Enablers of the vaccine-autism manufactroversy

The fence-sitters, the concern trolls, and the shruggies. Yes, they are a significant problem. They don't promote either side directly, but their very loud posturuing about not holding an opinion really only benefits one side of the "debate" -- the anti-vaccine side. The anti-vaxxers will say that this is because vaccine-advocates are of a "with us or against us" mentality, but that's not true. The truth is that the anti-vax argument is largely based on sowing doubt about the efficacy of vaccines. Therefore, a person who refuses to form an opinion because of doubts is definitely supporting the anti-vax position, whether they realize it or not.

These are people who either lack the scientific knowledge and critical thinking skills to see what a load of bollocks anti-vaccine arguments are or are so assiduously dedicated to fence sitting that they have a fence pole permanently lodged in their nether regions.

This reminds me of a great song from the Alan Parsons album "Try Anything Once". The song is "Turn It Up", and it's about speaking out when something needs to be said. My favorite bit from the song:

It's no good you trying to sit on the fence
And hope that the trouble will pass
Because sitting on fences will make you a pain in the ass.

The whole song is excellent.

Lyrics, Audio Clip

The question remains: How do we counteract the Jenny McCarthy nonsense? I don't think we can completely eradicate the probably neurological tendency toward "belief". Education in science and logic are the only hope I see and that is long term even if the will was there to institute a rigid program. Our devotion to religious freedom will always interfere with attempts to educate.

Terrific post and it's particularly good to see an American use the phrase 'load of bollocks' confidently and in an appropriate context.

One of the more encouraging findings of the Pew/AAAS survey last week was that 69% of the public support mandatory childhood vaccinations

http://people-press.org/reports/pdf/528.pdf

Of course there will also be a lot of people who think that vaccines are a good thing but are against making them mandatory, a postition popular with those who favour a small state. The Pew survey result indicates that despite all the anti-vaccination propaganda of the past few years and the easy ride and in some cases support that anti-vaccinationists have been given by some sections of the media there is still overwhelming public support for childhood vaccination.

This is something that must be remembered by those engaged in the debate. There is no need to pander to the anti-vaccination position, since that can only serve to raise more doubts than it eases.

While I certainly don't think scientists should get angry or shouty when dealing with anti-vaccination campigners, the contrast between their aggressive and rude behavior and the scientists likable and reasonable behavior is not an asset that should be thrown away lightly, I don't think scientists should hold back from pointing out just how foolish and dangerous they are.

Of course there will also be a lot of people who think that vaccines are a good thing but are against making them mandatory, a postition popular with those who favour a small state.

Indeed, I actually oppose mandatory vaccination, except conceivably in the case where an epidemic were imminent.

However, there is a middle ground here that I think is quite reasonable: Entirely eliminate the religious exemption for kids attending public schools. Want to forgo vaccination? Fine, but don't bring your kids 'round here! And of course I would hope there would be strong pressure on private schools to adopt a similar policy.

Anecdotally, it is my impression that the difficulty of getting the religious exemption and/or finding alternative schooling already results in a significant number of parents who have been (understandably) affected by the anti-vaxers scare tactics, to just give in and vaccinate anyway. If the religious exemption weren't even an option, that would mean that the only parents who would avoid vaccination would be the ones who were so hardcore they were willing to homeschool -- and those people aren't reachable anyway.

I've never understood religious exemptions anyway. So, the only way we'll let you get out of the draft/forgo vaccination/take peyote/etc. is if you admit you have absolutely no rational reasoning for your decision? Um, okay... In the case of the draft, it's particularly messed up that people who chose to be pacifist for secular ethical reasons got less leeway than people who chose to be pacifist because their mythology told them so.

Parents have *empathy* with the Jen-creature-maybe a way to counter this (a parallel to educating parents of people with SMI)is to find well-educated(or professional) *parents* or family members of children with autism(or their writing).This way, it's not just some *cold scentists*(as if that were a *bad* thing),but a *mother*(a father,a sister, etc.)relating their experiences and instructing the public(e.g.read James Laidler,MD of AutismWatch).I also suspect that the whole "education problem" includes not just "lack of",but "mistrust of those with it".

While I certainly don't think scientists should get angry or shouty when dealing with anti-vaccination campigners, the contrast between their aggressive and rude behavior and the scientists likable and reasonable behavior is not an asset that should be thrown away lightly, I don't think scientists should hold back from pointing out just how foolish and dangerous they are.

Actually scientists, and others, should be angry. If a person is not angered that anti-scientific luncacy is putting lives at risk then what will make them angry ?

That should be *cold scientists*

I'm not anti-vaccine.

In fact, I'm pro-vaccine. I just wanted to mess with Orac's 99% statistic.

Hi Matt, perhaps I didn't phrase my point very well. There's nothing wrong with being angry at what anti-vaccionationists say, it's one of my usual responses, and anger is a very good motivator! What I had in mind was more giving in to the anger and therefor appearing aggressive and unreasonable in interviews etc.

Hi Matt, perhaps I didn't phrase my point very well. There's nothing wrong with being angry at what anti-vaccionationists say, it's one of my usual responses, and anger is a very good motivator! What I had in mind was more giving in to the anger and therefor appearing aggressive and unreasonable in interviews etc.

Fair point, although I think a bit of passion can help. Ranting during an interview will not be effective, but being controlled whilst hinting at anger under the surface might not be a bad thing. Especially if you are discussing the damage measles ,and other diseases for which there are vaccines, can do.

Then there are also the genuinely grass-roots movements of "concerned moms" who buy the quackery wholeheartedly (personality cult of Drs. Wakefield and Moulden, anyone?) and pass it on with enthusiasm to their peers; and worse yet, many "researchers" (as they bill themselves) who apparently have no training and no basic understanding of science whatsoever, but write as if they consider themselves professionals, and sell themselves to the rest of the scientifically illiterate public that way. Like this one: http://iconicwoman.com/topics/vaccination-policy/ .

These are people that share the public mistrust of government, and the new conspiracy bogeyman "Big Pharma", and are "ordinary soccer moms" so that, like Palin, people identify with them whether or not that is deserved. It's like Jenny McCarthy, but closer to people's hearts. How do you counter that? The pro-evidence-based-medicine crowd doesn't seem to be as good at the sympathy/empathy/"I'm just like you"/heartfelt outrage thing that works in a country which glorifies emotion over reason.

Then there are also the genuinely grass-roots movements of "concerned moms" who buy the quackery wholeheartedly (personality cult of Drs. Wakefield and Moulden, anyone?) and pass it on with enthusiasm to their peers... It's like Jenny McCarthy, but closer to people's hearts. How do you counter that?

Well, one possible answer is an equally grass-roots movement working at the very same peer-based level to spread the truth. But as I can personally attest, it is no picnic...

BTW, the "personality cult of Dr. Wakefield" was something I wasn't prepared for. I thought he had been thoroughly discredited... but I guess the fact that he is apparently "sooooo good-looking" makes up for all that??

Man, anti-vaxers are confusing.

@Denice Walter,

I suppose that I and our band of merry woo-fighters fit the bill quite nicely for what you are calling for. I have three children on the spectrum and teach psychology and English part time for a community college. I write Countering Age of Autism and Detritus, sister blogs that focus on outing the most egregious of the articles and comments found concerning autism and vaccination and promoting more positive pieces on parenting children with autism. In addition, I co-run Raising Autism (www.raisingautism.co.nr/) and Countering AoA, a facebook group with a band of four other mothers of children with autism. We welcome any and all to our woo-free autism groups. And to our many blogs (each woman has at least one blog of her own). I hope you will check us out and join us in our fight against the woo, the anger, the bitterness and our attempts to redirect attention to positive perspectives of and more adaptive coping skills with the very real difficulties that helping our children with autism often entail.

@James Sweet:

Wakefield discredited? Not in Austin, TX! He runs "Thoughtful House" for "treatment" of autistic kids there (not sure whether he bothered getting a TX medical license, but nobody bothers him about it, apparently), and he has quite the local fan following of people who feel that he is the classic Brave Maverick Doctor ™ who genuinely has the best interest of children at heart and who is being unfairly persecuted by the Evil General Medical Council of the UK. That is how he sells himself, and it gets bought wholesale -- certainly at least in part because of the widespread paranoia about government and Pharma conspiracies.

The July 10 issue of Science has an article about two resignations from the board of Autism Speaks over the organization's support and advocacy of research into an autism-vaccination link. It is worth noting that Autism Speaks is a group that funds a great deal of worthwhile legitimate research into autism, but the board members who resigned, Eric London and Alison Singer, were concerned about the potential harm from giving apparent legitimacy to parental fears regarding autism and vaccination.

Lisa Jo Rudy has been driving me nuts for ages with that fence sitting. Take a stand, woman!

Many medical practices collectively purchase services that they cannot afford in-house full time. Payroll is one obvious example.

Would it be feasible to offer vaccine educational services to many practices in a geographic area where science is presented and woo debunked? Physicians could purchase shares in the service and sign up patients with young children or are expecting (as part of pre-natal care). The service would present maybe once or twice a month in different venues and present, answer questions, etc.

With the blog history stored here at Orac alone, a presentation could be built which presents all the studies, science and facts while spotlighting the woo, danger and lies.

The problem with manufactroversies (love that term) that involve kids is that if you're a childless person who gets off the fence and onto the side of science, you always - ALWAYS - get hit with the argument, "Well, you don't have kids, so clearly you don't understand how important this is/don't have that protective urge/don't like kids so you aren't willing to protect them." And so forth. It's an utterly baseless claim that, like false charges of racism and sexism, are intended to stop people like me in our tracks.

I don't usually let parents get away with this. But I can't help but notice that they always use it, and so I'm wondering how many fence-sitters out there have no kids and are not willing to deal with the crap they get when they posit that vaccines do not cause autism, child molesters are not waiting around every corner, etc.

When I was a teenager, I was one of those people sympathetic to the anti-vaccer's arguments myself.

I was very concerned about the environment (I was in high school at the time of the Exxon Valdez accident), and I had developed a mistrust of the scientific community - not because I didn't think science worked, but because I knew that science had been put to use for what I considered "evil purposes" - things like the Occidental Chemical accident in Bhopal, the unintended consequences of DDT, the monoculture farming and loss of genetic diversity in foods enabled by "evil big corporations" like Monsanto. So, I did believe that science worked, but I was concerned about what happened when science and Big Business worked together. If some scientists who worked for the tobacco companies had lied for years about the safety of tobacco, then why wouldn't it be possible for other scientists to be lying about the safety of vaccinations? It seemed reasonable to me. At the age of eighteen, I was thinking that if I ever had children, I might not get them vaccinated.

Then I went to college. And while I was in college, I took some tremendously wonderful science classes for non-science majors to fulfill my graduation requirements. The class I'm thinking of specifically here is a class on environmental science. What made the class remarkable for me is that my instructor spent a lot of time teaching her students how to think about the natural world with a scientific eye in addition to thinking about it with a sense of wonder. So, I learned to think about natural systems with a "cost-benefit" sort of approach; DDT may have done horrible things to the raptor population, but if a certain area had a severe problem with mosquito-borne illnesses, that harm to raptors might still be the best possible choice out of all the possible choices. Monoculture farming might indeed be harmful to plant genetic diversity - but it might also be the best possible way to limit human malnutrition around the world. I am not saying that I now think DDT or monoculture farming are wonderful things, mind you; I'm saying that this class taught me to stop thinking about science in terms of good versus evil and wicked conspiracy theories, and to start thinking of science - and human use of science - in terms of choices that have to be made in the real world, where everything is a trade-off and everything we do has both good and bad effects, whether we like it or not.

The class also taught me that scientists can have just as much of a love for the natural world as anybody else - my instructor was an avid cyclist, and would pepper her lectures with little anecdotes about various things she'd seen while riding her bike outdoors, which I also loved.

How does that all end up converging on vaccines? Well, it affected my views in two ways: first, it made me finally realize that even if vaccines ARE "harmful", they might STILL be a better choice than the alternative (don't worry; I no longer even think that there's any possible significant harm to worry about with vaccines), and second, that while some scientists might be evil, greedy, corporate shills, there's no way that ALL scientists could be evil, greedy, corporate shills. I knew for a fact that my instructor was a scientist, and there was nothing "evil" at all about her - she even shared some of my environmental concerns. So not only were all scientists not evil, but the "non-evil" scientists were probably the only people who could help the rest of us take action against the "evil" scientists. If some Union Carbide scientist was lying about the safety of his company's pesticide, there's no way that I would know enough about chemistry to be able to catch his lies....but another chemist certainly would.

