Framing vaccines

I didn't follow the framing debate, but I'll take a stab at it. These are just my thoughts on the kinds of feelings I would try to evoke if I were designing a public information campaign about childhood vaccination.

Vaccination = security, shielding the vulnerable, an anointing, happy healthy kids surrounded by a halo of protection.

Nonvaccination = uncertainty, big germy world, Mom isn't living up to her duties.

Maybe to sum it up (to use a phrase which has been misused by antivacciners): Safe vs. Sorry.

I wonder why CNN removed the video of Jenny?
http://img211.imageshack.us/my.php?image=witchiepoofy9.jpg

Could it be that someone complained that she had been subtly framed as really being a witch? I wonder who picked that photo of her to put up on the screen behind her?

Appart from vaccines, for a minute, I think it's important to see how autism has been framed and how that can be bad apart from anti-vaxism.

First of all, they seize a patch of imaginary "high ground" by stating, "Autism is treatable." "Autism is curable." "Recovery is possible." Then it's the siren song: "Come, come parents, come with us to the imaginary high ground where you will meet a gajillion parents like yourself who will never have a cured kid and five or six who do have a somewhat credible story of a kid who progressed from obviously impaired to almost normal. Don't listen to the stick in the mud AAP, they don't want your kid to recover anyway! It was a pediatrician who gave your kid autism. It was a pediatrician who broke your heart! Come. Come with us to a world away from mainstream medicine where we have.... HOPE! Bright shiny intoxicating HOPE!!"

One thing that really gets me, and I think it also belongs on your list of their main frames is "autism must be curable by medicine."

So, how dare, I mean, how DARE any doctor send a parent with a new diagnosis of autism out of the office WITHOUT a prescription for the cure? How DARE they not have a pill for this?? How exactly evil ARE they because they don't have one???

This thinking always blows me away. I've had parents ask me, "So you think you're so smart! You think alternative medicine and DAN! are a waste of time and money and dangerous, do you??? Well then, Ms. Smartypants, what exactly is straight medicine/ allopathy/ the AMA doing for our kids??? Do they have a cure??? NO!!! So we MUST get our cure from the DAN! quacks. It's obvious!!!"

Since when? Since-stinking-when is autism a disease? It's not a disease!

Parents of mentally retarded kids don't go storming into a doctors office or to the CDC or AMA or AAP and DEMAND a pill to cure their kids MR. This is patently ridiculous.

Some parents of CP kids get caught up in quack cures, but it seems kind of not their thing. They realize that their kid needs special education and therapies, not a pill to fix their learning differences/disabilities.

Somewhere... I guess maybe it started with Bernie Rimland who told everyone that B6 and magnesium could cure some autistic kids, practically... then his followers kept pushing everything else, including Secretin... as cures.

Before Bernie and his pills there was Ivaar Lovaas promising a cure with ABA and before that Bettelheim who also "cured" kids besides demonizing moms.

Allied with this is the frame that doing less than whatever the quacks are selling at the moment is to condemn your child to a lifetime of hell.

A frame that they are avoiding is the true one... that sometimes ASD kids start out totally impaired appearing, totally disabled appearing, and they ... get this... actually grow out of autism. Without ridiculous amounts of expensive ABA, without a pill, without a special diet.

One can debate whether or not those who end up pretty normal acting have just learned to act better than others, or if they were actually autistic to begin with... deaf kids DO get misdiagnosed as autistic fairly often as toddlers and vice versa, so a deafness caused by bad ear infections could get resolved and the kid could start developing more normally.

At any rate, the quacks aren't going to frame autism as something that a kid might grow out of. No. You have to sell your kidneys and your grandmother's kidneys to get the money to buy that cure before it's too late.

And part of that is the idea that no one could possibly have met an adult who was an obviously autistic kid and not know that he was an obviously autistic kid (before when he was a kid). So that although you might be able to name a hundred quirky and socially awkward, even odd speaking, odd looking adults, it's not possible that any of them were actually autism spectrum kids 30 or 50 years ago. And Bill Gates couldn't possibly be on the spectrum, because... because it makes people uncomfortable to say that he might be. And... same goes for the Woz.

And that all ties in with... there's the NEW autism and the OLD autism. The OLD autism is rare and the NEW autism is common (epidemic). The NEW autism is GUT autism and IMMUNE autism and is curable. The OLD autism is... who the heck cares what that was.

The "NEW autism" garbage...makes me angry... really angry ... is also fed by guys like David Amaral and Robert Hendren and other fairly "biggish" name scientists.

They shoot themselves in the foot because they refuse to look at the OLD autism and the OLD autistics since they are not the NEW autism that is caused by toxins and can be cured/prevented by avoiding toxins/maybe vaccines... whatever will fill the coffers this week.

So you can look at the antivax problem as separate from the idiot view of autism problem... they are overlapping right now, but already there's Lyme-caused autism in the wings, it's not about vaccines but it's being promoted by quacks and is detrimental to autistic people.

The antivax contingent will move on to another disease and another vaccine if they tire of autism.

My field is not science, its ways in which the new media (sorry! I hate the term too) of the 21st century can be used to communicate or enhance communication.

As such I think the issue goes beyond framing, although there is no doubt that is vital. It goes on to how we communicate these days. In fact, I think that will be my next post....

Orac is incorrect to say that Nisbett and Mooney's original framing plea provoked hostility amongst the sciencebloggers. Initially their message was recieved well. It was only when they started to attack some outspoken non religious pro-evolutionists that they aroused hostility.
Anyway thats a side issue.
In my opinion there is no easy answer. What is really required is to ensure that the scientific method is valued amongst the general population.
When you have two differing hypothesis this is really the best way to determine which one is correct and which one is wrong. Its a simple idea - only believe things which have evidence to back them up - but if it was a widely accepted by the population at large (it clearly isn't at present) then we would have a simple basis for challenging pseudoscientific nonsense.

I think it's better to keep the target on new/expecting parents, since it's clear you can't change an anti-vaxxer's mind. With that in mind, maybe there could be some sort of emphasis that, no matter what, without vaccinations there will be lots and lots of suffering, permanent injuries, and (occasional) death. Guaranteed. And autism will continue to rise.
But, of course, the question is how to get that message across as thoroughly and quickly as "Green our vaccines." That was a brilliant slogan.
Maybe pediatricians need to get more assertive. Maybe parents who refuse vaccinations should get detailed info on the diseases--after all, they will at least need to know what to be on alert for. The info can include side effects from the vaccines arrayed against known reactions to /complications of the various disesases.
But again, the message needs to be tidy in order for it to be framed properly. Sigh. It sucks that a basic public health policy has to be thought of through a PR lens.

In the competition between science and anecdotes, I don't think science loses every time, but it's a bit of an uphill battle. I think humans are adapted to be convinced by anecdotes.

A good approach is to use anecdotes, not as evidence, but to illustrate scientific principles. Dr. Offit's anecdote about the kid who has a seizure moments before he or she is vaccinated I believe is very effective at making a point.

Apart from that, popularizing science, that is, explaining research and data at a level that anyone can follow, probably helps. Published science is too abstract and inaccessible to most people. It's very easy for them to dismiss it based on things like "conflicts of interest."

Orac is incorrect to say that Nisbett and Mooney's original framing plea provoked hostility amongst the sciencebloggers.

Nope. That's not the way it went down; I was involved in the initial kerfluffle, and I remember. You may quibble that the reactions were only just very skeptical. Certainly overall it was not initially "well" received. Then, within a few days at the very most initial skepticism turned hostile, with attacks on Mooney and Nisbett's thesis from PZ, Larry Moran, ERV, and others labeling framing as "spin" and worse, as I documented in the two posts to which I linked in my post above. Those posts were written mere days after Mooney and Nisbet's article in Science.

Im not a scientist. For what its worth, I am a first-time mother. My interest in this vaccine manufactroversy began last year when I actually took my doctors advice and got the flu shot at work (gasp) while six months pregnant (double gasp). Afterwards, a few coworkers insisted that I shouldnt have gotten the shot citing the harmful chemicals. Well, I spent the next few days terrified that I had ruined my sons life before he was even born. I read online about vast cover-ups, greed, the evil puppet group that is the CDC, Jenny McCarthys warrior spirit, or whatever and I kind of lost touch with reality. (I blame the hormones). Anyway, what brought me back was thinking of my doctor. Hes a kind, intelligent man with two children (both vaccinated). Hes not a shill. And I realized if anti-vaxers are to be believed, Id have to buy into a giant conspiracy theory. Anti-vaxers are, in essence, accusing every doctor who follows the recommended schedule of either (A.) poisoning children for money or (B.) being too stupid/lazy to know as much about vaccines as Jenny McCarthy does. Both these notions are ridiculous.

I think vaccine advocates need to present the controversy to parents for what it is: a far-fetched conspiracy theory. Once thats accomplished the evidence, the BS rhetorical tactics, and the paranoia become abundantly clear. Its easy for worried parents to believe that faceless Big Pharma will poison children with vaccines just as Big Tobacco poisoned grandma with cigarettes. But its harder to believe that the human being with the medical degree in front of you is perpetrating an evil master plan for no reason.
Conspiracy theorists have the luxury of dismissing evidence out of hand, of implying opponents are criminals without proof, and (usually) without having to accuse them directly to their faces. Ask the public to avoid these lazy and dishonest modes of thinking. Vaccine advocates need to humanize their side. (If that makes any sense.) I couldnt honestly look my doctor in the eye and say I think youre trying to give my child autism. And (perhaps Im being too optimistic) I imagine most reasonable parents would have trouble doing this as well.

The pseudoscience advocates and antivaxers like to put people up front to tell personal stories. For them, thats all they have. In the case of scientists trying to make a point, the same tactic can be applied. Get parents who lost their children to diseases that should be properly defended against with a vaccinated populace to take a stand and help tragedies like their own from happening to other families. These would be powerful anecdotes, and if the public wants to look further into it, there is all the science and epidemiological studies to support the pro-vaccine camp. Personal stories are what tug at the publics heart, and a strong foundation of reason and logic will only strengthen the point.

I for one have been hugely disappointed with the lack of balance in the media coverage of this 'manufactroversy' (love that word, Mary C.). It's distressing that Jenny is getting as much press as she is in the first place, but the elements of our media and our society that contribute to the popularity of her message are undeniable, and where we must begin the counter-attack. To combat Jenny, her ilk, and her frame, I think that clinicians, scientists, and parent/patient advocates need to start lobbying HARD for equal time in the media. The journalists are failing, at both the local and national levels, to provide context and balance to their coverage of medical or scientific issues, and this is certainly not limited to the vaccination topic. We, as professionals, parents, and citizens, need to hold them accountable for this reporting. Pediatricians and Epidemiologists need to organize a rebuttal team and make themselves available to appear on any program, or in any mainstream article, that gives time or space to the Jenny McCarthy viewpoint. We need to identify and endorse spokespeople (Amanda Peet is a good start, but she can't do it on her own, and I have yet to see any of her anticipated advertisements) to do the same, and, where needed, we need to provide additional training to health care professionals in order to arm them with the best, most reassuring and confidence-inspiring, valid information, not only to address the concerns of parents of ASD kids, but for all parents with young children in need--yes, need--of vaccines. We need to repair confidence in mainstream, evidence-based medicine and pre-empt many of the hollow promises of the quacks with lay-accessible literature and discussion up front.

It's hard to know where to begin, but the current inaction has allowed the other side a huge head start. Something must be done--or begun--at once.

Orac, from experience (and I say this with some regret), I believe some significant part of the problem may originate with pediatricians.

My nephew was very much speech-delayed and had digestive problems. The parents' anxious questions were met by rebuffs, non-answers, and a generally cold and non-communicative manner from first one, then a second pediatrician. After that, the increasingly desperate parents weren't satisfied with cautious "we don't know yet" or "there's nothing specific we can do" responses from the next pediatricians they met. They finally met a group of parents who plugged them in to various types of training they could use with their child, available therapy options with state financial assistance, and unfortunately, a woo-pitching doctor(? - not sure if he's actually an M.D.) who told them vaccines and mercury were to blame and "treated" the boy accordingly.

Besides the new course of "medical care," the boy's mom in particular has been heroic in both the amounts of daily time, effort and love she personally has lavished on her child and the absolute persistence with which she tapped every available therapeutic and educational resource for him. He is now one of the higher academic achievers in his class in a public elementary school. I realize that this couldn't have happened if his initial problem had been profound, but on the basis of my (admittedly anecdotal) personal observation, the mother's help has contributed significantly.

The very same single-mindedness and stubborn refusal to take no for an answer that served my wife's brother and sister-in-law so well in other respects concerning my nephew has made them utterly certain that their child's doctor is correct and his "treatment" is a big reason for the child's improvement. You and I can well imagine the disdain with which they would react to the certitude of medical professionals that they are wrong, when the medical profession offered them no such certitude, or even decent advice about what they *could* do for their child (therapy and education) in their time of need.

Unfortunately, rushed consultations with overworked, brusque, but ethical professionals are often proving no match for the warmth and easy salesman's friendliness of the huckster.

I wouldn't necessarily disagree. Doctors can be just as bad at communication as anyone else, which is a shame. Personally myself I wouldn't say I'm as good a communicator with patients as I wish I could be; still a little of the nerdy shyness, I guess. And it's true. Quacks, having no real effective medicine to offer, do tend to offer what parents crave: Time and concern. Unfortunately, they also offer validation of parents with woo-ish beliefs.

Jud wrote that his nephew had speech delay and digestive problems and that the doctors didn't have anything to offer and were cold.

Now, it's possible that the doctors were cold and unfeeling, it's also possible that the parents were expecting something unrealistic. If anything less than, "Here's the prescription for your child's problem, have him take it twice a day for a year and he'll be fine," is an insult or a huge disappointment to parents (it can be for some), then the parents can remember him as being "cold." I remember taking my ASD kid to a doctor and my mom went along (the only time she ever went along to a doctor's appointment). My mom was asking dumb questions (in my view) and the doctor told her that her idea was wrong. I thought he said it politely and I was a little embarrassed that my mom was asking unnecessary questions. I don't know why she wanted to go in to see the doctor with me, I know it wasn't my idea... anyway, to this day she remembers how "rude" that doctor was to her.

I didn't think he was rude at all, he was just being professional and didn't give her the answer she wanted... it was a dumb question anyway. Sorry, to sound mean but she was totally out of the loop with what was going on in that room and what information I needed.

I have met really mean doctors who didn't like me at all, I have aggravated a few with my former slightly woo-oriented approach to medicine, so I know that there can be problems with dumb doctors and dumb patients.

At any rate, I think that maybe your brother and sister in law might have had that attitude to some extent that a doctor ought to know how to fix autism.

The child might have had constipation because of being developmentally delayed. Kids who don't communicate well or who are retarded have a hard time figuring out when to "go" and so are going to have more "gut" problems in that way. Your nephew could have had a genetic problem that was messing with his digestion but not all genetic problems are easy to spot.

I really wonder, is it a pediatrician's job to be aware of all the non-medical therapies out there? Are they really supposed to be education experts? Do parents of MR kids expect their pediatricians to know how to get the kid into special ed? Why? Why isn't that the job of regional center (developmental center) experts?

It's great that your sister-in-law put so much attention into your nephew. That's what moms are supposed to do. They aren't supposed to walk into an office and literally demand a pill for their kid's developmental problems... which is what many do, not necessarily your sister-in-law, but many do. I really don't understand it, but they do.

Part of the difficulty in "framing" the vaccination "debate" is the appallingly short memory of human culture.

In my father's childhood, he had friends crippled by polio, blinded by measles and brain-injured by mumps. The municipal swimming pools were closed every summer by polio outbreaks and most of his friends never learned how to swim.

During my childhood, the vaccines to prevent these diseases were developed and the fear of these diseases receded into dim memory.

Now - during my children's childhood - parents who were vaccinated as small children have never seen these diseases and have begun to fear the vaccines.

Perhaps it is an echo of early childhood fears of trips to the pediatrician's office and the inevitable needles, maybe it's just a fear of things they can't understand. At any rate, some parents are being convinced that the risk of the vaccines is greater than the risk of the disease.

Strangely enough - they are correct: at this moment, in most parts of the US, the risk of the vaccine does exceed the risk of getting the disease and having a long-term adverse reaction to it.

That's a lot of caveats, and I hope that everybody took note of them.

First off, the risk of the vaccination is exceedingly small, but it is not zero.

Secondly, in most parts of the US, at this time (although probably not for much longer), your risk of getting most vaccine-preventable communicable diseases (key exceptions: pertussis, chicken-pox) is very low.

[Note: Tetanus is not a communicable disease but the causative organism is ubiquitous - it's in the soil almost everywhere. Not getting a child vaccinated against tetanus is stupid in the extreme, since even a full-blown case of tetanus will not produce protective immunity.]

Thirdly, since only a small percentage of people who get most of the vaccine-preventable diseases (key exceptions: tetanus, diphtheria, polio) have any long-term consequences (except, of course, shingles from chicken-pox), the the risk of having a long-term consequence (as opposed to a week or two of misery or six months of coughing) is fairly low.

However, this looks like it will be changing very soon. Measles is already endemic in parts of the UK. Pertussis has been endemic in many US cities for years. Mumps and rubella are not far behind measles. Polio could re-enter the country at any time and find a "target-rich" environment.

When that happens, the whole "risk dynamic" of vaccination will change radically (and, I suspect, abruptly). People who had been concerned about "too many, too soon" and "green our vaccines" will find themselves "out of frame".

In short, I think it will take a number of injuries and deaths from vaccine-preventable diseases to undo three (at least) decades of anti-vaccination propaganda. I hope that I'm wrong, but I fear that I'm not.

Only time will tell.

Prometheus

Nonvaccination = uncertainty, big germy world, Mom isn't living up to her duties.

My suggestion about framing is to make sure and not use "Mom isn't living up to her duties." I think a lot of parents, moms especially, feel conflicted over balancing caring for their kids with other aspects of life, and worry about not living up to their duties, and the anti-vaxers really play in to these feelings of conflict and guilt. There are a lot of undercurrents about how we only need vaccines because moms are "selfishly" working outside the home or sending their kids to day care or public school instead of homeschooling them, etc. from a subset of the antivaxers. Plus there's a pretty high baseline level of anxiety around pregnancy in our culture these days and a fear of doing/eating/drinking the wrong thing. So I think the proper frame should try to not place more pressure on Mom. That and there's the whole history of blaming autism on "refrigerator mothers."

I'm not sure how this relates to "framing", but I noticed something when I picked up Dr. Offit's book on my lunch hour. B&N has a table of new non-fiction books (which apparently includes Sylvia Browne, but that's a different conversation). They had Jenny McCarthy's new book out on the table, so I figured Dr. Offit's would be there as well. It wasn't. It also wasn't in current affairs or parenting, two places I tried to look. Eventually I asked one of the store employees to find it for me, and happily purchased the only copy they had on the shelf.

Something I thought about when I wandered around the store looking for the book is how inaccessible the science and science-related sections are in your average bookstore. They're generally tucked away in the back, they're poorly organized, and there aren't any endcaps or tables to promote new books. Science writers (or their publishers) seem to have gotten better with their book titles and covers, but that doesn't help if the books aren't displaying in a way to make the cover visible. If you're not either actively looking for a title, or browsing the science section because you're interested in science, you won't be snagged by an intriguing volume.

Proofreading fail. First sentence should be "I'm not sure how this relates to "framing", but it seemed like the best post for this. I notice something..." My way of saying "slightly off topic, but..."

