It's now been over a week since the first installment of Brian Deer's expose in the BMJ revealing the depths of Andrew Wakefield's fraudulent research. Over that week and a half or so, I've wondered just how someone like Wakefield could have had so much influence over so many parents. True, the British press was guilty as sin when it comes to credulous reporting of Wakefield's original case series, which, even if it hadn't been fraudulent, would not have justified Wakefield's promotion of the idea that the MMR vaccine caused a syndrome consisting of regressive autism and enterocolitis. However, no matter how much medical authorities and scientists tried to counter Wakefield, it didn't seem to work.
What might work is parents talking to parents, which is why I'm glad I've discovered The Vaccine Times, whose purpose is:
The purpose of this site will be to present the best information available (that I can unearth), and trying to stay clear of expressing too many opinions, although I may fail in that regard every now and then. Every entry will be chock full of links to the sources of my information, so the reader can judge for herself if my conclusions are warranted. The idea is to make information available to anyone interested, so we may all make our decisions based on the facts not the hype.
The latest issue is here.
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This is an awesome project by Leart and co. Here's hoping that it's here to stay. We need to get more people subscribing to make this so.
ORAC
You who published here January 10, 2011 2:36 PM Mr Deer's formal looking statement which included this:
Unfortunately, Mr Deer's statement misses out the crucial family doctor [ie. General Practitioner or GP] National Health Service records. These were not provided to the Royal Free Hospital, were not part of the hospital records and are the key documents upon which all his allegations are based regarding The Royal Free team's 1998 Lancet paper ["early report"].
Could Mr Deer please clarify his statement regarding the GP records as a great many people would like to know the answer?
And what is the relevance?
Mr Deer claims to have gone behind the paper - but he has not. It is clear now from his publication in the British Medical Journal that he compared the Lancet paper's findings with the GP records. That is comparing apples with concrete.
The 1998 Lancet paper was written by Wakefield based on the data and results provided to him by those specialists. They had the initial referral letter from the GP, the "Red Book" of developmental progress [held by the parents], fresh parental histories taken by Professor Walker-Smith [not Wakefield], test and clinical examination results and any further information in any ensuing correspondence with GPs.
If Mr Deer wanted to "go behind" the paper then he needed to have that data and those results and compare it with the contents of the Lancet paper.
He did not do that, but in his statement he claims to have used just the hospital records "read under legal supervision".
The hospital records did not include the GP records. The GP records were not available to, did not form part of the hospital records at The Royal Free and were not used by the treating specialists at the Royal Free.
GP records are made by non specialists [General Practitioners], taken over years, by more than one person, omit information provided by parents and contain other information unknown to parents.
It is also clear from the transcripts at the GMC that the GP records are riven with fundamental errors like incorrect dates of vaccinations [eg. Child 8 - 7th January instead of 27th January - "I think" said the GP in evidence] and incorrect types of vaccinations being recorded [eg. Child 4 - was it measles vaccine or was it MMR - the records say MMR - the GP said in evidence it was measles].
The Royal Free Team consisted of 13 specialists who did their own examinations, took fresh histories and made their own specialist diagnoses afresh. They did not rely on shaky family doctor [ie. non specialist] records. This is standard practice in British NHS hospitals.
And there are significant inconsistencies in the account Mr Deer has now published in detail in The British Medical Journal. We will be happy to point these out in a later post. Child 1, 8 and 11 are easy examples and there are many more.
Furthermore, the GP records which Mr Deer cites extensively and in detail but regrettably inaccurately in the British Medical Journal are sealed under Court order. They are not available from the General Medical Council - only extracts read out in the GMC proceedings from the transcripts are available.
Mr Deer does not take shorthand notes but managed to publish in February 2009 allegations that Wakefield "fixed the data" based on the GP records. He has now published in the same general vein more extensively and in greater detail "fraud" allegations when fraud by Wakefield was impossible. If he had committed fraud then that would have been noticed by the other 12 authors of the 1998 Lancet paper long before now and before it was ever published.
As you can see therefore, an answer to the question about the GP records is fundamental. Can Mr Deer therefore please clarify his statement as this cuts across the entire credibility of everything he has ever published about Wakefield.
CORRECTION:
This ... "The 1998 Lancet paper was written by Wakefield based on the data and results provided to him by those specialists."
should read:
"The 1998 Lancet paper was written by Wakefield based on the data and results provided to him by the other 12 Royal Free team of specialists."
Vaccine Times may need to appeal to reticent parents' concerns without patronizing or preaching.
Priorties may need to be discussed. I noticed the Indiana Whooping Cough section. I think DTaP is a more important shot. If you can only spend effort to get 1-2 shots placed with a laggard family, as "most important" and that's it, which 1-2 would you promote?
I hired an elder care, minority worker. She had a nephew later die of H1N1 in the late fall, of the first year, before general availability of an H1N1 vaccine. What difference would 1500-4000 iu per day of vitamin D3 made? A Japanese study suggests 40+% reduced incidence of Influenza A at 1200 iu.
"Mr Deer does not take shorthand notes.."
I can confirm this having often sat within view of him at the hearing. I was also astonished to see the name of Harvey Marcovitch, chair of GMC panels but an associate editor of BMJ on the BMJ's editorial denouncing Andrew Wakefield. He notes whimsically:
"HM chairs GMC fitness to practise panels. He had no association with the Wakefield hearings and the views expressed in this article are his own and do not represent those of the GMC."
But it is very clear that if all this was to come unstuck the panel would be in the firing line. As I pointed out in my initial response to the editorial:
"Incidentally, the GMC case hinged on the claim that the Lancet was a misconducted version of the Legal Aid Board protocol 172-96 and not an "early report" as stated. The panel, for which Harvey Marcovitch has executive responsibility, found this to be the case beyond reasonable doubt but I was unable to find any specific evidence cited in the findings on the fact that it was so. I wonder if anyone can explain this apparent lacuna?"
And, of course, nobody has (and most notably not Brian Deer). In the interim it has come to my attention that Marcovitch failed to disclose his membership of UKRIO (United Kingdom Research Integrity Office) which is funded by a number of interested public bodies but also the Association of the British Pharmaceutical Industry.
As Deer once remarked "the ruling elite remains surprisingly small".
And Andrew Wakefield can join the legion of formerly promising cranks and quacks.
Orac - can you do something about the spammers?
From another website, I learn that Clifford Miller is child health safety (I am not sure what the ethical position of being a malevolent troll pretending to be a body for the protection of children, but we will leave that).