So, thanks to the work of a few skillful, patient science educators, I managed to develop a much more balanced, reasonable view of the benefits and dangers of all aspects of scientific work. However, I will say that I think the only reason such education was effective with me is that I began my studies already committed to a naturalistic, evidenced-based outlook on the world. Because I had an outlook on the world that said that evidence matters, I was inherently amenable to rational argumentation on things like vaccination. I think that having a positive attitude toward evidence-based argumentation is the thing that makes the difference between people whom you will (eventually) be able to persuade about vaccines and those whom you won't. People who have a religious or mystical sort of outlook on the world may not ever be convinced, because they may not really have a commitment to the idea that evidence makes a persuasive argument.

Sorry this turned out to be so long. It's just that helping laypersons to make sense of science is one of my pet interests.

But I can't help but notice that they always use it, and so I'm wondering how many fence-sitters out there have no kids and are not willing to deal with the crap they get when they posit that vaccines do not cause autism, child molesters are not waiting around every corner, etc.

Maybe. Another possibility is that folks with no kids aren't motivated to actually find out who is telling the truth, and end up as fence-sitters.

That was definitely the case with me. Before I had a son, I had heard a fair bit about the vaccine-autism "controversy" just from being a news junkie, but I hadn't really looked into any of it. What little I got from mainstream so-called "science journalism" led me to basically adopt a stance of: Well, I'm certain the benefits of vaccines outweigh the costs, and some of the folks pushing this are a bit fishy... but who knows, maybe there is something to the link after all?

In fact, my fence-sitting stance didn't even change immediately when I had a son. What finally changed it was after my wife had gotten scared by some anti-vax propaganda and wanted to use a delayed vaccination schedule. At first I basically shrugged and said, "As long as he eventually gets all his shots, I'm supportive of what you want to do." My wife wouldn't accept this, though, and pressured me to help her come up with a schedule that made sense -- and as soon as I caved in and started educating myself on the subject, I became adamantly against delaying the vaccines at all. heh...

Great post Jillian! It was almost a tl;dr for me, but I'm glad I read the whole thing. I especially appreciated this:

I am not saying that I now think DDT or monoculture farming are wonderful things, mind you; I'm saying that this class taught me to stop thinking about science in terms of good versus evil and wicked conspiracy theories, and to start thinking of science - and human use of science - in terms of choices that have to be made in the real world, where everything is a trade-off and everything we do has both good and bad effects, whether we like it or not.

Bingo. People forget, for example, that Orac has harshly criticized pharmaceutical companies on his blog as well. There isn't a "good team" and a "bad team", except maybe in the dichotomy between those who are committed to evidence and those who aren't. As far as "natural" vs. "artificial", or "grassroots" vs. "corporate", or whatever, one is not inherently better than the other. These choices do not exist in a vacuum.

Hi,

Lets get this right.

Most so called "antivaxers" are not anti-vaccine but against organomercury vaccines which may now be subjecting more babies than ever to mercury with the rising number of vaccines eg flu for the pregnant mother.

My three or so vaccines were fine for me (including smallpox vaccines) and the 60 plus now is insane. There are 3 500 000 illnesses, so we have to choose.

Giving 6 vaccines for one illness is not only insane but against the proven science of anaphylaxis.

Also for the record Jenny McCarthy only came into this war thanks to her belief in vaccinating to the current USA regulations.

Lisa Jo is not on any side and certainly is not always right but then no one is.

Who knows where autism comes from? I know of many recognised ways that it can be induced and lead is a metal less powerfully affecting the brain than mercury. Rubella virus is another way babies get autism and yet all babies get rubella vaccine of which one blog claimed significant numbers get the live virus but can't produce antibodies.

This is not good news.

Finally soon, maybe next month I take it all you will get your untested flu vaccines? This is one measly shot and you seem to take joy in forcing 60 plus on a baby that can't even walk or talk, let alone think of what an organomercury shot might do to them.

Jane Buergermeister has filed criminal charges against Baxter and coincidentally, at the same time and probably not associated has got the sack.

But all power to this new addition to the vaccine wars.

Most so called "antivaxers" are not anti-vaccine but

Q. E. D.

It's sixty vaccines now? I thought you guys were complaining about thirty-six. Where'd the sixty come from?

And that smallpox vaccine was worth many of the vaccines today. I think in fact it's even more than all vaccines combined.

Flu shot? If I can afford it. Heck, my sister said she'd get all thirty-six or so vaccines in a row while simultaneously drinking the contents of thirty-six others, provided anti-vaxers would shell out money for it. Since she has Asperger's, we could even see if it worsened that!

And yet another fact free ramble from John Fryer, where he cannot make up his mind whether it is mercury or part of the MMR vaccine.

This is precious:

Rubella virus is another way babies get autism and yet all babies get rubella vaccine of which one blog claimed significant numbers get the live virus but can't produce antibodies.

Oh, dear. For one thing the MMR is only given after the child is over a year old, typically around 15 months. Congenital Rubella Syndrome is from getting exposed to rubella while still a fetus.

More bogosity with:

you seem to take joy in forcing 60 plus on a baby that can't even walk or talk, let alone think of what an organomercury shot might do to them.

What? John Fryer (ex chemist), could you kindly list those 60 vaccines, the form of "organomercury" and how much is in those vaccines?

John Fryer Chemist
That is one big load of bull without citation.

I take it if we wait for the babies to talk, that would work for you? How about all those dead of vaccine preventable illness before they learn to talk? That okay too?

What a maroon.

And yes, already in line for my flu shot.

Hi Jillian

Yes, your long blog or blog response was wonderful.

But do we have to consider things in the way your tutor thinks?

The effect of such trade offs in the long term is catastrophic.

No river in the USA is now fit to fish and eat what you catch.

Organo chlorine pesticides are persistant and are still in the ground today.

Do you ever wonder why we sleep after a meal?

Try eating truly organic food and wonder why we donât get sleepy.

Organomercury in one flu vaccine evenly diluted can be seen destroying our brain cells.

The trick of removing ethyl mercury from classification with methylmercury to eliminate it as a toxic substance has sadly backfired and the reference levels should be reduced ten fold.

Do we need to have answers?

Those that induce sudden death or autism et al after vaccines should make better products.

The disgraceful race to rush through a new vaccine after the April Fool spin of âfatalâ flu to a vaccine by August means there can be no adequate safety testing.

How can we justify 1 million SIDS and currently 12 million neurologically ill children in USA alone by 2009?

You are of course correct about Monsanto but add to that Baxter at least who have been caught out this year sending contaminated vaccines to many countries which picked the bad vaccines up and probably many that are keeping quiet as they did not.

Figures of hundreds of thousands dying from vaccine preventable illness is SPIN.

If numbers did rise, of course people would rush for the vaccines.

No country I know of uses TB vaccines. Why? There is more TB around the world today than ever. It didnât work.

Did smallpox vaccine bring about the end of smallpox? No. The vaccine use in USA was stopped before it was made extinct. No pandemics of smallpox occurred when it remained in small pockets in countries with no vaccines in USA and many other countries.

Your risk-benefit was then used properly.

Today, economics and benefit work without regard to safety.
The arguments arenât clear cut either way in any event
But hold to where does SIDS and autism come from?

Until we know EVERYTHING is under suspicion.

And for me vaccines come top as the number one cause.

Why is it vaccines first and not something else?

"Truly organic food?" Who's eating inorganic food? Mmm. Pebbles. Oh, wait, those are organic too. Mmm. Plutonium.

John Fryer, you are again making stuff up.

Here are some of your claims, provide evidence or go away:

No river in the USA is now fit to fish and eat what you catch.

Love how a resident of the UK can make such a statement about a place he has never been to. So exactly where did the Copper River salmon we paid a premium price come from?

Do you ever wonder why we sleep after a meal?

Who is "we", and do you actually fall asleep after breakfast?

Organomercury in one flu vaccine evenly diluted can be seen destroying our brain cells.

Please provide a cite showing that any thimerosal in any influenza has any effect on brain cells.

The trick of removing ethyl mercury from classification with methylmercury to eliminate it as a toxic substance has sadly backfired and the reference levels should be reduced ten fold.

You do realize that ethylmercury is completely different from methylmercury, right? One used to be used in vaccines, and the other is contained in fish.

Those that induce sudden death or autism et al after vaccines should make better products.

What evidence do you have that vaccines cause autism or sudden death. Real evidence, a cite from a real medical journal would be required (and by "real" that excludes "Medical Hypothesis" and the Journal of American Physicians and Surgeons).

How can we justify 1 million SIDS and currently 12 million neurologically ill children in USA alone by 2009?

Even though I know you just made up these numbers, could you tell us how you came up with those numbers?

According the Wikipedia page of American Demographics about five million babies are born per year. Are you now claiming that close to 20% of babies born in the USA die before they are one year old?

Anyway, here is how I am going to use my two URLs:
Do immunisations reduce the risk for SIDS? A meta-analysis., which says:

Immunisations are associated with a halving of the risk of SIDS. There are biological reasons why this association may be causal, but other factors, such as the healthy vaccinee effect, may be important. Immunisations should be part of the SIDS prevention campaigns.

and Encephalopathy after whole-cell pertussis or measles vaccination: lack of evidence for a causal association in a retrospective case-control study.

No country I know of uses TB vaccines. Why? There is more TB around the world today than ever. It didnât work.

You need to provide a cite. The TB vaccine was not used in the USA, but is still offered in other countries... and it was not very effective. But you need to provide actual evidence there is more now than a century ago.

Did smallpox vaccine bring about the end of smallpox? No. The vaccine use in USA was stopped before it was made extinct. No pandemics of smallpox occurred when it remained in small pockets in countries with no vaccines in USA and many other countries.

You obviously do not have a clue. Of course it being stopped being used in the 1970s in the USA, after several decades of the last smallpox case in that country.

As has been said before: John Fryer is a liar. He makes stuff up and expects us to believe him.

Has anyone addressed the autism rates in other countries with vaccination programs similar to the USA's? It seems to me I only hear anti-vax alarmism from the USA and from the UK to a lesser extent (Wakefield's legacy).

If childhood vaccinations were linked to autism, then we would expect to see higher autism rates in other countries, too. Right? But we don't. Ergo ...

Of course, this line of thinking may be too logical for the anti-vaxers.

Playing with John Fryer the Liar's numbers:

How can we justify 1 million SIDS and currently 12 million neurologically ill children in USA alone by 2009?

According to Children Characteristics there are 73,357,484 children in the USA. The 12 million number you quote is 16% of the total. Funny how that number matches those children who are one standard deviation away from the mean on either the low or high side: http://en.wikipedia.org/wiki/Standard_deviation

Do you have any real data other than playing with the "half of all children are below normal!" game?

Where is John Fryer a chemist at anyway? Kazakhstan?

Shorter Wheatdog

thinking may be too logical for the anti-vaxers

The rest of your sentence was superfluous

John,

What you seem to be lacking here is a good perspective on American history. Up until about a hundred years ago or so, the mortality rate from diseases that we can now prevent with vaccines was staggering. Truly staggering. I actually teach history, so this is something I have spent a little bit of time studying. If you want to read something that will chill your blood, find some of the personal accounts of the Progressive volunteer hygiene workers in big cities from the turn of the century. These were people who were offering assistance to the ghetto-trapped poor in urban areas. In their diaries and letters, you'll find stories about what it was like in the poor parts of Chicago and New York, and the parts of these accounts that always stand out to me is when the Progressives write about the sound of the ghettos. In the summertime, as these hygiene workers went door to door through the tenements, they had to listen to the sounds of thousands of people screaming and sobbing in grief, because every summer, thousands of ghetto children would die of horrible, horrible diseases.

What you need to remember is that if we stop vaccinating children, that sort of prodigious child mortality will return. It won't return today, or next week, or next month, but within a few years, we will again have to deal with thousands upon thousands of childhood deaths every single year from measles, rubella, pertussis, polio, diphtheria, tetanus, you name it. We can't really be certain that any of these illnesses has been completed eradicated in the wild - in fact, we know that many of them are definitely still around - and with all the rapid global travel we have today, if there's some isolated pocket of pertussis or polio in some small corner of Nowhere-istan, then it is an absolute certainty that it will end up here in America. The only question would be when.

Let's look for a minute at the vaccination question from the sort of cost-benefit viewpoint that I learned in my environmental science class. Lots of people claim that "vaccines cause autism". Just for the sake of argument, let's assume for a minute that this is actually true. In order to make some sort of informed decision about what we should now do, we need to know a few more things - namely, we need to know what sort of autism vaccines are causing, and in what percentage of the population vaccines are causing autism.

