I'm angry so today you get what you came for...
I wrote a post on Autism and Vaccines a while back that went through why there are people still arguing about this and took the position that I don't think that there is a link between autism and thimerosal but that some of the arguments that people on the other side make do have some validity, though not compelling. I specifically ended the post saying that I fully believe that all children should get vaccinated, that mine are, and that in any event thimerosal isn't in the single dose shots anymore. I won't go into the whole thing here but apparently not being rabidly pro or con and calling the other side idiots makes me an idiot. Fascinatingly the worst ones are from those I agree with (no link with thimerosal; vaccines good), although the opposition ones aren't all that friendly either, especially on the original post. I got one such comment on the 21st. Here's the last paragraph:
I think what you're not getting is the danger inherent in continuing to describe this as an open question. For parents, this is as good as saying vaccines are dangerous. Possibly dangerous, maybe dangerous, potentially dangerous...all adds up to "dangerous" in the minds of people looking to do right by their kids. What they need to hear, loud and clear, is that the science shows there is no issue as to thimerosal. I know you said that...after a long post insinuating the opposite.
Well, let me retort. Your argument that we need to say firmly that there is nothing going on is the absolute worst crap from scientists and public health officials that infuriates me. Your premise is: Vaccines are good, people should take them, we should tell them what they need to hear to get them. Your implication is that people are stupid and can't understand complexity and will run away because you told them that one small point of the opposition has some validity. "Oh my God, we can't admit that people that don't agree with us could have a valid point!" I do not believe that and I also refuse to withhold the whole truth from people, complicated as it may be (well, it's not that much - Vaccines good, people should take them, science is complex).
Who do you think the public will listen to?
Public health official 1: No problem, no problem, no problem. Anything you've heard otherwise is wrong. They are idiots as is anyone who questions this position.
Public health official 2: I understand your concerns and the scientific issues behind them. There are reasons why those issues when taken into context of other data aren't compelling. The overall picture of x is of safety.
You will convince no one with your 'no problem, no problem' and in fact will get people's backs up and less likely to trust you (DDT, no problem; leaded gasoline, no problem; lead paint, no problem; PCBs, no problem; asbestos, no problem; tobacco, no problem; arsenic, no problem....um until they were problems and everyone knew it. Whoops! There went our credibility!). This is the problem with much of the government and the public health community in general - "Don't scare the public, they're like little kiddies you don't want to spook". The end result is that when something really is a problem that you thought wasn't likely a problem, the public realizes you weren't being straight with them and loses all trust. The same applies for preparing for a flu pandemic/epidemic that Effect Measure covers so well. It all has an aspect of "Let's not do anything to prepare people for a potential problem in the name of people keeping calm (and probably $$)." This doesn't mean sounding the alarm at the smallest thing but it means being straight with people when they want answers.
People can handle things better than you think. They deal with uncertainty and complex problems every day. Our fast paced media makes us think that we have to deliver sound bytes too. You don't, you just have to be a smart communicator. Scientists (as much as we like to think we do) don't have a monopoly on understanding complexity. Sure, some people will over-react because they don't want to take any risk voluntarily and they may be harmed. I believe that there are enough people out there to do the right thing. For me, I'd rather tell the truth and let people make informed decisions (good or bad), than lie in the name of health.
You are a person who appreciates nuance.
Sadly, you are in a minority.
The average person doesn't want a nuanced response. They don't have the educational background, the time, or even really the interest.
Don't believe me? Just look at the US presidential elections for the last 50 years. 'Nuanced' responses by candidates universally got them hammered in the press as 'wishy-washy' or 'flip-flopping' and so on.
The average person does want a clear 'yes or no' not 'here are the uncertainties and this is our best advice, which could be wrong'.
Well, in general I would agree - most people are capable of dealing with complexity and uncertainty. Unfortunately, most journalists don't seem to fall into that category, and they're the ones who are doing the bulk of the communicating with the general public.
For example, witness the latest kerfuffle triggered by the Observer in the UK, via Ben Godlacre's Bad Science.
Who do you think the public will listen to?
Public health official 1: there is no evidence whatsoever of any link between thimerosal and autism. Multiple well-designed studies provide strong evidence that such a link does not exist.
Public health official 2: well, sure, studies are nice, but they could be wrong. And the thimerosal-autism link is plausible, you know? I mean, I don't think there is one, but still.
Sadly, the answer is probably 2.
