A horrendously bad "vaxed/unvaxed" study rises from the dead yet again

Some posts I really enjoy doing. I'm so fired up by the topic that the words flow, and I finish a post in record time. Other posts are more of a chore, written not so much because I'm excited by the topic, but because I feel duty bound to address it. I feel the need to write such posts when, for example, a bit of pseudoscience has gained traction in mainstream groups and readers keep writing me about it, to the point where I finally give in. This is one of the latter posts. None of this is to say that I don't still do my best with these posts to explain and argue my points. Fear not, I'll get some good Orac snark in. It's just that duty tends to be less fun than passion.

One of the most frequent topics for posts like this is a pseudoscientific or just plain bad study that, despite being retracted, keeps rising from the grave, like the proverbial zombie. I call them, appropriately enough, zombie studies. Depending on my mood when I write posts like this, I often add imagery featuring zombies (or, if you're into The Walking Dead, walkers). Other times, I'll include imagery featuring Jason Vorhees or Michael Myers, two supernatural slashers who would routinely through misbehaving teens for a whole movie, die (or appear to die) at the end of the movie, only to come back in the next installment in the series to kill again. Antivaccine pseudoscience (for example) is a lot like these monsters. In actuality, they're probably more like Jason or Michael Myers than walkers because you can actually kill walkers dead for good. Be that as it may, whenever a truly awful study that should never have been accepted in the first place for publication in a peer-reviewed journal is retracted, you can be sure that it won’t be too long before it is magically resurrected and rears its ugly head again in some form or another, to be wielded not just as a weapon to frighten parents with but as a bogus example of how the peer-reviewed medical literature “suppresses” science that doesn’t support vaccines, to be used to feed the conspiracy theories behind the antivaccine movement. Same as it ever was.

This time around, the zombie study is one that I've been checking in with and covering periodically ever since its inception in 2012, when antivaxers were fundraising for it. The principal investigator was Anthony R. Mawson, M.A., DrPH. Indeed, J.B. Handley himself spearheaded the fundraising effort. It is, unsurprisingly, the Holy Grail of antivaccine studies, the mythical "vaccinated/unvaccinated" study. Antivaxers, at least the ones who retain a bit of reason with respect to medical ethics, have come to realize that a randomized, double-blind, placebo-controlled trial of vaccinated versus unvaccinated children is considered utterly unethical because it would leave half the children unprotected against vaccine-preventable diseases. They might not accept how unethical such a study would be, but they do realize that scientists do consider such a study unethical.

So they fall back on comparing health outcomes in children who are vaccinated to those who are unvaccinated (or undervaccinated). They're pretty much all crap, because those carrying the studies out are biased and/or incompetent. Examples include a telephone survey disguised as a "study" done ten years ago and a survey disguised as a "study" performed by a German homeopath. This study is different in that it isn't an antivaccine activist parent with no background in science or a homeopath but an actual academic. He is, however, clearly biased towards antivaccine views, as he has defended Andrew Wakefield's 1998 Lancet case series and is a vocal supporter of his.

I've written about this study before. Hilariously, when it was published in its first form, the full study wasn't published, only the abstract. Then the abstract was, in essence, retracted. Even more hilarious, it was a Frontiers journal, which is an even bigger dis because Frontiers journals are known for tending to be pay-to-publish predatory open access journals. If a Frontiers journal retracts your paper, it's plenty bad indeed. It turns out that the manuscript had been reviewed by a chiropractor and a peer reviewer without expertise,

Then, back in February, the Mawson zombie study rose from the dead again, as antivaxers spread around copies of the retracted article and crowed that it had been accepted for publication elsewhere, and indeed it has. It's fallen even farther down the food chain than a Frontiers journal, having been published by Mawson et al in the Journal of Translational Science, a journal published by Open Access Text, as Pilot comparative study on the health of vaccinated and unvaccinated 6- to 12- year old U.S. children.

There's nothing new in this study that makes it any better than it was in its previous incarnations. Indeed, its introduction alone contains a boatload of fail that gives away the antivaccine leanings of Mawson et al. For example, there's the implication of "too many too soon":

Under the currently recommended pediatric vaccination schedule [7], U.S. children receive up to 48 doses of vaccines for 14 diseases from birth to age six years, a figure that has steadily increased since the 1950s, most notably since the Vaccines for Children program was created in 1994. The Vaccines for Children program began with vaccines targeting nine diseases: diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b disease, hepatitis B, measles, mumps, and rubella. Between 1995 and 2013, new vaccines against five other diseases were added for children age 6 and under: varicella, hepatitis A, pneumococcal disease, influenza, and rotavirus vaccine.

The implication is, of course, the common antivaccine trope that as a result of the gradual expansion of the recommended vaccine schedule children are getting, yes, "too many too soon," with adverse health effects. Then there's this:

A complicating factor in evaluating the vaccination program is that vaccines against infectious diseases have complex nonspecific effects on morbidity and mortality that extend beyond prevention of the targeted disease. The existence of such effects poses a challenge to the assumption that individual vaccines affect the immune system independently of each other and have no physiological effect other than protection against the targeted pathogen [21]. The nonspecific effects of some vaccines appear to be beneficial, while in others they appear to increase morbidity and mortality [22,23]. For instance, both the measles and Bacillus Calmette–Guérin vaccine reportedly reduce overall morbidity and mortality [24], whereas the diphtheria-tetanus-pertussis [25] and hepatitis B vaccines [26] have the opposite effect. The mechanisms responsible for these nonspecific effects are unknown but may involve inter alia: interactions between vaccines and their ingredients, e.g., whether the vaccines are live or inactivated; the most recently administered vaccine; micronutrient supplements such as vitamin A; the sequence in which vaccines are given; and their possible combined and cumulative effects [21].

The wag in me can't help but provide Mawson with an example of a "complex nonspecific effect on morbidity and mortality" due to a vaccine. He's not going to like it, though, because it shows that the benefits of the measles vaccine go beyond just preventing measles. Basically, there is a prolonged period of immunosuppression after the measles that lasts up to three years. Vaccinating against the measles prevents that immunosuppression and therefore lowers the death rate due to other infectious diseases to which children are more vulnerable after having had the measles.

The bias is also apparent in the statement of purpose for the study:

The aims of this study were 1) to compare vaccinated and unvaccinated children on a broad range of health outcomes, including acute and chronic conditions, medication and health service utilization, and 2) to determine whether an association found between vaccination and NDDs, if any, remained significant after adjustment for other measured factors.

This is serious bias, as the authors assume that vaccines cause harm. It's not quite explicitly stated, but certainly implied. They clearly expected to find an association between vaccination and neurodevelopmental conditions, despite all the copious evidence that there is no such association.

I also can't help but turn a frequent antivaccine trope back on itself. Antivaxers and promoters of alternative medicine often criticize studies of drugs and vaccines because the drug and vaccine manufacturers are frequently the funding source. That is not an entirely unreasonable objection—to a point. I myself look more skeptically at studies funded by drug companies, but with this caveat. If the study is well-designed, executed, and analyzed, I take its results seriously, regardless of funding. However, since antivaxers seem to think that even a whiff of pharma funding of a study invalidates it, I can't help pointing out the funding of Mawson's study:

This study was supported by grants from Generation Rescue, Inc., and the Children’s Medical Safety Research Institute, charitable organizations that support research on children’s health and safety. The funders had no role or influence on the design and conduct of the research or the preparation of reports.

Generation Rescue is Jenny McCarthy's antivaccine organization, although it was originally founded by J.B. Handley, and the CMSRI is one of the looniest of the loony antivaccine groups. Sure, it's probably true that Generation Rescue and the CMSRI didn't directly influence design or execution of the study, but ask yourself this: Would these groups have funded an investigator if they weren't pretty sure how his study would turn out? I think you know the answer to that question.

Of course a study this flawed is close to guaranteed to find a positive result. The flaws begin with the selection of study population:

The study was designed as a cross-sectional survey of homeschooling mothers on their vaccinated and unvaccinated biological children ages 6 to 12. As contact information on homeschool families was unavailable, there was no defined population or sampling frame from which a randomized study could be carried out, and from which response rates could be determined. However, the object of our pilot study was not to obtain a representative sample of homeschool children but a convenience sample of unvaccinated children of sufficient size to test for significant differences in outcomes between the groups.

We proceeded by selecting 4 states (Florida, Louisiana, Mississippi, and Oregon) for the survey (Stage 1). NHERI compiled a list of statewide and local homeschool organizations, totaling 84 in Florida, 18 in Louisiana, 12 in Mississippi and 17 in Oregon. Initial contacts were made in June 2012. NHERI contacted the leaders of each statewide organization by email to request their support. A second email was then sent, explaining the study purpose and background, which the leaders were asked to forward to their members (Stage 2). A link was provided to an online questionnaire in which no personally identifying information was requested. With funding limited to 12 months, we sought to obtain as many responses as possible, contacting families only indirectly through homeschool organizations. Biological mothers of children ages 6-12 years were asked to serve as respondents in order to standardize data collection and to include data on pregnancy-related factors and birth history that might relate to the children's current health. The age-range of 6 to 12 years was selected because most recommended vaccinations would have been received by then.

Notice how Mawson claims that this is a cross-sectional study, when in reality it's a survey targeting parents who homeschool. Of course, parents who choose to home school are not like your average parents. There are a lot of confounding factors that go along with home schooling, including the association between home schooling and antivaccine views. This association is very clear in the data, which show that 261 of the 666 subjects were unvaccinated. Of these 405 who were vaccinated, only 197 were "fully vaccinated." Thus, less than 1/3 of the children in the study were fully vaccinated according to the CDC's recommended schedule, and well over 1/3 were completely unvaccinated. This is not in any way representative of the population at large. Add to that the likelihood of selective memory and reporting, and the likelihood of this survey providing useful information is vanishingly small. Also, surveys are not the best means of gathering health data, and in this case it was a particularly bad situation. Mothers were asked whether their children were vaccinated, unvaccinated, or "partially vaccinated," and what conditions or diseases their children had had. There was no effort to make any independent assessments of the children's health, nor was there any attempt to account for bias, and there almost certainly was a lot of bias here:

A number of homeschool mothers volunteered to assist NHERI promote the study to their wide circles of homeschool contacts. A number of nationwide organizations also agreed to promote the study in the designated states. The online survey remained open for three months in the summer of 2012. Financial incentives to complete the survey were neither available nor offered.

Even more telling, consider how the subjects were recruited. The authors admit that the "object of our pilot study was not to obtain a representative sample of homeschool children but a convenience sample of unvaccinated children of sufficient size to test for significant differences in outcomes between the groups." In other words, no effort was made to construct a representative sample.

So what are we to make of the results of this study, which show:

The vaccinated were less likely than the unvaccinated to have been diagnosed with chickenpox and pertussis, but more likely to have been diagnosed with pneumonia, otitis media, allergies and NDD. After adjustment, vaccination, male gender, and preterm birth remained significantly associated with NDD. However, in a final adjusted model with interaction, vaccination but not preterm birth remained associated with NDD, while the interaction of preterm birth and vaccination was associated with a 6.6-fold increased odds of NDD (95% CI: 2.8, 15.5). In conclusion, vaccinated homeschool children were found to have a higher rate of allergies and NDD than unvaccinated homeschool children. While vaccination remained significantly associated with NDD after controlling for other factors, preterm birth coupled with vaccination was associated with an apparent synergistic increase in the odds of NDD.

Nothing. The bias and flaws in this study guaranteed no other result, particularly when you consider another confounding factor, namely that the parents of children who are fully vaccinated are very different in their health-seeking behavior than those whose children are unvaccinated. They tend to take their children to visit the doctor more regularly, which means that health disorders their children have are more likely to be diagnosed and treated. They're also less likely to be seeing naturopaths and other alternative practitioners.

I'll conclude by pointing out yet again that it is a myth that there are no studies comparing the health of vaccinated children compared to unvaccinated children. In fact, there have been several. It turns out that they don't show what antivaxers think a vaxed/unvaxed study will show. Basically, all of the vaxed/unvaxed studies not done by antivaccine-friendly scientists or quacks have shown either no differences in the prevalence of neurodevelopmental or chronic diseases between vaccinated children and unvaccinated children or have actually found better health outcomes in the vaccinated population. Mawson concludes by arguing that further "research involving larger, independent samples and stronger research designs is needed to verify and understand these unexpected findings in order to optimize the impact of vaccines on children’s health." Mawson's study is so biased, flawed, and incompetently carried out and analyzed that its results can be discounted as almost certainly worthless. It doesn't provide the rationale for "more studies." Quite the contrary.

Yet, that's how antivaxers are spinning it, as they always do.

Same as it ever was.