He evidently has neither read Mr Deer's report, nor indeed Dr Wakefield's, which says under 'methods': 'Children underwent gastroenterological, neurological, and developmental assessment and review of developmental records.'
Under 'patients and methods' it explains:
'Developmental histories included a review of prospective developmental records from parents, health visitors, and general practitioners.'
This is quoted verbatim in Mr Deer's report.
So, if Clifford Miller is correct, and Dr Wakefield did not have access to these records, his study is fraudulent in this respect also.
Perhaps 'childhealthsafety', as he wishes to be known, would like to explain the position.
Wakefield may have been discredited and his work shown to be nothing more than manufactured, fraudulent data but at least it is still rigorous enough to hold up to AoA standards of science. =P
childhealthsafety.com might have a horrible layout and spits out the usual anti-vaxx rhetoric and misinformation...
But at least no one is seeing it....
Alexa ranking of 16,611,754.
Hmmm, from looking at the "child health safety" site:
Uh-huh.
To Norman42 January 15, 2011 9:44 AM who said
You have not understood the post. You may like to re-read it.
In the meantime Brian Deer remains silent - even on the British Medical Journal responses and on his Blog in The Guardian newspaper.
To CaptTu - January 15, 2011 11:03 AM who said:-
This is in the usual vein of disparagement bullying and abuse you get on this blog - but no substance.
Got anything useful to say? No, didn't think so.
To Matthew Cline - January 15, 2011 11:30 AM [who appears interested in smallpox].
If you want to debate smallpox you can post on CHS - childhealthsafety.com
Many people are waiting to hear what Brian Deer has to say in response to the criticisms of his work - these appear on his The Guardian blog, on leftbrainrightbrain, in The British Medical Journal responses, on CHS and here on ORAC's blog.
He is unusually quiet.
Norman42
I answered your virtually identical comment on another thread but in case you missed it here it is again:
'In UK medical practice it would be unusual if not unprecendent for General Practitioner notes to be sent on to consultants. However, there is a booklet in red plastic covers which circulates between parents, GPs and health visitors in which standardised developmental histories are kept, and this is what is signified.'
@John Stone:
How are medical researchers supposed to operate if they don't get the full medical history of the people in their study?
Well then, it sounds like the red booklets Royal Free got was missing critical information (or Wakefield simply ignored anything in the red booklets he didn't like).
"I've wondered just how someone like Wakefield could have had so much influence over so many parents"
I've wondered how Wakefield can live with himself.
"Wakefield having so much influence over so many parents." This is a huge mistake to be assuming this. Most parents have not ever heard of Wakefield, especially back 10 years ago when people started to become leery of the ever- increasing schedule. I say this, not to stir up trouble but it is an honest fact. You do even your side a disservice to simplify the issue down to Wakefield. Most parents talk (after the hockey game, at the bus stop, at the front doors of the school etc.) And I guarantee you they don't mention him. They say things like, "wow, now there's a chicken pox vaccine" or" did you hear that they give hep b to babies in the US?" stuff like that. It's a pretty important first step to identify the problem and Wakefield really isn't the problem. Not having enough safety studies is a problem and distrust of some that supposedly exonerate things like thimerosal (Keersten Matsen et. al's Danish study) is a huge problem.
Jen, have you heard of word-of-mouth? It's not only a very effective marketing technique but how most myths, fallacies, misinformation, rumors and more get started. Think of other popular myths that so many people take as fact. "We only use 10% of our brains." "Don't go swimming within an hour of eating." No one can ever recall quite all the details, but this one starts with "Did you hear there was some study...?" Of course the Doctor's names are never mentioned. The exact shot is never mentioned. Afterall, we didn't carry around iphones and google with us all those years ago to instantly recall all the information. It passes from person-to-person becoming more vague, more broad, until it includes "all vaccines" and "a lot of doctors".
This is how information and stories have spread for hundreds of years. You even confirmed it in your post "Most parents talk (after the hockey game, at the bust stop, at the front doors of the school etc.)" Most can't recall the exact date, the details, but they hear "from a friend of a friend" or "I read something somewhere". Just because in this case we can pinpoint the starting point doesn't change the fact that the damage was done. Doesn't change the fact that Wakefield is responsible or that his influence started it. He is the problem.
Jen, have you heard of word-of-mouth? It's not only a very effective marketing technique but how most myths, fallacies, misinformation, rumors and more get started. Think of other popular myths that so many people take as fact. "We only use 10% of our brains." "Don't go swimming within an hour of eating." No one can ever recall quite all the details, but this one starts with "Did you hear there was some study...?" Of course the Doctor's names are never mentioned. The exact shot is never mentioned. Afterall, we didn't carry around iphones and google with us all those years ago to instantly recall all the information. It passes from person-to-person becoming more vague, more broad, until it includes "all vaccines" and "a lot of doctors".
This is how information and stories have spread for hundreds of years. You even confirmed it in your post "Most parents talk (after the hockey game, at the bust stop, at the front doors of the school etc.)" Most can't recall the exact date, the details, but they hear "from a friend of a friend" or "I read something somewhere". Just because in this case we can pinpoint the starting point doesn't change the fact that the damage was done. Doesn't change the fact that Wakefield is responsible or that his influence started it. He is the problem.
You really think that a parent who has never heard of Wakefield would know that the Danish study even existed?
Jen,
if Wakefield has no influence over parents, why do I hear them say stuff like "I'm not sure I should give my child the MMR because I'm worried about autism"?
Where did that worry come from?
Andrew Wakefield, parroted by Jenny McCarthy shouting from the rooftops.
Parents need to learn that this particular worry is groundless and based on scientific fraud.
Wakefield isn't the whole problem.
But he is a very big part of it.
Jen, only a few decades ago parents would talk about the little boy down the road on an iron lung because of polio, or the little girl who hasn't been the same since she got encephalitis due to chicken pox, or if they were going to the latest funeral of a child who had died from an infectious disease that is now preventable.
Vaccines are the victims of their own success, in a sense.
Then do you blame Wakefield for the DpT scare, too? Honestly, I hear parents speak of the increase on asthma and seizure, chronic illness and we do hear first hand accounts by people who have experienced the seizures following a vaccine, so I'm just saying it's too simplistic to think it all stems from Wakefield. Parent's stories of having witnessed a regression in skills were happening 10 years ago. I do get your point, Paul. I just think (and obviously many parents agree) that every childhood illness isn't direly in need of preventing. You have to weigh benefit VS risk.I remember an American doc on t.v. Talking about chicken pox and honestly his main talking point was how the parents wouldn't have to take sick days to look after a child with this illness anymore. That didn't impress me. Parents also question, in particular, the addition of hep b to day old infants when the mother can be tested for it. Yes, I know, what if she tested at 3 months and the dad cheated at 4 months, then of course it would make a difference but honestly that one seemed like a grab for money. It just didn't make sense.
