL-17a production is an intermediate step between IL-6 production and autism. So, Choi et al provides both a confirmation and extension of IL-6-autism causality. No wonder this paper was published in one of the most important scientific journals in the world.

    IL-17a plays an important role in autoimmune diseases and asthma.”
    Can this be a cause for autism and not the metals or other ingredients at all?
    http://vaccinepapers.org/category/immune-activation/

  12. #13 Chris
    July 28, 2016

    Please do not spam “Vaccine Papers” here. We will not give it any traffic.

    Please stick to provide the PubMed indexed studies, you can use the PMID.

  13. #14 James Castle
    July 29, 2016

    …vaccines are literally a drop in the ocean.” In fact, Dr. Offit’s studies show that in theory, healthy infants could safely get up to 100,000 vaccines at once.”

    That is an understatement. If we are to take that analogy literally, like Offit stated, we would have:

    Volume of Ocean=1.5(10⁹)km³
    Volume of a Drop=(.5)cm³
    1.5(10⁹)km³=X(.5)cm³
    X=1.5(10⁹)km³/(.5)cm³
    1015cm³=km³
    X=1.5(10⁹)1015cm³/(.5)cm³
    X=3(1024)

    3(1024) vaccines is a bit more than 10⁵. It is such a large number of vaccines, that I am not sure how to put it into words.

    To be true to analogy, 3(1024) vaccines would be equal to the sum of immunological challenges that an infant would typically encounter, such as: bacteria in food and the dust they breathe.

    I have a hard time believing in Offit’s analogy. I think that it is a gross exaggeration. I would venture to guess that even 10 vaccines given on the same day would cause issues.

  14. #15 James Castle
    July 29, 2016

    Looks like the superscript function took a dive on the larger numbers. The final number of vaccines should read 3(10^24).

  15. #16 Chris Preston
    In the library
    July 29, 2016

    “But it should be the least of your worries. “Children have an enormous capacity to respond safely to challenges to the immune system from vaccines,” says Dr. Offit. “A baby’s body is bombarded with immunologic challenges – from bacteria in food to the dust they breathe. Compared to what they typically encounter and manage during the day, vaccines are literally a drop in the ocean.” In fact, Dr. Offit’s studies show that in theory, healthy infants could safely get up to 100,000 vaccines at once.”

    No the statement did not come from Paul Offit. It was written by Beth Howard. She got a fair bit right in her article, but got this bit wrong.

    The actual quote by Offit is from this paper and states that an infant’s immune system could theoretically respond to the antigens in 10,000 vaccines at once.

    There was never a suggestion that anyone should be given 10,000 vaccines at a time.

    Reading and comprehending are wonderful skills to learn.

  16. #17 James Castle
    July 29, 2016

    @Chris Preston There was never a suggestion that anyone should be given 10,000 vaccines at a time.

    Duh. Who is saying that?

    We all know that Ofit is sometimes misquoted, But Beth Howard did said that “healthy infants could safely get up to 100,000 vaccines at once

    This is absurd. How many people here actually believe this???

    And Offit did say that: “ Compared to what they typically encounter and manage during the day, vaccines are literally a drop in the ocean

    This analogy is absurd. The immunogenic potential of vaccines are on a much larger scale than he is implying.

  17. #18 Chris Preston
    Australia
    July 29, 2016

    Duh. Who is saying that?

    Well let me see. Joey did. And then Concerned did. So there do seem to be people suggesting it is a possible activity.

    We all know that Ofit is sometimes misquoted, But Beth Howard did said that “healthy infants could safely get up to 100,000 vaccines at once”

    This is absurd. How many people here actually believe this???

    That is hard to tell. I don’t as I pointed out. Howard made an error in her interpretation. I also pointed out the significant difference between the various vaccine quotes and what Offit actually wrote, which was about antigens.

    And Offit did say that: “ Compared to what they typically encounter and manage during the day, vaccines are literally a drop in the ocean”

    This analogy is absurd. The immunogenic potential of vaccines are on a much larger scale than he is implying.

    This is an old and longstanding idiom

    Anyone who makes a serious attempt at calculation to see if it fits would have to be either unfamiliar with English usage or a few sandwiches short of a picnic.

  18. #19 James Castle
    July 29, 2016

    This is an old and longstanding idiom

    So this somehow justifies its use in this case?

    Anyone who makes a serious attempt at calculation to

    I calculated how many drops were in the ocean to make a point A**hole, not to “see if it fits”. Anyone that implies otherwise must be a few neurons short of autistic.

    Have you taken your recommended vaccines Chris?

  19. #20 Helianthus
    July 29, 2016

    This analogy is absurd. The immunogenic potential of vaccines are on a much larger scale than he is implying.