More like this

There are a lot of confounding factors that go along with home schooling, including the association between home schooling and antivaccine views.

This is particularly true of Mississippi, which at the time was one of only two states that did not allow nonmedical exemptions to vaccine requirements. So parents in that state who do not want to vaccinate their special snowflakes have no choice but to homeschool.

Oh, and one of the other confounding factors with homeschooling is one that would lead me, at least, to regard the parents as less trustworthy than others. I'll leave it at that, before this turns into an off-topic rant.

By Eric Lund (not verified) on 08 May 2017 #permalink

Another confounder (IIRC pointed out on FB), is that fully vaccinated children would have been more likely to regularly see a physician, therefore receiving diagnoses for illnesses and issues as opposed to unvaccinated children who might only see a doctor rarely.

Also...no attempt was made to validate what parents said. No medical records were requested. In fact, the DATES vaccines were given weren't requested - "to decrease the burden of the respondents". Which tells me the whole survey was a load of cr@p.

The fact that the same people who reject large, well controlled studies have no criticism of this is also very, very telling.

By Dorit Reiss (not verified) on 08 May 2017 #permalink

#3 MI Dawn -
That would be an apt description of this POS.
It isn't a "study", it is a survey of anonymous respondents from a biased pool of a very rare and unique group of persons: All home schooled. 39% completely unvaccinated when the anti-vaccinationists repeatedly assure us that completely unvaccinated children only make up about 1/2% of school children? Pending participants recruiting additional participants from their social circle.
No wonder it took over a year to find a scum sucking journal to accept it.

I suggest confounding the anti-vaxers by presenting an analogous and equally flawed survey:
- Select congressional districts in Cali, Oregon, Washington, NY, NJ, etc. that are heavily Democratic.
- Survey the voters about the intelligence of their children allowing anonymous responses and making clear that no evidence for the responses will be asked.
- Be amazed when the results come back that the children of Democratic Party parents are all reported to be very much above average with IQs of 140+ and the children of Republican Party parents are all reported to be very troubled and of average to below average intellect with IQs of <100 - Because no Democrat would ever lie or pretend they were Republican with a below average child just to make the Repubs look bad.
[Reverse the parties if the anti-vaccine believer is an All Gnatchrule Left-wing neo-Hippie instead of a Sovrun Libertarian Right-wing Anarchist Trumpet.]

How this "study" is even a thing is explainable only in context of the intellects and dishonesty of the fanatics that are embracing it.

More than intentionally pretending their children are vaccinated, I suspect what Orac described previously is going on - these parents seeing their vaccinated children through very, very negative lenses and looking to validate their prejudices about their unvaccinated one.

In a particularly ugly form of in-family favoritism, the problematic Vaxxed crew do "vaccinated v. unvaccinated" videos in which families talk about how wonderful their unvaccinated children and how less good their vaccinated children are. In front of said kids.

By Dorit Reiss (not verified) on 08 May 2017 #permalink

In reply to by Reality (not verified)

The same bias is probably at work here.

By Dorit Reiss (not verified) on 08 May 2017 #permalink

#6 Dorit -

Yeah, the Vaxxed team are a bunch of real sweethearts...
That's if you spell "sweethearts" thusly: "psychopaths".

As are the parents who play along with this disgusting differential in children appreciation within the family.

This study sounds terrible. However, wouldn't a properly done study also compare vaccinated vs unvaccinated homeschoolers? Otherwise, wouldn't the differences between the populations be more pronounced?

By Heidi_storage (not verified) on 08 May 2017 #permalink

In a particularly ugly form of in-family favoritism, the problematic Vaxxed crew do “vaccinated v. unvaccinated” videos in which families talk about how wonderful their unvaccinated children and how less good their vaccinated children are. In front of said kids.

That is despicable. I haven't seen those videos, fortunately.

"However, wouldn’t a properly done study also compare vaccinated vs unvaccinated homeschoolers? Otherwise, wouldn’t the differences between the populations be more pronounced?"

A properly done study of vaccinated versus unvaccinated would only be ethical in the days of Edward Jenner, the late 1700s. Back then, the benefits of vaccination were not known. Today, you couldn't possibly randomize one group into getting no vaccines and another into getting a vaccine. Can you imagine deliberately exposing children to polio, measles, influenza?

Here's a modest proposal for a vax v. unvax study. I hope you see the satire in it: ht_tp://www.chadhayesmd.com/vaccinestudy/

Heidi: yes. That's why this study cannot be considered representative of the population at large. Because it only compared vaccinated vs unvaccinated homeschoolers, and thus the results are greatly distorted . . . and that's assuming the data collected is even reliable, which it is not.

If Dr. Mawson had submitted this study as his dissertation, his doctorate would not have been granted.

While I agree with your dissection of the study, I disagree with "Even more hilarious, it was a Frontiers journal, which is an even bigger dis because Frontiers journals are known for tending to be pay-to-publish predatory open access journals." This is exactly what antivaccinationists sometimes resort to, that is, calling open-source journals who receive a fee to publish articles, vanity press and other journals for receiving pharmaceutical advertisements. There are good open-source journals, e.g. PLOS group, and bad journals; but what counts is not where something is published, even a blog, but the actual content of the article. Bringing up the journal or publisher is, in my opinion, a form of ad hominem attack and detracts from your otherwise excellent dissection of Mawson's study.

By Joel A. Harris… (not verified) on 08 May 2017 #permalink

I strongly disagree. The reason is simple. The primary reason antivaxers publish in these bottom-feeding predatory journals is because they can't get published anywhere else. Believe me, if Mawson could have gotten his study accepted for publication in a halfway decent journal, he most certainly would have. Indeed, he started at the more "respectable" level of predatory open access journals, Frontiers, and then when even Frontiers figured out his study was too bad even for its journals he went to an even lower tier of dodgy journal.

There is nothing wrong at all with pointing out when a study is published in a crappy journal known for publishing basically anything, as long as you pay it enough. That's the dark side of open access; While there are quite a few reputable open access journals, there are a lot of predatory ones too. In fact, I would go further. I would argue that, whenever you see an article in one of these journals, your skepticism should be turned up to 11. Similarly, I consider funding sources fair game, too. This study was funded by antivax groups (Generation Rescue and CMSRI). It's all a package.

What is NDD? The only thing relevant I found when I searched was "Nutrient Deficit Disorder" which is a quack diagnosis--"He isn't autistic! He has NDD!" It doesn't seem relevant here as you can cure NDD by buying supplements.

By Christine Rose (not verified) on 08 May 2017 #permalink

The authors should be congratulated for the only study in about 50 years that did not find prematurity associated with neurodevelopmental disability.

NDD = Neurodevelopmental disorders.

Which is a huge catch-all and presents another confounder for this survey. I didn't see that this was clarified but CMSRI is Claire Dwoskin's charity.

By Science Mom (not verified) on 08 May 2017 #permalink

what counts is not where something is published, even a blog, but the actual content of the article

As somebody with your claimed credentials should know, this is not the world we actually inhabit. People who follow such things can and do take into consideration where the article was published. I have heard of departments where your publication only counts if it was in Nature, Science, or Physical Review Letters (these are physics departments; replace PRL with Cell if you are in a biomedical field).

As Orac implies, the business model of these journals is to provide the appearance of peer review while actually not imposing any quality control beyond whether the check for the publication fees clears. Inevitably, we point to articles such as this one to make the point that these journals are not worth the pixels they are printed on.

Orac's point is not limited to OA journals, either. Medical Hypotheses is an Elsevier title. I have also encountered a journal called Physics Essays--I don't recall exactly who the publisher is, but it is otherwise the physics equivalent of Medical Hypotheses.

By Eric Lund (not verified) on 08 May 2017 #permalink

Thank you--yes, that alone is depressing enough. Many of these people diagnose their own progeny with all sorts of nonsense, then cure them the same way.

By Christine Rose (not verified) on 08 May 2017 #permalink

Joel A. Harrison, PhD, MPH (#14) writes,

Bringing up the journal or publisher is, in my opinion, a form of ad hominem attack...

MJD says,

Orac has journal fever (i.e., bias) which often brings entertainment value to the subject.

Q. If Orac's prodigy published in a "lesser" journal would he use the same respectful-insolence zeal?

By Michael J. Dochniak (not verified) on 08 May 2017 #permalink

"Have" is such a strong word.

In an ideal world, there would be an Orac post on that bad study. But I know Orac has many calls on his time.

I figured the facebook post I saw was this study resurrecting itself. Graphic about how vaccinated children are eleventy billion times more likely (OK, OK 30x or so in one category) more likely to be terribly ill,disabled and damaged.

I didn't realize he found a journal to re-publish it (why am I surprised some journal will take his money?)

And I'll just put my soapbox away before going on my "least publishable unit" rant, I've been yelling at more things than is good for my blood pressure lately.

And I strongly disagree with you. Once again, it doesn't matter if it was on a blog. I think your articles are excellent; but where is the peer-review? Just as antivaccinationist blogs, this is just a blog. Does that mean your articles have NO validity?

I wrote an article several years ago reviewing Andrew Wakefield's book, "Callous Disregard." I went point by point through his claims against vaccine safety. The article was 15,000 words. I submitted it to several journals. Each said they would be interested if I cut it to 2,500 words. I was considering finding a blog to post it when one open-source vaccine journal editor accepted it and arranged, since I am retired and not affiliated with anyone, to publish it waiving any fees. The journal, Open Vaccine Journal, was one of many published by a for-profit company, some of their journals quite reasonable due to editor and others less so. And since it wasn't one of their profitable journals, the company has discontinued it, maintaining the published articles in an archive.

Antivaccinationists, Age of Autism, included in their attacks on me that it was for-profit vanity press journal that I paid to get published. I challenge you or anyone else to find fault with my article. And I remind you that almost every major journal has had retractions and articles that were less than good. How about NEJM's article years ago on coffee and pancreatic cancer?

It is OK to mention funding source; but, again, if I had not found a journal to publish my article and posted it on a blog, would that change its content? Or that your articles are on a blog, does that make them less valid?

Don't stoop to the level of antivaccinationists. The fact that Paul Offit was one of the developers of an excellent rotavirus vaccine and the Children's Hospital of Philadelphia shared royalties with him and other developers doesn't change the validity of his journal articles.

You did an excellent job of dissecting Mawson's article. Attacking the journal was unnecessary and affirms that what antivaccinationists do is legitimate. Mentioning the funding source is OK; but should NOT be emphasized. Focus on the science and logic!

For those interested, you can find my article: "Wrong About Vaccine Safety: A Review of Andrew Wakefield’s “Callous
Disregard”" at: https://benthamopen.com/contents/pdf/TOVACJ/TOVACJ-6-9.pdf

By Joel A. Harris… (not verified) on 08 May 2017 #permalink

@ Eric Lund:

All science is tentative. One study, whether in the best journal or not, is just one study. This is a point that should be emphasized again and again. The absolute best study, even a double blinded randomized trial, is subject to random variables that can influence the results. Also, there is a bias in publishing against publishing negative results, so even the best journals often get it wrong. Peer-review helps; but is no guarantee. I know of several instances personally where a journal sent a manuscript to someone for peer-review and he gave it to a grad student. Once again, I repeat, what is important is the science and logic AND to explain over and over that one study should NOT be relied upon. Replication, which doesn't have to be a perfect replica of a previous design, is one of the sine qua nons of science.

This blog should serve as a model for science and logic, not stoop to the same level as antivaccinationists. Of course, some of them are so outrageous that they deserve this being pointed out. They love to resort to ad hominem attacks which, in my opinion, are clear evidence of their inability to actually deal with the science and logic.

Besides my article on Wakefield, I have written another 10 articles debunking antivaccinationists, one 45,000 words, so even this blog would probably not be interested. For those interested, you can find the summaries of my articles which link to the full pdfs at: http://www.ecbt.org/index.php/facts_and_issues/article/expert_commentary

By Joel A. Harris… (not verified) on 08 May 2017 #permalink

The mechanisms responsible for these nonspecific effects are unknown but may involve inter alia:

SRSLY? Who uses legalese in medical "journals"?

^ G-ddamn blockquotes.

Don’t stoop to the level of antivaccinationists. The fact that Paul Offit was one of the developers of an excellent rotavirus vaccine and the Children’s Hospital of Philadelphia shared royalties with him and other developers doesn’t change the validity of his journal articles.

You did an excellent job of dissecting Mawson’s article. Attacking the journal was unnecessary and affirms that what antivaccinationists do is legitimate. Mentioning the funding source is OK; but should NOT be emphasized. Focus on the science and logic!