I guess too, that whatever the starting point (wakefield's study, parent's regression stories, the feeling of adding an alarming number of vaccines to the schedule), the fact is that now, there actually are researchers who are exploring vaccine problems, inadequacies in studies have been pointed out and people are aware that there really should be a vaccinated VS unvaccinated study ( I realize you guys think this is unethical, but there are ways that it could be done or even primate studies comparing vaccinated VS unvaccinated). I guess what I'm saying is the past doesn't matter so much but if people are concerned with vaccine uptake then the onus is on them to do some serious reassuring studies, whether they like it or not. As health consumers we are also very aware of changing positions on health interventions. The HRT reversal comes to mind. As I said I think many parents want to pick and choose which vaccines to take. I gave some but not all to my kids and I wouldn't give them flu shots due to my nana having had guillaume-barre. My mother was outright told never to get one in case of a similar reaction. I had pneumonia 2 years ago and admittedly it wasn't much fun. I would also never give my daughter Gardasil based on all the serious adverse events-and I did have serious dysplasia that was treated. I assume you guys give your children every single recommended vaccine but you have to keep in mind that *if* you had kids back before chicken pox shots or hep b shots or flu shots for 6 month olds and on yearly, I think it may be hard for you to empathize with what they (parents of younger children) are having to think through. I know most of you won't agree with me but however it has come about, trust doesn't seem too high with this very packed vaccine schedule.
I also forgot to add that (again despite how this distrust all started) we are also hearing of increased numbers of children improving,even losing their autism daignosis due to bio-medical interventions- they can't have all not really had autism in then first place- and this tends to make it pretty obvious that many (though admittedly not all) cases of autism are due to environmental assaults of some sort. Neither of my children have autism, I work with special needs kids.
I would also never give my daughter Gardasil based on all the serious adverse events
*sigh*
Jen, about 4,000 women die per year in the US, due to cervical cancer. This is with screenings and treatments available.
There were 30 potential/possible deaths which were attributed by a lay public predisposed to disliking vaccines, over a period of more than 3 years, due to the vaccine.*
Even if the vaccine only prevented 70% of cases of HPV infection, and even if we make the extremely dubious assumption that every single one of those presumed deaths was a result of the vaccine (for purposes of this illustration, in reality this is not the case) -- that is still thousands of lives per year saved vs. a maximum of ten lost.
Nothing is risk free, but this is about playing the odds for what gives your daughter the *least* chance of a poor outcome.
The reality is that Gardasil must be one of the most-tested and most-scrutinised vaccines EVER to hit the market, and it was years in the making with the involvement of teams around the world -- and it represents what I genuinely would have thought was a gold medal winner for most people, it is a vaccine against CANCER; nevertheless, the anti-vaccinationist groups swing the propaganda machine into full gear to make sure that people hated it and feared it, using a lot of misinformation about how it had "never been properly tested."
Seriously, the test pool for the vaccine was over 22,000 people. How many clinical studies and test groups would it take to satisfy you?
-----
*I've had up-close-and-personal encounters with some of the people who have posted, re-posted and actively disseminated the list of girls who supposedly died as a result of the vaccine. Even after I pointed out that some of the deaths they listed occurred during a clinical trial as a result of the girls being in a car accident, they refused to alter the list. Apparently, if they hadn't been enrolled in the trial of the vaccine, they wouldn't have been hit by the car. So goes the reasoning, apparently. I'm still stumped as to how that implicates the safety of the vaccine, but it's kind of the level of reasoning I found.
Jen: "I had pneumonia 2 years ago and admittedly it wasn't much fun"
Oh you poor thing. Pneumonia can be such a drag. Good thing it's just a minor nuisance, right?
Broadcast singer Trish Keenan dies after suffering pneumonia
http://www.guardian.co.uk/music/2011/jan/14/broadcast-singer-hospitalis…
"...Keenan was earlier reported to have contracted the H1N1 flu virus along with pneumonia."
Jen, we also hear about how so many cancer patients "considered terminal by mainstream medicine" (so goes the standard spiel) are miraculously saved by such-and-so "natural intervention" or miracle alt-med cure. The problem comes in locating all these people who supposedly exist. Strange how remarkably quiet they all are.
There is also one big, glaring, important issue: autism is a disorder of developmental delay, that doesn't mean that there is no change or growth. An awful lot of autistic kids will make several large leaps of development during adolescence, absent any special intervention whatsoever (this is a documented feature of autistic development, which is becoming more and more documented as more attention is paid). And my husband and I have a number of adult autistic friends, now in their 30s and 40s, who got no intervention whatsoever, but are nevertheless managing their adult lives independently (if not always smoothly). One of them works in our mailroom, in fact. :)
It's a classic fallacy of attribution, to see that someone improves and attribute it to the last thing done to them -- but because that doesn't rule out coincidence in any way, that is why we have clinical trials. Blinded trials are specifically designed to rule out coincidence and biased memory or perceptions, and to demonstrate whether or not there is any rate of improvement over and above what would normally happen. ...And this is where the biomedical treatments which "recover" autistics inevitably seem to fail. Those things which have been tested at all don't show an effect above placebo, and some things are actually so dangerous in themselves (like chelation) as well as so biologically implausible, that no medical ethics board will approve testing. So, on the one hand you are kicking against the evidence for the safety of vaccines as inadequate, but on the other hand, you are pushing to use interventions which are entirely evidence-free. :-/
On a side note, as our understanding of autism improves, we are also able to spot it earlier and earlier -- or have you somehow missed the stories about screening of infant autistic behaviours now being possible? This really points to something which may even be in place by birth, but which just doesn't become glaringly apparent until more complex behaviours emerge.
As a mum in the UK with two young children (3 and 5) I cannot believe anyone would look at a red book as evidence of anything other than the date and batch number of vaccines given, and even then only those for which mum didn't forget the red book. My children's GPs have seen their red books exactly once, at their 2 month vaccinations. Other than that, it has been seen by health visitors and nurses if I happen to have had it with me when I spoke to them. Outside of the vaccination record, I believe there are only 3 entries in my daughter's red book. I rarely took her to see a health visitor as my regular clinic closed when she was 6 weeks old and none of the others suited my schedule. The GP never even asked to see the book after the 2 month jabs.
