Amanda: "I Love Vaccines"

Someone I knew who wasn't Jewish, once asked me what I could do to stop anti-Semitism. I responded that, if combating anti-Semitism is solely the responsibly of Jews, then we're done for. The point being that you need more than a small minority to fight what is. I've often thought the same about the War on Science: if fighting it is only left to scientists, we really don't stand much of a chance.

This is why I was heartened to read Amanda's double-barreled blast against anti-vaxxers:

Anti-vaccination cranks make me see red, in no small part because there's no excuse for the levels of ignorance they demonstrate about the real value of vaccines. It would be more understandable if the invention of the polio vaccination, for instance, was so far in the past that there were no survivors of the disease hanging around being reminders of how terrible it really is. But there are plenty of people who had the disease that are around, suffering the lifelong effects of even the minor cases that would have allowed you to reach middle age after suffering that disease in your youth. I for one am incredibly grateful to have never known anyone with small pox, tetanus or even the fucking mumps my whole life.

Like all good cranks, anti-vaccination assholes move the goal posts constantly. The big hobbyhorse of anti-vaccination cranks is autism rates (even though the connection between autism and vaccinations has been thoroughly debunked), but of course, the invention of the HPV vaccine hasn't passed notice, though you get that when you're like 12 years old, so even if you believe childhood vaccinations have something to do with autism (which you shouldn't), then you should realize that 12 is way too late to "develop" autism. But it's this lightening rod because it's new and it's sex-related and thus the cranks can hang their hat on it, and get all excited about building a coalition between the usual anti-vaccination cranks and the sexphobes, getting more power.

And thankfully, most of the commenters were members of the Coalition of the Sane, but, of course, there are always a few people citing a few spurious stories (e.g., the Japan measles vaccination canard). I wish there were a way that these idiots could be forced to link to a cited article--PubMed is free, after all--to 'prove' their points, or at the least, refer to a source that cites published, peer-reviewed articles.

If you think that's elitist, well, yes, it is. If you are incapable of supporting your claims by referring to primary literature (or highly vetted secondary literature), then don't make those claims. If you can't do that, then you're just bullshitting. That's fine for the corner bar (albeit, a bit tedious), but unacceptable for policy decisions.

Particularly when the wrong decision results in lots of dead people.