Journals are not blogs and are evaluated by different standards—higher standards. Also, pointing out that a dodgy predatory journal is a dodgy predatory journal is legitimate criticism, as is pointing out that a study is published in a dodgy predatory open access journal, as long as it's not the central reason for dismissing the study (which it wasn't in this case). Basically, to me characterizing the journal is no different than characterizing the funding source—and just as much fair game, as long as it isn't central to the criticism.

I tried to be very calm in my initial response, but now I'm starting to get irritated, because you appear to me to be acting as though my citing how this is a dodgy predatory open access journal is somehow central to my criticism of Mawson's study when it's obvious that it isn't. We should probably just let this argument drop, because nothing good will come of pursuing it, particularly if you continue to characterize me of "stooping to the level of antivaccinationists." Them's fightin' words, so much so that I wrote and almost posted a response that we would've both regretted. Fortunately, I put it aside for a while before coming back to it and was thus able to delete the more...colorful...passages before hitting "Submit comment."

Can you imagine deliberately exposing children to polio, measles, influenza?

Something something Salk vaccine field trials something.

"This is not in any way representative of the population at large."

To do a study of unvaccinated kids with meaningful results, you have to have a sample with more unvaccinated kids than in the overall population. This is a strength of the study, not a weakness.

At least you didn't call the results statistically insignificant this time, illiterate shill.

By Jake Crosby (not verified) on 08 May 2017 #permalink

The problem of poor science/pseudoscience and predatory "pay to view" journals is becoming a really serious one.

These journals are multiplying in number; their content is inferior and of poor quality, and the public (and many in the scientific arena too) cannot distinguish the useless from the useful.

What can be done about them? Science publishing as we know it needs to address the issue somehow.

Argh. Do I have to subject myself to this one too?

Mawson's motto seems to be "Trust me, thistime I've got it right." I guess someone will have to endure his "publications" until he actually does get one right. Just another form of job security or punishment for some past sins.

To do a study of unvaccinated kids with meaningful results, you have to have a sample with more unvaccinated kids than in the overall population. This is a strength of the study, not a weakness.

Jake, I understand you pretend to know epidemiology?
If so, then you will know that you might need more of one group (unvaccinated) in your sample, but to achieve this you address it through your sampling process, for instance recruiting two unvaxed kids for every vaxed kid, but still maintaining the unbiased randomisation so that the samples you picked were representative of the background population.

You cannot find a subgroup who have generated your "more unvaxed" through the selection bias of differential parental choice about vaccines.

I don't pretend to be an epidemiologist, but the principle of what I am saying here should be obvious to even you.

Given that the ranking of journals (and, yes, I know about the pitfalls of impact factors) is a critical metric of academic performance, one would have to wonder why anyone would publish in such an outlet.

It simply isn't true that the merit of studies can be assessed just by reading them. If Wakefield's seminal deception isn't evidence of that, then what is it? Peer review at least gives a sense that a person or persons who are very familiar with the specialist field have said it doesn't suck.

The idea that all words on a page are of equal merit if you know how to read is just crazy.

Broad and Wade said there were too many biomedical journals 30 and more years ago. Nowadays most of the entire output is crap, as the general journal editors are fond of suggesting.

By Brian Deer (not verified) on 08 May 2017 #permalink

Oh, goody. The Gnat is buzzing again. The Gnat, for someone training to be an epidemiologist (allegedly), sure seems pretty ignorant of epidemiology. He also seems to be oblivious to the use and abuse of p-values. You know, I forgot to check if Mawson controlled properly for multiple comparisons. Any bets on whether he did so correctly or not? :-)

I bet if I discussed p-hacking and the arguments between Bayesian and frequentist interpretations of p-values and statistical significance his little Gnat head would explode.

It simply isn’t true that the merit of studies can be assessed just by reading them.

I disagree with this assertion as a blanket statement. Certainly, for many studies, just reading the paper, looking carefully at the figures and tables, and determining if the data support the conclusions can allow one to make a good assessment of the merit of the study. However, that is not to say that such assessments are easy or straightforward or that there aren't pitfalls that trip up even experienced reviewers. Also, such assessments assume that the scientists who wrote the paper describing the study are basically honest.

That's where Wakefield's 1998 case series comes in. In the case of scientific fraud, you are correct that reading a paper isn't enough to be able to assess its merit. However, on the optimistic side, I like to point out that, if there's anything that PubPeer has shown, it's that careful examination of papers by many people interested in detecting fraud often leads to fraud being detected.

I still don't understand what the hypothesis is that justifies comparing completely unvaccinated children as a category to anyone unless you buy into the completely unfounded idea that any vaccine does something irreversible to you, which doesn't quite go with claims that there has been a change in recent generations - after all, almost all adults have got at least one vaccine.

What's the alleged biological mechanism that makes comparing completely unvaccinated children valid, but something like Smith and Wood or DeStefano et al that looks at children getting more or less vaccines not valid?

What am I missing?

By Dorit Reiss (not verified) on 08 May 2017 #permalink

@dingbat:

"Jake, I understand you pretend to know epidemiology?"

Pretend epidemiology: "You cannot find a subgroup who have generated your “more unvaxed” through the selection bias of differential parental choice about vaccines."

You have no f*cking idea what selection bias is or how it works.

By Jake Crosby (not verified) on 08 May 2017 #permalink

"Something something Salk vaccine field trials something."

Something something Barrack Obama, something, something, Baby Face.

Seriously, though, did Salk have IRB approval? Because I just got approval for my dissertation project, and, well, it was hard to get.

You have no f*cking idea what selection bias is or how it works.

Jake,
I take it from your answer that neither do you.

Put another way, do you think there was any selection bias present in this sample conducted by Mawson?
Yes or No?

I wonder if he thinks there was any in Wakefield's twelve.

By Dorit Reiss (not verified) on 08 May 2017 #permalink

In reply to by dingo199 (not verified)

"You have no f*cking idea what selection bias is or how it works."

Are you sure that it's because you're autistic that women won't date you, Jake? It seems to me that it might have something to do with your demeanor, your inability to be cordial, or your propensity to get triggered.

See, when someone gets something wrong, you're better off pointing that they're wrong and then offering the correct solution. For example, you could have quoted what Boston University School of Public Health has on their site regarding selection bias:

"Selection bias can result when the selection of subjects into a study or their likelihood of being retained in the study leads to a result that is different from what you would have gotten if you had enrolled the entire target population."

In this case, this vax v. unvax study clearly had subjects in their study survey who were more likely to be surveyed than others. Again, Epi 101, if sampling is done in such a way that probability of exposure is not the same in the two groups, then the study is showing selection bias.

Watch how Jake ignores the above comments and goes straight at my assertion of his propensity to be triggered.

The declaration of Helsinki gives more details on trials outwith the "Humanitarian crisis" scenario.

@Ren #41

In the 1950's IRB, not so much, IIRC those really became a thing in the 1970's

I will say research done before an after wide-spread implementation of an effective protocol may have different ethical concerns. Why some trials compare with "usual care" rather than a true placebo.

And IRBs are constantly evolving. Seems every time I renew one of ours there is some new question or nuance that has to be addressed. Sometimes procedural (do you remove consent forms once you are done enrolling patients), but sometimes because of evolving ethical standards.

There are statistical methods to handle small numbers of the subjects of interest. Propensity score matching is one. Small numbers can be dealt with through appropriate analysis.
Also, many home schooled children are home schooled because of their NDD. I saw no effort to account for this in the study.

@ Brian Deer:

While it is true that your excellent investigative journalism uncovered flaws/fraud in Wakefield's 1998 article, there were obvious problems that could be seen in the article itself. First and foremost, it was supposed to be an article looking at GI tract and regressive disorders. So, the mention of what the parents thought as the cause was totally irrelevant. It was a dead giveaway that the article had an agenda. And it was, at a case series. So, even if Wakefield had been on the up and up, the article, as a case series, claiming to find an association, at best, would have been the basis for subsequent research. Case studies and series are NOT for hypothesis testing but hypothesis generating. And after your investigative series, one of the most prestigious peer-reviewed medical journals, The Lancet, took more than a half dozen years to finally retract it. More and more articles are being retracted, most from less reputable journals; but even from the "best" journals. See website, Retraction Watch, http://retractionwatch.com

There have been occasions where an article was rejected by journal after journal and eventually found some obscure journal to publish it, only to later become a classic.

There have been a number of recent reports critical of peer-review. Until one develops another format for reporting research, journals are the usual venue, and each journal can only publish so many studies and, especially the print journals, are limited in space , so I disagree with Broad and Wade. A colleague once told me how he had included a "caveats section" in an article which was published in a good journal; but they cut it due to space.

As I mentioned in a previous comment, my review of Wakefield's paper was 15,000 words. I know you have read it and thought it quite good. As I wrote above, I tried numerous journals. No way could I have cut it to 2,500 words, so I was fortunate to find a journal editor willing to publish it. Once published, at least, it was available for people to read and decide for themselves its merits. My final choice would have been a blog.

And I repeat, that one article should NEVER be relied on. Even the best of research, published in the best of peer-reviewed journals, is tentative. And, on the whole, journals do NOT publish negative results which means even peer-reviewed publications often give a biased picture. Eventually, negative findings do get published; but sometimes long after the impact of the original publication has been felt.

One approach is to go back to how academia was 60 - 70 years ago when teaching and community service were more valued instead of publish or perish; but given that, in US, universities make a lot of money from grants, indirect costs, the pressure to get grants and publish is enormous.

But there are more researchers and, though a lot of garbage, more and more good stuff as well. With the limited space of the more prestigious journals, how would you get the information out?

I would love to see a system where abstracts of ALL research was available on an easily accessed website, e.g. PubMed, with links to pdf of articles articles and data, etc (the articles wouldn't have to be limited in size, appendices, etc.) Keep in mind that one of the criticisms of the "prestigious" journals is that they get much of their funding from the pharmaceutical industry. In several of my articles for Every Child By Two I refute this with numerous examples of their publishing articles critical of the industry.

And the "prestigious" journals limit the number of articles posted as open source, so when I want one of their articles, I have to drive to university to photocopy. Otherwise, many charge up to $40 for a 10 page pdf. If the goal of publishing, of science, is to disseminate information, certainly not well served by these journals.

And I remind you that your original investigative series on Wakefield wasn't in a peer-reviewed journal. It was excellent, well-researched and has subsequently been confirmed by other sources as well; but, at the same time, I can give examples of articles in major newspapers that didn't come remotely close to the quality of yours.

Orac misses the point I was trying to make which is, if he had not mentioned anything about the journal, his dissection of Mawson's study was EXCELLENT and was all that was necessary. This blog and the other Science-Based Medicine blog represent SCIENCE and LOGIC. Both blogs have articles that are excellent representations of science. In my opinion, by using science and logic to refute antivaccinationists and other anti-science claims, one reinforces scientific thinking, a role model for scientific thinking.

You have been the target for numerous ad hominem attacks, none valid or justified. In fact, in my opinion any ad hominem attack not only shows the authors inability to make a valid argument; but their being unethical as well. I mean by ad hominem, attacking someone for being a shill, for being bought and paid for. However, though unnecessary and probably counterproductive, some antivaccinationists are so outrageous, so infuriating, that attacking them as some sort of moron on steroids is something I plead guilty to.

As for the pharmaceutical industry, yep, many of the studies they sponsor are flawed. Ben Goldacre's excellent book, "Bad Pharma", documents this; but even more he documents with extensive footnotes flaws in even all peer-reviewed journals.

My first comment was NOT meant to attack Orac. Maybe I could have worded it better; but just to make clear that he usually does such an excellent job of dissecting antiscientific thinking as he again did in this article that it is an unnecessary distraction to mention the quality of the journal.. And that even the most egregiously greedy journal can publish something of merit that for some reason did not make it into one of the more "prestigious" journals.

By Joel A. Harris… (not verified) on 08 May 2017 #permalink

To do a study of unvaccinated kids with meaningful results, you have to have a sample with more unvaccinated kids than in the overall population. This is a strength of the study, not a weakness.

For someone who is an alleged epidemiology student, that is one dumb statement.

<

At least you didn’t call the results statistically insignificant this time, illiterate shill.

Says the kid knows nothing about statistical power, confounding or selection bias among other things.

By Science Mom (not verified) on 08 May 2017 #permalink
“Something something Salk vaccine field trials something.”

Something something Barrack Obama, something, something, Baby Face.

Oh, relax. It was in reference to both "only be ethical in the days of Edward Jenner" and it's support of "exposing children to polio, measles, influenza." I was hurrying to get out the door.

Seriously, though, did Salk have IRB approval?

The trials were led by Thomas Francis, but anyway, they postdated the Nuremberg Code. There's a brief history here; Lambert & Markel conclude that "in organizing the trials, researchers at both the NFIP and the University of Michigan Vaccine Evaluation Center proceeded according to the ethical standards of their day."