A red book may show evidence of an early concern about a child's development, if the parent discussed said concern with a health visitor and had the red book available that day (or remembered to add in an extra sheet used to record it). It cannot really show whether a child has developed normally, as even the short standardised pages for developmental checks are optional. I was told with both of my children, in two different parts of the UK, to come in for a developmental check if I had a concern. In no way were the checks mandatory and the 8 month and 18 month checks, the ones most commonly used, could easily miss signs of autism.
If Wakefield and co relied on the red book alone for developmental histories, they made a serious mistake. I don't believe anyone engaged in clinical research would believe the red book is sufficient for that purpose and would, in fact, request copies of the GP's notes as well as taking a medical history from the parents and perhaps checking the red book as well.
@ Jen #26
"I assume you guys give your children every single recommended vaccine but you have to keep in mind that *if* you had kids back before chicken pox shots or hep b shots or flu shots for 6 month olds and on yearly, I think it may be hard for you to empathize with what they (parents of younger children) are having to think through."
I am in a somewhat unique position in that 2 of my kiddos were born and had had most of their infant vaccine series before Wakefield's study, and I had a third child in 2007 (surprise!). I did not know there was a controversy until I had my *bonus baby* and I started reading on mommy boards about others delaying or not vaccinating altogether. I was completely shocked that people would even consider not vaccinating. This was not even a whiff of a consideration with my mid-1990s babies - everyone got their kids their shots. All my kids have had all their shots, or will when my oldest daughter gets her Gardasil series this year.
Given my experience, I'm pinning it all on Wakefield and the internets which really started becoming mainstream in the mid to late 1990s.
GPM - I agree. Stupidty is contagious & unfortunately the Internet is an extremely good carrier.
Jen, since you bring up the vax vs unvax study question, let me pose a question to you.
Would you volunteer yourself or your children for a randomized, double-blind, placebo-controlled clinical trial for a vaccine?
Honestly, would you? Since it's random and placebo controlled, you won't know whether you received the vaccine or the placebo until years later.
To save you the suspense, I can give you my answer right now: yes for me, no for my kids. I want them to get the vaccine. I asked my husband, and he wouldn't even pass up the vaccine for himself either.
And, no, I don't blame Wakefield for the DPT scare. I lay blame for that on Barbara Loe Fisher. But you know what? I'm in So Cal, and parents here aren't afraid of the DTaP vaccine. We're worried about the fact that there have been pertussis cases reported in our local schools.
The vaccine issue will NEVER go away. EVER! Too many parents have seen their children devastated after medical/governement ordered injections.
Too many scienceblobbers believe the lies that vaccines can not cause devastating harm to children.
Too many scienceblobbers believe that someone gets hurt but will never admit a single individual becomes permanently damaged.
augustine, please, seek help. I'm genuinely worried for you.
The whole Red book smokescreen is kind of hilarious,because from the GMC hearing we actually have a fairly good idea of exactly what information Wakefield had at the time he produced the case studies. There is no way that a reasonable individual can reconcile the information that Wakefield had at his disposal with the descriptions he gives in the Lancet paper.
The anti-vax and (Mr. Miller's) explanation's to the contrary are laughable and either centre on Wakefield's own paper thin defenses or that Wakefield and his team of specialists were simply far more awesome then other doctors. Both arguments fail in the face of reality.
The next time John Stone or CLifford Miller (CHS) suggest the red book is what Wakefield et al were referring to, ask for evidence of that. Wakefield et al make no mention of it in their retracted paper.
Hi Wren/Boojum,
I can confirm that the "red book" nonsense is purely sand thrown in our faces. There was never any mention of these at the General Medical Council inquiry, despite that inquiry going into all the documentation which could shine any light at all on what was wrong with the children, or what the doctors did to them.
One of several reasons why the GMC hearing went on for 217 days was that (to, I think, everyone's surprise) after the prosecution closed in 2007, the defence changed their case. Initially, the defence case was that they had ethical committee approval for the research. When, however, the prosecution plainly proved that they did not, the defence changed their story and argued that all children were seen on purely clinical grounds.
This new position required John Walker-Smith's legal team (he was the second defendant in the case) to try to prove clinical indication for each and every investigation and test. Most remarkably, it required Walker-Smith himself to attempt to pull off two astounding feats.
Firstly - because the distinction between research and clinical practice turns on intent - he had to retrospectively change his intent, in the face of a mass of documents, from the time, referring to research, ethics approval and so on. This, of course, is a priori impossible.
Secondly, he had to retrospectively diagnose a clinical indication for each and every investigation and test. His heart was more in this exercise, since he took the view that he was more expert than anybody else, and hence what he thought was necessarily so. His case was very arrogantly presented by his counsel. Most close observers think he should have just said "sorry", and he wouldn't have ended his career in disgrace.
So - back to the point - the records of the children were entered into the proceedings in the most excruciating detail. Had there been any "red book", or any slip of paper of any relevance to anything, it would have been read, more than once. And, of course, any such item could not have accounted for the developmental records described in the Lancet paper to have been reviewed.
Having spent so long preparing my reports (the first drafts were filed last July), and spent so many hours undergoing editorial and legal checking (which I repeatedly asked for and encouraged), plus peer review for my first report, I'm not surprised that these people are unable to find fault. Indeed, they have poured over the GMC transcripts for months, and their silence over what they found is deafening.
That we are now offered claims that 16,000 words of highly-specific, tabulated, immensely referenced, and independently checked, material from me, is all wrong, or somehow made up, on the basis of a paper in the Lancet being dependent on "red books" for its data is so pitiful that I don't know whether to laugh at these individuals or cry for them.
I think their attempts on this basis to cover for Wakefield's outrageous conduct - which I regard to be sickening moral, if not legal, crimes against sometimes very vulnerable families - should appall any right-thinking person.
To Wren January 15, 2011 9:35 PM
That is what they did do except that instead of having the full notes they had a referral letter from the GP setting out the child's history.
@Brian Deer:
How did they reconcile the PCR tests for measles with non-research intent? To pull that off, wouldn't they have to claim that it was already accepted medical wisdom that a persistent measles infection could cause gastrointestinal problems?
@ChildHealthSafety:
So, what, any discrepancies are the fault of the GPs for writing incomplete and/or erroneous referral letters?
We interrupt this thread for wonderful breaking news in the Winkler County, Texas, case of the quack seeking revenge against the nurses who blew the whistle on his quackery:
http://www.nytimes.com/2011/01/15/us/15nurses.html
:-)
Correction: Reading my last post, I should have said that no red book was produced or anything from them adduced at the GMC hearing. I recall that Wakefield - alone - did claim to have seen red books, but this was a mere assertion.