The phrase "Four Horsemen of the Vaccipocalypse" is too perfect.

I regularly visit parenting boards (being an inexperienced first-time mother) and the sheer numbers of militant anti-vaxers that hang out there really caught me by surprise. I was under the misguided perception that it was a few fearful parents or religious extremists... and I was wrong. Unsuspecting mothers who are just visiting these sites to find out how long until they can expect their baby to sleep through the night are bombarded by anti-vax information. A lot of these moms become scared and immediately start questioning their vax decisions and their pediatricians.

I could have turned a blind eye but being an optomistic dummy I tried combatting the misinformation and outright lies with careful explainations of ingredients, how viruses are grown, purified and turned into vaccine components and links to (gasp) published studies (which I am often told not to do because they can't understand scientific papers... then WHY are you pretending to know so much about immunology and biology in your anti-vax rantings?). The best line I was told today takes even my use of published works out of the debate: "Even the published medical journals, which seem to be the gold standard of studies, are "sponsored" by vaccine manufacturers. Which means that the studies that the vaccine makers don't like will remain unpublished and therefore dismissd as quackery."

I just want to bang my head against the wall... but then they will have won and my 8 month old daughter and her generation will be the losers.

Enkidu said "I was under the misguided perception that it was a few fearful parents or religious extremists... and I was wrong."

Actually, you are not wrong. It is that they are very loud. You are not the only new parent to give up on those forums because of how loud and demanding those other parents are.

To illustrate, see what happened to this "survey" once it was publicized on both PZ Myer's Pharyngula blog and the AoA blog (the latter moderates comments with an iron clown glove, dissent is not allowed!):
http://www.ecorazzi.com/2008/09/30/jenny-mccarthy-strikes-back-at-amand…

Also, you can see some parents here (like Kev) started out thinking vaccines caused autism, but have open enough minds to believe and be swayed by the data.

Oh, as a point of interest, today I watched a video of someone who talked what it was like to deal with some conspiracy theorists. When he would show them real data that was counter to their beliefs they could not look at it! See it here:
http://podblack.com/?p=906 ... this is very similar to dealings with the folks on AoA.

My experience with B&N was similar to Natalie's. However, when I had the time on the next visit, I spoke with the store manager, and asked why a solid online seller like AFP was not readily available in the store. She had no answer. My response was that it looked as if B&N was promoting an attack on public health. She did not like that.

However, tonight they had three copies on a front table.

i think 'every child by two' is actually a pretty good slogan/frame. the problem with finding a good frame, i think, is that vaccination right now is the norm, and it's hard to make the norm trendy and urgent. but every child by 2 has some of the urgency, and shifts the focus back to the fact that we're talking about protecting the smallest and most vulnerable among us from some really horrible diseases.

the other think that i think must happen is that people who care about vaccination rates have to speak out more often. a few weeks ago, i heard from a friend that a childbirth education center type place in manhattan was hosting a talk about vaccines (realbirth, the name should tell you something...). i checked the announcement online, and then googled the doctor giving the talk. it was glaringly obvious that the talk would be rabidly anti-vaccine. i didn't go ($45 for individuals and $75 for couples, ALL the way in midtown, and i have a small baby...). but there are 3 more scheduled this year, and the thought bothers me. all these parents who are going to buy what this guy has to say, no one there to ask critical questions... it bothers me. but at the same time, i'm not sure what i should do... go and be critical of the guy? i was thinking i'd email realbirth and tell them they're way off base hosting this guy, at least that's something. enough though? maybe i could even get other moms who care about vaccination rates to email too... anyway, i'm starting to ramble, but i think this war is going to have to be fought on the ground as well as in the media.

Diane said:

Maybe parents who refuse vaccinations should get detailed info on the diseases--after all, they will at least need to know what to be on alert for. The info can include side effects from the vaccines arrayed against known reactions to /complications of the various disesases.

I think this is an excellent way to go. It's often put forward that this generation of parents don't know anything about the diseases these immunizations prevent, and this is a perfect way to counter that.

Mary C. said:

what brought me back was thinking of my doctor. He�s a kind, intelligent man with two children (both vaccinated). He�s not a shill. And I realized if anti-vaxers are to be believed, I�d have to buy into a giant conspiracy theory. Anti-vaxers are, in essence, accusing every doctor who follows the recommended schedule of either (A.) poisoning children for money or (B.) being too stupid/lazy to know as much about vaccines as Jenny McCarthy does. Both these notions are ridiculous.

I think vaccine advocates need to present the �controversy� to parents for what it is: a far-fetched conspiracy theory.

Another excellent point. It would also be helpful in addition to the above explanations of the dieases that the pediatricians need to make sure that it is well explained and that the parents understand what the decision not to vaccinate really means. Yes, doctors are rushed a lot, and they need to keep their appointments from going too long over, but it's an extremely important decision that parents must not make based on propaganda.

TheProbe said: "tonight [B&N] had three copies [of AFP] on a front table."
Awesome. Good job. :D

"Oh, as a point of interest, today I watched a video of someone who talked what it was like to deal with some conspiracy theorists. When he would show them real data that was counter to their beliefs they could not look at it!... this is very similar to dealings with the folks on AoA."

@HCN - thanks for the link - if you would like to HEAR the entire interview I did, it is the feature of the very first episode on the Skeptic Zone vodcast, at www.skepticzone.tv.

I hope you enjoy the entire show and the discussion of how Mark 'Gravy' Roberts experienced first-hand how the conspiracy-theorists just 'couldn't look' at the evidence presented to them. :)

Thanks to fearmongering over vaccines, measles is already endemic again in the U.K., after previously having been conquered, while in the U.S. it is surging back as well, fueled by lower vaccination rates. If current trends continue, and antivaccine activists make good on an earlier promise of a "fall offensive" against the vaccination schedule, it won't be long before other vaccine-preventable diseases start making a comeback as well.

I think that you pretty much have your frame right here. Whereas the effects of global warming and creationism have uncertain effects in the distant future, failure to vaccinate has concrete consequences in the here and now. I'd emphasize that not vaccinating has had negative effects already.

The primary effect of Nisbet's and Mooney's essays on framing was to convince a great many otherwise intelligent people that framing is spin. You should probably refer your readers to Lakoff's explanations of framing instead, as most people who have read Lakoff seem to have understood. Perhaps more importantly, Lakoff doesn't try to spin the need for framing as a need to make baseless personal attacks on scientists who say 'offensive' things about religion.

podblack said "@HCN - thanks for the link - if you would like to HEAR the entire interview I did, it is the feature of the very first episode on the Skeptic Zone vodcast, at www.skepticzone.tv."

Started listening to it Thursday while at the orthodontist with my daughter. It is a fun to listen to... oh, and I also checked out your other videos, including all the DragonCon ones (we can't go to that, though I do take my daughter to http://sakuracon.org/ in March/April).

Orac said "The best we can do is estimate the probability, and the existing science is conclusive that there is very, very little chance that vaccines cause or contribute to autism. We can never say "zero" chance, but we can say the chance is vanishingly small."

Dr. Offit does go into great detail of how the statistics work on pages 208 to 209.

Once upon a time used to predict that the vibration a structure will experience does not go beyond its limits (going on memory, I've gone off to other things). I can only predict up to a certain limit of confidence, and I usually go to about 3 or 4 standard deviations from the mean (that is lots!, and if I went past the design would be impractical). Imagine driving down a bumpy road, while your car can handle most of the bumps, at some point you might to hit a pothole that will knock the suspension out of alignment, and sometimes a pothole that will actually cause severe structural damage. If your car was designed for those once every 10000 or more mile potholes as if they occurred for every mile you drive, you would be driving an armored tank.

Despite it being obvious, I still had to explain multiple times to the other engineers that there will always be an uncertainty to the dynamic force estimates (okay, stress engineers who do not deal much with second order differential equations). These are the same people with very much the same level of math education I had, even to the engineering statistics. Except they did not have to use it day to day.

I see the same thing with the folks trying tell us we need 100% safety with all medical interventions, including vaccines. The biggest failure is that they underestimate the risk of the actual microbes, and in most things in life. Oddly, those who want vaccines to 100% safe seem to be willing to give their children unproven and questionable treatments (see pages 145 to 147, and all throughout the book).

This is not to be unexpected, since they show a complete failure to understand the properties of a normally distributed curve (the "Bell curve"). See pretty picture here:
http://en.wikipedia.org/wiki/Standard_deviation#Rules_for_normally_dist…

Whenever I hear the one out of six have some dread something (learning disabilities, IQ, etc), I realize they are discussing those who fall below the first deviation of the mean in a normal distribution. In that curve it is impossible for "all children to be above average". What happens is that the data shows that about 68% fall within the first standard deviation of the mean. That means about 16% fall above that level, and 16% fall below, or about 1 in 6.

All of the frames of the anti-vaccinationists rest on incorrect notions about what autism is and how to treat it and I have been thinking, we need also and just as much to find frames for autism, such as (just suggestions; trying to get away from simply rephrasing the DSM).

Autism is more prevalent than believed in the past. (I.e., there is no epidemic of autism.)

Autism is a neurodevelopmental disability.

etc.

One thing I keep in mind when I find myself sighing over yet another example of the seemingly unending ignorance out there about autism and vaccines is one previous theory of autism causation---namely, the refrigerator mother theory. Everyone is quick to say "no one believes that" and "how can people have believed that?" but people did. And I honestly think that, one day, people will be looking back at the vaccine-autism claims and saying, how could those people have actually believe that?

I had the same experience at the B&N Bookstore here.

"False Prophets..." was at the back of the store in the Health section, on the very top shelf, and there was only one copy. It took me quite a while to even find it, and I had to have help getting it off the shelf.

I had already ordered it from Amazon, so I didn't buy it. I did take it to the front and center table and propped it up in a very prominent display.

Speaking of Amazon, when I went there, it said the book was unavailable and out of print. I clicked on "Buy from another seller" and it took me right to the usual Amazon.com book page. Something funky about that too, IMO.

"We are not 'antivaccine'; we're pro-safe vaccine."
Same sort of doublespeak as "love the child, hate the autism".

Same experience for me at B&N. I went straight to the section, I believe it is a parenting section, where all of the autism books are, and there was not one copy of AFP. AFP was in an out-of-the-way section of the store that is hardly perused. BTW, from my college days (a while back) I remember that book stores usually shelve the books according to their classification. I worked at a Waldenbooks, and when organizing sections of the store, there was a computer-generated form that dictated the shelving of the books. I believe the classification as to where to shelve the books comes from the publisher. Maybe someone can clear this up with the book stores. Maybe we should all visit our local B&N and speak with the store manager about the placement of these books. I think we need some good PR for this book so we can get the word out. I agree with former threads that an attractive blonde sells more books than a scientist (sorry Dr. Offit). Sex sells in our culture. What is so funny to me is that my family member who thinks she is an anti-vax expert had no idea that McCarthy's credentials (or should I say notoriety) involved bunny ears. I kindly informed this family member that I would much rather receive my data from an M.D., not an O.D. or a chiropractor who claims to have the latest "cure" for autism, but a medical doctor with a specialty in developmental pediatrics or in pediatric neurology.

As you probably know, the large chain bookstores are paid by publishers for shelf position. If the publisher wants a book to be prominently displayed at the front of the store on one of those large table you see as you walk in. The better the positioning and for the longer period of time, the more the publisher pays. Somehow I doubt that Dr. Offit's publisher can afford to fork out the same amount of money for promotion as Jenny McCarthy's publisher can. She's had prior bestsellers before, going to show how vapid the tastes of the American public are. She clearly has a much larger promotion budget and a publicist capable of getting her on Oprah, Ellen, etc.

I have not had to think about placement of the books in the stores prior to now, so I have not pondered the methodology, but, of course, it makes perfect sense that the books on the endcaps and front tables are placed in the most desirable sections due to good PR and money to back that PR. I agree that the tastes of the American public are vapid, but I also believe that in communities at large, individuals who may be viewed as "experts" in the field of early childhood education, early childhood intervention, or as being revered in their religious settings are doing more damage than the PR companies. Call me naive, here, I am new to all of this, but in my own personal experience it has been one individual or a couple of individuals who are respected in a community spreading this ideology. It is an individual who buys into these theories and then feels the need to "educate" those in his or her sphere of influence as to the ills of vaccines and potential availability of "cures." This ideology of toxicity, chelation, gluten-free/casein-free diets, has permeated my community to the point that most people with whom I have had contact have suggested one or all of these so-called cures for my son. Not all of the individuals who have recommended one or all of these "cures" has been personally affected by ASD. The individuals I have encountered have either watched the Oprah show or just heard from someone whom they trust that toxicity and/or mercury poisoning from vaccines are the cause, and then they run with it. These people have meant well, in my opinion. I dare to opine that the average person resonates with another seemingly "average" individual like McCarthy under the guise of being in the "Mommy club" with innate "Mommy instincts." There may be an innate distrust of the medical/scientific community by the average person because their differing vernacular. Maybe there is an inability to relate on a personal level. Yes, Oprah obviously has done considerable damage promoting the likes of McCarthy, but I think it is the average individual with some sphere of influence in his own community who is spreading the maddness.

Well, I'm one of those non-vaxing parents you guys are quaking in your panties about. I'm also a health care provider.

I've done the full risk-benefit analysis for my child, which includes detailed, in-depth research about the the diseases for which there are vaccines. As well as for diseases that don't have associated vaccines.

All of the other parents that I personally know of who are non/selective/delaying vaccines have done the same.

So that "frame" won't work.

Back to the drawing board! Nice try, though.

snvm said "I've done the full risk-benefit analysis for my child, which includes detailed, in-depth research about the the diseases for which there are vaccines. As well as for diseases that don't have associated vaccines."

Yeah!!! Finally someone who can answer my questions!

Okay, can you tell me what real actual scientific evidence you uncovered that shows the that MMR is riskier than the measles (which kills at a rate of about 1 in 1000), mumps and rubella?

And the same for the evidence (remember, the papers have to be published in journals I would find in my local medical school library, so no news reports, random websites or personal anecdotes) that the DTaP is worse than pertussis (which still kills over a dozen babies each year in the USA, even with about 90% vaccine coverage), tetanus and diphtheria.

I would really appreciate it. Because I only find papers like these:
http://archpedi.ama-assn.org/cgi/content/full/160/3/302 ... which says things like measles causing mental retardation in about 1 in 5000 cases.

Where is YOUR citation for your 1/1000 death rate for measles?

Let's start with that and we can move on to the other questions.

A person who really had the information she claimed to have would present it; a liar who probably has neither a child nor a health care career would make a claim and then refuse to back it up. Looks like we know what we have here.

Oh, please. Accusing me of being a liar and/or a troll?

Social skills, much?

Since I have a busy toddler to chase after, I can only answer one question at a time until naptime. But before I did, I requested a citation for the above referenced measles death rate. Because, even according to the CDC, the 1/1000 is wrong.

Check it yourself in the Pink Book. Here's a linky for you, lazybones.

http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf

Page 10:

Before 1963, approximately 500,000 cases and 500 deaths
were reported annually, with epidemic cycles every 2�3
years. However, the actual number of cases was estimated
at 3�4 million annually. More than 50% of persons had
measles by age 6, and more than 90% had measles by age
15. The highest incidence was among 5�9-year-olds, who
generally accounted for more than 50% of reported cases.

Even taking the best case scenario of 3 million cases and 500 deaths, according to my handy dandy calculator, that's 1/6000.

Apologies for the weird formatting from the CDC quote above, don't know what happened with that. Those gibberish figures are supposed to be hyphens.

Well, the 1 in 1000 death rate does appear to be a little on the low side.

According to a study, Acute measles mortality in the United States, 1987-2002, by Gindler et al, the number appears to be twice as big.

We used capture-recapture methodology to estimate total deaths and efficiency of reporting for 2 systems. During 1987-1992, there were 165 measles-associated deaths in the multiple-cause mortality database at the National Center for Health Statistics (NCHS) and 184 reported to the measles surveillance system at the National Immunization Program (NIP). We estimated that 259 measles deaths actually occurred; the reporting efficiencies were 64% for the NCHS and 71% for the NIP. Overall the death-to-case ratio was 2.54 and 2.83 deaths/1000 reported cases, using the NCHS and NIP data, respectively. Pneumonia was a complication among 67% of measles-related deaths in the NCHS data and 86% of deaths in the NIP data. Encephalitis was reported in 11% of deaths in both databases. Preexisting conditions related to immune deficiency were reported for 16% of deaths in the NCHS system and 14% in the NIP; the most common was human immunodeficiency virus infection. Overall, 90% of deaths reported to the NIP occurred in persons who had not been vaccinated against measles. During 1993-1999, only 1 acute measles-related death was reported to the NCHS and no deaths were reported to the NIP. This is consistent with the extremely low reported incidence of measles in the United States during these years.

Good catch snvm. Now, back to HCN's questions to you.

Even taking the best case scenario of 3 million cases and 500 deaths, according to my handy dandy calculator, that's 1/6000.

Actually, the "best case scenario" is 500,000 cases and 500 deaths, as this is what were reported. Now, it's true that we know that the case numbers were under-reported, but we have no knowledge if the number of deaths were accurately reported, so it's impossible to do the math you just did.

And even if it was, is 1/6000 an acceptable death rate to you? To me, personally, it sounds frightening high.

Then anyone who cites a 1/1000 death rate MUST at the very least disclose that the number is calculated for reported cases, right?

And to also disclose that the rate for the estimated number of deaths to cases from the highest public health authority in our country is different than that.

Do you understand what I'm getting at, here?

I'm a mom, and a HCP, and I'm trying to get straight answers so I went to the top, which one would imagine would be our illustrious Centers for Disease Control. And I even looked up the info for physicians (the Pink Book) vs. the parent pages.

snvm "Do you understand what I'm getting at, here?"

That you don't want to answer my questions. And that you are relying on herd immunity due to the high vaccine rates we still enjoy. Something my first born was denied because due to his seizure disorder he was only given the DT vaccine while there was a pertussis epidemic in our county.

You are not being a "smart mama", you are being a parasite.

I have no idea what an "HCP" is, but if you went to the "top" it is obvious you are filtering the information through a preconceived conclusion.

The 1 in 1000 is a generous estimate using historical figures and not as dire as those reported in the 1987 to 1991 measles outbreak:
http://www.ncbi.nlm.nih.gov/pubmed/15106092 ..."We estimated that 259 measles deaths actually occurred; the reporting efficiencies were 64% for the NCHS and 71% for the NIP. Overall the death-to-case ratio was 2.54 and 2.83 deaths/1000 reported cases, using the NCHS and NIP data, respectively"

So how about that CDC Pink Book. How closely did you look at it? Actually, I've looked at it quite a bit and compiled some numbers comparing the fifty years of data in Appendix G:
This is for pertussis:
Year____Cases____Deaths__Year____Cases____Deaths
2000_____7867______ 12___1950___120718____1118
2001_____7580______ 17___1951____68687_____951
2002_____9771______ 18___1952____45030_____402
2003____11647______ 11___1953____37129_____270
2004____25827______ 27___1954____60886_____373
2005____25616______ 39___1955____62786_____467
2006____15632______ 16___1956____31732_____266
Total__103940______140__________426968____3847

The death figures for 2004 through 2006 are from this slide set:
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/Slides/Pertussis10… ... Slide 9. Of the 82 deaths from pertussis during 2004 through 2006, 69 were of infants under the age of three months, while the remaining 13 were older than three months.