I'd have to go back to the original publication series to see whether there was something that would approximate an IRB, which I can't do at the moment.

To do a study of unvaccinated kids with meaningful results, you have to have a sample with more unvaccinated kids than in the overall population. This is a strength of the study, not a weakness.

For someone who is an alleged epidemiology student, that is one dumb statement.

Yah, I was going to ask him for a mathematical proof of Crosby's Sampling Assertion.

“Alleged epidemiology student?” Surely, he studied under Mark “I must have missed a zero” Geier.

http://briandeer.com/wakefield/dtp-garth.htm

Oh yea, thanks for refreshing my memory. Incompetent birds of a feather or something like that.

By Science Mom (not verified) on 08 May 2017 #permalink

"a mathematical proof of Crosby’s Sampling Assertion"

I expect the number 'i' would appear at least once in said proof.

Aw, I can't get the study to load - did it already get retracted again? :)

Disappointed because I wanted to see a few more of their comparisons - and laugh at the yyyyyyyuge confidence intervals.

By HeatherVee (not verified) on 08 May 2017 #permalink

"In this case, this vax v. unvax study clearly had subjects in their study survey who were more likely to be surveyed than others."

Who are the "others" and how does that equate to below?

"Again, Epi 101, if sampling is done in such a way that probability of exposure is not the same in the two groups, then the study is showing selection bias."

By Jake Crosby (not verified) on 08 May 2017 #permalink

These journals are multiplying in number; their content is inferior and of poor quality, and the public (and many in the scientific arena too) cannot distinguish the useless from the useful.

When a publisher is known to be fraudulent (claiming to be UK-based when in fact it operates out of Hyderabad; claiming to have peer-review when none exists; etc). it creates an obligation to point and laugh at the authors who use it to pretend that their press-releases are actually papers.
It is also fair to wonder why the authors could not publish through one of the alternative journals known to have actual standards, and resorted to a pukefunnel instead.

By herr doktor bimler (not verified) on 08 May 2017 #permalink

OT(ish) but Wakefield just appeared at the end of Channel 4 news in the UK. Go Cathy.

By NumberWang (not verified) on 08 May 2017 #permalink

To do a study of unvaccinated kids with meaningful results, you have to have a sample with more unvaccinated kids than in the overall population. This is a strength of the study, not a weakness.

To search for lost keys with meaningful results, you have to look under the streetlight rather than in the dark alley where your dropped it. This is a strength of the search, not a weakness.

By herr doktor bimler (not verified) on 08 May 2017 #permalink

@ Jake Crosby:

You write: "“Again, Epi 101, if sampling is done in such a way that probability of exposure is not the same in the two groups, then the study is showing selection bias.”

You apparently don't understand different types of sampling. One is done to try to equate as much as possible the two groups being compared. The other, representative sampling, deals with whether either group is representative, finding can be generalized to some larger group. In the Mowrer study, the choice of home schooled who received vaccinations certainly wasn't a random sample of home schooled in general, not even close.

By Joel A. Harris… (not verified) on 08 May 2017 #permalink

@ Herr Doctor Bimler:

I suggest you read carefully what I wrote in several previous comments. There are too many studies trying to get published in too few journals. What is your solution if one believes they have done a good study and can't get it into one of the "respected" journals, either because doesn't fit their present areas of interest, too long, or just too many submissions.

Read also Ben Goldacre's book, "Bad Pharma", which has a well-documented extensive footnotes that make a strong case that many journal articles, etc. can't be trusted, despite peer-review.

I remind you that Wakefield's 1998 article passed peer-review in one of the most prestigious medical journals, the Lancet, and it took an intrepid investigative journalist, Brian Deer, to uncover all the problems with it, the fraud. And what about NEJM's peer-reviewers and the article of coffee and pancreatic cancer? Once published, it was subject to the same kind of scientific refutations as demonstrated by Orac and others. .

By Joel A. Harris… (not verified) on 08 May 2017 #permalink

Sampling is fine - but there was not even an attempt to confirm the results of the survey....nobody looked at medical records.

How can the Gnat defend any conclusions made, if there was never any confirmation of even the answers being correct?

Good grief, my epi professors would have a field day with this study.
No defined population, no sampling frame, no randomization, no response rate, no power calculation, no addressing of any of the obvious sampling biases.
No verification of vaccination status.
No verification of NDD diagnosis.
No verification of any other diagnosis.

Also, convenience samples are generally for hypothesis *generating* studies, not hypothesis verifying studies.

It's too bad we don't get to see the survey tool also, so I can imagine what my survey professor would say about that.

By JustaTech (not verified) on 08 May 2017 #permalink

@Joel:

Ren wrote that, not me.

By Jake Crosby (not verified) on 08 May 2017 #permalink

Yeah, of course you would need to look at a larger group of unvaccinated kids than you would normally have by just randomly picking a group of 666 kids . . . because randomly picking a group of 666 kids you would end up with less than 10 who were completely unvaccinated. Really, you'd need a group of *thousands* of unvaccinated kids to confidently pick out health differences between a vaccinated and an unvaccinated group.

But sampling by using a survey of homeschooled kids is not going to be representative of the population. I don't know what kind of bias that is (I'm just an engineer, not even pretending to be an epidemiologist), but it is surely a problem.

By HeatherVee (not verified) on 08 May 2017 #permalink

While not a study, in large parts of the world children that get vaccinated live and children who aren't tend to die early.

In the US we have 1 to 3 people year die from rabies (usually they didn't know they had been infected and it was to late for the vaccine). In the rest of the world about 49,000 people die each year because they can't afford the rabies vaccine.

For anyone with a brain larger than a gnat, this shows being vaccinated is orders safer VS being unvaccinated.

Aw, I can’t get the study to load – did it already get retracted again? ?

Disappointed because I wanted to see a few more of their comparisons...

The link does seem to be dead. If you want to read the paper, you can see it at
http://www.rescuepost.com/files/mawson-et-al-2017-vax-unvax-jnl-transla…

I went searching for the paper at http://oatext.com, and the results were interesting.

They have a search box, and when I plug Journal of Translational Research into it, this "study" pops up as number 2 on the list. The URL is the same as our host links to in his post. But I didn't see any other hits for Journal of Translational Research, just a bunch or partial matches (I admit that I didn't look at all 995 results). When I add quotes around it, the result is zero hits.

I want to say that the paper is so bad that they not only retracted it, but retracted the entire journal. But I'm sure there is a different explanation.

@ herr doktor

Thanks for the update and link!

By HeatherVee (not verified) on 08 May 2017 #permalink

Golly, herr Doctor, I have to learn to type faster. I've a post in moderation that is going to mostly come out as a 'me too'.

(I thought that 2 links were safe, and 3 triggered moderation)

@Joel:

Ren wrote that, not me.

How do you get into a graduate program without being able to type (and there are apps that do it for you) <blockquote> and </blockquote>?

By The Very Rever… (not verified) on 08 May 2017 #permalink

@Reverend - lots of your parent's money, apparently.

(I thought that 2 links were safe, and 3 triggered moderation)

It wasn't the links - I messed up my e-mail.

HDB @66: Thanks!
Yeah, my survey prof would have a field day with this too. Let's start with the income question: that's almost always one of the last questions because people don't like answering it.
Why on earth does the child'd hair color matter?
Those are some super leading questions about why they homeschool and why the kids aren't vaccinated.

By JustaTech (not verified) on 08 May 2017 #permalink

Here's something else I want to know: why on earth does this paper even mention the BCG vaccine (for systemic TB in children) when it is *not* a vaccine that is given in the US?
I mean, it's just not relevant at all.

By JustaTech (not verified) on 08 May 2017 #permalink

I want to say that the paper is so bad that they not only retracted it, but retracted the entire journal. But I’m sure there is a different explanation.

Try searching for Mawson, or for "Journal of Translational Science". The dudes at OAText are low-life grifters and a decent Search function is not high on their priorities. Nor is a formal retraction procedure, which is why there is no notification or explanation, only a couple of 404s where the PDFs used to be. They have Mawson's money, is what they care about.

By herr doktor bimler (not verified) on 08 May 2017 #permalink

I don’t know what kind of bias that is (I’m just an engineer, not even pretending to be an epidemiologist), but it is surely a problem.

I am not an epidemiologist either--I am a physicist by training and trade--but there are multiple problems with drawing a study group exclusively from homeschooled children. There are what are called confounding factors: for instance, homeschool parents are disproportionately likely to be anti-vaccine. And there is a selection bias as well. Not to mention response bias, because this study depended on parents filling out the survey truthfully and returning the forms to the investigators.

Doing such a study right is actually quite hard. One cannot rely on public school children alone for such a survey either, especially when collecting data in Mississippi, which only allows medical exemptions to vaccine requirements. There, if you choose only public school students for your study group, you are guaranteed to find that vaccinated children are healthier than unvaccinated children, because the unvaccinated children will invariably have some medical condition which means that they cannot or should not be vaccinated.

Selection bias is an issue in my field, because I work with geophysical data sets, and big events tend to be rare. We have to be careful that a major event doesn't bias our results.

By Eric Lund (not verified) on 08 May 2017 #permalink

Just found the following on the WA DOH Website. Thought it might be of some interest.

Latest School Report, Most Kindergartners Are Immunized

OLYMPIA – The Department of Health recently released school immunization results for 2016-2017, and for the second year in a row, 85 percent of kindergartners had received the required vaccinations to start school.

Nearly 5 percent of kindergartners have an exemption or waiver from immunizations on file for a medical, personal, or religious reason. This means more than 4,000 children in Washington aren’t protected from diseases that vaccines prevent. While the exemption rate hasn’t increased since 2011, it’s more than double the national average of 2 percent.

About 8 percent of kindergartners are out of compliance with school immunization requirements. These students don’t have all of their immunizations up to date, haven’t submitted an exemption, or are missing paperwork. The remaining students are “conditional,” or getting caught up on their vaccinations or paperwork.

More than 95 percent of schools submitted data this year. Explanations of school immunization rates, as well as trends and data, can be found at the department’s website.

Parents and guardians can access their child’s immunization records at MyIR and locate school immunization rates on SchoolDigger.com.

Washington provides vaccines at no cost for all kids up to age 19 through the Childhood Vaccine Program.

Here’s something else I want to know: why on earth does this paper even mention the BCG vaccine (for systemic TB in children) when it is *not* a vaccine that is given in the US?
I mean, it’s just not relevant at all.

Offhand, I'd guess they were citing Aaby's Guinea-Bisssau work for that part of "put reference here."

@ Joel #62: I get it. I really do. In today's academic world of publish or perish for tenure, the pressure to have publications to get tenure or post doc grants or whatever can be pretty intense.

My college does emphasize teaching and service over publication. Officially. And yet the RPT folders of my colleagues have tended to have a lot of presentations, posters, and publications in them.

I have a teaching idea I've been working on for four years now. I've tried to get published in Nurse Educator or the Journal of Nursing Education but the idea wasn't ready for prime time, and it was rejected. It happens every day to perfectly good articles, as well as to horrid ones, for the very reasons you cite: not enough press space.

There is a place for open access journals to improve the landscape, especially for novice writers and researchers looking to get their foot into the door. I'm doing that, with the article rejected by the aforementioned journals.

However, there are key differences between what I'm doing and what Mawson has done. My article did undergo peer review; it took the editors awhile to find someone qualified to peer review it. I do not have to pay for publication; while open access, the journal is supported by my university. I had to heavily revise the article to get it ready for prime time.

That's how the process should work. If you're having to pay to get something published because you've been rejected by every one else, including small onine OA presses, then the problem is your work and not the system.

There's still a chance the work could be good, but a rational reader will subject it to extra scrutiny. It does matter.

@Joel

If your work is so very good, you can cut it and maintain the essence. Going to a crappy journal just to get published just isn’t a good enough argument. Personally, I am damned happy that Orac has taught me about these journals so I don’t fall prey to them. That means I will miss your brilliant writing--well, better that than get sucked into the void.

By darwinslapdog (not verified) on 08 May 2017 #permalink

From Jake's latest temper tantrum about this study:

"Please also be sure to troll the bitch who has led the charge for the study’s removal."

By "bitch," he means Dr. Tara C. Smith of Aetiology fame. I'm sure women just swoon at the level of respect and admiration Jake shows for the opposite sex.

Jake also seems to think that he wields some immeasurable amount of power:

"Autism Investigated sent a letter to the publisher Frontiers telling them we would make sure their index on the National Library of Medicine would be taken away."

Is that the royal "we"? Unless some of those Iraqi oil dollars can wield that much power, I'd say that this is another one of those temper tantrum empty threats.