You may not know this, but autism is now considered a condition with a wide spectrum of presentations. In fact, when I get a student in one of my classes with autism (I'm a public school teacher), his or her special education paperwork will indicate that he/she has an "autism spectrum disorder". Autism can range from complete disability, where the affected cannot ever really learn to communicate effectively or interact with other people, to really mild, where the affected person just needs careful direction and minimal distraction to be able to function. Last year, I had an ASD student in one of my classes, and he was pretty much fine. As long as I gave him very specific, one on one instructions about how to do his classwork, he did a fabulous job on his work. When he finished his work early, he'd take some of my upper-level textbooks off the shelf and leaf through them, because he liked to look at the pictures. He was completely accepted by his classmates, who treated him like any other student. I never even saw any other students tease him over his physical ASD presentations (he blinked his eyes more than is usual and would sometimes be a little twitchy).

To take a pretty famous example of a parent with an ASD child - just because it's easier to discuss an example that everyone's already familiar with - I have seen pictures of Jenny McCarthy hugging her son and walking with him while holding his hand. While I do not mean in any way at all to lessen the difficulties a parent has in raising an ASD child, this visual evidence leads me to conclude that McCarthy's son does not have one of the more severe, debilitating forms of autism. So, even if the vaccine DID "give" him autism (a statement I don't believe, but am just discussing for the sake of argument) it seems fair to conclude that vaccinations don't necessarily give children severe autism.

So, if we are assuming that vaccines give a certain percentage of children a mild autism spectrum disorder, does this mean that we now automatically stop vaccinating children? I'm going to argue that, even if this were true, we would STILL vaccinate children.

If vaccines are giving 5% of children mild autism, this is STILL a better outcome than we would be facing if we didn't vaccinate children. Because if we didn't vaccinate children, within the span of a generation, we would be back to childhood mortality rates that we would now consider unacceptably, astronomically high. To put it in its most naked form, if I had to choose between giving your child a mild form of autism or letting my child die, I would choose to give your child autism to save my child's life. And I'm willing to bet that any parent who is being honest would make the same choice. You would give my child autism to save the life of your own child. It's as simple as that.

In fact, we have a real-world example that indicates that people are willing to make exactly this sort of choice when placed in this sort of situation. The older form of polio vaccine would cause a mild form of polio in a very small number of children who received the vaccination. The chance of getting polio from the oral vaccine was extremely small - nearly one in a million. I'm willing to bet anything, however, that this statistic provided cold comfort to the parents of that one in a million child who got sick from the vaccine.

So, why on earth did we continue to vaccinate children when we knew for a fact that a certain number of the children we were going to vaccinate would get sick? Simple: the number of children who got sick from the vaccine was orders of magnitude smaller than the number of children who would get sick if we DIDN'T vaccinate. I think that here in the U.S., our government used to maintain a fund that was used to reimburse the families of those who got sick from the vaccine, but I'm not sure of that - I am young enough that polio as a summertime terror never existed in my lifetime.

If the anti-vaccers were making the argument that vaccines caused a serious form of autism in a large number of children - and if that claim were actually true - then it would be time for us as a nation to sit down and critically reevaluate our vaccine policies. Of course, that would also mean we'd have to get used to having tens of thousands of our children die every year. But if all you want to claim is that vaccines may cause milder autism in some children, then it honestly doesn't even matter whether the claim is true or not, because that claim provides no justification whatsoever for changing our current vaccine policies.

God, I'm longwinded. Many humble apologies for that.

Jillian -- we don't have to find pertussis or diphtheria in Nowhereistan. They're right here in the USA, still in circulation. Pertussis, diphtheria, tetanus, HIB, pneumococcus, and several other bacterial diseases aren't going to be eliminated -- the bacteria that cause them don't need us.

We're just snack food for them, convenient if available.

Also -- as long as you're looking at the 19th century, check out the New York Department of Health records for diphtheria deaths in the birth-to-ten-years ages.

D.C. -- yeah, you're definitely right about that. I've talked before to doctors who work at inner-city hospitals, and they've told me they get a fair number of children with pertussis in their ERs. The only reason why it doesn't spread out of those neighborhoods is because the rest of us are vaccinated. I suppose a lot of low-income parents either don't realize they can get vaccinations for next to nothing at clinics, or they may not know about vaccinations at all. I've also heard they see a surprising number of kwashiorkor cases, and I even have a student attending the school where I work who has rickets - and I teach in frigging Miami! But that's a whole other story.

There was an entire genre of literature aimed at romantic young girls in the nineteenth century where the beautiful but impoverished woman falls in love with the wealthy man of her dreams and plans her wedding, only to be stricken with consumption and wasting away in her beloved's arms. A little poking around on Wikipedia showed me that there is still an active sanitorium in the U.S.

If you want to live in a densely populated area like the United States and enjoy all the nice things you can get when you live in such an area, then you have to play by the rules that make it possible for us to maintain that population density. Vaccines are a key method for making our current lifestyles possible - along with things like water treatment plants and sewage systems. Anti-vaccers are the equivalent of people refusing to use a toilet and just crapping in a bucket all the time and dumping the bucket out on the street. I don't care how much animus you may have for the trappings of modern life - your animus does not trump my right to live in the healthiest society possible.

I shouldn't pile on here, but it's too tempting for me to resist. Just one of Mr. John Fryer Chemist's comments:

"The disgraceful race to rush through a new vaccine after the April Fool spin of âfatalâ flu to a vaccine by August means there can be no adequate safety testing."

The use of quotes around the word fatal means...what? That the 263 reported H1N1-related deaths (in the U.S. and its territories so far) are fiction? No doubt Mr. John Fryer Chemist will enlighten us.

"What finally changed it was after my wife had gotten scared by some anti-vax propaganda and wanted to use a delayed vaccination schedule. At first I basically shrugged and said, "As long as he eventually gets all his shots, I'm supportive of what you want to do." My wife wouldn't accept this, though, and pressured me to help her come up with a schedule that made sense -- and as soon as I caved in and started educating myself on the subject, I became adamantly against delaying the vaccines at all."

This reminds me of how when I was about 16 or 17, while I understood the evidence supported vaccination, I was getting involved in autistic advocacy, and so found myself both countering anti-vaxxers and talking to them in a way that wouldn't alienate them - a balance of politics sort of way. So at first, while I understood that there was absolutely no reason to delay vaccinations or spread them out, I would occasionally make a reference to such a thing (as better than not vaccinating) in order to placate people concerned about vaccinations and also the target of my own messages. This was before I realized the risks of spacing out the schedule (namely that babies would be more susceptible to vaccine-preventible diseases), so I realized that just supposing "oh, well if you're uncomfortable with vaccines, you can space them out" isn't a good answer, especially since babies are more prone to the worst effects of these diseases. This whole "delaying the vaccines" idea probably gets a lot of people who are nervous about vaccines but not enough to deprive their kids of the immunity to vaccine-preventable diseases, to delay them, since they figure the kids will get them eventually and it would be "the best of both worlds". No, not when you have been realistically informed about the (unlikely) side effects (that don't include autism) and the harmful potential of delaying immunity from the diseases.

However one chooses to articulate, it is better that an idea be distinctly conveyed, so that it can be agreed or disagreed with, the points discussed and the evidence examined. Otherwise, when one effective presents an evidence-based viewpoint and an anti-vaccine viewpoint, and says that they are in between, they are not helping to reconcile, but to obfuscate the issue and on the tipping point, the anti-vaccine is what is promoted, even if both perspectives are offered, and presented as both your own.

I am a life-long fence-sitter, one who would always hesitate to take a position because I preferred unity and calmness among everyone, sometimes enough that I would downplay the truth in order to be conciliatory. This is something in myself that I have had to fight and fight hard to become an advocate. Yes, the tact is a good thing to keep, so long as you don't bend over backwards and drop the evidence and your values to appease everybody (which is never really possible, even among your own community, whether that's the advocacy community, local community, etc.). The key is to take a stand, have sound reasoning behind it, and to explain it in terms that are as clear and not insulting as you can. There are niches for taking a rougher examination of those unscrupulous woo-sters (such as this blog), though I would never show this blog to my aunt for instance, who's into a number of woos, but is often receptive to logical reasoning, and I think of her as a generally reasonable person with a few blind spots in areas she doesn't know about (I think the Internet can help facilitate people's blind spots, although surely before the Internet they would just go to the local health food store or to a book store, snake oil peddler, or someone handing out pamphlets at a bus stop, in addition to word of mouth - but apparently there's something called a "brown recluse spider first aid kit" or something that is some herbal goo, and some people in California coast where Loxosceles reclusa doesn't even have a population, so while in an extremely rare event one in California may be bit by l. reclusa, especially if they had recently moved from a state where it lives, such as Missouri or Texas, there are many times when a necrotic lesion is assumed to be due to a brown recluse, even if they didn't even see a spider bite them - anyway my aunt apparently saw this on the Internet and mentioned that doctor should have it in the hospital, apparently stemming from the idea that it wouldn't be accepted due to a prejudice against herbal products or something, which is the main point of my run-on).

"No country I know of uses TB vaccines. Why? There is more TB around the world today than ever. It didnât work."

TB immunisation is compulsory in France. You have to have it to place your children in school. Have you heard of France? It's not the only one either. Ever heard of South Africa.

Just to point out one more lie from our "Chemist" friend. A stupid, pointless, easy to falsify lie.

I wish I could be as absolute and confident in my views as you, Orac -- or as the "true believers" in any perspective, from fundamentalist religion to absolute faith in anything labeled "science."

The truth is, I will never be able to shut the doors as firmly as you do. And I notice that you include in your list of items on which the door is slammed not only "true woo" but also accupuncture, which has been well-documented as a useful tool for pain relief.

My fear is that our culture of science seems to mean "if we science-oriented thinkers all agree, then we have discovered the truth." But consider the many, many revolutionary breakthroughs that seemed nonsensical to scientific peers until they'd been fully researched.

From radium to penicillin, we've found scientific truth in the oddest and least likely places. Sometimes we've discovered the truth by absolute accident -- and often the discoverers went through hell while trying to prove themselves right. Thomas Kuhn's History Of Scientific Revolution tells this story very well indeed.

On the specific subject of autism, I think it's clear that there is no one "autism." There are, instead, a wide collection of symptoms which, IMHO, are probably caused and treatable by a very wide variety of factors.

It seems clear to me that there is a group of people with "autism-like" behaviors who are also physically ill -- most with fairly severe GI symptoms. This group may be small, but that doesn't make them non-existent (heaven knows their parents speak up!).

I don't believe that there's any way you, ANB, or anyone else can claim that they fully understand the etiology of what I would term "autisms." If we knew, we'd all be in agreement, and could move on. Could some of these autisms be related to vaccines? My guess is that very few are -- but I don't rule out that possibility, especially given that vaccine damage is NOT unheard of by any means.

Meanwhile, a lot of the blog you cite also focuses on the issue that vaccines clearly have rare but dire side effects. I'm not sure why we wouldn't want to do all we can to lessen or eliminate those side effects, which include outcomes that are far more frightening than, say, Asperger syndrome.

Best,

Lisa Jo Rudy (Autism.about.com)

Lisa Jo Rudy
Acupuncture is NOT proven. Studies point overwhelmingly to a placebo effect. If it makes you feel better and you have the extra cash, go for it.

As for the 'rare but dire side effects' of vaccines: Autism is NOT one. No proof anywhere with the exception of liars like Wakefield. The other, rare and real side effects are well worth the risk to prevent the diseases the vaccines were designed for. Should we stop looking to make vaccines even safer? No. But the money fools like Jenny McCarthy have siphoned from real research might have helped in the effort. Instead it is wasted down the woo rabbit hole. Do not kid yourself that a 100% safe anything exists where human diversity is part of the equation. Take you best shot, back the best science and you will come out ahead as a population.

Lisa Jo,

I've seldom seen so many straw men argument in a single post. I did, however, expect from you the "fundamentalist" scientist ploy, in which you falsely label confidence in the science thus far as "belief." Here's the difference: I will change my mind if someone can show me some science as compelling as all the basic science, epidemiological studies, and clinical data that have failed to find even a whiff of a link between vaccines and autism or thimerosal and autism. The issue has been studied time and time again, and time and time again the answer has been the same. The only exceptions are poorly designed studies carried out by the likes of Mark and David Geier, etc.

Next, my inclusion of acupuncture was quite deliberate. I used to think there might be something to acupuncture, but then I actually read the scientific literature extensively. It is very clear that any effects of acupuncture are placebo effects. Here's a sampling:

http://scienceblogs.com/insolence/2008/08/the_largest_randomized_acupun…
http://scienceblogs.com/insolence/2009/05/another_acupuncture_study_mis…
http://scienceblogs.com/insolence/2007/09/yawnanother_acupuncture_study…
http://scienceblogs.com/insolence/2008/04/sham_acupuncture_is_better_th…
http://scienceblogs.com/insolence/2008/12/yet_another_acupuncture_metaa…
http://scienceblogs.com/insolence/2009/01/can_we_finally_just_say_that_…
http://scienceblogs.com/insolence/2008/02/yawn_still_one_more_overhyped…

No, Lisa Jo. Acupuncture is woo. Just like anti-vaccine lies.