Now for tetanus:
Year____Cases____Deaths__Year____Cases____Deaths
2000_______35______ 5____1950_____486_____336
2001_______37______ 5____1951_____506_____394
2002_______25______ 5____1952_____484_____360
2003_______20______ 4____1953_____506_____337
2004_______34______ NA___1954_____524_____332
2005_______27______ NA___1955_____462_____265
2006_______41______ NA___1956_____468_____246
Total_____219______19 or more____3436____2270

Now for measles:
Year____Cases____Deaths__Year____Cases____Deaths
2000_______86______ 1____1950___319124____468
2001______116______ 1____1951___530118____683
2002_______44______ 0____1952___683077____618
2003_______56______ 1____1953___449146____462
2004_______37______ NA___1954___682720____518
2005_______66______ NA___1955___555156____345
2006_______55______ NA___1956___611936____530
Total_____460______3 or more___3831277___3624

Now for mumps (no data before 1960):
Year____Cases____Deaths
2000______338______ 2
2001______266______ 0
2002______270______ 1
2003______231______ 0
2004______258______ NA
2005______314______ NA
2006_____6584______ NA
Total____8261______3 or more

(the "NA" means that the information is "Not Available", it usually takes time for the data from city, county and state health departments to reach the CDC)

Total of cases of those four disease over the seven year period of 2000 though 2006 is 112880, with at least 165 deaths. This does not include the 16 cases of Congenital Rubella Syndrome listed in the table for the years 2000 through 2006.

Now if we were as "smart" as you and decided to be parasites on the waning herd immunity and skip the DTaP and the MMR then we will go back to the numbers that are listed for the 1950s (the return of pertussis is already happening, and measles and mumps have returned to Japan and the UK, the USA is not far behind, evidenced by measles outbreaks in under vaccinated populations in California, Illinois and Washington). The number of measles cases were in the millions for the seven year period fifty years ago, with deaths of over 3500. During the years 1950 to 1956 for the three diseases that there is data, the total cases were 4261681 with at least 9741 deaths. And I left out polio.

Please answer my question, try again. Because from using the Pink Book information above, and the report on the early 1990s measles epidemic, plus the report on the 2006 mumps outbreak in the American Midwest (where four people lost their hearing, I'm at my two URL limit... but you can find it on the CDC search window by using "2006 mumps outbreak update")... I still have the feeling that it is smarter to not be a parasite.

So again, what real scientific evidence do you have that the MMR is riskier than measles, mumps and rubella and that the DTaP is riskier than diphtheria, tetanus and pertussis?

I'll bet a shiny new copy of Jenny Mc's book that snvm's identity as a "Health Care provider" = naturopath or some other altie med discipline.

Any takers?

Never in a million years.

If I had to guess, though, I'd guess naturopath.

Danio - I won't be a taker. Most licensed "Health Care Providers" will say what they are: i.e. I am a nurse (RN), Orac is a MD. The only people who call themselves HCP's are non licensed people like nurses' aides. Very important people in healthcare (and no, I am NOT being sarcastic; we need NA's). However, they are not trained in comprehension of medical data, statistics, etc. SNVM just MIGHT be a licensed care provider, but I am not sure.

My local BN had AFP on one of its front tables, and the employees found it for me quite quickly (I was looking on the shelves and not finding it). There were quite a few copies. It was, ugh, next to Jenny's book.

Let's stick with measles right now. If I'm looking at your chart above correctly, there were 3831277 cases of measles and 3624 reported deaths between 1950 and 1956, and 460 cases of measles and 3 deaths between 2000 and 2006, correct? What happened? Did measles get more virulent in the modern post-vaccine era? Because getting back to that handy dandy calculator, I get 1 death in 1057 for the 50's and 1 death in 153 in the 2000's. Not good! What happened?

Are you a doctor, HCN? Highly doubtful, as any physician would know that a risk-benefit analysis is done FOR THE INDIVIDUAL and not for the "herd". I discussed this issue at length with our family pediatrician, and he supported us, our research and taking our family's health history into consideration. You don't have to like it that there are intelligent, conscientious physicians that are out there that are respectful and completely supportive of families like ours, but there are. They are practicing medicine as it should be...looking at the individual and acting as trusted colleagues and advisors to optimize a child's health.

I don't know why I even bother here, with the negativity, namecalling and ad hom attacks. Do you think calling non/delayed/selective vaxing families "parasites" really helps your cause? Amanda Peet and her No Child By Two shenanigans has been a real turn off to a lot of families. Even fully vaxing moms that I've talked to have actually said how rude, obnoxious and unnecessary it is to stoop to that level.

"discussed this issue at length with our family pediatrician, and he supported us, our research and taking our family's health history into consideration."

Of course he did SNVM, he wants your money. Providing a family with even preventive health care over a lifetime is far more profitable than vaccines.

Wow, economic conspiratorial thinking of the anti-vax movement turned upon itself.

"They are practicing medicine as it should be...looking at the individual and acting as trusted colleagues and advisors(SIC) to optimize a child's health."

Why? I don't want to be my doctor's adviser or colleague, I want him to find what is wrong and fix it.

Besides SNVM, what qualifications do you have to raise children besides the fact you've bred them? In Baltimore, spawning is not proof of parental quality, only proof of a failure to properly use birth control.

snvm "Did measles get more virulent in the modern post-vaccine era?"

There are lots of theories. One of them is that measles was so common it was not reported as often.

But you cannot deny the most recent numbers of the time period that Dr. Offit writes about in the prologue. Nor can you deny that measles spread quite quickly in San Diego, with some hospitalizations.

Back to the book: what was your reaction when you read page "pv" in the prologue of the book. Do you think it was fair to the two children who, like several in San Diego, were too young for the MMR vaccine?

Re frame:
"It is not us, but our children, who will suffer" - I think that's an effective point there. I know you were talking about global warming, but it is true of not vaccinating as evidenced by the resurgence of measles. Effective and backed up by facts, no? Also if vaccination rates are decreasing in those areas with measles coming back, are the autism rates also decreasing? I'm guessing not.

I missed the first post with this "central idea" as you said, so thanks for putting this up.

HCP = Holistic Cupping Practitioner or Happy Cup Provider

Sorry, just reading http://scienceblogs.com/denialism/2008/10/a_cup_of.php ...

By the way, saying you are a parasite who is not smart is not an ad hominem argument. See http://en.wikipedia.org/wiki/Ad_hominem .

I did not say you were wrong because you are a parasite who is not smart... I just said you were being a parasite, and that you are not very smart. That is an observation, which can be an insult... though I just think of it is an accurate description of you depending on everyone else vaccinating. You are being a parasite by hoping that enough people will risk the real but teeny tiny risk of vaccines, so your children will not come into contact with the real diseases. Though you are not being smart in encouraging others to follow your lead, since that diminishes herd immunity... the results being the return of measles to the USA from countries that have almost no herd immunity anymore (Japan, Switzerland, UK), and the increasing incidences of pertussis.

On the second part of the ad hom... I also did not say you were wrong. I just presented the information I had gleaned from what you said what you said you had read. I could not call you wrong because you did not provide ANY evidence.

So there are still no answers to my questions. Oh, well, I actually thought someone calling herself smart might have actually had the answers. Obviously, I was wrong.

Oh, I said "There are lots of theories. One of them is that measles was so common it was not reported as often. "

I forgot to mention the deaths from measles were not reported as often. The reporting was not rigorous fifty years ago, and even today there may have been kids with measles who were not reported.

Just realizing this as I am watching the just downloaded to my computer of the film we had converted to digital tape of the movies my grandfather took of my mother in the late 1930s. My mother was their first surviving child after twenty years of marriage. It shows her playing with her only cousin, whose daughter recently sent me the family Bibles. In those Bibles was the first I had learned that my grandmother had two brothers. One died when he was about ten months old, and the other when he was about seven years old. sigh

Still, I am interested in your interpretation of the MMR studies done by Wakefield almost three decades after that vaccine was introduced in the USA. Those would be Chapters 2 and 3.

I am particularly interested on the conclusion of the UK Legal Services Commission on page 52... A short transcription to prompt your memory (or tell those who do have not read the book what I am talking about):

"The commission concluded: "In retrospect, it was not effective or appropriate to for [us] to fund research. The courts are not the place to prove medical truths." The commission reasoned that science directed by a team of personal-lawyers wasn't likely to be the best kind of science."

What happened? Did measles get more virulent in the modern post-vaccine era? Because getting back to that handy dandy calculator, I get 1 death in 1057 for the 50's and 1 death in 153 in the 2000's. Not good! What happened?

If the actual probability of death from measles is 1 in 1057, the odds of exactly 3 people dying out of 460 cases is roughly 9% (that goes to almost 10% if you say 3 or more deaths). So it shouldn't be that surprising to see a death rate of 1 in 153 when there are only 460 cases.

Are you a doctor, HCN? Highly doubtful, as any physician would know that a risk-benefit analysis is done FOR THE INDIVIDUAL and not for the "herd".

Let me translate here:
THE INDIVIDUAL = my precious child
the "herd" = the rest of society (who obviously don't count)

Care to tell us what your qualifications are, "s"nvm? Several people have asked, now.

"Whatever the frame, it has to be simple, scientifically supported, and able to resonate with typical parents. Hardcore antivaccine activists won't be persuaded by any frame we can think of, but there are a lot of parents out there who aren't hardcore antivaccinationists but have heard their rhetoric and are afraid of vaccines because of it. How do we reach them?"

Certainly not by the way that you have addressed me, that's for sure. Bringing it back to the original topic of this post, the way you all are "framing" this argument with me is an EPIC FAIL.

Drilling it into my head that I am "not smart", throwing it back in my face that my child is a "parasite", pounding the point over and over how superior and intelligent you are, saying that I don't have the answers for MY family and MY child when you don't know anything about me and my family...

FAIL, FAIL, FAIL and FAIL.

Keep on doing what your doing, fellas. You're doing a bang up job! Good luck with that.

Re #1:

Safe or sorry! That's great!

I'm not likely to come up with a slogan as good as that, but I think that it's important to emphasize that parents who don't vaccinate their children are putting other children at risk. Maybe emphasize the rights thing, e.g., "They don't have the right to put your children at risk."

snvm said "FAIL, FAIL, FAIL and FAIL."

So you are not even going to attempt to answer my questions?

Could you at least read the book we are trying to discuss?

(for the record, I used to be an engineer, I was and am used to looking at risk factors for the whole system, not just the individual part... I had to quit work twenty years ago to take care of my baby who had seizures and his disabilities... if you had read some of my entries on Orac's and other blogs you would know that my kid required herd immunity for pertussis, but there wasn't any because our county was in the midst of a pertussis epidemic when he was a baby --- more likely due to "smart moms" just like you!)

Certainly not by the way that you have addressed me, that's for sure.

(a) People whose minds are already made up do not comprise the intended audience, thus the framing is not aimed at you.

(b) A blog discussion is not the same as public outreach.

Drilling it into my head that I am "not smart", throwing it back in my face that my child is a "parasite", pounding the point over and over how superior and intelligent you are, saying that I don't have the answers for MY family and MY child when you don't know anything about me and my family..

Straw man argument. Where did I say your child is a "parasite" or those of antivax parents like yoursel? Never. Where did I say I was superior or more intelligent? Not here. I will admit that I frequently bash Jenny McCarthy, but I do it because she keeps spouting easily refutable and incredibly dumb unscientific nonsense. Pointing out mind-numbingly obvious ignorance is a public service, as far as I'm concerned.. If you find her arguments compelling, I'm sorry to have to tell you that that's unlikely to impress anyone.

As for you, you come here spouting your own brand of nonsense and can't even back it up with any science at all. None. Nada. Zip. You won't tell us what kind of "health care professional" you claim to be. Meanwhile you go on and on about how mean we all are while throwing around ad hominems. Talk about EPIC FAIL.

snvm, if all these diseases became a significant risk again (due to lack of herd immunity) would you then choose to vaccinate your child? Alternatively, do you believe that the danger (perceived, at least) of vaccination would always outweigh the benefits?

Perhaps saying "group immunity" is more helpful than "herd immunity". It avoids the whole "Oh so we're just cattle, dumb animals" etc kind of tactic. I think that's one of those things were scientists don't see any problem with it, but the general public can easily be offended.

Overall, I think that Autism's False Prophets is an excellent read, and a fine piece of scientific journalism. It is clearly and engagingly written, accessible to the nonscientist, and with respect to all key issues, it is scientifically accurate. I think that Dr. Offit made a good choice by first building up the MMR/autism and thimerosal/autism hypotheses before knocking them down. It is chronologically accurate, and it also helps the reader to understand how reasonably sane parents of autistic children could have become so invested in these ideas and "cures" that they become enraged when anybody challenges them.

Although much of the material of the book was familiar to me, I was particularly interested to learn more about the facilitated communication debacle. While I had heard about this, I was unaware of just how widely this approach had been embraced by therapists and parents of autistic children.

I do have some quibbles, although they are largely minor:

Although Dr. Offit usually bends over backwards to be fair to the mercury/autism hypothesis, there are a few points at which this is not the case. In describing Dr. Richard Deth's results, Dr. Offit writes, "Deth knew that autism was a problem with nerve cells from the brain, not nerve cells found in muscles or organs. He also knew that autism wasn't associated with cancer of the brain. And he knew that autism affected cells that had the normal number of chromosomes....Nonetheless, Deth chose to study cancerous nerve cells from outside the brain that had an abnormal number of chromosomes."

While this account is not factually incorrect, it is misleading to the nonscientist. As phrased, it sounds like Deth's choice of experimental preparation was irrational. But he could just as accurately have written, "Deth chose to study the effect of thimerosal in a standard laboratory human neuronal cell culture line originally derived from an adrenal tumor, which has been shown to reproduce many of the properties of brain nerve cells."

The general point being made by Dr. Offit is valid: studies of nerve cells in culture provide limited information regarding what is going on in the brain (although I think that most neuroscientists would agree that a basic biochemical result such as that described by Deth would likely hold true for normal nerve cells), and even less information as to what the consequences of such an effect would be for function or behavior. In fact, if Dr. Deth had used normal nerve cells, his results would have been in some ways more suspect, because normal nerve cells grow more poorly in culture, and are likely to be more vulnerable to toxic insults. Moreover, there is not practicable way to do such as study on normal human nerve cells, so Deth would have had to have studied animal cells instead of human cells. If epidemiological evidence supported a role for thimerosal in autism, Dr. Deth's observations would offer an attractive possible mechanism. Absent such evidence, however, Deth's results provide weak evidence at best for toxicity--all sorts of things produce toxic effects in cell culture that are not relevant to an intact organism. Nevertheless, I think that Dr. Offit could have made his point without rhetorically "stacking the deck."

I also think that Dr. Offit crosses a line when he implies that Dr. Deth chose to focus on thimerosal because he received a $60,000 research grant from Safe Minds. The public is not generally aware that getting a research grant has little if any effect on the remuneration of a university professor, because most of the money goes to pay for the research itself--and in any case $60,000 is a very small grant, hardly more than "seed" money. The notion that Deth was improperly influenced by such a piddly grant is fairly ridiculous. A basic researcher can sometimes get a bit carried away when it looks like his own research may tie into a major medical issue. Deth has been studying the biochemistry of sulfur for many years, and since mercury interacts with sulfur, it is a natural direction for his research to take--it is far more likely that he got the grant because his research fit the interests of Safe Minds than the other way around. Deth might reasonably be characterized overinterpreting his data, but framing it as some kind of conflict of interest is uncomfortably similar to the tactics utilized by the antvaxers.

Dr. Offit also makes a few careless scientific errors in areas that, while irrelevant to his thesis, negatively impact his credibility. For example, when discussing cold fusion, he states "Most scientists, however, were immediately skeptical, and for good reason: the Pon- Fleischmann experiment violated the first law of thermodynamics, which states that one can't get more energy out of something than is put into it." This is, of course, quite incorrect--if it were true, the sun would not shine and hydrogen bombs would not explode. Fusion produces more energy than is put in by conversion of mass into energy, which does not violate the first law as currently understood. Skepticism was because current theories of nuclear physics do not predict that this sort of nuclear reaction would occur under the conditions used by Pons and Fleischmann, not because such a reaction cannot yield energy.

Dr. Offit also makes an error when he states that bending of light rays by the sun proved Einstein right in his explanation of the photoelectric effect. The bending of light was predicted by Einstein's General Theory of Relativity, and because it is a consequence of the curvature of space-time, it is not dependent upon the quantum nature of light.

I agree with Orac that Dr. Offit's argument is weakened when he cites a crackpot web site like junkscience.com. Dr. Offit also apparently still carries a grudge against Richard Horton at the Lancet, stating "Richard Horton has published papers in the Lancet claiming that...casualties suffered during the U.S.-led invasion of Iraq totaled 655,000 (about ten times the actual number)." I can't help wondering if Dr. Offit read this at junkscience.com. The Lancet estimate, based upon established epidemiological sampling methods that have been validated in other conflict zones, is toward the high end of published estimates, but no serious study supports the notion that the actual number is 10 times lower. The Lancet estimate is not even the highest; the London based ORB survey estimated 1.2 million. Even the Iraqi government-sponsored study came up with estimate of 150,000. It has been suggested, based on some ambiguities in the description of the sampling method, that the sampling method in the Lancet study might have missed some neighborhoods with lower casualties (although the principal investigator has denied that this is the case, and it would have to have missed a lot of extraordinarily peaceful neighborhoods for the result to be in error by an order of magnitude). Tim Lambert at Deltoid has covered the issue in more detail.

Orac said "Where did I say your child is a "parasite" or those of antivax parents like yoursel? Never. Where did I say I was superior or more intelligent? Not here."

Well, actually that was me... and really only me. Though I tried to explain exactly why I said that. Though to be clear I did not call the child a "parasite".

And I will not apologize for those observations...

Especially since Dr. Bob Sears writes in his book (page 97): "I also warn them not to share their feelings with their neighbors, because if too many people avoid the MMR, we'll likely see the diseases increase significantly."

Trrll,

I agree with some of what you said. However, I do not know enough about Deth's work to determine the validity of what you wrote. I do however thank you for reminding me about the Iraqi body count controversy regarding the Lancet papers. Indeed, although I, too, initially was exceedingly skeptical of the studies, Tim Lambert's writing and that of others brought me around to some extent. I'm still of the mind that the studies probably overestimated the Iraqi casualties, but I agree now that there's no way they overestimated them by ten-fold or more. You're right. Dr. Offit's mentioning those Lancet studies so dismissively also undermined his point. Now that you mention it, I remember being a bit jarred by that passage as well.

It would seem to me that Dr. Offit needs to be more careful when he wanders out of his area of expertise (as do we all, for that matter). I'd be lying if I didn't admit that I sometimes have embarrassed myself when discussing matters about which I'm not an expert. I wish now that I had read the uncorrected proof right when I got it a few months ago; I would have strongly advised him to remove the passages quoting industry apologists and global warming denialists Steve Milloy and Michael Fumento. Theyr'e totally cranks who always rubbish any science that goes against industry positions and virtually never criticize industry science. Most people who are of a skeptical bent know that. I also would have strongly recommended removing the passage about the Lancet Iraq casualty studies.

SNVM brings up an interesting point:

"Did measles get more virulent in the modern post-vaccine era?

It has been about 40 years since the introduction of the measles vaccine, which works out to roughly two human generations. That's two generations of children born without the natural selection of measles virus to remove those who are inherently more susceptible to the virus.

In addition, the various medical advances in the past four decades have led to a larger number of "medically fragile" children living among us - children who would not have survived infancy (or even to birth) in the years prior to the measles vaccine.