I think that your experience here is part of a larger issue. Let me begin by saying I agree with you completely; so far the overwhelming evidence is that any risks associated with universal vaccination (or the preservatives that keep said vaccine viable) are outweighed many times over by its benefits. Let me go even further (and closer to my point) by saying that I also think that there is some room in the whole climate change arena for valid (if not compelling) arguments that human interference may not be the deciding factor in global warming, that our current view of evolution is almost definitely incomplete and may possibly be fundamentally flawed, and that embryonic stem cell research may never lead to any fundamental or practical advances in medical science (to pick a few items that receive disproportionate political attention). I have come to these conclusions by seeking out and following, to the best of my limited ability, the arguments presented as the consensus of the scientific communities surrounding each of these issues. That doesn't mean that I don't understand that it is almost certain that the huge rise in greenhouse gases due to human industry is responsible for the observed global warming trend, that evolution theory as it is currently understood is the best explanation of fossil and genetic evidence, and that any research into embryonic stem cells will almost certainly result in fundamental advances in our understanding of embryology and cell physiology.
Unfortunately, and this is the larger issue, it seems that these commenters are presenting direct evidence to contradict your premise that 'the people' are capable of following a complex, nuanced logical argument. I'm sure you've noticed that the majority of the comments on Science Blogs resemble those that you've picked out - dogmatic, immature, even petty. Even some of the bloggers themselves can sound very much the same - dogmatic, irrational and seemingly arbitrary when it comes to avoiding logical fallacy.
I didn't want to be a cynic. I really didn't. I wanted to believe Dr. Sagan when he said, like you, that people need only a little encouragement, some basic instruction in the art of 'baloney detection', and objective data, and they too will be able to make intelligent, rational decisions that would propel the country to new heights of human achievement.
But I know too many people. I've seen how people actually make decisions. It is my sad opinion that people that are capable of following a reasoned, nuanced argument do, and that those that can't don't. I don't mean this to sound as elitist as it does. I don't think that there is anything fundamentally inferior about someone that makes decisions based on 'gut instinct' or how they feel about the most recent sound-byte they've heard. It seems to me that they are in the majority, and are therefore more 'human' (whatever that means) than those that bring their rational abilities to bear on every aspect of their lives. The metaphysical questions 'what makes a life worth living' and 'is there any meaning to a life beyond its own subjective self-evaluation' don't and, I think by definition, can't have an objective answer. In the end, we're all worm food anyway, and however frustrated I may be when somebody can't follow a carefully reasoned argument, I don't think that my fleeting sense of superiority is any more valid than the opposing side's sense that I'm being too nitpicky over something that's perfectly obvious to them. They live lives that are as meaningful to them as mine is to me - who am I to say that the way I live my life has any more objective meaning than theirs?
If it's not true that everybody is as capable of following a rational argument as everybody else, we're left with the question of how best to present issues that aren't clear enough to be distilled into five or ten second sound-bytes. As we are still, at least nominally, a democracy, those in a position to understand issues of profound public import, issues that require some sort of action or legislative attention, would seem obligated to at least facilitate the public's understanding of these issues, since the voting public is ultimately responsible for whatever actions are taken. I think the best approach is a combination of your egalitarian approach and the opposition's elitist/authoritarian approach - put out the clearest uncompromising argument that accounts for the facts and acknowledges descrepancies, and include a digest form that resembles the authoritarian 'this is how things are' approach.
I may be wrong. I may be confusing ignorance (in its non-pejorative sense) or even laziness (in its cognitive sense) with incapability. It may be that with proper education many or even most people that are now incapable of logical argumentation could follow a nuanced argument and make rational probabilistic decisions when faced with uncertain or even seemingly contradictory facts. But in a practical sense, there's not much difference between a person that is incapable of cold rationality, and one that just doesn't practice it for whatever reason. That's why I think that you are partially right: deliver the best argument you can, as complex as it needs to be. But, and this is where I think I may differ with you, don't be too shy to give your best interpretation of the issue, authoritatively if necessary, for those that can't or won't understand the issue at hand.
I think this boils down to one of the major philosophical differences between scientists and non-scientists (or "sciency" and "non-sciency" people). Certain words are rarely used in science - like 'never', 'always', '100%'. Instead we use words like 'likely', 'trend', 'correlation', etc. Unfortunately, when non-sciency people hear these words they often jump (illogically) to the conclusion that we are swimming in a sea of uncertainty. Even if we say that there is a 99.9% probability that autism and thimerosal are unlinked, non-sciency folks will say, "So, you're saying they might be."
Not sure if there is a deeply programed human trait to look for that 0.1% risk or if it is simply (hah!) a lack of good science education. I don't think scientists should change the way they report results - to start using language of absolute certainty would be very unscientific, not to mention the pitfalls raised above about what happens on those occasions when certainty fails. We don't need wishy-washy statements that beat around the bush either ("Well, it might be, maybe possibly true, but..."). I like the manner used above - "Can we say with 100% certainty that autism and vaccines are unlinked? No. (Why? Because science doesn't deal in absolutes). But there is very strong evidence that the benefits of vaccines far outweigh the slim chance that there is." Or something like that.