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I'm going to take the comment that I posted at Pandagon, (comment #49 over there) edit it slightly, and post it here, as I think it is something that needs to be said as frequently as possible.
My perspective on the autism-vaccine debate is a bit different than many other people's for a pair of reasons. Firstly, I have autism. Yes, I'm high-functioning. I can talk, care for myself, hold down a job, and get a college degree. Nonetheless, I am autistic. Meet me in the real world and speak with me, and you'll notice that I'm different. I am highly socially awkward. I can't read body language or facial expressions. I am very skilled in some areas and absurdly unskilled in others.
Secondly, autism (high-functioning, mostly) is rampant in my family. Of the six descendants of one pair of my great-grandparents, four (yes, four) have an autism-spectrum disorder of some variety - an incidence of 67%. When we look back at people before that, we see anecdotal evidence of autism frequently. I tell people who believe that vaccines cause autism this and they tell me that I'm lying. This is impossible, they tell me. Many anti-vaxxers - and their cousins in woo, the people who think that autism can be cured by chelation therapy - firmly believe that autism is a horrible disease with no positives and that all autistics and their families are damned to a horrible existence without hope. Quite frankly, this is offensive. I do have problems. I will not attempt to deny them. Yet I have a life, I am content with my lot in life, I have accomplishments, and I do not need to be "cured," thank you very much. Also, I firmly think that if the antivaxxers focused their energy (and money) on understanding the real cause of autism and possibly finding a way to help those who need it badly, then we would be further along.
My opinion on the autism-vaccine theory in short: bogus.
Long answer: vaccines do not cause autism. Autism is a genetic disorder affecting the formation of synapses in the brain (for the non-neuroscientists: synapses are the connections between nerve cells; the more synapses you have in your brain, the more interconnected the various parts of your brain are). Autistic brains seem to have too many synapses in specific areas, leading to information overload. End result: loss of regulation of brain pathways (and thus improper functioning of their related behaviors and/or bodily functions), over-regulation of other pathways, and the inability to process certain types of information. Many autistics have abnormal blood levels of hormones (most notably elevated levels of the neurotransmitter serotonin, which is heavily implicated in mental illnesses such as major depression and the effects of psychotropic drugs such as ecstasy and LSD).
I sympathize with the parents of autistic children, especially children who are highly hyperactive, unmanageable and socially incompetent. Yet I firmly believe that the problem is not the vaccines. Vaccines are good things. Yes, there are some people who are injured by vaccines. This occurs rarely, however. Very rarely. Vanishingly rarely.
My theory on the reason for the rising rates of autism: it isn't happening. Rather, society has changed, medicine has changed, and people�s perceptions of things have changed.
Firstly, 50 years ago, many children now diagnosed as autistic would have been diagnosed as mentally retarded. Due to better diagnostic analyses, these children are now being given a proper diagnosis. The diagnosis of "mentally retarded" is about as firm and precise as saying that everyone in a hospital is "sick." Yes, it is true, but it also misses the point. That's reason #1 for rising diagnoses.
Secondly, a century ago, a person like me (a high-functioning autistic) would have been described as "odd" (probably rebellious and/or hysterical too, as I'm a woman). I most likely would not have been seriously evaluated by a psychiatric professional. If I had ever met such a person, they probably would have said that I was "unfeminine" or some similar nonsense. The very idea that I might be autistic would never have been considered. The definition of autism has broadened. Today, people who 20 years ago would not have been considered autistic are. That's reason #2 for rising diagnoses.
Thirdly, society itself has changed. A century ago, a person who was socially incompetent (even totally nonverbal) but who was nonetheless physically healthy could work on the family farm or do menial labor and thus be productive. These days, there are fewer jobs that both provide wages sufficient to live on and can be done by a person with mental handicaps. Also, the attitude of society towards such people has changed. In those days, families made efforts to hide them away (especially if they were middle- to upper-class) or minimize the perception of their disability. This was true of people with all sorts of disabilities, not just autistic people. These days, the social acceptability of hiding the physically or mentally handicapped child away from company is decreasing. It is not gone, but it is much, much less than it was. Many families have swung completely in the opposite direction. They are open and vocal about their family member and demand attention and support. Thus, society's perception of the incidence of autism has tended upward. Reason #3.
Finally, consider how much health in general has changed. Many people with autism-spectrum disorders have physical ailments as well. In previous times, they may have died or have been invalids. Now, they survive and may be effectively treated for their physical ailment. Even if the absolute number of people born with autism remains constant, the number of living, non-invalid autistics is larger. Just as there are more living, non-invalid people alive today who were born with spina bifida, harelips, deformed limbs, hydrocephaly, and cerebral palsy than there used to be. Such conditions are now either no longer automatic death sentences or were never death sentences but are now more treatable, allowing those born with them to live more normal lives. So, in a sense, I am contradicting what I said previously - there are more autistic people today. But this increase does not even begin to account for the larger diagnosed number that exist today. So call this reason #4, with a caveat.
This obscenely long-winded rant brought to you by Esteleth, a high-functioning autistic who thinks that society, not her, is what needs healing.

Also speaking as someone with a high-functioning autism, I find the sort of reasoning the anti-vaxxers use downright offensive. I'd like to make more points but Esteleth kinda said basically everything that could be said already, and there's nothing left to the anti-vaxxers reasoning to be refuted.