Finally, there is the possibility - which has been touched on already - that measles is under-reported today because most "health care providers" wouldn't recognize it, never having seen a case before.

Let me play Advocatus Diaboli for a moment:

SNVM's "analysis" of the situation vis a vis vaccines may be correct - for the moment. In most of the US, the risk of contracting measles is currently very small - not at all as high as the risk (about 100%) of contracting measles in the "good old days" prior to vaccines.

As a result, the risk - to her child - from the vaccine may be greater than the combined risk of contracting measles and having a long-term complication of measles (like death or permanent disability). At the moment.

Unfortunately, as more and more parents take the route SNVM advocates, the "odds" will shift. Then SNVM will discover two salient facts that may have been missed in her research:

[1] The measles vaccine (like all vaccines) is safer than the disease it was developed to prevent.

[2] Adults who contract measles usually have a more severe course than children (apart from young infants), which leads to a higher risk of serious sequelae (like death and permanent disability).

Personally, I have no problem calling SNVM's strategy what it is: parasitism. She is counting on the rest of us ("society at large") to take the risks with our children in order to keep her child safe from measles and a host of other communicable diseases. This meets the biological definition of parasitism.

If SNVM has no problem acting as a parasite, she should at least have the common courtesy to not act as though someone had deeply insulted her when they use the proper name for her actions.

Prometheus

SNVM's "analysis" of the situation vis a vis vaccines may be correct - for the moment. In most of the US, the risk of contracting measles is currently very small - not at all as high as the risk (about 100%) of contracting measles in the "good old days" prior to vaccines.

This is a fundamentally misleading way to think about it. No effective treatment, including vaccination, is entirely without risk. So let's imagine the limiting case of a vaccine that is absolutely effective and absolutely necessary--let's suppose that the disease is 100% fatal and 100% infectious, and that the vaccine is 100% effective in preventing the disease. In such a case, all of the risk in the vaccinated population will be due to the vaccine, and the ratio of casualties due to the vaccine to casualties due to the disease will be infinite.

trrll,

You are absolutely correct that SNVM's "analysis" is a fundamentally misleading way to look at the risk:benefit ratio of vaccines, but it is the calculus that many of the "green our vaccines" crowd are using. I just want to get it out on the table.

The vaccine parasites are looking at the current high level of immunity (the result of vaccines) and low level of measles virus exposure (ditto) and calculating that the risk of their child getting measles - if unvaccinated - is very low. This is correct.

The are again correct in assuming that the combined risk of exposure to measles AND developing long-term sequlae from measles is also very low.

The question not answered - except by "guesstimation" - is if the risk of a child being killed or seriously injured by measles is less than the risk of the vaccine. The vaccine parasites are assuming that the answer is "no".

Let's run the numbers, shall we:

There have been 129 cases of measles in 2008 (as of Sept 27); there are about 300 million people in the US as of August 2008 (the latest numbers available) and 90% of them have received the recommended 2 MMR vaccinations (or had the diseases). Over 90% of the cases of measles have been in people who had not received the recommended two MMR vaccinations. So, with 10% of the population "undervaccinated" - this gives a "population at risk" of 30 million and "risk" of getting measles of about one in 23,000.

Multiplying this by the risk of "serious" sequelae from measles of about 1 in 1000 (this only includes permanent sequelae, such as death and brain injury) gives a combined risk of about 1 in 230,000 - at the present time.

By comparison, the risk of long-term sequelae from the MMR vaccine - which (lest we forget) protects against two other diseases which can also cause death and permanent injury (wild-type rubella - the "R" in MMR - has been shown to cause autism, while the vaccine strain has not) - is less than 1 in 1,000,000.

So, even in today's rather sheltered (although growing less so every day) measles environment, the risk of not vaccinating is over four times the risk of vaccinating. As more measles cases "pop up" in the US, the balance will tip even further in favor of vaccination.

Of course, the vaccine parasites will probably argue that the risk of "getting autism" from the MMR (or other, presumably "non-green") vaccines is greater than 1 in a million - even though that has never been shown.

The fact is that the "green our vaccines" and "too many too soon" and "vaccines cause autism" arguments have no data to support them (and lots of data refuting them).

If - as the data suggest - it turns out that vaccines do not cause autism (or the vaguely worded "neurological disorders") at a rate higher than the previously mentioned "less than one in a million", then the vaccine parasites are "betting against the house" - their odds of "winning" are significantly less than "even money".

Again, my point is not to show that the vaccine parasites are making a good - or even rational - choice. My point is to outline their "reasoning" behind making a bad choice. They think that they're freeloading on everyone else's herd immunity, but the fact is that they are putting their children at a higher risk of death or disability.

Prometheus

Quoted by HCN
"if you had read some of my entries on Orac's and other blogs you would know that my kid required herd immunity for pertussis, but there wasn't any because our county was in the midst of a pertussis epidemic when he was a baby --- more likely due to "smart moms" just like you!)"

HCN, the DTaP does not prevent transmission of pertussis. There is no "herd" protection with this vaccine. Vaccinated people can and do spread pertussis.

You should also watch how you throw around the term "smart moms". Doesn't help your argument any, especially when you don't have your facts straight.

You can find several reputable sources cited here.
http://insidevaccines.com/wordpress/pertussis-vaccine-and-transmission/

VS lied with "HCN, the DTaP does not prevent transmission of pertussis. There is no "herd" protection with this vaccine. Vaccinated people can and do spread pertussis."

Actually, it is not as effective as other vaccines, and it wears off after a while (and the vaccinated who get pertussis get better sooner than those who do not). Which is why it is needed to be boosted more, and to maintain as high of herd immunity as possible. This is why my teenagers have all had a Tdap.

Your "reasoning" is a not so subtle and idiotic anti-vax argument of "If it is not perfect it is not worthwhile". There is no way that someone who says something that ridiculous would have a website worth visiting. The use of statistics in that site was discussed here:
http://badscience.net/forum/viewtopic.php?f=3&t=5764&p=100958&hilit=ins… ... "I consulted the Family Oracle. She says that there has been some remarkable quote-mining and distortion from the paper that would be hard to disentangle."

I enjoyed this description of you website here:
http://forums.randi.org/showthread.php?p=3630225#post3630225 ... ""Inside Vaccines" is just JABS in its best sunday clothes. Would you like to link to a Whale.to page next...?"

(As an explanation of that remark: JABS is a UK anti-vax forum, that is so secure in its stance that it bans anyone who dares confront the lunacy... one of the banned has created a blog called JABSloonies.blogspot dot com, where one of the regular commentators is a JABS regular who is quite entertaining to read, and it is not for his wit!)

Instead you are better off going here to the Pertussis chapter of the CDC Pink Book and/or the NHS Green Book.

HCN, the DTaP does not prevent transmission of pertussis. There is no "herd" protection with this vaccine. Vaccinated people can and do spread pertussis.

This does not make much sense. The primary route of transmission of pertussis is respiratory, and a major symptom is violent coughing, which spreads the bacteria widely. So even if vaccination only reduces the severity of the symptoms without preventing infection entirely, it will reduce the risk of transmission.

trrll said "This does not make much sense."

I saw that argument once before, "if the vaccine does not work perfectly than it does not work at all"... it really does not make sense. Especially since it is so easy to find many of the studies of the effectiveness of the DTaP vaccine on PubMed... even from the country that developed it, Japan.

Including this very interesting history of their pertussis vaccine experience:
http://www.ncbi.nlm.nih.gov/pubmed/15889991? ... this is the abstract (I'm sure the full paper is very interesting)...
"An antivaccine movement developed in Japan as a consequence of increasing numbers of adverse reactions to whole-cell pertussis vaccines in the mid-1970s. After two infants died within 24 h of the vaccination from 1974 to 1975, the Japanese government temporarily suspended vaccinations. Subsequently, the public and the government witnessed the re-emergence of whooping cough, with 41 deaths in 1979. This series of unfortunate events revealed to the public that the vaccine had, in fact, been beneficial. Furthermore, researchers and the Japanese government proceeded to develop safer pertussis vaccines. Japan now has the most experience worldwide with acellular pertussis vaccines, being the first country to have approved their use. This review describes the major events associated with the Japanese vaccination program. The Japanese experience should be valuable to other countries that are considering the development and use of such vaccines."

and http://www.ncbi.nlm.nih.gov/pubmed/15660862 ... "RESULTS: High acceptance rates of acellular pertussis vaccine combined with diphtheria and tetanus toxoids (DTaP) has been maintained and a dramatic decrease in pertussis was noted over the past 23 years. Neurological illnesses temporally associated both with whole cell and with acellular pertussis vaccination has been a rare phenomenon. However, incidences of encephalopathy/encephalitis and status epileptics/frequent convulsions, febrile seizures/provocation of convulsions, and sudden deaths were significantly lower with acellular pertussis vaccination than with whole cell pertussis vaccination. CONCLUSION: With the use of acellular pertussis vaccine which has been accepted by the public, pertussis has been well controlled in Japan."

There should be no reason to even glance at the "Inside Vaccine" website.

HCN, I didn't lie. DTaP does not prevent transmission of pertussis. I cited the CDC, AAP, WHO, etc. Instead of bashing a website why not refute the CDC, AAP, WHO, etc. with your own sources? And I never said it did not reduce disease severity, just that it does not prevent transmission. I made no such "idiotic anti-vax argument".

trrll, you can actually argue the exact opposite. An unvaccinated individual is more likely to have the "whoop" and know they are contagious, stay home and not infect others. A vaccinated individual is likely to think they just have another cough and continue to go about their daily lives infecting others.

I assume that "VS" is the anonymous author of the website (s)he cited. All the better.

Some of the quotes from the articles cited in that 'blog post seemed rather "cherry-picked" to conform to VS's message that the pertussis vaccine is not effective. However, when I read the articles in their entirety, I found that the studies' results told a slightly different tale. Perhaps I can summarize:

[1] Pertussis vaccine - like many vaccines against bacterial infectious diseases - has a problem with relatively high failure rates and relatively short-lived (5 - 10 years) immunity. This is also seen in vaccines against typhoid fever and the plague.

[2] Acellular pertussis has been more effective than the preceding whole-cell vaccine (contrary to what VS claimed). The reasons for this are not yet clear, but the Canadian experience showed a clear improvement in efficacy.

[3] The pertussis vaccine is not effective at clearing pre-existing nasal carriage of pertussis, which is why antibiotics are needed to treat household contacts.

[4] The immunity from pertussis vaccine declines after 5 - 10 years. Adult "booster" vaccinations are needed, but it has been hard to get that through to the community.

[5] Pertussis in partially-immune people can be difficult to diagnose, since the symptoms are not as severe.

[6] People who have been vaccinated against pertussis are less likely to have nasal carriage of B. pertussis after exposure than are people who have not been immunized.

[7] Given the higher rate of vaccine failure with pertussis vaccine, the dramatic reductions in pertussis seen after vaccine introduction - and the Japanese experience when they delayed vaccination 'til 2 years old - point to a significant "herd immunity".

VS can try to "spin" this into a story of how "the pertussis vaccine doesn't work", but the facts remain that getting a pertussis vaccine is better and safer than not getting one. Additionally, any measure that significantly reduces the number of people who have a communicable disease (like pertussis) will also significantly reduce the risk of a non-immune person contacting - and possibly contracting - that disease.

Prometheus

VS, you are pretty comical. If you did use those sources, you looked at them through a preconceived conclusion filter... lots of cherry picking.

Forget it... post the journal papers that support your statement HERE, do not lead us to the website that was described as "JABS in its best sunday clothes". Tell us what research goes counter to the papers from Japan that I posted.

This is an analysis of how "Inside Vaccines" deals with a paper:
http://forums.randi.org/showthread.php?t=107054 ..."The selective removal of vital information (highlighted by me in red) by the "Inside Vaccines" team distorts the entire findings of the paper, and is designed to fool readers into thinking the opposite of what the article actually concludes."

"Minority View" is the one defending Inside Vaccines, and may be our "VS". When called out about the way she was misrepresenting the papers, PLUS when she was pretending to have only "found the website recently" by DeeTee...she took her toys and ran home in a huff. This is what DeeTee wrote:

"Hang on.... are you just pretending you have only just discovered the "Inside vaccines" web site as a result of this JREF thread?

I assume you are the same "Minority View" that has been promoting this website on JABS since the 1st February. You also posess intimate knowledge of which specific articles are due for posting on the site, so I conclude the site is actually yours. To suggest, 35 days later, that you have only just gone and "checked it out" is an example of the dishonesty that pervades the site.

On the web site you are scare-mongering about life-saving vaccines in a totally dishonest way, by cherry picking and misquoting to support your antivaccine agenda. I have nothing but disdain for people like you."

By the way, it is not an ad hominem to point out the dishonesty of a website being flogged.

Stop trying to change my statements to suit your arguments. I'm not trying to counter the Japan papers. What I said is not related to those at all.

The DTaP does not prevent transmission. It only reduces disease severity. It mediates the toxin, not the bacteria. The bacteria is still transmitted person to person, vaccinated or not.

The vaccine is effective at reducing disease severity. A vaccinated individual might just have a normal cough. If you had a normal cough, would you go to the doctor to be diagnosed for pertussis? Probably not. So the pertussis *reported incidence* goes down but that does not mean pertussis transmission is decreased. Babies are still at risk. Even the vaccine manufacturers admit that in their tiny print. That's all I'm saying.

You can keep saying I think the vaccine doesn't work or whatever. I never said that. Have fun with your "framing". I'm sure you'll be highly successful with it.

VS said "blah blah blah"...

And not a thing with real evidence. And the effectiveness of DTaP is exactly what the Japan papers are about. Why are you ignoring them?

By the way a "pertussis cough" is not a normal cough... and while it is more difficult to diagnose pertussis in a vaccinated person, it does not mean that the DTaP is useless. Did you miss the graphs on both the CDC Pink Book and NHS Green Book chapters of pertussis?

I asked for journal papers, cough them up or go away (pun intended).

trrll, you can actually argue the exact opposite. An unvaccinated individual is more likely to have the "whoop" and know they are contagious, stay home and not infect others. A vaccinated individual is likely to think they just have another cough and continue to go about their daily lives infecting others.

Pertussis commonly infects children--which means that they are unlikely to live alone. So staying home does not prevent contagion. Common sense tells you that less coughing is going to mean less contagion. Indeed, there is a substantial medical literature (which the web site you cited somehow did not see fit to mention) describing herd immunity from pertussis vaccination. Just go to Pubmed and type "pertussis herd immunity" into the search box.

VS and others,

Do you think that a toxoid vaccine such as the pertussis vaccine can induce "herd immunity".

How would it?

I can understand that a toxoid vaccine would induce immunity (antibody response and memory)to a bacterial toxin and thus ameliorate symptoms due to future exposure and infection of the bacteria. but would that toxin immunity equate to some sort of overarching bacterial immunity? I don't know.

It seems that a strong immunity to the various pertussis toxins would inhibit its proliferation in the host and limit severe symptoms. Which could decrease length of infection and quantity of contagion, thereby decreasing the possibility of passing it on and benefiting the community.

On the other hand, as VS pointed out, this could be detrimental as far as increased dissemenation goes, because of undetected infection due to less severe "whooping cough" symptoms.

I did type in "pertussis herd immunity" and nothing really came up in a pubmed search.

What's the rationale behind a toxoid vaccine inducing herd immunity?

When I was a child I had the pertussis vaccine, apparently I was in the 20% that it didn't work for, cuz I got it. It wasn't the end of the world, but it wasn't fun.

I did type in "pertussis herd immunity" and nothing really came up in a pubmed search.

52 result is "nothing really"?

You need to check pages 2 and 3, there are several studies that discuss the clear herd immunity. Read beyond the titles.

Ms. Clark at #13 wrote that parents may unreasonably expect a "cure" for autism.

Perhaps that's true, though I think what's most scary about any mental illness is the overly pessimistic feeling that there's nothing that can be done.

In the specific case of my wife's brother and sister-in-law, it wasn't that they wanted a cure for autism. It was that their son wasn't speaking or even trying to, had repetitive behaviors (e.g., apparent fascination with endlessly twirling a lock of his hair) and zero social interest, but the first two pediatricians they saw were repeatedly dismissive of their concerns that anything at all might be wrong, and thus had no suggestions for any steps the parents should take to look into matters further. (Yes, I'm certainly aware that many parents have concerns about "something wrong" with their children that turn out, thank goodness, to be unfounded.)

I did type in "pertussis herd immunity" and nothing really came up in a pubmed search.

Really? so you didn't find

this one?

Or this one?

Or this one?

Or this one?

Selective blindness?

"You need to check pages 2 and 3, there are several studies that discuss the clear herd immunity. Read beyond the titles."

I will read some more tonight after work. (sorry it was late, I figured something of note would have popped up on the first page of results)

Anyway, I am still wondering how a toxoid vaccine could potentially induce herd immunity (although the dtap vaccine does contain filametous hemagglutinin, fimbriae aggluttinin and pertactin as well as pertussis toxin. Maybe it has to do with one of these other components. If you have any way of briefly summarizing how this would happen (toxoid induced herd immunity) that would be great. (if not I will try to figure this out later)

gotta go to work

"You need to check pages 2 and 3, there are several studies that discuss the clear herd immunity. Read beyond the titles."

I will read some more tonight after work. (sorry it was late, I figured something of note would have popped up on the first page of results)

Anyway, I am still wondering how a toxoid vaccine could potentially induce herd immunity (although the dtap vaccine does contain filametous hemagglutinin, fimbriae aggluttinin and pertactin as well as pertussis toxin. Maybe it has to do with one of these other components. If you have any way of briefly summarizing how this would happen (toxoid induced herd immunity) that would be great. (if not I will try to figure this out later)

gotta go to work

Skeptique said: [On the other hand, as VS pointed out, this could be detrimental as far as increased dissemenation goes, because of undetected infection due to less severe "whooping cough" symptoms.]

I find it to be a bit of a double standard for subclinical cases to be "ok" while the other (regardless of why) is not. Congation is present for both, and there is no way to know what will be enough to infect a person that comes into contact with either carrier. (if *that* person is immune compromised... being unvaccinated is a crime and being asymptomatic is ok?)

The fact remains that those that present true pertussis symptoms (unvaccinated) are more likely to be kept from mingling about the herd (because of marked illness) whereas their counterpart will not.

AA

Typo:

Congation should be Contagion

Apologies,
AA

That may be true, anonymous antivaccinationist, but I don't know; I don't know how these vaccines work specifically. However, that's all speculative, and fortunately, we don't need to rely on speculation. The Japanese studies make it very clear that regardless of whether vaccinated people can be pertussis carriers, pertussis rates drop dramatically when vaccination rates are high.

Now, this may be merely a case of few people being vulnerable rather than true herd immunity, but I'm not clear on why that would be a problem. Just look at tetanus. That's certainly an example of something where herd immunity is utterly useless, but it's still a recommended routine vaccine right into adulthood. (Which reminds me, I'm coming due for my next booster. I'll have to get it when I go in for my next flu shot.)

Calli Arcale said: [However, that's all speculative, and fortunately, we don't need to rely on speculation. The Japanese studies make it very clear that regardless of whether vaccinated people can be pertussis carriers, pertussis rates drop dramatically when vaccination rates are high.]

But you *are* relying on speculation. You are applying the same temporal association as those claiming vaccine "damage/injury". I have not read the Japan papers in full, so I am reluctant to comment and I'm not completely done with AFP, so I hope my posts aren't out line. That said, I'm very skeptical of abstracts or summaries that set out to identify "anti-vaccine" movements, then backfill.