Eric, I think we agree more than you think. In fact, I'd agree with almost everything you wrote (a long but very good comment). While I believe in the nuanced argument, I believe in making a clear statement at the beginning and the end as to where I stand. Vaccines are good. There are some studies that show some risks...Other studies show that the benefits vs risks...Vaccines are good. (Sounds sort of like the summarize-elaborate-summarize theme you learned in 7th grade lit, doesn't it. A good idea never dies.)
Everybody else, I think that a lot of the discussion here surrounds in what sort of media you are talking. There are appropriate ways to talk to each (live TV and radio are the best, you say it your way until you get cut off). Usually print outlets will call you and fact check that they got your quotes right and facts for background. Besides, when it comes to public health, the officials have the bully pulpit. They should use it to craft messages that work. The media isn't evil. And if it gets things wrong, that's no reason to quit trying to get it right.
Also, blaming the media for simplicity is an easy cop-out but not a good one. My experience is that scientists are woeful at explaining things to reporters. Once the reporter gets it, they are usually pretty good. Sometimes this takes a bit of work. A common communication cop-out is: "They just don't get the issue" or they "just don't understand". Well, then you didn't describe it well enough or succinctly enough; the problem is usually not on the listener's side.
I will admit that the media has just as bad of an impulse to dumb things down, if you give them the tools to say something succinctly they'll usually get it right (I said usually; I've seen some fantastic reporting ruined by an editor who wants a hotter story).
Also, people that won't believe in human caused global warming or whatever while it is 95% certain, won't believe you when you say it's 100% certain either so there's no reason to be so adamant about the certainty. Those people are lost to you anyway. I know people that refuse to do the right thing on [name your issue], but they understand it. We confuse knowing with doing (or irrationality with a difference in values that we don't like). People have known that global warming is real, they just don't want to do anything about it so they say it isn't real as a way to deflect the fact that, really they are uncomfortable with the consequences that has on their lifestyle. We shouldn't confuse irrationality with a difference in values.
As a final word; whatever excueses there are, I see no justification for taking a position that you know is false. That will always bite you in the ass in the end (see above: DDT, lead, arsenic, PCBs...). Oh, and it's just plain wrong.
Could someone please summarize Eric's comment for me? That is just WAY too much to read.
Also, there's the iterated situation to consider; that is, public health officials have to come out and tell it like it is many times. Imagine the consequences if they express complete confidence and deride anyone who thinks otherwise, and they turn out to be wrong?
Well, we don't have to imagine it, it's actually happened in more authoritarian decades in the past. It's the reason people have a strong sceptical reaction to "authority spokesman expresses complete confidence" today. We don't need any more of that poisoning our relations with the public.
So, one of the ethical balances in medicine is "autonomy" vs "paternalism", a pendulum that has swung quite a bit over the decades. Complete paternalism in the model of mid 20th century medicine is, in the US, generally considered undesirable, but I would argue that complete autonomy (here are your choices, Sick Guy; Choose!) is not a great idea. Anyway, presentation is important...don't deceive, but that doesnt mean that you have to tell someone, "1 in 100,000 people have reaction x. When that happens, your genitals turn purple and fall off slowly, after causing excruciating pain". No one signs up for that.
As a biologist and parent of young children (with a toxicologist spouse), I've gone through evaluating vaccine risks myself.
Thanks for your thoughtful and accurate post on the subject. I'm sorry you got slammed by partisans.
You're doing good, please keep it up.
Usually print outlets will call you and fact check that they got your quotes right and facts for background.
OK, so you haven't read about the latest Observer MMR articles - where they completely made up quotes from researchers they hadn't even spoken to, and completely misrepresented the competence and affiliation of the ones they had spoken to. Seriously, read the link I provided above, and be appalled.
And the Observer is one of the quality papers...
I have read it Dunc. I said usually. From personal experience, I've never had a misquote, and only a couple of occasions have I seen the story completely off base.
Fair enough. Maybe we fare worse here in the UK. Whenever I read a science article in the general media on a topic I have even moderate familiarity with, odds are there'll be something hideously wrong with it.
Of course, that could be a result of selection / confirmation bias...
Children's lab tests help clarify vaccine safety issues.
The boy I know whose intestinal scoping finds vaccine-strain measles in lesions lining the mucosa.
The normally developing toddler who went into seizures and stopped breathing within a few hours of receiving several vaccines at once, who after lengthy hospitalization emerged retarded.