In normal referral circumstances, without research being involved, yes, all they would have had at the hospital would be a referral letter from the GP including relevant patient history. In a research situation such as this, notes should have been requested.
Wakefield may have seen a or all of the red books, but this would have been provided directly by the parents and should have been noted. A red book is in no way a substitute for GP notes and the difference would be well understood by the GMC.
I'm certain the red book smokescreen is being put up as it is unlikely Brian Deer had access to these, as they are held by parents. If they were not mentioned in the GMC hearings, I don't see how they can now be relied upon for anything.
For those who are unfamiliar with them, the red books are small books given to all parents at the first health visitor visit, normally between 10 and 14 days after the birth. It is about 6" by 11", give or take. The official title is a Personal Child Health Record, and it is as such that it would have been referred to officially. The red book "developmental checks" in the old style books consist of a single short page of questions for the parent to answer (yes, no or not sure) and a quick list of checks for the health visitor or GP. These are provided for a 6-8 week review (usually done by a GP before the first vaccinations), a 6-9 month review, a 18-24 month review, a 3-3 1/2 year review and a pre-school and school entry review. None of these are routinely done in all areas except the 6-8 week review. The new style, which do not apply to the children in this study, have onlt the 6-8 week review and room for other reviews without specific timings except for the school entry review. The "developmental" section is a list of firsts for baby which parents may choose to fill in with the date the child reaches these milestones. Additionally, there is a set of growth charts going up to 20 years on which the height and weight of the child may be plotted. It's a nice thing to have and as I've reviewed my children's today, I've enjoyed seeing when the kids did things but it's really not much more than a baby book combined with a vaccination record.
@ Matthew Cline. Yup. You got it. While most of the hearing was enough to bore the paint off an Oldsmobile, some of the rest was a high energy game of whac-a-mole as anomalies the defendants tried to nail down in one place then caused more to pop up somewhere else. At times it was hilarious.
So, on the point you raise, when the clinicians switched their position to deny their previous formal statements about ethical approval, and to claim pure clinical need, they left Wakefield, who was contractually forbidden from clinical work, standing on the wrong foot.
To explain hunting MV in matched sets of both formalin-fixed and fresh frozen biopsies, he relied on a Chinese menu of purported permissions, including both a standing permission to take (with consent) two extra biopsies for research, AND a permission to do a study of 25 children with childhood developmental disorder, vaccinated with measles or measles-rubella vaccine, which the clinicians denied had ever even started.
A GMC FTP hearing is a statutory inquiry, run to criminal law ++ standards, so panel members don't laugh at the evidence. But there was a moment when I think some of them were on the edge of slapping their necks when Wakefield's counsel took him through the menu, set out as a table of biopsies.
Mr Coonan: "So, Dr Wakefield, child six, that biopsy would be?"
Wakefield: "Six? That would be the chicken fli lie."
Mr Coonan: "And 7?"
Wakefield: "Noodle soup."
And on it went, back and forth between permissions, one of which he didn't know at the time Walker-Smith had (for two), and the other which Walker-Smith said was for a project that had never started (for, generally, about another six).
Suffice it to say, the panel was not convinced.
Re Brian Deer @ January 16, 2011 3:45 AM
Grateful to Brian Deer for finally surfacing @ 07:45 am London time and especially for now confirming that:
* he did not know that the reference to "prospective developmental records" in the 1998 Lancet paper was to records in the Red Book
* that he had not had seen these at any time - before or after he wrote his paper
* he did not know they were used as part of the basis for the developmental histories of these children
* they were not in the GMC proceedings [unsurprising as no parents were witnesses other than the one who was called by the prosecution but thought she was giving evidence for the Defendants]
So despite Mr Deer not having the correct records, he wrote a "peer reviewed" paper in the British Medical Journal which the BMJ reviewers passed and the BMJ published claiming fraud. He also claims to have "gone behind" the paper but has not seen the children's prospective developmental records.
Thanks again.
Brian Deer January 16, 2011 7:14 AM said:-
Thanks again for confirming the sworn evidence in the GMC hearing confirmed the Red Books were used by The Royal Free team for the prospective developmental records of the children which were relied on for and referred to in the Lancet paper specifically in that context.
And of course that also confirms this is not recent invention by anyone and that you published your paper in the British Medical Journal knowing they existed and had been referred to in the GMC proceedings but you had not in fact seen those records or checked them before going into print.
Its a bit late for that now of course.
FYI:
New interview with Mnookin posted:
http://www.wnyc.org/shows/bl/2011/jan/13/dissecting-panic-over-immuniza…
Wow, so many points to respond to and I don't want to distract too much from the Wakefield issues. But I will address some points. Luna, I still think there are way too many serious adverse events- of course key to the car accidents is why did they happen? Was it the error of the other driver or did the diseased who had Gardasil suffer a syncope, which seems to be a common reaction to that vaccine. I know pap smears are key- the woman down the road died due to cervical cancer and for some reason she had not had pap smears for a few years (and she was a doctor's daughter!). I also don't like that they compared the vaccine to a placebo containing aluminum ( even if that is apparently the industry standard).
Anon, I do agree pneumonia can be extremely serious. I have got our whole family on d drops as we live quite far north ( with a lot higher rates of MS etc.)
Gpm trixie, I do remember vaccination (to or not to) being topical in the 90's, a friend had read BLF's book. Both kids got chicken pox naturally and were fine. Lie I said, hearing that American doctor on t.v. Stressing the "sick days" as the main reason to give this new vaccine set off alarm bells in my head. My daughter had all her dpt's under 18 months and I'm pretty sure she got it anyways so skipped the 18 month one. Boys are more likely to have autism and on my mothers side there is a fairly strong history of allergies. On that basis my son is minimally vaccinated. Chemmomo, for that same reason I would never enter a study such as you suggested. I have had no vaccines since childhood, no boosters and never will. The pneumonia vaccine (not flu) does look interesting.
, I do remember it being topical and my friend gave me BLF's book in the the early 90's. Both my kids got chicken pox naturally and were fine. Like I said, that American doctor stressing "sick days" as the main reason to give this new vaccine set off alarm bells in my head. My daughter had all the early dpt's and I'm sure she ended up with pertussis anyways around 18 monhs. Boys are more likely to have autism and on my side there is a fairly strong history of allergies. On that basis my son is minimally vaccinated. Chemmomo, for the same reason, I would not enter myself or my children to a double-blind randomized trial for a vaccine because a) do we really need protection for the disease the vaccine was created for and b) allergy risk makes me lean toward no vaccine for any of us. I have not had any vaccines since childhood and will noy in the future. The pneumonia shot (not flu shot) does look interesting, though.