I know I'm really socially inept, there's all sorts of cues I miss or don't understand, as my social mistakes have been kindly pointed out by friends who help me work on fitting in more. Having experienced this social barrier and alienation from humanity, I wouldn't wish this sort of problem on anyone, so if there was a way to prevent or treat autism I'd be all for it. The problem is that the anti-vaxxers, as Esteleth has already shown, have no ground to stand on and I personally find their claims to be pretty much the dumbest heap of garbage I've listened to ever. The only thing anti-vaxxers cause is people getting diseases that are preventable and some are highly damaging. I know it's too much to ask or hope for, but it would be nice if they could just shut up about autism when they speak, cause I for one don't appreciate them using my problems in a BS way to support their agenda I don't agree with at all.

By Felstatsu (not verified) on 14 May 2008 #permalink

Medical doctors should be the ones fighting for safer vaccines, pharmaceutical drugs ,surgical procedures, and safety in hospitals, not laymen , not chiropractors, not journalists! We know in the US that each year 100-400 thousand die using peer-reviewed and approved procedures and drugs, (it is difficult to do double-blind surgeries,... "approved-as-safe- and-effective" drugs get taken off the market all the time...) Any problems that the mass inoculation experiment seems to cause must take a back seat to the problems/procedures/drugs that cause the greatest harms...and it is for the medical doctors and pharma giants to do. Take your time though.

Rob-
Seriously, some anti-vaxxers are so immersed in woo that they don't understand reason when it is presented to them. Once I was discussing autism/vaccine stuff with an anti-vaxxer. I explained that I was autistic and my view of the matter. The conversation that followed:
Them: You were vaccinated as a child and you are autistic?
Me: Yes.
Them: Do you blame your parents?
Me: For what? *confusion*
Them: For vaccinating you and thus causing your autism!
This is after I had said that I do not believe that vaccines are connected to autism. I reiterated my statement, refuted their woo-tastic blatherings, and was finally informed that I was (1) deluded and (2) not autistic (!)

I hope, of course, that it never comes to this; but I imagine that anti-vax sentiment would probably prove self-limiting at the point where nasty childhood diseases hit an uptick. I'm in my early 20s, and I know only a single person with (fairly minor) polio symptoms and I don't think I could even describe the symptoms for more than about half of the diseases that children are routinely vaccinated for. While I am aware in theoretical terms of the risk, there certainly isn't any visceral sense of threat. It wouldn't take much concern about vaccine dangers to make not using them look like a good idea. If kids start routinely being carried off in boxes again, I'd imagine that the anti-vax movement will dwindle to a few true believers pretty quickly.

Unfortunately I don't think even that would lower their numbers by much, phisrow. The few anti-vaxxers I have listened to have all demonstrated a huge disconnect with reality, and I don't think they'd be capable of logically connecting deaths from disease A to no one getting vaccinated for disease A. The deaths of children from horrible preventable diseases will likely only stop people from converting over to the anti-vaxxer side and bring back only the least indoctrinated, best case scenario. Worst case, they say something to tick me off like "at least the kid didn't get autism from those nasty vaccines" and no one wakes up from their delusions.

By Felstatsu (not verified) on 14 May 2008 #permalink

I aim to please.

No seriously, I agree. More non-scientists need to defend science, because crankery and woo are political issues. They may not initially seem like it, but having to cater to people that are just wrong is one reason that right wing nuttery has so much traction in our society.

The first poster confirms what I have been thinking for some time. Looking back on my family tree, there have always been individuals that have had few social skills and others who demonstrated more serious forms of autism.

When my child was a "terrible two", I complained to my mother about the whining and demanding attention expecting some sympathy. What a got was furious lecture on how lucky I was to have a normal child. Didn't I know that the children to look out for were not the one's wanting to be the centre of attention, but rather the ones that were "too quiet', who could amuse themselves for hours on end, who did not want to be included? She didn't call it autism, but she knew that some children around the age of 2 or 3 just changed.

This was long before vaccinations became routine.

How do the anti-vax crowd explain this?

How many anti-vaxxers even know what PubMed is? They seem the technophobic types who can barely figure out how to turn the "Caps Lock" key off if they hit it by accident. So I wouldn't expect them to realize that there is actually something useful out in the intertubes.