"Please tweet the link to the republished study to Frontiers on Twitter, repeating the threat of National Library de-listing."

Yes, please do, loons.

Is that the royal “we”?

As I remember from his earlier post, he thinks he can convince Orange Thinskin, thru his appointed toadies, to order the National Library of Medicine to 'delist' Frontiers.

Like Trump, I doubt Jake has read the Constitution, or if he did, he never made it down to those pesky amendments.

@ Panacea and darwinslapdog

I really wish people would take the time to carefully read what I wrote; but I guess that is expecting too much. I covered a number of points.

Panacea wrote: "There’s still a chance the work could be good, but a rational reader will subject it to extra scrutiny. It does matter." Actually, as I explained, even the so-called best journals have had numerous retractions and those decent studies they published have often not been replicated, so one should be careful about how much one believes from any article. Read Ben Goldacre's book, "Bad Pharma," and do what I do, put a post-it on page of footnotes and check them out.

darwinslapdog writes: "If your work is so very good, you can cut it and maintain the essence. Going to a crappy journal just to get published just isn’t a good enough argument. Personally, I am damned happy that Orac has taught me about these journals so I don’t fall prey to them. That means I will miss your brilliant writing–well, better that than get sucked into the void."

First, as I explained, I could have posted it on a blog. My article refuted each claim in Wakefield's book, point by point, and I did it with direct quotes from numerous sources so as not to rely on one article as antivaccinationists often do. My article had 150 references. It would have been absolutely impossible to cut down from 15,000 to 2,500 words. And, as I wrote, once it was available online, it didn't matter who put it up, people could read it, check out the references (I gave hyperlinks to most of them) and decide for themselves. I repeat, once it was available online, anyone could judge for themselves. Who put it up was irrelevant.

Try read my article yourself and if you have even a modicum of a brain, please tell me how it could have been shortened from 15,000 to 2,500 words? And I also explained that there is much more research going on than could possibly be published in the major journals, including replications that don't back up key articles. Please explain how we would find out about them?

Everyone should in today's society understand some of the basics of science and take the time to read carefully articles and understand that every piece of research is tentative.

One last thing, most of the even egregious for-profit companies do arrange some type of peer- review. May not be great; but what type of peer-review does one find on blogs such as this; yet, readers such as I think many of the articles are good to excellent. Being an obsessive-compulsive, I actually click on links, go to mentioned articles, and download them, often reading them.

By Joel A. Harris… (not verified) on 08 May 2017 #permalink

@Joel: That the reputable journals have had retractions is not the issue. It is not an excuse to pay to have your work published in what is in essence a scam journal. Smaller, less well known journals, sure. But when you pay to get published its a vanity press and it simply isn't worth it to you.

I don't know how you could have cut down 15,000 words to 2500. Perhaps you could have serialized it. Or maybe you had redundancies you haven't acknowledged. But a publisher can't take up that kind of space, especially in a print journal.

JK Rowling's books got longer and longer as the Harry Potter series went on. To their detriment. Her editors lost control over her, and it didn't do her work any favors. A good editor helps a writer tighten up and clarify the core message. It's your work; you don't have to change it. But the editor is under no obligation to publish it, either. And sadly, neither of us is JK Rowling.

@ Panacea:

I guess you are unaware of the PLOS and BMC open source collection of journals, many top rated with excellent editorial staff and peer-reviewers. They charge fees to publish and, at the same time, they have NO advertisers. More and more researchers are turning to such journals because they get a much wider readership. As I wrote in a previous comment, when I have found abstracts of articles that aren't available online, I have to drive to university library and photocopy or if the local university library doesn't have the journal, have to ask friends/colleagues to photocopy at their respective universities. Otherwise, most of the "prestigious" journals charge up to $40 for a pdf of an article that may be less than 10 pages long. Not exactly conducive to sharing of science. So, open source journals are more and more playing a roll.

If it is vanity to get ones article published in an open source journal that charges, what type of vanity to create ones own webpage and post away?

You write: "I don’t know how you could have cut down 15,000 words to 2500. Perhaps you could have serialized it. Or maybe you had redundancies you haven’t acknowledged. But a publisher can’t take up that kind of space, especially in a print journal."

It is really STUPID to make such statements when you haven't even bothered to read my article. I guess you pull your thoughts out of your, you know what.

And, none of the print journals are going to serialize an article like mine. And, as I wrote earlier, the journal that posted my article, as many of the open source journals sometimes do, waived any fees on my part. And the editor is a well-respected virologist and assured me that it was reviewed by FIVE qualified reviewers.

As I explained and you are apparently too dense to understand, I wanted to get my article online so that people could see it. Anyone who seriously reads it and is open-minded will see that Andrew Wakefield's clams about vaccine safety are just bogus. I guess you think that anyone who takes the time and effort to refute others who are hurting public health, if they can't get their refutations published in a peer-reviewed journal, regardless of how good they are, should just forget it?

Read my article you frigging idiot!

https://benthamopen.com/contents/pdf/TOVACJ/TOVACJ-6-9.pdf

By Joel A. Harris… (not verified) on 08 May 2017 #permalink

Joel, I don't have to read your article to identify potential problems with an analysis that long. If you'll note I didn't suggest it was badly written in anyway.

I really don't have time to read something that long about an issue I'm already familiar with.

You have a tendency here, though, to rely on argumentum ad nauseum. I understand; I can be verbose myself.

I don't understand why you have to drive to your university to get articles behind paywalls, though. I can get pretty much anything online from my university library, including NEJM, JAMA, Lancet and more.

And I still haven't said paying for publication means bad. It simply means, I take a much harder look at it.

Quit being so defensive.

While I agree with your dissection of the study, I disagree with “Even more hilarious, it was a Frontiers journal, which is an even bigger dis because Frontiers journals are known for tending to be pay-to-publish predatory open access journals.” This is exactly what antivaccinationists sometimes resort to, that is, calling open-source journals who receive a fee to publish articles, vanity press and other journals for receiving pharmaceutical advertisements. There are good open-source journals, e.g. PLOS group, and bad journals; but what counts is not where something is published, even a blog, but the actual content of the article. Bringing up the journal or publisher is, in my opinion, a form of ad hominem attack and detracts from your otherwise excellent dissection of Mawson’s study.

I am going to disagree with what you have written here. An ad hominem attack is one where the character or personal traits are attacked in order to undermine an argument. However, ad hominem does not occur when the character or personal traits are part of the argument.

In this case, it is well known that there are stables of predatory open access publishers who lie about their editorial boards, lie about peer-review and happily publish any old junk so long as the author pays. Practicing scientists generally steer clear of these journals, meaning they only publish work that cannot pass peer review elsewhere.

If someone tells me that a paper was published in a Frontier's journal, I immediately know it didn't pass proper peer review and probably would not have passed peer review in another journal. Therefore, it is junk science.

That doesn't mean that there is not junk science published in other journals (look at Scientific Reports for examples), but if you have to stoop to a predatory open-access journal to get published, then there is something seriously wrong with the work.

By Chris Preston (not verified) on 08 May 2017 #permalink

As I remember from his earlier post, he thinks he can convince Orange Thinskin, thru his appointed toadies, to order the National Library of Medicine to ‘delist’ Frontiers.

Nonono, it's better (boldface added):

"Autism Investigated sent a letter to the publisher Frontiers telling them we would make sure their index on [sic] the National Library of Medicine would be taken away."

I have a Kraken to be unleashed, you dykes!

“Autism Investigated sent a letter to the publisher Frontiers telling them we would make sure their index on [sic] the National Library of Medicine would be taken away.”

Jake is going to be beside himself when he discovers that OAText has done the same to Mawson's papers.

I suspect a letter writing campaign will work less well on an outfit run out of Hyderabad, but with a fake mail address in London.

By Chris Preston (not verified) on 08 May 2017 #permalink

^ Oh, rats, Ren already got that. So much for reading comments from the bottom up.

Quit being so defensive.

This. We've (tinw) been through it all before, anyway.

@ Ren he is truly off the rails. I found this stupid turd of a tweet on his sh!teshow of a twitter feed:
Deplorable Autist @JakeLCrosby Apr 16

"Science Mom" of @JusttheVax is actually Camille Clark, once known as "Autism Diva" (and still just as big a bitch).

By Science Mom (not verified) on 08 May 2017 #permalink

The Gnat can be hysterically stupid sometimes in his speculations.

@Science Mom: wait, what? I thought you were Bonnie Offitt. ;) :p

By Julian Frost (not verified) on 08 May 2017 #permalink

Julian, I thought you were Bonnie Offit. ;^Þ

By Se Habla Espol (not verified) on 08 May 2017 #permalink

I am Bonnie Offitt!!

By herr doktor bimler (not verified) on 09 May 2017 #permalink

I am Bonnie Offitt!!

I have never been accused of being Bonnie Offitt. But I have been accused of being Paul Offitt.

Why Paul Offitt would be commenting on the internet using the name Chris Preston was never properly explained. But that is anti-vaccine logic for you.

By Chris Preston (not verified) on 09 May 2017 #permalink

Didn't you guys know that I'm Brian Deer?

(not that I mind being compared to an award winning journalist & all)

If someone tells me that a paper was published in a Frontier’s journal, I immediately know it didn’t pass proper peer review and probably would not have passed peer review in another journal. Therefore, it is junk science.

I know Jeff Beall channelled his inner Savonarola and was wont to denounce Frontiers as an instrument of the Devil profit motive, but they could still get their act together and stop publishing bafflegab (or at least bring down the ratio of bafflegab to that of longer-established profiteers like Elsevier). It's not going to be easy, of course, because of the way they incorporated the Multilevel Marketing business model into their structure, and decentralised the incentive to accept bad papers in exchange for $$$.

Full disclosure: I have reviewed manuscripts for Frontiers journals. In fact I have published with Frontiers journals, so I have a vested interest in them rebuilding their reputation.

By herr doktor bimler (not verified) on 09 May 2017 #permalink

Well, Joel, you wasted a good paragraph up there at #87 quoting me in full rather that simply referencing the comment #. You call it “meticulous”, I’m not surprised, as you say you are OCD (-ish at least) This is further demonstrated by your going on and on with your argument even though perfectly good arguments and alternatives have been suggested. Did you ever submit your draft to an editor? I have found that when forced to to so, I can cut my writing drastically and still make my point.

By darwinslapdog (not verified) on 09 May 2017 #permalink

@ Panacea:

You write: "Joel, I don’t have to read your article to identify potential problems with an analysis that long. If you’ll note I didn’t suggest it was badly written in anyway. I really don’t have time to read something that long about an issue I’m already familiar with."

Really, you don't have to read something? You are already familiar? What an arrogant idiot!

You write: “I don’t understand why you have to drive to your university to get articles behind paywalls, though. I can get pretty much anything online from my university library, including NEJM, JAMA, Lancet and more.”

First, to get it online from a university library one has to either be an employee or student to have an account. I am neither. Second, I’ve asked friend’s to get me articles and our university libraries online electronic databases do not include many journals. In fact, fewer and fewer each year as the library funds are reduced and the journals charge more and more.

You write: “And I still haven’t said paying for publication means bad. It simply means, I take a much harder look at it.”

I agree and have said so in several of my previous comments, except if I think an article important, I become more critical, regardless the source and I keep in mind at all times that even a well-done piece of research’s findings are tentative.

Once again, use a little of your “precious time” and read my paper and then comment on it. You might learn something, if that is possible:
https://benthamopen.com/contents/pdf/TOVACJ/TOVACJ-6-9.pdf

By Joel A. Harris… (not verified) on 09 May 2017 #permalink

@ Chris Preston:

You write:

“If someone tells me that a paper was published in a Frontier’s journal, I immediately know it didn’t pass proper peer review and probably would not have passed peer review in another journal. Therefore, it is junk science. That doesn’t mean that there is not junk science published in other journals (look at Scientific Reports for examples), but if you have to stoop to a predatory open-access journal to get published, then there is something seriously wrong with the work.”

Really, “you immediately know it is junk science.” And, I guess one should know that any research published in a journal that gets much of its funding from the pharmaceutical industry is suspect? And anything written on blogs like this are . . . well, you know. I’ve dealt with your idiotic statement in several of my previous comments. What amazes me is the arrogance of certainty that exactly mirrors that found on many antivaccinationist websites. They too automatically know which studies are good and which biased. Must be nice. Can you walk on water as well?

By Joel A. Harris… (not verified) on 09 May 2017 #permalink

@ darwinslapdog:

You write: “Did you ever submit your draft to an editor? I have found that when forced to to so, I can cut my writing drastically and still make my point.”