Next, you use the "science was wrong before" argument. This is best refuted by these articles:

http://skeptico.blogs.com/skeptico/2005/11/science_wrong.html
http://www.skeptics.org.uk/article.php?dir=articles&article=science_has…

This is a gambit beloved of anti-vaccine cranks and, indeed, cranks of all stripes. Here's the problem again: Show me the evidence that science is wrong in this case.

Finally, you use another logical fallacy. Indeed, I liken you to a pyromaniac in a field of straw men, the biggest straw man of which is your claim that I (or ANB) have ever made the claim that we "understand completely" autism and ASDs. We most categorically have not. What we have said is that there is no good evidence to suggest a link between vaccines and autism. That we know to a high degree of certainty what does not cause autism does not in any way imply that we know what does cause autism, nor did we ever make such a claim. In any case, science is always provisional. It can be changed, but changing it requires evidence--evidence the antivaxers do not have.

In other words, your argument rests on multiple logical fallacies (straw men, false dichotomy, and, above all, the classic argument from ignorance, which states that, because we do not know something with absolute certainty we must assume that it is a strong possibility that it is true), not to mention a massive misunderstanding of science. Simply because we cannot ever completely prove a negative, you seem to be arguing that there is still a scientific controversy (that's the argument from ignorance). The problem is that, while we can never absolutely prove the negative (that vaccines absolutely, positively, never cause autism), we do have sufficient evidence to conclude that vaccines are so incredibly unlikely to be a cause of autism that provisionally it is reasonable to conclude that they do not. You then top that off by the logical fallacy of the golden mean, in which you try to assert that the "right" answer must lie somewhere between the anti-vaccine position and the scientific position that asserts that there is no compelling evidence linking vaccines with autism. Would you try to do the same thing with the Holocaust and Holocaust deniers? I doubt it? 9/11 history versus the 9/11 "Truth" movement? I doubt it. Evolution versus creationism? I doubt it. Yet you do it with the anti-vaccine movement versus science.

The reason most people use the "golden mean," I suspect, is that assiduous fence-sitting allows them (1) not to commit to a position and (2) (most importantly) to feel "superior" to the "fundamentalists" and paint themselves as being the "rational" ones trying to find a middle ground between two warring factions. All it does in reality is to demonstrate that their critical thinking ability and understanding of science are very deficient. Compromise may often represent the best course in politics, but it is a fallacy to carry it over to matters of science. Moreover, because the tactics of the anti-vaccine movement involve sowing fear, uncertainty, and doubt (FUD), your fence-sitting and expressing doubts plays into its hands perfectly. By taking the (falsely) seemingly "reasonable" course, you make yourself the perfect tool of the anti-vaccine movement, though you don't realize it.

If there is another panel about the anti-vaccine movement, I will be using you as exhibit A of enablers of the movement.

@ Jillian; @ DC: Exactly.In Brooklyn,NY is a national historic 19th century cemetary(Green-wood):being rather scenic with romantic era statues and buildings,it gets many tourists. I was taken there as a teenager and was shocked to see the the *ages* of those buried there.Young women, infants, children,young adults.Idea for an anti-anti-vax ad? Actress strolls through,looking at grave stones,she asks:"Why so many children and young people?"

Call me paranoid, but there's something creepy or altogether too naff about Lisa Jo's post. It almost reads as some sort of reporter set-up.

Then again, it's past midnight here in Australia. I may be just annoyed that we are getting trounced in the cricket.

Orac notes the fallacy of the golden mean.

It is human nature to believe in that. Don't think for a moment that groups like Generation Rescue (and 9/11 truthers and holocaust denialists) don't understand that quite well.

Generation Rescue's mission is quite clear: convince as many people as they can that vaccines cause autism. They then use the results of their public relations campaign to say, "well, so many people believe vaccines cause autism, there must be some truth to it." It is disingenuous and circular.

The fact of the matter is that Geneation Rescue lies. They aren't after the truth, but after convincing the public.

Lisa, I recently asked you a number of questions on your blog. I didn't intend those to be rhetorical.

Lisa, can you answer a couple of simple questions?

1) Did thimerosal cause an epidemic of autism?
2) did MMR cause an epidemic of autism?

If you can't answer those very clear questions with a "no", you haven't looked at the data. There is no claiming "there could be validity in either side" to those questions.

My fear is that our culture of science seems to mean "if we science-oriented thinkers all agree, then we have discovered the truth".

We couldn't ask for a clearer demonstration of complete lack of understanding of rudimentary science or the scientific method.

While on the surface, this appears to be logicalesque, expressing fear of an argument from popularity, it really applies to people who don't understand how science works as a methodology, and is therefore a straw man argument. No real scientist claims that because scientists agree that no link (epidemiological or biological) has been demonstrated for autism and vaccines, it is therefore true. That scientists agree, scientifically speaking, is an effect (irrelevant to the science itself), of understanding the data that does not reject the null hypothesis.

If Lisa Jo would learn how to look at the data, as well as understand the data, she might not have to fall back on (and project to others) her own emotional appeal (fear).

Lisa Jo's background is theology - she earned a masters of divinity from Harvard. Her reluctance to close the door on vaccines reminds me of Pascal's Wager - that we should be open to God's existence not because of any putative proof, but because it is the safest bet.

Orac, maybe you'd like to reference some of these studies involving autism and vaccines. You seem to be sharing Paul Offit's delusion about their having been done

epidemiological studies, and clinical data that have failed to find even a whiff of a link between vaccines and autism. The issue has been studied time and time again

I'm only aware of studies involving the MMR and thimerisol. If I'm not mistaken there are a few other vaccines protecting our vulnerable children from deadly, killer diseases that are only a plane ride away

Lisa Jo states:

My fear is that our culture of science seems to mean "if we science-oriented thinkers all agree, then we have discovered the truth".

Three problems with this "concern":

[1] Science is about "fact", not "truth" - if you want "truth", study religion. Scientific "facts" are generated by data, not simply made up by "science-oriented thinkers" sitting in armchairs. If the data support a particular hypothesis, model or theory, then it is accepted (by "science-oriented thinkers") as provisionally valid unless (or until) new data shows it is wrong.

[2] Concensus among "science-oriented thinkers" is irrelevant. Even if 99.9% of "scientists" believe something, all it takes is one person with data to overturn that "belief". To be sure, it won't happen overnight and it won't happen without a number of other people coming up with the same results (anyone can make a mistake), but the success story of science isn't that it never makes mistakes but that it automatically corrects those mistakes.

[3] Finally, Lisa Jo seems concerned that a consensus of "science-oriented thinkers" might be wrong about a scientific "fact". Her alternative seems to be a consensus of "non-science-oriented thinkers" - such would be the most accurate description of the "vaccines-cause-autism" movement. How this would be an improvement is left to our imaginations.

Lisa Jo gives equal weight to the scientific opinion of scientists and the non-scientific (one might even say anti-scientific) fears, imaginings and rumors of actors, businessmen and reporters. It is only in fiction (in which category Lisa Jo's writings belong) that people who are utterly unschooled in a field are able to make "startling discoveries" that the "dogmatic mainstream" have overlooked.

Rather than being "neutral" by giving "both sides of the story" equal weight, Lisa Jo is giving the "vaccines cause autism" side more weight than it is due by this (false) comparison. The vast preponderance of data available today indicate that vaccines do not cause autism. The only "data" suggesting that they do consists of a few discredited (and possibly fabricated) "research studies" and the "narratives" (i.e. anecdotal evidence) of some (not all, by a long shot) parents.

This is not a case of two equally valid "sides" - it is a case of a hypothesis ("vaccines cause autism") that is clearly dying for lack of supporting data. Attempts to breathe life back into this "dead parrot" hypothesis by claiming that it has the data it lacks are have been futile.

Lisa Jo is taking a slightly different path in trying to revive this hypothesis by claiming that data are irrelevant, that "truth" (I prefer "fact") is merely a consensus of the beliefs of "the people" and that "science-oriented thinkers" are no better at ascertaining scientific "fact" ("truth", to her) than any other group. This sort of muddled post-modernistic thinking is typical of the "vaccines cause autism" movement.

If Lisa Jo (or the movement she enables) wish to change the scientific "paradigm" on autism and vaccines, she (or they) should try to generate some actual data - not merely claim that data are irrelevant.

Prometheus

James Sweet @22,

Bingo. People forget, for example, that Orac has harshly criticized pharmaceutical companies on his blog as well. There isn't a "good team" and a "bad team", except maybe in the dichotomy between those who are committed to evidence and those who aren't

Thank you. I think there is a small but definite percentage of amoral people who think nothing of harming others for their own personal agendas and this is where the problem is started, then compounded by the rest of us who do or say nothing.this percentage is everywhere , in and out of corporations, anti and provax, on either side of most arguments;its up to us to call the b.s. on both sides.As for John,yes, France and Mexico use the BCG among several other countries.Uh, no that sleepiness after eating is a well defined medical phenomena associated with changes in blood distribution after stimulating the gut.I don't have enough room to address the errors in the the rest of the post but, Jeez, read up before you post again will you? And Sid, dear sweet Sid.All you have to do is read over a few of your own posts, here in the last few months to see your contradictions for yourself.I can't decide whether you have a horrible untyped progressive dementia or are just a pathological liar.

Finally, Lisa Jo seems concerned that a consensus of "science-oriented thinkers" might be wrong about a scientific "fact". Her alternative seems to be a consensus of "non-science-oriented thinkers" - such would be the most accurate description of the "vaccines-cause-autism" movement. How this would be an improvement is left to our imaginations.

D'oh! How did I forget to address this aspect of Lisa Jo's sad attempt to equate the "vaccines cause autism" belief system with the science that has utterly failed to find any whiff of a connection? She seems to think that relying on shoddy science, testimonials, and fear would somehow be the equal of relying on science. Another fallacy.

Ah the mystery contradiction gambit. Perhaps you'd like to enlighten me.

Perhaps you'd like to enlighten me.

http://www.youtube.com/watch?v=k55NuWQCh78

@DC

Looks like footage from the Simpsonwood meeting

Um, it took me a whole 15 seconds on PubMed to find more references than I could copy to studies on the possible side-effects of pertussis vaccines, just as an example, Sid. If you don't think these exist you cannot possibly have looked.

Most so called "antivaxers" are not anti-vaccine but against organomercury vaccines which may now be subjecting more babies than ever to mercury with the rising number of vaccines eg flu for the pregnant mother.

This is kind of dumb. How could vaccines be exposing "more babies than ever to mercury" when mercury preservatives are no longer used in any infant vaccines?

Giving 6 vaccines for one illness is not only insane but against the proven science of anaphylaxis.

You'll need to cite where the "proven science" is published that shows that multiple vaccines cause anaphylaxis. You might also want to consider that vaccines in general expose one to no more (and in many cases, much fewer) antigens than the common cold. So if exposure to a lot of antigens were a risk factor for anaphylaxis, there would be a lot of anaphylactic reactions to colds. Have you ever seen one. Note also that anaphylactic reactions are very distinctive (and not associated with autism, by the way). They generally require emergency care, so it is the sort of thing that gets noticed. So where is the evidence for a big increase in anaphylactic reactions?

Who knows where autism comes from?

Nobody knows for sure, but there is strong evidence of a very powerful genetic component.

I know of many recognised ways that it can be induced and lead is a metal less powerfully affecting the brain than mercury.

Yet there have been many documented instances of both lead and mercury poisoning, and in neither case is autism a result.

Rubella virus is another way babies get autism and yet all babies get rubella vaccine of which one blog claimed significant numbers get the live virus but can't produce antibodies.

Rubella vaccination declined in England following the Wakefield scare, with no effect on the incidence of autism.

Ah the mystery contradiction gambit. Perhaps you'd like to enlighten me.

Uh, read your own posts;no gambit, O Wise One, simply your citing of the studies in prior posts that you now say your're not aware of.

Not having a degree, or a huge amount of tertiary education, I am not as well versed scientifically as I would like to be. I also feel helpless in the face of such overwhelming publicity given to the anti vaccination mob.

I have read a lot of the literature and references. I sort of understand them, but again, not being especially 'scientific', have trouble conveying them into lay-terms.

But I have learned enough to decide that the science is as right as I can tell and the anti vaccination stance just does not add u. I defend vaccination, and have never backed away from intervening when seeing people trying to bullshit others (Mums at school with babies, expecting mums etc).