The family whose urinary porphyrin profiles show the biomarkers of mercury toxicity, and the health improvements shown after chelation treatment.
Statistically insignificant? Not to parents. Is "safe" defined by Webster, or as "benefits outweigh risks"?
What has repulsed this vaccine consumer is the realization that the government's response is:
2. Do nothing.
There is no "Department of Helping Children Injured By Vaccines." No medical care. No rehab. And the NVICP is a joke.
You can return a vacuum bag at Wal-mart and get better post-marketing service.
Public health administrators, take heed:
Vaccine recipients need to know that if something goes wrong, they will be taken care of. Especially the little children. But that's not happening. And the word spreads.
AT, if you can bear it, I would like to hear a toxicologist's opinion on the urinary prophyrin tests/profiles to which I have seen so many references.
Some colleagues and I have been in touch with the Guardian/Observer several times to ask them to correct factual errors both in the (currently) withdrawn story, the accompanying interview with Andrew Wakefield, and a follow-up piece that repeated some of the erroneous facts from those articles. Our first few attempts were met with indifference and comments along the lines of, "We don't understand. None of us is a scientist in this office" - we hadn't sent along anything difficult, just straightforward text with links to official data tables etc. to verify.
Thanks to a colleague's perseverance, we may get somewhere, but there are no guarantees and it is far too little and way too late. I mention this because we have encountered resistance over things that are facts and a matter of public record, no interpretation involved.
Nuance? Yes, I think it is appropriate but getting people to sit still for it is a very different matter.
I think you can have it both ways.
Open with a strong statement that here is no link between thimerosal and autism.
Terry Public will read that sigh with relief and, generally (sadly) stop reading.
Continue with the nuanced argument (I do like tha phrase :))
A little trickier to write, but often doable.
I do appreciate your feelings, though :)
"People can handle things better than you think."
If this is true, why did the citizen-legislators of the North Carolina House of Representatives vote a few days ago to approve a bill that would ban thimerosal-containing vaccines?
Angry Toxicologist, I hope you will take the time to investigate this issue further and learn why it's not just that the average person needs a definitive statement, but that in the case of vaccines and autism, a definitive statement is entirely appropriate.
I also hope SharonAnn was being intentionally ironic.
Nhokkanen, you write pretty well; it confuses me that you are not also bright enough to realize the reason no one has compensated you for your child's vaccine injury is that your child was not injured by a vaccine.
The problem with saying "Science was wrong about (tobacco, asbestos, PCBs etc.) is that an equivalence cannot be drawn with vaccination.
Vaccination represents a public health initiative with a long and well-established safety record to start with, not an environmental chemical used for industrial or recreational purposes. Further, responsible and competent science can be credited with establishing the risks of those environmental chemicals.
In the case of vaccination and thimerosal, careful and diligent study has debunked bad (and corrupt, in the case of Andrew Wakefield) science and scaremongering by people with preexisting antivaccination agendas. It is a strawman tactic to argue that everyone with doubts about vaccination and autism is referred to as "idiots". All the ire I've seen in the provaccination community has been reserved for the antivax leaders whose activities (designed for self-enrichment or to promote anti-evidence-based medicine agendas) have prompted a resurgence of preventable childhood diseases.
Unfortunately the news media too often treats both "sides" with equal respect, even as the evidence keeps piling up for vaccination safety (including a continued rise in autism rates in countries that have eliminated thimerosal from most or all childhood vaccines).
All you need to do is compare about 3000 people with no thimerosol exposure to 3000 people with 1991 levels. Until this study is done everything is speculation, and mercury shouldnt be in any vaccine because its a known toxin at low doses.
Dr. Ayoub has a good lecture where he went over the studies the IOM used and he made a good case they were fixed. Making fun of him is childish.
I did not see anyone making fun of Ayoub in this blog posting. I see it here though:
Oh, wow... I linked to the Ayoub video (which is described in the link I posted). I don't even have to see the video when its description is: "David Ayoub, M.D. goes through the relations of Mercury to Autism as well its connections to National Security Study Memorandum 200; for ... all » population control. Showing its shocking connections to todays G.A.V.I. Are powerful forces really trying to help the poor people or could it be for another agenda; the sterilization of the poor? This is an upsetting video, so brace yourself."
The comments are even more amusing.
well, between slavery, tuskegee experiment, the holocaust etc history is full of conspiracies, who knows what to believe anymore....Ayoub's point is that it is so idiotic to put this toxin in vaccines, and then he speculates in whether its stupidity or intent,.............the first half of the lecture is much better, when he shows how the IOM lied about the studies and how they were fixed by the drug companies.
Vaccines and population control?
I bet you also believe in the Illuminati and the Tooth Fairy.