Sorry for repeat. Something weird happened while editing. Second paragraph is redundant.
Marcia, I just saw some of the comments and someone named Levi makes some good points, I think. He is pro- science but he mentions how poorly this forcing/mandating of every single vaccine is what may be doing in the industry's credibility or at least it is pissing off a lot of parents who are almost acting out of contrariance.. ( is that even a word? Someone can substitute a better one). Maybe just defiance is better, come to think of it.
What does a high rate of MS have to do with anything?
I think the Mark of the Beast technology is here. Thousands, if not even a few million, already have the chip embedded in their body via vaccines. I think we are much closer than we realise to that technology becoming mandatory. All we need is one more big catastrophe (like the scam bird flu or swine flu) which they will engineer and "Oh, everyone come down and get a microchip. We've got too many cases of swine flu and, you know, too many terrorists crossing the border."
Jen
My italics
I hope you didn't pull something with that reach.
I think if someone was eaten by an alligator after getting the Gardisil vaccine Jen would find a way to tie the 2 events together.
Jen @50
Contrarianism (from contrarian) is the word you were looking for.
The Gardisil vaccine makes you smell irresistibly yummy to alligators. It's like catnip: we don't notice it but the alligators ... that car accident was probably caused by an alligator crawling into the road, lured by that scent.
And do you have any studies proving me wrong? No! QED.
Agashem, I believe I mentioned the high incidence of MS in light of the vit d issue and the apparent low serum levels that I had. I believe there are some studies linking a lack of vit d to high incidence of MS - and flu as well. Admittedly, this is a fairly new area of research; I believe MS Direct (Embry, himself a scientist has done some research into the issue). Vitamin d is really being studied a lot lately in connection with immune system. Of course the new CCSVI theory is also interesting for MS.
I live in Canada fairly far North. My doctor did find low vit d levels. I don't have MS but since I got the flu (with pneumonia) my doc suggested increasing vit d.
I live in Canada fairly far North. My doctor did find low vit d levels. I don't have MS but since I got the flu (with pneumonia) my doc suggested increasing vit d.
Side note: @Scottynuke, that IS good news. I hope they nail him but good.
Jen, I think you've kind of missed, or dodged, the point about the simple math.
Augustine, you've officially gone off the deep end.
So according to you, when we are vaccinated, a tiny chip too small to be seen by the naked eye is inserted into our bodies? Please go to your nearest mental health professional and get yourself assessed.
As if augustine wasn't annoying enough, now there's a troll pretending to be him.
@Brian Deer:
Is that like a British version of a facepalm??
And in other off-topic news, Salon has formally and publicly withdrawn Robert F. Kennedy's "Deadly Immunity".
This was the one where Kennedy lied about thimerosal dangers and a government coverup.
Our good Orac was classic Salon.com flushes its credibility down the toilet.
Though I kill-filed little augie a while ago, I still get to see the responses. I doubt this other person is our old augie, because otherwise he/she/it has gone completely off the deep end & should be seeking serious psychiatric counseling.
Jen writes, "I also forgot to add that (again despite how this distrust all started) we are also hearing of increased numbers of children improving,even losing their autism daignosis due to bio-medical interventions- they can't have all not really had autism in then first place"
And yet, so far, no "bio-medical" intervention has been shown to be effective in any kind of properly controlled trial. The impression that these "bio-medical" treatments work is probably derived from the myth (which Jen seems to share) that autistic people never improve on their own. A little time reviewing the literature on placebo-controlled trials for autism treatments rapidly disabuses one of that notion. In fact, the placebo group virtually always shows substantial improvement, with typically perhaps a third of the children "responding" to the placebo.
The most dramatic example of this is the secretin debacle. After a case study reported that 3 autistic children had recovered from autism following a single injection of the peptide secretin, many parents of autistic children went secretin-crazy. Thousands of children received injections of secretin at great expense. Eventually a controlled trial was done, replicating the treatment in the original case study. The secretin-treated kids showed significant improvement. The placebo-treated kids improved just as much. People were so certain that it had to work that the trial was repeated multiple times with variations--more doses, higher doses, human instead of pig secretin (although that was what was used in the original cases). One study even made it into an ointment and rubbed it on the skin! All showed the same result--equal benefit from placebo. As a result, we know more about secretin than almost any pharmacological treatment. And what we know is that it doesn't work. Yet even to this day, there are still some parents treating their children with secretin.
Mr Deer's recent BMJ peer reviewed paper contains some significant anomalies which were alluded to in an earlier post.
Could Mr Deer please explain these please?
______________________________
Examples - Child 1, 8, 11
In order to âgo behindâ the 1998 Lancet paper, Mr Deer needed the original data and records provided to Mr Andrew Wakefield by his 12 other professional specialist colleagues at The Royal Free Hospital, London.
Does Mr Deer have exactly that data and those records? Or has Mr Deer instead relied on such of the NHS records of children either disclosed to him under Court rules [CPR 31.22] in the Wakefield v Channel 4 & Deer libel litigation and/or information contained in the transcripts of the General Medical Council proceedings.
Child 11âs medical records were not available for the GMC hearings. Very little mention was made of Child 11. Can Mr Deer explain upon what particular medical records for Child 11 he relies?
DEVELOPMENTAL HISTORIES
This is what the 1998 Royal Free Lancet paper said about all the Lancet 12 children:-
That was a main issue the 1998 Royal Free Lancet paper was reporting on scientifically and medically. It also states clearly it was an âearly reportâ and called for further investigation.
CHILD 8
Mr Deer says about Child 8:-
For Child 8 specifically the Lancet paper stated:-
Let us now compare what The General Medical Council hearing transcripts show regarding Child 8âs specialist developmental pediatricianâs opinions. This specialist was not any part of the Royal Free team and was part of the normal UK NHS health service.
May 1994 age 10.5 months:
23 December 1994 (approx 18 months) â developmental pediatrician wrote:
17 February 1995: The developmental pediatrician writes three weeks after MMR:
As this is a scientific medical paper specifically focussed on developmental histories, can Mr Deer please explain where he believes the discrepancy is between what is reported in the Lancet paper and what the developmental pediatrician recorded in his clinical opinion.