The other day I was searching (in vain) for a copy of Autism's False Prophets (for further education), when I happened upon a copy of THAT ^)*&^ing book "Healing and Preventing Autism". In the health section no less.

I was so bloody mad, I picked it up and hid it in what I thought was the least popular place in the bookshop - the accountancy reference section (apologies to Accountants).

I had thought of complaining to the bookshop, but being a large franchise, why should they care? It's a book and it sells. The two kids behind the counter were (a) supremely disinterested, and (b) not in a position to do anything about it.

I just wish there was more I could do actively. That being said, I will continue to promote and point people to the relevant blogs and websites in an effort to try and expose 'seekers' to the facts, not the fiction.

Orac, you continue to be an inspiration.

@Dr P

Uh, read your own posts;no gambit, O Wise One, simply your citing of the studies in prior posts that you now say your're not aware of.

You're speaking gibberish

@Annie: I have an extra copy of AFP (bought one, then won a copy). If you would like it, I'd be happy to send it to you. Send me an email at triskelethecat(at)gmail(dot)com.

Hey, if absence of the causal agent works in homeopathy, why not in vaccination?

On a more serious note, if fetal and infant mercury exposure is implicated in autism, there are more significant mercury pathways for that exposure: studies have found that mercury in the maternal bloodstream passes to the fetus through the placenta, and through breastmilk to infants.

That suggests some testable hypotheses: children in the same whose mothers have higher rates of mercury should have higher rates of ASD, and/or the rate should also vary with the duration of breastfeeding. Assuming there is an effect, it might also shed light on the significance of mercury exposure in utero or post-natal.

george, that type of study has been done. You can try looking it up in PubMed. Look up the Faroe Islands (different kind of mercury compound, but you get the idea).

Back to "What to do with Jenny McCarthy?": IMO, we slap her down. HARD. No, Lisa Jo, her opinion is NOT worth listening to. Nor is her boyfriend's. Nor are any other lay-parents, for that matter, although they for the most part aren't out pretending to be experts. I have, in fact, been very critical of the medical organizations for not taking a strong enough stand against pseudo-experts who are putting our children's health at risk. My usual line is that in response to any statement made by JM etc, the AAP and/or CDC needs to put out a counter statement like "The current vaccination schedule was created by internationally recognized experts in the areas of children's health and diseases, and is constantly under evaluation. We do not rely on the advice of washed up nude models nor two-bit comedic actors."

OTOH, folks like Jay Gordon, Bob Sears, Andrew Wakefield and even JB Handley need to be handled a little more delicately, because one could claim that they are also "health experts." They are wrong, of course, but they are in a different category.

Notice that even Amanda Peet doesn't say, "Vaccinate because I say so," but instead says, "Listen to our doctors."

"Giving 6 vaccines for one illness is not only insane but against the proven science of anaphylaxis."

Do you mean prophylaxis?

Do you mean prophylaxis?

No, the original statement was included for shock value.

Wrong again,Sid;read your old posts that cite the SAME articles you say you now have never heard of; I'm not going to do your work for you but take the time or don't post talking of gibberish.Hint; multiple studies, not just MMR,no evidence of autism.

Can one be a moderate about facts? Can one be a "math moderate"? Can one be a moderate about gravity?

Michael Goudeau had a great response on the panel when asked how we can counter Jenny McCarthy's popular appeal.
"I'd be glad to show my tits!" Look out, Jenny.

Can one be a moderate about facts? Can one be a "math moderate"? Can one be a moderate about gravity?

Michael Goudeau had a great response on the panel when asked how we can counter Jenny McCarthy's popular appeal.
"I'd be glad to show my tits!" Look out, Jenny.

I have wondered sometimes if the following sort of approach might make a positive impact on the "fence-sitters"....

Ask them to consider, just for a minute, what if vaccines really did cause some form of autism in some children. Ask them what type of autism they think it might cause (there's a vast, vast spectrum of autism disorders out there). Ask them how many children vaccines might cause autism in - what percentage of the vaccinated population, in other words.

Then show them mortality statistics for children from the pre-vaccine era. Explain to them that if we stop vaccinating children, it would be reasonable to expect us to revert to something similar to those levels within a couple of generations. Then ask them which would they prefer: to have a grandchild with autism, or to have a grandchild that dies before the age of five? Keep it simple, and let them know that the choice to not vaccinate is the choice to kill somebody's child.

I'm not a parent, but if I were, I think it would be a fairly easy choice to make if I had to choose between giving YOUR child autism, or letting MY child die. I bet just about every parent out there would make the same choice - sorry your kid has to be autistic, but I don't want my child dead. And what keeps a choice like that from being somehow selfish is that it is the choice we ALL would have to make if vaccines really did cause autism. Everyone would be sharing equally in that risk every time they had their children vaccinated.

It's almost as though these anti-vax parents are saying that it's better to have a dead child than an autistic child, and I don't think they quite realize this is what they are saying.

The problem is, Jillian, that in fact anti-vaxxers don't, in fact, risk their own children's death. They legitimately point out that mortality rates for these diseases are currently really low. And that's right. BUT it's because we vaccinate! They take advantage of the herd immunity that we provide for them. Therefore, they count on us to absorb this serious (at least to them) risk, but they get to share the benefits.

Unfortunately, this only works if their numbers are small. When too many start thinking they can sponge off the rest of us, all of sudden the risk goes up for everyone. But they don't care. For them, the effect on everyone else doesn't matter. Just a bunch of selfish freeloaders.

Then show them mortality statistics for children from the pre-vaccine era. Explain to them that if we stop vaccinating children, it would be reasonable to expect us to revert to something similar to those levels within a couple of generations.

Confounders? Are you suggesting the environment has not changed and has no effect on the transmission of infectious disease?

sorry your kid has to be autistic, but I don't want my child dead.

Compassionate.

It's almost as though these anti-vax parents are saying that it's better to have a dead child than an autistic child, and I don't think they quite realize this is what they are saying.

Um, that's not what I hear them saying. They are saying that the majority (typical, robust children that handle encounters with infectious disease fairly well) vaccinate to protect the minority (immune-compromised, those that don't seroconvert and the elderly)... among other things.

As a person with no children that has been vaccinated, I don't understand why others are relying on perfect strangers to protect them or their children from infectious disease. Arguments like herd immunity don't appear to stand up to scrutiny very well, and there are documented outbreaks of vaccine preventable disease in vaccinated people.

Knocking "fence sitters" with legitimate questions, because there are some, likely won't go far in swaying them into your camp. Saying stuff like you're sorry their kid's autistic, but at least YOURS isn't dead probably won't either.

cynical:

Arguments like herd immunity don't appear to stand up to scrutiny very well, and there are documented outbreaks of vaccine preventable disease in vaccinated people.

The only people who think herd immunity does not stand up to scrutiny because vaccinated people get disease are those who do not understand:

1) basic mathematics
2) basic fact that vaccines are not 100% effective (if you look you will see only the anti-vaxers are claiming that others think vaccines are 100% effective).
3) basic epidemiology

Again I shall post some herd immunity arithmetic:

Take 1000 people (ignoring the infants under 2 months who cannot be vaccinated, or babies under a year who can only be partially vaccinated), if 5% refuse vaccines then the numbers are:

950 vaccinated persons (assuming full schedule)
50 unvaccinated persons

The pertussis vaccine is actually only 80% effective at worse, so the numbers are:

760 protected persons
190 vaccinated but vulnerable persons
50 unvaccinated persons

There is an outbreak and it gets spread to 20% of the population, then:

760 protected persons without pertussis

38 vaccinated persons get pertussis
152 vaccinated person who may still get pertussis

10 unvaccinated persons get pertussis
40 unvaccinated persons who may still get pertussis.

This is how more vaccinated persons get the disease than unvaccinated. Even if the infection rate was at 100%, there would still be more of the vaccinated getting the diseases because there are more of them!

Actually, the question really is not "YOUR child autistic or MY child dead", the question is genuinely "the [unproven] risk of YOUR child autistic or the [demonstrable]risk of YOUR child dead."

"cynical" -- are you claiming that confounders, such as the general health of the population, hygiene standards, etc. HAVE changed so much since the 60s????

And besides, immune-compromised people often cannot be vaccinated. And, healthy, non-immune-compromised children are still, also, vulnerable to the sequelae of infectious diseases such as measles -- for gods sake, all you have to do is look at the deaths and the cases of deafness and brain-damage from encephalitis in religious communities in the Netherlands, non-immunizing populations in Wales, and in the "healthy, wealthy" upper-middle-class suburbs in California where false vaccine scares discouraged vaccinations! A little bit of observation would go a damned long way!

"cynical" -- The principle of herd immunity is simple -- when there are not enough vulnerable individuals in a population to sustain a population of the disease organism, then you don't get outbreaks of the disease in those vulnerable populations which remain -- and it is basic, logical, and demonstrable. Why on earth do you think it isn't? Recent outbreaks have happened because we have dipped below the level of herd immunity in recent years because of these false fears of vaccination, and there ARE enough vulnerable individuals in the population to sustain populations of the disease organisms.

This isn't rocket science -- or at least it shouldn't be.

Knocking "fence sitters" with legitimate questions, because there are some, likely won't go far in swaying them into your camp. Saying stuff like you're sorry their kid's autistic, but at least YOURS isn't dead probably won't either.

But it works both ways - if I get my kids vaccinated, and one of them becomes autistic, it would be the price I would have to have paid to keep THEIR child from dying, as well.

Like I pointed out before, the oral polio vaccine is known to cause polio in a small percentage of people who take it. Despite that known risk, America STILL required children to get the polio vaccine. Why? Because fewer people got polio when everyone got vaccinated than the number of cases caused by the polio vaccine itself. Cold comfort if YOUR child is the one who got polio from the vaccine - but while I am sympathetic to the travails of the parent whose child gets polio from the vaccine, I am completely unsympathetic to the parent who thinks it's okay to spare THEIR child from the risk that the rest of us have to undertake. Living with population densities as high as we have them today is going to inherently entail certain risks. If you're not willing to do your part to help mitigate them, then please leave.

Of course, this entire discussion is academic, because paper cuts pose bigger health risks than MMR vaccines.

Can one be a moderate about facts? Can one be a "math moderate"? Can one be a moderate about gravity?

I feel that the value for pi is way to confusing, and thus unnecessary. I mean, who needs to carry pi to 10,000 places? Isn't that what calculators are for? It's too many, too soon. As a math moderate, I feel pi should be something more manageable, like 2.0. I've witnessed regression to the mean shortly after carrying pi to the 200th decimal point. My anecdote is my math.

if I get my kids vaccinated, and one of them becomes autistic, it would be the price I would have to have paid to keep THEIR child from dying, as well.

Ok, it would be, IF vaccination had anything at all to do with autism. Current evidence suggests that there is no correlation, much less causation between vaccination and autism risk. If your kid is autistic (and autism is something that they probably had from conception, it's just that it isn't until about 2 years that their behavior becomes complex enough for it to be noticed) then your choices are having a child with autism and an increased risk of dying from preventable diseases versus having a child with autism who is protected from measles, polio, etc. I'd take option B myself but then again I'm not one of those who say that autism is worse than death, being autistic and happily alive myself.

I can understand the existance of moderates. I have witnessed the 'masters' of acupuncture with many years of training and study demonstrate very skill and results which appear to back their predictions. It is very hard to dismiss them lighty. As far as I know they have never taken part in any of the studies or been observed by the 'anti-woo camp'. Similarly some anti-vaxers I have met appear to have done endless research and provide me with much written material whereas the local health professionals mainly put me on a guilt trip. So I believe the the 'logical, scientific' camp have a challenge to research and present their case convincingly.

@Jillian

You have added a great deal to this discussion, but there is a problem with saying "I would rather your child be autistic than my child be dead" since there is no such choice to be made, since autism is not a possible outcome of vaccination.

It's merely a thought experiment that just gives the anti-vax fuel for their outrage. "Why that's cold and cruel of you!" and then they clutch their pearls, with a Godwin fail close on the heels of their saucer-eyed shock.

It's no different than saying (supposing someone believes that the MMR vaccine might possibly make your child homely and socially awkward), "I would rather my child be homely and geeky rather than dead from a preventable illness!"

Except that homely and geeky is not a possible outcome of the MMR vaccine. So this choice is purely speculative and entirely intellectual--disconnected from the real world.

An either/or proposition where either the "either" or the "or" is not a possible outcome is not helpful, especially when you are dealing with people who are as immune to fact and reason as some anti-vaxers are.

(One must presume they came on this immunity "naturally" rather than from an inoculation.)