Rates of infectious disease are *also* speculative in absence of laboratory diagnosis. And whilst vaccination programmes may indeed reduce clinical symptoms of disease, thereby reducing overall disease incidence reporting, it's widely misleading.

I believe herd immunity to be strengthened by dealing with, and overcoming contact with "disease" (with some exceptions, tetanus being one of them). Can all people handle being exposed to disease? Likely not. Can all people handle being exposed to vaccines? I'm not sure of that answer either.

AA

Once again there is the hang up on the very small percent of people who experience legitimate adverse reactions to vaccination. If polio taught us anything, its that many can handle the vaccine, few the disease.

I believe herd immunity to be strengthened by dealing with, and overcoming contact with "disease" (with some exceptions, tetanus being one of them). Can all people handle being exposed to disease? Likely not. Can all people handle being exposed to vaccines? I'm not sure of that answer either.

Yeah, like that worked sooooo well in the past before vaccination. There's a word for what you propose: It's called an epidemic.

Orac said: [Yeah, like that worked sooooo well in the past before vaccination. There's a word for what you propose: It's called an epidemic.]

I proposed nothing. I simply made an observation regarding herd immunity (vaccine induced or otherwise). Are you really implying that every person that comes into contact with {insert germ here} will become sickened because of it? I'm not sure this kind of sensaltionism over disease is helpful. I'm also not sure that comparing the last couple hundred years of domestication to current affairs is accurate either.

AA

Huge straw man. No one ever said that every person who comes in contact with a disease needs to get it for an epidemic to occur. In fact, it doesn't even necessarily require that most people who come in contact become sick in order for an epidemic to start, just a certain critical threshold percentage, which can vary depending on the organism and the population contact pattern, both of which can be modeled.

In the absence of a population rendered highly immune to vaccines, attempts to fight disease with herd immunity have a high probability of turning into epidemics.

Orac said: [Huge straw man. No one ever said that every person who comes in contact with a disease needs to get it for an epidemic to occur.]

Your previous entry stated that I proposed 'something' which would result in an epidemic - when I simply stated that overcoming infection results in a stronger herd. I didn't mean to set up a straw man if that how it is being perceived, apologies.

Orac said: [it doesn't even necessarily require that most people who come in contact become sick in order for an epidemic to start, just a certain critical threshold percentage, which can vary depending on the organism and the population contact pattern, both of which can be modeled.]

Whilst I agree somewhat, any model based upon such would still carry a percentage of systematic error - and *assume* identical (or thereabout depending on adjustments made) host reaction to the threat. I find the definition a bit loose.

I'm not convinced that civilization today is as susceptible to epidemics of any particular disease as previous generations and don't think it is accurate to extrapolate disease incidence of the past to 21st century humans.

I also contend that lacking proper symptom expression to above said disease, is *equally* dangerous to the herd and to those that are compromised. Focus is left upon the unvaccinated, as if they are the only member capable of spreading disease.

AA

Focus is left upon the unvaccinated, as if they are the only member capable of spreading disease.

The focus is actually on the willfully unvaccinated, those who could be immunized but have chosen not to for spurious reasons. And I would argue that the focus is on them for a very good reason - they are the only group of potential carriers who could mitigate the risks somewhat (by getting vaccinated) and have chosen not to.

Getting all irritated at immuno compromised people or young infants or those in whom the vaccine doesn't take is pointless, because there is no feasible way to reduce the risk of members of those populations spreading disease.

Natalie said: [The focus is actually on the willfully unvaccinated, those who could be immunized but have chosen not to for spurious reasons. And I would argue that the focus is on them for a very good reason - they are the only group of potential carriers who could mitigate the risks somewhat (by getting vaccinated) and have chosen not to.]

Please elaborate on your use of the word spurious. You are assuming that a person that chooses not to vaccinate *could* mitigate the risk. Of the potential carriers we are addressing, the risks by those *not* presenting appropriate symptoms to disease are greater - because there are more of them, and they are unaware of their carrier state.

Natalie said: [Getting all irritated at immuno compromised people or young infants or those in whom the vaccine doesn't take is pointless, because there is no feasible way to reduce the risk of members of those populations spreading disease.]

I'm not irritated. Are you talking about me? It's extremely common for vaccine proponents to bring attention to the risk posed to compromised individuals, yet they seemingly overlook the fact that nonvaccinators are not the only risk. Logically, those that are asymptomatic (yet still contagious) pose a *larger* risk - as they carry on undetected. That is my singular point and if we are talking about framing, this is entirely relevant.

AA

How are we less susceptible to disease epidemics today? Civilization today is likely more susceptible to disease epidemics due to greater population sizes across the globe, as well as the ability to move relatively easily between these populations, be they cities or countries or neighborhoods. There were less epidemics in primitive eras because communities were much smaller than today, and virulent diseases burned themselves out quickly before they could spread far. In addition, if one coughs less from an airborne disease because they have been vaccinated, then they are less likely to spread the disease. By suppressing the symptoms that serve as vehicles to pathogens to some extent, transmission is lessened.

But you *are* relying on speculation. You are applying the same temporal association as those claiming vaccine "damage/injury".

No, what I was calling "speculative" was your premise that if the pertussis vaccine doesn't provide actual immunity, pertussis-vaccinated individuals could be pertussis-carriers, and that if that's true, then pertussis vaccine cannot produce herd immunity.

My point was that we have actual hard data showing that regardless of that, pertussis vaccine has a dramatic influence on pertussis rates -- in other words, it did result in a much lower rate of disease, and it seems reasonable therefore to conclude that it is worthwhile from a public health standpoint.

I believe herd immunity to be strengthened by dealing with, and overcoming contact with "disease" (with some exceptions, tetanus being one of them).

"Herd immunity" does not occur through routine exposure to the disease itself. If it did, we wouldn't need vaccines, and diseases such as measles would've gone extinct centuries ago. The reason it doesnt' occur is simple -- in a massive epidemic, lots of people are exposed but not everyone, and even many of those exposed do not contract the disease. It's very hit-or-miss. Those who contract the disease and survive may be immune, but their neighbor won't be.

Vaccination allows an entire population (with a few exceptions who, for whatever reason, cannot get the vaccine) to be exposed to a pathogen in controlled circumstances -- in other words, to train their immune systems to it without actually giving them the disease. This allows far greater immunity to be built up within the population. This is what allows for triumphs such as the eradication of smallpox. Immunize everyone, and you deny the pathogen a reservoir in which to survive.

We're not going to wipe out polio completely until there is worldwide vaccination against it. But we've pretty much extirpated it from most first-world nations. Measles could go the same way. Bacteria are trickier, since in most cases they don't actually depend on us to survive. (They just happen into a human's personal ecology by chance, and cause havoc once they get there.)

Can all people handle being exposed to disease? Likely not. Can all people handle being exposed to vaccines? I'm not sure of that answer either.

Well, you don't have to just content yourself with uncertainty. There is a lot of data out there about the safety of vaccines. In fact, if your doctor is any good at all, he/she should have a handy-dandy sheet available listing the risks associated with each vaccine, and should be willing to discuss them openly with you. If your doctor is a dink and won't talk about it, get a different doctor -- being unwilling to discuss side effects is a red flag, in my opinion, and any doctor worth his/her salt should have no problem discussing this with you.

"Herd immunity" does not occur through routine exposure to the disease itself. If it did, we wouldn't need vaccines, and diseases such as measles would've gone extinct centuries ago. The reason it doesnt' occur is simple -- in a massive epidemic, lots of people are exposed but not everyone, and even many of those exposed do not contract the disease. It's very hit-or-miss. Those who contract the disease and survive may be immune, but their neighbor won't be.

It depends on the disease. A pattern of epidemics (as contrasted to a disease that just remains endemic at a more or less constant level) tends to reflect the occurrence of herd immunity. After an epidemic sweeps through, the density of susceptible individuals may fall below the critical value needed to propagate the infection (i.e. infected people are likely to die or recover before transmitting the infection). But as new people are born, and as immunity wanes somewhat over time, the density of susceptible individuals rises above the critical value, at which point reintroduction of the disease into the population will initiate another epidemic. Epidemic diseases like measles do not go extinct because epidemics do not happen everywhere simultaneously.

I was going to say something like what trrll said (wrote). One way the herd gets a higher level of immunity after an epidemic rolls through is that the ones with more susceptibility are dead after it rolls through.

Smallpox, over time becomes a childhood disease like measles, which will roll through a community every few years taking a few and leaving the surviving children who get the disease immune. Because the Conquistadors were from communities with a history of lots and lots of repeated bouts with smallpox, and who the Conquistadors represented were a bunch of survivors and children and grandchildre and great-grandchildren of survivors.

So how was it they introduced smallpox to South America? Did they land on the shore all germ-free and ask someone to courier over a batch of smallpox germs so they could do some biological warefar? No.

How did a ship full of men survive the journey across the ocean if one of them got on the ship in Spain (or Portugal) with a case of smallpox? Wouldn't all of the men have died before they got to S. America?

They could carry it because they were immune to it, but they still had some live virus somewhere among the batch of men so they could spread it.

The S. American's didn't have any immunity, basically, to smallpox so it totally decimated them, and may have led to their accepting the Conquistador's version of Christianity if you buy the idea in "Plagues and Peoples", but I digress.

In a community where no one has ever come across measles for generations, then that community would be decimated by measles in the same way smallpox decimated the S. Americans.

Pertussis tends to crop up in areas where there are antivaccinationist groups, more than in areas where everyone is vaccinated.

And there's no connection between any vaccine and autism, anyway, so there's no point in demonizing vaccines as if they were all scary and a cause of autism.

Correction: There is a negative correlation between vaccines and autism (or is it between autism and vaccines?). Vaccines can prevent autism and they can prevent brain damage, encephalopathies, that causes autistic-like behaviors.

Correction: There is a negative correlation between vaccines and autism (or is it between autism and vaccines?). Vaccines can prevent autism and they can prevent brain damage, encephalopathies, that causes autistic-like behaviors.

Yes, the antivaxxers don't like to talk about the Generation Rescue phone survey that found that unvaccinated siblings of autistic kids were more likely to have autism spectrum disorders than kids in the general population. This doesn't make sense if autism is caused by vaccination, but it is of course what you expect if autism is genetic, and the correlation of development of clear symptoms with time of vaccination is coincidental.

But what was particularly interesting is that while unvaccinated male siblings were only about 4 times more likely to have ASD than the general population. Unvaccinated girl siblings were fifteen times more likely to have ASD--and three times more likely than vaccinated girl siblings. So it really looks like vaccination may be substantially protective for girls.

How can this be? Oddly enough, the Hannah Poling case, a cause celebre for antivaxxers, suggests a possible explanation. Hannah Poling developed a fever followed by encephalopathy accompanied with autistic-like symptoms after vaccination, and was discovered to have a genetic mitochondrial defect. The Vaccine Court concluded that it was possible that her mitochondrial defect could have predisposed her to develop encephalopathy after a fever. While it is plausible that the vaccination could have induced a fever that triggered her condition, there is a strong possibility that her condition would have eventually have been triggered by an infection--and almost certainly if she had contacted any of the severe illnesses that vaccination protects against.

Girls are less likely to develop ASD than boys, but there are some genetic conditions that cause ASD symptoms that are more common in girls--Rett syndrome, for example. So it may well be that ASD in girls tends to have a different cause than autism in boys. If girls are more likely to have conditions in which any infection or fever can result in encephalopathy, then vaccination might pose some risk, but the risk of not being vaccinated would be even greater, resulting in a net protective effect of vaccination.

I'm not convinced that civilization today is as susceptible to epidemics of any particular disease as previous generations and don't think it is accurate to extrapolate disease incidence of the past to 21st century humans.

Wow. Beyond the effect of measures such as public sanitation on disease vectors, what biological explanation would you propose for this lack of susceptibility, and where is the scientifically valid evidence for that explanation?

Oh, and you might want to let these folks know we don't need 'em anymore:

http://www.nothingbutnets.net/

http://www.who.int/csr/don/archive/year/en/index.html

Jud said: [Wow. Beyond the effect of measures such as public sanitation on disease vectors, what biological explanation would you propose for this lack of susceptibility, and where is the scientifically valid evidence for that explanation? ]

Would you agree that we've become fairly antiseptic, and that infrastructure has advanced to accommodate growth? Previous civilizations were undergoing several changes at once, notably diet (Agriculture has only been around about 11,000 years... an eyeblink). I'm not sure what evidence you'd like to see? I'm simply referring to human history, more specifically, the birth of the Industrial Revolution and agricultural plundering which severely affected the domestication of human beings.

Calli Arcale said: [Those who contract the disease and survive may be immune, but their neighbor won't be.]

I certainly understand this point of view.

["Herd immunity" does not occur through routine exposure to the disease itself. If it did, we wouldn't need vaccines, and diseases such as measles would've gone extinct centuries ago]

Whilst I understand what you are trying to convey, routine exposure does assist in training immune response. I'm concerned with the artificial manipulation of disease cycle and disrupting ecology. In the early 20th century, herd immunity was the result of the natural fight against disease.

[There is a lot of data out there about the safety of vaccines. In fact, if your doctor is any good at all, he/she should have a handy-dandy sheet available listing the risks associated with each vaccine, and should be willing to discuss them openly with you.]

Well, I've been vaccinated so it's rather moot for me. I've even got that lovely scar on my arm from the 60s campaign against the bloody pox. This doesn't mean I'm not a reservoir for some derivative of small pox, I'd venture to guess I am. The safety data that I've reviewed are more or less anecdotal reports of side effects. The animal models I've reviewed are limited, and do not do a fair job addressing systemic damage.

I do agree that doctors should be open in addressing concern. I've seen a general growing irritation at the task, and it doesn't serve physicians or public health at all to behave in this manner.

Ms. Clark,

I've not made any assertion that vaccines are responsible for Autism, the evidence does not support this hypothesis. It doesn't make it false, but at present the evidence does not support it. There are several issues outside of Autism that one must consider.

1. Contamination from bovine sources, avain and chicken sources, mycoplasma etc...

2. Nervous system deterioration or assault

3. Genetic predisposition to various neurological conditions or immune system dysfunction

4. Host protein interaction

5. Anaphylaxis

The literature is simply lacking on the above IMHO. Whilst my chosen name calls me an antivaccinationist, I'm simply trying to be honest in my position. I am more against, than for - this is not to say that adequate evidence would not be able to influence me. Epidemiological evidence does little for me unfortunately, but this is not to say that this kind of evidence is useless, it just is to me.

I've tried joining the discussion at Respectful Insolence, because I think open dialogue with dissent is crucial for both sides of this issue. It's not an easy task, I appreciate the comments that have been made to me in a courteous fashion.

AA

Ms. Clark said "Pertussis tends to crop up in areas where there are antivaccinationist groups, more than in areas where everyone is vaccinated."

This is the paper backing up that statement:
http://jama.ama-assn.org/cgi/content/full/296/14/1757 ..."Conclusions Permitting personal belief exemptions and easily granting exemptions are associated with higher and increasing nonmedical US exemption rates. State policies granting personal belief exemptions and states that easily grant exemptions are associated with increased pertussis incidence. States should examine their exemption policies to ensure control of pertussis and other vaccine-preventable diseases."

anon-antivax said "The literature is simply lacking on the above IMHO. ...I am more against, than for - this is not to say that adequate evidence would not be able to influence me. Epidemiological evidence does little for me unfortunately, but this is not to say that this kind of evidence is useless, it just is to me..."

It would help if you provided some evidence (and there are plenty of papers that evaluate the list you posted, especially the anaphylaxis bit), and perhaps if you actually READ the book under discussion. That way you would understand the importance of the epidemiological studies.

I do find it disturbing that you want to rely on "natural herd immunity" that comes from actually having the disease. As the above article shows, lessened vaccine coverage means increased pertussis rates. While most do actually survive the disease after suffering for several months (it is called the "100 day cough" for a reason), it is deadly to infants and babies under age one. They are the ones who suffer the most when vaccine levels go down (see Japan articles I posted, plus the data I posted from the CDC Pink Book pertussis slide set).

I believe that anyone who says vaccination for pertussis is unnecessary either does not know the real risks, or feels that babies who suffer and die from pertussis did not deserve to live. The latter seems to be a special kind of eugenics, and that is not a good thing.

Whilst I understand what you are trying to convey, routine exposure does assist in training immune response. I'm concerned with the artificial manipulation of disease cycle and disrupting ecology. In the early 20th century, herd immunity was the result of the natural fight against disease.

It is certainly true that we as humans are disrupting ecology by dying less from disease and living longer lives. Nevertheless, as a human being, it is difficult for me to see this as a bad thing.

It sounds as if you are slipping into the fallacy of "Appeal to Nature" Biologists and physicians are less prone to fall into this fallacy, because we have it repeatedly impressed upon us that nature is not our friend. In the natural war against disease, the microorganisms have a big advantage over us--they have short generation times, and evolve much faster than we do--in a biochemical sense, they are the most highly evolved creatures on the planet. Our own "natural" advantage is the use of "artificial" technologies such as vaccination to shift the balance of power more to favor human health and to reduce human suffering.

Please elaborate on your use of the word spurious.

AA, I am referring to those who do not vaccinate because they believe that vaccines cause autism. As there is no good evidence to suggest that they do, and plenty of good evidence to suggest that they do not, I consider this objection spurious.

Of the potential carriers we are addressing, the risks by those *not* presenting appropriate symptoms to disease are greater - because there are more of them, and they are unaware of their carrier state.

Yes, but as far as I am aware there is nothing that can be done about that. That is, we have no mechanism to make asymptomatic people suddenly become symptomatic. Personally, I generally find it more effective to focus first on problems that actually have solutions.

I'm not irritated. Are you talking about me?

No, I was not. I was referring to those of us who are concerned about the rise in infectious diseases, as a result of lower vaccination uptake rates. Sorry that wasn't terribly clear.

HCN said: [Ms. Clark said "Pertussis tends to crop up in areas where there are antivaccinationist groups, more than in areas where everyone is vaccinated."...This is the paper backing up that statement:]

This article begins with the discussion of exemptions. I'm sorry if you are unable to see the possibility that it is political in nature.

[It would help if you provided some evidence (and there are plenty of papers that evaluate the list you posted, especially the anaphylaxis bit), and perhaps if you actually READ the book under discussion. That way you would understand the importance of the epidemiological studies.]

PMID: 1665699, 1665460, 11402667, 8162609, 11264350, 9784140, 10364336, 11266296, 8925516, 11774744, 9467032, 11425741, 9126441, 10508494, 10667765, there are more - you get the idea. These issues have already been raised, and you are attempting to shift the burden of proof onto me. It's not on me.

I AM reading this book. You're attempt to attack me, and exclude me because I do not agree with you is puzzling. It is NOT my fault if the author has failed to convince me of the superiority of epidemiological data. It is NOT my fault that statistical abuse has shaped a view that differs from yours.

[I do find it disturbing that you want to rely on "natural herd immunity" that comes from actually having the disease.]

I suppose that's your right. I'm not pretending to rely on others to protect me, that's not a reasonable expectation. Being exposed to communicable disease is the risk I take by living in a society full of human organisms with immune responses of varying degrees. I've not really made any proposals that relate to herd immunity, simply made the observation that it is strengthened by dealing with disease. You are drawing a conclusion to my statement based on your vehement disapproval of my opinion.