    It’s true that vaccines are meant to induce a strong immunogenic response.
    But that Offit – and any biologist who spent some time on immunology – is saying, is that there is a continuous background of immunological challenges happening every day. Stuff we got with our food, from our food, stuff we inhale from dust to pollen to all forms of perfumes, plus the stuff we got from the occasional paper cut or the odd chainsaw accident…
    And all the viruses and bacteria which are piggybacking on all the above-mentioned vehicles.

    If vaccines were compared to a 100m-sprint, most, in not all of us are doing daily a 20km-walk, at the minimum, with the occasional sprint from time to time.

    Most of the foreign things our body encounter are harmless, and quickly disposed of (except for allergies)
    But you will have a hard time convincing me that the dead (or almost dead) pathogens in a vaccine present a challenge on a “much higher scale” than, by example, catching a good old rhinovirus on the bus and spending the the next weeks with overacting sinuses*.

    * some collect Pokemon, I collect cold viruses and all their cousins.

  20. #21 Helianthus
    July 29, 2016

    @ Castle

    Have you taken your recommended vaccines Chris?

    Speaking for myself, yes.

    Anyone that implies otherwise must be a few neurons short of autistic.

    As I understand it, autistic people may have troubles with analogies. So, I suppose your insult is factually true.
    OTOH, this is an insult, and using autistic people as the bogeyman. So, I’ll just say:
    Stay classy, sir.

  21. #22 herr doktor bimler
    July 29, 2016

    As an aficionado of well-done trolling, I would be happier if “James Castle” tried a little harder to keep his persona different from the other sock-puppets.

  22. #23 James Castle
    July 29, 2016

    @Helianthus
    If vaccines were compared to a 100m-sprint, most, in not all of us are doing daily a 20km-walk, at the minimum, with the occasional sprint from time to time.

    This is a much more realistic analogy than Offit’s.

    @Herr Doktor
    Takes one to know one Doktor. We all know that you are “MI Dawn” in drag.

  23. #24 MI Dawn
    July 29, 2016

    @James Castle: That would be a good trick, since our good HDB is across the pond from where my ISP is located. But thank you for the compliment. I sincerely appreciate being put into the same league of snark.

    (BTW – our gracious host can well confirm my identity. I don’t know if he’s ever met HDB on his trips to Europe).

  24. #25 Helianthus
    July 29, 2016

    @ MI Dawn / HDB

    We all know that you are “MI Dawn” in drag.

    Some people can pick-up any clothes and look good in it, some other don’t. It helps when the clothes were tastefully chosen.
    I don’t worry. If either MI Dawn or HDB borrows from the other’s dress cabinet, I am sure they will look awesome.

  25. #26 Concerned
    The 99%
    July 31, 2016

    http://www.ncbi.nlm.nih.gov/pubmed/26908667
    Only 68% effective the first year then drops to 8.9% in less than 4 years. Routine DTaP did not prevent pertussis outbreaks. So that litle protection remained 2-3 years after vaccination.
    Now according to this study,
    (Because the effectiveness of diphtheria-tetanus-acellular pertussis (DTaP) vaccine wanes substantially after the fifth dose at ages 4 to 6 years, there is a growing cohort of adolescents who rely on tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) for protection against pertussis. Yet despite high Tdap vaccine coverage among adolescents, California experienced large pertussis outbreaks in 2010 and 2014. We investigated Tdap vaccine effectiveness (VE) and waning within Kaiser Permanente Northern California among adolescents exclusively vaccinated with DTaP vaccines.)
    The media coverage Insaw on the outbreaks of pertussis during this time was mostly blamed on the anti Vaxxed children of which they said California had too many of. This coupled with the measles out break of 40 children who later were found to have been vaccinated with the MMR, helped usher in the plan for mandatory vaccinations in California. I find it appalling that this study was never mentioned in the media as they were pushing their issue forward. What do you scientist think? I mean it is from your glorious Pubmed.

  26. #27 squirrelelite
    July 31, 2016

    Dear Concerned,

    Clearly we need a better pertussis vaccine. The problem of declining immunity occurs with people who had the disease naturally as well.

    And this problem wasn’t just discovered this year.

    Try reading this article from 4 years ago, for instance.

    https://www.sciencebasedmedicine.org/the-problem-of-waning-pertussis-immunity/

    But that doesn’t mean the current vaccine is worthless. It means we need more research, a way to generate longer lived immunity, and perhaps an adjustment in the recommended vaccine schedule.