Donald C:

Similarly some anti-vaxers I have met appear to have done endless research and provide me with much written material whereas the local health professionals mainly put me on a guilt trip. So I believe the the 'logical, scientific' camp have a challenge to research and present their case convincingly.

The problem with the "endless research" they say they have done is that it is seriously flawed. It is often from questionable sources, makes inaccurate conclusions from studies (the Burbacher study is a case in point), takes teeny tiny studies and blows them out of proportion (like Wakefield's study of a dozen specially selected children) or the documentation is purposely wrong (the entire Generation Rescue website with their laughable "Fourteen Studies" bit).

If you have issues with your local health provider putting on a guilt trip, contact your local public health agency and ask for information. There is plenty out there.

The "logical" camp have been putting their information out there. Have you read much of this blog since its inception on blogspot almost five years ago? Have you heard of the CDC Pink Book? Have you heard of Rosalyn Carter's organization Every Child by Two? (I am at my two URL limit, so you will have to find these websites yourself) Have you been to the American Academy of Pediatrics website? How about the Immunization Action Coalition? Have you heard of the two websites by non-medical professionals; stopjenny and jennymccarthybodycount?

I agree with the critique of Rudy's argument. Orac, you are an excellent philosopher. However, I still find myself critical of the vaccine schedule.

I wonder if the rate at which vaccines are administered is due in part to cost and convenience, ie to cut down the number of visits to pedi's office. I often hear those reasons in support of the current schedule. My concern stems from anecdotal experience, but not having anything to do with the vaccine/autism link. My child suffered from multiple adverse reactions, which my pedi told me were attributable to different vaccines administered via the same shot. Each of the reactions was relatively common. At some point, aren't we morally obligated to factor in the risk of multiple adverse reactions and should it not be given more weight than cost/convenience?

Laura @ 81:

You are "critical" of the schedule because you "wonder" about the motivations behind it? That's just nonsense. Let's call a duck a duck and admit that you believe you KNOW what the motivations are. Too bad you're wrong.

There are many other reasons why fewer shots are better. Just ones I can list off the top of my head, not even being a doctor:
- REDUCED other adverse reactions (anything that's a per-shot risk).
- Reduced risk of complications (e.g. infection of the puncture)
- Reduced pain from the injections
- Greater odds of compliance

Let's also not discount cost, of which you seem so contemptuous. It's crucially important. Convenience less so, but still a factor that absolutely should be considered.

And that's all assuming that your report of what the pediatrician said is accurate, AND that he was right. It seems implausible to me that synergistic effects leading to adverse reactions really would be common. And even if they were, I 100% guarantee you that such things were very carefully considered when settling on the standard schedule.

Splitting up vaccines for certain individuals with a demonstrated problem specific to the combined form, sure - absolutely. But you're going beyond that into pure unfounded conspiracy theory.

Laura,
These adverse reactions, were they as serious as measles or mumps? Polio?

The schedule is certainly for the benefit of the majority (within medical reason). Shots are combined for the convenience of everyone concerned. I don't remember loving the pediatrician's waiting room with sick, screaming kids. Going 3 or 4 times rather than once would have been a burden on my time and exposed my kids to more sickness. The schedule is reasonable and safe for the vast majority of kids. Reactions happen, usually not serious and in very small numbers.

Obviously, looking for conspiracies, one might expect that the docs and big pharma would love the extra cash for extra visits and extra packaging but, in fact, most docs prefer to see more patients thereby providing more service and big pharma doesn't make huge profits from vaccines. The only side that might push hard for combining is insurance so that payments are reduced but I have seen no credible reports to that effect.

Sorry your kids got sick but these are human populations and with the variability of genetics, variability of results must be expected and tolerated.

"I wonder if the rate at which vaccines are administered is due in part to cost and convenience, ie to cut down the number of visits to pedi's office."

Countering that we have lower cost and greater convenience for the parents based on fewer doctor visits, plus a lack of evidence that multiple vaccinations at one time pose a higher risk of side effects than doling out each vaccine one at a time over multiple visits. It is also important to avoid unnecessary delays in achieving full vaccine protection (which you'd have by stringing out visits).

A point of clarification:

It seems implausible to me that synergistic effects leading to adverse reactions really would be common.

I mean specifically "common" relative to adverse reactions that are either a per-shot or per-disease risk. (The former being decreased by combining shots, the latter being unaffected.)

Damn, the medical community can't win, can they?

On one side, you have the "Pediatricians are conspiring with Big Pharma to boost profits by having so many vaccines." On the other side you have Laura with, "They are combining vaccines in order to reduce the number of office visits." So are they money hungry, or not?

The funny thing is, I've actually asked the same question in return about Bob Sears's "alternate schedule." By spreading out the vaccines over more visits, Sears gets to charge for more office visits, and therefore gets more money out of each patient. If the AAP were really interested in boosting profits, they would be all over a more drawn out schedule.

So Laura, have you ever questioned the motives of those who advocate spreading the vaccines out? Especially given that even Bob Sears will admit that he has no evidence that it is any safer.

"They spew so much misinformation with such enthusiastically burning stupid, and they continue to do it after having been corrected time and time again, having been shown time and time again where they are in error, not just by me but by many, many others".

Talk about spewing so much misinformation... What about those who spout about the wonders of the Danish epi Autism studies or Fombonne's bogus study out of Canada (where he mistakenly confused Montreal with Quebec City). Talk about burning stupid.... What say you?

"My little five minute introductory talk for the panel was entitled: "I'm not 'antivaccine'":The biggest lie."

If I were to give a little introductory talk to your 'skeptics' there... I would entitle it:

"We have open minds just show us the science: The biggest lie".

I have never seen one 'skeptic' who says something like this actually accept that their science is faulty in any way. None of you would ever consider that vaccines can be a huge problem... it shows your ignorance/possible intentional reasons for misleading the public.

Hi Scott -

I mean specifically "common" relative to adverse reactions that are either a per-shot or per-disease risk. (The former being decreased by combining shots, the latter being unaffected.)

According to the CDC, some types of adverse reactions seem more common with single type shots as opposed to their broken apart counterparts.

http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/pediarix/faqs-hcp-pe…

Is the safety profile of Pediarix similar to that of the three component vaccines?

Overall the rates of other adverse events were comparable in clinical trials, although infants who received Pediarix had somewhat higher rates of fever >100.4°F than infants who received the component vaccines injected at separate sites.

Is it safe to give Pediarix with Hib and PCV at the same visit?

These vaccines may be given at the same visit. However, safety information is not yet available for all doses in the primary series when Pediarix, Hib and PCV are given at the same visit. After the first dose of Pediarix with Hib and PCV, the rate of fever >100.4°F was higher than when hepatitis B vaccine (Engerixâ¢), DTaP (Infanrixâ¢), Hib, and PCV were administered separately at the same visit.

Also, I believe that the MMR+Chicken Pox vaccine, ProQuad, was found to cause seizures in a much larger number of children than in children getting MMR + CP in separate shots. Apparently, in order to get titers up, ProQuad had 5X the concentration of CP antigens than the standlone shot; it is speculated this could be the reason for the observation of increased seizures, but a real answer really isn't known. They also aren't exactly clear why increased concentrations of antigens were really necessary; just that the titers didn't get there until they pushed them in there.

http://www.msnbc.msn.com/id/23388526/

- pD

The one who can never stick to a 'nym said "Talk about spewing so much misinformation... What about those who spout about the wonders of the Danish epi Autism studies or Fombonne's bogus study out of Canada (where he mistakenly confused Montreal with Quebec City). Talk about burning stupid.... What say you?"

Hello Common Sue. Have you ever tried to read for comprehension, or to actually post real evidence instead of your strings of insults and idiocies?

According to the CDC, some types of adverse reactions seem more common with single type shots as opposed to their broken apart counterparts.

Never said it couldn't happen; I questioned how often it happened relative to the reverse. Your link makes zero attempt to address the relative rates and is therefore entirely irrelevant.

Also, I believe that the MMR+Chicken Pox vaccine, ProQuad, was found to cause seizures in a much larger number of children than in children getting MMR + CP in separate shots. Apparently, in order to get titers up, ProQuad had 5X the concentration of CP antigens than the standlone shot; it is speculated this could be the reason for the observation of increased seizures, but a real answer really isn't known. They also aren't exactly clear why increased concentrations of antigens were really necessary; just that the titers didn't get there until they pushed them in there.

Got any real cites? But even taking the MSNBC article on its face, it does quite a nice job making the other part of my argument - that doctors keep close tabs on such possibilities, and will split the vaccines back up if it turns out to be warranted by an increase in adverse reactions.

And for the central point of which type of reaction is more common, it's again a single example and irrelevant to that point.

Whatever ..... Sue M,
AoA spouts bull start to finish. If that's where you feed, its no wonder you have indigestion.

I'm truly sorry someone confused a city. Good reason to assume he can't do science. I'm sure that never happens to you.

The advantage of science and the scientific method is that science expects errors, investigates and corrects them in time. AoA is perfect, always right - just ask them. When do you suppose AoA will post the headline: "Wakefield Research Fraud Proven - Brian Deer was Right!"? Just for starters. I'll wait.

"One of the issues that came up over which there was somewhat of a disagreement is exactly how to deal with prominent antivaccine activists, people such as Jenny McCarthy."

Why make things difficult. Hire Major Gen. Bertie Stubblebine (ret) and Dr. David Morehouse, Ph.D., to perform their well-known thought process "The Men Who Stare At Breasts" until Jenny's C-Cups shrink. After that no one will pay any attention to her.

"AoA spouts bull start to finish. If that's where you feed, its no wonder you have indigestion".

What does AoA have to do with Fombonne and the Danish epi studies being bogus?

"I'm truly sorry someone confused a city. Good reason to assume he can't do science. I'm sure that never happens to you".

Right... Fombonne published a study in which he confused Montreal and Quebec City in the study... Thereby making his results rubbish. So, you are correct... He can't do science. And yes, I have made mistakes previously... however, what do my mistakes have to do with a supposed "expert" making such a lame mistake and then having his results (again based on a mistake) published in scientific journal. How sad... Even more sad that a lot of pediatricians probably believe the Fombonne/Danish studies nonsense.

"Have you ever tried to read for comprehension, or to actually post real evidence instead of your strings of insults and idiocies"?

My reading comprehension is fine thank you. Real evidence? Do you mean like Fombonne's bogus Canandian study or the Danish Epi Autism studies? Is that what you consider real evidence? Just wondering.

Showing the faults of a study is not evidence that vaccines cause autism, celiac, diabetes or anything else.

All you have ever presented is either denigrating comments, anecdotes and insults (one of your "proofs" was a photo of a sign at some rally!). What you need to show is actual factual evidence that I can read in a paper available in my local medical school library. This has been mentioned before, but you don't seem to understand that. I attribute that your lack of reading comprehension.

"Showing the faults of a study is not evidence that vaccines cause autism, celiac, diabetes or anything else".

No kidding, HCN. I never stated otherwise. Here's the thing... Orac discusses this Tam7 meeting that he attended. In looking at the information there is actually a blurb which states:

"A conference on critical thinking"

So, can someone use their critical thinking skills here and explain to me how it is ok to publish studies which are proven to be frauds? Can someone explain to me how it is ok for the CDC to use the Danish epi studies as 'evidence' of the safety of vaccinations.

Let's see how much Orac et all learned from the 'critical thinking' conference.

Remember, of course, that Fombonne's study actually didn't confuse Montreal and Quebec City, it's merely that Sue is confusing Quebec City and Quebec Province.

And then remember the "problems" with the Danish study were that one epi study by Danish people was required to shift from a single category to two combined categories because the way the data had been reported shifted, therefore every Danish epi study ever is wrong. Even though that specific study noted the problem and did their best to break the numbers down into a consistent format.

But being proven a liar over and over hasn't stopped Sue yet, so I don't see why it will now.

"Remember, of course, that Fombonne's study actually didn't confuse Montreal and Quebec City, it's merely that Sue is confusing Quebec City and Quebec Province".

Liar, Liar... pants on fire. Either that or you can claim ignorance. It's one or the other. You pick. Read this, Fombonne is either a fraud or a horrible researcher.

http://vran.org/legacy/docs/Yazbak_2007-03-07_FLAWED_EPIDEMIOLOGY.pdf

"In âPervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizationsâ (1) Fombonne et al reported that in a group of English-speaking Montreal children born from 1987 to 1998, the prevalence of pervasive developmental disorders (PDD) was high and increasing. They also claimed that during the same period, Measles-mumps-rubella (MMR) vaccination coverage had decreased and concluded âThus, pervasive developmental disorder rates significantly increased when measles-mumps-rubella vaccination uptake rates
significantly decreased.â

The MMR uptake data used âwere available through N. Bouliane, BN, MSc of the Direction de Santé Publique de la Capitale Nationaleâ and were âroutinely collected in the region of Québec among 5-year-old children attending kindergarten during 1993-2004.â

La Capitale Nationale refers to Quebec City, located 265 kilometers from Montreal. Ms. Bouliane confirmed that the MMR vaccination rates were indeed from the Quebec City area but refused to release them to me because they were administrative internal information only intended for research.