Yes, I did. In fact, prior to trying to get it published anywhere, I had friends/colleagues (over 10), several who are excellent editors, critique and edit it. And the editor who finally accepted my article actually did edit it and more changes were made following evaluations from FIVE peer-reviewers. I am “meticulous”. I have edited books, theses, articles; but never rely on my own editing of my own writings. I mentioned some of the people who reviewed/critiqued my articles in an Acknowledgments section; but some preferred to remain anonymous, given that antivaccinationists have been known to harass people.

In fact, even the 10 articles I wrote for Every Child By Two were looked at by up to 10 friends/colleagues. As I wrote in several previous comments, I could have just posted it on a blog and it was the article on Wakefield that led to Every Child By Two allowing me, as a volunteer, to post additional articles on their website. I don’t work for them; but they seem to like my articles and post them. And each article is long with quite a few references.

Antivaccinationists rely on one or two articles, or, sometimes, just take something from an article out-of-context. I write my articles intentionally to demonstrate how one writes a scholarly review, that is, not relying on one or two; but building my case with numerous credible articles. In a way, one could consider my articles a form of legal brief.

By Joel A. Harris… (not verified) on 09 May 2017 #permalink

Well, since I'm such an idiot, I see no point in reading your analysis. Probably over my head anyway.

And if you think that's what I actually mean, you should rethink it.

Didn’t you guys know that I’m Brian Deer?

I can outdo that: I've been accused of being "Brain Deer."

@Joel Harrison #109

“I mentioned some of the people who reviewed/critiqued my articles in an Acknowledgments section;”

I note that you listed Steven A. Rubin PhD in your acknowledgements. That would be the same Steven A. Rubin who along with Stanley A. Plotkin in their excellent paper recorded the rate of meningitis in Canada following administration of a urabe containing vaccine to be 1 case in 62,000 doses?.

"In Canada, the observed rate of meningitis after vaccination with Urabe strain was calculated to be 1 in 62,000 doses of the vaccine manufactured by GlaxoSmithKline"
Stanley A. Plotkin and Steven A. Rubin (" Mumps Vaccine chapter 20")

Maybe you’d like to explain why you erroneously wrote it up in your article, as 1 case per 100,000 doses………..

"Based on reports of aseptic meningitis, the Canadians estimated its occurrence in association with the vaccine as 1 case per 100,000 compared with 1 in 400 following
natural mumps"

By Wendy Stephen (not verified) on 09 May 2017 #permalink

If someone tells me that a paper was published in a Frontier’s journal, I immediately know it didn’t pass proper peer review and probably would not have passed peer review in another journal. Therefore, it is junk science.

I would have phrased this differently. I would have said that if a paper is published in a Frontiers journal I know that the probability of its being junk science is much, much higher than if it had passed peer review in an established journal.

@ Wendy Stephen:

You write: “Maybe you’d like to explain why you erroneously wrote it up in your article, as 1 case per 100,000 doses………..”

If you actually carefully read my paper, you would see that I referred to the UK decision in 1988 to continue use of the Urabe containing vaccine while trying to obtain an adequate supply of a Jeryl Lynn containing vaccine. This decision was made based on a 1987 Canada Diseases Weekly Report and a visit to Canada, which, as you know, clearly indicated that the Urabe vaccine associated aseptic meningitis was a benign condition. Benign doesn’t mean totally nice, just no need for heroic medical interventions and no disabilities on follow-up. The stats you give were contained in a December 1990 Canada Diseases Weekly Report, two years after the UK decision. If you had bothered to check out reference [57] in my paper it would have been obvious., I know you would love to find fault with anything related to me; but sorry to disappoint you as I used the stats available to the UK at the time, so what I wrote wasn’t “erroneous. “

Below are the actual quotes from the two Canadian Reports.

You claimed in comments quite some time ago that you are NOT an antivaccinationist; yet, are obsessed with the Urabe strain of mumps containing vaccines which has not been used in UK or Canada in over 20 years. Not once have you written something like: “There were problems with MMR vaccines containing the Urabe strain of mumps; but the vaccine currently being used in UK, US, and Canada contains the Jeryl Lynn strain of mumps which has a good safety record and I would recommend it for anyone’s children.”

In addition, you indicated that you would e-mail me the official document regarding your daughter’s case. So far, I haven’t received it. You can e-mail it to Every Child By Two and they will forward it to me. I am currently working on an article on Mumps and intend to do my best to cover everything, including as many case reports and studies on the Urabe strain vaccine. Currently I have over 200 documents, articles, chapters, reports, etc. So, send me any relevant papers related to your daughter’s case. If not, I will evenutally obtain them, just more work getting colleagues in UK involved.

CANADA WEEKLY DISEASES REPORTS

“Based on the assumption that approximately 250 000 to 300 000 doses of this vaccine may have been given in the past 12 months, the expected rate of reported CNS reactions would be 1 per 100 000. This is consistent with the reported rate of the CNS reactions for this vaccine worldwide which ranges from 1 in 70 000 to 1 in 200 000. This is also comparable to the incidence of about 1 in 100 000 reported in the literature for CNS involvement after use of a trivalent vaccine containing other measles and mumps strains or another monovalent mumps vaccine.
The “background” incidence of aseptic meningitis (of unknown etiology, or due to mumps) requiring hospitalization can be estimated historically from hospital discharge diagnoses. The average incidence in any given 4-week period for the years 1978 through 1983 in Canada was about 1 case per 100 000 children age 1 to 14. This is remarkably similar to the estimates of vaccine-associated CNS illness. All of these estimates are insignificant when compared to the rates of meningitis/encephalitis following natural measles (1in 2000) or mumps (1 in 400) infections.

Canada Diseases Weekly Report, September 5, 1987 Available at: http://publications.gc.ca/collections/collection_2016/aspc-phac/H12-21-…

In Table 22-10 of Rubin’s chapter on Mumps in the 6th Edition of the book, Vaccines, it does give 1/62,000 based on an article by Furesz which states; “Since the laboratory findings confirmed conclusively that the meningitis observed in recipients of TRIVIRIX vaccine was caused by the Urabe mumps vaccine, the latter vaccine was not considered safe for immunization of Canadian children. Effective May 1990, TRIVIRIX measles, mumps and rubella vaccine is not longer licensed for sale in Canada.”

Canada Diseases Weekly Report, December 15, 1990. Available at: http://publications.gc.ca/collections/collection_2016/aspc-phac/H12-21-…

By Joel A. Harris… (not verified) on 09 May 2017 #permalink

Joel, the definition of an antivaccinationist is………………….

“One who opposes vaccination”

I have asked you previously to provide evidence of any conduct on my part which might support your continued accusations that I am an antivaccinationist. You have failed to do so, probably because it doesn’t exist. I do however have an interest in the urabe mumps vaccine which I have never sought to hide. What is extremely important to me is that the Urabe vaccine ‘story’ is portrayed accurately, not manipulated into being anything more than it realistically was, but also that it is not played down into a non event as you repeatedly seek to do.

In your article you questioned what the UK decision to license the URABE MMR vaccine was based upon.

In response to your own question, you note that in 1987 the UK conducted MMR vaccine trials in approximately 5,000 children.

A clinical trial with 5,000 of a cohort is a respectable sized trial to establish the safety, efficacy and efficiency of a product, however what you failed to mention in relation to your own question was that just over a mere 600 children received the URABE containing Pluserix vaccine (the vaccine you are referring to), the remaining 4,400 did not. Only feedback from the 600 could have been relied upon to influence the UK decision to license and implement a URABE containing MMR as to its safety and efficacy. By comparison a trial with a cohort of 600 children on board, isn’t nearly so impressive as your quoted 5,000. Why would you seek to convey to the reader that the clinical trial relied upon to establish the safety of the Urabe containing Pluserix MMR which influenced the decision to introduce the urabe MMR into the UK, was far greater than it actually was?

Additionally, you reference three “reported studies using the Urabe strain that found no serious problems” where none of the brands involved remotely resembled, let alone matched, the urabe containing Pluserix MMR vaccine which the UK authorities were seeking to introduce in 1988. Just as negative safety issues and adverse reactions etc following the use of one brand of vaccine cannot be visited on to another entirely different brand, neither can the positive results from studies involving entirely different brands with entirely different component parts, excipients and dosages be used to assert the safety of the Pluserix MMR vaccine. Anyone who sought to do so would be entirely remiss not to mention unscientific and I have seen no evidence anywhere that the UK decision to introduce the Urabe MMR was based on the studies you propose.

By Wendy Stephen (not verified) on 10 May 2017 #permalink

@ Wendy Stephen:

You write: “I have asked you previously to provide evidence of any conduct on my part which might support your continued accusations that I am an antivaccinationist. You have failed to do so, probably because it doesn’t exist. I do however have an interest in the urabe mumps vaccine which I have never sought to hide. What is extremely important to me is that the Urabe vaccine ‘story’ is portrayed accurately, not manipulated into being anything more than it realistically was, but also that it is not played down into a non event as you repeatedly seek to do.”

You continue to ignore my asking why you haven’t once in any comment I have seen by you in any way encouraged people to get their kids vaccinated. All you do is harp on the Urabe vaccine, not later developments. As I suggested, if you were NOT antivaccine, you could have said that an earlier MMR that contained a strain of mumps called Urabe was found to be associated with unacceptable adverse events; however, a new strain of mumps called Jeryl Lynn, that has been used in UK and Canada for about 20 years has a good safety profile and I recommend it to all parents for their children. The fact that you go on and on about something that occurred over two decades ago and don’t make it clear to the reader that, even if it was a problem, that it isn’t today, easily can be read by anyone as valid today. Antivaccinationists, for example, continue to harp on the Cutter Incident, something neither I nor anyone I know downplays; but it happened in 1955 and led to far more stringent requirements for vaccines and oversight. However, if all one were to hear was the Cutter Incident they would think that the polio vaccine of today is unsafe. So, yes, whether you like it or not, you come across as antivaccine.

And anyone who reads my paper would see that I did NOT “play down” the adverse event findings associated with the Urabe; but made clear that it was still far safer than the wild-type disease and that, at the time, the data available did NOT indicate it differed in its adverse event profile from the Jeryl Lynn. You continue to twist things to give the impression that the UK continued using the Urabe without taking into consideration possible adverse events when they decided to use it as it was better than the natural disease and immediately began trying to get an adequate supply of the Jeryl Lynn containing vaccine. In another post you found that the UK had approved a Jeryl Lynn mumps vaccine in 1972; but you assume that the pharmaceutical company kept their production facility ready for a program that the UK began in late 1988. Without any evidence that the company was producing or capable of immediately producing quantitities of the vaccine, you assume so. In law courts that is termed “facts not in evidence.” Actually, I am trying to find out; but it isn’t easy.

I noticed that you failed to admit that you misread my paper regarding the 1 in 100,000 vs 1 in 62,000. And even if I had gotten it wrong, whether 1 in 100,000 or 1 in 62,000, the Canadian report gave the risk for aseptic meningitis from the wild-type mumps as 1 in 400. So, the Urabe was still the safer bet. And if you actually carefully read Steven Rubin’s chapter, safer in regard to a number of other adverse events associated with the natural disease. And your choice of word “erroneous” was obviously not just to point out a possible error. I edit books and articles written by quality people and always find a few errors. I remember once in a graduate statistics course arguing with the prof about an error in a formula. Turns out his copy was a later printing, so the authors had corrected it. It was an excellent book with a couple of errors. Happens all the time; but that wasn’t your intention. Antivaccinationists and other unscientific types believe if they find one or two errors that it discredits an entire work. Not true anymore than if a defense lawyer discredits one witness, the jury should then ignore the entire prosecution’s case.

And you continue to try to find fault with my paper and again are wrong. From my paper:

“Before the beginning of the program, vaccine trials were conducted in the UK, starting in early 1987 [69]. By the beginning of October 1987, data had been collected for five months from three districts: Somerset, Fife and North Hertfordshire. The data included health diaries kept by the parents covering the three weeks before vaccination and three weeks after [58]. Approximately 5,000 children were included in these studies [70]. However, the diaries were not the only means used for reporting adverse events (see below)” (Wrong About Vaccine Safety, p. 13. Available at: https://benthamopen.com/contents/pdf/TOVACJ/TOVACJ-6-9.pdf

If you checked out reference [70]. I was citing a UK committee:

“Dr Cameron Bowie spoke on the MMR trials which had been carried out using Health diaries on approximately 5,000 children . . .”

Joint Sub-Committee on Adverse Reactions to Vaccination and Immunisation, March 8, 1988. Available at:
http://webarchive.nationalarchives.gov.uk/20120907090205/http://www.dh…

And do notice that I wrote: “However, the diaries were not the only means used for reporting adverse events (see below).”