Can Mr Deer also please confirm that the appropriate opinion to rely on in such a case is that of the specialist developmental pediatrician and not the views of Child 8âs mother nor the view of the referring General Practitioner.
Would Mr Deer like to confirm that in scientific terms in a scientific medical paper reporting on the history of development, Child 8âs clinical history was normal prior to MMR vaccination â or as the specialist developmental pediatrician stated within the ânormal rangeâ.
CHILD 11
Assuming Mr Deer did not have Child 11âs full medical records, on what basis can anyone make a serious allegation of fraud?
CHILD 1
Mr Deer implies [but does not say] that Child 1 may have had symptoms of an autistic condition aged 9 months â well before the MMR vaccination:
The additional GP records disclosed in the GMC proceedings (but not available to the Royal Free team) contain an entry documenting in addition to his motherâs concerns about Child 1âs hearing, her additional concern was about a discharge from Child 1âs left ear. Is it not correct that this concern is not suggestive of an incipient developmental disorder but of an ear infection?
BMJ FACT CHECKING
In The Sunday Times last, 9th January, Mr Deer says he insisted the BMJ checked his facts. Did they do so? And if so, what did they do?
INSPECTION OF DATA
Perhaps Mr Deer would be kind enough to confirm where the data relied on in this article can be inspected please?
Mr Deer claims to have gone behind the Royal Freeâs 1998 Lancet paper to expose fundamental flaws.
Would Mr Deer perhaps agree that it now seems from this BMJ paper by him that is not what he has done?
It appears Mr Deer has compared the Lancet paperâs findings with the childrensâ GP records instead of with the data and results provided to Mr Andrew Wakefieldâs other 12 authors on an interdisciplinary team of medical specialists.
It would be helpful for Mr Deer to explain how on such a basis can an allegation of fraud be sustained?
If Mr Deer wanted to âgo behindâ the paper then he needed to have the data and results provided for the preparation of the Lancet paper and compare it with the contents of that paper.
The 1998 Lancet paper was written by Mr Andrew Wakefield based on the data and results provided to him by those other 12 specialists.
If there was any falsification as is now being alleged in the British Medical Journal Mr Wakefieldâs 12 other authors would have noticed immediately.
Those other authors had the initial referral letter from the GP, the âRed Bookâ of developmental progress [held by the parents], fresh parental histories taken by Professor Walker-Smith [not Wakefield], test and clinical examination results and any further information in any ensuing correspondence with GPs.
The Royal Free Team did their own examinations, took fresh histories and made their own specialist diagnoses afresh. They did not rely on family doctor [ie. non specialist] GP records. This is standard practice in British NHS hospitals.
GP records are made by non specialists [General Practitioners], taken over years, by more than one person, omit information provided by parents and contain other information unknown to parents.
It is also clear from the transcripts at the GMC that the GP records are riven with fundamental errors like incorrect dates of vaccinations [eg. Child 8 â 7th January instead of 27th January â âI thinkâ said the GP in evidence] and incorrect types of vaccinations being recorded [eg. Child 4 â was it measles vaccine or was it MMR - the records say MMR - the GP said in evidence it was measles].
Additionally the 1998 Lancet paper stated prominently on the first page âEarly Reportâ and it called for further investigation.
Does Mr Deer not agree that an âearly reportâ is an alert to other medical practitioners of a potential problem and not a claim to have found and proven one?
Trrll, well maybe there should be more properly controlled trials re. Bio-med treatment. I do wonder if this kind of research could be very poorly received by institutions since it *could* potentially mean that autism wasn't just a genetic condition. Look what has happened with MS and the new CCSVI theory! My friend was not expected to get better or even have another remission(secondary progressive MS) but she had her vein's valves enlarged (not just ballooning of veins) and she is so much better. Her feet are not purple,cold and swollen anymore. She still needs physio due to atrophy of her leg muscles. And MS was viewed as having a pretty high genetic component- maybe it's more genetic in terms of heritability of veins being blocked! Lots of research dollars goes to gene studies re. MS and yet her neurologist wih the MS clinic was furious with her for going ahead with the angioplasty. It all is very new, admittedly, but it looks promising. I do understand your point
about kids getting better through time ( with early intervention, speech therapy, just being in school
etc.). Luna with our allergy history I am still more comfortable with no Gardasil and regular paps.
I know my views are pretty opposite to yours but I do thank you for discussing it.
Actually, I should have clarified that, we still don't know if blocked veins are a cause or result of MS, but it may mean a lot of displaced dollars *if* angioplasty replaces all those MS drugs (of which there are tons-chemotherapeutic agents, interferon, pain meds, anti-inflamms, anti-tremor meds, anti- depressants, numbness meds, experimental meds etc. etc. It is a very exciting time for all the MS patients.
Jen,
since you're still following this thread let me ask you another question.
You're concerned about autism. Rubella infection in pregnancy is a known risk factor for autism (among other even worse things rubella causes).
Are both of your children immunized against rubella? If not, will you immunize them when they're older, and brains further developed, but before they're having children of their own (and yes, I'm asking about both children because sons can infect their wives)?
If not, please explain.
And what about pertussis? Are you willing to risk the deaths of your grandchildren because your children infected them? Is it really worth that risk?
Chemmomo:
Chris, you're ahead of me with the reading list: Amazon has delivered Offit's book, but I'm still working my way through Oshinksy's Polio book which the library wants back, and I've only glanced at Offit's first few pages.
As for pertussis, from Jen's post (48) it's unclear whether she read BLF's book or her friend read it. I brought up BLF before she did. Regardless, I suspect as since she lives "quite far north" in Canada, she doesn't see pertussis as much of threat as you or I do, on the west coast of the US: she ignored the part of my comment where I explained the disease was causing more concern among my fellow parents than the DTaP.
I'm just hoping Jen answers the questions. If not for us, at least for herself.
Chemo:
You are statistically more likely to get pertussis from a vaccinated person than an unvaccinated one.
Maybe Chris thinks we should bring back the whole cell pertussis vaccine. It was considered more effective.
And I don't follow your rhetoric on protecting your grandchildren's "deaths" (notice it's deaths not life).
In your opinion, how long do you think the vaccine lasts? If it was to protect future grandchildren couldn't your children get the vaccine later when they're adults to "protect" your future grandchildren?
You do know the vaccine is for the toxin not the bacteria, right? So even if they did get the vaccine it doesn't stop them from spreading the bacteria. Maybe you could argue something about less coughing or something but that's shaky.
augustine,
in case your comment @73 is attempting to address me: I'll address your questions if you address me by my handle. There's 2 "M" letters in there for a reason. Your turn.