[(it is called the "100 day cough" for a reason), it is deadly to infants and babies under age one. They are the ones who suffer the most when vaccine levels go down (see Japan articles I posted, plus the data I posted from the CDC Pink Book pertussis slide set). ]

I'm not entirely sure that proves your point, but I understand your passion regarding pertussis given your personal history with the disease. There are often concomitant issues that involve pertussis mortality.

[I believe that anyone who says vaccination for pertussis is unnecessary either does not know the real risks, or feels that babies who suffer and die from pertussis did not deserve to live. The latter seems to be a special kind of eugenics, and that is not a good thing. ]

Perhaps you can explain why you feel the need to sensationlise this issue. You have set up a fallacious position then surgically placed me in it, as you seem to do with everyone that disagrees with you. You make your claim, then ask me disprove it. I don't believe this to help bridge the gap between dissenting opinion, nor do I find it productive to condescend to those that disagree with me.

AA

trrll said: [Biologists and physicians are less prone to fall into this fallacy, because we have it repeatedly impressed upon us that nature is not our friend.]

If we are speaking of the human species in general, we can agree that acts and laws of nature have certainly shaped humans for millions of years. Advances over the last few hundred years are in their infancy if we are to keep things in perspective. I understand your statement though, and appreciate you framing it in a way that actually explains why there is a difference of opinion.

[Our own "natural" advantage is the use of "artificial" technologies such as vaccination to shift the balance of power more to favor human health and to reduce human suffering.]

This assumes there are no ecological consequences by the use of those technologies. Using vaccination to shift the disease burden to different members of society has actually placed them at more risk, IMHO. I believe all compassionate human beings want to reduce human suffering, but the implementation of a programme which by its very use that has the ability to create a completely different kind of suffering doesn't seem very balanced. I'm simply not convinced that there isn't more systemic damage going on than that which meets the eye and I'm trying to keep longevity in perspective... objectively. I hope you can agree that there are many in both camps that are unable to do so.

Natalie said: [I am referring to those who do not vaccinate because they believe that vaccines cause autism. As there is no good evidence to suggest that they do, and plenty of good evidence to suggest that they do not, I consider this objection spurious.]

Thank you for clarifying. Are there any vaccine refusals that you consider acceptable? {standard disclaimer of immune compromised etc...}

[Personally, I generally find it more effective to focus first on problems that actually have solutions.]

If that focus on a set of problems refuses to address any problems it *creates*, how is it a solution? Refusing to acknowledge those problems only creates more dissent. Truth be told, *that* is why Jenny McCarthy has been successful with her message.

I am coming up against a deadline, I'll not be back for at least a day. I just want to offer disclosure should there be a delay in responding to anyone that addresses my posts.

AA

AA said "You make your claim, then ask me disprove it. I don't believe this to help bridge the gap between dissenting opinion, nor do I find it productive to condescend to those that disagree with me."

I made the claim that reduction of pertussis vaccination increases the numbers of cases.

You made the claim that herd immunity can be acquired effectively through getting the actual disease.

Of course I sensationalize it... because getting the actual disease carries more risk of death and disability. You have not really answered how your "plan" avoids that... other than saying we don't get epidemics anymore (though my county having a pertussis epidemic in the early 1990s, at about the time measles returned at epidemic levels in the country don't seem to county since that was almost 20 years ago).

Though I did notice that you answered with a Gish Gallop (see http://www.theskepticsguide.org/sgublog/?p=295 ) by a list of the PubMed identification numbers. When I do not wish to post a study with a URL, as a courtesy I post the information from the page, like the Journal, date, and title. Here, I did it for you:

1665699, Biologicals. 1991 Oct;19(4):265-70. Links
Bovine polyomavirus, a frequent contaminant of calf serum.

1665460, Dev Biol Stand. 1991;75:173-5.Links
Viral contamination of fetal bovine serum used for tissue culture: risks and concerns..."Its significance remains uncertain."

11402667, Acta Vet Hung. 2000;48(4):501-13.Links
Bovine herpesvirus type 4: a special herpesvirus (review article).

8162609,Cancer Detect Prev. 1994;18(1):9-30.Links
Poultry oncogenic retroviruses and humans..."It is concluded, virological evidence indicates, that these viruses could conceivably have a carcinogenic potential for humans, but if so, at a level much less than in chickens. Whether this is insignificant, or translates to a real risk, is not known at the moment. "

11264350, J Virol. 2001 Apr;75(8):3605-12. Links
Characterization of endogenous avian leukosis viruses in chicken embryonic fibroblast substrates used in production of measles and mumps vaccines..." Selecting either line 0 chickens, which do not possess ALV-E sequences, or CEF from chicken flocks screened to eliminate infectious ev loci would provide vaccine substrates that do not express infectious ALV-E. Although such substrates will probably express RT-positive EAV, these are believed to be defective particles. Likewise, quail cells, which are not known to express infectious retroviruses, may provide an alternate avian substrate for vaccine manufacture" (full article available free online, it basically is determining which are better eggs to use to make vaccines)

9784140, J Clin Virol. 1998 Jul 24;11(1):19-28.
Analysis of a coded panel of licensed vaccines by polymerase chain reaction-based reverse transcriptase assays: a collaborative study [seecomments].."Only vaccines produced in chick embryo cells had significant RT activity. Because RT activity was present in the allantoic fluid of uninfected chick embryos and culture medium from chick embryo fibroblasts, the RT activity arises from the cell substrate used for vaccine production. The PBRT assays were reliably able to detect the low levels of RT activity in chicken-derived vaccines."

10364336,J Virol. 1999 Jul;73(7):5843-51. Links
Evidence of avian leukosis virus subgroup E and endogenous avian virus in measles and mumps vaccines derived from chicken cells: investigation of transmission to vaccine recipients..."The present data do not support transmission of either ALV or EAV to recipients of the U.S.-made vaccine and provide reassurance for current immunization policies."

11266296, Emerg Infect Dis. 2001 Jan-Feb;7(1):66-72. Links
Lack of evidence of endogenous avian leukosis virus and endogenous avian retrovirus transmission to measles, mumps, and rubella vaccine recipients.

8925516,Cancer Detect Prev. 1995;19(6):472-86.Links
Detection of antibodies to avian leukosis/sarcoma viruses and reticuloendotheliosis viruses in humans by western blot assay.

11774744, Hum Cell. 2001 Sep;14(3):244-7.Links
Prevention of mycoplasma contamination in leukemia-lymphoma cell lines.

9467032, Biologicals. 1997 Dec;25(4):365-71. Links
Detection of Mycoplasma in avian live virus vaccines by polymerase chain reaction.

11425741, Appl Environ Microbiol. 2001 Jul;67(7):3195-200. Links
Species-specific PCR for identification of common contaminant mollicutes in cell culture.

9126441, Emerg Infect Dis. 1997 Jan-Mar;3(1):21-32.Links
Mycoplasmas: sophisticated, reemerging, and burdened by their notoriety

10508494, Int J Cancer. 1999 Nov 12;83(4):555-63. Links
Widespread intraspecies cross-contamination of human tumor cell lines arising at source..."The misidentified cell lines reported here have already been unwittingly used in several hundreds of potentially misleading reports, including use as inappropriate tumor models and subclones masquerading as independent replicates. We believe these findings indicate a grave and chronic problem demanding radical measures, to include extra controls over cell line authentication, provenance and availability"

10667765, Nature. 2000 Jan 27;403(6768):356. Links
Comment on:
Nature. 1992 May 21;357(6375):261-2.
Cell contamination leads to inaccurate data: we must take action now...

Have you ever heard of the phrase "Making mountains out of moleholes"? From your quickly gathered mass of papers I can see that your fears are being investigated, and that vaccine safety is taken quite seriously in several countries.

Now really, tell me exactly how the DTaP vaccine is more risky than diphtheria, tetanus and pertussis.

HCN,

You make it difficult to have a civilised discussion.

I gave you PMID numbers, because the comment would have been held up due to spam if I provided links - true or false? Gish gallop? Thank you for the link, I guess? Is it really that difficult to type the ID into pubmed? No, it's not. I already gave you a list of considerations, to which the references supported - and based upon the list alone those ID's would have surfaced. You asked for evidence, it was provided. Are you asking for some sort of recognition because you cut and paste, and discriminating against me for not doing so? I suppose if we tried, we could address something more irrelevant?

I'll try to be as clear as I can. I don't have a plan. I never claimed to have one. No matter how many times you claim that I have one, it doesn't make it any more true than the first time you mistakenly said it.

Who's making mountains? The evidence of contamination is already there (I'd post more, but I'm afraid to be scolded again based on how I'd post it), and the burden of proof is NOT ON ME. It is not upon the masses to prove the safety of these biologics.

As to your last statement, I wish I had a euro for every time I've seen you post it (or something like it) in various different places in cyberspace. I'm not aware of any evidence on human populations that has effectively compared 21st century human susceptibility to these diseases versus receiving the vaccine. Actually, I'm not aware of any human vaccine study that offers anything more than seroconversion. Are you? That said, I've not seen anything more than anecdotal reports of side effects for said vaccine trials either (never mind what might be occuring within). Are you? That question is a bit of a red herring, and is specious at best.

You are reminding me why I don't post on Science Blogs. And of the anti-vaccine people that do post on Orac's blog or elsewhere, I consider myself to be fairly reasonable. You are simply demonstrating that some vaccine proponents are incapable of reasonable discussion.

Back to lurking.

Cheerio-AA

If we are speaking of the human species in general, we can agree that acts and laws of nature have certainly shaped humans for millions of years.

And the way virtually everybody, except for a few very primitive lost tribes, lives today is quite different from the conditions that shaped humans for millions of years. So that "shaping" is likely inappropriate for our modern circumstances. Even if "nature" and evolution had our best interests at heart (which they don't), and cared about things like individual suffering, we have been out of the nest for a long, long time, and we have no choice but to take care of ourselves.

This assumes there are no ecological consequences by the use of those technologies.

Of course there are ecological consequences! When we have more people, because people are no longer dying in huge numbers before age 40 because of infectious disease, the ecology is affected. When people are no longer starving because huge tracts of land are devoted to agriculture, the ecology is affected. We can no longer expect the ecology to autoregulate--we long ago assumed the responsibility for maintaining our own ecology, and there is no way of going back.

Using vaccination to shift the disease burden to different members of society has actually placed them at more risk, IMHO.

Protecting some people from infectious disease with sanitation, antibiotics, and vaccination does not magically cause other people to get sick. The evidence is quite clear that there is a net benefit in reduction of disease. It is not a zero sum game, nor is there any rational reason to imagine that it should be.

AA said "I gave you PMID numbers, because the comment would have been held up due to spam if I provided links - true or false?"

True, which is why I always include the Journal, Date and Title. This shows what kind of evidence is actually being used, and you see I actually did it for you.

AA said "As to your last statement, I wish I had a euro for every time I've seen you post it (or something like it) in various different places in cyberspace."

Then answer the question.

AA said "I'm not aware of any evidence on human populations that has effectively compared 21st century human susceptibility to these diseases versus receiving the vaccine."

Have you gotten to page 110 yet? That explains much of what you are skipping over. There have been several studies in several countries that have evaluate both the effectiveness and safety of several vaccines. When vaccines are shown to cause more risks than the disease, they are removed from the regular schedule (smallpox, OPV, typhus, typhoid, Rotashield, etc).

The cell lines, and micromanaging studies you went over do little to explain the true risks... You are looking at teeny tiny bits of evidence, and turning into larger talking points than they deserve. Hence the making mountains out of molehills. What do count are large scale observations in human populations.

As of yet, there has not been any real evidence that the vaccines cause the amount of harm attributed, and that when vaccine uptake is reduced, the diseases come back with more harm. When measles vaccination was made voluntary in Japan, measles returned --- and in numbers large enough for them to close college campuses. Also when Japan decided to delay pertussis vaccination to after two years, more babies died from pertussis, and SIDS could no longer be blamed on vaccines. When the UK press went on about the MMR (which has been used in the USA since 1971) with little data, vaccine take up was reduced and measles is now endemic in the UK, with at least two deaths. When clerics in Nigeria interrupted the polio vaccine program with rumors, polio returned to Nigeria and was exported to other countries.

You claim to want a reasonable discussion, yet you get mad at me for re-asking the questions you refuse to answer. You finally respond to a request for data by placing a bunch of studies that are tangential to the issues, and in the end really did not support your reasons for avoiding vaccines.

My point, Anonymous Antivaccinationist, is that this is not a blog designed to answer every possible question about vaccines that can be created in the mind of non-expert. I've seen antivaxers who can not find any intelligent discussion about vaccines on ANY website on the whole web, apparently, come to discussions that are supposed to be primarily about autism, or the juncture between autism and vaccines, to discuss every topic related to vaccines that occurs to them... apparently it's because only the vaccine-fans/ pro-vaccine people who associate around the autism topic who can intelligently discuss vaccines... No, wait, the same people can also be found on James Randi's Foundation websit (JREF). So I think that it's that the antivaxers want to keep autism associated with the idea that vaccines aren't perfect, and that gov'ts are bad and so probably lying to us about vaccines.

Seriously, why try to have a discussion on the relative benefits of pertussis vaccine here on this blog (or on another atuism blog) if pertussis vaccine has absolutely nothing, nothing, nothing to do with autism.

Why not take the discussion to a cooking blog? Surely you can find a cooking blog where the blogger says she just had her flu shot, then an antivaccine comment would be on topic.

I'm getting my flu shot tomorrow and so is my ASD kid.

AA, were you surprised that I actually looked at those abstracts?

Or are you more upset that I don't like that special kind of eugenics that postulates that only children who can naturally survive diseases should be allowed to live?

HCN said: [When vaccines are shown to cause more risks than the disease, they are removed from the regular schedule (smallpox, OPV, typhus, typhoid, Rotashield, etc).]

Shoot first, ask questions later. Human observation is not the same as a systemic breakdown of biochemical events.

[The cell lines, and micromanaging studies you went over do little to explain the true risks... You are looking at teeny tiny bits of evidence, and turning into larger talking points than they deserve. Hence the making mountains out of molehills. What do count are large scale observations in human populations. ]

That is positively absurd. Vaccines are only as good as the cell lines used in manufacture. To suggest that contamination is a teeny tiny bit of a puzzle that I needn't worry about is beyond foolish. Devil's in the details.

[As of yet, there has not been any real evidence that the vaccines cause the amount of harm attributed, and that when vaccine uptake is reduced, the diseases come back with more harm.]

Why would there be? We monitor side effects anecdotally, sometimes the vaccine recipient does so in a journal. This is not scientific, and it is the same anecdotal process that is used when people report vaccine injuries which is then cited as inaccurate. The lack of balance is highly problematic.

[You claim to want a reasonable discussion, yet you get mad at me for re-asking the questions you refuse to answer. You finally respond to a request for data by placing a bunch of studies that are tangential to the issues, and in the end really did not support your reasons for avoiding vaccines.]

Mad? Just pointing out the obvious, which is that you have a tendency to create an argument for your opponent, and hammer them to defend it. You are asking me to prove your assertion. I comprised a list, outside of Autism, that are real issues that relate to vaccine programmes to which you asked me to supply you with evidence. I did. NOW, you are telling me that what I supplied did not support my viewpoint but have failed to demonstrate why. They unequivocally do. Then you later say:

[AA, were you surprised that I actually looked at those abstracts? Or are you more upset that I don't like that special kind of eugenics that postulates that only children who can naturally survive diseases should be allowed to live?]

The whole point of posting the PMIDs was for you to look at them. You then continue to bloviate my position by adding your own nauseating spin. You're not looking for reasonable discussion, you're looking to deconstruct your opponent with tired "skeptical" talking points.

trrll said: [Of course there are ecological consequences! When we have more people, because people are no longer dying in huge numbers before age 40 because of infectious disease, the ecology is affected.]

I'm sorry, but a domesticating civilization that is introducing new foods to their species, and reproducing at massive rates (yes because their offspring weren't as strong as their ancestors, but also because they were settling down and producing grains at such an enormous rate they could afford to feed them... feed them appropriately? No) that lacks the infrastructure to maintain that growth, the antiseptic care that would be required to care for them due to the susceptibility created because of it - yes, you have people dying.

I'm a little unclear on the time frame you are describing, but based on history, humans have removed themselves from the process of natural selection for the last 10,000 years or so. Not always bad, and yes by our own doing. You don't go back, you adapt. Being arrogant enough to believe that what we've learned in the last 300 years about human physiology in *any* way pales in comparison to our existence on this planet, is not something you can force upon everyone.

[Protecting some people from infectious disease with sanitation, antibiotics, and vaccination does not magically cause other people to get sick.]

I'm not sure what you mean. I only stated that people that are asymptomatic carriers of disease pose the same risks to society as those that actually do show symptoms.

Ms. Clark said: [this is not a blog designed to answer every possible question about vaccines that can be created in the mind of non-expert. I've seen antivaxers who can not find any intelligent discussion about vaccines on ANY website on the whole web, apparently, come to discussions that are supposed to be primarily about autism, or the juncture between autism and vaccines, to discuss every topic related to vaccines that occurs to them... apparently it's because only the vaccine-fans/ pro-vaccine people who associate around the autism topic who can intelligently discuss vaccines...]

No. This *thread* in this blog relates to framing. I've not posted this information on other threads, but they would be appropriate in at least three that I have read. I find the majority of what you've said to be rather conceited, and demonstrates the incapacity of those in your camp to deal with those that disagree with you.

[Seriously, why try to have a discussion on the relative benefits of pertussis vaccine here on this blog (or on another atuism blog) if pertussis vaccine has absolutely nothing, nothing, nothing to do with autism.]

Perhaps you should ask HCN that? He's the one that predictably posted pink book excerpts and asked his famous questions regarding the disease.

[Why not take the discussion to a cooking blog? Surely you can find a cooking blog where the blogger says she just had her flu shot, then an antivaccine comment would be on topic.]

This thread relates to the ways that anti-vaccine people frame their position. This comment says quite clearly that it wouldn't matter if the anti-vaccine camp framed a cogent discussion or not. If you are suggesting that I have not, through this clever sarcasm and condescention, perhaps you should outline why, instead of claiming that I am off topic, when I am not.

I've read all the threads covering this book club. Cries for "how to reach people" and what not and might I suggest, that this isn't the way.

Forcing other people to accept the willful change created by others, while acting superior, completely contradicts the "compassion" supposedly invoked by the use of vaccines in the first place. But since pro-vaccine people are the only intelligent people discussing the issues, I suppose you already knew that.

AA

I said: Beyond the effect of measures such as public sanitation on disease vectors, what biological explanation would you propose for this lack of susceptibility, and where is the scientifically valid evidence for that explanation?

In response to which the anonymous antivaccinationist said: Would you agree that we've become fairly antiseptic, and that infrastructure has advanced to accommodate growth? Previous civilizations were undergoing several changes at once, notably diet (Agriculture has only been around about 11,000 years... an eyeblink). I'm not sure what evidence you'd like to see? I'm simply referring to human history, more specifically, the birth of the Industrial Revolution and agricultural plundering which severely affected the domestication of human beings.

As I noted in my original comment, of course public sanitation measures will cut down on disease vectors for which such sanitation measures are relevant, e.g., measures that cut down on the rat population will tend to diminish the chances that there will be a plague epidemic, or, as in one of the links I provided, mosquito nets with insecticide will cut down on the incidence of malaria.

None of these methods works by some magic diminution of human "susceptibility" to the disease. The mechanism is quite simple - a step in the transmission of the disease to humans is disrupted.