There are several published vaccine uptake surveys of Montreal. MMR vaccination rates of
children 24 to 30 month-old in the Montreal area increased from 85.1% in 1983 (Baumgarten) (2) to 88.8% in 1996-97 (Valiquette) (3) to 96% in 2003-04 (Health Department Survey) (4)

The above suggests that in Montreal PDD prevalence and MMR vaccination rates were in fact increasing in tandem during the study period.

The readers deserve to know why the authors compared developmental data from a specific group of children in Montreal with MMR vaccination data from the city of Quebec, some distance away".

"And then remember the "problems" with the Danish study were that one epi study by Danish people was required to shift from a single category to two combined categories because the way the data had been reported shifted, therefore every Danish epi study ever is wrong".

EXACTLY. They are all WRONG. So, feel free to use your critical thinking skills to explain why it is ok to continue using these studies as back-up information for the safety of vaccines side... Bogus.

"But being proven a liar over and over hasn't stopped Sue yet, so I don't see why it will now".

Who's the liar, Michael? I'm pretty sure that it might be you. Feel free to check on that...

Common Sue said "So, can someone use their critical thinking skills here and explain to me how it is ok to publish studies which are proven to be frauds?"

Like the stuff by Wakefield and the Geiers? (for review on Wakefield and Geiers, read http://scienceblogs.com/insolence/2006/06/antivaccination_warriors_vs_r… ) Or that Poling did not declare a conflict of interest on his paper about his daughter? Then there was a paper written by someone whose husband is the AoA webmaster (I can't remember the name).

These seem to get Common Sue's stamp of approval. Either she does not understand what fraud is, or her reading comprehension is worse than I thought.

Common Sue, you obviously did not read with comprehension the last time you pulled Yazbak "criticism" on Fombonne out, here it is for you to review (since Robster is better):
http://scienceblogs.com/insolence/2008/02/still_more_evidence_that_its_…

And I found more:
http://interverbal.blogspot.com/2007/03/review-of-critiques-of-fombonne… ...

__Begin Quote__
Dr. Yazbak goes on to assert:

âWhen he was in France, Dr. Fombonne was a well known psychiatrist who published articles on psychiatric topics. He was still a psychiatrist when he moved to England â¦until Andrew Wakefield suggested that the link between MMR vaccination and autism should be further investigated and suddenly â¦Dr. Fombonne became a âpsychiatrist / epidemiologistâ and a consultant to the UK medical authorities on MMR vaccination and autismâ

The Wakefield controversy began in 1998. So:

Fombonne, E. (1996). Is the prevalence of autism increasing? Journal
of Autism and Developmental Disorders, 6, 673â676.

Fombonne, E. (1997). The prevalence of autism and other pervasive
developmental disorders in the UK. Autism, 1, 227â229.

QED.

The author further asserts that:

âIt is obviously customary to disclose sources of funding, Disclosing sources of âNon-Fundingâ on the other hand is unusual. In any case, it is nice to know that Dr. Fombonneâs research was never funded by the âIndustryâ.â

This is easily explainable in that Dr. Fombonneâs work has been informally criticized as being supported by the pharmaceutical industry, possibly with the intent that he would manipulate the data in favor of finding no association. This statement may have been given to help put such non-sense to rest.

Conclusion

It is important to remember that the weak criticisms in the critiques above do not remove the genuine and quality criticisms. The authors do point some genuine problems. The failure of both editor and Dr. Fombonne to make adequate response is also disagreeable.

By the same token some of the criticisms are remarkable for their lack of relevancy or factual basis. There are problems with these critiques that have a real potential to mislead others. It is to be hoped that the NAA and the authors will take steps to amend this, leaving their better criticisms intact.

__End Quote__

Question, why should we take Yazbak's word on anything after he helped a baby killer get out of jail? This is a serious question on how to evaluate Yazbak's motives and ability to give an unbiased critique, especially when he could not do a simple PubMed search to see how far back Fombonne has published.

Anyway, Common Sue, you still have not brought any real evidence to the discussion. You still cling to the anti-vax literature like it gives you some kind of edge. You don't even understand if you reject a paper for fraud, you must also reject other papers with obvious fraud (ever hear of Wakefield and the Geiers?).

And there are still these papers:
Autism and Measles, Mumps, and Rubella Vaccine: No Epidemiological Evidence for a Causal Association.
Taylor B et al.
Lancet 1999;353 (9169):2026-9

Prevalence of Autism and Parentally Reported Triggers in a North East London Population.
Lingam R et al.
Arch Dis Child 2003; 88(8):666-70

MMR-Vaccine and Regression in Autism Spectrum Disorders: Negative Results Presented from Japan.
Uchiyama T et al.
J Autism Dev Disord 2007; 37(2):210-7

Measles Vaccination and Antibody Response in Autism Spectrum Disorders.
Baird G et al.
Arch Dis Child 2008; 93(10):832-7

Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study.
Hornig M et al.
PLoS ONE 2008; 3(9): e3140 doi:10.1371/journal.pone.0003140

Autism and Thimerosal-Containing Vaccines. Lack of Consistent Evidence for an Association
Stehr-Green P, Tull P, Stellfeld M, Mortenson PB, Simpson D
American Journal of Preventive Medicine, August 2003, Vol. 25(2):101-6

The Evidence for the Safety of Thimerosal in Newborn and Infant Vaccines
Clements CJ
Vaccine, May 7, 2004, Vol. 22(15-16):1854-1861

Thimerosal Exposure in Infants and Developmental Disorders: A Prospective Cohort Study in the United Kingdom Does Not Support a Causal Association
Heron J, Golding J, ALSPAC Study Team
Pediatrics, September 2004, Vol. 114(3):577-583

Neuropsychological Performance 10 years after Immunization in Infancy with Thimerosal-Containing Vaccines
Tozzi AE, Bisiacchi P, Tarantino V, De Mei B, D'Elia L, Chiarotti F, Salmaso S.
Pediatrics, February 2009, Vol. 123(2):475-82

Impact of specific medical interventions on reducing the prevalence of mental retardation.
Brosco JP, Mattingly M, Sanders LM.
Arch Pediatr Adolesc Med. 2006;160:302-309.

Encephalopathy after whole-cell pertussis or measles vaccination: lack of evidence for a causal association in a retrospective case-control study.
Ray P, Hayward J, Michelson D, Lewis E, Schwalbe J, Black S, Shinefield H, Marcy M, Huff K, Ward J, Mullooly J, Chen R, Davis R; Vaccine Safety Datalink Group.
Pediatr Infect Dis J. 2006 Sep;25(9):768-73.

Childhood vaccinations, vaccination timing, and risk of type 1 diabetes mellitus.
DeStefano F, Mullooly JP, Okoro CA, Chen RT, Marcy SM, Ward JI, Vadheim CM, Black SB, Shinefield HR, Davis RL, Bohlke K; Vaccine Safety Datalink Team.
Pediatrics. 2001 Dec;108(6):E112.

Okay, last thing today, I promise. And this is not even directed at Common Sue. Really!

Orac said "What specific evidence would it take for you to accept that vaccines are safe relative to the risk of disease and to vaccinate your children and urge your friends to vaccinate theirs?"

This is something I have wanted to know for a while. I have asked, asked again, reworded and asked what actual factual evidence that any one has that the MMR or the DTaP are worse than the diseases. This is especially crucial since measles as returned to the USA, the rate of American babies being killed by pertussis is increasing, and it won't be long before we will see Congenital Rubella Syndrome, more mumps, tetanus and even diphtheria.

I have yet to get a real answer.

Of course I have conditions: no random websites, no studies bought and paid for by lawyers (especially if they were retracted!), no studies in "Medical Hypothesis", no news reports --- just a real paper I can read in a medical school library (oh, and in vitro studies don't compare the risk of the vaccine with the disease, just as showing bleach kills bacteria in a petri dish does not make it a good way to get rid of strep throat in a three year old!).

So here is another study I found that shows the effectiveness of vaccines:
http://pediatrics.aappublications.org/cgi/reprint/110/4/653

It says "Without a Hib vaccination program, the model estimated that 17 589 Hib invasive disease cases and 665 deaths would occur among a cohort of 3 815 469 children. From the direct cost perspective, these cases would result in costs of $1.35 billion, including a cost of $7.6 million for rifampin prophylaxis used for household contacts and child care contacts. From the societal perspective, these cases would result in costs of $2.58 billion (Table 3). In the presence of a national Hib vaccination program, the number of Hib cases and deaths is reduced by 99.7% and 99.6%, respectively. The Hib vaccination program results in 97 878 years of life saved, 27 301 discounted years of life saved, and 113 644 QALYs gained."

Yep, it said that 655 children would have died without the vaccines. The number of kids who would live and yet be permanently disabled is more (the discounted years of life and QALY (Quality Adjusted Life Year) numbers give you a hint as to that effect).

I am now convinced that the anti-vaxers who discount the value of the vaccines versus their real risks are either deluded, or really really hate children.

Can someone explain to me how it is ok for the CDC to use the Danish epi studies as 'evidence' of the safety of vaccinations.

What specifically are your criticisms of "Danish epi studies" and which studies are you criticizing? Without that information it's hard to tell if you have a point or not.

"Like the stuff by Wakefield and the Geiers? (for review on Wakefield and Geiers, read http://scienceblogs.com/insolence/2006/06/antivaccination_warriors_vs_r… ) Or that Poling did not declare a conflict of interest on his paper about his daughter?"

Apparently, you are confused. Maybe Wakefield and Geier are frauds... (I don't think so) but anything is possible. So, Wakefield and Geier, Poling, etc... give their accounts... and ask for what? More studies to be done. A closer look into the possibility. In the case of Wakefield... trying to understand what is going on with children with autism who have bowel disease - what a concept a doctor actually trying to get a handle on bowel disease. How horrible of him. What's the other side... The CDC resorts to using bogus studies as their "defense" of vaccinations. Who's wrong.

(hint: You)

"What specifically are your criticisms of "Danish epi studies" and which studies are you criticizing? Without that information it's hard to tell if you have a point or not".

Sorry Dianne ...

This is literally something that I have personally done here AT LEAST 10 times. I have taken the time to link to reports. I (actually real experts) have shown over and over again how there is no way that the Danish studies can be used to show anything of substance. I just can't do it again... but anyone who follows the controversy knows that this is correct.

Study up.

"Common Sue, you obviously did not read with comprehension the last time you pulled Yazbak "criticism" on Fombonne out, here it is for you to review (since Robster is better):
http://scienceblogs.com/insolence/2008/02/still_more_evidence_that_its_…"

LOL! Good one HCN. Let's see what he said:

"Is it possible that his concerns on where numbers came from and how they were treated have merit? Yes, and perhaps they suggest that further study should be performed to determine what the larger trend is".

So, there you have it. Fombonne - the genius that he is - used faulty information in his "study". Thereby making his study garbage. The fact that instead of simply acknowledging that and moving on with more studies, etc... He instead wants to turn this back around on Yazbak... Gets a big old 'WHATEVER' from me. The facts are the facts. Whether it was Yazbak or Donald Duck who brought to our attention the lack of attention to detail that Fombonne used in his "study" doesn't make much of a difference to me. In fact, what it says to me is that Donald Duck would be one step ahead of Fombonne in the researcher category.

Silly Sue,
So many words, so little sense.

Wakefield is a fraud. His fraud has cost many children their health and some their lives. He continues to spout rot.

There is no link between vaccines and autism. Genetics is the key and if so much money hadn't been wasted fighting that truth, we'd be a lot closer to finding those genetic links.

Sue:

This is literally something that I have personally done here AT LEAST 10 times. I have taken the time to link to reports. I (actually real experts) have shown over and over again how there is no way that the Danish studies can be used to show anything of substance. I just can't do it again... but anyone who follows the controversy knows that this is correct.

Actually you have not shown where they are in error. You just say they are and for some odd reason expect us to take your word for it. Which really is not good enough. Also links to websites like vran, generationrescue, safeminds and nvic are also not good enough.

So what? It does not matter in that there are several other studies from several other countries that show no real link between vaccines and autism, and like MikeMa said, there are several that point to several genetic sites.