And the UK looked at the Canadian data and other studies. Yes, not every vaccine was exactly the same; but they looked at everything available at the time. And, once more, despite the Urabe assocation with adverse events, it was till much safer than the natural disease. Can you accept that? ? ?

You continue to misread what I write because you need to given your obsession with the Urabe vaccine.I consider any child injured whether from the natural disease or a vaccine a tragedy; but since life isn’t black and white, I choose to weigh benefits vs risk. If the risks from the natural disease outweigh those from a vaccine, I choose to vaccinate. However, I also choose to not only compensate children hurt by vaccines; but a society where all children are given whatever help, medical/educational etc. is necessary to allow them to reach their full potential. Given what I so far know about the Urabe, if it was the only available vaccine available I wouldn’t hesitate to give it to children.

It really is a waste of my time responding to you as you refuse to admit when wrong, e.g. 1 to 100 000 and you continue to focus on only part of my paper. As I said, I am working on a paper just on the Mumps. As opposed to you, if I find more evidence against earlier versions of Mumps vaccine or even the current, I will include it. You said a while back that you would e-mail me the decision on your daughter’s case and any relevant papers; but I haven’t received them, so I guess I will have to request colleagues in UK to help. Do you have something to hide? So, are you going to send the info via Every Child By Two or not? ? ?

By Joel A. Harris… (not verified) on 10 May 2017 #permalink

Joel @117

“In another post you found that the UK had approved a Jeryl Lynn mumps vaccine in 1972; but you assume that the pharmaceutical company kept their production facility ready for a program that the UK began in late 1988. Without any evidence that the company was producing or capable of immediately producing quantitities of the vaccine, you assume so”.

No Joel, I make no assumptions. I learned from the 17th May 1988 MMR Working Party Minutes that even as far back as May 1988, (four months before the launch of the UK MMR campaign) an approach had been made to the Department of Health in the UK advising that MMR II vaccine “wished to join the MMR market”.

Even before the launch of the campaign in the UK there is a clear indication that the MMR II production facilities were ready for the UK program otherwise they would not have indicated that they wished to join the market. MMR II was implemented in November of 1988 and continued without interruption even after the withdrawal of the urabe containing brands.

Additionally, the Minutes of the JCVI meeting on 6th November 1992 record how

“Department of Health officials visited the MSD factory in Philadelphia and obtained agreement for the supply of the additional amounts required by the UK”.

I’d say that was ample evidence that the company was (a) capable of supplying the UK market with MMR II even before the campaign was launched and (b) was immediately capable of increasing their supplies to the UK to meet our entire demand when asked to do so, after the withdrawal of the two urabe containing brands.

By Wendy Stephen (not verified) on 10 May 2017 #permalink

@ Wendy Stephen:

You write: “No Joel, I make no assumptions. I learned from the 17th May 1988 MMR Working Party Minutes that even as far back as May 1988, (four months before the launch of the UK MMR campaign) an approach had been made to the Department of Health in the UK advising that MMR II vaccine “wished to join the MMR market. Even before the launch of the campaign in the UK there is a clear indication that the MMR II production facilities were ready for the UK program otherwise they would not have indicated that they wished to join the market.

According to the document you refer to: “Dr Salisbury reported that he hoped the SKF MMR vaccine would be license shortly since its constituent parts were already licensed. Wellcome contacted him to say they wished to join the MMR market. Their vaccine contains the Jeryl-Lynn strain of mumps. The MSD vaccine already has a product licence. Dr Thorne asked whether there would be central purchasing . . .”

JCVI Working Party on the Introduction of Measles, Mumps and Rubella Vaccine, May 17, 1988. Available at: http://webarchive.nationalarchives.gov.uk/20120405095146/http:/www.dh.g…

“Wished to join” doesn’t mean that they were ready on a moment’s notice to begin production!

And my article makes clear that they did, indeed, once awareness of problems in Canada, “despite the benign nature of vaccine-induced meningitis” start to obtain MMR with Jeryl Lynn.

In the UK, “despite the benign nature of vaccine-induced meningitis, a decision was made to replace the brands containing Urabe (Immravax by Merieux, and Pluserix MMR by SmithKline Beecham) with that containing Jeryl Lynn” [91].
[91] Peltola H (1993). Mumps vaccination and meningitis. Lancet; 341(8851): 994-995.

However, as another document makes clear: “The Health Departments had had a difficult time with regard to MMR supply, problems caused in the main by the manufacturers. Other vaccine manufacturers producing MMR which contained the Jeryl Lynn strain of the mumps virus included RIVM (under a very prescriptive license from MSD making sale in the UK impossible) and Rubini in Switzerland (a vaccine which lacked sufficient study in the field to be certain that there would not be a Urabe-like problem). Merck and Merieux were collaborating to produce a Jeryl Lynn strain vaccine [90].

[90] UK Department of Health. Joint Committee on Vaccinationa and Immunisation. Minutes of Meeting, May 7, 1993. Available at: http://webarchive.nationalarchives.gov.uk/20120907090205/http://www.dh…

So, yes, a Jeryl Lynn containing vaccine had been approved ; but that doesn’t mean that the company, despite their interest, was able to produce the quantities necessary as indicated in the above document. In addition, the UK had decided to use the Urabe containing MMR and it wasn’t until after they learned of the Province of Ontario’s recall on July 18, 1988 of the TRIVIRIX that they looked into it and decided to obtain Jeryl Lynn containing vaccines. This means than the URABE containing vaccine, Pluserix, would have been in production and once they agreed to MSD, MSD would have had to play catchup. So, as usual, it is you who overplay your hand. Once again, as made clear in quote from UK document, the manufacturers of Jeryl Lynn containing MMR had production difficulties. DO YOU UNDERSTAND? ? ?

As for: Additionally, the Minutes of the JCVI meeting on 6th November 1992 record how
“Department of Health officials visited the MSD factory in Philadelphia and obtained agreement for the supply of the additional amounts required by the UK”.

Incredible. You don’t understand the basics of calendar time. November 6, 1992 is four years after the UK started the vaccination program. And the report doesn’t mention anything about the production capabilities of the MSD factory in Philadelphia, that is, at what time was their facility capable of both supplying US and UK? There is NO indication from any document I have obtained that they could have done so in Fall of 1988. Otherwise, why would MSD, after indicating their interest in marketing their vaccine, not avail themselves of their production capabilities in Philadelphia? Why did UK document from 1993 discuss difficulties in production by manufacturers of Jeryl Lynn containing MMR?

And still, you refuse to simply state something endorsing use of the current MMR, obsessing on the Urabe. I guess given your inability to actually understand simple dates, why should one expect more of you?

And, again, you posted in a comment some time ago that you would send me the documents related to your daughter’s case; but I guess that won’t happen?

I am busy proof-reading a microbiology textbook which will be used by thousands, a much more valuable use of my time.

By Joel A. Harris… (not verified) on 10 May 2017 #permalink

Joel @119

“And my article makes clear that they did, indeed, once awareness of problems in Canada, “despite the benign nature of vaccine-induced meningitis” start to obtain MMR with Jeryl Lynn”.

Joel, it is acknowledged that that the “problems in Canada” were known to the UK authorities long before Pluserix entered the market. It is not correct to say that ONCE awareness of the problems in Canada became known, supplies of MMR II were obtained.

In case you missed it, the MMR II proportion of the UK market INCREASED (ie from the 15% share of the entire UK market it had held since 1988) in 1992 after the withdrawal of the two urabe containing brands at which time MMR II became the only brand used. This came about when the laboratory confirmed rate of urabe vaccine induced aseptic meningitis was found by a UK Public Health Laboratory to be much higher than previously thought. The Chief Medical Officer of the time, Dr Kenneth Calman, distributed an official letter to all doctors etc in the UK on 14th September 1992 advising them of the new statistical findings from the UK facility and how, from then on, only MMR II vaccine would be available.

That all took place long AFTER the “problems” in Canada were known about and two years AFTER the Canadians had removed the licence for Trivirix. The situation in Canada was not the catalyst for either the decision to remove the urabe containing MMR’s in 1992 or the timing of a decision to switch to only MMR II. That all came about solely as a consequence of our scientists determining that the rate at which aseptic meningitis was occurring in UK children was much higher than originally thought.

If your article states anything other than that to be the sequence of events, then it is wrong

By Wendy Stephen (not verified) on 11 May 2017 #permalink

@ Wendy Stephen:

You write: “It is not correct to say that ONCE awareness of the problems in Canada became known, supplies of MMR II were obtained.”

But that is NOT what I wrote, which was:

“And my article makes clear that they did, indeed, once awareness of problems in Canada, “despite the benign nature of vaccine-induced meningitis” start to obtain MMR with Jeryl Lynn.”

The UK started an effort to obtain the MMR with Jeryl Lynn. Thank you for once again proving my point that you really don’t read carefully or understand what people write. Try carefully reading my article.

And once again, you refuse to admit you were wrong, wrong about claiming I “erroneously” used 1 in 100 000, wrong about using 1992 arrangement to get supplied from MSD in Philadelphia, ignoring that the UK MMR program began four years earlier and so it goes.

One other thing that, if you actually read my article you missed: “Note that the Canadian decision to withdraw the vaccine was based partly on laboratory data from the UK. . . . Canada was not the only country to base its decision partly on data from the UK; but “the [JCVI] committee was told that all the countries which had had a choice had switched from Urabe to Jeryl Lynn; the UK data had been accepted by all these countries” [79]. In other words, it was the quality of the UK surveillance data that prompted its worldwide use for vaccination decisions; and although the “UK’s quality of surveillance was unsurpassed . . . Many lessons had been learnt from MMR. It was agreed that better surveillance was needed as well as a consideration of how adverse events were followed up [79].”

You claim that all you want to do is: “What is extremely important to me is that the Urabe vaccine ‘story’ is portrayed accurately, not manipulated into being anything more than it realistically was, but also that it is not played down into a non event as you repeatedly seek to do.” AND "If your article states anything other than that to be the sequence of events, then it is wrong," So, you are commenting on what I wrote; but have obviously NOT read it. How pathetic!

Yet, that is NOT what you are doing. Your daughter lost hearing in one ear and you want to blame someone. You need to portray the British decision and those who made it as either incompetent or worse. You need to claim that I downplayed the risks and problems with the Urabe strain containing MMR. What you refuse to accept is that, as with anything that people do, they do their best and then learn from their mistakes. I simply described in my paper the events as they transpired and that, in fact, at the time, the UK surveillance for adverse events was probably either the best in the world or up there.

You criticize the sample sizes and follow-up times; but they were not out of line with most studies of this type. Years later, in the US we approved the first rotavirus vaccine based on a study sample of over 10,000 and on post-marketing surveillance a rare problem, intussusception, was found, so it was taken off the market. Until the next vaccine based on a sample of 72,000 was approved, each year several dozen children died and 10s of thousands were hospitalized to prevent a dozen or so cases of intussusception and one possible death. I’m sure you approve.

You claim to NOT be an antivaccinationists; yet I asked you, not only in this exchange, but numerous others to simply state something like: “Based on my understanding several decades ago an MMR vaccine containing a strain of the mumps called Urabe was associated with unacceptable adverse events and I believe this could have been avoided if the decision process had been better. With that said, today’s MMR vaccine has an excellent safety profile and I recommend that all parents should vaccinate their children.”

If you can’t say something positive about current vaccines and continue to twist and distort what happened 20 years ago, then YOU ARE AN ANTIVACCINATIONIST.

And once more you fail to answer if you will send me the documents on your daughter’s case. As I wrote, I am working on an article on mumps and intend to create numerous tables, including one for hearing loss, both stats on natural disease and vaccines, as many papers as I can find. I don’t down play anything as I think, as I’ve written numerous times, that even one injured child is a tragedy; but, living in the real world, one has to make choices and I choose vaccination over the natural diseases. Who would you be blaming if UK had withdrawn MMR and your daughter was injured from one of the natural diseases which would have had, without vaccines, a much higher probability of occurring?

So, post a comment promoting the current MMR and answer if you intend to send me the documents on your daughter’s case.

And just to be clear, you come across as not only an antivaccinationist; but a bitter obsessed person.

By Joel A. Harris… (not verified) on 11 May 2017 #permalink

Joel @121

“I simply described in my paper the events as they transpired and that, in fact, at the time, the UK surveillance for adverse events was probably either the best in the world or up there”.

You certainly did cover the adverse event surveillance system in place AT THE TIME but it’s a pity you got that wrong as well. And as for being “the best in the world or up there” it might surprise you to know that even our own authorities acknowledged that in respect of urabe, the system had failed to identify the scale of the problem.