There isn't any equivalent simple physical or public sanitation means of disruption available for many extremely problematic human diseases, such as polio, measles, or flu. There, the only effective means of disruption known are vaccines, and the history bears this out in each case - that is, pre-vaccine there's a tremendous problem with these diseases, post-vaccine they nearly vanish (as with polio and measles), or worldwide epidemics killing millions become a thing of the past (as with flu). No vague, magic diminution of "susceptibility," just good medical science having the intended results.

So why was it you were "anti-vaccine" again?

AA, would you mind re-iterating your basic point? It seems to have gotten lost in all the verbiage.

Do you agree that vaccines have vastly reduced the number of people who suffer from the disease? Do you agree that that is a good thing?

Autism is "new" in that it is now diagnosed, with more and more subtleties to the diagnosis. It is no more related to vaccines than the number of satellites in the sky.

We know that vaccines aren't 100% safe. Nothing is. (I always find it ironic that people who want 100% safety seem to have no paricular fears about getting into a car) Epidemiology finds even rare adverse affects in vaccines--and they are investigated. But compared to the diseases, the side effects of vaccines are very small.

That is positively absurd. Vaccines are only as good as the cell lines used in manufacture. To suggest that contamination is a teeny tiny bit of a puzzle that I needn't worry about is beyond foolish. Devil's in the details.

One thing that you learn doing biological research is that there are always a huge number of details, and most of them turn out to be irrelevant. Most of the components of cell lines are very similar to the natural components of your body and present at very low concentration, so the likelihood that one of them will cause a problem is extremely small to begin with.

We monitor side effects anecdotally, sometimes the vaccine recipient does so in a journal. This is not scientific, and it is the same anecdotal process that is used when people report vaccine injuries which is then cited as inaccurate.

Anecdotes are only a starting point. Most of the time they turn out to be false alarms. But when the same problem crops up repeatedly, then a statistically valid epidemiological study is conducted to determine the truth of the matter, as has been done for many of the claimed hazards of vaccines.

I'm a little unclear on the time frame you are describing, but based on history, humans have removed themselves from the process of natural selection for the last 10,000 years or so. Not always bad, and yes by our own doing. You don't go back, you adapt. Being arrogant enough to believe that what we've learned in the last 300 years about human physiology in *any* way pales in comparison to our existence on this planet, is not something you can force upon everyone.

It is not a matter of arrogance, it is recognition of the fact that we have no choice--it has already been forced upon all of us. We have already changed the foods we eat, the conditions in which we live, the animals, insects, and microorganisms we interact with, the extent to which different human population intermix, and all of this has happened much faster than the slow process of evolution can adapt. The evolutionary adaptations of human prehistory leave us poorly adapted for the modern environment, and we have no choice but to do the best we can to improve the human condition. The improvement of life span and health over recent history suggests that we aren't doing too bad a job.

With regard to the idea that asymptomatic carriers spreading diseases are created by vaccinating (to paraphrase), I think this is a legitimate, although minor, concern. Mostly because the risk of harming immunosuppressed individuals is much greater in a non-vaccinated populace, versus not knowing exactly who is sick with what due to suppressed symptoms. In addition, there are many cases where the main symptoms of a disease are the primary ways it is transmitted (like massive coughing), so to decrease the symptoms decreases the chance of infecting others. Overall, we need to remember that this is about figuring out how to clearly and efficiently create a dialogue concerning science and the safety of treatments derived thereof. We all can get a bit emotional in these topics, but we have to keep from getting too heated. However, AA highlights a particular issue in the science/safety discourse; they have several issues they want addressed about vaccines, and in order to fully refute or discuss them it takes quite a bit of explanation and scientific reading. The devil is very much in the details, but it takes a lot to get such a large amount of info to one person, let alone the public. I feel this is the main issue in framing vaccines and other related medical treatments. Also, to address the cell culture papers, contamination is an issue any lab working with cell lines must be highly watchful of. These lines get thrown out all the time because something like mycoplasma show up. Its a serious concern, but is usually watched pretty closely. Cell line experiments and results should also be taken with a grain of salt because in vitro studies (as cell line assays are considered) often do not correlate with in vivo or human studies. I conduct research in mitochondrial toxicology, and we are working hard to design in-vitro assays that do correlate with in-vivo results of drug development. This further emphasizes the amount of explanation and knowledge needed to address just a few concerns about vaccines. How to do this on a larger scale is a problem for sure.

I know AA likes to denigrate my arguments, instead of answering the questions I pose. But there is a reason for the frame of my queries: risk assessment.

You cannot discuss vaccine safety, or safety of anything in life without thinking about the relative risks of that activity.

In trying to point to the risks of certain cell lines AA was doing something akin to that of a former co-worker. She used to tell us that we must only buy organic food (and this was over 20 years ago when it was even more horribly expensive and hard to get) because it was so much healthy, while she was surrounded by a cloud of smoke from her chain-smoking.

To tell me that to not vaccinate is safer, is like telling me that seat belts are dangerous because a child is better off being thrown clear of the car (and just a couple of weeks ago I saw a crunchy couple get in their car and drive off with the mom sitting in the front passenger seat holding her baby in her arms!).

Oh, and seat belts do cause injury. I spent a weekend in the hospital due to a seat belt injury (broken ribs, and being watched for bleeding spleen). But I am glad I had that lap belt (it was a 1960s era car), because I did see the dashboard get closer to my head before I was jerked back. I think the broken ribs were a lesser injury than a crushed skull.

So I will continue to ask about the relative risk of the vaccines versus the diseases much to the annoyance of AA until someone satisfactorily answers those questions!

Jud said: [None of these methods works by some magic diminution of human "susceptibility" to the disease. The mechanism is quite simple - a step in the transmission of the disease to humans is disrupted....There isn't any equivalent simple physical or public sanitation means of disruption available for many extremely problematic human diseases, such as polio, measles, or flu. There, the only effective means of disruption known are vaccines, and the history bears this out in each case - that is, pre-vaccine there's a tremendous problem with these diseases, post-vaccine they nearly vanish]

If you could have the choice between uncramped living quarters, indoor plumbing, fresh food and a vaccine but could only have one, which would you choose? Your observation does not negate the fact that assuming the vaccine is entirely responsible for reduced incidence in disease reporting (which carries its own margin of error) and it is *still* a temporal association that cannot be directly proven.

[No vague, magic diminution of "susceptibility," just good medical science having the intended results...So why was it you were "anti-vaccine" again?]

What do you mean "magic", and would you please give me your definition of sucseptibility. I consider myself "anti" vaccine, because I disagree with cumpulsory vaccination. I have an enormous amount of respect for my planet, and do not believe it to be hostile. Whilst there is no denying the propensity for corrections, there needs to be some level of understanding *for* the corrections. Because I believe the theory of evolution to be scientifically valid, evolutionary discordance is something that I'd like to avoid. After all, it's my planet too.

Diane said: [would you mind re-iterating your basic point]

Certainly. I originally replied to a poster that brought up subclinical cases of {insert disease here} and how (in the case of pertussis) those not vaccinated are likely to show true symptoms to disease, wherease those that have been vaccinated do not are a risk in their own. From that comment, I responded to several people that responded to me and in that posted a small list of contamination issues that I have because the safety data is lacking which then escalated from there into a handful of topics.

trrll said: [most of them turn out to be irrelevant. Most of the components of cell lines are very similar to the natural components of your body and present at very low concentration, so the likelihood that one of them will cause a problem is extremely small to begin with.]

I don't know that I entirely agree with what is irrelevant and what is not. The complexity of the human organism supercedes human observation in this case, (for me).

[We have already changed the foods we eat, the conditions in which we live, the animals, insects, and microorganisms we interact with, the extent to which different human population intermix, and all of this has happened much faster than the slow process of evolution can adapt. The evolutionary adaptations of human prehistory leave us poorly adapted for the modern environment, and we have no choice but to do the best we can to improve the human condition.]

This is a superb observation and nicely said, and I disagree on only one point. *I* have a choice. I'll eat the foods my hunter/gatherer ancestors ate. I'll wake with the sun, and go to bed when it sinks instead of staying up into the wee hours of the morning bathing myself in artificial light. You cannot force *everyone* to make the choices you deem necessary. I do not expect people to accept my choices, I do not expect others to "protect" me from disease.

MitoScientist said: [ AA highlights a particular issue in the science/safety discourse; they have several issues they want addressed about vaccines, and in order to fully refute or discuss them it takes quite a bit of explanation and scientific reading. The devil is very much in the details, but it takes a lot to get such a large amount of info to one person, let alone the public]

I do agree that this is a difficult task. With these issues *already* there, I feel that those continue to force these products upon others is inappropriate.

[ These lines get thrown out all the time because something like mycoplasma show up. Its a serious concern, but is usually watched pretty closely. Cell line experiments and results should also be taken with a grain of salt because in vitro studies]

Whilst I agree somewhat, a notable exception would be HeLa cells. There is simply not enough assurance for me, and I do appreciate your response and respectful tone in acknowledging my points. My only real disagreement is that unvaccinated people that do show "stronger" symptoms, are typically *not* sent back into the herd. They know they are sick.

HCN said: [instead of answering the questions I pose. But there is a reason for the frame of my queries: risk assessment.]

I don't need to denigrate your arguments, and I do not. I will not argue your point, that is your job.

[You cannot discuss vaccine safety, or safety of anything in life without thinking about the relative risks of that activity.]

On this, we agree.

[In trying to point to the risks of certain cell lines AA was doing something akin to that of a former co-worker. She used to tell us that we must only buy organic food (and this was over 20 years ago when it was even more horribly expensive and hard to get) because it was so much healthy, while she was surrounded by a cloud of smoke from her chain-smoking.]

And you are doing it again. You are setting up my position and putting words in my mouth by using a very poor analogy. How dare I suggest that the vaccine you are trying to force me to receive is not contaminated with bovine pestiviruses, mycoplasma, bacterial toxins, cross (species) contamination or HeLa cells. If such information were more readily available regarding these biologics, I might feel otherwise. As it stands, vaccine makers submit *their own* safety data.

[To tell me that to not vaccinate is safer, is like telling me that seat belts are dangerous because a child is better off being thrown clear of the car (and just a couple of weeks ago I saw a crunchy couple get in their car and drive off with the mom sitting in the front passenger seat holding her baby in her arms!).]

No HCN, it's not. You are fully aware of the potential consequences that can happen when not wearing a seat belt.

[So I will continue to ask about the relative risk of the vaccines versus the diseases much to the annoyance of AA until someone satisfactorily answers those questions!]

I'm not annoyed. In the risk studies you've posted previously (elsewhere) they say one thing to me. Keeping people subclinical keeps them out of hospitals because they don't know their sick and that saves everyone money. It says nothing about individual health.

AA

Apologies in advance for the length.

AA wrote: What do you mean "magic," and would you please give me your definition of susceptibility.... I have an enormous amount of respect for my planet, and do not believe it to be hostile.

The second sentence quoted above, that you do not "believe" the planet to be "hostile" is as good a definition of magic as I could hope to find. It is utterly unscientific, vague, and apparently depends upon your own mindset rather than any objectively verifiable fact.

Your belief, of course, matters not a whit in determining what is factual and what is not, or do you really think you can fly if you just disbelieve in gravity hard enough?

Regarding whether the planet is "hostile," insofar as such a vague anthropomorphism has any substance, have you looked at the numbers of deaths worldwide from storms, earthquakes, volcanic eruptions, etc.?

If you wish to remove the inanimate from consideration and restrict this to the question of whether some forms of life are "hostile" to other forms (or, to be more precise, whether some forms of life kill or cause bad outcomes for other forms of life, specifically humans), the answer is, of course. See, once again, the link regarding mosquito netting and its impact in helping to prevent malaria by the simple expedient of stopping the insect vector for the malaria parasite from transmitting it to human bloodstreams. Stop Falciparum from reaching human bloodstreams, you stop malaria. No vague notions of "susceptibility" or "hostility" involved, just keep the mosquito's schnozz out of your vein. On the other hand, if mosquitoes *do* dine on people, then by gosh you will see plenty of "susceptibility" and "hostility," or to put it plainly, millions dying unpleasantly courtesy of Falciparum.

Because I believe the theory of evolution to be scientifically valid, evolutionary discordance is something that I'd like to avoid.

My very strong guess based on what you've written above is that you have no least idea how evolution works. Evolution works by chance (random genetic drift) and necessity (selection). Natural selection, according to the Britannica, "may arise from differences in *survival*, fertility, rate of development, mating success, or any other aspect of the life cycle." [Emphasis added.] It "multiplies the incidence of beneficial mutations over generations and eliminates harmful ones, *since the organisms that carry them leave few or no descendants*. [Emphasis added.]

Thus natural selection, one of the main engines of evolution, depends upon death ("differences in survival," "leave few or no descendants"). Far from being an "evolutionary discordance," death caused by environmental factors, including other life on the planet, is at the very heart of evolution.

Now, with regard to susceptibility, I'm quite happy with dictionary definitions: "easily influenced or affected," "likely to be affected." So, are humans susceptible to malaria? Yup, unless they have mosquito nets. Are they susceptible to influenza? Yup, by the tens of millions. How does one render oneself less susceptible, since influenza transmission methods aren't liable to simple physical blocks like mosquito nets (unless you want to run around wearing one of those Intel bunny suits, which I would be reluctant to characterize as "simple" in any case)? By utilizing well-known scientific principles to leverage the body's immune system without the necessity of being exposed to the fully potent disease-causing agent, i.e., with vaccines.

Your observation does not negate the fact that assuming the vaccine is entirely responsible for reduced incidence in disease reporting (which carries its own margin of error) and it is *still* a temporal association that cannot be directly proven.

Willful disbelief in mountains of carefully gathered and collated peer-reviewed data is a violation of the rules of intelligent scientific discourse. Bzzzzt! You've been disqualified, thanks for playing.

AA said "Keeping people subclinical keeps them out of hospitals because they don't know their sick and that saves everyone money. It says nothing about individual health."

That makes absolutely no sense, even after I substitute "they're" for the "their".

Jud said "Willful disbelief in mountains of carefully gathered and collated peer-reviewed data is a violation of the rules of intelligent scientific discourse. Bzzzzt! You've been disqualified, thanks for playing."

I agree.

Jud,

Humans have removed themselves from the process of natural selection has been manipulated to various degrees by various applied sciences dating back thousands of years. Passing on robust traits may be something you deem useless, but don't expect everyone else to follow suit.

Of course I've watched the organism that we tread upon make adjustments. You are free to continue to blame those forces and while claiming no responsibility. I don't believe it's that simple.

Your focus upon my word hostile is interesting, almost as much as it being all that you have focused your energy. Excluding one from discourse because you don't agree is close minded. Excluding one from discourse because they want something more than epidemiological garbage proving the safety of vaccine products is complacent and has no business being in a place of power.

HCN,

Out of courtesy, I didn't want to flood the thread with reponse posts to every person that addressed me and as a result the post got rather long. The focus upon a single grammatical error is... what did you call it? A mountain out of a molehill?

Anyway, I'm growing wary of the circular argument.

Troll on.

AA

I was not referring to your simple and common grammatical error. It was the focusing on "subclinical" nonsense.

I should add that one reason why the "subclinical" bit does not make much sense it that adults who get pertussis seem like they only have bad colds. They were usually the source of infection in children.

Since the drops in pertussis vaccination, more kids have been getting infected (the paper that shows that states with more exemptions is not "political", but illustrates a trend of vaccine levels versus infection levels). One solution has been to also vaccinate adults with Tdap, to stem the tide of infection.

Basically, the more people who are vaccinated against pertussis the less chance of passing the infection. With a reduction of vaccine coverage, there are more infections. Also the risk of vaccination is much much less than any of the three diseases. So even if there are those walking around with "subclinical" infections, the chance of spreading the disease is reduced. That is what the statistics show in several countries and over several different sets of time. Why is that so hard to understand?

Also, note that there have been cases of those who have diseases at "subclinical" levels who have spread the cases, but have been found out and contained (Typhoid Mary is one, and in my own household a child with a strep infection but no symptoms who kept re-infecting his siblings, the cycle was stopped when all three were put on antibiotics). They do exist, and when a trend of infection is found (that is where epidemiological studies also come into play) it is hopefully interrupted.

I forgot to add... I am still not quite sure what you really mean by "subclinical", but if it is the spreading of disease because the person does not have symptoms, it is not a valid argument against vaccination. Measles, mumps, chicken pox and a few others are infectious prior to symptoms (sometimes up to a week). This is why vaccines are more effective than just avoiding the sick person.

I think what AA is trying to say is that since the Pertussis vaccine is directed against bacterial pertussis toxin, the population could have a number of "subclinical positive pertussis cases." In other words cases of perstussis that are not recognized clinically.

I had asked some relevant questions earlier regarding the physiology of this and got epidemiological answers.

So if somone who has been vaccinated with the pertussis toxoid contracts Bordetella pertussis What happens physiologically?

Does the pertussis organism get cleared before it can establish itself intracellularly?

Does the pertussis organism establish some pathogenic activity, but in a subdued manner due to antibody activity against the various toxins the bacteria produce?

In the epi studies that have been posted, Is pertussis identified by culture techniques(quite difficult with B pertussis) or by clinical observations? Could these people that have been deemed to not have pertussis because of lack of standard clinical presentation still have a pertussis infection that is just subdued?

Could someone who has been vaccinated but presents "subclinically" be a risk for transmission? i.e. what is the difference in that bacterial load,Is the bacterial load still sufficient to infect other people?

On top of this how do you effectively assess the risks of vaccines. Adverse reporting has only been in place for 17 years and how is anybody supposed to know if all adverse events are actually reported. In my opinion the risks associated with vaccines are very much up in the air, I personally don't think anybody can discount vaccines as a contributing factor to the etiology of Autism (in some cases). The way that I see it is Vaccines have been an ongoing experiment in the human population. The policy has always been shot first questions later. At the very least we have to change this ass backwards way of doing things.

skeptique said "The way that I see it is Vaccines have been an ongoing experiment in the human population. The policy has always been shot first questions later. At the very least we have to change this ass backwards way of doing things."

Then you have not read the book, nor checked the extensive research that have been done on vaccines over the past 60 plus years. Read the section starting at page 110, and you should also read two of Dr. Offit's books, "The Cutter Incident" and "Vaccinated". Of course, you might object to the fact that the vaccines are tested on real humans before being licensed, but there really is no other way to check for safety and efficacy.

Adverse reporting of vaccine reactions have been around for several decades. The PubMed index has papers on safety and adverse vaccine issues going back to the 1950s. This one is even available to be read online:
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1620937&blobtype=… (I think I saw some of those charts in "The Cutter Incident" or Oshinksky's "Polio, an American Story")

skeptique said "ongoing experiment in the human population. "

Everything humans have done to themselves and their environment has been an ongoing "experiment", starting from the time the first ancestor decided to become bipedal. How do you think that farming started? Or that it was simpler to keep animals than to go out and hunt them (by the way, living near the animals is thought to be how many of the diseases like measles came to become a human infection)? Or that using fire was useful or that trees were good for chopping down?

Read any book on the development of human civilization and you will find all sorts of other "experiments" on human populations. What happened to the native populations on the American continents when Europeans came? How was using lime to treat blue corn discovered? How did the "fertile crescent" the place where Western civilization started become a desert? What happened after WWII with the development of antibiotics?

Really, nature wants us dead... Is everything we do to prevent nature from killing us an "experiment on human populations"?