The science has been done, the link between vaccines and autism does not exist. It is a dead link⦠âItâs not pininâ! âItâs passed on! This link is no more! It has ceased to be! Itâs expired and gone to meet its maker! Itâs a stiff! Bereft of life, it rests in peace! If you hadnât nailed it to the perch itâd be pushing up the daisies! Its metabolic processes are now âistory! Itâs off the twig! Itâs kicked the bucket, itâs shuffled off its mortal coil, run down the curtain and joined the bleedinâ choir invisible!! THIS IS AN EX-LINK!! â (hat-tip to Monty Python and the dead parrot sketch)

"Wakefield is a fraud. His fraud has cost many children their health and some their lives. He continues to spout rot".

As I said... Maybe, maybe not. To say that he has cost many children their health and some their lives is crazy talk. As we know, thousands of children are also injured/killed by their childhood vaccines. To say that he 'spouts rot' means that apparently you KNOW what causes autism? Since you can't be sure... all opinions are still on the table, friend.

Genetics ONLY is a complete joke. I have no issue with saying that autism has a genetic factor but clearly there are environmental triggers as well. Anyone who says otherwise is uniformed (or not very smart).

"The science has been done, the link between vaccines and autism does not exist".

Here we go again... By "science" you mean all those studies which were done that have been shown to be frauds? Just so we are clear, you claim that the "science" has shown that there is no link between vaccines and autism - yet when we show that this "science" is based on bogus information... you still feel comfortable saying that the "science" is conclusive? Apparently, you didn't go to the TAM7 conference. Where is your critical thinking cap?

It's no wonder that people don't trust people like you anymore. It may help your cause to get people to trust you if you actually admit that the "science" is not there to make any conclusive arguments. Just a thought. Typically people can smell through the bs that you spout :)

Sue:

By "science" you mean all those studies which were done that have been shown to be frauds?

There have been over thirty studies done in half a dozen separate countries that show no relationship between vaccines and autism. They have been linked to several times, and yet you just claim they are fraudulent --- yet claiming that Wakefield has not committed fraud when there is real evidence to back that up. Plus you have posted one iota of evidence to back up your claims (links to a critique is not evidence).

Oh, well. You have a closed mind.

"There have been over thirty studies done in half a dozen separate countries that show no relationship between vaccines and autism".

Oh super. Post your Top 5 studies for review.

Thanks so much! LOL...

@moron
See post 101, you twit. I count 12 studies there.

"I count 12 studies there".

So, which of those are your top 5? I ask because many of those are VERY lame attempts. Very lame.

Let's get something straight here.

YOU do not get to decide which studies are "better" or "lame."

You are just one person, as am I. Neither of us gets to say "Well this study looks lame, so it doesn't count."

That is the job of the scientific community. And when these studies were published, the community looked at them and accepted them.

Beyond that, consider the following:

Number of nonfraudulent, peer-reviewed studies showing no significant risk from vaccines cited in this thread alone: 12.

Number of nonfraudulent, peer-reviewed studies showing significant risk from vaccines in the entire world: 0.

Ziltch. Nada.

The side with no evidence does not get to declare that it's the other side's job to prove their point.

The side with no evidence's job is to shut the fuck up and find some, or accept that they were wrong.

Of course, this point has no chance of getting through to your ideologically inoculated skull, but it has to be said nonetheless.

Meh, it doesn't matter how many studies are posted, or how good they are. Sue/moron has made up her mind, and that's that.
-- Anyone who is capable of holding onto Wakefield's study as "probably not fraudulent" despite the fact that he misreported the medical records of at least 8 of the 12 kids in his study in order to manipulate the number, type and timing of symptoms, all other more arcane issues with the study aside...
-- and yet can magnify any possible minute issue with the other studies, such as finding that the number of categories had to be changed in light of data, into "fraud"...
-- you know perfectly well that an individual doing this has no interest in reason or reasonableness, they are simply looking for excuses.

"No evidence of connection" and "no statistical correlation whatsoever" are awfully intellectual and abstract concepts, when someone is simply operating off a visceral hatred of vaccines.

Thank you Luna. Starting to feel like herding cats or smacking smoke. The entertainment value fades.

Each one of Sue's heroes will be laid waste and her villains exonerated or replaced. It won't matter. She will not vaccinate and it will not matter what proofs exist. She will not believe nor understand. Time to move on.

I (actually real experts) have shown over and over again how there is no way that the Danish studies can be used to show anything of substance.

Funny how Generation Rescue will claim that when they want to discount the Danish studies, then turn around and use the same data to "prove" vaccines cause autism.

Oh Really @ 109:
"Wakefield is a fraud. His fraud has cost many children their health and some their lives. He continues to spout rot".

As I said... Maybe, maybe not. To say that he has cost many children their health and some their lives is crazy talk. As we know, thousands of children are also injured/killed by their childhood vaccines. To say that he 'spouts rot' means that apparently you KNOW what causes autism? Since you can't be sure... all opinions are still on the table, friend.[/quote]

We don't know what causes autism, but surely we can rule some things out? There's enough evidence that it isn't vaccines. It's a dead horse, and a lot of effort has been spent investigating it.

If you accept all opinions uncritically, then you must also accept the opinion that autism is demonic possession. Do you? Or are you willing to actually form an opinion when it comes to parents burning their child alive to try to purge the demon?

Genetics ONLY is a complete joke. I have no issue with saying that autism has a genetic factor but clearly there are environmental triggers as well. Anyone who says otherwise is uniformed (or not very smart).

Nice attempt to proactively discredit anyone daring to hold a contrary opinion. How does that fit with your plea to keep all opinions on the table, exactly?

Fact is, you aren't open-minded at all, nor are you a fence-sitter. You have a clearly established opinion and are openly hostile to all others, despite your pretense of fence-sitting.

Another good question is, "Do you know that the recommended childhood vaccines have dropped 96% of their antigens in the last twenty years and now have 4% of the antigen load they had in 1980?" (Follow link for graph of antigen amounts from 1900 to 2000.)

"There's enough evidence that it isn't vaccines. It's a dead horse, and a lot of effort has been spent investigating it".

Really? There's enough evidence that it isn't vaccines? No, so sorry. That isn't true... Vaccines are a very likely trigger to autism.

"Fact is, you aren't open-minded at all, nor are you a fence-sitter. You have a clearly established opinion and are openly hostile to all others, despite your pretense of fence-sitting".

I'm not a fence-sitter at all... I absolutely believe that vaccines trigger autism (and other conditions). I try not to speak in definitives because I don't think that the 'science' is established either way... but my beliefs are my beliefs. I do have issues with the morons who claim that the evidence is conclusive that it isn't vaccines. That's just stupid.

This whole "responses to vaccines" thing reminds me of several years ago when the B.C. government was going to spray insecticide to control cedar bud-worm (or some such). On the scheduled day, dozens if not hundreds of parents called to say that their children had had a bad reaction and the insecticide had made them sick. Unfortunately, spraying had been cancelled for that day due to weather conditions...

I know that some visits on the immunization schedule call for separate injections in different parts of the body. It's tough to be a little kid getting five needles in a visit for different diseases (not six for one as someone said above) but it makes them more effective and allows smaller amounts to be used. But the reaction, if any, is likely to be redness, soreness, or perhaps fever. It does not compare with deafness, paralysis, or death as a consequence of not getting vaccinated.

There have been over thirty studies done in half a dozen separate countries that show no relationship between vaccines and autism.

This is intellectually dishonest. Studying one component of vaccines, and a combo shot on the schedule does NOT mean "vaccines don't cause autism". I don't know if they do or not, and really, I don't care. But crappy epi studies that look at thimerosal only, and a handful of others that looked at bowel disease and MMR, used as the means to proclaim that the science has spoken is plain wrong. If that's all it takes to convince you folks, well fine. Don't expect everyone else to follow suit. If fence sitters do so because they realize that the statement that "science has spoken" is riddled with holes, how can you blame them?

Post #35 said âWhat you seem to be lacking here is a good perspective on American history. I actually teach history, so this is something I have spent a little bit of time studying.â Citations of infectious disease mortality rates at the turn of the 20th century which then skip directly to post-vaccine mortality statistics convey an incomplete, and therefore inaccurate, history of the 20th century decline in childhood infectious disease mortality in the US. This cursory examination omits several important pages of history which demonstrate that 85% of the 20th century mortality decline occurred in the first half of the century, prior to antibiotics and vaccines.

A 2000 Pediatrics article has this to say on the subject of the 20th century decline in mortality: âFor children older than 1 year of age, the overall decline in mortality experienced during the 20th century has been spectacular. Nearly 85% of this decline took place before World War II, a period when few antibiotics or modern vaccines and medications were available.â Vaccination, while first used in the 18th century, became more widely implemented in the middle part of the 20th century. âVaccines against diphtheria, tetanus, and pertussis became available during the late 1920âs but only widely used in routine pediatric practice after World War II. Thus vaccination does not account for the impressive declines in mortality seen in the first half of the century.â

Annual Summary of Vital Statistics: Trends in the Health of Americans During the 20th Century, Guyer B. Freedman MA Strobino DM and Sondik EJ, Pediatrics 2000; 106;1307-1317

A 1999 JAMA article contains some enlightening graphs illustrating the dramatic decline of infectious disease mortality in the first half of the century, see figures 1, 3 and 4.

Armstrong GL, Conn LA, Pinner RW, Trends in Infectious Disease Mortality in the United States During the 20th Century, JAMA 1999;281(1):61-66

Even post-vaccine declines in disease incidence and mortality are not completely understood. Columbia professor of public health James Colgrove, PhD, MPH writes:

âOver the course of the 1930âs, the incidence of diphtheria plummeted even as rates of immunization remained flat or declined. The rate of diphtheria had been dropping slowly for decades before toxin-antitoxin came into use, and even supporters of the practice conceded that it was difficult to state definitively how much of the reduction was attributable to immunization and how much to overall improvements in hygiene or a natural decline in the virulence of the disease.â

On the decline of polio in the 1960âs: âOverall vaccination rates did not correlate neatly with the rapidly dwindling number of cases: the percentage of the population immunized against polio peaked in 1964 around three-quarters, and then hovered at around two-thirds for the rest of the decade. Whether the remarkable decline was due to the ability of the Sabin vaccine to spread attenuated strains to unvaccinated members of the community or was the result of some other epidemiological phenomenon remained a matter of speculation.â

Colgrove J, State of Immunity: The Politics of Vaccination in Twentieth-Century America (2006) University of California Press. (pages 107 and 147)

Oh yes, cynical, then there are all the studies showing a relationship of vaccination to autism, such as...um...well...you know! All those studies!

@Diatom: do the articles that report the decreases in mortality report the morbidity of the disease? Do they report on the increase in licensed nurses who did home visits or the improvement in enforcement of isolation (either at home by quarantine signs or by hospital isolation wards? Mortality from those decreased in many states with the establishment of the VNA. They taught families ways to cope with disease. But still, many died. And of those that didn't, what were the changes in disease morbidity as mortality went down? Sure, fewer people died, if that's all you look at. But how many suffered from the sequelae of the disease, or died and had the death attributed to another cause? Recently I found a letter from a family member, reporting the death of her young child from "pneumonia" in the 1950's. However, other letters from family members (her own letters and other family members) which cover the same time, state the baby was sick with "hooping cough" (sic). What did the baby die of? Pneumonia? Pertussis? Pneumonia as a sequelae from pertussis?

My mother remembers the summer terrors of polio. On the hottest days they weren't allowed to go swimming because of polio outbreaks. Her best friend got it and spent the rest of her life in an iron lung.

I'll happily take vaccines with their proven assistance in decreasing the incidence of disease over a hypothetical "vaccines-cause-autism" mindset.

Science and ethics really aren't quite as separate as all that... as this conversation makes extremely clear.

Jillian says:

"the oral polio vaccine is known to cause polio in a small percentage of people who take it. Despite that known risk, America STILL required children to get the polio vaccine. Why? Because fewer people got polio when everyone got vaccinated than the number of cases caused by the polio vaccine itself. Cold comfort if YOUR child is the one who got polio from the vaccine - but while I am sympathetic to the travails of the parent whose child gets polio from the vaccine, I am completely unsympathetic to the parent who thinks it's okay to spare THEIR child from the risk that the rest of us have to undertake. Living with population densities as high as we have them today is going to inherently entail certain risks. If you're not willing to do your part to help mitigate them, then please leave."

This is tough stuff. Is a parent's first responsibility to his own child? or to the greater community? Is your OWN responsibility to yourself and your integrity, or to the community that supports you? This question arises when young men have to register for the draft; when parents decide whether to vaccinate; when we may choices throughout our lives.

Not simple questions to answer -- and the subject of great debate throughout the centuries.

Lisa Jo