In your article you asked what type of surveillance system did the UK use? In response to your own question you mention the Yellow Card Scheme and say that “suspected ADR’s can be reported by anyone; this is usually done by healthcare professionals …including doctors, pharmacists and nurses…………but patients and care givers also made reports”

Given that you are talking about what was in place AT THE TIME you should be aware that nurses were only allowed to report via the Yellow Card system after November 2002 (ten years after Urabe was withdrawn), Pharmacists in November 1997 (5 years after Urabe was withdrawn) and patients and caregivers since November 2005. What you have described is the scope of the yellow card system today not how it was back at the time you are talking about.

The BMJ (vol 301 1st December 1999) “The Yellow Card Mark II) said of the system.....

"There is of course considerable under reporting"

Additionally, the 1995 edition of POST (Parliamentary Office of Science and Technology) stated the following……..

"The Urabe experience was exacerbated by the failure of the yellow card surveillance system to detect the scale of the problem.............."

Also from the Minutes of ARGOS (Adverse Reaction Group of Sear) (CSM 1992 8th meeting) it was said of the Urabe problem that……….
"The BPSU has failed to adequately identify an important public health problem"

If the BMJ, POST and ARGOS are all willing to concede the failures in respect of urabe surveillance and the limitations of the yellow card scheme, why cant you?

By Wendy Stephen (not verified) on 11 May 2017 #permalink

@ Wendy Stephen:

You write: "it might surprise you to know that even our own authorities acknowledged that in respect of urabe, the system had failed to identify the scale of the problem."

So what. At the time they did the best they could. Admitting later that in hindsight they could have done better is not an admission of negligence. It has normal rational people progress and improve things. You obviously are not rational.

And my article doesn't just give the Yellow Card Scheme as the only source. You are really dishonest when you take only one of the ways that the UK conducted surveillance which my article covers. Typical antivaccinationist. They think the Vaccine Adverse Events Reporting System in the US is the only program for post-marketing surveillance of vaccines; but it is only one of several.

And you keep ignoring that the Urabe was still much safer than the natural disease and that all experts considered aseptic meningitis as a benign condition and the risk of hearing loss from the vaccine exponentially less than from the natural disease.

So, I gave what was used at the time, which was the basis for decisions in many other countries. And you continue to fail to admit the erroneous claims against me that you have made in previous comments on this exchange.

I've tried to be polite; but you are either psychologically disturbed or just plain dishonest. You want to blame people based on hindsight and, again, you refuse to endorse current vaccines or to answer if you will send me documents on your daughter's case.

I sincerely suggest you seek therapy!

By Joel A. Harris… (not verified) on 11 May 2017 #permalink

Joel @ 123

“And my article doesn’t just give the Yellow Card Scheme as the only source. You are really dishonest when you take only one of the ways that the UK conducted surveillance which my article covers. Typical antivaccinationist”

Well, if you really want to go there!

The other types of surveillance you identify in your article were….

(1) The BPSU which I have already pointed out was described in the ARGOS Minutes as having failed to adequately identify the Urabe problem.

"The BPSU has failed to adequately identify an important public health problem"

(2) “Adverse Reactions Surveillance – Dr. Bowie advised that active surveillance of MMR vaccine in Somerset had just started”

The JCVI in their Minutes of the Meeting on 7th March 1990 noted………..
“the surveillance of MMR vaccine in Somerset is unlikely to detect issues of concern, problems exist with under reporting”

(3) The surveillance diaries given to vaccinated children

The three week follow up diaries given to vaccinated children as part of the surveillance would have missed a significant number of cases of aseptic meningitis which occurred after the 21 day cut off.

Miller, E. et al in their paper “Risk of Aseptic Meningitis After Measles, Mumps and Rubella vaccine in UK Children”, published in the Lancet, Vol 341, April 17th, 1993 noted that “half the aseptic meningitis cases identified in children aged 12-24 months were vaccine associated with onset 15-35 days after vaccine”

The Canadian Medical Association Journal, Vol 138, January 15th 1988 reports on a case of mumps meningitis in a 14yr old, twenty six days post vaccination with the urabe containing Trivirix.

In their paper “Clinical and Epidemiologic Features of Mumps Meningoencephalitis and possible Vaccine-related Disease”, Vol 8, Paediatric Infectious Disease Journal November 1989, McDonald et al report on a 4yr old who developed mumps meningitis twenty six days after receiving Trivirix.

The Canadian Diseases Weekly report 5th September 1987 "a history of recent vaccination suggested an association between the vaccine and the development of meningitis although the time between the 2 events was 26 days - somewhat longer than the incubation for the wild virus"

In your article you stated that……..
“It is highly unlikely that many, if any, cases of aseptic meningitis would have been missed.”

I put it to you based on all the material I have placed before you from reputable sources, it was more likely than not, that a huge number of cases were missed.

If you don’t get that, it’s not me what needs therapy.

By Wendy Stephen (not verified) on 11 May 2017 #permalink

@ Wendy Stephen:

Again, it was the best surveillance system for the time. Yes, it missed cases; but, in your immense STUPIDITY, you fail to accept that it was cases of a BENIGN condition. Do you understand the word "BENIGN."

And you continue to use studies and data conducted later to blame something that occurred in the past. How really really STUPID.

And, again, for the umpteenth time, you fail to endorce the current MMR vaccine and to let me know if you intend to send to me documents related to your daughter's case.

Just for your dense brain, there is NO surveillance system that I know of that captures everything and it was NOT necessary because the cases of aseptic meningitis reported in Canada and the UK were enough to decide on halting use of the URABE. Does it really matter if they didn't capture all or even close to all cases if they captured enough to make a valid decision? Don't you understand anything?

I suggest you post regularly on Age of Autism. You can state that the world is flat and it is vaccines that distort of perceptual abilities and I'm sure some comments will applaud you.

Since you fail continuously to respond to my questions and continue to drag up the future to criticize the past and since you fail to understand that the surveillance systems at the time captured enough cases for decision making, there is only one way to describe you, STUPID ON STEROIDS!

By Joel A. Harris… (not verified) on 11 May 2017 #permalink

Joel@127

“Again, it was the best surveillance system for the time. Yes, it missed cases;”

Joel, in your article you argue against the fact that the UK surveillance system for adverse events was “inadequate” saying that to be, “not true”

Now you agree that it missed cases, what is that if not inadequate? Many of the references I have provided to you in previous posts from reputable bodies readily acknowledge the inadequacy of the surveillance.

That has got nothing to do with it being the best that was available at the time, and I agree that no system would be entirely effective in capturing everything. The point is that not only do you present an inaccurate picture of the state of the UK surveillance system in your article, suggesting it to be entirely capable of detecting a problem with Urabe were it to be occurring, you steadfastly reject any suggestion that it was inadequate.

And as for this bit……….

"Does it really matter if they didn’t capture all or even close to all cases if they captured enough to make a valid decision?"

I can only draw you back to this quote from one of my previous posts……..

"The Urabe experience was exacerbated by the failure of the yellow card surveillance system to detect the scale of the problem.............." POST July 1995

Consider this. Had the system not been so flawed and the “scale” of the Urabe problem picked up on earlier, that “valid decision” you speak of, would have been made much earlier. When the issue is one of adverse reactions following administration of a medicinal product, I put it to you that it DOES “really matter” that (a) problems are detected (b) the scale of the problem is accurately (as far as possible) recorded and (c) immediately acted upon as necessary.

By Wendy Stephen (not verified) on 12 May 2017 #permalink

@ Wendy Stephen:

In a previous comment I wrote that NO surveillance system is perfect, that is, captures every case. The reason for, as the UK had in 1988, having several different surveillance systems is that each has its strengths and weakness and each will capture some cases not captured by one of more of the other systems. So, the sum of cases captured by all the systems will be greater than any one of them. However, NO system, even today captures ALL or even most cases. Typical antivaccinationist, either or, black and white.

And I stand by what I wrote: “Does it really matter if they didn’t capture all or even close to all cases if they captured enough to make a valid decision?”

I remind you that the Canadians decided to stop using the Urabe based on only 15 days follow-up (not at the time knowing that Miller four years later would find they needed a longer follow-up time) and their less than perfect surveillance system and the UK decided to try to get Jeryl Lynn based on what they learned from the Canadian’s, that the decision was actually made prior to the data obtained from their surveillance systems. The UK surveillance data did not change the decision to switch to the Jeryl Lynn; but it did lead to the Urabe completely losing its approval. Newspapers go by the motto: “if it bleeds it leads”, that is, they exaggerate. Typical of an antivaccinationist that you cherry pick articles where you can find them, regardless of their validity and the article only refers to one of the UK surveillance systems.

You write: “Consider this. Had the system not been so flawed and the “scale” of the Urabe problem picked up on earlier, that “valid decision” you speak of, would have been made much earlier. How could it have been made earlier than when they learned about the Canadian report? If not for the Canadian report, the UK would have begun using the Urabe and then waited until reports came in from their surveillance systems. Even if they caught every single case, it would have delayed the decision to switch to the Jeryl Lynn. It would have delayed their trying to obtain Jeryl Lynn from the very beginning. You are totally illogical.

You write: “When the issue is one of adverse reactions following administration of a medicinal product, I put it to you that it DOES “really matter” that (a) problems are detected (b) the scale of the problem is accurately (as far as possible) recorded and (c) immediately acted upon as necessary.”

First, as I wrote above, they did early on decide to try to obtain Jeryl Lynn. The problem was detected. In the US, our Vaccine Adverse Events Reporting system received reports of intussusception associated with the rotavirus vaccine. Only a very few; but immediately an investigation began. Investigators went out to the various hospitals to double check the actual records. They didn’t need to get every case to act. The problem was detected. As for the scale of the problem, again, once they realized that the Urabe was associated with aseptic meningitis, they did act, they began trying to obtain Jeryl Lynn; but as I’ve written umpteen times, aseptic meningitis is a benign condition, the risk of it from the natural disease is much higher, and the natural disease causes several other more serious problems, so, they had the choice of halting vaccinations until they could get enough Jeryl Lynn (and as I cited in a previous comment, there were production problems with the Jeryl Lynn), or risk a benign condition from the vaccine or the greater risks from the natural disease. Even if you doubled the number of cases captured of aseptic meningitis associated with the Urabe it would still have been better to use it than the natural disease. And they still would have needed to get the Jeryl Lynn. And the system wasn’t “so flawed”, it captured enough to make a decision and that is all one can expect. We do have better systems; but they developed based on what we learned from earlier ones and even they do NOT capture everything.

The UK system was NOT inadequate as it obtained the data needed to make a valid decision. You can cite all the studies you can find that they didn’t capture all the cases; but it doesn’t matter. Decisions aren’t based on perfect or complete data, except in the minds of antivaccinationists.

So, in 1988 when the UK had already contracted for the Urabe vaccine and it was in production, based on what they learned from Canada, they decided to switch. If their surveillance systems had captured every single case it would have made NO difference. You fail to understand this. You fail to understand that using several systems the UK data was considered the best available at the time and was used by many other countries.

It is really a shame that you hadn’t contacted the UK Vaccine Committees in 1987. I’m sure your immense knowledge, including of future developments, would have been welcome. You really are STUPID ON STEROIDS.

If one used your approach, we would have very little modern medicine because early approaches would NOT have proceeded because years in the future there would have been better treatments and better data.

As I wrote, you are obsessed with the Urabe. In your obsession you twist and distort events. And you NEVER once state that, despite what happened in the past, the current MMR vaccine has a good safety profile and you recommend it.

It is a tragedy that your daughter may have lost hearing in one ear from the Urabe vaccine. I say may have because what you have said is that the decision was that it was “likely” not certain; but people die from the common cold. You are so bitter at what happened to your daughter that your are obsessed.

When I wrote that the WHO continued to use the Urabe, you needed to point out that they discontinued it in 2015, which means they used it on millions of children with an excellent benefits/risk ratio for over a decade after Canada and the UK stopped its use. I’m sure that sometime in the future they will replace the Jeryl Lynn with a better vaccine, so I guess at that time you will point it out as if it was wrong to have used it all the years prior.

You are a disturbed individual and what you write, since it implies incompetence and dishonesty by those who decide vaccine policy, could influence parents to not vaccinate their children today. Nowhere do you clarify that vaccine surveillance and vaccines have improved. You are both tiresome and keep making a fool of yourself.

And, once again, you fail to respond to two questions I have posed umpteen times:

Do you recommend that parents vaccinate their children with the MMR vaccine currently being used in the UK?
Are you going to send me the documents related to your daughter’s case?

Are you totally incapable of giving two simple answers to two simple questions? Given how you twist things and what I and others have written, I wonder what the documents regarding your daughter’s case actually say? What are you hiding?

By Joel A. Harris… (not verified) on 12 May 2017 #permalink