  27. #28 Peter Harris
    Australia
    August 28, 2016

    Wow.
    Never before I have come across such a shill fest as this website, which is clearly full of industry flunkies, apparatchiks and enablers.
    This is just one great wank for all the medical/pharmaceutical industrial complex hacks.
    I read a Dr bollocks (Really, thats his name?. . . That’s funny, but appropriate) disparage Naturopathy, when he and his fellow doctors, are the ones that supply me with customers.
    As a practising Naturopath, most of my customers come to me for 2 reasons.
    1st, the conventional doctor has not cured them of their disease, and only exacerbated the problems by treating the symptoms.
    And 2nd, I have to repair the body, because their doctors have given them far too many pharmaceutical drugs, which have created chronic and debilitating side-effects.
    And they call me a quack??
    At least I don’t intentionally harm people, by giving them dangerous, and deadly remedies.
    So much for the Hippocratic oath in the medical profession.

    • #29 Dorit Reiss
      August 28, 2016

      Do you have any thoughts in relation to the actual post you’re commenting on?

  28. #30 Science Mom
    http://justthevax.blogspot.com/
    August 28, 2016

    At least I don’t intentionally harm people, by giving them dangerous, and deadly remedies.

    Is not intentionally harming them by giving them dangerous and deadly naturopathic remedies any better?

  29. #31 TBruce
    August 28, 2016

    Never before I have come across such a shill fest as this website, which is clearly full of industry flunkies, apparatchiks and enablers.

    Hey! Get it right. Some of us are not apparatchiks. Some of us are apparatdudes.

  30. #32 Dangerous Bacon
    August 28, 2016

    Actual reasons customers (interesting that Peter views them as such, not as patients or people in need of quality healthcare) go to naturopaths:

    1) swayed by deceptive advertising
    2) prone to naturalistic fallacy
    3) have conditions that can be managed by evidence–based medicine but which in the patient’s perception are not optimally treated and who is looking for woo, new drugs and exciting placebos.
    4) are mentally ill
    5) combination of all or part of the above.

    “And they call me a quack??”

    You nailed it.

  31. #33 Jay
    August 28, 2016

    Hi Peter, how good are you at surgery, how would you treat multiple gunshots to the chest?

  32. #34 Peter Dugdale
    homeofhomeopathy
    August 28, 2016

    Peter Harris –
    if someone comes into your practice complaining of, say, a lump that’s appeared on their hand, what do you do?

  33. #35 JP
    August 28, 2016

    Actual reasons customers (interesting that Peter views them as such, not as patients or people in need of quality healthcare) go to naturopaths:

    4) are mentally ill

    What’s funny is that even the flat-earth Jesus freak conspiracy theorist I met in the psych ward (no joke) wasn’t anti-vax. (Nice guy*, actually, wrote me a long goodbye letter. With many scriptural references.)

    *Is soon getting married to the woman who swallowed a screw, who is indeed a nice lady. Pysch ward romances** are probably not to be encouraged, but I know of at least one that worked out well.

    **I think that the time I sleepwalked out of my room and kissed M. Mendez doesn’t count. I have since run into her several times around the hood and at DSHS; mainly I am happy that she wasn’t sent to the state hospital, where the same shrink had wanted to send both of us.

  34. #36 JP
    August 28, 2016

    ^ He probably would go to a naturopath, though. Sorry, brain fog.

    One might ask why one conspiracy theorist is locked up for being crazy and another is not; the answer, I suppose, is that one is a danger to himself or others and the other is not.

    So why aren’t people promoting naturopathy over legitimate medical treatment not locked up?* It would only be fair. I say round ’em all up, with the anti-vax loons, and send them off to the state hospital. Whether the danger comes from a length of rope or prescribing honey and cinnamon for sepsis shouldn’t matter.

    Except that I don’t like the ITA** in the first place, I guess.

    *In Washington State, at least, there is no “imminent” requirement.

    *Involuntary Treatment Act.

  35. #37 Ted Striker
    August 28, 2016

    @JP Whether the danger comes from a length of rope or prescribing honey and cinnamon for sepsis shouldn’t matter.

    Well, you are the crazy one!

  36. #38 JP
    August 28, 2016

    Well, you are the crazy one!

    Not only crazy, but crazy and dangerous!

  37. #39 Ted Striker
    the seediest dive on the wharf
    August 28, 2016

    I just don’t think that we should have the Thought Police in force.

    I should be able to think about robbing the candy-store every day without being guilty of a crime. I mean, who doesn’t think about wading through piles of free candy with pretty ladies wearing fur coats!

    Crimes should be actions; and never thoughts.

  38. #40 JP
    August 28, 2016

    @Ted Striker:

    Agreed, but to be fair, I had taken things to the point of action. Given that most of the people in the “treatment and evaluation center” had come in from jails or emergency departments, I would guess they had as well.

    Although there were people there who were simply suicidal and hadn’t done anything but tell somebody about it. My friend Mendez was actually there because she told somebody she had been feeling homicidal and was then suicidal, which is the wrong thing to tell somebody, but still, she hadn’t done anything.

    The second time I was in this summer, all I had done was talk.

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