Chemmommo, I was first in line to get a library copy. I learned lots of things, like the interesting testimony of Gordon Stewart on page 35. He was asked by the Wellcome Foundation's attorney, Machin, about the age and ethnicity of a children in a certain age. Dr. Gordon replied "No, I cannot remember that. It was an American study, I know that." Then Machin handed Stewart the study, it had been done of rats. Oops.
I am now waiting for The Panic Virus from the library.
There were issues with the DTP vaccine, but seizures were not one of them, which is why it was removed as a table injury. The research by Dr. Samuel Berkivic on Dravet's Syndrome.
Chemmomo, yes, my kids have been given MMR. My daughter 2 doses and my son just one. I may decide to give the booster or do titers for him later-more due to mumps. I did give dpt to my daughter at 2,4 and 6 months but I'm almost positive she got pertussis anyways around 18 months (doc thought it was very likely, but didn't bother testing). I skipped her 18 month dpt. My son only had a dpt somewhere around 3 months, then 10 months. Then not again 'till age 7 ish. In Canada, the majority of provinces don't give hep b series at birth. It sure wasn't done in the 90's or early 2000 in Canada.
I will definitely not get a pertussis (or dpt booster). No more for my kids, either. If they want to get hep b as adults that is up to them. I don't like all the auto-immune problems I've heard of (and seizures) with that vaccine. Again with our history of allergies I am careful.
Oops, Chemmomo, sorry for misspelling your name.
Jen:
Uh, huh. Except in the real scientific literature the DTaP is not associated with those. That is why seizures were removed as a table injury for DTP/DTaP. If you have any real evidence that they cause autoimmune problems, present it. Just don't include anything by Bart Classen.
augustine @ 73 said:
"You are statistically more likely to get pertussis from a vaccinated person than an unvaccinated one."
Yes. People can be carriers of a disease that they're immune to. This happens naturally as well as after medical intervention.
What exactly is your point?
Will you avoid contact with vaccinated people?
Here's my point:
You are statistically more likely to get pertussis if you're unvaccinated.
DUH.
So I'm vaccinating my kids (and myself because asthma's enough of a bitch as it is).
Jen,
thank you for answering, and answering honestly. I am very much relieved that your children did get the MMR.
Even if you don't want to keep up on pertussis immunity throughout your life, you--and your children--might want to think about getting immunized against it right before your children have infants. Seriously, think about it. Risk vs benefit.
And speaking of risk vs benefit: the risks vary region by region. Where you are, right now, Hep B might not be much of a threat. But where I am, it's out there, and that changes the picture for me, vs you. The virus can live for 7 days on surfaces. The fact that it is reasonable for Canada or Sweden only to vaccinate high risk infants doesn't meant that the United State's policy of universal vaccination is not reasonable, once you take into consideration the different populations and immigration patterns. Risk vs benefit: we are at a much higher risk than you.
Mandrellian:
The results are striking. Vaccine refusal is associated with a nearly 23-fold increased risk of developing pertussis.
@42Norman. Thanks for revealing the identity of the poster ChildHealthSafety. According to a web site that identifies well known trolls he is a lawyer (wonder if he has any "vaccine-injured" clients?) and he always trolls sites with his buddy John Stone/John D. Stone. On the Guardian.UK website he and his tag-team buddy have attempted to overwhelm the discussion with the same postings that they have posted here.
Just a comment about the latest postings regarding pertussis vaccine and disease. Thirty years ago when my daughter accompanied dad on a business to Germany and stayed with the some family friends...whose younger children were not immunized against pertussis, she was exposed to pertussis. A day after her return, I received a telephone call from my friend to let me know about the exposure. She was immediately put on antibiotics to protect her, in spite of having completed the pertussis vaccine series...it was known even then, in the medical profession, that the protection offered in early childhood by the vaccine, can wane; she did not get pertussis, most probably because of the antibiotics, prescribed.
Fast forward, 30 years (September 2010) and I caught pertussis. I have no idea where the exposure took place. After one day of chest wracking coughing spells...and one night's lost sleep I went to the doctor for antibiotics, even though my chest x-ray was normal. My doctor and I had a heated discussion about his diagnosis (viral bronchitis) and my self-diagnosis and I won the argument. (I'm a public health nurse who has the investigated and reported to the CDC incidents of infectious diseases). The antibiotics worked to shorten the duration of the disease and the growth of additional bacteria, but I needed an inhaled steroid and a very large bottle of codeine cough syrup for five weeks. Fortunately, I didn't have any contact with young infants prior to the onset of my cough. A visit to the CDC website and their MMWR (Morbidity and Mortality Weekly Report) website will explain the devastation and deaths of young infants that have been reported in California and elsewhere due to exposure to children whose parents have opted out of childhood immunizations and exposure to adults who have waning immunity against pertussis.
The CDC has issued new recommendations for adult booster shots; pertussis vaccine along with tetanus and diphtheria vaccines are now recommended as part of the every-10-year booster
@Mandrellian:
I believe I've seen some people make the following argument (which isn't my argument):
Pertussis is most dangerous to kids, while among adults it just manifests as a bad cold. So adults shouldn't get the pertussis vaccine, so they'll be symptomatic instead of asymptomatic, and parents can keep their children away from anyone who's coughing/sneezing/etc. Or, better yet, don't vaccinate children against pertussis either, so all the asymptomatic children become symptomatic children who can be kept away from uninfected children by alert parents.
Mandrellian
Yet, most who contract pertussis are vaccinated.
And I would try to explain some basic stats to you if I didn't already know that it would get lost in the vast space above your neck.
@85
But what else would you expect from him?
@Science Mom:
Not only has that been done, but augustine also acknowledged them. However, he said that his quote of "most infected with pertussis are vaccinated" was never meant to imply that the vaccine is ineffective, and that even if the vaccine is effective the fact that most who are infected were vaccinated is still (somehow) a black mark against the vaccine. As far as I can remember, how it's a black mark against the vaccine he never answered.
Sounds like something a lawyer would say.
Pertussis vaccine does not confer life-long immunity, hence new recommendations from the CDC...as already posted here.
Probably the most dangerous time for transmission is before the onset of any symptoms...it is assumed that once symptoms occur that no one would expose a newborn infant to upper respiratory infection and accompanying cough. This asymptomatic period which varies from 4 days up to 21 days is when infected people inadvertently pass the illness to vulnerable infants.
The MMWR (Morbidity and Mortality Weekly Reports) available on the web provide weekly updates about this disease outbreak.