(sorry, I hate it when I think of something after posting... but now I must go and harvest my pears, plant my bulbs, remove the branch of the apricot tree that is blocking the security light, pick my huckleberries and grapes --- you know, the stuff that humans have experimented on for eleven thousand years, using the unnatural selection of plants, especially since the grapes are seedless!)

Quick couple of observations. Re "herd" immunity for pertussis, apart from the numerous publications attesting to this phenomenon, one must consider that natural pertussis infection typically occured in 4 year cycles.
Childhood infections often have cycles - what happens is that there is a year during which outbreaks occur, then herd immunity rises, and over the next few years it wanes gradually until there are sufficient numbers of unprotected kids for further outbreaks to occur among the unprotected, raising herd immunity again, and the cycle repeats. If pertussis did not engender herd immunity, there would be steady incidence rates.

Secondly, earlier someoen asked why case fatality for measles might be higher today than it was say 40 years ago. A major reason for this is in the age shift to more kids under the age of one who are infected than used to be the case in the past, and these kids are more susceptible to the complications. No mystery really. Previously, measles was a disease of school-age kids. With near universal vaccination, the susceptible pool has shifted to include those who have not been vaccinated - namely the under ones.

HCN wrote Adverse reporting of vaccine reactions have(sic)
The reporting HASn't been so adverse(unless of course you are a vaccine manufacturer), more so the vaccine reactions have been adverse.

Anyway, sorry to nitpick but I figured tit for tat.

The sytematic reporting of adverse events caused by vaccines was put in place in 1991, it is called V.A.E.R.S (vaccine adverse event reporting system). Before this, yes, publications in medical journals documented adverse events. Unfortunately, this does little to document the actual risk quantitatively, the documentation provides more of a qualitative or physiological context to analyze the risks.

Within the first five years ~33,000 adverse reactions were reported. Since this is a passive reporting system there are problems with it. For example, it is estimated that actual reporting of adverse events can be as low as 1%. So who knows how much is actually reported. If it is only 1% then you do the math, 10% same thing. We just dont have an accurate estimate of risk and reaction incidence.
Here is a recent example of an adverse reaction to the MMR vaccine

http://www.kspr.com/news/local/30808289.html

In regards to all the analogies you decided to throw out there, was there any rationale behind those. IMO you seemed to highlight your inability to analogize, but I will give you the benefit of the doubt if you can clarify these:

analogy #1: "humans experimenting with going bipedal" : "humans experimenting with vaccines"

analogy #2: humans experimenting with farming : humans experimenting with vaccines

analogy #3: experimenting with domestication of animals : experimenting with vaccines

Analogy # 4 experimenting with using fire and trees : experimenting with vaccines

Analogy #5 experiments on native populations when Europeans arrived in America : experimenting with vaccines

Analogy #6 lime to treat blue corn : experimenting with vaccines (this one may be valid, I am not aware of the blue corn lime connection

There were a few more, I just dont have time to address silly discordant analogies.

skeptique said "The sytematic reporting of adverse events caused by vaccines was put in place in 1991, it is called V.A.E.R.S (vaccine adverse event reporting system)."

Actually, there were more systematic systems in place before. The difference is that VAERS is a PASSIVE reporting system, and is essentially just a collection of anecdotes. In their raw form many are just useless, as illustrated by a citizen of the UK submitting a report that the vaccine turned his daughter into Wonder Woman:
http://leftbrainrightbrain.co.uk/?p=342

Actually, would you have preferred that I took your statement that the vaccines are an experiment on human evolution to mean that you would prefer that we get the diseases, and let only those who survive live? That is a rather special and abhorrent type of eugenics.

HCN,

Subclinical is not a nonsensical term. If an organism has been repeatedly vaccinated and seroconverted to what scientists consider "immune", then they have circulating antibody which destroys much of the pathogen/virus so that the host exhibits no symptoms. Overlooked is the fact that simply not presenting standard symptoms to disease does NOT mean that person is not in fact ill from said disease and just as contagious as one that shows proper symptoms.

Skeptique elaborated on my position well, thanks.

You've actually said something I'd like to respond to:

HCN said: [Read any book on the development of human civilization and you will find all sorts of other "experiments" on human populations. What happened to the native populations on the American continents when Europeans came?]

White men forced them to lay crops and they began to experience the "white man" diseases like pertussis, influenza and measles where before they had been nearly non-existent.

[Really, nature wants us dead... Is everything we do to prevent nature from killing us an "experiment on human populations"?]

I suppose you are entitled to that opinion, but I don't think I'm reaching when I say that I believe it to be defeatest and irrational. The implementation of certain technologies are experiments, and time will tell whether their use affected our species in a positive or negative fashion.

[you know, the stuff that humans have experimented on for eleven thousand years, using the unnatural selection of plants, especially since the grapes are seedless!]

Is sarcasm your only point? The point of reminding readers of the time frames surrounding the advent of agriculture is to remind them that evolutinarily speaking, this is not even an eyeblink. Nutritional science goes out of its way to isolate that which is good, seemingly to avoid anything that might be bad. Reminds me of vaccinology. To further clarify that point, some modern foods are simply not species appropriate - no matter how well they are advertised, or how hard the grain industry lobbies the USDA.

AA

AA said "Subclinical is not a nonsensical term. If an organism has been repeatedly vaccinated and seroconverted to what scientists consider "immune", then they have circulating antibody which destroys much of the pathogen/virus so that the host exhibits no symptoms."

Please link to an official medical definition.

AA said "White men forced them to lay crops and they began to experience the "white man" diseases like pertussis, influenza and measles where before they had been nearly non-existent."

Actually, the evidence of smallpox and measles decimation was evident in native populations that had not encountered Europeans (actually the Plymouth were the Pilgrims settled was a native village with prepared fields where the population was taken out by disease). The diseases were transmitted through trade. This is why when Capt. Vancouver went along the northwest coast he encountered people who had already been visited by the European germs before any actual Europeans:
http://historylink.org/index.cfm?DisplayPage=output.cfm&file_id=5100

Read McNeill's "Plagues and Peoples", plus Diamond's "Guns, Germs and Steel" (which references the prior book).

HCN said: [Please link to an official medical definition.]

? Wiki, FreeDictionary, Medicinenet.com, Harrison's... I'm extremely puzzled by your denial of asymptomatic states.

Here's medline - type subclinical in the search box.

http://www.nlm.nih.gov/medlineplus/mplusdictionary.html

[Actually, the evidence of smallpox and measles decimation was evident in native populations that had not encountered Europeans (actually the Plymouth were the Pilgrims settled was a native village with prepared fields where the population was taken out by disease). The diseases were transmitted through trade.]

I think this will depend on which historian you read. Those that share similar ideals, are those that one tends to align. One saw "small pox tear through the wheat fields". As domestication continued west, and native lands were "purchased" - there is an undeniable flourish of certain communicable disease. The disturbance to the Earth from agricultural practice did indeed improve the virulence of many organisms/viruses.

Thank you for the link, and the book reference, I will indeed read it.

AA

AA said "Here's medline - type subclinical in the search box.

http://www.nlm.nih.gov/medlineplus/mplusdictionary.html"

Which brings up: Main Entry: sub·clin·i·cal
Pronunciation: -primarystressklin-i-kschwal
Function: adjective
: not detectable or producing effects that are not detectable by the usual clinical tests .....

Okay, this may not include pertussis, since it is detectable with clinical tests, as noted in http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5450a3.htm ..."
A confirmed case is defined as 1) a cough illness of any duration with isolation by culture of Bordetella pertussis or 2) a case that is consistent with the clinical case definition and is confirmed by polymerase chain reaction (PCR) testing or epidemiologic linkage to a laboratory-confirmed case. In addition, Massachusetts uses an in-state, standardized serologic assay for persons aged >11 years as a confirmatory test."

For something like pertussis where symptoms are low for older kids and adults, there are tests for it. So your logic still does not seem to be coherent.

Now, perhaps you could help show some evidence of your "subclinical pertussis" hypotheses that reduction of the use of the DTaP vaccine reduces the level of pertussis in a populaltion because because the sufferers are more obvious.

Call it a special case of my quest for the real scientific evidence that the DTaP is worse than pertussis, diphtheria and tetanus.

AA continued "I think this will depend on which historian you read."

You obviously did not read the Historylink, which posts several theories and is referenced. You are also ignoring that agriculture was also practiced extensively in the Americas prior to the arrival of the Europeans. This is where corn, squash, potatoes and lots of other crops were developed (the terraces created by the Inca many centuries ago are still in use!).

American Indian Holocaust and Survival: A Population History Since 1492... found on Google books:
http://books.google.com/books?hl=en&id=9iQYSQ9y60MC&dq=American+Indian+… ... pages 60 through 100 were available online, most of the population reduction occurred between 1500 and 1800.

Though my main reference for the 90% reduction on native population has been http://www.amazon.com/Plagues-Peoples-William-H-McNeill/dp/0385121229/ .

Actually, there were more systematic systems in place before. The difference is that VAERS is a PASSIVE reporting system, and is essentially just a collection of anecdotes. In their raw form many are just useless, as illustrated by a citizen of the UK submitting a report that the vaccine turned his daughter into Wonder Woman:

I am aware of one system in place before VAERS but it only predated the intro of VAERS by 5-6 years. I am not sure as to your claim "more systematic systems" existed. How were they more systematic?

You claim that VAERS is a collection of anecdotes. In Actuality VAERS represents an organized documentation of CLINICAL observations pertaining to adverse reactions from vaccinination. In fact, 84% of VAERS reports are submitted by 1.Vaccine manufacturers, 2. Health care providers, 3. State immunization programs. In light of this information your notion that VAERS is storybook of fairtales made up by crackpot parents, is downright misinformation.

Whether or not someone from the UK could submit a false report has little bearing on the legitimacy of the VAERS database. Did you ask yourself this question, Why would people submit false reports? what is the end goal of doing such a thing? Answer: there is no point to doing this.

From my perspective is seems you disregard the reporting system as bogus. from a logical standpoint this only confounds your refutation. If you deem the only large scale population based reporting system as bogus then you are stuck in the inescapable position of not having a clue of what the true level of risk associated with vaccination is. That seems like it would be a little bit of a problem if you were trying to rationally analyze risk of vaccines. What do you think HCN?

If you read some of the individual reports you will find documentation of less serious reactions such as general malaise, and fever, inflamed injection site, to more serious reactions such as cellulitis at injection site, Guillian Barre syndrome, encephalitis, to shock and death.

Like I have already stated the true incidence of these types of events is not known because of retristions and problems with in the system.

HCN wrote: "Actually, would you have preferred that I took your statement that the vaccines are an experiment on human evolution to mean that you would prefer that we get the diseases, and let only those who survive live? That is a rather special and abhorrent type of eugenics."

Well you have managed to pack two logical fallacies into this last paragraph. First, your creation of a strawman "you would prefer that we get the diseases, and let only those who survive live?" then you go ahead and knock down that strawman with an ad hominem. Try to develop a more rational argument and response to the items I am bringing up it will be more fruitful in the end.

Did it dawn upon you that dismissing hundreds of thousands of documented events, some of which were the death of somebody's child could be construed as cold hearted. Where do you stand HCN, should a better system be developed for adverse event reporting? Or do you and everyother pro vaccinationist omnisciently conceive the level of risk using your higher powers.

AA wrote: Humans have removed themselves from the process of natural selection has been manipulated to various degrees by various applied sciences dating back thousands of years. Passing on robust traits may be something you deem useless, but don't expect everyone else to follow suit.

I'd ask (politely and sincerely) that you try to edit your responses so readers don't have to parse compounded sentence fragments. In the first sentence, are you trying to say humans have removed themselves from the process of natural selection, or that natural selection has been manipulated by humans "to various degrees" for thousands of years?

I'll answer both. We humans haven't removed ourselves from the process of natural selection (simply put, we still die), though we've certainly manipulated the selective environment. We aren't at all unique in this. We haven't manipulated the environment anywhere near so profoundly as, e.g., bacteria, which, to take just one example, are very likely the reason the sky is blue (nitrogen-oxygen mixture) rather than pinkish (hydrogen sulfide, among other gases invidious to most current life on the planet). And while we *intend* to change the selective environment to our advantage, we haven't managed to accomplish exactly what we intended. While mosquito-netted bedding may help to change the current sad statistic that a million children under the age of 5 die each year from malaria in sub-Saharan Africa alone, non-communicable chronic diseases - cardiovascular, respiratory, type 2 diabetes, some cancers - already cause 60% of deaths worldwide. http://www.nature.com/nature/journal/v450/n7169/full/450494a.html

Regarding "passing on robust traits," I of course never said that was useless. Rather, I said you were talking vague nonsense about evolution. Millions of years of hominid evolution has hit upon some genetic answers to diseases like flu or measles, but they still leave us with an unacceptable death rate. So we rig the odds in our favor with vaccines, ginning up the resistance evolution has given us without exposing ourselves to the risk of death that fully potent disease organisms pose.

Of course I've watched the organism that we tread upon make adjustments. You are free to continue to blame those forces and while claiming no responsibility. I don't believe it's that simple.

Please. I never contended the planet was "to blame" or "responsible" for all death and disease (and would not, since to me such anthropomorphised terms are meaningless nonsense). In fact the article I've cited in this reply provides actual statistics (rather than vague unscientific notions of "evolutionary discordance") regarding the degree of human participation in what, as an actuarial matter, is killing most of us. But nothing you've said alters the simple facts, amply supported by evidence, regarding vaccine efficacy.

Jud said: [I'd ask (politely and sincerely) that you try to edit your responses so readers don't have to parse compounded sentence fragments.]

I did leave out the word "and" in that first sentence, and will try to proof read a bit better. I don't typically participate in debate, and am certainly not trying to be difficult to understand. Your suggestion is duly noted.

[And while we *intend* to change the selective environment to our advantage, we haven't managed to accomplish exactly what we intended.]

Whilst this is a fair statement, are you able to concede that individuals should be able to decide which "manipulations" they'd like to participate in?

[Rather, I said you were talking vague nonsense about evolution. Millions of years of hominid evolution has hit upon some genetic answers to diseases like flu or measles, but they still leave us with an unacceptable death rate.]

Most people discuss Darwin, overlooking the later, greater work - and I felt that was the avenue that you were taking. Able to realise I could be incorrect, I do retract any words I may have wrongfully put in your mouth. My "vague nonsense" mostly dealt with diet, and agricultural effects on modern humans. It's not a vague notion. http://www.ajcn.org/cgi/content/full/81/2/341 I apologise for being unclear.

[I never contended the planet was "to blame" or "responsible" for all death and disease (and would not, since to me such anthropomorphised terms are meaningless nonsense). ]

I'm not entirely sure what you are getting at here. What you've written amply demonstrates that you feel there is a power struggle between humans and the universe in which they occupy. Nature is killing us and to be feared, and I strongly disagree.

[(rather than vague unscientific notions of "evolutionary discordance") regarding the degree of human participation in what, as an actuarial matter, is killing most of us.]

I've provided a citation that hopefully assists you in realising my position. My evolutionary observations, are that modern humans (mostly scientists and western doctors) are altering our species faster than any other preceding civilisation. Rather forcefully, I'd add.

[ But nothing you've said alters the simple facts, amply supported by evidence, regarding vaccine efficacy.]

Simple facts? A simple fact, is that we've been unnaturally introducing disease to our species for only a couple centuries. Evolutionarily speaking, about how long is that? What might be the long term consequence to humans? Does anyone care? Does anyone get a choice? Why are those choices made for everyone based upon fear of previous disease cycles afflicting previous generations of people? Thank you for the link.

AA

AA said "Simple facts? A simple fact, is that we've been unnaturally introducing disease to our species for only a couple centuries."

So this is worse than letting the "natural diseases" in what way? So how exactly are the vaccines worse than the natural diseases?

By the way the natural diseases do produce evolutionary change. The most known about is the difference that creates sickle cell anemia. The gene that causes it also protects against malaria, but if a child gets it from both parents they get the very painful sickle cell anemia. Another interesting book:
http://www.amazon.com/Survival-Sickest-Medical-Maverick-Discovers/dp/B0…

Also, you are still tripping close to declaring that only those who survive the natural diseases deserve to live, and that vaccines have essentially "weakened" humans.

AA wrote: What you've written amply demonstrates that you feel there is a power struggle between humans and the universe in which they occupy. Nature is killing us and to be feared, and I strongly disagree.

Either I've been exceptionally unclear, you haven't been paying attention, or some combination. The only thing I'm doing is restating what natural selection is. "Selection" means some traits are "selected," and by definition in the case of natural selection, the method by which they're "selected" is that some organisms survive to pass on their genes to the next generation, while others die before they can do that. With what part of this fundamental proposition of evolutionary biology do you disagree?

This isn't some "power struggle," it is the continuous condition of all life on Earth, and it is, as I've noted before, one of the prime drivers of evolution. This all takes place in a context, that context being the environment. Though we humans can alter our environment, these alterations will change but not eliminate natural selection pressures. (Natural selection pressures aren't eliminated unless none of us dies without passing on our genes, just as sexual selection pressures aren't eliminated unless individuals consider any possible choice of mates equivalent.)

A simple fact, is that we've been unnaturally introducing disease to our species for only a couple centuries. Evolutionarily speaking, about how long is that?

Wherever did you get this idea? Malaria is considered the disease that has exerted perhaps the strongest evolutionary pressure on humans, and estimates of the age of its impacts on our genome in the literature I've read range from 5 *thousand* to 50 *thousand* years. Other less virulent and widespread diseases would exert less evolutionary pressure, and so, in accordance with the mathematics developed by evolutionary science in the early to mid-twentieth century (see Sewall, Haldane, and others) would take *longer* to show visible genetic impact.

My evolutionary observations, are that modern humans (mostly scientists and western doctors) are altering our species faster than any other preceding civilisation.

Huh? What specific widespread recent genetic alterations in the human population have taken place due to the action of "scientists and western doctors"? Remember, malaria, which kills millions every year, has taken millenia to show its effects on the human genome. So what force at the hands of "scientists and western doctors" has had an exponentially quicker impact on us than the deaths of millions annually? (This is evolutionary math at work - if it shows effects more quickly, it means whatever is causing the effects must have greater impact.)

[A]re you able to concede that individuals should be able to decide which "manipulations" they'd like to participate in?

Ah, but there are caveats you haven't mentioned. I'd gladly grant your right to free speech, but what if there's an angry crowd gathering and I, your friend, am with you? Would you grant an interest on my part in whether or not you continue speaking? Now suppose what you're saying is irrational (you've got paranoia that centers on Jews and you're giving vent to your opinions about them as we walk down the street in Williamsburg, Brooklyn). Would you feel my interest in having you stop talking is more justified because your interest in speaking is irrational?

You know what comes next, right? If you don't get vaccinated, I'm at risk, too. If your anti-vaccination position is irrational, then why shouldn't my rational, legitimate interest in not getting sick prevail?

Why are those choices made for everyone based upon fear of previous disease cycles afflicting previous generations of people?

Because from the standpoint of evolution, a couple of generations is an eyeblink. Remember, the most powerful evolutionary change agent known among diseases, malaria, has taken between 5 thousand and 50 thousand years to have its genetic effects (e.g., sickle cell trait), and this is something that kills a significant percentage of the relevant population. A few tens of millions killed by flu worldwide in the twentieth century is not going to result in immunity for the current billions of humans on the planet, particularly when the virus that will cause the next epidemic won't be the same as the one people developed immunity to during the last epidemic.

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